Some time ago, police and addiction counselors were awash with people who were experimenting with the hallucinogenic drug N-Dimethyltryptamine (DMT). This drug is a chemical that is found in a wide species of plants that grow worldwide. It is also endogenously produced in humans and can be found in virtually every mammal on planet Earth. In humans, very small amounts of DMT seem to be derived from tryptophan, an essential amino acid that plays a vital role in the synthesis of the brain neurotransmitter serotonin. As a standalone drug, DMT can be purchased with relative ease from Internet sources. A number of American cities, especially those in the Midwest, have inveterate, concentrated pockets of DMT abusers. Indiana has seen some of the greatest concentrations of DMT abuse.

DMT is usually purchased and ingested in a powder or granular, crystalline form. The drug can be taken orally. It is generally found crammed into gelatin capsules that are washed down in the same way as an aspirin. In its powder form, it can also be mixed with marijuana in the bowl of a bong or marijuana pipe and then smoked. It appears that the smoking of DMT is the most popular means of ingestion as the oral route often times results in the incidence of nausea and vomiting, all a prelude to the desired DMT high. It does not appear that physical dependency can ensue from DMT abuse, but there are a good number of users who regularly and frequently use the drug and would clearly meet the DSM definition of an addict.

Called the "God molecule," DMT is reverentially admired by users as a means of escaping the boundaries of the mortal human experience and broaching the domain of the Almighty. Users cite the ability of DMT to transport them to a parallel consciousness of beauty, relaxation, and inner peace. Some users describe it as a magic mushroom high, only better. Because DMT is a neuromodulator of the central nervous system, it is fairly clear that the drug is manipulating the mechanisms that cause the release and reuptake of serotonin. It is a veritable overdose of serotonin that is responsible for the auditory, tactile, and visual disturbances that occur while high. Veteran DMT users heighten their experiences by adding another drug, a rather obscure anti-depressant drug to the mix. Monoamine oxidase inhibitor (MAOI) drugs are suggested for the devoted user to try out when using DMT. MAOI drugs are relatively old pharmaceuticals that are used to treat severe and resistant forms of depression. These drugs block the reuptake of monoamine transmitters in vital areas of the brain; serotonin happens to be one of those transmitters. So a DMT user who concurrently uses an MAOI drug will experience an extended high with perhaps heightened sensory distortions and more enveloping mood. This practice of coupling to MAOI drugs is very dangerous with the potential for life threatening hypertension and stroke.

On the streets there are a number of other drugs similar to DMT and sometimes purported to be DMT. Drugs such as 5-Meo-DMT can be easily acquired from dealers claiming that they have the real McCoy; bufotenine, a drug best associated with the licking of the slime produced by cane toads is also sometimes sold and represented as being DMT. And to the uninitiated, no difference can probably be discerned between these two drugs when high. But to the veteran DMT user, real DMT is held out as the only safe and predictable way for a hallucinogen user to get high.

DMT is a Schedule I drug in the United States; it sits alongside other hallucinogenic drugs such as LSD and mescaline in the penal and health and safety codes of all 50 states. And although the drug has advocates that extol its virtues as an antidepressant, DMT is essentially a drug whose only calling is as an illicit hallucinogen destined for use by quirky people who are intent on escaping the reality of their lives.

The DMT-triggered high is relatively short, usually no more than 60 to 90 minutes in duration. The short life of the high is the principle reason why the MAOI drugs are taken concurrently. The MAOI drugs can extend the DMT high for up to 3 or 4 hours. But compared to LSD for instance, the DMT high is relatively short lived.

Signs and symptoms of a DMT high may include the following:

• Dilated pupils. Eyes may be dilated to such a point where they could be assessed as "rimmed out."
• No nystagmus; no non-convergence
• Dry mouth
• Rapid, nonsensical speech alternating with no speech or slurred speech
• Laughter and crying jags alternating back and forth between excesses
• Rapid heartbeat; increased respirations; elevated systolic blood pressure (high number)
• Flushed facial appearance
• Distorted internal clock (probably very fast clock)
• Resistance to movement-will not want to walk or display balance and gait
• Piloerection (hair standing on end)

DMT is a drug with obvious potential for abuse. Young kids to middle-aged adults to older, non-reformed hippies are very much aligned with DMT. But for the most part, DMT is a drug that is abused by younger members of society. Perhaps they're the folks in most need of a conversation with the Almighty? For older users, the experience with DMT is less divine and more pedestrian.

Stay tuned for more important hallucinogen news about the newest wave of bath salts, ant powders and glass cleaners, as designer drug abuse appears to be her to stay.

The title of this essay conveys an important clue to the identity of this month's mystery drug. It's a relative newcomer, a drug that was only recently added to the substance abuse "street drug" watch lists. And although initially thought to be a safer alternative to older drugs, this one has proven to possess liabilities that could be quite dangerous.

This month's drug is a prescription medication, it is a controlled substance under federal schedule IV; patients can obtain prescriptions in writing or by having a physician call it in to a local pharmacy. This drug's official systematic chemical name is N, N,6-Trimethyl-2- (4-methylphenyl)- imidazo (1,2-a) pyridine-3-acetamide. This drug is prescribed and sold worldwide; over 12 billion doses of this drug have been distributed to patients. The drug comes in a number of different formulas; some are designed for instant release into the bloodstream, while others have been altered for controlled or continual release.

This drug and others like it came to market with some hype and excitement. This substance was the first of a class of credible alternatives to the use of the benzodiazepine class of drugs. This latter family of drugs includes well-known sedatives like Valium (diazepam), Xanax (alprazolam) and Ativan (lorazepam). The benzodiazepines are very effective drugs when properly used; these drugs fulfill very necessary roles as sedatives and hypnotics. Xanax and Ativan are well-known anxiolytics that are very effective in the management of anxiety disorders; Valium is a very effective muscle relaxant. The benzodiazepines are also used in the role as sleep aids. Drugs such as Restoril, Halcion, and Dalmane are examples of benzodiazepine hypnotic sleep aids. As effective as these drugs are, they have well-worn histories as drugs of abuse. Originally developed as safer alternatives to the use of barbiturates (Secobarbital, etc.), the benzodiazepines turned out to have their own issues as addictive and abused drugs. It is to this backdrop that this month's drug emerged into the sedative-hypnotic drug marketplace. As pharmaceutical research progressed into the 1980s, a new type of sedative-hypnotic drug was created. This new line of drugs was best characterized by calling them what they were not, they were nonbenzodiazepine-nonbarbiturate. This month's drug is arguably the most widely prescribed drug of that class.

In the brain, this drug works similarly to Valium and the other drugs of the benzodiazepine family. The drug seeks out GABAA receptors in the brain; these chemical nerve centers are responsible for slowing and reducing central excitatory chemical messages. By slowing down the excitatory amino acid messages, the body can quickly slow down, relax, and fall asleep. The GABAA receptor complexes are mostly clustered in the brain. This means that the actions of this drug are mostly confined to the central nervous system; peripheral effects are rare. Comparatively, the benzodiazepines have broader, more widespread impacts; they bind with several types of GABA receptor types that are located both in and outside of the brain. This distinction partially explains why this month's drug is relatively ineffective as a skeletal muscle relaxant while Valium and Ativan are. The selective receptor site action of this drug was an attractive pharmacologic feature when it was brought to market. This month's drug, unlike many other drugs of the sedative-hypnotic class, is fast acting; the drug is quickly absorbed and swiftly bound to targeted receptors. One of the frustrating features of this drug though is that its hypnotic effects are relatively short-lived. The half-life of this drug is barely 3 hours; that is not too impressive for a drug that is essentially a "sleeping pill." Time-release formats of the drug have helped it overcome that it is quickly eliminated from the blood stream.

Other drugs with similar properties and pharmacologic features include the prescription medications Sonata and Lunesta. This month's drug is the more popular and most often prescribed drug of this class. Despite the appeal of this drug as a substance that poses less addiction potential than the benzodiazepines, there have been alarming reports of its abuse; patients addicted to this drug are now appearing at drug treatment centers across America. Adding to the growing concerns about the abuse of this drug are vexing reports that legitimate and appropriate use of it can lead to bouts of somnambulism, sleepwalking essentially. It seems that some people have predispositions for these effects when they take sleep aids. Many cases have now been documented where prescription users of the drug were later found sleepwalking, sleep-eating and in some cases even sleep-driving has been reported. Complicating these events is that anterograde amnesia frequently occurs with the use of the drug. These developments prompted the FDA to require drug manufacturers to publish more stern warnings about the possibility for side effects like somnambulism. In law enforcement circles, suspected cases of drugged or drunk driving have been complicated by later claims of sleepwalking and sleep driving. Adding to the intrigue caused by this drug's bizarre side effects is a growing body of evidence that this drug may be an effective therapy in the treatment and management of schizophrenia. Investigation continues into the role that this drug may play in the treatment of a variety of psychological disorders.

Earlier this month the FDA published a rare advisory recommending a change in dosing strengths for this drug. The FDA has recommended that female patients who use this drug should cut their standard dose for this drug in half. The FDA's concern is for hangover effects that might persist well into the next day following a night of sleep.

This month's mystery drug continues to grow in popularity as a drug of abuse on the street. Especially within the club and rave scene, the drug has a cult following. It goes by a variety of street names: zombie, A+ and mash. Because the drug is a sleeping aid, the most common direct effect of the drug is sleep. This can be a problem for a recreational user who'd like to stay awake while high. To avoid falling asleep, the drug is used in small doses. For instance, an ordinary nighttime dose of 10 mg will be cut in half or in a quarter and then taken. At that concentration, the effects of this drug are "zombie-like." Tolerance to the effects of the drug does occur over time; it does not appear that physical dependency occurs. A recreational abuser of this drug will present like someone who has had too much alcohol to drink, but without the odor of it. For DAR & DRE trained readers, the symptoms associated with the use of this drug will be consistent with drugs of the depressant class. Some of the symptoms include the following:

• Slurred speech
• Droopy eyelids
• Nystagmus and non-convergence
• Poor balance; staggered, wobbly gait
• Poor hand-eye coordination
• Nodding off

In the club scene and with teens, this drug is sometimes combined with hyper caffeinated beverages to create a "speed-ball" (antagonistic) effect; sometimes hyper-caffeinated beverages are spiked with alcohol. When mixed with alcohol, the combined depressant and sedative effects are synergistic; the stupefying effects of the drug combination are much more than their additive sum. Caffeine does not reduce the drug's central sedative effects but it may keep the user awake a bit longer.

Of great concern nowadays is that this month's drug has become a regular feature of adolescent, high school "cabinet parties." These affairs involve raiding of the family medicine cabinet by teenagers who then bring the loot to a party spot where friends and acquaintances pick through the stash in search of drugs like Vicodin, Valium, and Soma.

Callers to the DAR Hotline have also claimed that this month's drug is touted as an antidote to "bad highs" caused by bath salts and glass cleaners. Apparently users of these unpredictable products have resorted to using this mystery drug as a means of turning down the hyper-stimulation caused by the black market powders.

Click Here for this month's mystery drug.

For those who are unable to open the link, email info@darstraining.com for the answer.

The club and hip-hop scenes have always been places where the seeds of vogue drug trends are sown. Over the past several years, the genre known as "designer drugs" has emerged as hip, cool, and trendy. Hip-hop songs have included references to these drugs, especially to the drug "Molly." Kanye West's song "Mercy" goes, "Something about Mary, she gone off that Molly." There are passages in other lyrics that reference Molly as well, leaving listeners to mull over what Molly really is. Molly is a troublemaker.

Molly is methylone, one of the original components of the concoctions that came to be known as bath salts and glass cleaners, the notorious substances that ushered in the contemporary designer drug era. Officially known as methylenedioxymethcathinone, methylone brings together the effects and symptoms of two different classes of drug. Molly is one part stimulant in the mold of amphetamine and another part hallucinogen with similarities to ecstasy, aka: MDMA. Molly was made famous by drug guru Alexander "Sasha" Shulgin, an American chemist who almost singlehandedly launched the drug and others like it into the U.S. drug scene. Shulgin is the vaunted author of two books that are perhaps the most thorough drug use tomes ever written. Oftentimes mistaken as ecstasy, Shulgin's Molly is substantively different from MDMA in terms of its net effects with users. A close analog of MDMA, Molly takes users down a different experiential road. Whereas ecstasy creates a magical experience for its users, Molly on can stimulate and agitate a user. Further, as the dosage increases, users can experience frank hallucinations and bizarre ideations. The Molly experience can vary wildly between the experiences of a gentle reduction in anxiety and tension to that of a rapid escalation in confrontation and pugilism.    

Sold on the street as powder stuffed into gelatin capsules, users have few clues as to the potency and purity of the Molly they buy. Sometimes the capsules are "bunk," containing nothing more than caffeine or other over-the-counter stimulants that are sold as a rip-off to the unknowing buyer. Some capsules contain a blend of other drugs, a drug cocktail made of a Neapolitan mix of random substances. And that's where the real trouble with Molly begins. Many Molly drug users have shown up in hospital emergency rooms in serious physical distress. Flummoxed emergency room personnel are forced to adlib treatments because there are no ingredient labels on Molly packages for them to work from and form a therapeutic response. ER patients often present with racing heart rates, skyrocketing blood pressure, and on the brink of seizure. There have been fatalities reported with the use of Molly. Others have been seriously injured as a result of seizures caused by the drug. For the chemically naïve user, Molly is very dangerous experimentation.

Methylone is a substance that delights a younger drug-using crowd. This is unfortunate. The club scene is the perfect social environment for dealers of this drug. The pitch goes that if you like ecstasy then you'll really like Molly. Outdoor music festivals and techno-music gatherings are examples of the types of events that tend to attract methylone-using crowds. There, first aid clinics are packed with Molly overdose victims, many of whom get carted out in ambulances.

Frequent users of Molly can become addicted. It is not believed to be a drug capable of causing physical dependence. But frequent use can lead to compulsive reliance on the drug; recovery from Molly "highs" can take several days following a "run." Some users have cited 3- or 4-day cycles of continual use that are then followed by similarly long breaks from the drug. Then the process is started all over again.

Molly is ordinarily found as a white to beige crystalline substance that is typically packed into gelatin capsules.  But over the Internet, it can be frequently found in the form of small baggies filled with the raw powder. If that is the case, a user can choose to snort or smoke the crystals. In rare instances, the drug is found in a solution with water that is then injected intravenously. Some of the product names for Molly are Boom, Lady Ex and Night Life. Product names are surely not coincidental; they typically reflect the potent nature of the drug's direct effects.

Someone under the influence of Molly will present with a potential constellation of symptoms. Some of the signs of Molly use are the following:

• Very dilated pupils that are very slow to react to light
• Flushed facial appearance
• Dry mouth; cracked lips
• Rapid speech that frequently alternates between topics and points of view
• Tendency to engage in long philosophical discussions of personal feelings of love and devotion
• Sudden changes in emotion; expressions of excitement that are rapidly replaced by depression
• Bouts of laughter quickly followed by crying jags
• Fast moving mannerisms; inability to sit still for long
• Tendency to touch, embrace or intimately hug people who they are engaged with

A decade ago, the release of Suboxone to the drug treatment community was heralded as a near miracle in therapy. Evolved as a mixed property semi-synthetic opiate with little potential for abuse, the drug was viewed by many as a cure-all for the treatment of individuals dependent on heroin and prescription opiates. In many ways, the drug has lived up to the hype. Suboxone's active ingredient is buprenorphine, a complicated synthetic opioid that has vexed and enticed addiction professionals for nearly 25 years. Buprenorphine is a drug that is entirely unique in how it binds with and activates the three principle opiate receptors in humans. Without digressing into a lengthy discussion of the drug's precise biological actions, it is clear that buprenorphine's properties and actions suit it very well as a substitute drug for patients addicted to narcotics (i.e. oxycodone, hydrocodone, and heroin). In addition, buprenorphine, in the hands of a trained physician, can be used to affect physical withdrawal from opiate dependency. In the treatment of opiate addiction and dependency, buprenorphine can be utilized to pursue several different therapeutic objectives.

Like most other powerful narcotics, buprenorphine is a potent agonist of the primary mu opiate receptor. But it has weak intrinsic activity there. As a result, the drug fails to trigger the signs and symptoms of other mu receptor agonists such as morphine, oxycodone, and methadone. At the delta and kappa receptor subtypes the drug's biologic activity results in only modest levels of opiate-mediated effects. Because of the drug's mixed properties, it was initially believed that buprenorphine poised little threat in becoming and abused drug. Unfortunately, there are individuals who abuse the drug and who even prefer it over other more traditional opiates.

Patients who abuse buprenorphine frequently report mixed symptoms of euphoria that is tempered by a sense of unease or anxiety, a rather uncomfortable set of contradictory symptoms. For many, buprenorphine has been compared to butorphanol (Stadol), a drug developed in the 1960s as a synthetic alternative narcotic thought to be a safer alternative to the use of codeine and morphine. Although butorphanol is still commercially available, it is infrequently prescribed in the United States; it never really caught on as a useful analgesic drug because of its mixed agonist and antagonist properties. Butorphanol abusers describe their high in ways that are similar to those experienced with buprenorphine. Based on the subdued narcotic effects seen with buprenorphine, it was widely believed to be a drug that did not possess significant risk as a drug of abuse. But that is not the case. As many communities now know, buprenorphine has a dedicated following and is in demand as a diverted drug.

Over the course of the last 10 years, medical utilization of buprenorphine has increased dramatically, both as a narcotic substitute for patient titration and withdrawal and as an analgesic prescribed for moderate pain (Butrans patch). In a recently published monograph by the Centers for Disease Control and Prevention in the Morbidity and Mortality Weekly Report, buprenorphine exposure and abuse was evaluated over a 10-year period as detailed by calls made to a poison control center in Utah. [1] The numbers are pretty staggering. During 2002 to 2011, prescriptions for buprenorphine grew 67 fold. In 2011 alone, patients filled over 106,000 prescriptions for buprenorphine. The explosive growth in the rate of buprenorphine utilization added to the risk for diversion and accidental exposure. Calls to the DARS Hotline reflect growing abuse of buprenorphine on the black market. DARS operators reported 152 calls in 2012 for inquiries involving the drug. Most callers were interested in learning the signs and symptoms of someone who may be abusing buprenorphine. Some were interested in learning about the nature of people who might take up with buprenorphine abuse.

Because of the drug's unique pharmacological properties, it is not a suitable substitute for people who are already tolerant of and physically dependent on opiates. In fact, for someone who is a frequent abuser of opiates with noticeable physical dependency issues, ingestion of this drug could be dangerous. In such a situation, an opiate abuser would quickly degrade into withdrawal if the abuser substituted their daily opiate with one of the available commercial buprenorphine products. For the naïve or recent opiate abuser though, buprenorphine works as a different tonic. For the new user, a buprenorphine high will not be much different than what would be experienced with abuse of a drug like Vicodin. A modest opiate euphoria will create a buprenorphine "buzz." The drug will also depress basic physiological signs such as heart rate, blood pressure, and respirations. The eyes will constrict somewhat, but not as completely as they would with abuse of a drug like oxycodone or heroin. For the truly non-tolerant user, there may be signs of noticeable sedation that could very well look like the classic opiate-induced "on the nod" phenomenon. A buprenorphine high will last for 3-4 hours. Taking more of the drug though will do little. A plateau of effects is reached rather quickly with this drug. Adding more into the mix does not achieve much.

Chronic use of the drug can lead to dependency. Detoxification from buprenorphine is difficult. For some patients it is nearly impossible to quit. Physicians and patients using the drug as a means of titrating off of opiates need to guard against using this drug for extended periods of time. Doing so can lead to a transference of dependency from the abused opiate. Only trained physicians are authorized to use this drug and prescribe it. Making buprenorphine products even more prone to diversion is the fact that it is regulated under terms of DEA Schedule III and, as a result, it can be dispensed and utilized in private medical practices. Physicians can prescribe buprenorphine and authorize refills for patients; telephone prescriptions are also allowed under terms of Schedule III regulation.

The DARS Journal has frequently reported on news associated with the use and abuse of over-the-counter (OTC) cough syrups, especially those that contain the ingredient dextromethorphan (DXM). In addition to OTC cough suppressant abuse is the diversion of prescription (Rx) codeine and promethazine compounded products (Phenergan and codeine compounds). Devotees call the latter by the names of "lean" and "purple drank." The lessons in the use of these drugs are clear. Whether it is DXM syrups, such as Delsym or specially flavored "lean" cocktails, cough syrup "highs" carry significant, life-threatening consequences. Making this behavior all the more risky is that overdoses and accidents have very unpredictable outcomes. Overdose deaths are not uncommon.

And cough syrup abuse is not just an American phenomenon. Other countries, even those with draconian drug and alcohol laws suffer from the same public health threat as Americans. For instance, just a few weeks ago, Pakistani drug enforcement officials reported that 33 people in the eastern part of that country had recently died as a result of their pursuit of a cough syrup high. Another 50 patients are still in the hospital. They had each taken a significantly higher dosage than was recommended on the product label.

For abusers who seek a cough syrup high, the endeavor requires drinking 75-100 ml of the liquid. Noxious as these products are, it is a remarkable feat to drink that much. For the tolerant or addicted user, it is not uncommon for someone to drink down an entire bottle of cough syrup. So, for instance, someone who acquires a generic 4 ounce bottle of cough syrup for the purpose of getting high will need the entire 120 milliliters of liquid. Although cough syrup abusers may seem quite odd in the minds of the uninitiated, those who are drawn to this form of substance abuse find it to be a cheap and reliable method to achieve a break from the problems. For a good number of users, a cough syrup high results in temporary amnesia as well.

In the United States, cough syrup abusers fall into one of two categories of use: those who seek out opiate containing products (codeine, hydrocodone, and oxycodone), and those who hunt for compounds that contain dextromethorphan (DXM). Some prescription formulas contain both types of drug in a special compound. A doctor's prescription is required for any preparation that contains an opiate; dextromethorphan-based products are typically available as OTC medications, although some unique products do fall under some form of federal control. In many states, OTC DXM products are secured behind the pharmacy counter and are in the control of pharmacy technicians. It is of no surprise that when left out in the aisles with other OTC products, medicines containing DXM seem to grow wings and fly out the doors. Adolescents are the most commonly cited suspects in those types of theft.

DXM cough suppressants can be powerful drugs that often trigger a cascade of dangerous effects that are eerily similar smoking PCP. Dextromethorphan is a dissociative anesthetic and, in sufficient doses, can cause users to experience hallucinations, distortions, and disturbances in thought processes. DXM can create an out-of-body effect that users describe as a detachment from mind and body.

For those abusers who are drawn to the codeine/promethazine-based products, the effects are noticeably, but not entirely different from dextromethorphan syrups. Promethazine is a sedative, a member of the phenothiazine family of depressant drugs. Compazine, Thorazine, and Stelazine are sibling drugs of promethazine. All of these chemicals are capable of causing significant sedation and amnesia. The cocktail combination of promethazine and codeine, the concoction at the center of "lean" and "purple drank" is a reliably intoxicating compound that could lead to serious medical complications that can lead to hospital emergency rooms.

For someone taking loaded doses of dextromethorphan-based cough syrups, signs of intoxication will look something like the following:

• Blank stare
• Difficulty in verbalizing
• Dry mouth
• Sweating, may sweat profusely
• Dilated pupils-near normal reaction to direct light
• Possible nystagmus and lack of convergence (higher doses)
• Increased heart rate
• Distorted internal clock (may be fast or slow)
• Piloerection (hair standing on end)
• Loss of coordination; distorted depth perception
• Slow moving gestures
• May become frozen in motion when standing or sitting

For users who are intoxicated from ingestion of codeine/promethazine-based cough syrups, the symptoms will be a little different. Because of the involvement of codeine in the formula, pupil size will constrict and will become non-reactive to light. Nystagmus is probably present as promethazine is a potent sedative and central nervous system depressant. Users will likely exhibit poor coordination. These folks however will be able to communicate with others, a notable difference when compared to the circumstances surrounding a DXM user.

Cough syrup abuse under any circumstances is a dangerous undertaking. And keep in mind, many of these abusers will add alcohol to their menu. With promethazine and codeine, people on the west coast frequently add vodka to the mix of syrup, diet cherry Bubble Up, Jolly Rancher candy, and cubed ice. Vodka escalates the symptoms of intoxication and creates a very dangerous synergy when combined with promethazine.

Thank you subscribers. We appreciate your dedicated readership. At DARSYS we are committed to providing clients with the service and solutions you need to run successful drug awareness programs. Our Journal is just one way that we show that commitment. We always encourage feedback from our Journal readers. Please send your thoughts to info@darstraining.com.

Sincerely,

DARSYS Journal