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Development of legal highs

Published online by Cambridge University Press:  02 March 2015

Brenda Wasunna ,
Emily Thomas  and
Sally Morgan
Brenda Wasunna*
Affiliation:
gether Foundation Trust, Gloucester, UK
Emily Thomas
Affiliation:
gether Foundation Trust, Gloucester, UK
Sally Morgan
Affiliation:
gether Foundation Trust, Gloucester, UK
*
Correspondence to: Dr Brenda Wasunna, c/o Dr Sally Morgan, Park House, Park Road, Stroud, Gloucestershire, GL5 2JG. E-mail: bwasunna@gmail.com
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Abstract

New psychoactive substances (NPS) or ‘legal highs’ are defined as unregulated psychoactive substances including synthetic and/or plant derived substances (marketed as research chemicals, party pills and herbal highs) that are intended to mimic the effects of controlled drugs. Psychiatric services around the country are seeing a rise in the use of NPS complicating mental health presentations. The challenge surrounding these substances is the fact that they are not under the international drug control system and are proving to have a detrimental health effect on users. This article reviews the current literature on this subject and discusses some of the most common examples of NPS and their potential effects on mental health.

Keywords

New psychoactive substanceslegal highsschizophreniaNPS
Type
Review Articles
Information
Journal of Psychiatric Intensive Care , Volume 11 , Issue 2 , August 2015 , pp. 128 - 137
Copyright
© NAPICU 2015 

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References

Ahern, N. and Greenberg, C. (2011) Psychoactive herb use and youth: a closer look at Salvia divinorum. Journal of Psychosocial Nursing Mental Health Services. 49(8): 16–19. doi:10.3928/02793695-20110705-05 CrossRefGoogle Scholar
Alatrash, G., Majhail, N.S. and Pile, J.C. (2006) Rhabdomyolysis after ingestion of ‘foxy’, a hallucinogenic tryptamine derivative. Mayo Clinic Proceedings. 81(4): 550–551.CrossRefGoogle ScholarPubMed
Austin, H. and Monaterio, E. (2004) Acute psychosis following ingestion of ‘Rapture’. Australasian Psychiatry. 12(4): 406–408.Google ScholarPubMed
Bajaj, N., Mullen, D. and Wylie, S. (2010) Dependence and psychosis with 4-methylmethcathinone (mephedrone) use. BMJ Case Reports. doi:10.1136/bcr.02.2010.2780 CrossRefGoogle ScholarPubMed
Castellanos, D., Singh, S., Thornton, G., Avila, M. and Moreno, A. (2011) Synthetic cannabinoid use: a case series of adolescents. Journal of Adolescent Health. 49(4): 347–349. http://dx.doi.org/10.1016/j.jadohealth.2011.08.002 CrossRefGoogle ScholarPubMed
Corkery, J., Claridge, H, Loi, B., Goodair, C. and Schifano, F. (2013) Drug-related deaths in the UK: January-December 2012: Annual Report 2013. London: International Centre for Drug Policy. 133 pp.Google Scholar
Dargan, P.I. and Wood, D.M. (2013) Novel psychoactive substances: classification, pharmacology and toxicology. London: Academic Press. 440 pp.Google Scholar
Dillon, P., Copelan, J. and Kansen, K. (2003) Patterns of use and harms associated with non-medical ketamine use. Drug and Alcohol Dependence. 69(1): 23–28.CrossRefGoogle ScholarPubMed
Driesen, N.R., McCarthy, G., Bhagwagar, Z., Bloch, M., Calhoun, V., D'Souza, D.C., Gueorguieva, R., He, G., Ramachandran, R., Suckow, R.F., Anticevic, A., Morgan, P.T. and Krystal, J.H. (2013) Relationship of resting brain hyperconnectivity and schizophrenia-like symptoms produced by NMDA receptor antagonist ketamine in humans. Molecular Psychiatry. 18(11): 1199–1204. doi:10.1038/mp.2012.194 CrossRefGoogle ScholarPubMed
EMCDDA (2011) Online sales of new psychoactive substances/‘legal highs’: summary of results from the 2011 multilingual snapshots Briefing Paper. European Monitoring Centre for Drugs and Drug Addiction. 8 pp.Google Scholar
EMCDDA (2012) EMCDDA–Europol 2011 annual report on the implementation of Council decision 2005/387/JHA. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. 29 pp.Google Scholar
EMCDDA (2013) EU drug markets report: a strategic analysis. Luxembourg: Publications Office of the European Union. 160 pp.Google Scholar
Feyissa, A.M. and Kelly, J.P. (2010) A review of the neuropharmacological properties of khat. Progress in Neuro-Psychopharmacology. 32(5): 1147–1166.CrossRefGoogle Scholar
Freeman, T.P., Morgan, C.J., Vaughn-Jones, J., Hussain, N., Karimi, K. and Curran, H.V. (2012) Cognitive and subjective effects of mephedrone and factors influencing use of a ‘new legal high’. Addiction. 107(4): 792–800. doi:10.1111/j.1360-0443.2011.03719.x CrossRefGoogle ScholarPubMed
Gee, P., Jerram, T. and Bowie, D. (2010) Multiorgan failure from 1-benzylpiperazine ingestion – legal high or lethal high? Clinical Toxicology. 48(3): 230–233. doi:10.3109/15563651003592948 CrossRefGoogle ScholarPubMed
Global Weekends (2014) Premium supplier of good times. http://globalweekends.co.uk [Accessed 21 May 2014].Google Scholar
Hoffman, R. and Al’Absi, M. (2010) Khat use and neurobehavioral functions: suggestions for future studies. Journal of Ethnopharmacology. 132(3): 554–563. doi:10.1016/j.jep.2010.05.033 CrossRefGoogle ScholarPubMed
Home Office (2013) Guidance for local authorities on taking action against ‘head shops’ selling new psychoactive substances (NPS). London: Home Office. 5 pp.Google Scholar
INCB (2013) Report of the International Narcotics Control Board for 2012. E/INCB/2-12/1. New York: United Nations.Google Scholar
Jan, R.K., Lin, J.C., Lee, H., Sheridan, J.L., Kydd, R.R., Kirk, I.J. and Russell, B.R. (2010) Determining the subjective effects of TFMPP in human males. Psychopharmacology. 211(3): 347–353. doi:10.1007/s00213-010-1911-y CrossRefGoogle ScholarPubMed
Jansen, K.L. (2000) A review of the non-medical use of ketamine: use, users and consequences. Journal of Psychoactive Drugs. 32(4): 419–433.CrossRefGoogle Scholar
Kalsi, S.S., Wood, D.M. and Dargan, P.I. (2011) The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerging Health Threats Journal. 4: 1–9. doi:10.3402/ehtj.v4i0.7107 CrossRefGoogle ScholarPubMed
Klaassen, T., Pian, K.L.H., Westenbery, H.G.M., den Boer, J.A. and van Praag, H.M. (1998) Serotonin syndrome after challenge with the 5-HT agonist meta-chlorophenylpiperazine. Psychiatry Research. 79(3): 207–212.CrossRefGoogle ScholarPubMed
Krystal, J.H., Karper, L.P., Seibyl, J.P., Freeman, G.K., Delaney, R., Bremner, J.D., Heninger, G.R., Bowers, M.B. Jr and Charney, D.S. (1994) Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses. Archives of General Psychiatry. 51(3): 199–214.CrossRefGoogle ScholarPubMed
Lahti, A.C., Koffel, B., LaPorte, D. and Tamminga, C.A. (1995) Subanesthetic doses of ketamine stimulate psychosis in schizophrenia. Neuropsychopharmacology. 13(1): 9–19. doi:10.1016/0893-133X(94)00131-I CrossRefGoogle ScholarPubMed
Lin, J.C., Bangs, N, Lee, H., Kydd, R.R. and Russell, B.R. (2009) Determining the subjective and physiological effects of BZP on human females. Psychopharmacology. 207(3): 439–446. doi:10.1007/s00213-009-1669-2 CrossRefGoogle ScholarPubMed
Luft, B. (2013) Emerging psychoactive substances – spotlight on ‘legal-highs’. North Metropolitan Health Service - Mental Health. 20(4): 1–4.Google Scholar
Malhotra, A.K., Pinals, D.A., Adler, C.M., Elman, I., Pikar, D. and Breier, A. (1997) Ketamine-induced exacerbation of psychotic symptoms and cognitive impairment in neuroleptic-free schizophrenics. Neuropsychopharmacology. 17(3): 141–150.CrossRefGoogle ScholarPubMed
Mohandas, A. and Vecchio, D. (2008) A case report of Bezylpiperazine induced new onset affective symptoms in a patient with schizophrenia. European Psychiatry. 23(suppl. 2): S315–S316. doi:10.1016/j.eurpsy.2008.01.1085 CrossRefGoogle Scholar
Morgan, C.J.A. and Curran, H.V. (2006) Acute and chronic effects of ketamine upon human memory: a review. Psychopharmacology. 188(4): 408–424. doi:10.1007/s00213-006-0572-3 CrossRefGoogle ScholarPubMed
Morgan, C.J.A. and Curran, H.V. (2011) Ketamine use: a review. Addiction. 107(1): 27–38. doi:10.1111/j.1360-0443.2011.03576.x CrossRefGoogle ScholarPubMed
Morgan, C.J.A., Rossell, S.L., Pepper, F., Smart, J., Blackburn, J., Brandner, B. and Curran, H.V. (2006a) Semantic priming after ketamine acutely in healthy volunteers and following chronic self-administration in substance users. Biological Psychiatry. 59(3): 265–272.CrossRefGoogle ScholarPubMed
Morgan, C.J.A., Perry, E.B., Cho, H.S., Krystal, J.H. and D'Souza, D.C. (2006b) Greater vulnerability to the amnestic effects of ketamine in males. Psychopharmacology. 187(4): 405–414. doi:10.1007/s00213-006-0409-0 CrossRefGoogle Scholar
Morgan, C.J., Meutzelfeldt, L. and Curran, H.V. (2010) Consequences of chronic ketamine self-administration upon neuro-cognitive function and psychological wellbeing: a 1-year longitudinal study. Addiction. 105(1): 121–133. doi:10.1111/j.1360-0443.2009.02761.x CrossRefGoogle Scholar
Misuse of Drugs Act (1971 c. 38) London: The Stationery Office.Google Scholar
Olney, J.W., Newcomer, J.W. and Farber, N.B. (1999) NMDA receptor hypofunction model of schizophrenia. Journal of Psychiatric Research. 33(6): 523–533.CrossRefGoogle ScholarPubMed
Pal, H.R., Berry, N., Kumar, R. and Ray, R. (2002) Ketamine dependence. Anaesthesia & Intensive Care. 30(3): 382–384.CrossRefGoogle ScholarPubMed
Patel, N.B. (2000) Mechanism of action of cathinone: the active ingredient of khat (Catha edulis). East African Medical Journal. 77(6): 329–232.Google ScholarPubMed
Paulzen, M. and Gründer, G. (2008) Toxic psychosis after intake of the hallucinogen salvinorin A. Journal of Clinical Psychiatry. 69(9): 1501–1502.CrossRefGoogle ScholarPubMed
Regan, L., Mitchelson, M. and Macdonald, C. (2011) Mephedrone toxicity in a Scottish emergency department. Emergency Medical Journal. 28(12): 1055–1058. doi:10.1136/emj.2010.103093 CrossRefGoogle Scholar
Rose, S.R., Poklis, J.L and Poklis, A. (2013) A case of 25I-NBOMe (25-I) intoxication: a new potent 5-HT2A agonist designer drug. Clinical Toxicology (Phila). 51(3): 174–177. http://dx.doi.org/10.3109/15563650.2013.772191 CrossRefGoogle ScholarPubMed
Schep, L.J., Slaughter, R.J., Vale, J.A., Beasley, D.M. and Gee, P. (2011) The clinical toxicology of the designer ‘party pills’ benzylpiperazine and trifluoromethylphenylpiperazine. Clinical Toxicology. 49(3): 131–141. doi:10.3109/15563650.2011.572076 CrossRefGoogle ScholarPubMed
Stewart, C.E. (2001) Ketamine as a street drug. Emergency Medical Services Journal. 30(11): 2–4.Google ScholarPubMed
Toennes, S.W., Harder, S., Schramm, M., Niess, C. and Kauert, G.F. (2003) Pharmacokinetics of cathinone, cathine and norephedrine after the chewing of khat leaves. British Journal of Clinical Pharmacology. 56(1): 125–130.CrossRefGoogle ScholarPubMed
UNODOC (2013) World Drug Report 2013. United Nations Office on Drugs and Crime. New York: United Nations.Google Scholar
Vandrey, R., Dunn, K.E., Fry, J.A. and Girling, E.R. (2012) A survey study to characterize use of Spice products (synthetic cannabinoids). Drug and Alcohol Dependence. 120(1–3): 238–241. doi:10.1016/j.drugalcdep.2011.07.011 CrossRefGoogle ScholarPubMed
Wikström, M., Holmgren, P. and Ahlner, J. (2004) A2 (N-benzylpiperazine) a new drug of abuse in Sweden. Journal of Analytical Toxicology. 28(1): 67–70.CrossRefGoogle ScholarPubMed
Wilson, J.M., McGeorge, F., Smolinske, S. and Meatherall, R. (2005) A foxy intoxication. Forensic Science International. 148(1): 31–36. doi:10.1016/j.forsciint.2004.04.017 CrossRefGoogle ScholarPubMed
Winstock, A. (2011) The 2011 MixMag drugs survey. MixMag. 251: 68–73.Google Scholar
Winstock, A.R. and Barratt, M.J. (2013) Synthetic cannabis: a comparison of patterns of use and effect profile with natural cannabis in a large global sample. Drug and Alcohol Dependence. 131(1–2): 106–111. doi:10.1016/j.drugalcdep.2012.12.011 CrossRefGoogle Scholar
Winstock, A.R., Mitcheson, L.R., Deluca, P., Davey, Z., Corazza, O. and Schifano, F. (2011) Mephedrone, new kid for the chop? Addiction. 106(1): 154–161. doi:10.1111/j.1360-0443.2010.03130.x CrossRefGoogle ScholarPubMed
Winstock, A.R., Mitcheson, L., Gillatt, D. and Cottrell, A.M. (2012) The prevalence and natural history of urinary symptoms among recreational ketamine users. BJU International. 110(11): 1762–1766. doi:10.1111/j.1464-410X.2012.11028.x CrossRefGoogle ScholarPubMed
Wood, D.M. and Dargan, P.I. (2012) Novel psychoactive substances: how to understand the acute toxicity associated with the use of these substances. Therapeutic Drug Monitoring. 34(4): 363–367. doi:10.1097/FTD.0b013e31825b954b CrossRefGoogle ScholarPubMed
Zelger, J.L., Schorno, H.X. and Carnili, E.A. (1980) Behavioural effects of cathinone, an amine obtained from Catha edulis Forsk.: comparisons with amphetamine, norpseudoephedrine, apomorphone and nomifensine. Bulletin on Narcotics. 32(3): 67–81.Google ScholarPubMed