ExamOne University Webinar Series Presents: 2010 Insurance Laboratory Trends

Highlights and interpretation of the 2010 trends; trends in default profiles, reflex testing, specific test trend review

Join our informational webinar, 2010 Insurance Laboratory Trends, for a review of last year’s testing highlights, trends in default profiles and reflex texting trends.  Betsy Sears, ExamOne’s EVP of Client Solutions, will also review specific test trends and provide time for open discussion with the audience regarding your company’s questions and concerns about test trends. 

• Topic: 2010 Insurance Laboratory Trends
• When: Tuesday, February 15, 2011
• Time: 1 - 2 p.m. Central Time
• Duration: 45 +/- minutes with 15 minutes of QA
• Presenter: Betsy Sears, Executive Vice President of Client Solutions

About the Presenter

Betsy is Executive Vice President, Sales Support/Client Solutions at ExamOne.   She has more than 24 years of experience in the insurance laboratory environment.  She works closely with ExamOne's laboratory operations, medical and sales staff on customer issues and supports insurance customers through a variety of presentations on laboratory, medical and risk assessment topics.   Her duties also include managing some of the International sales initiatives and overseeing Insurance Client Solutions in the U.S. and Canada 

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“Herbal Incense”: K2, Spice and “Synthetic Marijuana”

Overview

“Herbal incense” has gained increasing media attention of late, as an “alternative” or “legal high.” It goes by a number of names – K2, Spice, Genie, Yucatan Fire and many others. In these products, plant material that does not contain marijuana or other psychoactive plants, is surreptitiously sprayed with one or more chemicals. While the chemicals in these substances target the same receptors as marijuana/THC, and produce a similar euphoric high, it is important to note that these chemicals are engineered and not “naturally occurring”.

The dried, treated, organic plant material is packaged and sold over the Internet or over the counter in some stores. These products are abused similarly to traditional marijuana – by smoking like a cigarette; inhaling the smoke from an open container or pipe; or by ingesting the dried, leafy contents.

Early evidence suggests that these non-FDA approved chemical substances are more potent than THC. The use of these substances may lead to a series of harmful effects including the potential for increased dependence and the possibility of overdose, in addition to other adverse physiological effects.

What Are These Products?

The purveyors of these “synthetic marijuana” products claim that they are selling “herbal” and “incense” blends or that the products are composed of “natural essences.” While the actual plant components listed on the label may differ slightly, materials common to many of these products include: Baybean, Lion’s Tail, Indian Warrior, Maconha Brava, Marshmallow and Siberian Motherwort. The plant material may also be scented with flavors such as vanilla, honey, strawberry, cherry or blueberry.

What’s not listed on the label are the chemicals that are sprayed on the plant material. These chemicals are the active ingredients that act on the cannabinoid receptor(s) responsible for marijuana/THC’s effects. The chemicals were originally synthesized by researchers and pharmaceutical manufacturers studying possible therapeutic uses for drugs interacting with the cannabinoid receptors. Some of the synthetic cannabinoid receptor drugs that have been identified in these “herbal” blends include: HU-210, homologs of CP 47,497, JWH-018, JWH-073, JWH-250, and JWH-398. In addition, vitamin E, caffeine, menthol, and chromium have been identified in some “herbal incense” samples examined by researchers. It is interesting that many of these misrepresented “herbal” products carry a warning that “Contents are non-toxic and are NOT approved by the FDA for HUMAN CONSUMPTION.”

The manufacturers of these “herbal incense” products may apply one or more of these synthetic chemicals to their product. Moreover, the substance(s) applied to the plant material has been shown to vary between products and even between batches of the same product. Consequently, K2, Spice and other “herbal incense” blends are not a single product/drug, but a family of substances that may be abused for their “high.” Another aspect of concern is that the amount (dose) of the synthetic substance(s) applied may be inconsistent, which may further complicate any adverse effects associated with the use of these substances.

Are They Dangerous?

Many of the synthetic compounds added to these products would be expected to produce marijuana-like effects through their action on the cannabinoid receptor. However, unlike THC and marijuana which have been studied extensively, very little is known about the dose, effects, metabolism and toxicity of these substances. All of the published studies with the synthetic compounds have either been in-vitro or in animals – there have been no published, controlled human studies, to date.

What is known is that many of these synthetic compounds are more potent than THC – potentially, more than 50-fold in one instance. Given the higher potency and inconsistency in the amount and specific substance(s) applied to the plant material, the risk of overdose and adverse psychiatric effects is possibly greater than with marijuana/THC. The length of time users feel the effects is also different as compared with THC – with the effects lasting for a shorter period of time for some substances and longer for others. In one published study, the researchers reported feeling “minor after effects the whole next day.” Furthermore, there is a published study suggesting that tolerance to these synthetic drugs occurs more rapidly which could lead to a greater risk for dependence.

Other adverse effects include dry mouth, increased heart rate, feelings of impaired motor skills, agitation, unconsciousness and altered mood and perception. The chemical structure of some of these synthetic compounds has led to speculation of carcinogenic potential and the presence of other contaminates such as chromium and caffeine all raise toxicological concerns. Clearly, controlled studies are needed to assess the full-range of risks associated with these “herbal incense” products and “synthetic marijuana” compounds.

Legality and Restrictions

Unlike drugs of abuse like marijuana, cocaine, heroin, methamphetamines or PCP, most of the chemicals added to “herbal incense” are not listed as controlled substances by the United States Federal Government. At this point, only one of these substances – HU-210 – is classified as a controlled substance due to the fact that it is a cannabinoid that is structurally and pharmacologically similar to THC. While a handful of states are taking legislative action against “synthetic marijuana”/“herbal incense” products, only two – Kansas and Kentucky – currently have laws in place that limit the distribution, possession or consumption of K2, Spice, other related products and/or the synthetic compounds added to these products. At least two other states have passed laws which are pending signature by their respective governors. Legislation has been proposed or passed in at least one chamber of seven other states.  Spice is also reportedly banned by some U.S. military commands and there are a number of countries in Europe that have banned K2, Spice or similar products.

Testing

When a user ingests traditional marijuana, THC is the chemical that affects the receptors in the brain and creates the high. The body metabolizes THC and eliminates it from the system in the urine. When a urine drug test detects “marijuana”, it is actually detecting a marijuana metabolite – carboxy-THC. It is not known how, or to what extent, these “synthetic marijuana” compounds are metabolized. Furthermore, as K2, Spice and other related “herbal incense” products are not composed of a single substance, any laboratory analysis would need to test for a variety of “synthetic marijuana” metabolites. Therefore a urine drug test for K2, Spice, or “synthetic marijuana” metabolite(s) is not feasible at this time.

Tip for Scheduling Your Exams

Did you know you can schedule a paramedical examination appointment via Schedule Now after an order is placed and submitted on ExamOne's member website, https://services.examone.com? Schedule Now can be accessed from the order confirmation page immediately after you have entered your order information or directly from the applicant record after the order is submitted.  

To access Schedule Now after the order is submitted simply select your pending applicant case and click on the "Schedule this order using Schedule Now" link located in the upper left hand corner of the page.  The Schedule Now option will not be available if the exam has already been scheduled, please contact our Client Solution Group if rescheduling is required.

Rewarding Employees for Healthy Outcomes Archived Webinar

In case you missed our last wellness webinar, it is now archived online. Learn how when employees receive incentives for achieving defined outcomes their engagement grows. This approach to driving better outcomes has emerged as a cornerstone of healthcare benefit design.

Leaders from Quest Diagnostics and IncentOne discuss the combination of technology and science that forms the basis of the solution that integrates biometric screenings and incentives. Hear how this solution is proving to be an effective healthcare cost reduction strategy.

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Visit ExamOne

ExamOne has a busy spring full of industry events. Check out the list of conferences we are attending and be sure to stop by our booth if you are in the area.

February

Texas Home Office Underwriters Association

• February 24, 2011
• Dallas, Texas

The Marketing Alliance (TMA)

• February 27 – March 2
• Tampa, FL

American National Insurance Company

• February 8 – 10
• Galveston, TX

March

LifeMark

• March 6 – 9
• Key Biscayne, FL

iPipeline

• March 9 – 11
• Las Vegas, NV

GAMA/LAMP

• March 20 – 22
• Washington, D.C.
• Booth #716