The global drug landscape has undergone significant changes in recent decades, with a notable increase in the production and use of synthetic drugs. This article analyzes the information presented in the House of Lords report on the emerging threat of synthetic drugs, highlighting the types of drugs, their effects, and public health implications. To download the full presentation by Thom Browne Jr., CEO of the Colombo Plan, click here.
Types of Emerging Synthetic Drugs
Synthetic Opioids
Synthetic opioids represent one of the most dangerous categories due to their high potency and ability to cause fatal overdoses. Between 2018 and 2021, several new synthetic opioids were detected, including:
- Benzimidazoles/Nitazenes: Etonitazene (1000-1500 times more potent than morphine), Isotonitazene (500 times), Metonitazene (100 times), Protonitazene (200 times).
- Fentanyls: Variants such as fluorofentanyl, valeryl fentanyl, and ortho-fluorofentanyl have appeared in street drug samples.
Synthetic Cannabinoids
Synthetic cannabinoids, such as 5F-MDMB-PICA, have been linked to numerous overdose cases. Between 2016 and 2018, more than 340 reports were registered in U.S. forensic laboratories, with severe adverse effects, including death.
Synthetic Stimulants
Eutylone, a synthetic cathinone, has shown pharmacological effects similar to cocaine and MDMA. Reports of its presence increased from 29 in 2017 to 3958 in 2019, highlighting its rapid proliferation and risk.
Synthetic Benzodiazepines
Clonazolam, one of the most potent synthetic benzodiazepines, can induce intense sedation with small doses, and doses higher than 0.5 mg can cause overdose.
Changing Patterns of Fentanyl Use
Fentanyl and its analogs continue to dominate street drug samples in various U.S. regions. Combinations of fentanyl with other opioids, stimulants, and adulterants have increased overdose risks.
In several states, such as Vermont and Kentucky, drug samples have revealed complex mixtures of fentanyl with other compounds, significantly increasing user risks. In Illinois, for example, multiple fentanyl compounds were found along with other adulterants, such as xylazine and aminopyrine, exacerbating toxic effects.
Toxic Adulterants and Public Health
The use of adulterants such as xylazine, aminopyrine, and levamisole in street drugs poses serious public health threats. These compounds can cause:
- Xylazine: Prolonged sedation and respiratory depression, increasing the risk of fatal overdose.
- Aminopyrine: Severe immunosuppression and risk of serious infections.
- Levamisole: Decrease in white blood cells, increasing vulnerability to opportunistic infections.
The report also highlights the presence of other dangerous compounds in street drugs, such as dipyrone, which can potentiate the effects of opioids and increase the risk of complications.
Overdose Prevention and Risk Mitigation
The use of fentanyl test strips and the administration of naloxone are critical measures in preventing overdoses. Test strips allow users to identify the presence of fentanyl in drugs, while naloxone can reverse the effects of an opioid overdose. However, the effectiveness of naloxone can be compromised by the presence of other compounds, such as benzodiazepines and xylazine.
The report emphasizes the importance of education and awareness among drug users about the risks associated with adulterated drugs and the availability of tools like test strips to reduce the risk of overdose.
The proliferation of synthetic drugs and toxic adulterants represents a growing threat to global public health. It is crucial to implement monitoring, prevention, and treatment strategies to address this emerging crisis. Education and awareness, along with robust public health policies, are essential to mitigate the risks associated with the use of these substances.
