‘Designer Drugs’

Abstract

'Designer drugs' are substances intended for recreational use which are derivatives of approved drugs so as to circumvent existing legal restrictions. The term as popularised by the lay press lacks precision. Contrary to the popular belief that 'designer drugs' are original creations, the majority of these agents are 'borrowed' from legitimate pharmaceutical research. They merely represent the most recent developments in the evolution of mind-altering chemicals. The most extensively studied class of psychoactive compounds is the phenylethylamines (mescaline analogues). This class includes catecholamines, therapeutic agents and numerous illicit derivatives. Subtle alterations of the phenylethylamine molecule give rise to a spectrum of pharmacological properties ranging from pure sympathomimetic stimulation to primarily psychoactive effects. Although most of these compounds are only of historical interest, amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), and 3,4-methylenedioxymethamphetamine (MDMA) continue to be used recreationally. Many deaths have been ascribed to this class of compounds. In overdose the differences between these compounds blur and the clinical presentation is similar to that of amphetamine overdose characterised by tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis, agitation, muscle rigidity, and hyper-reflexia. Death usually results from arrhythmias, hyperthermia or intracerebral haemorrhage. Treatment is aggressive and supportive with careful attention to temperature, blood pressure and seizure control. Synthetic opioid derivatives, which represent the second major class of 'designer drugs', are derivatives of fentanyl (e.g. alpha-methylfentanyl, 3-methylfentanyl) or pethidine (meperidine) and are extremely potent compounds responsible for numerous overdose deaths. Attempts to synthesise pethidine have resulted in the accidental production of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a compound which is metabolised in the brain by the monoamine oxidase system to a toxic intermediate (MPP+) which selectively destroys the sustantia nigra, resulting in the rapid onset of severe Parkinsonian symptoms. Naloxone will antagonise the opiate effects of this drug class, although high doses may be required. Arylhexylamines constitute the third class of 'designer drugs'. The predominant member of this class is phencyclidine (PCP), a derivative of the anaesthetic ketamine. This unique class of psychoactive agents exhibits broad and complex pharmacological effects.(ABSTRACT TRUNCATED AT 400 WORDS)

The Common Drugs of Abuse in Hong Kong

“…Chronic usage is associated with panic attack, Obsessive Compulsive disorder, fatigue, poor concentration, depression, insomnia, restlessness and paranoid psychosis which can be indistinguishable from schizophrenia. 9 In severe case, it causes seizure, cerebral infarct & haemorrhage, coma and respiratory failure. 9 Investigation Continuous cardiac monitoring is needed, together with regular measurement of blood pressure, urine output and core temperature.…”

Analysis of Synthetic Cannabinoids Using High-Resolution Mass Spectrometry and Mass Defect Filtering: Implications for Nontargeted Screening of Designer Drugs

“…1 One family of designer drugs that has gained considerable attention recently is synthetic cannabinoids. Examples such as JWH-018, CP 47,497, and AM-2201 are commonly found in herbal incense blends sold at gas stations, “head shops,” and on the internet.…”

Declines, and Pronounced Regional Disparities, in Meperidine Use in the United States

“…Not effective oral analgesic in dosages commonly used; may have higher risk of neurotoxicity, including delirium, than other opioids, safer alternatives available. 2019 American Geriatrics Society Beers Criteria 7 Strong recommendation based on moderate quality evidence to avoid meperidine. Not effective in dosages commonly used; may have higher risk of neurotoxicity, including delirium, than other opioids, safer alternatives available.…”

“…Moreover, meperidine’s misuse potential is higher than that of many other opioids due to its rapid onset of action [6]. Attempts at home synthesis of a meperidine analogue resulted in MPTP which became an import research tool to study Parkinson’s in experimental animals [7-8].…”