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Designer Drugs Bath Salts? Plant Food? Amy Miles Advanced Chemist WI State Lab of Hygiene Phone: 608-224-6244 Jennifer Messick.

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Presentation on theme: "Designer Drugs Bath Salts? Plant Food? Amy Miles Advanced Chemist WI State Lab of Hygiene Phone: 608-224-6244 Jennifer Messick."— Presentation transcript:

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3 Designer Drugs Bath Salts? Plant Food? Amy Miles Advanced Chemist WI State Lab of Hygiene Phone: 608-224-6244 amy.miles@slh.wisc.edu Jennifer Messick Traffic Safety Resource Prosecutor (907) 343 6434 messickj@muni.org Thank you: Anchorage Police Department Alaska Highway Safety Office

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5 Objective Increase Officer Safety Increase DUI detection and prosecution by providing comprehensive information about some of the most common Designer Drugs and how they differ from traditional drugs

6 What are “Designer Drugs”? “a drug produced by a minor modification in the chemical structure of an existing drug, resulting in a new substance with similar pharmacologic effects, especially one created to achieve the same effect as a controlled or illegal drug” - (dictionary.com)

7 Designer Drugs - Interpretation Designer vs. Rx DRE Information Limited scientific references Police reports –DRE observations Tox report may not = impairment Tox report may not = presence

8 Designer Drugs covered in this presentation: 1.Synthetic Cannabinoids Spice/K2 (Marijuana) 2. Cathinone Derivatives Bath Salts / Plant Food (cocaine, ecstacy, meth) 3. 2C- family (Hallucinogen) 4. Krokodil

9 Road Map For Each Drug: General Identification –Marketing, packaging, history Methods of ingestion Common signs/symptoms, case example Detection: NIC, blood, urine Legal Status Officer Safety

10 What is SPICE / K2 ? Dangerous, synthetic research chemicals that have been dissolved in acetone and sprayed onto dried plant material

11 SPICE / K2 Marketed as incenseMarketed as incense Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)Smells nasty (watermelon, vanilla, rootbeer, tropical, etc) Smoked, mixed in drink, injectedSmoked, mixed in drink, injected

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13 SPICE / K2 Marketed as incenseMarketed as incense Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)Smells nasty (watermelon, vanilla, rootbeer, tropical, etc) Smoked, mixed in drink, injectedSmoked, mixed in drink, injected Sold LEGALLY and LOCALLY (well, kind of)Sold LEGALLY and LOCALLY (well, kind of) 1g -3g packages1g -3g packages $25 - $40 / g (about 2x price of pot)$25 - $40 / g (about 2x price of pot) 1 pkg = 3-5 doses1 pkg = 3-5 doses Used since about 2007Used since about 2007

14 SPICE / K2 Ingredients: Baybean, Blue Lotus, Lion's Tail, Lousewort, Indian Warrior, Dwarf Scullcap, Maconha Brava, Pink Lotus, Marshmallow, Red Clover, Rose, Siberian Motherwort, Canavalia Maritime, Leonotis Leonurus, Leonurus Sibiricus, Pedicularis Densiflora, Scuttellaria Nana, Vanilla Planifolia, Zorinia Latifolia, Magnolia Officinalis, Rosa Gallica, Trifolium

15 Brands/Flavors

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17 John W. Huffman - Clemson University –First to synthesize delta-9 analogues in 1984 450+ different types –Sold in Germany around 2007 "I figured once it got started in Germany it was going to spread. I'm concerned that it could hurt people," Huffman said. "I think this was something that was more or less inevitable. It bothers me that people are so stupid as to use this stuff".

18 Motor control Cognition, memory, perception, learning endocrine function, food intake, body temp regulation Motor control, learning, action selection Cerebral Cortex Higher cognitive function Medulla Nausea, vomiting Hypothalamus Appetite

19 Synthetic Marijuana CB 1 receptors –Expressed mainly in the brain, CNS, muscle, liver, lungs, kidney CB 2 receptors –Expressed in the immune system, evidence of location in the brain CB receptors are activated by three main groups –Endocannabinoids –Plant cannabinoids –Synthetic cannabinoids

20 Missouri Human Dosing Study 6 subjects (one dose 2x) over two days –2 female, 4 male Allowed maximum of 2 “hits” –Blood, urine and oral fluid samples Each subject (but one) commented they would “hit” again Five of the six subjects reported previous experience with synthetic cannabinoids

21 Missouri Human Dosing Study Male, 39 yo, 5’10”, 190# No drug history –First time user ParameterPre-dosePost-dose Blood Pressure124/80140/88 Highest Pulse72116 Body Temp97.898 Draeger 5000Neg Urine Dip TestNegNA

22 Missouri Human Dosing Study Pre-dosePost-dose Attitudecooperative Coordinationnormaljittery Speechnormal Breathnormal Faceflushedred Eyesnormalbloodshot Pupilsequal Follow stimulusYes Eyelidsnormal Trackingequal

23 Missouri Human Dosing Study DRE ObservationPre-dosePost-dose HGNNone VGNNone LOCNonePresent Body TremorsNonePresent Pupil Size 5.0/7.5/5.5-6.55.0/8.0/4.5-5.0 Rebound dilation NonePresent*

24 Missouri Human Dosing Study WAT –Lack of coordination, balance –Raised arms –Stepped off the line OLS –Sway, used arms, put foot down, leg and body tremors Romberg –Sway – 2inch front to back, 1inch side –Estimated 30 seconds in 37 FTN –Quick and lethargic movements, 6 errors

25 Missouri Dosing Study University of Central Missouri Bob Welsh Tracey Durbin NMS Labs Dr. Barry Logan

26 Symptoms Not always a bad trip, but if you’re involved it probably is Elevated BP (140-210 / 100-110)Elevated BP (140-210 / 100-110) Tremors / SeizuresTremors / Seizures UnconsciousnessUnconsciousness Hallucinations / Delusions / Paranoia / AnxietyHallucinations / Delusions / Paranoia / Anxiety Numbness / TinglingNumbness / Tingling

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28 Symptoms Not always a bad trip, but if you’re involved it probably is VomitingVomiting Memory LossMemory Loss Incoherent/slurred speechIncoherent/slurred speech User may feel coldUser may feel cold 6-8hr high (some effects up to 30hrs)6-8hr high (some effects up to 30hrs) Death?? Death?? APD#10-14949 3 raised medians, 2 concrete retaining walls, broken axle, flat tire, driving sidewalk 6HGN + VGN.000 BrAC Slurred/incoherent “Death all around” Going to kill officer

29 DETECTION OF SPICE/K2 (NIC negative for pot) Blood (NMS) $195Blood (NMS) $195 –Within 6-8 hours; can detect some JWH compounds –Can’t detect all compounds –Screen + confirmation / quantitation –Impairment vs particular level of drug Urine $35 - 50Urine $35 - 50 –Within 3 days; can detect some JWH compounds –Cannot detect all compounds (LC / Tandem MS normally used)

30 Spice v. POT ? Blood shot / Red eyesBlood shot / Red eyes Maybe HGN / VGNMaybe HGN / VGN Lack of ConvergenceLack of Convergence +- Normal Pupil size+- Normal Pupil size Normal light reactionNormal light reaction Temperature ↓ or normalTemperature ↓ or normal Blood pressure ↑ or ↓Blood pressure ↑ or ↓ +- Rigid muscle tone+- Rigid muscle tone Blood shot / red eyes No HGN / VGN Lack of Convergence Dilated Pupils Normal light reaction Temperature normal ↑Blood Pressure ↑ Normal muscle tone

31 Which category?? Million Dollar Question:

32 DRE MATRIX

33 What is Everyone Else Doing About It? ILLEGAL In most European and Scandinavian countries Still Legal in Canada 25 States in US + Military Problems with legislation and analog compounds ready to goProblems with legislation and analog compounds ready to go

34 What is the U.S. doing about it? DEA Emergency Ban - Sch I (JWH-018,JWH-073, JWH-200 and CP47-497) - Sell or possess - Became effective when published in CFR (3/1/11) - Remains in effect for 12 months - Can be extended 6 months

35 11078 Federal Register / Vol. 76, No. 40 / Tuesday, March 1, 2011 / Rules and Regulations PART 1308 - SCHEDULES OF CONTROLLED SUBSTANCES § 1308.11 Schedule I. * * * * * (g) * * * (1) 5-(1,1-Dimethylheptyl)-2-[(1R,3S)- 3-hydroxycyclohexyl]-phenol, its optical, positional, and geometric isomers, salts and salts of isomers— 7297 (Other names: CP–47,497 ) (2) 5-(1,1-Dimethyloctyl)-2-[(1R,3S)-3- hydroxycyclohexyl]-phenol, its optical positional, and geometric isomers, salts and salts of isomers—7298 (Other names: cannabicyclohexanol and CP- 47,497 C8 homologue) (3) 1-Butyl-3-(1-naphthoyl)indole, its optical, positional, and geometric isomers, salts and salts of isomers— 7173 (Other names: JWH–073 ) (4) 1-[2-(4-Morpholinyl)ethyl]-3-(1- naphthoyl)indole, its optical, positional, and geometric isomers, salts and salts of isomers—7200 (Other names: JWH–200 ) (5) 1-Pentyl-3-(1-naphthoyl)indole, its optical, positional, and geometric isomers, salts and salts of isomers— 7118 (Other names: JWH–018 and AM678 )

36 What is the law in my State? Traffic Safety Resource Prosecutors –Contact Jenn to find out who your TSRP is messickj@muni.org (907) 343 6434 National Traffic Law Center (NTLC) http://www.ndaa.org/apri/programs/traffic/ntl c_home.html#crash

37 Solid DUI Cases ( The Defendant is your Crime Scene) Can I arrest for DUI?Can I arrest for DUI? –Impairment vs Controlled Substance –Even if legal, may still be DUI Detail / describe observationsDetail / describe observations –Smell (or lack of) –Hear – speech, statements, admissions Turn on Recorder (if permitted)Turn on Recorder (if permitted) Get BloodGet Blood –Can I prove the charge without blood? –If it comes back ‘nothing detected’ is my case sunk?

38 Officer Safety Unregulated mixture of you name it (higher potential for overdose)Unregulated mixture of you name it (higher potential for overdose) Mixed / Unpredictable symptomsMixed / Unpredictable symptoms –You are the frontline – Be Careful! Acetone is flammable!Acetone is flammable!

39 Officer Safety Be AwareBe Aware Wear GlovesWear Gloves If ‘incense’ burning in home, re-evaluateIf ‘incense’ burning in home, re-evaluate Call / wait for back-upCall / wait for back-up Exposure Report?Exposure Report? Call medics / poison controlCall medics / poison control Poison Control 1-800-222-1222

40 Cathinone Derivatives What are Bath Salts?

41 It’s all about the bath right?

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43 This is what we mean...

44 What are Bath Salts? Cathinone Derivatives Synthetic drugs – stimulant, similar to ecstasy, cocaine and/or meth “Not for human consumption” White, odorless, “pills”, fine-grained powder or crystals (oxidizes to yellow or tan)

45 Cathinone Derivatives Khat

46 Cathinone Derivatives Mechanism of Action Cathinone –Induces release of dopamine Similar to amphetamines –Similar in structure to bupropion, methcathinone, diethylpropion –Catecholamine release “Fight or flight” hormones

47 NameR1R1 R2R2 R3R3 R4R4 R5R5 MephedroneMethylH4-MethylHH Methylone (βk- MDMA) MethylH3,4-MethylenedioxyHH Butylone (βk-MBDB) MethylH4-MethylMethylH Pyrovalerone{pyrrolidino}4-MethylEthylH MDPV{pyrrolidino}3,4-MethylenedioxyEthylH

48 Cathinone Derivatives HomologuesAnalogues VS.

49 MDPV Marketed as “Bath Salts” and “plant food” CNS stimulant (3-4 hrs ) Chemical analog of Cathinone (Sch 1 C.S.) NOT Controlled Substance Detectable in blood and Urine (special test) Not to be confused with MDMA “ecstasy”

50 Common Packaging Plastic jars or foil packets

51 Case Examples APD#11-1234 - Stopped at green light - Clumsy, poor dexterity - Sluggish speech, no odor alcohol - 2 HGN, 4 WAT, 4 OLS -Eyes non-reactive to light * Blood positive MDPV APD#11-1234 -Wrong way / one way, curb, sidewalk, yards, pedestrian, eluding, multiple LSA -Delusion Marshalls after him (tow truck driver) -Small jar white powder, NIC positive cocaine -Syringe, pipe -Normal pupils, no HGN *Blood positive MDPV

52 Snort What?

53 Plant Food = Mephedrone

54 Mephedrone “Plant fertilizer” and “bath salts” Chemical analog of Methcathinone (Sch 1) More common in “plant food”

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56 Common Packaging

57 Methods of Ingestion Snorting – onset quick Oral - onset 15 – 45 min Injection Smoking – onset quick Atomizing Effects 6+hrs * Rush of ecstasy, no hard come-down * Binges for several days or even weeks *Also used as cutting agent for meth

58 Bath Salts / Plant Food Legal in US (well, sort of) Illegal in Canada (but we love the internet) Available gas stations, truck stops, head shops, tattoo parlors 50 – 500 mg $20 - $50 DEA “drug of concern” Different than 2-CE

59 Case Examples Welfare check: uncontrollable, non-compliant, taser used, little effect Pennsylvania Fidgety, talking fast, no pain, invincible, likened to coke OD, used with meth, couldn’t perform SFST Broke window, jumped through glass door, jumped on hood of patrol car, rolled off into fetal position, incoherent. Pennsylvania 3 days intermittent delirium, slit throat, shotgun Louisianna Soldier, 3 tours, speeding on freeway, eluding, shot wife in car; vehicle, pockets, house loaded with bath salts, both blood positive for MDPV. Seattle

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61 Case 1: Domestic Bliss Sgt Aaron Watson, Nebraska State Patrol, Ogallala NE

62 Case Study #1 DV - H discharges shotgun in home Marijuana & bath salts found in home H&W admit to using bath salts & marijuana

63 “Ladies First” Defendant Statements She has a Rx for appetite stimulants but hadn’t taken it in 10 days Snorted bath salts ~10 a.m. day prior Snorted again around 1:00 p.m. Snorted again between 9 p.m.-12:00 a.m. Makes her talkative Causes some hallucinations

64 Admissions Effects of bath salts last about 4 hours Like drinking red bulls, but not quite like meth Burns nostrils, but not as bad as meth. Not numbing like cocaine Euphoric, not excessive Increased alertness Believes bath salts caused H violent behavior Observations Irritable,restless,and runny nose Dazed appearance, paranoia, sweating Poor perception of time and distance Eye / body tremors Blisters on tongue White residue in nose

65 Case #1 – DRE SFSTs OLS Swayed Used arms for balance Put foot down Tremors Romberg Balance 2 in front/back sway Eye tremors, constant twitching Estimated 30 sec in 33 Finger to Nose Missed tip 5/6 times Slow reaction time Eyelid tremors Swayed throughout test

66 Case #1 HGN NONE VGN NONE Lack of convergence PRESENT Pupil size RM: 5.5, DRK: 9.0, DL: 4.0 Reaction to light SLOW Pulse 104, 106, 98 Blood Pressure152 / 112 Body Temp 98.4 Muscle Tone NEAR NORMAL DRE Opinion: CNS Stimulant & Cannabis

67 –Urine collected –Ethanol: None detected –Drugs: MDPV (Methylenedioxypyrovalerone) Diphenhydramine Lidocaine Cannabinoids Toxicology results

68 Case 2: “Too Much of a Good thing” Ofc Mitchell, Marietta PD, Marietta, GA

69 “The Better Half” Initial Observations 21 year old male brought in to ER overdosing on unknown drug –Restless, Visible body tremors –Talkative –Anxious, paranoid, hallucinations –Slurred speech –Dry, cracked lips –Clenching fists to the point of causing bleeding –Very alert –Bruxism –Redness to nasal passage

70 Case Study #2 Father says son has been acting that way for 2 days Gives officer empty packets labeled “B – invigorating bath salts – 500 mg“ Father says he found 6-8 empty packets empty in his room

71 “Too Much of a Good Thing” Subject Statements Subject yells “It is legal!” Subject purchased from a head shop Directions are to mix it into a drink and ingest it orally, but he snorted about half the bag

72 “Too Much of a Good Thing” DRE Observations While speaking to the subject he was banging his head into the wall and not even noticing it Pulls out IV twice –Restraints ordered While being restrained, he began to hallucinate and asked security if they drank the rest of the beer

73 DRE Evaluation – Day 1 HGN (in hospital bed) –Lack of smooth pursuit Possibly due to restlessness, unable to appropriately follow stimulus

74 DRE Evaluation – Day 1 Pulse: 112 bpm Blood Pressure: 144/94 Body Temperature: 98.5 Pupils: 9 – 10 mm in all lighting conditions Muscle Tone: Rigid DRE Opinion: CNS Stimulant

75 “Too Much of a Good Thing” DRE Observations – Day 2 Took 3 doses of Lorazepam and 1 dose of Haloperidol to get subject under control Transported to ICU When he awoke the next day, he was violent again 12 people restrain him; injures security guard

76 “Too Much of a Good Thing” DRE Observations – Day 3 DRE interviews subject again on day 3 Subject is sleeping with a resting pulse of 120 Subject states he is exhausted, body hurts, struggling to stay awake Subject has no memory of who DRE was or ever talking to him

77 Toxicology Results Hospital urine sample All testing negative Why? –Type of screen –Target compounds –Lack of metabolites identified –Hospital screen vs. toxicology lab testing

78 American Association Synthetic Cannabinoids –All of 2010: Total of 2,874 calls –Jan – May 12, 2011: 2,052 calls Bath salts –All of 2010: Total of 298 calls –Jan – March, 2011: 1,241 calls 9 Deaths reported in U.S. with more suspected (52+ in EU)

79 TESTING Cathinone Derivatives Sodium Nitroprusside Reagent (NarcoPouch) –Turns blue-purple MDPV, Mephedrone, Methylone, 4-fluoro (Flephedrone), 3-fluoro, 3-methoxymethcathinone

80 TESTING Cathinone Derivatives Scott’s Reagent (Nik Test) –Blue positive reaction MDPV Cocaine, Methadone, Ketamine, Procaine and Lidocaine will also cause a positive reaction

81 TESTING Cathinone Derivatives Marquis Reagent –Bright yellow positive MDPV Diphenhydramine will also cause yellow reaction

82 Legal Status EU, Australia, Canada and Israel = illegal Federal: MDPV and Mephedrone not approved by FDA, but not controlled by DEA yet –Sen. NY introduced federal legislation to add to Sch. 1 (February 2011)

83 Legal Status 13 States Contact your TSRP to find out legal status in your state

84 Cathinone Derivatives – Nationwide Legislation (April 2011)

85 Phenethylamines -2C Group “Tripstacy” (Hallucinogen, + /- Stimulant) Made by brilliant guy who just loved drugs

86 Ok, a Scary, Brilliant Guy

87 Phenethylamines -2C Group “Tripstacy” (Hallucinogen, + /- Stimulant) 2CB – Sch I –Often with MDMA to prolong high –On set 20min – 1 hour –Lasts 4 -6 hours (longer with X) 2C-E –Legal in US –Analog of 2C-B, 2C-T7 & mescaline?

88 2CI –Illegal in UK, legal US –Stronger than 2CB –Lasts longer, 8hrs + –Effects similar to LSD+MDMA without being chatty –White powder / pills UPD#11-1234 -No Headlights -Disjointed response / slow, slurred speech -1000 yard stare -Seeing ‘tracers’ -No HGN, 7 WAT, 3 OLS -User reports effects last 6-12 hrs (contact was 7hours after ingestion)

89 Krokodil / Crocodile Majority of case reports out of Russia Desomorphine – first synthesized in the 1930’s –Alternative to morphine, shorter lasting Manufactured from OTC codeine using industrial chemicals Lack of clean up during synthesis leads to injection of iodine and other metals –Shut down of endocrine and immune systems

90 Officer Safety Unknown substance: –They’re all white powders! Unpredictable Behavior: –They all act crazy!

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92 Officer Safety Unknown substance: –They’re all white powders! Unpredictable Behavior: –They all act crazy! Glove up Exposure Report

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94 Thank you! If you have additional information to contribute, or if you would like to schedule this presentation or get a copy of this Power Point, please contact Jenn Messick messickj@muni.org 907 343 6434 Questions / comments / feedback WELCOMED

95 Salvia Plant

96 Saliva Flowers Blue Salvia Red Salvia Purple Salvia

97 Dried Leaf Packaged

98 Seeds

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101 Piperazines - BZP (Schedule I) Stimulant “PEP, Majik, Frenzy” Releases dopamine and seratonin Often sold as “dietary supplement” No dietary value Not a “natural” product Lasts 4-8 hours Has not been found to occur naturally CASE STUDY Speeding, delayed yield Ptosis, constricted pupils, 2 HGN (unable to complete) 3 WAT, 4 OLS Cocaine and beer in car D falls asleep in cruiser Blood: carboxy, DXM, BZP, TFMPP, Alprazolam

102 Phenazepam (Legal in US, not controlled) CSN Depressant Taken in place of Alprazolam, Clonazepam and Diazepam Benzodiazepines are generally Schedule IV substances CASE STUDY -LSA with semi, hits tree, slumped across seat, SFST’s limited for safety (on backboard) -6 HGN + VGN, slurred speech Blood: positive phenazepam

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