This article has been medically reviewed by Dr Robert Lefever, a world-leading addictions specialist.
Are you familiar with the name “smarts”, “herbal highs”, or “designer drug”? These are just a few names. And if you or anyone else you know knows about the legal highs or are consuming it, then its effects may not be novel to you. However, just like other drugs, you may get addicted to these and can suffer from health deteriorating conditions.
If you or your loved one is introduced to the drug, this article contains all the information you need to know. And if you need any help, call 0203 955 7700 because help4addiction provides evidence-based treatments to help patients achieve life-long sobriety. It is one of the best places to get help for alcohol, drugs, and addiction-related issues.
What is a Legal High?
Intoxicating substances have been changing ever since. And in many countries, new synthetic substances have emerged beyond legal control. As a result, manufacturers have changed the type, effects, and composition of intoxication substances to don’t fall under the category of illegal drugs, hence, called “legal highs”.
Legal highs are also called new psychoactive substances (NPS). As these are psychoactive drugs, they change the functioning of the nervous system. This change in nervous system functioning alters consciousness, perception, mood, behaviour, and cognition. These substances are termed legal because apparently, these drugs contain ingredients that don’t come under the category of illegal substances. Moreover, legal highs are sold with the label “not for the consumption of humans”. And manufacturers have tweaked their composition at the molecular level as well.
However, NPS mimic illegal drug effects, but these differ in potency, half-life, chemical structure, metabolism, and the severity of side effects. These drugs are derived from plants, synthetic, or can be a mixture of plant extracts, chemicals, or synthetic substances. Manufacturers also advertise these drugs in different ways, such as bath salts, room fresheners, or incense sticks.
Legal highs are divided into three categories: hallucinogens, depressants, and stimulants. One can find them in different forms, such as salts, powders, pills, herb mixtures, and roll-ups. Moreover, manufacturers disguise these drugs in separate packages, names, and forms and apply unique symbols or passwords. Such symbols and passwords help consumers understand the slang names for these drugs along with the effects they induce.
Some slang names for narcotics are Sub-Soca, White Ice Resin, Snow Blow, X Pillz, Snow Power, Diablo, Chaos, Golden Bullet, Lucifer, Trans, Dragon Blister, Grove, Summer Daze, Moon Dust, and Dynamind Euphoria. These names and different forms help dealers offer their products easily on the internet and in other shops.
Prevalence Of Legal High use
The intoxication reports on novel psychoactive substances are infrequent compared to cocaine, cannabis, or alcohol. For example, a survey in Germany reported that approximately 9% of 15-18-year-old students smoked NPS once in their lifetime. And around 2% smoked these in the last 30 days. In 2020, some areas of the UK reported about 20.3% lifetime prevalence rates of mephedrone use.
Moreover, some people may consume these drugs due to them being considered legal. In contrast, these drugs are just different derivatives of their original products and have effects and dependencies similar to others’.
What are the effects of legal highs?
Legal highs have a different composition for which no clinical or laboratory investigations have been carried out. Therefore, no reliable data have been known regarding the toxic hazards of NPS. Furthermore, the duration of action of the drugs and their long effects are also unpredictable. Moreover, due to changes in ingredients and faulty descriptions, people don’t know about the actual ingredients involved, which also poses a risk to the consumers.
Moreover, there is no proper guidance about the dose of drugs mentioned for consumers. Not only doses but the content of the psychoactive agents are also not specified. Therefore the term legal high may be misleading as these are not the milder version of other drugs.
Although sold in different names and forms, the legal highs generate effects similar to those of illicit drugs. Various studies show that minor or moderate poisonings are associated with the use of novel psychoactive substances. Some standard clinical features that people complain about are chest pain, hypertension, hallucinations, and agitation.
The consumption of high doses of legal highs can result in psychotic symptoms, including visual and auditory hallucinations. In addition, peripheral activity affects the thermoregulation process and cardiovascular system. As a result, the individual may experience increased blood pressure, tachycardia, hyperthermia, and cardiac arrhythmias. Other conditions include dryness of the skin and mucous membranes, dilated pupils, tremors, and convulsions.
Severe fatal poisonings cause brain oedema due to hyponatremia, seizures, and serotonin syndrome. Moreover, the individual suffers from CNS and cardiovascular system disorders, irritability, increased mental tension, anxiety, aggressiveness, fever, panic attacks, hallucinations resulting in delirium, and even suicidal tendencies.
What is the mechanism of Legal Highs?
Compared to other psychoactive substances, the toxic and pharmacological properties of legal highs are not fully known. However, a study on the composition of these drugs most commonly used in the UK categorised the substances in legal high in three groups of compounds. These three groups are derivatives of piperazine, ephedrine/caffeine, and cathinone.
Moreover, Baumeister et al. (2015) divides this wide and rapidly expanding variety of novel psychoactive substances into the following five categories. These categories are formulated based on the parent’s compound’s properties.
These are the legal highs that mimic psychostimulants such as amphetamine or cocaine. The site of the efficacy of these drugs is the monoamine system and increases the levels of monoamines.
- Synthetic cannabinoids
These mimic the effects of cannabis by with the efficacy sites being cannabinoid receptors1&2 and G-protein coupled receptors.
- Derivatives of benzodiazepines
These legal highs act on GABA receptors through allosteric modification.
These mimic the action of phencyclidine by acting on glutamate and NMDA receptors via competitive antagonism.
These are similar to psilocybin or LSD and act on serotonin receptors.
Although this is not the exact, rather a reasonable approach to the classification that can give an idea about the mechanism of legal highs and approximate effects.
Treatment for legal high
Individuals who overdosed usually have hallucinations or are unconscious when they reach the hospital. Whether they are hospitalised or not depends on the severity of the poisoning. For the individual experiencing psychotic symptoms, intense mental and physical stimulation is used. However, if psychotic symptoms persist, they are moved to psychiatric hospitals for further treatment.
The physician toxicologists usually describe the condition of the intoxicated individual as aggressive and aroused. Hence, treatment mainly focuses on administering sedatives. However, hospitalisation is not always required.
Moreover, considering the toxic effects of the legal highs, the treatment for these drugs is supportive. Medical health professionals carefully monitor body temperature, heart rate, and blood pressure. In addition, they carry out different tests depending on the clinical features. Laboratory tests include testing cardiac enzymes, creatine kinase, electrolytes, and liver enzymes.
For the symptoms caused by the sympathetic nervous system activation, professionals include fluid replacement and benzodiazepines in acute treatment. These treatment strategies control hyperthermia, cardiovascular stimulation, and agitation. However, specialists don’t prescribe haloperidol without benzodiazepines as legal highs reduce the threshold of seizures and dysrhythmias and increase psychological effects such as anxiety.
For individuals consuming legal high, nitrates are recommended to treat hypertension, and β-blockers are avoided as they can increase blood pressure due to ɑ-adrenergic stimulation.
Phentolamine may be useful, but being an alpha-receptor blocking agent, it can increase tachycardia caused by legal highs. On the other hand, Carvedilol combined with ɑ-β-blockade results in reducing the increased level of body temperature, heart rate, and blood pressure. Moreover, in case of severe hyperthermia, medical professionals may recommend relaxation and physical cooling.
However, all these treatments depend on the individual’s condition and the type of substance used. Medical professionals also rule out other underlying conditions that may be the cause of symptoms. Despite the toxic effects, addiction and dependence are serious matters that need to be addressed as soon as possible. To seek help for drug or alcohol-related effects, dependence, and addiction, consulting a professional counsellor is the right step to take. Help4addiction has a team of qualified professionals that can help you choose the best treatment program for you. Call 0203 955 7700 and start your consultation now.
Legal highs are gaining popularity among young people due to their colourful packaging and ease of purchase. But as these substances are sold without content description, quantity specifications, and a mixture of substances creating a dangerous cocktail, legal highs have significant toxic effects. Moreover, assessment of the complete risk of these polysubstance is not possible. However, its effects, signs, and symptoms indicate the urgency to address the problem. For more information or in case of help and urgency, call 0203 955 7700. Help4addiction is here to help.
Frequently Asked Questions
Are legal highs legal in the UK?
Where are legal highs sold?
The second route is the traditional supply of drugs through friends, dealers, and non-formalized third parties. CSEW data shows that this is still the largest supply stream for legal highs. Finally, the third mechanism is the internet that is another commonly used source for the sale and purchase of legal highs.
What are the names of legal highs?
What are the signs of alcohol abuse?
Behavioural signs of drug abuse are neglecting responsibilities and personal hygiene, withdrawing from social activities, stealing or borrowing money for drugs, etc.
How to reduce the level of risk from legal highs?
Avoid using more quantities at once. Instead, start with small amounts and don’t take too often because you don’t know the exact content and portion of ingredients involved in a substance. Moreover, one must avoid mixing different meanings as mixing drugs can have dangerous side effects. And to further reduce health risks, avoid operating machinery, driving, or swimming after consuming the drug.
What is the treatment of drug abuse?
- Legal highs – legal aspects and legislative solutions.
- Analysis of psychoactive and intoxicating substances in legal highs.
- Novel psychoactive substances (designer drugs): overview and pharmacology of modulators of monoamine signalling.
- Understanding the prevalence of ‘Legal High’ misuse in early adulthood.
- Psychoactive Substances Act 2016
- Drug addiction: getting help
- What are legal highs, and has the government ban worked?
The misuse of legal highs has been becoming a growing problem. In addition, new synthetic substances have emerged beyond legal control. Unfortunately, due to their changing composition, names and form, we don’t have much reliable evidence, but their potential dangers are apparent.