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December 26, 2014
by David Porter, MA

Update on New Drugs of Abuse for 2014

December 26, 2014 04:55 by David Porter, MA  [About the Author]

The use, popularity, and availability of illicit drugs changes from one geographical region  and time period to another. Certain illicit psychoactive drugs will fade from common use and then re-emerge. Substances which may have been discovered decades ago will experience a sudden surge in popularity. Familiar substances may be administered in new ways, or chemically altered or combined for a different effect. In other instances, something truly new may emerge on the illicit drug market. Here I will introduce and discuss drug trends in the United States for 2014.  This will include:

1.      Oxycontin Diversion

2.      Buprenorphine Strips vs. Pills

3.      Bath Salts

4.      Salvia

5.      Krokodil

6.      K-2

7.      Vodka Tampons

8.      Purple Dran

Oxycontin (aka Oxy's) Diversion

Oxycontin is a synthetic opiate prescribed for management of severe pain. It is time- released and intended for oral administration. It is diverted and can be purchased on the street for about $160 for one 80mg tablet. The tablets are crushed to defeat the time- release coating and snorted, or mixed with water and injected intravenously. Either method of illicit administration will produce a euphoric rush followed by 4-6 hours of a warm, soothing,  relaxed feeling. The effects are indistinguishable from heroin. Oxycontin administered in this manner is highly addictive. Intense flu-like symptoms will emerge about 12 hrs after the last use once the user becomes physiologically addicted. This can occur within a matter of weeks. A new formula was introduced by Perdue Pharmaceuticals in 2010 which was intended to be abuse resistant- the pills were spongy, and therefore could not be crushed. However, about 72 hours after this version became available to the public, information was  available on-line-a  procedure to render the new formulation of  Oxycontin abuseable- e.g., crushable- so it can be snorted or injected as described above. Oxycontin diversion continues to be a major public health and law enforcement problem in the United states.

Buprenorphine  (Suboxone/Nalaxone) Strips (aka Bup)

Buprenorphine is a combination of Suboxone and Nalaxone- a weak opiate agonist combined with an opiate antagonist. It is used for management of Opiate addiction. They are diverted from legitimate use, as the Nalaxone can be bypassed by crushing the pills, and snorting them, or mixing them with water and injecting them. Some opiate addicts also use them to self- treat their dependence without having to submit to the stringent requirements and expectations of a recovery program.  Buprenorphine strips were introduced by the manufacturer in 2011. They were intended to be abuse resistant- the strips will gel and clog a syringe if mixed with water, they can’t be snorted, and they are traceable by Law enforcement- each strip is in a foil packet with a serial number traceable to the pharmacy where it was purchased,  and the patient it was prescribed  to. If the strip is outside the foil packet, it rapidly degrades from being handled, due to moisture in the handlers palm, and from the air. However, within 72 hours of it's availability on the legitimate market, information was posted on the internet which detailed a procedure to make the strips abuseable  by rendering them into a form which could be injected. An unintended consequence of switchover from strips to pills was that the price of pill form suboxone on the street has gone up from about $10 a pill to $30 a pill.

Bath Salts (aka Plant Food)

 Bath Salts are a combination of up to 20 different chemical compounds with hallucinogenic and stimulant properties. It is being sold over the counter labeled as Bath Salts, with a disclaimer: Not for Human Consumption. (Gardner, 2011). This illicit product should not be confused with Epsom salts, which are used in bath water for soaking sore muscles, and may be infused with different scents and colors to make them more attractive to the consumer. Epsom salts do not have psychoactive properties, but are rather a purgative, or laxative if consumed orally.

The active ingredients in Bath Salts vary and can include:

Mephedrone, which is also known as:

·         M4

·         Meph

·         Drone

·         MCAT

Other psychoactive compounds include: 

·         MDPV (3,4-Methylenedioxypyrovalerone),

·         Alpha-PVP

·         Methylone

(McMillen & Martin, 2012).

Mephedrone and MDPV are synthetic versions of Methcathinone- the central nervous system stimulant which naturally occurs in a leafy plant- Khat (Catha edulis), found in eastern Africa (NIDA, 2011). 

The effects of Bath Salts are variable, and can include:

·         Euphoria

·         Hyper-sexuality

·         Intensified sense of touch

·         Bruxism ( Jaw grinding)

·         Paranoia

·         Tachycardia ( elevated heart rate)

·         Hypertension ( Elevated  blood pressure)

·         Hyperthermia (High body temperature)

·         Sleep deprivation

·         Vivid hallucinations

·         Hostility or aggression

·         “Strange eye movements”

·         Diaphoresis (sweating)

·         Panic attacks

·         Suicidal thoughts

(Erowid, 2011 ; Haiken, 2012 ; NIDA, 2011).

The duration of action is two- seven hours, depending on method of administration, and the composition of a specific dose of Bath Salts. The legal status of Bath Salts varies depending on the jurisdiction. Generally, they are not FDA or DEA regulated. Three of the typical ingredients found in Bath Salts - mephedrone, MDPV, and methylone- are illegal to possess or sell according to the terms of an emergency ban effective October 2011-October 2012.  Bath Salts are not detectable on most urine screens.

Salvia Divinorum ( aka Salvia)

Salvia is a green leafy plant, which resembles mint. It is dried and smoked for a brief high- the duration of which is only about ten minutes-pseudo- paralysis, and perceptual distortions result. Salvia metabolites are not detectable on most urine screens, and currently not FDA or DEA regulated.

The effects include: 

·         Incoordination

·         Laughter

·         Visual distortion

·         A sense of peace

·         Sense of profound understanding

·         Derealization

·         Disorientation

·         Tunnel vision

·         Depersonalization

·         Sense of flying, floating, twisting, or turning

·         Feeling of being underground or underwater

·         Becoming an inanimate object

·         Paralysis

The effects are not like those produced by Cannabis- but Salvia is marketed as a legal substitute for cannabis .

The methods of administration include: Infusion with boiling water and taken orally, Quid- leaves are chewed, and the active drug is absorbed by the buccal route ( cheek and gums), or smoking – inhalation ( users have described the smell as resembling “ burnt fish” ).

The duration of action of Salvia depends on the method of consumption, and the amount consumed. The range is as low as 15 minutes to  over three hours. Smoked Salvia has a faster onset and shorter duration than if drank as an infusion or chewed as a quid. The legal status of Salvia is it is currently not FDA or DEA regulated, and it is not detectable on most urine screens.

Krokodil (Desomorphine)

This is a very dangerous compound. Krokodil is codeine which has been chemically altered with red phosphorous and iodine, to enhance the psychoactive effects. It can be injected and snorted. It will produce a high similar to heroin, and other opiates. It was first seen in Russia, but has been introduced into the United States in the past several years. When administered either intravenously or by snorting, the red phosphorous and iodine can produce third degree chemical burns and necrosis ( tissue death) resulting in severe infection, including gangrene, which may require amputation. There are grotesque images of users with severe tissue necrosis available on-line, but this has apparently not dissuaded some from trying this drug (Snopes Urban Legend Reference Pages, 2013).

K-2 ( aka Spice)

This is a combination of dried herbs, incense, and other dried leafy vegetation which has been treated with a synthetic cannabanoid, similar to cannabis sativa, which is commonly known as Pot, Grass, or marijuana (Drugs.com, 2014). It has been argued by many that canabanoids are a harmless psychoactive compound, but the synthetic cannabanoid compounds in K-2 have the potential to induce a psychotic state that can be enduring in some individuals. This is unclear, and limited to anecdotal reports, as the empirical information on the effects of this drug are largely unavailable. The legality of selling and possessing it varies between jurisdictions.

Vodka tampons

It has been widely reported in the media and many websites that young girls and are soaking tampons in vodka or Ever Clear (a brand of 190 proof alcoholic beverage), and inserting them vaginally. The alcohol is absorbed through the mucus membranes of the vagina, and produces intoxication without the obvious odor of alcohol on the person's breath. An investigation by Snopes.com,  an urban legend research site,  indicates this is false, (Snopes Urban Legend Reference Pages, 2012)  in that there are no official reports of people engaging in this practice. However it can be reasoned that there are young women (and possibly men inserting the tampons rectally) who have tried this out of curiosity because they have heard so much about it.

Purple  Drank ( aka Lean, aka Sizzurp)

This is a psychoactive cocktail with various ingredients. The base ingredient is cough syrup containing codeine, sometimes with vodka or Ever Clear ( see definition above in Vodka tampons). Jolly Ranchers hard candies or Skittles candies are dissolved in it,  and Mountain Dew soft drink, or Red Bull or Monster energy drink may be added. It will produce drowsiness, relaxation, difficulty maintaining balance (thus the name Lean) loss of coordination, loss of consciousness, and can lead to fatal respiratory depression if consumed in large quantities. It can be consumed somewhatdiscreetly by drinking it out of a soda bottle.  It has become very popular with urban youths, partly due to Rap star L'il Wayne glorifying it until his own publicized overdose on it, and subsequent retraction as to the benefits of consuming it. There are numerous sites on -line about how to make it and the effects (Rossen, and Davis, 2014).

The drug trends discussed in this paper are dynamic , and there will undoubtedly be new trends emerging on an ongoing basis. There is a limited amount of information available on some of these trends, and a great deal more misinformation, unsubstantiated rumors, and anecdotal information which may or may not apply to an empirical sample. Moral Panic- jumping to conclusions and outrage based on scant information – should be avoided. As time passes, more research and empirical finding should become available. In the meantime, treatment providers, family members, and law enforcement should be aware of these substance and trends.

_________________________________________________________________________________________________________________________________

Drugs.com. (2014). Synthetic Marijuana - Spice or K2. Drugs. com. Retrieved August 12, 2014 from http://www.drugs.com/illicit/synthetic-marijuana.html 

Erowid (2011). MDPV effects. Erowid Vaults. Retrieved August 12, 2014,  from: http://www.erowid.org/chemicals/mdpv/mdpv_effects.shtml 

Gardner, A. (2011). Hallucinogens Legally Sold as 'Bath Salts' a New Threat. Bloomberg Business Week. Retrieved August 12, 2014,  from: http://www.businessweek.com/lifestyle/content/healthday/649596.html 

Haiken, M. (2012). 'Bath Salts' - A Deadly New Drug With A Deceptively Innocent Name. Forbes. Retrieved August 12, 2014,  from: http://www.forbes.com/sites/melaniehaiken/2012/06/04/bath-salts-a-deadly-new-drug-with-a-deceptively-innocent-name/

McMillen, M, and Martin, L.J. (2012). Bath Salts Drugs: Problems, Ingredients, Dangers, and More. WebMD. Retrieved August 12, 2014,  from:http://www.webmd.com/mental-health/features/bath-salts-drug-dangers

NIDA. ( 2011). "Bath Salts" - Emerging and Dangerous Products. National Institute on Drug Abuse. Retrieved August 12, 2014,  from:

http://www.drugabuse.gov/about-nida/directors-page/messages-director/2011/02/bath-salts-emerging-dangerous-products

Rossen, J and  Davis, J. (2014). What's 'sizzurp'? A dangerous way for kids to get high. Today News. Retrieved August 12, 2014,  from: http://www.today.com/news/whats-sizzurp-dangerous-way-kids-get-high-2D11976739

Snopes Urban Legend Reference Pages. (2012) Boozing it Up. Snopes.com. Retrieved August 12, 2014,  from: http://www.snopes.com/risque/kinky/vodka.asp

Snopes Urban Legend Reference Pages. (2013). Krokodil. Snopes.com.  Retrieved August 12, 2014,  from:http://www.snopes.com/medical/drugs/krokodil.asp

WebMD. (2011. )Bath Salts Drug Trend: Expert Q & A. WebMD. Retrieved August 12, 2014,  from:http://www.webmd.com/mental-health/features/bath-salts-drug-danger

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