Designer drugs 2015: assessment and management
Addiction Science & Clinical Practice – March 11, 2015
Source: OpenAlex
Summary
Multiple deaths have occurred from designer drugs, including Mephedrone, synthetic hallucinogens, and synthetic cannabinoids. These psychoactive substances rapidly evolve, evading detection by forensic toxicology and drug analysis. Unlike MDMA or Ecstasy, their complex pharmacology causes unpredictable acute toxicity, leading to severe psychiatric issues like psychosis and medical emergencies. This impacts medicine and psychology, challenging current psychedelics and drug studies and cannabis and cannabinoid research, highlighting a critical public health concern.
Abstract
Recent designer drugs, also known as "legal highs," include substituted cathinones (e.g., mephedrone, methylone, and methylenedioxypyrovalerone, often referred to as "bath salts"); synthetic cannabinoids (SCs; e.g., Spice); and synthetic hallucinogens (25I-NBOMe, or N-bomb). Compound availability has evolved rapidly to evade legal regulation and detection by routine drug testing. Young adults are the primary users, but trends are changing rapidly; use has become popular among members of the military. Acute toxicity is common and often manifests with a constellation of psychiatric and medical effects, which may be severe (e.g., anxiety, agitation, psychosis, and tachycardia), and multiple deaths have been reported with each of these types of designer drugs. Clinicians should keep designer drugs in mind when evaluating substance use in young adults or in anyone presenting with acute neuropsychiatric complaints. Treatment of acute intoxication involves supportive care targeting manifesting signs and symptoms. Long-term treatment of designer drug use disorder can be challenging and is complicated by a lack of evidence to guide treatment.