Within the past decade new psychoactive substances, commonly referred to as “synthetic drugs” have emerged, presenting a serious threat to public health and safety. While anecdotes of synthetic drug overdose deaths and synthetic drug use-related violence have surfaced in the past, they are now at the forefront of the news. Hospitalizations and calls to poison control centers for synthetic drug use are increasing across the country. Synthetic drugs are chemicals produced worldwide in clandestine laboratories. These drugs include synthetic cathinones misleadingly labeled as “bath salts,” and synthetic marijuana or synthetic cannabis sometimes called SC, K2, or Spice and often labeled as “incense.” Collectively these chemicals are also called “designer drugs” because they are designed to evade the law and drug tests. Commonly marketed to teens, these new drugs are sold not only by drug dealers but also in convenience stores and gas stations. Although often labeled “not for human consumption” to avoid oversight by the Food and Drug Administration (FDA) their drug-using customers easily decode these transparent disguises.
Bath salts contain chemicals related to the stimulant cathinone found naturally in Khat, a drug long used in the Middle East, in the same part of the world that gave us coffee. The cathinones are biologically similar to amphetamines and MDMA. Common adverse reactions include both cardiac and psychiatric disorders. While synthetic marijuana contains chemicals with some similarity to tetrahydrocannabinol (THC), their effects can be drastically different. According to the National Institute on Drug Abuse, “users can experience anxiety and agitation, nausea and vomiting, high blood pressure, shaking and seizures, hallucinations and paranoia, and they may act violently.”
The full effects of these novel drugs are not just unknown but each batch and package of synthetic drugs can vary drastically. As leading epidemiologist Eric Wish, PhD of the Center for Substance Abuse Research (CESAR) said of using synthetic marijuana, “When they take this drug, they are literally playing Russian Roulette with their body.”
Synthetic drugs are difficult to identify because drug tests identify specific drugs and metabolites. Chemists who create synthetic drugs merely have to tweak a drug molecule to evade all commonly used drug tests. The Community Drug Early Warning System (CDEWS), which collects information about emerging drug use, tested urine samples of offenders in the criminal justice system using an expanded panel of over 75 drugs identified the presence of synthetic cannabinoids. Results show that offenders in the criminal justice system commonly use synthetic cannabinoids to evade drug tests.
Reducing the use of synthetic drugs and negative consequences of their use requires a two-pronged approach of both supply reduction and demand reduction. The law enforcement challenge is great because the chemicals are so varied and they are ever changing. In addition, their supply chain is entirely different from other drugs of abuse. Demand reduction is similarly challenged because these drugs fly under the banner of their being safe “like marijuana.” Public education is a challenge because the widespread focus on these severe and even bizarre results of using these drugs is belied by the experiences of many initial users who do not experience these grave ill effects.
America’s drug problems are changing rapidly in menacing ways. Nowhere is this more true than when it comes to synthetic drugs.