Severe Illness Associated with Reported Use of Synthetic Cannabinoids — Mississippi, April 2015

Abstract

On April 2, 2015, four patients were evaluated at the University of Mississippi Medical Center (UMMC) in Jackson, Mississippi, for agitated delirium after using synthetic cannabinoids. Over the next 3 days, 24 additional persons went to UMMC with illnesses suspected to be related to synthetic cannabinoid use; one patient died. UMMC notified the Mississippi State Department of Health, which issued a statewide alert via the Health Alert Network on April 5, requesting that health care providers report suspected cases of synthetic cannabinoid intoxication to the Mississippi Poison Control Center (MPCC). A suspected case was defined as the occurrence of at least two of the following symptoms: sweating, severe agitation, or psychosis in a person with known or suspected synthetic cannabinoid use. A second statewide alert was issued on April 13, instructing all Mississippi emergency departments to submit line lists of suspected patients to MPCC each day. By April 21, 16 days after the first alert was issued, MPCC had received reports of approximately 400 cases, including eight deaths possibly linked to synthetic cannabinoid use; in contrast, during April 2012–March 2015, the median number of telephone calls to MPCC regarding synthetic cannabinoid use was one per month (range = 0–11). The Mississippi State Department of Health, with the assistance of CDC, initiated an investigation to better characterize the outbreak, identify risk factors associated with severe illness, and prevent additional illnesses and deaths.

New psychoactive substances: driving greater complexity into the drug problem

“…There is strong evidence that some new substances are causing serious harms. These include serious non-fatal as well as fatal poisonings [11][12][13][14]. One striking development are outbreaks of mass poisonings caused by 'legal highs' containing synthetic cannabinoids.…”

“…One striking development are outbreaks of mass poisonings caused by 'legal highs' containing synthetic cannabinoids. In 2014 in Russia, products containing MDMB-FUBINACA were linked to more than 600 poisonings including 15 deaths over two weeks [11]. More than 700 suspected poisonings including 9 deaths with a possible link to ADB-FUBINACA were reported in Mississippi, United States over one month in 2015 [12].…”

Peculiarities of mental and behavioral disorders due to use of designer drugs among young population and problems of early diagnostics (literature review).

“…За повідомленнями фахівців, поширеність канабіноїдної наркоманії, в цілому, в період з 2000 по 2007 р. зросла з 10,8 до 16,6 осіб на 100 тис. населення і вживання мари-хуани, гашишу, а тепер -і спайсів, посідають провідне місце саме серед молоді [10,17,24].…”

“…В січні 2009 року «Спайс» і аналогічні суміші були заборонені в Німеччині, а в березні -у Франції, аналогічні заборони готуються ввести влади деяких інших держав. В Україні спайси також законодавчо заборонені з 2010 року, проте їх можна купити через Інтернет-магазини як пахощі, солі для ванн, добрива для кімнатних квітів [9,20,24]. Але вся проблема в тому, що кінцева формула курильних сумішей оновлюється до двадцяти разів на рік.…”

“…Три-валість психотичного стану може досягати 1-2 тижнів. При тривалості психозу 1 місяць і більше необхідна диференціальна діагностика з дебютом ендогенного захворювання, що буває особливо ускладнене при приховуванні пацієнтом фактів вживання наркотичних речовин [19,24].…”