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Sales and use of Cloud 9, a synthetic drug gaining popularity in Metro Detroit, have led to several dozen hospitalizations in recent weeks. Most of those harmed are teenagers. It’s not a new problem, but a different version of an ongoing problem. These emergencies are preventable but require committed and cooperative action on several fronts.

Cloud 9 and Hookah Relax are the newest versions of synthetic cannabinoids created to mimic the effect of THC, the main active ingredient in marijuana. As a retail product, Cloud 9 is a clear liquid sold in vials and eyedropper bottles. Cloud 9 can be ingested using an e-cigarette, hookah, or by dropping it into marijuana or energy drinks.

Teens underestimate the risks of using synthetic drugs. They’re perceived as natural and relatively harmless, but are neither. Cloud 9 is a synthetic compound created by underground chemists. The disorderly production method of synthetic drugs means the actual content of a vial is uncertain and inconsistent.

As far as being “harmless,” physicians who’ve treated Cloud 9 users describe the consequences as both physical and psychological. These include racing pulse, difficulty breathing, high blood pressure, chest pains, hallucinations and psychotic episodes.

The frustrating part here is that these hospitalizations are the direct result of teenagers purchasing Cloud 9 at gas stations, convenience stores and smoke shops around Metro Detroit. Underground chemists make minor alterations to the formula and some store owners agree to retail the new versions of the products.

If it seems like we’ve been here before, it’s because we have. There’s a pattern. Synthetics first appeared on Michigan store shelves in 2008. Since that time, different variations have been shuffled in and out of the area. In 2012, sale of Spice, K2 and Bath Salts were implicated in a rash of hospitalizations and several local crime incidents.

That year, I worked with community coalition members to canvas local stores asking owners to pull K2 and Spice from the shelves. Many store owners responded positively, and some had proactively decided that synthetic drug products were too dangerous to sell. These exemplary retailers were genuinely concerned with the safety and health of local young people. Unfortunately, we also heard the response “it’s legal, so I sell it. What happens later is not my business.”

Customers can help by paying attention during visits to local party stores and gas stations. If you see a suspicious product, ask. Let retailers know you want them to stop sales of Cloud 9 and other synthetic drugs. Where possible, refuse to spend money in stores that won’t pull these drugs. Officials from Wayne and Macomb Counties have issued imminent danger orders banning Cloud 9. Customers who see suspicious products retailing in these counties can contact their health department for follow up. The Michigan Department of Community Health is considering a statewide ban which may occur at any time. These bans are helpful, but not foolproof, as new formulations are being created.

As with other drugs, parents should know about the hazards of Cloud 9 and warn teens against its use. Cloud 9 is particularly challenging for parents to detect. Parents should be alert for vials of clear liquid, which may be labeled or described as air freshener. A fact sheet issued by Macomb County public health officials is available online.

Community and retailer cooperation, aided by law enforcement and health officials, can protect young people, prevent health emergencies, and stop to Metro Detroit’s synthetic drug shuffle.

Margaret Farenger is a public health advocate and consultant working in southeast Michigan.

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