Dear Healthcare Provider Letter: Alert - Emerging Threat to Public Health Associated With the Use of Synthetic Cannabinoids

March 22, 2012

Dear Healthcare Provider:

The purpose of this letter is to alert you of an emerging threat to public health associated with the use of synthetic cannabinoids, which are used often by teens and young adults to mimic the effects of marijuana. Synthetic cannabinoids are marketed as "legal" and consist of plant material coated by chemicals which mimic THC, the active principle of marijuana.

Calls to New York State Poison Control Centers have increased dramatically in 2012 and severe side effects including death, acute renal failure, as well as other significant negative effects to the cardiovascular and central nervous systems have been linked to use of these products. It is important to note that these products do not show up on a urine drug screen as THC.

The products are sold as incense, herbal mixtures or potpourri, online and in convenience or smoke shops, and often carry a "not for human consumption" label in order to disguise the true purpose of the substance. Various formulations are being sold under names such as: K2, Spice, Blonde, Summit, Standard, Blaze, Red Dawn X, and Citron.

The most common route of administration of these synthetic cannabinoids is by smoking (using a pipe, a water pipe, or rolling the drug-spiked plant material in cigarette papers). Users report highs that last between 30 minutes and two hours, and at times describe out-of-body experiences. The most common symptoms that have been reported include:

  • tachycardia (increased heart rate)
  • paranoid behavior, agitation/irritability
  • nausea and vomiting
  • confusion
  • drowsiness
  • headache
  • hypertension
  • electrolyte abnormalities
  • seizures
  • syncope (loss of consciousness).

Due to the imminent threat to the public safety, the Drug Enforcement Administration (DEA) used its emergency powers to render these substances illegal for sale by making them Schedule I controlled substances. Should you become aware of retailers selling these products, you may report it to the DEA by calling 877-883-5789.

More information on these products may be found on the DEA website at:

as well as at the American Association of Poison Control Centers at:


The Department of Health will continue to monitor this important issue. Calls or questions regarding these products may be directed to the Bureau of Narcotic Enforcement at 1-866-811-7957.


Nirav R. Shah, M.D., M.P.H
Commissioner of Health