Beginning Tuesday afternoon, people in New Haven, Conn. began exhibiting overdose symptoms  in large numbers. By Wednesday at least 70 people overdosed. By Friday, that number reached almost 90. The cause was the inhalation of a substance known as ‘K2,’ or ‘Spice,’ which may have also been laced with the powerful opioid fentanyl. So what is K2 and why is it dangerous?

What is K2?

K2 is a strain of synthetic marijuana that can be bought and sold at convenience stores, depending on location. Though synthetic marijuana varies from producer to producer, it is essentially dried leaves sprayed with chemicals that affect cannabinoid receptors in the brain.

According to Dr. Kathryn Hawk, assistant professor of emergency medicine at the Yale School of Medicine, synthetic marijuana like K2 are often “made in these kind of clandestine laboratories that are predominantly overseas… But they don’t represent, in any way shape or form, something that is kind of diverted from a pharmaceutical company or anything along those lines.”

Why is K2 Dangerous?

What is scary about synthetic marijuana is that nobody really knows what it is produced with. It can be laced with other, sometimes more powerful substances like fentanyl, which was suspected in the New Haven case. Fentanyl is a synthetic opioid so powerful it is estimated to be between 25-50 times stronger than heroin, and 50-100 times stronger than morphine.

People tend to think that because a substance like K2 is referred to as “synthetic marijuana,” it has the same effects as actual marijuana but that is not true. As noted by the Drug Policy Alliance, negative side effects of synthetic marijuana can include nausea and vomiting, seizures, aggression and agitation, respiratory failure, and loss of consciousness.

Emergency room visits and calls to poison control centers peaked in the early 2010s, but the accessibility of synthetic marijuana makes it a continuous issue. In some cases, users have died of complications.

Is K2 legal?

Generally, K2 and other synthetic marijuana strains are illegal. In 2012, President Obama signed the Synthetic Drug Abuse Prevention Act, labeling multiple types of the substance a Schedule I drug. Nearly every single state has its own laws, too, though they vary in scope. Synthetic marijuana manufacturers have found ways to circumvent these laws by slightly altering the chemical formulas found in their synthetic products.

In Massachusetts, the law against synthetic drugs is punishable by a $200 fine, six-month prison sentence, or both.

The Massachusetts law states:

“No person shall intentionally smell or inhale the fumes of any substance having the property of releasing toxic vapors, for the purpose of causing a condition of intoxication, euphoria, excitement, exhilaration, stupefaction, or dulled senses or nervous system, nor possess, buy or sell any such substance for the purpose of violating or aiding another to violate this section.”

Some states have also proposed strengthening the laws they already have on the books; for some, the crime outweighs the punishment.

Treatment

Because synthetic marijuana does not contain THC, the cannabinoid agent active in marijuana, K2 does not show up in toxicology results. This makeS it difficult for healthcare providers and emergency response teams to determine patterns for who uses them and which ones they use.

In New Haven, public health officials administered the overdose reversal drug Naloxone, commonly known as narcan. According to the Washington Post, at least 50 doses were given out. Some did not initially respond to the narcan and had to be given higher concentrations at the hospital.

Some people who experienced overdose symptoms were treated only to return to the New Haven Green, take more of the K2, and need narcan treatment again.

Luckily, none of the New Haven victims died.

Image via Public Domain/ Courtesy of the DEA