With a new school year about to begin, state health authorities are partnering with law enforcement, community health and substance abuse prevention agencies to warn parents and kids about the dangers of synthetic cannabinoids.
On Thursday, Gov. Maggie Hassan declared a state of emergency for New Hampshire after dozens of people in Manchester and several in Concord suffered adverse medical reactions after using products labeled "Smacked!" that were sold at city convenience stores.
Dr. Jose Montero, public health director at the Department of Health and Human Services, said those who are misusing these products, sometimes called Spice, are mostly young people. His agency will work with any and all partners to "alert the kids about the dangers and alert the parents," he said.
Dr. Elizabeth Talbot, deputy state epidemiologist, said "Smacked" causes "psychotropic intoxication." And that's what makes it dangerous.
"What we're hearing from our front-line providers is this product causes severe altered mental status and often seizures," she said.
Talbot said she's concerned that because the product is sometimes referred to as "synthetic marijuana," there may be a misperception that it's less dangerous than it really is. As public attitudes about marijuana use have changed, she fears that some may think "Spice" is safe and recreational.
"We don't know all the chemicals that are in these products," she said. "We don't understand what they are, we don't understand fully what their effects are yet, and we strongly discourage their use to the point we are willing to act under a health emergency."
Police in Manchester last week encountered users in public places who were incoherent, lethargic or unconscious.
Assistant Police Chief Nick Willard said one man was found in a city park on all fours, shoveling dirt and grass into his mouth. As officers were talking with him, he suddenly lurched forward and fell unconscious.
Spice is a mixture of herbs and spices that is typically sprayed with a synthetic compound chemically similar to THC, the active ingredient in marijuana, according to police. It is often packaged and sold as incense or potpourri.Montero said stores that are selling these products do so under the pretense that they are for legal uses. However, because the products contain a controlled substance, they are illegal, he said.
"And that is where we are exercising our public health authority," he said. "It shouldn't be out there so we have the right to remove it."
The emergency declaration triggered the health department's public health powers, authorizing the agency to "investigate, isolate or quarantine, and require the destruction of the commodity in question," according to the governor's office.
Nashua police last week announced they were actively checking all stores and would remove any "Smacked" product found.
In Manchester, the city clerk's office revoked the business licenses of three convenience stores that allegedly were selling the suspect products, blamed for nearly 50 adverse reactions. At least one store owner is challenging that closure in court.
Montero said his team has distributed information about symptoms and treatment to clinicians across the state. Health officials have been working with local and state police and the New Hampshire Information and Analysis Center to monitor whether other communities are experiencing these sorts of adverse medical reactions.
"And so far, as of now we have no reports of any other findings beyond what was already reported" in Manchester and Concord, Montero said.
Health authorities are also working with the Poison Control Center, both for advice about the poisoning component of the emergency and to find out if it has received reports from emergency rooms or individuals about adverse reactions.
Officials have contacted neighboring states to see if they're experiencing similar problems, he said. "So far, we have no data showing anything abnormal or unusual ...," Montero said.
One challenge in combatting synthetic drugs is that the products sold are constantly changing, Montero said. Even if all the "Smacked!" product is removed statewide, it's likely another version will appear in the future, he said.
"This is an ongoing battle."
Current state law bars the sale of a "controlled drug analog," defined as "a substance that has a chemical structure substantially similar to that of a controlled drug and that was specifically designed to produce an effect substantially similar to that of a controlled drug."
A bill last session that would have stricken the latter half of that definition was sent to interim study.
The Legislature did create a study committee to look into how to regulate and control synthetic drugs. That group will meet on Aug. 27.
Given what's going on, Montero said he hopes "all this new information will provide for that group better grounds to analyze these and come up with a proper piece of legislation that will prevent distribution of these types of products that are only hurting our people."