Criminal chemists already have found a way to circumvent a new Hawaii law to crack down on synthetic drugs, but local authorities are fighting back.
Act 29, signed by Gov. Neil Abercrombie in April, made it illegal to sell, buy or use nine families of previously legal synthetic marijuana and stimulants.
The law, which local officials say is among the nation’s most proactive, curtailed public distribution of much of Hawaii’s synthetic drug trade. But drug manufacturers and dealers soon began bringing to Hawaii another family of these drugs, which hadn’t yet been identified as illegal but had similar characteristics to others covered in the law.
The latest version, called tetramethylcyclopropanoylindols, is similar to the previously banned Spice and is sold under names like Blue Kush and UR-144 mostly in "smoke shops" or similar stores. It’s temporarily illegal under a special emergency order issued by the state Department of Public Safety in October, but officials will have to go before the Legislature again next month to pass a new law to get the newest family of dangerous synthetic drugs off the streets.
"Government is always in the catch-up stage," said Keith Kamita, deputy director of public safety. "We have to be vigilant about these new drugs because maybe our kids are going to try them. If we can get them to think twice, maybe we’ll save a life."
While it’s nearly impossible to create a law that would control all versions of a synthetic drug, the department is able to temporarily label formulas considered a threat as Schedule 1 drugs, the category reserved for the most harmful drugs like Ecstasy that have no known medical use.
"Hawaii is very lucky," Kamita said. "The federal government can do this, too, but most other states envy our ability."
THE POWER to temporarily schedule drugs before they are written into law gives DPS and local law enforcement agencies the opportunity to respond to threats sooner, he said.
"The idea behind emergency scheduling is to save people from getting seriously hurt," Kamita said. "Once the Legislature is back in session, I expect that they will support us. They have been very proactive."
Still, Hawaii’s law enforcement officials say it’s difficult to halt the distribution of new synthetic drugs like Blue Kush and UR-144 because laws can’t keep pace with the underground market. When a synthetic drug is scheduled, chemists try to find unnamed families of these drugs or alter the drug’s molecules to make new drugs.
"Manufacturers and dealers watch what the states do and keep changing the formulas because it’s a moneymaker," Kamita said.
The Honolulu Police Department has seen an increase in synthetic drugs in the past few years, following national and international trends, said Maj. John McEntire, commander of HPD’s narcotics/vice division.
Locally, HPD has seen K2 and Spice, synthetic forms of cannabis, as well as synthetic cathinones, known as "bath salts," which are stimulants that can mimic cocaine, LSD, methamphetamine or methylenedioxymethamphetamine (Ecstasy), McEntire said.
"Stopping the distribution and use of synthetic drugs is critical," he said.
There were 4,905 synthetic marijuana and 2,550 bath salt exposure calls to America’s 57 poison centers in 2012 through November, according to the Alexandria, Va.based American Association of Poison Control Centers.
Through November, the Hawaii Poison Control center handled nine cases of Spice poisoning and three for bath salts, said the center’s medical director, Alvin C. Bronstein. While there were relatively few poison calls in Hawaii, Bronstein said the issue is a great concern.
"People don’t always call poison control about illicit drugs," he said. "Most of the calls that we get are from the hospital."
Synthetic marijuana or cannabinoids are marketed under innocuous names like Spice, K2 and No More Mr. Nice Guy, while bath salts are known by names like Bliss and Cloud 9. However, they are powerful drugs with harmful effects, said the center’s nurse educator, Cindy Deutsch.
"Parents need to be aware of these slang terms," Deutsch said. "Bath salts aren’t really bath salts and Spice isn’t really spice."
Kamita adds that parents should investigate if their children are acting strange or come home with something that looks like potpourri, bath salts, plant food, or designer tea and coffee.
"You know it’s strange if your kid paid $25 or $35 for a tea bag or a sachet," he said. "But really, most of the time, it’s the behavior that alerts us to the problem. The military brought the first report to us because some guy was acting bizarrely."
In Hawaii and elsewhere, there have been cases where users have displayed dangerous behavior, McEntire said. The case of Bryan Roudebush, who beat up his girlfriend and attempted to throw her off a Waikiki balcony in 2010 while under the influence of Spice, made news locally and in military publications.
Using synthetic marijuana can cause severe agitation and anxiety, a racing heartbeat and higher blood pressure, nausea and vomiting, muscle spasms, seizures and tremors, intense hallucinations and psychotic episodes, and suicidal thoughts and behavior, Bronstein said.
Similarly, bath salts can cause paranoia and violent behavior, hallucinations, delusions, suicidal thoughts, seizures, panic attacks, increased blood pressure and heart rate, chest pain, nausea and vomiting, he said.
"Marijuana is a very mild drug in my opinion," said Dr. Howie Klemmer, an emergency room physician at the Queen’s Medical Center. "People don’t become agitated or wild. But synthetic cannabis can be very different depending on how they tweak the chemical and sometimes it’s mixed with other things. A big ER like ours has to have a security guard and trained staff to control (synthetic drug users). They are very often paranoid, out of touch with reality or psychotic and violent."
State Sen. Josh Green (D, Kona-Kau), who works as an emergency room physician on Hawaii island, estimates that he gets at least one synthetic drug case a month and that it’s probably a daily occurrence in the state’s busier emergency rooms.
"It’s catastrophic," said Green, who supported the bill leading up to Act 29 and said that he plans to give full backing to public safety’s latest bill.
There’s no comparison between marijuana and what is being marketed as the synthetic varieties, he said.
"I’ve never seen any long-term devastating effects from marijuana," Green said. "I don’t take it lightly. I have concerns as any father or physician would, but it doesn’t compare to synthetic drugs."
In the past few weeks, Green said he saw a 30-year-old who had a seizure disorder as a result of taking synthetic drugs. He also treated a 28-year-old woman who had damaged the circuitry of her heart by using synthetic drugs.
"She had to get a pacemaker at 22," he said. "It’s not surprising. I’ve seen people in their 20s have strokes from these synthetic drugs."
A few years ago, Green said he saw a 40-year-old patient die from advanced heart failure due to synthetic drug use.
"He had been at least a college football player. He was super strong. He should have been in the best of health, but a methamphetamine derivative caused a cardiomyopathy," Green said. "We definitely need to support efforts to rid Hawaii of synthetic drugs."
