Designer drugs: An escalating public health challenge (2012)

Designer drugs are created to be similar to, but not identical with psychoactive drugs that are illegal to possess or sell for human consumption. A recurring threat to public health, the designer drug subculture has exploded over the past decade. The rapid expansion can be attributed to a convergence of key technological advances combined with devious, aggressive marketing schemes. Globally accessible internet sites provide detailed information on the sensations produced by newly created drugs, how to synthesize them, and easy venues for buying the "research chemicals", "bath salts", "plant foods", "incense", and "plants" from websites. Frequently, these sites are impervious to legal sanctions, as it takes time to deliberate the evidence and move newly emerging drugs into a legally restrictive zone.
This challenge is compounded by imperfect international agreements and a gradual dissolution of international resolve for combating drug use with supply side restrictions and laws. The designer drug industry is a niche business with a simple strategy to: (a) circumvent existing drug laws and promote their "products" as legal, (b) create new markets with rapid profits, (c) undercut producers and prices of common illegal drugs (e.g. cocaine, marijuana, and heroin), and (d) undermine routine clinical drug testing. The consumer misperceives the drugs as legal, less hazardous than conventional street drugs, and more intriguing. They are more challenging to detect and easier to evade routine clinical drug testing. This overview summarizes legal, biological and psychoactive effects of two classes of designer drugs, cathinone-based psychostimulants packaged as "bath salts" and synthetic cannabinoids sold as "Spice" or "K2". The essay concludes with a set of policy recommendations.