Previous K2 Spice/synthetic marijuana coverage in The Washington Post

In remarking Sunday on coverage of the synthetic marijuana products in The New York Times, I totally missed that a more detailed article appeared the day before in The Washington Post.
With contributions from Aaron C. Davis, the article by writer Michael W. Savage provided an insight into Spice use in Adams Morgan and around the District. The second page of the online article goes into much more detail than the NYT article by addressing the pros and cons of state approaches to outlaw the compounds and products.
Savage also included commentary by Marilyn Huestis, chief of chemistry and drug metabolism at the National Institute on Drug Abuse (NIDA), and focused in on a problem we discussed Sunday, namely, that the content of active components in the synthetic products and dosing with the pure compound(s) can vary wildly and account for reports of safe use vs. those of intense anxiety, cardiac disturbances, and seizures.
Savage quotes Dr. Huestis:

“These different, synthetic compounds are up to 100 times more potent than THC and have not been tested on humans,” she said. “When people take it, they don’t know how much they’re taking or what it is they’re taking.”

It’s a really nice overview and it won’t take you terribly long to read it.
As more states move toward regulating JWH-018, related compounds, and incense products that contain one or more of the compounds, we will be seeing more of these kinds of articles in the legacy media.
By the way, if you are looking for more science writing, check out Carl Zimmer’s fantastic article, How Microbes Defend and Define Us, in today’s NYT Science Times section on the microbes that live in our bodies and how “fecal transplants” have proven effective in treating infectious diseases – I kid you not.

Hallucinations and hospitalizations: Angel’s Trumpet

Toxicity reports are re-emerging in southern California this week after a dozen hospitalizations of kids using teas made from a fragrant flowering plant called Angel’s Trumpet. A tea made from the plants is used to produce hallucinations, but they can progress to extremely unpleasant experiences. Moreover, Angel’s Trumpet can be deadly, accelerating the heart rate and causing fatal cardiac rhythmic disturbances and bronchoconstriction that can trigger asthma attacks in sensitive individuals.
220px-Atropine.svg.pngAngel’s Trumpet is one of a series of plants in the Brugmansia genus that make a variety of muscarinic cholinergic antagonists such as atropine (dl-hyoscyamine, pictured to the right) and scopolamine (l-hyoscine). These compounds are also known chemically as tropane alkaloids or belladonna alkaloids, the latter derived from their classical isolation from Atropa belladonna. The belladonna name derives from the use of eye drops made from the plants that prevent constriction of the pupils (mydriasis), back when the size of a woman’s pupils was a sign of beauty and arousal.
The tropane alkaloids are ubiquitous in plants and fungi and act as classic hallucinogens when used in high doses. Their legend goes back to witches brews, which we discussed here, and beyond. A wonderfully colorful history of tropane alkaloids by Robert S. Holzman of Children’s Hospital and Harvard Medical School was offered in this free 1998 paper in the journal, Anesthesiology (1998; 89:241-249).
However, the aftermath of Angel’s Trumpet use isn’t all fun and games. In cases like these, I like to turn to the Erowid site, a respected, user-supported site that offers non-judgmental information on plant-derived and synthetic psychoactive agents. The Erowid Experience Vault has several descriptions of the use of Angel’s Trumpet but this one is the most detailed and representative of the downsides of this plant. (Note that the colloquial term for Angel’s Trumpet in Australia is sometimes “Tree Datura,” although Brugmansia is a closely-related but distinct genus from Datura within the Solanaceae family.)

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Agility of the community college system in preparing for BP oil spill landfall

FKCC.gifThe leadership team and all the staff here at Terra Sigillata world headquarters was taken aback yesterday when reports surfaced about the appearance of tar balls on the beach at Fort Zachary Taylor State Park and Bahia Honda State Park, the closest long beach to Key West, Florida. A Coast Guard marine laboratory in Connecticut is currently examining the content of the tar balls to determine if they are indeed from, as feared, the BP Deepwater Horizon well. (Someone in the field has to help me out here but I believe there are an awful lot of LC/tandem mass spectrometers at Florida’s institutions of higher education and research institutes.).
We have spoken previously of our education and research work with colleagues at the Key West Tropical Forest & Botanical Garden together with Duke University conservation biologist, Stuart Pimm. This area holds great personal and professional meaning for us here. The apparent spread of the oil spill not only means that the Gulf Coast from Louisiana to the west coast of Florida will be affected but that oil may begin to find its way up the Atlantic coast. Not that any place is more or less important or environmentally sensitive, but the long range effects of the spill may be coming to realization.
We keep a subscription to Key West’s The Citizen newspaper and I’ve been really impressed by how active the community has been in mobilizing for combating the spill. The maps and current profiles I see remind me of those we see when a hurricane is approaching. As such, Florida Keys Community College has launched today one of two planned, three-day training sessions for responding to volunteer to help mitigate damage from the spill. The $575 tuition also certifies one to meet OSHA requirements for Hazardous Material Technician.

24-Hour OSHA HAZWOPER (Hazardous Waste Operations and Emergency Response Standard) Technician Level Training:
Wednesday May 19 – Friday May 24
8:00a.m.-5:00p.m. at FKCC’s Key West campus
Cost: $575/person
Monday May 24 – Wednesday May 26
8:00a.m.-5:00p.m. at FKCC’s Key West campus
Cost: $575/person
Description: The 24-hour course is designed for persons who respond to a hazardous materials incident for the purpose of stopping, containing, controlling and cleaning up the release. This level of training is also appropriate for persons performing limited tasks at an uncontrolled hazardous waste site and who are unlikely to be exposed above permissible exposure limits. This training meets all OSHA requirements for the Hazardous Material Technician (29 CFR 1910.120).
Please note: Those who have received the 4-hour Marine Oil Spill Cleanup course will be dismissed at 12:00p.m. on the last day of class.
For more information or to register, contact FKCC Director of Continuing Education Cathy Torres at 305-809-3250.

Not written in the workshop description is the likelihood that such training would place one at the top of the list should federally-funded employment become available for cleanup efforts as happened following the Exxon Valdez spill in Prince William Sound in Alaska.
I applaud my colleagues across the Lower Keys and at Key West Community College for mobilizing so quickly and providing timely education to serve the community. We take our community colleges for granted sometimes, so I want to draw attention to one of the underappreciated functions of this facet of higher education.

What’s my poison? Pulitzer-prize winning journalist, author, professor Deborah Blum

The Poisoner's Handbook.pngThis is going to be a quick welcome to Deborah Blum (@deborahblum) who has just moved her blog, Speakeasy Science, to ScienceBlogs.
Why quick?
Because I am only 22 pages away from finishing her latest book, The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York. This engaging tale of the race of science and medicine against chemical poisonings for profit and punishment features the true story of NYC chief medical examiner Charles Norris and toxicologist Alexander Gettler. Of course, the other actors are arsenic, methanol, chloroform, thallium, and radium, among others. In the teens through the mid-1930s, long before benchtop atomic absorption spectrophotometry and LC/MS instruments, Norris and Gettler devised methods to detect poisons in human tissues with high sensitivity. These advances led to the prosecution of some, the absolution of the wrongly-accused, and revealed that our own government poisoned citizens who dared to challenge Prohibition.
Blum’s colorful biography accounts somewhat for her fixation with insects, chickens, monkeys, and chemistry, a discipline she pursued at Florida State University until setting her braid on fire and switching to journalism at the University of Georgia.
Blum won the 1992 Pulitzer Prize for beat reporting in a newspaper series that led to her book, The Monkey Wars, about the ethics and polarization of primate research. A couple of books (Sex on the Brain, Love at Goon Park, and Ghost Hunters) and a plethora of writing assignments since, Blum now holds an endowed chair at the University of Wisconsin and as the Helen Firstbrook Franklin Professor of Journalism.
But before I learned of her award-winning writing, I first came upon Deborah Blum as co-editor (with Mary Knudson and Robin Marantz Henig) of A Field Guide for Science Writers, the official guide of the National Association of Science Writers (NASW). The guide was recommended to me by Tom Linden, MD, when I joined the graduate advisory board of his medical journalism program at UNC-Chapel Hill in his attempt to give a scientist some background on the profession.
Regular readers know that I am a huge fan of the history of science and medicine, so you can probably understand why I can’t wait to get back to reading The Poisoner’s Handbook. I was also originally trained as a toxicologist and published one of my first papers on heavy metals effects in the kidney before I moved to the discipline that chemicals are best used for therapeutic benefit. Hence, I am honored to now be writing under the ScienceBlogs masthead with a wonderful writer who has been one of my inspirations and with whom I share several passions.
But while I offer I warm welcome to Deborah Blum, a part of me also wants to warn those in her real life not to leave their beverage unattended in her presence.

Indiana University student’s suicide due to hydrogen sulfide (H2S)

Down on the left sidebar you’ll see a little gizmo for SiteMeter, a service that measures one’s blog traffic and gives all sorts of tidbits about how readers got to the blog and a very general idea of where they are coming from. Most bloggers pay attention to the numbers of visitors but I have always been more interested in how readers get here and what posts they are reading.
Willoughby IU H2S suicide.jpgOne value of SiteMeter is to keep tabs on search terms that bring people here to learn of breaking stories. So, when I saw a bunch of hits starting yesterday with search terms like “hydrogen sulfide,” I feared the worst: that another young person had committed suicide by mixing household chemicals to release the toxic and potentially fatal gas and search engines were driving traffic to one of my earlier hydrogen sulfide posts.
Indeed, this story is more heartbreaking than usual (not that any suicide isn’t) because it was a highly-promising young man who was an academic standout in the sciences and a musician:

Gregory Willoughby was an academic standout at Warren Central before he began his study at IU. This community as well as the Bloomington campus is shocked to hear of his death as police continue to search for answers.
A junior at Indiana University, Gregory Willoughby was an accomplished academic and musician. A biochemistry major with minors in mathematics and psychology, Willoughby was a chemistry tutor who played the cello. [According to the IU student newspaper, Willoughby was co-principal chair in the All-Campus Orchestra in spring 2008.]
In 2007 he was named a Wells Scholar, one of the most competitive and prestigious awards offered at an American university.

The young man was found in his closet with a bucket of liquid, a sign on the door reading, “Warning H2S,” a common feature of recent cases of suicide by this method. As in this other case we wrote about, the victims seem to care more about the safety and welfare of others than that of themselves.
The account from the Indiana Daily Student leads me to believe that Mr. Willoughby lacked a support network. The medical examiner estimates that young man was dead for seven to ten days. Caitlin Johnston writes that few people in the Willkie dormitory actually know one another and it is described as “a closed off community for independent people.” So even if Willoughby had been experiencing suicidal thoughts that might have been evident in his behavior or language, it doesn’t seem that anyone would have known.
However, he is reported to have been a research assistant in the Cognitive Neuroimaging Laboratory in the Department of Psychological and Brain Sciences. Beyond no one there recognizing any warning signs, I’m surprised that his absence was not noted by anyone in the laboratory. Or by any of his professors in class.
But then again, suicidal signs are not always evident. Early in my career, a top student in my pharmacology class committed suicide with sedatives over a weekend. She had sat in the front row, right in front of the lectern, and her best friend said she had been to the opera with her the very night she overdosed without any indication that she was distraught.
I have yet to find any comments in any news stories to date that come from any friends or family. [Since writing this, a great many friends, family, lab co-workers, and fellow students have come forward to comment below and in subsequent coverage by the Indiana Daily Student. According to commenters below, reporters (with the exception of Caitlin Johnston at the student paper) were less than sensitive in seeking background information.]
This case makes me very, very sad.
Addendum April 15th: You will see in the comments below the outpouring of love for Gregory from people who knew him. One noted specifically that they chose not to respond to interview requests. I am grateful to those of you who have taken the time to express your sentiments and share your stories. You have my personal condolences on the tragic loss of this fine young man who you know and love.

Another hydrogen sulfide (H2S) suicide, with altruism

A year ago we wrote about a death of a San Jose teenager from poisoning by hydrogen sulfide gas, or H2S. At the time, I had hypothesized that the death might have been from an attempt at synthesizing methamphetamine gone awry.
But while one can mistakenly generate hydrogen sulfide gas from improper meth synthesis, I soon learned that intentional suicides with H2S is an increasing US trend imported from Japan. One can easily mix commonly-available consumer products to generate the gas and high enough concentrations can cause death. The gas acts in a manner similar to cyanide by binding to the heme in cytochrome c oxidase and inhibiting electron transport and ATP production by oxidative phosphorylation in the mitochondria. (Interestingly, small amounts of H2S are made in the body and is being investigated as a neurotransmitter and biological modulator.)
So deadly is hydrogen sulfide that it is considered a major occupational safety hazard for workers in municipal sewage services, industrial manure management on factory farms, and the growing aquaculture industry – the US National Oceanographic and Atmospheric administration provides detailed background and training videos here.
Now we can add first-responders like EMTs to that list. Pulitzer Prize-winning author Deborah Blum alerted me to an article in The Tampa Tribune about hazards to emergency personnel responding to “detergent suicide” attempts. (By the way, Blum just released her new book, “The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York,” and writes the beautifully-designed Speakeasy Science blog about culture and chemistry.)
This past Monday a 30-year-old Cary, NC, man committed suicide with hydrogen sulfide by mixing chemicals in a 5-gallon bucket inside his Toyota Camry. The gentleman was well-aware of the risk he posed to those who would find him there. As detailed in the WTVD-TV report embedded below, the man was found slumped over the wheel of his car in his apartment complex parking lot but had left warning signs on the dashboard and seats that read, “HAZMAT TEAM NEEDED” and “DO NOT OPEN!!! POISON GAS!!! Hydrogen sulfide.”

I went back and re-read The Tampa Tribune article and learned that the 23-year-old man who committed suicide similarly in St. Petersburg, FL, over Valentine’s Day weekend had also left similar warning notes in his car.
But in the event readers and emergency personnel see unconscious people inside parked vehicles without warning notes, be aware of the telltale smell of hydrogen sulfide: intense, rotten eggs. In the Cary case, authorities measure hydrogen sulfide gas in the car at three times the lethal concentration and a police officer responding in the St. Petersburg case had to be treated at the hospital after inhaling some of the gas.
I am deeply saddened by these stories because these people felt so badly about themselves so as to end their lives, yet they were compassionate enough to think about the welfare of those who would face risks finding them there.

Heavy metal-laden African morning sickness remedy now found in New York City

Just before Christmas, the US FDA issued a warning regarding a clay-based traditional West African remedy for morning sickness called Nzu or Calabar or Calabash clay. We discussed this topic here when the initial health warning came out from Texas.
The problem with the product is that it contains high levels of lead and arsenic that could be toxic to both fetus and mother.
And now the problem has expanded beyond Texas.
Scott Gavura at his excellent Science-Based Pharmacy blog tweeted earlier that the New York City Department of Health issued a similar warning today:

Calabash chalk.jpgFebruary 16, 2010 – A traditional morning sickness remedy, commonly known as calabash chalk, has been found to contain lead and arsenic, the Health Department warned today. The agency warns pregnant women not to use the product, which was recently found in local New York City stores selling African remedies. The Health Department was alerted to the potential hazard by the U.S. Food and Drug Administration. The chalk-like substance – also known as calabash clay, nzu, poto, calabar stone, mabele, argile or la craie – can be sold as large pellets or in blocks that resemble clay or mud. It is often packaged in clear plastic bags, with or without labeling. The remedy is used mainly by women from West African communities.

As shown above, the product looks like innocuous chalk. But the city is alerting both consumers and health care providers:

“Using calabash chalk is unhealthy for pregnant women and their unborn children,” said Nancy Clark, assistant commissioner for the Health Department’s Environmental Disease Prevention Bureau. “And the sale of these products is illegal.” Anyone who has used calabash chalk should call the Poison Control Center at 212-POISONS (764-7667). The Poison Control Center does not check immigration status, and its services are available in many languages. . .
. . .The Health Department is also alerting city healthcare providers about the use of calabash chalk. If you suspect you may have been poisoned, call the Poison Control Center at 212-POISONS (764-7667) or 212-VENENOS (836-3667) for Spanish speakers.

As we have quite a few readers in the New York City Tri-State area, please pass the word around, particularly if you work with colleagues who are from West African countries. “voluntarily” recalls 17 steroid-laden dietary supplements

It seems that bodybuilding supplement makers are challenging erectile dysfunction supplement makers to see who can recall the greatest number of products adulterated with undeclared, unapproved drugs.
In this case, an internet retailer of the following supplements has issued a voluntary recall of the following supplements sold between June 1, 2009 and November 17, 2009. The recall follows an FDA warning letter on detection of undeclared, synthetic anabolic steroids in these products:

  • Advanced Muscle Science Dienedrone, 60 caps
  • Advanced Muscle Science Liquidrone, 60 ml
  • Anabolic Formulation M1, 4AD, 60 caps
  • Anabolic Formulations 1, 4 AD, 60 caps
  • Anabolic Xtreme Hyperdrol X2
  • Anabolic Xtreme 3-AD, 90 caps
  • BCS Labs Testra-Flex, 90 caps
  • Competitive Edge Labs M-Drol, 90 Caps
  • Competitive Edge Labs P-Plex, 90 caps
  • Competitive Edge Labs X-Tren, 90 caps
  • 4Ever Fit D-Drol, 60 caps
  • Gaspari Novedex XT 60 Caps
  • Gaspari Halodrol Liquigels, 60 gels
  • iForce 1,4 AD BOLD 200, 60 Caps
  • iForce MethaDROL, 90 caps
  • iForce Dymethazine, 60 caps
  • Monster Caps, 60 caps

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Quick question for readers who conduct research with vertebrate animals.
We were gazing lovingly at the PharmBeagle this morning and got into a discussion that the beagle is on one of the primary model species for long-term toxicology studies required of drug companies by the US Food and Drug Administration.
Is there a comparative pharm/tox reason why do we not use squirrels, the arch enemy of the beagle?

Is Alexa Ray Joel’s “homeopathic overdose” possible?

Alexa Ray Joel, the daughter of Billy Joel and Christie Brinkley, was hospitalized Saturday with what I originally thought was an overdose of some type of sedative.
However, today’s Newsday and MTV are reporting that the family is calling this an overdose of a homeopathic medication called Traumeel. Traumeel is manufacturer by an Albuquerque-based company called Heel USA, a company founded by a German physician in the 1920s.
If Traumeel is truly homeopathic, there is absolutely no way this product could have caused Joel’s hospitalization.
If you are new to our blog, you may not know the different between herbal medicines and homeopathic remedies. Herbal folk remedies are actually the source of some commonly used pharmaceuticals. And like drugs, herbs have the potential to have a therapeutic effect in direct proportion to the dose given. The more herb, the more likely a benefit – or side effects – may be observed.
Homeopathic remedies, however, have nothing to do with herbal medicines. In fact, the basic principles underlying their use are diametrically opposed to everything we know about physics, chemistry, and biology. They are the remnants of a pseudoscientific practice developed in the 1800s whereby it was deemed that a substance which produces effects similar to an illness can be diluted out (or “potentized”) to create a remedy that might treat that illness. Hence, extremely dilute ipecac (which is used to induce vomiting) might be used homeopathically to treat disorders that involve vomiting.
The primary reason people get confused between herbal/botanical medicines and homeopathic remedies is that both are often derived from similar plant materials.
However, homeopathics differ in one critical respect: they are often so dilute that they contain not a single molecule of the original starting material. Homeopathic remedies are essentially water that is sold at even more exorbitant prices than bottled drinking water.
An excellent and approachable overview of homeopathy can be found in this 1996 article (free PDF) in the American Journal of Pharmaceutical Education by Dr W Steven Pray of Southwestern Oklahoma State University’s School of Pharmacy. I have used it for over 10 years in teaching students and educating the public.
So let’s look at the composition of Traumeel, purported for used as an anti-inflammatory agent for musculoskeletal injuries. Traumeel comes in several dosage forms, including one for injection, but let’s look at the tablets, especially since the New York Daily News reported reports a 911 call that Joel “had taken some pills”:

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