“The spice must flow” was the mantra underscoring David Lynch's 1984 movie Dune.

But here in Los Angeles, another kind of spice is flowing on downtown's Skid Row.

And it's sending people to hospitals.

Yesterday, 14 people in the area of 429 E. Fifth St. were hospitalized after they were possibly exposed to “an illicit substance or intoxicant,” according to Los Angeles Fire Department spokeswoman Margaret Stewart. Another four people were checked out at the scene, she said. On Friday, paramedics also treated 18 people for similar symptoms. And in April, 15 people in the area were taken to hospitals after they were exposed to drugs.

“We can't confirm it, but individuals at the scene said they ingested spice,” Los Angeles Police Department Officer Aareon Jefferson said of yesterday's events.

Dr. Marc Eckstein, the Los Angeles Fire Department's medical director, told reporters yesterday that spice on Skid Row was “becoming a public health crisis.”

The drug, also known as synthetic marijuana or K2, has been wreaking havoc on Skid Row for about three years, said Andy Bales, CEO of Union Rescue Mission. “Now it's a bigger issue because it's been tainted by some ingredient of some kind that's even more dangerous than it has been in the past,” he said.

It's not clear if dosage or a new formula is causing illness on the Row. “It’s incredibly potent, meaning it takes just a little bit to have an effect, and this can lead to problems with dose control,” Lewis S. Nelson, a medical toxicologist at NYU, told the Partnership for Drug-Free Kids last year.

Spice is rolled up in cigarette papers as joints, according to Bales. At $1 per piece, spice offers a cheap high. “It's the most affordable drug,” he said. 

Yet spice can produce horrific effects, from agitation and anxiety to hallucinations, psychosis and coma-like states. “I've seen people appearing to go nearly comatose,” Bales said.

“A guy we watched — as he withered away — would either be comatose leaning against the wall slobbering, or he would be violent,” he said. “He once saw me through a block window and punched it and broke it. They're unpredictable.”

Dr. Marc Futernick, medical director of the emergency department at California Hospital Medical Center downtown, said his staff has seen an increase in visits from people who appear to have taken spice. However, the patients his emergency room has seen were not in life-threatening situations. The effects “faded away” over time, he said.

“My understanding is they seem more high, more anxious, less coherent than you might see,” he said. 

Synthetic marijuana is not related to marijuana, although it is considered to be a “synthetic cannabinoid.” U.S. Drug Enforcement Administration spokesman Timothy J. Massino, basing his remarks on DEA documents, sent us this description:

“Spice” is a street name for any number of synthetic cannabinoids, which are man-made chemicals applied (often sprayed) onto plant material and marketed as a “legal” high. Synthetic cannabinoids are designed to mimic the biological effects of delta-9-tetrahydrocannabinol (THC).

The contents and effects of synthetic cannabinoids are unpredictable due to a constantly changing variety of chemicals (in attempt to bypass existing drug laws) used in manufacturing processes devoid of quality controls and government regulatory oversight. The chemicals are smuggled into the United States (usually from labs in Asia) often mislabeled as “industrial solvent,” “rust inhibitor” or “shampoo.” Once in the United States, the chemicals are typically mixed with plant materials such as the Damiana leaf (grown in Mexico, Central America and the West Indies) or Marshmallow leaf (a wild plant that grows in Europe, parts of Southwest Asia and in the Northeast and Midwestern United States and Canada).

The DEA has used the the Synthetic Drug Abuse Prevention Act of 2012 as well as “emergency scheduling” to prohibit 29 types of synthetic cannabinoids, Massino said.

Last year, the U.S. Centers for Disease Control reported that calls to poison control center reports about the drug increased 330 percent in four months. Fifteen deaths related to spice were reported in 2015, the CDC stated. “The increasing number of synthetic cannabinoid variants available, higher toxicity of new variants, and the potentially increased use as indicated by calls to poison centers (2–3) might suggest that synthetic cannabinoids pose an emerging public health threat,” it said.

But Bales has another solution. “What I feel needs to be done is[that the homeless] need a place to go off the street so they're not left in that brutal reality searching for escape,” he said. 

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