[di meliora]

James L. Knoll IV, MD, provide a quick reference summary on synthetic legal intoxicating drugs (SLIDs) here (You may have to register): http://www.psychiatrictimes.com/subs.../10168/2076439

Knoll says:

After being retained as a forensic psychiatrist in a number of cases involving defendants who were intoxicated with “bath salts” and/or “herbal incense” at the time of their crimes, I conferred with several colleagues working in emergency settings. [Note: Listen to the podcast here.] They confirmed my disquiet as they acknowledged seeing an increase in the number of patients brought to the emergency room as a direct result of using these “legal” substances.

According to the American Association of Poison Control Centers, there were 6138 calls for exposures to bath salts in 2011.1 As of January 31, 2012, there were already 228 calls. These substances have potentially serious adverse psychiatric effects including acute psychosis, delirium, violent behavior, seizures, and cardiovascular emergencies.2 With increasing reports in the media about synthetic legal intoxicating drugs (SLIDs) resulting in serious medical consequences and dangerous behavior, many psychiatrists will have at least a passing knowledge of these dangerous substances.3,4 Because of their variable legal status and numerous brand names, many may be unfamiliar with their mechanism of action and abuse potential. This article will provide a quick reference summary on SLIDs—what they are, what they do, and how to treat their adverse effects.

Dr. Knoll also is concerned that:

Recently, the US and Canada banned these substances. Yet the problem persists because manufacturers are a step ahead, ready to produce other slightly modified synthetic variants.5 To date, more than 140 different synthetic cannabis products have been identified.5 Another problem is that the SLIDs may not be identified by standard urine drug screens, particularly if they have been newly developed. It has been my experience that persons on probation or parole (who must undergo random urine drug screens) are fond of using SLIDs for this very reason. In addition, physicians treating military personnel have also reported cases of synthetic cannabis use, likely because of the decreased chances of detection by urine drug screens.10 Often, a more complex and time-consuming toxicology analysis is required to detect the presence of SLIDs.

Another serious problem to face.