“Designer DrugS” - “getTING high, sick,

disabled, and dead on SYNETHETIC DRUGS”©

A Primer on Designer Drugs by

Judge Kevin R. MadisonPresiding Judge lakeway Municipal court, texas

PRESIDING JUDGE HORSESHOE BAY MUNICIPAL COURT, texasPRESIDING JUDGE BRIARCLIFF MUNICIPAL COURT, texas

PRESIDING JUDGE JOHNSON CITY MUNICIPAL COURT, texasEmt-intermediate (advanced lifesaving skills)

State certified Firefighter

© copyright Judge Kevin R. Madison

Educational Objectives Educational Objectives At the end of this presentation, participants will be able to:At the end of this presentation, participants will be able to:

1. Understand the basic physiology of how these drugs affect behavior.

2. Identify some of the new designer drugs that are emerging throughout the U.S.

3. Describe some of the effects and signs of use of these designer drugs.

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Points about this presentationPoints about this presentation

1. I am not an expert on this topic - I am not a Chemist or Biologist.

2. A class on Designer Drugs could easily last several days. This topic is very complex because it intertwines criminal jurisprudence, law enforcement, medicine, physiology, psychiatry, organic chemistry, and politics.

3. It is impossible to discuss all the different new designer drugs popping up across the country. We will touch on a few of the most common designer drugs. There are hundreds out there.

4. I encourage you to get on the Internet: Google, Medscape, National Institute on Drug Abuse (NIDA), and You Tube and explore this topic in greater detail on your own.

5. We should strive to know as much about Designer Drugs as the kids in our community know.

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What are “Designer Drugs?”

• “Designer drugs” are chemicals that have been specifically made or “designed” by underground chemists so that they:

(1) are not covered by controlled substance statutes (and hence are not illegal), and

(2) still have the same “psychotropic affect” (cause stimulation, sedation, or hallucination, etc.) of the illegal popular drugs that people use.

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What are “Designer Drugs?”

Designer Drugs are drugs that are chemically created with different molecular structures than the original drugs that they imitate.

Example: synthetic marihuana called “Spice” or “K-2” is a chemical that mimics the chemical structure of THC in marihuana and its effects.

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syn·thet·icsinˈTHetik/

adjective: synthetic(of a substance) made by chemical synthesis, esp. to imitate a natural product. "synthetic rubber“

noun: synthetica synthetic material or chemical, esp. a textile fiber.

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How Psychoactive Substances WorkHow Psychoactive Substances Work

• Because of their chemical structure, alcohol and drugs have dramatic effects on receptor cells and neurotransmitters in Central Nervous System.

• Effects on:– Mental processes– Behavior– Perception– Alertness 7

Our body and brain operate by maintaining, increasing, or decreasing chemicals and hormones that affects

Neuro-receptors and Neuro-transmitters

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For those who want to alter Sensation, Behavior, and Bodily Functions it’s all about ingesting drugs that affect neuroreceptors and neurotransmitters.

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How these drugs work

When absorbed into the body, drugs interact with and modify cells, organs, and bodily systems by:•Altering the way the body normally functions (increasing, slowing, or enhancing bodily processes, or level or quality of functioning),•Altering the operation of tissues, organs, and systems,•Affecting hormones and enzymes, and•Impacting processes such as digestion, respiration, circulation, and mental functioning.

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Commonly Used Psychoactive SubstancesCommonly Used Psychoactive Substances

SOURCE: National Institute on Drug Abuse.SOURCE: National Institute on Drug Abuse.

SUBSTANCE EFFECTS

Alcohol (liquor, beer, wine)

euphoria, stimulation, relaxation, lower inhibitions, drowsiness

Cannabinoids (marijuana, hashish)

euphoria, relaxations, slowed reaction time, distorted perception

Opioids (heroin, opium, many pain meds)

euphoria, drowsiness, sedation

Stimulants (cocaine, methamphetamine)

exhilaration, energy

Club Drugs (MDMA/Ecstasy, GHB)

hallucinations, tactile sensitivity, lowered inhibition

Dissociative Drugs (Ketamine, PCP, DXM)

feel separated from body, delirium, impaired motor function

Hallucinogens(LSD, Mescaline)

hallucinations, altered perception11

“Psychoactive” and “Psychotropic Drugs”

These drugs affect the brain, brain chemicals, and brain receptors.

These drugs are “mind altering” and affect a person’s mind and body because they are able to cross the blood-brain barrier, which many drugs cannot cross.

Alcohol, Marihuana, Cocaine, Heroin, Amphetamines are all examples of drugs that can cross the blood-brain barrier.

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Problem with Designer Drugs

Although the chemical structure may be barely changed, the problem is that the properties of these drugs dramatically changes!

Super-enhanced properties of the drugs they copied: hyperactivity

hallucinationsparanoiasuperhuman strength

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Problem with Designer Drugs

Because molecular structure different these drugs are usually not illegal; however, legal does not mean safe!

New molecular structure creates whole new effects on mind and body:

increased heart rateheart attacksstrokes (brain attack)permanent brain injuries

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Close but drastically different!

Making one small change to a molecular structure of a compound can lead to drastic changes in the properties of that substance.

For example: H20 is water, of course.If you add another oxygen atom: H202The water becomes Hydrogen Peroxide, not poison but toxic and corrosive to human tissue...causes burns. Used for rocket fuel and making bombs. 15

Designer Drugs

Bath Salts

Spice/K2

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Food and Drug Administration (FDA)

• Designer drugs do not have FDA approval and are produced by underground chemists who do not care about quality control of the product.

• Designer drugs are not correctly synthesized and purified.

• Designer drugs contain numerous toxic impurities not separated from the desired active ingredient after the synthesis was completed.

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Where do Designer Drugs Where do Designer Drugs come from?come from?

• Chemical Research

• Published articles by Pharmaceutical Companies and Chemists

• Independent Chemists who love drugs

• “Basement Chemists”

• Made/imported from China and India then “assembled” and marketed in U.S.

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Underground Chemists

• Underground chemists first determine which drugs are listed in the jurisdiction’s controlled substance statute.

• Then these chemists make changes to the molecular structure of these drugs creating a slightly altered compound.

• May have very bad effects!• Legal Safe!!!!

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Common Characteristics of Common Characteristics of Designer DrugsDesigner Drugs

• Synthetic

• Marketed as something else – Incense, Bath Salts, Glass

Cleaner, Plant Food, Room Spray

• Attractive packaging

• Very small quantity (250mg-3gm) to obtain “high” thus many people overdose!

• “Not for human consumption”

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Common Characteristics of Common Characteristics of Designer DrugsDesigner Drugs

• White Powder or capsule

• No Ingredients listed

• Sold in Head Shop or Internet

• “Research Chemicals”

• “Does not contain . . .”

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Dangers of Bath Salts

• Abuse of recreational drugs sold as "bath salts" has sent an increasing number of people to hospitals in the United States and has resulted in deaths.

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What are Bath Salts?

• Synthetic Stimulant, similar to

ecstasy, cocaine and/or methamphetamine

• Derived from Cathinone from Khat plant

• “Not for human consumption”• White, odorless, “pills”, fine-grained

powder or crystals (oxidizes to yellow or tan)

• Can be ingested by snorting, smoking, swallowing, and intravenous access.

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MDPV= Active compound • Marketed as “Bath Salts”• Chemical analog of

Cathinone (Schedule 1 C.S.)

• Dose: 25mg – 500mg• CNS stimulant (up to 3 days)

– Delusional– Seizures– Restless / Irritated– Inflammation of heart– Teeth Grinding

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1 Dose Bath Salts…

DAY 1 Banging head into wall Pulled out IV twice Hallucinating, thought security

guard drank his beer

• HGN: 2• Pulse: 112 bpm• Blood Pressure: 144/94• Body Temperature: 98.5• Pupils: 9 – 10 mm in all lighting

conditions• Muscle Tone: Rigid

DAY 2• Combative• 12 people to control, injures 1

security guard• Lorazepam x 3, Haloperidol x1

to control• Moved to ICU• Combative again when woke

up

DAY 3 • Resting pulse 120• Exhausted, no memory

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Effects of Bath Salts

DESIRED• Euphoria• Empathy/decreased hostility• Hallucinations• Increased insight/self-

discovery• Increased energy• Enhanced music

appreciation

WHAT REALLY HAPPENS• Restless / irritated• Delusional / paranoia• Nose bleeds, headache• Dilated pupils, blurred vision• Blue/cold extremities• Nausea/vomiting• Seizures, teeth grinding• Chest pain (inflamed heart)• Excessive sweating• Go to Jail Go to Morgue!28

Synthetic Marijuana

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Synthetic Marihuana and Driving

Michigan Criminal Case APD#10-14949•Crossed raised median 3 times, hit concrete wall 2x, driving on sidewalk w/ broken axle / tire•6HGN + vertical•.000 BAC•Hallucinating•“Death is all around me”•Going to kill Officer

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What is SPICE / K2What is SPICE / K2 ??Dangerous, synthetic research chemicals that have been dissolved in acetone and sprayed onto dried plant material (herbs)

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SPICE/K2

• Plant material

• Marketed as incense

• Laced with various synthetic compounds that behave like THC

• Smoked or mixed in drink or food

• Was sold LEGALLY and LOCALLY

• 1g -3g packages About 2x price of marihuana

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Spice/K2

Ingredients: Baybean, Blue Lotus, Lion's Tail, Lousewort, Indian Warrior, Dwarf Scullcap, Maconha Brava, Pink Lotus, Marshmallow, Red Clover, Rose, Siberian Motherwort, Canavalia Maritime, Leonotis Leonurus, Leonurus Sibiricus, Pedicularis Densiflora, Scuttellaria Nana, Vanilla Planifolia, Zorinia Latifolia, Magnolia Officinalis, Rosa Gallica, Trifolium 34

Brands/Flavors

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SymptomsSymptomsNot always a bad trip, but if you’re involved Not always a bad trip, but if you’re involved it probably isit probably is

•Elevated BP Elevated BP (140-210 / 100-110)(140-210 / 100-110)

•Rapid heart rate (110-150bpm) – can be decreased BP / heart rate

•Tremors / SeizuresTremors / Seizures

•UnconsciousnessUnconsciousness

•Hallucinations / Delusions / ParanoiaHallucinations / Delusions / Paranoia

•Numbness / Tingling / Muscle LossNumbness / Tingling / Muscle Loss36

SymptomsSymptomsNot always a bad trip, but if you’re involved it Not always a bad trip, but if you’re involved it probably isprobably is

• VomitingVomiting • Memory Loss Memory Loss • Incoherent/slurred Incoherent/slurred

speechspeech• May feel cold / hot May feel cold / hot • Excessive thirstExcessive thirst• 6-8hr high 6-8hr high (some (some

effects up to 30hrs)effects up to 30hrs)

Death??Death??

• Cyclic Symptoms• Effects vary from use to use

and person to person• “Excited Delirium”

– No pain– No clothes

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Treatment?• No antidote• Symptoms more like

Stimulants and Dissociative Anesthetic than Marihuana

• Not detectable on standard screen

• Flush with Fluids (but not too much)

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NHTSA 2005-2009 StudyNational Highway Traffic Safety Administration

Press Release # 16-10 Tuesday, November 30, 2010

Alcohol-related

incidents

Drug-related

incidents

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KratomKratomAsian leaf 'kratom' making presence felt in US emergency rooms (NBC News March 19,

2012)

opiate-like leaf from Southeast Asia is well known in the worlds of alternative medicine and the drug culture

dozens of companies selling kratom leaf and touting it as a way to combat fatigue, pain and depression — even as an antidote to heroin addiction

But in addition to its possible medicinal uses, kratom is beginning to show up in U.S. emergency rooms, with doctors saying they are dealing with people sick from taking it — especially teens who try it to get high 40

KratomKratomAsian leaf 'kratom' making presence felt in US emergency rooms (NBC News March 19,

2012)

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Kratom- Kratom- Available now at your local “Head Shop” or “Smoke Shop”

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Kratom Sold in Austin, TexasKratom Sold in Austin, Texas

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Conclusion

Legal Safe!!! Many items are legal, but dangerous.

Gasoline, rat poison, bleach, drain cleaner, spray paint, glue...

There are and will be hundreds and thousands of synthetic drugs...always morphing and changing.

Most synthetic drugs are more dangerous than the original drugs they copy/mimic.

Expect the unexpected when dealing with people under the influence of synthetics

Special Thanks to:Kenneth Stecker

Michigan Traffic Safety

Resource Prosecutor

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Judge Kevin R. Madison

Presiding Judge lakeway Municipal courtPRESIDING JUDGE HORSESHOE BAY MUNICIPAL

COURTPRESIDING JUDGE BRIARCLIFF MUNICIPAL COURT

PRESIDING JUDGE JOHNSON CITY MUNICIPAL COURT

Emt-intermediate (advanced lifesaving)Firefighter-first responder

© copyright Judge Kevin R. Madison