Transcript Slide 1

The Designer Drug – What You
Always Wanted to Know
Steven Kipnis MD, FACP, FASAM
Medical Director, NYS OASAS
Thanks to:
Paul L. Cary
Toxicology Laboratory
University of Missouri
Steve Hanson
Acting Associate Commissioner - NYSOASAS
CASE
A healthy 48-year-old man has a generalized convulsion after ingesting a powder he
purchased through the Internet. The powder was sold with the wording “not for
human consumption” listed on the packaging.
The seizures continue in the pre-hospital setting, as well as in the ED, for approximately
15 minutes in total before ceasing after administration of lorazepam 4 mg IV.
Initial vital signs after cessation of his seizures include a blood pressure of 140/88 mm
Hg; pulse, 106 beats/min; respiratory rate, 22 breaths/min; temperature, 37.7°C.
Physical examination is notable for mydriasis and diaphoresis with 5 beats of
myoclonus in the bilateral lower extremities. Shortly after arrival in the ED, the patient
is intubated for airway control.
Finding on noncontrast CT of the brain are unremarkable, and EEG results are normal.
Initial pertinent laboratory values include normal electrolyte, creatinine, and glucose
levels. His creatine phosphokinase level is elevated, at 2,500 U/L. Toxicology screening
does not detect acetaminophen, ethanol, or salicylates
CASE
A healthy 48-year-old man has a generalized convulsion after ingesting a powder he
purchased through the Internet. The powder was sold as “research grade JWH-018 –
synthetic cannabinoid,” with the wording “not for human consumption” listed on the
packaging.
The seizures continue in the prehospital setting, as well as in the ED, for approximately
15 minutes in total before ceasing after administration of lorazepam 4 mg IV.
Initial vital signs after cessation of his seizures include a blood pressure of 140/88 mm
Hg; pulse, 106 beats/min; respiratory rate, 22 breaths/min; temperature, 37.7°C.
Physical examination is notable for mydriasis and diaphoresis with 5 beats of
myoclonus in the bilateral lower extremities. Shortly after arrival in the ED, the patient
is intubated for airway control.
Finding on noncontrast CT of the brain are unremarkable, and EEG results are normal.
Initial pertinent laboratory values include normal electrolyte, creatinine, and glucose
levels. His creatine phosphokinase level is elevated, at 2,500 U/L. Toxicology screening
does not detect acetaminophen, ethanol, or salicylates
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A 36-year-old male in the Netherlands became acutely agitated and
enraged after ingesting mephedrone along with cocaine, and subsequently
lost consciousness and died despite resuscitation efforts.
A 29-year-old male found unresponsive at a nightclub died of cerebral
edema and brainstem herniation. Serum sodium was
noted to be 125 mmol/L, later suggested by laboratory data to have resulted
from water intoxication.
The first synthetic cathinone-related death in the United States, described in
the scientific literature, involved a 22-year-old male who was found
unresponsive and subsequently died at the receiving hospital.
One case of mephedrone-related myocarditis has also been reported in the
literature. A 19-year-old male presented with crushing chest pain after
ingesting mephedrone sold as ‘‘not for-human-consumption’’ plant food.
Drive to Get High
• People will seek any
means to alter their
state of
consciousness
THE STORY OF
DESIGNER DRUGS
Designer Drugs:
Created (or reformulated, if the drug already
existed) to get around existing drug laws
(Controlled Substance Act), usually by
modifying the molecular structures of existing
drugs to varying degrees.
Designer Drugs:
• Second International Opium Convention in 1925 which
specifically banned alternative esters of morphine
• 1960s - 1970s, new synthetic hallucinogens
(modifications of LSD & PCP)
• “Designer drug” was first coined by law enforcement in
the 1980s
• 1980s - 1990s, design of MDMA (ecstasy) &
methcathinone
• 2000 - 2005, derivatives of psilocybin & mescaline,
anabolic steroids
• European authorities have identified 41 new
psychoactive drugs in 2010 alone
What Drives the Production
Designer Drugs ?
• Consumer preferences
• Law enforcement
control
An agonist is a chemical that binds
to a receptor and triggers a
response – often mimicking the
action of a naturally occurring
substance.
Receptor
Drug (agonist)
Why Change the Key?
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Prolong the effect of the drug
Increase the potency of the drug
“Select” the desired effect
Make the drug more difficult to
detect
• Avoid patent infringement
• Make an illegal drug “legal”
Drug
SPICE/K2 AND SYNTHETIC
CANNABINOIDS
(HMA – HERBAL MARIJUANA ALTERNATIVES)
No! We’re
not talking
about this!
We’re talking about this! There are
hundreds of synthetic cannabinoids.
Brand Names of Common HMA’s
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Spice
K2
Tai Fun (Blackberry, Vanilla, Orange)
Exclusive (Original, Mint, Cherry)
Chill Zone (Berry, Mint, Original)
Chill Out (Cherry, Mint, Original)
Sensation (Vanilla, Orange, Bkberry)
Chaos (Mint, Original, Cherry)
Zen
Zen Ultra
WHAT’S IN THESE
“INCENSE”
PRODUCTS?
“Listed” Ingredients in Spice
•Canavalia rosea: beach bean or bay
bean
•Nymphaea caerulea: Blue Egyptian
water lily
•Scutellaria nana: Dwarf skullcap
•Pedicularis densiflora: Indian warrior
•Leonotis leonurus: Lion's Tail and Wild
Dagga
•Cannabis – like effect
•Zornia latifolia: is a perennial herb
•Nelumbo nucifera: Lotus
•Leonurus sibiricus: Honeyweed or
Siberian motherwort
•Vanilla
•Honey
Preparation of the “incense”:
• Botanicals (vegetable matter) are
sprayed with liquid preparations of:
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HU-210
HU-211
CP 47,497
JWH-018
JWH-073
Origins of Synthetic Cannabinoids
• CP 47,497 - developed by Pfizer in 1980 as an
analgesic
• HU-210 & HU-211 - synthesized at Hebrew
University, Israel in 1988. HU-210 is an antiinflammatory; HU-211 as an anesthetic
• JWH-018 & JWH-073 - synthesize by a
researcher at Clemson (1995) for use in THC
receptor research - John W. Huffman
• more than 100 different synthetic cannabinoids
have been created
Usage
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Very little known about the extent of use
2009 Survey in Frankfurt
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Surveyed 1463 students aged between 15 and 18 at schools providing
general and vocational training.
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Prevalence of use was 6% of respondents reported using Spice at least
once
National Poison Data System in 2010 (Aurora, CO)
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During the 9 month study period, there were 1898 exposures reported
with a mean age of 22.5 years old
o
Most cases reported were in men.
Community Epidemiologic Work Group (CEWG) noted K2 epidemic in
Midwest US in 2010
Appears to be shifting from marijuana to synthetics
Usage
• Mode of use:
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Smoked
Drink as an infusion/herbal tea
Availability
• Sold in metal-foil sachets
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Typically contain 3 g of smoking mixture sufficient for 8 joints
Typical cost is 20 – 60 dollars per pack
• Sold in:
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Internet sites
Tobacco stores
Head shops
Some gas stations
• Often sold as “incense” labeled with disclaimer: not for
human consumption
Smoking Cannabinoids
What does CB1 receptor
control?
• Basal Ganglia: motor
control, learning
• Hippocampus: memory,
spatial navigation
• Cerebrum: cognitive
functions - attention,
language, emotions
*CB2 found in blood cells, immune tissue and spleen. ? in CNS
• Dual effects:
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Herbs (very little medical literature of effects)
Synthetic cannabinoid
Pharmacological Effects of Synthetic
Cannabinoids are Similar to THC
• Mental (these affects predominate):
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Altered state of consciousness
Mild euphoria and relaxation
Perceptual alterations (time distortion)
Intensification of sensory experiences
Pronounced cognitive effects
Impaired short-term memory
Anxiety
Paranoia
Avoidant eye contact
Agitation
Delusions (paranoid, grandiose)
Psychosis
Pharmacological Effects of Synthetic
Cannabinoids are Similar to THC
• Physical:
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Increase heart rate & blood pressure
Dry eyes
Diaphoresis
Mild decrease in potassium
Seizures
Reduction in motor skill acuity
Increase in reaction times
Dependence
Syndrome
Similar to
Marijuana
Withdrawal:
•“Inner unrest”
•Drug craving
•Nightmares
•Profuse sweating
•Nausea
•Tremor
•Headache
•Hypertension
•Increased HR
Reported Effects of Synthetic Cannabinoids
are Different Than THC
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Production inconsistencies
Herbal incense blends are harsher to inhale
Effect on appetite is non-existent
Increased restlessness & aggressive behavior
Herbal incense produces a shorter “high”
(perceptual alterations & sensory effects are limited)
• Doesn’t mix well with alcohol (hangovers)
• Incense costs more than marijuana
Synthetic Cannabinoid Data
Percentage of U.S. 12th Grade Students Reporting Past Year Use of
Drugs*
Other Than Alcohol and Tobacco, 2011
(N=approximately 14,900)
• Marijuana and synthetic
marijuana are the most
prevalent illicit drugs used by
12th graders, according to
recent data from the 2011
Monitoring the Future (MTF)
survey. Slightly more than onethird (36.4%) of high school
seniors reported using
marijuana in the past year,
including 11.4% who reported
using synthetic marijuana,
compared with less than 10%
for all other illicit drugs.
Marijuana
(including Synthetic Marijuana)
Synthetic Marijuana
36.4%
11.4%
Other Narcotics
8.7%
(e.g., Vicodin®, Oxycontin®)
8.2%
Amphetamines
Tranquilizers
OTC Cough/Cold
Hallucinogens
Sedatives
5.6%
5.3%
5.2%
4.3%
Inhalants
3.2%
Cocaine
2.9%
0%
10%
20%
30%
40%
Percentage of U.S. 12th G rade Students
Legal Status of Synthetic Cannabinoids
(DEA)
• March 1, 2011, the DEA, issued final notice to
temporarily place five synthetic cannabinoids into the
Controlled Substances Act (CSA) for at least one year
• Synthetic cannabinoids treated as Schedule 1 drugs
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A drug that has a high potential for abuse
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A drug that has no currently accepted medical use in
treatment in the United States
There is a lack of accepted safety for use of the drug
under medical supervision
Legal Status of Synthetic
Cannabinoids (DEA)
• DEA took action - imminent hazard to the public
safety
• Imposes criminal sanctions and regulatory
controls of Schedule I substances under the CSA
• Covers the manufacture, distribution, possession,
importation, and exportation
• US Senate considering a bill permanently
banning these drugs
State Laws
• Some states have passed their own laws banning the
substance
• New York has pending legislation
Synthetic Cannabinoids “Banned”
by the (DEA)
• Synthetic cannabinoids covered under the
DEA’s new rule includes the following:
o JWH-018 *
o JWH-073 *
o JWH-200
o CP-47,497
o CP-47,497 (C-8 homologue)
CAN SYNTHETIC
THC CHEMICALS BE
DETECTED BY
DRUG TESTING?
Drug Testing:
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New on-site, rapid, instant tests
Numerous laboratories employing
LC/MS/MS technology
$$$ per sample
Many unknowns regarding this
testing
• While parent drugs are detectable, metabolites of
synthetic cannabinoids may be the only detectable
compounds found
• Can use blood and urine as sample
Unresolved Issues of Concern:
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What synthetic compounds (or metabolites)
are being tested by these laboratories?
No standardized urine cutoff levels
No standardized methods (LC/MS/MS)
Tests detect metabolites
No independent quality control materials
No proficiency testing
Detection window unknown
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May be 48 – 72 hours
What to test for ? ? ?
More dangerous than we first thought?
Management
• No pharmacolgically
specific antidote
• Supportive care
• Benzodiazepines for
agitation and anxiety
• Intubation in one case
for decreased
respiratory rate
• Duration of effects???
BATH SALTS
Bath Salts:
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Ivory Wave
Ivory Pure
Ivory Coast
Purple Wave
Vanilla Sky
Appealing Product?
Not talking about this:
What’s in Bath Salts
• Cathinone
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Known for centuries
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Active metabolite is cathine
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Found in leaves and twigs
of Khat plant (Catha edulis)
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Original synthetic
cathinone is methcathinone
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Produced in 1928
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Public Health hazard as
per League of Nations in
1933
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Schedule I drug in 1993
Mephedrone
• Reformulation of cathinone is a chemical found
in the khat plant of Eastern Africa
• Khat existence traced to 15th C. Ethiopia
• Grown in Somalia, Yemen, Kenya, Ethiopia
• Khat is banned in the U.S.
Methylmethcathinone (Mephedrone)
• Designer drug chemically similar to
cathinone
• First synthesized in 1929
• Amphetamine-like properties
• Powerful synthetic stimulant
• “Rediscovered” by synthetic chemists
in 2003
• Widespread in Europe, Australia, US
What’s in Bath Salts:
• Methylenedioxypyrovalerone (MDPV) is a psychoactive
drug with stimulant properties which acts as both a
norepinephrine-dopamine reuptake inhibitor (NDRI).
• MDPV has four times the potency of Ritalin
• MDPV - no history of FDA approved medical use
• Sold since 2007 as a research chemical
• September 2011 – DEA Schedule I (mephedrone,
methylone and MDPV)
MDPV:
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Currently popular in Europe, UK & Australia
Is usually snorted - similar to cocaine
Considered extremely addictive
MDPV was “legal” – now Schedule I
Adverse medical/psychiatric ramifications
No on-site or screening drug tests
4-methylethcathinine (4-MEC)
• Found commonly used as the active ingredient in
"Ecstasy" pills in some countries such as New Zealand
• Referred to as “Molly”
Usage
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UK online study of club-goers reported:
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41% tried methedrone
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10% tried methylone
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33% used in the last month
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14% used it weekly
Blood samples from Finland were taken from 3000 drivers suspected to be
under the influence
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286 (8.6%) had positive for bath salts
Administration – white/brown powder;
capsules and tablets also available
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Oral (mouth, “bombing”)
Intranasal (snorting, “keying”)
Intramuscular
Intravenous
Rectal
Gingival
Inhalation via smoking
Onset and Duration of Action
• Onset:
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Mephedrone 30-45 min
Methylone 30 – 45 min
MDPV 15 – 30 min
• Duration
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Mephedrone 2 – 5 hrs
Methylone 2 – 5 hrs
MDPV 2 – 7 hrs
1. Inhibitor of reuptake
of dopamine,
serotonin and NE
2. Increased
presynaptic release
of same
monoamines though
less effect than
number 1
Pharmacological Effects of “Bath Salts”:
• Physical:
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Increase heart rate & blood
pressure
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Pupil dilation
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Dizziness
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Nausea
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Breathing difficulties
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Headache
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Chest pain
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Bruxism
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Tremors
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Insomnia
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Myocardial infarction
Pharmacological Effects of “Bath Salts”:
• Mental:
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Hyperactivity, arousal & over stimulation
Increased energy & motivation
Euphoria - agitation
Diminished perception of the requirement for food
and sleep
Talkativeness
Increases sexual arousal
Crave to redose frequently
Health Hazard?
Health Hazard?
• Bizarre behavior
• Phenomenal physical
strength
• Self mutilation
• Suicide
• Persistent paranoid
psychosis
• Persistent symptoms of
paresthesias and mood
changes for days to
weeks after using
?
Dependence
• Like amphetamines – induce tolerance and dependency
in at least 30 percent of users with craving and impaired
control
Long Term Effects
• Little is know as relatively recent use
• Potential neurotoxicity with decrease dopamine
transporter activity in the basal ganglia leading to a
parkinson’s like disorder
Detection
• Not detected in routine urine Elisa testing
• May cause false positive methamphetamine screen
• GC-MS test available for mephedrone, MDPV,
methylone
Management
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No specific antidote exists
Supportive care
Aggressive sedation with benzodiazepines
for increased heart rate, seizures, agitation
and hypertension
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Avoid beta blockade due to potential
exacerbation of hypertension due to
unopposed alpha-adrenergic
stimulation
Hyperthermia may require cooling
If severe (persistent vital sign elevation,
neuro and psychiatric abnormalities), all
patients should be admitted and have:
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EKG
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Serial temperature checks
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CPK
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Lytes
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Renal/liver functions
On September 8, 2011, the Drug Enforcement
Administration (DEA) published a Notice of
Intent to place three synthetic cathinones into
Schedule I of the Controlled Substances Act
(CSA)
• mephedrone,
• 3,4 methylenedioxypyrovalerone (MDPV)
• methylone
New York
Bath Salt Data
The Next
Wave (or a
repeat of an
old wave
repackaged)?
Kratom
• Legal plant product –
Mitragyna speciosa Korth
o
South Eastern Asia
tree
• Used to treat opioid
withdrawal
• Access via internet
without prescription
• Dual properties of
stimulation and analgesia
M. Speciosa Korth
• Plant with greater than 25 alkaloids
• Mitragynine responsible for opioid effect
• Works at the mu and delta supraspinal opioid receptors,
serotonin and noradrenergic pathways in spinal cord
Mitragynine
• 13 times more potent than morphine
• Powder, leaves, gum
• Smoked or tea
Reported Benefits
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Analgesic
Anti-inflammatory
Anti-pyretic
Anti-tussive
Antihypertensive
Local anesthetic
Hypoglycemia
Antidiarrheal
Anti-malarial
Clinical Effects
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5 – 10 minutes after consumption effects start
Last about one hour
Low dose – stimulant effect
High dose – opioid effect
Seizures can be seen
Detection
• Liquid chromatography/MS
Management
• Supportive
• Airway management
The New “Designer Drugs”
• Hallucinogens - This class has many different compounds
that can be used for this purpose. These include:
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Salvinorin A (Salvia divinorum)
Lysergic Acid Amide
Leunorine (Lion’s Ear)
Tropane Alkaloids (atropine, scopolamine)
• Datura stramonium
• Atropa Belladonna
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Psilocybin
Muscarine
N,N-Dimethyltryptamine
The New “Designer Drugs”
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Hallucinogens
o
Salvinorin A:
• Street names include: Magic Mint,
Seer’s Sage, Lady SD, and Sally D.
• used for centuries by the Mazatec
shamans in Oaxaca Mexico for spiritual
healing
• used by chewing the fresh leaves,
ingesting a tincture or juice from the
leaf, or smoking dried leaves
• The psychoactive component is
neoclerodane diterpene Salvinorin A.
• It is the most potent of all naturally
occurring hallucinogens and is equal to
LSD.
• Unlike LSD which acts on the serotonin
receptors, this works at the Kappa
Opioid receptor as an agonist.
• There is rapid onset when smoking (one
minute) to ten minutes seen with buccal
(oral) absorption.
• It has a short half-life as the effect
usually lasts 20 minutes
The New “Designer Drugs”
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Hallucinogens
o
Salvinorin A:
• Users state that they “enter
another reality”, have improved
mood, are calm, have increased
insight and have a floating feeling.
There are visual and auditory
hallucinations that occur with use.
• Adverse effects have included:
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Sweats
mind racing
Yawning
anxiety
irritability
insomnia
dizziness
fatigue
loss of coordination
mental slowness
Detection
• High performance liquid chromatography
• MS
Management
• Supportive
• No antidote
• ?? if naloxone can reverse effects
The New “Designer Drugs”
• Hallucinogens
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Lysergic Acid Amide (LSA):
• ergot and fungi infected
plants and produce
• ten times less potent than
LSD (Lysergic Acid
Diethylamide)
• Seeds are crushed and
eaten or soaked in water or
alcohol and eaten.
• The effects last four to eight
hours and can include:
auditory and visual
hallucinations; elevated
blood pressure and heart
rate; memory loss; anxiety;
panic attacks; acute
psychosis; and suicidal
thoughts.
DESIGNER DRUGS
• MDMA (ECSTASY)
PMA
(CARDIO AND NEUROTOXIC)
PMMA
(NEUROTOXIC)
• PCP
PCC(DEATH)
Molly
• Hallucinogenic
amphetamine
• Similar effects to
MDMA and
methamphetamines
• $50 - $100 per gram
2C-E Nicknamed "Europa"
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synthesized in 1970’s -1980’s
psychedelic phenethylamine
taken orally
powerful hallucinogenic effects
high can last 6- 12 hours
sold through European sources
one death reported in MN on March 11, 2011
2C-E Nicknamed "Europa"
• synthesized by Alexander Shulgin
• popularized MDMA (Ecstasy)
• 2C-I another phenethylamine
available
• 2C-E is chemically related to other 2C
phenethylamines
• exact legal status is unclear - 2C-B
banned under CSA
Methoxetamine
• Access via the internet
• “Legal ketamine” – ketamine analog
• Discovered in 2010
Piperazine Derivatives
• Amphetamine like – originally developed as an
antihelminthic
• BZP, TMFPP – “legal ecstasy”
• Schedule I in 2004
BZP
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Antidepressant
Inhibits serotonin transporter
Pills/powder
Effect lasts 6 – 8 hours
Takes 2 hours to get first effect
Management:
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Benzodiazepines
Fluids
Cooling
EKG
“Krokodil”
•Desomorphine
(Dihydrodesoxymorphine) is an
opiate analogue invented in 1932 in
the United States that is a derivative
of morphine
•Desomorphine has attracted attention
in Russia due to its simple production,
utilizing codeine, iodine, gasoline,
paint thinner, hydrochloric acid, lighter
fluid and red phosphorus.
•The street name in Russia for homemade Desomorphine made in this way
is "krokodil" (crocodile), reportedly
due to the scale-like appearance of
skin of its users
•Since the mix is routinely injected
immediately with little or no further
purification, "Krokodil" has become
notorious for producing severe tissue
damage including injury to the veins
(phlebitis) and gangrene. Other
consequences of use have included
severe withdrawal, spread of HIV
through the use of contaminated
needles and death.
Pump-it! Powder:
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Methylhexanamine
Source - found naturally in the
geranium plant
It is not scheduled by the DEA - legal
Banned in athletics
Stimulant
Not widely studied
Wet Marijuana
• Embalming Fluid-Soaked Marijuana:
o
The trend of smoking marijuana soaked in embalming fluid is
gaining popularity throughout the United States. The syndrome
of intoxication looks nearly identical to that seen following
phencyclidine (PCP) use, with agitation, disorganized speech
and thoughts, and diminished attention. The authors believe
that this new trend in drug use involving marijuana also presents
a resurgence in PCP use.
• Soaked in water – uneven burn
• Mixed with THC: wet, fry, crystal joint, supergrass
“Jenkem”:
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Fermentation of human
waste
Feces and urine stored in
tight container for several
days
Reaction produces
methane gas
Methane major component
of natural gas
“Huffed” by users
producing anoxia
Growth of Designer Drugs
What’s different today then in the 1970’s when
the drug Ecstasy (MDMA) was popularized?
What has changed to fuel the rapid
development and distribution of designer
drugs?
Internet
!
What does the Internet offer?
• Improved accessibility
• Increased affordability
• Enhanced anonymity
Unfortunate Truisms:
• Legal controls that prohibit
designer drugs will always lag
behind their production
• Drug detection methods for the
identification of designer drugs
may also not be available when
these compounds become
popular
Erowid
Designer Drugs:
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Designer drugs are here to stay
Rapid evolving landscape
Testing will nearly always lag behind
Legal controls with be challenging and
delayed
• Growing evidence of adverse effects
• Some become fads, others stay around
(MDMA)
A Final Note
• New legislation
Legislation 2012
•
The Synthetic Drug Control Act of 2012 (US Senate .3189) amends the Control Substance Act to add two classes
of substances to schedule 1 – most addictive and most restrictive use with the highest legal implications if found to
be using or selling:
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Cannabimimetic substances and analogs- all analogs of cannabinoid receptor agonists (CB1). This is the
class of THC which stimulates the cannabinoid type 1 receptors in the brain
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Stimulants (bath salts are in this class) and all the isomers and analogs:
• Methedrone
• MDPV
• Methylone
• Naphyrone
• Flephedrone
• Methedrone
• Ethcathinone
• Butylone
• Alpha-PPP
• MOPPP
• MDPPP
• Alpha-PVP
• MDAI
• MPBP
Legislation 2012
• FDA Safety and Innovation Act (Reauthorization Bill)will change
emergency scheduling of drugs from one year with a possible 6
month extension to 2 years with a possible 1 year extension.
• All future analogs of synthetic drugs (structure and/or function) will
be schedule 1 if the bill is signed by the President.
• ONDCP will be unveiling a Synthetic Drug Prevention
Toolkit, which we hope will serve as a resource for
communities dealing with this issue.
• Governor Cuomo Announces State Makes it Illegal to
Sell or Possess Bath Salts or Synthetic Drugs
(August 7, 2012)
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Governor Andrew M. Cuomo today announced that the New York State Department of Health (DOH) has
issued new regulations to crack down on the increasingly widespread use of bath salts and other synthetic
drugs.
The new regulations, issued today by DOH and approved by the Public Health and Health Planning Council,
will expand the existing list of prohibited drugs and chemicals to include dozens more substances that are
now used to make synthetic drugs, better ensuring that distributors can no longer skirt the law by simply
modifying the drug's ingredients. In addition, the regulations will allow for the first time an owner of an
establishment and/or an employee selling synthetic drugs to be charged with possession of an illicit
substance. Further, to support enforcement, the regulations will increase the criminal penalties for those who
violate the rules. Violators will face fines up to $500 and potentially up to 15 days in jail.
• The Governor also announced a new toll-free hotline 1888-99SALTS (1-888-997-2587). Individuals with
information about illegal distribution of bath salts or
synthetic drugs are encouraged to call this hotline.
Resources
• Synthetic Cannabinoids
• 1. http://www.redwoodtoxicology.com/resources/drug_inf
o/synthetic_cannabinoids.html
• 2. http://www.ncsl.org/issues-research/justice/syntheticcannabinoids-enactments.aspx
• 3. http://www.justice.gov/dea/pubs/abuse/drug_data_she
ets/K2_Spice.pdf
• 4. http://www.drugfreeinfo.org/PDFs/Synthetic%20Mariju
ana%20Fact%20Sheet.pdf
• 5. http://www.drugfreeinfo.org
•
Resources
• Bath Salts:
• 1. http://www.webmd.com/mental-health/features/bathsalts-drug-dangers
• 2. http://www.drugabuse.gov/about-nida/directorspage/messages-director/2011/02/bath-salts-emergingdangerous-products
• 3. http://www.iowa.gov/odcp/docs/BathSaltsAlert.pdf
• 4. http://www.iowa.gov/odcp/docs/IAPoisonhotlineBathS
alts.pdf
• 5. http://www.drugfreeinfo.org
•
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