Designer drugs 2015: assessment and management
Addiction Science & Clinical Practice March 11, 2015 Michael F. Weaver, John A. Hopper, Erik W. Gunderson 135 citations
Designer drugs, marketed as 'legal highs,' include substituted cathinones (e.g., mephedrone, methylone, MDPV), synthetic cannabinoids (e.g., Spice), and synthetic hallucinogens (e.g., 25I-NBOMe). Their availability changes rapidly to evade legal controls and detection. Young adults are the main users, with growing use in the military. Acute toxicity frequently causes severe psychiatric and medical effects such as anxiety, agitation, psychosis, and tachycardia, and deaths have been reported for each drug type. Clinicians should consider these drugs when evaluating substance use in young adults or patients with acute neuropsychiatric symptoms. Treatment of acute intoxication is supportive, while long-term treatment of designer drug use disorder lacks evidence-based guidance.