This is the last of three articles about substance abuse issues impacting Americans today.
“Drugs like ‘spice’ pose a significant public health threat. Since the exact compounds contained in these products change so frequently, it’s often impossible for users to know exactly what they are putting in their bodies.” -Dr. H. Zucker, NY State Health Commissioner
Many “new“ drugs of abuse are not really new: they are either derivatives of existing compounds (designer drugs) or substances (like marijuana or cough medicine) that have been around awhile, but are being abused more frequently or in new ways.
A designer drug is a drug that is created to be only slightly different from an illegal drug, so that it will not be considered illegal. The ease of manufacturing designer drugs as well as increased access provided by the Internet has resulted in a dramatic increase in the use of these substances.
Some of the more common designer drugs include:
--Synthetic marijuana, sold under brand names such as Spice and K2. Synthetic marijuana is sold as a “safe” or “legal” alternative to marijuana that is not easily detected in standard drug screens. A large variety of herbal materials may be in synthetic marijuana; it is made by spraying chemicals that mimic the effects of marijuana onto dried plant leaves. These chemical additives are responsible for the mind-altering effects of synthetic marijuana – they are not natural. It is often impossible to know exactly which additives were used when a certain batch of synthetic marijuana was produced, adding to the danger of its use.
The use of synthetic marijuana has been growing: A University of Michigan study (2012) showed that 11% of high school students used synthetic marijuana in a year – its use was second only to marijuana. Easy access coupled with the misperception that synthetic marijuana is natural has contributed to its popularity. A federal designer drug law signed by President Obama in 2012 made many of the chemical components found in synthetic marijuana illegal; its sale has also been banned in 41 states.
“I’m in the club high on Purp with some shades on.” -singer Miley Cyrus
Especially in states where it is legal, the use of non-synthetic marijuana (cannabis) is also increasing. “Purp,” the virtues of which are extolled by Miley Cyrus in a recent song, is slang for a high grade strain of this ever popular plant. Though controversial, many medical professionals still believe that marijuana can serve as a “gateway” to the use of other, more dangerous drugs. Though medicinal uses of marijuana are being researched, the American Medical Association (AMA) states in H-95.998 AMA Policy Statement on Cannabis: “Our AMA believes that cannabis is a dangerous drug and as such is a public health concern.”
--Bath salts, sold online in convenience stores or “head shops” under many names including “Ivory Wave,” “Eight Ballz,” “Vanilla Sky,” and “Bliss.” In no way are these substances related to the aromatic crystals that people put in their bathtubs. Alarming news stories have reported that the use of bath salts has transformed average people into monsters or “zombies.” Since 2011, bath salt abuse has resulted in thousands of ER visits and calls to poison control.
Because bath salts are designed to imitate the effects of illegal stimulant drugs like cocaine or methamphetamine, they are sometimes called “legal cocaine.” As a result of the 2012 federal designer drug law, however, most of their ingredients are no longer legal. Bath salts are often snorted or injected, but some users mix them with food and drink even though they are commonly labeled “not for human consumption.”
As with other designer drugs, the exact chemical composition of bath salts varies depending on the manufacturer. These substances are dangerous both because their exact composition is not known, and because they produce physical effects similar to cocaine combined with a hallucinogen. Most bath salts contain an amphetamine-like compound such as mephedrone, which has been found in Europe to cause many overdoses. Like cocaine, bath salts probably also pose a high risk for cravings and addiction. Users of bath salts often experience dangerous symptoms including high blood pressure, reduced blood supply to the heart, chest pain, agitation; they can also have seizures, paranoia, hallucinations or suicidal thoughts. Regular users may experience withdrawal and addiction symptoms.
New prescription or over-the-counter drugs of abuse:
--GHB, Gamma-hydroxybutyrate - street names include cherry fX bombs, everclear, blue nitro, and “grievous bodily harm.” GHB is also called “poor man’s heroin” because, like heroin, it is sedating while often causing an initial euphoric effect. A form of GHB (sodium oxybate; trade name Xyrem) has recently been approved by the FDA to treat symptoms of narcolepsy when prescribed by a doctor to patients enrolled in the “Xyrem Success Program.” Illegal and potentially dangerous uses of GHB include being used as a “club drug,” as a body building supplement alleged to help burn fat or build muscle (it does not really do these things), and as the infamous “date rape” drug due to its sedating effects.
--DXM (dextromethorphan) – an over the counter (OTC) cough suppressant found in many cold medicines such as Robitussin or Coricidin Cough and Cold capsules (called “Triple C”). Overuse of DXM, a dangerous practice, can produce euphoria, dissociation (out of body sensation), confusion, or hallucinations. Taking more than the recommended dose of medicines containing DXM is called “robo-tripping” or “skittling.”
In addition to the federal designer drug laws, many states have banned the sale of these substances. Stricter state and federal laws now govern the sale of certain over-the-counter medicines that are used in the manufacturing of designer drugs. Recent studies about teenage drug use (University of Michigan, 2013 and 2014) are encouraging - they suggest that teens may be starting to exercise more caution in using synthetic compounds.
Because users of designer drugs often cannot know what they are putting into their bodies, even recreational use of these substances is dangerous. If you know someone who is abusing or is addicted to dangerous substances, help them seek treatment or contact your EAP for more assistance.
For more information:
The second blog article in this series discusses substance abuse treatment in more detail.
AMA policy statement on cannabis:
University of Michigan study about drug use (December, 2013):
http://home.isr.umich.edu/releases/teens-more-cautious-about-using-synthetic-drugs/
American Society of Addictive Medicine:
NIDA (National Institute on Drug Abuse):
www.drugabuse.gov/related-topics/trends-statistics/national-drug-early-warning-system-ndews
About drug overdose: