Monday, October 18
Designer drugs
 Editor's note: This is the last of an eight-part series of articles examining the effects of commonly abused substances on athletic performance and overall health. Dr. Gary Wadler, a New York University School of Medicine professor and lead author of the book "Drugs and the Athlete," has also won the International Olympic Committee President's Prize for his work in the area of performance-enhancing drugs in competitive sports. He joined us to address the issue of designer drug use.

What are designer drugs?

Designer drugs are a class of drugs that are frequently associated with all-night high school and college underground dance parties commonly referred to as "raves," known for their dance music and drug experimentation. These dangerous drugs are created by changing the molecular structure of an existing drug to create new drugs with similar pharmacological effects. "Designer drugs came into vogue to get around the Controlled Substances Act," says Wadler, "a federal law that banned the routine sale of drugs such as amphetamine and methamphetamine." Prepared by "underground chemists," known as "cookers," designer drugs can be injected, smoked, snorted or ingested. By the mid-1980s, many of the designer drugs were added to the Drug Enforcement Agency's list of controlled substances.

The three drugs (all regulated by the Controlled Substance Act), which serve as the basis for designer drugs, are PCP, fentanyl, and amphetamine/methamphetamine. Not surprisingly, the designer drugs are known by a variety of street names, including XTC, Ecstasy, Adam, Eve, Lover's Speed, GHB, Special K, Fantasy and Nature's Quaalude.

Are designer drugs dangerous?

"Yes," says Wadler. "Because they are created in clandestine labs by unlicensed and untrained amateur chemists, they can be extremely dangerous, in many cases more dangerous than the original drug from which they are synthesized. For example, the pharmaceutical drug fentanyl, originally created as an anesthetic, was modified into designer drugs which are extremely potent, extremely dangerous and which have an extraordinary potential for fatal overdosing." Fentanyl analogs can be 80 to 1,000 times more potent than heroin and have a very rapid onset (1 to 4 minutes) and a short duration of action (about 30 to 90 minutes).

The designer drugs derived from Methylene-Dioxy-Amphetamine (MDMA), frequently sold under the name of Ecstasy, usually come as tablets or capsules and produce feelings of stimulation and euphoria, a sense of well-being and sensory distortions. Structurally similar to methamphetamine, higher doses of MDMA can result in paranoia, depression and violent irrational behavior, and in hallucinations akin to those associated with LSD. Legally banned in the United States in 1985, Ecstasy can induce a high lasting from six to 24 hours, although the average "trip" lasts about three to four hours.

GHB, gamma-hydroxybutyrate, previously had been sold in health-food stores as a performance-enhancing additive to body building formulas. Despite claims that GHB stimulated muscle growth, it has never been substantiated. A central nervous system depressant, abused for its intoxicating effects, its use was banned by the FDA in 1990, except under the supervision of a physician. Usually sold as a slightly salty clear liquid, GHB is often used as a sedative as the individual comes off stimulants such as Ecstasy. The drug takes effect within 15 minutes to one hour after ingestion. It can produce nausea, vomiting, visual disturbances, delusions and seizures, and it has the potential to produce profound respiratory depression and death, especially when combined with other CNS depressants like alcohol, sedatives or tranquilizers.

Are designer drugs safe, effective or pure?

"Unlike the drugs that are approved by the Food and Drug Administration, which must meet strict standards of safety, efficacy and purity, the designer drugs manufactured by underground 'chemists' with little or no quality control, and, the drugs they offer certainly do not meet FDA standards," says Wadler. It is likely that no two doses of any of the designer drugs are identical in structure or strength, changing from batch to batch and from "chemist" to "chemist." Consequently, the possible side effects are as endless as the chemicals themselves and as unpredictable as Russian roulette. It is only a matter of time before the user experiences one or more negative and potentially harmful side effects.

In general, the physical symptoms that are common among users of designer drugs include:
  • Hypertension
  • Increased heart rate
  • Clenched teeth
  • Blurred vision
  • Uncontrolled tremors
  • Drooling
  • Anorexia
  • Nausea and vomiting
  • Impaired speech
  • Total paralysis
  • Chills and sweating
  • Dehydration and heat exhaustion
  • Respiratory depression
  • Seizures
  • Permanent brain damage
  • Death

Some common psychological side effects include:
  • Confusion
  • Irritability
  • Severe anxiety
  • Extreme emotional sensitivity
  • Irrational thinking
  • Depression
  • Amnesia
  • Violent behavior
  • Insomnia
  • Hallucinations

Are designer drugs illegal?

Yes. In 1970, amphetamines constituted 14 percent of all psychoactive drugs prescribed by physicians in the United States. The passage of the Controlled Substances Act abruptly changed the availability of amphetamines by imposing severe manufacturing quotas and by establishing strict guidelines for their use. However, with the passage of the 1970 law, illicit drug sales escalated as drugs were designed and manufactured in clandestine laboratories so as to circumvent laws regulating the manufacturing and prescribing of controlled substances. In response, the federal government modified the Controlled Substances Act in 1986 banning all designer drugs and all possible variations of controlled substances, even if yet manufactured.


Drugs and Sports: Anabolic steroids

Drugs and Sports: Marijuana

Drugs and Sports: Cocaine

Drugs and Sports: Barbiturates

Drugs and Sports: Amphetamines

Drugs and Sports: Alcohol

Drugs and Sports: Inhalants