Two synthetic drugs pose an enormous threat to public health. What are they?

Victims of a new and deadly street drug which is similar to the legal version of  the drug authorities say killed pop icon Prince are being seen in more and more emergency rooms around  the country. 

Five times more potent than herion, acetyl fentanyl is often mixed with the herion, or sold as oxycodone on the street,  leaving those to take it little chance of knowing what they are ingesting. 

Overdoses with this synthetic drug have happened across the country, putting state and federal officials on alert for the latest in mixed street drugs.

According to an Associated Press story, some of the pills taken from Prince's estate in Paisley Park after his death were counterfeit drugs that contained fentanyl — a synthetic opioid 50 times more powerful than heroin, an official close to the investigation said Sunday. Acetyl fentanyl is very similar to fentanyl and often made using it.

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Here’s a look at two classes of synthetic drugs that the federal government is warning citizens about.

Types of synthetic drugs

There are two types of synthetic drugs the government has issued warnings about  -- cannabinoids and cathinones. 

Cannabinoids

Cannabinoids as often called synthetic marijuana, K2 or Spice. It is sold in legal retail outlets as as “herbal incense” or “potpourri”.

  • There are more than 120 known chemical variants that make up synthetic cannabinoids, with 50 or so of these chemical either regulated by U.S. law, or that are illegal in the United States.
  • The bulk of synthetic marijuana is produced in China where the “recipe” is altered to skirt U.S.. law.
  • Cannabinoids are sold in packets which carry one of  more than 500 brand names such as Spice, Ace of Spades, Demon, King John Pot Pourri, Mojo and Mr. Bad Guy.
  • Because they are labeled “not for human consumption” they are not regulated by the Food and Drug Administration. Cannabinoids and other synthetic drugs are also readily available via the Internet. 
  • For a list of more than 600 names for synthetic cannabinoids, click here. 

How can cannabinoids be a part of the plant material sold as synthetic marijuana?

After the chemical is created it is often sprayed on plant material. The material is chopped up and packaged.

According to the government, the synthetic cannabinoids gives users a high similar to marijuana because it mimics THC, the primary psychoactive ingredient of marijuana.

How long has this been going on in  the U.S.?

Synthetic cannabinoids on plant material were first reported in the United States in Dayton, Ohio, in December 2008. In 2009, two synthetic cannabinoids were identified by authorities. In 2012, 51 new  synthetic cannabinoids had been identified.

It is generally transported into the United States in powder form where it is tableted, pilled or changed into some other from prior to sale.

How prevalent is its use?

According to a survey in 2012, one in nine U.S. high school seniors reported using synthetic cannabinoids, making it the second most frequently used illegal drug after marijuana. 

What are the risks of cannabinoids?

The effects of synthetic cannabinoids include severe agitation and anxiety, nausea, vomiting, a fast, racing heartbeat, elevated blood pressure, tremors and seizures, hallucinations and dilated pupils. Suicidal and other harmful thoughts and/or actions have also been reported.

Cathinones

Cathinones, a naturally occurring stimulant found in the leaves of khat, is used in combination with other chemicals to make a drug similar to amphetamines.

  • Synthetic cathinone products often consist of methylenedioxypyrovalerone (MDPV), mephedrone, and methylone.
  • Like cannabinoids, most cathinones are produced in China. They are referred to as “bath salts,”  and distributed under trade names such as 'Ivory Wave', 'White Lightning' and 'Vanilla Sky.’ They are also  labeled as "not for human consumption" to avoid penalty under the Analogue Enforcement Act.
  • Bath salts are generally snorted, but some smoke it, inject it or take it as a pill.

How long has  this been going on in the U.S.?

Four synthetic cathinones were identified in 2009. By 2012, 31 new synthetic cathinones were identified. According to the U.S. Drug Administration, synthetic cathinone drug reports to the National Forensic Laboratory Information System (NFLIS) increased from 34 in 2009 to 628 in 2010. 

What’s the risk of cathinones?

• The risk in the synthetic cathinones come from a complete lack of knowledge as to what and how much of any substance is in the drug.  It is not difficult to overdose on cathinone.

Similar to the adverse effects of cocaine, LSD, and methamphetamine, synthetic cathinone use is associated with increased heart rate and blood pressure, chest pain, extreme paranoia, hallucinations, delusions, and violent behavior.

What is the government doing?

• The Synthetic Drug Abuse Prevention Act, which is part of the FDA Safety and Innovation Act of 2012, placed 26 types of synthetic cannabinoids and cathinones into Schedule I of the Controlled Substances Act (CSA)  - meaning they are illegal to possess or distribute. The problem with legislating against synthetic drugs is that they are altered so quickly.

Sources:

• National Institute on Drug Abuse

• American Association of Poison Control Centers

• Congressional Research Service

• National Conference of State Legislators

• National Center for Biotechnology Information 

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