States can pass all of the laws they want but a US Army soldier, active duty or otherwise, is going to be in serious trouble if there is evidence they have used marijuana. It does not matter if you claim to have pain or get a note from your doctor, the Army has its own standards above and beyond what Washington, D.C. mandates and states have no more jurisdiction than foreign countries do.

Yet some soldiers are reckless and risk their careers and among that group, many think Spice - synthetic marijuana - will be harder to detect. Social workers from the University of Washington have found that among active-duty Army personnel they surveyed, Spice is the most abused substance.

Spice is made with shredded plant material coated with chemicals that are designed to mimic THC, the psychoactive compound found naturally in marijuana. The U.S. Drug Enforcement Administration has listed several of synthetic marijuana's main compounds as Schedule 1 substances, making them illegal, but producers of the drug keep synthesizing new compounds to try to get around those bans. 

"Because the formulation is constantly changing, one batch could be innocuous while the next batch affects you totally differently and you land in the hospital with seizures," said Tom Walton, a research coordinator in social work. "So the health effects are very unpredictable."

Those health effects have not been widely studied yet, but emergency rooms have reported seizures, nausea, vomiting, and cardiovascular and respiratory problems. Psychological effects of using synthetic marijuana can include anxiety, confusion, agitation, irritability, depression and memory issues.

Participants in the survey came from the Department of Defense-funded Warrior Check-Up, a telephone-based intervention trial for Army personnel with untreated substance use issues. All participants were stationed at Joint Base Lewis-McChord in Washington state at some point during the 2011-2014 recruitment period.

Nearly one-third said they had used illicit substances within the previous 90 days; 38 percent of those used synthetic marijuana, twice as many as had used regular marijuana. 
Users of synthetic marijuana were younger and less educated than those who were dependent only on alcohol. They were more likely to be single and earned less money than those who were dependent on other drugs or alcohol. But there were no differences in ethnicity, race, deployment history or religion. Researchers also found that synthetic marijuana users were two-and-a-half times more likely to develop drug dependence than those who used other drugs (but not alcohol).

Study participants told researchers they believed that use of synthetic marijuana was significantly higher in the military than in the civilian population. It was the only substance that soldiers believed they used more than civilians, which supports the idea that synthetic marijuana is particularly attractive to military personnel, the scholars said.

"What we think other people do tends to be important in prevention efforts and intervention efforts," said lead author Denise Walker, an associate professor of social work at University of Washington. "If soldiers think it's common for military personnel to use Spice, then they might think it's OK to use it."

Walker said soldiers tend to avoid treatment for substance abuse issues because seeking treatment automatically goes on their record.

"Who would sign up for that in the civilian population if your boss and your coworkers will immediately know?" Walker said.

The Warrior Check-Up is not considered treatment, and participation is confidential.

The majority of participants believed their use of synthetic marijuana resulted in failing to meet obligations, such as being late for work, doing their job poorly, or not handling home and child care responsibilities well.

One hazard of using synthetic marijuana was needing more and more to get the same effect, a hallmark of drug dependence. More than three-quarters of users reported using it for much longer than intended (i.e., planning to take just a few puffs after work, but then smoking it for hours).

Walker said there are many reasons why someone would become dependent on alcohol or drugs, but soldiers face added stressors.

"They live very stressful lives. Most of them are young, and they may be going to war or coming back from war," she said. "Being in the Army is very demanding."

The military recently announced that it has developed a urinalysis that can detect synthetic marijuana, but Walton said that test doesn't necessarily have a very high success rate.

"Those drug tests aren't identifying all the users out there," he said. "And, unfortunately, because of the consequences of self-reporting to substance use treatment, positive drug tests are the primary reason soldiers enter treatment. The Warrior Check-Up hopes to change that by helping military personnel change their substance use before it negatively impacts their lives and careers."