Designer drugs: legal, but not safe

Party-goers are increasingly replacing known drugs such as XTC, speed or ketamine with designer drugs*. In the last 15 years, close to 900 new designer drugs have entered the market, but little is known about the effects and risks of these unregulated drugs. PhD candidate Anne Zwartsen conducted research at Utrecht University on the effects of designer drugs, in order to better understand the hazards.

Zwartsen made a number of discoveries in her study on neuronal and heart cells. First, her research showed that, the day after a five-hour exposure to drugs, changes in brain cell activity could still be observed for some substances. It is not yet known what this means for users, but it could offer an explanation for the 'blue Mondays' that users can experience.

Increased body temperature of 41 degrees

Zwartsen also made a discovery on a known side-effect of psychoactive drugs: an elevatedbody temperature. An elevated body temperature can occur as a result of drug use, potentially in combination with the high temperatures in dance clubs. Zwartsen's research showed that a raised temperature of 41°C can cause the effects of drugs to be noticeable at a lower dosage. As it can also reduce the recovery of brain cell activity, it is important to prevent this temperature increase.

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‘Since the risks of designer drugs are unknown, there will most likely be many additional cases of poisoning, and potentially also deaths.’

Designer drugs: legal, but not safe!

Faster risk assessment

As the use of designer drugs has increased in recent years and their harmfulness is not yet known, there will most likely still be many additional cases of poisoning, and potentially also deaths. This means that there is an urgent need for good risk assessment, which Zwartsen contributed to. She determined the potency of the most commonly used psychoactive substances for influencing neuronal targets or brain activity, and for triggering changes in heart cells. This information makes it possible to assess the hazards for not just the substances tested, but also for new designer drugs entering the market, as the effects can now partly be linked to certain chemical structures. This will expedite the risk assessments for new designer drugs. Zwartsen exclusively experimented on cells, as it is the Utrecht University's ambition to refine, reduce and replace the use of laboratory animals.

Different effects

Another finding of Zwartsen's research pertains to the dopamine transporter, one of the well-known targets of drugs and psychotropics. Changes in this dopamine transporter that result from (congenital)  changes in the DNA appear to contribute to the differing effects of drugs and medication on users and patients. Besides this, these and similar changes to the transporter can influence the treatment efficiency of certain medication. This is a surprising find, as the differing reactions of patients are often linked to changes in enzymes related to the metabolisation of medicine and drugs, not directly to mutations in the dopamine transporter.

* Designer drugs are also called 'new psychoactive substances' (NPS). The drugs can be 'designed', by making small changes in the chemical structure, to ensure a certain effect. One designer drug discussed frequently in recent years is fluoroamphetamine (4-FA). At the time, 4-FA was used by about 25% of young Dutch festival-goers. While the media described the drug as XTC light, it turned out to cause cerebral haemorrhages, arrhythmia and even death. As a result, the drug was classified as a List 1 drug in the Opium law.