In health care, drugs are both dangerous and essential. Illegal drugs including heroin and cocaine can cause severe physical and mental damage, but at the same time, drugs such as codeine, NSAIDs and of course antibiotics are indispensable to the provision of modern medical care. However, the line between safe legal drugs and dangerous illegal drugs is not always so clear.
According to new research, more and more people every year are dying from drugs – and ones that are, technically, legal. Last month, the National Programme on Substance Abuse Deaths based at St George's, University of London reported that 68 people in the UK died in 2012 in circumstances in which “legal highs” or “designer drugs” were directly implicated. This is a sharp rise from 2009, a year in which only 10 people died in this manner.
Even before this new evidence of an increasing death toll due to legal drug highs, experts in the field were aware of the growing popularity of new, so-called “designer drugs.” The European Monitoring Centre for Drugs and Drug Addiction identified 73 new drugs on the market in 2012 alone, including substances such as 2C-E, a synthetic psychedelic compound that may produce effects similar to those of LSD, and the amphetamine-like drug bath salts. Both 2C-E and bath salts have only been criminalized in the past few years.
Why are these new, manufactured drugs so dangerous? Unlike traditional illegal substances such as marijuana, cocaine or ecstasy, designer drugs haven’t been used for very long, and therefore their potency and safety hasn’t gone through any kind of informal safety testing. Of course, official safety testing hasn’t been performed, either: newer drugs vary in their potency and quantity of ingredients, and can affect different users in very different ways.
Many designer drugs include strong stimulants, causing users to experience increased heart rate, erratic behavior and difficulty sleeping. Interruptions to sleep alone can have a huge effect on overall immunity and health, and even a small overdose of a stimulating drug can lead to heart failure, seizure and death. Because new drugs tend to be chemically stronger than the drugs they are intended to imitate (bath salts, for example, are similar to cocaine but more potent), the medical risks are even greater.
Over the past five years, the most popular new designer drug in the UK has undoubtedly been mephedrone. Some studies rank it as the most widely consumed drug in the country after the mainstays of cocaine, cannabis and ecstasy, and the sudden rise of mephedrone has taken many people, in both the government and the health care industry, by surprise. The drug itself induces sensations similar to ecstasy and cocaine, and part of its current popularity is allegedly due to a huge fall in the purity of cocaine sold in the UK. Given a choice between an uncertain purchase of a class A drug, and a more reliable and technically legal alternative, the rise of mephedrone is hardly surprising – but users are sorely misinformed if they think that mephedrone is safer than its criminalized counterparts.
Similar to bath salts, mephedrone produces feelings of happiness and energy – along with paranoia, breathing problems and difficulty concentrating. Long term health effects may include loss of short-term memory, damage to the central nervous system, and mental instability. Mephedrone is now illegal in the United Kingdom.
On the other side of the Atlantic, there has been a rise in the number of cases involving bath salts, a drug very similar to mephedrone. Like mephedrone, bath salts are a member of the cathinone family of drugs, and are reported to induce a high similar to cocaine or ecstasy. When the media first became aware of bath salts, sensationalist stories about the drug and its effects quickly began to spread. The most widely reported of these was the “Miami Cannibal Incident” in 2012, in which a man believed to be under the effects of bath salts attacked and tried to chew the face off a homeless man, until being was shot and killed by the police. Despite the fact that coroners found no evidence of bath salts use, countless YouTube videos emerged showing bath salt users behaving in violent and disturbing ways.
Like mephedrone, bath salts have now been banned in the United States, but the overarching problem of designer drugs remains: enterprising chemists will always be one step ahead of the law in the creation and distribution of new drugs. Lawmakers at the moment only have the power to ban a particular combination of ingredients; they cannot ban any substance that produces a certain set of effects – therefore creating an arms race of sorts between drug manufacturers and the governments that seek to legislate them. Some would say it’s an arms race that has been on-going for nearly a century: when the United States banned morphine in 1925, other substances with a slightly different chemical makeup that provided exactly the same effects were immediately manufactured and sold. Later, the rise of lysergic acid diethylamide - better known as LSD - during the countercultural 60s saw a similar pattern: the government would ban the substance, only to find underground chemists making a new version that followed the letter of the law, but had roughly the same hallucinogenic effects.
In the coming decade, it’s likely that the struggle to prohibit legal drugs will continue. Until comprehensive legislation can be approved that will prevent drug manufacturers from carrying out their production work, it is up to health care workers and educators to keep promoting information on the dangers of drugs that might not even exist yet.