By Randi B. Hagi, assistant editor
Sometimes it makes people agitated. In other cases, it seems to knock them out, making them difficult to wake. Commonly, it produces a zombie-like state. It’s a drug that medical professionals and authorities alike struggle to treat, regulate, and even characterize: synthetic cannabinoids, often referred to as K2 or spice.
“It’s an emotional roller coaster ride,” said Betsy Sydnor, who has been sober for six years. “And the hard thing about K2 is every batch is really different.”
That’s in part because the umbrella term includes hundreds of different chemical compounds with one common factor: they interact with the same brain cell receptors as tetrahydrocannabinol, or THC – the primary active component of marijuana. The compounds are then sprayed or dusted onto potpourri or other vegetative materials that can be smoked. K2 is often marketed as a type of “synthetic weed,” but the chemicals being sold under that term are strikingly different from marijuana, and even from one another.
“New ones with unknown health risks become available each year,” according to the Centers for Disease Control and Prevention (CDC).
K2 has been seen to cause psychosis, tachycardia, and in extreme cases, kidney damage, as documented by both the CDC and physicians who spoke with The Citizen.
For Sydnor, the drug was also physically addictive in a way that marijuana is not. She recalled one time when she was trying to quit using and went to her job at a hotel.
“I was freezing cold and sweating at the same time. It’s like the worst stomach virus ever,” she said. Those symptoms were so severe they prevented her from getting clean multiple times, until her kids were put into foster care.
It was, for her, a “fork in the road, so to speak,” she said. “I’m either going to stop this and get them back — or I’m going to continue doing this. There was nothing left to really live for.”
Sydnor found the most help by attending recovery groups at the Harrisonburg-Rockingham Community Services Board. She moved to Elkton to get a fresh start, and after eight months, she got her kids back. Now, she works as a peer recovery specialist and programs coordinator at Strength in Peers, an organization that provides support and advocacy for those overcoming substance use, mental health and trauma-related challenges.
“It’s a great source of continued recovery for me, being able to help people,” Sydnor said.
But she knows that many in the area are still suffering because of K2.
Sydnor said one reason people start smoking K2 is because they’re on probation, and the regular urine screens they have to take are less likely to detect K2 than other drugs.
In January, the Danville Register & Bee reported that K2 had become a major problem among inmates at the Danville Adult Detention Center.
“As for other substances among inmates, ‘we haven’t seen many of the other drugs lately,’” the newspaper quoted Andrew Shelton, a correctional health assistant at the detention center, as saying.
“They like the K2 more than anything else,” Shelton told the newspaper.
A dark art of chemistry
K2 first appeared in the United States in 2008, according to the CDC. In the first few years following its emergence, lawmakers across the country struggled to play catch-up by outlawing specific synthetic cannabinoid compounds that had been identified – but they couldn’t do that as fast as chemists could create new ones.
In 2011, Virginia joined 39 other states that had begun to regulate synthetic cannabinoids by outlawing the possession or sale of 10 chemical compounds, as The Washington Post reported.
In 2012, President Barack Obama signed the Synthetic Drug Abuse Prevention Act, which outlawed all substances containing “any quantity of cannabimimetic agents.”
In the earlier years of K2’s presence in Virginia, Dr. Ian Steines remembers a number of agitated college students coming into the emergency department of Sentara RMH, where he’s the medical director. They would tell the staff they’d been using either K2 or bath salts – the common name of another synthetic drug that became available around the same time.
Back in those days, when many of the compounds under the K2 umbrella hadn’t been outlawed yet, people could openly purchase the substance at area gas stations. Over time, though, legislation forced the drug underground.
In the meantime, Steines has noticed a shift in who’s using it.
“Now, I’ve seen it in younger people, but not so much college-age,” he said. He also has noticed older members of the community using it.
This is not just an occasional problem for the emergency room staff. Steines said while alcohol-related issues remain “far and away” the most common, K2 is probably the second most frequent source of problems for people showing up in the ER. Affected patients come in “at least several times a week,” he said.
The symptoms people exhibit when they come to the emergency room after smoking K2 vary widely.
Some are mildly agitated, Steines said, and staff will get them into bed in a quiet, dark room and talk them through the high, which several sources told The Citizen can last anywhere from 15 minutes to a few hours. Others experience nausea, vomiting, delirium or hallucinations, sometimes to the point where hospital staff will administer seizure medication.
“What is important to realize is that sometimes people think that they’re getting marijuana when they’re getting a synthetic cannabinoid, and sometimes these synthetic cannabinoids are laced or colored with other substances,” Steines said. “This is a completely different substance than marijuana would have been in the ‘60s or ‘70s.”
Dr. Chris Holstege, who directs the Blue Ridge Poison Center at the University of Virginia, said the facility gets 20-40 calls each year related to K2, which is down from the drugs earliest days in 2009. Some of the cases they deal with, though, are intense.
“The most problematic is the psychosis that can develop. People can get misperceptions of reality,” Steines said.
Much like someone who ingests too much of a hallucinogen like LSD, a few of those who undergo that psychosis are permanently scarred by it.
“Some of these psychotic breaks that we’re getting are long standing. It’s not really clear why,” he said. “I’ve had a few cases, really sad cases, where they have a psychotic break and have to be institutionalized.”
How is K2 getting into the community?
It’s one of the responsibilities of Daniel Long, an officer with the Harrisonburg Police Department and a member of the RUSH drug task force, to find out where local K2 dealers are getting their supply.
He said in an interview last week that officers on patrol recently have been “dealing with it a lot, with folks that have been using K2 and are under the influence of K2 and they’re acting strange, or they get calls for them being passed out.”
His job is not to pursue the people using the drug, though, but the ones selling it – who purchase it in bulk, out of town, to sell in small quantities here.
Long said he’s noticed a trend from the cases he’s worked on.
“Everyone I’ve talked to, they go up to Baltimore, Philly, Pittsburgh, one of those cities,” Long said. “From what people have told me, they’re buying it at stores. Now is that going to be on the counter? No, it’s probably underhand.”
He said heroin being sold in the Harrisonburg area comes from those cities as well. They’re bigger metropolitan areas only a few hours away, and we’re “a consumer end of that distribution line.”
Long and the task force, which covers Harrisonburg and Rockingham County, seized 1,595 grams of K2 in 2020, although he noted that much of that came from a single drug bust.
In 2019 and 2018, respectively, the task force seized 359 grams and 249 grams of K2.
Preying on the homeless community
Long and Sydnor agreed that one appeal of the drug is its price. It costs roughly the same as marijuana by weight. That’s cheaper than harder drugs, while creating a more intense, if unpredictable, high than weed.
Those who work with the homeless population of Harrisonburg have noticed a sharp increase in K2 use.
Ashley Robinson, the shelter director at Open Doors – a homeless shelter in Harrisonburg that typically runs during the coldest months, from November to April – saw this unfold.
“At the beginning of the season it did really seem to be a problem with a lot of guests,” Robinson said. “And usually [with] the ones we didn’t have an issue with too much before.”
Open Doors is a low barrier shelter, so the staff doesn’t bar people from staying there for being drunk or high, so long as they aren’t violent or otherwise disruptive to everyone else. However, guests aren’t allowed to imbibe any substances at the shelter.
Robsinson said starting last spring when the shelter was housed at JMU’s Godwin Hall, they noticed a number of folks who would go outside to smoke hand-rolled cigarettes and come back acting differently.
“If you’re able to go outside, walk yourself outside to smoke a cigarette, but you’re unable to walk yourself back in, that’s generally an indication of use,” Robinson said. “You know immediately when they’re on it because it’s that zombie-like state … and so we told them, if there’s any changed behavior like that, there’s going to be an eviction that takes place.”
Robinson said after giving everyone multiple warnings, Open Doors did buckle down and evict a handful of guests for smoking K2. Typically, eviction from Open Doors for drug or alcohol use on the property lasts three nights, although Robinson said they’d sometimes limit it to one night if the weather was especially bad.
After they started cracking down, Robinson said guests generally stopped using at the shelter, although the staff would still hear stories of their guests occasionally having seizures or other issues potentially related to K2 elsewhere in town.
“I think it is a bigger deal than people think, not just with our folks who are homeless, but I think it could be an issue with others, too, like maybe the younger population,” Robinson said. “Especially during the pandemic and the mental health crisis that we’re seeing.”
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