3.12 Legal highs

Question 1

What are the effects of mephedrone?

Answer 1

Inhibits reuptake of serotonin, noradrenaline, and dopamine
Stimulates dopamine release
Stimulant: talkative, self-confident
Empathogenic: intimacy, appreciates music, openness, desire to dance

Question 2

What are the effects of cocaine?

Answer 2

Inhibits the reuptake of serotonin, norepinephrine, and dopamine
Can trigger cardiac events.

Question 3

What are the effects of amphetamines?

Answer 3

Stimulates the release of:

• Dopamine
• Norepinephrine

Can trigger psychosis.

Question 4

What are the effects of MDMA?

Answer 4

Stimulates the release of:

• Serotonin
• Norepinephrine
• Dopamine

Question 5

What are the negative effects of mephedrone?

Answer 5

Sympathetic SE: palpitations, tachycardia, mydriasis, chest pain, agitation, sweating, headache, insomnia
Jaw clenching, nausea/vomiting, paranoia, hallucinations
Craving, dependency

Question 6

What does “benzo fury” do?

Answer 6

It is a triple monoamine reuptake inhibitor

Question 7

What are the effects of empathogens?

Answer 7

Emotional openness
relatedness
empathy and sympathy

Question 8

What are the specific risks of cocaine and amphetamines?

Answer 8

Cocaine- cardiac

Amphetamines- psychosis

Question 9

What does ‘sympathetic toxidrome’ mean?

Answer 9

They are the acute toxic effects of amphetamine-like substances 
-tremor
-tachycardia
-sweating
-n/v
-hyperpyrexia 
-metabolic acidosis
-serotonin syndrome 
etc.

Question 10

What is serotonin syndrome?

Answer 10

agitation/restlessness
hyper-reflexia
tremor
myoclonus
sweating 
diarrhoea
shivering 
ataxia
fever
confusion
hypomania 
confusion 

Empathogens/entactogens, antidepressants, OTC cough syrup, antimigraine, antibiotics, tramadol, and herbal products all increase risk

Question 11

What is methiopropamine? (MPA)
-pink panther
-cherly sheen
-

Answer 11

It is a structural analogue of methamphetamine
Effects:
NA and DA reuptake inhibitor

Question 12

What is CHING/Mr. White?

Answer 12

Ethylphenidate
It is used as a cocaine substitute
Cut with lignocaine

Effects:
NA and DA reuptake inhibitor

Question 13

What is the difference between synthetic cannabinoids and cannabis?

Answer 13

• up to 800x more potent
• inconsistent
• less cannibidiol
• may cause psychosis increased agitation
• more hallucinations
• 2-3x more sympathomimetic effects, cardiovascular problems

Question 14

What are depressants like Etizolam used for?

Answer 14

Increased sociability, enhanced mood
to decrease HR and RR
Decreased LOC may lead to coma and death however
-may be used as a ‘come down’ in club drug use

MoA: decreased neurotransmission levels
-inhibit glutaminergic/catecholaminergic levels

Question 15

What is AH7921 a member of?

Answer 15

It is a part of the synthetic opioids class of drugs
-mu opioid receptor agonist
-?80% potency of morphine
Class A drug now

Question 16

What is acetylfentanyl famous for?

Answer 16

having 5-15x the potency of heroin

has caused deaths esp in Estonia

Question 17

What are the effects of hallucinogens?

Answer 17

Change perceptions
illusions, hallucinations and pseudohallucinations

Less likely to be used frequently
does not lead to dependence
tachyphylaxis- acutely decreased effect to drug
some sympathemimetic

Question 18

What are the effects of ketamine?

Answer 18

Detachment from reality 
derealisation 
depersonalisation 
dissociation 
hallucination 
sedative 

However: laryngeal and pharyngeal reflexes maintained

Highest risk due to accidental due to intoxication
SE: Ketamine bladder

Question 19

What is ketamine bladder?

Answer 19

Scarring of the lining of the bladder, may contract and cause increased frequency, haematuria
may eventually result in kidney failure