Synthetic Cannabinoid Bleeding Risk

Synthetic cannabinoids are an unregulated mixture of designer drugs that are called cannabinoids because they act on the same CNS receptors as tetrahydrocannibinol (THC), the main active ingredient in marijuana. They can be sprayed onto herbs and smoked; mixed into a liquid and vaped; or added to herbal tea or food and ingested. Synthetic cannabinoids are commonly known as fake pot, fake weed, legal weed, spice, K2, KD, Mind Trip, OMG, Black Giant, Matrix, Kush, Kronic, Scooby Snacks, AK-47, Mr. Happy, Genie, and Sexy Monkey. Smoking these products has been associated with many adverse reactions. Signs and symptoms include:

Tachycardia
Hypertension
Anxiety
Agitation
Hallucinations
Pallor
Numbness and tingling
Tremors and seizures

This constellation of signs and symptoms suggest that K2 is often contaminated with other unknown chemicals in addition to synthetic cannabinoid.

Most recently, FDA’s Center for Biologics Evaluation and Research (CBER) has reported multiple cases of severe bleeding in individuals who have used synthetic cannabinoids. Multiple deaths have occurred. Testing revealed that these products were contaminated with brodifacoum, a superwarfarin sold as a rodenticide. Like warfarin, brodifacoum inhibits hepatic synthesis of vitamin K dependent coagulation factors II, VII, IX and X. Unlike warfarin, Brodifacoum has a much longer half-life of approximately 24 days.

Individuals who use these synthetic cannabinoids donate plasma frequently. Because of its long-lasting effect, plasma contaminated with brodifacoum may cause anticoagulation in recipients of plasma or its derivatives.

It is important to realize that K2 does not cross-react with tetrahydrocannibinol (THC) and is not detected by most drug screens performed in hospital laboratories.

References

Regulatory Updates: Warnings Regarding Synthetic Marijuana Use by Plasma and Blood Donors, http://www.aabb.org/advocacy/regulatorygovernment/Pages/Warnings-Regarding-Synthetic-Marijuana-Use-by-Plasma-and-Blood-Donors.aspx

Synthetic Cannabis Laced With Poison Linked to Severe Bleeding, CDC Warns, Medscape, April 6, 2018

About Synthetic Cannabinoids, Centers for Disease Control and Prevention https://www.cdc.gov/nceh/hsb/chemicals/sc/About.html/