Tox Tuesday: Virginia’s synthetic drug and heroin problem

DesperateSpreading like wildfire from state to state, officials from Virginia are the latest to report an uptick in use of synthetic drugs including synthetic marijuana and other synthetic stimulants like bath salts and gravel. Gravel, also called flakka, has appeared in the state previously, but according to a recent article, is rearing its ugly head again and showing up in some counties for the first time. This is in addition to the nationwide heroin epidemic that like other states, Virginia is fighting as well.

Gravel is a white granular material that mimics the look of a fine aquarium rock, or even the popular candy, Pop Rocks. Users can snort, swallow, inject or smoke it through a glass pipe, or even those vaporizers that have become popular.

The drug’s active ingredient is a chemical compound called alpha-Pyrrolidinopentiophenone (alpha-PVP), which was first developed in the 1960s and according to the U.S. Department of Justice Drug Enforcement Administration, is considered a Schedule I drug under the Food and Drug Administration Safety and Innovation Act.

Alpha-PVP contains a pyrrolidine ring, a 5-sided nitrogen-containing component that enables the molecule to effectively block reuptake of dopamine and norepinephrine, with much weaker effects at the serotonin transporter. This causes feeling of euphoria, heighten awareness and increased energy, while also causing hallucinations that lead to bizarre behaviors.

“The drug takes users to another dimension,” Lieutenant Doug Gregg, of the Washington County Sheriff’s Office said in the article. “And they tend to do what’s called ‘snacking’ which means they smoke gravel, get high, and before they completely come down from that high they smoke again, or ’snack’ on the drug, and it pushes their euphoric high even higher.”

The U.S. Drug Enforcement Administration lists alpha-PVP on the controlled substances most likely to be abused list, and is usually made overseas in countries such as China and Pakistan.

“Gravel is the most dangerous drug for the user, law enforcement and other people,” Gregg said. “Users do things they would not think of doing (otherwise).”

To go along with the fight against synthetic drugs, officials in the state are also dealing with a heroin epidemic that has reached nationwide proportions over the past few years. In fact, recent statistics from The Centers for Disease Control and Prevention (CDC) show that fatal overdoses from heroin have tripled in the U.S. since 2010.

A recent article states that in Northern Virginia, heroin deaths jumped about 165% between 2011 and 2013 and in Loudoun County alone, heroin overdoses have skyrocketed 400% since 2012.The same type of numbers are also being seen in surrounding areas such as Maryland and D.C., where officials have declared it a “public health emergency.”

“Nobody starts with heroin. Nobody wakes up today and says, ‘Eh. Let me try some heroin,’” Major Jason Bogue of Prince George’s County Narcotics Enforcement Division, said in the article. Instead, he added, prescription painkillers are often the first step.

That’s because painkillers such as OxyContin, Vicodin, Percocet, Oxycodone, Hydrocodone, and Demerol are all pharmaceutical drugs that are opioids, like heroin. They all work the same way by binding to molecules on cells known as opioid receptors in the brain, especially those involved with the perception of pain and in reward. Opioid receptors are also located in the brain stem, which controls automatic processes critical for life, such as blood pressure, arousal, and respiration.

Because of this, heroin overdoses frequently involve a suppression of breathing. This can affect the amount of oxygen that reaches the brain, a condition called hypoxia, another article explains. Hypoxia can have short- and long-term psychological and neurological effects, including coma, permanent brain damage, and death.

The CDC reports nearly four times as many people died from painkillers in 2012 than in 1999, mostly because these drugs were more available than ever before. However, when a prescription drug runs out or becomes too expensive, addicts turn to the cheaper high that gives them the same euphoric rush – such as heroin.

The article goes on to say that today one bag of heroin costs less than $10. Dealers often cut it with other lethal drugs, such as Fentynal, a powerful anesthetic. Along with being inexpensive, heroin is more potent than ever before. Forty years ago, heroin had a purity level of just three to 5%. Today, it is about 90% pure.

“It’s pure enough that you don’t need to inject it,” Bogue said in the article. “And that’s one of the drivers.”Instead of using needles like drug users did in the 1970s, addicts are snorting heroin and leaving few visible signs of abuse, he added.

Because of this, the call to increase funding for mental health and drug treatment centers has never been louder in the state of Virginia as a number of bills have been approved to help deal with the heroin crisis. One of these bills is making it legal for law enforcement and others to administer Naloxone, a drug that when taken during a heroin overdose can actually reverse the effects.

The drug has reversed more than 10,000 overdoses between 1996 and 2010 and prior to now, has been very difficult to get, Virginia Gov. Terry McAuliffe, said in an article.

Initially, only doctors, paramedics and anesthesiologists could administer the drug, but that all changed last year when EMT’s around the state began training on how to administer it as well.

“Expanding access to Naloxone for all laypersons and providing immunity from liability are essential strategies to combat the continued increase of opioid overdoses in Virginia,” Dr. Debra Ferguson, from the Department of Behavioral Health and Developmental Services, said in the article.

Another bill recently passed grants immunity to someone who witnesses an overdose, calls for help, and stays on the scene until help arrives. A similar, “Good Samaritan” bill is also being worked on in congress by Sen. Tim Kaine, D-Va.

It was also recently announced that a regional heroin operations team will focus on combating the issue in the Loudoun County region and will focus on areas of enforcement, education and prevention by integrating local, state, and federal law enforcement, the public schools, and county mental health, substance abuse, and developmental services departments.

“Before, it used to be that if you possessed heroin, we’re going to take you to jail. Now, we’re trying to break the cycle by the way we’re viewing it and try to get you help up front,” Captain Paul Cleveland, the Commander of the Organized Crime and Narcotics Division in Fairfax County, said.

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