“Spice” Linked to Stroke

strokeAccording to the American Stroke Association, “ischemic stroke occurs as the result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases.”[1] This type of stroke is also associated with the recreation street drug “spice, ” according to a team of neurologists from the University of South Florida (USF).[2]

USF researchers have released a new report that discusses the cases of two young, and previously healthy, siblings, aged 19 and 26, who experienced acute ischemic stroke shortly after smoking spice.2 Imaging found that the strokes were caused by an embolism, or the lodging of an embolus—blood clot, fat globule, or gas bubble—in the bloodstream, causing a blockage.2 Neither sibling were genetically predisposed to developing blood clots.2

USF Vascular Neurology Fellow, Melissa J. Freeman, M.D., said “We are proposing that perhaps it is a cardioembolic etiology, because smoking the synthetic marijuana spice has been associated in the medical literature with myocardial infarction and seizures. If people are having heart attacks from it, perhaps there is a cardiac reason for the strokes.”2

Common side effects of smoking spice are tachycardia, vomiting, agitation, confusion, and hallucinations; however, national news media have also reported many spice-associated deaths within the past several months.2

Sibling A, a 26-year-old male, was brought to the emergency room with sudden-onset dysarthria—the difficulty of using or controlling the muscles of the mouth, tongue, larynx, or vocal cords—with expressive aphasia—knowing what you want to say, but having difficulty saying or writing what you mean.2 Sibling A also had weakness in his right face and arm. He was found to have a clot in his left, middle cerebral artery.2

Sibling B, a 19-year-old female, was brought to the emergency room on a separate occasion, where they found a large clot in her left, middle cerebral artery, as well.2 Both siblings had tested positive for regular cannabis use, and admitted to smoking spice shortly prior to the onset of their stroke symptoms.2 They had obtained the spice from the same supplier.2 In that batch of spice, the active chemical ingredient was JWH-018; however, different compounds are constantly being developed, making spice harder to regulate and more dangerous for users.2

Synthetic cannabinoids have several times the potency of THC, the active ingredient in natural marijuana, and there have been 59 reported cases of marijuana-related, not spice-related, strokes in the medical literature.2

John C. M. Brust, of the New York Neurological Institute and Columbia University College of Physicians and Surgeons, said, “If marijuana can cause ischemic stroke, and if anything pot can do, spice can do better, neurologists will likely encounter increasing numbers of spice-associated strokes in the years ahead.”2

Therefore, Brust encourages doctors who treat stroke patients who are not within the usual age range of those normally considered at risk of stroke to ask if they have smoked spice recently.2 Freeman agrees.2

“I think it should be reported because we won’t be able to figure anything more out unless we have more information,” said Freeman.2

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