Date post: | 17-Dec-2015 |
Category: |
Documents |
Upload: | bartholomew-wheeler |
View: | 217 times |
Download: | 3 times |
Synthetic Drugs of Abuse: ‘Spice,’ ‘K2’ and ‘Bath Salts’
Erik Gunderson, MD
Assistant Professor
Department of Psychiatry and Neurobehavioral Sciences and Department of Medicine
Director, Clinical Pharmacological Research Unit
University of Virginia
April 14, 2011
Synthetic Cannabinoids (SCs) Spice/K2 brands
marketed as natural herbal incense
“Not for human consumption”
Available convenience stores, gas stations, Internet
Cannabis substitute Psychonaut Web Mapping Research Group (2009.) Spice Report. Institute of Psychiatry, King’s College London: London UK.
Spice and K2
Cost: $30-45 per 3gm
Route: pipes, water pipes or rolled cigarettes
Contents: inert plant material sprayed with SCs
JWH-018, JWH-073, JWH-250, CP-47,497, HU-210
http://buyherbalspice.com/spice_reviews/category/news/
Pharmacology
delta-9 tetrahydro-cannabinol (∆9-THC) agonism of cannabinoid receptor type 1 (CB1)
SCs more potent
Typical doses are often less than 1mg
Not readily detectable JWH-018
∆9-THC
Psychoactive Effects
Marketed as similar to cannabis: Euphoria Sociability Anxiolytic Relaxation Stimulant
Cross tolerance with THC?
http://buyk2spice.net/
Side Effects of SC Products
Anxiety Paranoia Headache Vomiting Psychosis Diaphoresis HR/BP increase Seizures http://investigationmiami.blogspot.com/2011/01/be-afraid-really-afraid.html
Legal Timeline for SCs 2009: Restricted in the UK, EU
11/2010: DEA Notice of Intent to temporarily ban 5 SCs
3/1/2011: Five SCs Designated Schedule I
JWH-018, JWH-073, JWH-200, CP-47,497, and cannabicyclohexanol
Effective for one year
Current and Future Epidemiology?
No data on prevalence of use
American Association of Poison Control Centers:
Synthetic cannabinoids: 2009: 13 calls 2010: 2304 calls (Nov), a projected 200x increase
Marijuana: 2008: 4009 calls, with 1020 for marijuana alone
Synthetic Stimulants
Methylenedioxypyrovalerone (MDPV) and Mephedrone Sold as “bath salts” or “plant fertilizer”
Currently legal in the United States
Available online and in convenience stores
MDPV and Mephedrone CNS stimulants Related to cathinone, an active alkaloid
found in the khat plant (N. Africa) Previously abused
primarily in
Europe and
Australia
http://www.herbalextracts.net/library/supplements/khat_uses.html
Product Marketing Mtv MDPK Magic Super Coke Peevee Energy-1 (NRG1) Charge Plus White Lightning Scarface
Cloud 9 Ocean Ivory Wave
http://www.helphopehealing.org/
MDPV Route: Intranasal most
common Also: oral, smoking,
rectal, and IV White to light brown
crumbly powder Degrades if exposed to
air for significant periods of time
http://www.stompin-gardeners.com/index.
MDMA
Pharmacology of MDPV CNS stimulant similar to methamphetamine,
MDMA, or cocaine Norepinephrine-dopamine reuptake inhibitor
(NDRI) Increased alertness, arousal, anxiety, agitation,
diminished requirement for food and sleep, sexual arousal
Tachycardia, hypertension, vasoconstriction, diaphoresis
Effects of MDPV “High” lasts 3-4 hours Physical effects may
last 6-8 hours May cause seizures,
panic attacks, or psychosis with high doses or increased frequency of use
Avg dose: 5 to 20mg http://www.tradevv.com/chinasuppliers/chwhtltd_p_198b58/china-Mdpv-by-pevukka.html
Other Sequelae of MDPV Trismus (inability to open mouth) or
bruxism Panic attacks Psychosis with sleep deprivation Hallucinations, delusions, suicidal ideation Abstinence syndrome: depression,
lethargy, anxiety, postural hypotension Leads to frequent re-dosing
MDPV’s Legal Status UK: MDPV regulated under the Misuse of Drugs Act 1971
US: Not scheduled but banned in some states
DEA: controlled by the Federal Analogue Act?
http://addiction-dirkh.blogspot.com/2010/11/dea-slaps-temporary-ban-on-spice-and.html
Mephedrone 4-methylmethcathinone (4-MMC)
Meow Meow MCAT Miaow Drone Plant Feeder Bubbles
http://www.synchronium.net/2010/01/05/mephedrone-cat/
Pharmacology NE-DA reuptake inhibitor Similar to MA/MDMA
Reportedly less potent, shorter duration
Oral dose: 20-50mg
“Come up”: 10-20 min
Peak: 45-60 min
“Comedown”: 60-120 min
Re-dosing: commonMephedrone
Amphetamine
Routes of Administration Oral ingestion
Swallowing capsules Bombing (swallowing
powder wrapped in cigarette paper)
Insufflation (snorting) Rectally (either plugging
or enema) IV (use 1/2 to 1/3 dose)
http://www.guardian.co.uk/society/mephedrone
Effects of Mephedrone
Euphoria
Sociability
Stimulation
Sexual Arousal
Music Appreciation
Hallucinations
http://www.drugs.org.im/campaigns.htm
Mephedrone Side Effects Loss of appetite Increase in body temperature,
sweating, hot flushes Tense jaw, bruxism, stiff neck,
muscle clenching HR/BP elevation, chest pains Dehydration Mydriasis, nystagmus Painful nasal drip/ulcers in mouth
(after insufflation) Insomnia, paranoia, anxiety,
dysphoria, psychosishttp://theblackheartofgrahamquirk.blogspot.com/
Mephedrone’s Legal Status
2008-2010: Banned in many European counties
December 2010: Illegal throughout the EU
Mephedrone is not specifically banned in the United States However, some states have banned mephedrone
DEA: may be controlled by the Federal Analogue Act as an analogue of methcathinone
Current and Future Epidemiology?
No data on prevalence of use
American Association of Poison Control Centers:
Bath Salts: 2010: 292 calls 2011: 469 calls (2/14/11), a projected14-fold
increase
References Brunt, T.; Poortman, A.; Niesink, R.; Van Den Brink, W. (2010). "Instability of the ecstasy market and a new kid on the
block: mephedrone". Journal of psychopharmacology. Drug Enforcement Administration: Office of Diversion Control; Drug and Chemical Evaluation Section.
Methylenedioxypyrovalerone [(MDPV) (1-(1,3-Benzodioxol-5-yl)-2-(1-pyrrolidinyl)-1-pentanone]. Available at: www.deadiversion.usdoj.gov/drugs_concern/mdpv.pdf. Accessed February 7, 2011.
EMCDDA (2009). Action on new drugs briefing paper: Understanding the ‘spice’ phenomenon. A report from an EMCDDA expert meeting, 6 March, 2009, Lisbon.
"Europol - MCDDA Joint Report on a new psychoactive substance: 4-methylmethcathinone (mephedrone)". European Monitoring Centre for Drugs and Drug Addiction. 27 May 2010.
Psychonaut WebMapping Research Group (2009). MDPV report. Institute of Psychiatry, King’s College London: London UK. Available at: www.nascsa.org/news/psychonautmdpvreport.pdf. Accessed February 23, 2011.
Psychonaut WebMapping Research Group (March 2010). "Mephedrone Report." Institute of Psychiatry, King's College: London UK.
Psychonaut Web Mapping Research Group (2009.) Spice Report. Institute of Psychiatry, King’s College London: London UK.
United States Drug Enforcement Agency. Office of Diversion Control. Drugs and Chemical of Concern: 4-methylmethcathinone [Mephedrone, 4-MMC, meow meow, m-CAT, bounce, bubbles, mad cow]. July 2010.
United States Drug Enforcement Agency. Office of Diversion Control. Rules 2011:Schedules of Controlled Substances: Temporary Placement of Five Synthetic Cannabinoids Into Schedule I. Federal Register Volume 76, Number 40 (Tuesday, March 1, 2011).
Wehrman J. U.S. Poison Centers Raise Alarm about Toxic Substance Marketed as Bath Salts; States Begin Taking Action. AAPCC. February 14, 2011. Available at: http://www.aapcc.org/dnn/Portals/0/prrel/FEB14BATHSALTSUSE.pdf
Winstock, A.; Mitcheson, L.; Deluca, P.; Davey, Z.; Corazza, O.; Schifano, F. (2010). "Mephedrone, new kid for the chop?". Addiction 106 (1).
Acknowledgement
Laura Willing, BS
Contact Information
Erik Gunderson, MD434-924-8013 [email protected]