WARWICK, R.I. (WPRI) — Rhode Island public schools have seen a surge in use of ultra-potent levels of THC — the psychoactive ingredient in marijuana — over the past year, resulting in some students to be hauled away in an ambulance, the Target 12 Investigators have learned.

The explosion of THC in schools comes as vaping has grown in popularity, and teenagers are swapping out nicotine cartridges, or “pods,” for those filled with THC oil, according to Candace Caluori, principal of Toll Gate High School in Warwick.

“Normal marijuana can go to 30% potency,” Caluori said. “THC pens can go up to 99.9% of THC.”

Unlike traditional smoking, vaping is difficult for school leaders to police because the water vapor dissipates and the odor doesn’t linger. Toll Gate assistant principal Timothy Kane said sometimes students themselves are the ones that fess up.

“Sometimes it’s knowing the kids and knowing what their demeanor is, what their personality is,” Kane said. “Some kids are remarkably honest, and we’ve had a couple of cases where the kids have been scared.”

Scared, and sometimes requiring medical attention — like the students who wound up carted off in an ambulance. In just a four-month period this academic year, four Toll Gate students were taken away in a rescue after having an adverse reaction to the drug.

“They are dramatic, frightening incidents for not only the nurse, the student, but our administrators and teachers,” Caluori said. “To watch a kid struggle to breathe, or a kid … think that they’re having a heart attack or that they’re having a psychotic break and they don’t know where they are and they don’t know what’s happening.”

Dr. Jack Rusley, an adolescent medicine specialist at Rhode Island Hospital and Hasbro Children’s Hospital, said the increased potency of THC is a cause for concern.

“We could argue about the politics and medical implications to adults,” Dr. Rusley said. “But there is a pretty widespread agreement to adolescents: there is no safe amount of exposure to THC and marijuana.”

High doses of THC can have cardiovascular effects like a racing heart, loss of consciousness and psychosis, Rusley said.

“I think that is the tip of the iceberg,” he said. “I see patients in the hospital – it’s not five minutes; they are psychotic for days and weeks, they don’t know who they are, where they are, they can be aggressive to themselves and others.”

“It’s no small thing when a person has a psychotic episode,” he added. “It’s not just an issue in schools.”

‘It’s out of control’

Of the 13 school districts Target 12 surveyed seeking information on emergency calls related to THC, three did not respond — Bristol/Warren, Pawtucket and Newport.

Among the others, the Coventry school department confirmed they had several medical incidents related to THC use, but would not provide a number. The fire department said it sent a rescue to the high school twice this year for an “overdose call.”

While Barrington schools said they had zero rescue calls related to THC, Police Chief Dino DeCrescenzo said police have had at least two students taken away in an ambulance this school year after having an adverse reaction to potent levels of THC.

“Whether we are seeing the transports or not, we are seeing the uptick in activity. It’s out of control,” DeCrescenzo said. “We are finding those vials that have THC in it — they are much more frequent this school year.”

A spokesperson for Providence schools said she was “unaware of any big spike in emergency calls to schools,” but also said the department could not provide information either way because it is considered to be protected under federal health privacy laws.

West Warwick school leaders said they have had 14 incidents involving THC, but none of them resulted in requiring an ambulance.

At Toll Gate, Caluori has a warning for her peers in the rest of the state: be ready.

“It’s coming,” she said. “It makes me sad to say that, but it’s coming, so they should be prepared.”

Caluori asked David Neill, an outreach coordinator with the Rhode Island U.S. Attorney’s Office, to give a presentation at her school for parents, teachers and students about the dangers of THC, and how teenagers are concealing the products.

It was really in the last year that THC use in her school saw a dramatic uptick, Caluori said.

“We have to be proactive about it,” Caluori said. “We have a problem that’s increasing exponentially, and quickly, and the access that these kids are getting to these cartridges and to the THC … it’s amazing.”

“It’s an epidemic,” Caluori added. “I know it is a strong word and I don’t take saying it lightly.”

The U.S. Attorney’s Office gives the informational sessions on THC and other drugs to schools, sports teams and other organizations. In a statement, U.S. Attorney Aaron Weisman said that “educating students, teachers, and parents in schools and in the community about the impact that THC carries is critical.”

“There is a legitimate public health concern about the impact consumption of high-potency marijuana has on adult, never mind developing, brains,” Weisman said.

Suspensions on the rise

The top drawer of Kane’s desk at Toll Gate fills up quickly with paraphernalia that has been confiscated from students. The vaping products come in many forms, from bulky older products called “mods” to objects that look like USB sticks or inhalers.

“Devices get taken for a short period of time and some of those devices will get turned over to Warwick Police for destruction,” said Kane.

Caluori said if police are able to figure out the device contains THC they may issue the student a citation, and students are often suspended.

Suspensions for tobacco and drug use are tracked by the R.I. Department of Education (RIDE). In the 2015-16 academic year, there were 158 suspensions statewide for tobacco use, which includes vaping. Two years later, the number swelled to 839.

THC use and possession fall under the category of “controlled substances,” and that category went from 431 suspensions in the 2015-16 school year to 507 two years later.

RIDE spokesperson Meghan Geoghegan said while it’s difficult to diagnose the uptick in THC use because the data is all lumped together, “anecdotally this is certainly an area of concern that we’ve heard from superintendents and school leaders.”

“Those concerns do appear to be substantiated by the data, particularly when you look at the increase of tobacco-related infractions compared to the other drug-related categories,” Geoghegan said in an email.

“The growing availability of these products and their popularity among young people are a serious concern for student health and safety in Rhode Island and beyond, and it’s important for all of us – at school, in the community, and at home – to reinforce to our kids the harmful effects of these products,” she said.

To Caluori, there is no question the numbers provided by RIDE mirror what she is seeing in her building.

“They’re getting it online, they’re getting it from people who have maybe medical cards for that and then sell it,” Caluori said. “How they market to our youth is unreal.”

Caluori said earlier this academic year Toll Gate leaders notified police after becoming aware that someone was allegedly selling THC to students.

In a different case this March, Richmond police arrested a 17-year-old juvenile for possession with the intent to distribute several drugs including “9 commercially packaged 1-gram THC oil packages with a potency range of 92%-93.01% THC,” according to a news release at the time.

Legalization debate

In Massachusetts, recreational marijuana use is now legal for those ages 21 and older. In Rhode Island — where Gov. Gina Raimondo is pushing wary legislative leaders to follow Massachusetts’ lead this year — policy watchers say it is a matter of when, not if, pot is legalized.

Caluori calls that her “worst nightmare.”

“Now it’s becoming even more available to the general public,” she said. “Certain people are going to take advantage of that to make money, and they’re going to say that they want it legally and then they’re going to sell it. And then they’re going to sell it to my kids.”

Unlike THC sold on the black market, Raimondo’s proposal would cap THC potency levels, according to the state’s chief marijuana policy expert, Norm Birenbaum.

“THC level and possession and acquisition by children are two things the governor’s proposal specifically addressed,” Birenbaum said. “Anything above 50% THC would be banned. That’s not something that’s in place in really any other place in the country right now.”

The governor’s proposal envisions creating an Office of Cannabis Regulation that would oversee marijuana sales in Rhode Island. A portion of the $6.5 million in new state revenue expected from pot during the 2019-20 budget year would be put toward public awareness campaigns and abuse prevention.

“These are the products that can do the most harm especially to youth with developing brains,” he said.

But Caluori said even with reduced potency level, her concern is students will think they can just vape the drug more often.

“Once you’ve experienced one kid going out on a rescue it will leave an impression on you for the rest of your life,” she said.

Dr. Rusley said there may be benefits to decriminalizing a small amount of marijuana, such as fewer incarcerations and legal problems for his patients. But from a medical perspective, he has strong reservations about legalizing recreational marijuana, which would lead to the increase in availability of marijuana “lower perception of risk of adolescent marijuana use, and the health impacts of high potency marijuana on teens.”

“My short answer is I am very concerned,” Rusley said. “The impact on young people is something that is very rarely talked about in these debates.”

“I think it’s not clear that legalizing marijuana has any beneficial effects for adolescents and it’s clear it has negative effects for adolescents,” he added. “And that gets lost in the legalization debates.”

Tim White (twhite@wpri.com) is the Target 12 investigative reporter and host of Newsmakers for WPRI 12 and Fox Providence. Follow him on Twitter and on Facebook

Hannah Dickison contributed to this report

This story was modified from the original. Two school districts that were listed as not responded had.