Synthetic drugs: A "viral" outbreak (2015)

The term "synthetic drugs" is no longer a non-specific pharmacological phrase but one that describes a group of "designer drugs" which are responsible for global morbidity and mortality. In 2009, the United States (US) began experiencing the rapid emergence of these compounds and by 2010, cannabinoids (e.g. "K2," "spice") and cathinones (e.g. "bath salts," "flakka") had become known on the street as the new designer drugs of choice.
By definition, a "designer drug" is an analogue of a controlled substance which allows the user to experience the same, or similar, feelings as that from the controlled substance. With many derivitizations possible, new analogues may not be scheduled in the Controlled Substance Act (CSA). This permits the user to obtain a "legal high" with less fear of submitting a positive drug sample or other legal consequences. This is of paramount importance to our current synthetic drug abuse crisis as the Drug Enforcement Administration (DEA) is being inundated with new analogues at a rate faster than their ability to schedule these compounds within the CSA.
Synthetic drugs represent a considerable threat to the user as they may experience a desired euphoria, but with the risk of concomitant central nervous system (CNS) stimulation resulting in tachycardia, hypertension, agitation, hyperthermia, seizures, rhabdomyolysis, excited delirium and violent behavior. Medical professionals attempting to treat these patients lack information regarding the chemical composition of these drugs and thereby can only offer symptom-based supportive care. However, treatment is often further hampered by the violent behavior manifested by these patients and protective actions needed by the medical team.
The synthetic drug abuse crisis reflects a number of similarities to a viral pandemic. The disease has spread rapidly throughout multiple countries via the assistance of a global carrier (the internet), with the virus mutation (analogue production) occurring at a pace that makes it difficult for agencies to quickly identify and regulate. Therefore, as in any disease outbreak, it becomes imperative for healthcare providers, scientists and law enforcement agencies to foster a mutual relationship of information exchange. Establishing an international database containing chemical structures of synthetic drugs, and their analogues, would allow for more prompt identification and regulation by policy makers looking to deter synthetic drug abuse worldwide.