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Synthetic Drugs Fact Sheet

Main Points

  • Synthetic (chemically enhanced) drugs are rapidly becoming popular, widely available and widely abused.
  • Over the past several years, these previously unseen and unknown drugs have surfaced in our communities, being sold in convenience stores, head shops, and on the internet.
  • More than 95 percent of emergency physicians polled in 2016 said that the number of patients they’ve treated for synthetic drug use had either increased or remained the same from 2014 to 2015. [i]
  • Nearly 90 percent of emergency physicians polled reported seeing violent acts associated with the use of these drugs.
  • ACEP advocated for legislation (S.3187) to ban some chemicals that are currently, and legally, sold in the United States — it was signed into law in 2012.  This is an important step forward, but more government intervention is needed.

What are synthetic drugs?

Synthetic drugs are chemically enhanced drugs. Synthetic marijuana (often known as “K2” or “Spice”) and bath salts products are often sold in legal retail outlets as “herbal incense” and plant food, respectively, and labeled “not for human consumption” to mask their intended purpose and avoid FDA oversight. 

These drugs contain chemicals that imitate the hallucinogenic or stimulant properties of marijuana, cocaine, ecstasy and methamphetamine, which can create sever paranoia that may cause users to harm themselves or others.

Use of synthetic marijuana is very high.  More than 11 percent of seniors in high school have used Spice or K2 in the past year, making it the most commonly used illicit drug among their age group. [ii]

The class of synthetic drugs consists of several different types of substances.

Cannabinoids

First, there are cannabinoids. The original compounds in this group were first synthesized at Clemson University in an attempt to find better pharmaceutical agents for legitimate medical purposes. While they have a variety of chemical structures, they all bind to the same marijuana (THC) receptors in the brain with an affinity that is sometimes several hundred times stronger than THC. Sold by names such as Diablo, 7H, Diesel XXX, SenorLoko, Blue Magik, Scooby Snax, and Killer Buzzz, these compounds have been very effectively marketed by drug dealers who target our youth and young adults.

Typically, these compounds are simply sprayed onto inert plant materials in order to be smoked. More recently, liquid forms of these compounds have been sold to be used in electronic cigarettes called “vaping.” These drugs are well known to cause alarming effects such as hallucinations, paranoia, seizures, violent behaviors, kidney damage, and hemodynamic effects such as dangerously high blood pressure, heart rates, and body temperatures. These drugs have both directly and indirectly resulted in many deaths. The use of these compounds is widespread and growing rapidly.  

Cathinones

The second group of drugs are cathinones, which are stimulants. They have effects that mimic those of methamphetamine, cocaine, and ecstasy, or a combination thereof. These compounds affect serotonin and dopamine receptors in the brain. They often have somewhat similar chemical structures, and most can be characterized as phenethylamines. Also effectively marketed by drug dealers targeting our youth and young adults, these drugs are sold by names such as Molly’s Plant Food, Ultra Molly, Kamikaze, XTC, SkarFace, and Space Dust. These drugs appear in a variety of forms, but most commonly are sold as a powder or perhaps a powder filled capsule.

These drugs are consumed by smoking, snorting, swallowing, but most commonly by intravenous injections. Intravenous use of these drugs is also associated with all of the typical intravenous drug risks such as hepatitis, endocarditis and HIV/AIDS. “Vaping” these compounds is a new and growing method of consumption. These drugs cause alarming effects such as hallucinations, paranoia, seizures, violent acts and hemodynamic effects such as dangerously high blood pressures, heart rates, and body temperatures. The use of these drugs is well known to directly and indirectly result in death. As these compounds affect serotonin and dopamine receptors in the brain, they are also associated with a condition known as excited delirium. Excited delirium is suspected to be the result of defective dopamine and serotonin receptors in the brain. Individuals who suffer excited delirium display bizarre and often very violent behavior in a hyper dynamic state of physical activity. Body temperatures, heart rates, and blood pressures soar to critical and immediately dangerous levels. Left untreated, and even at times with the best of treatment, these individuals suddenly become very still and quiet as they collapse and very quickly deteriorate on to cardiorespiratory arrest and death. The use of these compounds is widespread and growing.     

What are “bath salts”?

Make no mistake, these are not actually bath salts or any type of bath products.  Instead this term is an informal “street name” for a family of designer drugs.  Their only known purpose is for consumption as a recreational drug and have no medicinal value.  These drugs are intentionally mislabeled by their manufacturers as “bath salts,” “plant food,” “air freshener,” etc. in order to trick purchasers into thinking the drugs are mild or innocuous. Sixty percent of users are young people ages 25 years old and younger. [iii]

These drugs are derivatives of methcathinone, also known as khat.[iv]  As a derivative of a Schedule I drug, the federal Controlled Substances Act would then designate these drugs as schedule I “to the extent that they are intended for human consumption.”  These synthetic drugs are sold with labeling “not intended for human consumption,” clearly circumventing the Controlled Substances Act.  With this labeling, drug dealers can and do call their products whatever they choose. 

Marketing websites report that these drugs are legal in all 50 states.  In fact, many are sold over the counter in places like convenience stores and head shops. [v]   Dr. Smith also says that the vast majority of these drugs do not show up on standard drug screening, so the magnitude of the problem is probably seriously underestimated or perhaps under-realized.

What can these drugs do to a person?

These bath salts can have very harmful effects on its users.  Some involve bizarre, violent behavior and tragic outcomes.  Users have reported impaired perception, reduced motor control, extreme paranoia and violent episodes. These synthetic drugs have been popular among teens and young adults, and are sold at retail outlets and over the Internet.  These drugs can also be highly addictive to its users.

The use of synthetic drugs have led to several tragic outcomes.  For example, there was a boy in Louisiana who snorted bath salts and spent the next few days experiencing intermittent psychotic episodes which resulted in him committing suicide.  In another case, there was a teen in Illinois who smoked synthetic marijuana and died when he drove his car into a house.  He crashed into the bedroom of a 2-year-old child, who, fortunately, was playing in the backyard at the time.

Another case in Tennessee happened when a patient walked into the emergency department naked, trying to remove the “snake” that was attacking him from his body.  There was also a case where an adult male attacked his girlfriend’s children because he believed they were demons who were attacking him.  He repeatedly peppered sprayed the two and four year old children and had to be subdued by police.  Both of these cases involved bath salts. 

What are emergency physicians seeing inside their emergency departments?

Emergency physicians treat patients every day who have ingested synthetic drugs.  They present with a variety of different symptoms associated with synthetic drug use, including chest pain, elevated blood pressure, nausea, erratic heartbeat, agitation, paranoia, muscle breakdown and /or hypothermia. 

In January of 2015, the American College of Emergency Physicians (ACEP) surveyed its membership about the emergency care issues associated with the cathinones and cannabinoids. More than 1500 emergency physicians representing every state in the Union and the District of Columbia responded to the survey. The questions asked were framed for consideration of the patients seen from 2014 to 2015. The responses were startling. According to the survey: 

  • More than 95 percent of the responding physicians said that the number of patients that they treated for synthetic drug use had either increased (61 percent) or remained the same (35 percent). [vi] 
  • 72 percent saw an increase in the use of cannabinoids.  
  • Many respondents reported seeing and expressed concerns about “vaping” liquid forms of these drugs.  
  • Demographically, respondents categorized those using these drugs as 55 percent teenagers and 35 percent middle aged, 54 percent white and 25 percent African American.  
  • Most alarming, 87% of responding emergency physicians reported seeing violent acts and 42% had seen staff injured within the last year by patients using these drugs.  

What is the government doing to protect people from synthetic drugs? 

In July, 2012, President Obama signed into law (S.3187) legislation to ban some chemicals that are currently, and legally, sold in the United States.[vii]  The law also extends the DEA’s authority to temporarily schedule controlled substances for up to 3 years.  While it’s clear that more government intervention is needed — it is a significant step forward to combating this new, growing trend within the war on drugs. 

 

[i] American College of Emergency Physicians Member Survey on Synthetic Drug Use, 2016

[ii] White House Office of National Drug Control Policy: Synthetic Drugs, http://www.whitehouse.gov/ondcp/ondcp-fact-sheets/synthetic-drugs-k2-spice-bath-salts

[iii] American Association of Poison Control Centers, 2012 http://www.aapcc.org/dnn/NewsandEvents/NewsMediaResources.aspx

[iv] National Institute on Drug Abuse, 2011 http://www.drugabuse.gov/publications/drugfacts/khat

[vi]Deadly Synthetic Drugs: The Need to Stay Ahead of the Poison Peddlers, June 1016 Smith, Sullivan K.  https://www.judiciary.senate.gov/imo/media/doc/06-07-16%20Smith%20Testimony.pdf

[vii] S. 3187: Food and Drug Administration Safety and Innovation Act, 2012: http://www.govtrack.us/congress/bills/112/s3187/text


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