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Study links use of ‘spice’ to strokes


Less than a year ago, a high school student was checked into the emergency room at Tampa General Hospital (TGH) suffering from an acute stroke.

He was unable to speak, and the right side of his body was weak.

When young people come in with symptoms of a stroke, doctors at TGH’s Comprehensive Stroke Center usually have a different set of questions to ask.

Once the student was able to speak, Dr. Scott Burgin, a neurology professor at USF and director of TGH’s stroke center, asked him what he was doing before he had his stroke.

The student replied he had been smoking “spice,” a common name
for synthetic marijuana compounds.

“At the time, we kind of just filed it away thinking ‘Well, you have to be doing something right before you
have a stroke, right?’” Burgin said.

When another young stroke victim, a college-aged woman, came into the center suffering from a similar type of stroke, Burgin said
he thought he had seen her before.

He later realized he remembered the young woman because she had been visiting her younger brother a few months earlier when he had his stroke caused by “spice.”

The woman admitted to smoking the drug just hours before her stroke, and the results of a drug test showed she tested positive for JWH-018, a compound that mimics marijuana.

That’s when Burgin, along with USF neurology fellow Dr. Melissa Freeman, began studying the link between synthetic marijuana and strokes in young adults. The results of the study were recently published in Neurology, the journal of the American Academy of Neurology.

Burgin said “spice” has been sold in convenience stores for years as “potpourri” and “incense.”

The drug has been marketed as “K2,” “Kush,” “Mr. Smiley” and a number of other creative names.

The product consists of a number of marijuana-mimicking compounds and chemicals that are sprayed onto plant material and then rolled up in a joint to smoke.

Legislation to make the drug illegal on both a state and federal level has not deterred users, who can still buy the drug from wholesalers online.

As law enforcement continues to make new compounds illegal, what Burgin calls “closet chemists,” are in a constant game of cat-and-mouse making slight alterations to illegal compounds.

“There are thousands of these synthetic marijuana chemicals floating around out there, and right now there are only about six that are specifically banned by the government,” Burgin said. “It’s crazy to think that at one point, none of these things were illegal.”

This cat-and-mouse game also has serious effects on researchers, who are hindered from doing further research into “spice,” because of its relatively unknown chemical makeup.

“It’s a complete mess,” he said. “You can buy two shipments of the same product and not know what you are going to get from one product to the next. How do you know that two shipments with the same packaging even contain the same compound at the same strength and purity? You don’t.”

Burgin and Freeman said they believe the strokes suffered by the two individuals began in the heart.

Freeman said many users have reported symptoms similar to cardiac arrest when smoking “spice.”

“We don’t really know why these strokes happen, but it does look like other strokes we see where the clots form in the heart and then are pumped out to the brain,” she said.

Since publishing their case study, Freeman said she has heard of a few more cases in which stroke victims have admitted to using “spice” right before suffering from a stroke.

“I know that, from talking with other doctors, there have been other reports of ‘spice’ causing strokes,” Freeman said. “We are hopeful more research will be done to examine that link in the future.”

Burgin said he hoped their case study can dispel the myth that synthetic marijuana is a safer alternative to natural marijuana.

“There’s this belief that some of these synthetic drugs are a safe, legal alternative to marijuana, but that’s not the case,” he said. “You can look at the literature and say that no one has ever died from marijuana, but you can’t say the same thing for an unknown substance made in a lab some place by someone you don’t know, sprayed on some unknown clipping sold over the Internet. That is a far more nebulous situation that you just can’t take as a safer scenario.”