Synthetic Drugs Novel Psychoactive Substances (NPS)
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Transcript of Synthetic Drugs Novel Psychoactive Substances (NPS)
Synthetic cannabinoidsin herbal produc\
Synthetic cannabinoidsin herbal products
Adult Drug Court Practitioner Perspective
Natalie Reyes
Program Coordinator
Multnomah County, Oregon
Synthetic cathinone use• Bath salts, flakka, gravel..
Synthetic cannabinoid use• Spice, K2, incense, fake weed..
Mitragyna speciosa• Kratom, kratum..
Fentanyl• China white, apache, china girl,..
Others?YES!
Similar to methamphetamine use• Hyperactivity• Euphoria and agitation• Anxiety• Confusion and/or
forgetfulness• Suicidal thoughts• Weight loss
Available at head shops • Difficult to find• Also sold on the street
*based on observations and reports from drug court participants
Similar to marijuana use• Paranoia
• Confusion
• Anxiety
• Hallucinations
• Delusions
• Sedation
Sprayed on dried leaves
for smoking
Liquid form for vaping
Available at head shops
• Relatively easy to find
*based on observations and reports from drug court participants
Similar to opiate use• Binds with opiate receptors
• Users report mixed stimulant
and sedation effects
• Sweating
• Weight loss
• Recreationally used for pain
and opiate addiction
Available at head
shops • Very large selection
• Clearance sales!
*based on observations and reports from drug court participants
Similar to opiate use• According to drugabuse.gov:
50 to 100 times more potent
than morphine
• Slurred speech
• Heavy sedation
• Drooling
• Unresponsive
Mostly purchased
online or on the street
*based on observations and reports from drug court participants
Extent of use in drug courts specifically is unknown
Designed to avoid detection
Testing is expensive• No standardized cutoff limits, methods vary, and uncertainty regarding
detection window
Patients in a residential treatment facility found that
71% used synthetic cannabinoids to “get high without
having a positive drug test.”
(Bonar, Ashrafioun & Ilgen, 2014).
Have a clear understanding in participant manual, drug
testing contract, etc.
Ban use of substances sold as “not for human
consumption”
Let participants know they will have regular and
random expanded testing(if so is true)
Have policy discussions on how to address positive
synthetic drug tests
• Before it happens!
Get to know what’s sold at your local head shops
Two possible behaviors to address:
• New Use
• Effort at deception (occurs more frequently with synthetic drug use)
1. New Use• Follow proximal / distal goal model
2. Efforts of Deception• Did the participant report synthetic drug use prior to collection
of UA or prior to being told it was being sent in for expanded
testing?
Yes – honest - did not attempt to defraud the test
No – dishonest – attempts to defraud the test
Treatment response • Revisit level of care, needs, etc.
A known synthetic drug user must continue to
have random and regular expanded drug testing
• Similar to ETG’s for alcoholics
Use can develop within participant cliques
Find out what your local Medicaid plans cover
If using community justice agency for drug testing,
consider doing expanded testing through treatment
provider in order to bill
Shop around – prices vary!
• Instant tests, GC/LS/MS, urine, saliva, custom panels
etc..
Consider incorporating into grant requests
• Argument:
NADCP Adult Drug Court Standards Vol. II – Section VII
Create a budget for expanded testing
• Reallocate resources?
• Request additional resources from funders
• Discuss synthetic drug use with policy team
Integrity of the program, best practices, etc.
Synthetic cannabinoid • Marijuana users
Synthetic Cathinones• Methamphetamine, amphetamine and cocaine users
Mitragyna Speciosa• Opiate users primarily but also stimulant users
Fentanyl• Opiate users
Utilize current research on synthetic drug user demographics (see: Stogner & Miller, 2014; Johnson & Johnson, 2014; Strote, Lee & Wechsler, 2002).
If sending a urine sample to the lab, do not disclose to participants what it will be tested for
• Create this understanding in participant manual
• Increase honesty and accountability
• Discourages efforts of deception
• Cost effective
Create a disputed drug test agreement• Disputed tests are costly – confirmation testing, docket time, staff time, witnesses, etc.
• Stop and think! Play the tape all the way through
• Further sanctioning for dishonesty
• Subject to lab fees if found dishonest
Talk about synthetic drug use • It’s not something they haven’t already heard about
• Acknowledges drug court team is aware of synthetic drug use and testing for it (if so is true)
Natalie [email protected]
Dr. Leo [email protected]
[email protected]://cms.american.edu/spa/jpo
@AU_JPO facebook.com/aujpo
