SCRAs are accessible and affordable, sold online, in gas stations, and in “head” shops for $5-30 per package.[1] While marijuana is a schedule 1 narcotic, unavailable for any use, SCRAs navigate the legal landscape with marketing as non-consumable and frequent modifications to the active ingredients that outpace lawmakers’ updates. When consumed, SCRAs bind the same receptor as the active ingredient in marijuana with 10-1000 times the affinity.

BioSense 2.0 has become a platform for technical receipt and analysis of syndromic surveillance data for many jurisdictions nationwide, as well as a collaborative effort that has engaged a larger community of syndromic surveillance practitioners, Governance Group, and federal agencies and organizations. The potential longterm benefits of BioSense 2.0 for resource and data sharing have at times been overshadowed by the short-term limitations of the system and disconnected efforts among the CoP.