December 14, 2016 / 10:12 PM / 7 months ago

New York ‘zombie’ outbreak shows value of predicting future designer drugs

4 Min Read

(Reuters Health) - Researchers in California say they have found a faster method for identifying designer drugs similar to one that caused a "zombie" outbreak on a Brooklyn, New York block this summer.

The method, outlined in the New England Journal of Medicine, could make it easier for officials to quickly outlaw a synthetic drug and law enforcement officials to get it off the street.

It involves developing a catalog of potential drugs before they hit the black market, making identification faster.

"The way to respond to designer drug intoxication requires a totally different approach that may not necessarily be available to ordinary clinical labs,” said senior author Roy Gerona of the University of California, San Francisco.

The development is part of an ongoing race by chemists to develop powerful new mind-bending drugs before officials can outlaw them. They tweak psychoactive molecules to create chemicals that appeal to people looking for a cheap high. They're sometimes sold as incense, smoked like marijuana and don't become known to authorities until the people who take them suffer their ill effects.

That's what happened in July when an herbal "incense" product sold as "AK-47 24 Karat Gold" hit the streets. A Facebook live feed at the time showed people severely intoxicated by the drug, known generically as K2 or Spice.

In the video, some are lying catatonic on the ground and one is propped up by a fire hydrant as the videographer describes them as zombies. The characterization stuck, perpetuated in part by a New York Post story and other media reports.

More than 200 such compounds have been identified since 2014. Many come from laboratories in China or Southeast Asia.

Because they are created and distributed so quickly, it can take two to six months to identify a new chemical, Gerona said. In the New York case, it was done in 17 days because Gerona and his colleagues at the UCSF Clinical Toxicology and Environmental Biomonitoring Laboratory had used already-known drugs to develop a catalog of potential compounds that psychoactive drug developers might create.

"We've been preempting what they could possibly synthesize in the future," he told Reuters Health in a telephone interview.

In the new analysis, Gerona and his colleagues studied 18 people who were hospitalized for exposure to the drug, later identified as AMB-FUBINACA. It depresses the central nervous system and causes "zombielike" behavior. Thirty three people were known to have been exposed.

The typical victim was a 28-year-old man with a blank stare who was slow to respond to questioning. He tested negative for all known illegal drugs and alcohol. He periodically groaned and had slow movements of his arms and legs. He didn't ask for brains. He needed nine hours to recover.

It turns out that Gerona and his colleagues had synthesized the compound last winter, before it had shown up on the black market. If there had not been some bureaucratic delays, identification might have occurred even faster, perhaps within a week, Gerona said.

It was the U.S. Drug Enforcement Administration that had to arrange to get Gerona and his team involved. "That's when we were able to respond quickly," he said.

Identifying the drug allowed officials to take steps to outlaw it.

"We're always chasing whatever new drug comes in so perhaps we should change the way these compounds are regulated. Now we just react," Gerona said. "What happens if it's an ultra-potent drug that kills more than 1,000 people in the first strike? That's 1,000 lives lost before we actually do something about it," he added.

"As the number and complexity of new psychoactive substances increases," the researchers write in their report, "this type of coordination among multiple agencies is important for the timely resolution of future outbreaks."

SOURCE: bit.ly/1rzGOHe New England Journal of Medicine, online December 14, 2016.

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