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The Real Dangers of Synthetic Drugs in The 21st Century

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Title: Synthetic Drugs Author: kdickinson Created Date: 3/19/2013 8:16:12 PM Document presentation format: On-screen Show (4:3) Company: enzia Other titles – PowerPoint PPT presentation

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Title: The Real Dangers of Synthetic Drugs in The 21st Century


1
The Real Dangers of Synthetic Drugs in The 21st
Century
  • Ken Dickinson, M.S., R.Ph.
  • kdickinson_at_gaudenzia.org
  • 610-291-3109

2
Introductions
  • Presenter
  • Ken
  • Attendees
  • Experience with Bath Salts and K2/Spice
  • Expectations or goals for this workshop

3
Objectives
  • Describe the current trend of synthetic drugs
    of abuse being marketed as legal household
    products
  • Identify the compounds referred to as bath
    salts and K2/synthetic marijuana 
  • Demonstrate the effects on users with emphasis
    on the high incidence of psychosis
  • Review the legal aspects and current
    legislation aimed at regulating and limiting
    access to these chemicals
  • Discuss prevention and treatment approaches

4
Please Take Note
  • Very little science
  • Very little research
  • Now accumulating data science
  • Todays information anecdotal
  • Face to face with users, Law Enforcement, etc
  • Forums discussions on web
  • Some research

5
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6
Designer Drugs Background
  • Trend started in late 1970s
  • Drugs of abuse are classified by DEA
  • Drugs of abuse work according to structure
  • Analogs
  • Can design an analog to have same or similar
    activity but not listed as a controlled
    substance
  • Not subject to legal penalties and restrictions

7
Mephedrone Methamphetamine
8
Designer Drugs Evolution
  • Internationally do not have such laws
  • Being manufactured in other countries
  • Many designer drugs do not test ()
  • A way to Beat the Bladder Police

9
Designer Drugs
  • Todays trend
  • Make an analog that is not listed in laws
  • Since legal can make an distribute as an everyday
    household product e.g. Bath Salts Plant
    Food, potpourri, incense, jewellery cleaner,
    hummingbird attractant, etc.
  • Then label not for human consumption
  • Market via social media and retail outlets

10
European Drug Monitoring
  • 24 new psychoactive drugs 2009
  • 41 in 2010
  • 49 in 2011
  • 57 in 2012
  • Since 2012 more than one a week
  • Synthetic cathinones synthetic cannabinoids
    make up more than 2/3 of new drugs

11
Research Chemicals
  • Schematic highlighting the major families and
    subfamilies of research chemicals, and some of
    their most prominent members.

12
Phenylethylamines I Have Known Loved
  • Alexander Shulgin Ann Shulgin
  • Book PiHKAL A Chemical Love Story (1991)
  • Lists 179 psychoactive compounds
  • A prerequisite to the psychedelic experience
  • The book is arranged into two parts
  • A fictionalized autobiography of the couple.
  • Detailed synthesis instructions for over 200
    psychedelic compounds (most of which Shulgin
    discovered himself), including bioassays,
    dosages, and other commentary.

13
Historical Background
  • All drugs of abuse started out as legal
    (uncontrolled) substances in US
  • Heroin, LSD, Cocaine, Amphetamine, Marijuana and
    MDMA (ecstasy)
  • Many sat on the shelf for years before becoming
    abused
  • A mixture of rumor, myth and science have all
    contributed to changes in the legal status of
    these substances

14
Web Sites
  • www.k2info.org
  • www.bluelight.ru
  • www.drugs-forum.org
  • www.erowid.org
  • www.lycaeum.org

15
K2 Products
16
Description of the Drug
  • Mixture of herbal and spice plant products
  • Leaf can be marshmallow leaf, parsley, etc.
  • Sprayed with synthetic cannabinoids
  • Marketed as incense and not for human
    consumption
  • No regulations to list ingredients or age
    requirements to purchase
  • First generation called K2 or Spice
  • Second generation called K3 or Splice

17
Synthetic Marijuana (JWH- 018)
  • K2 originated at Clemson University, where
    researchers developed synthetic cannabinoids in
    an effort to create therapeutic drugs. But the
    cannabinoids also have effects akin to THC, the
    key ingredient in marijuana
  • K2 is largely created by individual sellers, it's
    anyone's guess what else is added to the mix.

18
Synthetic Cannabinoids Pharmacology
  • Research supported by NIDA-John W.Huffman
  • Two cannabinoid receptors in human brain CB1 and
    CB2
  • CB2 affects inflammatory pain (target of NIDA
    study)
  • JWH analogs target both receptors
  • Huffman JWH is easiest to make outside of a lab
    only need two commercial products
  • Transferring to plant material only requires
    using acetone

19
Any Dangers Involved in Spice/K2 Use?
  • Yes. Until a drug is tested, it cannot be
    considered safe. Not only have synthetic
    cannabinoids not been tested, nearly all were
    created for experimental use in animals and cell
    cultures, not tested for use in humans.
  • JWH-018 inventor John W. Huffman, PhD, puts it
    bluntly "It is like Russian roulette to use
    these drugs. We don't know a darn thing about
    them for real."
  • These synthetic cannabinoids have been associated
    with impaired driving incidents, attempted
    suicides, and emergency department visits, and
    have been linked to such adverse effects as
    increased anxiety, panic attacks, heart
    palpitations, respiratory complications,
    aggression, mood swings, altered perception, and
    paranoia.

20
Dangers Involved in K2
  • Recent reports (Jan 2013) of kidney failure
  • Reports of cardiac events such as heart attack in
    young male users
  • Medical reports indicate that K2/Spice drugs
    potentially result in users developing a rapid
    and powerful addiction on a level not usually
    found among smokers of real marijuana.

21
Teens K2 Effects in ER
  • One 16-year-old girl was catatonic, unable to
    speak or respond to any touch, when she arrived
    in the emergency room. A urine drug test showed
    she had cannabinoids in her system.
  • Another teen, a 16-year-old boy, had problems
    with movement and trouble with his speech.
    Although he was alert, he seemed confused, and
    could only answer simple questions.
  • And an 18-year-old boy was brought to the
    emergency room agitated and excessively sweating.
    He was restless, aggressive and uncooperative.

22
Alarming Fact
  • Tests show that even the same brand may have
    different drugs in different amounts-at
    different times
  • User has no way of knowing what or how much they
    are taking

23
K2 Data
  • American Association of Poison Control Centers
  • Reported in article June 2012
  • Year 2010 2, 906
  • Year 2011 6,959
  • Year 2012 5,205

24
Spice is typically smoked like marijuana
25
On Line Reported K2 Effects
  • Strong dysphoria -Panic attacks -Heavy body
    load -Extreme nausea -Fear, Panic,
    Anxiety -Strong aural hallucinations --Racing
    heart (higher doses)
  • Heart attack

26
On Line Reported K2 Effects
  • Self mutilation
  • Paranoia
  • Auditory visual hallucinations
  • Delirium
  • Agitation

27
On Line Reported K2 Effects
  • Marijuana-like effects
  • Euphoria
  • Giddiness
  • Silliness
  • Impaired short-term memory and concentration
  • Increased appetite

28
K2 Products
29
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30
Scooby Snacks K2
31
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32
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33
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34
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35
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38
What Are Spice Users Saying?
  • But when I smoked this sonic boom stuff, I was
    completely high. I was trippin for over an hour.
    Its insane but fun. I got to the point where my
    vision kept zooming in and out.
  • But I do not recommend this drug if you are a
    first time smoker or you dont like weed. This
    stuff gives you an intense head high, thus
    starting to trip and having hallucinations.
  • This is very similar to the marijuana high but
    just a bit stronger. The only bad thing about
    this is that it is very bad for you because its
    an incense.

Source Various Blog Sites
39
What Are Spice Users Saying?
  • Spice is nowhere near as dangerous as some people
    say it is.
  • Sure its in no way good for you and it would
    kill you from the carcinogens eventually but
    thats about it.
  • If youre responsible and just smoke a little
    every now and again youre not going to die and
    youre definitely not going to get addicted.
  • I have literally taken a drug test the day after
    smoking it and passed no problem.

Source Various Blog Sites
40
Why the Discrepancy in Reports?
  • Use of other drugs with incense
  • Varying potency
  • Overdose
  • Presence of different cannabinoids
  • Knock-offs
  • User/environment characteristics
  • Set setting, etc.

41
Spice Withdrawal
  • Unrest Agitation
  • Anxiety Panic Attacks
  • Tremors
  • Heart Palpitations
  • Nausea Vomiting
  • Sweating
  • Nightmares
  • Cravings
  • Depression

42
K2 Treatment Issues
  • High rates of addiction (K2info.org)
  • Withdrawal due to physical addiction
  • Treated with sedatives and clonidine
  • Before DA treatment need to be medically and
    psychiatrically safe and stable
  • Residual effects for weeks (or months) due to
    long half-life fat storage
  • Unpredictable

43
K2 Testing
  • Many labs have a test for the first generation
    JWH chemicals
  • In February 2010, Redwood Labs, California
    developed a saliva test for JWH-018, JWH-073 and
    JWH-250
  • Saliva and urine tests recently developed for
    second generation JWHs
  • http//www.redwoodtoxicology.com/documents/service
    s/3369_sc_sellsheet.pdf

44
K2 Testing
  • Following a single low dose exposure, synthetic
    cannabinoids can be detected up to 72 hours in
    human urine.
  • In case of chronic exposure the window of
    detection is much longer
  • http//www.redwoodtoxicology.com/services/syntheti
    c_cannabinoid_testing.html

45
When Done Right, Drug Testing Works!
  • Traditional lab-based drug testing methods work
    at detecting synthetic marijuana, including
  • Urine
  • Oral fluid
  • However, the lab will not conduct a traditional
    test for THC its a different test to detect
    chemical structure of synthetic marijuana but it
    can be detected with lab-based oral fluid and
    urine.
  • So far, no evidence that instant urine testing
    devices, including products marketed as home
    drug test kits, work at detecting synthetic
    marijuana.

46
Then Came Oral Fluid Testing
  • Well, its not urine
  • Easy to administer internally
  • Virtually impossible to adulterate
  • Legal in most jurisdictions
  • Legally defensible
  • Rapidly increasing in popularity

47
Oral Fluid Testing
  • Drugs are detected immediately after use
  • Under the influence indicator
  • Less invasive collection process
  • Comparable to blood
  • Science continues to progress and get better
  • Flexible sample can be collected any time,
    anywhere
  • There are FDA cleared oral fluid collection and
    testing products (for laboratory based testing)

Source Myths Facts About Oral Fluid Drug
Testing, On File OraSure Technologies, 3/2011
48
Cheating
  • Urine tests are susceptible to drug test cheating
  • Oral fluid is very difficult to adulterate
  • Collection takes place in the presence of both
    the donor and the administrator of the test
  • Typical cheating methods such as switching
    samples or adding something to a sample are
    virtually impossible to successfully pull off
  • A search of the Internet will find thousands of
    hits for cheating on a urine drug test only a
    handful for oral fluid testing

49
Cheating
  • A good website for oral fluid drug test cheating
    is wikihow.com/pass-a-drug-test. Quoting directly
    from the website
  • Try to avoid the test. If one is being tested
    and has used in the past 3 days you will need to
    overcome the saliva collection. To do this you
    will have to avoid submitting saliva and perform
    the steps requested of you by the instructor.
    Another offers this advice
  • To pass this an oral fluid test you should
    always know the detection time of the drug you
    have taken. Marijuana can be detected via saliva
    drug testing from an hour after ingestion up to
    24 hours depending on use. Between these periods
    of time, you must avoid being screened or you
    will surely test positive.

50
Dignity
The testing process protects the dignity and
privacy of the donor.
  • No urine, no bathroom no humiliating observed
    collections, no gender match-up issues, no
    threats of drug test cheating
  • Donor and administrator observe the collection
    together
  • Specimen never leaves the donors sight
  • Embarrassing shy bladder issues are eliminated
  • Theres virtually no way to cheat

51
Testimonials
  • We find the ability to test quickly and to
    collect the sample with minimal exposure to staff
    is a great advantage.
  • -- Janet Ward, Former Drug Court Coordinator,
    Anne Arundel County (MD) District Court
  • We are a very client-focused program and oral
    fluid testing allows us to concentrate on
    building the relationship rather than on drug
    testing.
  • -- Keith Spare, Former Director of Rodgers South
    Drug Treatment, Kansas City, MO
  • Intercept is more sensitive to patients needs
    by being less embarrassing and easier for
    patients to provide an oral fluid sample compared
    to that of urine.
  • -- Dr. Beny Primm, Addiction Research Treatment
    Corp, New York City

52
OraSure Intercept
  • Intercept Oral Fluid Collection Device
  • Oral Fluid Drug Assays Used in Laboratory

53
K2 Overview
  • No quality control
  • Manufacturing process may be associated with
    adverse effects
  • Subjective effects most closely resemble those of
    very powerful marijuana
  • Almost complete lack of scientific study
  • Street information very inconsistent

54
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55
Mitragyna Speciosa
  • Used in
  • Malaysia
  • Thailand
  • Indonesia
  • Local names
  • Ithang
  • Biak Biak
  • Ketum
  • Kakuam

56
Kratom Pharmacology
  • Mitragynine
  • Structurally similar to some hallucinogens
  • No hallucinogenic activity or effects
  • Acts on opioid receptors

57
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58
Kratom Opioid Treatment
  • Currently used for heroin and methadone
    dependence in some countries
  • New Zealand
  • Thailand
  • Used in detox to manage withdrawal symptoms from
    opioids
  • Millenium Labs announced test Aug. 2012

59
Kratom Opioid Treatment
  • www.bluelight.ru
  • Forum with much Kratom info
  • Participants using Kratom to week off of oxy,
    heroin, Bup, etc.
  • Majority unable to ween off of Kratom
  • Descriptions of withdrawal
  • Descriptions of how to prepare dosage
  • Descriptions of which to buy and where

60
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61
Kratom
  • Seems to be a stimulant in lower doses
  • Mitragynine
  • Seems to be sedative in higher doses
  • 7 hydroxymitragynine
  • Often produces a mixed effect
  • Onset 5 t o 10 minutes
  • Duration several hours

62
Kratom Side Effects
  • Short term (immediate)
  • Dry mouth
  • Increased or decrease urination
  • Loss of appetite
  • Nausea and/or vomiting
  • Side effects
  • Anorexia/weight loss
  • Depression
  • Addiction

63
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64
Kratom
  • EFFECTS
  • Kratom is often described as producing
    simultaneous, contradictory effects- both an
    opiate-like sedation and coca-like stimulation.
    The stimulating effects tend to predominate at
    low dose levels, which may cause alertness,
    energy, and mild euphoria. Higher level doses are
    usually more tranquilizing, causing an
    opiate-like dreamy effect. Excessive doses can
    cause severe nausea. As with opium, it is known
    for causing constipation, and is sometimes used
    as a treatment for diarrhea.
  • Onset
  • When taken orally, the effects of kratom usually
    become noticeable in 15-20 minutes and clearly
    apparent in 30-60 minutes. Strong doses tend to
    have a more quicker, more dramatic onset.
  • Duration
  • A moderate dose of kratom may cause strong
    effects that last 2-4 hours, with residual
    effects lasting hours longer.

65
Kratom
  • Visual Effects
  • Some visual effects have been reported, including
    both open-eye and closed-eye effects. Effects
    reported include wavering, shifting, and strobing
    in the visual field. There was also some
    patterning with eyes closed, as well as increased
    closed-eye visualizations.
  • PROBLEMS
  • Kratom is not known to be toxic, but can cause
    unpleasant symptoms at high doses such as nausea
    and vomiting. Regular use can lead to physical
    dependency. Kratom use can cause constipation
    similar to that caused by opiates. Chronic heavy
    use is reported to cause darkening of skin,
    insomnia, dry mouth, and anorexia.
  • Addiction Potential
  • There are reports of physical dependency after
    frequent, heavy kratom use. Individuals who use
    it regularly or in large doses may have trouble
    quitting. Withdrawal symptoms include
    irritability, yawning, diarrhea, runny nose, and
    pain in the joints or muscles.
  • http//www.bing.com/videos/search?qYouTubeKrato
    mviewdetailmidEC48A0AFEDFBEA20762AEC48A0AFEDFB
    EA20762Afirst0FORMLKVR16

66
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    Kratom you can find anywhere! And at a great
    price. This powdered Mitragyna speciosa leaf is
    high alkaloid like the previous product but has
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    to the young, cultivated leaf material which
    copycat sellers have tried to sell, and of course
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    Ships SAME-DAY if ordered by 3 PM central!
  • Product not available to Australia, Denmark,
    Finland, Malaysia, Myanmar, New Zealand, Norway,
    Romania, Thailand.

67
Kratom E-Cigarettes
  • Kratomite Adventure Industries' Kratomite is the
    world's first electronic cigarette to deliver
    Kratom, a medicinal herb known for its
    concentration of alkaloids, according to the
    company. Kratom interacts with opioid receptors,
    which may offer users relaxing sensations. Unlike
    tobacco-alternative electronic cigarettes,
    Kratomite is a personal vaporizer that uses a
    proprietary, herbal-infused formula, said the
    maker. Adventure Industries Pembroke Park, Fla.
    (800) 999-2483, ext. 1287 sales_at_adventureindustri
    es.com

68
Mephedrone (4-Methylmethcathinone)
69
Bath Salts
  • Toxic psychoactive drugs disguised or
    pretending to be Bath Salts
  • They are NOT
  • Some people have snorted real BSs

70
Bath Salts Are
71
Khat
  • Native to tropical East Africa and the Arabian
    Peninsula
  • Fresh Leaves/tops chewed or consumed as tea
  • Stimulation and euphoria
  • Part of social culture in many countires (coffee,
    tea, coca or khat)

72
Khat
  • Coca ---------------cocaine
  • Khat ----------------cathinone (Schedule I)
  • Cathinones Structure similar to amphetamines
  • Euphoria
  • Anorexia
  • Stimulation
  • Dilated pupils
  • Hypnagogic hallucinations when wearing off

73
What are Synthetic Cathinones?
  • Synthetic cathinones are related to the parent
    compound cathinone.
  • Since the mid-2000s, unregulated ring-substituted
    cathinone derivatives have appeared in the
    European and American recreational drugs market.

74
What are Synthetic Cathinones?
  • The most commonly available synthetic cathinones
    sold on the recreational market in the period up
    to 2012 appear to be 3, 4-Methylenedioxypyrovalero
    ne (MDPV), mephedrone, and methylone.
  • These products are usually encountered as highly
    pure white or brown powders. Cathinone
    derivatives are claimed to have effects similar
    to those of cocaine, amphetamine or MDMA
    (ecstasy), but little is known of their detailed
    pharmacology.

75
Mephedrone Background
  • Discovered 1929
  • Rediscovered 2003 web site The Hive
  • Was a replacement for Ecstasy
  • Sold as plant food later bath salts
  • Manufactured in clandestine labs
  • Methylenedioxypyrpvalerone (MDPV)
  • Known as substituted cathinones

76
MDPV Timeline
  • MDPV was developed in the 1960s, and has been
    used for the treatment of chronic fatigue, but
    caused problems of abuse and dependence.
  • 1969 Boehringer Ingelheim files a patent
    application for MDPV.
  • 2005 MDPV appears as a recreational drug first
    mention on Drugs-Forum.
  • 2007 First seizure of MDPV as a recreational
    drug, by customs officials in the German state of
    Saxony. The drug had been shipped from China.
  • 2008 First seizure of MDPV in the United States.

77
MDPV Timeline
  • 2009 MDPV made illegal in Denmark.
  • 2010 MDPV made a controlled drug in the UK,
    Sweden, Germany, Australia and Finland. First
    reports of the widespread retail marketing of
    'bath salts' containing MDPV in the US. The US
    considers both Mephedrone (July, 2010) and MDPV
    (December, 2010) "a drug and chemical of
    concern".
  • 2011 2012 MDPV sale and possession are banned
    in most US states with legislation being
    introduced in Maryland and other states.

78
Bath Salts (Cathinones) Appearance
  • Distinctive odor
  • Fishy
  • Vanilla
  • Stale urine
  • Bleach
  • Circuit boards

79
Cathinones Use
  • Capsules, tablets or white granuels
  • Can be swallowed, smoked, snorted, injected
  • Prominent use in Europe
  • Out of 70 Dutch users of mephedrone, 58 described
    it as an overall pleasant experience and 12
    described it as an unpleasant experience

80
Cathinones Effects
  • Duration
  • Total 2 5 hours
  • Onset 15-45 minutes
  • Coming up 15 30 minutes
  • Plateau 15 30 minutes
  • Coming down 30 90 minutes
  • After effects 2 4 hours

81
Cathinones Desired Effects
  • Mental and physical stimulation
  • Euphoria, mood lift
  • Feelings of empathy, openness
  • Increase in sociability, desire to talk with
    others
  • Pleasurable rushing
  • Sense of being sped up

82
Cathinones General Effects
  • General change in consciousness (as with most
    psycho-actives)
  • Decreased appetite
  • Pupil dilation
  • Unusual body sensations (facial flushing, chills,
    goose bumps, body energy)
  • Change in body temperature regulation
  • Sweating
  • Increase in heart rate and blood pressure

83
Cathinones General Effects
  • Sleep deprivation
  • Bruxism
  • Motor automatisms (compulsive repeated hand
    washing)
  • Hyper-alertness

84
Cathinones Toxic Effects
  • Strong desire to re-dose, craving to recapture
    initial euphoric rush
  • Uncomfortable changes in body temperature
    (sweating/chills)
  • Heart palpitations, sense of racing heart
  • Impaired short term memory
  • Insomnia
  • Skin lesions (?)

85
Cathinones Toxic Effects
  • Severe paranoia
  • Psychosis (Excited Delirium)
  • Hypersexuality
  • Aggression
  • Hallucinations
  • Anxiety and depression
  • Seizures

86
Bath Salt Data
  • American Association of Poison Control Centers
    of calls
  • June 9, 2012 report
  • Year 2010 304
  • Year 2011 6,138
  • Year 2012 2,656
  • Year 2013 Jan-April 350

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90
Cathinones Treatment Issues
  • Similar to strong amphetamine addiction
  • Similar to PCP abuse/addiction
  • Non-psychotic withdrawal use Benzos
  • Stabilization and Safety highest priority
  • Safety of client
  • Safety of staff and others

91
Cathinones Treatment Issues
  • If psychotic or dissociated need to medicate
  • Neuroleptics
  • Haldol for emergency stabilization
  • Atypicals (Seroquel/Respirdol/etc.) for ongoing
    stabilization
  • Decease sensory exposure
  • Rock or Rave medicine
  • Talking down bad trips
  • De-escalation techniques

92
Cathinones Treatment Issues
  • Once stable and safe be aware of cognitive
    impairment
  • May need tincture of time to grasp recovery
  • Supportive non threatening environment
  • Screen for COD (high probability)
  • Buproprion for concurrent depression

93
Synthetic Cathinones Effects Summary Sheet
  • Aggression
  • Agitation
  • Breathing difficulty
  • Bruxism (grinding teeth)
  • Confusion
  • Dizziness
  • Extreme anxiety sometimes progressing to violent
    behavior
  • Fits and delusions
  • Hallucinations
  • Headache
  • Hypertension (high blood pressure)
  • Increased alertness/awareness
  • Increased body temperature, chills, sweating
  • Insomnia
  • Kidney pain
  • Lack of appetite
  • Liver failure
  • Loss of bowel control
  • Muscle spasms
  • Muscle tenseness
  • Vasoconstriction (narrowing of the blood vessels)
  • Nausea, stomach cramps, and digestive problems
  • Nosebleeds
  • Psychotic delusions
  • Pupil dilation
  • Renal failure
  • Rhabdomyolysis (release of muscle fiber contents
    myoglobin that could lead to kidney problems)
  • Severe paranoia
  • Suicidal thoughts
  • Tachycardia (rapid heartbeat)
  • Tinnitus

94
Synthetic Drug Abuse Prevention Act of 2012
  • July 10, 2012 President signed Law making
    temporary law permanent
  • October 1, 2012 Synthetic Drugs now listed as
    Schedule I
  • All substituted cathinones now Schedule I
  • Chemists working on making non-cathinone
    stimulants
  • http//www.ncsl.org/issues-research/justice/synt
    hetic-drug-threats.aspx

95
Prevention For K2 Bath Salts
  • Heighten awareness via Education
  • Schools, parent groups, community groups, law
    enforcement, medical treatment, etc.
  • Legislation against precursor chemicals
  • Legislation making drugs Schedule I
  • Patrick Meehan Synthetic Drug Control Act
  • Goes into effect October 1, 2012!!!
  • Hit the retailers in their pocket book
  • Civil suits by victims (users and families)
  • Authorities appealing to retailers with amnesty
    if stop and destroy

96
Urine Detection Information
  • Redwood Toxicology Laboratory shows currently
    they have detection for MDPV and Mephedrone. (see
    w.K2info.org/drugtesting)
  • June 11, 2012 Redwood expanded to test for 21
    designer stimulants
  • http//www.redwoodtoxicology.com/services/designer
    _stimulant_testing.html
  • Atlantic Labs- Bensalem, PA Bath Salts 20.00 and
    K2 15.00.
  • Most labs now testing
  • Check with your lab

97
On-Site Testing
  • Many labs now have available
  • On site urine may be useful in treatment
  • Problem labs report as high as 35-40 false
    negatives with on-site.
  • On-site shows no use but when testing for
    accuracy they send to lab for confirm and up to
    40 tested positive
  • Saliva test available

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99
2C-1 or Smiles
  • Reports now in Mid-Atlantic states (Sept 2012)
  • Prevalent on YouTube (users)
  • Similar to a mix of ecstasy LSD but with longer
    high higher potency than either
  • Unusual unpredictable effects
  • Not detectable like bath salts
  • Potency not consistent from batch to batch

100
2C-1 or Smiles
  • Usually sold in white powder form and can be
    melted into chocolate candy, but can also be
    taken as a tablet
  • Also sold as breath mint or drops
  • Both a hallucinogen and a stimulant- has been
    linked to recent teen deaths
  • Can cause heart to beat out of control, seizures
    and foaming at the mouth

101
Krokodil
  • Opioid- desomorphine
  • Result of attempt to extract codeine
  • Injected can be used by other routes
  • Russia spreading through Europe
  • Tissue breakdown
  • Highly addicting- Usually fatal

102
Desomorphine
  • 8-10 X more potent than morphine
  • First discovered in 1932
  • Sedative opioid effects
  • Made from codeine, red phosphorous Iodine
    (similar to methamphetamine)
  • Made in 30 minutes injected immediately
  • Produces gangrene phlebitis

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106
Mollys
  • Pure molecule of MDMA
  • Popular in rap music lyrics
  • Used at parties and raves
  • Lately Mollys have contained cathinones
  • Familiar effects of XTC
  • Bruxism, hyperthermia, anxiety, depression,
    dehydration, etc

107
Salvia divinorum
  • Regulated in PA
  • Legal for over 21 y.o. in MD
  • Not regulated by Feds
  • Dissociative effects
  • Visions and hallucinations
  • Purchased on internet or locally
  • Most potent hallucinogen mg by mg
  • Smoked

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109
Benzo Fury
  • 6- APB
  • Entactogenic phenylethylamine
  • Not scheduled and not approved for human
    consumption by FDA
  • Use is rapidly on rise
  • Number of websites selling on the rise
  • Sold as research chemical

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111
Benzo Fury
  • Effects including both positive and negative
    ones.Increased happiness, euphoria, extreme mood
    lift, increased self-acceptance, feelings of a
    peace and love toward others, increased intimacy
    and closeness with others, closed-eye
    hallucinations, ability to discuss topics with
    others that would not normally be discussed,
    pleasurable body rushes, increased sexual
    interest,

112
Weed Oil or Honey
  • Recent resurgence
  • Butane method popular
  • Fires explosions
  • Solvent with heat extracts the THC
  • 30 and higher THC
  • Recipes cook books on web
  • YouTube demonstrations

113
Weed Oil or Honey
  • Onset of action longer 45 to 60 minutes
  • Duration of action 6 hours and maybe longer
  • Intensity of high greater due to high THC
  • Can also be smoked
  • Vaporizers used

114
Weed Oil or Honey
  • Edible Marijuana
  • Ice Cream

115
Points to Ponder
  • WHAT
  • Did I learn today?
  • What do I think about it?
  • How do I feel about it?
  • So WHAT
  • Does this information mean to me professionally
    and personally?????
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