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A Straight Look at 10 Hyped Highs

Hysteria over Benzo Fury, Bromo Dragonfly or kratom can drown out the true dangers—or potential benefits—of these gray-market drugs. The Fix seeks some matter-of-fact guidance.

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By Tony O’Neill

06/12/13

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The market for legal—or until recently legal—highs is booming. A recent report by the EU’s drug agency, for example, shows that it is currently monitoring a staggering 280 of them. What exactly are these myriad substances? Thanks in part to the media’s habit of lumping them together into one scary whole—with regular outbreaks of frenzy, such as with Bath Salts last year—they often remain shrouded in mystery and rumor.

To get closer to the truth I decided to ask Jeff Lapoint, MD, an attending physician in emergency medicine and medical toxicology at Kaiser Permanente in San Diego, who is also a former senior toxicology fellow at New York University’s Bellevue Hospital. He’s an expert who both understands these drugs’ complex chemistry and, through his work with New York City’s Poison Control, has hands-on experience of how the can affect users. Despite having seen their dark side, he retains a cool head when it comes to the future of this market, recognizing that harsher laws will do nothing to help users, and that there’s no such thing as a “bad” chemical. But in their current unregulated condition—with dosing, toxicity, cuts, etc., all a crap shoot—using some of these chemicals as drugs can be very bad indeed.

Legal highs vary wildly in their effects—and have-a-go chemists are constantly developing new compounds. Trying to map such a market isn’t easy, but with Lapoint’s expertise—and some user experiences, including one or two of my own—we’ll make a start. 

1. Synthetic Cannabinoids (Spice, K-2, etc.)

“Man has been smoking marijuana for 4,000 years,” says Dr. Lapoint. “That’s a pretty damn good human trial. Compare that to five years of synthetic cannabinoids. We have no idea what the long-term effects of those might be, and that’s scary.” Lapoint concedes that the debate on the medical properties of marijuana is still up for grabs, though “what you cannot argue with is marijuana’s safety.” But he warns that synthetic cannabinoids are an entirely different ball game. In fact, he says, calling this stuff “synthetic marijuana” at all is a fallacy.

Synthetic cannabinoids have been sold under countless brand names; the more famous include Spice, K2 and Black Magic. As with many legal highs, the ingredients listed on the package usually comprise a selection of allegedly benign legal herbs, but lab testing tells a different story. The psychoactive effects are caused by spraying certain chemicals—most commonly JWH-018, HU-210 and CP-47/497—onto the plant material. Their active ingredients are lab-tweaked variations of THC—pot’s active ingredient—that often “do not even [structurally] look like THC anymore,” says Lapoint. “The only similarity between this stuff and marijuana is that these substances bind to cannabinoid receptors in the brain. This is worrying because we do not fully understand these receptors.” Some synthetic cannabinoids bind to these receptors up to 100 times more effectively than THC, with wildly unpredictable effects, including psychosis and depression.

Synthetic marijuana briefly took off among users who enjoyed the novelty of a legal drug that actually worked. Experiences ranged from the sublime: “I felt a very familiar sensation of ‘getting high’ exactly as if I had just hit some decent bud,” to the terrifying: “Marijuana is simply lovely. However, I consider Spice to be the lovely Mary Jane's psychotic sister that stays locked in the attic, chained to a pole and wearing a muzzle.”

Last year the US government outlawed many of the more popular synthetic cannaboids, but there is almost no end to the tweaking that can be done to THC’s chemical structure. Chances are, the next wave of “synthetic marijuana” will act even less like pot than the first. Lapoint compares the dangerous boom in these substances to the mass production of dangerous bathtub hooch during Prohibition. “The sad truth is that there is a safer substance that humankind has extensive experience with, yet it remains illegal.”

 

2. 2M2B

2M2B (2-methyl-2-butanol) is used primarily as a pharmaceutical or pigment solvent but has recently been popping up for sale—usually in doses of five or 10 ml—on legal high sites. It is marketed as a depressant and intoxicant, and the chatter on drug forums suggests that it’s beginning to catch on. “We don’t see it out there a lot, and my comments are purely theoretical,” Dr. Lapoint says, adding that on a purely chemical level 2M2B is a fascinating substance.

It acts upon the same GABAa receptor as ethanol—the active ingredient in booze—but has some unique characteristics. “It’s not metabolized the same way that ethanol is,” Lapoint explains. “Ethanol has to be broken down by two specific enzymes in your body. We can actually block those, with Antabuse, for example. By playing with those enzymes you can even make people get an instant hangover when they drink booze.” But 2M2B is broken down differently and has one startling advantage over traditional cocktails: no hangovers. “Imagine if you could get drunk and not pay the piper,” Lapoint says. “That’s what makes it so attractive as a substance of abuse. However, it’s maybe several thousand times more potent than ethanol on the sedative/hypnotic scale, which brings up some serious risks like respiratory depression.” This makes it less booze than barbiturate.

Despite these dangers, small groups of 2m2b users are posting enthusiastic reports, its nasty camphor-like taste notwithstanding. They describe an initial rush—“[7.5 ml] feels like 5 shots of vodka. Slightly wobbly, focusing becoming harder” that leads to “somewhere between benzos and ethanol.” While it remains to be seen if this compound will find mass appeal, there are at least five vendors in the UK alone. (In the world of legal highs, Britain and Europe often act as testing grounds for substances that later find popularity in the US.)

 

3. Bromo Dragonfly

This extremely potent psychedelic has a small but devoted following of psychonauts. Dave Nichols’ team at Purdue Pharmaceuticals originally designed the chemical behind Bromo Dragonfly to further research the brain’s serotonin receptors, which are the targets of hallucinogenic and some prescription anti-psychotic drugs. Nichols has since expressed his regret that his work inadvertently gave rise to this dangerous legal high. Dr. Lapoint—hardly prone to “drugs are bad, m’kay” hysteria—simply describes this substance, which is sold in powder or blotter form, as “terrifying.”

Users all seem to agree that Bromo Dragonfly takes a long time to kick in—up to five hours. “I dosed the same time [as my friend] took acid, and by the time I was only just starting to peak, [he] was already down from the peak into the plateau,” one user says. Others also report extremely potent psychedelic effects: “I heard drums turning into children’s voices and ocean waves. The real world turned into a mosaic-like grid. Trees were bursting apart into fractals. Walls turned invisible.”

Bromo Dragonfly made headlines in 2009 when it was linked to at least two deaths and several hospitalizations, after being mislabeled and sold as a different designer drug by a Chinese vendor. Even those who ingest it knowingly are liable to hit problems. “This substance just tends to produce a very gross toxic chemy feeling,” one user reports. “And I could definitely see OD'ing on Bromo Dragonfly being one of the shittiest ways to leave this world. So be safe, fellow travelers.”

Another potential danger is severe narrowing of the blood vessels and constriction of blood flow. Lapoint mentions an infamous case in Sweden in which a user’s “extremities just died.” He survived, but lost all the fingers on his left hand and several toes. Couple the slow onset with the high potency, and the truth is that it’s incredibly easy to accidentally overdose on this drug. Lapoint warns that “Bromo Dragonfly is probably the scariest thing on this list.”

 

4: O-Desmethyltramadol

Given the backlash against doctors over-prescribing painkillers, a legal compound mimicking the effects of opioids might be widely seen as a Holy Grail. O-Desmethyltramadol is the active metabolite of tramadol—a prescription analgesic painkiller that is weaker and typically less prone to abuse than the likes of oxycodone. Recreational users are beginning to share their experiences via specialist websites. Some are enthusiastic, while one writes, “It definitely feels like an opioid, but it is very much lacking in that classic opioid euphoria that we all use for.”

Sold as a powder that can be snorted or swallowed, many users report the effects of O-Desmethyltramadol as being on a par with buprenorphine or tramadol. And there, says Lapoint, lies the rub: “Some people love the novel psychoactive effects of tramadol. Theoretically, while Tramadol is an opioid agonist that hits the same receptors as other narcotic painkillers, it also works on the serotonin neurotransmitter—the target of many anti-depressants. Many people find it causes dysphoria—feelings of emotional or mental discomfort.

I can relate. As a one-time aficionado of opiates, when I was prescribed tramadol I found it a deeply unpleasant experience.

A tramadol-derived drug also raises an interesting “what if” about unregulated legal derivatives of narcotic painkillers. So far Lapoint hasn’t seen it widely used. “Of course,” he says, “even if they wind up in the ER, finding if someone has used this particular substance versus other opiates will be a game of CSI.”

 

5. 2C-P

2C-P is a synthetic psychedelic and a close chemical cousin of 2C-B, which briefly thrived on the US club scene until it was outlawed in 2001. Users report that 2C-P—which itself was made illegal in the US last year—causes stronger visual hallucinations and way longer effects: “at least 16 hours of very good visually and mentally tripping,” writes one. As with all psychedelics, the quality of the trip depends a lot on the psychological state of the user. While some praise 2C-P’s “interesting, powerful and enlightening” effects, others find the experience “somewhat disturbing. I wish I had never thought of some of the things I thought of during that long, sleepless night.”

2C-P is a phenethylamine, a class of chemicals that release high amounts of dopamine and/or serotonin. 2C-P is classified as an amphetamine because it mainly targets dopamine—the brain chemical responsible for stimulant reactions. But it also targets serotonin—the brain chemical behind hallucinogenic effects. In fact, 2C-P’s hallucinogenic effects are more powerful than its stimulant ones.

“If you look at Alexander Shulgin’s book PIHKAL [Phenethylamines I Have Known and Loved], he gives you a cookbook and a user report on every one of these compounds,” Dr. Lapoint says. “While Shulgin really loved the effect of 2C-P, ever since this compound found its way to the gray market, there have been horrible cases—a recent incident in Minnesota, for example, where people may have actually gotten Bromo Dragonfly.” One teen died and ten others were hospitalized.

As with most of these drugs, you rarely know what you’re really ingesting. “If you are Alexander Shulgin and make it yourself, that’s one thing,” says Lapoint. “As far as buying it from some anonymous vendor? That’s always sketchy.”

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