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Synthetic Drugs of Abuse: ‘Spice,’ ‘K2’ and ‘Bath Salts’ Side effects and Long term consequences

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Synthetic Drugs of Abuse: ‘Spice,’ ‘K2’ and ‘Bath Salts’ Side effects and Long term consequences. Willie A. Hamilton, BC-FNP Board Certified in Sports Medicine & Nutrition. Synthetic Cannabinoids (SCs). Spice/K2 brands marketed as natural herbal incense “Not for human consumption”

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Synthetic Drugs of Abuse: ‘Spice,’ ‘K2’ and ‘Bath Salts’

Side effects and Long term consequences

Willie A. Hamilton, BC-FNP

Board Certified in Sports Medicine & Nutrition

synthetic cannabinoids scs
Synthetic Cannabinoids (SCs)
  • Spice/K2 brands marketed as natural herbal incense
  • “Not for human consumption”
  • Available convenience stores, gas stations, Internet
  • Cannabis substitute

Psychonaut Web Mapping Research Group (2009.) Spice Report. Institute of Psychiatry, King’s College London: London UK.

pharmacology
Pharmacology
  • delta-9 tetrahydro-cannabinol (∆9-THC) agonism of cannabinoid receptor type 1 (CB1)
  • SCs more potent
  • Typical doses are often less than 1mg
  • Not readily detectable

∆9-THC

JWH-018

psychoactive effects
Psychoactive Effects

Marketed as similar to cannabis:

  • Euphoria
  • Sociability
  • Anxiolytic
  • Relaxation
  • Stimulant

Cross tolerance with THC?

http://buyk2spice.net/

side effects of sc products
Side Effects of SC Products
  • Anxiety
  • Paranoia
  • Headache
  • Vomiting
  • Psychosis
  • Diaphoresis
  • HR/BP increase
  • Seizures

http://investigationmiami.blogspot.com/2011/01/be-afraid-really-afraid.html

current and future epidemiology
Current and Future Epidemiology?
  • No data on prevalence of use
  • American Association of Poison Control Centers:

Synthetic cannabinoids:

    • 2009: 13 calls
    • 2010: 2304 calls (Nov), a projected 200x increase

Marijuana:

    • 2008: 4009 calls, with 1020 for marijuana alone
synthetic stimulants
Synthetic Stimulants
  • Methylenedioxypyrovalerone (MDPV) and Mephedrone
    • Sold as “bath salts” or “plant fertilizer”
  • Currently legal in the United States
  • Available online and in convenience stores
mdpv and mephedrone
MDPV and Mephedrone
  • CNS stimulants
  • Related to cathinone, an active alkaloid found in the khat plant (N. Africa)
  • Previously abused

primarily in

Europe and

Australia

http://www.herbalextracts.net/library/supplements/khat_uses.html

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MDPV
  • Route: Intranasal most common
  • Also: oral, smoking, rectal, and IV
  • White to light brown crumbly powder
  • Degrades if exposed to air for significant periods of time

MDMA

http://www.stompin-gardeners.com/index.

pharmacology of mdpv
Pharmacology of MDPV
  • CNS stimulant similar to methamphetamine, MDMA, or cocaine
  • Norepinephrine-dopamine reuptake inhibitor (NDRI)
  • Increased alertness, arousal, anxiety, agitation, diminished requirement for food and sleep, sexual arousal
  • Tachycardia, hypertension, vasoconstriction, diaphoresis
effects of mdpv
Effects of MDPV
  • “High” lasts 3-4 hours
  • Physical effects may last 6-8 hours
  • May cause seizures, panic attacks, or psychosis with high doses or increased frequency of use
  • Avg dose: 5 to 20mg

http://www.tradevv.com/chinasuppliers/chwhtltd_p_198b58/china-Mdpv-by-pevukka.html

other sequelae of mdpv
Other Sequelae of MDPV
  • Trismus (inability to open mouth) or bruxism
  • Panic attacks
  • Psychosis with sleep deprivation
  • Hallucinations, delusions, suicidal ideation
  • Abstinence syndrome: depression, lethargy, anxiety, postural hypotension
    • Leads to frequent re-dosing
mdpv s legal status
MDPV’s Legal Status
  • UK: MDPV regulated under the Misuse of Drugs Act 1971
  • US: Not scheduled but banned in some states
  • DEA: controlled by the Federal Analogue Act?

http://addiction-dirkh.blogspot.com/2010/11/dea-slaps-temporary-ban-on-spice-and.html

mephedrone
Mephedrone
  • 4-methylmethcathinone (4-MMC)
  • Meow Meow
  • MCAT
  • Miaow
  • Drone
  • Plant Feeder
  • Bubbles

http://www.synchronium.net/2010/01/05/mephedrone-cat/

pharmacology1
Pharmacology
  • NE-DA reuptake inhibitor
  • Similar to MA/MDMA
    • Reportedly less potent, shorter duration
  • Oral dose: 20-50mg
  • “Come up”: 10-20 min
  • Peak: 45-60 min
  • “Comedown”: 60-120 min
  • Re-dosing: common

Amphetamine

Mephedrone

routes of administration
Routes of Administration
  • Oral ingestion
    • Swallowing capsules
    • Bombing (swallowing powder wrapped in cigarette paper)
  • Insufflation (snorting)
  • Rectally (either plugging or enema)
  • IV (use 1/2 to 1/3 dose)

http://www.guardian.co.uk/society/mephedrone

effects of mephedrone
Effects of Mephedrone
  • Euphoria
  • Sociability
  • Stimulation
  • Sexual Arousal
  • Music Appreciation
  • Hallucinations

http://www.drugs.org.im/campaigns.htm

mephedrone side effects
Mephedrone Side Effects
  • Loss of appetite
  • Increase in body temperature, sweating, hot flushes
  • Tense jaw, bruxism, stiff neck, muscle clenching
  • HR/BP elevation, chest pains
  • Dehydration
  • Mydriasis, nystagmus
  • Painful nasal drip/ulcers in mouth (after insufflation)
  • Insomnia, paranoia, anxiety, dysphoria, psychosis

http://theblackheartofgrahamquirk.blogspot.com/

mephedrone s legal status
Mephedrone’s Legal Status
  • 2008-2010: Banned in many European counties
  • December 2010: Illegal throughout the EU
  • Mephedrone is not specifically banned in the United States
    • However, some states have banned mephedrone
  • DEA: may be controlled by the Federal Analogue Act as an analogue of methcathinone
current and future epidemiology1
Current and Future Epidemiology?
  • No data on prevalence of use
  • American Association of Poison Control Centers:

Bath Salts:

    • 2010: 292 calls
    • 2011: 469 calls (2/14/11), a projected14-fold increase
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Contact Information

Willie A. Hamilton, BC-FNP

LIVEfit Medicine

1901 Brookside Dr.

Kingsport, TN 37660

(423)765-9500

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