Designer Drugs –
What Drug Court Practitioners
Need to Know
By: Paul L. Cary
Toxicology Laboratory
University of Missouri
2C-I NBOME
History of Designer
Drugs
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
Internet Transformed Designer Drug Trade
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
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 $$$$$
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
Source of Designer Drugs
Synthetic Cannabinoids
(Spice/K2)
Preparation of “herbal incense”:

botanicals are sprayed with liquid
preparations of:
HU-210
HU-211
CP 47,497
JWH-018
JWH-073
Smoking Cannabinoids
What does CB1 receptor control?



BG: motor control, learning
Hippo: memory, spatial
navigation
CB: cognitive functions attention, language,
emotions
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
Public Perception of
“Legal Highs”
Synthetic cannabinoids are
as safe as marijuana.
Forensic Science Review
Volume: Twenty-Six
Number One
January 2014
25 pages
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)
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.”
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

Acknowledgment:
Dr. Barry Logan
National Medical Services
Willow Grove, PA
Evolutionary Landscape
Lab-Based Drug Testing:
Designer Stimulants
(Synthetic Cathinones)
Designer Stimulants:
bath salts/bath bubbles
 plant foods/plant vitamins
 glass cleaners/computer screen cleaners
 soft drink additive
 “novelty collectors item”

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
MDPV:
Methylenedioxypyrovalerone (MDPV) - a
psychoactive drug with stimulant properties
which acts as both a norepinephrinedopamine reuptake inhibitor (NDRI).
 often snorted - similar to cocaine
 considered extremely addictive
 adverse medical/psychiatric ramifications

Methylmethcathinone (Mephedrone)





designer drug chemically similar to cathinone
first synthesized in 1929
amphetamine-like properties
powerful synthetic stimulant
adverse medical/psychiatric ramifications
Summer, 2014 - Bath Salt Data
25I-NBOMe
Substituted
phenethylamine
psychedelic 2C-I
stimulant
hallucinogen
20 linked deaths
In US
Adverse Effects of Designer Stimulants:


surge in neurotransmitters:
 dopamine
 serotonin
 norepinephrine
psychiatric symptoms:
 severe
paranoia
 hallucinations
 panic
attacks
 “excited
delirium”
Adverse Effects of Designer Stimulants:

dehydration

skeletal muscle degeneration

kidney failure

breathing difficulties

seizures

death
Miscellaneous Designer
Drugs










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
Legal Controls
Legal Controls

Controlled Substances Analogue
Enforcement Act of 1986

Scheduling of Synthetic Drugs:
Controlled Substances Act

DEA’s Temporary Scheduling
Drug Testing for
Designer Drugs
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
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

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”
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
Drug Courts Response
 Step
5: community supervision
“eyes & ears” of the court
PO, law enforcement, marshals,
case workers, etc.
Fourth Amendment waivers
search & seizure
Drug Courts Response

Step 5: community supervision
continued:
 be proactive
 home visits (announced &
unannounced)
 persons, places, vehicles, etc.
 under participants control
Drug Courts Response

Step 5: community supervision
continued:
 computer & smart phones
 text messages, social network
 Internet ordering practices
 shipping labels, receipts
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!
email address:
carypl@health.missouri.edu