Synthetic marijuana and the latest trends in substance abuse Nancy V Rodway MD MS MPH Medical Director Occupational Services and Employee Health Lake Health.

Synthetic marijuana Synthetic marijuana and the latest trends and the latest trends in substance abusein substance abuse

Nancy V Rodway MD MS MPHNancy V Rodway MD MS MPHMedical Director Occupational Medical Director Occupational Services and Employee HealthServices and Employee Health

Lake HealthLake Health

ObjectivesObjectives

Describe the origin of novel substances Describe the origin of novel substances and their marketingand their marketing

Review the manufacture of these Review the manufacture of these substancessubstances

Describe the human effects of these Describe the human effects of these substances and signs of overdosesubstances and signs of overdose

Legality of these substancesLegality of these substances Screening for abuse of novel Screening for abuse of novel

substancessubstances

Synthetic MarijuanaSynthetic Marijuana

Synthetic marijuana killed nine Synthetic marijuana killed nine adults in 2010 in the U.S.adults in 2010 in the U.S.

Synthetic MarijuanaSynthetic Marijuana

An 18 year old in Iowa smoked Spice An 18 year old in Iowa smoked Spice and “felt like he was in hell” and shot and “felt like he was in hell” and shot himself with a shotgunhimself with a shotgun

A Hawaii man threw his girlfriend off an A Hawaii man threw his girlfriend off an 1111thth floor balcony while high on Spice floor balcony while high on Spice

A customs agent seized 1500 packets of A customs agent seized 1500 packets of Spice at an express parcel service hub Spice at an express parcel service hub in Wilmington Ohio in 2009in Wilmington Ohio in 2009

Tripoint Medical Center Tripoint Medical Center admitted 11 in January and admitted 11 in January and

February due to dangerously February due to dangerously high BP and pulse after high BP and pulse after

smoking synthetic marijuanasmoking synthetic marijuana

Synthetic marijuanaSynthetic marijuana

Blaze

Red X Dawn

Yucatan Fire

Genie

Synthetic marijuanaSynthetic marijuana Structurally related to THC, the Structurally related to THC, the

active compount in marijuanaactive compount in marijuana Basically, five types:Basically, five types:

– JWH-018JWH-018– JWH-073JWH-073– JWH-200JWH-200– CP-47,497CP-47,497– CannabicyclohexanolCannabicyclohexanol

Two synthesized at Clemson in the Two synthesized at Clemson in the 1980s for research purposes1980s for research purposes

Most made in China, India and Asia Most made in China, India and Asia then routed through Europethen routed through Europe

Synthetic marijuana isn’t Synthetic marijuana isn’t marijuanamarijuana

Plant matter dried Plant matter dried Chemical is dissolved in a Chemical is dissolved in a

liquid then sprayed on liquid then sprayed on plant matterplant matter

Mixture is then smoked or Mixture is then smoked or ingestedingested

Synthetic MarijuanaSynthetic Marijuana

Sold as herbal incenseSold as herbal incense– Substances have no odorSubstances have no odor

Sold as plant food (Bonsai-18)Sold as plant food (Bonsai-18)

““Not for human consumption”Not for human consumption”

Sold at head shops, internetSold at head shops, internet

A brand new way A brand new way to traffic drugsto traffic drugs

Over the counterOver the counter

“I assumed it was safe because it was legal”

What it does to youWhat it does to you

HIGH heart rate (120-150)HIGH heart rate (120-150) ConvulsionsConvulsions Anxiety attacksAnxiety attacks HIGH blood pressureHIGH blood pressure DisorientationDisorientation Hallucinations and paranoiaHallucinations and paranoia

– Monsters demons aliensMonsters demons aliens– Suicidal thoughts and actionsSuicidal thoughts and actions

It looks like marijuana but It looks like marijuana but it feels like LSDit feels like LSD

Legal actionLegal action

On March 1, the DEA temporarily On March 1, the DEA temporarily made synthetic marijuana a made synthetic marijuana a Schedule 1 substance of the Schedule 1 substance of the Controlled Substance ActControlled Substance Act

Like LSD, heroin and cocaineLike LSD, heroin and cocaine Illegal to manufacture, distribute Illegal to manufacture, distribute

possess, import and export synthetic possess, import and export synthetic cannabinoidscannabinoids

Done to avoid an imminent Done to avoid an imminent hazard to public safetyhazard to public safety

Bath SaltsBath Salts

They are not your grandma’s bath They are not your grandma’s bath salts!salts!

According to the Ohio According to the Ohio Dept of Alcohol and Dept of Alcohol and

Drug Addiction Services, Drug Addiction Services, bath salts are used most bath salts are used most

frequently in Dayton frequently in Dayton and Clevelandand Cleveland

Hurricane Charlie

Ivory Wave

Cloud 9

White Rush

Bath saltsBath salts

A Kentucky woman became A Kentucky woman became convinced that her 2 year old was a convinced that her 2 year old was a demon. She picked the child up and demon. She picked the child up and dropped him on his headdropped him on his head

A Mississippi man cut his face and A Mississippi man cut his face and stomach with a hunting knife stomach with a hunting knife

A Mentor man tried to hang himself A Mentor man tried to hang himself with a belt after snorting bath saltswith a belt after snorting bath salts

Bath saltsBath salts

No legitimate use for bath No legitimate use for bath water—marketed “for novelty water—marketed “for novelty use only”use only”

Mimics cocaine, LSD and Mimics cocaine, LSD and methamphetaminemethamphetamine

Snort, inject and ingest Snort, inject and ingest

What it does to youWhat it does to you

Cause paranoia, hallucinations, Cause paranoia, hallucinations, suicidalsuicidal

Can’t sleepCan’t sleep Bizarre behaviorBizarre behavior Rapid heart rateRapid heart rate Difficulty breathingDifficulty breathing Much longer duration than synthetic Much longer duration than synthetic

marijuanamarijuana

Bath saltsBath salts Contain the chemical Contain the chemical MephedroneMephedrone

and/or and/or MDPVMDPV (methylenedioxypyrovalerone)(methylenedioxypyrovalerone)

Synthesized from the naturally Synthesized from the naturally occurring stimulant occurring stimulant CathinoneCathinone

Cathinone from the Khat plantCathinone from the Khat plant

CathinoneCathinone

Schedule 1 Schedule 1 drugdrug

AmphetamineAmphetamine

Khat is common Khat is common in Columbus in Columbus Ohio!Ohio!

Legal ActionLegal Action

None at the federal level yetNone at the federal level yet

Ten states have banned bath Ten states have banned bath saltssalts

Ohio ban currently in legislationOhio ban currently in legislation

Arrest on disorderly conductArrest on disorderly conduct

Urine Drug ScreeningUrine Drug Screening

These two drugs are These two drugs are not detectednot detected on routine urine drug screenson routine urine drug screens

To add urine testing for these drugs, To add urine testing for these drugs, the cost is approximately $75 to the cost is approximately $75 to $100 per group (synthetic marijuana $100 per group (synthetic marijuana group and bath salts group)group and bath salts group)

Lake CountyLake County