New and re-emerging Abused Drugs

Prescription-Drug-Abuse The greatest challenge for physicians today is to be up to par with the new and remerging drugs of abuse. The problem is the law enforcers have declared certain drugs that were perceived to have medicinal qualities into illegal drugs. Most of these drugs are those used in cooling pain. Having these drugs classified as illegal has led to many street doctors to adopt ways through which they can continue using such drugs without being at loggerheads with the law enforcers and that has led to mixing certain substances with these drugs in a bid to conceal what the real contents of the drugs are. They have also branded this drugs with strange names all in a in a bid to hide them from the law enforcers. The packages of these drugs are written as ‘not for human consumption’ among other strange names that has been given to these new and re-emerging drugs of abuse to enable them trade safe. Emerging drugs of abuse are forever changing and involve manipulation of basic chemical structures to avoid legal ramifications. The structural changes are important to those dealing in these drugs as they help them evade forensic chemical tests hurdles. The names given to these drugs may not even have a relation to their contents and so not as important as understanding the classes of these drugs. Most of the synthetic new drugs of abuse result in psychoactive and sympathomimetic effects.

For emphasis this needs to be repeated many of these drugs are marketed as “legal highs despite being labeled “not for human consumption” to avoid regulation. The availability of these substances over the Internet and in “head shops” has led to a multitude of emergency department visits with severe complications including deaths worldwide. Today there are still new drugs of abuse that are not yet known by physicians. The drugs are not easy to tame since even the slightest alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown hence very dangerous to the users. Some of these drugs that are being abused greatly today hence not very easy to tame are piperazines.

Piperazines

Piperazines have often been referred to as failed pharmaceuticals. This is because some had been evaluated as potential therapeutic agents by pharmaceutical companies but never brought to the market .One piperazine that has been commonly used as NPS is 1-benzylpiperazine (BZP) though other piperazine derivatives have also been reported to be useful in medicine. These include among others 1-(3-chlorophenyl) piperazine (mCPP), 1-(3-trifluoromethylphenyl) piperazines (TFMPP), 1-benzyl-4-methylpiperazine (MBZP), 1-(4-fluorophenyl) piperazines (pFPP) and 1-cyclohexyl-4-(1,2-diphenylethyl) piperazine (MT-45).

BZP itself was initially developed as a potential antidepressant drug, but was found to have similar properties to amphetamine and therefore liable to abuse. In the 1980s, it was used in Hungary to manufacture piberaline, a substance marketed as an antidepressant. This substance was later withdrawn since it was thought liable to abuse as well. In the late 1990s, BZP emerged in New Zealand as a ‘legal alternative’ for MDMA and methamphetamine. In Europe, its use was first reported in Sweden in 1999, but it only became widespread as a NPS from 2004 onwards until controls over the substance were introduced in 2008, in the European Union. mCPP was developed during the late 1970s and is used as an intermediate in the manufacture of several antidepressants, e.g. trazodone and nefazodone. TFMPP is almost always seen in combination with BZP to produce the entactogenic effects of MDMA.

Neither BZP nor any other piperazines are under international control, although several (BZP, TFMPP, mCPP, MDBP) were pre-reviewed by the WHO Expert Committee on Drug Dependence in 2012. Several countries have introduced national control measures over piperazines. The control measures are however still challenged as those dealing in these drugs are adopting ways to beat the authorities in this trade. Piperazines are frequently sold as ‘ecstasy’. Some of the generic names for these substances include; pep pills, social tonics or simply as party pills.

These drugs are mostly used recreationally and two groups of these drugs feature here and these are benzylpiperazines and phenylpiperazines. Most of the pills sold as ecstasy and amphetamines have been found to contain components of Piperazines or its substitutes. They can also come as mixtures of more than one piperazine (such as BZP/TFMPP) or in combination with other drugs of abuse. Today Piperazines are some of the most common active substances found in Internet purchased drugs and they are majorly abused by young people.

Can adversely affect the users

Piperazines have been found to act as stimulants as a result of dopaminergic, noradrenergic, and predominantly serotoninergic effects produced in the brain. The majority of pharmacological studies of piperazines has focused on BZP and have indicated that it produces toxic effects similar to amphetamine and other sympathomimetics. According to animal studies, its effects are less potent than amphetamine, methamphetamine and MDMA. TFMPP, used in conjunction with BZP, has been reported to produce some of the effects of MDMA, but with a lower potency, while mCPP has been indicated to produce similar stimulant and hallucinogenic effects as MDMA.

In New Zealand, toxic seizures and respiratory acidosis after the use of BZP alone or in conjunction with other drugs were reported from three patients. Another study of 61 patients reported toxic effects of BZP, with two cases presenting life-threatening toxicity. Hyperthermia, rhabdomyolysis and renal failure associated with BZP ingestion have also been reported. In the United Kingdom, self-terminating grand mal seizures after the use of BZP have also been reported. All these findings prove how fatal the use of these drugs is and so should be avoided at all costs.

Finally, Dr. Dalal Akoury (MD) is an experienced doctor who has been in the frontline fighting drug addiction. He runs a website that equips readers of better ways to overcome not only drug addiction but also serious health problems that have caused nightmares to the world population. Get in touch with her today and learn more.