American Association of Poison Control Centers Issues Warning About Reemerging Synthetic Drugs

Marijuana leaves

ALEXANDRIA, VA – The American Association of Poison Control Centers (AAPCC) and the experts at America's 55 poison centers are warning the public about a group of dangerous new synthetic cannabinoids which have recently led to a dramatic spike in poison center exposure calls in the United States, according to Stephen T. Kaminski, JD, AAPCC executive director.

Poison centers across the country have been receiving increased levels of calls related to these substances. From Jan. 1, 2015, through April 22, 2015, poison centers have received 1,900 exposure calls from people seeking help for adverse reactions to these drugs; this is almost four times the rate of calls received in 2014. In New York, Governor Andrew Cuomo issued a health alert stating that New York emergency departments have reported seeing more than 160 patients in a nine day period. Alabama has seen 317 synthetic cannabinoid-related emergency department visits in an 18 day window as of April 20, 2015. Other states such as New Jersey, Mississippi, Texas, Florida and Arizona have also seen dramatic increases in reports, signaling this is a national problem.

Synthetic "marijuana" products, also known as THC homologs, are in reality very different from marijuana. Health effects from the drug can be life-threatening and can include:

• Severe agitation and anxiety
• Fast, racing heartbeat and higher blood pressure
• Nausea and vomiting
• Muscle spasms, seizures, and tremors
• Intense hallucinations and psychotic episodes
• Suicidal and other harmful thoughts and/or actions

Physicians can experience difficulty trying to determine the cause of severe medical problems seen in users of these substances when they present to emergency departments due to the wide variety of chemicals used to make synthetic cannabinoids. These drugs are imported into the United States and can be sprayed on plant material or combined in other ways and marketed under such names as "Spice," "K2," "Keisha Kole," "Summit," "AK-47" and many others.

The harmful effects from these products were first reported in the U.S. in 2009. Since then, the synthetic drugs have spread throughout the country due to ease of access. For example, people are able to purchase them at gas station convenience stores. The chemical formula of these substances changes from one week to the next to avoid regulations banning specific compound formulations. As a result, the same brand purchased at different times may produce vastly different effects.

"These synthetic drugs present a potentially fatal risk that is not well recognized by people consuming these products," said AAPCC President Jay Schauben, PharmD, DABAT, FAACT. "The recent death of five people suspected of using this category of drugs underscores the urgency of controlling these drugs and educating the public of their dangers."

The Centers for Disease Control and Prevention (CDC) and AAPCC have conducted public health surveillance using data stored in the National Poison Data System (NPDS) since 2000 to help identify and characterize emerging public health threats.

"We're greatly concerned by the rise in calls to poison centers regarding synthetic cannabinoids," said Dr. Amy Wolkin, chief of the CDC's Health Studies Branch. "The perception that these drugs are harmless is dangerous. People and hospitals need to be aware of the potential harm they can do."

"Our research shows that people are playing Russian Roulette with their lives because only the chemist creating the synthetic cannabinoid really knows what is in it," said Dr. Eric Wish, director of the Coordinating Center for the National Institute on Drug Abuse (NIDA) funded National Drug Early Warning System (NDEWS) located at the University of Maryland, College Park. "We have found very different metabolites in different sites across the country and even in the same site over time."

Erin Artigiani, NDEWS co-investigator, added, "We are very excited about the new partnership between NDEWS and AAPCC and the unique opportunity it provides to work together to identify and discuss new synthetic drugs as they emerge."

"One of the strengths of the poison center network is its ability to identify emerging public health threats virtually in real-time," said Kaminski. "Poison centers are staffed with medical professionals who are available 24 hours a day, seven days a week, to answer questions about 'K2,' 'Spice,' or any other substances that could be harmful to your health. All calls are confidential."

For more information, the media may contact Brett Schuster, AAPCC associate manager, Public Relations and Member Services, at 703.894.1865 or schuster@aapcc.org.

For information about NDEWS, please contact Erin Artigiani at 301-705-9794 or eartigia@umd.edu.

AAPCC supports the nation's 55 poison center members in their efforts to treat and prevent drug, consumer product, animal, environmental and food poisoning. Members staff the Poison Help hotline at 1-800-222-1222 that provides free, confidential, expert medical advice 24 hours a day, seven days a week, 365 days a year from toxicology specialists, including nurses, pharmacists, physicians, and poison information providers. In addition, AAPCC maintains the only poison information and surveillance database in the United States, providing real-time monitoring of unusual poisoning patterns, chemical exposures and other emerging public health hazards. AAPCC partners with federal agencies such as EPA, HRSA and the CDC, as well as private industry.
To learn more, visit www.aapcc.org, like us on Facebook, follow us on Twitter (@AAPCC), and read our blog at aapcc.wordpress.com.
To learn more about NDEWS, visit http://www.cesar.umd.edu/cesar/cesarfax/vol23/23-12.pdf and http://www.drugabuse.gov/news-events/news-releases/2014/07/nih-system-to-monitor-emerging-drug-trends.
People interested in joining the ongoing discussions about synthetic cannabinoids are welcome to join the NDEWS Network, a virtual community of more than 500 substance abuse experts, practitioners and concerned citizens working together to educate each other and the general public about substance abuse and its consequences.