6148944 Health, Department of - Notice of Second Emergency Rulemaking - Extension of time period of testing for synthetic cannabinoids

DEPARTMENT OF HEALTH

 

NOTICE OF SECOND EMERGENCY RULEMAKING

 

The Director of the Department of Health (“DOH”), pursuant to the authority set forth in Section 5(a) of the Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983 (“Act”), effective February 24, 1984 (D.C. Law 5-48; D.C. Official Code § 44-504(a) (2016 Supp.)), and in accordance with Mayor's Order 98-137, dated August 20, 1998, hereby gives notice of the adoption, on an emergency basis, of an amendment to Section 2039 of Chapter 20 (Hospitals) of Title 22 (Health), Subtitle B (Public Health and Medicine), of the District of Columbia Municipal Regulations (“DCMR”).

 

This rulemaking is identical to the Notice of Emergency and Proposed Rulemaking adopted on an emergency basis on March 29, 2016 and will be published in the D.C. Register on August5, 2016.

 

This second emergency rulemaking action is necessary as the proposed regulations were not timely submitted to the Council of the District of Columbia, as required by D.C. Official Code § 44-504(j), and the Council of the District of Columbia will be on its summer recess from July 15, 2016 through September 15, 2016.  The identical emergency regulations adopted on March 29, 2016 expired on July 26, 2016.   

 

This emergency rulemaking changes the expiration date from March 31, 2016 to August 31, 2016 for the Testing for Synthetic Cannabinoid Surveillance regulations. Under the regulations, (1) hospitals are required to collect urine samples from patients who present and have symptoms consistent with having taken a synthetic cannabinoid; (2) it is recommended that hospitals collect blood samples from patients who present and have symptoms consistent with having taken a synthetic cannabinoid; (3) hospitals are required to store urine and blood samples in accordance with protocols provided by the Department of Health; and, (4) hospitals are required to turn over the urine and blood samples for testing by the Office of the Chief Medical Examiner.

 

This emergency rulemaking action is necessary for the Department to continue tracking the use of the illegal synthetic cannabinoid products commonly known as K-2, Spice, ScoobySnax, Bizarro, Synthetic Marijuana, and other names, which are readily available in the District.  K-2 is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to tetrahydrocannabinol, the psychoactive ingredient in marijuana, but with the potential for a much more powerful and unpredictable effect.  The Partnership for Drug-Free Kids lists the effects of using K-2 as increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled/spastic body movements, elevated blood pressure, elevated heart rate, and palpitations.  The National Institute on Drug Abuse reports that Spice abusers who have been taken to Poison Control Centers report symptoms that include rapid heart rate, vomiting, agitation, confusion, and hallucinations.  Spice can also raise blood pressure and cause reduced blood supply to the heart (myocardial ischemia), and in a few cases it has been associated with heart attacks.

 

Regular users of synthetic cannabinoids may experience withdrawal and addiction symptoms and often graduate to other, more powerful substances, such as MDMA (3, 4-methylenedioxy-methamphetamine), popularly known as Ecstasy or, more recently, as Molly, with potentially deadly consequences.  Multiple incidents linked to use of a synthetic cannabinoids have been reported the District.  The District needs to continue to determine the level of synthetic marijuana usage in the District and how to best educate the community of the inherent dangers of synthetic marijuana and implement appropriate measures to treat those who have become habitual users.  Enactment of this amendment will immediately allow the Department to continue to better determine the level of use of synthetic marijuana in the District and to determine the locations where use is especially prevalent, in order to better protect the health, welfare and safety of residents of and visitors to the District. 

 

The District experienced an upward spike in the unconfirmed use of illegal synthetic cannabinoids last summer for which the Testing for Synthetic Cannabinoid Surveillance regulations were promulgated.  Having the Testing for Synthetic Cannabinoid Surveillance regulations continue until August 31, 2016 will allow the Department to confirm whether an upward spike occurs in this summer. 

 

DOH intends for the testing of the urine samples and the blood samples to be conducted by the Office of the Chief Medical Examiner (“OCME”) or its contractor.  Because this is only a surveillance program, DOH does not want to receive any individually identifying information.  For this reason, it is intended that the OCME will, upon receipt of the samples from the hospitals, assign a unique identifier to each sample to remove individually identifying information from test results that are shared with DOH.  Therefore, under this surveillance program, DOH will not have access to any individually identifying information for the tested samples and will only receive de-identified information, which DOH will use solely for surveillance purposes.  

 

This emergency rulemaking was adopted on July 26, 2016 and became effective on that date.  This emergency rulemaking may remain in effect for up to one hundred twenty (120) days after the date of adoption, expiring on November 23, 2016, or upon earlier amendment or repeal by the Director or publication of a final rulemaking in the D.C. Register, whichever occurs first.  However, available funding for the testing conducted by OCME is certified only through August 31, 2016.  This emergency rulemaking will expire on August 31, 2016 as intended. 

Chapter 20, HOSPITALS, of Title 22-B DCMR, PUBLIC HEALTH AND MEDICINE, is amended as follows:

 

Section 2039, TESTING FOR SYNTHETIC CANNABINOID SURVEILLANCE, Subsection 2039.11, of is amended to read as follows:

 

2039.11           These rules will expire on August 31, 2016.