SAMHSA: Synthetic Marijuana linked to thousands of Emergency Department Visits

First report on Synthetic Marijuana use highlights dangers, healthcare impact

The Substance Abuse and mental Health Services Administration (SAMHSA) has released a study highlighting the impact of synthetic marijuana use. Drug Related Emergency Department Visits Involving Synthetic Cannabinoids appears in the December, 2012 issue of The Drug Awareness Warning Network (DAWN) Report.

Synthetic drugs are generally considered to include synthetic Bath Salts (sBS) and synthetic marijuana (sM). Both sBS and sM are sold under a variety of names and are made up of any number of chemical compositions. Both classifications of drugs have been linked to thousands of emergency department visits and hospital admissions as well as a variety of medical and psychiatric outcomes. The exact composition of synthetic cannabis and bath salts may change with manufacturer. For more on chemical composition and effects on the body, see Bath Salts: Stronger than dirt!.

According to the DAWN report, 11,406 emergency department visits involved a synthetic cannabiod product. Ages 12 to 29 years made up three quarters of those visits with an overwhelming majority of users being male.

The DAWN report also notes that:

"They [synthetic marijuana] have been reported to cause agitation, anxiety, nausea, vomiting, tachycardia, elevated blood pressure, tremor, seizures, hallucinations, paranoid behavior, and nonresponsiveness."

Polypharmacy use is often seen with synthetic bath salts, it may not be a large issue among synthetic marijuana usesers. Fifty-nine percent of those reporting to ED after synthetic marijuana use (12 to 29 age group) had no other substances involved. When polypharmacy was present, alcohol was found in 13% of cases and other pharmaceuticals used in 17%.

Synthetic drugs including bath salts and synthetic marijuana have captured the attention of public health officials, hospital staff and the media. The use of these materials continues to climb as does the awareness to the consequences. The CDC published its first article on the subject of bath salts in the May, 2011 edition of Morbidity and Mortality Weekly Report (MMWR) [Emergency Department Visits After Use of a Drug Sold as "Bath Salts"]. Since that report nearly two years ago, the use of synthetic drugs continues to rise.

A recent high profile case involving a young woman from Texas and a new CDC finding have added to the list of dangers from synthetic drugs use. A CNN news story indicates that a teenage girl from Cypress, Texas had been diagnosed with vasculitis after smoking synthetic marijuana that may have contributed to a stroke and resulting in two weeks ICU care. The CDC is reporting in its February 15, 2013 MMWR cases of unexplained acute kidney injury associatied with synthetic cannabinoid use. MMWR report indicates:

"AKI has not been reported previously in users of SCs and might be associated with 1) a previously unrecognized toxicity, 2) a contaminant or a known nephrotoxin present in a single batch of drug, or 3) a new SC compound entering the market."

Also, according to the CDC; "Synthetic cannabinoids (SCs) are psychoactive chemicals dissolved in solvent, applied to plant material, and smoked as a drug of abuse. They are sold in "head shops" and tobacco and convenience stores under labels such as "synthetic marijuana," "herbal incense," "potpourri," and "spice." Most reports of adverse events related to SCs have been neurologic, cardiovascular, or sympathomimetic."

 References.
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (December 4, 2012). The DAWN Report: Drug-Related Emergency Department Visits Involving Synthetic Cannabinoids. Rockville, MD.

Acute Kidney Injury Associated with Synthetic Cannabinoid Use - Multiple States, 2012. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. February 15, 2013 / 62 (06); 93-98

Teen narrowly escapes death after smoking synthetic marijuana CNN and affiliate news reporting.

Synthetic cannabis, Wikipedia