"Legal highs"--toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration.

The easily available "legal highs", which are products containing psychoactive substances, such as cathinones, piperazines and synthetic cannabinoids, are abused by adolescents in Poland and in the world as alternatives to classic drugs, such as amphetamines or marijuana. The majority of these potentially dangerous substances are still legal and they are associated with a risk of severe poisoning or even death, and provide new challenges in clinical and forensic toxicological practice. Investigations in the field of "designer drugs" may be well illustrated by the case of a suicide of a 21-year old male who ingested a specified dose of a preparation called "Amphi-bi-a" that contains bk-MBDB, chemically 2-methylamino-1-(3,4-methylenedioxyphenyl) butan-1-one, which belongs to the cathinone group, as a synthetic euphoric empathogen and psychoactive stimulant that is chemically similar to MDMA. It is one of more common components of "legal highs" examined in Poland and other countries. The documentation of the case includes a clinical assessment of the patient's health status performed during his almost 4-h hospitalization before death, autopsy and histological examinations supported by toxicological findings revealing bk-MBDB at extremely high concentrations (at 20 mg/l in the blood and 33 mg/kg in the liver); hence, this body of evidence contributes to knowledge in the field of "designer drugs". Inventions of designers of new psychoactive xenobiotics, which are much in demand, especially in view of the dynamic Internet marketing, which drums up narcobusiness, must be balanced by a national strategy developed by medical, legal and educational circles in the modern civilized world in order to prevent the spreading of the phenomenon.

Comparison of "herbal highs" composition.

Popularity of new psychoactive substances, known as legal highs or herbal highs, is continuously growing. These products are typically sold via internet and in so-called head shops. The aim of this study was to identify active ingredients of herbal highs and to compare their chemical composition. Twenty-nine various products seized by the police in one of the "head shops" were analysed. Herbal mixtures (0.2 g) were prepared by ultrasonic-assisted extraction with 2.0 ml of ethanol for 2 h. The extracts were analysed by gas chromatography coupled to mass spectrometry (GC/MS). The main active compounds of the herbal mixtures were synthetic cannabinoids: JWH-018, JWH-073 and cannabicyclohexanol (CP-47,497-C8-homolog). Their content differed between the products; some contained only one cannabinoid whereas the others contained two or more. Cluster analysis and principal component analysis revealed that chemical composition of many products was very similar. The similarity was connected with their flavour and not the common name. This statement was true for the synthetic cannabinoids, other potential agonists of cannabinoid receptors (amides of fatty acids) and ingredients of natural origin and confirms that herbal highs are a threat to human health because the purchaser has no information on their real composition.