July 12, 2010 -- A blend of herbs laced with synthetic marijuana known popularly as K2 is being sold openly in head shops and online, often sending people who smoke it to hospitals with symptoms ranging from soaring heart rates to paranoia to near-death experiences, according to health professionals.
Little is known about the long-term effects of the legal substance, also known as Spice, Demon, Genie, Zohai and a host of other names. But authorities believe it could have been behind the death of an Iowa teenager who committed suicide last month shortly after smoking it.
Last week, Missouri became the eighth state in the country to ban the marijuana substitute, which is marketed as incense. Arkansas Gov. Mike Beebe signed an emergency order banning K2 earlier this month, and similar legislation is pending in New York, New Jersey, Illinois, Louisiana, Michigan and Ohio.
"Whatever is being done is not being done fast enough," Brendan Bickley, the clinical director of an addiction treatment center in Southern California, said. "It's the perfect drug. It's legal. It's undetectable. It's odorless. It's cheap."
K2 sells for about $40 an ounce.
At the Orange County treatment center, with 75 inpatient beds, Bickley said K2 has become so popular that staff must routinely search rooms for hidden stashes. K2 has also become popular among high school and college students.
"I call it a treatment-center killer," said Bickley, adding that patients are lighting up at treatment centers and group outings. "You can't detect it. It's more powerful than marijuana. People who smoke it say it really does mess you up. It causes a person to become extremely high. The withdrawals are horrible. Clients get very angry and agitated."
Although banned in many European countries, the substance has largely avoided regulation in the United States because it is sold as incense and in packages that state it's not for human consumption.
Dr. Anthony Scalzo, a professor of emergency medicine at St. Luis University, said there have been 567 K2-related calls in 41 states this year, compared to 13 in 2009. Scalzo, the medical director of the Missouri Poison Control Center, first reported a spike in K2 cases earlier this year and immediately started studying the effects of the substance.
K2 Chemicals Designed for Research
"The common thread throughout all the cases is this degree of anxiety, agitation, fast heart rate and elevated blood pressure," Scalzo said.
Some people reported hallucinations and near-death experiences but Scalzo added, "The hallucinations are not always consistent and I suspect it's perhaps a dose effect. Maybe some individuals are using more."
Health professionals and toxicologists are studying the death of 18-year-old David Rozga, who committed suicide in Iowa last month after smoking K2. Police said Rozga smoked the substance with friends before "freaking out" and saying he was "going to hell."
At home later, the recent high school graduate took a rifle and shot himself in the head.
"Smoking something that's supposed to be substitute for marijuana, you're expecting to be mellow," Scalzo said. "Unfortunately, you're not getting that. No one really sort of field tested these chemicals. We don't even know where exactly this stuff is made."
K2 was first developed by an undergraduate student in the lab of Clemson University chemist John Huffman. Its active ingredients are synthetic cannabinoids, chemicals that imitate the effects of tetrahydrocannabinol (THC), the active ingredient in marijuana.
Huffman said the chemicals were designed as "research tools" and never intended for human consumption.
The synthetic compound is known as JWH-018, the first three letters being Huffman's initials.
"Some of the compounds that are turning up in K2 and Spice samples are very sophisticated," Huffman said. "They are in fact not known cannabinoids. ? They are unique and very well designed and require considerable chemical expertise."
Increasingly, pure forms of the chemical are being mixed with other herbs and compounds and then marketed as K2.
"Anybody that tries it is like playing Russian roulette," Huffman said. "You don't know what you're getting. It's just insane. Anybody who uses it is out of their tree." Huffman said he heard about a Russian girl who killed herself by jumping out a 10-story window after smoking K2.
The DEA Is Reviewing K2
Missouri's ban goes into effect Aug. 28. It prohibits several cannabinoids that have been found in K2 and other similar products.
But many experts question the effectiveness of the bans because chemists can easily alter the substance's molecular structure and resell it under another name.
"People are hysterical," Huffman said. "They do not know what to do about it."
The federal Drug Enforcement Administration is reviewing cannabinoids and could eventually classify them under the Controlled Substances Act, according to a spokeswoman. Only one cannabinoid is classified as a controlled substance while four others, including K2, are listed as "chemicals of concern."
Throughout the nation, meanwhile, legislators are attempting to put controls in place.
In Arkansas earlier this month, Dr. Marvin Leibovich, chairman of emergency medicine at the University of Arkansas for Medical Sciences, cast the lone vote against the K2 ban. He said there had been only 26 K2-related cases across the state, compared to an estimated 40,000 annual emergency room visits tied to alcohol abuse.
"In my opinion, we simply reacted to political pressure to get some law in place to ban the substance," he said. "We did that without any medical justification. ? We have 40,000 problems from alcohol abuse and 26 possible cases from K2. So what are we going to do? We're going to go address the problem with K2. That just strikes me as being a little hypocritical."
K2 has also become popular with people tested for drugs. The substance does not show up on drug tests.
"At least with pot you know what it is," DEA spokeswoman Barbara Carreno said. "You have some idea how potent it is and you know how it affects you. With these things, you don't what you're getting.
"You kind of hope you don't have a subway driver that's been smoking this stuff all weekend and is paranoid."