Designer Drugs

Bath Salts? Plant Food?Amy MilesAdvanced Chemist

WI State Lab of Hygiene

Phone: 608-224-6244amy.miles@slh.wisc.edu

Jennifer MessickTraffic Safety Resource

Prosecutor

(907) 343 6434

messickj@muni.org

Thank you:Anchorage Police DepartmentAlaska Highway Safety Office

Objective

• Increase Officer Safety • Increase DUI detection and prosecution

by providing comprehensive information about some of the most common Designer Drugs and how they differ from traditional drugs

What are “Designer Drugs”?

“a drug produced by a minor modification in the chemical structure of an existing drug, resulting in a new substance with similar pharmacologic effects, especially one created to achieve the same effect as a controlled or illegal drug”

- (dictionary.com)

Designer Drugs - Interpretation• Designer vs. Rx• DRE Information• Limited scientific

references• Police reports

–DRE observations

• Tox report may not = impairment

• Tox report may not = presence

Designer Drugs

covered in this presentation:

1.Synthetic CannabinoidsSpice/K2 (Marijuana)

2. Cathinone DerivativesBath Salts / Plant Food (cocaine, ecstacy, meth)

3. 2C- family (Hallucinogen)

4. Krokodil

Road MapFor Each Drug:

• General Identification– Marketing, packaging, history

• Methods of ingestion• Common signs/symptoms, case example• Detection: NIC, blood, urine• Legal Status• Officer Safety

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

SPICE / K2 •Marketed as incense•Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)•Smoked, mixed in drink, injected

SPICE / K2 •Marketed as incense•Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)

•Smoked, mixed in drink, injected•Sold LEGALLY and LOCALLY (well, kind of)

•1g -3g packages•$25 - $40 / g (about 2x price of pot)

•1 pkg = 3-5 doses•Used since about 2007

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

Brands/Flavors

• John W. Huffman - Clemson University–First to synthesize delta-9 analogues in 1984

• 450+ different types

–Sold in Germany around 2007• "I figured once it got started in Germany it

was going to spread. I'm concerned that it could hurt people," Huffman said. "I think this was something that was more or less inevitable. It bothers me that people are so stupid as to use this stuff".

JWH – The Life of the Party….

Motor control

Cognition, memory, perception, learning endocrine function, food intake, body temp regulation

Motor control, learning, action selection

Cerebral Cortex

Higher cognitive function

Medulla

Nausea, vomiting

Hypothalamus

Appetite

Synthetic Marijuana

• CB1 receptors–Expressed mainly in the brain, CNS, muscle,

liver, lungs, kidney

• CB2 receptors–Expressed in the immune system, evidence of

location in the brain• CB receptors are activated by three main groups

– Endocannabinoids– Plant cannabinoids– Synthetic cannabinoids

Missouri Human Dosing Study

• 6 subjects (one dose 2x) over two days–2 female, 4 male

• Allowed maximum of 2 “hits” –Blood, urine and oral fluid samples

• Each subject (but one) commented they would “hit” again

• Five of the six subjects reported previous experience with synthetic cannabinoids

Missouri Human Dosing Study

• Male, 39 yo, 5’10”, 190#• No drug history

–First time user

Parameter Pre-dose Post-dose

Blood Pressure 124/80 140/88

Highest Pulse 72 116

Body Temp 97.8 98

Draeger 5000 Neg Neg

Urine Dip Test Neg NA

Missouri Human Dosing Study

Pre-dose Post-dose

Attitude cooperative cooperativeCoordination normal jitterySpeech normal normalBreath normal normalFace flushed redEyes normal bloodshotPupils equal equalFollow stimulus Yes YesEyelids normal normalTracking equal equal

Missouri Human Dosing Study

DRE Observation Pre-dose Post-dose

HGN None None

VGN None None

LOC None Present

Body Tremors None Present

Pupil Size 5.0/7.5/5.5-6.5 5.0/8.0/4.5-5.0

Rebound dilation None Present*

Missouri Human Dosing Study

• WAT– Lack of coordination, balance– Raised arms– Stepped off the line

• OLS– Sway, used arms, put foot down, leg and body tremors

• Romberg– Sway – 2inch front to back, 1inch side– Estimated 30 seconds in 37

• FTN– Quick and lethargic movements, 6 errors

Missouri Dosing Study

• University of Central Missouri

• Bob Welsh• Tracey Durbin

• NMS Labs• Dr. Barry Logan

SymptomsNot always a bad trip, but if you’re involved it probably is

•Elevated BP (140-210 / 100-110)

•Tremors / Seizures•Unconsciousness•Hallucinations / Delusions / Paranoia / Anxiety•Numbness / Tingling

SymptomsNot always a bad trip, but if you’re involved it probably is

• Vomiting • Memory Loss • Incoherent/slurred

speech• User may feel cold• 6-8hr high (some

effects up to 30hrs)

Death??

APD#10-14949• 3 raised medians, 2 concrete

retaining walls, broken axle, flat tire, driving sidewalk

• 6HGN + VGN• .000 BrAC• Slurred/incoherent• “Death all around”• Going to kill officer

DETECTION OF SPICE/K2(NIC negative for pot)

• Blood (NMS) $195– Within 6-8 hours; can detect

some JWH compounds – Can’t detect all compounds– Screen + confirmation /

quantitation– Impairment vs particular

level of drug

• Urine $35 - 50– Within 3 days; can detect

some JWH compounds– Cannot detect all

compounds

(LC / Tandem MS normally used)

Spice v. POT?

• Blood shot / Red eyes• Maybe HGN / VGN• Lack of Convergence• +- Normal Pupil size• Normal light reaction

• Temperature ↓or normal

• Blood pressure ↑or ↓• +- Rigid muscle tone

• Blood shot / red eyes• No HGN / VGN• Lack of Convergence• Dilated Pupils• Normal light reaction• Temperature normal

• Blood Pressure ↑• Normal muscle tone

Which category??

Million Dollar Question:

DRE MATRIX

•

What is Everyone Else Doing About It?

ILLEGAL In most European and Scandinavian countries

Still Legal in Canada

25 States in US + Military

• Problems with legislation and analog compounds ready to go

What is the U.S. doing about it?

DEA Emergency Ban

- Sch I (JWH-018,JWH-073, JWH-200 and CP47-497)

- Sell or possess

- Became effective when published in CFR (3/1/11)

- Remains in effect for 12 months

- Can be extended 6 months

11078 Federal Register / Vol. 76, No. 40 / Tuesday, March 1, 2011 / Rules and

RegulationsPART 1308 - SCHEDULES OFCONTROLLED SUBSTANCES

§ 1308.11 Schedule I.* * * * *(g) * * *

(1) 5-(1,1-Dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol, itsoptical, positional, and geometricisomers, salts and salts of isomers—

7297 (Other names: CP–47,497)(2) 5-(1,1-Dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol, its opticalpositional, and geometric isomers, saltsand salts of isomers—7298 (Othernames: cannabicyclohexanol and

CP- 47,497 C8 homologue)

(3) 1-Butyl-3-(1-naphthoyl)indole, itsoptical, positional, and geometricisomers, salts and salts of isomers—

7173 (Other names: JWH–073)(4) 1-[2-(4-Morpholinyl)ethyl]-3-(1-naphthoyl)indole, its optical, positional,and geometric isomers, salts and salts ofisomers—7200

(Other names: JWH–200)(5) 1-Pentyl-3-(1-naphthoyl)indole, itsoptical, positional, and geometricisomers, salts and salts of isomers—

7118 (Other names: JWH–018 and AM678)

What is the law in my State?

• Traffic Safety Resource Prosecutors– Contact Jenn to find out who your TSRP is

• messickj@muni.org • (907) 343 6434

• National Traffic Law Center (NTLC)http://www.ndaa.org/apri/programs/traffic/ntlc_home.html#crash

Solid DUI Cases(The Defendant is your Crime Scene)

• Can I arrest for DUI?– Impairment vs Controlled

Substance – Even if legal, may still be DUI

• Detail / describe observations – Smell (or lack of) – Hear – speech, statements,

admissions

• Turn on Recorder (if permitted)

• Get Blood– Can I prove the charge without

blood?– If it comes back ‘nothing detected’

is my case sunk?

Officer Safety• Unregulated mixture of you name it (higher

potential for overdose)

• Mixed / Unpredictable symptoms– You are the frontline – Be Careful!

• Acetone is flammable!

Officer Safety

• Be Aware• Wear Gloves • If ‘incense’ burning in home, re-evaluate• Call / wait for back-up • Exposure Report? • Call medics / poison control

Poison Control 1-800-222-1222

Cathinone Derivatives

What are Bath Salts?

It’s all about the bath right?

This is what we mean. . .

What are Bath Salts?Cathinone Derivatives

• Synthetic drugs – stimulant,

similar to ecstasy, cocaine and/or meth

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

powder or crystals (oxidizes to yellow or tan)

Cathinone Derivatives

• Khat

Cathinone DerivativesMechanism of Action

• Cathinone– Induces release of dopamine

• Similar to amphetamines–Similar in structure to bupropion,

methcathinone, diethylpropion–Catecholamine release

• “Fight or flight” hormones

Name R1 R2 R3 R4 R5

Mephedrone Methyl H 4-Methyl H H

Methylone (βk-MDMA)

Methyl H 3,4-Methylenedioxy H H

Butylone(βk-MBDB)

Methyl H 4-Methyl Methyl H

Pyrovalerone {pyrrolidino} 4-Methyl Ethyl H

MDPV {pyrrolidino} 3,4-Methylenedioxy Ethyl H

Cathinone Derivatives

Homologues AnaloguesVS.

MDPV

• Marketed as “Bath Salts” and “plant food”

• CNS stimulant (3-4 hrs)• Chemical analog of

Cathinone (Sch 1 C.S.)

• NOT Controlled Substance

• Detectable in blood and Urine (special test)

• Not to be confused with MDMA “ecstasy”

Common PackagingPlastic jars or foil packets

Case Examples

• APD#11-1234- Stopped at green light- Clumsy, poor dexterity- Sluggish speech, no odor

alcohol- 2 HGN, 4 WAT, 4 OLS- Eyes non-reactive to light

* Blood positive MDPV

• APD#11-1234- Wrong way / one way, curb,

sidewalk, yards, pedestrian, eluding, multiple LSA

- Delusion Marshalls after him (tow truck driver)

- Small jar white powder, NIC positive cocaine

- Syringe, pipe- Normal pupils, no HGN

*Blood positive MDPV

Snort What?

Plant Food = Mephedrone

Mephedrone

• “Plant fertilizer” and “bath salts”

• Chemical analog of Methcathinone (Sch 1)

• More common in “plant food”

Common Packaging

Methods of Ingestion

• Snorting – onset quick• Oral - onset 15 – 45 min• Injection• Smoking – onset quick• Atomizing

Effects 6+hrs* Rush of ecstasy, no hard come-down* Binges for several days or even weeks*Also used as cutting agent for meth

Bath Salts / Plant Food

• Legal in US (well, sort of) • Illegal in Canada (but we love the internet)

• Available gas stations, truck stops, head shops, tattoo parlors

• 50 – 500 mg• $20 - $50• DEA “drug of concern”• Different than 2-CE

Case Examples• Welfare check: uncontrollable, non-compliant, taser

used, little effect Pennsylvania

• Fidgety, talking fast, no pain, invincible, likened to coke OD, used with meth, couldn’t perform SFST

• Broke window, jumped through glass door, jumped on hood of patrol car, rolled off into fetal position, incoherent. Pennsylvania

• 3 days intermittent delirium, slit throat, shotgun Louisianna

• Soldier, 3 tours, speeding on freeway, eluding, shot wife in car; vehicle, pockets, house loaded with bath salts, both blood positive for MDPV. Seattle

Case 1: Domestic Bliss

Sgt Aaron Watson, Nebraska State Patrol, Ogallala NE

Case Study #1

• DV - H discharges shotgun in home• Marijuana & bath salts found in home• H&W admit to using bath salts & marijuana

“Ladies First”Defendant Statements

• She has a Rx for appetite stimulants but hadn’t taken it in 10 days

• Snorted bath salts ~10 a.m. day prior• Snorted again around 1:00 p.m. • Snorted again between 9 p.m.-12:00 a.m.

• Makes her talkative• Causes some hallucinations

Admissions • Effects of bath salts last

about 4 hours• Like drinking red bulls,

but not quite like meth• Burns nostrils, but not as

bad as meth. • Not numbing like cocaine• Euphoric, not excessive• Increased alertness• Believes bath salts

caused H violent behavior

Observations• Irritable,restless,and runny

nose • Dazed appearance,

paranoia, sweating• Poor perception of time and

distance• Eye / body tremors• Blisters on tongue• White residue in nose

Case #1 – DRE SFSTs

• OLSSwayedUsed arms for balancePut foot downTremors

Romberg Balance 2 in front/back sway Eye tremors, constant twitching Estimated 30 sec in 33

Finger to NoseMissed tip 5/6 timesSlow reaction timeEyelid tremorsSwayed throughout test

Case #1

HGN NONE

VGN NONE

Lack of convergence PRESENT

Pupil size RM: 5.5, DRK: 9.0, DL: 4.0

Reaction to light SLOW

Pulse 104, 106, 98

Blood Pressure 152 / 112

Body Temp 98.4

Muscle Tone NEAR NORMAL

DRE Opinion: CNS Stimulant & Cannabis

– Urine collected

– Ethanol: None detected– Drugs:

• MDPV (Methylenedioxypyrovalerone)• Diphenhydramine• Lidocaine• Cannabinoids

Toxicology results

Case 2: “Too Much of a Good thing”

Ofc Mitchell, Marietta PD, Marietta, GA

“The Better Half”Initial Observations

• 21 year old male brought in to ER overdosing on unknown drug– Restless, Visible body tremors– Talkative– Anxious, paranoid, hallucinations– Slurred speech– Dry, cracked lips– Clenching fists to the point of causing bleeding– Very alert– Bruxism– Redness to nasal passage

Case Study #2

• Father says son has been acting that way for 2 days

• Gives officer empty packets labeled “B – invigorating bath salts – 500 mg“

• Father says he found 6-8 empty packets empty in his room

“Too Much of a Good Thing”Subject Statements

• Subject yells “It is legal!” • Subject purchased from a head shop• Directions are to mix it into a drink and

ingest it orally, but he snorted about half the bag

“Too Much of a Good Thing”DRE Observations

• While speaking to the subject he was banging his head into the wall and not even noticing it

• Pulls out IV twice– Restraints ordered

• While being restrained, he began to hallucinate and asked security if they drank the rest of the beer

DRE Evaluation – Day 1

• HGN (in hospital bed)– Lack of smooth pursuit

• Possibly due to restlessness, unable to appropriately follow stimulus

DRE Evaluation – Day 1

• Pulse: 112 bpm• Blood Pressure: 144/94• Body Temperature: 98.5• Pupils: 9 – 10 mm in all lighting conditions• Muscle Tone: Rigid

• DRE Opinion: CNS Stimulant

“Too Much of a Good Thing”DRE Observations – Day 2

• Took 3 doses of Lorazepam and 1 dose of Haloperidol to get subject under control

• Transported to ICU• When he awoke the next day, he was

violent again• 12 people restrain him; injures security

guard

“Too Much of a Good Thing”DRE Observations – Day 3

• DRE interviews subject again on day 3 • Subject is sleeping with a resting pulse of

120• Subject states he is exhausted, body

hurts, struggling to stay awake• Subject has no memory of who DRE was

or ever talking to him

Toxicology Results

• Hospital urine sample• All testing negative

• Why?– Type of screen– Target compounds– Lack of metabolites identified– Hospital screen vs. toxicology lab testing

American Association

• Synthetic Cannabinoids– All of 2010: Total of 2,874 calls– Jan – May 12, 2011: 2,052 calls

• Bath salts– All of 2010: Total of 298 calls– Jan – March, 2011: 1,241 calls

9 Deaths reported in U.S. with more suspected

(52+ in EU)

TESTINGCathinone Derivatives

• Sodium Nitroprusside Reagent (NarcoPouch)– Turns blue-purple

• MDPV, Mephedrone, Methylone, 4-fluoro (Flephedrone), 3-fluoro , 3-methoxymethcathinone

TESTINGCathinone Derivatives

• Scott’s Reagent (Nik Test)– Blue positive

reaction• MDPV• Cocaine,

Methadone, Ketamine, Procaine and Lidocaine will also cause a positive reaction

TESTINGCathinone Derivatives

• Marquis Reagent– Bright yellow positive

• MDPV• Diphenhydramine will

also cause yellow reaction

Legal Status

• EU, Australia, Canada and Israel = illegal

• Federal:

MDPV and Mephedrone not approved by FDA, but not controlled by DEA yet

– Sen. NY introduced federal legislation to add to Sch. 1 (February 2011)

Legal Status

• 13 States

• Contact your TSRP to find out legal status in your state

Cathinone Derivatives – Nationwide Legislation (April 2011)

Phenethylamines -2C Group “Tripstacy”(Hallucinogen, + /- Stimulant)

• Made by brilliant guy who just loved drugs

Ok, a Scary, Brilliant Guy

Phenethylamines -2C Group “Tripstacy”(Hallucinogen, + /- Stimulant)

2CB – Sch I – Often with MDMA to prolong high– On set 20min – 1 hour– Lasts 4 -6 hours (longer with X)

2C-E – Legal in US– Analog of 2C-B, 2C-T7 & mescaline?

2CI– Illegal in UK, legal US– Stronger than 2CB– Lasts longer, 8hrs +– Effects similar to LSD+MDMA without being

chatty– White powder / pills

• UPD#11-1234- No Headlights- Disjointed response / slow, slurred speech- 1000 yard stare- Seeing ‘tracers’- No HGN, 7 WAT, 3 OLS- User reports effects last 6-12 hrs (contact was 7hours

after ingestion)

Krokodil / Crocodile

• Majority of case reports out of Russia• Desomorphine – first synthesized in the

1930’s– Alternative to morphine, shorter lasting

• Manufactured from OTC codeine using industrial chemicals

• Lack of clean up during synthesis leads to injection of iodine and other metals– Shut down of endocrine and immune systems

Officer Safety

• Unknown substance: – They’re all white

powders!

• Unpredictable Behavior: – They all act crazy!

Officer Safety

• Unknown substance: – They’re all white powders!

• Unpredictable Behavior: – They all act crazy!

• Glove up • Exposure Report

Thank you!

If you have additional information to contribute, or if you would like to

schedule this presentation or get a copy of this Power Point,

please contact

Jenn Messickmessickj@muni.org

907 343 6434

Questions / comments / feedback WELCOMED

Salvia Plant

Saliva FlowersBlue Salvia

Red Salvia

Purple Salvia

Dried Leaf Packaged

Seeds

Piperazines - BZP(Schedule I)

Stimulant“PEP, Majik, Frenzy” • Releases dopamine and seratonin • Often sold as “dietary supplement” • No dietary value• Not a “natural” product• Lasts 4-8 hours• Has not been found to occur naturally

CASE STUDY• Speeding, delayed yield• Ptosis, constricted pupils,

2 HGN (unable to complete) 3 WAT, 4 OLS

• Cocaine and beer in car• D falls asleep in cruiser• Blood: carboxy, DXM,

BZP, TFMPP, Alprazolam

Phenazepam(Legal in US, not controlled)

• CSN Depressant• Taken in place of Alprazolam, Clonazepam

and Diazepam• Benzodiazepines are

generally Schedule IV

substances

CASE STUDY- LSA with semi, hits

tree, slumped across seat, SFST’s limited for safety (on backboard)

- 6 HGN + VGN, slurred speech

Blood: positive phenazepam