Un­knowns of syn­thetic drugs have D.C. un­nerved

The high tak­ing over streets is so vari­able, it’s hard to stop or treat

The Washington Post Sunday - - FRONT PAGE - BY ABI­GAIL HAUSLOHNER AND PETER HER­MANN

The man in the Mickey Mouse shirt was cling­ing to a light pole on H Street NE when po­lice showed up, and then he dropped his pants. Another man near Eastern Mar­ket was laugh­ing so hard that paramedics had trou­ble keep­ing him on a stretcher. A third, whom po­lice found pranc­ing through Capi­tol Hill, started kick­ing and scream­ing when eight po­lice and fire of­fi­cials tried to re­strain him.

Paramedics rushed all three men to hos­pi­tals in sep­a­rate in­ci­dents Thurs­day night, and all three said they had taken syn­thetic drugs — a set of sub­stances so alarm­ing to Dis­trict author­i­ties that Po­lice Chief Cathy L. Lanier re­cently likened them to crack co­caine in their propen­sity to in­duce vi­o­lence and death.

Syn­thetic drugs have been around for years. Also known as “syn­thetic cannabi­noids,” the term en­com­passes a range of mind-al­ter­ing chem­i­cals that are con­stantly evolv­ing and are mar­keted in wildly di­ver­gent ways, some­times as mar­i­juana sub­sti­tutes on the streets and as in­cense in con­ve­nience stores.

Author­i­ties say the prob­lem spiked in June, with a sud­den rash of 911 calls. And they are blam­ing the drugs for a grow­ing list of fright­en­ing in­ci­dents across the city. Of­fi­cials have linked the drugs to two homi­cides, in­clud­ing a grisly Fourth of July killing in which an al­legedly

high man stabbed a Metro rider nearly 40 times on a train. D.C. Mayor Muriel E. Bowser (D) said last week that the drugs con­sti­tuted a “se­ri­ous threat to our public health and public safety.”

But links be­tween the drugs and vi­o­lence are al­most en­tirely grounded in anec­do­tal ev­i­dence rather than hard data. Be­cause the mix­tures change by the batch in part to skirt drug laws, the drugs are dif­fi­cult to test — and over­doses are dif­fi­cult to treat.

Author­i­ties said they’re still test­ing the Metro stab­bing sus­pect for signs that he was us­ing syn­thetic drugs, which they say they sus­pect from his be­hav­ior. And a Depart­ment of Health spokesman said the agency had yet to col­lect sta­tis­tics on over­doses or deaths linked to the chem­i­cals. Even as Bowser signed a newlawlast week rais­ing penal­ties for stores caught selling, her health chief ac­knowl­edged that test­ing wouldn’t be­come avail­able to area health providers un­til the fol­low­ing week.

The truth about syn­thetic drugs, law en­force­ment of­fi­cials and sci­en­tists say, is that the dan­ger lies in the mys­tery. “Syn­thetic drugs” don’t re­fer to a sin­gle sub­stance but to a mul­ti­tude of com­bi­na­tions con­cocted in lab­o­ra­to­ries that fed­eral in­ves­ti­ga­tors say are mostly in China.

The ac­tive in­gre­di­ents are so shift­ing in form — the U.S. Drug En­force­ment Ad­min­is­tra­tion has tracked more than 300 it­er­a­tions in less than a decade — that no one can say defini­tively what ef­fect they have on users or those around them.

Nonethe­less, there is a grow­ing sense that those ef­fects are wors­en­ing in the Dis­trict, where po­lice, paramedics and even users say that syn­thetic drugs are be­com­ing more preva­lent, caus­ing more over­doses and lead­ing to more vi­o­lence. ‘We see this ev­ery day’

Those same first-hand observers de­scribed dozens of in­ci­dents. Re­ac­tions, they said, range from a blank, zom­bielike stare to twitchy ag­i­ta­tion and un­con­scious­ness.

Lanier has de­scribed see­ing three peo­ple over­dose at a no­to­ri­ous strip of pave­ment near Bladens­burg and Ben­ning road­sNEin a sin­gle hour—“peo­ple com­pletely dis­ori­ented, dis­con­nected and un­con­scious, some­times in the mid­dle of the street.”

On a re­cent evening at that in­ter­sec­tion, about three dozen peo­ple had spread across the side­walk in var­i­ous stages of con­scious­ness. Some clus­tered un­der trees, as they smoked and passed cig­a­rettes be­tween them. Oth­ers slumped over con­crete ta­bles and benches. A few ap­proached a tall man on a bench and asked if he had the “good stuff.”

“We see this ev­ery day,” said oneD.C. po­lice of­fi­cer who was on the scene, re­fer­ring to a man cling­ing to a util­ity pole.

Some peo­ple be­come amorous on the drugs, said another vet­eran para­medic. Oth­ers be­come an­gry and some­times vi­o­lent. “The scary part is you never know what you’re go­ing to get,” said Capt. An­gel M. Lewis, a 20-year vet­eran para­medic who was able to coax the man away from the util­ity pole af­ter he had pulled down his pants.

The man gripped by hys­ter­i­cal laugh­ter near the East­ern­Mar­ket Metro ap­peared to ex­pe­ri­ence a “happy high” at first, Lewis said. But when they cor­nered him he screamed un­con­trol­lably, and when they lifted him into the am­bu­lance, he be­gan chew­ing through his re­straints.

The danc­ing man on Capi­tol Hill was clearly high, but “he didn’t ap­pear vi­o­lent at all,” said a woman who was sip­ping wine with two other res­i­dents of a cor­ner row­house as spec­ta­tors ap­plauded a soc­cer match across the street.

Lewis ap­proached, plead­ing with the man to let her take his blood pres­sure and prick his fin­ger to test his blood-sugar level. He walked to her su­per­vi­sor’s ve­hi­cle, a red Chevro­let Ta­hoe, and sat on the back bumper, the po­lice of­fi­cer at his side. “Did you do any drugs tonight?” Lewis asked. “K2?”

The man, in his mid-30s, told her he had smoked a full pack of a syn­thetic drug called Bizarro. He then fought her and oth­ers’ at­tempts to get him on a stretcher, and then he lay on his back in the mid­dle of the street.

“They can go from half asleep to com­bat­ive and rag­ing,” said Holly O’Byrne, a para­medic who said some pa­tients have been found nearly un­con­scious, and one re­cently tried to bite off a col­league’s fin­ger. “The drug is a game changer.”

The worst part of the epi­demic, of­fi­cials say, is that the con­coc­tions ap­pear to keep chang­ing. Sev­eral said they have seen signs re­cently of a more dan­ger­ous of­fer­ing known as Train­wreck that com­bines syn­thetic drugs with heroin and PCP. First re­spon­ders say they sus­pect some users are mix­ing the syn­thet­ics with pre­scrip­tion men­tal-health med­i­ca­tions.

True ef­fect is un­known

Data ob­tained byTheWash­ing­ton Post show that emer­gency room vis­its for syn­thetic cannabi­noids— com­monly re­ferred to on the street by such names as K2, Spice, Scooby Snax and Bizarro— have grown steadily since 2013.

Then came June, when D.C. paramedics recorded 439 am­bu­lance trips— roughly 15 per day— rep­re­sent­ing more than eight times the num­ber of emer­gency room vis­its made for syn­thetic drugs dur­ing the same pe­riod last year.

So far in July, am­bu­lances have car­ried sus­pected syn­thetic drug users to the hos­pi­tal 149 times, and that num­ber is ex­pected to rise. On the most re­cent date of data col­lec­tion — July 12 — Dis­trict am­bu­lances picked up 22 peo­ple be­lieved to have used the drugs.

The prob­lem ap­pears less acute in the Dis­trict’s sub­urbs, of­fi­cials say, though Mont­gomery County of­fi­cials re­ported a po­ten­tial link be­tween syn­thetic drug use and vi­o­lent crime and sui­cide. DEA of­fi­cials say the preva­lence — and dead­li­ness — of the drugs have fluc­tu­ated for years across the coun­try.

In the past, the drugs ap­peared de­signed to pro­vide a le­gal high that would sub­vert state bans on mar­i­juana while in­duc­ing sim­i­lar ef­fects. As laws were passed to tar­get the new chem­i­cals, man­u­fac­tur­ers al­tered their prod­ucts to stay one step ahead. It has worked — with con­se­quences not only for en­force­ment but for med­i­cal care.

“You’re talk­ing about a poi­son,” said An­dre W. Kel­lum, the as­sis­tant agent in charge of the DEA’s Washington Field Di­vi­sion. “Any time you have peo­ple dy­ing, it be­comes an is­sue. And now, hav­ing seen it the past few months, peo­ple dy­ing from this sub­stance, it opens your eyes. Just like we don’t know the com­pounds, we re­ally don’t know the true ef­fect of what can hap­pen to ev­ery in­di­vid­ual that takes it.”

Paramedics say that a vi­o­lent syn­thetic-drug user might not re­spond to seda­tives the way a PCP user would. And doc­tors with proven suc­cess re­viv­ing vic­tims of heroin over­doses with Nalox­one can be stymied by syn­thet­ics.

Eric Wish, an as­so­ciate pro­fes­sor and di­rec­tor of the Cen­ter for Sub­stance Abuse Re­search at the Univer­sity of Mary­land, said re­searchers “are re­ceiv­ing con­stant re­ports of peo­ple show­ing up in emer­gency rooms with all sorts of bizarre symp­toms.”

Be­cause doc­tors know so lit­tle about the chem­i­cals in­volved, the users are ef­fec­tively “play­ing Rus­sian roulette with their bod­ies,” Wish said.

Ac­cord­ing to DEA of­fi­cials, the chem­i­cals are of­ten in­ten­tion­ally mis­la­beled, for ex­am­ple as “white paint pow­der,” when they ar­rive from China. Amer­i­can man­u­fac­tur­ers then mix them with ace­tone and spray them onto leaves.

The drugs are pack­aged and sold as “in­cense” or “pot­pourri” in col­or­ful pack­ets fea­tur­ing car­toon char­ac­ters. They’re easy to come by on the In­ter­net. OneWeb site boasts “the most ad­vanced sci­en­tific prod­uct avail­able” — of­fer­ing, for in­stance, 20 grams of Scooby Snax for $34 and 250 grams of Bizarro for $432.90.

In the Washington area, lo­cal gas sta­tions and con­ve­nience stores of­ten sell the drugs in smaller pack­ets for $5. On the street, a sin­gle rolled cig­a­rette can sell for $2. There is no telling how one packet dif­fers from another with the same la­bel.

“They are be­ing mar­keted as a le­gal high,” said Joshua Wans­ley, who works in­tel­li­gence in the DEA’s Washington of­fice. “The im­plicit mes­sage is that it’s safe.”

Nearly im­pos­si­ble to po­lice

One way man­u­fac­tur­ers have been able to ex­ploit loop­holes in the Con­trolled Sub­stances Act is by mark­ing pack­ages “Not for hu­man con­sump­tion.”

D.C. Po­lice of­fi­cials say it’s nearly im­pos­si­ble to charge a per­son for pos­ses­sion of a sub­stance that takes so long to test and of­ten isn’t de­tectable. Users, too, say they smoke the syn­thetic sub­stances in­stead of other drugs pre­cisely so they can pass a drug test.

One 38-year-old home­less man said he was ar­rested two months ago for pos­ses­sion but was promptly re­leased when po­lice re­al­ized they didn’t have much of a charge. “Some peo­ple use it so they can get jobs,” he said.

In one of the few stud­ies of syn­thetic drug use, Wish at U-Md. found that out of a sam­ple of pa­role and pro­ba­tion­ers who had tested neg­a­tive for tra­di­tional drugs, half had pos­i­tive re­sults when tested for a panel of syn­thet­ics.

In Fe­bru­ary, Rep. Mac Thorn­berry (R-Tex.) in­tro­duced a bill that at­tempts to elim­i­nate some of the ex­ist­ing loop­holes by broad­en­ing the terms of the Con­trolled Sub­stances Act.

In the Dis­trict, of­fi­cials have launched a new of­fen­sive to cut down on the sup­ply by go­ing af­ter the busi­nesses that sell it — of­ten liquor shops and con­ve­nience stores in poor neigh­bor­hoods.

In the past year, the U.S. at­tor­ney’s of­fice has tar­geted at least five busi­nesses and their work­ers or own­ers for selling syn­thetic drugs in­side the Dis­trict. Last week, the D.C. At­tor­ney Gen­eral’s Of­fice and po­lice tem­po­rar­ily shut­tered two stores, in­clud­ing one owned by a re­tired po­lice of­fi­cer, that they said were selling syn­thetic drugs.

Grant Smith, the deputy di­rec­tor of na­tional af­fairs at the Drug Pol­icy Al­liance, which ad­vo­cates for lib­eral drug poli­cies, be­lieves that link­ing the drugs to vi­o­lence, as city of­fi­cials have done, could ul­ti­mately prove mis­lead­ing and coun­ter­pro­duc­tive.

“We should be fo­cused more on other types of ser­vices — treat­ment ser­vices, and hav­ing a bet­ter un­der­stand­ing of what these sub­stances are,” Smith said.

But Wish said the syn­thetic drugs are so dan­ger­ous that some­thing needs to be done quickly to stem their use with or with­out a firm grasp of the chem­istry.

“You have to get peo­ple’s at­ten­tion, and if link­ing it to vi­o­lence gets peo­ple’s at­ten­tion, then I think it’s worth it,” Wish said. “This is an in­cred­i­bly dan­ger­ous sub­stance.”

RICKY CAR­I­OTI/THE WASHINGTON POST

Capt. An­gel M. Lewis, a para­medic, and a D.C. po­lice of­fi­cer, right, ap­proach a man be­lieved to be un­der the in­flu­ence of syn­thetic drugs. The man co­op­er­ated in be­ing taken to the hos­pi­tal.

PHOTOS BY RICKY CAR­I­OTI/THE WASHINGTON POST

TOP: D.C. po­lice and paramedics tend to a man un­der the in­flu­ence of syn­thetic drugs. In June, D.C. paramedics made 439 am­bu­lance trips for syn­thetic drug users. ABOVE: Para­medic An­gel M. Lewis, cen­ter, per­suades an im­paired man to let go of a light pole.  For more photos, go to wash­ing­ton­post.com

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