Following up on yesterday's report, where the Illinois Department of Public Health announced 22 recent cases of severe internal bleeding linked to synthetic cannabinoid use, we have today's update which adds 10 more cases to the list.
For background on Spice/K2 you'll want to revisit yesterday's blog.
First today's update, then I'll return with a bit more.
As of March 30, 2018, IDPH has received reports of 32 cases linked to an outbreak, since March 7, 2018; cases report using synthetic cannabinoid products before suffering from severe bleeding.
***Numbers are provisional and subject to change; IDPH will update the website every day at 1:30pm, for the duration of the outbreak***
While many of the cases report acquiring the synthetic cannabinoid products in the Chicagoland area, contaminated products could be in counties across the state. Individuals reported obtaining synthetic cannabinoid products (i.e., K2, spice, synthetic marijuana, and legal weed) from convenience stores, dealers, and friends.
If you have purchased any of this product in the past month, do not use it. If you have used any of these products, and start experiencing severe, unexplained bleeding or bruising, please have someone take you to the hospital immediately or call 911. Do not walk or drive yourself. Tell your health care providers about the possible link between your symptoms and synthetic cannabinoid use.
Since this side effect doesn't appear to have been reported before, something about the chemical witches' brew which is used to make this drug has apparently been changed.
But whatever they are using hasn't been identified yet.A reader yesterday left a link to a 2014 study called Spice/K2 drugs – more than innocent substitutes for marijuana, which raises one possibility. According to the authors:
In addition, Spice products are supposed to contain up to 15 different vegetal compounds, which gives rise to a wide variety of drug combinations (Dresen et al., 2010; Zuba et al., 2011). Moreover, they have been found to contain large amounts of vitamin E, added to hamper the analysis of the active cannabinoids (Dresen et al., 2010; Zuba et al., 2011).Vitamin E, at least in very large doses, can have a significant anti-coagulating effect - but it is usually only a concern for those who have a bleeding disorder or are taking other Rx blood thinners.
It would take a very large dose of Vitamin E on its own to provoke the kind of bleeding being reported in these patients. The wild card is that Vitamin E is rarely absorbed through the lungs.So while plausible, we'll simply have to wait to see if Vitamin E is the culprit, or if something else is going on here.