NPS: Dangers of Designer Drugs Addiction

Last Updated: February 23, 2021

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 which produces similar effects. The word designer is used because these compounds have been created or “designed” through alterations in a pre-existing chemical structure.
What is NPS? NPS refers to new psychoactive substances manufactured by underground chemists in secret laboratories for sale on the black market. Young adults are most likely to use these substances which are usually available at clubs, parties, and raves. Most designer drugs have unpredictable and dangerous side effects. They are powerful substances with a very high potential for addiction. When used in combination with other illicit substances and alcohol, they can have fatal results. Learn about new psychoactive substances and the dangers of abusing these drugs.

Designer Drugs: An Overview

chemists illegal drug labIn the United States, the Drug Enforcement Administration (DEA) regulates the use of controlled substances, including illegal drugs 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. Designer drugs or “legal highs” 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.
Designer stimulants are mostly used intranasally, but some may be ingested orally or taken by injection (intramuscular or intravenous). Synthetic cannabinoids are smoked via a joint, water pipe, or bowl. Synthetic hallucinogens are administered via inhalation, nasal insufflation, oral ingestion, sublingually, or by injection.
Designer drugs are often promoted as herbal substances to avoid regulation by law. They produce marijuana- or cocaine-like effects and are associated with a number of negative health consequences. These dangerous chemicals are more potent than street drugs and have a high potential for abuse. There have been reports of fatalities associated with the abuse of new psychoactive substances and synthetic stimulants.

Designer Drugs List

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. 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 (bath salts) including methylenedioxypyrovalerone sold on the market as sextacy and mephedrone sold under slang names such as vanilla sky, ivory wave, M-cat, and meow-meow.
  • Synthetic Cannabinoids available on the market as SCs, spice, K2, K9, scobby snax, herbal highs, and aroma.
  • Synthetic Hallucinogens sold as Smiles, Solaris, N-bomb, and Cimbi-5.

There are hundreds of 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.
  • PCP is a synthetic hallucinogen which was originally developed as a veterinary anesthetic but is abused under the slang name angel dust. It is associated with disorientation and unpredictable psychotic behavior.

It is difficult for law enforcement agencies to control the production of illegal designer drugs in clandestine laboratories. These powerful compounds have dangerous physical and psychological effects. Some new psychoactive substances are far more potent than the drugs they are meant to mimic, thereby increasing the chances of a fatal overdose. In addition, minor errors in the manufacturing process by self-proclaimed chemists can result in substances that are far deadlier than the intended compound.

Who Is at Risk of Abusing Lab-Synthesized Drugs?

overdosed teen lying on the floorThe abuse of designer drugs is most prevalent among single males in their mid to late 20s with low income and education. Certain products are popular in niche populations, such as university students (SCs and bath salts) and rave party goers (ecstasy).
According to one study, the number of emergency room visits involving synthetic cannabinoids increased 2.5 times from about 11,000 visits in 2010 to about 28,000 visits in 2011. When categorized by age, the number of ER visits increased fourfold in young adults aged 18 to 20 years. It is evident from these statistics that youth are at highest risk from the harmful effects of designer drugs, but other their use is increasing in other populations, such as the military.
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. 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. Youth in the criminal justice system or foster care also have a higher risk of abusing new psychoactive substances.

Side Effects of Designer Drugs

People abuse synthetic drugs for effects such as energy, alertness, mood enhancement, and decreased appetite, but these compounds are associated with a number of adverse side effects. Psychiatric side effects of designer drugs include agitation, paranoia, visual hallucinations, and delusions. Physiologic side effects include palpitations, sweating, high blood pressure, increased heart rate, muscle spasms, and jaw clenching. Other dangerous side effects include organ damage, seizures, and loss of consciousness.
Prolonged use of substituted cathinones and SCs leads to tolerance with the user requiring more frequent and larger doses for the desired effect. Chronic users may suffer from withdrawal symptoms such as irritability, dry mouth, lightheadedness, headache, fatigue, insomnia, depression, and difficulty concentrating. Hallucinogens may produce delirium, aggression, violence, and self-harm. Some abusers of designer drugs experience strong cravings, leading to compulsive use. In addition to the effects of the product itself, contaminants can cause dangerous adverse effects and toxicity.

NPS Testing Challenges

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. In fact, it is impossible for standard urine and blood tests for illicit drugs to detect all the designer drugs that have been synthesized and placed on the market. 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. People in the criminal justice system use these drugs to avoid detection by probation officers. Soldiers in the military abuse designer drugs because they have a lower chance of detection on urine drug tests.
Young adults who present for emergency medical care with signs and symptoms of substance use should be questioned directly about designer drug abuse. This is in light of the fact that laboratory testing cannot be solely relied upon to detect these illicit substances. Even though new psychoactive substances are not picked up on routine drug screening tests, it is still advisable to screen urine and serum for common drugs of abuse because this helps healthcare providers become aware of potential interactions and toxicity.

Addiction Treatment for Designer Drugs

What are the addiction treatment services for new designer drugs? Because the chemical structure of synthetic psychoactive substances is constantly changing, there is no specific antidote available for these compounds. 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. 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 are able to manage more severe symptoms, such as agitation and seizures, with medications. Some psychoses due to new psychoactive substances may require prolonged inpatient rehab and behavioral therapy, especially in patients with co-occurring psychiatric disorders.
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 designer drugs. 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.

Designer Drugs and the Law

In the 1980s, law enforcement was focused on dealing with the crack-cocaine problem, but the 1990s saw the emergence of the designer drug culture with an increasing use of ecstasy and methamphetamine by young adults. There were media reports about date rape drugs such as Rohypnol and GHB (gamma hydroxybutyrate). Ecstasy (molly) consumption at raves became a popular youth subculture.
Manufacturers of designer drugs are constantly creating different versions of the same drug to evade regulations. Legislators pass laws to prohibit a particular new psychoactive substance, only to see a marginally different compound appear on the market, created with chemicals not covered by the existing laws. The Controlled Substance Analogue Enforcement Act and the Synthetic Drug Abuse Prevention Act (SDAPA) are some of the laws passed to address this problem. They prohibit the manufacture of analogs that are substantially similar to banned chemicals and help control the sharp increase in new designer drugs.
One of the biggest DEA takedowns in recent years was Project Synergy which targeted dangerous designer drug trafficking organizations in 35 states. Approximately $50 million worth of assets, cash, cathinone bath salts and cannabinoid drugs were seized during this operation. The DEA’s operation Web Tryp led to the arrest of 10 people involved in online sales of designer drug analogs masquerading as research chemicals and linked to a number of fatal and non-fatal overdoses.

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Published on: May 30th, 2018

Updated on: February 23rd, 2021

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.


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