Pubdate: Sun, 04 Oct 2015
Source: Alaska Dispatch News (AK)
Copyright: 2015 Alaska Dispatch Publishing
Note: Anchorage Daily News until July '14
Author: Laurel Andrews


On a warm and sunny Wednesday afternoon in downtown Anchorage, two 
men leaned against the outside wall of Bean's Cafe. Their eyes were 
closed, mouths open, arms hanging limp. Their heads and torsos swayed 
side to side as employees gathered nearby. An ambulance was on the way.

"Once I see their eyes roll back in their heads, I always call 911," 
said Andre Boyd, a monitor at the nonprofit, who on Wednesday made 
the call that brought medics to the agency within minutes. The two 
men had smoked the synthetic drug Spice, Boyd said.

As the ambulance arrived, one man opened his eyes and with a startled 
look reached toward the other man, but he did not respond.

Medics wrapped one man in a sheet and laid him on a stretcher; the 
other was monitored for vital signs before medics led him to an ambulance.

"The people who walk away, they're the lucky ones," Bean's executive 
director Lisa Sauder said Wednesday as she watched what has become a 
familiar scene at the social services organization.

Since mid-summer, medical emergencies stemming from suspected use of 
the drug have increased drastically in Anchorage, and as winter 
approaches there seems to be little relief for the city.

 From July 18 to Sept. 27, suspected Spice use comprised 10 percent 
of all Anchorage Fire Department emergency transports, according to 
data provided by Erich Scheunemann, assistant chief of emergency 
medical service operations. Three-quarters of the calls came from downtown.

"Anecdotally, we see much more Spice now than meth and heroin 
combined," Scheunemann said.

Boyd said the 911 dispatchers recognize him by name; some recognize 
his phone number.

Facing an ongoing battle, the city is grasping for ways to combat the issue.

So far, police have had little power to stall the sale or use of the 
drug. Possessing and selling Spice is not a crime -- the $500 fine is 
a civil violation, akin to a traffic ticket, and no criminal charges 
can be filed unless police can prove criminal intent, a tricky endeavor.

That's because the chemical compounds in the drug are ever-changing; 
outlaw one compound and another is introduced. The state imposed a 
$500 fine for selling or possessing Spice last year, but the drug 
remains legal and easy to import.

On Friday, city officials hinted at solutions on the horizon that may 
beef up enforcement power, allowing police to make criminal charges 
around Spice. The city is also asking for help from federal authorities.

'It's been a long time since I've seen anything like this'

Since Spice cases exploded in mid-July, emergency calls fluctuate day 
by day. Calls peaked in early August, then again on Aug. 20, before 
settling down for much of September. But as the last weekend in 
September approached, the numbers shot back up again.

"It's been a long time since I've seen anything like this," said 
David Cadogan, emergency room physician and chief medical officer at 
Alaska Regional Hospital.

Symptoms manifest across a spectrum, Cadogan said. On one end, 
patients arrive heavily sedated and unresponsive. On the other end, 
patients are agitated and combative, Cadogan said.

Some days are worse than others. There may be a slow trickle of 
patients one day and a deluge the next. "One evening we had, I think, 
six patients within an hour," Cadogan said.

Many involve people Anchorage police call "high-risk" -- including 
the homeless and people with addictions. The homeless population has 
been hit disproportionately in this wave of emergency calls, Cadogan said.

Part of the reason is the cost. The drug sells for $5 to $10 a 
"stick," essentially a Spice cigarette, Boyd said.

Alaska is not alone in dealing with this issue. Nationwide, emergency 
calls related to the drug have topped 6,000 this year -- almost as 
many as the previous two years combined, according to the American 
Association of Poison Control Centers.

The state Department of Health and Social Services is attempting to 
analyze the problem, but had little new information on its 
investigations since asked in mid-August. Preliminary patient chart 
reviews have given way to "more methodical reviews." Preliminary 
autopsy tests have led to more testing, said state epidemiologist 
Louisa Castrodale.

For some patients, the ER is a revolving door. "We had two yesterday 
that came in with a mild intoxication ... they came back that same 
evening ... and were even more symptomatic," Cadogan said.

At Bean's, the continuing problem is diverting resources away from 
the agency's other focuses, Sauder said.

"It's really frustrating and it's heartbreaking," Sauder said.

Seeking solutions

Sauder hopes that changes to city law and investments in more 
treatment centers could help.

"I'd like to see some teeth to the law ... some more detox and 
treatment options. Because we kind of have a perfect storm," Sauder said.

Bean's isn't the only agency that's diverting its resources to combat 
Spice. At the Anchorage Police Department, two officers normally 
slated for patrol have been reassigned to work with undercover 
detectives on the issue, acting deputy chief of police Gary Gilliam 
said Wednesday. "It's enough of a public safety issue that we are 
diverting patrol services," he said.

On Wednesday, Anchorage Mayor Ethan Berkowitz said that a $5 million 
budget increase in funding to police and fire departments will help 
address the issue. The mayor's office has also hired a homelessness 
coordinator, Nancy Burke, who said in August that the Spice crisis is 
another reason to get homeless people into housing.

Meanwhile, the city is also looking to strengthen its own Spice 
ordinance -- perhaps making the sale and use a crime instead of a 
simple ticket.

What shape that may take is not yet finalized, but "other states have 
found a way to draft code that is broad enough to, they think, cover 
a wide variety of synthetics," city prosecutor Seneca Theno said. A 
similar ordinance in Alaska would give police more power to charge 
people criminally.

There's also a chance that existing Spice may fall under some 
criminal codes: Preliminary results suggest that a controlled 
substance has been found within Alaska Spice samples, Theno said. 
That would mean police would have much more power to attack the issue.

Anchorage is also hoping for help from the federal government. In 
late August, Theno reached out to the U.S. attorney's office. The 
feds may have more power to go after Spice criminally, as the federal 
controlled substances list is "a little longer and a little broader" 
than Alaska's, Theno said.

The prosecutors can also use other federal agencies, such as the DEA, 
the Postal Service, the FBI and the FDA, to tackle the problem, Theno 
said. It's not yet clear, though, whether the feds will intervene.

Meanwhile, emergency responders continue to combat Spice use as each 
case arises. "By end of the year we'll have a better idea if this is 
going to be the new norm or just ... a passing trend," Schuenemann said.

And at Bean's, Boyd said he, too, feels like a medic. "I worked on 
one and saved his life out here in middle of the street. And he died 
a week later," Boyd said, referring to one of the seven Bean's 
clients who died over the summer.

"A lot of them left (Spice) alone and they've been encouraging others 
to leave it alone," Boyd said of the clients. "But you've just got 
some that are hardheaded and won't do it."

Photojournalist Marc Lester contributed to this story.
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