Baths Salts, Spice, and Related Designer Drugs: The Science Behind the Headlines

Abstract

The abuse of synthetic psychoactive substances known as "designer drugs," or "new psychoactive substances" (NPS), is increasing at an alarming rate. NPS are purchased as alternatives to traditional illicit drugs of abuse and are manufactured to circumvent laws regulating the sale and use of controlled substances. Synthetic cathinones (i.e., "bath salts") and synthetic cannabinoids (i.e., "spice") are two types of NPS that have received substantial media attention. Although low recreational doses of bath salts or spice compounds can produce desirable effects, high doses or chronic exposure often leads to dangerous medical consequences, including psychosis, violent behaviors, tachycardia, hyperthermia, and even death. Despite the popularity of NPS, there is a paucity of scientific data about these drugs. Here we provide a brief up-to-date review describing the mechanisms of action and neurobiological effects of synthetic cathinones and cannabinoids.

Synthetic Cannabinoids (SCs) in Metaphors: a Metaphorical Analysis of User Experiences of Synthetic Cannabinoids in Two Countries

“…One such NPS are the synthetic cannabinoids (SCs) known as Spice, K2, Kronic (Bright et al 2013;Baumann et al 2014;Fantegrossi et al 2014;Zawilska and Wojcieszak 2014), intended to replace natural cannabis and generally sold as herbal smoking mixtures. SCs emerged in Europe as early as 2004 (Griffiths et al 2010;Schifano et al 2009).…”

“…Given the variability in content and potency of SC products, duration of effect (and residual effects) can last for hours (Schneir et al 2011;Spaderna et al 2013), and can contribute to a range of unpleasant experiences and risk of overdose (Tuv et al 2012;Van Hout and Hearne 2017). Serious side effects include anxiety, decreased motor coordination, fast or irregular heartbeat, psychotic presentations and agitation (Every-Palmer 2011; Müller et al 2010;Nacca et al 2013;Barratt et al 2013;Bassir Nia et al 2016;Baumann et al 2014;Fattore 2016;Hurst et al 2011;Tuv et al 2012). Emergency presentations describing such acute intoxication report on patient panic attacks, loss of consciousness, nausea, tachycardia, paranoid ideation, agitation, suicidal ideation, confused states and hallucinations, with symptoms emerging in the hours post consumption (Vearrier and Osterhoudt 2010;Sobolevsky et al 2010;Van Der Veer and Friday 2011;Bebarta et al 2012).…”

Synthesis and spectroscopic characterization of emerging synthetic cannabinoids and cathinones

“…A range of different intoxications have been reported, ranging from cardiovascular and neurological to psychiatric effects, like tachycardia, arterial hypertension, hallucinations, aggressiveness, agitation, hyperthermia and locomotor behaviour alterations. [54][55][56][57] Further lethal intoxications have also been reported. Similarly, as with the synthetic cannabinoids, five structural positions are frequently exposed for alterations ( Figure 14).…”

Las nuevas drogas: origen, mecanismos de acción y efectos. Una revisión de la literatura

“…En ambos casos, el resultado es un incremento en la concentración de estos neurotransmisores, con lo que se produce un estado de estimulación excesivo y sostenido. También se ha planteado que algunas de estas drogas activan directamente receptores adrenérgicos (Baumann et al, 2014).…”

“…Estos efectos en conjunto producen una inhibición neuronal. Dado que los receptores CB 1 se encuentran en neuronas que manejan distintos neurotrasmisores, los efectos son complejos (Baumann et al, 2014;Seely et al, 2012;Castaneto et al, 2014).…”