A sign outside a medical marijuana dispensary in Manitou Springs, Colo. Voters amended the state's constitution to legalize marijuana for recreational use in November 2012.


A sign outside a medical marijuana dispensary in Manitou Springs, Colo. Voters amended the state's constitution to legalize marijuana for recreational use in November 2012.



Eric Whitney
A sign outside a medical marijuana dispensary in Manitou Springs, Colo. Voters amended the state's constitution to legalize marijuana for recreational use in November 2012.


A sign outside a medical marijuana dispensary in Manitou Springs, Colo. Voters amended the state's constitution to legalize marijuana for recreational use in November 2012.


Eric Whitney


More than 150 people are now believed to have been sickened by synthetic marijuana in Colorado, which legalized recreational use of real pot last November. Three people may have died.


State and federal investigators are scrambling to identify the exact source of the illnesses. The state health department has named about a dozen illicit products, often sold as "incense," that it believes are responsible for at least some off the illnesses. The stuff goes by names like "Spice," "Crazy Clown" and "Dead Man Walking."


Real marijuana is widely available in Colorado. The state legalized pot for medical use in 2000, and hundreds of dispensaries statewide sell it to licensed patients, generally adults.


What's more, possession of pot for recreational use became legal after voters OK'd that change last November. Still, commercial sale of recreational marijuana remains illegal until licensed stores open after the first of the year. In the meantime, there continues to be a thriving black market for marijuana in Colorado.


Hospital emergency departments across the state are reporting victims coming in with "agitation and delirium, confusion," says Dr. Tista Ghosh, Colorado's acting chief medical officer. Some have acted very aggressively toward staff and required restraints. "We're also seeing unresponsiveness, extreme sleepiness, seizures." Several people have required treatment in intensive care units.


About 1 in 5 of those hospitalized in Colorado appeared to be teenagers. Forty-four percent were 20-29 years old, based on 58 cases investigators have reviewed.


"We're not exactly sure what molecule or chemical we're looking for," Ghosh says. "It's pretty rare to be able to do this kind of testing. There's not that many labs in the country that can do this."


On Monday a five-person team from the Centers for Disease Control and Prevention arrived in Denver to help with the investigation at the state health department's request.


Even determining the number of victims is difficult. Health officials first became aware of the suspected poisonings when a cluster of people with similar illnesses and who reported smoking synthetic pot began showing up in hospitals around Denver in late August.


The state health department then told health facilities to be on the lookout for people with similar symptoms, whether or not they admitted to using the drug, which is illegal. Investigators are also reviewing past patient records to see if other cases might have been missed.


The CDC says it's aware of clusters of similar illnesses in Georgia and Oregon but is not actively involved in investigating them. Recent media reports say synthetic marijuana is suspected in illnesses and at least one death in Alabama and Oklahoma.


A CDC investigation of a similar, but much smaller, rash of illnesses in Wyoming last year found that synthetic marijuana smokers suffered kidney damage as a result, with some requiring dialysis. Colorado officials say they're not seeing those kinds of problems in this outbreak, at least not yet.


"In [the Wyoming] investigation, they did find a novel compound that was being put into the synthetic marijuana," Ghosh says. "That makes this kind of investigation more challenging, because they are constantly changing the chemical compositions that are in synthetic marijuana."


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