12/17/14

Is a Gram Better than a Damn?

Stockfresh Image by leedsn

Stockfresh Image by leedsn

I first became aware of dietary supplements such as DMAA a few years ago. I was meeting with an individual at an outpatient drug treatment center to work out how his urine test came up positive for stimulants when he insisted he hadn’t taken any. It turns out he had been encouraged by a friend to try a pre-workout dietary supplement, “Jack3d,” that was supposed to improve his workout. The market has exploded since then with various analog stimulants being sold as “smart drugs” or brain enhancers, as well as bodybuilding, athletic and weight-loss enhancers.

Andrew Seaman on Yahoo News reported on a joint announcement from Harvard Medical School and two public health organizations of a study they conducted that found the stimulant DMBA in multiple dietary supplements. DMBA is an analog of the synthetic stimulant DMMA. In April of 2013, the FDA issued a warning that DMMA was associated with serious illness and even death. The FDA even went as far as saying to companies known to use DMAA in dietary supplements that products containing DMAA were illegal.

Compared to its authority over drugs and other medical products, the FDA has limited authority over dietary supplements. It is required to undertake lengthy scientific studies and complex legal steps to force the removal of dietary supplements that may be unsafe or illegal—IF the company refuses to remove the products voluntarily. The issued warnings are typically complied with. After the FDA’s warning about DMAA, all but one of the 11 companies stopped making and selling products containing DMAA. The one company who didn’t was the company making Jack3D.

The new concern is for DMBA, allegedly a natural product “extracted from pouching tea.”  Look at the above link for “a joint announcement” to see how similar the chemical structures of DMAA and DBMA are. Following the release of the above noted study, two U.S. senators called on the FDA to inspect products containing DMBA:

Given FDA’s existing authority, your agency should immediately launch an investigation of products containing these untested stimulants and issue warning letters to manufacturers demanding that they provide the necessary safety information. If necessary, we urge you to exercise the full range of your authority to rein in adulterated and misbranded products, which includes warning letters to facility inspections, product seizures, injunctions, and criminal prosecutions.

The problems with synthetic, analog drugs and dietary supplements are now a global concern. See other articles on Faith Seeking Understanding that address the explosion of new psychoactive substances (NPS). The analog chemical market has expanded to include so-called “smart drugs” or nootropics such as: Alleradd, Modfanil, Nuvigil, New Mood or Alpha Brain. You can find information on several different smart drugs here on the website Erowid.

Alleradd is clearly meant as a substitute for the prescription ADHD medication Adderall. As Paul Gaita noted in his article, “Brain Boosting ‘Smart Drugs’ on the Rise,” like the makers of NPS, “many smart drug manufacturers sidestep government intervention by either labeling their substance’s compounds as ‘not for human consumption’ or listing the ingredients under different brand names.” By the way, Alleradd seems to have been rebranded as OptiMind. These substances are even available on Amazon. Prescription medications beyond ADHD medications are also being used off label for increased cognitive functioning and academic performance.

Modafinil (also known by the brand name of Provigil) was approved by the FDA as a treatment for narcolepsy and other sleep disorders. But it is reported to be used by 1 in 5 students to enhance their academic performance. An estimated 90 percent of Modafinil’s users take it to increase attention, wakefulness and cognitive functioning. Armodafinil (Nuvigil) is a close cousin to Modafinil that reportedly has some benefits over Modafinil in promoting wakefulness. Airline pilots, medical personnel and others are taking  them. More information on Modafinil and Armodafinil is available on Erowid.

A new study published in PLOS One suggests that the reported cognitive enhancement of Modafinil doesn’t work with everyone. And when it does, it only helps people who are not creative.

Our study backs up previous research that suggests psychostimulants improve people at the lower end of the spectrum in cognition, whereas they impair people who are at the optimum level of cognitive function — healthy people for example.

It seems that we are increasingly moving towards a society like that portrayed in Aldous Huxley’s novel, Brave New World. The phrase “a gramme is better than a damn” in the book stood for the belief that the greatest good for the greatest number of people was to minimize any negative emotions or feelings. The question we face as we continue to move inexorably closer to a “better living through chemicals” world is this: is a gram of the drug promising to make us smarter, skinnier, or more focused worth it?

12/8/14

The New Frontier of Synthetic Drugs

In 1988, Gary Henderson, a professor of pharmacology at the University of California-Davis Medical School, predicted the coming global problem with synthetic drugs. He wrote that the scientific literature was full of potential synthetic routes and pharmacological properties for a wide variety of drugs. He said that information was readily available for “clandestine chemists” to exploit. Restricting access was not feasible and controlling the chemicals needed to make these drugs would only have a minimal effect. Henderson prophetically said:

It is likely that the future drugs of abuse will be synthetics rather than plant products. They will be synthesized from readily available chemicals, may be derivatives of pharmaceuticals, will be very potent, and often very selective in their action. In addition, they will be marketed very cleverly.

Today, news about the problems with synthetic drugs or new psychoactive substances (NPS) is hard to avoid. The parents on a 19-year-old who died after smoking synthetic marijuana started a facebook page in his memory. The governor of New Hampshire declared a state of emergency because of the overdose deaths from “Smacked,” a synthetic marijuana sold in convenience stores.

A Minnesota teen pled guilty to third-degree murder when the N-Bomb, a synthetic form of LSD, he supplied to several other teens resulted in an overdose death. The DEA reported that N-Bomb was responsible for at least 19 deaths between March of 2012 and November of 2013. A survey of 15,000 high school students in Minnesota revealed that 12% had used synthetic drugs. Minnesota has responded by launching a synthetic drug awareness website, KnowTheDangers.com. Drug WarFacts.org has a page devoted to information on NPS.

The problem is truly a worldwide one. By 2013, NPS had been identified in every region of the world. The majority of NPS worldwide were in three basic groups: synthetic cathinones, synthetic cannabinoids and phenethylamines. Together they accounted for 70% of the total number of reported NPS. See the following chart found in the 2014 Global Synthetic Drugs Assessment:

UntitledJapan introduced new laws to combat its growing synthetic drug problems. “Speckled Cross” resulted in 20 deaths in Northern Ireland. Synthetic cannabis is a growing problem in UK prisons. One prison reported that 85% of its inmates were using or supplying Spice. The chief inspector of prisons in the UK said: “What we can say for definitive is that spice is a significant problem in a number of prisons and it is rising.” DrugScope put together a status report on NPS and ‘club drugs’ in the UK.

A DEA spokesperson, Rusty Payne, called synthetic drugs the new frontier: “As chemistry and science advances, we’re seeing more and more drugs, designer drugs, new derivatives, new compounds that are making their way into the Unites States and across the world.”

Effects and Risks Associated with Novel Psychoactive Substances” gathered together helpful information on the pharmacology, clinical effects and adverse effects of the more common classes of NPS. See the original article for more details than the following summary.

Synthetic cathinones or “bath salts” can have both stimulant and hallucinogenic effects. They can cause severs intoxication. Their adverse effects include cardiovascular problems such as tachycardia—a faster than normal heart rate (22-56%), arterial hypertension (4-25%), palpitations (11-28%), dyspnea—shortness of breath (8-11%), and others. Psychiatric adverse effects include: agitation (50-82%), aggression (57%), hallucinations (27-40%), confusion (14-34%), anxiety (15-17%), and others. The psychotic adverse effects often consist of paranoia and hallucination (auditory and visual) that can persist for up to four weeks.

“Spice” or synthetic cannabinoids are much more potent, longer-acting and have worse adverse effects than THC. These adverse effects include: cardiovascular problems such as tachycardia (36-76%), arterial hypertension (10-34%), ECG changes (2-14%), chest pain (7-10%) and others. Neurological effects are present and can include: dizziness (9-24%), loss of consciousness (2-17%), somnolence—sleepiness (17-19%) and others. Psychiatric adverse effects include: agitation (19-41%), hallucinations (11-38%), anxiety/panic attacks (21%), and others.

Effects and Risks” also had some information on a phenylethylamine first synthesized in 1998, “Bromo-dragonfly.” It has a LSD-like effect that could last up to six hours. The effect includes visual and auditory hallucinations and a feeling of well-being that could last up to three days. It is highly toxic and has been associated with a number of deaths from overdose (study abstract here). A pro-drug website, Erowid, has a page of information (positive and negative) on Bromo-Dragonfly that included difficult experiences, bad trips and health problems. One report was titled: “Thankful That I’m Alive.” Probably the most disturbing piece I saw was a YouTube video, “My Bromo-DragonFLY Trip” by a young woman who sounded like she was describing an exciting, unexpected encounter while on a road trip with friends.

The 2014 Global Synthetic Drugs Assessment said it was still not clear if NPS were replacing other controlled substances. Maybe they are simply supplements to the existing bevy of drugs under international control. Then again, maybe we ain’t seen nothing yet.