designer drugs – what drug court practitioners need to know by: paul l. cary toxicology laboratory...
TRANSCRIPT
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Designer Drugs – What Drug Court Practitioners
Need to Know
By: Paul L. CaryToxicology LaboratoryUniversity of Missouri
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2C-I NBOME
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History of Designer Drugs
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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 2006 - everything changes introduction of synthetic cannabinoids (Spice & K2) quickly followed by the introduction of bath salts today - newer, bolder, experimental cocktails
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Internet Transformed Designer Drug Trade
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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
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Why Create a Designer Drug?
• prolong the effect of the drugprolong the effect of the drug• increase the potency of the drugincrease the potency of the drug• ““selectselect”” the desired effect the desired effect• make the drug more difficult to detectmake the drug more difficult to detect• make an illegal drug make an illegal drug ““legallegal””• PROFIT! Make $$$$$PROFIT! Make $$$$$
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Unknowns Associated with Designer Drugs
inconsistencies in production (variable drug concentrations)
purity of the product (contaminates) mislabeling of packages false, misleading & deceptive salesfalse, misleading & deceptive sales Russian rouletteRussian roulette
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Source of Designer Drugs
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Synthetic Cannabinoids
(Spice/K2)
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Preparation of “herbal incense”:
botanicals are sprayed with liquid botanicals are sprayed with liquid preparations of:preparations of: HU-210HU-210 HU-211HU-211 CP 47,497CP 47,497 JWH-018JWH-018 JWH-073JWH-073
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Smoking Cannabinoids
BG: motor control, learningBG: motor control, learning Hippo: memory, spatial Hippo: memory, spatial
navigationnavigation CB: cognitive functions - CB: cognitive functions -
attention, language, attention, language, emotionsemotions
What does CBWhat does CB11 receptor receptor control?control?
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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
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Public Perception of “Legal Highs”
Synthetic cannabinoids Synthetic cannabinoids are as safe as marijuana.are as safe as marijuana.
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Forensic Science Review Volume: Twenty-Six
Number OneJanuary 2014
25 pages
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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)
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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.”
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Evolutionary Landscape
appearing & disappearingappearing & disappearing whatwhat’’s popular today cycles out to be s popular today cycles out to be
replaced by new synthetic THC analogsreplaced by new synthetic THC analogs labs testing for common compounds a labs testing for common compounds a
few months ago may not be testing for few months ago may not be testing for same chemicals nowsame chemicals now
difficult to keep pace using legal difficult to keep pace using legal remedies remedies
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Acknowledgment:
Dr. Barry LoganNational Medical ServicesWillow Grove, PA
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Evolutionary Landscape
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Lab-Based Drug Testing:
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Designer Stimulants (Synthetic Cathinones)
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Designer Stimulants:
bath salts/bath bubblesbath salts/bath bubbles plant foods/plant vitaminsplant foods/plant vitamins glass cleaners/computer screen glass cleaners/computer screen
cleanerscleaners soft drink additivesoft drink additive ““novelty collectors itemnovelty collectors item””
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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
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MDPV: Methylenedioxypyrovalerone (MDPV) - a Methylenedioxypyrovalerone (MDPV) - a
psychoactive drug with stimulant psychoactive drug with stimulant properties which acts as both a properties which acts as both a norepinephrine-dopamine reuptake norepinephrine-dopamine reuptake inhibitor (NDRI). inhibitor (NDRI).
often snorted - similar to cocaine often snorted - similar to cocaine considered extremely addictiveconsidered extremely addictive adverse medical/psychiatric ramificationsadverse medical/psychiatric ramifications
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designer drug chemically similar to designer drug chemically similar to cathinonecathinone
first synthesized in 1929first synthesized in 1929 amphetamine-like propertiesamphetamine-like properties powerful synthetic stimulantpowerful synthetic stimulant adverse medical/psychiatric ramificationsadverse medical/psychiatric ramifications
Methylmethcathinone (Mephedrone)
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Summer, 2014 - Bath Salt Data
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25I-NBOMeSubstituted
phenethylaminepsychedelic 2C-I
stimulanthallucinogen
20 linked deathsIn US
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Adverse Effects of Designer Stimulants:
surge in neurotransmitters: dopamine dopamine serotoninserotonin norepinephrinenorepinephrine
psychiatric symptoms:
severe paranoia
hallucinations
panic attacks
“excited delirium” depressio
n & suicidal th
oughts
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Adverse Effects of Designer Stimulants:
dehydration skeletal muscle
degeneration kidney failure breathing difficulties seizures death
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Miscellaneous Designer Drugs
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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
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Legal Controls
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Legal Controls
Controlled Substances Analogue Enforcement Act of 1986
Scheduling of Synthetic Drugs: Controlled Substances Act
DEA’s Temporary Scheduling
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Drug Testing for Designer Drugs
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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
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Unfortunate Truisms:
legal controls that prohibit legal controls that prohibit designer drugs will always lag designer drugs will always lag behind their productionbehind their production
drug detection methods for the drug detection methods for the identification of designer drugs identification of designer drugs may also not be available when may also not be available when these compounds become these compounds become popularpopular
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Drug Courts Response Step 1: acknowledge the problemStep 1: acknowledge the problem
understanding the complexity understanding the complexity and challengesand challenges
Step 2: ban designer drugsStep 2: ban designer drugs even if purchased even if purchased ““legallylegally”” false pretenses - false pretenses - ““not for human not for human
consumptionconsumption””
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Drug Courts Response Step 3: put it in writingStep 3: put it in writing
best practices researchbest practices research Step 4: abstinence monitoringStep 4: abstinence monitoring
acknowledge limitationsacknowledge limitations develop a drug testing plandevelop a drug testing plan identify appropriate labidentify appropriate lab limited amnesty initiativelimited amnesty initiative
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Drug Courts Response Step 5: community supervisionStep 5: community supervision
““eyes & earseyes & ears”” of the court of the court PO, law enforcement, PO, law enforcement,
marshals, case workers, etc.marshals, case workers, etc. Fourth Amendment waiversFourth Amendment waivers search & seizuresearch & seizure
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Drug Courts Response Step 5: community Step 5: community
supervision continued:supervision continued: be proactivebe proactive home visits (announced & home visits (announced &
unannounced)unannounced) persons, places, vehicles, persons, places, vehicles,
etc.etc. under participants controlunder participants control
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Drug Courts Response Step 5: community Step 5: community
supervision continued:supervision continued: computer & smart phonescomputer & smart phones text messages, social text messages, social
networknetwork Internet ordering practicesInternet ordering practices shipping labels, receipts shipping labels, receipts
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Conclusion escalating public health issueescalating public health issue accept unfortunate truisms accept unfortunate truisms challenge of designer drugs will challenge of designer drugs will
require creativity & vigilancerequire creativity & vigilance fidelity to the Drug Court modelfidelity to the Drug Court model follow best practicesfollow best practices we know how to do this!we know how to do this!