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The Problems Posed D esigner Drugs (Spice/K2, Bath Salts, Etc.) By: Paul L. Cary Toxicology Laboratory University of Missouri.

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Presentation on theme: "The Problems Posed D esigner Drugs (Spice/K2, Bath Salts, Etc.) By: Paul L. Cary Toxicology Laboratory University of Missouri."— Presentation transcript:

1 The Problems Posed D esigner Drugs (Spice/K2, Bath Salts, Etc.) By: Paul L. Cary Toxicology Laboratory University of Missouri

2 The Story of Designer Drugs

3 Designer Drugs: drugs, which are created (or reformulated, if the drug already existed) to get around existing drug laws (CSA), usually by modifying the molecular structures of existing drugs to varying degrees

4 Designer Drugs: n designer drug was first coined by law enforcement in the 1980s n second International Opium Convention in 1925 which specifically banned alternative esters of morphine n 1960s s, new synthetic hallucinogens (modifications of LSD & PCP) n 1980s s, design of MDMA (ecstasy) & methcathinone n , derivatives of psilocybin & mescaline - anabolic steroid

5 What Drives the Production Designer Drugs ? n consumer preferences n law enforcement control

6 Spice/K2 and Synthetic Cannabinoids

7 Whats in these incense products?

8 Listed Ingredients in Spice n n Canavalia rosea : commonly known as beach bean or bay bean - vine found in tropical and subtropical beach dunes n n Nymphaea caerulea : also known as Blue Egyptian water lily n n Scutellaria nana : perennial herb also known as Dwarf skullcap n n Pedicularis densiflora : known commonly as Indian warrior - a perennial herb n n Leonotis leonurus : also known as Lion's Tail and Wild Dagga - a perennial shrub native to southern Africa n n Zornia latifolia : is a perennial herb n n Nelumbo nucifera : known by a number of names including Indian Lotus, or simply Lotus - aquatic perennial commonly found in China n n Leonurus sibiricus: commonly called Honeyweed or Siberian motherwort, herbaceous plant native to Asia n n vanilla n n honey

9 Preparation of the incense: n botanicals are sprayed with liquid preparations of: u HU-210 u HU-211 u CP 47,497 u JWH-018 u JWH-073

10 Synthetic cannabinoids are not Salvia divinorum. Salvia divinorum is a psychoactive plant which can induce dissociative effects.

11 Where can these incense products be purchased?

12 Sources of Incense Products: n n head shops/alternative medicine stores n n internet/on-line sources (2004) n n 1-(800) phone ordering services n n individual distributors

13 Internet Sources:

14 Buy on ebay:

15 How is herbal incense promoted?

16 The Directions:

17 The Benefits:

18 More Directions: There is 1.5g of Natural Super Puff in each package. Super Puff incense is an ultra strong aromatic incense, and is one of the world's strongest herbal incense blends available. It contains an extremely potent blend of herbal resins, extracts, and leaves. This incense is for botanical use only and is not for human consumption.

19 Terms: You affirm and agree to the following: That you are 18 years of age or older. NO EXCEPTIONS! You agree to use our products for their intended purposes only. You waive without exception your right to hold Seller liable in any way for the misuse of Sellers products. Buyer understands that all of Sellers products are offered for scientific research purposes only and that these products are not intended for human consumption. Buyer understands that Sellers products are not meant for oral consumption or inhalation of smoke/hot vapors. The Seller does NOT supply instructions on proper use of any product provided.

20 Whats the story behind these synthetic THC chemicals?

21 Synthetic Cannabinoids n HU-210 n HU-211 n CP 47,497 (and related chemicals) n JWH-018 n JWH-073

22 Origins of Synthetic Cannabinoids n HU-210 & HU synthesized at Hebrew University, Israel in HU-210 is an anti- inflammatory; HU-211 as an anesthetic n CP 47,497 - developed by Pfizer in 1980 as an analgesic n JWH-018 & JWH synthesize by a researcher at Clemson (1995) for use in THC receptor research - John W. Huffman n more than 100 different synthetic cannabinoids have been created

23 Synthetic Cannabinoids Timeline: n first appearance on the Internet 2004 n Europe was original target market n by 2008 widespread in Europe n 2008 introduced into US n widespread in US by late n late 2008 University Hospital Freiburg, Germany first analysis of incense n first Spring 2009 n laboratory testing available late 2010

24 Pharmacological Effects of Synthetic Cannabinoids n HU-210 n CP 47,497 n JWH-018 n JWH-073 n All act as THC agonists

25 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)

26 CB Receptors: n CB 1 and CB 2 n CB 1 receptor influence mainly the brain (central nervous system, CNS), but there are also effects expressed in the lungs, liver and kidneys n CB 2 receptor effects mainly the immune system and in certain stem cells

27 Why Change the Key? prolong the effect of the drugprolong the effect of the drug increase the potency of the drugincrease the potency of the drug select the desired effectselect the desired effect make the drug more difficult to detectmake the drug more difficult to detect avoid patent infringementavoid patent infringement make an illegal drug legalmake an illegal drug legal Drug

28 CB Receptors:

29 Smoking Cannabinoids n BG: motor control, learning n Hippo: memory, spatial navigation n CB: cognitive functions - attention, language, emotions What does CB 1 receptor control?

30 Pharmacological Effects of Synthetic Cannabinoids are Similar to THC n n increase heart rate & blood pressure n n altered state of consciousness n n mild euphoria and relaxation n n perceptual alterations (time distortion) n n intensification of sensory experiences n n pronounced cognitive effects n n impaired short-term memory n n reduction in motor skill acuity n n increase in reaction times

31 Dependence Syndrome Similar to Marijuana

32 Reported Effects of Synthetic Cannabinoids are Different to THC n n production inconsistencies n n herbal incense blends are harsher to inhale n n effect on appetite is non-existent n n increased restlessness & aggressive behavior n n herbal incense produces a shorter high (perceptual alterations & sensory effects are limited) n n doesnt mix well with alcohol (hangovers) n n incense costs more than marijuana

33 Abuse of Synthetic Cannabinoids versus Methamphetamine n n Spice/K2 can be legally purchased n n synthetic cannabinoids are not as overtly addictive n n difficult to detect by most drug testing methods n n are not dangerous to manufacture & necessary chemicals are easier to purchase

34 Whats the legal status of synthetic cannabinoids?

35 Legal Status of Synthetic Cannabinoids (DEA) n 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 n synthetic cannabinoids treated as Schedule 1 drugs u a drug that has a high potential for abuse u a drug that has no currently accepted medical use in treatment in the United States u there is a lack of accepted safety for use of the drug under medical supervision

36 Legal Status of Synthetic Cannabinoids (DEA) n synthetic cannabinoids covered under the DEAs proposed new rule includes the following: u JWH-018 * u JWH-073 * u JWH-200 u CP-47,497 u CP-47,497 (C-8 homologue)


38 Legal Status of Synthetic Cannabinoids (DEA) n DEA took action - imminent hazard to the public safety n when finalized - impose criminal sanctions and regulatory controls of Schedule I substances under the CSA n covers the manufacture, distribution, possession, importation, and exportation n Christine Sannerud, Ph.D., Chief, Drug & Chemical Evaluation Section, Office of Diversion Control

39 Ramifications of DEA Action: n eliminate the commercial distribution of synthetic cannabinoids n drive synthetic cannabinoids underground n limit their availability n impact on criminal justice - wait and see?

40 Prevalence of Synthetic THC? n no national statistics n n Louisiana: u 9 clients pre-selected based upon suspicion u 7 tested positive n Columbia MO: u 17 clients pre-selected based upon suspicion u 12 tested positive u 5 self-admissions

41 National Statistics for Synthetic THC n American Association of Poison Control Centers has reported: n n All of 2009 u 13 cases n First half of 2010 u 567 cases in 41 states u 4000% increase

42 Can synthetic THC chemicals be detected by drug testing?

43 Drug Testing: n NO on-site, rapid, instant tests n NO laboratory-based screening tests n Five laboratories employing LC/MS/MS technology n $20 - $50 per sample n many unknowns regarding this testing

44 Five Laboratories Are: n Redwood Toxicology Laboratory Santa Rosa, CA n National Medical Services Willow Grove, PA n MedTox Scientific St. Paul, MN n NorChem Flagstaff, AZ n Sterling Reference Laboratories Tacoma, WA

45 The Wild, Wild West (Issues of Concern): n What synthetic compounds (or metabolites) are being tested by these laboratories? n no standardized urine cutoff levels n no standardized methods (LC/MS/MS) n tests detect metabolites n no independent quality control materials n no proficiency testing n detection window unknown n caveat emptor!

46 Are There Control Strategies Other Than Testing?

47 Alternative Control Strategies: n community supervision n search & seizure (client contract) u car, home, possessions

48 Courts Response: n place specific synthetic cannabinoid prohibition in your client contract n establish a date certain testing date - inform client population n establish sanction severity n n select participants for testing where there are indications of herbal incense use n n identify positive participants in court & sanction openly to enhance deterrent effect n n provide opportunity for participants to self- report

49 A New Designer Drug – Ivory Wave

50 Bath Salts: n The term bath salts refers to a range of water-soluble products designed to be added to a bath. They are said to improve cleaning, improve the experience of bathing, serve as a vehicle for cosmetic agents, and some even claim medical benefits. Bath salts have been developed which mimic the properties of natural mineral baths or hot springs.

51 Sold Under the Names: n Ivory Wave n Ivory Pure n Ivory Coast n Purple Wave n Vanilla Sky



54 Health Hazard?

55 What is Ivory Wave: n Methylenedioxypyrovalerone (MDPV) is a psychoactive drug with stimulant properties which acts as both a norepinephrine-dopamine reuptake inhibitor (NDRI). n MDPV has four times the potency of Ritalin n MDPV - no history of FDA approved medical use n sold since 2007 as a research chemical

56 MDPV: n currently popular in Europe, UK & Australia n is usually snorted - similar to cocaine n considered extremely addictive n MDPV is legal n adverse medical/psychiatric ramifications n Few drug tests available commercially

57 n designer drug chemically similar to cathinone n cathinone is a chemical found in the khat plant of Eastern Africa n powerful synthetic stimulant n first synthesized in 1929 n rediscovered in 2003 n widespread in Europe, Australia, US Methylmethcathinone (Mephedrone)

58 Client Prohibition Guidance: Any and all designer drugs that can be purchased legally, over the counter without a physicians prescription are strictly prohibited. Any and all smoking mixtures (other than products specifically designated to contain only tobacco) are strictly prohibited. Any and all products sold or marketed under false pretenses with the warning Not for Human Consumption are strictly prohibited.

59 Designer Drugs: n brings me no joy to alert you of this trend n designer drugs are here to stay n evolutionary patterns n testing will lag behind n legal controls with be difficult n BE PROACTIVE! n build community supervision/expand search & seizure efforts

60 address: n

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