Due to excessive cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2) receptor agonism, use of SCs has been associated with unexpected and significant toxicity, including lethargy, agitation, tachycardia, hyperthermia, acute tubular necrosis, myocardial infarction, seizure and even death.1 Marketed as “Spice” and “K2,” its popularity among adolescents and adults has risen substantially and is the second most common drug of abuse (after marijuana) among high school students.2 Here, CNR1 is linked to myocardial infarction.