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 The method, outlined in the New England Journal of Medicine, could
make it easier for officials to quickly outlaw a synthetic drug and
law enforcement officials to get it off the street.
It involves developing a catalog of potential drugs before they hit
the black market, making identification faster.
"The way to respond to designer drug intoxication requires a totally
different approach that may not necessarily be available to ordinary
clinical labs,” said senior author Roy Gerona of the University of
California, San Francisco.
The development is part of an ongoing race by chemists to develop
powerful new mind-bending drugs before officials can outlaw them.
They tweak psychoactive molecules to create chemicals that appeal to
people looking for a cheap high. They're sometimes sold as incense,
smoked like marijuana and don't become known to authorities until
the people who take them suffer their ill effects.
That's what happened in July when an herbal "incense" product sold
as "AK-47 24 Karat Gold" hit the streets. A Facebook live feed at
the time showed people severely intoxicated by the drug, known
generically as K2 or Spice.
In the video, some are lying catatonic on the ground and one is
propped up by a fire hydrant as the videographer describes them as
zombies. The characterization stuck, perpetuated in part by a New
York Post story and other media reports.
More than 200 such compounds have been identified since 2014. Many
come from laboratories in China or Southeast Asia.
Because they are created and distributed so quickly, it can take two
to six months to identify a new chemical, Gerona said. In the New
York case, it was done in 17 days because Gerona and his colleagues
at the UCSF Clinical Toxicology and Environmental Biomonitoring
Laboratory had used already-known drugs to develop a catalog of
potential compounds that psychoactive drug developers might create.
"We've been preempting what they could possibly synthesize in the
future," he told Reuters Health in a telephone interview.
In the new analysis, Gerona and his colleagues studied 18 people who
were hospitalized for exposure to the drug, later identified as
AMB-FUBINACA. It depresses the central nervous system and causes "zombielike"
behavior. Thirty three people were known to have been exposed.
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The typical victim was a 28-year-old man with a blank stare who was
slow to respond to questioning. He tested negative for all known
illegal drugs and alcohol. He periodically groaned and had slow
movements of his arms and legs. He didn't ask for brains. He needed
nine hours to recover.
It turns out that Gerona and his colleagues had synthesized the
compound last winter, before it had shown up on the black market. If
there had not been some bureaucratic delays, identification might
have occurred even faster, perhaps within a week, Gerona said.
It was the U.S. Drug Enforcement Administration that had to arrange
to get Gerona and his team involved. "That's when we were able to
respond quickly," he said.
Identifying the drug allowed officials to take steps to outlaw it.
"We're always chasing whatever new drug comes in so perhaps we
should change the way these compounds are regulated. Now we just
react," Gerona said. "What happens if it's an ultra-potent drug that
kills more than 1,000 people in the first strike? That's 1,000 lives
lost before we actually do something about it," he added.
"As the number and complexity of new psychoactive substances
increases," the researchers write in their report, "this type of
coordination among multiple agencies is important for the timely
resolution of future outbreaks."
SOURCE: http://bit.ly/1rzGOHe New England Journal of Medicine,
online December 14, 2016.
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