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Clinical Pearl: An Update on Designer Drugs Gabriela Dimitrievski, PharmD PGY2 Psychiatric Pharmacy Resident Purdue University/Eskenazi Health

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Presentation on theme: "Clinical Pearl: An Update on Designer Drugs Gabriela Dimitrievski, PharmD PGY2 Psychiatric Pharmacy Resident Purdue University/Eskenazi Health"— Presentation transcript:

1 Clinical Pearl: An Update on Designer Drugs Gabriela Dimitrievski, PharmD PGY2 Psychiatric Pharmacy Resident Purdue University/Eskenazi Health September 18, 2014 This speaker has no actual or potential conflicts of interest to disclose in relation to this presentation

2 Objectives Identify the importance of being aware of new, popular, and upcoming “designer drugs” Describe the methods of use, effects, and dangers associated with several popular designer drugs Detail ways in which pharmacists can help with substance abuse issues

3 Impact of Substance Use Drug use linked to more deaths than suicides, firearms, or school violence 40,239 drug-induced deaths in the United States in 2011 –Additional 26,256 alcohol-induced deaths Substance abuse as the single largest contributing factor to U.S. crime Cost of drug abuse estimated at $52 billion US Dept. of Justice Drug Enforcement Agency. “Drugs of Abuse.” Available at: National Vital Statistics Report. “Deaths: Preliminary Data for 2011.” Available at:

4 Indiana Statistics SAMHSA. Behavioral Health Barometer, Indiana, Available at: SAMHSA. Indiana Adolescent Behavioral Health In Brief. Available at: Annually, 154,000 individuals aged 12 years or older abused or were dependent on illicit drugs from Equivalent to 2.9% of the population 52,000 (9.7%) of adolescents in Indiana used an illicit drug in the past month 35,000 used marijuana 27,000 used other illicit drugs

5 Popular Media – Deaths Due to Designer Drugs

6 Common Drugs of Abuse Narcotics –Heroin –Opioids –Crocodile Stimulants –Cocaine –Bath salts/synthetic cathinones –Methamphetamine –Caffeine Marijuana/Cannabis –K2/Spice –Wets Depressants – Alcohol – Benzodiazepines – GHB Hallucinogens – Synthetic phenethylamines Smiles, Nexus, Blue Mystic, Europa, N-Bomb – Ecstasy – Molly – LSD – Mushrooms – PCP

7 Molly What is it? –“Purified” MDMA Often combined or substituted with caffeine, dextromethorphan, amphetamines, cocaine, or PCP Desired Effects –Both hallucinogenic and stimulant properties Mental stimulation, emotional warmth, decreased anxiety, euphoria, enhanced perceptions Dangers –Muscle tension, increased heart rate and blood pressure, tremors, teeth clenching, depression –Neurotoxicity, nephrotoxicity, cardiovascular toxicity, hyperthermia, seizures, intracranial hemorrhage Steinhardt et al. Ment Health Clin. 2014;4(5):64. NIDA for Teens. Drug Facts: MDMA. Available at:

8 Powdered Alcohol What is it? –Freeze-dried powder formulation of alcohol –Most notably marketed in the US under the name Palcohol Labeling originally approved by the Alcohol and Tobacco Tax and Trade Bureau, but withdrawn days later Desired Effects –Discreet means of intoxication –Use on food products for “an extra kick” –Snorting powder as a means of immediate intoxication Dangers –Over-consumption of alcohol, addictive potential, attractiveness to young children

9 N-BOMe Substances What is it? –25I-NBOMe, 25C-NBOMe, and 25B-NBOMe Street names: N-bomb, Smiles, Boom, Gnome, Dime, 25I, 25C, 25B –Synthetic phenethylamines with effects similar to LSD –Powders, liquids, edibles, blotter papers Desired Effects –Potent hallucinogenic activity –Euphoria, loving feelings, enhanced awareness, sexual sensations/desires Dangers –Psychosis, agitation, erratic behavior, depression, anxiety, paranoia –Seizures, cardiac arrest, respiratory arrest, death

10 Powdered Caffeine What is it? –Powdered form of pure caffeine –One teaspoon is equivalent to approximately 25 cups of coffee –Marketed as a dietary supplement Desired Effects –Energy boost, weight loss Dangers –Vomiting, diarrhea, stupor, disorientation –Rapid and abnormal heartbeat, seizures, death

11 What Can I Do? ASHP Statement on the Pharmacist’s Role in Substance Abuse Prevention, Education, and Assistance –Pharmacists as having unique knowledge, skills, and responsibilities to take on an important role with substance abuse –Roles centered around: Preventing Educating Assisting specificstsubstance.aspxhttp://www.ashp.org/doclibrary/bestpractices/ specificstsubstance.aspx

12 Gabriela Dimitrievski, PharmD PGY2 Psychiatric Pharmacy Resident Purdue University/Eskenazi Health


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