This morning New Yorkers awoke to news in the New York Times and New York Post that on Tuesday dozens of people in Bedford Stuyvesant, Brooklyn had severe reactions to a batch of K2, a commonly used name for synthetic cannabinoid products. This most recent outbreak follows a spate of emergency room admissions last summer centered on K2 use in East Harlem and unfortunately illustrate all too clearly the continued failure of our prohibitionist and punitive drug laws. The outbreak also serves as an important cautionary tale of basing policy on fear instead of facts.
Synthetic cannabinoids, work by acting on various cannabinoid receptors in the brain. However, their effects are different and often stronger than marijuana. Synthetic cannabinoids in their original form are powder or liquid chemicals, sometimes sprayed on herbal matter and sold in packages. One of the main risks of use of K2, as well as other novel psychoactive substances (NPS), is that very little is actually known about their composition or their effects on people who use them. Because the synthetic cannabinoid market is completely unregulated, people who use these substances never know what they are getting, and bad batches can easily flourish on the illicit market.
Last month, the Drug Policy Alliance, the New School for Social Research, and the John Jay College of Criminal Justice hosted New Strategies for Novel Psychoactive Substances, in an effort to bring some concrete facts to the conversation about how to respond to NPS. In the case of K2, researchers, service providers, and people who use K2 concurred that one of the primary factors driving the use of K2 is marijuana prohibition. Unlike marijuana, K2 cannot be routinely detected by drug tests, and people who use K2 often do so to avoid detection on drug tests that may be required by probation, parole, shelters, or drug treatment programs. Moreover, according the limited epidemiology available, the vast majority of those ending up in NYC hospitals from K2 use are people who are homeless, have a mental illness, or both. It’s no coincidence that use spikes in our most impoverished neighborhoods -- many people are using these drugs to cope with desperate social circumstances.
Given these motivations for using K2, it is perhaps not surprising that an effort to take K2 products off shelves has failed to solve the problem. Policymakers in New York responded to last year’s outbreak in East Harlem by criminalizing the sales of K2, failing to heed to call of advocates who suggested that this approach would only worsen the problem. While K2 may no longer be on bodega shelves, the ban has merely moved the problem to another part of the city, and such bans can lead to the proliferation of new, often riskier versions of K2 as illicit manufacturers create new chemicals that skirt the latest laws.
Prohibitionist policies are not the only problem. The media needs to take some of the blame here for exacerbating the stigma surrounding the people who use these drugs and fomenting fear rather than focusing on solutions. Headlines that sensationalize the problem and refer to people who use these drugs as “zombies” only serve to dehumanize a group of people who clearly need our help and compassion, not our scorn. This kind of stigmatizing language and the inciting of “drug scares” in the absence of real facts is part of a long, despicable history in this country of using drugs to promote racist attitudes and policies.
So what does work? First, we need to take a step back from the fear and the rhetoric and ground our responses in research and science. We need more research and more timely research on what these substances are, what effects they have, who is using them, and how and why people are using them. This kind of information can help guide the thoughtful responses we need at both at the individual and policy level.
At the New Strategies Summit last month, for example, clinical and harm reduction providers offered a number of suggestions for immediate responses to people, such as offering them a safe space to come down from the substances, while monitoring their health and ensuring their safety. Peer education and programs that allow those using these substances to check or test them to know what they are getting could also help avoid large-scale severe reactions like the kind we saw yesterday. Public health experts at the Summit also noted that we need to address the underlying social circumstances of those using these substances, including providing housing, medical services, and mental health care. Investments in a comprehensive harm reduction and public health response would be much more effective than stigma and criminalization.
Beyond responding to the immediate crisis, we need to take a broader look at our approach to drug policy writ large. The emergence of so many new “synthetic drugs” like K2 is yet another sign of the failure of the war on drugs. For instance, as the New York City Council Speaker has pointed out, one response to the emergence of synthetic cannabinoids ought to be revisiting our marijuana policies. K2 use would likely dramatically decrease if marijuana were legal and drug testing for marijuana was no longer used to penalize people.
Finally, it is time to acknowledge that prohibition does not work, and it never has. If we really want to improve the health and safety of our communities, we need look at system of regulation, not prohibition. Were we to enact a regulatory scheme, like that proposed in New Zealand, we could permit commercial sale of these substances but hold retailers accountable for products they sell, restricting access to vulnerable populations, like youth. We cannot afford to keep repeating the mistakes of the past. It’s time for thoughtful and innovative solutions based on science and compassion, not fear and stigma.
Julie Netherland, PhD, is the Director of the Office of Academic Engagement for the Drug Policy Alliance.