NPR News:Syracuse, N.Y., Experiences Spike In Synthetic Marijuana Hospitalizations

"Spice" or "spike" are the innocuous names for a cheap, unpredictable drug that emergency rooms across the country are struggling to handle.

Reporter Steve Featherstone has watched patients overdose on synthetic marijuana in several hospitals in Syracuse, N.Y., where emergency room doctors are overwhelmed by the outbreak. He tells NPR's Kelly McEvers about his reporting for a piece in the New York Times Magazine, titled "Spike Nation."

"A lot of the people who have been coming into the emergency rooms across Syracuse, this isn't their first time this has happened, so a lot of them actually have like histories of overdosing more than once on spike," Featherstone says.

On the origins of the drug

It was billed as synthetic marijuana, but it has nothing to do with marijuana. It's a completely chemical product. It kind of has the look of marijuana, maybe, because it's a plant material, it's dry, it comes out of a pouch, you roll it up, you smoke it like you would a marijuana joint. But the effects are completely different. Pharmacologically it's completely different. Chemically, it's completely different. These cannabinoids were invented in research labs decades ago and never marketed, never made it out of the lab, and then they just suddenly started appearing in these products. And they are mainly, almost exclusively, made in China in sort of industrial facilities. And then they're shipped here, where they are applied using a spray bottle onto dried plant material — could be lawn clippings, could be autumn leaves. There's absolutely no regulation, so it could be anything.

On the people who are doing this drug

I think maybe a couple of years ago, the typical user might have been like maybe a curious teen going into the head shop and picking up a pack of this stuff because they might think it's like a legal high, which it is not, and then trying it, and then getting sick. The people that I saw in Syracuse who are using it are largely poor, many are homeless, many have diagnosed or undiagnosed psychiatric problems. And so it's really the poorest of the poor, at least in Syracuse, who are getting hit hardest by this.

On why people use this drug

I think the No. 1 reason why anybody would smoke this drug is because it does not show up on a drug test, and that's really important if you're on parole. If you are homeless, and they screen — here at least, there's a shelter here, one of the biggest shelters, screens for drugs. Spike, of course, doesn't show up on any of those tests, so you can get a bed and get high.

On the legality of spike

This is something I really struggled with because when you talk to attorneys who prosecute cases like this — mainly we're talking federal attorneys — they'll say, "Of course not." And technically that's true. Every state has a ban on these chemicals and on this product. Now, these substances have to be listed by the DEA as a controlled substance, and they literally will list the chemical structure. So what you have then is a list of a specific chemical structure that's illegal, and then traffickers will simply order a new compound from China that's slightly different. And when it gets over here it is technically, arguably, legal.

On the local level, the most (law enforcement) can do, at least here in Syracuse, if you are in possession of a packet of spike, all the cops can do is take it from you. If you are selling it, the most that the city can do is give you an appearance ticket — which is the same thing as maybe a loitering charge, something like that — but you're not going to be hauled off to jail like you would if maybe you were a heroin trafficker. It's easy to say, "Well, we need to arrest our way out of this problem," and the fact is, if you look at the population of the people who are using it and dealing it, I mean there's a whole host of problems and social problems that are tied into this knot.

KELLY MCEVERS, HOST:

Spice or spike - innocuous names for a cheap, unpredictable drug that emergency rooms across the country are struggling to handle. Reporter Steve Featherstone has seen patients coming in on spike overdoses in several hospitals in Syracuse, where ER doctors have been overwhelmed.

STEVE FEATHERSTONE: They're cutting his clothes off. Oh, they're going to do it. That guy's really convulsing.

UNIDENTIFIED WOMAN: You're OK, honey. Hold still.

FEATHERSTONE: Things are starting to go downhill.

MCEVERS: Featherstone recorded his notes as he worked on a piece that's in this week's New York Times Magazine. It's called "Spike Nation," and he's with us now from member station WAER in Syracuse. Thanks so much for being with us.

FEATHERSTONE: Thank you, Kelly.

MCEVERS: That tape we heard from a trauma center there - tell us what was happening in the moment.

FEATHERSTONE: Well, I was there talking to doctors about the spike outbreak that's been occurring in Syracuse. And at the moment I was talking to this particular physician, a spike overdose patient came into the trauma room, and he was just kind of what they call somnolent. He was just sort of almost sleepy and laying on the backboard and not moving at all. And within the course of about five minutes, he started to get what doctors call agitated, which looked to a layperson like, you know, like a marionette was pulling his limbs. He was just jerking and convulsing, and he had trouble breathing. My heart started to race just being in the back of the room watching this. It was really actually hard to watch.

MCEVERS: And so was it later determined that he had overdosed on spike?

FEATHERSTONE: Exactly. He was a known spike user, too. A lot of people who come into the emergency room or who have been coming into the emergency rooms across Syracuse - this isn't their first time this happened, so a lot of them actually have, like, histories of overdosing more than once on spike.

MCEVERS: So spike or spice is also known as synthetic marijuana. I mean, what does that mean? What is this drug?

FEATHERSTONE: So, it was billed as synthetic marijuana, but it has nothing to do with marijuana. It's a completely chemical product. It kind of has the look of marijuana maybe because it's a plant material. It's dry. It comes out of a pouch. You roll it up and you smoke it like you would a marijuana joint. But the effects are completely different. Pharmacologically, it's completely different. Chemically, it's completely different.

These cannabinoids were invented in research labs decades ago and never marketed, never made it out of the lab. And then they just suddenly started appearing in these products, and they are mainly - almost exclusively made in China in sort of industrial facilities. And then they're shipped here where they are applied, you know, using a spray bottle, onto dried plant material. It could be lawn clippings. It could be autumn leaves. There's absolutely no regulation, so it could be anything.

MCEVERS: And so you reported on people coming into emergency rooms having overdosed on this. Who are these people? Who is doing this drug?

FEATHERSTONE: That's a good question because I was surprised that - I think maybe a couple of years ago, the typical user might have been, like, maybe a curious teen going into the head shop and picking up a package of these stuff because they might think it's a like a legal high, which it is not, and then trying it and then getting sick. The people that I saw in Syracuse who are using it are largely poor. Many are homeless. Many have diagnosed or undiagnosed psychiatric problems. And so it's really the poorest of the poor, at least in Syracuse, who are getting hit hardest by this.

MCEVERS: And you tried to get at the question of why. You know, why do people do this drug? And what was your takeaway?

FEATHERSTONE: I think the number-one reason why anybody would smoke this drug is because it does not show up on a drug test. And that's really important if you're on parole. If you are homeless and they screen - here, at least - there's a shelter here - one of the bigger shelters screens for drugs. Spike, of course, doesn't show up on any of those tests, so you can get a bed and get high.

MCEVERS: I want to talk about the legality of this drug. Is it illegal?

FEATHERSTONE: (Laughter). Boy, this is something I really struggled with because when you talk to attorneys who prosecute the cases like this - and mainly we're talking federal attorneys - they'll say, of course not, and technically that's true. Every state has a ban on these chemicals and on this product. Now, these substances have to be listed by the DEA as a controlled substance, and they literally will list the comical structure. So what you have, then, is a list of a specific chemical structure that's illegal, and then traffickers will simply order a new compound from China that's slightly different. And when it gets over here, it is technically, arguably legal.

MCEVERS: And so how does law enforcement deal with that?

FEATHERSTONE: Well, on the local level, the most they can do, at least here in Syracuse, if you are in possession of a packet of spike, all the cops can do is take it from you. If you're selling it, the most that the city can do is give you an appearance ticket, you know, which is the same thing as maybe, you know, like a loitering loitering charge or something like that. But you're not going to be hauled off to jail like you would if you were a heroin trafficker. It's easy to say, well, we need to arrest our way out of this problem. And the fact is, if you look at the population of the people who are using it and dealing it, I mean, there's a whole host of problems and social problems that are tied into this knot.

MCEVERS: Steve Featherstone is a Syracuse-based writer. His piece in this week's New York Times Magazine is called "Spike Nation." Thanks so much for joining us.

FEATHERSTONE: Thank you, Kelly.

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