The Centers for Disease Control and Prevention (CDC) published the latest indictment against synthetic cannabinoids (SC) in the February 15 Morbidity and Mortality Weekly Report directly linking kidney damage to synthetic cannabinoids. We had been warning about renal damage for almost a year, so it’s great news when case studies are reported confirming our warnings.
Also, University of Alabama at Birmingham nephrologists have reported 4 cases of acute kidney injury directly linked with synthetic cannabinoid use in a study which will be published in the March issue of the Clinical Journal of the American Society of Nephrology. The authors of the UAB report recommend that physicians inquire about the use of designer drugs when evaluating patients with acute kidney injury — especially in cases where the cause is unknown and the urine drug screen is negative.
(Even if a synthetic drug screening is negative, it does not indicate certainty that the patient has not been ingesting drugs because tests are relatively unreliable. The tests do not detect the newest chemicals used to make synthetic drugs. Of the 16 cases, toxicologic analysis of implicated SC products and clinical specimens was only possible in seven.)
Management of suspected SC toxicity is systemic (step-by-step) and should be medically supervised; no antidote exists.
The UAB report outlined four different cases of previously healthy young men whose acute kidney injury was linked to ingestion of synthetic marijuana. All the patients were residents of the same northeastern Alabama community and presented to UAB or a community hospital within a nine-week period showing symptoms of nausea, vomiting and abdominal pain after using synthetic marijuana.
Co-author Gaurav Jain, M.D., assistant professor in the Division of Nephrology said, “It is very likely that a possible nephrotoxin adulterated the preparation used by our patients.” Adulterated means “to make impure by the addition of a foreign or inferior substance or element.” I know what he meant, but an untrained mind might think he was saying, “The poison’s been poisoned!” After all, most synthetic cannabinoids are categorized as “poison” on the Material Data Safety Sheets, which are legally required by legitimate laboratories to handle and ship.
Use of synthetic cannabinoids is relatively new and authorities are just beginning to gather the information required to be able to make such an assumption.
Our experience tells us that the young people effected with medical conditions and mental disorders often do not make the connection to their use of spice. It’s worth saying that prior to 2012 many, if not most, medical professionals often were not aware of the many side effects of synthetic cannabinoids. Most did not even know of the existence of synthetic cathinones and cannabinoids.
Victims exhibiting signs of drug use were given standard drug tests and rarely were tested for synthetic drugs. Even if they were tested for synthetics, the tests were unreliable, at best.
One of the reports indicates that medical professionals believed that the kidney damage may have been caused by the solvents used to make Spice.
It’s been reported that renal failure may be a result of use of the newest SC on the market. They fail to consider that medical professionals often did not even know of the existence of SC chemicals and tests were rarely used to even attempt to detect them in patients. Also, synthetic drug testing was unreliable, at best.
They also don’t consider that medical professionals may not have made the connection between the kidney damage and the drug because the causation hadn’t been reported yet. “Cases of acute coronary syndrome associated with synthetic marijuana use have been reported, but our publication is the first to associate use with acute kidney injury,” said Jain, “Tachycardia (rapid heart rate) and seizures have also been reported with synthetic cannabinoids.”
We’ve been reporting the link between kidney damage and synthetic cannabinoids (SC) for almost a year, after the first reports came out of Casper, Wyoming where three people were hospitalized with kidney failure and a dozen others were sickened from smoking Spice.
A few months later, authorities in Alabama reported 30 people hospitalized in as a result of renal damage after smoking SC. Investigators were quoted as saying that they were “working to find the tainted spice,” which spurred a phrase that many of us who fight this industry have used repeatedly thereafter: “The poison’s been poisoned!”
It is currently unknown how synthetic cannabinoids cause kidney damage. However, an analysis of synthetic marijuana samples smoked by the individuals in the CDC study who suffered kidney damage found that five samples contained a substance known as XLR-11, which has only recently been found in synthetic marijuana products.
XLR-11 was first identified (in SC products) by laboratories in 2012. We do not believe that XLR-11 has a monopoly on kidney damaging qualities. We believe that those included in the studies were only a fraction of the total number of kidney damaged victims.
Our logs are loaded with testimonials from people whose nightmares were never reported or were not reported to be attributed to SC. Young people historically do not confess to authorities about taking drugs. We receive reports almost daily from people that will give us testimonials, but admit to lying to law enforcement and medical professionals.
One young woman comes to mind who underwent a number of tests, including an MRI of the brain, after experiencing repeated seizures following ingestion of SC. She’s been treated for a year for her seizures and has been diagnosed with epilepsy.
In the CDC study, kidney function recovery was apparent within 3 days of creatinine peak in most patients. However, five of the 16 patients required hemodialysis, and four patients received corticosteroids; none died.
However, risk of long-term kidney disease continues for years. Recent studies suggest an increased risk for chronic renal disease following kidney injuriess, despite initial recovery (Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after kidney injury: a systemic review and meta-analysis. Kid Int 2012;81:442–8).
“Synthetic Marijuana Linked to Acute Kidney Injury” http://www.medscape.com/viewarticle/779161
“Kidney failure cases linked to synthetic drug” http://m.eastoregonian.com/mobile/news/local_news/kidney-failure-cases-linked-to-synthetic-drug/article_d4fc444c-2314-11e2-802a-001a4bcf887a.html