The saying "so many ways to die" is true -- and they're available on the internet in the form of legal drugs. One of these drugs, Phenazepam, is usually made in Russia and is available legally, without prescription, throughout much of the world. This drug is not on the list of controlled substances for many nations (including the U.S. and U.K.). Recently, University of Dundee forensic pathologist Richard Maskell and his research group found phenazepam in the systems of nine people dead from overdose.
What is Phenazepam?
Why is it Dangerous?
Benzodiazepines are most commonly used as anti-anxiety or sleeping pills -- they relax muscles and give many people a "buzz." All benzodiazepines can be abused, not only causing sedation, disinhibition and confusion, but in high doses, death. The problem is particularly acute when adding alcohol. People also do not know that alcohol consumed at midnight can have two to three times the psychomotor effects that drinking at 6 p.m. can have. That's scary because relatively low, often forgotten doses of long-acting drugs like Phenazepam can -- in combination with late night alcohol -- lead to fatal accidents. I personally have seen cases like this.
Who Can Get These Drugs Over the Internet?Anybody. That's why former secretary of Health Education and Welfare Joseph Califano has said
And it's also true for any adult.
"The Internet is still a pharmaceutical candy store for any teenager who wants to get drugs."
What Other Drugs Can You Get Over the Internet?
You can get anything not specifically banned. That includes all "research chemicals" made by both certified and non-certified labs. One such drug is cannabinoids, which have similar effects to the active ingredient in marijuana, but are presently still legal in many states. Generally they are sold as incense or as "herbal" drugs. Fortunately, many states are now banning synthetic cannabanoids and the Federal government can use the "Analog Act" to pursue new drugs that are fundamentally copies of previously banned drugs. As The New York Times has recently reported, the epidemic of subsituted cathinone "bath salts" (which have properties similar to the banned drug Khat) has now prompted relatively prompt action by many states.
However, lots of drugs beat the "Analog" restriction for years -- especially when the market for a drug is relatively small. New anabolic steroids, routinely used by athletes or body builders to get their "edge" are a perfect example of this. Consumers begin to buy these steroids online and a successful "product" begins its run.
Do You Always Get What You Pay For?
Many internet drugs are ineffective and sometimes even laced with other ingredients, like ephedrine or steroids, that in combination with whatever else people decide to take can provoke lethal effects. One such drug is MPTP, an adulterant of a "designer drug" hallucinogen whose users developed a ugly version of Parkinson's disease early in the 1990's. The drug's effect was so specific and so toxic that it led to new scientific understanding of the disease.
Why is it So Easy to Get These Drugs?
It's so easy because they are often experimental, not listed in any scientific literature and therefore legal. Since the authorities don't know they exist they are free to be used.
What Can Be Done to Ban Phenazepam and "Research Chemicals?"
As is the case with the new cannabinoids, some states have legislated a ban on particular classes of drugs -- so that not yet created versions of older, toxic drugs would not be legal. These more narrow versions of the Analog Act generally have considerable legal teeth. However, banning drugs of a chemical class not yet discovered is legally very difficult.
Can the Problem Be Solved?
It will require constant vigilance. New drugs can and will be produced. Previously they were difficult to distribute. Now they can be distributed rapidly via the internet and make people lots of money -- often before medical or political authorities know that anyone is using them.
For many the news of their dangers proves too late.
Follow Matthew Edlund, M.D. on Twitter: www.twitter.com/therestdoctor