A beginning course on Designer Drugs that are sweeping across the United States and the dangers they pose to our teenagers by a Texas Municipal Court Judge who is also an EMT/Firefighter and First Responder, and former police chief.

1. “Designer Drugs” -
“getting high, sick,
DisableD, anD DeaD on
sYnethetic Drugs”©
a Primer on Designer Drugs bY
JuDge kevin r. maDison
PresiDing JuDge lakewaY municiPal court, texas
PresiDing JuDge horseshoe baY municiPal court, texas
PresiDing JuDge briarcliFF municiPal court, texas
PresiDing JuDge Johnson citY municiPal court, texas
emt-intermeDiate (aDvanceD liFesaving skills)
state certiFieD FireFighter
© coPYright JuDge kevin r. maDison

2. Educational ObjectivesEducational Objectives
At the end of this presentation, participants will be able to:At the end of this presentation, participants will be able to:
1. Understand the basic physiology of how these drugs affect
behavior.
2. Identify some of the new designer drugs that are emerging
throughout the U.S.
3. Describe some of the effects and signs of use of these
designer drugs.
2

3. Points about this presentationPoints about this presentation
1. I am not an expert on this topic - I am not a Chemist or Biologist.
2. A class on Designer Drugs could easily last several days. This topic is very
complex because it intertwines criminal jurisprudence, law enforcement,
medicine, physiology, psychiatry, organic chemistry, and politics.
3. It is impossible to discuss all the different new designer drugs popping up
across the country. We will touch on a few of the most common designer
drugs. There are hundreds out there.
4. I encourage you to get on the Internet: Google, Medscape, National Institute
on Drug Abuse (NIDA), and You Tube and explore this topic in greater detail
on your own.
5. We should strive to know as much about Designer Drugs as the kids in our
community know.
3

4. What are “Designer Drugs?”
• “Designer drugs” are chemicals that have
been specifically made or “designed” by
underground chemists so that they:
(1) are not covered by controlled substance
statutes (and hence are not illegal), and
(2) still have the same “psychotropic affect”
(cause stimulation, sedation, or hallucination, etc.)
of the illegal popular drugs that people use.
4

5. What are “Designer Drugs?”
Designer Drugs are drugs that are chemically
created with different molecular structures
than the original drugs that they imitate.
Example: synthetic marihuana called “Spice”
or “K-2” is a chemical that mimics the chemical
structure of THC in marihuana and its effects.
5

6. syn·thet·ic
sin THetik/ˈ
adjective: synthetic
(of a substance) made by chemical
synthesis, esp. to imitate a natural
product. "synthetic rubber“
noun: synthetic
a synthetic material or chemical, esp. a
textile fiber.
6

7. How Psychoactive Substances WorkHow Psychoactive Substances Work
• Because of their chemical
structure, alcohol and
drugs have dramatic
effects on receptor cells
and neurotransmitters in
Central Nervous System.
• Effects on:
– Mental processes
– Behavior
– Perception
– Alertness 7

8. Our body and brain operate by
maintaining, increasing, or decreasing
chemicals and hormones that affects
Neuro-receptors and Neuro-transmitters
8

9. For those who want to alter Sensation, Behavior,
and Bodily Functions it’s all about ingesting drugs
that affect neuroreceptors and neurotransmitters.
9

10. How these drugs work
When absorbed into the body, drugs interact with
and modify cells, organs, and bodily systems by:
•Altering the way the body normally functions
(increasing, slowing, or enhancing bodily
processes, or level or quality of functioning),
•Altering the operation of tissues, organs, and
systems,
•Affecting hormones and enzymes, and
•Impacting processes such as digestion,
respiration, circulation, and mental functioning.
10

11. Commonly Used Psychoactive SubstancesCommonly Used Psychoactive Substances
SOURCE: National Institute on Drug Abuse.
SUBSTANCE EFFECTS
Alcohol
(liquor, beer, wine)
euphoria, stimulation, relaxation,
lower inhibitions, drowsiness
Cannabinoids
(marijuana, hashish)
euphoria, relaxations, slowed
reaction time, distorted perception
Opioids
(heroin, opium, many pain meds)
euphoria, drowsiness, sedation
Stimulants
(cocaine, methamphetamine)
exhilaration, energy
Club Drugs
(MDMA/Ecstasy, GHB)
hallucinations, tactile sensitivity,
lowered inhibition
Dissociative Drugs
(Ketamine, PCP, DXM)
feel separated from body, delirium,
impaired motor function
Hallucinogens
(LSD, Mescaline)
hallucinations, altered perception
11

12. “Psychoactive” and
“Psychotropic Drugs”
These drugs affect the brain, brain chemicals,
and brain receptors.
These drugs are “mind altering” and affect a
person’s mind and body because they are
able to cross the blood-brain barrier, which
many drugs cannot cross.
Alcohol, Marihuana, Cocaine, Heroin,
Amphetamines are all examples of drugs that
can cross the blood-brain barrier. 12

13. Problem with Designer Drugs
Although the chemical structure may be barely
changed, the problem is that the properties of
these drugs dramatically changes!
Super-enhanced properties of the drugs they
copied: hyperactivity
hallucinations
paranoia
superhuman strength
13

14. Problem with Designer Drugs
Because molecular structure different these
drugs are usually not illegal; however, legal
does not mean safe!
New molecular structure creates whole new
effects on mind and body:
increased heart rate
heart attacks
strokes (brain attack)
permanent brain injuries 14

15. Close but drastically different!
Making one small change to a molecular
structure of a compound can lead to drastic
changes in the properties of that substance.
For example: H20 is water, of course.
If you add another oxygen atom: H202
The water becomes Hydrogen Peroxide, not
poison but toxic and corrosive to human
tissue...causes burns. Used for rocket fuel and
making bombs.
15

16. Designer
Drugs
Bath Salts
Spice/K2
16

17. Food and Drug Administration
(FDA)
• Designer drugs do not have FDA approval and
are produced by underground chemists who do
not care about quality control of the product.
• Designer drugs are not correctly synthesized
and purified.
• Designer drugs contain numerous toxic
impurities not separated from the desired active
ingredient after the synthesis was completed.
17

18. Where do Designer Drugs comeWhere do Designer Drugs come
from?from?
• Chemical Research
• Published articles by Pharmaceutical
Companies and Chemists
• Independent Chemists who love drugs
• “Basement Chemists”
• Made/imported from China and India then
“assembled” and marketed in U.S. 18

19. Underground Chemists
• Underground chemists first determine
which drugs are listed in the jurisdiction’s
controlled substance statute.
• Then these chemists make changes to the
molecular structure of these drugs
creating a slightly altered compound.
• May have very bad effects!
• Legal Safe!!!!
19

20. CommonCommon
Characteristics ofCharacteristics of
Designer DrugsDesigner Drugs• Synthetic
• Marketed as something else
– Incense, Bath Salts, Glass
Cleaner, Plant Food, Room Spray
• Attractive packaging
• Very small quantity (250mg-
3gm) to obtain “high” thus many
people overdose!
• “Not for human
consumption”
20

21. CommonCommon
Characteristics ofCharacteristics of
Designer DrugsDesigner Drugs
• White Powder or capsule
• No Ingredients listed
• Sold in Head Shop or
Internet
• “Research Chemicals”
• “Does not contain . . .”
21

22. 22

23. 23

24. Dangers of Bath Salts
• Abuse of recreational drugs sold as
"bath salts" has sent an increasing
number of people to hospitals in the
United States and has resulted in
deaths.
24

25. What are Bath Salts?
• Synthetic Stimulant, similar to
ecstasy, cocaine and/or methamphetamine
• Derived from Cathinone from Khat plant
• “Not for human consumption”
• White, odorless, “pills”, fine-grained
powder or crystals (oxidizes to yellow or tan)
• Can be ingested by snorting, smoking,
swallowing, and intravenous access.
25

26. MDPV= Active compound
• Marketed as “Bath Salts”
• Chemical analog of
Cathinone (Schedule 1 C.S.)
• Dose: 25mg – 500mg
• CNS stimulant (up to 3 days)
– Delusional
– Seizures
– Restless / Irritated
– Inflammation of heart
– Teeth Grinding
26

27. 1 Dose Bath Salts…
DAY 1
 Banging head into wall
 Pulled out IV twice
 Hallucinating, thought security
guard drank his beer
• HGN: 2
• Pulse: 112 bpm
• Blood Pressure: 144/94
• Body Temperature: 98.5
• Pupils: 9 – 10 mm in all lighting
conditions
• Muscle Tone: Rigid
DAY 2
• Combative
• 12 people to control, injures 1
security guard
• Lorazepam x 3, Haloperidol x1
to control
• Moved to ICU
• Combative again when woke
up
DAY 3
• Resting pulse 120
• Exhausted, no memory
27

28. Effects of Bath Salts
DESIRED
• Euphoria
• Empathy/decreased hostility
• Hallucinations
• Increased insight/self-
discovery
• Increased energy
• Enhanced music
appreciation
WHAT REALLY HAPPENS
• Restless / irritated
• Delusional / paranoia
• Nose bleeds, headache
• Dilated pupils, blurred vision
• Blue/cold extremities
• Nausea/vomiting
• Seizures, teeth grinding
• Chest pain (inflamed heart)
• Excessive sweating
• Go to Jail  Go to Morgue!28

29. Synthetic Marijuana
29

30. Synthetic Marihuana and Driving
Michigan Criminal Case APD#10-14949
•Crossed raised median 3 times, hit concrete
wall 2x, driving on sidewalk w/ broken axle / tire
•6HGN + vertical
•.000 BAC
•Hallucinating
•“Death is all around me”
•Going to kill Officer
30

31. 31

32. What is SPICE / K2What is SPICE / K2 ??
Dangerous, synthetic research chemicals
that have been dissolved in acetone
and sprayed onto dried plant material (herbs)
32

33. SPICE/K2
• Plant material
• Marketed as incense
• Laced with various synthetic compounds
that behave like THC
• Smoked or mixed in drink or food
• Was sold LEGALLY and LOCALLY
• 1g -3g packages About 2x price of
marihuana
33

34. Spice/K2
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 34

35. Brands/Flavors
35

36. SymptomsSymptoms
Not always a bad trip, but if you’re involvedNot always a bad trip, but if you’re involved
it probably isit probably is
•Elevated BPElevated BP (140-210 / 100-110)(140-210 / 100-110)
•Rapid heart rate (110-150bpm)
– can be decreased BP / heart rate
•Tremors / SeizuresTremors / Seizures
•UnconsciousnessUnconsciousness
•Hallucinations / Delusions / ParanoiaHallucinations / Delusions / Paranoia
•Numbness / Tingling / Muscle LossNumbness / Tingling / Muscle Loss
36

37. SymptomsSymptoms
Not always a bad trip, but if you’re involved itNot always a bad trip, but if you’re involved it
probably isprobably is
• VomitingVomiting
• Memory LossMemory Loss
• Incoherent/slurredIncoherent/slurred
speechspeech
• May feel cold / hotMay feel cold / hot
• Excessive thirstExcessive thirst
• 6-8hr high6-8hr high (some(some
effects up to 30hrs)effects up to 30hrs)
Death??Death??
• Cyclic Symptoms
• Effects vary from use to use
and person to person
• “Excited Delirium”
– No pain
– No clothes
37

38. Treatment?
• No antidote
• Symptoms more like
Stimulants and
Dissociative Anesthetic
than Marihuana
• Not detectable on
standard screen
• Flush with Fluids (but not
too much)
38

39. NHTSA 2005-2009 Study
National Highway Traffic Safety Administration
Press Release # 16-10 Tuesday, November 30, 2010
Alcohol-
related
incidents
Drug-
related
incidents
39

40. KratomKratom
Asian leaf 'kratom' making presence
felt in US emergency rooms (NBC News March 19,
2012)
opiate-like leaf from Southeast Asia is well known in the
worlds of alternative medicine and the drug culture
dozens of companies selling kratom leaf and touting it as
a way to combat fatigue, pain and depression — even as
an antidote to heroin addiction
But in addition to its possible medicinal uses, kratom
is beginning to show up in U.S. emergency rooms,
with doctors saying they are dealing with people sick from
taking it — especially teens who try it to get high 40

41. KratomKratom
Asian leaf 'kratom' making presence
felt in US emergency rooms (NBC News March 19,
2012)
41

42. Kratom-Kratom- Available now at your local “Head Shop” or “Smoke Shop”
42

43. Kratom Sold in Austin, TexasKratom Sold in Austin, Texas
43

44. Conclusion
 Legal Safe!!!
 Many items are legal, but dangerous.
Gasoline, rat poison, bleach, drain cleaner, spray paint, glue...
 There are and will be hundreds and
thousands of synthetic drugs...always
morphing and changing.
 Most synthetic drugs are more dangerous
than the original drugs they copy/mimic.
 Expect the unexpected when dealing with
people under the influence of synthetics

45. Special Thanks to:
Kenneth Stecker
Michigan Traffic Safety
Resource Prosecutor
45

46. Judge Kevin R. Madison
PResiding Judge laKeway MuniciPal couRt
PResiding Judge HoRsesHoe Bay MuniciPal couRt
PResiding Judge BRiaRcliFF MuniciPal couRt
PResiding Judge JoHnson city MuniciPal couRt
eMt-inteRMediate (advanced liFesaving)
FiReFigHteR-FiRst ResPondeR
© coPyRigHt Judge Kevin R. Madison