November 16, 2018

ED Doctors Are on The Front Lines of Synthetic Drug Abuse

Emergency medicine jobs have certainly changed a lot over the last decade or so. Today’s ED physicians are experiencing cases that previous generations would never have thought of. At the top of the list are drug overdoses linked to new synthetic drugs that are evolving so quickly modern medicine cannot keep up. To say that ED doctors are on the front lines of synthetic drug abuse is to understate what is becoming an overwhelming problem.

Our decades-old efforts to eliminate illicit drug use have led drug dealers down the path of creating their own synthetic products that push the envelope of legality. These drugs are often packaged and marketed as plant food, but everyone knows what they are really for. Everything from synthetic marijuana to synthetic cannabinoids are now flooding the market, often with detrimental effects on users. Emergency room doctors see it every day.

No One Really Knows

To illustrate just how bad the synthetic drug problem is becoming, consider a two-year-study out of the University of Maryland Medical Center. With the help of the U.S. Office of National Drug Control Policy, scientists at the university’s Center for Substance Abuse Research began looking at reports of illicit drug use and how they relate to crime patterns.

That led to further research into how emergency rooms treat patients suspected of drug overdoses. What they found was shocking. Keep in mind that urine samples are one of the primary methods for figuring out what drugs a patient has overdosed on.

Looking at 175 urine samples from two facilities, researchers looked at test results for synthetic cannabinoids, other designer drugs, and illicit and prescription drugs. Their research uncovered the following:

  • Just 25% of the samples tested positive for synthetic cannabinoids
  • More than 20% of the samples tested positive for synthetic drugs other than cannabinoids
  • More than 60% of the samples tested positive for as many as six substances.

The research also showed a disparity between what doctors perceived patients were overdosing on, what the patients themselves claimed to have taken, and what urinalysis actually showed in the patient’s system. In short, the biggest problem with today’s synthetic drugs is that no one really knows what’s in them. The patient can assume he or she is smoking synthetic marijuana when it is something entirely different.

Overdoses Becoming More Complicated

The overreaching concern here is how complicated overdose situations are becoming. ED physicians – residents, employed doctors, and locum tenens physicians alike – are trained to rely on certain symptoms and tests to determine what’s going on with an overdosing patient. Yet new psychoactive substances often go outside that training.

A doctor can find him/herself treating a patient with a drug like naloxone only to have to turn around and treat that same patient for symptoms common to opioid withdrawal. Another doctor can treat a patient for what he/she believes is a synthetic marijuana overdose when, in reality, the patient has taken something entirely different.

A Whole New World

The emergence of synthetic designer drugs has created a whole new world for emergency medicine. Now would be a great time to get into the field if you’re the kind of doctor that likes a challenge. There certainly is no shortage of open positions at emergency departments around the country.

Will modern medicine ever get a handle on synthetic drugs? Maybe, or maybe not. But for now, the main goal of ED doctors is to try to keep up as best they can with a constantly changing environment. Synthetic drugs are unlike anything else they have dealt with.