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US drug laws ‘accidentally’ prevented a spice vape crisis, toxicologist says
There has never been a more dangerous time to take drugs in the United Kingdom, according to their National Crime Agency. A flurry of news reports have since appeared, detailing the vicious cycle young people fall into after trying Spice vapes. But is there a danger for teens in the US, too?
Vape is the colloquial term for e-cigarettes, while Spice is a brand of synthetic cannabinoid. These are chemical compounds made by modifying forms of naturally occurring cannabinoids like THC, the main psychoactive constituent of cannabis. The Focus spoke to Dr Ryan Marino, a medical toxicologist and emergency physician, about how Americas decriminalization of cannabis has made it resistant to some of the pitfalls currently bedeviling British schools.
What is Spice, and why are Spice vapes dangerous?
Spice has become a general nickname for a lab-made substance containing synthetic cannabinoids. These were originally meant to mimic the effects of cannabis, according to NHS Inform, but many are more harmful and unpredictable than cannabis.
Dr Ryan Marino explains that, like Kleenex and Xerox (and Biro, and Hoover), Spice went from referring to a specific brand of synthetic cannabinoid to being a catch-all term for them.
Synthetic cannabinoids can have a wide range of unexpected or undesired effects, he adds.
While the majority are usually similar to compounds like THC, they have been documented to cause health problems like organ failure, agitation, and more extreme psychiatric symptoms like hallucinations and psychosis.
The UK Vaping Industry Associations director general, John Dunne, assures consumers that purchasing vapes from a reputable vape supplier will get them nicotine vapes which are designed to help them transition from cigarettes.
But he adds: I am worried, however, that there are vape devices available from unofficial sources which may contain illegal drugs and that those who buy them may have no idea what is contained in these products.
Meanwhile, a UK government spokesperson told The Guardian: We are banning vapes from being branded and advertised to appeal to children, including restricting their packaging, flavors, and display.
In addition, the government provides funding to Trading Standards and Border Force to crack down on illegal sellers and undertake testing of products.
Vaping is legal but America and UK differ when it comes to cannabis
In the UK, cannabis is classified as a class B drug, meaning it is illegal to possess, grow, distribute, or sell it. Offenders can get up to 14 years in prison and/or an unlimited fine, depending on their charge(s).
Meanwhile, ingredients in nicotine-containing vapes are regulated (in the UK) under the Tobacco Related Products Regulations 2016. But these regulations don’t cover illegal THC products.
Its in this legal context that synthetic cannabinoids like Spice have found a foothold. Research published in August 2024 found that 1 in 6 vapes tested across 38 schools in England contain Spice. The National Crime Agencys assessment is that taking drugs [in the UK] has never been more dangerous, due in part to an expanding synthetic drugs market.
For the sake of comparison, cannabis is legal in 38 states of the United States for medical use and 24 states for recreational use. Another seven states have decriminalized it, and commercial distribution is legal in areas where possession is legal. Recent reports suggest the US Drug Enforcement Administration is looking to reclassify it as an even less dangerous drug.
Certain synthetic cannabinoids are legal in various states, including Marinol, Syndros, Cesamet, and Epidiolex. There are still many states where recreational use of cannabis carries the risk of a fine or jail time, but in several, it is treated as a misdemeanor, at least for the first offense.
Changes in US drug laws ‘accidentally’ reduced harm
Dr Marino says problems caused by excessive synthetic cannabinoid use were relatively widespread in the US within the past decade.
This is partly because manufacturers could evade drug laws by modifying the chemical structures in their products. They would label them incense or not for human consumption, and get around legal restrictions.
However, the federal governments decision to allow states to set their own cannabis laws has caused rates of synthetic cannabinoid use to dramatically decline, says Dr Marino, and adverse medical effects are now rarely seen.
Data from the American Association of Poison Control Centers confirms this: Since 2011, the number of people reported to poison centers in the US with exposure to synthetic cannabinoids each year has fallen from nearly 7,000 to just over 300.
Dr Marino cautions that cannabis is not necessarily safe at any age, and the use of cannabinoids such as THC is not without possible risks for anyone.
However, he sees the aforementioned legal changes as a real-life example of harm reduction.
Adolescents will experiment with substances regardless of their legal status, he says. Since they are at particularly high risk due to their ongoing brain development, it is especially important to provide an environment in which resorting to needlessly dangerous synthetic cannabinoids is discouraged.
The best way to protect young people, he says, is to have honest conversations with them.
By accident, Dr Marino adds, the US seems to have addressed the problem of harmful synthetic cannabinoids at least for now.
But as evidenced by our ongoing overdose crisis, we continue to see many similar issues from a toxic, unregulated supply of illicit drugs.
Dr Ryan Marino is a medical toxicologist, emergency physician, and addiction medicine specialist. He is an assistant professor in medicine and psychiatry at Case Western Reserve University School of Medicine, with expertise in best-practice medical management of substance use disorders.
