Not for Human Consumption: Spice and Bath Salts

03/03/2015

Eighteen-year-old Kurtis Hildreth likely had no idea how dangerous and deadly Spice was, but in 2013 he smoked a fatal dose of the synthetic cannabinoid. His family has since spoken out publicly, raising awareness of the legal drug, marked “not for human consumption.” A recent SAMHSA report revealed emergency department visits resulting from the synthetic marijuana more than doubled in just one year.

Most commonly known as Spice, synthetic cannabinoids go by many different street names: K2, Spice Diamond, fake weed, Yucatan Fire, Moon Rocks, and Skunk. The herb is often marketed as herbal incense and potpourri and labeled “not for human consumption,” making it legal to sell and for minors to purchase the drug. Manufacturers sometimes include “organic” in the product name to give the appearance of a natural product that does not harm health. Similar to how cigarettes were once marketed, Spice packaging often features cartoons and images appealing to the 12 to 18 age group, and the product can easily be purchased online, or in convenience stores or head shops.

What makes Spice so dangerous?

Spice (synthetic cannabinoid) is a designer drug that is made with analogs or a chemical structure similar to commonly used illicit drugs. The composition of these products changes constantly, as manufacturers create new variations to remain under the radar. The manmade chemicals are typically sprayed on a plant or herb (not marijuana) that is most commonly smoked, and mimics the effects of the psychoactive ingredient in marijuana. Because it is marked as “not for human consumption,” the intended use is masked and it is not subject to any quality control in manufacturing procedures or oversight that would be applied to other drugs. Because there is no oversight of the product or its production, what makes its way into the hands of teens may contain substances that can have serious health consequences. With no warning labels, young people are not aware that using these products can be harmful or even deadly.

It is most often young men who reach the point of crisis and seek medical care for a range of symptoms that can include severe agitation, anxiety, nausea, vomiting, rapid heartbeat, elevated blood pressure, tremors, seizures, hallucinations, paranoia, and unresponsiveness. And for Kurtis Hildreth, the effect of the drug was so sudden there was no time to call for help.

Another threat to teens: bath salts

Bath salts are another drug made, manufactured, marketed, and used by youth in a similar fashion. Known commonly as Bliss, Bloom, Ivory Wave, and Scarface, bath salts contain synthetic cathinones similar to amphetamines. Sometimes referred to as jewelry cleaner, plant food, or phone screen cleaner, bath salts are presumed to contain methylenedioxypyrovalerone (MDPV) and other chemicals similar to MDPV, although there is uncertainty because tests do not always detect these substances. When bath salts are used, the effects can include agitation, aggression and violent behavior, anxiety and panic attacks, paranoia, confusion, hallucinations and delusions, psychosis, chest pains, increased heart rate, heightened blood pressure, and sometimes suicidal ideation or suicide attempts.

SAMHSA’s recent Advisory: Spice, Bath Salts, and Behavioral Health reports that fewer young people are using bath salts than Spice. Bath salts are also used by a slightly older age group, those 20 to 29 years old.

Undetectable in drug screens

The synthetic designer drugs are also popular with people who are subject to mandatory drug testing. Although some of the psychoactive compounds can be detected in tests, many routine drug screens do not pick up these chemicals.

Prevention and Treatment

There have been some policy advancements to help regulate synthetic drugs. The Controlled Substances Act of 2014 marked some synthetic cannabinoids as Schedule I drugs, listing them with the most dangerous drugs that lead to potentially severe psychological or physical dependence.

Behavioral health providers should be aware that clients may not think to report use of Spice or bath salts, since they are “legal.” Inquiring about these drugs during an assessment, especially with youth, may reveal important health information. Treatment is similar to that used to treat conditions caused by use of marijuana or other stimulants.

More detail can be found in SAMHSA’s Advisory: Spice, Bath Salts, and Behavioral Health andUpdate: Drug-Related Emergency Department Visits Involving Synthetic Cannabinoids.