During March of this year, without warning, many young men came to the hospital acting extremely violent and confused. While many patients had positive drug tests, the degree of violence and confusion was much higher than what my colleagues and I would have anticipated. After our patients had been sedated for a few days, the stories we heard about what led them to the hospital had a similar thread: They all used synthetic marijuana, which, although similar in name, is different from the marijuana you're probably familiar with.
Montefiore was not the only hospital that saw a spike in patients suffering from the harmful effects of synthetic marijuana. In April, synthetic pot sent 160 people to hospitals in the state of New York in a little over a week. Alabama public health officials shared that nearly 100 people had been hospitalized for problems linked to synthetic marijuana between March and April, while police in Virginia reported that someone died from a synthetic marijuana overdose in April.
The surge of patients seeking emergency care after using synthetic marijuana is cause for concern. It's unlikely that synthetic marijuana will be wiped out in the near future, and it's important that everyone educates themselves to help avoid ending up in the emergency room.
What Is Synthetic Marijuana?
Synthetic marijuana often goes by street names such as "K2," "Spice" and "Green Giant," and it can be bought at certain bodegas for as little as $5. Unlike heroin and cocaine, it's not made using just one chemical. Synthetic marijuana can be made with nearly 100 different chemicals that are often sprayed onto dried, shredded plant material. While different chemicals are used, the compounds have similar traits:
-- Mostly concentrated in China and Pacific Rim countries, commercial chemistry labs produce the chemicals on-demand for distributors.
-- All of them are active at the CB1 receptor in the brain. This is the same receptor activated by consuming marijuana which is why this class of drugs is commonly called "synthetic cannabinoids."
-- The activity of these synthetic cannabinoids can be hundreds of times stronger than marijuana on a dose-by-dose comparison.
-- All of the synthetic chemicals used to make synthetic marijuana are illegal to possess, sell and use in the United States.
How Does Synthetic Pot Get From a Lab in China to Your Home?
Synthetic drugs are not only dangerous, they are also easily obtainable. Potential dealers can simply order the chemical compound online, and while illegal to import, the ever-changing structures make them nearly impossible to intercept on entry to the United States.
Most of the chemicals arrive as a powder, but some come with a syrupy texture. Regardless, the chemical can be dissolved in an organic solvent that evaporates easily. This solvent is often sprayed onto some oregano or other plant product. Once the organic solvent has evaporated, the chemical-plant combo can be cut and placed into professionally labeled and decorated bags.
The attraction to the substance comes from its cheap price, intense high and easy availability. The fact that it is "not real pot" leads some unsuspecting users to believe it's safe.
The Effects and the Treatment
As I've already mentioned, I've seen gross confusion and violence directed that has at times taken on sexualized form. A handful of patients become so violent that they require general anesthesia and intubation to protect them from hurting themselves or others. Increased heart rate with chest pain and kidney failure have been observed with some regularity in our hospital. Emerging data on synthetic marijuana also lists anxiety, vomiting, high blood pressure, tremor, seizures, hallucinations and paranoia as common effects of the drug.
There is no antidote for synthetic marijuana. As clinicians, we simply treat the complications and hope the patient will eventually make it through the acute confused state without doing too much damage to themselves or others.
Educating Each Other
It's important for people to understand that the effect of synthetic marijuana varies among its users. While a close friend may not experience violent behavior after using the drug, it can cause another user to behave in a way that can land them in prison, or even lead to death
Not enough is known about which compounds someone is actually purchasing when they buy "K2" or "Spice." The most important message we can share with friends, children and patients is that synthetic marijuana is capable of causing serious harm to its users and those around them.