Within the past decade, forensic and toxicology labs have had difficulty keeping abreast of the number of substances individuals are testing positive for. As soon as an analog has a corresponding toxicology test, it seems as though another has been synthesized. Unfortunately, this is occurring at a rapid pace and the number of alternative substances are being created exponentially. The number of healthcare providers experiencing this issue will continue to grow requiring education for all fields.
Designer drugs, also called novel psychoactive substances, are drugs that share similar chemical structures of certain controlled substances, and mimic their effects, but have not been declared controlled substances themselves. Designer drugs continually circumvent laws created by governmental agencies and it has been a constant battle to keep up with new formulations that are constantly emerging.
Designer drugs have infiltrated communities around the country. Synthetic marijuana, synthetic opioids, synthetic stimulants and designer benzodiazepines are marketed as a desirable alternative to an adolescent or young adult who cannot access illicit substances.
Sold legally and inexpensively online as “research chemicals,” these substances have little to no research to support their use. The chemicals also bear the label “not for human consumption” to absolve the manufacturer of any liability for its use. There is no verification process required to buy these substances online, that is if they are not located in smoke shops or gas stations, and the buyer is simply mailed the substances without question.
The ease of purchase of these chemicals and substances is matched only by the dangers they pose. The following are examples of drugs commonly used, their respective designer versions and the possible effects of use.
Designer drugs: K2, Spice, Black Mamba, Fake Weed, Genie, Kronic
Marketed as “herbal incense,” “herbal products,” or “potpourri,” K2, Spice and other similar substances are all synthetic cannabinoids that are doused with a mixture of chemicals. The desired effect that users of these substances are trying to achieve is one caused by THC, the psychoactive compound in marijuana.
These substances activate the CB1 receptor at a level that is several hundred times higher than THC and leads to severe toxic effects. Reported effects include violent behavior, psychosis, seizures, increased heart rate and blood pressure, respiratory depression, suicidality and death. Those who are vulnerable to mental health issues have relapsed after the use of these drugs.
Designer drugs: U4/Pink/Pinky (U-47700), Gray Death, Krokodil, China White, Apache, Green Jollies
This country is no stranger to the effects of synthetic opioids — the number of deaths due to synthetic opioids continues to skyrocket each year. Fentanyl is responsible for a significant number of deaths, but unfortunately, a number of other, different synthetic opioids and opioid concoctions are also increasing in presence.
U-47700, also known as “pink” or “pinky,” is a very potent synthetic opioid that often presents as a typical prescription pain pill. It is often combined with fentanyl or heroin, which typically proves to be fatal. Fentanyl and its analogs are being made and transported illicitly into the United States and have contributed to now the majority of these opioid overdoses. Fentanyl and U-47700 were found in the system of late musician Prince.
Designer drugs: Bath Salts, Flakka, Vanilla Sky, Zoom, Hurricane Charlie, Cloud 9, Pixie Dust
Designer stimulants gained popularity in the late 1990s after drugs such as MDMA were banned. They were created to mimic the effects of amphetamines and LSD, and were made from a compound called piperazine, which is used to treat parasitic worm infections. After piperazines were banned, a class of drugs called synthetic cathinones took its place. Derived from cathinone, the psychoactive component in khat, a shrub native to Ethiopia, synthetic cathinones are typically referred to as “bath salts” and marketed as such.
These drugs have stimulant and hallucinogenic effects that may include anxiety, delusions, persistent psychosis, seizure, suicidal ideation and death.
Bath salts are sold under a number of different aliases: “plant food,” “stain removers,” “insect repellant,” “party pills,” “herbal highs,” “legal X” or simply “synthetic stimulants.” They also carry the disclaimers that other designer drugs have: “research chemicals” and/or “not for human consumption.” The accessibility to these substances listed under various names is both worrisome and incredibly dangerous.
Designer drugs: Flubromazepam, diclazepam, clonazolam, meclonazepam
Designer benzodiazepines are one of the newest designer drugs and quickly becoming a growing issue, especially in the past couple of years. Sold in the form of blotters, tablets or capsules, the drugs deemed “designer benzodiazepines” are compounds created by pharmaceutical companies that have never been authorized for medical use anywhere in the world. They are labeled “research chemicals” with the added oft-mentioned disclaimer that other designer drugs list – “not for human consumption.”
These drugs work in the same manner as their prescription counterparts, but because there are no quality standards or safety testing, the potency, mechanism of action and the possibility of unforeseen consequences are not known for all potential analogs.
It should be noted that many of these substances are completely legal. These drugs have not been declared as controlled substances at the federal level, so purchasing them online is easy.
The legality of these deadly chemicals certainly must be addressed. The ease with which a young person, let alone anyone else, can purchase many of these items is alarming considering the addiction crisis we are currently experiencing. Also, the lack of safeguarding against substances that can increase the chance of an overdose and/or death to anyone with internet access should never exist. It seems as though legal recourse regarding designer substances is not quite on the horizon. It may be some time before action is taken, which is why education about these substances and what they’re often called can help society be diligent in preventing their use.
Photo: Jeffrey Hamilton, Getty Images