Synthetic weed may cause heart attacks, but it's tough to ban

Spice, Blaze, K2, Red X Dawn. Any of them sound familiar? They're different brands of synthetic pot — psychoactive drugs (commonly marketed in head shops as incense) which contain chemicals that, much like the THC in marijuana, act on the cannabinoid receptors in your brain. Sounds peachy, right? There's a catch. Unlike pot, which is known to increase heart rate but is otherwise rarely linked to heart problems, the synthetic stuff appears to be leading to heart attacks, most recently in three Texas teenagers.

Back in November, 80beats' Douglas Main gave this rundown of the circumstances surrounding the cases, which are published in that month's journal Pediatrics:

Serious as a Heart Attack:

  • All three teenagers were seen at the University of Texas Southwestern Medical Center in Dallas within three months of one another, after complaining of chest pain for several days. Myocardial infarctions were confirmed with EEG readings and the presence of troponin, a chemical released when heart muscles are damaged. Each was treated and released.
  • Though all three admitted to smoking marijuana in the previous few weeks, their use of K2 occurred just before symptoms of chest pain began. Two tested positive for THC; all tested negative for other drugs of abuse. Only one patient was tested for two synthetic cannabinoids, which weren't detected. This is likely due to the widely varying blend of cannabinoids used in these products.
  • Very rarely, marijuana use has been linked to heart attacks, thought to arise from THC's ability to increase heart rate and cardiac output.
  • K2 may cause an increased risk for a heart attack due to a stronger activation of this same pathway, or via another unknown route. Colin Kane, a pediatric cardiologist at UT Southwestern & Children's Medical Center in Dallas told Reuters he was "certainly suspicious that there was something in the K2 that would have caused these heart attacks."
  • No chemical analysis was done on the products the teenagers smoked and is only described in the paper as, "K2, Spice (Dallas, Texas, manufacturer unknown)."

In any case, all these adverse reactions to synthetic weed were obviously attracting the attention of the U.S. DEA, which promptly stepped in to ban the stuff; but — surprise, surprise — attempts to curb the sale of these substances have been woefully unavailing. On July 9th, President Obama signed into law the Synthetic Drug Abuse Prevention Act of 2012, a federal ban on, as its name suggests, synthetic drugs. But as Wired's Brandon Keim reports, the ban has managed to become obsolete in a manner of days:

Drug formulations not covered by the law's language, and almost certainly synthesized in direct response to legal pressure, are already on sale. If synthetics are supposed to be part of the War on Drugs, then this battle may already be lost.

"There are several compounds out there now, in mixtures that I've tested myself, that would not fall under this ban," said Kevin Shanks, a forensic toxicologist at AIT Laboratories, an Indiana-based chemical testing company. "The law just can't seem to keep up."

It's hard to watch this kind of scenario unfold and not reflect on the absurdity of marijuana criminalization. Is this a preview of what the war on drugs will look like in the years to come — a continuously escalating back-and-forth between the laws that would see a substance like marijuana banned, and the (potentially dangerous) reactionary measures designed to exploit loopholes in those laws?

"In this area of Indiana, we're not seeing any of the classical compounds we've seen in the last year," Shanks said. "We're seeing the uncontrolled ones. I have no doubt they were designed specifically for that reason."

Read more at 80 beats, Terra Sigillata and Wired.