Not everything is Louis Vuitton -New Designer Drugs of Abuse

Ricardo Jimenez, Pediatric Emergency Medicine Physician

As physicians working in acute care centers or emergency departments, it’s a daily challenge dealing with patients who are intoxicated. But as new street drugs emerge in the community this challenge is even more difficult. Street drugs or designer drugs, are those drugs that are produced by “street pharmacists” at home or in clandestine laboratories. The goal of these drugs is to mimic the most common general classes of drugs that are abused. These new designer drugs are more easily found and affordable than their counterparts, most of them can be found on the internet or local smoke shops, and are considered “legal highs”. Because the street drug’s chemical composition is different from those that they try to mimic, in most cases the US DEA has no jurisdiction over them. At the same speed that the DEA is developing laws to govern these new chemicals, the street pharmacists can easily change the chemical composition,  thus  avoiding the DEA’s jurisdiction. To be prepared to manage intoxications from these new designer drugs, the physician must have a strong knowledge of the common drugs of abuse toxidromes. It’s impossible in the length of this article to discuss all the common designer drugs.  I will discuss those that mimic the most common general classes of drugs of abuse; Synthetic Cannabinoids, Synthetic Cathinones and opioid analogues.  

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