The hospitalisation of six people after allegedly taking 2C-B is a prime example of the potential dangers of consuming a so-called designer drug.
It is one member of the 2-C family of synthetic (manmade) phenethylamines, many of which are reported to induce hallucinations in addition to other effects on the body.
The drug is closely related to mescaline, a natural drug produced by several cacti, including the Peyote cactus.
The chemical name of 2C-B is 4-bromo-2,5-dimethoxyphenethylamine, hence the use of the more straightforward abbreviation “2C-B”.
So-called designer drugs are often referred to in the media and online with obscure abbreviations, as with the case of 2C-B.
These acronyms are usually based on the chemical structures and other chemical features of the drug. For example, the “B” of 2C-B refers to the chemical element bromine, which is part of 2C-B’s molecular architecture. Replacing this atom with alternative chemical elements results in the production of many other members of the 2-C drug series, with similar pharmacological effects to 2C-B itself.
2C-B, as with many designer drugs of abuse, are often synthesised and imported from Eastern Europe and Asia in a bulk powder or liquid form.
Once within Europe, they are typically mixed with other inert ingredients, packaged into smaller quantities and units, labelled, and then made available to individuals.
Drugs of abuse such as 2C-B have typically little, evidence-based, reliable data available in the public arena with regards to their pharmacological and potentially toxic effects on the human body.
The packaging of the products (if there is any in the first place) typically contains limited, if any, information, on the name and quantity of the drug present, dose, onset of action, duration of action in the body, possible side effects, effects if taken with alcohol or other drugs (prescription or otherwise).
The quality of the drug and other ingredients within the drug packaging is also an unknown variable, and may be contaminated with impurities from the manufacturing process, bacteria and viruses, other drugs of abuse, and substances which have not been identified on the products packaging but may have the potential to cause additional harm and injury to the user.
It often occurs that there is no drug or a different, unexpected drug present in the product to that listed on the packaging, resulting in unanticipated and possibly harmful effects to the drug user.
The approach to bringing a designer drug of abuse to the illicit public market is in stark contrast to the process a pharmaceutical company must abide by when manufacturing and making available a therapeutic drug to patients and healthcare professionals.
The pharmaceutical industry is one of the most highly regulated environments in the world, with patient safety and drug quality and efficacy always at the top of its priority.
Pharmaceutical companies typically spend hundreds of millions of euro before ever being allowed to bring a therapeutic drug to the market, after having spent many years researching its potential side effects, efficacy, quality control and safety, and subsequent independent scrutiny of all of the evidence by a regulatory authority, such as the Health Products Regulatory Authority (HPRA) in Ireland.
The use of acronyms and the myriad of other, more colloquial street names for designer drugs can be confusing, and can result in their misidentification. There has been some misreporting in media with regards of the name of the suspected drug substance involved on Tuesday’s incident, with some suggesting the implicated substance to be 2C-B whereas others describing it as 2-CP.
However, the HSE subsequently confirmed in a statement during the late afternoon that the drug under suspicion was 2C-B.
Interestingly, 2-CP, which is not implicated in the Cork case, is also a member of the 2-C phenethylamine-type drug of abuse series, and thus has reported hallucinogenic-type activities similar to that of 2C-B.
Such confusion further highlights the difficulty of providing rapid and accurate information to the public, healthcare professionals and An Garda Síochána with regards to specific drugs of abuse.
Although most would not have heard of 2C-B before, the drug was first manufactured and documented in the literature in 1975, with initial reports of its abuse during in the 1980’s.
The drug was originally first controlled in Ireland under the 1988 Misuse of Drugs Regulations, which were subsequently replaced by the 2015 Misuse of Drugs (Amendment) Act. At an International level, 2C-B is listed since 2001 as a Schedule II substance of 1971 United Nations Convention on Psychotropic Substances. Schedule II also includes drugs such as amphetamine and methamphetamine.
The rapid expansion of the number of different designer drugs of abuse, particularly since the 1980s has proven to be a major challenge for many countries around the world, including Ireland, with regards to putting mechanisms to place them under legal control in within a timely manner.
While 2C-B is not specifically named as a controlled substance within the 2015 Irish Misuse of Drugs Act, the chemical features of the drug are instead described in a generic fashion within the legislation.
This general description, which also encompasses the chemical features of many other molecules related to 2C-B, results in the control of potentially hundreds of chemically related molecules without ever having to name the molecules specifically in the act.
This approach of generic control helps, to an extent, to future proof our controlled drugs of abuse legislation, so long as the latest drug of abuse to be encountered on the Irish market has chemical features included by the generic legislation already in place.
Those who manufacture and introduce new drugs of abuse to the public are often well aware of these legal controls, resulting in them designing new drugs of abuse with chemical features not controlled by the laws of the country.
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