For the past few years, Dr. Keir Swisher has seen few patients in the Salina Regional Health Center emergency department suffering symptoms as a result of smoking potpourri.



But what he�s seen in the past few months reminds him of four years ago, when there was a local spike in medical emergencies as a result of people using so-called potpourri, �bath salts� and other, similar substances.



�We were seeing 20 cases a week for a few months back then,� Swisher said.



Back then, the number of



cases quickly declined after some publicity about the unpredictable side effects of the products made by what Swisher calls �amateur chemists.�



�Suddenly now, we�re seeing five or 10 cases a week,� Swisher said.



This past weekend, five people who had been smoking potpourri together arrived at the hospital�s emergency department at nearly the same time.



Swisher said that in the past six weeks, about 60 people have come into the emergency department after using potpourri, and that 95 percent have been brought in by ambulance, �either seizing, convulsing or unconscious, in a coma.�



�They�re highly agitated, a lot of rage, spitting, hallucinating,� Swisher said. �I did medical training in Chicago, where there was a lot of PCP use, and a lot of the patients resemble PCP users, with super-human strength. I�ve seen a 170-pound patient, and it took six people to hold them down so we could sedate them.�



In addition, Swisher said, a dose of sedatives that should be strong enough to render someone unconscious sometimes has little effect.



Chemicals more potent



The potpourri itself is just a mix of leafy plant material; what makes it potent is the chemicals sprayed onto the potpourri, said Lt. Bill Cox, commander of the I-135/I-70 Drug Task Force.



Cox and Swisher said they believe the potpourri now in circulation in Salina is more potent than what was popular a few years ago.



�We�re seeing more side effects than in the past,� Cox said. �People don�t know what�s in it, or how much.�



The chemicals used often mimic the effects of tetrahydrocannabinol, or THC, found in marijuana, and there are dozens of such chemicals.



Under Kansas law, chemicals that are �analogs� or close enough to already illegal substances are considered illegal as well, but that�s a tough determination to make.



�We have test kits, but they can�t test for all these chemicals,� Cox said. �We have to send everything to the KBI lab, and until we get the lab results, we don�t know if it�s legal or not.�



Laced with meth



Swisher said the potpourri is more potent than before.



�We�ve found one that was laced with methamphetamine,� he said.



The hospital doesn�t have the equipment needed to test for the wide variety of chemicals that could be added, or the new ones that seem to appear regularly.



�It keeps changing. They keep raising the bar,� Swisher said.



Potpourri more accessible



Swisher also thinks many people don�t realize how dangerous and unpredictable potpourri can be.



�Teenagers, they don�t have legal access to alcohol, and this is sometimes sold in convenience stores,� Swisher said.



He said that most of the patients he�s seen are 16 to 25 years old.



�It�s more accessible than marijuana, and it looks safe,� he said.



In August, Salina police searched Pump Mart, 1118 N. Ninth, and Food Mart, 220 W. Crawford, and seized bottles and packages of suspected illegal potpourri.



Since then, Cox said, it�s become more difficult to track down local sources; he suspects many people are ordering potpourri from Internet sources.



Long-term effects unknown



The side effects can last six to eight hours, Swisher said.



�But we don�t know what the long-term side effects are,� he said. �They�re almost all amnestic, have no recollection of what happened, even of being brought in by the police. I wish I could video them to show them what they looked like. I think a lot of them would be appalled.�



Back in 2010, Swisher talked to students at area schools about the dangers of potpourri.



To help illustrate that what�s in potpourri is unknown � and that it can be dangerous � he would blindfold a student volunteer and give him or her something to drink, such as cola mixed with tomato juice.



�It tasted really bad,� Swisher said. �One girl threw up. I felt bad about that, but it did make the point.�



Reporter Mike Strand can be reached at 822-1418 or by email at mstrand@salina.com