Monthly Archives: June 2011

Answers to Common Questions About K2/Spice

As a follow up to our recent posting about K2/Spice, below is a Q&A on the drug and issues related to testing.

Q: What is K2/Spice?
A: This is a synthetic chemical that is slightly different from THC, the active ingredient in marijuana.

Q: Is K2/ Spice illegal?
A: The Federal Government, through the DEA, made K2/Spice a Schedule 1 Drug, the most restrictive category, identifying the substances as unsafe, highly abused substances with no medical usage. That action placed K2/Spice on par with marijuana, cocaine and heroin. It is illegal to sell, possess or use these drugs.

Q: Is K2/Spice legal under the medical marijuana laws?
A: Spice is a synthetic chemical that is sprayed on a dried plant. There is no marijuana plant in K2/Spice. The synthetic marijuana chemical is different from THC. K2/Spice is not legal under any present medical marijuana law.

Q: How does K2/Spice affect someone?
A: The effects are similar to being intoxicated on marijuana. Because this is a new designer drug, risks from short or long term use are not yet known. Previous designer drugs like Ecstasy have proven to have dangerous medical consequences that were unknown in the early years of use.

Q; Will someone who smokes K2/Spice test positive on a drug screen for marijuana?
A: No. The active chemical in K2/Spice is slightly different from THC. It is different enough that it won’t test positive on a marijuana drug screen. That is why K2/Spice was invented – to avoid detection but still get the same effects as smoking marijuana.

Q: Is there a drug screen for K2/Spice?
A: Yes. CRL has created a test that will detect K2/Spice. CRL is the largest lab in the country and is federally licensed. The K2/Spice test is of the same high and accurate standards as present drug screens for marijuana. U.S. HealthWorks recommends MRO review of any positive drug screen. Each positive urine test will be confirmed by a second GC/MS test, as is the current standard practice on all drug screens.

Q: Is the collection procedure any different for K2/Spice?
A: No. Normal drug screen collection procedures are followed. No additional urine is needed. The test for K2/Spice can be administered by itself (separately) or added to any non-DOT drug screen panel.

Q: Can K2/Spice be done on a DOT test?
A: No. DOT Part 40 specifies the exact drugs to be tested in federal DOT testing. K2/Spice is not currently permitted on a DOT test.

Q: Why is there an additional charge to test for K2/Spice?
A: It is an additional and separate test from marijuana and, therefore, an additional cost is applied.

Dr. B

The Hidden Dangers of Third-Hand Smoke

Dr. Wagner

Our own Dr. Alesia J. Wagner, DO, Regional Medical Director for U.S. HealthWorks, is featured in this post on, an American Osteopathic Association blog focused on health issues for 20-Somethings


When you first walk into a room, it usually doesn’t take long to notice if someone has been smoking. You probably describe the scent as stale or lingering but what you might not know is that recent research suggests that “third-hand” smoke – the residue from tobacco smoke clinging to surfaces long after the smoke has settled – leaves behind more than just a bad odor.

The New View on Sunscreen

After many years, the FDA has taken steps this week to clear up “some” of the confusion regarding the use and effectiveness of sunscreen products. Comparing the various products on the market is very challenging for consumers. Inconsistent and misleading claims have been tolerated for far too long. Although the recent changes in labeling regulations are welcomed, they do not completely clear all the discrepancies.

Dermatologists have long recommended regular use of sunscreen to prevent the damaging effects of the sun leading to skin cancer and premature wrinkling of the skin. The medical consensus has been that SPF of 15 was the minimal strength that provided protection. Now under the newest regulations no product can make claims of that cancer protection without being at least that strong. Sunscreen products will also be required to protect against both ultraviolet A and B rays (UVA& UVB). This will eliminate some confusion about which protection is provided. Both cause the damaging effects that lead to skin cancer.

After 30 years of wrangling, the FDA regulations have caught up with the medical science that an SPF higher than 50 is no better. The higher or more expensive products do not provide greater protection contrary to popular belief. The science behind this is well established.

No product will be allowed to claim being waterproof. However, manufacturers will be allowed to estimate how long their product may be water or sweat resistant.

This still allows some room for confusion as the reality of individuals and their activities can create vast differences in the product performance.

Typical outdoor activities with prolonged sun exposure require reapplication of sunscreen for adequate protection. Specialists have also advocated reapplication as frequently as every 20 to 30 minutes or after swimming or excessive sweating. At the very least, once every hour sunscreen should be reapplied. These activities simply dilute the product applied and make it much less effective. For adequate protection, it has to be reapplied.

It’s important to remember that none of these products completely block the damaging UV rays. They filter it and slow the burning, damaging process.

For common everyday use, a product with SPF 15 is probably adequate. For outdoor recreation or work in the sun, SPF of 40 to 50 is recommended. Product claims of outlandish performance will no longer be allowed.

There still are issues of controversy that remain unresolved. It is not clear whether there is any advantage of spray over lotion. There have been some questions raised regarding safety of aerosol propellants and the sunscreen chemicals themselves. More study is needed to determine answers to these questions.

Yet it is clear that sun damage accumulates in the skin over time causing potentially deadly cancers that are easily prevented. Even one or two episodes of sunburn dramatically increase the risk of skin cancer.

Enjoy the summer, but protect your skin – and your life.

Dr. Bruce Kaler

The Snakes of Spring

A friendly python?

Everything you know about rattlesnakes and their bites is probably wrong.

They are not an aggressive reptile, unless you are a small warm-blooded mammal. They prefer to hide, and they retreat if you are bigger that a gopher. They will rattle their tails off trying to make you go away. They understand you are too big to swallow and only bite in self defense, when they think you are trying to kill them. Keep in mind that their brain is the size of a pea.

Rattlesnakes are near and dear to me, probably because I live in Phoenix, Arizona, the rattlesnake capital of the nation. Did you know we have 17 different species of rattlesnakes in Arizona – the most of any state? It kind of makes you rethink the Desert Retirement Plan, doesn’t it? My wife has called me saying, “Honey, there is a rattlesnake on the porch.” We see them not infrequently. They usually slither off.

Rattlesnake bites in Arizona are largely limited to the upper extremities, between the fingertips and the elbows. Not coincidentally, most “victims” (if you want to call them that) are young, often intoxicated males. They were playing with the snake, often with a short stick (imagine that).

When I talk about rattlesnakes, my best advice on what to do if you encounter one is: immediately put your hands in your pockets and don’t take them out.

So let’s say you didn’t listen, or were just plain unlucky, and the rattlesnake bites you. You are going to be in a lot of pain, but you are not going to die. Ninety-nine percent of bites don’t result in death.

About 20% of bites do not envenomate you, which is a so-called dry bite. This is a bite that is no more painful than a vaccination. You still need to get it checked out, pronto, but you will not need antivenom.

So what do you do when you get bit? Get away from the snake, so you don’t get bit again because the snake still has spare venom. Pick up your cell phone and call 911.

What don’t you do? Do not cut and suck! You cannot even hope to get the venom out. A home study experiment: Take blue dye in a syringe and inject it into an orange. Now try to get the dye out of the orange without destroying the orange. Try cutting and sucking. Doesn’t work, does it?

Besides not cutting and sucking, you never apply a tourniquet. Rattlesnake bites swell like crazy. They do a lot of local tissue damage. Cut off the blood supply with a tourniquet, and you will lose the limb. Keep in mind, as long as you can get medical attention within two hours, you have a 99% chance of survival.

Symptoms of a rattlesnake bite are pain, sometimes severe pain, at the bite. The area will swell markedly. Systemic (generalized) symptoms include nausea and vomiting, weakness and potential heart failure.

Antivenom is used if you have severe local symptoms, such as swelling so bad that the limb will rupture the skin. It is almost always used if you have generalized symptoms.

Antivenom is made up of neutralizing antibodies from a horse. The antivenom maker injects rattlesnake venom in a horse and then collects the antibodies the horse makes against the venom. Pretty neat. Remember that these are antibodies from a horse, so you are going to have some reaction. Rarely this reaction can get exciting (that’s the 1%).

You almost always have the opportunity to avoid a bite. The snake will warn you with a dry-sounding rattle. It sounds like you put dry rice in a paper bag and shook it. There is nothing else that commonly rattles, so assume it’s a snake. Stop and listen to decide which direction the snake is, then go the opposite direction immediately. That will almost always keep you from being bitten.

Take care,

Dr. B

K2 — Not Just A Mountain Anymore

Synthetic cannabis first appeared about 8 years ago in Europe. It goes by the names Spice and K2. It is a designer drug, which means the basic marijuana molecule was altered to change its behavior. Often the goal is to increase the strength of a drug as in Ecstasy – made on the amphetamine blueprint. In the case of marijuana, the characteristic altered was the recognition that it was marijuana. A minor structural change can make a molecule unrecognizable. This was a marijuana that can’t be tested for.

It is not so much surprising that an enquiring mind could come up with a variation on the basic THC molecule, but that it was considered worth doing. Marijuana has not become an endangered species in recent years with various medical marijuana laws in 14 States.

While pot “scientists” were busy creating in their labs, the pharmaceutical laboratories were working on spoiling their plans. Tests specifically designed to recognize the synthetic marijuana molecule were developed. That isn’t too arduous a process as the initial screening test is an antibody test. An antibody to identify the new synthetic marijuana molecule is easily made. The confirming test, GCMS, only needs some synthetic marijuana to analyze, and it can happily identify synthetic marijuana down to the nanogram amount.

Of course getting around pesky government laws was the goal of this designer drug. The government simply wrote new laws outlawing this drug.

If you are concerned about the use of K2 or Spice, these can be included in your drug testing panel. Call your U.S. HealthWorks representative to enquire.

Take care.

Dr. B

The Placer (Calif.) Herald: Sun can pose long-term danger to outdoor workers

By Dr. Donald Bucklin, U.S. HealthWorks

June 9, 2011

With the summer and its heat approaching, almost everyone will be out in the sun more than they were during the winter.

What to Sweat Over When It Comes to Sports Drinks

Every time I see a “Gatorade shower” after a sporting event, I ask myself if this is a waste of a great hydration resource or just a cheap replacement for champagne.

Gatorade was the original sports beverage, invented in 1965 by a “medical team” in Florida. That all sounds pretty impressive, but 1965 was practically the Middle Ages in the world of medicine. Sports drinks have proliferated in recent years; Gatorade, Power Aid, Sobe and Vitamin Water all compete for your attention and hydration dollar. Each comes in multiple flavors and special formulas. I have to admit that it wasn’t long ago that I expected a measurable and substantial increase in my performance due to the consumption of a sports beverage or bar. I thought of it as pouring rocket fuel into my ski legs. It even seemed to work.

Nevertheless, water has been the hydration “beverage of choice” for more than 200,000 years, and that was without the benefit of research, television or advertising. You have to admire the audacity of the “medical team” that sought to improve on water. They started with the simple discovery that sweat is salty. This is something that any of us non-scientists could have explained after mowing the lawn on a summer afternoon in Florida.

This what my dad spends money onphoto © 2008 Zac Zellers | more info (via: Wylio)Sports beverages, first and foremost, provide hydration. Their claim to fame is the provision of electrolytes (salt) and carbohydrate for muscle energy. This salt and carb combo is touted to be an improvement on water for sustained performance.

The whole point of sports drinks is to replace sweat. So what is sweat? It’s salt water, more or less. To make comparisons of saltiness, we use milligrams per liter (mg/l). This is handy because sport drinks come in roughly liter bottles (a little more than a quart).

Sweat is about 97% water. Sodium, the next most common element in sweat, weighs in at a whopping 900mg/l. Potassium is next at 200mg/l. There are many other elements in small amounts, but sodium and potassium are the main ones. We can sweat a liter per hour during heavy exertion, mostly as a way to dissipate the heat of muscle use.

When sports drinks talk electrolytes, they are talking sodium. Sodium is a plentiful element in human beings. There is a lot of it in sweat (900mg/l), but even more in the blood (3100 mg/l). So looking at electrolytes in sports drinks, it is obvious that the amount of sodium in them (100 mg/l) is trivial compared to the sodium in sweat or blood. Drinking a sports drink will replace about 3% of the electrolytes you lose in sweat.

So there may be good reasons for drinking sports drinks, but electrolyte replacement isn’t one of them.

Carbohydrates, and specifically glycogen, are the preferred fuel of working muscles. Your internal store of this sugar molecule is in the muscles and the liver. You have a couple of hours worth of fuel stored before turning to the much-less-efficient fat metabolism. The carbohydrate in a sports beverage provides 15 to 20 grams of sugar, something like 5 teaspoons which supplies 60 fuel calories. Strenuous physical activity burns about 300-400 calories per hour. Again, the sports beverage provides fuel, but only a very minor amount.

So there may be good reasons for drinking sports beverages, but fuel replacement isn’t one of them.

Which brings me back to the true strength of sports beverages. Most people would rather drink Gatorade than water. It just tastes better. Hydration is absolutely crucial to maintain during exercise. This not only helps maintain performance, but also prevents exhaustion, shock and even death. Many studies of exercise show people drink more sports beverages than water.

So bring what you’ll drink to your next session of strenuous exercise. Your drink will sustain you whether it is the highest tech beverage or very old school H2O.

For those on budget: a little orange juice mixed with a lot of water ends up being pretty close to the sports beverage formulae – not to mention, cheap and palatable.

Keep drinking and take care,

Dr. B

Is Cell Phone Use Linked to Brain Cancer?

Cell phones are in the news again. The World Heath Organization says they may be associated with brain cancer. This immediately brings to mind a picture of people with aluminum foil wrapped around their heads (probably from an old “Saturday Night Live” skit). Many of us probably would get out the aluminum foil before giving up our beloved cell phones.

Is cell phone radiation worth worrying about or simply the Alarming Headline of the Week?

Finding out increased risk for any exposure, including cell phones, is all about the numbers. Really big numbers give us the statistical power to find even tiny risks. There are 4.3 billion cell phone users on the planet. That should certainly be enough to find some answers.

Businessman on the phonephoto © 2010 Yago Veith – Switzerland | more info (via: Wylio)One of the problems with the whole cell phone radiation-brain cancer debate is the use of the word “radiation,” which is used for anything from cell phones to Fukushima. Radiation from nuclear sources is ionizing radiation. This radiation breaks down DNA and is a known risk for cancer. Cell phones emit radiation of an entirely different type. Cell phones emit low-level microwave radiation which is non-ionizing.

You are surrounded by microwave radiation all day, and you practically can’t find a microwave-free place on the planet (maybe a really deep mine shaft, but that offers dangers of its own).

You probably heated your coffee this morning in a microwave oven, then drove to work listening to broadcast FM radio, which is a microwave signal. The GPS in your car works on a microwave satellite signal. Your computer could be hooked to a Wi-Fi network (microwave), and your Bluetooth mouse is also a microwave emitter. Your garage door opener uses microwaves as well as your satellite TV. Your cordless landline phone generates microwaves – all in addition to your cell phone.

If microwave radiation exposure was smoking, we would all be 100 packs-a-day smokers. At that level, it wouldn’t take three months to find a cancer risk. But interesting enough, the brain cancer rate is stable or decreasing over the last 30 years despite the enormous increase in microwave radiation.

The World Heath Organization came to its conclusion based on a small study by Swedish scientists. The study showed an apparent association between cell phone use and a brain tumor called gliomas.

This conclusion has generated tremendous controversy in the scientific community. To start, there is no theoretical basis for microwave radiation to cause tumors. We have a lot of experience with carcinogens, and they have mechanisms that make sense. They damage or modify DNA (the blueprint of life). Microwave radiation doesn’t affect DNA in any way known. So while the lack of a mechanism doesn’t disprove anything, it sure makes the scientific community question the finding.

Other studies, one involving 14 nations, found no increase in brain cancer from cell phone use.

Where do we go from here? One thing I know for sure: we can count on many more studies on this issue and a lot more conversation.

Take care,

Dr. B

Sun Poses Long-Term Dangers to Outdoor Workers

By Dr. Donald Bucklin

With the summer and its heat approaching, almost everyone will be out in the sun more than they were during the winter.

For 9 million Americans, being outside and in the sun is not just for summer fun – it’s a part of their job.

Workers in farming, landscaping, construction, recreation and even postal workers will spend hours in the sun – and consequently be exposed to potentially harmful levels of ultraviolet radiation.

Working in the Heatphoto © 2011 | more info (via: Wylio)Ultraviolet radiation, and specifically UVB, is the main environmental hazard to the outdoor worker. Most workers’ shifts include the peak intensity hours of UV exposure – 10 a.m. to 2 p.m. Since this type of radiation, UVB, easily penetrates clouds, it can reach worrisome levels even on days where little sun is visible. It easily passes through glass and can be reflected into areas of apparent shade.

UVB penetrates through the tough, dead outer layers of skin, into the replicating layers. It is there that it interacts with the living tissue, not entirely in a negative fashion – UV radiation on unprotected skin produces Vitamin D. Many believe, and there is some evidence to back it up, that there are anti-cancer properties in this potent antioxidant vitamin.

But radiation on living tissue also has a biologic cost. UVB radiation causes DNA damage and is officially listed as a carcinogen. This damage is cumulative. Ultraviolet radiation and skin cancer share a similar relationship to that of cigarette smoking and lung cancer. According to the Skin Cancer Foundation, those who work outside are twice as likely to contract skin cancer as indoor workers.

To protect workers from this hazard, we need to reduce the dose of UVB radiation.

The obvious solution for employers is to instruct workers to avoid sun exposure and seek shade when available. When possible, employers can rotate or stagger work shifts so that employees spend less time working during the sunniest parts of the day.

While the suggestion that people wear long-sleeve shirts during high temperature periods usually is greeted with derision, in fact there are a variety of new fabrics with high Sun Protection Factor values that are light weight, breathable and durable.

One of the oldest fabrics, cotton, has long been recognized for its skin protective value in the hottest climates. Cotton long-sleeved, loose-fitting shirts and pants, and broad-billed hats are some effective clothing options for outdoor workers. In dry climates, the fabric actually soaks up sweat and is an effective evaporative cooler.

Sunblock provides UV protection, but the level of protection is almost universally overestimated.

The most common error people make is using high Sun Protection Factor, sweat-proof sunblock and applying it only once. Sunblock generally loses effectiveness after about two hours due to sweating, the friction of clothing and deterioration due to sunshine. And too often, too little is applied. An ounce is recommended to get advertised protection. But remember, sunblock isn’t “liquid shade.”

These common sense protective measures can help safeguard you and your employees year round, but particularly during the summer months when, in most parts of the country, exposure to UVB radiation is highest. With awareness and a few simple steps, we can help workers avoid the short-term sting of a sunburn and the long-term consequences of too much sun exposure.