man holds a K2 cigarette
Enlarge / A man holds a K2 cigarette in an area that previously witnessed an explosion in the use of synthetic marijuana, in East Harlem on August 31, 2015, in New York City.

The Centers for Disease Control and Prevention published a report just hours before President Biden unveiled a major effort to reform federal marijuana laws.

The report documented a mass poisoning from alternative marijuana products tainted with rat poison. The event—which severely sickened 52, killing four—isn't the first or even the largest of such poisonings. In 2018, rat poison-laced fake products sickened nearly 200 in a multi-state rash of poisonings that also left four dead.

Health officials in Florida began to notice the cases in December of last year. They linked the illnesses to synthetic cannabinoids based on the outbreak of the year.

Synthetic cannabinoid products are often sold in small foil packages containing shredded plant material that has been sprayed with lab-made, mind- altering chemicals meant to mimic components of marijuana. Sometimes they're sold as liquid. The products are poorly regulated and can contain an ever changing lineup of substances. They're often marketed as safe, natural, and legal alternatives to marijuana, but they're not.

Products containing brodifacoum, a rat poison, are particularly dangerous because of the questionable nature of synthetic cannabinoids. The active ingredient in rat bait used to be Brodifacoum. The toxic chemical blocks the activity of a specificidase. This results in an increase in an inactive form of vitamins K and K2. Prothrombin is a clotting factor that is dependent on vitamins K and C.

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Potent hit

Bleeding can be caused by ingestion of brodifacoum. It takes months to treat poisonings because it is a long-acting drug. Researchers have observed Brodifacoum staying in the body for up to 270 days after exposure.

Most of the symptoms of the poisonings in Florida were abdominal pain, pee blood, and vomiting blood, according to the new report. It wasn't easy to treat. The authors noted that many patients needed high doses of oral vitamins K1 and needed to take 30 tablets a day for 3 months after discharge.

The cost to treat them was also high. The K1 treatments can cost as much as $65k a month. The cost to test for brodifacoum poisoning is more than $750. Two-thirds of the patients were uninsured and a private pharmaceutical company donated enough vitamins to treat all 52 patients.

Researchers speculated that brodifacoum could prolong or enhance the effects of synthetic cannabinoids, but officials don't know for certain. Marijuana and cocaine have been tainting by Brodifacoum.

Advocates for drug policy reform have called for legalized and regulated marijuana because of the poisonings. According to the National Organization for the Reform of Marijuana Laws, 37 states and the District of Columbia have medical marijuana laws. There are 19 states and the District of Columbia that allow some recreational use.

The president issued mass pardons for federal simple possession offenses on Thursday. He ordered federal officials to review the status of marijuana as a "Schedule 1 drug", which is used for the most dangerous drugs.