What Liquid K2 on Paper or K2?

The cannabinoid compounds found in these synthetic agents act on the same cell receptors as those affected by the THC in natural marijuana. Identified compounds include²:

• HU-210
• CP 47,497 and homologues
• JWH-018
• JWH-073
• JWH-398
• JWH-250
• oleamide

Some of the synthesized compounds in synthetic cannabinoids bind much more strongly to THC receptors than regular marijuana, which can lead to more powerful, unpredictable or dangerous effects. Some synthesized compounds have been noted to be 100 times more potent than the average THC found in marijuana. The stronger binding of the synthetic chemicals to the THC receptor sites in the brain may lead to the extreme anxiety and paranoia that have been reported in some users.

In addition, as with many illicit designer drugs, the chemical composition may be unknown and some products may be combined with other toxic chemicals. In 2018, reports surfaced of synthetic cannabinoids being laced with fentanyl in Connecticut, as reported by NPR.

The chemicals used in these products have a high potential for abuse and no medical benefit. The Drug Enforcement Administration (DEA) has designated many active chemicals found most frequently in synthetic cannabinoids as Schedule I controlled substances, the most restrictive schedule, making it illegal to sell, buy, or possess them. Manufacturers attempt to evade these legal restrictions by substituting different chemicals in their mixtures, while the DEA continues to monitor and update the list of banned cannabinoid derivatives.¹

Are Liquid K2 on Paper dangerous?

Yes, synthetic cannabinoids can be dangerous, as described in several case reports and alerts from U.S. health care authorities. Complications due toLiquid K2 on Paper  use may include:

• high blood pressure
• nausea and vomiting
• anxiety or agitation
• seizures
• rapid heart rate (tachycardia)
• excessive sweating
• confusion
• hallucinations

Liquid K2 on Paper, as they are commonly called, can also raise blood pressure and cause reduced blood supply to the heart (myocardial ischemia), and in a few cases it has been associated with heart attacks.¹

Published case reports in Pediatrics describe three teenagers who were hospitalized after using synthetic cannabinoids. These patients demonstrated varying degrees of catatonia (an inability to respond to verbal or physical stimulation, including pain) an elevated heart rate, agitation, anxiety, dizziness, headaches, excessive sweating, slowed speech, and confusion. Two of the patients recovered to normal function in three to four hours, while the third patient was kept in hospital overnight before being released.^3,4

Synthetic cannabinoids and bleeding risk

The Illinois Department of Heath reported several cases of severe bleeding in people who had used synthetic cannabinoids, such as Liquid K2 on Paper, contaminated with blood thinners. Subsequently, the Centers for Disease Control and Prevention (CDC) posted an Outbreak Alert warning of life-threatening vitamin K-dependent antagonist bleeding disorders linked with synthetic cannabinoid use in Illinois and other states. Four deaths due to severe bleeding were reported in Illinois.⁵

Laboratory testing confirmed that patients were exposed to brodifacoum (an a