Dr Mark Ryan, the director of the Louisiana Poison Centre, has never seen a worse drug crisis than the one which has gripped the United States over the past two years. Dr Ryan, who has been at the frontline of the drug war for 20 years, says the rise of the synthetic drug trade poses unprecedented problems.
Bath Salts, or Toilet Cleaners, are crystalized chemicals produced in laboratories. They are usually snorted and contain two powerful stimulants: methylenedioxypyrovalerone (or MDPV) and mephedrone, which mimic the effects of cocaine, LSD and methamphetamine. The products have been sold on the internet, at gas stations and head shops. They are known by a variety of names, including Red Dove, Cloud Nine, Purple Wave and Bliss. Physicians generally treat overdoses with anti-anxiety medication such as Valium and Xanax, which eases the drug-fuelled activity in the brain and body.
Bath Salts are the second wave of synthetic drugs to hit the US. Last year, the synthetic drug of choice was fake marijuana, which is marketed under brand names such as Spice, K2, Skunk and Zohai. It is made by spraying dried plant material with one of several synthetic cannabinoids, such as cannabicyclohexanol, JWH-018, JWH-073, or HU-210. It is packaged to look like pot and smoked, but the effects are different.
The American market for synthetic drugs has exploded at breakneck speed. In 2010, there were 2,915 calls about synthetic marijuana to the US’s 57 poison centres, but this year there had already been 5,741 calls by October 31. Bath Salts were a relatively rare commodity in 2010, with just 303 calls, but have become as common as synthetic marijuana, with 5,625 calls by October 31.
When the first cases involving Bath Salts arrived in Louisiana last September, Dr Ryan was at a loss to understand the symptoms. There had only been a handful of cases around the US at that time, but in Louisiana the numbers soared suddenly. In December 2010, Louisiana, which has a population of 4.5 million, had 61 percent of Bath Salts’ cases reported to US Poison Centres.
Louisiana Police also reported encounters with people suffering from bizarre types of psychosis.
Dr Ryan contacted colleagues at other US Poison Centres, but most of them were still in the dark. He found himself almost alone in the United States fighting a new drug phenomenon and turned to European research for answers. Europe was where the first synthetic drugs had emerged in 2007. What Dr Ryan learned about the substances made him realise the urgency of getting a state ban on the substances in Bath Salts, or synthetic cathinones.
By the end of 2010, Louisiana had counted 172 cases of Bath Salt poisoning, including the first death, and there had only been 303 cases all over the US. Louisiana State Police had their eye on a small number of manufacturers who were making heaps of cash, around $150,000 a week, but there was nothing legally that could be done to stop them.
“We talked with health officials and state legislature, and we said we can’t wait for new laws in spring or summer. We need something now,” said Dr Ryan. “Credit has to go the governor and state officials because they acted quickly and Louisiana passed the first comprehensive ban on synthetic cathinones on January 6, 2011.”
The ban had an immediate effect. The Bath Salts started disappearing from grocery stores, gas stations and head shops in Louisiana. The problem has not gone away, but the Louisiana Poison Centre is getting 8-11 calls a month now, which is just 1 percent of calls in the US.
Florida was the next state to issue a ban. Worried about teens arriving for Spring break, officials quickly consulted with the state of Louisiana, then outlawed the same six substances. Some other US states followed suit, but too many were slow to react and their problems got worse.
More horror stories emerged from around the US. They ranged from the tragic to the utterly bizarre, but each one involved hallucinations and psychosis. In Kentucky, a mother high on Bath Salts abandoned her two-year-old son along a highway after imagining he was a demon; in West Virginia, a man dressed up in a bra and panties stabbed his neighbour’s pygmy goat to death; in Hawaii, a man threw his girlfriend off an 11th-floor balcony while high on Spice; in Fulton, Mississippi, a man slit his face and stomach with a hunting knife after Bath Salts-induced hallucinations.
But the most notorious case involved 18-year-old David Rozga, from Indianola. He got high on K2, then complained to a friend “that he felt like he was in hell”. Despite never having suffered from depression, he returned home and killed himself with a shotgun.
Chemicals are suspected in at least nine Bath Salts-related deaths in the US, but it was not until October 21, 2011 that the national Drug Enforcement Administration (DEA) banned mephedrone, methylenedioxypyrovalerone (MDPV) and methylone, the three products used to make Bath Salts. The chemicals are in the Schedule I list, which is reserved for substances with high potential for abuse. Studies will now determine if they should be permanently banned.
The Bath Salts ban followed the DEA’s earlier March 1 ban on five synthetic pot chemicals - JWH-018, JWH-073, JWH-200, CP-47,497, and cannabicyclohexanol.
DEA special agent Jeffray Scott said there was anecdotal evidence that the bans had slowed down sales of the drugs. But he admitted that the DEA was playing a game of cat and mouse with the drug producers.
In theory, there is a US law which prevents the manufacturers playing ‘chase the molecule’. The 1986 Federal Analog Act allows for “analogue” chemicals that are “substantially similar” to controlled substances listed in Schedule I or II to be treated in the same way. But in practice, the legislation is rarely effective. Not only must prosecutors prove the substances are chemically similar, they must also show they “do the same things to the human body”. That requires scientific testing, which is expensive, takes time and is not foolproof.
Dr Ryan said that it was like fighting a many-headed beast. In the case of LSD, there is one substance to track down. But in the case of Bath Salts, there are 40, and many more like them on the way.
To confound the law enforcers and physicians even more, “brand” names, such as Purple Wave, are not always a reliable indicator of the constituents of the drugs. Dr Ryan’s tests on Bath Salts in Louisiana produced many confusing results. In one city, Cloud 9 had MDVP in it, but in another city it had mephedrone in it, and in yet a third city it was made of three different compounds.
“Even more confusingly, we found Bath Salts in New York which were sold as Stain Remover – but contained JWH 018, which is synthetic marijuana. Bath Salts are normally mixed with water and ingested, whereas synthetic marijuana is usually sprayed on plant material and smoked,” Ryan said. “In another test, in California, on Black Rose Feeder, which is supposed to be a Bath Salts product, we found lidocaine, a powerful anaesthetic which can cause cardiac arrhythmias and seizures, rather than hallucinations and psychosis,” he said.
The variance in the make-up of the drugs inevitably produces different symptoms, making it hard for toxicologists to treat. But the unpredictability in the list of ingredients also highlights the dangers for consumers.
The US is not the only part of the world battling the elusive phenomenon of synthetic drugs. Europe gave birth to most of the new formulations and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) said in its 2011 report that new synthetic substances continue to be developed. So far in 2011, 39 new substances have been reported, with another 41 identified in 2010.
Britain has a particularly strong market and produced 16 new synthetic substances in 2010. The country has also become the European capital for the synthetic stimulant mephedrone, which has been banned, but is frequently sold online and through illegal networks.
EMCDDA director Wolfgang Goetz said the biggest difficulty for European authorities was the large number of online stores offering “legal highs”, including 600 shops touting psychoactive substances.
Clearly, the internet has played a major role in the rapid dissemination of new substances. And it also makes it easy for producers to buy the chemicals required from the Chinese suppliers. But the internet’s role is not solely malign.
As for stopping the products coming into the US from China, there is only a certain amount that can be achieved. “US customs are doing great work with the resources they have. They helped us years ago fight the date rape drugs GHB and rohypnol, which was coming from Australia and Mexico. And they have made some progress against synthetic drugs. Since law enforcement and customs teamed up on this issue, we’ve seen three seizures of MDPV powder in the port of New Orleans. But the reality is that the volume of products and all the different types make it truly impossible to check all of them,” he said.
The only way to fight the issue, he said, was to take a multi-pronged approach. “Law enforcement has to be trained to deal with people they encounter; schoolchildren need to know the dangers; physicians and toxicologists need to know how to treat symptoms.”
There is, however, no magic bullet.
“This problem is here to stay. It will evolve and it’s partly because of a mentality I’ve seen in the target age group who are usually between 24 and 34 years old,” said Dr Ryan.
“They will try almost anything once if someone tells them can get a buzz off it. One guy called the Louisiana Poison Centre a few months ago with severe symptoms. He said he had dipped his cigarette into liquid rat poison. We asked him why? His response, shockingly, was ‘I didn’t know if it would give me a buzz, but if it did, I wanted to be the first to try it’.”
Related: Drug Capitals of the World
Related: Drugs Trade, Drugs Trafficking
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