Designer Drugs Bath Salts? Plant Food? - PowerPoint Presentation

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Designer Drugs

Bath Salts? Plant Food?

Amy Miles

Advanced Chemist

WI State Lab of HygienePhone: 608-224-6244amy.miles@slh.wisc.edu

Jennifer Messick

Traffic Safety Resource Prosecutor

(907) 343 6434

messickj@muni.org

Thank you:

Anchorage Police Department

Alaska Highway Safety OfficeSlide3
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Objective

Increase Officer Safety

Increase DUI detection and prosecution by providing comprehensive information about some of the most common Designer Drugs and how they differ from traditional drugsSlide5

What are “Designer Drugs”?

“

a drug produced by a minor modification in the chemical structure of an existing drug, resulting in a new substance with similar pharmacologic effects, especially one created to achieve the same effect as a controlled or illegal drug” - (dictionary.com)Slide6

Designer Drugs - Interpretation

Designer vs. Rx

DRE InformationLimited scientific referencesPolice reportsDRE observationsTox report may not = impairmentTox report may not = presenceSlide7

Designer Drugs

covered in this presentation:

Synthetic CannabinoidsSpice/K2 (Marijuana)2. Cathinone Derivatives Bath Salts / Plant Food

(cocaine, ecstacy, meth)

3. 2C- family

(Hallucinogen)

4. KrokodilSlide8

Road Map

For Each Drug:

General Identification

Marketing, packaging, history Methods of ingestion

Common signs/symptoms, case exampleDetection: NIC, blood, urineLegal StatusOfficer Safety Slide9

What is

SPICE / K2

?

Dangerous, synthetic research chemicals

that have been dissolved in acetone and sprayed onto dried plant materialSlide10

SPICE / K2

Marketed as incense

Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)

Smoked, mixed in drink, injectedSlide11
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SPICE / K2

Marketed as incense

Smells nasty (watermelon, vanilla, rootbeer, tropical, etc)

Smoked, mixed in drink, injectedSold LEGALLY and LOCALLY (well, kind of)1g -3g packages$25 - $40 / g (about 2x price of pot) 1 pkg = 3-5 doses

Used since about 2007Slide13

SPICE / K2

Ingredients: Baybean, Blue Lotus, Lion's Tail, Lousewort, Indian Warrior, Dwarf Scullcap, Maconha Brava, Pink Lotus, Marshmallow, Red Clover, Rose, Siberian Motherwort, Canavalia Maritime, Leonotis Leonurus, Leonurus Sibiricus, Pedicularis Densiflora, Scuttellaria Nana, Vanilla Planifolia, Zorinia Latifolia, Magnolia Officinalis, Rosa Gallica, Trifolium Slide14

Brands/FlavorsSlide15
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John W. Huffman

-

Clemson UniversityFirst to synthesize delta-9 analogues in 1984450+ different typesSold in Germany around 2007"I figured once it got started in Germany it was going to spread. I'm concerned that it could hurt people," Huffman said. "I think this was something that was more or less inevitable. It bothers me that people are so stupid as to use this stuff

".

JWH – The Life of the Party….Slide17

Motor control

Cognition, memory, perception, learning endocrine function, food intake, body temp regulation

Motor control, learning, action selection

Cerebral Cortex

Higher cognitive function

Medulla

Nausea, vomiting

Hypothalamus

AppetiteSlide18

Synthetic Marijuana

CB

1 receptorsExpressed mainly in the brain, CNS, muscle, liver, lungs, kidneyCB2 receptors

Expressed in the immune system, evidence of location in the brainCB receptors are activated by three main groups

EndocannabinoidsPlant cannabinoidsSynthetic cannabinoidsSlide19

Missouri Human Dosing Study

6 subjects (one dose 2x) over two days

2 female, 4 maleAllowed maximum of 2 “hits” Blood, urine and oral fluid samples

Each subject (but one) commented they would “hit” againFive of the six subjects reported previous experience with synthetic cannabinoidsSlide20

Missouri Human Dosing Study

Male, 39 yo, 5’10”, 190#

No drug historyFirst time user

Parameter

Pre-dose

Post-dose

Blood Pressure

124/80

140/88

Highest Pulse

72

116

Body Temp

97.8

98

Draeger 5000

Neg

Neg

Urine Dip Test

Neg

NASlide21

Missouri Human Dosing Study

Pre-dose

Post-dose

Attitude

cooperative

cooperative

Coordination

normal

jittery

Speech

normal

normal

Breath

normal

normal

Face

flushed

red

Eyes

normal

bloodshot

Pupils

equal

equal

Follow stimulus

Yes

Yes

Eyelids

normal

normal

Tracking

equal

equalSlide22

Missouri Human Dosing Study

DRE

Observation

Pre-dose

Post-dose

HGN

None

None

VGN

None

None

LOC

None

Present

Body Tremors

None

Present

Pupil Size

5.0/7.5/5.5-6.5

5.0/8.0/4.5-5.0

Rebound dilation

None

Present*Slide23

Missouri Human Dosing Study

WAT

Lack of coordination, balanceRaised arms

Stepped off the lineOLSSway, used arms, put foot down, leg and body tremors

RombergSway – 2inch front to back, 1inch sideEstimated 30 seconds in 37FTNQuick and lethargic movements, 6 errorsSlide24

Missouri Dosing Study

University of Central Missouri

Bob WelshTracey DurbinNMS LabsDr. Barry LoganSlide25

Symptoms

Not always a bad trip, but if you’re involved it probably is

Elevated BP

(140-210 / 100-110)

Tremors / SeizuresUnconsciousnessHallucinations / Delusions / Paranoia / AnxietyNumbness / TinglingSlide26
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Symptoms

Not always a bad trip, but if you’re involved it probably is

Vomiting

Memory Loss Incoherent/slurred speechUser may feel cold6-8hr high

(some effects up to 30hrs)

Death??

APD#10-14949

3 raised medians, 2 concrete retaining walls, broken axle, flat tire, driving sidewalk

6HGN + VGN

.000 BrAC

Slurred/incoherent

“Death all around”

Going to kill officerSlide28

DETECTION OF SPICE/K2

(NIC negative for pot)

Blood

(NMS) $195Within 6-8 hours; can detect some JWH compounds Can’t detect all compoundsScreen + confirmation / quantitationImpairment vs particular level of drug

Urine $35 - 50

Within 3 days; can detect some JWH compounds

Cannot detect all compounds

(LC / Tandem MS normally used)Slide29

Spice

v.

POT?

Blood shot / Red eyesMaybe HGN / VGNLack of Convergence+- Normal Pupil sizeNormal light reactionTemperature ↓

or

normal

Blood pressure

↑

or

↓

+- Rigid muscle tone

Blood shot / red eyes

No HGN / VGN

Lack of Convergence

Dilated Pupils

Normal light reaction

Temperature normal

Blood Pressure

↑

Normal muscle

toneSlide30

Which category??

Million Dollar Question:

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DRE MATRIX

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What is Everyone Else Doing About It?

ILLEGAL

In most European and Scandinavian countries

Still Legal in Canada25 States in US + MilitaryProblems with legislation and analog compounds ready to goSlide33

What is the U.S. doing about it?

DEA Emergency Ban

- Sch I (JWH-018,JWH-073, JWH-200 and CP47-497) - Sell or possess

- Became effective when published in CFR (3/1/11) - Remains in effect for 12 months - Can be extended 6 monthsSlide34

11078 Federal Register

/ Vol. 76, No. 40 / Tuesday, March 1, 2011 / Rules and Regulations

PART 1308 - SCHEDULES OFCONTROLLED SUBSTANCES

§ 1308.11 Schedule I.* * * * *(g) * * *(1) 5-(1,1-Dimethylheptyl)-2-[(1R,

3S)-3-hydroxycyclohexyl]-phenol, itsoptical, positional, and geometricisomers, salts and salts of isomers—7297 (Other names: CP–47,497)(2) 5-(1,1-Dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol, its optical

positional, and geometric isomers, salts

and salts of isomers—7298 (Other

names: cannabicyclohexanol and

CP- 47,497 C8

homologue

)

(3) 1-Butyl-3-(1-naphthoyl)indole, its

optical, positional, and geometric

isomers, salts and salts of isomers—

7173 (Other names:

JWH–073

)

(4) 1-[2-(4-Morpholinyl)ethyl]-3-(1-

naphthoyl)indole, its optical, positional,

and geometric isomers, salts and salts of

isomers—7200

(Other names:

JWH–200

)

(5) 1-Pentyl-3-(1-naphthoyl)indole, its

optical, positional, and geometric

isomers, salts and salts of isomers—

7118 (Other names:

JWH–018 and AM678

)Slide35

What is the law in my State?

Traffic Safety Resource Prosecutors

Contact Jenn to find out who your TSRP ismessickj@muni.org (907) 343 6434

National Traffic Law Center (NTLC)

http://www.ndaa.org/apri/programs/traffic/ntlc_home.html#crash Slide36

Solid DUI Cases

(

The Defendant

is

your Crime Scene) Can I arrest for DUI?Impairment vs Controlled Substance Even if legal, may still be DUIDetail / describe observations

Smell (or lack of)

Hear – speech, statements, admissions

Turn on Recorder

(if permitted)

Get

Blood

Can I prove the charge without blood?

If it comes back

‘nothing detected’

is my case sunk?Slide37

Officer Safety

Unregulated mixture of you name it

(higher potential for overdose)

Mixed / Unpredictable symptomsYou are the frontline – Be Careful!

Acetone is flammable! Slide38

Officer Safety

Be Aware

Wear Gloves If ‘incense’ burning in home, re-evaluate

Call / wait for back-up Exposure Report? Call medics / poison controlPoison Control 1-800-222-1222Slide39

Cathinone Derivatives

What are Bath Salts?Slide40

It’s all about the bath right?Slide41
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This is what we mean. . . Slide43

What are Bath Salts?

Cathinone Derivatives

Synthetic drugs – stimulant, similar to ecstasy, cocaine and/or meth“Not for human consumption”

White, odorless, “pills”, fine-grained powder or crystals (oxidizes to yellow or tan)Slide44

Cathinone Derivatives

KhatSlide45

Cathinone Derivatives

Mechanism of Action

CathinoneInduces release of dopamineSimilar to amphetaminesSimilar in structure to bupropion, methcathinone, diethylpropionCatecholamine release“Fight or flight” hormonesSlide46

Name

R

1

R

2R3

R

4

R

5

Mephedrone

Methyl

H

4-Methyl

H

H

Methylone

(

β

k-MDMA)

Methyl

H

3,4-Methylenedioxy

H

H

Butylone

(

β

k-MBDB)

Methyl

H

4-Methyl

Methyl

H

Pyrovalerone

{

pyrrolidino

}

4-Methyl

Ethyl

H

MDPV

{

pyrrolidino

}

3,4-Methylenedioxy

Ethyl

HSlide47

Cathinone Derivatives

Homologues

Analogues

VS.Slide48

MDPV

Marketed as

“Bath Salts” and “plant food”

CNS stimulant (3-4 hrs)Chemical analog of Cathinone (Sch 1 C.S.)NOT Controlled SubstanceDetectable in blood and Urine (special test)Not to be confused with MDMA “ecstasy”Slide49

Common Packaging

Plastic jars or foil packets

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Case Examples

APD#11-1234- Stopped at green light- Clumsy, poor dexterity

- Sluggish speech, no odor alcohol- 2 HGN, 4 WAT, 4 OLSEyes non-reactive to light

* Blood positive MDPV APD#11-1234Wrong way / one way, curb, sidewalk, yards, pedestrian, eluding, multiple LSADelusion Marshalls after him (tow truck driver)Small jar white powder, NIC positive cocaineSyringe, pipe

Normal pupils, no HGN

*Blood positive MDPVSlide51

Snort What?Slide52

Plant Food = MephedroneSlide53

Mephedrone

“Plant fertilizer”

and “bath salts”Chemical analog of Methcathinone (Sch 1) More common in “plant food”Slide54
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Common PackagingSlide56

Methods of Ingestion

Snorting

– onset quickOral - onset 15 – 45 minInjectionSmoking

– onset quickAtomizingEffects 6+hrs

* Rush of ecstasy, no hard come-down* Binges for several days or even weeks*Also used as cutting agent for methSlide57

Bath Salts / Plant Food

Legal in US

(well, sort of) Illegal in Canada (but we love the internet)Available gas stations, truck stops, head shops, tattoo parlors 50 – 500 mg

$20 - $50DEA “drug of concern”Different than 2-CE Slide58

Case Examples

Welfare check: uncontrollable, non-compliant, taser used, little effect

PennsylvaniaFidgety, talking fast, no pain, invincible, likened to coke OD, used with meth, couldn’t perform SFST

Broke window, jumped through glass door, jumped on hood of patrol car, rolled off into fetal position, incoherent.

Pennsylvania3 days intermittent delirium, slit throat, shotgun LouisiannaSoldier, 3 tours, speeding on freeway, eluding, shot wife in car; vehicle, pockets, house loaded with bath salts, both blood positive for MDPV. SeattleSlide59
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Case 1: Domestic Bliss

Sgt Aaron Watson, Nebraska State Patrol, Ogallala NESlide61

Case Study #1

DV - H discharges shotgun in home

Marijuana & bath salts found in homeH&W admit to using bath salts & marijuanaSlide62

“Ladies First”

Defendant Statements

She has a Rx for appetite stimulants but hadn’t taken it in 10 daysSnorted bath salts ~10 a.m. day prior

Snorted again around 1:00 p.m. Snorted again between 9 p.m.-12:00 a.m. Makes her talkative

Causes some hallucinationsSlide63

Admissions

Effects of bath salts last about 4 hours

Like drinking red bulls, but not quite like methBurns nostrils, but not as bad as meth. Not numbing like cocaine

Euphoric, not excessiveIncreased alertnessBelieves bath salts caused H violent behavior

ObservationsIrritable,restless,and runny nose Dazed appearance, paranoia, sweatingPoor perception of time and distanceEye / body tremorsBlisters on tongueWhite residue in noseSlide64

Case #1 – DRE SFSTs

OLS

Swayed

Used arms for balancePut foot downTremors

Romberg Balance

2 in front/back sway

Eye tremors, constant twitching

Estimated 30 sec in 33

Finger to Nose

Missed tip 5/6 times

Slow reaction time

Eyelid tremors

Swayed throughout testSlide65

Case #1

HGN

NONE

VGN

NONE

Lack of convergence

PRESENT

Pupil size

RM: 5.5, DRK: 9.0, DL: 4.0

Reaction to light

SLOW

Pulse

104, 106, 98

Blood Pressure

152 / 112

Body Temp

98.4

Muscle Tone

NEAR NORMAL

DRE Opinion: CNS Stimulant & CannabisSlide66

Urine collected

Ethanol: None detected

Drugs:MDPV (Methylenedioxypyrovalerone)Diphenhydramine

LidocaineCannabinoids

Toxicology resultsSlide67

Case 2: “Too Much of a Good thing”

Ofc Mitchell, Marietta PD, Marietta, GASlide68

“The Better Half”

Initial Observations

21 year old male brought in to ER overdosing on unknown drugRestless, Visible body tremorsTalkativeAnxious, paranoid, hallucinations

Slurred speechDry, cracked lipsClenching fists to the point of causing bleeding

Very alertBruxismRedness to nasal passageSlide69

Case Study #2

Father says son has been acting that way for 2 days

Gives officer empty packets labeled “B – invigorating bath salts – 500 mg“Father says he found 6-8 empty packets empty in his roomSlide70

“Too Much of a Good Thing”

Subject Statements

Subject yells “It is legal!” Subject purchased from a head shopDirections are to mix it into a drink and ingest it orally, but he snorted about half the bagSlide71

“Too Much of a Good Thing”

DRE Observations

While speaking to the subject he was banging his head into the wall and not even noticing itPulls out IV twiceRestraints orderedWhile being restrained, he began to hallucinate and asked security if they drank the rest of the beerSlide72

DRE Evaluation – Day 1

HGN (in hospital bed)

Lack of smooth pursuitPossibly due to restlessness, unable to appropriately follow stimulusSlide73

DRE Evaluation – Day 1

Pulse: 112 bpm

Blood Pressure: 144/94Body Temperature: 98.5Pupils: 9 – 10 mm in all lighting conditionsMuscle Tone: RigidDRE Opinion: CNS StimulantSlide74

“Too Much of a Good Thing”

DRE Observations – Day 2

Took 3 doses of Lorazepam and 1 dose of Haloperidol to get subject under controlTransported to ICUWhen he awoke the next day, he was violent again12 people restrain him; injures security guardSlide75

“Too Much of a Good Thing”

DRE Observations – Day 3

DRE interviews subject again on day 3 Subject is sleeping with a resting pulse of 120Subject states he is exhausted, body hurts, struggling to stay awakeSubject has no memory of who DRE was or ever talking to himSlide76

Toxicology Results

Hospital urine sample

All testing negativeWhy?Type of screenTarget compoundsLack of metabolites identifiedHospital screen vs. toxicology lab testingSlide77

American Association

Synthetic Cannabinoids

All of 2010: Total of 2,874 callsJan – May 12, 2011: 2,052 callsBath saltsAll of 2010: Total of 298 calls

Jan – March, 2011: 1,241 calls9 Deaths reported in U.S. with more suspected (52+ in EU)Slide78

TESTING

Cathinone Derivatives

Sodium Nitroprusside Reagent (NarcoPouch)Turns blue-purpleMDPV, Mephedrone, Methylone, 4-fluoro (Flephedrone), 3-fluoro , 3-methoxymethcathinoneSlide79

TESTING

Cathinone Derivatives

Scott’s Reagent (Nik Test)Blue positive reactionMDPVCocaine, Methadone, Ketamine, Procaine and Lidocaine will also cause a positive reactionSlide80

TESTING

Cathinone Derivatives

Marquis ReagentBright yellow positiveMDPVDiphenhydramine will also cause yellow reactionSlide81

Legal Status

EU, Australia, Canada and Israel = illegal

Federal: MDPV and Mephedrone not approved by FDA, but not controlled by DEA yetSen. NY introduced federal legislation to add to Sch. 1 (February 2011)Slide82

Legal Status

13 States

Contact your TSRP to find out legal status in your stateSlide83

Cathinone Derivatives – Nationwide Legislation

(April 2011)Slide84

Phenethylamines

-2C Group “Tripstacy”

(Hallucinogen, + /- Stimulant)Made by brilliant guy who just loved drugsSlide85

Ok, a Scary, Brilliant GuySlide86

Phenethylamines

-2C Group “Tripstacy”

(Hallucinogen, + /- Stimulant)2CB – Sch I Often with MDMA to prolong highOn set 20min – 1 hourLasts 4 -6 hours (longer with X)

2C-E Legal in USAnalog of 2C-B, 2C-T7 & mescaline?Slide87

2CI

Illegal in UK, legal US

Stronger than 2CBLasts longer, 8hrs +Effects similar to LSD+MDMA without being chattyWhite powder / pillsUPD#11-1234

No HeadlightsDisjointed response / slow, slurred speech1000 yard stare

Seeing ‘tracers’No HGN, 7 WAT, 3 OLSUser reports effects last 6-12 hrs (contact was 7hours after ingestion)Slide88

Krokodil / Crocodile

Majority of case reports out of Russia

Desomorphine – first synthesized in the 1930’sAlternative to morphine, shorter lastingManufactured from OTC codeine using industrial chemicalsLack of clean up during synthesis leads to injection of iodine and other metalsShut down of endocrine and immune systemsSlide89

Officer Safety

Unknown substance:

They’re all white powders! Unpredictable Behavior: They all act crazy!Slide90
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Officer Safety

Unknown substance:

They’re all white powders! Unpredictable Behavior: They all act crazy!Glove up

Exposure ReportSlide92
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Thank you!

If you have additional information to contribute, or if you would like to schedule this presentation or get a copy of this Power Point,

please contact

Jenn Messickmessickj@muni.org907 343 6434

Questions / comments / feedback WELCOMEDSlide94

Salvia PlantSlide95

Saliva Flowers

Blue Salvia

Red Salvia

Purple SalviaSlide96

Dried Leaf PackagedSlide97

SeedsSlide98
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Piperazines - BZP

(Schedule I)Stimulant“PEP, Majik, Frenzy” Releases dopamine and seratonin Often sold as “dietary supplement”

No dietary valueNot a “natural” productLasts 4-8 hoursHas not been found to occur naturally

CASE STUDYSpeeding, delayed yieldPtosis, constricted pupils, 2 HGN (unable to complete) 3 WAT, 4 OLSCocaine and beer in carD falls asleep in cruiserBlood: carboxy, DXM, BZP, TFMPP, AlprazolamSlide101

Phenazepam

(Legal in US, not controlled)

CSN DepressantTaken in place of Alprazolam, Clonazepam and DiazepamBenzodiazepines are generally Schedule IV substances

CASE STUDYLSA with semi, hits tree, slumped across seat, SFST’s limited for safety (on backboard)

6 HGN + VGN, slurred speechBlood: positive phenazepamSlide102
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