As with all designer drugs, “bath salts” and synthetic marijuana are difficult to identify and test for, because their chemical structure can and does change often, largely in response to laws trying to outlaw them. In order to test for them, diagnostic companies need to create tests for each version variant, once they know that it exists, which may be why the face-eating attacker in Florida could not be identified as a bath salt user. We talk about the new law attempting to ban all such substances signed recently by President Obama, the relationship to the clap-down on Rx drugs, how it impacts the synthetic drug marketplace, and how it relates to traditional illicit drugs, as witnessed by the increased incidence of heroin ODs.
Transcript (edited):
Podcast #118
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions I am Howard La Mere. Bath salts are still in the news bath salts along with synthetic marijuana. And, Darryl, you were interviewed for an article in Gentlemens Quarterly recently on bath salts – explaining the drama that has ensued, which certainly began when that person in Florida attacked the homeless person and chewed his face off. So, Darryl, you want to talk about that Gentlemens Quarterly article or the topic in general?
DARRYL: The Quarterly article is worth mentioning because it is a fairly well investigated article and a lot of fact checking went on. Interesting information was provided in the article by the author, Robert Moore, who interviewed me and interviewed Dr. David Smith, a colleague from the Haight Ashbury Free Clinic. Bath Salts harkens back to that era as we see so many new designer synthetic drugs today and the fact that there are a number of these chemicals are used as stimulants, acting like cocaine or methamphetamine. We really dont know much about these substances yet and how theyre going to affect human beings and what the potential is, for more tragic outcomes. I dont know if the word is exotic, but nothing is more frightening than the cannibal who ate off the homeless person’s face. There is still a question about whether he had used any bath salts. He was shot dead of course and the autopsy found only marijuana, but they tested for only 5 of the chemicals that are known to be in bath salts because there are no tests yet for the 40 chemicals that have been found in bath salts – so the attacker may have gotten a hold of one of the new formulations. But the article does present a fairly accurate, frightening picture of how these substances mess up a person’s brain – and how the country is reacting right now. Its not just Gentlemens Quarterly, but everybody is very much interested in whats happening and whats going to happen and this signals a major shift in drugs of abuse hearkening back to the 1960s when we saw a lot of synthetic designer drugs come out and were set for another round of that today. So, hows this going to end? I dont know. The cocaine era crack cocaine exploded and there was a lot of newspaper coverage on crack cocaine and we saw a proliferation in heavy abuse patterns with cocaine and its possible, with the media now so interested in these bath salts and their ability to change states of consciousness. We’ll have to see how the law that was signed by President Barack Obama last week is going to play out. The law named 10 of the 40 or so bath salt chemicals specifically named them, but also had wording that makes “any other current or future substances that act like” or tries to act like the stimulants in cocaine and methamphetamine – illegal .
HOWARD: Did they how did they technically describe them there? Did they describe them as aspects, (analogs) of amphetamines?
DARRYL: Well, no thats the problem with these types of laws, theyre so general, and there are loopholes. The way it was worded it bans similar compounds to the 10 currently named bath salt compounds that may be produced in the future and you know, theres a lot of compounds that might be used in the future – substances that act like the baths salts, these might have been developed to produce some industrial effect, like a lubricant or a solvent or typewriter cleaner, whatever, and then somebody discovers that it also acts like a bath salt and starts abusing it. And I think that will change the language – the language in the past was you have to prove that the intent was to produce something that was going to be abused – and if you proved that, then these people were in violation of the law. And of course, proving that intent might be very difficult because the street chemists and the street providers of these things are very smart at developing ways to circumvent the law. The other things that the federal law bans is internet as well as retail store sales. Currently bath salts and the synthetic marijuanas are available in convenience stores, in head shops, even in gas station markets – now it is illegal to sell any of those things in those places anymore.
HOWARD: But of course you cant ban it when it comes from another country.
DARRYL: Well, the law tries to. It says if it comes from another country, but its in this market and its being sold as one of these stimulant bath salts – its breaking our laws regardless of what the compound is if its a compound thats used for that purpose. Part of what the president did was to close the loopholes between various state laws. In Oregon I think weve banned about 5 or 6 of these chemicals, and 10 were banned by the federal government. New Jersey, Iowa, places like that have banned maybe 12, so each state has their own bath salt stimulant law and their own synthetic marijuana spice law and each specifically names several compounds. But say, there is a compound thats banned here in Oregon, but allowable in Washington, – people just crossed that border into Washington. An article in our local paper reported a huge something close to a 40% increase in alcohol sales in northern Oregon because Washington just enacted a new law which allows alcohol to be sold in grocery stores and in retail markets, rather than in state controlled stores but in order to make up the revenue that the state will lose by allowing it to be sold in retail outlets, the government was imposing a 10% commodity tax and a 17% sales tax – that equals a 27% increase in the price of alcohol. That just drives people up in southern Washington right across the border to buy their booze at a cheaper price. So similarly – if some bath salts or spices or synthetic marijuana are legal in one state, but not another state, many people who want to use them just cross the state line to get a hold of that commodity. But by placing these chemicals (under federal jurisdiction) – 10 of the bath salts and 21 of the synthetic marijuana chemicals, the new law closes that loophole. Regardless of individual state laws its federally illegal in both states.
HOWARD: Okay, well that brings to mind a question then as to what extent do you think that the increased scrutiny of prescription drugs is driving the demand for these synthetic drugs – synthetic marijuana or bath salts or heroin?
DARRYL: I think it would be hard for the pharmaceutical companies to argue as they did earlier this year that the diversion of prescription drugs and abuse of prescription drugs has not reached epidemic proportions. Every statistic measures an increase in deaths, emergency room treatment visits, and other things that pretty much puts the nail in the coffin that were out of hand. The U.S. government and lawmakers and the DEA are right now considering shifting their strategy because a lot of their strategy is targeted towards preventing the traditional illicit drugs like marijuana, heroin, cocaine, methamphetamine from getting on the street when in fact the greatest danger is abuse of prescription drugs . obtained through diversion. So they have to invest more resources towards decreasing the demand somehow, through education, treatment get more people in treatment while decreasing the diversion of prescription drugs onto the street. When Oxycontin in 2010 changed their formula and added the clumping agent so that when it was smashed to eliminate the time release system it would clump up and gum up and make it very difficult to snort or inject – the manufacturer claimed success and over 95% of the outlets for Oxycontin, the pharmacies switched to their new product. Now a ton of papers have come out citing a huge abuse of alternate opiate medication. Opana is the big one that is being abuse back East. Also the Vicodin derivatives of Norco are abused because people can find access to opiates in a different way. Additionally, a lot of stories came out this week reporting that many of the Oxycontin addicts who became addicted from diversion Oxycontin are now switching to heroin because heroin does not clump up on them, it is more available and is probably a lot cheaper because of the low demand and the bumper crops all over the world. Were seeing an increase in heroin use even here in the small valley of southern Oregon. So, heroin use is an unintended consequence, I guess, of trying to control the diversion of prescription drugs. All of this stems from the fact that addicts are going to get what they need in order to maintain their addiction and the best way we can intervene is to get addicts to realize that they have an illness. They have a disorder theyre different. Most of the people in this country are normies and theyre not going to use a substance to the point that it causes catastrophic consequences in their life. If we can get them to understand that and get them into treatment and maintain their treatment, that will stem the tide of this great demand to replace the thing thats changed or has been altered to make it less abusable. Theres always going a replacement for that which is hard or unavailable and theres always going to be a market of those addicts who remain un-treated.
HOWARD: Well, it does seem like theres a higher awareness of the importance of reducing the demand and of increasing treatment. One of the articles this week mentioned Governor Christie of New Jersey who has come out a number of times in the last couple of months saying quite blatantly that in his opinion, the war on drugs has failed and we need to look at reducing the supply and make use of things like Drug Court that will reduce the demand.
DARRYL: Let me comment on that. Did he actually say we should look more at decreasing the supply or simply lessen our investment in decreasing the supply? Because thats an interesting counter statement to what Ive always said and I agree as does everybody that I know of we have a failed on the war on drugs, so much that were not even using that term anymore. There is no war on drugs, you know, its over.
HOWARD: Its over.
DARRYL: It didnt happen.
HOWARD: We didnt win. It never happened. No, its actually in a New York Times story quoting him directly saying that the war on drugs failed and that imprisoning people is a mistake when they really need treatment.
DARRYL: Oh, so hes talking about demand. Thats actually demand. People who need treatment if we treat them, we decrease we fight the demand side of the war previous war on drugs.
HOWARD: And he was advocating Drug Court also.
DARRYL: That makes sense. So, he is agreeing with what weve always said weve invested in that war on drugs – 80 cents of every dollar was to decrease the supply and that doesnt make any sense. We keep losing that war
I recently read a story about an undercover sheriff officer who posed as a patient to a known or suspected script doctor – she said she was in need of pain medications and she brought in a picture an x-ray supposedly showing how messed up her left leg was and she needed to be treated for chronic pain. The doctor readily looked at the x-ray one time and wrote her a huge prescription and the cops immediately busted the doctor, especially because the x-ray was an x-ray of a dog actually
HOWARD: With the tail
DARRYL: Yes… it was actually
HOWARD: Oh, youve got the x-ray here .
DARRYL: Yes, a picture of the dog
HOWARD: Let me hold it up to the mike here!
DARRYL: You look and its clearly not a human leg.
HOWARD: Thats a tail!
DARRYL: Thats a tail there and in between the 2 legs and you know, so obviously we have a problem with diversion of prescription drugs and part of that problem script doctors and unscrupulous prescribers, but still, most reports claim 70% of drugs come from friends and relatives who are prescribed too much, dont use them, but make them available for people who dont have a prescription for them.
HOWARD: Yes, that makes it a different problem because the drugs are legitimate in n a lot of cases. Sometimes theyre stolen from pharmacies, but in a lot of cases they start out being legally prescribed drugs that are diverted later on.
Another section of the story about the war on drugs in the New York Times talks about the new president of Mexico his focus on changing the unsuccessful war on the drug cartels and reducing the violence that has been endemic in Mexico for the last several years. Again, talking about ways to look at demand reduction as opposed to supply reduction – and it’s not just in Mexico, but other Central American states also.
DARRYL: Theyre taking a little bit of a different track from what Ive been reading in the news about Mexico. Their take on demand reduction is legalization or decriminalization. If they can legalize, it takes the criminality, money making system out of it they think that will reduce, if not the total overall demand, the profiteering that occurs with drugs and therefore some of the violence will be eliminated. I think, as weve talked about before, they have to recognize that addiction is addiction and it doesnt matter if its legal, illegal an addict is going to make sure they have their supply of drugs and this just changes the focus of who gets rich from selling the drugs. With nicotine, the big corporations and cigarette companies get rich, but with illegal drugs, the drug cartels and undercover street vendors get rich. So, if they dont really address the problem in terms legalization or not, but in terms of treatment and prevention, Im not sure it will produce the expected impact.
HOWARD: Well, perhaps not, but at least its encouraging to try something different rather than persist using strategies that weve tried for a long time and have done nothing except exacerbate the problem.
DARRYL: We do need to try something different. Theres no doubt about that, but we must be cautious that we don’t just try something different because it is different, but we really look at what that difference is going to be.
HOWARD: And have a plan.
DARRYL: And have a plan because its very clear that the drug war thats fought on the front of supply reduction does not work. So, we have to do more on the demand reduction side and we have to have a plan as to what that demand reduction is going to look like, what is it going to consist of? There are some places that advocate providing certain medications or drugs to people so that there is no demand for them other than what comes in medically and how that might be effective. There are different ways of looking at that, but I really think if we look at the outcome data that continues to pile up in terms of various research looking at what happens to people when they get treatment and of course what happens because of relapse. There will be relapses in the same way that treating diabetes have relapses, but all the studies show that the treatment of addiction stacks up comparatively well with the treatment of other chronic diseases and overall its probably a much bigger bang for the buck than the supply reduction strategies.
HOWARD: Yes, thats been quite clearly shown, which makes me think we should discuss the drug war .drug courts more because we havent done that in awhile. But we will have to save that for a future episode because were out of time for today. So, as ever, thanks to you for listening and your questions, comments and suggestions are always welcome.
DARRYL: Hey, Howard, thanks for pulling all these loose ends together. Right now there seems to be a potpourri or plethora, I dont care what you call it – just tons of different pieces on drug addiction, drug treatment, on the science of drugs, different legislation, all kinds of things are out there and theyre all over the place and you seem to pull it together well, so thank you.
HOWARD: That wraps our pod for today. Please check back soon for the next in the series and visit our website, www.cnsproductions.com