Reflections on synthetic marijuana outbreaks: our own local zombie apocalypse

Imagine chaos, a scene akin to a zombie apocalypse only footsteps away from an Ivy League institution of higher learning: people screaming, fighting, and then suddenly dropping to the ground in convulsions, limbs flailing in all directions. This became reality in downtown New Haven after over 100 people overdosed on synthetic marijuana, “K2,” leaving onlookers in awe and our hospitals in  crisis.

Only a month before, 14 other victims overdosed at the same location. And now, a month later, the Wisconsin Department of Health announced another outbreak totaling 80 people – 16 of whom suffered severe bleeding that resulted from using synthetic marijuana contaminated with rat poison.

These were not isolated events. This scene is becoming more common across the nation, as K2, or “Spice” — a dried herbal blend coated with one or more industrial chemicals that is smoked to induce euphoria – remains widely accessible. It is cheap and often sold in local gas stations masked as herbal incense. Many mistakenly believe that since they can get it over the counter at a gas station, it is safe.

This is not the case.

Some are contaminated with unknown toxic substances, such as opioid variants or poison, which can cause someone to stop breathing, and die.

But how can such a toxic chemical remain legally available? Since K2 may contain hundreds of different organic compounds, there isn’t a simple way to ban its sale or use. U.S. lawmakers claim the difficulty with criminalizing synthetic or designer drugs is that one tiny change to the ingredient produces a whole new drug. Unfortunately, The DEA’s controlled substance list is not refreshed frequently enough to keep up as new synthetic cannabinoids are discovered. To put it simply, drug makers easily stay one step ahead of laws by slightly shifting the chemical content to manufacture technically legal products.

Even when outlawed by specific states, K2 and Spice can still be found in local shops. Connecticut outlawed the sale of both compounds in 2012 – but  that didn’t stop me from finding it prominently displayed for the purchase right next to the register on my recent trip to get gas. All it took was a simple name change by manufacturers, and they were able to thwart the law.

Many cities in the United States are creating innovative ways to confront their own epidemics.  Instead of chasing chemistry and pharmacology, one approach is to focus on distribution and marketing. A city could fine stores selling the drug or ban it entirely based on product name, quantity or appearance resembling a controlled substance.

For example, if a product package implies  it claims to be a “homeopathic,” herbal or natural substitute for a controlled substance, then the sale could be prohibited. Or, if packaging fails to or inaccurately lists all active ingredients, or does not list the name and place of manufacturer, it could be banned. Such regulations could be enforced by local law enforcement, with penalties for offenses including  revocation of a business certificate of occupancy.

But what about the people this substance is harming? Solutions focused on community outreach and increasing mental health programs are very promising in providing assistance to those using K2 who need help. On site drop-in centers equipped to provide homeless individuals access to addiction and mental health services and basic medical needs are crucial in advancing the front lines in this K2 epidemic.

What is being done locally? Gov. Dannel Malloy, U.S. Sen. Richard Blumenthal, Mayor Toni Harp and other officials recently hosted a forum to discuss the issue, but unfortunately, it did not result in any tangible action. Will it be tabled until the next time – and there will be a next time? We must find a solution. We cannot sit idly as our front yards turn to chaos and our citizens suffer. Our neighbors in need deserve better.

Jesse O’Shea MD, MSc practices internal medicine at Yale New Haven Hospital.