Synthetic Marijuana Crisis

We have experienced a public health crisis over the last 2 years in New York due to the rise in use of synthetic marijuana. This has impacted both psychiatric and medical ERs, leaving our staff overwhelmed. Since the drug cannot be detected in urine toxicology screens, this leaves the staff at times puzzled as to the cause of the ER presentation.

Since April 1, 2015, articles have been circulated from the Centers for Disease Control and Prevention (CDC) to all healthcare providers asking them to be more vigilant and aware of the rise of these drugs and the potential risks of these drugs on society. K2 and Flakka, or any other synthetic marijuana, have led to a public health crisis, especially since patients have presented to the ERs agitated or psychotic, and traditional forms of injectable medications are taking longer to demonstrate, if any, physical improvements in the psychiatric ERs.

If the patient presents with multiple medical complications, one of them being cardiac issues, they have to be placed on a “one-to-one” (to be monitored by staff at all times), due to worsening physical agitation, paranoia, and delusions. We have seen the impact these drugs have on patients and their families in the ER, having witnessed up close the deterioration the abuse of these drugs can cause.

In addition, both the medical and psychiatric ERs have become, over time, detoxification units, since many of the designated detoxification units have closed down throughout the city over the last 2—3 years. People who are getting high are often not aware of the consequences and the risks involved with these drugs. Patients cite that some of the reasons they use these drugs are because they are affordable and they do not show up in a urine drug screen. However, the longterm consequences remain and their symptoms can mimic those of psychosis, aggression, and paranoia. Therefore, in conjunction with the CDC, Poison Control, social media, law enforcement, and government officials have made consistent attempts to remove access to these drugs by placing a ban on the sale of these drugs, making multiple arrests, and providing psychoeducation to people about the negative effects of these drugs.

Over the last several months, the use of multiple news outlets and signs posted in the ER triage area have been essential in providing education about the risks and hazards of these drugs to the general population.

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