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What are Designer Drugs? Dangers of New Psychoactive Substances Addiction

Last Updated: July 13, 2022

Reviewed by Michael Espelin APRN

Designer drugs are chemicals that are manufactured in a laboratory to imitate the effects of commonly abused illicit drugs. They constitute a substantial portion of the illegal drug trade. In most cases, the molecular structure of a well-known existing illegal drug is modified to create an entirely new drug that produces similar effects. As cited in the report published in the Journal of Urban Health, the lifetime use of any single designer drug lies at 15% or below. This means that the extent of the use of these psychoactive drugs is high. Because of these statistics, it is necessary to learn the dangers of these substances.

What Are Designer Drugs?

In terms of designer drugs definition, according to the National Institute on Drug Abuse, the word designer is used because these compounds have been created or “designed” through alterations in a pre-existing chemical structure. Designer drugs or legal highs refer to new psychoactive substances manufactured by underground chemists in secret laboratories for sale on the black market.

Some of These Designer Drugs Include the Following:

The mechanism of action of these substances is similar to the traditional drugs of abuse like opium, cocaine, and heroin but their side effects are more severe. Furthermore, most designer drugs or club drugs have unpredictable and dangerous side effects but these substances do not provide the same addiction level as cocaine and opium. They are more powerful substances with a very high potential for addiction. When used in combination with other illicit substances and alcohol, they can pose fatal results.

What Are The Types Of New Psychoactive Substances

The manufacture and distribution of synthetic analogs of controlled substances is a growing international concern. Underground chemists synthesize these compounds in secret labs with legally available raw materials. This is done to exploit loopholes in controlled substance legislation. Additionally, designer drugs have psychotropic effects and are marketed for recreational use, often under misleading or inaccurate packaging.

New Psychoactive Substances Can Be Broadly Categorized as Follows:

  • Substituted Cathinones– Most synthetic drugs come from the derivatives of cathinone and are being sold as bath salts. These cathinones include methylenedioxypyrovalerone sold on the market as “sextacy” and mephedrone sold under slang names such as vanilla sky, ivory wave, M-cat, and meow-meow. Generally, the pharmacology of these types of designers appears similar to amphetamines and cocaine.
  • Synthetic Cannabinoids– These synthetic drugs use the parent compound delta-9-tetrahydrocannabinol (THC) and they are available on the market as SCs, spice, K2, K9, scooby snax, herbal highs, and aroma.
  • Synthetic Hallucinogens– This type of designer drug has the same structure related to the MDMA substance but they also promote hallucination effects by stimulating the serotonergic activity of the brain. Additionally, they are sold as Smiles, Solaris, N-bomb, and Cimbi-5.

Take note that there are hundreds of dangerous designer drugs on the market. Some of the synthetic stimulants or hallucinogens that have gained popularity among drug abusers are listed below:

  • Fentanyl is a potent synthetic narcotic that is 50-100 times more powerful than morphine. It is administered by injection and abused for its pain-relieving properties.
  • LSD is a powerful synthetic hallucinogen. This psychedelic drug is abused for its ability to alter awareness of surroundings, feelings, and perceptions.
  • Phencyclidine (PCP) is a synthetic hallucinogen that was originally developed as a veterinary anesthetic but is abused under the slang name angel dust. It is related to disorientation and unpredictable psychotic behavior.

It is difficult for law enforcement agencies to control the production of illegal designer substances in clandestine laboratories. In a case report of medical doctors from Minnesota, these powerful compounds have dangerous physical and psychological effects and some new psychoactive substances are far more potent than the substances they are meant to mimic, thereby increasing the chances of a fatal overdose. For example, designer drugs of synthetic cannabinoids type are more potent than cannabis. In addition, minor errors in the manufacturing process by self-proclaimed chemists can result in substances that are far deadlier than the intended compound.

A person holds a small bag of yellow drugs and test tunes on the background.

In the United States, the Drug Enforcement Administration (DEA) regulates the use of controlled substances, including illegal substances and prescription medications with a potential for abuse. The Controlled Substances Act prevents the sale, distribution, and use of dangerous scheduled drugs. Manufacturers of synthetic compounds are liable to criminal prosecution if the designer drug is proven to be pharmacologically or structurally similar to an already-identified illicit substance.

Illegal drug manufacturers and drug users are always looking for ways to circumvent the law. Club substances are created as a loophole to evade regulations and prevent detection on routine drug testing. These new psychoactive substances are chemically similar to illegal substances, but the manufacturers constantly change their chemical structure to avoid criminal prosecution. For example, in 2011, the DEA issued a Schedule I status on the compounds that were sold as bath salts. Thus, illegal manufacturers designed functional groups, formulated new substitutions, and altered the moieties and dosage form of compounds and substances to avoid the said prosecution.

What Are The Effects Of Designer Drugs

Although it is already known that the effects of designer drugs are more potent and can cause more severe toxicity than the substances they mimic, take note that these effects vary depending on the type of club substances.

Physical Effects of Substituted Cathinones

Bath salts act on the neurotransmitters dopamine, norepinephrine, and serotonin. They work by inhibiting the reuptake of these neurotransmitters, providing the following physical effects:

  • Increased energy
  • Sexual stimulation
  • Tachycardia
  • Decreased appetite
  • Diaphoresis
  • Palpitations
  • Muscle spasms
  • Hypertension
  • Jaw clenching

Same from the source above, the most fatal physical side effect of substituted cathinones includes cardiac arrest. In case these side effects are being observed in a drug user, it is highly advised to seek help through resources like rehab centers.

Psychological Effects of Substituted Cathinones

Researchers from Baltimore report that the psychological effects of substituted cathinones appear similar to amphetamines and cocaine. Some of these psychological include the following:

  • Increased alertness
  • Increased sense of empathy
  • Enhanced mood
  • Pronounced psychosis
  • Visual hallucinations
  • Delusions

According to a study published in the Journal of Addiction Medicine, the hallmark of substituted cathinones toxicity is acute agitation. So, if the patient consumes larger doses of these bath salts, those side effects mentioned above will appear severely along with toxicity.

Physical Effects of Synthetic Cannabinoids

Scientists from Virginia report that the physical side effects of synthetic cannabinoids are similar to the side effects of cannabis and they may appear 10 minutes after administration. Some of these include the following:

  • Tachycardia
  • Dry mouth
  • Lightheadedness
  • Headache
  • Diaphoresis
  • Tremors
  • Dystonia
  • Dyspnea

In one case report of surgeons from Texas, bradycardia and hypertension with chest pain may also be experienced with the use of synthetic cannabinoids. Although this is rare to occur, it may lead to fatality.

Physical Effects of Synthetic Hallucinogens

In a study published in the Journal of Psychopharmacology, the side effects of synthetic hallucinogens start to peak 20 minutes after administration and may last for 3 to 13 hours.  Some of the physical side effects include:

  • Tachycardia
  • Hypertension
  • Mydriasis
  • Hyperthermia
  • Pulmonary Edema
  • Coma
  • Hyperreflexia
  • Clonus

In the same report, it was stated that these physical side effects may also last for several days. In case this happens to the users, it is highly advised to seek medical help to safely manage the side effects and prevent future health dangers.

Psychological Effects of Synthetic Hallucinogens

Violence is the most severe and dangerous side effect of synthetic hallucinogens because users do not only harm themselves but may harm others as well. Other psychological effects of these types of substances include:

  • Severe agitation
  • Aggression
  • Visual and auditory hallucination
  • Delirium
  • Paranoia
  • Dysphoria
  • Severe confusion

Many users who experience these side effects, especially visual and auditory hallucinations may require medical attention and services as these effects can lead to psychiatric consequences.

Some pills on the table and a man having heart attack on the background.

Psychoactive Drugs Addiction And Abuse Overview

The United Nations Office on Drugs and Crime reported in 2014 that the use of legal highs has increased significantly at national and international levels in the past years, additionally stating that designer drug addiction and abuse is highly possible for users of these substances. As published in the Journal of Pharmacy Practice, these substances are very toxic and dangerous that may require patients to seek emergency services.

Psychoactive Drugs Addiction Signs And Symptoms

Designer substances are escalating out of control that is why governments need to adopt national and international measures to prevent the addiction to these substances. Since the possibility of addiction and dependence on these new psychoactive substances is high, addiction signs and symptoms will also be easily observed. Moreover, take note that there are physical and psychological drug addiction signs and symptoms such as the following:

Physical Psychoactive Drugs Addiction Signs And Symptoms

  • Neglected appearance and hygiene changes
  • Sleep pattern changes
  • Lack of energy
  • Weight changes
  • Redness of eyes

Psychological Psychoactive Drugs Addiction Signs And Symptoms

  • Difficulties handling school or work duties
  • Relationship issues
  • Memory problems
  • Extreme paranoia
  • Severe aggression
  • Extreme mood swings
  • Financial problems

Keep in mind that aside from addiction and dependence, tolerance is also associated with the use of new psychoactive substances, leading to severe health dangers. Because of this, it is highly advised for drug users to seek medical resources as early as possible to avoid the occurrence of unwanted events.

Who Is at Risk of Abusing Lab-Synthesized Substances?

According to a study published in the Journal of Drug and Alcohol Dependence, young adults are most likely to use these substances which are usually available at clubs, parties, and raves. Certain products are popular in niche populations, such as university students (SCs and bath salts), rave party-goers (ecstasy), and in the military.

  • Age– In China, 75% of the 7 million designer drug users are below 35 years old. In the United States, the average age of designer drug users is 24 years old.
  • Gender and Economic Status– Same, in the report from China, the abuse of legal highs is most prevalent among single males in their mid to late 20s with low income and education.
  • Educational Status– With regards to this, most users are university students. However, it was also reported that even 12th graders are fond of using these dangerous substances.
  • Family Background– Young people who are especially at risk of designer drug abuse include those with parents who have substance use disorders and those in families with conflict, poor relationships, and lack of discipline.

Young people are attracted to new psychoactive substances because of clever marketing and easy availability. The attractive and colorful packaging of these products and their widespread accessibility, both online and over-the-counter, make it easy for the youth to experiment with legal highs.

Health Risks of Abusing New Psychoactive Drugs

The psychoactive drugs act on the nervous system to mimic the effects of traditionally illicit substances. Thus, repeated dosing of these dangerous substances promotes long-term health effects especially in the heart and brain of the user. Since dependence is also associated with legal highs, withdrawal can occur.

  • Cardiovascular– The main body system that is affected by the use of designer drugs is the cardiovascular system. According to the American Heart Association, these legal highs are considered “heart attack drugs”. Collapsed veins and bacterial infections of the blood vessels and heart valves may be experienced by the users.
  • Brain– Since legal highs also act on the brain, prolonged use of psychoactive drugs can cause brain damage. As cited in the American Journal of Psychiatry, club substances may promote chronic psychosis that can last for months to years.
  • Overdose– Overdose is possible with the use of legal highs especially when it is combined with alcohol. As per the report of researchers from Norway, men are most at risk of overdose compared to women, and usually, the most initial sign of overdose includes unconsciousness. Moreover, there is a late-night, weekend pattern regarding club drug overdose.
  • Withdrawal– When users become dependent and tolerant to these substances, they will experience withdrawal once they stop using these substances. As published in the Annals of Internal Medicine, the withdrawal symptoms for these substances include nausea, vomiting, and irritability.

How Long Do New Psychoactive Drugs Stay In the System?

Again, how long new psychoactive drugs stay in the system depends on their type. This means that substituted cathinones, synthetic cannabinoids, and synthetic hallucinogens have different half-lives. Take a look at the information below:

  • Substituted cathinones– These types of legal highs have short half-lives (around 2-3 hours). This means that their effects can disappear quickly as well.
  • Synthetic cannabinoids– These types of legal highs also have long half-lives. As published in the Journal of Analytical Toxicology, it will take 14 days for these substances to reduce 50% of their concentrations. In the same report, it was stated that these substances can be detected in the urine even after 3 weeks.
  • Synthetic hallucinogens– Although the half-lives of synthetic hallucinogens is only 3 hours, their effects can last longer. As stated above, the effects may last for up to 13 hours.

From the information above, it can be noted that the duration of the effects of designer drugs does not depend on their half-lives. This simply means that these substances are too potent and dangerous to take.

NPS Drug Testing Challenges

Scientists state that illicit drug manufacturers have the advantage of considerable flexibility in changing the molecular structure of designer drugs. This makes it difficult to detect these compounds and their metabolites on routine drug screening. It is impossible for standard urine and blood tests for illicit substances to detect all the designer drugs that have been synthesized and placed on the market because of the drugs’ heterogeneity. This poses a major challenge for law enforcement officers and clinicians. Although laboratory tests are expanding, the constantly changing content, concentration, and chemical structure of new psychoactive compounds make it difficult to identify these drugs on laboratory tests. For example, substituted cannabinoids come with a lower risk of detection.

Addiction Treatment for Designer Drugs

What are the addiction treatment services for new designer drugs? The majority of non-psychiatric symptoms are self-limited and resolve with supportive treatment over a few days. Psychological side effects such as agitation, paranoia, and anxiety are managed with monitored observation. Severely intoxicated patients may require pulse oximetry, continuous cardiac monitoring, and frequent neurologic checks. However, some users refuse to seek help due to privacy issues. Furthermore, withdrawal symptoms of designer drugs are not usually severe or life-threatening and are typically limited to irritability and nausea. Supportive care with antiemetics and intravenous fluids may be all that is needed. Healthcare personnel at addiction treatment facilities can manage more severe symptoms, such as agitation and seizures, with medications while keeping the patient’s privacy.

An important component of the treatment for designer drug addiction is advising patients about the grave dangers of these compounds. Education is the cornerstone of confronting the challenges presented by new psychoactive substances. Accurate information about the potential risks of these products and gentle encouragement to make healthy choices can go a long way in helping drug users make informed decisions about changing their behavior.

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Published on: May 30th, 2018

Updated on: July 13th, 2022

About Author

Decyry Jhoy Serrano, RPh

In 2017, Decyry Jhoy Serrano completed the postgraduate course Drug Menace at St. Luke’s Medical Center in Manila, Philippines. In 2019, she volunteered in the local government’s Narcotics Anonymous and Anti-Drug Abuse programs. She is a speaker and an advocate of anti-drug addiction campaigns. As a remembrance for her late father, Decyry dedicates her time writing the proper use of medications as well as the dangers of drug addiction to educate the people, especially the youth.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.