The business of producing and selling illicit drugs of abuse is subject to the laws
of commerce just as surely as any legitimate business. Specific drugs go in and out
of fashion based on consumer demand, price, and availability. The promise of something
new and improved appeals to drug users just as it does to people shopping for a new
car. Legal efforts to control or eradicate drugs of abuse affect the price, availability,
and profitability of a given drug. One approach drug traffickers can take to law enforcement
efforts is to overwhelm police and customs officials with the volume of drug being
sold; this is the approach of traffickers in cocaine or heroin. Another approach,
which requires a degree of sophistication in chemistry, is to create new, more potent
compounds that evade existing laws by virtue of their novel chemical structures. These
new drugs are chemical variations of existing stimulants, hallucinogens, or opiates.
This article gives an overview of these new drugs of abuse, which are listed in Table 1. (Subsequent articles in this issue discuss bath salts and synthetic cannabinoids
in greater detail.) This article also presents some new trends in drug abuse, as well
as some resources for investigating or learning about trends that will develop in
the future.
KEY POINTS
- •Various new drugs of abuse that are not yet regulated are available for purchase at stores and over the internet.
- •Drugs with new chemical structures may be missed on routine drug screens that are not designed to detect them.
- •Bath salts labeled “not for human consumption” are amphetamine analogs that cause cardiac, neurologic, and psychiatric symptoms characteristic for amphetamines.
- •Herbal incense blends labeled “not for human consumption” contain synthetic cannabinoids that are more potent than marijuana.
- •The incidence of drug abuse in the elderly is increasing and is projected to double by 2020.
Table 1Emerging drugs of abuse
| Name | Alternate Names | Effect | Chemical Analog | Clinical Effects |
|---|---|---|---|---|
| Bath salts | Charge Plus Cloud 9 Hurricane Charlie Ivory Wave Ocean Snow Red Dove Scarface White Dove White Lightning White Rush (many more exist) |
Stimulant | Amphetamine | Hypertension Tachycardia Dysrhythmia Myocardial Infarct Seizures Tremors Psychosis Paranoia |
| Legal ecstasy | Benzo fury Exotic super strong Head rush MDAI party pills XXX Strong as Hell (others exist) |
Stimulant | Piperazine | Tachycardia Palpitations Prolonged QT Interval Headache Seizures Anxiety |
| Mephentermine | Potenay Potemax |
Stimulant | Amphetamine | Same as for bath salts |
| Herbal incense | Black Magic Cloud 9 K2 Smoke Spice Diamond Spice Gold (many more exist) |
Hallucinogen | Cannabinoids | Supraventricular Tachycardia Seizures Psychosis Paranoia |
| Methoxetamine | None found | Hallucinogen | Ketamine | Tachycardia Hypertension Nystagmus Confusion Dissociation |
| Salvia | Diviners Sage Magic Mint Maria pastora Purple Sticky Sally D |
Hallucinogen | Salvinorin A | Hallucinations (seldom present for medical evaluation) |
| Kratom | Ithang Kakuam Ketum Krypton Thom |
Opiate | Mitragynine | Low dose – stimulant High dose – opiate effect |
| Xylazine | Anestesia de Caballo | Tranquilizer | Xylazine | Skin ulcers |
Note. Street names for herbal incense and kratom obtained from reports and user experience
pages at http://www.erowid.com.
Keywords
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References
- ‘Designer drugs’.Med Toxicol Adverse Drug Exp. 1988; 3: 1-17
- Emergency department visits after use of a drug sold as “bath salts” – Michigan, November 13, 2010-March 31, 2011.MMWR Morb Mortal Wkly Rep. 2011; 60: 624-627
- The toxicology of bath salts: a review of synthetic cathinones.J Med Toxicol. 2012; 8: 33-42
- Synthetic legal intoxicating drugs: The emerging ‘incense’ and ‘bath salt’ phenomenon.Cleve Clin J Med. 2012; 79: 258-264
- Here today, gone tomorrow … and back again?.J Med Toxicol. 2012; 8: 15-32
- College students and the use of K2: an emerging drug of abuse in young persons.Subst Abuse Treat Prev Policy. 2011; 6: 16
- Methoxetamine: a novel ketamine analog and growing health-care concern.Clin Toxicol (Phila). 2011; 49: 874-875
- Phenomenon of new drugs on the internet: the case of ketamine derivative methoxetamine.Hum Psychopharmacol. 2012; 27: 145-149
- Ketamine-like effects after recreational use of methoxetamine.Ann Emerg Med. 2012; 60: 97-99
- College student use of Salvia divinorum.Drug Alcohol Depend. 2008; 94: 263-266
- Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton.J Anal Toxicol. 2011; 35: 242-247
- Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review.Curr Drug Abuse Rev. 2011; 4: 28-41
- Xylazine (veterinary sedative) use in Puerto Rico.Subst Abuse Treat Prev Policy. 2011; 6: 7
- Mephentermine: rediscovering its biology and use, misuse and their implications.Rev Bras Psiquiatr. 2011; 33: 98-99
- Illicit and nonmedical drug use among older adults: a review.J Aging Health. 2011; 23: 481-504
- General principles of pharmacology.(In: Halter JB, Ouslander JG, Tinetti ME, et al, editors. Hazzard's geriatric medicine and gerontology. 6th edition) (Accessed May 21, 2011)
- Analytical toxicology of emerging drugs of abuse.Ther Drug Monit. 2010; 32: 532-539
Article info
Publication history
Published online: June 29, 2012
Footnotes
Disclosure: The author has no relationship with a commercial company that has a direct financial interest in the subject of this article, in the materials discussed within this article, or with a competitor to any company or substance discussed in this article.
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© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
