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Synthetic cannabinoid use is increasing (Physician's First Watch Jul 15 2016), and use of new compounds can result in clusters of patients with unique and significant side effects (Physician's First Watch Dec 15 2016). Superwarfarins, developed as rodenticides (i.e., rat poison), are sometimes added to prolong the effects of the drugs. These authors describe a case series of 34 patients admitted to one Illinois hospital with coagulopathy associated with superwarfarin added to synthetic cannabinoids. These patients were only some of the 255 patients with synthetic cannabinoid–associated coagulopathy reported to the Illinois Department of Health between March and July 2018, eight of whom died.
Of the 34 patients, 71% were men and the median ag…