Designer Drugs Bath Salts Plant Food Jennifer Messick

Designer Drugs Bath Salts? Plant Food? Jennifer Messick Traffic Safety Resource Prosecutor Amy Miles Advanced Chemist WI State Lab of Hygiene (907) 343 6434 messickj@muni. org Thank you: Anchorage Police Department Alaska Highway Safety Office Phone: 608 -224 -6244 amy. miles@slh. wisc. edu

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 drugs

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)

Designer Drugs - Interpretation • Designer vs. Rx • DRE Information • Limited scientific references • Police reports – DRE observations • Tox report may not = impairment • Tox report may not = presence

Designer Drugs covered in this presentation: 1. Synthetic Cannabinoids Spice/K 2 (Marijuana) 2. Cathinone Derivatives Bath Salts / Plant Food 3. 2 C- family (Hallucinogen) 4. Krokodil (cocaine, ecstacy, meth)

Road Map • For Each Drug: General Identification – Marketing, packaging, history • • • Methods of ingestion Common signs/symptoms, case example Detection: NIC, blood, urine Legal Status Officer Safety

What is SPICE / K 2 ? Dangerous, synthetic research chemicals that have been dissolved in acetone and sprayed onto dried plant material

SPICE / K 2 • Marketed as incense • Smells nasty (watermelon, vanilla, rootbeer, tropical, etc) • Smoked, mixed in drink, injected

SPICE / K 2 • Marketed as incense • Smells nasty (watermelon, vanilla, rootbeer, tropical, etc) • Smoked, mixed in drink, injected • Sold LEGALLY and LOCALLY (well, kind of) • 1 g -3 g packages • $25 - $40 / g (about 2 x price of pot) • 1 pkg = 3 -5 doses • Used since about 2007

SPICE / K 2 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

Brands/Flavors

JWH – The Life of the Party…. • John W. Huffman - Clemson University – First to synthesize delta-9 analogues in 1984 • 450+ different types – Sold 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".

Cerebral Cortex Higher cognitive function Appetite Hypothalamus Motor control, learning, action selection Motor control Nausea, vomiting Medulla Cognition, memory, perception, learning endocrine function, food intake, body temp regulation

Synthetic Marijuana • CB 1 receptors – Expressed mainly in the brain, CNS, muscle, liver, lungs, kidney • CB 2 receptors – Expressed in the immune system, evidence of location in the brain • CB receptors are activated by three main groups – Endocannabinoids – Plant cannabinoids – Synthetic cannabinoids

Missouri Human Dosing Study • 6 subjects (one dose 2 x) over two days – 2 female, 4 male • Allowed maximum of 2 “hits” – Blood, urine and oral fluid samples • Each subject (but one) commented they would “hit” again • Five of the six subjects reported previous experience with synthetic cannabinoids

Missouri Human Dosing Study • Male, 39 yo, 5’ 10”, 190# • No drug history – First 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 Urine Dip Test Neg NA

Missouri Human Dosing Study Pre-dose Attitude cooperative Coordination normal Speech normal Breath normal Face flushed Eyes normal Pupils equal Follow stimulus Yes Eyelids normal Tracking equal Post-dose cooperative jittery normal red bloodshot equal Yes normal equal

Missouri Human Dosing Study DRE Observation Pre-dose Post-dose HGN None VGN 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*

Missouri Human Dosing Study • WAT – Lack of coordination, balance – Raised arms – Stepped off the line • OLS – Sway, used arms, put foot down, leg and body tremors • Romberg – Sway – 2 inch front to back, 1 inch side – Estimated 30 seconds in 37 • FTN – Quick and lethargic movements, 6 errors

Missouri Dosing Study • University of Central Missouri • Bob Welsh • Tracey Durbin • NMS Labs • Dr. Barry Logan

Symptoms Not always a bad trip, but if you’re involved it probably is • Elevated BP (140 -210 / 100 -110) • Tremors / Seizures • Unconsciousness • Hallucinations / Delusions / Paranoia / Anxiety • Numbness / Tingling

Symptoms Not always a bad trip, but if you’re involved it probably is APD#10 -14949 • Vomiting • 3 raised medians, 2 concrete • Memory Loss retaining walls, broken axle, • Incoherent/slurred flat tire, driving sidewalk speech • 6 HGN + VGN • User may feel cold • . 000 Br. AC • 6 -8 hr high (some effects up to 30 hrs) h? ? • Slurred/incoherent • “Death all around” Deat • Going to kill officer

DETECTION OF SPICE/K 2 (NIC negative for pot) • Blood (NMS) $195 – Within 6 -8 hours; can detect some JWH compounds – Can’t detect all compounds – Screen + confirmation / quantitation – Impairment 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)

Spice • • • Blood shot / Red eyes Maybe HGN / VGN Lack of Convergence +- Normal Pupil size Normal light reaction • Temperature ↓or normal • Blood pressure ↑or ↓ • +- Rigid muscle tone POT? v. • • • Blood shot / red eyes No HGN / VGN Lack of Convergence Dilated Pupils Normal light reaction Temperature normal • Blood Pressure ↑ • Normal muscle tone

Million Dollar Question: Which category? ?

DRE MATRIX •

What is Everyone Else Doing About It? ILLEGAL In most European and Scandinavian countries Still Legal in Canada 25 States in US + Military • Problems with legislation and analog compounds ready to go

What is the U. S. doing about it? DEA Emergency Ban - Sch I (JWH-018, JWH-073, JWH-200 and CP 47 -497) - Sell or possess - Became effective when published in CFR (3/1/11) - Remains in effect for 12 months - Can be extended 6 months

11078 Federal Register / Vol. 76, No. 40 / Tuesday, March 1, 2011 / Rules and Regulations PART 1308 - SCHEDULES OF CONTROLLED SUBSTANCES § 1308. 11 Schedule I. * * *(g) * * * (1) 5 -(1, 1 -Dimethylheptyl)-2 -[(1 R, 3 S)3 -hydroxycyclohexyl]-phenol, its optical, positional, and geometric isomers, salts and salts of isomers— 7297 (Other names: CP– 47, 497) (2) 5 -(1, 1 -Dimethyloctyl)-2 -[(1 R, 3 S)-3 hydroxycyclohexyl]-phenol, its optical positional, and geometric isomers, salts and salts of isomers— 7298 (Other names: cannabicyclohexanol and CP- 47, 497 C 8 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 AM 678) and

What is the law in my State? • Traffic Safety Resource Prosecutors – Contact Jenn to find out who your TSRP is • messickj@muni. org • (907) 343 6434 • National Traffic Law Center (NTLC) http: //www. ndaa. org/apri/programs/traffic/ntl c_home. html#crash

Solid DUI Cases (The Defendant is your Crime Scene) • Can I arrest for DUI? – Impairment vs Controlled Substance – Even if legal, may still be DUI • Detail / 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?

Officer Safety • Unregulated mixture of you name it (higher potential for overdose) • Mixed / Unpredictable symptoms – You are the frontline – Be Careful! • Acetone is flammable!

Officer Safety • • • Be Aware Wear Gloves If ‘incense’ burning in home, re-evaluate Call / wait for back-up Exposure Report? Call medics / poison control Poison Control 1 -800 -222 -1222

Cathinone Derivatives What are Bath Salts?

It’s all about the bath right?

This is what we mean. . .

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)

Cathinone Derivatives • Khat

Cathinone Derivatives Mechanism of Action • Cathinone – Induces release of dopamine • Similar to amphetamines – Similar in structure to bupropion, methcathinone, diethylpropion – Catecholamine release • “Fight or flight” hormones

1 R 2 R 3 R 4 R 5 Name R Mephedrone Methyl H 4 -Methyl H H Methylone (βk. MDMA) Methyl H 3, 4 -Methylenedioxy H H Butylone (βk-MBDB) Methyl H 4 -Methyl H Pyrovalerone {pyrrolidino} 4 -Methyl Ethyl H MDPV {pyrrolidino} 3, 4 -Methylenedioxy Ethyl H

Cathinone Derivatives Homologues VS. Analogues

MDPV • Marketed as “Bath Salts” and “plant food” • CNS stimulant (3 -4 hrs) • Chemical analog of Cathinone (Sch 1 C. S. ) • NOT Controlled Substance • Detectable in blood and Urine (special test) • Not to be confused with MDMA “ecstasy”

Common Packaging Plastic jars or foil packets

Case Examples • APD#11 -1234 - Wrong way / one way, curb, - Stopped at green light sidewalk, yards, pedestrian, eluding, multiple LSA - Clumsy, poor dexterity - Sluggish speech, no odor - Delusion Marshalls after him (tow truck driver) alcohol - Small jar white powder, NIC - 2 HGN, 4 WAT, 4 OLS positive cocaine - Eyes non-reactive to light - Syringe, pipe - Normal pupils, no HGN * Blood positive MDPV *Blood positive MDPV

Snort What?

Plant Food = Mephedrone

Mephedrone • “Plant fertilizer” and “bath salts” • Chemical analog of Methcathinone (Sch 1) • More common in “plant food”

Common Packaging

Methods of Ingestion • • • Snorting – onset quick Oral - onset 15 – 45 min Injection Smoking – onset quick Atomizing Effects 6+hrs * Rush of ecstasy, no hard come-down * Binges for several days or even weeks *Also used as cutting agent for meth

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

Case Examples • Welfare check: uncontrollable, non-compliant, taser used, little effect Pennsylvania • Fidgety, 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. Pennsylvania • 3 days intermittent delirium, slit throat, shotgun Louisianna • Soldier, 3 tours, speeding on freeway, eluding, shot wife in car; vehicle, pockets, house loaded with bath salts, both blood positive for MDPV. Seattle

Case 1: Domestic Bliss Sgt Aaron Watson, Nebraska State Patrol, Ogallala NE

Case Study #1 • DV - H discharges shotgun in home • Marijuana & bath salts found in home • H&W admit to using bath salts & marijuana

“Ladies First” Defendant Statements • She has a Rx for appetite stimulants but hadn’t taken it in 10 days • Snorted 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 hallucinations

Admissions • Effects of bath salts last about 4 hours • Like drinking red bulls, but not quite like meth • Burns nostrils, but not as bad as meth. • Not numbing like cocaine • Euphoric, not excessive • Increased alertness • Believes bath salts caused H violent behavior Observations • Irritable, restless, and runny nose • Dazed appearance, paranoia, sweating • Poor perception of time and distance • Eye / body tremors • Blisters on tongue • White residue in nose

Case #1 – DRE SFSTs Finger to Nose • Missed tip 5/6 times OLS Slow reaction Swayedtime Eyelid. Romberg tremors Balance Used arms for balance Swayed throughout 2 Put in front/back foot down sway test Eye tremors, constant Tremors twitching Estimated 30 sec in 33

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 & Cannabis

Toxicology results – Urine collected – Ethanol: None detected – Drugs: • • MDPV (Methylenedioxypyrovalerone) Diphenhydramine Lidocaine Cannabinoids

Case 2: “Too Much of a Good thing” Ofc Mitchell, Marietta PD, Marietta, GA

“The Better Half” Initial Observations • 21 year old male brought in to ER overdosing on unknown drug – Restless, Visible body tremors – Talkative – Anxious, paranoid, hallucinations – Slurred speech – Dry, cracked lips – Clenching fists to the point of causing bleeding – Very alert – Bruxism – Redness to nasal passage

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 room

“Too Much of a Good Thing” Subject Statements • Subject yells “It is legal!” • Subject purchased from a head shop • Directions are to mix it into a drink and ingest it orally, but he snorted about half the bag

“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 it • Pulls out IV twice – Restraints ordered • While being restrained, he began to hallucinate and asked security if they drank the rest of the beer

DRE Evaluation – Day 1 • HGN (in hospital bed) – Lack of smooth pursuit • Possibly due to restlessness, unable to appropriately follow stimulus

DRE Evaluation – Day 1 • • • Pulse: 112 bpm Blood Pressure: 144/94 Body Temperature: 98. 5 Pupils: 9 – 10 mm in all lighting conditions Muscle Tone: Rigid • DRE Opinion: CNS Stimulant

“Too Much of a Good Thing” DRE Observations – Day 2 • Took 3 doses of Lorazepam and 1 dose of Haloperidol to get subject under control • Transported to ICU • When he awoke the next day, he was violent again • 12 people restrain him; injures security guard

“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 120 • Subject states he is exhausted, body hurts, struggling to stay awake • Subject has no memory of who DRE was or ever talking to him

Toxicology Results • Hospital urine sample • All testing negative • Why? – Type of screen – Target compounds – Lack of metabolites identified – Hospital screen vs. toxicology lab testing

American Association • Synthetic Cannabinoids – All of 2010: Total of 2, 874 calls – Jan – May 12, 2011: 2, 052 calls • Bath salts – All of 2010: Total of 298 calls – Jan – March, 2011: 1, 241 calls 9 Deaths reported in U. S. with more suspected (52+ in EU)

TESTING Cathinone Derivatives • Sodium Nitroprusside Reagent (Narco. Pouch) – Turns blue-purple • MDPV, Mephedrone, Methylone, 4 -fluoro (Flephedrone), 3 -fluoro , 3 -methoxymethcathinone

TESTING Cathinone Derivatives • Scott’s Reagent (Nik Test) – Blue positive reaction • MDPV • Cocaine, Methadone, Ketamine, Procaine and Lidocaine will also cause a positive reaction

TESTING Cathinone Derivatives • Marquis Reagent – Bright yellow positive • MDPV • Diphenhydramine will also cause yellow reaction

Legal Status • EU, Australia, Canada and Israel = illegal • Federal: MDPV and Mephedrone not approved by FDA, but not controlled by DEA yet – Sen. NY introduced federal legislation to add to Sch. 1 (February 2011)

Legal Status • 13 States • Contact your TSRP to find out legal status in your state

Cathinone Derivatives – Nationwide Legislation (April 2011)

Phenethylamines -2 C Group “Tripstacy” (Hallucinogen, + /- Stimulant) • Made by brilliant guy who just loved drugs

Ok, a Scary, Brilliant Guy

Phenethylamines -2 C Group “Tripstacy” (Hallucinogen, + /- Stimulant) 2 CB – Sch I – Often with MDMA to prolong high – On set 20 min – 1 hour – Lasts 4 -6 hours (longer with X) 2 C-E – Legal in US – Analog of 2 C-B, 2 C -T 7 & mescaline?

2 CI – – Illegal in UK, legal US Stronger than 2 CB Lasts longer, 8 hrs + Effects similar to LSD+MDMA without being chatty – White powder / pills • UPD#11 -1234 - No Headlights - Disjointed response / slow, slurred speech - 1000 yard stare - Seeing ‘tracers’ - No HGN, 7 WAT, 3 OLS - User reports effects last 6 -12 hrs (contact was 7 hours after ingestion)

Krokodil / Crocodile • Majority of case reports out of Russia • Desomorphine – first synthesized in the 1930’s – Alternative to morphine, shorter lasting • Manufactured from OTC codeine using industrial chemicals • Lack of clean up during synthesis leads to injection of iodine and other metals – Shut down of endocrine and immune systems

Officer Safety • Unknown substance: – They’re all white powders! • Unpredictable Behavior: – They all act crazy!

Officer Safety • Unknown substance: – They’re all white powders! • Unpredictable Behavior: – They all act crazy! • Glove up • Exposure Report

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 Messick messickj@muni. org 907 343 6434 Questions / comments / feedback WELCOMED

Salvia Plant

Saliva Flowers Blue Salvia Red Salvia Purple Salvia

Dried Leaf Packaged

Seeds

Piperazines - BZP (Schedule I) Stimulant “PEP, Majik, Frenzy” • Releases dopamine and seratonin • Often sold as “dietary supplement” • No dietary value • Not a “natural” product • Lasts 4 -8 hours • Has not been found to occur naturally CASE STUDY • Speeding, delayed yield • Ptosis, constricted pupils, 2 HGN (unable to complete) 3 WAT, 4 OLS • Cocaine and beer in car • D falls asleep in cruiser • Blood: carboxy, DXM, BZP, TFMPP, Alprazolam

Phenazepam (Legal in US, not controlled) • CSN Depressant • Taken in place of Alprazolam, Clonazepam and Diazepam • Benzodiazepines are generally Schedule IV substances CASE STUDY - LSA with semi, hits tree, slumped across seat, SFST’s limited for safety (on backboard) - 6 HGN + VGN, slurred speech Blood: positive phenazepam