A report from the Substance Abuse and Mental Health Services Administration’s Drug Abuse Warning Network found that in 2011, there were 28,531 emergency department visits involving a synthetic cannabinoid. That was 2.5 times higher than in 2010, said Michael Botticelli, deputy director of the Office of National Drug Control Policy, at the hearing.
From 2010 to 2011, the number of calls to poison control centers about synthetic cannabinoids jumped from 2,906 to 6,959, said Grassley, and calls about synthetic cathinones increased from 304 to 6,138.
After Congress passed the synthetic drug ban in 2012, however, those incidents began to drop. The ban passed as part of the Food and Drug Administration user fee reauthorization law. It added certain classes of synthetic drugs to those covered by the Controlled Substances Act.
“There is some evidence that that legislation had a positive effect. In 2012, calls to poison control centers on synthetic marijuana dropped to 5,205, and calls on bath salts dropped to 2,657,” Grassley said.
Now, however, traffickers and drug manufacturers have adapted to the ban, making small adjustments to the chemical structures of their products so they no longer qualify as a controlled substance.
“DEA is constantly behind the clandestine chemists and traffickers who quickly and easily replace newly controlled substances with new, non-controlled substances,” said Joseph Rannazzisi, deputy assistant administrator of the Drug Enforcement Administration’s Office of Diversion Control, in his hearing testimony.
Already this year, from January to August 2013, poison control centers received 1,821 calls regarding exposures to synthetic marijuana, he said.
Experts say that they often don’t know what exactly is in the substances, given the changes manufacturers make to stay ahead of the law and the variety of substances used in the drug-making process. Many of the substances were initially created as research tools, but have been modified for unregulated sale.
“The contents and effects of synthetic cannabinoids and cathinones are unpredictable due to a constantly changing variety of chemical compounds used in manufacturing processes that are devoid of quality controls and regulatory oversight,” Botticelli said in his testimony.
And because users often buy the unregulated substances in gas stations or over the Internet, there is no way for them to verify the actual contents of a packet.
“The user is unwittingly a guinea pig in an uncontrolled laboratory test, and the consequences can be deadly,” Rannassizi said.
Feinstein said that law enforcement told her staff that virtually all of the substances arrive in bulk from other countries. At the hearing, she also displayed photos of a synthetic drug lab to show that the products are not made in clean or sterile facilities.
Instead, she said, many of the substances are made secretly in warehouses and storage facilities, using tools such as cement mixers and hand-held pesticide sprayers.
Lawmakers have also expressed particular concern about how the products are marketed to, and frequently used by, teenagers and young adults.
A survey by the National Institute on Drug Abuse found that 11.3 percent of high-school seniors reported using the synthetic cannabinoid spice within the past year in 2012. That made it the second-most-abused illicit drug, following marijuana.
National Institute on Drug Abuse Director Nora Volkow found that 60 percent of people admitted to hospital emergency departments for spice use are between 12 and 20 years old. Synthetic cathinones are most popular with people ages 20 to 29, she added.