K2

18G

18G

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I wanted to inquire if anyone has had any first hand experience in dealing with patients who had smoked K2.

I had a call yesterday where the dispatch information enroute told us that the patient had just smoked K2 and was now experiencing cardiac issues. Once we arrived, the 17 yo female patient and her boyfriend informed me that she didn't just smoke it and that she smoked it last night before bed.

The story goes like this.... patient was sitting down holding her infant son, no recent S/S of illness, perfectly healthy. Sudden onset of chest palpitations, SOB, nausea, vomiting, dizziness, and a very unsteady gait. Skin is pale and boyfriend comments that patient is normally really tan. HR was 102, BP like 96/54 initially... subsequent BP's are like 1-teens /80s', no resp distress, lungs clear, SpO2: 100%(RA). Patient vomited x2 enroute, remained nauseated and dizzy. I was not the primary Medic and the charge Medic did not want a 12-lead performed, but the 3-lead just showed a sinus tach without any ectopy.

Pt. had no history other than relating a previous episode of chest palpitations in which she felt similar as today but not near as bad. Pt. stated that her "potassium was low" during the last presentation. So that was a little concerning but she nor the boyfriend were very good historians so it was difficult to paint a real clear picture.

So... after the call it bugged me because I did not have a good understanding of K2 and how it presented. And after doing some reading today it sounded like the patient fit the presentation of someone who had just smoked K2. I'm thinking we were fooled and that it was not GI related.

Information on K2 is very limited and I was not able to find a lot but what I did find fit the patient:

- Vomiting
- Nausea
- Tachycardia
- Pallor
- Rapid onset

The primary Medic had never even heard of K2. And from what I gather, even the chemists who created the active components states that its effect in humans is unknown as the compounds have never been studied in humans.

If anyone has any patient experiences to share or can point me to some good resources on K2 it is much appreciated.

Thanks!
 
http://www.deadiversion.usdoj.gov/drugs_concern/spice/index.html


These chemicals are known on the street as RC's, aka Research chems. There are a whole host of synthesized entheogens available. Once the DEA Schedules come out for these substances, new ones are created.

K2 is a chemical known as JWH-018 (1-Pentyl-3-(1-naphthoyl)indole). It is a synthetic cannabinoid, more information of JWH, HU-210, HU-211, and their homologues can be found at the following links.

http://www.deadiversion.usdoj.gov/drugs_concern/spice/spice_jwh018.pdf

http://www.erowid.org/experiences/subs/exp_JWH018.shtml

http://www.erowid.org/experiences/subs/exp_Products_Spice_and_Synthetic_Cannabinoids.shtml

http://www.mindfully.org/JWH/JWH-018/
 
The patient I dealt with that had smoked K2 was interesting to say the least.

She was a mid 50's lady who had gotten it from her grandkids of all things.

She came to ER with the following S/S:

Tachycardic-170's
Hypertension- 210/140
She was complaining of palpitations (imagine that, huh)

Her manner was very "happy", but very restless and talked non-stop.
We are seeing a lot of K2 in our area of the Midwest and more and more of the users are ending up in ER's.
 
K2 is one of those recreational drugs where you need to take it easy. My guess would be that a lot of people who are having issues with it are overdoing it. Given how easy and cheap the stuff can sometimes be to obtain, and a shorter and more intense high than marijuana, I keep thinking people are overdosing on it. Wouldn't know anecdotal comments here.
 
18G said:
K2 is one of those recreational drugs where you don't need to be doing it at all!
Click to expand...

Bah, that could be said of all recreational drugs. But good luck getting everyone to put down their tobacco products and bottles of alcohol.
 
18G said:
K2 is one of those recreational drugs where you don't need to be doing it at all!
Click to expand...

I'm going to assume that you don't use tobacco products, alcohol, or caffeinated beverages. After all, none of those are things people need to be doing either. Also, prohibition so worked in the 1920s, correct?

Edit: Can we get this thread moved to the lounge before it gets locked? :D
 
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JPINFV said:
Also, prohibition so worked in the 1920s, correct?
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The answer to that would depend on if you were consuming or supplying. :unsure:
 
JPINFV said:
I'm going to assume that you don't use tobacco products, alcohol, or caffeinated beverages. After all, none of those are things people need to be doing either. Also, prohibition so worked in the 1920s, correct?
Click to expand...

I'm not seeing the relevancy. K2 is unregulated and causes very adverse effects and has caused some deaths. The active chemical JWH-018, was never intended for human consumption.

So, yeah no need to be inhaling an unregulated, non-human intended substance into your lungs that is unsafe with any level of use. I guess meth is also okay to use in moderation.

I am really interested in detailed information about case reports and effects so don't want the thread to get hijacked.
 
Keep it on track, Gang, we ALL might learn something!

I'm interested in the longevity of effect. Here, K2 has been identified as having effects stronger but more shorter acting than marijuana/THC, YET there seems to be a physiological rebound-effect going on.

Any cases of long-term hospitalization or death? Cocaine, for example (and it's derivatives) has been known to precipitate MI's. How about this?
 
Edited... Just saw Firetender's post. I'll leave this line of conversation with this final thought. It's no more my right to prohibit what you put in your body in terms of recreational drugs than it is my right to tell you to drop the Frito Lays, alcohol, or tobacco.
 
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JPINFV said:
It's no more my right to prohibit what you put in your body in terms of recreational drugs than it is my right to tell you to drop the Frito Lays, alcohol, or tobacco.
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People will do what they will do, regardless and it is our jobs to pull them out if we can, regardless. Sometimes, our friends or colleagues will need what we learn here. Judgments one way or the other don't really help us do our jobs.
 
firetender said:
People will do what they will do, regardless and it is our jobs to pull them out if we can, regardless. Sometimes, our friends or colleagues will need what we learn here. Judgments one way or the other don't really help us do our jobs.
Click to expand...

However, there's a difference between personal judgment and professional judgment. Yes, as professionals in the medical field, we can't afford to judge our patients based on their actions. However, outside of a patient-provider relationship, there's the argument about prohibition, be it prohibition of various types drugs or things like alcohol. The conversation was definitely starting to move towards discussing the pros and cons of prohibition.
 
I smoked k2 a few times when it was still legal here, for learning purposes of course :ph34r:

The problem i found with it is that it takes a while for you to start feeling the effects. If you keep smoking it until you feel the effects, then its too late(this is what happened to me the last time i did it) In my experience i was pretty lethargic, nauseated, palpitations, mild dystaxia and blurred vision.

It was not a fun experience.
 
I have run across K2 several times in the past year or so, seems to be the drug of choice for those really underage. Hypertension, tachy, and a strong sense of fear is what I have seen. Several kids have been hospitalized for several days due to it. The bad thing is that cops can't do anything about it. Its not illegal....yet.
 
Just got off a run where the patient smoked "Skyscraper". Anyone have any experience with it? I've had plenty of patients on K2 and Spice and all seemed like a fairly typical "bad" high. This girl had severe nausea/vomiting, but what threw me was she was essentially unresponsive for the greater part of care. Haven't seen anyone affected by K2 like that. Thoughts? Stronger than K2, completely different, or she just have a bad reaction?
 
Skyscraper is totally different, it is a drug of the chemical class Piperazine, these are some particularly nasty chemicals. When I get off work, I will post a background of piperazines, their chemistry, pharmacodynamics, and kinetics.
 
medicRob said:
Skyscraper is totally different, it is a drug of the chemical class Piperazine, these are some particularly nasty chemicals. When I get off work, I will post a background of piperazines, their chemistry, pharmacodynamics, and kinetics.
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Thanks, look forward to reading it.
 
Wow, this is the first I've ever heard of K2, sounds like a pretty nasty drug. Thanks for bringing it up 18g, and I can't wait to read all the info on it Rob!
 
I have never heard of the "skyscraper" drug either so am also looking forward to reading info about that.

I had just found out that in PA, the House had passed a Bill banning K2 and its active components in March, 2011. The Bill is currently in the Senate awaiting a vote.
 
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