K2, Spice, Bath Salts An Emerging Threat. Michael Chesbro, MA, CCIA November 28,

Transcription

1 K2, Spice, Bath Salts An Emerging Threat Michael Chesbro, MA, CCIA November 28,

2 K2, Spice, Bath Salts An Emerging Threat Since 2008 / 2009 the U.S. drug market has seen an increase in the use and availability of designer drugs (synthetic cannabinoids & synthetic cathinones) sold as a legal alternative to marijuana, cocaine, and Ecstasy (MDMA*). These drugs pose a significant threat to public health and safety. Users of these designer drugs have an increased likelihood of addiction (chemical dependency), and clinical evidence suggests that severe and life-threatening symptoms may also occur in users of these drugs. * 3,4-Methylenedioxymethamphetamine 2

3 K2, Spice, Bath Salts An Emerging Threat In March 2011, the U.S. Drug Enforcement Administration (DEA) recognized that these designer drugs posed an imminent threat to public safety. Because of this imminent threat to public safety the DEA exercised its emergency scheduling authority to bring the chemicals used in the production of K2, Spice, and Bath Salts under government regulation. Unfortunately these designer drugs are still easily obtainable and continue to pose a threat to the community. 3

4 Background According to the 2011 National Drug Threat Assessment: The abuse of synthetic cannabinoids and synthetic stimulants and the increasing availability of these drugs have emerged as serious problems in the United States over the past few years. Synthetic cannabinoid products were initially marketed as legal alternatives to marijuana and emerged in the U.S. drug market in

5 Background At least 500 different synthetic cannabinoids have been developed for research purposes; to date at least 25 have been identified in commercial products for example, brands such as K2 and Spice. Synthetic cathinones containing MDPV* are marketed as legal alternatives to cocaine or Ecstasy (MDMA) and emerged in the U.S. designer drug market during Alternate lifestyle retail establishments often sell these products labeled as bath salts. * (3,4 methylenedioxypyrovalerone) 5

6 Background On March 1, 2011, the DEA exercised its emergency scheduling authority to temporarily control five synthetic cannabinoids (JWH-018; JWH-073; JWH-200; CP-47, 497; and cannabicyclohexanol) as Schedule I controlled substances. Except as authorized by law, the action makes possessing and selling these chemicals or products that contain one or more of these chemicals (typically adulterated plant material sold as herbal incense) illegal in the United States for at least 1 year while the DEA and Health and Human Services (HHS) study whether the chemicals should be permanently controlled under Schedule I* of the CSA. 6

7 Background On September 8, 2011, the DEA published in the Federal Register Volume 76, Number 174 its intent to temporarily schedule three synthetic cathinones under the Controlled Substances Act (CSA). The substances are 4-methyl-Nmethylcathinone (mephedrone), 3,4- methylenedioxy-nmethylcathinone (methylone), and 3,4- methylenedioxypyrovalerone (MDPV). This action is based on a finding by the Administrator that the placement of these synthetic cathinones into Schedule I of the CSA is necessary to avoid an imminent hazard to the public safety (DEA, Office of Diversion Control, 2011a). 7

8 Effects of K2 and Spice The psychoactive ingredients of Spice and K2 are similar to those of naturally grown marijuana. Reports indicated that the "high" from Spice and K2 lasts approximately minutes, while anecdotal reports from users suggested effects lasting for 1-2 hours (Hunterdon Drug Awareness Program, 2011). Synthetic cannabinoids have tested at least five times more potent than the strongest naturally grown marijuana; and some reports indicate that it may be up to 100 times more potent than marijuana. 8

9 Effects of K2 and Spice Given the increased potency of the synthetic cannabinoids compared to naturally occurring THC, addiction potential is increased when Spice or K2 are used regularly. Synthetic cannabinoids have been associated with impaired driving, attempted suicides, and emergency department visits, and have been linked to such adverse effects as increased anxiety, panic attacks, heart palpitations, respiratory complications, aggression, mood swings, altered perception, and paranoia (Hunterdon Drug Awareness Program, 2011). 9

10 Effects of K2 and Spice U.S. Navy Surgeon General, Vice Adm. Adam M. Robinson, Jr. (2011) described the signs and symptoms of Spice use, saying: "Signs and symptoms onset within 5-10 minutes include relaxation and sedation, marijuana-like effects such as euphoria, giddiness, bloodshot eyes, impaired short-term memory and concentration... Other more serious signs and symptoms that may durate for 8-10 hours [include] internal unrest, tremor, panic attacks, rapid heart rate, agitation, insomnia, headache, seizures, diarrhea, nausea, vomiting, and some have reported paranoid hallucinations, confusion, mood disorders, loss of consciousness, and psychotic symptoms that can last for days and become debilitating." 10

11 Effects of Bath Salts Synthetic cathinones are related to the parent compound cathinone (found naturally in the plant Khat (Catha edulis)), and are sold in the U.S. designer drug market as bath salts. Synthetic cathinones have effects similar to those of cocaine, amphetamine or MDMA (ecstasy). Synthetic cathinones are usually encountered as white or brown powders, and are sold under a variety of names, including "Red Dove," "Blue Silk," "Zoom," "Bloom," "Cloud Nine," "Ocean Snow," "Lunar Wave," "Vanilla Sky," "Ivory Wave," "White Lightning," "Scarface" Purple Wave, Blizzard, Star Dust, "Lovey, Dovey," Snow Leopard, "Aura," and "Hurricane Charlie. 11

12 Effects of Bath Salts Synthetic cathinones are a powerful stimulant that functions as a dopamine-norepinephrine reuptake inhibitor (NDRI). It has stimulatory effects on the central nervous system and cardiovascular system. Physical symptoms include: rapid heartbeat, increase in blood pressure, vasoconstriction, sweating. Mental symptoms include: euphoria, increases in alertness & awareness, increased wakefulness and arousal, anxiety, agitation, perception of a diminished requirement for food and sleep, and an intense desire to re-dose (Hunterdon Drug Awareness Program, 2011a). 12

13 Increased Addiction Potential Research indicated that both synthetic cannabinoids and synthetic cathinones have an increased potential for addiction. Dr. J.M. Pierre (2011) writing in Current Psychiatry reported anecdotal cases of psychosis associated with herbal incense having emerged since These reports suggest that synthetic cannabinoid intoxication is associated with acute psychosis as well as exacerbations of previously stable psychotic disorders, and also may have a propensity to trigger a chronic psychotic disorder among vulnerable individuals (Pierre, 2011). 13

14 Increased Addiction Potential Dr. Howard Samuels (2011) wrote: Spice abusers report cravings of the drug that are extremely compelling and defy the logical portion of their brains, which tells them to abstain. When smoked over a long period of time, users develop a tolerance to the drug and find that they must smoke more and more to get the same high. As a result, some users develop a chemical dependency (Sovereign Health Treatment Center, 2011). 14

15 Additional Effects Samuels (2011) reported that other side effects from spice included but were not limited to: Panic attacks Hallucinations and delusions Nausea and/or vomiting Restlessness Dilated pupils and glazed eyes Impaired motor coordination Foggy memory capacity Hope By the Sea, Drug and Alcohol Treatment Center (2011) in Laguna Niguel, CA reported that patients who ingested bath salts (and a similar product called "Mad Hatter") displayed symptoms of agitation, vomiting, seizures, paranoid and hallucinations. 15

16 Increased Injuries & Death Seely, et.al. (2011). reported that: "Existing clinical literature suggests that severe and life-threatening symptoms may occur in users that naïvely consider these products to be marijuana substitutes. It is anticipated that reportable injuries and deaths will significantly increase as the availability and use of synthetic cannabinoids and synthetic cathinones increases. 16

17 Increased Injuries & Death On March 17, 2011, Senator Orin Hatch (R-Utah) stated Nationwide, Spice, K2 and other forms of the synthetic drug have been linked to 24 deaths. Moreover, poison control centers and emergency rooms throughout the U.S. have been flooded with users of the synthetic drugs suffering from increased agitation, elevated heart rate and blood pressure and seizures. Others have become violent under the influence of the drug, injuring themselves and others. 17

18 Increased Injuries & Death According to an article in the Huffington Post (2011) a 13- year old boy in PA died after smoking synthetic marijuana. The chemicals in the synthetic marijuana caused severe damage to the boy's lungs, necessitating a double lung transplant. He developed an infection and died following the surgery. In July 2010 a 17-year boy was treated in Providence St. Peter's Hospital after smoking 'Spice' he had purchase at a smoke shop in Olympia, WA. The boy was delirious and experiencing muscle contractions, had low blood pressure, and a heart rate of 170 beats-per-minute (Pawloski, 2010). 18

19 Increased Injuries & Death In June 2011, a Joint Base Lewis-McChord, WA Army Sergeant fatally shot his wife and then himself, while being pursued by the Washington State Patrol. The couple's 5- year old son was later found dead in their home with a plastic bag over his head and bruises on his body. Investigators found packets of the bath salts in the Soldier's car, on him, and in the couple s house (Mulick, 2011). Butz (2010) wrote that after smoking K2, an Indianola, IA teen suffered a panic attack and fatally shot himself. 19

20 Product Recognition 20

21 Product Recognition 21

22 Available On-Line 22

23 On-Line Sales Target Military 23

24 Military Readiness Senators Charles Grassley (R-Iowa), and Dianne Feinstein (D-California) wrote a letter to Secretary of Defense Robert Gates in which the Senators stated that the growing use of K2 and Spice by members of the armed forces posed a risk to the operational readiness of our armed forces (McMichael, 2011). Although the use of these drugs poses a clear risk to the safety of military personnel and to unit operational readiness; military commanders have generally not taken judicial action against service members who use and possess K2, Spice, or Bath Salts. 24

25 Conclusions The designer drugs, commonly known as K2, Spice, and Bath Salts, pose a significant threat to public health and safety. Use of these drugs presents an increased likelihood of addiction (chemical dependency). Severe and life-threatening symptoms may occur in users of K2, Spice, and Bath Salts. The effects of these drugs make those under their influence a danger to themselves and to others around them. 25

26 Conclusions The use, possession, sale, delivery, or distribution of these drugs and their analogs must be addressed through appropriate legislation and strong enforcement at all levels of government. The emerging threat from substances like K2, Spice, Bath Salts, and similar synthetic drugs must be addressed now. Failure to do so will almost certainly lead to increased public health and community safety risks as this new drug problem escalates. 26

27 References Butz, D.A. (2010). After teen's death, more states pursue K2 ban. Sioux City Journal. July 17, Retrieved from Drug Enforcement Administration. (2011). Chemicals used in "Spice" and "K2" type products now under federal control and regulation. Retrieved from Drug Enforcement Administration. Office of Diversion Control. (2011). Controlled Substance Schedules. Retrieved from Drug Enforcement Administration. Office of Diversion Control. (2011a). Schedules of controlled substances: Temporary placement of three synthetic cathinones into Schedule I. Rules Retrieved from Hatch, O. (2011). Hatch Co-sponsors Bill to Ban Chemicals Used in Synthetic Marijuana. Retrieved from Huffington Post. (2011). Synthetic Marijuana Death: Double Lung Transplant Recipient, 13, Dies After Smoking Fake Pot. Retrieved from Hope By the Sea, Drug and Alcohol Treatment Center. (2011). Mad Hatter Abuse in Ohio. Retrieved from Hunterdon Drug Awareness Program. (2011). Comprehensive drug information on Spice and K2 (Synthetic Cannabinoids). Retrieved from Hunterdon Drug Awareness Program. (2011a). Comprehensive Drug Information on MDPV, Mephedrone ("Bath Salts"). Retrieved from 27

28 References McMichael, W.H. (2011). Senators say spice use could affect readiness. Army Times. March 29, Retrieved from Mulick, S. (2011). Bath salts found in murder-suicide autopsies: Designer drug found in autopsy of soldier, wife. The Olympian Newspaper. June 14, Retrieved from Pawloski, J. (2010). 'Herbal spice' dangerously sickens teen. The Olympian Newspaper. July 27, Retrieved from Pierre, J.M. (2011). Cannabis, synthetic cannabinoids, and psychosis risk: What the evidence says. Current Psychiatry. Vol. 10, No.9 September Retrieved from Robinson, A.M. (2011). Surgeon General's Corner: Navy medicine focuses on spice. Navy Medicine Magazine. Fall Retrieved from Samuels, H. (2011). Facts about spice addiction. The Hills Treatment Center. Los Angeles, CA. Retrieved from Seely, K.A., Prather, P.L., James, L.P. & Moran, J.H. (2011). Marijuana-based Drugs: Innovative Therapeutics or Designer Drugs of Abuse?. Molecular Interventions. doi: /mi American Society for Pharmacology and Experimental Therapeutics. Retrieved from Sovereign Health Treatment Center. (2011). K2/Spice addiction. Retrieved from U.S. Department of Justice. National Drug Intelligence Center. (2011). National Drug Threat Assessment Retrieved from 28