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ISSUE BRIEF

A CHALLENGING DESIGN: ADDRESSING SYNTHETIC AND DESIGNER

DRUGS INTRODUCTION Over the last decade, the prevalence of synthetic and designer IN ADULT COURTS has increased at alarming rates. The European Monitor - ing Centre for Drugs and identified thirteen new By: Blaine Stum psychoactive substances (NPSs) in 2008 and ninety-eight NPSs in 2015, a 653 percent increase in only seven years. 1 A total of 480 NPSs were identified during that time frame. NOVEMBER 2016 This surge in availability, along with reported increases in use, difficulties associated with detection of emerging synthetic and designer drugs, and a murky legal landscape create myriad challenges for court practitioners and treatment organizations. The National Drug Court Resource Center Number of New Psychoactive Substances By Year (NDCRC) is housed at the Justice Programs 120 101 100 98 Office, a center in American University’s 81 80 73 60 49 School of Public Affairs, and is funded by 41 40 24 the Bureau of Justice Assistance. Issue 20 13 0 briefs, such as this, are created to educate 2008 2009 2010 2011 2012 2013 2014 2015 Source: European Monitoring Centre for Drugs and Drug Addiction and inform the treatment court field about topics of importance. For more information LEGAL STATUS Currently, there are two laws that specifically address synthetic please visit the National Drug Court or designer drugs: Resource Center at www.ndcrc.org. 1) The (21 U.S.C. § 813) 2) The Synthetic Drug Abuse Prevention Act (21 U.S.C .812(c)) The Federal Analogue Act was passed by Congress in 1986. AMERICAN UNIVERSITY’S SCHOOL OF PUBLIC AFFAIRS The bill amended the Controlled Substances Act (21U.S.C. The Justice Programs Office, a center in American University’s §801 et. Seq) so that synthetic or designer drugs that are School of Public Affairs, supports the National Drug Court Resource “substantially similar” to drugs already on Schedule I or II are Center, part of a BJA-funded drug court initiative. This issue brief treated the same as those controlled substances. 2 was created to respond to significant issues identified during the provision of technical assistance to the field. For more information about accessing technical assistance services or to learn more about the AU Justice Programs Office, go to www.american.edu/justice. 2 ADDRESSING SYNTHETIC AND DESIGNER DRUGS IN ADULT COURT

INCIDENCE OF USE To better understand populations that are at risk for synthetic drug use, researchers have surveyed a variety of groups during the last several years. In general, these surveys show that synthetic are the most widely abused synthetic drug. The Monitoring the Future Survey, for instance, found that ten percent of high school seniors reported using in the previous year, compared to 1.1 percent of high school seniors who reported using synthetic in the previous year. 10 Use rates fluctuate depending on the popula - tion being surveyed however; and survey literature does not suggest that synthetic or The Synthetic Drug Abuse Prevention Act substance analogue shall, to the extent designer drugs are “drugs of choice” for most was passed by Congress in 2012. It added intended for human consumption, be treated, users. Below is a sampling of studies on “cannabimimetic agents” to Schedule I of for purposes of this title and title III as a synthetic drug use: the Controlled Substances Act, as well as in schedule I.” 6 Packages fifteen specific compounds and of synthetic cannabinoids, , and • A survey of current users by eleven synthetic and hallucino - other synthetic drugs will often have warnings Gunderson, et al. found that twenty-four gens. 3 on them that state “Not Intended for percent of respondents reported currently using synthetic cannabinoids. 11 This sug - In addition to these laws, the United States Human Consumption” as a way to exploit this gests that current cannabis users are more Attorney General (AG) possesses the authority language. likely to be using synthetic cannabinoids. to temporarily list a substance under Schedule FORM AND MODES OF I if such an action is “necessary to avoid an ADMINISTRATION • Wagner et al. found that seven percent of 4 injection drug users reported using imminent hazard to the public health.” Of Synthetic cannabinoids are man-made synthetic cathinones. 12 the thirty-seven times this authority has been chemicals that are functionally similar asserted by the AG, thirty-two have been to Δ9- (THC), the • Caban et al. surveyed 155 army patients at 5 within the last five years. psychoactive constituent found in cannabis. Fort Bragg, North Carolina, who admitted Despite these laws and actions, sellers and These chemicals are either sprayed on dry or were suspected of using an illegal users of synthetic drugs have been able to plant materials for users to smoke or sold as substance. Tests revealed that 7.7 percent advertise these drugs as “legal highs” because liquids for vaporizing in e-cigarette devices. had recently used spice. 13 of language in Section 203 of the Federal Synthetic cathinones, also known as “bath Two studies of synthetic cannabinoid use have Analogue Act. It states that “a controlled salts,” are a class of drugs that are chemically specifically surveyed criminal justice popula - related to the plant found in Southern tions: The Community Drug Early Warning Synthetic Drugs Arabia and East Africa. They usually take the System (CDEWS) Pilot Project in 2013, and a CDEWS replication study conducted two Substances wherein the form of white or brown crystal-like powder that can be snorted, ingested, smoked or years later. psychoactive properties of a injected. 7 Similarly, non-pharmaceutical In both studies, researchers tested urine scheduled drug have been , a potent , comes in powder or samples that were previously tested using a tablet form, that users can snort, ingest, or standard drug testing panel with an expanded retained, but the molecular inject. 8 drug panel. The results suggest that synthetic structure has been altered in Kratom comes from the plant Mitragyna cannabinoid use is relatively frequent. In the speciosa Korth. Kratom users chew the leaves pilot project study, they found that thirty-nine order to avoid prosecution or gum infused with kratom or brew dried percent of urine specimens from parolees and under the Controlled kratom leaves or powder in a . 9 Kratom is probationers in Washington, DC, whose not a synthetic drug, but due to increased standard was negative tested positive Substances Act. use and awareness of kratom in the U.S. for synthetic cannabinoids. 14 The expanded D.E. Smith and R.B. Seymour, 1985 researchers have used the label “designer sample used in the replication study produced drug,” which is why it is included here. similar results, finding that thirty-six percent

For more information: [email protected], 202.885.2875, www.american.edu/justice 3 of parolee and probationer urine samples who endorsed using spice products to “achieve fully known at this time, 23 although some tested negative under a standard panel tested intoxication while avoiding detection in drug research suggests that low doses produce positive for synthetic cannabinoids. 15 urinalysis testing.” 19 -like effects, while high doses can 24 The replication study also obtained urine EFFECTS AND HEALTH IMPACTS mimic the effects of . specimens from an adult drug court in Denver, The short-and-medium term effects of using Colorado, and found that three percent of synthetic cannabinoids, bath salts, fentanyl, specimens who tested negative under the Emergency Department Visits and kratom manifest in a variety of ways that Involving Synthetic Cannabinoids standard panel tested positive for synthetic drug court programs should be on the lookout 16 cannabinoids. for: 30,000 What factors influence the decision to use Synthetic cannabinoids: Use of synthetic 25,000 synthetic drugs? No doubt the costs, increased cannabinoids may have similar effects as 17 20,000 availability, and legal ambiguity play a role. cannabis use, although the effects are less But surveys have also found that many people predictable. 20 Users can exhibit sedation, 15,000 use synthetic drugs to specifically avoid paranoia, anxiety, confusion, and delusions. 21 detection. Bonar, Ashrafioun, and Ilgen found 10,000 Bath salts: These drugs produce effects akin that seventy-one percent of patents in residen - 5,000 tial treatment facility used synthetic cannabi - to use, such as hyperactiv - noids to “get high without having a positive ity, , anxiety, confusion, suicidal 0 22 2010 2011 drug test.” 18 Another survey (Vandery et al.) thoughts, and weight loss. Kratom: The exact effects of kratom use on of people who reported using spice at least Source: Drug Abuse Warning Network. once in their life found that thirty percent the behavior and health of humans are not

WHAT CAN DRUG COURTS DO? thetic drugs are often used to avoid detection in standard drug tests (Perone et al.), 30 drug Communicate with law enforcement, emer - • Testing should be frequent, random, and courts should consider sanctions that address gency departments, and treatment facilities. test for possible dilution or adulteration. two behaviors: the use of the synthetic drug in question and the potential effort to deceive the They may be able to share information on • Results should be available within forty- court. 31 what synthetic and designer drugs are most eight hours of sample collection. commonly used in the area, or specific drugs Utilize random searches and seizures. Before Conduct drug tests with extended panels. that are emerging. Drug courts may also using this strategy, drug courts should make Some companies are beginning to release consider scouting local head shops to see what sure they understand all applicable laws expanded panel tests, but the costs are often drugs are being sold. related to search and seizure, probationary much higher. Prices for confirmation of conditions, and parties authorized to perform Include language in manuals and contracts synthetic cannabinoids and bath salts can a search. that explicitly mentions synthetic drugs. range from $15 to $40 per unit. 27 Drug courts Contracts and manuals should give partici - may be able to cover some of these costs Synthetic and designer drugs are often sold 32 pants a clear understanding of what consti - through reimbursements from Medicare. The online (Fattore & Fratta; Hillebrand, 33 34 tutes a prohibited substance, including any current Clinical Laboratory Fee Schedule Olszewski & Sedefov; Curtis et al.; Meyers 35 illicit synthetic or designer drugs. Beyond (CLFS) includes synthetic cannabinoids, opiate et al. ), so drug courts may want to consider mentioning these drugs specifically, drug analogues, and synthetic stimulants under searching internet cache history, online courts may want to include language that applicable drug classes. 28 receipts, and ATM transactions in addition to prohibits the use, possession, or distribution traditional search areas. Drug courts should be aware of the limitations of drugs that are marked “Not for Human of these extended drug panel tests however. Provide effective treatment services. While Consumption.” 25 Current tests only detect a small handful of there is no standard protocol currently avail - Maintain best practices for drug testing synthetic cannabinoid metabolites, standard - able for synthetic or use treat - protocol. The National Association of Drug ized cutoff limits have yet to be established, ment, current literature suggests treatment Court Professionals suggests: 26 the methods of these tests vary, and there is should use components similar to those of • Drug testing procedures should be clearly some uncertainty about windows of detection other types of addiction treatment, including 36 articulated in participant contracts. for newer synthetic or designer drugs. 29 medication assisted treatment (MAT) and individual and group therapy with cognitive Develop sanctions that specifically address • Urine specimen collection should be behavioral therapy. 37 witnessed. synthetic drug use. Due to the fact that syn -

For more information: [email protected], 202.885.2875, www.american.edu/justice 4 ADDRESSING SYNTHETIC AND DESIGNER DRUGS IN ADULT COURT

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For more information, please contact us: This project was supported by Grant No. Justice Programs Office 2012DC-BX-K005 awarded by the Bureau of American University Justice Assistance, U.S. Department of Justice. 4400 Massachusetts Ave., NW The opinions, findings, and conclusions or Washington, DC 20016-8159 recommendations expressed in this publication/ [email protected] program/exhibition are those of the author(s) (202) 885-2875 and do not necessarily reflect the views of the www.american.edu/justice Department of Justice or grant-making component.