Current Trends K2/Spice, Bath Salts & Others. Al Meyer

Transcription

1 Current Trends K2/Spice, Bath Salts & Others Al Meyer

2 Objectives History and background of new synthetic designer drugs Epidemiology and current trends Effects and dangers of these drugs How sold, what they look like and how used Legal, prevention and treatment issues

3 Please Take Note Very little science Very little research Now accumulating data & science Today s information anecdotal Face to face with users, Law Enforcement, etc Forums & discussions on web Some research Will highlight small studies

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5 Designer Drugs: Background Trend started in late 1970 s Drugs of abuse are classified by DEA Drugs of abuse work according to structure Analogs Can design an analog to have same or similar activity but not listed as a controlled substance Not subject to legal penalties and restrictions

6 Mephedrone & Methamphetamine

7 Designer Drugs: Evolution U.S. Designer Drug Act 1983 Internationally do not have such laws Being manufactured in other countries Many designer drugs do not test (+) A way to Beat the Bladder Police

8 Designer Drugs Today s trend Make an analog that is not listed in laws Since legal can make an distribute as an everyday household product e.g. Bath Salts Plant Food, potpourri, incense, jewellery cleaner, hummingbird attractant, etc. Then label not for human consumption Market via social media and retail outlets

9 K2 Products

10 Description of the Drug Mixture of herbal and spice plant products Leaf can be: marshmallow leaf, parsley, etc. Sprayed with synthetic cannabinoids Marketed as incense and not for human consumption No regulations to list ingredients or age requirements to purchase First generation called K2 or Spice Second generation called K3 or Splice

11 Synthetic Marijuana (JWH- 018) K2 originated at Clemson University, where researchers developed synthetic cannabinoids in an effort to create therapeutic drugs. But the cannabinoids also have effects akin to THC, the key ingredient in marijuana K2 is largely created by individual sellers, it's anyone's guess what else is added to the mix.

12 K2 For under $35, users can buy 3 grams of K2 "incense" with nothing more than a credit card or PayPal account. Did not have drug test or it Now do but extra expense and only some labs Smokable herbal blends marketed as "legal highs" have become increasingly popular and as easy to buy as cigarettes. (before )

13 K2 Spice K2 contains synthetic chemicals, known as JWH-018 and JWH-073, that mimic THC by acting on the cannabinoid receptors in the brain Other analogs detected HU-210 AM-2201 CP-47, CP-497, C6, C8, C9

14 Alarming Fact Tests show that even the same brand may have different drugs in different amountsat different times User has no way of knowing what or how much they are taking

15 K2 Data American Association of Poison Control Centers Reported in article June 2012 Year 2010 #2, 906 Year 2011 #6,959 Year 2012 up to May 31 #2,883

16 K2 Addiction Medical reports indicate that K2/Spice drugs potentially result in users developing a rapid and powerful addiction on a level not usually found among smokers of real marijuana.

17 Missouri K2 Administration Study Bob Welsh- PI IRB Human subjects approval Six subjects smoked K2 Summit Each contained JWH-018 & JWH-073 or CP47, 497 Subjects performed Standardized Field Sobriety Tests, cognitive tests & Drug Recognition Expert Exam Blood, urine and oral fluid collected

18 K2 Study (cont d) Onset of effects in about 2-3 minutes Dry mouth Light headedness Blurred vision Agitation, Motor restlessness Time dilation (?) Theory in physics, time travel

19 K2 Study (cont d) Drug Recognition Expert Exam Increased pulse and blood pressure Lack of convergence Movement of the two eyes so coordinated that the images of a single point fall on corresponding points of the two retinas No horizontal or vertical gaze nystagmus Pupils normal, muscle tone normal

20 K2 Study (cont d) Field Sobriety Tests 3 to 4 inches of sway, leg body tremors Loss of balance Loss of motor coordination

21 Missouri Study Self Reported K2 Effects Tachycardia Dry Mouth Felt Impaired, subjective thought disruption Changes in perception Impaired sense of time Mild anxiety, paranoia Sedation & Post-intoxication exhaustion

22 On Line Reported K2 Effects Strong dysphoria -Panic attacks -Heavy body load -Extreme nausea -Fear, Panic, Anxiety -Strong aural hallucinations --Racing heart (higher doses) Heart attack

23 On Line Reported K2 Effects Self mutilation Paranoia Auditory & visual hallucinations Delirium Agitation

24 On Line Reported K2 Effects Marijuana-like effects Euphoria Giddiness Silliness Impaired short-term memory and concentration Increased appetite Most angiogenic substance I ever ingested

25 How Diagnosis is Made Usually access system via behavioral crisis Criminal Justice system Crisis Centers, ER s & Psychiatric Hospitals ER s are seeing and identifying more due to acute intoxication Toxicology testing continues to improve

26 K2 Treatment Issues High rates of addiction (K2info.org) Withdrawal due to physical addiction Treated with sedatives and clonidine Before D/A treatment need to be medically and psychiatrically safe and stable Residual effects for weeks (or months) due to long half-life & fat storage

27 K2 Testing Many labs have a test for the first generation JWH chemicals In February 2010, Redwood Labs, California developed a saliva test for JWH-018, JWH-073 and JWH-250 Saliva and urine tests recently developed for second generation JWH s services/3369_sc_sellsheet.pdf

28 K2 Testing Following a single low dose exposure, synthetic cannabinoids can be detected up to 72 hours in human urine. In case of chronic exposure the window of detection is much longer synthetic_cannabinoid_testing.html

29 Mephedrone (4-Methylmethcathinone)

30 Bath Salts Toxic psychoactive drugs disguised or pretending to be Bath Salts They are NOT Some people have snorted real BS s

31 Bath Salts Are

32 Khat Native to tropical East Africa and the Arabian Peninsula Fresh Leaves/tops chewed or consumed as tea Stimulation and euphoria Part of social culture in many countires (coffee, tea, coca or khat)

33 Khat Coca cocaine Khat cathinone (Schedule I) Cathinones: Structure similar to amphetamines Euphoria Anorexia Stimulation Dilated pupils Hypnagogic hallucinations when wearing off

34 What are Synthetic Cathinones? Synthetic cathinones are related to the parent compound cathinone. Since the mid-2000s, unregulated ringsubstituted cathinone derivatives have appeared in the European and American recreational drugs market.

35 What are Synthetic Cathinones? The most commonly available synthetic cathinones sold on the recreational market in the period up to 2012 appear to be 3, 4- Methylenedioxypyrovalerone (MDPV), mephedrone, and methylone. These products are usually encountered as highly pure white or brown powders. Cathinone derivatives are claimed to have effects similar to those of cocaine, amphetamine or MDMA (ecstasy), but little is known of their detailed pharmacology.

36 Mephedrone/MDPV Appearance Distinctive odor Fishy Vanilla Stale urine Bleach Circuit boards

37 Mephedrone/MDPV Effects Duration Total 2 5 hours Onset minutes Coming up minutes Plateau minutes Coming down minutes After effects 2 4 hours

38 Mephedrone/MDPV Desired Effects Mental and physical stimulation Euphoria, mood lift Feelings of empathy, openness Increase in sociability, desire to talk with others Pleasurable rushing Sense of being sped up

39 Mephedrone/MDPV General Effects General change in consciousness (as with most psychoactives) Decreased appetite Pupil dilation Unusual body sensations (facial flushing, chills, goosebumps, body energy) Change in body temperature regulation Sweating Increase in heart rate and blood pressure

40 Mephedrone/MDPV General Sleep deprivation Bruxism Effects Motor automatisms (compulsive repeated hand washing) Hyper-alertness

41 Mephedrone/MDPV Toxic Effects Strong desire to re-dose, craving to recapture initial euphoric rush Uncomfortable changes in body temperature (sweating/chills) Heart palpitations, sense of racing heart Impaired short term memory Insomnia

42 Mephedrone/MDPV Toxic Effects Severe paranoia Psychosis Hypersexuality Aggression Hallucinations Anxiety and depression Seizures

43 PA Criminal Intelligence Center February 2011, Lebanon County: PSP, Jonestown members responded to a burglary where a subject broke a window and jumped through a glass door. After he was confronted by the occupant, the subject ran outside and kicked in a garage door. While being interviewed by troopers, he jumped onto the hood of the patrol car, rolled off, and went into a fetal position. The subject was incoherent, claimed he was being electrocuted, and was eventually transported to the hospital.

44 Bath Salt Data American Association of Poison Control Centers # of calls June 9, 2012 report Year 2010 #304 Year 2011 #6,138 Year 2012 to May 31 #1,320

45 Mephedrone/MDPV Treatment Issues Similar to strong amphetamine addiction Similar to PCP abuse/addiction Stabilization and Safety highest priority Safety of client Safety of staff and others

46 Mephedrone/MDPV Treatment Issues If psychotic or dissociated need to medicate Neuroleptics: Haldol for emergency stabilization Atypicals (Seroquel/Respirdol/etc.) for ongoing stabilization Decease sensory exposure Rock or Rave medicine Talking down bad trips De-escalation techniques

47 Mephedrone & MDPV Treatment Issues Once stable and safe be aware of cognitive impairment May need tincture of time to grasp recovery Supportive non threatening environment Screen for COD (high probability)

48 Synthetic Cathinones Effects Summary Sheet n n n n n n n n n n Aggression Agitation Breathing difficulty Bruxism (grinding teeth) Confusion Dizziness Extreme anxiety sometimes progressing to violent behavior Fits and delusions Hallucinations Headache n n n n n n n n n n n Hypertension (high blood pressure) Increased alertness/ awareness Increased body temperature, chills, sweating Insomnia Kidney pain Lack of appetite Liver failure Loss of bowel control Muscle spasms Muscle tenseness Vasoconstriction (narrowing of the blood vessels) n n n n n n n n n n Nausea, stomach cramps, and digestive problems Nosebleeds Psychotic delusions Pupil dilation Renal failure Rhabdomyolysis (release of muscle fiber contents [myoglobin] that could lead to kidney problems) Severe paranoia Suicidal thoughts Tachycardia (rapid heartbeat) Tinnitus

49 Synthetic Drug Abuse Prevention Act of 2012 July 10, 2012 President signed Law making temporary law permanent October 1, 2012 Synthetic Drugs now listed as Schedule I All substituted cathinones now Schedule I Chemists working on making noncathinone stimulants synthetic-drug-threats.aspx

50 Urine Detection Information Redwood Toxicology Laboratory shows currently they have detection for MDPV and Mephedrone. (see w.k2info.org/drugtesting) June 11, 2012 Redwood expanded to test for #21 designer stimulants designer_stimulant_testing.html Atlantic Labs- Bensalem, PA Bath Salts $20.00 and K2 $ Most labs now testing Check with your lab

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52 Used in: Malaysia Thailand Indonesia Local names: Ithang Biak Biak Ketum Kakuam Mitragyna Speciosa

53 Kratom Pharmacology Mitragynine Structurally similar to some hallucinogens No hallucinogenic activity or effects Acts on opioid receptors

54 Kratom & Opioid Treatment Currently used for heroin and methadone dependence in some countries New Zealand Thailand Used in detox to manage withdrawal symptoms from opioids Millenium Labs announced test Aug. 2012

55 Kratom & Opioid Treatment Forum with much Kratom info Participants using Kratom to week off of oxy, heroin, Bup, etc. Majority unable to ween off of Kratom Descriptions of withdrawal Descriptions of how to prepare & dosage Descriptions of which to buy and where

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57 Kratom Seems to be a stimulant in lower doses Mitragynine Seems to be sedative in higher doses 7 hydroxymitragynine Often produces a mixed effect Onset 5 t o 10 minutes Duration several hours

58 Kratom Side Effects Short term (immediate) Dry mouth Increased or decrease urination Loss of appetite Nausea and/or vomiting Side effects Anorexia/weight loss Depression Addiction

59 Kratom EFFECTS Kratom is often described as producing simultaneous, contradictory effectsboth an opiate-like sedation and coca-like stimulation. The stimulating effects tend to predominate at low dose levels, which may cause alertness, energy, and mild euphoria. Higher level doses are usually more tranquilizing, causing an opiate-like dreamy effect. Excessive doses can cause severe nausea. As with opium, it is known for causing constipation, and is sometimes used as a treatment for diarrhea. Onset When taken orally, the effects of kratom usually become noticeable in minutes and clearly apparent in minutes. Strong doses tend to have a more quicker, more dramatic onset. Duration A moderate dose of kratom may cause strong effects that last 2-4 hours, with residual effects lasting hours longer.

60 Kratom Visual Effects Some visual effects have been reported, including both open-eye and closedeye effects. Effects reported include wavering, shifting, and strobing in the visual field. There was also some patterning with eyes closed, as well as increased closed-eye visualizations. PROBLEMS Kratom is not known to be toxic, but can cause unpleasant symptoms at high doses such as nausea and vomiting. Regular use can lead to physical dependency. Kratom use can cause constipation similar to that caused by opiates. Chronic heavy use is reported to cause darkening of skin, insomnia, dry mouth, and anorexia. Addiction Potential There are reports of physical dependency after frequent, heavy kratom use. Individuals who use it regularly or in large doses may have trouble quitting. Withdrawal symptoms include irritability, yawning, diarrhea, runny nose, and pain in the joints or muscles. +Kratom&view=detail&mid=EC48A0AFEDFBEA20762AEC48A0AFEDFBEA20 762A&first=0&FORM=LKVR16

61 Kratom & E-Cigarettes Kratomite Adventure Industries' Kratomite is the world's first electronic cigarette to deliver Kratom, a medicinal herb known for its concentration of alkaloids, according to the company. Kratom interacts with opioid receptors, which may offer users relaxing sensations. Unlike tobaccoalternative electronic cigarettes, Kratomite is a personal vaporizer that uses a proprietary, herbal-infused formula, said the maker. Adventure Industries Pembroke Park, Fla. (800) , ext sales@adventureindustries.com

62 2C-1 or Smiles Reports now in Mid-Atlantic states (Sept 2012) Prevalent on YouTube (users) Similar to a mix of ecstasy & LSD but with longer high & higher potency than either Unusual & unpredictable effects Not detectable like bath salts Potency not consistent from batch to batch

63 2C-1 or Smiles Usually sold in white powder form and can be melted into chocolate candy, but can also be taken as a tablet Also sold as breath mint or drops Both a hallucinogen and a stimulant- has been linked to recent teen deaths Can cause heart to beat out of control, seizures and foaming at the mouth

64 Krokodil Opioid- desomorphine Result of attempt to extract codeine Injected can be used by other routes Russia & spreading through Europe Tissue breakdown Highly addicting- Usually fatal

65 Desomorphine 8-10 X more potent than morphine First discovered in 1932 Sedative & opioid effects Made from codeine, red phosphorous & Iodine (similar to methamphetamine) Made in 30 minutes & injected immediately Produces gangrene & phlebitis

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68 Molly s Pure molecule of MDMA Popular in rap music lyrics Used at parties and raves Lately Molly s have contained cathinones Familiar effects of XTC Bruxism, hyperthermia, anxiety, depression, dehydration, etc