Synthetic Cannabinoid Induced Psychosis in a Previously Nonpsychotic Patient

Synthetic cannabinoids are relatively new substances that have become rapidly popular among young adults. Despite their legal status in most states, they are virtually unregulated and unstudied. Nevertheless, recent case studies have brought new attention to their potentially harmful side effects, such as psychosis, agitation, and withdrawal. This case report examines the acute psychosis displayed by a psychiatric patient after smoking “Spice,” a substance comprised of various synthetic cannabinoids, on three separate occasions. Furthermore, in comparing this patient’s lack of psychotic symptoms after tetrahydrocannabinol (THC) use, to the episodes of psychosis experienced after “Spice” consumption this case study explores the possibility that synthetic cannabinoids are more potent than their organic counterpart. This is the first case report of synthetic cannabinoid-induced psychosis in a previously nonpsychotic patient. “Spice,” comprised of various synthetic cannabinoids, is a growing trend within substance use in young adults. It has been tried by up to 6% of 15to 18-year-olds in Germany.1 Despite the current lack of data revealing the prevalence of “Spice” use within any age group in the United States, case reports are documenting a recent increase in emergency room and forensic presentations related to its use.2,3 To date, there are no studies of inhaled synthetic cannabinoid use in humans. Nevertheless, recent case reports have shown a correlation between synthetic cannabinoid consumption and acute psychosis2,4 and agitation.3 Another study describes acute withdrawal in a patient smoking up to 3 g/day for 8 months.5 Despite mounting public health concerns and concomitant legislative effort to remove it from the public domain, this compound is still legal in various forms in most states. Given its increased potency compared to harvested