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ST. LOUIS • Even after the drug K2 put Cassandra Clinton in a hospital for six days a few years back, she still fires up a joint once in a while.

“Now, I smoke a stick every now and then, but I need to quit,” said Clinton, 28, who is homeless in St. Louis but originally from Mexico, Mo. “I’ve seen some people do some off-the-wall things on it.”

Clinton, who hangs out at the New Life Evangelistic Center, a shelter downtown, has seen friends overdose in recent weeks while trying to get high on strains of synthetic drugs being sold cheaply on the street.

Almost 300 people, most of them homeless and stricken in the neighborhood around the downtown shelter, have been hospitalized since Nov. 7 from overdoses of synthetic versions of THC, the psychoactive ingredient in marijuana.

This month, police arrested six men for possession or distribution of a controlled substance. But prosecutors have yet to file charges. Two suspected dealers were seen on surveillance video making suspicious exchanges.

Synthetic cannabinoids, known as K2 or Spice, and cathinones, which are more commonly called bath salts, have been around for years. Bath salts mimic the effects of methamphetamine or cocaine.

Some of them are outlawed, but makers often tweak the formulas, using nuances of chemistry to argue that their products are legal. Law enforcement finds itself in a cat-and-mouse game.

Meanwhile, medical providers are struggling to treat victims who ingested unknown chemicals.

“It would be nice for the drugs to get off the streets,” Clinton said. “But at the same time, as soon as they outlaw it, (drugmakers are) going to come out with something else.”

K2 is the buzzword to describe hundreds of different synthetics sold in colorful packages with creative name brands. People on the street say a single joint may cost one or two dollars.

Potent, unknown chemicals

Officials say the synthetics circulating now are much different from those marketed legally as “fake pot” years ago. The new ones can be dramatically more potent and harmful than marijuana, in part because it is unclear what chemicals are in them.

“There have been deaths from these compounds, and there will continue to be deaths from these compounds,” said Dr. Anthony Scalzo, director of toxicology for St. Louis University and Cardinal Glennon Children’s Medical Center. “It’s like Russian roulette because you don’t know what’s in them.”

The Missouri Poison Center, at Cardinal Glennon, has tracked K2 cases since 2010. As of Monday, it had received 118 calls in November. That’s the highest one-month total this year, and more than double the 51 reports in all of last year. The annual count has not been so high since the center received 286 calls in 2011 and 149 in 2012.

The total for synthetic cathinones, or bath salts, is far lower: 21 so far this year.

Symptoms linked to synthetic drugs include rapid heartbeat, high blood pressure, anxiety and hallucinations, Scalzo said. There is no easy way to test for these drugs and no antidote. Doctors are left to treat the symptoms and wait for the drug to wear off.

The compounds are as diverse as their brand names, which include Scooby Snax, Green Giant, WTF, Mr. Happy, Stona Lisa and Yellow King Kong. The chemicals usually come from Chinese suppliers and are sprayed on dried shrubs grown domestically and packaged in the U.S. for sale, law enforcement officials say.

Franklin County sheriff’s Lt. Jason Grellner, president of the Missouri Narcotics Officers Association, said thousands of different substances are routinely sold in gas stations, corner stores and online as potpourri, incense, jewelry cleaner or even badger repellent, he said.

They are usually sold with a disclaimer printed on the packages that say “not for human consumption” to circumvent Food and Drug Administration rules. Until the substance is tested in a lab, it’s impossible to know what’s in it and whether it’s illegal.

“The biggest issue that we’re dealing with in St. Louis is that because these chemicals were never meant for human consumption, there are no blood or urine tests for these substances,” Grellner said, so “ ... we have absolutely no idea what chemical they’re being metabolized into.”

Prosecution is difficult

The testing process is time-consuming. It can take months for the Drug Enforcement Administration to prove a drug is harmful and being widely consumed before it can be added to the list of banned substances.

“It can take several months,” said Scott Collier, diversion program manager for the DEA’s St. Louis division. “The barn door is already open we’re usually chasing the animals.”

Another problem with tackling synthetic drugs is that prosecutors are reluctant to file charges because lab tests may not be entirely clear on whether the chemical makeup is illegal, Grellner said.

“We need prosecutors and scientists to get together and agree on the language of the law,” Grellner said.

Ed Postawko, chief warrant officer for the St. Louis circuit attorney’s office, said few cases have made it to court in recent years.

“In large part, we have to rely on what the lab says,” Postawko said. “If the chemist isn’t sure, how can we be? That’s the thing — you make something illegal, then (drugmakers) change the chemical compound into something that’s not illegal. Laws don’t get changed overnight.”

Chris Perry, 35, who is homeless, said he has seen some people have bad reactions but thinks the fears are overblown.

“I don’t think it’s that bad,” Perry said. “I zombied out once. You build up a tolerance to it. They’re making a big deal out of it because it’s the homeless, and they’re trying to clear us out. They want us out of downtown.” He said an overdose “is the last thing I’m worried about.”

Some people on probation for crimes choose synthetic drugs instead of marijuana, heroin or cocaine to avoid failing drug tests, said Bryan Goodlow, 28, who is homeless and on probation. He knows smoking K2 can be risky but said he does it anyway, despite seeing others overdose in recent weeks.

“I’m going to die one day, anyway,” Goodlow said. “I just like getting high. That K2 is a mind trip. It pulls demons. If you don’t know what you’re getting into, if you’re in some pain, then don’t do it because when you hit that, your brain runs 100 miles an hour.”