Synthetic drug use is a tricky and dangerous problem that continues to evolve nationwide. The use of synthetics and designer drugs isn’t new to the U.S. Starting with morphine in the 1800s, to LSD in the 1970s, and ecstasy in the 1980s, a long list of synthetic drugs has gained popularity across the country.

In the past decade, a variety of psychoactive drugs not previously seen in the U.S. have become widespread and continue to become more popular today. The internet has fueled increased accessibility, affordability, and marketability. Herbal products like Kratom are unregulated in most states.

Originating heavily in Asia, a large percentage of synthetic drugs enter the U.S. from foreign nations, and are also manufactured domestically in at least 30 states (Cary, 2012). With both professional and amateur chemists having the ability to continually develop the composition of these man-made drugs and anonymously market them, subsequently avoiding current regulations and laws, this leaves the government with a challenging issue to regulate synthetic drug use and production.

The largest issue with synthetic drugs lies with their production. Clandestine labs tweak the chemistry just enough to keep the drugs legal. Because they are often marketed as herbal supplements, users believe the synthetics aren't dangerous. 

Synthetic drugs, known in the toxicology world as synthetic cathinones and synthetic cannabinoids, are produced in many variations. These drugs differ in side-effects but all have the common traits of aggressive and violent behavior.

Synthetic cathinones

Made to mimic the effects of methamphetamines, cocaine, PCP, and/or LSD, synthetic stimulants are generally snorted, injected, smoked, or orally consumed.  with effects taking place within 30 to 45 minute. Although the desired effects last from 1-3 hours, the negative side effects last from hours to days and result in similar behavior observed in users on . Data indicates that 23,000 emergency room visits were linked to synthetic stimulants in 2011 (SAMHSA, 2013). It has also been reported when treating these users, common techniques of chemical submission are often ineffective, making treatment difficult. Though synthetic stimulants, such as Flakka, have a more hazardous reputation, synthetic cannabinoids have exploded on the recreational drug market resulting from their ability to produce psychoactive cannabis-like effects. Known by a variety of names, such as ‘’Spice’’ or ‘’K2’’, synthetic cannabinoids are generally sprayed onto herbal products, adding harmful and dangerous chemicals to normally natural plants, and either smoked as herbal incense or sold as liquids to be vaporized. Effects of synthetic cannabinoids are similar to the effects of marijuana. Both types of synthetic drugs have serious adverse reactions, including impaired perception, racing heart, extreme paranoia, violent behavior, and psychosis. The long-term effects are unpredictable because the drugs have not been around long enough to determine such effects.

Since this is an obvious concern for public safety, how do you address it? Synthetic cannabinoids and cathinones are very difficult for laboratories to detect because of the large number of differing substances and the constantly changing structures of these drugs. Here are some tips on how to address in your program:

• Stay up-to-date with the latest trends in your market. Take note of which substances are confiscated during arrest. Become familiar with the effects of synthetics to help you detect client use and help you determine which substances are necessary to test for. Do the research, hold discussions with colleagues in your area in other programs, and contact an expert when you need assistance identifying these substances.
• Use treatment court contracts or probation agreements to ban all forms of synthetic substances. Add language stating, ‘I agree that I will not use, possess, consume or apply any of the following: Synthetic or mood altering chemical(s) or any substances deemed “not for human consumption,”
• Establish a drug testing program that works. If you already have a concrete drug testing program in place, does it allow you to truly test for the latest synthetics? Urine is the best sample for synthetic drug detection. The method for analyzing is liquid chromatography-tandem mass spectrometry (LC-MS/MS). LC-MS/MS is more costly than screening methods but allows you to have the broadest synthetic panel. That being said, it’s necessary to incorporate a drug testing program that is cost-effective while still being able to successfully detect synthetic substances. Often, synthetics are used in place of an offender’s drug of choice, so testing for these substances, along with other substances, is critical to recovery. Ask your laboratory to test for substances when there is suspicion and randomly incorporate popular synthetics in your drug panel. In addition, make sure the laboratory analyzing your samples tests for a broad spectrum of compounds so it isn’t money wasted. Laboratories should continuously update synthetic panels based on research market trends.
• Define sanction severity and communicate this with your client population.
• Monitor your client population with community supervision and, when necessary, select participants for testing where there are indications of synthetic drug use. Incorporate random and frequent field visits.
• Allow the opportunity for participants to self-report.
• Identify participants in court who are having positive results and showing improvement.

Unfortunately testing and legal controls will always be delayed behind the every changing world of synthetic drugs posing a challenge to keep up with the latest drugs on the market. As the speed of this issue escalates and the problem grows, it is necessary to be proactive by increasing awareness and creatively determining a program aimed to decrease synthetic use.

References

Cary, Paul L., National Drug Court Institute. (2014). Designer Drugs: What Drug Court Practitioners Need To Know.

Cary, Paul L., Designer Drugs- (Spice/K2, Bath Salts, & Beyond – 2012 Update). (2012).

Journal of Analytical Toxicology 37:135-146. (2013). Analysis of Synthetic Cathinones Commonly Found in Bath Salts in Human Performance and Postmortem Toxicology: Method Development, Drug Distribution and Interpretation of Results. Dayton, Ohio.

National Institute on Drug Abuse, DrugFacts: Synthetic Cannabinoids. (2015). Retrieved from http://www.drugabuse.gov/publications/drugfacts/synthetic-cannabinoids

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2012). The DAWN Report: Drug-Related Emergency Department Visits Involving Synthetic Cannabinoids. Rockville, MD.

Substance Abuse and Mental Health Services Administration. (2013). Report shows that “Bath Salts” drugs were involved in nearly 23,000 emergency department visits in one year. Retrieved from http://www.samhsa.gov/newsroom/press-announcements/201309171200