Advertisement

Q&A: Hillsborough doctor says Spice victims have long road to recovery

One patient died from blood loss, another came in naked and laughing from euphoria. They’re victims of a batch of the drug laced with a chemical found in rat poison.
 
Doctors are treating "Spice" victims with Vitamin K to prevent bleeding after a poisoned batch of the drugs made its way around Hillsborough County.
Doctors are treating "Spice" victims with Vitamin K to prevent bleeding after a poisoned batch of the drugs made its way around Hillsborough County. [ Florida's Poison Control Centers ]
Published Dec. 22, 2021

TAMPA — In the past two weeks, two people have died and at least 41 have been hospitalized in Hillsborough County after smoking synthetic cannabinoids that appear to have been laced with chemicals found in rat poison.

It’s the first time local medical experts have seen such an outbreak involving the drugs commonly called “K2″ or “Spice.” Law enforcement agencies are working with the Florida Department of Health and the Florida Poison Information Law Center to track down the source of the poisonous drugs.

To learn more about the dangers of contaminated Spice and the treatment of victims, the Tampa Bay Times spoke with Dr. Monica Bueso at St. Joseph’s Hospital, who is board-certified in providing special care for critically ill patients. Bueso’s team treated 10 patients for Spice poisoning last week. This Q&A has been edited for length and clarity.

Have you or your staff ever seen anything like this before, in such a concentrated period of time?

No, we’ve never seen an outbreak like this here. But in 2018, they had a similar outbreak in Illinois. And they noticed the same thing — that this synthetic cannabinoid these patients were smoking was all laced with this same ingredient called super-warafins, which is basically similar to what’s in rat poisoning.

The super-warafins cause a lot of impairment of the blood’s ability to coagulate, or make clots, so if you can’t clot and you start to bleed you just keep bleeding, and you start bleeding from your abdomen, your kidneys. Those patients have very similar presenting symptoms to ours — bleeding in the urine, severe abdominal pain because they start bleeding into the abdomen and coughing up blood because they start bleeding into the lungs as well as vomiting up blood.

The two most common early symptoms were blood in the urine and severe abdominal pain. But of course, because they’re high, many of these patients don’t realize that’s abnormal until it gets really bad and they start coughing up blood or vomiting blood. Then they finally come into the ER.

When a patient does come into your unit with these symptoms, what can you do to treat them?

So when they come in, we measure how impaired their blood is and we pump lots of vitamin K through their veins, which helps their blood thicken up and prevents it from getting too thin. Usually, these patients are coming in with very, very low levels of blood circulating in their system because they can’t stop bleeding, so we’ll have to transfuse them with a lot of blood to kind of stabilize them. Then we can start to give them platelets and other red blood cells population factors to just stop the body from bleeding out.

And once you get them stabilized, how long do patients typically have to stay in the hospital?

It really depends on how long they wait to come in. We had one patient that came in very early who didn’t smoke that much at all and we were able to turn her around from the ICU in 24 hours. She stayed in the hospital on a regular floor for a few more days so we could keep an eye on her and then she went home. But even she will have to continue taking large doses of the Vitamin K daily for at least a few weeks. Other patients will have to take Vitamin K for a few months before their bodies start to get back to normal.

What is the prognosis for these patients, and what kind of long-term damage could this drug cause?

Keep up with Tampa Bay’s top headlines

Subscribe to our free DayStarter newsletter

We’ll deliver the latest news and information you need to know every morning.

You’re all signed up!

Want more of our free, weekly newsletters in your inbox? Let’s get started.

Explore all your options

The longer they wait to come into the hospital, the more severe and the more long-term effects they will have. Some of these patients waited so long that now their kidneys are affected and we’ll never be able to turn them back to completely normal. We had one woman come in who waited too long and had bleeding in her brain that had already caused permanent brain damage. We couldn’t even do surgery on her to stop the bleeding because as soon as we opened her up, she was just going to bleed out until she died because her blood was so thin and impaired. So in the end, we couldn’t save her because there was too much of this drug built up in her system.

If this drug causes all of these horrible symptoms, what is the appeal?

So from what they’ve told me and what I’ve read, Spice gives them a very euphoric kind of high. We had one patient that actually came in completely naked and she was just laughing, in this amazing, happy place. Not only is this euphoric effect more intense than the high you would get from THC in marijuana, but it also lasts longer.

How addictive is Spice?

I know of other hospitals who have treated and released patients who had taken this strain of the drug only to have them come right back in. I think it’s the euphoric, long-lasting high that makes this drug so much more addictive than marijuana. It’s more like what you see with heroin with horrible withdrawals. One of the patients I talked to said he was getting such a big high from it that, even though there was blood in his urine and he was coughing up blood, he kept smoking this same stuff. So it’s definitely not just an alternative to smoking weed. It’s much more insidious.

Can you describe the demographics of the patients you’re seeing?

They’re definitely not all teenagers or partiers. We’ve seen adults in their 30s, 40s, and 50s. Many of them have become homeless because of their drug addiction. So even though people call it “synthetic marijuana” it’s much more insidious. People may start taking it because they can’t get marijuana and they think this is an alternative, but then it becomes its own monster.

How big of a public health issue has this become for the region?

So far, all of the Spice cases have been limited to Hillsborough County, so hopefully law enforcement and the state Department of Health and the Florida Poison Information Center were able to work fast enough to stop this drug from spreading to other places in our area. But this is still a huge issue for the community. Treatment is very, very expensive — a two-week course of oral doses of Vitamin K cost around $8,000 — and because most of these patients are now homeless or unemployed, the hospitals and taxpayers are incurring all of that cost.

Anyone with questions about synthetic cannabinoids can receive free, confidential help by calling the Florida Poison Information Center at 800-222-1222. Phone lines are staffed 24 hours a day, seven days a week. Police agencies also ask anyone who sees businesses selling “Spice” to contact them.