The Legal Highs of Novel Drugs of Abuse

Recreational use of synthetic drugs is rising in the US and Europe, creating challenges for healthcare and law enforcement. The nature of addiction is debated as either a lifestyle choice reflecting physiological vulnerability or a chronic brain disease with epigenetic, neurodevelopmental, and sociocultural components. New compounds, often called 'legal highs,' are easily available through head shops and the web, complicating tracking and increasing intoxication risk. This article reviews pharmaco-toxicological features of common drugs of abuse, including synthetic cannabinoids, cathinones, gabapentin, acetyl fentanyl, NBOMe, hallucinogenic mushrooms, piperazines, tryptamines, salvia, methoxetamine, kratom, and performance-enhancing drugs. Due to variable effects, suspected intoxication requires symptom-guided diagnosis and specific urine and blood analysis.

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Abstract

Abstract The abuse of drugs is a widespread and growing issue, both in United States and Europe, as a number of synthetic drugs have raised popularity over the past years for recreational use. Moreover, the nature of addiction is often debated as either a lifestyle choice that may underline a physiological vulnerability, or a chronic brain disease with remarkable epigenetic, neurodevelopmental and sociocultural components. Consciousness and treatment of new drugs of abuse give challenges for health care practitioners primarily due to a lack of quantitative reports. As law enforcements struggle to ban these often referred as “legal highs”, new compounds are produced. Also, a major problem in tracking these drugs is that they are easily available through head shops, the web and other sources, therefore giving rise to a high risk of suspected intoxication. The aim of this article is to highlight the pharmaco-toxicological features of some common drugs of abuse such as central nervous system stimulants as synthetic cannabinoids, synthetic cathinones, gabapentin, acetyl fentanyl, phenethylamine called NBOMe, hallucinogenic mushrooms, piperazines, tryptamines, salvia, methoxetamine, kratom and performance-enhancing drugs. The tremendous heterogeneity of these drugs results in variable pharmacokinetic and pharmacodynamic effects, thus suspected intoxication is a priority diagnosis in order to ensure safety of patients and needs to be handled with the guide of the patient’s symptoms through specific and detailed urine and blood analysis. Keywords: Drugs of abuse; Cannabinoids; Cathinones; Salvia; Kratom; Gabapentin