Hawaii is among 38 states that have outlawed synthetic marijuana and "bath salts" that mimic Ecstasy, LSD, cocaine and methamphetamine, but their popularity continues to grow. Although Congress took action on the issue in July, aggressive efforts are needed locally in response to slight chemical changes made by producers to skirt laws and market the potentially dangerous synthetic drugs. Fighting the problem will take an extensive combination of vigilance to outlaw evolving drugs and impactful education about the real dangers of these "recreational" substances, which entice teens and young adults with deceivingly benign marketing and are proliferating online.

Gov. Neil Abercrombie in April signed into state law Act 29, making it illegal to sell, buy or use nine families of previously legal synthetic marijuana and stimulants. In July, Congress enacted a comprehensive ban on compounds found in synthetic marijuana — called "K2" or "Spice" — or bath salts and hallucinogens, by placing them under Schedule 1 of the Controlled Substances Act.

Hawaii’s Department of Public Safety issued a temporary emergency order in October to a version of fake marijuana Spice labeled by such names as Blue Kush and UR-144 and will ask the Legislature to make the ban permanent. Chemists are known to alter the molecules to make new drugs with the same dangerous effects.

"Government is always in the catch-up stage," Keith Kamita, deputy director of public safety, told the Star-Advertiser’s Allison Schaefers. "We have to be vigilant about these new drugs because maybe our kids are going to try them. If we can get them to think twice, maybe we’ll save a life."

Kamita doesn’t exaggerate. Close to 5,000 synthetic marijuana and more than half as many bath salt exposure calls have been made to America’s poison centers this year, according to the Alexandria, Va.-based American Association of Poison Control Centers. The group notes that 60 percent of cases involve users who are 25 or younger, a troubling fact that speaks to the lack of awareness of the dangers of synthetic substances and adverse side effects. These include psychotic reactions involving extreme paranoid delusions, agitation, anxiety and heart palpitations.

The Office of National Drug Control recognizes that use of synthetic marijuana "is alarmingly high," citing a 2011 survey indicating that 11.4 percent of 12th-graders used Spice or K2 in the previous year, making it the second-most common illicit drug among high school seniors.

Unlike medical benefits acknowledged in natural marijuana, synthetic marijuana carries a lot of unknowns, such as chemical composition and health risks on developing brains. Psychotic symptoms are more likely with synthetic marijuana items because they do not contain cannabidiol, the chemical in natural marijuana linked to sedative and antipsychotic properties, notes the August issue of Social Work Today.

The synthetic drugs discussion also is likely to launch debate about the lesser harms of natural marijuana — perhaps even decriminalizing small amounts here, as was just enacted in Colorado and Washington state.

Already, state Sen. Josh Green, an emergency room physician on Hawaii island who has been skeptical about the use of legal medical marijuana, said he recently has seen serious medical problems from synthetic marijuana by two patients in recent weeks but has "never seen any long-term devastating effects" from real marijuana.

The legal marijuana shift in Colorado and Washington bears watching, as it will grow increasingly hard to ignore. At this point, though, federal and state efforts should remain focused on combating the increasing distribution of synthetic drugs that are unequivocally dangerous.