Extreme anxiety, racing heart and paranoia are among the symptoms patients have complained of after smoking synthetic marijuana.
All were teenagers or people in their early 20s, said Dr. Danyal Ibrahim, director of toxicology at St. Francis Hospital and Medical Center, and at least one had hallucinations. The most recent patient, he said, was sweaty, agitated, and "felt a sense of doom and felt that he was going to die."
More commonly known as "spice" or K2, synthetic marijuana is easy to buy — at gas stations, convenience stores, head shops and online. A small envelope was selling for $9.99 at one Hartford gas station.
The package touts "an exotic herbal incense blend composed of rare plants and herbal extracts." The chemical that's sprayed on the leaves — a synthetic form of THC (Tetrahydrocannabinol), the active ingredient in marijuana — is what's selling the product. Doctors at St. Francis and at Hartford Hospital said they first started seeing cases involving synthetic marijuana in the middle of last year.
While the products are sold as incense and bear the label "not for human consumption," Barbara Carreno, a spokeswoman with the U.S. Drug Enforcement Agency, said everything else about the marketing makes it obvious that the contents are meant to be consumed.
For instance, many packages are marked "for 18 years and over" and websites boast that it can't be traced in drug tests. That means it could run afoul of the Federal Analog Act of 1970, which regulates synthetic substances designed to mimic the effects of currently prohibited drugs.
In November, the DEA announced it would put synthetic marijuana under a 12-month ban. The temporary ban has not yet been enacted, but Carreno said it will be "any day."
At least seven states have banned the sale of synthetic marijuana. Several more states, including Connecticut, are considering bans.
State Rep. Michelle Cook, D-Torrington, is a co-sponsor of one of two proposed measures to prohibit the sale of the product. Cook said she first heard of synthetic marijuana when local police officers told her they were concerned about a surge in its use among young people. Cook and the police urged businesses in Torrington to withdraw the products from sale, but only one went along.
"There were a couple that said, 'We'll ID, we won't sell to anyone under 21,'" she said. "Even though it's legal, it's deadly."
If the state does enact a ban, she said, the real work will be keeping on top of the situation to keep the law effective.
"The manufacturing agencies are much smarter and quicker than we are," Cook said, "and they can dance around the bans that we've made by coming up with different chemical mixes."
Bad Reactions
The Connecticut Poison Control Center at the UConn Health Center has received "at least a couple dozen calls" from people reacting badly to synthetic marijuana, said Charles McKay, the center's associate director. And at Hartford Hospital, where he is director of toxicology, McKay said he has treated "a handful" of cases. Symptoms typically include paranoia and tachycardia, an unusually fast heart rate.
McKay said he generally treats patients with benzodiazepine, an anti-anxiety medication, and they usually are OK after a few hours under supervision. He said the effects of synthetic marijuana resemble those of natural marijuana: a sense of ease and heightened sensations. But other times, usually when synthetic pot is taken in greater doses, it has the opposite effect, he said.
Ibrahim said synthetic marijuana is much more dangerous than the natural substance. Although he has treated three people for fake pot in the past six months, Ibrahim said he has never treated anyone for a bad reaction to natural marijuana in the six years that he has worked in toxicology. For the people who have bad reactions to the synthetic version, he said, the symptoms are closer to those caused by cocaine and other stimulants.
Ibrahim and McKay both said none of the patients faced life-threatening conditions and in all cases, they were released within 24 hours. There have been reports elsewhere that the substances induced seizures, but neither Ibrahim nor McKay have seen that.
Medicinal Research
The chemicals used in synthetic marijuana are modeled after cannabinoids, the active agents in natural marijuana (THC is the most well-known). They're based on chemicals first developed in the 1980s at Clemson University and Hebrew University to research the medicinal use of cannabinoids. Because several papers on these studies have been published in science and medical journals, the public has had access to details about the substances' chemical makeup.
In Europe, synthetic marijuana first appeared in the middle of the last decade; in Connecticut in the last year or so. Exactly who is manufacturing it, Carreno said, is difficult to trace.
"The substances, a lot of them come from overseas — China, Middle East, Europe, all kinds of places," she said. "There are many different suppliers with different names and different contents."
Paul Armentano, deputy director of the marijuana legalization group NORML, said regulations will be hard to enforce and could possibly backfire.
"Most likely, the clampdown will likely only make the situation more dangerous from both a legal standpoint and from a health standpoint to the consumer," he said in an e-mail.
Carreno said the U.S. Department of Health and Human Services recommended the 12-month ban to allow time to test the chemicals on human subjects in clinical trials, something that's never been done before.
Carreno also acknowledged that regulating synthetic substances is difficult because federal drug laws have to be very specific. In this case, the ban names the five most commonly used chemicals in synthetic marijuana. For instance, the chemical JWH-018 is named in the ban, but JWH-073 — a slight variation — is not. Tweaking a banned chemical, even minimally, can be enough to skirt regulations.
The letters JWH come from the initials of John W. Huffmann, a Clemson University scientist who first developed synthetic cannabinoids in the 1980s. He did so to study their effects on animals and explore the chemicals' potential for treating such conditions as osteoporosis, liver disease and certain cancers. He developed JWH-018 and other chemicals in his lab with funding from the National Institute on Drug Abuse.
In an e-mail, Huffman stressed that these chemicals have not been tested on humans and could have toxic effects on people.
"They absolutely should not be used as recreational drug," Huffman said.
