- Common street names: spice, K2, Moon Rocks, Blue Lotus, many others
- Active ingredients frequently change to avoid legal proscription
- Generally contains cannabinoid receptor agonists (CB1 or CB2) that are far more potent than THC
- Does not show up on routine tox screen
- Generally smoked, but can be imbibed as a tea
- Similar effect to marijuana at low doses, but may be more intense and cause an acute Excited delirium
- Typical onset of 10-30 min and taper over 1-2 hours
- Tachycardia and hypertension common (distinguishing it from MJ use)
- Adverse effects:;nausea, vomiting, diaphoresis, anxiety, paranoia, hallucinations, agitation, delirium
- Use has been associated with AKI and acute cerebral ischemia.
- Serious bleeding as some synthetic cannibinoids contaminated with long acting vitamin K-dependent antagonists (brodifacoum) 
- Bath salts
- Gamma hydroxybutyrate (GHB)
- Inhalant abuse
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Clinical diagnosis
- Supportive care
- May require sedative agent such as benzodiazepines or antipsychotics, as well as physical restraints, if severely agitated and posing a threat to self and staff
- Generally may be discharged once sober (assuming no adverse effects that would mandate admission)
- Buser GL, Gerona RR, Horowitz BZ, et al. Acute kidney injury associated with smoking synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(7):664–73.
- Takematsu M, Hoffman RS, Nelson LS, Schechter JM, Moran JH, Wiener SW. A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid. Clin Toxicol (Phila). 2014;52(9):973–5.
- Moritz, E., Austin, C., Wahl, M., DesLauriers, C., Navon, L., Walblay, K., … Layden, J. (2018). Notes from the Field: Outbreak of Severe Illness Linked to the Vitamin K Antagonist Brodifacoum and Use of Synthetic Cannabinoids - Illinois, March-April 2018. MMWR. Morbidity and Mortality Weekly Report, 67(21), 607–608.