D.C. officials are trying to better understand the use and prevalence of synthetic drugs with newly required medical sampling at local hospitals.

On July 10, the District Department of Health adopted emergency regulations as part of a “surveillance program” for collecting data on synthetic cannabinoids such as K2, Spice, Bizarro, and ScoobySnax. The regulations, made public this past Friday in the D.C. Register, require area hospitals to collect urine samples from patients “with signs and symptoms of [synthetic-drug] overdose” after they’ve arrived at the emergency room. The regulations also recommend that clinicians take blood samples from these patients, though they are not required. Hospitals must then send collected samples to the Office of the Chief Medical Examiner for testing.

“This emergency rulemaking action is necessary for the Department to immediately improve tracking the upward spike in the use of the illegal synthetic cannabinoid products,” a DOH notice reads. “Enactment of these regulations will immediately allow the Department to better determine the level of use of synthetic marijuana in the District and to determine the locations where use is especially prevalent, in order to better protect the health, welfare and safety of residents of and visitors to the District.”

Asked why only urine samples are required by the regulations, DOH Director LaQuandra Nesbitt says in a statement that hospitals may not routinely draw blood from emergency room patients because doing so can pose safety risks, especially for uncooperative patients under the influence of drugs. In many cases, it is safer to collect a urine sample than a blood sample. Urine and blood samples test for different aspects of synthetic drugs, she adds.

“As synthetic drug testing has been implemented in recent weeks, we are still awaiting initial results [of the surveillance program],” Nesbitt says.

The D.C. Fire and EMS department has recorded several hundred synthetic-drug cases over the past two months. In June alone, the department saw 439 cases, representing a dramatic uptick in incidence: Until May 2014, when there were 50 synthetic-cannabinoid-related hospitalizations, there had been fewer than 30 such cases a month. Health officials say the drugs are particularly dangerous to users and others because they can cause violent behavior, seizures, and self-harm.

Similarly, the DOH regulation notes the drugs have “a more powerful and unpredictable effect” than normal marijuana; they can lead to vomiting, hallucinations, raised blood pressure, and pale skin.

The DOH regulations specify that hospitals are not responsible for “testing sample[s] or advising patient[s] of the results of [drug] test[s].” Moreover, OCME is expected to scrub the samples of any “individually identifying information” (including name, date of birth, race and gender, and even the sampling hospital’s ID), because DOH will use them “solely for surveillance purposes.”

The emergency regulations will remain in effect until Nov. 7—120 days after they were adopted—or until they are amended or repealed.

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