I was chatting with someone at a restaurant that we frequent about his tattoos. He has carbon rings tattooed along his arms, and I was interested in the story. Turns out, I got a lesson in drug use. He was more than happy to tell me about the new chemicals that are being used – some of which I’d never heard of, and some that I was shocked had any street value. Living in Colorado, I’ve seen the accidental marijuana ingestion causing symptoms. We had a stroke alert for “aphasia” for a woman who accidentally ate food with marijuana. I was glad that I didn’t give her tPA for her mutism, but I sure did think about it! I’ve also seen some people who use synthetic marijuana, which surprised me. Why would someone want to use a synthetic substance when marijuana is so easily obtained? Synthetic marijuana does not show up on drug tests, so work or parole consequences from use are avoided. The cost of synthetic marijuana can be less than the commercial preparations. Names like “Spice,” “K2,” and “Black Mamba” (among others) are given to products. People smoke the substance and have reactions similar to marijuana. Agitation, psychosis, and CNS depression are the most common clinical presentations. Elevated blood pressure and heart rate can occur.1 A little more than a year ago, a “zombie” outbreak happened in New York City, where 33 people smoked a synthetic …show more content…
However, the effect can be extended if it is taken with a MAOI; Ayahuasca is commonly used in combination with DMT. People describe out of body experience, depersonalization, hallucinations, and altered visual and auditory sensations. Some describe the experience as “life changing,” with insights from God or other magical beings.4 Patients present to emergency services due to hallucination, tachycardia, agitation, hypertension, and vomiting. A more rare complication is