Thursday, September 26, 2013

Club Drugs

Club Drugs
-Dr. Jeff Daiter

This was a lecture at the Canadian Society of Addiction Medicine Annual Meeting at the Hyatt Regency in Vancouver, BC Canada, Sept 26, 2013.  It was one of the most helpful presentations to me by a very impressive clinician and researcher.  All of us in front line addiction work encounter a deluge of names for street drugs and these recent new psychoactive drugs are the most trying. I'd heard more about them at a conference in Milan where the International Society of Addiction Medicine had a meeting and these drugs for a major concern for regulators. The danger to children was a major concern. I am sorry for my rough notes which only give a just of the excellent presentation by Dr Jeff Daiter who had superb slides which I wasn't able to copy due to time.  I hope this is helpful nonetheless.

Old def’n ‘designer drugs - 1980’s mdma
New term ‘Club Drugs”
  • included GHB,

  • late 1990’s marketeers of psychedelics becuase they could import ‘research’ materials from china

-uses unscheduled to imply legal for improved credibility

-psychoactive illicit drugs
  • ecstacy, methamphetamine, GHB, flunitrazepin

-Dr. Alexander Shulgin - original psychonaut - first venture - he did mescaline
  • introduced MDMA to Psychologists in late 70’s - unlock the Human Mind through Psychedelics.
  • psychostimulants
  • 4-mma and methyl-Ma;2,5 - dimethoxy-d-iodophenethylamine 2C1

he calls himself a ‘toolmaker’

in low doses increases alertness and endurance
-in higher doseses, they induce euphoria, stronger feelings of self -esteem, increased blood pressure, raised body temp, increase heart rate, cause hallucinations
  • we don’t see MDMA so much but the 200 other drugs of this class that are not illegal, not yet
  • Chronic use can entail psychosis

-first in 1953, big in new zealand
  • used first for anthelmintic properties
  • most common BZP, TFMPP and mCPP
  • euphoric and stimulant properties comparable to amphetamines

  • true dissociative
  • veterinarian use
  • k, special k, kit kat, cat valium, vitamin k, super k, 
  • originally developed as derivative of phencyclidine (PCP) drug controlled under Schedule II of the 1971 convention
  • -used primary for induction and maintenance of anesthesia in animals
  • K-Hole video
  • people taking K are trying to get to the K Hole -lots in down town toronto

alpha O, foxy methoxy, AMT
-effects similar to to magic mushrooms 

Plant based NPS
-Kratom  - investigated for opium dependence - stimulant at low dose and sedative at high - withdrawal may inculde muscle aches, irritability, crying, runny nose, diarrhoea, muscle jerking

Synthetic Cathinoes
  • most problematic group of NPS from perspective of pblic safety and health
  • stimulations simiar to amphetamines 
  • have all kind of adulterants
  • guy in ontario was eating live dog

Bath Salts is most unscheduled drugs getting hits on Google
Charting by Google trends

Synthetic Cathinoes have high abuse and addiction potential - but lots of unknown ingredients

Synthetic Cannabinoids
 J.W. Huffman - JWH-018  - categorized and published them and now people know how to make them - synthesized over 450 cannabinoids - organic chemist
Spice and K2 big names 2 years ago
Now called all sorts of different things - chill out
You can order off the internet

“It’s a legal high”.

Hard to engage someone in treatment - they say they’re not chasing it, 

3 deaths in Colorado due to synthetic marijuana -75 people sick
Probably not the cannabinoid that kills but what is mixed in with it in the laboratory

Synthetic Cannabinoids
Synthetic Cathiones

new emergency drugs

The mix in review - phethylamines, piperazeins, ketamines, typtamines, plant based, synthetic cathinoes, synthetic cannabinoids

Qand A
testing - seeing a lot of MPTP - metabolite of Trazadone

A- laboratory can’t keep up with what’s being used

MDMA - keeps being made with combination - toxicology - drugs by themselves may not be so bad as the combination - methedrone  - deaths in ICU

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