COLLEGE PARK, Md. — Back on Aug. 19, the Maryland Department of Health reported several incidents where patients experienced hallucinations and exhibited erratic and combative behavior at Baltimore’s Union Memorial Hospital. Those patients had one thing in common: they all took a substance — well, substances actually — called “trash can.”
It’s been circulating around Maryland since last year. “Trash can” usually comes in a colorful or clear capsule with a hinged lid. It can be ingested or snorted. It first appeared in northeast Maryland, according to a statement from the Maryland State Police.
Now, authorities believe the drug has spread all across the state, but, oddly, not really in neighboring ones.
Analyses of different containers called “trash cans” full of drug mixtures in the past two years show combinations of different drugs coming from different regions of the state.
In 2019, the Heroin Coordinator Intelligence Sharing Network reported seizing containers with suspected heroin from southern Maryland and the Eastern Shore (think Ocean City, etc.). Earlier this year, even more “trash cans” full of drug mixtures were seized from several locations across the state.
These “trash cans” don’t just hold one substance — some contain a mix of drugs, according to an information bulletin on “trash can” from the Washington/Baltimore High Intensity Drug Trafficking Areas program (HIDTA).
In northeast Maryland, seizures contained heroin and crack cocaine, as well as a mix of fentanyl and the tranquilizer Xylazine, or “Tranq.” Other trash cans recently seized in 2020 tested positive for Eutolyne, or “bath salts.”
In the statement, Maryland State Police wrote, “the ‘trash cans’ appear to be more about branding than being associated with any one specific drug.”
The statement said the common “trash can” container can help investigators track dealers as well as indicate if a single local drug trafficking organization is responsible. Investigators are following up on all leads.
John Cook, the deputy director for the Washington/Baltimore HIDTA, said the program is investigating the “trash cans” themselves and using the similar packaging as a thread tying different drugs together. Organizations might want to trademark their drugs with this specific type of packaging, Cook said — but not the big drug trafficking groups.
“Mid-level to lower-level dealers will use that [packaging] for their retail sales on the street,” Cook said. “It’s not like a very large drug trafficking organization is doing this.”
The patients at Union Memorial reported that the “trash cans” were being offered as free samples, a strategy Cook said dealers use to promote new drugs. Additionally, he said when a new drug enters a region, dealers will sometimes offer it at a significantly reduced price to get more buyers.
The Maryland Department of Health received word of the Union Memorial cases from the state’s Poison Center. Executive Director Bruce Anderson said that initially a source reached out to alert the center of these atypical patients.
However, Anderson added that the Poison Center is like an emergency responder. People report the cases, but the center doesn’t have the power or staff to investigate the cases themselves.
Anderson said the Poison Center learned about one new case last month — but it hasn’t heard of any new incidents since then.
“We only hear about the cases that are reported to us,” Anderson said. “If people are being seen in the emergency department … and we’re not being contacted, we’re not going to be able to document those cases or hear about them, know about them.”
Anderson is still hoping health officials across the state, such as the center’s colleagues in emergency medicine and the Maryland State Health Department, can help shed light on this mysterious new drug by alerting him as to whether they’ve seen any other “trash can” cases that the Poison Center hasn’t heard about.