Proliferations of synthetic drugs – an emerging issue for toxicology in Australia
Associate Professor Dimitri Gerostamoulos, Head of Forensic Science and Chief Toxicologist at the Victorian Institute of Forensic Medicine and Scientific Services, has been a representative of the United Nations Office of Drug and Crime (UNODC) for the past two years. Established in 1997, UNODC is a global leader in the struggle against illicit drugs and international crime. In his role with the UNODC, A/Prof Gerostamoulos is assisting in developing policies and procedures to reduce harm from new synthetic drugs.
In relation to drug overdoses, A/Prof Gerostamoulos says that positive tests are split about 50/50 between prescription drugs and illicit drugs. He explains that traditional illicit drugs such as methylamphetamine, cannabis, and heroin still remain prevalent and dominate in terms of their presence and their harm; however there is a significant rise in the use of novel synthetic drugs.
“Synthetic drugs are certainly increasing in prevalence not only in Australia but across the globe. Forensic laboratories have the capacity to measure some of these; however more than 750 new synthetic drugs have been identified and this list grows weekly. As a result, it is extremely difficult for laboratories to have standardised and validated methods to try to keep up with the proliferation of these new psychoactive substances.
“We know synthetic drugs are popular in terms of their use and distribution and, as a result, there are a number of deaths that have been reported due to their consumption. The amounts of new synthetic drugs required to have an effect have become much smaller, which is one of the reasons they have become popular. This is particularly true of some of the newer opioid derivatives. Instead of grams or kilograms, these drugs are available in the milligram level, which means they are far easier to shift in drug markets. I’m involved with the U.N. to try to establish an early warning system to raise awareness of the dangers of using these types of drugs, particularly where they have been identified in fatalities or overdoses.”
Fentanyl derivatives are far more dangerous than traditional illicit drugs. Their potency ranges from 100 to 1000 times greater than that of morphine. A/Prof Gerostamoulos explains that, although many of these fentanyl analogs are not in Australia as yet, and there isn’t any indication that they are coming to our shores, he recognises that Australia tends to follow a similar drug pattern to the U.S. in terms of opioid mortality and illicit drugs.
“This is the greatest surge in synthetic drugs that has been seen since these drugs were first characterised in 2008; this is especially true for the fentanyl derivatives over the past 12 to 18 months. It’s been suggested that there may be not hundreds, but thousands of possible fentanyl derivatives that might be chemically synthesised. Most of these fentanyl derivatives come from China and some from European and local markets. In a recent toxicology meeting I attended in Florida, the U.S. Drug Enforcement Agency (DEA) are quite concerned by the rapidity of distribution and uptake of many of these fentanyl derivatives.
“There have been a large number of deaths in North America due to overdoses involving these more potent fentanyl derivatives. There are hundreds of fentanyl derivatives that are being synthesised and have been distributed, mainly in Canada and in some parts of the U.S. These countries have experienced thousands of fentanyl-related deaths due to these very potent drugs.
“While we might not have the same level of cocaine use in Australia as that experienced in the U.S, we certainly have similar issues with all the other drugs, including opioids and benzodiazepines. The use of fentanyl analogs may become a significant issue in Australia in the future. There is some progress in relation to identifying if these drugs that are present in an overdose or in a fatality as well as seized material; however this is an emerging issue for toxicology and law enforcement in this country.”
A/Prof Gerostamoulos warns, “The messages and dangers surrounding traditional illicit drugs still stand; however, for people who are seeking the use of novel opioid derivatives which are very toxic indeed, they need to be aware of the high level of risk involved. These drugs are not just potent, but extremely toxic and potentially fatal, even at very low concentrations.”
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This article appeared in the February 2018 Edition of ePathWay which is an online magazine produced by the Royal College of Pathologists of Australasia (http://www.rcpa.edu.au/Library/Publications/ePathway).
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