Not For Human Consumption

Transcription

1 Not For Human Consumption Plant food, bath salts, incense and the internet Stephen Bright

2 Emergent Drug Trends Rapid increase in the availability of new drugs ECMDAA: from 24 in 2009 to 49 in 2011 $$$ Legal Highs Industry

3 What Products are Available? Synthetic cannabis Powder & Pills

4 1990 s: Shulgin A Brief History

5 Emergent Drug Trends The role of the internet: Research Chemicals: Not for Human Consumption

6 Emergent Drug Trends The role of the internet: Research Chemicals: Not for Human Consumption 2000 s: Emergence of legal highs & headshops

7 Headshops

8 Plant food (e.g., Dove feeder ) 2008/2009: Plant Food

9 2008/2009: Plant Food Israeli company Cathinone analogues

10 2008/2009: Plant Food Phthalimidopropiophenone

11 2008/2009: Plant Food Israeli company Cathinone analogues (e.g., mephedrone, see Caldicot et al.)

12

13 Bath Salts NRG 1: Naphthylpyrovalerone MDPV: Methylenedioxypyrovalerone

14 Synthetic Cocaine

15 2 nd Generation Synthetic Cocaine May 2012: MDPV Banned in Australia by TGA No published analysis of synthetic cocaine Shaman s dust white ball, etc. After US banned MDPV, new bathsalts contained: α Pyrrolidinovalerophenone (α PVP) Methyl α pyrrolidinopropiophenone (Shanks et al., 2012) Methoxetamine

16 Synthetic Cannabis

17 What is synthetic cannabis? 2004: Spice (Deluca et al., 2010)

18 Kronic 2011: Kronic emerged as a new drug in Australia Produced in New Zealand

19 Kronic April: First indication of media interest, which quickly grew June: WA government bans 7 synthetic cannabinoids JWH 018 JWH 073 JWH 122 JWH 200 JWH 250 CP 47,497 The C8 Homologue of CP 47,497

20 Google trends: Searches for Kronic

21 1 st hit on Google for Kronic

22 Social Media

23 Smoke em up Party

24

25 May 2012: Federal responses 8 broad groups of synthetic cannabinoid agonists: Benzoylindoles, Cyclohexylphenols, Dibenzopyrans, Naphthoylindoles, Naphthylmethylindoles, Naphthoylpyrroles, Naphthylmethylindenes & Phenylacetylindoles Synthetic cannabinomimetics

26 Outcomes of these legislative changes No real change in availability: New chemicals with unknown potential for harm Banned chemicals being sold as new legal products Problems with policing Substantially similar in structure? Time & $$$ for analysis Federal versus state law

27 Why do people use this stuff? They work! Media and online user forum It s apparently legal & safe Avoid drug tests Availability of new drugs vs. Ecstasy Unwittingly

28 Prevalence of use in Australia No accurate estimates of prevalence Indictors: Media reports AFP seizures EDRS 2010: Mephedrone : Increase in % of people using emerging drugs Wastewater 2010: Mephedrone : MDPV

29 How harmful are these new drugs? At least 2 Deaths Little data Powders/Pills Some are potent dopaminergic agents Halogenated chemicals might be Neurotoxic Synthetic Cannabis Toxicity? No Cannabidiol (CBD) psychosis/seizures Shorter duration of effect dependence

30 How harmful are these new drugs? Barratt et al. s survey of 136 SC users: < 1% sought help for these Sx

31 Acute settings Clinical signs and Sx Presentation: Ataxia, Tachycardia, Arrhythmia, Hypertension, Hyperthermia, Rhabdomyolysis, Kidney Failure, Nausea, Anxiety, Agitation, Confusion, and Paranoia. Assessment Lab results? Clinical presentation & careful questioning Treatment: Similar to prototype drug Benzo (not beta blockers), Antipsychotics, Cooling, IV Saline (Mas Morey et al. 2012; Castellanos & Thornton, 2012)

32 Clinical signs and Sx Treatment settings (e.g., AOD/MH) Presentation Similar to traditional drugs Might be secondary Assessment used anything that has been bought online or from adult stores? taken any: herbal supplements, legal highs, party pills, herbal highs, research chemicals, bath salts, incense? Treatment: Similar to prototype drug

33 Harm Reduction for Emergent Drugs Allergic reaction test (e.g., anaphylactic) Minimal possible dose Avoid if MH issues (esp. psychosis) Avoid other AODs Contraindicated for prople with cardiovascular disease NEVER INJECT Good scales