A street drug made of various chemicals sprayed on tea leaves, grass clippings and other plant material continues to send thousands of people suffering from psychotic episodes and seizures to emergency rooms around the country.

In 2015, calls to poison control regarding the drug already have almost doubled, compared to last year’s total, and health professionals and lawmakers are struggling to keep up with the problem.

Some call the drug K2, or spice. It’s also widely known as “synthetic marijuana,” because the key chemicals in the spray are often man-made versions of cannabinoids, a family of psychoactive substances found in marijuana.

But the ingredients and concentrations used in this street drug vary widely, and it can be very different from marijuana in its effects.

At a drug rehabilitation center a short drive north of Syracuse University, where 52-year-old Edwin Santana has come for treatment, they call the drug “spike.”

Santana, who was born in the Bronx, is a few weeks into his detox program at Syracuse Behavioral Healthcare. A longtime heroin user, he became homeless after multiple run-ins with the law. Then, he says, a couple years ago he developed a problem with spike.

“It was getting out of hand,” Santana says. “I was starting to smoke every day. And you know, spike is a drug I respect, because you don’t know what you’re getting.”

The drug also inspires fear in him.

“Not a little bit of fear. A lot of fear,” he adds.

It’s hard to guess what will happen after you smoke or ingest spike, users and drug enforcement officials say, because the chemists who make it are constantly changing the main ingredients — tweaking a cannabinoid’s chemical structure, or mixing it with other substances entirely, which can change its effects.

“You get stuck when you’re on spike,” Santana says. “And it makes you do all kinds of crazy things, man. I’ve seen people roll around on the floor and stuff like that.” Smoking the drug landed him in the hospital.

Angel Stanley, a psychiatric nurse at the rehab center, ticks off the symptoms she’s seen in patients who have smoked spike: “Auditory hallucinations, visual hallucinations, disorganized thinking, delusional thinking. Paranoia is a big one.”

Many of these patients, she says, expected that smoking spike would be just like smoking regular pot, because the drug was sold as “synthetic marijuana.” The drug first became popular with teens, who were looking for a new way to get high for just a few dollars.

But now, Stanley says, she’s seeing older users, too.

“They’ve gone from using some marijuana in the past, a little bit of alcohol use over the years, and now all of a sudden, they’re in their 50s and they’re addicted to spike,” she says.

Often users are also homeless.

“A lot of people who use it, their reality is pretty bleak, so they use spike to escape that reality,” explains Matthew, who asked that we not use his last name. He just finished an inpatient program at Syracuse Behavioral Healthcare to help him stop using spike and cocaine, and doesn’t want future employers to find out about his past.

“The main thing with spike,” Matthew explains, “is this: It is the cheapest, most effective high in Syracuse right now. Is it the most enjoyable high? Probably not. But it’s the cheapest, hands down.”

The question facing workers at rehab centers and emergency rooms is how to effectively treat users of a drug that’s essentially an unknown mixture.

“We know how to treat an alcoholic,” says Jeremy Klemanski, who heads Syracuse Behavioral Healthcare. “We know how to treat an opiate patient. We know how to treat somebody’s who’s using cocaine. But, when we say we know how to treat somebody who is using synthetics — to a certain extent we do.”

Health professionals faced with such a patient are usually flying blind, Klemanski says. Some types of spike can be detected in drug tests, but not all.

“Until we get to a point where the treatment system has as sophisticated testing as the labs that are inventing and creating these things, we’ll struggle,” he says.

Lawmakers are paying attention. The federal government has permanently banned more than a dozen types of synthetic cannabinoids.

But packets of “spike” and “K2” and “spice” are still sold in many mom-and-pop convenience stores, because they contain versions of cannabinoids not covered by the ban, says Matt Strait of the Drug Enforcement Administration.

“They are in a legal grey area,” Strait explains, “because they’re not specifically named in the statute.”

That keeps makers and dealers of spike one step ahead of state and federal laws. Congress is weighing how to streamline the process of regulating new versions. Meanwhile, the Drug Enforcement Administration has been investigating and temporarily banning some new forms of the drug.

But back in Syracuse, some health professionals and spike users say the government can’t move fast enough to keep up with new varieties hitting the streets.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript :

AUDIE CORNISH, HOST:

A dangerous synthetic drug has been sending tens of thousands of people to emergency rooms across the country. It’s often made from tea leaves or grass clippings that are sprayed with man-made chemicals. It’s known as synthetic marijuana, K2 or spice, and so far this year, calls to poison control centers have almost doubled compared to those related to the drug last year. NPR’s Hansi Lo Wang reports health professionals and lawmakers are struggling to keep up.

HANSI LO WANG, BYLINE: At a drug rehabilitation center a short drive north of Syracuse University, they call synthetic marijuana spike.

EDWIN SANTANA: You got a muffin – English muffin – no? A Kaiser roll is good – no fruit, no fruit, no.

WANG: This is Edwin Santana lining up for breakfast. He’s 52, born in the Bronx and a few weeks into his detox program at Syracuse Behavioral Healthcare.

SANTANA: I can’t complain, you know? Compared to what I was eating out in the street, you know, I was out two or three days without eating.

WANG: Santana says he became homeless after multiple run-ins with the law because of his drug addictions. Heroin was his drug of choice for more than a decade. Then, a couple years ago, he added spike to his daily routine.

SANTANA: It was getting out of hand ’cause I was starting to smoke every day. And you know, spike is a drug I respect because you don’t know what you’re getting.

WANG: So when you say you respect the drug, it sounds like there’s a bit of fear in that.

SANTANA: Lot of fear, not a little bit of fear, a lot of fear.

WANG: Fear because it’s hard to predict what happens after you smoke or ingest spike. And its makers are constantly changing the drug’s chemical makeup. Santana says smoking it has landed him in the hospital.

SANTANA: You get stuck when you’re on spike. And makes you do all kind of crazy things. I’ve seen people roll around on the floor and stuff like that.

ANGEL STANLEY: Auditory hallucinations, visual hallucinations, disorganized thinking, delusional thinking, paranoia. That’s a big one.

WANG: Angel Stanley is a psychiatric nurse practitioner at the rehab center. She’s seen a lot of patients who thought spike would just be like regular pot because it’s called as so-called synthetic marijuana. It first became popular with teenagers looking for a new way to get high for a few dollars. Now Stanley says she’s seeing older users.

STANLEY: They’ve gone from using some marijuana in the past, a little bit of alcohol use over the years. And now, all of a sudden, they’re in their 50s, and now they’re addicted to spike.

WANG: And they’re often homeless.

MATTHEW: A lot of people who use it, their reality is pretty bleak. So they use spike to escape that reality.

WANG: This is Matthew. He just finished another inpatient program and Syracuse Behavioral Healthcare to stop using spike and cocaine. And he asked us not to use his last name because he’s looking for work, and doesn’t want future employers to find out about his past.

MATTHEW: The main thing with spike is this. It is the cheapest, most effective high in Syracuse right now. Is it the most enjoyable high – probably not, but it’s the cheapest, hands down, no question asked.

WANG: The question facing rehab centers and emergency rooms is how to treat spike users. Jeremy Klemanski, who heads Syracuse Behavioral Healthcare, says this is new territory.

JEREMY KLEMANSKI: We know how to treat an alcoholic. We know how to treat an opiate patient. We know how to treat somebody who’s using cocaine. But when we say we know how to treat somebody that’s using synthetics, to a certain extent we do, but we still don’t know which ones or what’s in those that they used.

WANG: That means health professionals are usually flying blind. It gets even more complicated when a patient is also on other drugs. Klemanski says that some types of spike can be detected in drug tests but not all.

KLEMANSKI: Until we get to a point where the treatment system has as sophisticated testing as the labs that are inventing and creating these things, we’ll struggle.

WANG: And lawmakers are paying attention.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED WOMAN #1: Listen up, New York.

UNIDENTIFIED MAN #1: There’s a new drug out there.

UNIDENTIFIED WOMAN #2: And it’s trying to destroy our generation.

UNIDENTIFIED MAN #2: It’s called…

WANG: New York state recently released this PSA, and the federal government has permanently banned more than a dozen types of synthetic cannabinoids, but packets of it are still still sold in many mom-and-pop shops because new strains are not covered by the ban, says Matt Strait of the Drug Enforcement Administration.

MATT STRAIT: Yeah. They are in a legal gray area essentially because they are not specifically named in the statute.

WANG: That keeps makers and dealers of spike one step ahead of the law. Congress is weighing how to streamline the process to regulate new versions of the drug. But back in Syracuse, some health professionals and spike users say the government can’t move fast enough to keep up with the new strains hitting the streets. Hansi Lo Wang, NPR News. Transcript provided by NPR, Copyright NPR.