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Designer drugs are synthetic compounds that contain modified molecular structures of illegal or controlled substances. They are produced clandestinely with the intent to elicit effects similar to controlled substances while circumventing existing drug laws. Two classes of designer drugs that have risen to recent prominence are "spice," synthetic cannabinoid receptor agonists that mimic the effect of tetrahydrocannabinol, the active ingredient in cannabis, and "bath salts," synthetic cathinones, stimulants structurally related to amphetamines that have effects similar to cocaine and methamphetamine. Although these substances have only gained prominence recently, service members of the U.S. armed forces have not been immune to spice and bath salt abuse. These substances are often perceived as safe and are available via the Internet, in head shops and from dealers. Spice and bath salt abuse is increasingly associated with serious medical and psychiatric problems. Military health care providers must be familiar with these important new classes of drugs. This article discusses the background, current civilian and military legal status, clinical effects, pharmacology, and clinical management of synthetic cannabinoid receptor agonists and synthetic cathinones.

This study tested the hypothesis that inpatient/residential treatment for PTSD associated with military duty should result in significantly lower PTSD symptoms at patient discharge compared to patient intake. Meta-analysis of effects comparing intake and discharge PTSD symptoms from 26 samples, reported in 16 studies, supported this hypothesis (d = -.73; p < .00001). Moderator analysis indicated between-study variation in PTSD symptom changes was predominantly due to the type of measure used, with the Clinician Administered PTSD Scale producing the largest effect (d = -1.60). Larger effects were also observed for more recently published studies and studies with larger percentages of females. These findings support the efficacy of inpatient treatment for military PTSD, although a causal factor for effectiveness could not be identified. Further, the results indicate between-program comparisons of symptom reduction require the same measure of PTSD. (PsycINFO Database Record

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