Officials in New York are warning hospital emergency rooms about a new form of synthetic marijuana laced with rat poison that is linked to cases of uncontrolled bleeding.
The New York State Department of Health issued the warning on Monday. Officials say cases of severe and life-threatening bleeding have been reported in five states: Illinois, Maryland, Wisconsin, Indiana and Missouri.
Laboratory investigation has confirmed that some of these patients were exposed to brodifacoum, a long-acting anti-coagulant found in rat poison, according to the alert.
The guidance to hospitals and clinics instructs them to be on the lookout for people complaining of severe bleeding not related to an injury, or when the bleeding occurred after using synthetic marijuana.
Many different chemical compounds are used to manufacture so-called synthetic marijuana. While the substances are intended to mimic the effects of marijuana, they are often far more dangerous for users.
What are the Clinical Signs of Coagulopathy?
Clinical signs of coagulopathy include bruising, nosebleeds, bleeding gums, bleeding disproportionate to injury, vomiting blood, coughing up blood, blood in urine or stool, excessively heavy menstrual bleeding, back or flank pain, altered mental status, feeling faint or fainting, loss of consciousness, and collapse.
What Do Health Care Providers Need to Do?
Healthcare providers should maintain a suspicion for vitamin K-dependent antagonist coagulopathy in patients presenting with clinical signs of coagulopathy, bleeding unrelated to an injury, or bleeding without another explanation and with a possible history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use; some patients may not divulge use of synthetic cannabinoids. These patients should be screened for vitamin K-dependent antagonist coagulopathy by checking their coagulation profile (e.g., international normalized ratio (INR) and prothrombin time (PT).
Health officials note that they do not believe that there have been any cases in New York yet.
Synthetic marijuana is marketed as legal and sold in colorful packets with street names such as K2, Spice and AK-47. These packets typically consist of plant material coated by chemicals, which are supposed to mimic the effects of naturally grown marijuana. This makes synthetic marijuana both extremely unpredictable and dangerous.
Under current law, an owner of an establishment, as well as any other person possessing, distributing, selling or offering prohibited synthetic drugs for sale, will face a fine up to $500 and/or up to 15 days in jail. Civil penalties include a fine up to $2,000 per violation.
With the Associated Press