NAME THAT DRUG


BY DR. STEVEN SYKES AND NICOLE JUPE, QUEST DIAGNOSTICS Seemingly Superhuman T


his month’s mystery drug was discovered by Victor Maddox, a chemist of Parke Davis Laboratories


in the early 19th century as an anesthetic and analgesic without the adverse effects of respiratory and cardiac depression. Te drug was studied by Dr. Graham Chen a pharmacologist, who tested its effects on laboratory cats and monkeys and found it induced an unusual cataleptic state. During clinical trials, the intravenous drug showed promise as a general anesthetic in human patients and was approved for use in the United States in 1963. Only shortly aſter its approval, adverse


reactions such as delirium, disorientation, mania, muscle rigidity, and seizures were observed in patients post-surgery. Parke Davis immediately stopped marketing the drug for human use. It was officially recalled by 1965. It is not produced commercially, although clandestine labs do create their own erratic formulas. Te first accounts of recreational use of


our mystery drug originated in the Haight- Ashbury district of San Francisco, California in 1967. People believed that it had the potential to create mind-altering highs similar to the psychedelic drugs popular at that time. Te psychoactive drug was sought aſter as it created feelings of euphoria and power. Physical effects such as visual and auditory hallucinations, irregular heartbeat, disorientation, panic, loss of motor skills, and memory impairment varied by dose and typically appeared within minutes of taking the drug and lasting up to 24 hours in the human body. However, in a short time, drug users were


shaken by the unpredictable experience and labeled it a “bad trip.” Lacking sensory and muscle control, users unknowingly hurt themselves. Many first-time users also insisted that they would never knowingly take the drug a second time. As rumors


54 datia focus


spread about the drug, its hype quickly subsided. Te drug didn’t re-emerge until the 1970s and early 1980s when users again sought a cheap, easy-to-make hallucinogenic compound. People magazine crowned it as “America’s Most Dangerous Drug” in 1978 and reported 7 million users. Manufactured as a biter-tasting, colorless


to white crystalline powder, the mystery drug can be found in both pill and liquid form and is commonly mixed with other illicit substances. Routes of administration include oral ingestion, intravenous injection, inhalation, and topical dosing through the eyes via eye drops. Some users sprinkle the powder form on parsley, mint leaves, or cannabis, or swallow it as a capsule or tablet. Yet, according to the U.S. Drug Enforcement Administration, smoking is the most common way to take our mystery drug. Inadvertent absorption can occur through contact with the skin; hence the drug should be handled carefully. Onset of action aſter administering the


drug can occur between 2 to 5 minutes for inhalation and intravenous dosing, and 30 to 60 minutes via the oral route. Lighter 3 to 5 mg doses are usually smoked, injected, or inhaled, while heavier doses are ingested orally. Sedation can be produced with a 0.25 mg intravenous dose compared to oral or inhaled doses of 10 mg. Even though lower dosing can produce favorable recreational effects, overdosing on the drug can lead to dangerous complications including seizures, psychosis, and even coma. Once absorbed by the body, the brain and


adipose tissue are the major accumulation sites of the drug. Variable release from these faty regions can extend the half- life of the drug to around 48 hours or longer. A majority of the drug is heavily metabolized in the liver with a fraction excreted unchanged in the urine. Many workplace drug testing laboratories assay


for the parent compound and commonly use immunoassay techniques for the initial testing as well as gas chromatography- mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) to confirm. Law enforcement agents continue to


seize street drugs that appear to be ecstasy (MDMA) but are actually masquerading as our mystery drug. Te drug is oſten mixed with MDMA and various substances such as marijuana, methamphetamine, mescaline, and formaldehyde and as such, users are oſten uncertain of the identity of the substance. Another craze is utilizing the mystery drug as a dipping agent to intensify the high. Data published by scientists Bey and Patel in the California Journal of Emerging Medicine shows that 24 percent of marijuana cigaretes, also referred to as “wet” or “whacko tobacco,” are laced with 1 to 10 milligrams of the drug. Teir research also identified that a 5 to 10 milligram dose taken orally may induce acute schizophrenia and doses greater than 10 milligrams usually result in coma. Interestingly, this drug earned a reputation


for inciting violence as some users erupted in destructive behavior and seemed to demonstrate superhuman strength. Te media described stories of users who seem unable to feel pain commiting aggressive physical acts which rendered public safety and hospital personnel unable to stop them. Other narratives include users trying to stop a moving train, jumping from heights, atacking others, and even self- mutilation. One example that gained national atention was Aaron Hernandez, former tight end for the New England Patriots football team, who was charged with murder in 2013. Rolling Stone magazine reported that Hernandez was a heavy user of our mystery drug and the associated paranoia led him to arm himself with a gun because he believed people were ploting to kill him.


spring 2017


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