Designer Drugs, Deadly Consequences
Earlier this year, a 19-year-old Minnesota teen died and 10 others were injured after taking large doses of 2C-E -- a drug with far more potent and dangerous effects than the 2C-I they thought they were taking at a spring break party. The 21-year-old who supplied the drug -- police found him unconscious in a snow bank -- has been charged with third-degree murder.
Last May, in Oklahoma, two young people died and six were injured when they took what they thought was 2C-E, but which seems actually to have been the extra-dangerous 3C-bromo-dragonfly.
Most of the new designer drugs have psychedelic properties, although many have mixed features of psychedelics and other drug classes such as stimulants or amphetamines. They are dangerous for users who don't know what they're getting -- or getting into. And it's casting a pall over the renaissance of scientific research into legitimate uses for psychedelic drugs.
Both of these dangers worry Purdue University pharmacologist David E. Nichols, PhD, a leading figure in psychedelic research.
"These newer so-called 'legal' highs, we really don't know anything about them. They have never been tested. People are playing a game of Russian roulette with these things," Nichols tells WebMD. "These are proliferating now. A lot of them came from my lab. We may have done one or two rat studies, but we know nothing about what these compounds do in humans."
Designer Drugs: What's New, What's Not
What's new about the new drugs? In one sense they are not terribly new.
"A lot of these drugs have been around for a while, and many of them are derivatives of existing compounds," Shurtleff tells WebMD. "Take this 2C-E that resulted in the death in Minnesota, for example. That is the third, or fourth, or fifth of a line of compounds coming from ecstasy or MDMA."
One thing that makes this crop of drugs different is how they're sold.
"What is really a different factor here is the Internet -- information, right or wrong or indifferent, gets disseminated at lightning speed and changes the playing field for us," says the DEA's Boggs. "It is a perfect storm of new trends. Before the Internet these things took years to evolve. Now trends accelerate in seconds."
A quick web search turns up dozens of sellers offering not only the raw ingredients for making designer drugs, but brazenly advertising the drugs themselves.
Beyond the rapid spread of the new drugs and new drug trends, something else about these designer drugs is new. Terribly new.
In the 1960s and 1970s, people seeking psychedelic experiences usually took LSD, psilocybin (magic mushrooms), or mescaline (peyote). These drugs are potent hallucinogens. For people genetically predisposed to mental illness, or those who take the drugs in an unsafe setting, this is quite dangerous. But these drugs are not directly toxic, even at high doses.
"Things like LSD and mushrooms and mescaline have low toxicity," Nichols says. "The reason is that their target is the serotonin 2a receptor in the brain. They do not interact with receptors that control heart rate or vegetative functions that cause death. Drugs like 2C-E have effects on the serotonin receptors in the brain, but also in the blood vessels and elsewhere. So if you take a truly large dose, which is easy to do, you can have your blood vessels contract, your heart rate go way up, your temperature regulation go out of control. ... There have never been studies on what else they may hit."
LSD and psilocybin have specific effects on serotonin in the brain. But the new drugs are not nearly as specific. In addition to serotonin, they variously affect other vital chemical signals, particularly dopamine and norepinephrine. Because these chemical messengers affect cells throughout the body, they can have drastic, unexpected effects on vital functions such as heart rate and body temperature.
While the new drugs may be more dangerous, even those who value psychedelic experiences warn against the casual use of even the least dangerous psychedelic drugs.
Psychotherapist Neal M. Goldsmith, PhD, author of the book Psychedelic Healing, notes that psychedelic substances have been used for thousands of years by virtually every culture. He sees the "reintegration" of psychedelics into our science and our spirituality as a good thing -- but one "unfortunately fraught with some growing pains."
"With use increasing and prohibitions in place you find young people taking these drugs out of spiritual context, with no real knowledge of their safety or efficacy or dangers," Goldsmith tells WebMD. "It is not surprising people get into trouble. ... Knowledge increases safety ... and there is some danger in going from a state where these psychedelic drugs have been banned, as there is very little knowledge, or experience, or experienced elders to guide appropriate use."
Why Do People Take Designer Drugs?
When Goldsmith talks about the psychedelic experience, it's clear he's not talking about fun and games on a Friday night. For the unprepared, he says, the experience is frightening. And even in the right context, it's not an experience one would seek out for amusement.
"It is certainly a difficult experience," Goldsmith says. "It is like spending a rainy four-hour afternoon in your clergyman's office, crying your eyes out about how you have wasted your life and then coming out into the sun breaking through the clouds and feeling optimistic for the first time in years."
Yet 19% of U.S. males and 11% of U.S. females reported having used hallucinogens in a 2009 survey, according to the U.S. Substance Abuse & Mental Health Data Archive (SAMHDA).
Why are so many people risking their lives and risking imprisonment in order to take psychedelic drugs on their own, in uncontrolled settings, and at doses they can only guess at?
In a 2004 paper, Nichols offers a clue. He notes that "in much of the counterculture that uses these substances, 'entheogen' has replaced 'psychedelic' as the name of choice, and we may expect to see this trend continue."
"Entheogen" is from a Greek word meaning "god within." It refers to the deep spiritual experience reported by many people who have taken psychedelic substances while in a positive state of mind and in a supportive environment.
A recent clinical trial of psilocybin by Johns Hopkins researcher Roland R. Griffiths and colleagues found that mentally healthy adults reported "mystical-type experiences" with "substantial personal and spiritual significance." They said the experience caused "positive changes in attitudes, mood, and behavior."
The Minnesota teens injured by 2C-E mistakenly thought taking a psychedelic drug might be a fun way to party. But Goldsmith says many people knowingly seek out the difficult psychedelic experience because of a basic human need: the "urge to transcend."
"Not just transcend in the dreamy, wasted, blissed-out sense, but to transcend in the sense of integration into something deeper, something more fundamental: the ground of your being, your soul, who you were when you were born," he says. "And that is really the purpose of psychedelics, to get you down to who you really are, and in many cases to bond you with others in your family or tribe. [The experience] is not just for better personal integration but better community integration as well."
By community integration, Goldsmith is deliberately advising against the third part of Timothy Leary's infamous "Turn on, tune in, drop out" slogan of the 1960s. Goldsmith says that people who gain insights through spiritual psychedelic experience have a responsibility to reconnect with their families and their society at a deeper, more connected level.
Goldsmith is quick to note that he does not advocate illegal use of psychedelic drugs, nor does he offer such drugs to his psychotherapy patients. He warns against use of these substances by people with a family history of mental illness.
"But I do use it myself," he says. "What I see when I look inside and what I try to help my clients see is that there is a deeper truth, a deeper self. ... The knots in our psychological muscle can be released, unfurled, softened through love and warmth and acceptance. This is what psychedelics have done for me and what I try to do for my clients."
While true psychedelics, taken at precisely the correct dose in a supportive environment, appear to have these effects in people who are mentally prepared, it is impossible to know whether illicitly obtained drug truly are what they claim to be. Even if people do get the drug they think they are buying, there's no way to know whether it was made safely or at the correct dose.
The effects that Goldsmith talks about, and the positive changes seen in participants in the Johns Hopkins psilocybin study, are far from the disastrous effects seen in the Minnesota and Oklahoma youths.
Ongoing research is on the brink of finding legitimate uses for psychedelic drugs such as easing the fear of death in patients with terminal disease, helping addicts recover, and treating posttraumatic stress disorder. These findings may reintegrate the psychedelic experience into our culture, as Goldsmith suggests.
Society's reaction to rampant illicit use of psychedelic drugs derailed research from the early 1970s until the mid 1990s. It remains to be seen whether the current surge in illicit designer drugs once again creates a backlash that makes legitimate research impossible.