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Designer drugs, created to avoid drug laws, appear at a remarkable pace. ‘Spice’ refers to designer cannabinoids such as JWH-018, JWH-073, JWH-200 and (C8)-CP 47,497, initially found in ‘herbal smoking blends’; these are sold under many names, including K2, fake weed, Yucatan fire, skunk, moon rocks and others. Synthetic cannabinoid agonists, including RCS-4, RCS-8 and AB-001, are also available. Spice abusers report tachycardia, vomiting, agitation, confusion and hallucinations. Spice can raise blood pressure and cause myocardial ischaemia, and has occasionally been associated with heart attacks. Regular users may experience withdrawal and addiction symptoms. One concern is that there may be harmful heavy metal residues in spice mixtures.

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