From MedPage Today:

Synthetic marijuana products such as K2 and "spice" have been linked to reports of acute kidney injury (AKI), government researchers found.

Between March and December 2012, a total of 16 cases of AKI tied to these synthetic cannabinoids have been reported across the country, Michael Schwartz, MD, of the CDC, and colleagues reported in the Feb. 15 issue of the Morbidity & Mortality Weekly Report.

Clinicians who encounter otherwise healthy adolescents and young adults with unexplained kidney injury should ask about use of the drugs, they wrote, and cases should be reported to regional poison control centers and state health departments.

From CNN:

Hospital staff removed Emily Bauer's breathing tube and stopped all medication and nourishment at 1:15 p.m. December 16. Only morphine flowed into her body, as the family waited by her side in her final moments.

But the next morning, she was still alive.

"Good morning, I love you," her mother told Emily as she approached the bed.

A hoarse voice whispered back, "I love you too."

Emily was back.

Her family said the drug that landed the Cypress, Texas, teenager, then 16, in the ICU two weeks earlier wasn't bought from a dealer or offered to her at a party. It was a form of synthetic weed packaged as "potpourri" that she and friends bought at a gas station.

Best known by the street names "Spice" or "K2," fake weed is an herbal mixture sprayed with chemicals that's meant to create a high similar to smoking marijuana, according to the National Institute on Drug Abuse. Advertised as a "legal" alternative to weed, it's often sold as incense or potpourri and in most states, it's anything but legal.

Synthetic marijuana was linked to 11,406 drug-related emergency department visits in 2010, according to a first-of-its-kind report by the Substance Abuse and Mental Health Services Administration. This is when it first started showing up on health providers' radar, as the Drug Abuse Warning Nework detected a measurable number of emergency visits.

Who wound up in the emergency room the most? Children ages 12 to 17.

The first state laws banning synthetic drugs popped up in 2010. Now at least 41 states -- including Texas, where Emily lives -- and Puerto Rico have banned them, according to the National Conference of State Legislatures.

Older legislation targeted specific versions of the drug, but the makers of Spice were a step ahead.

"These drug manufacturers slightly change the chemical compound, and it becomes a different substance that's not covered by the law," said NCSL policy specialist Alison Lawrence. "That's why in 2011 and 2012, we saw the states enacting these broader language bans."

Common side effects to smoking synthetic marijuana include bloodshot eyes, disturbed perceptions and a change in mood, said Dr. Melinda Campopiano, a medical officer with the Substance Abuse and Mental Health Services Administration.

"People can become very agitated or can be come unresponsive -- conscious but not reacting normal to situations," she said. They may also appear paranoid or describe hallucinations. Some of the more potentially serious effects include an elevated heart rate and elevated blood pressure.

Campopiano said she had never heard of a patient having a stroke in these circumstances, but she described how high blood pressure could lead to one.

Knowing how different people will react to fake weed is impossible. There are a few reasons that explain why.

"You're hearing some pretty bad things with the synthetic cannabinoids -- part of that has to do with the potency. It can be 100 times more potent than marijuana," said U.S. Drug Enforcement Administration spokeswoman Barbara Carreno.

Carreno explained there's no consistency or quality control from one time to the next. The people making these products can be anyone from a college kid wanting to make extra cash to an operation blending large quantities in a cement mixer, she said. Two batches made by the same person could have different doses.

One in every nine high school seniors admits to having used fake weed in 2011, according to a national survey by the University of Michigan. Synthetic marijuana is the second-most popular illicit drug they use, behind marijuana.

In July 2012, President Barack Obama signed legislation banning five common chemicals used to make synthetic marijuana and bath salts. And that same month, the DEA seized almost 5 million packets of fake weed in its first national sweep of the drug.

States handle the penalties for drug offenses in lots of different ways and possession has varying definitions, according to NCSL's Lawrence.

From the Deseret News:

Matt Fairbanks, special agent with the Drug Enforcement Administration in Utah, calls it a game of "chemical cat and mouse."

As fast as law government agencies are banning synthetic substances such as spice and bath salts, criminals are changing a molecule or two to come up with a new substance just as dangerous that doesn't meet the criteria of the law that banned the last synthetic drug.

One of the latest substances that has law enforcers worried: synthetic marijuana brownies. "Candy Weed," as it's known, is synthetic THC mixed with flavored corn syrup and made into little candy squares. Fairbanks said it's a trend that law enforcement officers haven't seen in Utah yet. But once a new drug appears in places like California, he said it's only a matter of time before it finds its way to the Beehive State.

A 2011 National Institute on Drug Abuse survey found that more than 11 percent of twelfth-graders reported using synthetic marijuana, according to the Utah Attorney General's Office.

The American Association of Poison Control Centers reported receiving 2,906 calls because of Spice in 2010 and 6,955 in 2011, showing an increased popularity of the drug. Spice accounted for 11,206 emergency room visits in 2010, and 75 percent of patients were ages 12 to 29, according to recent survey by the Substance Abuse and Mental Health Services Administration.

Also from Action News (Philadelphia):

Parents are being urged to be on the lookout for a deceiving piece of candy. It's called weed candy, and police are concerned that it could be laced with more than marijuana.

It is an emerging trend in the world of illegal drugs, and they call it "pot candy" or "weed candy."

Authorities say what makes these candies particularly dangerous is that there is no telling if they might be laced with other drugs or toxic chemicals.

Any parents should look for unwrapped or re-wrapped candies that look like Jolly Ranchers.

From Mississippi News Now:

A man accused of attacking his pregnant wife and killing their unborn baby appeared in court for a hearing Thursday for the first time since the October incident. On his way into court, Jeffery Reynolds blamed synthetic marijuana for what happened.

The Livingston Parish Sheriff's Office said Reynolds attacked his wife, Paula, 28, with a kitchen knife at their Walker, LA home on Oct. 23, 2012.

Investigators said he stabbed her in the abdomen and cut their baby out of her. She survived the attack.

A toxicology test was run on Reynolds, but at last report, the results had not been sent back to authorities.

Reynolds remains behind bars on $500,000 bond. He is charged with first-degree feticide and second-degree attempted murder.

From Salon.com:

This is the year of the knockoff. A witch’s brew of new synthetic drugs, most of them stimulants, peddled as either bath salts or “spice” concoctions, has offered users new forms of Russian Roulette, and has irrevocably changed the face of international drug dealing. 2012 was also the year hysteria took over. Myths began to accumulate, and everywhere you looked, somebody was supposedly doing something psychotic due to the new synthetics.

By 2012, amphetamine-type stimulants, including synthetic bath salt derivatives, had become more popular worldwide than either cocaine or heroin, according to the United Nations Office on Drugs and Crime (UNODC). This international eclipsing of the plant-based “hard drugs” of the past represents a major paradigm shift in the landscape of the illegal drug trade. The stunning market growth of synthetic stimulants is not hard to understand. Bath salt drug products soared in popularity throughout 2012 due largely to the belief among users that the drugs were: 1) quasi-legal, 2) non-addictive, 3) relatively safe, and 4) invisible to drug tests.

By the end of the year, it had become clear that none of these things was still true.

To begin with, bath salts—just like Spice and other cannabis spinoffs—are no longer legal. And many of the drugs found in bath salts appear to be addictive. Some carry known health hazards. And, although it was the desire to finesse drug testing that gave a major push to this new class of recreational chemicals, major bath salt ingredients can now be detected in routine urinalysis. Researchers have teased out the main culprits in both categories of synthetics—for synthetic marijuana, it’s the JWH family of research chemicals. For stimulants, it’s the cathinones, compounds like mephedrone and MDPV, members of a family of psychoactive alkaloids that includes khat, the chewable form of speed popular in East Africa.

There are new drug tests out there that can detect many of the major ingredients in both bath salts and spice-style cannabis products. And that marks a major change that law enforcement hopes will cripple growth in this fast-moving industry.

“Increasingly, and especially in the U.S. military, testing firms are including these compounds in their methodology,” says Dr. Kroll. More drug test kit manufacturers are sure to ramp up production in the near future, but it is a costly effort. “Folks probably aren’t aware of how hard it is to develop methods to detect all of these compounds,” adds Kroll.

by Dr. Barry Logan

The news media has documented a growing trend in gruesome and violent “zombie-like” attacks in recent weeks. In Miami, a man was shot and killed by police while eating the face of another man. In Louisiana, a man bit off a chunk of his neighbor’s cheek. A woman in New York attacked her own three-year old child and then attempted to sink her teeth into a police officer. In Texas, a man tried to eat his family’s dog while the animal was still alive.

Shortly after the Miami attack, Pennsylvania Congressman Pat Meehan, a former U.S. Attorney, convened a meeting of local law enforcement, forensic scientists, drug experts, and school officials in Upper Merion, Pa. The goal of the meeting was to discuss the challenges posed by designer drugs such as “bath salts” and synthetic marijuana, also commonly referred to as “fake pot.” Law enforcement officials noted that the biting and the animalistic behavior that occurred in Miami and other recent incidents is a common behavior exhibited by individuals high on bath salts.

The group discussed how these drugs are readily available and freely marketed online as household items like incense, plant food and bath salts. In some cases, they are sold in local neighborhoods at corner markets and gas stations. And although they typically have the disclaimer “not for human consumption” they are produced with the specific intention of being smoked or injected by people looking for a quick high.

A major concern is that the ease with which these drugs can be purchased on the internet has sparked a surge in use among teenagers. A recent study commissioned by the National Institute for Drug Abuse revealed that one in every nine high school seniors (11.4 percent) reported using synthetic marijuana in the prior 12 months. Many teens believe the products are safe, “legal” highs that will not be detected in a routine drug test, and will not arouse parental suspicion. Others appear to believe they are safer alternatives to marijuana and amphetamines such as cocaine, which they are designed to mimic. In reality, they appear to be far more dangerous.

Bath salts are known to cause agitation, paranoia, hallucinations, chest pain, suicidal tendencies, and the animalistic behavior shown in recent violent attacks. Synthetic marijuana poses its own risks because of the way it alters the brain’s chemistry and has been linked to numerous deaths. Last June, police said a teenager jumped off the roof of a mall parking garage in Willow Grove after smoking fake pot.

Given their misleading marketing, heightened availability, and adaptive “legality,” it is not surprising that last year Poison Control Centers received over thirteen thousand human exposure calls regarding synthetic cannabinoids and bath salts. Last year, the U.S. Drug Enforcement Administration took steps to ban the chemicals used to make these designer drugs. But many manufacturers responded by slightly altering the chemical makeup of the compounds, effectively skirting federal law. This led to a new round of increasingly volatile and dangerous drugs.

As Congressman Meehan and stakeholders discussed, addressing this growing problem requires a multi-pronged effort. From a legislative perspective, instead of reactively banning substances, lawmakers must proactively classify the new non-scheduled substances being constantly reformulated by manufacturers as analogs, making them illegal under federal law. Meehan said this must be accompanied by a focused effort to go after and take down the internet sites that peddle these dangerous drugs.

Similarly, we need a concerted education effort aimed not just at teenagers, but parents as well. They need to be informed about what these substances look like, how they are packaged and marketed, and the negative long and short-term effects of the substances which at best alter brain chemistry, and at worst induce violent behavior, and sometimes even death.

At the same time, we must work to expand our forensic testing capabilities to detect and identify the use of bath salts and synthetic marijuana. If we are able to detect the use of these drugs in blood and urine as easily as we can detect marijuana or cocaine, these synthetic drugs will cease to be an alternative for individuals who are seeking to evade detection in standard drug tests.

These synthetic drugs do not just pose a danger to abusers. They also endanger innocent bystanders, law enforcement, and anyone else an individual high on these substances may come in contact with. It is time to step up and tackle this problem head on.
______________________________________________________________________________
Dr. Barry Logan is Director of Forensic and Toxicological Services for NMS Labs, in Willow Grove, Pa. and is President-Elect of the American Academy of Forensic Sciences (AAFS). For more information on synthetic drugs, including a brochure for parents, visit www.nmslabs.com.

From The Times Herald:

U.S. Rep. Patrick Meehan hosted a forum Tuesday at the Upper Merion School District Administration Building about the rise in synthetic drug use in local area high schools.

Though some synthetic drugs are illegal in Pennsylvania, not all of them are, and many are not banned federally, making it easy to purchase the drugs in other states or online.

Barry Logan, National Director of Forensic Services at NMS Labs said synthetic marijuana and bath salts are constantly changing, making it extremely difficult to detect them and to create laws to stop their use and production.

He said a major problem with the drugs is the extreme symptoms they cause. He said synthetic marijuana causes panic attacks, paranoia seizures and convulsions that real marijuana doesn’t typically cause. He said bath salts are like ecstasy and amphetamine and sometimes cause hallucinations, delusions and seizures.

Logan said since the drugs are constantly changing, users really do not know what they are consuming and how much of it they are taking in.

Kathleen Houston, Division Director of Health Services at Gaudenzia, said a major problem with synthetic drugs is that when someone who has consumed them is taken to the hospital, most times the drugs are undetected.

Because of this, medical officials are “blind sighted” by the way some patients act, which could cause harm to those who are treating the person.

She said she is also concerned for law enforcement officials because people who are on synthetic drugs sometimes experience paranoia, which is heightened when they are stopped by a police officer.

“This is horrific stuff,” Houston said. “It’s like nothing we’ve seen in a very long time.”

From The Associated Press:

The Navy soon will begin giving Breathalyzer tests to many of its sailors before they report to work aboard a ship under a new program that will spread to the Marine Corps later this year.

Details of the Navy program are still being worked out, but not every sailor who walks onto a ship will be given a Breathalyzer test. Navy officials estimate that between one sixth and one eighth of a ship's crew will be given the test, which will target those standing watch and overseeing important aspects of a ship, such as its nuclear reactors. Other sailors may be tested at random.

The Navy is setting aside $8 million to begin the program and anticipates spending $2 million to keep it going.

Mabus said sailors who are found to have been using alcohol before reporting to work won't necessarily be punished, but the tests will be used as a way to help identify sailors in need of treatment and to serve as a deterrent for those considering drinking heavily the night before a shift.

The tests are part of Mabus' 21st Century Sailor and Marine Initiative, an expansive program intended to improve the well-being of sailors and Marines after more than a decade at war.

Among other things, sailors also will be given random drug tests to check for the use of synthetic marijuana, which the military prohibits its members from using. Many states also outlaw synthetic drugs. Sailors caught using synthetic drugs through the urine tests will be prosecuted under military law.

From Outcome Magazine:

A type of fake pot has raised new health concerns in the United States after at least three users were hospitalized for kidney failure, authorities in the western state of Wyoming said Monday.

Often known as “Spice” or “K2,” the substance is marketed to young people as herbal incense, and creates a marijuana-like high when it is smoked like a joint or a cigarette.

“At this point we are viewing use of this drug as a potentially life-threatening situation,” Tracy Murphy, state epidemiologist with the Wyoming Department of Health, said in a statement sent to AFP.

State health authorities first learned of the latest incidents on Thursday involving three patients in central Wyoming who sought hospital care after smoking a product known as “blueberry spice,” a spokeswoman added.

There have been no deaths and no reports of connected cases in other areas, she added.

However, drug policy experts say that fake pot use has been on the rise in recent years.

From The Washington Post:

The Drug Enforcement Administration is extending emergency controls for six more months on five chemicals used to make fake pot products.

The agency is working on permanently designating smokable herbal products containing the five chemicals as controlled substances. The DEA took emergency action a year ago, making it illegal to possess and sell the five chemicals or products containing them.

The agency says the extension will provide time to complete the steps to permanent controls.