Synthetic cannabinoids contaminated with rat poison caused 174 cases and 5 deaths in Illinois | Research

The takeaway

A 2018 outbreak in Illinois linked synthetic cannabinoids contaminated with the rodenticide brodifacoum to 174 cases of severe bleeding disorder and 5 deaths.

Public health officials, emergency physicians, toxicologists, and drug policy makers.

174 cases, 5 deaths from rat poison-contaminated synthetic cannabinoids

What the researchers found

From March to July 2018, 174 confirmed and probable cases of severe coagulopathy (bleeding disorder) were identified among synthetic cannabinoid users in Illinois, including 5 deaths. Toxicology confirmed exposure to brodifacoum, a long-acting anticoagulant rodenticide. The outbreak required unprecedented coordination between public health and law enforcement.

Why it matters

This was one of the largest poisoning outbreaks from contaminated illicit substances in US history. It illustrates the extreme and unpredictable dangers of unregulated synthetic cannabinoids, which can contain any number of toxic adulterants.

The numbers in context

174 confirmed/probable cases; 5 deaths; March-July 2018; brodifacoum (long-acting anticoagulant rodenticide) identified as contaminant.

How the study worked

Public health outbreak investigation and response documenting 174 confirmed and probable cases of brodifacoum-contaminated synthetic cannabinoid exposure in Illinois, March-July 2018.

What this study cannot tell us

Outbreak investigation, not a designed study; actual number of exposed individuals likely higher than 174 documented cases; specific supply chain not fully mapped; retrospective identification of cases.

How to read the evidence

Strong: well-documented public health outbreak with toxicological confirmation and comprehensive case identification.

When this study was published

Published 2020.

The bigger picture

Synthetic cannabinoids are already more dangerous than cannabis due to their high potency, but contamination with industrial poisons adds an entirely different category of risk. This outbreak highlights why harm reduction experts advocate for regulated, tested cannabis products.

Questions still open

Was the contamination intentional or accidental? How can public health systems better prepare for outbreaks involving illicit substances?

Common questions

How were synthetic cannabinoids contaminated with rat poison?

The exact mechanism was not determined, but toxicology confirmed brodifacoum (a long-acting rodenticide) in patients who used synthetic cannabinoids. Whether contamination was intentional or accidental remains unclear.

Can you get rat poison from K2/Spice?

This 2018 Illinois outbreak proved it is possible. 174 people developed severe bleeding disorders and 5 died from synthetic cannabinoids contaminated with brodifacoum.

Read the original research

The Public Health Response to a Large Poisoning Outbreak Involving an Illicit Substance: Synthetic Cannabinoids Contaminated With a Long-Acting Anticoagulant Rodenticide, Illinois, March-July, 2018.

Journal of public health management and practice : JPHMP, 26(6), E1-E7

View on PubMed ↗Publisher’s paper ↗

Citation

Navon, Livia; Moritz, Erin; Austin, Connie; Wahl, Michael; Aks, Steven; Layden, Jennifer. (2020). The Public Health Response to a Large Poisoning Outbreak Involving an Illicit Substance: Synthetic Cannabinoids Contaminated With a Long-Acting Anticoagulant Rodenticide, Illinois, March-July, 2018.. Journal of public health management and practice : JPHMP, 26(6), E1-E7. https://doi.org/10.1097/PHH.0000000000001002