Drug use is constantly evolving, and everyone should keep an eye on the revolving door of drug trends so that we—as children, parents, siblings, friends and fellow citizens—can better understand two things: the true nature of addiction, and how we can better help people with substance use disorders. And with synthetic drugs, that revolving door is lightning quick. The National Institute on Drug Abuse warns us about the continuing evolution of drug use, highlighting the new and constantly changing chemical makeups and formulations of drugs. These new drugs are often produced in a lab, and vary markedly from naturally occurring drugs and mood-altering substances like marijuana, cocaine and morphine. And because some of these new synthetic drugs are sold legally through retail stores, the ability to easily obtain the drugs over-the-counter leads to the mistaken belief that they can be taken safely or with fewer consequences. In reality, synthetic drugs can be equally or more dangerous than other controlled substances. And sadly, the use of synthetic drugs has only increased over the past decade while new substances continue to be produced. So let's investigate the different types of synthetic and designer drugs, highlight the effects on the body and mind, cover any other risks associated with their ingestion and talk about the opportunity for treatment. What are the different types of synthetic drugs? Synthetic drugs, also known as designer drugs or club drugs, mimic or strengthen the effect of naturally occurring drugs. But unlike those natural drugs, synthetic drugs like K2, MDMA or bath salts are all manufactured from human-made chemicals and are usually produced in a lab setting. And they all fall into one of three synthetic categories: cannabinoids, cathinones or opioids. Some examples of synthetic cannabinoids include K2 and Spice, whose chemicals tend to mimic the effects of tetrahydrocannabinol (THC), the active mood-altering substance in marijuana. Although synthetic cannabinoids may be marketed as knockoff weed and share some effects with marijuana, other short-term effects on the mind and body are different and severe: rapid heart-rate, vomiting, hallucinations and confusion among them. For synthetic cathinones (stimulants), street and drug names include bath salts, Flakka and Bliss. Generally, these synthetic stimulants replicate the high and hallucinations associated with cocaine, LSD and methamphetamine, and are a large part of the revolving door of drug trends, as manufacturers continually create new drugs that briefly avoid detection and regulation, and can be sold without prescription. And then they release a newer drug with similar chemical compounds when authorities crack down. In addition to the hallucinations, the synthetic cathinones may result in paranoia, panic attacks and delirium. One of the most infamous synthetic drugs is fentanyl, a deadly example of synthetic opioids. Like the others, fentanyl is a lab-produced chemical that's legally available (although under prescription). But it's 80 to 100 times stronger than morphine, and is often laced in other illicit drugs like heroin, cocaine, methamphetamine and MDMA. Sadly, synthetic opioids like fentanyl are the most common drugs involved in overdose deaths in the United States. Their short-term side effects include drowsiness, nausea, constipation, confusion, troubled breathing and unconsciousness. What chemicals are in synthetic drugs? It's impossible to know every chemical that might be present in synthetic drugs. While synthetic cannabinoids, cathinones and opioids all contain some known ingredients, the U.S. Drug and Enforcement Administration has identified nearly 300 different types of synthetic drug compounds in existence, each with a unique chemical formula. Of this we can be sure: synthetic drugs are designed with psychoactive ingredients intended to alter the mind of those who use them. What makes synthetic drugs dangerous? As mentioned above, it's impossible to fully know the chemical makeup of any synthetic drugs, and the manufacturers often tinker with a drug's molecular structure to avoid scrutiny from governmental agencies like the Food and Drug Administration. Without any oversight, there's no way to accurately monitor, account for or report the long list of short-term risks or long-term side effects, and certain mixtures of drugs—like those with fentanyl—can and do prove fatal. What are the risks of taking synthetic drugs? Much like naturally occurring drugs, synthetic drugs have significant risks associated with their use. The risk for addiction is extremely high because of the manner in which the synthetic drugs interact with the brain. And since we can't rightly know the exact ingredients of synthetic drugs—again, due to the avoidance of oversight and regulation—it's impossible to know the wide-range of effects any one drug might have, which presents risks that we aren't even aware of. These drugs are even made to mimic the appearance of other medications or drugs, looking identical to prescription medication available through a pharmacy. So the drugs are hard to spot, impossible to measure, have unknown effects and can possibly prove deadly. Why do people use synthetic drugs? The internet has fueled the popularity of synthetic drugs because it provides a quick, easy avenue by which to obtain them. With a few web searches, someone can order synthetic drugs and have them delivered right to their door. So rather than dealing with a dealer or other more traditional methods of purchasing illegal drugs, people can browse right from their phone or computer. According to the American Association of Poison Control Centers, young people are particularly and increasingly at risk of synthetic drug use because of these reasons. How do synthetic drugs affect the brain and body? Synthetic drugs have similar relationships to the mind and body as naturally occurring drugs. Synthetic cannabinoids, or synthetic marijuana, bind to the same receptors in the brain as THC, but produce much stronger effects. So the risk for addiction is great, and it opens the door to kidney damage, high blood pressure, seizures and overdose, all of which take a great toll on the body and mind. Synthetic cathinones, or synthetic stumulants, have similarly devastating side effects. Although there is great variance to the form and function of synthetic cathinones (and how they interact with our bodies), they generally affect the brain in the same way that cocaine does but much more powerfully. The chemical known as 3,4-methylenedioxypyrovalerone (MDPV), for example, is the most common Bath Salt reported in emergency hospital visits, and is at least ten times more powerful than cocaine. Long-term effects to the mind and body include addiction, the breakdown of skeletal muscle tissue, kidney failure, brain swelling and death. And synthetic opioids like fentanyl bind to the body's opioid receptors—where pain and emotion are controlled—very similarly to naturally occurring opiates that derive from opium and semi-synthetic opioids like Vicodin. Confusing, we know. But the purely synthetic opioids created in labs are much, much more powerful, so the risk of overdose and death is extremely high, and the long-term effects are similar to other opioids. Slow breathing will limit the flow of oxygen to the brain and cause permanent brain damage or coma, and a person can also experience organ failure, damaged reward and pain pathways in the brain, and death Treatment options for synthetic drugs Although the production and appearance of drug use may be constantly changing, the first step toward recovery is always the same. Anyone with a substance use disorder should consult an addiction and recovery professional to get a better idea on treatment options. In-patient treatment, out-patient treatment and counseling are among the possible solutions, and professionals can also help loved ones better understand addiction and give advice on how to better manage it (and find healing of their own). If you or someone you know is struggling to maintain sobriety, please reach out to Hazelden Betty Ford for answers and help at 1-866-831-5700. You don't need to manage the situation alone. Substance use disorders of all varieties are common and treatable, and there is no shame in needing help with addiction. We're here for you.