Testing It Up

A case study presented Tuesday at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists showed that pregnant women who use synthetic marijuana may experience dangerous symptoms harmful for both the mother and the unborn child.

Dr. Cindy S. Lee and Dr. Sally Nalesnik, from Kern Medical Center in Bakersfield, CA, conducted research involving a pregnant woman who came to the labor and delivery floor agitated and had a seizure. The woman was approximately 35 weeks pregnant and did not previously have prenatal care. She was found to have elevated blood pressure and protein in her urine which are common symptoms of preeclampsia. After being resuscitated, the patient underwent emergency cesarean delivery in response to fetal distress.

The woman’s physicians successfully delivered a 28-week female baby who screened negative for drugs. Typically, eclampsia is cured with the delivery of the baby, but this particular patient did not  get better following delivery.

“This was an interesting, yet confusing presentation,” Dr. Lee said in a news release. “We wanted to report it so in the future if something similar came up, it would be in the literature and physicians could refer to it.”

The woman’s lab results showed very low potassium levels and her urine drug test returned negative. Her physicians later received information from an anonymous caller who said the patient was regularly smoking Spice Gold, one of the many street names for synthetic marijuana.

“This was not a pregnancy problem but a drug problem,” Dr. Lee added. She said it is important for ob-gyns to realize that emerging drugs represent growing challenges to medical practitioners because synthetic marijuana, for instance, cannot be detected in standard drug tests.

Synthetic marijuana is a mixture of herbs and spices that is typically sprayed with a synthetic compound that mimics the effect of THC, the psychoactive element in marijuana. Among the most popular compounds that illegal drug makers are using to create synthetic marijuana include JWH-018, JWH-073, and JWH-200, and HU-211. Although these chemical compounds are banned under federal and several state laws, drug makers are getting smart enough to  use other available synthetic cannabinoids that are not yet banned in order to avoid existing drug laws.

Law enforcement officials  and public health practitioners are concerned about the potential side effects of synthetic marijuana and bath salts, saying they don’t really know what those products can do to people.

A new study by the University of Alabama at Birmingham (UAB) nephrologists reported for the first time cases that directly linked acute kidney injury with synthetic marijuana use.

Senior author Dr. Denyse Thornley-Brown, associate professor in the UAB Division of Nephrology, and colleagues presented in their report four different cases of previously healthy young men whose acute kidney injury was linked to ingestion of synthetic marijuana. The patients came to UAB or a community hospital showing symptoms of nausea, vomiting and abdominal pain after using synthetic marijuana.

“Cases of acute coronary syndrome associated with synthetic marijuana use have been reported, but our publication is the first to associate use with acute kidney injury,” study co-author Dr. Gaurav Jain, assistant professor in the Division of Nephrology, said in a news release.

Noting that synthetic marijuana preparations involve using several additives, Jain said causative agent of the acute kidney injury in these cases may have been an additive rather than the cannabinoid itself.

“There is very little information regarding the ingredients in synthetic cannabinoids that are sold on the streets, although it is known that additional compounds are added to the preparations,” Jain added.

The researchers recommend doctors to inquire about the use of synthetic marijuana when evaluating patients with acute kidney injury, especially in young adults with negative urine drug screen.

The case studies are reported online in the Clinical Journal of the American Society of Nephrology and will appear in the March 2013 print edition of the journal.

Despite the fact that the state of Missouri has placed a ban on synthetic marijuana products, teens apparently still have access to them, as they continue to be sold at certain independently-owned gas stations and convenience stores.

Statistics from the National Institute on Drug Abuse indicated that nearly one in nine high school seniors have gotten high on the herb-based product, which mimics the effect of pot.

Synthetic marijuana is made from a mix of dead plants, flowers, and chemicals. These may be smoked in a pipe, mixed with marijuana, or snorted. While users experience the same effects as that which can be derived from using pot, they are also more likely to experience other symptoms as well, including rapid heartbeat.

Authorities in Kansas City’s Northland area were able to seize large amounts of suspected synthetic drugs. These products carry such brand names as Mr. Happy and Purple Diesel, and are sold as “plant food,” potpourri, and bath salts.

Platte County Prosecutor Eric Zahnd shared: “We are targeting merchants who sell synthetic drugs for one simple reason: Synthetic drugs are extremely dangerous. Their effect on the human body is very unpredictable… A few years ago, it was legal to sell these designer drugs. That is no longer true.”

Zahnd shared further that three young people were hospitalized due to kidney failure, while a dozen were sickened in Casper, Wyoming, early this month. All the cases, he said, could be traced back to a batch of a certain designer drug.

Packets of synthetic marijuana are normally being sold for $20. The merchants are able to acquire these from dealers for $4, while dealers can manufacture them for less than $1.

The city council of Chicago has proposed a measure that will ban the sale of synthetic marijuana. While there is a statewide ban on synthetic marijuana, there are substances that are yet to be banned in Chicago.

If the proposal pushes through, anyone who sells, or possesses, synthetic marijuana may face paying a fine of $500 and $1,000.

The council’s proposal is supported by Attorney General Lisa Madigan, who shared the dangers of synthetic marijuana, which could cause vomiting, agitation, and seizures: “Most parents, most adults don’t know about this – but the kids do. And the kids think because they can purchase these substances in stores, well it must be safe. And nothing could be further from the truth.”

According to the Illinois Poison Center, they have received more emergency room calls about people getting sick due to synthetic marijuana. From only 70 calls last year, they have received 304 so far this year.