CDC Alert Synthetic Cannabinoid-(AKA-herbal incense-smoking blends, K2 & Spice) may contain Brodifacoum (rat poison)
The Centers for Disease Control has updated its warning that synthetic cannabinoids are being sold with brodifacoum a chemical used in rat poison, causing dangerous bleeding and death
- Brodifacoum is a chemical used in rat poison can cause uncontrolled bleeding and death
- Synthetic cannabinoids, also known as “herbal incense,” “herbal smoking blends,” “K2,” “Spice” and “Synthetic Marijuana,” is sold as an alternative to marijuana
- Since CDC warning-March 8, 324 people have presented to healthcare facilities with serious bleeding from possible exposure (CDC, 2018)
- Laboratory investigation confirmed brodifacoum exposure in at least 150 patients
There have been at least eight (8) fatalities (CDC, 2018) - Brodifacoum compounds depress the hepatic synthesis of vitamin K1-dependent clotting factors (II, VII, IX, X) by inhibiting the vitamin K1 2,3-reductase enzyme in the vitamin K1-epoxide cycle. /Anticoagulant rodenticides/ (Pubchem, 2018)
- In adults after intentional brodifacoum ingestion, the man plasma half-life was 30 days (range, 16 to 62 days) (Pubchem, 2018)
Autopsy findings in patients who died of complications from brodifacoum toxicity include,
- hemarthrosis
- pulmonary hemorrhages
- renal calyceal hemorrhages
- adrenocortical hemorrhage
- petechial hemorrhages
- subarachnoid, subdural, intraventricular, and intraparenchymal hemorrhages
diffuse hemorrhagic diathesis
Treatment
- Vitamin K1 continues to be the recommended therapy as per CDC-for clinical treatment information see,
https://emergency.cdc.gov/han/han00416.asp
Resources
CDC: Fake marijuana can contain chemical used in rat poison-Norwalk Reflector (2018) ://www.norwalkreflector.com/Government/2018/12/12/Public-warned-again-about-synthetic-cannabinoids
Update—Outbreak of Life-threatening Coagulopathy Associated with Synthetic Cannabinoids Use-CDC (2018) ://emergency.cdc.gov/han/han00416.asp
Brodifacoum-Pubchem Open Chemistry Database (2018) ://pubchem.ncbi.nlm.nih.gov/compound/brodifacoum#section=Absorption-Distribution-and-Excretion
Brodifacoum-Pubchem Open Chemistry Database (2018) html://pubchem.ncbi.nlm.nih.gov/compound/brodifacoum#section=Biological-Half-Life
