In just one day in May, hospitals in Syracuse, New York, treated at least 18 overdoses, a significant spike for a community that usually sees one or two cases a day.
Opioids weren’t behind the overdoses: synthetic marijuana was.
There are at least 90 synthetic cannabinoids, according to the DEA, which are frequently marketed as spices and packaged in bright packaging under names like Spice or K2. Synthetics are chemically created to mimic the effects of other drugs, like marijuana, cocaine, or morphine. According to the DEA there are more than 200 synthetic drug compounds, but synthetic cannabinoids have several dangerous side effects and, among other things, can cause hallucinations, paranoia, and death.
This problem isn’t only in New York. Though affecting Americans less than the opioid epidemic, several cities across the country have been struggling for years to combat synthetic drug use. Treating a synthetic drug overdose is especially difficult, because the drugs are not always controlled substances or usually even recognizable by doctors.
"The emergence of synthetic drugs... changes the game in a lot of ways,” said Leo Beletsky, a professor at Northeastern University who specializes in drug policy. “This is because people don’t have a good handle on what it is that they’re taking, which makes the likelihood that they’ll overdose much higher and the onset much faster.”
These drugs are also notoriously difficult to regulate. If one substance is prohibited, manufacturers will tweak the chemicals and start pushing a new drug to evade regulation.
“You could have someone who used yesterday and expect the effect and get another batch later that day and suddenly have kidney failure or are really drowsy,” said Michele Caliva, the director of the Upstate New York Poison Center in Syracuse. “It’s not regulated so we really don’t know what will happen.”
Current laws can’t keep up, but that hasn’t stopped Congress from trying. Two bills were introduced in the House of Representatives in June, one to expand synthetic drug research and one to expand the criminalization of certain synthetic substances.
Rep. Nydia Velazquez’s legislation asks the CDC to create a comprehensive catalog of synthetic recreational drugs. Velazquez, a New York Democrat, also wants Congress to provide funding for a national outreach campaign to teach communities about synthetic cannabinoids.
Rep. John Katko, whose district includes Syracuse, introduced the Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act to the House last month. The bill would make it easier for the attorney general to temporarily or permanently add a synthetic compound as a controlled substance. The process currently takes years.
Lauren Krisai, the director of Criminal Justice Reform at the Reason Foundation, a libertarian think tank, said she is skeptical about the legislation’s broad reach when it comes to classifying new substances.
“I just think that this law isn’t going to do anything except give the [DEA] more power to do stuff,” Krisai said. “If it’s being advertised as something to rein in drug abuse or whatever, I don’t think it’s going to do that. Historically speaking, looking at all these different laws that have allowed us to schedule more and more substances hasn’t really reduced drug use or overdoses or anything like that, so I don’t know why this would be any different.”
Still, the bill has received not just bipartisan support in the House, but the support of law enforcement and several hospitals in Rep. Katko’s constituency.
Caliva said her colleagues are “absolutely thrilled” about the recent congressional recognition of synthetic drug use and the efforts to limit the supply of these substances and educate about their dangers. She said she likes that the bills address the problem widely because it’s hard to predict how the synthetic drug crisis will change.
“We keep talking about opioids, but that’s not sufficient,” Caliva said. “We need to open our dialogue to include everything because there’s a lot of synthetic stuff out there and that’s why this legislation is important.”
Still, Beletsky said there will always be some demand for these drugs. The SITSA Act, and other laws regarding the regulation of synthetic drugs, don’t address the underlying issues for non-medical synthetic drug use.
“We’ve had this approach in place for other things and it really wasn’t effective,” Beletsky said. “I would love for it to work and address the crisis but I don’t have a lot of confidence that it will... we can outlaw things all day long and it’s not going to make a difference.”