An overdose on these designer drugs can be very unpredictable and can lead to paranoid delusions, aggression, hostility, psychosis, and anxiety as well as cause nausea, vomiting, an irregular heart rate, and heightened blood pressure and body temperatures. Poison control call centers received over a thousand calls related to adverse reactions to Spice products in the first few weeks of April 2015 alone.  Spice abuse has decreased in the past few years as it becomes more difficult to obtain the psychoactive chemicals with them becoming more tightly controlled and their status switching from legal to illegal. Still one in 20 high school students admitted to using Spice in 2014. 
Drug trafficking is a significant problem in Indian Country, and ONDCP has made it a priority to collaborate with tribal leadership to enhance law enforcement and prevention responses. HIDTAs are uniquely positioned to work with local and tribal communities to promote and participate in community-based drug prevention programs. Currently, 10 HIDTA programs are collaborating in enforcement operations and training with Tribal Nations: Atlanta-Carolinas, Nevada, New York/New Jersey, Northern California, Northwest, Oregon, SWB Arizona Region, SWB New Mexico Region, Texoma, and Wisconsin.