A version of this story was originally published in the Salt Lake Tribune and The Investigative Journalism Project as “The Cheap Drug Spice is on the Rise In Salt Lake City—and It’s Killing People.”

When David Shay began smoking spice, he believed he was choosing a safe, legal alternative to marijuana. “I wasn’t able to smoke marijuana because of drug tests at my job,” he says, “but this I could do.”

At first, it was a lot like pot. “I’d smoke it after work and in the evenings, things like that.”

But Shay’s afternoon delight quickly turned into permanent midnight. “It went from being pretty much like marijuana to, towards the end, more like PCP. It can put you into convulsions, instant blackouts, shakes.”

Shay became addicted. He lost his $70,000-a-year job, his home and vehicles, two rental properties and his family. He found himself sleeping behind strip malls, selling blood for money, bent on getting and using spice, until he was arrested and charged with domestic violence over a family argument.

He had to demonstrate his sanity to the court before seeing a judge. Spice had rendered him incompetent. “I was so whacked out,” he explains. “I had to be seen by a psychiatrist on a daily basis. Narcosis is what I was dealing with.”

After spending 60 days in jail, 30 of them in psychiatric care, Shay was released sober and sane, and he’s since led a productive life.

Others aren’t so fortunate.

In Salt Lake City’s Rio Grande area, spice is commonplace, although hard to spot. Users can be seen at times slumping on sidewalks or moping like zombies down dingy sidewalks after puffing tiny joints. Operation Rio Grande — the $67 million, multiagency effort to rid the area of illicit drugs — has produced mixed results. While law enforcement has stifled the open heroin and meth market, the use of spice, easier to conceal and harder to prosecute, has increased.

Salt Lake City Police Detective Greg Wilking confirms that spice use, once common in the suburbs, now seems to be concentrated in the Rio Grande neighborhood.

“If you’re just walking down there and you’re not really looking, or even if you’re looking,” he says, “you may not understand all that you’re seeing.”

Sgt. Chris Turley of Utah Department of Public Safety confirms this. “Spice has become prevalent,” he says, “because of how easy it is to conceal and how cheap it is to purchase.”

Addicts among the homeless use spice not as an alternative to marijuana, as was the case with its original growth in the United States, but as a cheap alternative to hard drugs. A dab of heroin or meth runs $10, while a spice joint can be had for as little as a buck.

Rise of Spice

Often called synthetic marijuana, spice is a smokable substance that consists of a mild plant base treated with chemicals. It is derived from synthetic compounds originally developed in pharmaceutical or university labs testing for medicinal value.

It first appeared as a consumer product in Europe in 2004, most popularly under the brand name Spice, hence the generic term today. Within five years, it was widely available across the United States: the legal synthetic version of marijuana, with no laws hindering production or distribution. It was cheap, and it didn’t show up on drug tests.

“That’s where it started,” explains Wilking, of the Salt Lake City Police Department. “People were having to go in for urine samples — for jobs or probation — and here was this product that was very much like marijuana, or supposed to be very much like marijuana, but that you wouldn’t test dirty for.”

Business boomed. Hundreds of brands emerged, bearing names like K2, Black Mamba, Mojo and Mr. Nice Guy, which were sold as “incense” in smoke shops and gas stations for as little as $5.

Across the country, this indiscriminate and unregulated combining of herbs and chemicals, purchased through dubious channels, led to ill effects and emergency-room visits. Users had no idea what they were getting or in what concentrations, and distributors had little clue what they were selling.

From Legal to Lethal

As spice gained prominence, a handful of states acted to ban it. In late 2010, as Utah officials were determining how to respond to spice, Lt. Mike Ross, head of the Salt Lake City Police narcotics unit, told The Salt Lake Tribune he worried that outlawing spice would lead to a black market. Not long afterward — in early 2011 — the state Legislature banned the drug.

The following year, President Barack Obama signed the Synthetic Drug Abuse Prevention Act into law, classifying several synthetic compounds commonly found in spice as Schedule I drugs, highly restricted as having severe abuse potential and safety concerns. Manufacturers and street chemists reacted by altering spice formulations to circumvent the new restrictions.

The quickly shifting recipes resulting from this “cat-and-mouse game between drugmakers and lawmakers,” as Shay describes it, created more than a law-enforcement problem.

“It goes back-and-forth and back-and-forth,” Shay says, “and as it does, the strength of the drug changes, and how it affects you changes.”

Dozens of analogs and derivatives have sprung up, their effects unknown — except that some of them are killing people.

“We do see deaths from these synthetic cannabinoids,” says Utah Chief Medical Examiner Erik Christensen.

How many is an open question. “We find them only when we test for them specifically, which means we have to have some suspicion based on the information available at the time a death is reported to us.”

The Utah Department of Health confirms positive findings of synthetic cannabinoids from four deaths in 2016, four in 2017 and one so far in 2018, though the department acknowledges that it only began regularly testing for synthetics this year, thanks to recent grant funding.

Prohibition

Criminalizing spice has done little to curtail its availability or use.

On Dec. 20, the Utah Poison Control Center warned the public of a product labeled “CBD E-Liquid.” The center had responded to several cases of users experiencing slurred speech, confusion and seizures. “These symptoms,” the center warned, “are not consistent with CBD oil” — the nonpsychoactive compound in marijuana believed to alleviate neuroinflammation, epilepsy, vomiting and nausea, anxiety, chronic pain, schizophrenia and other ailments.

Later tested, the purported CBD oil obtained from a smoke shop was found to contain synthetic cannabinoid analogs.

A debate over medical marijuana currently rages in Utah. The Legislature just passed a bill that grants terminally ill patients a “right to try” medicinal cannabis products. But citizens’ initiative that looks likely to make the November ballot would legalize medical marijuana for a much longer list of patients, including those seeking relief from chronic pain.

Gov. Gary Herbert, the Utah Medical Association and the Mormon church have expressed opposition, suggesting the initiative would lead to legalized recreational use of marijuana.

“This is interesting,” says Wilking, the detective, of the relationship between spice and marijuana, “because you have places across the United States that have more open laws about marijuana, right? Is spice even an issue in those places? Not so much, because it doesn’t take hold, because marijuana is more readily available, and people know what that is.”

It’s difficult to prosecute possession or distribution of spice. Only a handful of these synthetics are explicitly outlawed, so the dozens of derivatives must be prosecuted under the Federal Analogue Act.

“You can be prosecuted for having a compound that has the same basic shape or structure as a scheduled compound, but the trouble with that is it takes quite a bit of effort,” says Jay Henry, director of the state crime lab. “When the crime lab says a compound is an analog, then defense attorneys can bring in their experts to say, ‘No, it’s not an analog,’ and you’ve got to go through a lot more work.”

Today there are 177 known synthetic cannabinoids, only a small number of them explicitly illegal. Testing is expensive and time-consuming.

Utah Department of Health spokesman Tom Hudachko says medical examiners send spice out for testing only when there’s evidence to suspect it was involved in a death. Costs for these tests run from $150 to $500 — many times the expense of testing for traditional drugs.

Even if brick-and-mortar shops pull the product, the web offers a veritable silk road for spice, or herbal and liquid “incense.”

Wilking said rather than try complex and ambiguous cases, law enforcement has focused on cutting off supply. Under current law, officers can arrest a person in possession of what appears to be spice and seize the product. If it turns out the product is formulated with some new and unknown derivative that hinders prosecution, at least the product is off the streets.

Spice Is Not Marijuana

Consensus today is that synthetic cannabinoids are nothing like marijuana. Some of them are up to 800 times more powerful than pot. While the common description of spice as “synthetic marijuana” or “fake weed” has likely encouraged widespread experimentation, many regular marijuana users who’ve tried spice say they’ll never touch it again, reporting that it feels “chemical-like” and “crazy.”

Spice today often contains a cocktail of chemicals rather than any single compound. Henry, of the state crime lab, says samples of spice seized from the Rio Grande area have contained, among other things, fentanyl, a synthetic opioid at least 75 times more potent than morphine. Experienced heroin users with high tolerance to opiates often overdose from fentanyl-laced heroin. To the uninitiated, the narcotic almost guarantees a trip to the emergency room — or the morgue.

Reports out of Indiana and Alabama in recent years say cockroach spray is being used to concoct spice.

And, on April 5, the Centers for Disease Control and Prevention said that 94 people in Illinois and four other states had been hospitalized for “serious unexplained bleeding” after use of spice. People suffering the symptoms of coagulopathy — unexplained bruising and bleeding from the nose, gums or vomiting blood, unconsciousness and collapse — were successfully treated with plasma infusions and high doses of vitamin K, according to the CDC. The symptoms and treatment suggest these spice users had been exposed to brodifacoum, better known as rat poison.

In the Rio Grande area, officers routinely respond to spice overdoses.

“We see spice on a daily basis down in the shelter area,” says Turley, who has been part of Operation Rio Grande crackdown since it was launched in August. “I’d say it is probably the most widely used drug in the area right now. We have made it more difficult to get drugs like methamphetamine and heroin. … We see a lot less of that and more of the spice now.”

Operation Rio Grande has now moved from the enforcement phase to the treatment phase with a focus on increasing treatment beds. Yet worry lingers that spice will continue to plague homeless people in the area.

Spice addicts are recognizable by their zombielike state. They’re often slumped unconscious on sidewalks and against buildings. They can even black out and hunch into a nod while standing up, only to come out of it a few minutes later and look around as if they don’t know where they are. Or they can appear mad, yelling nonsensically into the night, arguing with themselves, twitching and tweaking.

“It’s such a break from reality when you’re doing it,” explains Shay. “I was doing things and saying things and believing things that were just plain crazy, absolutely nuts.”

One couple in the Rio Grande area agreed to an interview about their use of spice, but then couldn’t communicate coherently.

“It’s wonderful,” the woman cackled. “It tastes like strawberry, pineapple, peach — whatever I want!” Presumably, she was referring to the various flavors of spice. She took a drag from a hand-rolled spice joint and fell into a stupor.

The man with her said spice helped him quit drinking. Then he took a hit and went catatonic.