Bath salts and other newer drugs - June 2012

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These slides provide some information on newer drugs that have come to market in the last few years. …

These slides provide some information on newer drugs that have come to market in the last few years.

The media has paid particular attention to “bath salts”, though much of the reporting has been sensationalized and not accurate; this is not to say there are not some serious side effects with these new substances.

Generally, I would advise most people to avoid these substances and stick to drugs they already know. However, if people are going to use them, they should be careful with dosing, the unpredictability of the effects, and be aware that nothing is really known of the long-term consequences.

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  • VISUALS are common to all 2Cs and usually include brightening and deepening of colours, coloured LSD-like trails coming off objects and flowing, weaving patterns.  Visuals may come and go in waves and at times may be too dense to see properly or function. STIMULATION can be an effect for some users on any 2C and varies widely in amount, but some never report this. SENSORY/TACTILE effects - smells, sounds and textures may seem richer, more intense or just plain strange or surreal. SYNAESTHESIA - A phenomenon where sensory data is read by one sense and felt (or interpreted) as another sense, such as smelling bright colours or hearing sounds when you smell a flower. This phenomenon happens for many while on phenethylamines but it can be a surprise if it is unexpected.  This seems to occur in tandem with being flooded with memories as your brain cross-references itself. If this occurs and you feel weird or alien, or like ‘deja-vu’, just remember that it’s temporary. MEMORY FLOODING and THOUGHT CROSS-REFERENCING-- Dr Shulgin found this mental cross-referencing effect to be the most beneficial aspect of 2C-B in terms of self-discovery and saw unlimited potential for use in psychotherapy.  In the wrong situation however, going through all your memories and what makes up who you are might not make for the best trip. The best way to get through this if it does happen is to try to get comfortable or somewhere calming and let the thoughts flow through your mind as freely as possible. Thoughts trigger other thoughts in a domino effect, and in such a fashion that if you listen to them instead of trying to block them out, you’ll work through the ideas quickly.
  • VISUALS are common to all 2Cs and usually include brightening and deepening of colours, coloured LSD-like trails coming off objects and flowing, weaving patterns.  Visuals may come and go in waves and at times may be too dense to see properly or function. STIMULATION can be an effect for some users on any 2C and varies widely in amount, but some never report this. SENSORY/TACTILE effects - smells, sounds and textures may seem richer, more intense or just plain strange or surreal. SYNAESTHESIA - A phenomenon where sensory data is read by one sense and felt (or interpreted) as another sense, such as smelling bright colours or hearing sounds when you smell a flower. This phenomenon happens for many while on phenethylamines but it can be a surprise if it is unexpected.  This seems to occur in tandem with being flooded with memories as your brain cross-references itself. If this occurs and you feel weird or alien, or like ‘deja-vu’, just remember that it’s temporary. MEMORY FLOODING and THOUGHT CROSS-REFERENCING-- Dr Shulgin found this mental cross-referencing effect to be the most beneficial aspect of 2C-B in terms of self-discovery and saw unlimited potential for use in psychotherapy.  In the wrong situation however, going through all your memories and what makes up who you are might not make for the best trip. The best way to get through this if it does happen is to try to get comfortable or somewhere calming and let the thoughts flow through your mind as freely as possible. Thoughts trigger other thoughts in a domino effect, and in such a fashion that if you listen to them instead of trying to block them out, you’ll work through the ideas quickly.
  • VISUALS are common to all 2Cs and usually include brightening and deepening of colours, coloured LSD-like trails coming off objects and flowing, weaving patterns.  Visuals may come and go in waves and at times may be too dense to see properly or function. STIMULATION can be an effect for some users on any 2C and varies widely in amount, but some never report this. SENSORY/TACTILE effects - smells, sounds and textures may seem richer, more intense or just plain strange or surreal. SYNAESTHESIA - A phenomenon where sensory data is read by one sense and felt (or interpreted) as another sense, such as smelling bright colours or hearing sounds when you smell a flower. This phenomenon happens for many while on phenethylamines but it can be a surprise if it is unexpected.  This seems to occur in tandem with being flooded with memories as your brain cross-references itself. If this occurs and you feel weird or alien, or like ‘deja-vu’, just remember that it’s temporary. MEMORY FLOODING and THOUGHT CROSS-REFERENCING-- Dr Shulgin found this mental cross-referencing effect to be the most beneficial aspect of 2C-B in terms of self-discovery and saw unlimited potential for use in psychotherapy.  In the wrong situation however, going through all your memories and what makes up who you are might not make for the best trip. The best way to get through this if it does happen is to try to get comfortable or somewhere calming and let the thoughts flow through your mind as freely as possible. Thoughts trigger other thoughts in a domino effect, and in such a fashion that if you listen to them instead of trying to block them out, you’ll work through the ideas quickly.
  • 3-Trifluoromethylphenylpiperazine (TFMPP) Benzylpiperazine (BZP)

Transcript

  • 1. “Bath Salts” and Other Newer Drugs Updated: June 28, 2012 Prepared by: OHSUTP
  • 2. “Bath Salts” and other newer drugs• These slides provide information on newer drugs that have come to market in the last few years.• The media has paid particular attention to “bath salts”: – Much of the reporting has been inaccurate and sensationalized. – However, there can be some serious side effects with these new substances.
  • 3. “Bath Salts” and other newer drugs• As with all substances, these newer drugs have inherent risks.• Generally, it is probably better to encourage people to avoid “bath salts” and stick to substances they are already familiar with.• However, if people are going to use them, they should be careful with dosing, the unpredictability of the effects, and be aware that nothing is really known of the long-term consequences.
  • 4. “Bath Salts” in the media• Numerous stories in the media of people acting very bizarrely after suspected use of “bath salts”.• Stories from the UK started 3-4 years ago and over the last year or two in Canada and the United States.• Sometimes toxicology reports show that “bath salts” were actually not ingested.• The extreme cases are the ones reported; many people have used the substances with no problems at all.
  • 5. Have you heard of MDPV?• Mystery drug causing freakouts Toronto Sun posted: January 19, 2012 http://www.torontosun.com/2012/01/19/mystery-drug-causing-freakouts• Owen Sound, Ontario, Canada “Four people have showed up at the hospital within a 24- hour period suffering from extreme paranoia, vivid hallucinations and thoughts of killing themselves after smoking or injecting a mysterious brown powder…”• In this case, lab analysis by Health Canada confirmed the use of MDPV.
  • 6. Miami Zombie Attack, May 2012• May 26, Miami Florida – Police shoot and kill a man who was attacking another person and “chewing his face”. Police suspect the attacker was high on “bath salts”.• May 30 – Miamis Naked Zombie Proves Need to Ban Bath Salts, Experts Say • http://www.usnews.com/news/articles/2012/05/30/miamis-naked- zombie-proves-need-to-ban-bath-salts-experts-say• June 02 – Drug Linked To Cannibalism Case Hits Edmonton Streets • http://www.huffingtonpost.ca/2012/06/02/bath-salts-drug-edmonton- cannibalism_n_1565046.html?utm_hp_ref=rudy-eugene
  • 7. June 28, 2012• “No Bath Salts in Miami Case” – Miami-Dade Medical Examiner, Bruce Hyma "The departments toxicology laboratory has identified the active components of marijuana... The laboratory has tested for but not detected any other street drugs, alcohol or prescription drugs, or any adulterants found in street drugs. This includes cocaine, LSD, amphetamines (Extasy, Meth and others), phencyclidine (PCP or Angel Dust), heroin, oxycodone, Xanax, synthetic marijuana (Spice), and many other similar compounds."
  • 8. Research Chemicals or “Legal Highs”• Popularized by “fringe scientist” and doctor, Alexander Shulgin.• Examples – 2CI, 2CB, 2CT2, 2CT7, 5-meo-DiPT, 5-meo-AMT, BZP, TFMPP, mephedrone• Have been easily obtained over the internet the last few years.• Often the ones with psychedelic properties are sought.• Some mimic amphetamine type substances (most have stimulant properties).
  • 9. “Legal Highs”• Some people have suggested these new chemicals have been created because they are not classified and existing drugs such as MDMA, Ecstasy and Cocaine are illegal.• Mephedrone is already illegal in Canada under the Controlled Drugs and Substances Act (CDSA).• In June 2012, Health Canada proposed to make MDPV a Schedule I substance; probably should consider it illegal.• UPDATE: MDPV now illegal in Canada as of Fall 2012
  • 10. Research Chemicals• Little is known of these substances, their long- term effects, potential contraindications with medications and other drugs.• Not a very high success rate: with several of the substances, only 50% of users will get the desired high, the other 50% will have vomiting and diarrhea.• Some suggest they should be referred to as “un-researched chemicals”.
  • 11. Research Chemicals• Usually come as crystalline powder; occasionally in pill form.• Marketed as “Bath salts” or “Plant food”• Sold in packages labeled “not for human consumption”• Common Product Names: – Meow Meow; Tranquility; Blue Silk; Cloud 9; Bolivian Bath; Ivory Wave; Bliss; Lunar Wave
  • 12. Research Chemicals - Concerns• Mislabelling• Bad batches• Dosing• Long-term effects unknown
  • 13. Research Chemicals - Safety• “There really is no safe way – it‟s all a gamble...”• What exactly are you taking?! – Mass spectrometry (cost prohibitive) – Home test reagent kits (not definitive) – User reports (subjective) – One person try sub-threshold dose before everyone else (guinea pig)
  • 14. “Bath Salts”• May refer to a number of compounds that are synthetic substances based on the (cathinone) compounds that exist in the Khat plant of East Africa. – Examples: mephedrone, methylone, and MDPV (methylenedioxypyrovalerone)• Typically they have strong stimulant effects and require a smaller dosage than drugs like methamphetamine or cocaine.• In higher doses, or with extended use, may cause strong “psychiatric effects” (psychosis).• TRIP! Info: www.tripproject.ca/trip/?q=node/1939
  • 15. “Bath Salts”
  • 16. The next few slides are adapted from:• “Characterization of Methylenedioxypyrovalerone (MDPV) and Mephedrone in “Legal High” Products by Chemical Color Tests, Microcrystalline Tests, with Confirmation by LC/MS”• Emmi Slivka• The Center for Forensic Science Research and Education Willow Grove, PA
  • 17. Structurally related to cathinone, a compound extracted from the khat plant of East Africa 4-Methylmethamphetamine 3-Fluoromethcathione Mephedrone 4-Fluoromethcathione
  • 18. PharmacologyMephedrone:• Promotes the release of monoamine neurotransmitters as well inhibiting their reuptake – norepinephrine, serotonin and dopamineMDPV:• Increases levels of dopamine and norepinephrine – Reuptake inhibitor
  • 19. Mephedrone & MDPV• Relatively strong stimulants: – Some users report heart palpitations and irregular or racing heartbeat which may last for quite some time after taking the drug. – Be careful mixing with other stimulants (e.g., energy drinks)• Safest to swallow or snort. Smoking and injecting more likely to induce “bad trips”.• The higher the dose and the longer you stay high, the greater the chance you may develop undesired effects such as paranoia or psychosis.
  • 20. How They Are Taken• Routes of administration: – Snorting and swallowing (“parachuting”) – Smoking, rectal administration and intravenous use are more likely to be associated with “bad trips”.• Common doses: – Mephedrone • Snorting- 25 to 75mg; >90mg considered high dosage • Oral- 150 to 250mg – MDPV: Range from 5mg-25mg
  • 21. MDPV – Orally/Swallowing Total Duration 2.0 - 7.0 hours Onset 15 - 30 mins Coming Up 30 - 60 mins Plateau 30 - 180 mins Coming Down 30 - 120 mins After Effects 2 - 48 hours Hangover / Day After ---Duration can be affected by the amount taken, a person‟s tolerance or experiencewith a drug, and what other substances a person might have taken.
  • 22. MDPV – Insufflated/Snorting Total Duration 2.0 - 3.5 hrs Onset 5 - 20 mins Coming Up 15 - 30 mins Plateau 30 - 120 mins Coming Down 30 - 60 mins After Effects 2 - 48 hours Hangover / Day After ---Duration can be affected by the amount taken, a person‟s tolerance or experiencewith a drug, and what other substances a person might have taken.
  • 23. Desired Effects of Mephedrone & MDPVEffects may vary dramatically from one person to another or oneexperience to another; factors such as body chemistry, age, gender,physical / psychological / mental health, size of dose, and how the drug istaken all affect the experience.• Increased energy or motivation• Stimulation (mental and physical)• Increased mental clarity or insight• Euphoria or elevated mood• Increased sociability and talkativeness• Enhanced creativity• Feelings of empathy• Sexual arousal• Hallucinations (enjoyable for some; frightening for others)
  • 24. Adverse Effects of Mephedrone & MDPVRisk of negative side effects increases with higher doses.• Increased heart rate; blood pressure; body temperature• Arrhythmia (irregular heart beat)• Seizures• Binging / fiending (re-dosing repeatedly)• Loss of appetite• Hard to fall asleep• Excessive excitation / hyperactivity• Anxiousness / nervousness• Confusion or scrambled thoughts• Paranoia / Hallucinations / Psychosis*• Muscle tension• Tightened jaw muscles, grinding teeth• Involuntary body movements (twitching, lip-smacking, etc.)• Eye spasm• Gastrointestinal disturbance (nausea; upset stomach)• Headache *As with all stimulants, chronic• Harsh comedown effects habitual use over many days,• Residual depressed mood combined with a lack of eating and sleeping, can result in paranoia and psychotic outbreaks, especially if an underlying mental health issue is present.
  • 25. The Owen Sound Cases• Mystery drug causing freakouts Toronto Sun posted: January 19, 2012 http://www.torontosun.com/2012/01/19/mystery-drug-causing-freakouts “Four people have showed up at the hospital within a 24-hour period suffering from extreme paranoia, vivid hallucinations and thoughts of killing themselves after smoking or injecting a mysterious brown powder…”• Lab analysis by Health Canada confirmed the use of MDPV, however it should be noted that the drugs were smoked and injected.
  • 26. UK Mephedrone Ban May Have Done More Harm Than Good• http://whyprohibition.ca/blogs/jesse-wentzloff/uk-mephedrone-ban- may-have-done-more-harm-good• The [ban], which came after mephedrone had been linked to a number of deaths, which were later found not to be attributable to the drug, could be driving demand for other new drugs.• It comes after recent research revealed that 40 new synthetic drugs have flooded into the UK during the past year
  • 27. Banning Mephedrone• "One of the dangers of the approach that has been taken is that if we ban every new drug without a balanced view, then people will keep making more new drugs to replace them and eventually they will make something that is extremely toxic which, when kids take it, they will die.”- Professor David Nutt, Independent Scientific Committee on Drugs• Commentary on recent (May 2012) case Miami, USA: http://www.guardian.co.uk/commentisfree/2012/may/31/miami-face- eating-case-bath-salts-ban
  • 28. Other Newer Drugs• There have been numerous other drugs developed in the last few years. The following are some of the more common ones and have not been marketed as “Bath Salts”.• Use of these is still very minimal.
  • 29. Phenethylamines• Phenethylamines are a family of chemicals structurally similar to the amphetamines that are naturally occurring plant and animal enzymes.• Synthetic phenethylamines are also made by chemists.• Examples: 2C-I, 2C-B, 2C-T-2, 2C-T-7, mescaline and others.• Illegal under the CDSA.• TRIP! Info: www.tripproject.ca/trip/?q=node/65
  • 30. 2C-* Effects• Visuals• Stimulation• Sensory and Tactile Effects• Synaesthesia• Memory Flooding and Thought Cross- Referencing
  • 31. 2C-* Effects• VISUALS are common to all 2Cs and usually include brightening and deepening of colours, coloured LSD-like trails coming off objects and flowing, weaving patterns. Visuals may come and go in waves and at times may be too dense to see properly or function.• STIMULATION can be an effect for some users on any 2C and varies widely in amount, but some never report this.• SENSORY/TACTILE effects - smells, sounds and textures may seem richer, more intense or just plain strange or surreal.• SYNAESTHESIA - A phenomenon where sensory data is read by one sense and felt (or interpreted) as another sense, such as smelling bright colours or hearing sounds when you smell a flower. This phenomenon happens for many while on phenethylamines but it can be a surprise if it is unexpected. This seems to occur in tandem with being flooded with memories as your brain cross- references itself. If this occurs and you feel weird or alien, or like „deja-vu‟, just remember that it‟s temporary.• MEMORY FLOODING and THOUGHT CROSS-REFERENCING - Dr Shulgin found this mental cross- referencing effect to be the most beneficial aspect of 2C-B in terms of self-discovery and saw unlimited potential for use in psychotherapy. In the wrong situation however, going through all your memories and what makes up who you are might not make for the best trip. The best way to get through this if it does happen is to try to get comfortable or somewhere calming and let the thoughts flow through your mind as freely as possible. Thoughts trigger other thoughts in a domino effect, and in such a fashion that if you listen to them instead of trying to block them out, you‟ll work through the ideas quickly.
  • 32. Phenethylamines - 2CB• White powder or tablet• $30 per dose• MDMA/LSD effect• Open and closed eye visuals• Mild stimulant and mood enhancer• Can cause cramps and diarrhoea• Lasts 4 to 6 hours• Can be “life altering”• Tolerance develops quickly
  • 33. Phenethylamines - 2CT7• Powder or tablet• 7 mg tabs sometimes sold as “E”• Change in perception & time• Increased sociability• Dissociative effect• May cause anxiety, confusion or panic attacks• Nausea and vomiting• Has resulted in death
  • 34. 2C-* Risk Reduction• Although each phenethylamine has its own distinct signature, there are some general concerns.• Dosages for each are very small (most are around 10mg) and as a powder it cannot be „eyed‟ out accurately. Weigh it out on a 3 decimal milligram scale.• Dosing more than 20milligrams can get really intense. Every few milligrams over 25 will double the intensity, but will most likely just increase the unwanted effects and any toxicity.• Don‟t snort any 2Cs! Death and OD cases seem to all have come when users snorted 2C-T-7 or 2C-B, and in any case it burns so badly that most of the your first hour high will be in pain and tears. Not good for sinuses!• The first time, any of the 2Cs will be extra-intense; try a half dose by itself at home or somewhere safe.• Wait at least 2 weeks or a month between trips. Frequent 2C trips will get less interesting even with increasing the dosage. Higher dosages often lead to more side-effects than wanted effects.
  • 35. 2C-* Risk Reduction• Phenethylamines are prone to causing mystical or life-changing experiences. Make sure that you are in a comfortable environment (mentally and physically) and have everything you‟ll need with you.• The onset of 2Cs can vary widely. On an empty stomach and swallowed as powder out of the capsule or dissolved in a drink, the onset will be quick (15-45 minutes.) Left inside the capsule or as a pill, or if taken on a full stomach, the onset will be delayed, sometimes up to 3 hours!• That said, don‟t take more if you aren‟t high. You may still be coming up 3 hours after dosing.• 2C-B has a rather brief duration, usually entirely over within 5 or 6 hours but other 2Cs will keep you up all night like E or speed.• 2C compounds can be dangerous in combination with MAO inhibitors such as syrian rue/harmaline or certain antidepressants (MAOIs and otherwise).• Be careful! Very little is known about these compounds. Make sure someone knows exactly what you‟re taking when you dose in case you need help (medical or otherwise!).
  • 36. Tryptamines• A family of chemicals that are found in animals, plants and fungi.• Neurotransmitters serotonin and melatonin are tryptamine-based structures.• Can be synthesized in laboratories – Foxy, LSD and melatonin sleeping pills have all come from the human imagination• Examples – AMT, DMT, “Foxy” (5-meo DIPT), “Moxy” (5-MeO-MIPT)• Illegal under the CDSA.• TRIP! Info: www.tripproject.ca/trip/?q=node/44
  • 37. Tryptamines - AMT• (Alpha-methyltryptamine) – Lasts 16 hours – Effect like combining MDMA & LSD – Wide range of experiences – Comes in a white powder – Can be swallowed, snorted or smoked – $20 – 25 – Only a small amount needed – Narrow dose range 10 – 15 mg. – Can cause unpleasant trips
  • 38. Tryptamines: 5-MEO-DIPT “Foxy”• Foxy-methoxy – White powder or tablet – 5 – 12 mg. Dose – $30 – 40 per dose – Causes body buzz, mood lift, euphoria, increased sex drive, and enhanced visuals – Long lasting – Can cause acute vomiting, long come down (12 hours), diarrhoea, a widely varied experiences.
  • 39. Foxy• “Foxy” (5-meo DIPT)• Synthetic tryptamine first developed by Alexander Shulgin in 1980.• It may be sold as a small amount of loose powder in a gel cap, or as a pressed pill.• Effects are wide-ranging and last 4 - 8 hours. They may include...
  • 40. Foxy - Effects• Audio distortions – Your own voice might sound strange, as will others; music you know may seem unfamiliar or different• Tactile sensitivity – Your skin may seem extra-sensitive; response to touch may range from feeling very good to not so good, or just plain odd• Enhancement of visual textures – Brightening of colours, trails and visual distortions• Nausea, diarrhoea, or an uneasy feeling.
  • 41. Tryptamines – Risk Reduction• Recreational use of Tryptamines requires only minute amounts of the substance, making it impossible to “eyeball” out doses. – Differences of 5 or 10mg between small lines of powder are impossible to judge. The difference between a good trip and bad time relies on DOSAGE. – Use a 3 decimal scale to measure doses.• Use the buddy system and have a “sober sitter”.• Tryptamines aren‟t necessarily party drugs; better to use at home.
  • 42. Tryptamines – Risk Reduction• Avoid mixing tryptamines with any other drugs such as downers, amphetamines or other stimulants.• MAOIs seriously potentiate their effects, and generally should be avoided when using tryptamines.• Most doctors and medics have no idea these drugs even exist, let alone what to do in an overdose situation. In case of an overdose, let the medics know exactly what has been ingested as well as any info like websites.• Tryptamines should be treated with a great deal of respect and only called on when your mind is clear before diving into the depths of your psyche.
  • 43. Ecstasy takers inhospitalCBC News Posted:Apr 8, 2011http://www.cbc.ca/news/canada/nova-scotia/story/2011/04/08/ns-ecstasy-halifax.htmlUnfortunately noinformation isprovided regardingthe appearance ofthe pills.
  • 44. Piperazines• Piperazine class of drugs.• Combination of BZP and TFMPP.• First popularized as “Social Tonics” in New Zealand and marketed as a “harm reduction” alternative to street laced ecstasy pills.• Were available in Canada online and in Toronto store-fronts around 2007/2008 branded and “Pure Pillz”, though no longer available this way.• Did not become too popular as decent quality MDMA was widely available and Pure Pillz only crudely mimic effects of MDMA.• BZP and TFMPP often show up in lab analysis of current ecstasy pills.• Sildenafil (Viagra) is a synthetic piperazine derivative.
  • 45. Pure Pillz
  • 46. Health Canada Advisory – Pure Pillz
  • 47. Resources• www.erowid.org/psychoactives/psychoactives.shtml (all about every drug)• www.tripproject.ca (Toronto based “party drug” harm reduction)• www.not4me.org (Fear and abstinence only drug education? Its not enough 4 me.)• www.torontovibe.com (AIDS Committee of Toronto‟s party drug info page)• www.dancesafe.org (U.S. based “party drug” harm reduction info)• www.cssdp.org (Canadian Students for Sensible Drug Policy) Contact: Nick Boyce Provincial Director, OHSUTP nboyce@ohsutp.ca 1.866.591.0347