Novel Psychoactive Substances- Not for Human Consumption 2014 Dr Duncan WA Stewart Consultant Addictions Psychiatrist

Content What are they and how they are distributed Concerns and problems Theo Shulgin Useful resources questions

What Are they ? Substances that mimic the effects of illegal drugs of abuse but are not (at present) covered by the Misuse of Drugs Act 1971. Chemical structure related to heroin, cocaine, cannabis, amphetamines, ecstasy, benzodiazepines, LSD. Illegal if sold for human consumption. Referred to as plant food, bath crystals, or pond cleaner.

What are they Synthetic stimulants Synthetic cannabinoids Synthetic hallucinogens Synthetic depressants

How are they sold ? Internet Head shops No legislation covering them if not for human consumption

Concerns and Problems IV use Psychological effects- highs and lows Systemic toxicity- hyperthermia, hyponatraemia and serotonin syndrome Rapid turnover of substances No testing Products can change constituents

Case review of patients reported mephedrone ingestion. Mephedrone toxicity in a Scottish emergency department (Regan et al 2011) Case review of patients reported mephedrone ingestion. 89 cases out of 20,712 ED cards reviewed over a period of 5 months. Mean age 19.8 years. Reason for ingestion was ‘wanting to get high’ in 85% and in 10% as part of their addiction. 68% reported ‘friends’ as source of mephedrone, clubs in 16% ,street in 8%, dealers and internet in 4% each.

Mephedrone toxicity in a Scottish emergency department

Alexander Shulgin ’65- left Dow to persue own research agenda Worked for the DEA Held DEA schedule 1 licence ’76- developed synthesis of MDMA and distributed to psychologists Married Ann in ’81 ‘Shulgin Rating Scale’- developed to document effects of hundreds of compounds self tested by Sasha and friends

Alexander Shulgin 1992 published ‘PiHKAL. A chemical love story.’ Over 150 phenylethylamines made and tried DEA spokesman-”those books are pretty much cookbooks on how to make illegal drugs.” Highlighted other classes of drugs likely amenable to synthesis and development : namely indoles, tryptamines and phenylethylamines

Useful websites www.talktofrank.com www.crew2000.org.uk- Drugs A to Z section useful. Also general advice. www.Erowid.org- more comprehensive American website for ‘Psychonauts’. Local Aids- no 134 New Psychoactive Substances. Available on Lothian Intranet