Warning Label on Cannabinoid use

“Drug poisoning deaths are the leading cause of injury death in the United States; they are currently at their highest ever recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide.” — Drug Enforcement Agency, 2017 National Drug Threat Assessment

In Illinois, the death toll is still being tallied from the use of rat-poison laced synthetic cannabis last month. Between March 7, 2018, and April 30, 2018, the Illinois Department of Public Health has received reports of at least 156 cases of severe bleeding and at least four deaths linked to the use of these man-made drugs. In about the same time frame in Maryland, the state’s Health Department also had an outbreak of hospitalizations due to the use of synthetic cannabis.

K2 typical packaging
Photo Caption: A package of Spice or synthetic cannabinoids, which contains herbs and spices sprayed with a synthetic compound chemically similar to THC. Some people in Illinois have bled out of their eyes and ears after taking the drug, according to Illinois state officials.

Only weeks before this outbreak, the Center for Disease Control (CDC) issued an emergency alert about the mind-altering substance that goes by more than 100 different street names, including K2, Spice, AK-47, Kush, Scooby Snax, Black Mamba and Mr. Happy. Since then multiple states have seen extended hospitalizations associated with their use.

This group of drugs categorized by the CDC and the Drug Enforcement Agency as new psychoactive substances (NPS) is frequently marketed as legal, safe alternatives to marijuana and other drugs. They are not new, however, and have actually been around for decades. They are labeled as new because the composition of these man-made substances is always changing. And – they are not safe. In fact, they can cause unpredictable, erratic behavior that can lead to seizures, comas and in some cases death, according to the nation’s leading experts.

This category of drugs has wide variations in potency and chemical makeup. They contain a toxic mixture of man-made chemicals that mimic the effects of tetrahydrocannabinol (THC), which is the substance that gives marijuana users the euphoric feeling. Instead of just the “high”, some users are experiencing bruising, bleeding of the gums, hallucinations, loss of consciousness and even bleeding from the eyes and excessive amounts of bleeding due to injuries. Due to the variations in the product and lack of consistency, the user has no way to predict what the effect of any given package could be.

According to the Drug Enforcement Agency (DEA), the most common NPS in the United States are synthetic cathinones and synthetic cannabinoids. Synthetic cannabinoids consist of drug-laced vegetative material to smoke or suspended in an oil form to be used in e-cigarettes. E-cigarettes have grown increasingly popular with many people who are either trying to quit smoking and/or also due to growing number of bans on smoking in public. The Center for Disease Control (CDC), says in a 2014 study, around 2.4 million middle and high school students were current (past 30-day) users of electronic cigarettes or e-cigarettes. The popularity of e-cigarette with teens continues to grow according to the Surgeon General’s Office.

Synthetic cathinones are usually powdered or crystal chemicals, commonly ingested in tablet or capsule form. Especially appealing to a young audience, they are packaged in colorful foil packets, with cartoons and other playful images and flavors such as apple, blueberry, and strawberry.

K2 variety packaging
Credit: New York State Department of Health

Federal Law Enforcement Works Locally and Globally to Halt the Trafficking and Sale of “Fake Weed”

The DEA says synthetic cannabinoids are widely available in the United States. According to Melvin Patterson, an agent with the Drug Enforcement Agency, “Dallas and Miami have reported high availability of these drugs, based on the 2017 National Drug Threat Assessment.” Three Field Divisions of the DEA, Houston, New England, and New Jersey, reported that the availability of synthetic cannabinoids and synthetic cathinones is increasing. DEA San Diego has also reported the increasing availability of synthetic cannabinoids. They can be found for sale in gas stations, adult stores, smoke shops, online and sometimes on the street in baggies. In shops, they are often labeled as “incense,” and described as “not for human consumption,” with manufacturers and distributors hoping to skirt legal repercussions.

Eric Wish, Ph.D., one of the nation’s top experts on these synthetics told DrugRehab.org “People who take it are playing Russian Roulette because they don’t know what they’re taking and how it will affect the body,” Wish says. In late 2015 DrugRehab.org wrote an article on the dangers of NPS.

Dr. Wish explained that NPS is not a single, standardized drug but ever-evolving, mysterious concoctions. According to the DEA, the always shifting recipes mean that typical drug tests do not pick up all NPS, making them popular with inmates, parolees, and probationers. The CDC says that manufacturers can easily stay ahead of the enforcement because as quickly as a specific compound is categorized as illegal, they adjust the recipe slightly and are back in business.

“It’s like the game Whack-A-Mole,” Dr. Wish said. “Every time a drug is identified, it gets put on the federal ban list. And then people who are making these chemicals tweak the chemical so it’s no longer illegal. One of the problems is that the federal laws are actually causing the drugs to keep changing so it’s impossible to test your way out of this problem.”

The Drug Enforcement Agency recognized this problem and has had success in scheduling more and more of these drugs. The Chinese have scheduled at least 116 NPS. The DEA has utilized this information and told us, “Since 2015, we have scheduled lots of the substances and precursors needed to manufacturer NPS,” paving the way for local enforcement to step in and halt sales. “The DEA has assisted United States Attorney’s Offices throughout the United States to successfully prosecute countless NPS cases,” since this scheduling, and since DrugRehab.org’s earlier article.

As the substances become identified and scheduled by the DEA, local law enforcement then has the authority to move forward with charging offenders for crimes such as distribution and sale of controlled substance. In the recent incident in Illinois, two men were pulled over in Pittsfield, Illinois and 96 separate packages, totaling more than 767 grams of synthetic cannabis, were found in their car. After the Illinois State Police Crime Lab confirmed that the packages contained an unlawful controlled substance, a warrant was issued for their arrest. The men said they were driving to Missouri.

The DEA works with the states to stop the trafficking and sale of these drugs. “The DEA was probably one of the first if not the first law enforcement component to begin aggressively investigating and bring NPS cases to the US Attorney’s Office for prosecution. Since then the DEA has shared lots of information about effectively investigating organizations that are trafficking NPS,” Patterson continued.

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US Drug Demand Drives Cash Flow to Global Networks

The proliferation of manufacturing, sale, and use of these synthetic drugs is a significant global problem to public health and a challenge to drug policy and enforcement. According to the 2017 World Drug Report published by the United Nations Office on Drug and Crime, between 2009 and 2016, 106 countries and territories reported the emergence of 739 different new psychoactive substantive drugs.

Patterson told us, “Since the emergence of these dangerous designer synthetic drugs such as cannabinoids and cathinones, DEA has seen millions of dollars in sales proceeds flow to Middle Eastern countries such as Lebanon, Yemen, Syria, and Jordan. While we can’t determine where these funds go once they end up in these countries, it is very disturbing given the instability in the region and the fact that many global terror networks use drug proceeds to finance their deadly activities. We are very concerned about global money flow from the sale of illegal, deadly drugs and we have seen it significantly with these substances.”

synthetics being poured out of a bottle

It’s hard to believe a child or anyone else could purchase such a harmful product at their local corner store. The DEA, CDC, and state health departments are among the most vocal organizations working to raise awareness of the dangers involved. Educating children about the real dangers of these substances is critical. Since many states are legalizing marijuana, or allowing marijuana for medical use, it is understandable how young people might be confused about the dangers involved in this drug that is commonly referred to as “fake weed”.

The Poison Control Center is on the front lines answering hundreds of thousands of calls for help. They share one young man’s tragedy in order to educate on the seriousness of the use of these unpredictable substances. They recount how a family member of the patient had been using the synthetic stimulant K-2 for two days prior to losing consciousness. “A 23-year-old man was agitated incoherent; he ran away from a minor car wreck. The police caught him; he lost consciousness as emergency physicians transferred him to an emergency room. He was sedated and put on a ventilator. He never woke up and died after three days in the hospital. An autopsy showed brain damage, kidney damage, and damage to his heart.” – The Poison Control Center.

Patterson reminds us, “We are talking about a substance that causes very unpredictable and erratic behavior. We would strongly advise anyone considering taking any NPS to rethink that decision.”

Drug Iq Challenge
Photo Caption: The National Institutes of Health has a website dedicated to educating teens, teachers, and parents on drug and alcohol prevention. They have interactive learning games, printable fact sheets and lots of information on how drugs affect the brain and body, which is especially important for growing adolescents.

Emergency Help:
If you have questions about synthetic cannabinoids, including whether or not to go to the emergency room, please call your healthcare professional or contact your local poison center by calling 1 800 222 1222. Dial 911 immediately if someone stops breathing, collapses or has a seizure.

Center for Disease Control information on synthetic cannabinoids:

Youth and E-cigarettes, Surgeon General