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How to Keep Up with the Growing List of Synthetic Drugs

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Synthetic drugs, or designer drugs, are substances that are created in illegal laboratories. They are designed to produce effects that are similar to other drugs, such as cocaine, MDMA, marijuana, and methamphetamine.1 They are often perceived as legal alternatives to illegal drugs.1 These drugs are quite dangerous and produce a variety of serious effects, such as paranoia, aggression, seizures, coma, and death.2,3 Currently, there are more than 200 different synthetic drug compounds in existence; new ones are being made on a daily basis.

There are more than 90 types of synthetic marijuana in existence.3 Synthetic drug use is a serious issue worldwide. A 2014 study found that, among current cannabis users, a substantial amount of individuals (24%) use synthetic marijuana products on a regular basis.4 Currently, synthetic marijuana is the second most popular illegal drug among American teenagers. In 2012, 11% of American high school seniors had admitted to using synthetic marijuana in the past year. In 2010, there were more than 11,000 synthetic marijuana-related emergency room visits. An estimated 75% of these emergency room visits involved adolescents and young adults between the ages of 12 and 29.5

For more information and links to information and news about synthetic drugs, visit the DEA Diversion Control Division website.6 This site also has a link to anonymously report new synthetic drugs.

Due to deceptive packaging or misinformed word-of-mouth, some designer or synthetic drugs may appear to be safe and contain legal, natural supplements or products. They may have names like Plant Food or Bath Salts and are sold at convenience stores, gas stations, on the internet, or at head shops. If you look closely, they might say “not for human consumption.” The reason for this is to allow the manufacturers to circumvent the Controlled Substance Analogue Enforcement Act, which would otherwise make these products illegal.1

Below are some of the most common synthetics that are often marketed as legal substances:1,7

  • K2 or Spice: K2 and Spice belong to the cannabinoid class of drugs, and numerous synthetic cannabinoids are sold as legal alternatives to marijuana. They are often marketed as organic, even though they are made in a laboratory; they are simply synthetic materials that are sprayed on or mixed with plant material. K2 and Spice may be vaporized through electronic cigarettes or smoked using a pipe or rolled cigarettes. They produce psychoactive effects similar to marijuana although they may elicit completely different effects as well, due to the unpredictable nature of the synthetic components. Some of the negative effects of synthetic cannabinoids include unconsciousness, seizures, vomiting, hallucinations, agitation, paranoid delusions, violent behaviors, and more.7
  • Designer or synthetic cathinones: Sometimes called bath salts, research chemicals, or glass cleaner, these may come in a capsule or in powder form. In powder form, they are snorted or sniffed. They can also be dissolved in liquid and injected. Cathinones are central nervous system (CNS) stimulants and mimic the effects produced by MDMA, methamphetamine, and cocaine; they cause increased energy and pleasure. Dangerous side effects may include agitation, psychosis, aggression, seizures, paranoia, and delusions. In addition, there have been reports of death related to overdosing on designer cathinones.7

Illegal Ones

In terms of health risks, the illegal synthetics are often similar to those that remain technically legal (by continuing to evade controlled substance status); the Drug Enforcement Administration (DEA) has simply recognized the risks of these drugs and labeled them as federally controlled substances, while legal ones may not have been discovered yet. Many times, synthetic drugs are made outside of the United States and illicitly smuggled into the country.1

The following are illegal synthetic drugs that are commonly abused:

  • Synthetic opioids: These substances are made in a laboratory and, similar to natural opioids, such as morphine, they act on the brain to produce pain relief. While there are pharmaceutical grade synthetic opioids used daily in clinical settings, there is also a street supply of illicit synthetics largely manufactured in clandestine labs overseas and then brought into the United States. Some of the most common illicit opioids are closely related to fentanyl, an FDA-approved synthetic opioid, and include butyryl fentanyl, acetyl fentanyl, and furanyl fentanyl. Synthetic opioids may be encountered in powder form. They may also be available pressed into tablet or pill form, the appearance of which mimics legal opioid products. Synthetic opioids produce feelings of sedation, euphoria, and relaxation. Negative effects include urinary retention, confusion, vomiting, respiratory depression, and coma. Many are more potent than prescription opioids and can result in potential overdose.7
  • MDMA: Also known as ecstasy, MDMA is often made in overseas labs and then smuggled into the United States, much like other synthetic drugs. MDMA is currently listed as a Schedule I controlled substance, which means that it has high potential for abuse and no accepted medical purpose. MDMA is most commonly sold as tablets, which are taken orally or crushed and snorted. The drug may be “stacked,” which means taking more than 3 doses at once. MDMA is often taken in combination with other drugs or alcohol. It produces feelings of euphoria, reduced inhibitions, and distortions in time and perception, and some of the harmful effects include anxiety, depression, paranoia, liver and kidney failure, and death.7
  • Ketamine: Although ketamine has legitimate uses in the United States as an anesthetic, it is often illicitly used for its hallucinogenic effects. Illicit ketamine is frequently encountered as a clear, white liquid or powder. It can then be laced with marijuana and smoked or mixed with drinks prior to consumption. Ketamine produces feelings of euphoria and detachment but can also cause agitation, unconsciousness, amnesia, and dangerously slowed breathing.7


Many designer drugs, including synthetic cathinones and synthetic cannabinoids, are addictive. Chronic abuse of these drugs may cause intense urges or cravings that cause a person to keep using them in spite of negative consequences. Some synthetic drugs produce withdrawal symptoms after long-term use. Withdrawal symptoms occur when drug use is suddenly stopped or dramatically decreased.

Abrupt discontinuation of daily synthetic cannabis has been associated with severe withdrawal symptoms including anxiety, depression, irritability, agitation, insomnia, seizures, and respiratory risks.8,12 The sudden cessation of synthetic cathinone abuse may cause the emergence of withdrawal symptoms, such as tremors, sleep disturbances, anxiety, paranoia, and depression.9 The severity is related to the frequency of use, the dose used, the length of use, polydrug abuse, and the presence of mental health or physical problems. These withdrawal symptoms can make it difficult for a person to stop using synthetic drugs without professional help.

Detox is the initial step of treatment for anyone wanting to stop using these drugs. Medical detox consists of supervision, monitoring, and any needed medical interventions to help safely manage the acute physical symptoms that occur when drug use is stopped.10 Not every type of detox program offers medical detox services; some utilize a more social detox approach, in which the focus is on emotional and psychological support throughout the detox process. A program that uses medical detox may be beneficial if a practitioner determines that you may be at risk for experiencing dangerous withdrawal symptoms related to synthetic drug abuse.

Detox is the first step on the continuum of care but it doesn’t constitute a comprehensive substance abuse treatment program. By itself, detox does little to change long-term drug abuse and drug-seeking behaviors. However, it is a strong precursor to effective drug addiction treatment. Here are some of the most common types of detox programs:

  • Inpatient detox: Inpatient detox involves around-the-clock care and monitoring. It usually takes place in a hospital or specialized clinic where medications may be administered to help reduce the intensity and severity of withdrawal symptoms. The individual is carefully monitored for complications of drug intoxication or withdrawal.
  • Outpatient detox: Outpatient detox is available at outpatient facilities, community clinics, and doctor’s offices. This type of detox is ideal for individuals attending school or work as they can continue with their daily activities. They usually attend several hours a day for a week or more.11

The specific interventions used during detox depend upon the drug used as well as other factors, such as co-occurring medical issues.

  • Detox for MDMA and other hallucinogens may include direct supervision to prevent self-harm or harm to others.11
  • Airway support and ventilation may be needed to manage ketamine detox and withdrawal.11
  • Sedating medications, such as benzodiazepines, are used to manage psychotic features and agitation during ketamine detox.11

Whether a person should receive inpatient or outpatient detox and which specific combination of interventions is used during detox depend upon a variety of factors, which is why it’s advised that you receive an assessment from a mental health or addiction professional before choosing a program that is right for you.

If you or someone that you care about is using synthetic drugs, it is important to get help immediately, as the effects of these chemicals can be very dangerous and even life-threatening. Contact a support representative today to get started on the road to recovery.


  1. Drug Enforcement Administration. (2013). Synthetic Drug Trafficking and Abuse Trends.
  2. Office of National Drug Control Policy. (2012). Synthetic Drugs (a.k.a. K2, Spice, Bath Salts, etc.)
  3. Drug Enforcement Administration. (2017). Just Think Twice: Facts About Synthetic Drugs.
  4. Gunderson E, Haughey H, Ait-Daoud N, Joshi S, Hart C. (2014). A Survey of Synthetic Cannabinoid Consumption by Current Cannabis Users. Substance abuse?: official publication of the Association for Medical Education and Research in Substance Abuse35(2), 184-189.
  5. National Institute on Drug Abuse. (2013). Synthetic Marijuana Lands Thousands of Young People in the ER, Especially Young Males.
  6. Drug Enforcement Administration: Diversion Control Division. (2017). Synthetic Drugs.
  7. Drug Enforcement Administration. (2017). Drugs of Abuse.
  8. National Institute on Drug Abuse. (2015). Synthetic Cannabinoids.
  9. National Institute on Drug Abuse. (2016). Synthetic Cathinones (“Bath Salts”).
  10. National Institute on Drug Abuse. (2016). 8: Medical detoxification.
  11. Cooper ZD. (2016). Adverse Effects of Synthetic Cannabinoids: Management of Acute Toxicity and Withdrawal. Current psychiatry reports18(5), 52.

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