For older children and adolescents, use a conventional screening tool such as HEADSS (Home; Education/Employment; Activities; Drugs; Sexuality; and Suicide/depression) to elicit key historical information, as those who use synthetic cannabinoids are more likely to engage in risky behaviors involving substance use and sexual activity when compared peers who use conventional marijuana only.
Assess patients for suicidality and common co-ingestions, as polysubstance abuse is common. In particular, acetaminophen overdose is concerning given the brief window of opportunity for intervention.
Conventional urine and serum laboratory studies cannot reliably detect the presence of all synthetic drugs and their metabolites. However, a urine toxicology screen that is positive for conventional marijuana should raise suspicion for synthetic marijuana use.
Provide supportive care for mild cases of synthetic cannabinoid intoxication.
Rosenbaum CD, Carreiro SP, Babu KM. Here today, gone tomorrow...and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines. J Med Toxicol. 2012;8(1):15-32. (Review article) DOI: http://dx.doi.org/10.1007/s13181-011-0202-2