Spice and K2: What clinicians need to know about synthetic marijuana

Often marketed as “synthetic marijuana,” drugs like Spice and K2 are unpredictable, dangerous, and increasingly relevant in clinical settings. In this episode of Fast Facts, pharmacology expert Tom Viola explains what these substances really are—and why dental hygienists should be paying attention.
Dec. 22, 2025
2 min read
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Synthetic marijuana products such as Spice and K2 are often misunderstood—and frequently underestimated. Despite their name, these substances have no real connection to marijuana, and their ever-changing chemical makeup makes their effects wildly unpredictable.

In this episode of Fast Facts: Ask the Expert, host Andrew Johnston is joined by Tom Viola, RPh, CCP, to unpack what’s really behind these drugs. Viola explains how Spice and K2 are manufactured, why no two uses produce the same effects, and how this unpredictability raises serious concerns for clinicians.

The conversation explores:

  • Why “synthetic marijuana” is a misleading label

  • How unknown ingredients and variable potency increase the risk of psychosis, seizures, and respiratory failure

  • The double standard some patients apply to prescription drugs versus illicit substances

  • What dental hygienists should understand when assessing patient risk and substance use history

For dental professionals focused on patient safety, prevention, and education, this episode offers essential context on a category of drugs that continues to evolve—and continues to harm.

Listen now to better understand the clinical and real-world implications of Spice and K2.

About the Author

Andrew Johnston, RDH

Andrew Johnston, RDH

Andrew Johnston, RDH, is your everyday hygienist who is passionate about sharing education and knowledge to others. Practicing in Washington State since 2009, Andrew enjoys utilizing his full scope of practice through traditional and restorative procedures on any given day—still working in the operatory 40-plus hours each week. In 2015, he started the wildly popular dental hygiene podcast A Tale of Two Hygienists with his cofounder Michelle Strange. Because of the podcast's success, they were able to begin a new chapter in dental audio content with The Dental Podcast Network, which consists of 10 short-format shows on different dental topics airing each day of the work week.

Tom Viola, RPh, CCP

Tom Viola, RPh, CCP

With more than 30 years’ experience as a board-certified pharmacist, clinical educator, professional speaker, and published author, Tom Viola, RPh, CCP, has earned the reputation as the go-to specialist for making pharmacology practical and useful for dental teams. He is the founder of Pharmacology Declassified and is a member of the faculty of more than 10 dental professional degree programs. Viola has contributed to several professional journals and pharmacology textbooks, and currently serves as a consultant to the American Dental Association’s Council on Scientific Affairs.

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