In Nigeria, they call it Black Mamba, and the papers report it's causing "convulsions, kidney failure and a ‘zombie-like’ state of intoxication that can lead to death." In Mumbai, kids are flocking to "Spice" because it doesn't show up in drug tests. Last week in Fort Wayne, Indiana, there were 20 overdoses in 24 hours attributed to a "bad batch" of Spice. The week before, there were 150 ODs – many requiring intensive care admission – in Lancaster County, Pennsylvania, where the director of emergency services speculated that "some bad K2 has hit the street."
No one knows whether Spice in Indiana contains the same things as Spice in Mumbai, or whether Black Mamba in Lagos is the same as the Black Mamba that killed a man in Birmingham. They're all just retail brands that have jumped the fence to become generic descriptors of a group of drugs.
In nearly all cases, these drugs entered their markets as mimics of cannabis in both a social and technical sense. But in the UK, last year's blanket ban on psychoactives is driving a move to new formats for "Spice" – including dipped cigarettes and sprayed rolling papers. Last month in Manchester, 10 people were taken to hospital after taking crystal billed as "pink champagne", a supposedly "particularly potent form of MDMA" – which turned out to be one or other cannabimimetic in its original crystal form.
What can be said, six days after the police and the Coroner's office sounded the alarm in New Zealand, is that it's a mess all over – but it didn't need to be such a mess here. Associate Health minister Peter Dunne revealed on Morning Report today that the government only knew about last week's warning – and its headline seven deaths – less than an hour before it was published. The Drug Foundation's Ross Bell says the Auckland DHB called him after the statement was published to see if he knew any more than they did.
Police messaging itself has been incoherent. We've gone from vague stuff in the original statement to a senior officer at the Avondale branch declaring: "Any drugs that we seize, we get them tested. What comes back are the technical aspects, which show things like fly spray and weed killer." And then, on Checkpoint yesterday, Acting Detective Inspector Peter Florence said that, contrast to reports, there is no evidence the product has been "spiked in any way – there's no other foreign substances in it":
Unfortunately, Florence immediately went on to declare that "synthetic cannabis" is "a drug in itself". No, it isn't. Fortunately, reporter Anusha Bradley also took the step of finding someone at ESR who could say something useful – and the upshot of that was some confirmation that that the chief suspect in the recent deaths and acute reactions is the cannabimimetic AMB-Fubinaca.
Like a number of the other cannabimimetics, AMB-Fubinaca was originally developed (and patented) as a potential painkiller by Pfizer. It's considerably more dangerous than the original JWH cannabimimetics banned in what now seem like the good old days, although it's related to AB-Fubinaca, which featured in a number of the products given interim approvals under the Psychoactive Substances Act. It's almost certainly made in China and sells online as powder for virtually nothing – maybe $2500 for a kilogram, which will probably break down in 15,000 doses. Suppose a dose is sold for $10 or $20, and do the math.
I was contacted yesterday by someone who said they had good information that "synthetic ketamine from China" was the problem chemical in synnies. That would be methoxetamine, or MXE, which has showed up here before in dance pills and as powder. It may now be being sprayed on herbs too, but the reported symptoms strongly indicate that the main problem is the cannabimimetics.
It's important for emergency medical staff to know these things, and unhelpful for them to have to deal with noise about fly spray and weedkiller. It was encouraging, therefore, to hear Dunne announce this morning that an "incident response team" involving police, DHBs and the Ministry of Health, is being established. Ideally, this would be the start of a proper early warning system to which everyone – including users – has access.
So maybe, just maybe, all this mess will do some good.