1. Designer Drugs – What Drug Court Practitioners Need to Know
By: Paul L. Cary
Toxicology Laboratory
University of Missouri

4. 2C-I NBOME

5. History of Designer Drugs

6. Designer Drugs Aren’t New
morphine invented in early 1800s from opium
in 1925 morphine was chemically altered to create heroin
1960s hallucinogens (LSD, STP)
late 1970s illicitly synthesized fentanyl (China White)
1980s - MDMA (Ecstasy)
around this time the term “Designer Drugs” was coined
everything changes
introduction of synthetic cannabinoids (Spice & K2)
quickly followed by the introduction of bath salts
today - newer, bolder, experimental cocktails

7. Internet Transformed Designer Drug Trade

8. What is a Designer Drug:
legitimate pharmaceuticals/research chemicals
botanicals (plants with psychoactive properties)
illicit compounds already banned
via reformulation of molecular structure in clandestine labs
newly created chemicals are formed (“Designer Drugs”)
effects to mimic the “original” drug/compound

9. Why Create a Designer Drug?
prolong the effect of the drug
increase the potency of the drug
“select” the desired effect
make the drug more difficult to detect
make an illegal drug “legal”
PROFIT! Make $$$$$

10. Unknowns Associated with Designer Drugs
inconsistencies in production (variable drug concentrations)
purity of the product (contaminates)
mislabeling of packages
false, misleading & deceptive sales
Russian roulette

11. Source of Designer Drugs

12. Synthetic Cannabinoids (Spice/K2)

13. Preparation of “herbal incense”:
botanicals are sprayed with liquid preparations of:
HU-210
HU-211
CP 47,497
JWH-018
JWH-073

14. Smoking Cannabinoids What does CB1 receptor control?
BG: motor control, learning
Hippo: memory, spatial navigation
CB: cognitive functions - attention, language, emotions

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

16. Public Perception of “Legal Highs”
Synthetic cannabinoids are as safe as marijuana.

17. Forensic Science Review
Volume: Twenty-Six
Number One
January 2014
25 pages

18. Synthetic Cannabinoids: Physical Effects
kidney damage (XLR-11)
pulmonary effects (lung dysfunction)
cardiovascular issues (tachycardia), increases in blood pressure
GI problems (pain, nausea, vomiting)
seizures (6 cases)
chemically-induced psychosis **
DUID (12 reported cases) **
three reported deaths (cardiac, suicide, OD)

19. Gurney Report conclusions:
“A review of the literature that exists to date suggests that synthetic cannabinoids may have side effects that are more severe than that of marijuana.”

20. Evolutionary Landscape
appearing & disappearing
what’s popular today cycles out to be replaced by new synthetic THC analogs
labs testing for common compounds a few months ago may not be testing for same chemicals now
difficult to keep pace using legal remedies

21. Acknowledgment: Dr. Barry Logan National Medical Services Willow Grove, PA

22. Evolutionary Landscape

23. Lab-Based Drug Testing:

24. Designer Stimulants (Synthetic Cathinones)

25. Designer Stimulants: bath salts/bath bubbles
plant foods/plant vitamins
glass cleaners/computer screen cleaners
soft drink additive
“novelty collectors item”

26. What are Designer Stimulants?
illegal psychoactive drugs that induce temporary improvements in either mental or physical functions
enhanced alertness, wakefulness, locomotion
produce a characteristic "up" feeling
similar to amphetamine & cocaine

27. MDPV:
Methylenedioxypyrovalerone (MDPV) - a psychoactive drug with stimulant properties which acts as both a norepinephrine-dopamine reuptake inhibitor (NDRI).
often snorted - similar to cocaine
considered extremely addictive
adverse medical/psychiatric ramifications

28. Methylmethcathinone (Mephedrone)
designer drug chemically similar to cathinone
first synthesized in 1929
amphetamine-like properties
powerful synthetic stimulant
adverse medical/psychiatric ramifications

30. Summer, Bath Salt Data

31. 25I-NBOMe Substituted phenethylamine psychedelic 2C-I stimulant
hallucinogen
20 linked deaths
In US

32. Adverse Effects of Designer Stimulants:
surge in neurotransmitters:
dopamine
serotonin
norepinephrine
psychiatric symptoms:
severe paranoia
hallucinations
panic attacks
“excited delirium”
depression & suicidal thoughts

33. Adverse Effects of Designer Stimulants:
dehydration
skeletal muscle degeneration
kidney failure
breathing difficulties
seizures
death

34. Miscellaneous Designer Drugs

35. Tryptamine-Based Drugs (e.g., Foxy, AMT, and DMT)— hallucinogenic
Mitragynine (Kratom)— sedative
Desomorphine (Krokodil)— heroin-like
Benzofurans (6-APB, or Benzo Fury)— stimulation to hallucinogenic
Piperazine-Based Drugs (e.g., BZP, TFMPP, and MeOPP)— stimulants
Phenethylamine-Like Drugs (e.g., Bromo Dragonfly, B-Fly, Fly, and 3CB-Fly)— synthetic hallucinogen
Sedative-Class Drugs (1,4-B and BDO)— derivatives of GHB
Dissociative Psychedelic Class (e.g., 3-MeO-PCP, 4-MeO-PCP)
Methoxetamine, MXE, Mexxy, Roflcopter)—Synthetic dissociative psychedelics like PCP and ketamine.
FAAH Inhibitors– enzyme is responsible for regulating brain chemicals

36. Legal Controls

37. Legal Controls Controlled Substances Analogue Enforcement Act of 1986
Scheduling of Synthetic Drugs: Controlled Substances Act
DEA’s Temporary Scheduling

38. Drug Testing for Designer Drugs

39. Drug Testing for Designer Drugs
designer drugs have made most detection methods obsolete
on-site, point of care devices
laboratory-based (LC/MS/MS)
not all labs are equal
urine remains the specimen of choice

40. Unfortunate Truisms:
legal controls that prohibit designer drugs will always lag behind their production
drug detection methods for the identification of designer drugs may also not be available when these compounds become popular

42. Drug Courts Response Step 1: acknowledge the problem
understanding the complexity and challenges
Step 2: ban designer drugs
even if purchased “legally”
false pretenses - “not for human consumption”

43. Drug Courts Response Step 3: put it in writing best practices research
Step 4: abstinence monitoring
acknowledge limitations
develop a drug testing plan
identify appropriate lab
limited amnesty initiative

44. Drug Courts Response Step 5: community supervision
“eyes & ears” of the court
PO, law enforcement, marshals, case workers, etc.
Fourth Amendment waivers
search & seizure

45. Drug Courts Response Step 5: community supervision continued:
be proactive
home visits (announced & unannounced)
persons, places, vehicles, etc.
under participants control

46. Drug Courts Response Step 5: community supervision continued:
computer & smart phones
text messages, social network
Internet ordering practices
shipping labels, receipts

47. Conclusion escalating public health issue accept unfortunate truisms
challenge of designer drugs will require creativity & vigilance
fidelity to the Drug Court model
follow best practices
we know how to do this!

48. address: