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Substance Abuse in the 21           st

  Century: A New Look
            Sue Parr
 Bragg Hill Community Coalition
 Community Coalitions of Virginia
The Latest Drug Crazes
•   Alcoholic Energy Drinks
•   Alcoholic Whipped Cream
•   Bath Salts (Ivory Wave)
•   K2/Spice
•   Pocket Shots
•   Cheese
•   Vaporizers
•   Hookahs
•   Bromo-Dragonfly
•   The “2C” Family
•   Kratom
Alcoholic Energy Drinks

•   Alcohol Energy Drinks (AEDs) are pre-packaged beverages containing
    alcohol, caffeine, and various other stimulants such as ginseng, guarana,
    and taurine.
•   The FDA limits beverages to 65 mg of caffeine. Some AEDs contained as
    much as 300 mg of caffeine—a dangerous amount of the stimulant,
    especially when combined with alcohol.
•   AEDs were sold under such brand names as Spark, Charge, Tilt, Joose,
    Four Loko, Liquid Charge, Rock Star 21, PINK Spirits and various others
•   Packaging of AEDs made them very difficult to distinguish from regular
    (non- alcoholic) energy drinks-very similar packaging styles.
•   Many states, including VA, required retailers to separate AEDs from
    regular, non-alcoholic energy drinks in their displays and provide training
    on this matter to state licensees.
•   To distinguish from regular energy drinks (no alcohol) you had to check
    for the standard nutrition label- alcohol energy drinks did not have a
    nutrition label, but listed the amount of alcohol by volume (abv) instead.
•   Some AEDs had as much as 12% alcohol content.
•   Some brands of AEDs were served in 23.5 oz containers that
    contained the equivalent of between 3 and 5 beers, as well as up to
    8 cups of coffee.
•   9) The combination of energy drinks (stimulants) and alcohol
    (depressant) can lead to serious health effects:
     – dehydration which can also cause the effects of alcohol to be extended
       up to 24 hours
     – stimulants mask the effects of alcohol so individuals are unaware of the
       amount of alcohol they have consumed
     – after the effects of stimulants wear off, the effects of the depressant
       remains which can potentially lead to respiratory depression, vomiting
       while sleeping (which could result in asphyxiation/death), and other
       alarming medical concerns.
•   A 16 year old (Joey Fonseca) died in the VA Beach area as the
    result of a car accident in which his friend was charged with a DUI
    from drinking an Alcohol Energy Drink-a growing trend nationwide.
•   According to the FDA Commissioner, Margaret Hamburg, the
    combination of alcohol and caffeine in AEDs causes a public health
    concern and can lead to a “wide awake drunk.”

•   The FDA issued a warning to the industry’s main manufacturers on
    Nov. 17th, 2010 stating that the caffeine in AEDs was considered an
    “unsafe food additive” and that they had to respond within 15 days
    indicating whether they intended to pull their product off the shelves
    or defend their products as safe. As a result, the manufacturers
    indicated that they would reformulate their products to meet FDA
    requirements, thus removing the caffeine.
Alcohol Energy Drinks
•   Now the manufacturers of AEDs have been forced to remove all
    caffeine from their products under the new FDA regulations.
•   The products are marketed with the exact same design as they
    were using prior to removal of caffeine- still “look” like energy drinks.
•   They are still sold in “super-sized” containers (23.5 +oz)
     that help promote binge drinking.
•   Most are now advertised as “malt” beverages but still displayed in
    many stores in manner that makes it hard to distinguish from non-
    alcoholic beverages.
•   Majority of marketing is still done in a manner very appealing to
    youth- check out the “Joose” website: :
•   http://drinkjoose.com/website/
Alcoholic Whipped Cream



•   This product is sold in aerosol cans with packaging similar to non-alcoholic
    whipped cream products.
•   It is sold currently in over 10 states, primarily in liquor/alcohol stores where
    consumers must be 21 years of age & provide valid ID to purchase.
•   The average cost of these products is about $13 per canister
•   It is also known as “whipahol” and sold under several brand names such as
    Get Whipped, Cream, and Whipped Lightning..
•   The average alcohol by volume content is about 15%, though the Whipped
    Lightning brand contains 16-18% alcohol by volume (equal to 3-4 beers).
    This is also comparable in content to such drinks as Bacardi Mojito and
    Bailey’s Irish Crème.
•   The product is sold in a variety of popular flavors ranging from simple
    raspberry, orange & cherry to more exotic flavors such as white chocolate
    raspberry, caramel pecan, German chocolate, tropical passion, spiced
    vanilla, hazelnut espresso and cinnamon-used to help mask flavor of alcohol
    content.
•   Since the product is not considered a food it does not currently fall under FDA
    regulations/guidelines. Manufacturers therefore are not required to list nutrition
    content-just alcohol content,
•   One concern already arising from sale of these products is their use by youth
    who exhibit “huffing” behaviors- able to get high off of the nitrous oxide from
    the aerosol container-but now combined with the effects from the alcohol
    content as well.
•   The Cream brand of the product has its own MySpace page encouraging the
    use of the product in conjunction with other items currently popular at college
    parties such as Jell-O shots significantly increasing the danger level.
•   Retailers in states where it is being sold indicate that it is very popular-flying off
    the shelves.
•   Another concern is the marketing style for the product. Though it is being
    identified as an “adult” product targeting primarily 25-35 yr. old consumers,
    many feel that the marketing strategy is actually designed to attract college
    students.
•   Federal and state regulatory agencies are indicating that it is a “product of
    concern” that warrants monitoring.
Bath Salts
•   Bath Salts (Ivory Wave) are a synthetic product that contains
    hallucinogenic, mind-altering chemicals similar in structure to those also
    found in cocaine and ecstasy, depending on which brand or form is
    purchased.
•   It is being sold as a bath salt, or plant food in some cases, labeled “for
    novelty use only” and/or “not for human consumption” in order to by- pass
    FDA regulations-not being sold as food or drug product.
•   It is most often sold in either 250 or 500 mg packets depending on brand
    or form purchased.
•   Though Ivory Wave is the most popular form/brand of this product, it (or
    similar products) is also sold under other names such as Vanilla Sky, Fly,
    Snow, Ivory, Charge, Ivory Coast, Purple Wave, Cristalius, Magic, and
    Ocean Blue. Some of these products are manufactured by a company
    called Papa Spice. There are also competitors with similar products made
    of the same chemical compounds identified as Columbian Salts and
    Bolivian Salts (claims that it “blows Ivory Wave away!”)

•   http://www.youtube.com/watch?v=8y4EARXFagQ
Bath Salts

•   The drugs identified in these products most often are MDPV
    (methylenedioxypyrovalerone) usually referred to as pyrovalerone, a
    powerful psychoactive chemical similar to Ritalin which acts as a stimulant
    that inhibits re-uptake of dopamine & norepinephrine while having minimal
    effects on serotonin levels. Tests have also identified most versions of these
    products as containing Lidocaine which is frequently used by dentists for
    anesthesia. Many versions may also contain similar components to 2-DPMP
    or the drug MDMA (aka ecstasy).
•   Sold under variety of names such as Vanilla Sky, Ocean Burst, Lunar Wave,
    Lady Bubbles, Arctic Blast, Sextacy, Disco, Snow Leopard, Natural NRG,
    Tranquility,…the most popular brand is Ivory Wave.
•   It appears to be purposely designed in a way that will mimic the effects of
    cocaine/crack or ecstasy and is most often used by snorting.
•   It is sold most frequently on-line, though also in some tobacco/smoke shops
    as a novelty item “not for human consumption” for about $30 for a small
    package. Many websites sell it in bulk (50-100 packets) for a discount rate.
    (Bath salts being sold in smoke shops should raise questions about its
    content with most people!)
•   Though it has been sold for quite some time in the UK (import of it banned
    there as of Nov. 5, 2010), Ireland (sold as Whack also) and Australia, it is
    just now becoming popular in the US, now showing up in states such as
    Utah, Missouri and Mississippi.
•   The side effects of these products include the following:
     –   hallucinations
     –   diminished cognitive ability
     –   tachycardia
     –   vasoconstriction
     –   hypertension
     –   blood pressure/heart rate elevated to medically dangerous levels
     –   prolonged agitation (lasting up to 5 days/may require physical restraint)
     –   muscular pain/ muscle spasms
     –   emotional fragility
     –   acute paranoid psychosis
     –   sore jaw
     –   kidney failure
     –   loss of bowel control
     –   intense high followed by painful hangover
     –   suppressed appetite
•   Has been marketed in some forms as an appetite suppressant/weight
    control enhancer which led to the death of a newlywed bride in the UK who
    dropped from a size 16 to a size 6 in just a few months but died from severe
    brain damage and elevated heart rate after using it regularly over this
    period. The UK also reported a related death by suicide/accidental fall of a
    young fisherman that occurred while high on Ivory Wave,
•   Appears to be extremely addictive with many users reporting an “almost
    uncontrollable urge for another hit” immediately, stating that its effects are
    several times stronger than cocaine when snorted.
•    A man was admitted to the University of Utah psychiatric hospital after
    taking Ivory Wave in combination with his prescribed bi-polar medication
    due to side effects-hands constantly shaking and requires constant
    monitoring due to hallucinations, severe agitation and acute paranoia.
•   A sheriff in Mississippi is requesting a ban on Ivory Wave products due to
    encounters that his deputies have had with users who thought they were
    demons.
•   There has been a recently reported death in Missouri due to use of Ivory
    Wave products.
•   Louisiana had 125 call to poison center in 3 months last year related to bath
    salts incidents resulting in a state ban by emergency order.
•   K2/Spice products are a mixture of herbal/spice plant
    products sprayed with potent psychotropic drugs, often
•   contaminated with unidentified toxic substances which
    contribute to various adverse health effects (also
    cause hallucinogenic effects similar to effects of PCP.

•   Marketed under variety of names including K2, Spice,
    Pep Spice, Spice Silver, Spice Gold, Spice Diamond,
•   Smoke, Sence, Skunk, Yucatan Fire, Genie & Zohai

•   sold in variety of colors/flavors- usually sold in foil
    packaging
K2/Spice Health Risks
• Symptoms/Side-Effects may include:
   – mimics marijuana “high” (often induced more quickly/more
     intense than “real” marijuana)
   – hallucinations
   – seizures/tremors
   – coma/unconsciousness
   – vomiting
   – numbness/tingling
   – increased respiration rate
   – elevated blood pressure (reported up to 200/100-medically
     dangerous)
   – elevated heart rate (reported up to rate of 150-medically
     dangerous)
   – increased level of anxiety/agitation leading to panic attacks
     (possible suicide attempts)
•       Depending on synthetic compound in specific commercial brand,
        can be anywhere from 4 times to over 100 times more potent than
        regular marijuana (THC)

•       Sold in tobacco shops, head shops, and convenience stores

•       Sold as “incense” marked “not for human consumption”

•       Price averages $45 for 3 grams (about equal to 3 sugar packets)-
        higher than good grade marijuana

•       Most often smoked but can be mixed in with food or drink
•       Most likely users:
    –      14-27 yr. olds
    –      Prisoners/probationers
    –      Military (use now banned by all military branches)
Creation of K2/Spice
•   Developed by Dr. John W. Huffman, a Clemson University
    professor, as part of research for National Institute for Drug Abuse
    (NIDA) on endogenous cannabinoid receptors-but never tested on
    humans nor approved by FDA

•   Dr. Huffman said in interview to WebMD “It is like Russian roulette
    to use these drugs. We don’t know a darn thing about them for real.”
    “It shouldn’t be out there.”

•   JWH-018 & many of its “cousins” such as HU-210/211, JWH-073 &
    CP 47/497 found in these drugs have a chemical structure shared
    with known cancer-causing agents.

•   All effects of K2/Spice drugs may not be known for very long time
    because of long time period that body stores them.
•   So far nothing is known about metabolism of the chemical
    compounds in K2/Spice drugs-some may be toxic and/or
    pharmacologically active-differing from batch to batch in
    kind/amount of applied drugs (synthetic) thus resulting in higher risk
    of accidental overdosing which has already been seen & is on rise
    with these drugs with increase numbers of ER & hospital incidents
    reported
•   There are hundreds more of these chemical compounds containing
    strong, active cannabinoid receptors agonists so can be safely
    assumed that further such substances will appear on market soon if
    not banned-greatly increasing challenges for toxicology testing, law
    enforcement and medical/healthcare professionals.
•   Causing difficulties for law enforcement agencies, including
    probation & parole, as well as drug courts due to difficulties in
    testing for presence-one lab test now known to detect it in system
    but at cost of $50 & will probably not test positive for all the known
    variations
•   Dr. Huffman & Dr. Huestis (Chief of Chemistry/Drug Metabolism at National
    Institute for Drug Abuse) indicate that when taking these drugs, it is
    “hijacking the part of the brain important for many major functions:
    temperature control, food intake, perception, memory and problem solving.
    Many people taking these high-potency drugs are affecting important
    functions throughout their bodies-hormone functions for example.” Doctors
    also express concern that the drugs may involve acute toxicity levels,
    possibly long term, as well as impacting cannabinoid receptors that regulate
    body’s immune system.

•   Retailers selling the drugs report a recent increase in sales from app. $1000
    daily up to $10, 000 daily.
•   Medical reports indicate that K2/Spice drugs potentially result in users
    developing a rapid and powerful addiction on a level not usually found
    among smokers of “real” marijuana.
•   Recently linked to over 352 nationwide emergency room incidents-includes
    suicide attempts, extremely elevated heart rate/blood pressure, comas,
    seizures, and anxiety attacks.
Status of K2/Spice
•   Police in Indianola, Iowa report 18 yr old smoking K2 resulting in
    severe anxiety attack-stated was “going to hell” and went home and
    shot & killed his self.
•   K2/Spice is labeled by users as the “stealth” marijuana.
•   Dr. Anthony Scalzo (professor of toxicology at St. Louis University)
    indicates he’s seen nearly 30 cases in past month involving
    teenagers experiencing hallucinations, severe agitation, elevated
    heart rate/blood pressuer, vomiting and tremors/seizures as result of
    smoking K2.
•   Dr. Scalzo says that what makes K2 (and other Spice derivatives)
    so dangerous is that its side effects suggest that it also affects the
    user’s cardiovascular system, as well as the central nervous
    system.
•   One sign of use that parents should look for is dried herbal residue
    in their children’s rooms, as well as the foil packets in trash.
•   Check out advertising at http://www.dutchincense.com/
•   http://www.youtube.com/watch?v=Mu0VmT5LWxc
•   http://www.youtube.com/watch?v=Mu0VmT5LWxc
•   http://www.youtube.com/watch?v=QQvqeT-7dSo&feature=related
VA Bans K2/Spice & Bath Salts
• Several state legislators in VA introduced
  bills in 2011 GA session to ban K2/Spice
  Drugs & Bath Salts. They were all rolled
  into one bill which was passed by GA on
  Saturday, Feb. 26th, 2011. Gov. McDonnell
  agreed to sign it into law as emergency
  legislation in Spring of 2011making VA
  one of about 18 states so far to officially
  ban the sale & use of these products
  statewide.
Cheese Heroin
                  http://www.youtube.com/watch?v=XLuqe2wWruU

                  http://www.youtube.com/watch?v=XLuqe2wWruU

•   Lab analysis shows that cheese contains app. 94.5-95% acetaminophen
    with app. 4.5-5% mixture of diphenhydramine (Benadryl) and black tar
    heroin- acetominophen and diphenhydramine is the drug combination
    that makes up Tylenol PM).
•   The Tylenol PM is ground into powder then mixed with sticky black tar
    heroin to form “cheese.”
•   Sometimes the black tar heroin is mixed with crushed Xanax (alprazolam)
    instead of Tylenol PM
•   :cheese” is said to refer to consistency of product which is similar to that
    of parmesan cheese (in shaker), as well as being a play on the slang
    term for heroin “chiva.”
•   ‘cheese” is popular with youth because it is so cheap-average cost of a
    hit or “bump” (equal to 1/10 gram) is about $2 and it produces a strong
    produces a sense of euphoria
•   most common method of ingestion is snorting, either directly or by using
    tube/straw
Cheese

•   signs to identify use include tan brown powder, usually folded into notebook
    paper (bindle) or in a small baggie
•   highly addictive due to heroin content-reportedly after only one use
    sometimes
•   users can suffer withdrawal symtoms within 12 hrs of taking a hit-including
    headaches, chills, nausea, muscle pains/spasms, extreme agitation, and
    various flu-like symptoms
•   referred to as a “starter” drug due to highly addictive nature tending to lead
    to use of more &/or stronger drugs
•   side effects include euphoric state, disorientation, lethargy, sleepiness, hunger,
    excessive thirst
•   Popular with the Hispanic population, as well as middle & high school students
•   often used by drug dealers to lure children & get them addicted so will continue to buy
    products
•   middle schoolers often use lunch money to purchase “cheese” since so inexpensive,
    then snort through hollowed out ballpoint pen
Cheese

•   produces a rush due to amphetamines in Tylenol PM/cold medicines that is
    similar to that produced by a “speed ball”-cocaine/heroin mix
•   continued use of such large quantities of Tylenol PM can result in liver
    damage or failure
•   Since Tylenol PM is analgesic/sedative & heroin is an opiod that mimics
    endorphin actions creating the euphoric state, users essentially get a
    “double whammy”-two downers at once, which potentially can result in
    dangerously decreased heart rate or heart stoppage (death).
•   all major ingredients are CNS and respiratory depressants so can overdose
    or used in combination with other depressants, such as alcohol, could lead
    to respiratory arrest & result in death
•   youth often hide “cheese” is some unique places: pants (cuffs, waistbands),
    hoodies, bras, hairbuns/twists, inside book binders, colored markers, belt
    buckles, cell phone battery compartments, tennis shoes (under soles, loop
    in tongue)
•   http://www.youtube.com/watch?v=yPZ-JmtZmn0
Lazy Cakes
                    http://www.youtube.com/watch?v=S40OWt_z7Mc




•   Lazy Cakes are also known as “the relaxation brownie” because they are
    brownies with melatonin (a hormone produced by pineal gland in brain
    that controls sleep cycle), valerian root, passion flower, rose hips,….
    baked into them-also sold under names such as “Unwind” and “Simmer.”
•   Sold in convenience stores, tobacco shops and online in 2.5’ squares-can
    be purchased individually for about $3-4 or by box of 12 for app. $25.
    Online they may also be purchased by the case (12 boxes) or by the
    pallet.
•   Each “cake” consists of two servings according to package, and each
    serving contains 3.9 mg of melatonin, equaling 7.8 mg per whole “cake.”
•   One “cake” has enough melatonin baked in to put the average adult into
    a deep sleep. The manager of a tobacco shop in Ohio said “I didn’t
    realize that it was two servings and ate the whole one. I fell asleep within
    15 minutes.” She also noted that her shop was selling “tons of them.”
•   Melatonin can be purchased in its synthetic form as a dietary supplement
    in many stores and is used to help induce sleep and regulate the sleep
    cycle. The recommended dosage for the average adult is about 0.2mg.
Lazy Cakes
               http://www.newsy.com/videos/relaxation-brownies-marketed-to-kids/




•   Many doctors and health experts consider melatonin dangerous to
    children.
•   A 2 yr old in Tennessee, Michael Cummings, ate one bite of a Lazy Cake.
    He soon began “acting all funny and wouldn’t play or nothing,” said his
    uncle, Cameron Cunnings, “he would sleep and he wouldn’t wake up,”
    but when he did wake up” he was crying a lot.” This incident resulted in
    an emergency room visit where his family was told that even a small dose
    of melatonin can be very dangerous for children.
•   The Memphis-based distributor of Lazy Cakes, Baked World, states that
    “these are not a snack for children. They are meant as dietary
    supplement for adults who lead a stressful, energy drink-fueled lifestyle
    unwind & relax.”
•   Fine print on the product wrapper indicates for “adults only” and “should
    not be mixed with alcohol or be eaten while driving.”
•   Though manufacturers claim Lazy Cakes are intended for adults only, the
    product is sold in a colorful, psychedelic designed wrapper with a cartoon
    character, Larry Lazycakes, and a slogan “Peace, love and Lazy Cakes”
    that are all very appealing to children.
Lazy Cakes
•   Dr. Ray Smith, Lubbock, TX, indicated that he is more concerned about
    the Valerian Root content of the brownies. He says that it is comparable
    to valium and that this herb has history of use as a sedative, similar to the
    way tranquilizers are used currently.
•   Dr. Ray Smith also stated that “I think it’s inappropriate that these Lazy
    Cakes are sold in candy like packaging and sold as a dietary supplement.
    That is very sneaky because selling it as a dietary supplement allows the
    cakes to bypass the FDA.” He also mentioned the manufacturers’ use of
    clever marketing combined with the power of chocolate to help boost
    sales, especially to children.
•    Data from the National Poison Center indicates that more calls come in
    related to melatonin than any other herb or supplement-approximately
    5,000 calls in 2009.
•   Some doctors believe melatonin can prove fatal. “It will kill you if you get
    the wrong dose, yes it’s a drug-those brownies are definitely a drug.”
    says Dr. Ann Payne-Johnson of Baptist Memorial Health Care in Virginia.
•   Anna Rouse Delaney, a toxicologist with the Carolinas Poison Center
    says that melatonin can lead the central nervous system to slow down
    and cause trouble breathing.” She also indicated that people becoming
    extremely sleepy and nauseated is a common side effect.
Lazy Cakes

•   Dr. Laura Aisenberg with HCA VA Health System indicated when
    asked about Lazy Cakes that it was actually the first time she had
    heard of them but that “it’s not surprising but makes me wonder
    what’s coming next. They could be getting thousands of times
    more than the body really needs, now you put that in the hands of
    children and it’s very concerning.”
•   The makers of Lazy Cakes have stated that since “relaxing folks
    is going so well” they may soon launch a product to counteract
    that effect-a caffeinated brownie called an “Up Cake.”
•   Though the makers of Lazy Cakes say they don’t currently
    distribute in all states, including Virginia, retailers can purchase
    their products online and sell them in their stores anywhere.
•   large doses of melatonin can be troublesome for people who
    suffer from depression. Lots of teens fit into that category.
Bromo Dragonfly
•   Bromo Dragonfly is a synthetic psychedelic hallucinogenic drug related to the
    phenethylamine family, also considered a potent serotonin agonist and causes effects
    consistent with 5-HT-2A hallucinogens.
•   Common brand names are 3c-Bromo-Dragonfly; DOB-Dragonfly, ABDF,
•   Chemical name: 1-(8-bromobenzo[1.2-b,4,5-b] dituran-4-yl)-2-aminopropane hydrochloride
•   Methods of use: blotter paper (similar to LSD), as well as in powder form (occasionally in
    pill)
•   Very little history of previous human use thus little known about possible side effects of
    human consumption including possible long term problems, addiction potential, allergic
    reactions, or acute overdoses.
    Known side effects include visual changes/visual distortion (patterns, shapes,…), short term
    memory scramble or disorientation/confusion, muscle tension
•   First synthesized by a chemist named Matthew Parker and used as a brain research chemical
    on rats at Purdue in the 1990’s
•   Bromo-Dragonfly is unscheduled in the United States though it’s possible that it could be
    considered an analog (of DOB or 2C-B), in which case, sales for human consumption or
    possession with the intent to ingest could be prosecuted under the Federal Analogue Act
    though it has not been thus far
•   There have been deaths/serious injuries related to Bromo-Dragonfly in US, Norway, Denmark
    & Sweden thus far-some were initially attributed to 2C-E or 2C-B but later identified correctly
    as FLY
•   potency 300 times stronger than mescaline, a mere 1/5 less potent than lysergic acid
    diethylamide (LSD )
Bromo-Dragonfly Dosage
•   Oral Bromo-Dragonfly Dosages 2006 American” Batch
•   WARNING: SEE NOTES ABOVE
•   Threshold500 ug Common800 - 1300 ug Strong1200 – 1800 Heavy1600 + ug

•   Oral Bromo-Dragonfly Dosages 2005 "European" Batch
    WARNING: SEE NOTES ABOVE
•   Threshold100 ug Common200-400 ug Strong500-800 ug Heavy800 + ug

    Onset : 20 - 90 minutes (depending on form and stomach contents)

    Duration : 10 - 24 hours
    Normal After Effects : up to 36 hours

    Overdose Effects:
    One report of a very high dose resulted in: extremely long duration (2-4 days),
    flushing, ego-loss, dissociation, headache, erratic behavior, etc.
Bromo-Dragonfly
•   The name comes from the lab at Purdue where it was first synthesized for use in
    research into the structure and activity of the serotonin receptors in the brain.
    Researchers had designed a related chemical that they called "fly" because of the
    two furanyl rings attached to the benzene ring. Upon discovery that changing the
    bonds on the furanyl rings increased the potency substantially over the original "fly"
    compounds, the new style of compounds were dubbed "dragonfly" compounds.

•   available online through research chemical vendors all across the world but buying
    from these vendors is tremendously risky – in a case in 2009 a batch of bromo-
    dragonfly was released and mislabeled as 2c-b-fly which is 20x less potent in weight
    terms-this led to an undisclosed amount of fatal overdoses and hospitalizations
•   One user described his overdose saying “it was like being dragged to hell and back
    again, Many times. It is the most evil thing I have ever tried. It lasted an eternity.”
•   Vasoconstriction, or the narrowing of blood vessels resulting from contraction of the
    muscular wall of the vessels, has also been noted in higher doses with one
    documented case of an overdose requiring a man in Switzerland to have half his foot
    and several fingers on one hand amputated.
•   Delayed onset of seizures and toxicity associated with recreational use of Bromo- Dragonfly
    have also been reported
Bromo-Dragonfly

• explicitly illegal only in Sweden and Denmark, although it
  may be considered a controlled substance analogue
  under US and Australian drug laws

•    increasing sales shown from online distributors to
    buyers in United States

http://www.youtube.com/watch?v=c8MmMjvZ6uk

http://www.doctoroz.com/videos/dr-oz-investigates-dragonfly-pt-
2C-B
•   The full name of the chemical is 4-bromo-2,5-dimethoxyphenethylamine.
•   Shulgin lists the dosage range as 16 to 24 mg.
•   2C-B is a white powder usually found in pressed tablets or gel caps, and
    almost always taken orally. Snorting is also an effective way to ingest the
    drug, though said to be painful
•   On December 20, 1994, the Deputy Administrator of the DEA proposed to
    place 4-bromo-2,5-DMPEA into Schedule I making 2C-B illegal in the United
    States. This became permanent law July, 2 1995.
•    Prior to this, 2C-B was commercially available as an aphrodisiac under the
    tradename "Eros" which was manufactured by the german phamacuetical
    company Drittewelle.
•    Recently 2C-B has been distributed under the street name "Nexus." In the
    past 2C-B has also been distributed as "Eve", "Venus", "Bees", and
    (incorrectly) "bromo-mescaline."
•   Not much information is known about the toxicity of 2C-B. Because 2C-B
    lacks an alpha-methyl group it is not considered an amphetamine such as
    MDMA, MDA, methamphetamine, or fenfluramine. 2C-B does not seem to
    deplete the brain of serotonin, and this suggests that it may not share the
    neurotoxic mechanisms of many amphetamines.
2C-I
•   Its full chemical name is 4-iodo-2,5-dimethoxyphenethylamine.
•   The drug is used recreationally, and perhaps as an entheogen, but no medical or
   industrial uses are known at this time
•   It is mostly commonly encountered in the form of hydrochloride salt, a fluffy white
   powder, or been pressed into tablet form.
•   Since it has become popular only recently slang terms vary widely, although the
   terms "iodo-mescaline" and "To See I" have been used.
• In the early 2000s, 2C-I in powder form became available for purchase from several
   online vendors of research chemicals in the United States, Asia, and elsewhere.
•   In the early 2000’s tablets of 2C-I were being sold illegally in Denmark at nightclubs
   and raves , and in the United Kingdom as a club drug, with tablets often being sold
   under the guise of being MDMA (ecstacy) or a mixture of some amphetamine (though
   it is not) , as well as LSD.
Legality
• 2C-I is an illegal, controlled substance in several European nations, including
   Denmark, Germany, Greece, Ireland, and the United Kingdom. In December 2003,
   the European Council issued a binding order compelling all EU member states to ban
   2C-I within three months. 2C-I is unscheduled and unregulated in the United States,
   however its close similarity in structure and effects to 2C-B could potentially subject
   possession and sale of 2C-I to prosecution under the Federal Analog Act.
2C-I
Effects
•2C-I is almost always taken orally, although it can also be inhaled (though painful),
smoked, or administered rectally
•A recreational dose of 2C-I is commonly between 10 and 25mg, although doses as low
as 2mg have been reported to be useful.
•The onset of effects usually occurs within an hour, and the effects of the drug typically
last somewhere in the range of 5 to 10 hours and are often described as quite similar to
those of its close chemical analog 2C-B, combining psychedelic/ hallucinogenic effects
typical of drugs such as LSD with the empathogenic or entactogenic effects of drugs such
as MDMA (ecstasy).
• Some users report that the effects are more mental and less sensory than those of 2C-
B. Users of 2C-I often report a physical stimulant effect that can be quite strong. Although
unpleasant physical side effects such as muscle tension, nausea, and vomiting have
been reported, their incidence in the use of 2C-I appears to be less common than in the
use of some of the other closely related phenethylamines
•User reports have said that 2C-I produces flashbacks in the weeks following its use.
These flashbacks can last anywhere from seconds to hours. Some users report being
able to trigger the flashbacks at will. However, these flashbacks do not occur in the
majority, but have been observed in a sampling of users. They are thought to be similar
in nature to LSD flashbacks, not particularly harmful or remarkable for a psychedelic
drug.
2C-E
• Many have reported that the general effects of 2C-E
   are similar to those of the other psychedelic
  phenethylamines, but far more intense. Vivid
  hallucinations similar to those experienced while
  under the influence of LSD are common, and many
  reports would indicate that the effects of this
  particular chemical may be overly intense for those
  not well experienced with psychedelics.
Properties
• 2,5-Dimethoxy-4-ethylphenethylamine is a colorless
  oil. Crystalline forms are obtained as the amine salt
  by reacting the free base with a mineral acid,
  typically HCl.
2C-E
Effects
•   The total duration of 2C-E's effects is generally between six and ten
    hours for an average dose, with the plateau lasting between 3-6 hours.
    The onset of effects takes approximately 20-90 minutes, but
    perception may be altered for up to a day after ingestion.
•    In extreme cases where between 75-100 mgs of 2C-E were ingested,
    the duration of effects has lasted past twenty-four hours, with plateaus
    exceeding 10 hours with the onset of effects within the first five
    minutes after thethe drug being ingested. A few users of very high
    doses reported "never feeling the same again" after having used this
    drug.
•   It has been described it as "difficult" by people who use it, including its
    inventor, Shulgin:
      – "I really don't know how to put into words, or how to describe what it did
         and how it acted in my mind. There were parts of it that reminded me of the
         other phenethylamines I've tried in one way or another, but the effects of
         this material are really difficult to express or generalize. I think Shulgin said
         it best when he commented in PiHKAL, 'Let it (2C-E) rest as being a difficult
         and worthwhile material.' I couldn't have said it any better myself."
2C-E
•At doses exceeding twenty to twenty-five milligrams, 2C-E has been
known to produce intensely colorful, highly complex, moving patterns,
Persian carpet-type visuals, three-dimensional visual effects, and visual
patterns resembling biological structures, such as vines, tentacles, and
even eyeballs.

• The visual distortions produced by 2C-E are comparable in some
respects to those produced by mescaline

•2C-E's distortion of sounds is also very intense, including echoing, pitch
shifting, and the perceived synthesis of new sounds not in one's
immediate environment, such as scraping, drilling, and popping. Most of
these unusual distortions are only experienced after the ingestion of a
higher dose.

•2C-E can also produce distortions in the user's perception of the
passage of time leading to an illusion of moderate to extreme time
dilation.
2C-E
Law
•  2C-E is unscheduled in the United States but there are currently several cases pending in
   U.S. federal court against online vendors for selling these research chemicals. These
   cases may address the question of whether this chemical could be legally defined as an
   analog of a scheduled substance. It could potentially be considered an analog of 2C-B or
   mescaline, in which case sale for human consumption or possession with the intent to
   ingest could be prosecuted as crimes under the Federal Analog Act.

•   Denmark added 2C-E, 2C-P, DOC, and DOI to the list of Schedule I controlled substances
    as of April 8, 2007.

•   New Zealand has a catch-all Analogues section in Schedule 3 / Class C of their drug laws
    that would make 2C-I, 2C-E, DOI, DOB, ephedrine, and pseudoephedrine Schedule 3
    compounds in New Zealand.

•   In Sweden, 2C-E has been controlled since Oct 1, 2004.

•   The UK has the strictest laws in the EU on designer drugs. The Misuse Of Drugs Act was
    amended in 2002 to include a "catch most" clause outlawing every drug, and possible
    future drug, from the LSD (ergoline) and ecstasy (phenethylamine) chemical families
    (including 2C-E).
Kratom
Kratom (Mitragyna speciosa) is a tropical tree growing 15-50 feet tall that is native to Thailand and
Malaysia. It has broad, oval leaves that taper to points, yellow flowers that grow in clusters, and
winged seeds.
•Primary active chemicals are mitragynine, mitraphylline, and 7-hydroxymitragynine found in the
leaves.
•Kratom leaves have been chewed for stimulant, sedative, and euphoric effects by people in Thailand
and South Asia for many centuries. They can also be smoked, brewed as a tea, or made into an
extract.

Dose
•Kratom leaves vary greatly in potency, depending on the type, grade, and freshness. Low doses =
2-4 g of plain dried leaf, moderate doses = 3-6 g, and strong doses= 5 g or more. When chewed
fresh, half of a large leaf (8-10") is often enough to produce noticeable effects.

Price
•Dried, untreated leaves are available from ethnobotanical vendors for 30-80 cents (USD)/gram.
Higher potency extracts may cost $2-8 USD/gram.

Law
•Kratom is currently uncontrolled in the United States. In 1946 it was made illegal to buy, sell, or grow
in Thailand. In 2005, both M. speciosa and mitragynine were made illegal to buy, sell or possess
without a license in Australia.
Kratom
Chemistry
•Kratom leaves contain the indole alkaloids mitragynine, mitraphylline, 7-hydroxymitragynine, and
numerous other alkaloids, including paynanthine, speciogynine, and speciofoline.

 Pharmacology
•Mitragynine is a partial agonist of the mu- and delta-opioid receptors. This may be the reason for its
apparent effectiveness in treating opiate withdrawal

Production
•Kratom grows wild in marshy regions in Asia and the Pacific Rim, especially Thailand,
Malaysia, Borneo, and New Guinea.

History
•Kratom has been used in Thailand for centuries, recreationally and as an antidiarrhetic.
Its was also used as an opiate substitute in Malaysia in the nineteenth century. Kratom
leaves became part of the ethnobotanical trade in the United States and Europe in mid
2000. In the early 2000s, stories about the use of kratom to reduce opiod withdrawal
effects began circulating on web forums.
Kratom
EFFECTS


•Kratom is often described as producing simultaneous, contradictory effects-
both an opiate-like sedation and coca-like stimulation. The stimulating effects
tend to predominate at low dose levels, which may cause alertness, energy,
and mild euphoria. Higher leveldoses are usually more tranquilizing, causing an
opiate-like dreamy effect. Excessive doses can cause severe nausea. As with
opium, it is known for causing constipation, and is sometimes used as a
treatment for diarrhea.

Onset
•When taken orally, the effects of kratom usually become noticeable in 15-20
minutes and clearly apparent in 30-60 minutes. Strong doses tend to have a
more quicker, more dramatic onset.

Duration
•A moderate dose of kratom may cause strong effects that last 2-4 hours, with
residual effects lasting hours longer.
Kratom
Visual Effects
•Some visual effects have been reported, including both open-eye and closed-
eye effects. Effects reported include wavering, shifting, and strobing in the
visual field. There was also some patterning with eyes closed, as well as
increased closed-eye visualizations.

PROBLEMS
•Kratom is not known to be toxic, but can cause unpleasant symptoms at high
doses such as nausea and vomiting. Regular use can lead to physical
dependency. Kratom use can cause constipation similar to that caused by
opiates. Chronic heavy use is reported to cause darkening of skin, insomnia,
dry mouth, and anorexia.
Addiction Potential
•There are reports of physical dependency after frequent, heavy kratom use.
Individuals who use it regularly or in large doses may have trouble quitting.
Withdrawal symptoms include irritability, yawning, diarrhea, runny nose, and
pain in the joints or muscles.
•http://www.bing.com/videos/search?q=You+Tube+Kratom&view=detail&mid=EC48A0
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    our Super Powder Kratom is of unrivalled potency. No need to shop around for blue light
    specials on garbage quality "kratom." We can guarantee that our Super Powder Kratom is
    the highest quality Kratom you can find anywhere! And at a great price. This powdered
    Mitragyna speciosa leaf is high alkaloid like the previous product but has it's own unique
    mix of alkaloids. It is superior to the young, cultivated leaf material which copycat sellers
    have tried to sell, and of course to the altogether fake "kratom" which other copycats have
    tried to offer. Our Kratom Super Powders are very, very fine powder, not crushed with
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    Product not available to Australia, Denmark, Finland, Malaysia, Myanmar, New Zealand,
    Norway, Romania, Thailand.
Meow Meow
•   http://www.cnn.com/video/?/video/health/2010/03/29/herriman.uk.meow.meow.drug.cnn#/vid
•   Other Street Names: MCat, Bubbles, Sunshine, Drone, Meph, Quat, miawo-miawo,
    Kitty Cat, Stardust
•   Chemical Name: Mephedrone (4-methylmethcathinone or 4-MMC)
•   Often sold as plant food/fertilizer; internet usually sells as “boutique alternative” to
    Miracle-Gro (plant food)
•   Derived from leaves of the Khat plant- leaves were chewed by Sudanese warriors to
    to achieve amphetamine- like high, producing an energy jolt before entering battle
•   Considered as new & latest designer “club” drug
•   Users report that it produces “the rush of cocaine with the sensory bliss of ecstasy.”
•   Side effect/symptoms:
    Central Nervous System: euphoria; anxiety, dysphoria; agitation & aggression;
    paranoid psychosis with both visual & tactile hallucinations; hypothermia, rigidity, &
    myoclonic movements; seizures
    Cardiovascular: tachycardia, dysrthyhmias, acute coronary syndrome, acute cardia
    myopathy, acute pulmonary oedema, haemoptysis
Meow Meow
•   Heart palpitations, blurred vision, profuse sweating, restlessness,
    agitation, tightening of chest are frequently reported by users
•   Though little is known about mephedrone intoxication, deaths have
    been reported as secondary to sympathemimetic complications or
    when taken in combination with other substances/co-ingestants such
    as alcohol, ketamine, and other recreational drugs
•   Usually manufactured as clear/white powder but also found as
    crystals, capsules or pills
•   Powder form has been known to be incorporated into other synthetic
    products such as “bath salts.”
•   The powder form is often mixed with water & swallowed (bombed)-
    also can be snorted/sniffed or taken intravenously
•   Mephedrone has a short half life (30-90 mins) which often results in
    frequent “re-dosing” by users
•   http://www.bing.com/videos/search?q=Meow+Meow+Mephedrone&mid=AFCEF7BB6C2A6081A56CAFC
Meow Meow
•   The drug’s half life is relatively short, but the side effects often last
    up to 4 hours
•   Though research is limited, indications are that it is likely first a
    stimulant, then inhibits the reuptake of manoamine
    neurotransmitters
•   Often causes severe peripheral vasoconstriction which some
    researchers believe is result of formation of highly potent
    vasoconstrictor, 4-methylephedrine, known to cause levels of
    cardiovascular toxicity significantly higher than regular ephedrine
•   Legal Status: purchased mainly from internet; identified as
    prohibited substance in Australia & illegal to import; classified as a
    “Class B” substance in Britian; currently legal in US
•   Before being banned in United Kingdom undergraduates were
    snorting it right off of public bars
•   There are at least 94 identified Facebook groups devoted to this
    drug
•   http://www.bing.com/videos/search?q=Meow+Meow+Mephedrone&mid=AFCEF7BB6C2A6081A56CAFCEF7BB6C2A6081
Vaporizers
•       Heats substances to temperature at which the active ingredient will turn into a
        gaseous state creating a thin, fine mist containing the active ingredient (THC in
        marijuana) in a higher concentration than in smoke form
•       The mist containing the concentration of the active ingredients is captured in a
        small glass dome from which it can then be inhaled at any time.
•       When smoking, the same substance is heated past the point at which the active
        ingredient becomes a gas & turns to smoke. The smoke contains less of the active
        ingredient, but also contains many of the same harmful toxins that cigarette smoke
        does.
•       Some “non-smokers” utilize this method of obtaining the substance claiming that it
        is much more pleasant since there is almost no smoke or odor involved-a “purer”
        high.
•       The effects of this method can be 3-4 times more potent since the vaporizing
        method produces the active ingredient in a more concentrated form.
•       Types of Vaporizers:
    –       Bubble- no technology involved in construction-simply place drug in bowl, heat gently &
            evenly until vapor or “mist” forms and rises into tube from which it can then be inhaled
    –       Regular-can be turned on by flick of a switch, usually operates on 110 volts, compact &
            easy to clean
    –       Digital-more technology involved, has convectional fan forced heating system with
            adjustable digital temperature control, works on 110 or 220 volts, priced considerably
            higher than others
Hookahs
•  Hookahs—sometimes called water pipes—are used to smoke specially made tobacco that are
   produced in a variety of flavors (e.g., apple, mint, cherry, chocolate, coconut, licorice,
   cappuccino, and watermelon).
•  Hookah smoking is usually done in groups, with the same mouthpiece often being passed from
   person to person.
•  Hookahs originated in ancient Persia and India , having been used extensively for centuries.
•  Today, hookah cafés are becoming more popular around the globe, including France ,Britain, the
   Middle East Russia, and the United States
•  Approximately 300 hookah cafés were in the United States in 2006, The numbers continue to
   grow contributing to an increase in hookah use most notably among youth.
•  Hookah is known by a number of different names, including, argileh, shisha, hubble-bubble,
   narghile and goza.
•  A typical modern hookah is made up of a head (with holes in the bottom), metal body, water
   bowl, and a flexible hose with a mouthpiece.
Compared with Cigarettes
•  While many hookah smokers may consider this practice not as harmful as smoking
   cigarettes, hookah smoking causes many of the same health risks as cigarettes.
•  Water pipe smoking delivers the same addictive drug (nicotine). It is at least as toxic as the
   smoke from a cigarette,
Hookahs
•   Because of the mode of smoking—frequency of puffing, depth of inhalation, and length of the
    smoking session—hookah smokers can absorb higher concentrations of the toxins found in
    cigarette smoke.
•   A typical 1hour session results in the inhaling of 100–200 times the volume of smoke inhaled
    from a single cigarette.
•   Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, which
    includes oral cancer, lung cancer, cancer of the esophagus, stomach cancer, as well as reduced
    lung function, and decreased fertility.

   Hookah smoking is NOT a safe alternative to smoking cigarettes.1
Health Effects
•  The charcoal used to heat tobacco in the hookah increases associated health risks by producing
   very high levels of carbon monoxide, metals, and cancer-causing chemicals.
•  Even though it has passed through water, the smoke produced by a hookah still contains high
   levels of toxic compounds .
•  Hookah tobacco and smoke contain numerous toxic substances known to cause lung, bladder,
   and oral cancers.
Hookahs
•  Irritation from the tobacco juices increases the risk of developing oral cancers. The irritation by
   tobacco juice products is likely to be greater among hookah smokers than among pipe or cigar
   smokers because hookah smoking is typically practiced (with or without inhalation) for longer
   periods of time.
Other Health Effects of Hookah Smoke
•  Hookah tobacco /smoke contain several toxic substances that cause clogged arteries and heart
   disease.
•  Infectious diseases can be transmitted by sharing a hookah.
•  Babies born to women who smoked one or more water pipes a day while pregnant have lower
   birth weights (at least 3½ ounces less) than babies born to nonsmokers , as well as being at an
   increased risk for respiratory diseases.
Hookahs and Secondhand Smoke
•  Secondhand smoke from hookahs poses a serious risk for nonsmokers, primarily because it
   contains smoke from the tobacco as well as from the heat source (e.g., charcoal) used in the
   hookah.

    Using a hookah to smoke tobacco poses a serious potential health hazard to smokers and
    others exposed to the smoke emitted.

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Substance Abuse in the 21st Century

  • 1. Substance Abuse in the 21 st Century: A New Look Sue Parr Bragg Hill Community Coalition Community Coalitions of Virginia
  • 2. The Latest Drug Crazes • Alcoholic Energy Drinks • Alcoholic Whipped Cream • Bath Salts (Ivory Wave) • K2/Spice • Pocket Shots • Cheese • Vaporizers • Hookahs • Bromo-Dragonfly • The “2C” Family • Kratom
  • 3. Alcoholic Energy Drinks • Alcohol Energy Drinks (AEDs) are pre-packaged beverages containing alcohol, caffeine, and various other stimulants such as ginseng, guarana, and taurine. • The FDA limits beverages to 65 mg of caffeine. Some AEDs contained as much as 300 mg of caffeine—a dangerous amount of the stimulant, especially when combined with alcohol. • AEDs were sold under such brand names as Spark, Charge, Tilt, Joose, Four Loko, Liquid Charge, Rock Star 21, PINK Spirits and various others • Packaging of AEDs made them very difficult to distinguish from regular (non- alcoholic) energy drinks-very similar packaging styles. • Many states, including VA, required retailers to separate AEDs from regular, non-alcoholic energy drinks in their displays and provide training on this matter to state licensees. • To distinguish from regular energy drinks (no alcohol) you had to check for the standard nutrition label- alcohol energy drinks did not have a nutrition label, but listed the amount of alcohol by volume (abv) instead.
  • 4. Some AEDs had as much as 12% alcohol content. • Some brands of AEDs were served in 23.5 oz containers that contained the equivalent of between 3 and 5 beers, as well as up to 8 cups of coffee. • 9) The combination of energy drinks (stimulants) and alcohol (depressant) can lead to serious health effects: – dehydration which can also cause the effects of alcohol to be extended up to 24 hours – stimulants mask the effects of alcohol so individuals are unaware of the amount of alcohol they have consumed – after the effects of stimulants wear off, the effects of the depressant remains which can potentially lead to respiratory depression, vomiting while sleeping (which could result in asphyxiation/death), and other alarming medical concerns. • A 16 year old (Joey Fonseca) died in the VA Beach area as the result of a car accident in which his friend was charged with a DUI from drinking an Alcohol Energy Drink-a growing trend nationwide.
  • 5. According to the FDA Commissioner, Margaret Hamburg, the combination of alcohol and caffeine in AEDs causes a public health concern and can lead to a “wide awake drunk.” • The FDA issued a warning to the industry’s main manufacturers on Nov. 17th, 2010 stating that the caffeine in AEDs was considered an “unsafe food additive” and that they had to respond within 15 days indicating whether they intended to pull their product off the shelves or defend their products as safe. As a result, the manufacturers indicated that they would reformulate their products to meet FDA requirements, thus removing the caffeine.
  • 6. Alcohol Energy Drinks • Now the manufacturers of AEDs have been forced to remove all caffeine from their products under the new FDA regulations. • The products are marketed with the exact same design as they were using prior to removal of caffeine- still “look” like energy drinks. • They are still sold in “super-sized” containers (23.5 +oz) that help promote binge drinking. • Most are now advertised as “malt” beverages but still displayed in many stores in manner that makes it hard to distinguish from non- alcoholic beverages. • Majority of marketing is still done in a manner very appealing to youth- check out the “Joose” website: : • http://drinkjoose.com/website/
  • 7. Alcoholic Whipped Cream • This product is sold in aerosol cans with packaging similar to non-alcoholic whipped cream products. • It is sold currently in over 10 states, primarily in liquor/alcohol stores where consumers must be 21 years of age & provide valid ID to purchase. • The average cost of these products is about $13 per canister • It is also known as “whipahol” and sold under several brand names such as Get Whipped, Cream, and Whipped Lightning.. • The average alcohol by volume content is about 15%, though the Whipped Lightning brand contains 16-18% alcohol by volume (equal to 3-4 beers). This is also comparable in content to such drinks as Bacardi Mojito and Bailey’s Irish Crème. • The product is sold in a variety of popular flavors ranging from simple raspberry, orange & cherry to more exotic flavors such as white chocolate raspberry, caramel pecan, German chocolate, tropical passion, spiced vanilla, hazelnut espresso and cinnamon-used to help mask flavor of alcohol content.
  • 8. Since the product is not considered a food it does not currently fall under FDA regulations/guidelines. Manufacturers therefore are not required to list nutrition content-just alcohol content, • One concern already arising from sale of these products is their use by youth who exhibit “huffing” behaviors- able to get high off of the nitrous oxide from the aerosol container-but now combined with the effects from the alcohol content as well. • The Cream brand of the product has its own MySpace page encouraging the use of the product in conjunction with other items currently popular at college parties such as Jell-O shots significantly increasing the danger level. • Retailers in states where it is being sold indicate that it is very popular-flying off the shelves. • Another concern is the marketing style for the product. Though it is being identified as an “adult” product targeting primarily 25-35 yr. old consumers, many feel that the marketing strategy is actually designed to attract college students. • Federal and state regulatory agencies are indicating that it is a “product of concern” that warrants monitoring.
  • 9. Bath Salts • Bath Salts (Ivory Wave) are a synthetic product that contains hallucinogenic, mind-altering chemicals similar in structure to those also found in cocaine and ecstasy, depending on which brand or form is purchased. • It is being sold as a bath salt, or plant food in some cases, labeled “for novelty use only” and/or “not for human consumption” in order to by- pass FDA regulations-not being sold as food or drug product. • It is most often sold in either 250 or 500 mg packets depending on brand or form purchased. • Though Ivory Wave is the most popular form/brand of this product, it (or similar products) is also sold under other names such as Vanilla Sky, Fly, Snow, Ivory, Charge, Ivory Coast, Purple Wave, Cristalius, Magic, and Ocean Blue. Some of these products are manufactured by a company called Papa Spice. There are also competitors with similar products made of the same chemical compounds identified as Columbian Salts and Bolivian Salts (claims that it “blows Ivory Wave away!”) • http://www.youtube.com/watch?v=8y4EARXFagQ
  • 10. Bath Salts • The drugs identified in these products most often are MDPV (methylenedioxypyrovalerone) usually referred to as pyrovalerone, a powerful psychoactive chemical similar to Ritalin which acts as a stimulant that inhibits re-uptake of dopamine & norepinephrine while having minimal effects on serotonin levels. Tests have also identified most versions of these products as containing Lidocaine which is frequently used by dentists for anesthesia. Many versions may also contain similar components to 2-DPMP or the drug MDMA (aka ecstasy). • Sold under variety of names such as Vanilla Sky, Ocean Burst, Lunar Wave, Lady Bubbles, Arctic Blast, Sextacy, Disco, Snow Leopard, Natural NRG, Tranquility,…the most popular brand is Ivory Wave. • It appears to be purposely designed in a way that will mimic the effects of cocaine/crack or ecstasy and is most often used by snorting. • It is sold most frequently on-line, though also in some tobacco/smoke shops as a novelty item “not for human consumption” for about $30 for a small package. Many websites sell it in bulk (50-100 packets) for a discount rate. (Bath salts being sold in smoke shops should raise questions about its content with most people!) • Though it has been sold for quite some time in the UK (import of it banned there as of Nov. 5, 2010), Ireland (sold as Whack also) and Australia, it is just now becoming popular in the US, now showing up in states such as Utah, Missouri and Mississippi.
  • 11. The side effects of these products include the following: – hallucinations – diminished cognitive ability – tachycardia – vasoconstriction – hypertension – blood pressure/heart rate elevated to medically dangerous levels – prolonged agitation (lasting up to 5 days/may require physical restraint) – muscular pain/ muscle spasms – emotional fragility – acute paranoid psychosis – sore jaw – kidney failure – loss of bowel control – intense high followed by painful hangover – suppressed appetite
  • 12. Has been marketed in some forms as an appetite suppressant/weight control enhancer which led to the death of a newlywed bride in the UK who dropped from a size 16 to a size 6 in just a few months but died from severe brain damage and elevated heart rate after using it regularly over this period. The UK also reported a related death by suicide/accidental fall of a young fisherman that occurred while high on Ivory Wave, • Appears to be extremely addictive with many users reporting an “almost uncontrollable urge for another hit” immediately, stating that its effects are several times stronger than cocaine when snorted. • A man was admitted to the University of Utah psychiatric hospital after taking Ivory Wave in combination with his prescribed bi-polar medication due to side effects-hands constantly shaking and requires constant monitoring due to hallucinations, severe agitation and acute paranoia. • A sheriff in Mississippi is requesting a ban on Ivory Wave products due to encounters that his deputies have had with users who thought they were demons. • There has been a recently reported death in Missouri due to use of Ivory Wave products. • Louisiana had 125 call to poison center in 3 months last year related to bath salts incidents resulting in a state ban by emergency order.
  • 13. K2/Spice products are a mixture of herbal/spice plant products sprayed with potent psychotropic drugs, often • contaminated with unidentified toxic substances which contribute to various adverse health effects (also cause hallucinogenic effects similar to effects of PCP. • Marketed under variety of names including K2, Spice, Pep Spice, Spice Silver, Spice Gold, Spice Diamond, • Smoke, Sence, Skunk, Yucatan Fire, Genie & Zohai • sold in variety of colors/flavors- usually sold in foil packaging
  • 14. K2/Spice Health Risks • Symptoms/Side-Effects may include: – mimics marijuana “high” (often induced more quickly/more intense than “real” marijuana) – hallucinations – seizures/tremors – coma/unconsciousness – vomiting – numbness/tingling – increased respiration rate – elevated blood pressure (reported up to 200/100-medically dangerous) – elevated heart rate (reported up to rate of 150-medically dangerous) – increased level of anxiety/agitation leading to panic attacks (possible suicide attempts)
  • 15. Depending on synthetic compound in specific commercial brand, can be anywhere from 4 times to over 100 times more potent than regular marijuana (THC) • Sold in tobacco shops, head shops, and convenience stores • Sold as “incense” marked “not for human consumption” • Price averages $45 for 3 grams (about equal to 3 sugar packets)- higher than good grade marijuana • Most often smoked but can be mixed in with food or drink • Most likely users: – 14-27 yr. olds – Prisoners/probationers – Military (use now banned by all military branches)
  • 16. Creation of K2/Spice • Developed by Dr. John W. Huffman, a Clemson University professor, as part of research for National Institute for Drug Abuse (NIDA) on endogenous cannabinoid receptors-but never tested on humans nor approved by FDA • Dr. Huffman said in interview to WebMD “It is like Russian roulette to use these drugs. We don’t know a darn thing about them for real.” “It shouldn’t be out there.” • JWH-018 & many of its “cousins” such as HU-210/211, JWH-073 & CP 47/497 found in these drugs have a chemical structure shared with known cancer-causing agents. • All effects of K2/Spice drugs may not be known for very long time because of long time period that body stores them.
  • 17. So far nothing is known about metabolism of the chemical compounds in K2/Spice drugs-some may be toxic and/or pharmacologically active-differing from batch to batch in kind/amount of applied drugs (synthetic) thus resulting in higher risk of accidental overdosing which has already been seen & is on rise with these drugs with increase numbers of ER & hospital incidents reported • There are hundreds more of these chemical compounds containing strong, active cannabinoid receptors agonists so can be safely assumed that further such substances will appear on market soon if not banned-greatly increasing challenges for toxicology testing, law enforcement and medical/healthcare professionals. • Causing difficulties for law enforcement agencies, including probation & parole, as well as drug courts due to difficulties in testing for presence-one lab test now known to detect it in system but at cost of $50 & will probably not test positive for all the known variations
  • 18. Dr. Huffman & Dr. Huestis (Chief of Chemistry/Drug Metabolism at National Institute for Drug Abuse) indicate that when taking these drugs, it is “hijacking the part of the brain important for many major functions: temperature control, food intake, perception, memory and problem solving. Many people taking these high-potency drugs are affecting important functions throughout their bodies-hormone functions for example.” Doctors also express concern that the drugs may involve acute toxicity levels, possibly long term, as well as impacting cannabinoid receptors that regulate body’s immune system. • Retailers selling the drugs report a recent increase in sales from app. $1000 daily up to $10, 000 daily. • Medical reports indicate that K2/Spice drugs potentially result in users developing a rapid and powerful addiction on a level not usually found among smokers of “real” marijuana. • Recently linked to over 352 nationwide emergency room incidents-includes suicide attempts, extremely elevated heart rate/blood pressure, comas, seizures, and anxiety attacks.
  • 19. Status of K2/Spice • Police in Indianola, Iowa report 18 yr old smoking K2 resulting in severe anxiety attack-stated was “going to hell” and went home and shot & killed his self. • K2/Spice is labeled by users as the “stealth” marijuana. • Dr. Anthony Scalzo (professor of toxicology at St. Louis University) indicates he’s seen nearly 30 cases in past month involving teenagers experiencing hallucinations, severe agitation, elevated heart rate/blood pressuer, vomiting and tremors/seizures as result of smoking K2. • Dr. Scalzo says that what makes K2 (and other Spice derivatives) so dangerous is that its side effects suggest that it also affects the user’s cardiovascular system, as well as the central nervous system. • One sign of use that parents should look for is dried herbal residue in their children’s rooms, as well as the foil packets in trash. • Check out advertising at http://www.dutchincense.com/ • http://www.youtube.com/watch?v=Mu0VmT5LWxc • http://www.youtube.com/watch?v=Mu0VmT5LWxc • http://www.youtube.com/watch?v=QQvqeT-7dSo&feature=related
  • 20.
  • 21. VA Bans K2/Spice & Bath Salts • Several state legislators in VA introduced bills in 2011 GA session to ban K2/Spice Drugs & Bath Salts. They were all rolled into one bill which was passed by GA on Saturday, Feb. 26th, 2011. Gov. McDonnell agreed to sign it into law as emergency legislation in Spring of 2011making VA one of about 18 states so far to officially ban the sale & use of these products statewide.
  • 22. Cheese Heroin http://www.youtube.com/watch?v=XLuqe2wWruU http://www.youtube.com/watch?v=XLuqe2wWruU • Lab analysis shows that cheese contains app. 94.5-95% acetaminophen with app. 4.5-5% mixture of diphenhydramine (Benadryl) and black tar heroin- acetominophen and diphenhydramine is the drug combination that makes up Tylenol PM). • The Tylenol PM is ground into powder then mixed with sticky black tar heroin to form “cheese.” • Sometimes the black tar heroin is mixed with crushed Xanax (alprazolam) instead of Tylenol PM • :cheese” is said to refer to consistency of product which is similar to that of parmesan cheese (in shaker), as well as being a play on the slang term for heroin “chiva.” • ‘cheese” is popular with youth because it is so cheap-average cost of a hit or “bump” (equal to 1/10 gram) is about $2 and it produces a strong produces a sense of euphoria • most common method of ingestion is snorting, either directly or by using tube/straw
  • 23. Cheese • signs to identify use include tan brown powder, usually folded into notebook paper (bindle) or in a small baggie • highly addictive due to heroin content-reportedly after only one use sometimes • users can suffer withdrawal symtoms within 12 hrs of taking a hit-including headaches, chills, nausea, muscle pains/spasms, extreme agitation, and various flu-like symptoms • referred to as a “starter” drug due to highly addictive nature tending to lead to use of more &/or stronger drugs • side effects include euphoric state, disorientation, lethargy, sleepiness, hunger, excessive thirst • Popular with the Hispanic population, as well as middle & high school students • often used by drug dealers to lure children & get them addicted so will continue to buy products • middle schoolers often use lunch money to purchase “cheese” since so inexpensive, then snort through hollowed out ballpoint pen
  • 24. Cheese • produces a rush due to amphetamines in Tylenol PM/cold medicines that is similar to that produced by a “speed ball”-cocaine/heroin mix • continued use of such large quantities of Tylenol PM can result in liver damage or failure • Since Tylenol PM is analgesic/sedative & heroin is an opiod that mimics endorphin actions creating the euphoric state, users essentially get a “double whammy”-two downers at once, which potentially can result in dangerously decreased heart rate or heart stoppage (death). • all major ingredients are CNS and respiratory depressants so can overdose or used in combination with other depressants, such as alcohol, could lead to respiratory arrest & result in death • youth often hide “cheese” is some unique places: pants (cuffs, waistbands), hoodies, bras, hairbuns/twists, inside book binders, colored markers, belt buckles, cell phone battery compartments, tennis shoes (under soles, loop in tongue) • http://www.youtube.com/watch?v=yPZ-JmtZmn0
  • 25. Lazy Cakes http://www.youtube.com/watch?v=S40OWt_z7Mc • Lazy Cakes are also known as “the relaxation brownie” because they are brownies with melatonin (a hormone produced by pineal gland in brain that controls sleep cycle), valerian root, passion flower, rose hips,…. baked into them-also sold under names such as “Unwind” and “Simmer.” • Sold in convenience stores, tobacco shops and online in 2.5’ squares-can be purchased individually for about $3-4 or by box of 12 for app. $25. Online they may also be purchased by the case (12 boxes) or by the pallet. • Each “cake” consists of two servings according to package, and each serving contains 3.9 mg of melatonin, equaling 7.8 mg per whole “cake.” • One “cake” has enough melatonin baked in to put the average adult into a deep sleep. The manager of a tobacco shop in Ohio said “I didn’t realize that it was two servings and ate the whole one. I fell asleep within 15 minutes.” She also noted that her shop was selling “tons of them.” • Melatonin can be purchased in its synthetic form as a dietary supplement in many stores and is used to help induce sleep and regulate the sleep cycle. The recommended dosage for the average adult is about 0.2mg.
  • 26. Lazy Cakes http://www.newsy.com/videos/relaxation-brownies-marketed-to-kids/ • Many doctors and health experts consider melatonin dangerous to children. • A 2 yr old in Tennessee, Michael Cummings, ate one bite of a Lazy Cake. He soon began “acting all funny and wouldn’t play or nothing,” said his uncle, Cameron Cunnings, “he would sleep and he wouldn’t wake up,” but when he did wake up” he was crying a lot.” This incident resulted in an emergency room visit where his family was told that even a small dose of melatonin can be very dangerous for children. • The Memphis-based distributor of Lazy Cakes, Baked World, states that “these are not a snack for children. They are meant as dietary supplement for adults who lead a stressful, energy drink-fueled lifestyle unwind & relax.” • Fine print on the product wrapper indicates for “adults only” and “should not be mixed with alcohol or be eaten while driving.” • Though manufacturers claim Lazy Cakes are intended for adults only, the product is sold in a colorful, psychedelic designed wrapper with a cartoon character, Larry Lazycakes, and a slogan “Peace, love and Lazy Cakes” that are all very appealing to children.
  • 27. Lazy Cakes • Dr. Ray Smith, Lubbock, TX, indicated that he is more concerned about the Valerian Root content of the brownies. He says that it is comparable to valium and that this herb has history of use as a sedative, similar to the way tranquilizers are used currently. • Dr. Ray Smith also stated that “I think it’s inappropriate that these Lazy Cakes are sold in candy like packaging and sold as a dietary supplement. That is very sneaky because selling it as a dietary supplement allows the cakes to bypass the FDA.” He also mentioned the manufacturers’ use of clever marketing combined with the power of chocolate to help boost sales, especially to children. • Data from the National Poison Center indicates that more calls come in related to melatonin than any other herb or supplement-approximately 5,000 calls in 2009. • Some doctors believe melatonin can prove fatal. “It will kill you if you get the wrong dose, yes it’s a drug-those brownies are definitely a drug.” says Dr. Ann Payne-Johnson of Baptist Memorial Health Care in Virginia. • Anna Rouse Delaney, a toxicologist with the Carolinas Poison Center says that melatonin can lead the central nervous system to slow down and cause trouble breathing.” She also indicated that people becoming extremely sleepy and nauseated is a common side effect.
  • 28. Lazy Cakes • Dr. Laura Aisenberg with HCA VA Health System indicated when asked about Lazy Cakes that it was actually the first time she had heard of them but that “it’s not surprising but makes me wonder what’s coming next. They could be getting thousands of times more than the body really needs, now you put that in the hands of children and it’s very concerning.” • The makers of Lazy Cakes have stated that since “relaxing folks is going so well” they may soon launch a product to counteract that effect-a caffeinated brownie called an “Up Cake.” • Though the makers of Lazy Cakes say they don’t currently distribute in all states, including Virginia, retailers can purchase their products online and sell them in their stores anywhere. • large doses of melatonin can be troublesome for people who suffer from depression. Lots of teens fit into that category.
  • 29.
  • 30. Bromo Dragonfly • Bromo Dragonfly is a synthetic psychedelic hallucinogenic drug related to the phenethylamine family, also considered a potent serotonin agonist and causes effects consistent with 5-HT-2A hallucinogens. • Common brand names are 3c-Bromo-Dragonfly; DOB-Dragonfly, ABDF, • Chemical name: 1-(8-bromobenzo[1.2-b,4,5-b] dituran-4-yl)-2-aminopropane hydrochloride • Methods of use: blotter paper (similar to LSD), as well as in powder form (occasionally in pill) • Very little history of previous human use thus little known about possible side effects of human consumption including possible long term problems, addiction potential, allergic reactions, or acute overdoses. Known side effects include visual changes/visual distortion (patterns, shapes,…), short term memory scramble or disorientation/confusion, muscle tension • First synthesized by a chemist named Matthew Parker and used as a brain research chemical on rats at Purdue in the 1990’s • Bromo-Dragonfly is unscheduled in the United States though it’s possible that it could be considered an analog (of DOB or 2C-B), in which case, sales for human consumption or possession with the intent to ingest could be prosecuted under the Federal Analogue Act though it has not been thus far • There have been deaths/serious injuries related to Bromo-Dragonfly in US, Norway, Denmark & Sweden thus far-some were initially attributed to 2C-E or 2C-B but later identified correctly as FLY • potency 300 times stronger than mescaline, a mere 1/5 less potent than lysergic acid diethylamide (LSD )
  • 31. Bromo-Dragonfly Dosage • Oral Bromo-Dragonfly Dosages 2006 American” Batch • WARNING: SEE NOTES ABOVE • Threshold500 ug Common800 - 1300 ug Strong1200 – 1800 Heavy1600 + ug • Oral Bromo-Dragonfly Dosages 2005 "European" Batch WARNING: SEE NOTES ABOVE • Threshold100 ug Common200-400 ug Strong500-800 ug Heavy800 + ug Onset : 20 - 90 minutes (depending on form and stomach contents) Duration : 10 - 24 hours Normal After Effects : up to 36 hours Overdose Effects: One report of a very high dose resulted in: extremely long duration (2-4 days), flushing, ego-loss, dissociation, headache, erratic behavior, etc.
  • 32. Bromo-Dragonfly • The name comes from the lab at Purdue where it was first synthesized for use in research into the structure and activity of the serotonin receptors in the brain. Researchers had designed a related chemical that they called "fly" because of the two furanyl rings attached to the benzene ring. Upon discovery that changing the bonds on the furanyl rings increased the potency substantially over the original "fly" compounds, the new style of compounds were dubbed "dragonfly" compounds. • available online through research chemical vendors all across the world but buying from these vendors is tremendously risky – in a case in 2009 a batch of bromo- dragonfly was released and mislabeled as 2c-b-fly which is 20x less potent in weight terms-this led to an undisclosed amount of fatal overdoses and hospitalizations • One user described his overdose saying “it was like being dragged to hell and back again, Many times. It is the most evil thing I have ever tried. It lasted an eternity.” • Vasoconstriction, or the narrowing of blood vessels resulting from contraction of the muscular wall of the vessels, has also been noted in higher doses with one documented case of an overdose requiring a man in Switzerland to have half his foot and several fingers on one hand amputated. • Delayed onset of seizures and toxicity associated with recreational use of Bromo- Dragonfly have also been reported
  • 33. Bromo-Dragonfly • explicitly illegal only in Sweden and Denmark, although it may be considered a controlled substance analogue under US and Australian drug laws • increasing sales shown from online distributors to buyers in United States http://www.youtube.com/watch?v=c8MmMjvZ6uk http://www.doctoroz.com/videos/dr-oz-investigates-dragonfly-pt-
  • 34.
  • 35. 2C-B • The full name of the chemical is 4-bromo-2,5-dimethoxyphenethylamine. • Shulgin lists the dosage range as 16 to 24 mg. • 2C-B is a white powder usually found in pressed tablets or gel caps, and almost always taken orally. Snorting is also an effective way to ingest the drug, though said to be painful • On December 20, 1994, the Deputy Administrator of the DEA proposed to place 4-bromo-2,5-DMPEA into Schedule I making 2C-B illegal in the United States. This became permanent law July, 2 1995. • Prior to this, 2C-B was commercially available as an aphrodisiac under the tradename "Eros" which was manufactured by the german phamacuetical company Drittewelle. • Recently 2C-B has been distributed under the street name "Nexus." In the past 2C-B has also been distributed as "Eve", "Venus", "Bees", and (incorrectly) "bromo-mescaline." • Not much information is known about the toxicity of 2C-B. Because 2C-B lacks an alpha-methyl group it is not considered an amphetamine such as MDMA, MDA, methamphetamine, or fenfluramine. 2C-B does not seem to deplete the brain of serotonin, and this suggests that it may not share the neurotoxic mechanisms of many amphetamines.
  • 36. 2C-I • Its full chemical name is 4-iodo-2,5-dimethoxyphenethylamine. • The drug is used recreationally, and perhaps as an entheogen, but no medical or industrial uses are known at this time • It is mostly commonly encountered in the form of hydrochloride salt, a fluffy white powder, or been pressed into tablet form. • Since it has become popular only recently slang terms vary widely, although the terms "iodo-mescaline" and "To See I" have been used. • In the early 2000s, 2C-I in powder form became available for purchase from several online vendors of research chemicals in the United States, Asia, and elsewhere. • In the early 2000’s tablets of 2C-I were being sold illegally in Denmark at nightclubs and raves , and in the United Kingdom as a club drug, with tablets often being sold under the guise of being MDMA (ecstacy) or a mixture of some amphetamine (though it is not) , as well as LSD. Legality • 2C-I is an illegal, controlled substance in several European nations, including Denmark, Germany, Greece, Ireland, and the United Kingdom. In December 2003, the European Council issued a binding order compelling all EU member states to ban 2C-I within three months. 2C-I is unscheduled and unregulated in the United States, however its close similarity in structure and effects to 2C-B could potentially subject possession and sale of 2C-I to prosecution under the Federal Analog Act.
  • 37. 2C-I Effects •2C-I is almost always taken orally, although it can also be inhaled (though painful), smoked, or administered rectally •A recreational dose of 2C-I is commonly between 10 and 25mg, although doses as low as 2mg have been reported to be useful. •The onset of effects usually occurs within an hour, and the effects of the drug typically last somewhere in the range of 5 to 10 hours and are often described as quite similar to those of its close chemical analog 2C-B, combining psychedelic/ hallucinogenic effects typical of drugs such as LSD with the empathogenic or entactogenic effects of drugs such as MDMA (ecstasy). • Some users report that the effects are more mental and less sensory than those of 2C- B. Users of 2C-I often report a physical stimulant effect that can be quite strong. Although unpleasant physical side effects such as muscle tension, nausea, and vomiting have been reported, their incidence in the use of 2C-I appears to be less common than in the use of some of the other closely related phenethylamines •User reports have said that 2C-I produces flashbacks in the weeks following its use. These flashbacks can last anywhere from seconds to hours. Some users report being able to trigger the flashbacks at will. However, these flashbacks do not occur in the majority, but have been observed in a sampling of users. They are thought to be similar in nature to LSD flashbacks, not particularly harmful or remarkable for a psychedelic drug.
  • 38. 2C-E • Many have reported that the general effects of 2C-E are similar to those of the other psychedelic phenethylamines, but far more intense. Vivid hallucinations similar to those experienced while under the influence of LSD are common, and many reports would indicate that the effects of this particular chemical may be overly intense for those not well experienced with psychedelics. Properties • 2,5-Dimethoxy-4-ethylphenethylamine is a colorless oil. Crystalline forms are obtained as the amine salt by reacting the free base with a mineral acid, typically HCl.
  • 39. 2C-E Effects • The total duration of 2C-E's effects is generally between six and ten hours for an average dose, with the plateau lasting between 3-6 hours. The onset of effects takes approximately 20-90 minutes, but perception may be altered for up to a day after ingestion. • In extreme cases where between 75-100 mgs of 2C-E were ingested, the duration of effects has lasted past twenty-four hours, with plateaus exceeding 10 hours with the onset of effects within the first five minutes after thethe drug being ingested. A few users of very high doses reported "never feeling the same again" after having used this drug. • It has been described it as "difficult" by people who use it, including its inventor, Shulgin: – "I really don't know how to put into words, or how to describe what it did and how it acted in my mind. There were parts of it that reminded me of the other phenethylamines I've tried in one way or another, but the effects of this material are really difficult to express or generalize. I think Shulgin said it best when he commented in PiHKAL, 'Let it (2C-E) rest as being a difficult and worthwhile material.' I couldn't have said it any better myself."
  • 40. 2C-E •At doses exceeding twenty to twenty-five milligrams, 2C-E has been known to produce intensely colorful, highly complex, moving patterns, Persian carpet-type visuals, three-dimensional visual effects, and visual patterns resembling biological structures, such as vines, tentacles, and even eyeballs. • The visual distortions produced by 2C-E are comparable in some respects to those produced by mescaline •2C-E's distortion of sounds is also very intense, including echoing, pitch shifting, and the perceived synthesis of new sounds not in one's immediate environment, such as scraping, drilling, and popping. Most of these unusual distortions are only experienced after the ingestion of a higher dose. •2C-E can also produce distortions in the user's perception of the passage of time leading to an illusion of moderate to extreme time dilation.
  • 41. 2C-E Law • 2C-E is unscheduled in the United States but there are currently several cases pending in U.S. federal court against online vendors for selling these research chemicals. These cases may address the question of whether this chemical could be legally defined as an analog of a scheduled substance. It could potentially be considered an analog of 2C-B or mescaline, in which case sale for human consumption or possession with the intent to ingest could be prosecuted as crimes under the Federal Analog Act. • Denmark added 2C-E, 2C-P, DOC, and DOI to the list of Schedule I controlled substances as of April 8, 2007. • New Zealand has a catch-all Analogues section in Schedule 3 / Class C of their drug laws that would make 2C-I, 2C-E, DOI, DOB, ephedrine, and pseudoephedrine Schedule 3 compounds in New Zealand. • In Sweden, 2C-E has been controlled since Oct 1, 2004. • The UK has the strictest laws in the EU on designer drugs. The Misuse Of Drugs Act was amended in 2002 to include a "catch most" clause outlawing every drug, and possible future drug, from the LSD (ergoline) and ecstasy (phenethylamine) chemical families (including 2C-E).
  • 42. Kratom Kratom (Mitragyna speciosa) is a tropical tree growing 15-50 feet tall that is native to Thailand and Malaysia. It has broad, oval leaves that taper to points, yellow flowers that grow in clusters, and winged seeds. •Primary active chemicals are mitragynine, mitraphylline, and 7-hydroxymitragynine found in the leaves. •Kratom leaves have been chewed for stimulant, sedative, and euphoric effects by people in Thailand and South Asia for many centuries. They can also be smoked, brewed as a tea, or made into an extract. Dose •Kratom leaves vary greatly in potency, depending on the type, grade, and freshness. Low doses = 2-4 g of plain dried leaf, moderate doses = 3-6 g, and strong doses= 5 g or more. When chewed fresh, half of a large leaf (8-10") is often enough to produce noticeable effects. Price •Dried, untreated leaves are available from ethnobotanical vendors for 30-80 cents (USD)/gram. Higher potency extracts may cost $2-8 USD/gram. Law •Kratom is currently uncontrolled in the United States. In 1946 it was made illegal to buy, sell, or grow in Thailand. In 2005, both M. speciosa and mitragynine were made illegal to buy, sell or possess without a license in Australia.
  • 43. Kratom Chemistry •Kratom leaves contain the indole alkaloids mitragynine, mitraphylline, 7-hydroxymitragynine, and numerous other alkaloids, including paynanthine, speciogynine, and speciofoline. Pharmacology •Mitragynine is a partial agonist of the mu- and delta-opioid receptors. This may be the reason for its apparent effectiveness in treating opiate withdrawal Production •Kratom grows wild in marshy regions in Asia and the Pacific Rim, especially Thailand, Malaysia, Borneo, and New Guinea. History •Kratom has been used in Thailand for centuries, recreationally and as an antidiarrhetic. Its was also used as an opiate substitute in Malaysia in the nineteenth century. Kratom leaves became part of the ethnobotanical trade in the United States and Europe in mid 2000. In the early 2000s, stories about the use of kratom to reduce opiod withdrawal effects began circulating on web forums.
  • 44. Kratom EFFECTS •Kratom is often described as producing simultaneous, contradictory effects- both an opiate-like sedation and coca-like stimulation. The stimulating effects tend to predominate at low dose levels, which may cause alertness, energy, and mild euphoria. Higher leveldoses are usually more tranquilizing, causing an opiate-like dreamy effect. Excessive doses can cause severe nausea. As with opium, it is known for causing constipation, and is sometimes used as a treatment for diarrhea. Onset •When taken orally, the effects of kratom usually become noticeable in 15-20 minutes and clearly apparent in 30-60 minutes. Strong doses tend to have a more quicker, more dramatic onset. Duration •A moderate dose of kratom may cause strong effects that last 2-4 hours, with residual effects lasting hours longer.
  • 45. Kratom Visual Effects •Some visual effects have been reported, including both open-eye and closed- eye effects. Effects reported include wavering, shifting, and strobing in the visual field. There was also some patterning with eyes closed, as well as increased closed-eye visualizations. PROBLEMS •Kratom is not known to be toxic, but can cause unpleasant symptoms at high doses such as nausea and vomiting. Regular use can lead to physical dependency. Kratom use can cause constipation similar to that caused by opiates. Chronic heavy use is reported to cause darkening of skin, insomnia, dry mouth, and anorexia. Addiction Potential •There are reports of physical dependency after frequent, heavy kratom use. Individuals who use it regularly or in large doses may have trouble quitting. Withdrawal symptoms include irritability, yawning, diarrhea, runny nose, and pain in the joints or muscles. •http://www.bing.com/videos/search?q=You+Tube+Kratom&view=detail&mid=EC48A0
  • 46. Kratom Online Ad http://www.ethnobotanicals.com/Kratom.html • Kratom Super Powder If you want the best of the best, as only the first Kratom supplier in the world can deliver, our Super Powder Kratom is of unrivalled potency. No need to shop around for blue light specials on garbage quality "kratom." We can guarantee that our Super Powder Kratom is the highest quality Kratom you can find anywhere! And at a great price. This powdered Mitragyna speciosa leaf is high alkaloid like the previous product but has it's own unique mix of alkaloids. It is superior to the young, cultivated leaf material which copycat sellers have tried to sell, and of course to the altogether fake "kratom" which other copycats have tried to offer. Our Kratom Super Powders are very, very fine powder, not crushed with stem bits as found elsewhere. Always in stock and ships to you TODAY! (M-F) You will love this material for your research! 25 grams / $35.95 50 grams; $69.95 100 grams / $134.95 Ships SAME-DAY if ordered by 3 PM central! Product not available to Australia, Denmark, Finland, Malaysia, Myanmar, New Zealand, Norway, Romania, Thailand.
  • 47. Meow Meow • http://www.cnn.com/video/?/video/health/2010/03/29/herriman.uk.meow.meow.drug.cnn#/vid • Other Street Names: MCat, Bubbles, Sunshine, Drone, Meph, Quat, miawo-miawo, Kitty Cat, Stardust • Chemical Name: Mephedrone (4-methylmethcathinone or 4-MMC) • Often sold as plant food/fertilizer; internet usually sells as “boutique alternative” to Miracle-Gro (plant food) • Derived from leaves of the Khat plant- leaves were chewed by Sudanese warriors to to achieve amphetamine- like high, producing an energy jolt before entering battle • Considered as new & latest designer “club” drug • Users report that it produces “the rush of cocaine with the sensory bliss of ecstasy.” • Side effect/symptoms: Central Nervous System: euphoria; anxiety, dysphoria; agitation & aggression; paranoid psychosis with both visual & tactile hallucinations; hypothermia, rigidity, & myoclonic movements; seizures Cardiovascular: tachycardia, dysrthyhmias, acute coronary syndrome, acute cardia myopathy, acute pulmonary oedema, haemoptysis
  • 48. Meow Meow • Heart palpitations, blurred vision, profuse sweating, restlessness, agitation, tightening of chest are frequently reported by users • Though little is known about mephedrone intoxication, deaths have been reported as secondary to sympathemimetic complications or when taken in combination with other substances/co-ingestants such as alcohol, ketamine, and other recreational drugs • Usually manufactured as clear/white powder but also found as crystals, capsules or pills • Powder form has been known to be incorporated into other synthetic products such as “bath salts.” • The powder form is often mixed with water & swallowed (bombed)- also can be snorted/sniffed or taken intravenously • Mephedrone has a short half life (30-90 mins) which often results in frequent “re-dosing” by users • http://www.bing.com/videos/search?q=Meow+Meow+Mephedrone&mid=AFCEF7BB6C2A6081A56CAFC
  • 49. Meow Meow • The drug’s half life is relatively short, but the side effects often last up to 4 hours • Though research is limited, indications are that it is likely first a stimulant, then inhibits the reuptake of manoamine neurotransmitters • Often causes severe peripheral vasoconstriction which some researchers believe is result of formation of highly potent vasoconstrictor, 4-methylephedrine, known to cause levels of cardiovascular toxicity significantly higher than regular ephedrine • Legal Status: purchased mainly from internet; identified as prohibited substance in Australia & illegal to import; classified as a “Class B” substance in Britian; currently legal in US • Before being banned in United Kingdom undergraduates were snorting it right off of public bars • There are at least 94 identified Facebook groups devoted to this drug • http://www.bing.com/videos/search?q=Meow+Meow+Mephedrone&mid=AFCEF7BB6C2A6081A56CAFCEF7BB6C2A6081
  • 50. Vaporizers • Heats substances to temperature at which the active ingredient will turn into a gaseous state creating a thin, fine mist containing the active ingredient (THC in marijuana) in a higher concentration than in smoke form • The mist containing the concentration of the active ingredients is captured in a small glass dome from which it can then be inhaled at any time. • When smoking, the same substance is heated past the point at which the active ingredient becomes a gas & turns to smoke. The smoke contains less of the active ingredient, but also contains many of the same harmful toxins that cigarette smoke does. • Some “non-smokers” utilize this method of obtaining the substance claiming that it is much more pleasant since there is almost no smoke or odor involved-a “purer” high. • The effects of this method can be 3-4 times more potent since the vaporizing method produces the active ingredient in a more concentrated form. • Types of Vaporizers: – Bubble- no technology involved in construction-simply place drug in bowl, heat gently & evenly until vapor or “mist” forms and rises into tube from which it can then be inhaled – Regular-can be turned on by flick of a switch, usually operates on 110 volts, compact & easy to clean – Digital-more technology involved, has convectional fan forced heating system with adjustable digital temperature control, works on 110 or 220 volts, priced considerably higher than others
  • 51. Hookahs • Hookahs—sometimes called water pipes—are used to smoke specially made tobacco that are produced in a variety of flavors (e.g., apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon). • Hookah smoking is usually done in groups, with the same mouthpiece often being passed from person to person. • Hookahs originated in ancient Persia and India , having been used extensively for centuries. • Today, hookah cafés are becoming more popular around the globe, including France ,Britain, the Middle East Russia, and the United States • Approximately 300 hookah cafés were in the United States in 2006, The numbers continue to grow contributing to an increase in hookah use most notably among youth. • Hookah is known by a number of different names, including, argileh, shisha, hubble-bubble, narghile and goza. • A typical modern hookah is made up of a head (with holes in the bottom), metal body, water bowl, and a flexible hose with a mouthpiece. Compared with Cigarettes • While many hookah smokers may consider this practice not as harmful as smoking cigarettes, hookah smoking causes many of the same health risks as cigarettes. • Water pipe smoking delivers the same addictive drug (nicotine). It is at least as toxic as the smoke from a cigarette,
  • 52. Hookahs • Because of the mode of smoking—frequency of puffing, depth of inhalation, and length of the smoking session—hookah smokers can absorb higher concentrations of the toxins found in cigarette smoke. • A typical 1hour session results in the inhaling of 100–200 times the volume of smoke inhaled from a single cigarette. • Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, which includes oral cancer, lung cancer, cancer of the esophagus, stomach cancer, as well as reduced lung function, and decreased fertility. Hookah smoking is NOT a safe alternative to smoking cigarettes.1 Health Effects • The charcoal used to heat tobacco in the hookah increases associated health risks by producing very high levels of carbon monoxide, metals, and cancer-causing chemicals. • Even though it has passed through water, the smoke produced by a hookah still contains high levels of toxic compounds . • Hookah tobacco and smoke contain numerous toxic substances known to cause lung, bladder, and oral cancers.
  • 53. Hookahs • Irritation from the tobacco juices increases the risk of developing oral cancers. The irritation by tobacco juice products is likely to be greater among hookah smokers than among pipe or cigar smokers because hookah smoking is typically practiced (with or without inhalation) for longer periods of time. Other Health Effects of Hookah Smoke • Hookah tobacco /smoke contain several toxic substances that cause clogged arteries and heart disease. • Infectious diseases can be transmitted by sharing a hookah. • Babies born to women who smoked one or more water pipes a day while pregnant have lower birth weights (at least 3½ ounces less) than babies born to nonsmokers , as well as being at an increased risk for respiratory diseases. Hookahs and Secondhand Smoke • Secondhand smoke from hookahs poses a serious risk for nonsmokers, primarily because it contains smoke from the tobacco as well as from the heat source (e.g., charcoal) used in the hookah. Using a hookah to smoke tobacco poses a serious potential health hazard to smokers and others exposed to the smoke emitted.