Toxicological drivers issues in "legal highs" use

Abstract

The regulation and control of psychoactive substances and their precursors is constantly counteracted by the imagination, inventiveness, experimentation and targeted research that consumers/manufacturers use in order to elude the laws, which during the last few years has led to a surge in the marketing and use of these products in the context of a missing or unclear legal framework. We are witnessing an explosion in the use of some products and substances which are either new intoxicants, or have been considered benign until recently (such is the case with numerous species of plants). The legal and medical systems are currently facing conceptual problems: how to define or characterise the product of interest (considering its ubiquitous availability and marketing forms), which of its active principles should be controlled (including by-products created by spicing the basic product), which are the applicable criminal, civil or commercial laws, how to control the "rerouting" of pharmaceutical/parapharmaceutical remedies, common drugs, nutritional supplements, exotic aromas, fertilizers or spices-the so-called unconventional intoxicants. The limitations of scientific knowledge, the novelty of various psychoactive blends, the appearance of new classes of substances, the mix with different plants etc. are major impediments for the increase in the reaction time and consequently for an efficient control by the authorities. In order to provide evidence for intoxication, a certain flexibility is needed for the on-site forensic investigation, analysis of the corpus delicti (toxicology and botanics), and the clinical examination, while toxicological detection may be of support in the context of technical-scientific difficulties. Driving under influence thus becomes a challenge for the traffic safety and for the authorities or persons authorised to conduct the inquiry and limit the phenomenon. The present article aims to provide a synthesis of the current scientific knowledge on legal highs and an overview of the limitative, but also promising toxicological issues which are needed for the description of the phenomenon.

Drug related deaths between 2008 and 2011. A retrospective study in 32 Romanian counties

“…In each of these cases a "classical" illegal substance was identified during the autopsy (most often morphine, methadone or ketamine). This pattern (history of legal highs use and positive toxicology for classical drugs) may be caused by one or more of the following: (1) use of legal highs "enhanced" by the seller/producer with classical illegal drugs, (2) difficulties in the detection of most legal highs using current techniques and apparatus, (3) legal highs were added by the addicts to their usual mix of classic illegal drugs [16].…”

“…DRDs associated with legal highs were not identified. However, there have been cases in which a history of legal highs use was obtained [16]. In each of these cases a "classical" illegal substance was identified during the autopsy (most often morphine, methadone or ketamine).…”

“…By only comparing the first ten months, the difference is also extremely high (70 cases in the last ten months of 2010). The most likely explanation is an increased use of legal highs (herbal highs, "legal" drugs) [15][16][17][18], but better preventive measures may play a part as well. DRDs associated with legal highs were not identified.…”

Prevalence and Drug Consumption Habits at the 2011 Peninsula Festival in Tîrgu Mureș

“…herbals with narcotic, psychotropic, psychedelic, "entheogen", hallucinogen or psychomimetic properties: Salvia divinorum, Mitragyna speciosa, Amanita muscaria, Psilocybe). Spicing of herbal products is common practice in the marketing of legal highs: a dried and ground herbal product is "spiked" with psychoactive synthetic substances, (Ketamine, Piperazine derivatives, Mephedrone) which are not on the list of controlled substances [2]. In this paper we will use the term "ethnobotanicals" limited to this (rather artifi cial) sense of herbals with mindaltering properties [3].…”

Challenges to Forensic Medicine in the Postmodern Era the Impact of the New Technologies

“…Overall, advantages of new technologies in forensic toxicology concern various aspects such as: improvement of ruggedness which made it useful in hair analyses, blood and soft tissues; decrease in the time required for analysis; simpler and faster procedures due to the new designs of the software; increased veracity of the findings; increase in the resolution and precision; decrease in the limit of detection; possibility to widen the expertise of the toxicology laboratory due to better quality of the sample and, finally, increased reliability of the evidences provided to justice (Smith et al, 2007;Gorun et al, 2010).…”