Authored by: Dr. Michael Roach, Corporate Medical Director

In early March 2018, a deadly new problem has hit the area.  A rodenticide, Brodifacoum, has been added to synthetic marijuana in the Midwest.  So far, the outbreak has been linked to brands of synthetic marijuana known as Matrix and Blue Giant.  The majority of cases have been identified in Cook, Peoria, and Tazewell Counties in Illinois.  This mixture has resulted in 126 cases, including several deaths, and the number continues to rise.

Brodifacoum is a cumulative drug used in poisoning rodents.  This means as you ingest more of the drug, it gets stronger within your body.  The half-life of the drug is very long; 20 to 130 days.  It is very potent and is considered a second-generation anticoagulant or super coumadin.  The raw material must be handled with care due to its ability to absorb through the skin.

Signs of ingestion of this material include, but are not limited to, back pain, blood in urine or stool, bloody gums or nose, bruising easily, and coughing up blood.  If any of these symptoms are found without cause (remember, patients may not always disclose recreational drug use) or if you know the patient has used K2, spice, or synthetic marijuana and they display these symptoms, the person is to be taken to the emergency department immediately.

Treatment for overdosed patients is very difficult because the poison is slow to release from the body.  The patient must be started with an IV infusion of vitamin K followed by months of oral vitamin K taken four times daily.  There must be close monitoring with labs to follow.  In severe cases, blood, plasma, or clotting factors must be given.

When a person is incarcerated with spontaneous bleeding from the gums, nostrils, or has blood in their urine or in stool, it should be considered an emergency.  The patient should be sent to the emergency department and medical personnel should be notified.

Resources for this article include:

http://dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis/synthetic-cannabinoids

https://www.cdc.gov/nceh/hsb/chemicals/sc/

https://idph.iowa.gov/Portals/1/Publishing/Files/7/3d4dd310-685d-410f-b312-186715a61cf0.pdf?utm_medium=email&utm_source=govdelivery

http://pmep.cce.cornell.edu/profiles/rodent/rodent_A_L/brodifacoum/brodif_prf_0185.html

http://npic.orst.edu/factsheets/rodenticides.html

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All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis.