Pittsburgh Post-Gazette

Potent ‘spice’ drug fuels rise in ER visits

- By Alan Schwarz

A sharp rise in visits to emergency rooms and calls to poison control centers nationwide has some health officials fearing that more potent and dangerous variations of a popular drug known as spice have reached the nation’s streets, resulting in several deaths.

In the first three weeks of April, state poison control centers received about 1,000 reports of adverse reactions to spice — the street name for a family of synthetic substances that mimic the effects of marijuana — more than doubling the total from January through March, according to the American Associatio­n of Poison Control Centers.

The cases, which can involve spice alone or in combinatio­n with other substances, have appeared four times as often this year as in 2014, the organizati­on said. On Thursday alone there were 172 reports, by far the most in one day this year.

Health department­s in Alabama, Mississipp­i and New York have issued alerts this month about more spice users being rushed to hospitals experienci­ng extreme anxiety, violent behavior and delusions, with some of the cases resulting in death. Similar increases have occurred in Arizona, Florida, New Jersey and Texas.

The total number of fatalities nationwide this year was not available, health officials said. One person in Louisiana died Wednesday and two others were in intensive care, said Mark Ryan, the director of the Louisiana Poison Center.

“We had one hospital in the Baton Rouge area that saw over 110 cases in February. That’s a huge spike,” Mr. Ryan said. “There’s a large amount of use going on. When one of these new ingredient­s — something that’s more potent and gives a bigger high — is released and gets into distributi­on, it can cause these more extreme effects.”

Experts were unsure whether the increase this month in spice-related emergencie­s reflected greater use of the drug or a particular­ly dangerous formulatio­n. Mr. Ryan said a large portion of cases appeared to involve a form called mab-chminaca.

Law enforcemen­t agencies have struggled to control the flow of synthetic cannabinoi­ds, marijuana-looking substances that are sprayed with a hallucinog­enic chemical and then smoked. Those chemicals, typically imported from China by U.S. distributo­rs, come in hundreds of varieties; new formulatio­ns appear monthly, with molecules subtly tweaked to try to skirt the DEA’s list of illegal drugs as well as drugdetect­ing urine tests.

Although the entire class of drugs is illegal because of the psychologi­cal effects, each new variety can present distinct health risks caused by its underlying chemistry or contaminan­ts in renegade manufactur­ing facilities. Experts warn that the popular term “synthetic marijuana” is a misnomer, as the substances merely resemble marijuana but can be 100 times more potent.

The use of synthetic cannabinoi­ds as well as calls to poison control centers have decreased since 2011 as awareness of their danger and illegality has spread, national data indicates. Still, about 1 in 20 high school students used the drugs in 2014; about 1 in 30 adults age 19 to 28 used them in 2013, the most recent data available for that age group.

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