Extreme Psychotic Reaction to Spice Reveals Risks of Synthetic Marijuana

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Psychosis is an extremely dysfunctional mental state most commonly associated with the presence of schizophrenia and certain other severe mental illnesses. Addiction specialists and researchers know that marijuana can produce a temporary psychosis-like state in active users and also potentially increases the odds that a person with latent psychotic tendencies will experience psychotic episodes. In a study published in June 2014 in the journal Psychiatry: Interpersonal and Biological Processes, a team of Spanish researchers investigated the possible role of synthetic marijuana in the onset of severe psychosis symptoms.


Psychosis centers on a range of symptoms that seriously degrade an individual’s ability to stay oriented to reality and his or her surroundings. Chief among these symptoms are hallucinations that substantially alter the brain’s capacity for accurately interpreting sensory information and delusional thought patterns that feature patently false but highly tenacious beliefs and mental scenarios. Additional symptoms found in people impacted by psychosis include a loss of the ability to organize thoughts or verbal statements, and trains of thought that veer abruptly between subjects or topics with no logical link. In addition to the use of marijuana, psychosis is linked to the use of other substances such as alcohol, methamphetamine and amphetamine. Apart from diagnosable mental illness, additional potential sources of a psychotic mental state include Alzheimer’s disease and other forms of dementia, advanced HIV/AIDS infection, strokes, Parkinson’s disease, tumors inside brain tissue and certain forms of epilepsy.

Synthetic Marijuana

Synthetic marijuana is the commonly used name for illicit/illegal products that contain a mixture of some sort of dried plant matter and any one of dozens of artificially produced chemicals designed to mimic the effects of the main cannabis ingredient THC (tetrahydrocannabinol). In attempts to evade legal scrutiny, manufacturers of these products typically conceal their drug content and falsely market them as harmless commodities such as potpourri or incense. In the U.S., street and brand names associated with synthetic marijuana include Spice, Scooby Snax and K2. The active ingredients in synthetic marijuana products usually have much more mundane laboratory names such as JWH-250, HU-210 and CP 47,497. All of these ingredients trigger a drug effect by accessing the same brain pathways as THC, and in some cases they have a potency roughly equivalent to that of THC. However, some of the chemicals found in synthetic marijuana outstrip the potency of naturally occurring THC by as much as 500 times. In addition, unknown and unregulated substances in any given synthetic marijuana product may also produce unpredictable mind-altering effects.

Potential Link to Persistent Psychosis

In the study published in Psychiatry: Interpersonal and Biological Processes, researchers from several Spanish institutions conducted a detailed investigation of a 19-year-old Spanish woman with a known history of using several synthetic marijuana products. After roughly half a year of consuming these products, the woman had developed a number of ongoing psychosis-related symptoms, including visual hallucinations and a delusional, self-referential form of thought and speech known as soliloquy. In addition, she had developed symptoms that mimicked some of the physical effects of a profoundly unresponsive state called catatonia. The researchers found that the woman did not use marijuana or any other form of cannabis; however, after conducting blood tests, they found four active synthetic marijuana ingredients in her system.

During treatment, the woman discontinued her intake of synthetic marijuana and received several anti-psychotic or anti-anxiety medications, including lorazepam (sold as Ativan in the U.S.) and aripiprazole (sold as Abilify in the U.S.). Two months after treatment began, this medication regimen led to a partial restoration of the woman’s normal mental function, as well as a partial restoration of her ability to move normally. Next, the woman took part in approximately nine months of psychotherapy individualized to her specific needs. At the end of this second round of treatment, she experienced a full recovery of her mental and physical health.

The study’s authors believe they are the first research team to identify such psychotic experiences in a person using synthetic marijuana who was not affected by Parkinson’s disease or other psychosis risk factors. Previous researchers had only identified these types of experiences in laboratory animals given large doses of the drug. They believe that awareness of the potential for extreme psychotic events must be increased in order to give a fuller picture of the risks associated with synthetic marijuana use and offset the drug’s social acceptability.

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