SYNTHETIC CANNABINOID (SYNTHETIC MARIJUANA) WARNING FROM NYS DOH

SUMMARY
- New York State Department of Health has been informed of a recent increase in synthetic cannabinoid-related adverse events and emergency department visits, with over 160 individuals visiting health care facilities since April 8th.
- Healthcare providers should consider synthetic cannabinoid use when evaluating patients who have compatible signs and symptoms.
- Health care providers should call the Poison Control Center (PCC) (1-800-222-1222) for guidance on the management of these patients and to report adverse events associated with synthetic cannabinoids.

BACKGROUND
The New York State Department of Health has been informed of a recent increase in synthetic cannabinoid- related adverse events and emergency department visits during this month, with over 160 individuals visiting health care facilities since April 8th. Reported cases were mostly in New York City and Syracuse.

Synthetic cannabinoids are marketed as "legal" and typically consist of plant material coated by chemicals which mimic THC, the active principle of marijuana. The products are sold as incense, herbal mixtures or potpourri, online and in convenience or smoke shops, and often carry a "not for human consumption" label in order to disguise the true purpose of the substance. Synthetic cannabinoids are often referred to by different names, including: K2, Spice, Blonde, Summit, Standard, Blaze, Red Dawn X, Citron, Green Giant, Smacked, WickedX, AK-47, synthetic marijuana, or legal marijuana. Additional names from some recent reported
cases include: Geeked up, Ninja, Caution, Red Giant or Keisha Kole.

Healthcare providers should consider synthetic cannabinoids when evaluating patients who
have compatible signs and symptoms. Signs and symptoms of synthetic cannabinoid use
include agitation, anxiety, nausea, vomiting, high blood pressure, tremor, seizures,
hallucinations, paranoia, and violent behavior. These effects can be similar to those of
phencyclidine (PCP). It has been reported that several recent patients are also presenting with
somnolence and bradycardia, some requiring endotracheal intubation. These effects can appear
similar to those of clonidine. Synthetic cannabinoids are not detected by standard urine
toxicology screens; therefore, synthetic cannabinoid exposure should not be ruled out based on
negative screening results.

Since the exact compounds contained in synthetic cannabinoid products change frequently,
risks and adverse consequences are unpredictable. No antidote is presently available for
synthetic cannabinoid intoxication; however, symptoms are usually short-lived and self-limited.

Since the exact compounds contained in synthetic cannabinoid products change frequently,
risks and adverse consequences are unpredictable. No antidote is presently available for
synthetic cannabinoid intoxication; however, symptoms are usually short-lived and self-limited.
Health care providers should call the Poison Control Center (PCC) (1-800-222-1222) for
guidance on the management of these patients and to report adverse events associated with
synthetic cannabinoids.

Call 1-888-99-SALTS (1-888-997-2587) to report synthetic drug sale and distribution.

Predator Heroin - Pittsburgh Heroin OD Epidemic -

There is another batch of super potent heroin hitting the streets again. It is going by the street name of Predator, with a shark image on the bag. Other bags stamped with "Chocolate" and “Chicken / Waffle" have also been found at OD scenes. This Heroin appears to be laced with another unknown substance (probably another Opiate) that is adding to its potency. This is causing the patients to go into respiratory arrest quicker and not leaving enough time for rescuers to arrive and administer Narcan. . While Narcan is still effective in treating these patients; the deaths have been attributed to the rapid onset of unconsciousness and respiratory depression / arrest. See the rest of the article below.

Two people are dead in the largest wave of heroin overdoses in the Pittsburgh area since a fentanyl-laced batch killed almost two dozen in 2014, officials said.

Ten people survived when paramedics administered Narcan, a drug that reverses the opioid's deadly effects, police Cmdr. RaShall Brackney said Wednesday. The dozen overdoses were reported between Tuesday morning and Wednesday afternoon, most on the South Side and in neighborhoods on the West End, Brackney said.

“This huge spike in the last 24 hours is causing us extreme concern,” Brackney said.

Patrick Byrnes, 38, of Beechview and James Nardozi, 31, of Dormont died Tuesday of suspected overdoses. The official cause of death for the men is pending, Allegheny County spokeswoman Amie Downs said, but added that Dr. Karl Williams, the county medical examiner, indicated they appear to be heroin-related. Relatives for Byrnes and Nardozi declined to comment.

Police found bags stamped with the word “predator” and the image of a shark at the scene of several overdoses, police Cmdr. Larry Scirotto said.

A bag found by Byrnes was stamped “Chocolate,” while a bag found near Nardozi had the stamp, “Chicken/Waffle,” according to Downs.

The Allegheny County Crime Lab is analyzing the stamp bags.

It appears the heroin came from the same distributor, but, “It's hard to predict if this is more potent or if it's laced with something else,” Scirotto said.

Asked if the dealer who sold the heroin could face homicide charges, Mike Manko, spokesman for Allegheny County District Attorney Stephen A. Zappala Jr., said, “I would not speculate on something in which we don't know all of the facts.”

Officials say the latest rash constitutes the largest number of drug overdoses since a batch of fentanyl-laced heroin killed nearly two dozen people in Western Pennsylvania in January 2014. Investigators are looking for the original source of the heroin-fentanyl combo, a spokeswoman for the U.S. Attorney's Office said. Fentanyl is a synthetic opioid.

U.S. Attorney David Hickton announced last month that a federal grand jury indicted 14 people in connection with a drug ring that was made public in October. That brought to 54 the number of indictments in that investigation, much of it involving heroin.

Brackney said paramedics carry Narcan to treat suspected opioid overdose victims. Pittsburgh EMS Chief Mark Bocian has said city paramedics have carried Narcan for at least 20 years.

There has been talk of equipping city police officers, Bocian has said. No one with the Pittsburgh Bureau of Police would comment Wednesday.

Westmoreland County Sheriff's deputies began carrying Narcan last year; state police troopers will carry it soon.

Narcan wipes opioid molecules from brain receptors to send users into sudden withdrawal. It costs about $20 per dose.

When Narcan first came out, it had to be injected with a syringe. But now it is available as a nasal spray, which makes it easier for law enforcement or family members to administer, said Dr. Neil Capretto, medical director at Gateway Rehabilitation Center.

Read more: http://triblive.com/news/allegheny/8176738-74/heroin-scirotto-overdoses#ixzz3Xwz07Hl5 

Pittsburgh Heroin OD Article