Rebecca Bradley worried about her 17-year-old daughter when she missed class and slept at odd hours, even more when her skin and hair starting looking different, less healthy.
Bradley knew the problem had evolved into something bigger than teenage rebellion the day she found her daughter in a strange house, smoking synthetic marijuana with some of her newfound friends.
Bradley drove her daughter straight to Medical University Hospital, where doctors admitted the high school senior to their Institute of Psychiatry.
Within months, South Carolina would join a growing number of states to outlaw the fake pot that so captured the attention of Bradley's daughter that her high school graduation this spring still hangs in the balance of her recovery.
Yet the South Carolina ban limited itself by listing just five ingredients.
"We all feel very safe," said Bradley, a health-care executive. "But it's fake."
After the new law was enacted, Bradley sent her son into convenience stores to buy the same stuff in different packaging that often flaunted its re-emergence. Labels depict young women in short skirts and midriffs under the branding "Barely Legal."
They describe the contents as potpourri or incense, some even noting that the herbs inside these $30-a-pop pouches are not for human consumption. Employees at stores that sell it say they can't talk about it as anything other than incense.
Bradley called police, local mayors and state lawmakers. She launched a Facebook page seeking a stiffer ban in South Carolina.
"I feel like, as a parent, I'm not alone," Bradley said. "I want to know if there are more people like me. We need to beef up this law and stop messing around."
'Blessing in disguise'
The October ban reclassified chemicals in synthetic marijuana as well as chemicals in so-called bath salts that users sniff to get high. The new designations, first enacted by the federal Drug Enforcement Administration and then enforced by the S.C. Department of Health and Environmental Control, put fake pot into the same group of drugs as heroin, cocaine and authentic marijuana.
Following the federal lead seemed the fastest way to get quick action, said S.C. Department of Health and Environmental Control spokesman Adam Myrick. But health regulators knew copycat brands that barely skirted the law would emerge quickly.
"We really expected that," Myrick said. "We knew that would happen, but we also knew ... that lawmakers have latitude to use more broad language."
Rep. Anne Thayer, an Anderson Republican, authored a bill last year to prohibit bath salts and synthetic marijuana. The session ended without any new law, but Thayer called the delay a blessing in disguise.
"Not for the lives that got held up," she said, "but we put together an amendment with 110 compounds on it."
The beefed-up bill received Senate approval last week and could become law this spring.
Sen. Larry Grooms, a Bonneau Republican, co-sponsored a similar bill on that side of the Statehouse. He said members of the Senate's Medical Affairs Committee were "shocked to find (state) authority was very limited when some ingredients were changed and names were changed.
"It just seemed inconceivable that you have a product as dangerous as what was out there that the state wouldn't regulate that," Grooms said. "This bill would seek to cure this."
South Carolina history
Two of the five compounds included in the original ban are JHW-018 and JHW-073, an alphabet soup that actually represents its South Carolina roots. The compounds are named for their creator, retired Clemson University researcher John W. Huffman.
Huffman developed the two compounds more than 15 years ago with funding from the National Institute on Drug Abuse to study how cannabinoids, such as the psychoactive compound in marijuana, interact with receptors in the brain.
He studied how cannabinoids could affect conditions such as osteoporosis, liver disease and some kinds of cancer.
"Their effects in humans have not been studied and they could very well have toxic effects," Huffman wrote in an email. "They absolutely should NOT be used as recreational drugs."
Huffman studied cannabinoids for more than 25 years until his retirement in 2010. He explained that the receptors exist, not to make people high, but to regulate appetite, nausea, mood, pain and inflammation.
His research wound up in scientific publications, where he believes the manufacturers of synthetic marijuana discovered the formula. Huffman now takes every opportunity to emphasize the risk of smoking the compounds that began in his lab.
"We simply don't know what the health effects might be," he wrote.
Risk of side effects
Viktoriya Magid, an assistant professor of psychiatry at the Medical University of South Carolina, knows some of the effects all too well. One of her patients in the Center for Drug and Alcohol Programs suffered a heart attack at age 17 from smoking too much synthetic marijuana, she said.
At least half the patients she sees between ages 13 and 17 have used synthetic marijuana, Magid said, and half of those patients then struggled to quit using synthetic marijuana -- or authentic marijuana as a substitute.
"Kids will smoke it, thinking it's like marijuana, but it's not," Magid said. "Not only is it much more addictive, but it carries much more serious consequences."
She said fake pot comes with a shorter half-life, so users need to smoke more frequently to continue to feel euphoric. And sometimes they don't feel euphoric at all.
Magid said patients often report experiencing a rapid heart rate and nausea or vomiting as their young bodies try to expel the chemicals. Synthetic pot seems to cause more hallucinations, paranoia and agitation than natural marijuana, she said.
Magid said the law passed in the fall made no difference in her practice. Patients tell her they continue to purchase the stuff just as easily online or in local stores under new names or slightly altered formulas.
"Since then, unfortunately, we don't see the consumption going down," Magid said.
Cheaper and legal
Herbal incense accounts for half of Tyler Dorman's business at The Up in Smoke Shop on Ashley River Road. Dorman said he spends about $6,000 a week just stocking his store with a variety of brands and flavors.
"I personally don't like herbal incense," he said. "But in this business, you're not going to be able to survive without it."
He said undercover investigators occasionally stop in his store, where customers can leave friendly messages in chalk on the black walls. Dorman said alcohol and tobacco present more dangers than anything he sells, including herbal incense.
"It's advertised that the way you're supposed to smoke it is to put it on a plate and burn it in an open room," Dorman said. "If people choose to smoke it, I don't have any control over that."
Dorman said his business only grew after the ban in October. He said his suppliers promise new formulas to respond to new laws and to keep his shelves stocked.
"If they change the law, the product will change too," Dorman said.
Two of his customers, women ages 19 and 22 who asked not to be identified, also wondered why lawmakers want to regulate synthetic marijuana. The 19-year-old said it calms her and focuses her for the day ahead, and her friend said she can smoke it and still pass drug screenings while she searches for a job.
Plus, they agreed, it's cheaper than the real thing. They pay about $30 for a five-gram pouch, $5 less than they would pay for marijuana on the street. And it's stronger, they said, so they don't have to smoke as frequently.
Neither has experienced any negative side effects that Magid described or that Rebecca Bradley saw in her daughter.
Bradley's daughter spent a week at Medical University Hospital's psychiatry unit before heading to a wilderness camp in Asheville last fall.
There she not only learned to live without synthetic marijuana but without makeup or a hair dryer or even a toilet. Relieved to return home, the teen began outpatient treatment and seemed on track for a full recovery.
Earlier this year, she relapsed.
Reach Allyson Bird at 937-5594 or Twitter.com/ allysonjbird.
Questions and Answers
Viktoriya Magid, an assistant professor of psychiatry at the Medical University of South Carolina, works with teenagers in the Center for Drug and Alcohol Programs and answers some basic questions about synthetic marijuana.What is synthetic marijuana? Smokable herbal blends, often marketed as incense or potpourri and primarily sold in packets at head shops and convenience stores for about $10 per gram. Common names include K2, Spice and Blaze.What are some warning signs? Mood swings, falling grades, a change in friends, secretive behavior and lack of money.Does it show up in a drug screening? Generally, no. A test at the Center for Drug and Alcohol Programs, however, specifically checks for compounds commonly found in synthetic marijuana.Why is the relapse rate so high? The brain essentially gets "hijacked" by the compounds and goes into hunger mode. The user stops making rational decisions while trying to fill the need.What treatments work? Teenagers sometimes begin with residential treatment, then graduate to an education program. Those patients who still struggle to quit can participate in outpatient programs as well.How can parents keep their kids from using synthetic marijuana? Don't be afraid to talk to kids, especially teens, when they are prone to experiment. A quicker intervention means a quicker recovery, especially if a parent can stop the problem before addiction sets in.