With the increased use of designer drugs among adolescents, nurses need to take an active role in educating and treating patients as well as in changing health care practice and policy for banning new substances.

Katharine Frances Drobile-Landis, RN, BSN, Community College of Philadelphia, Philadelphia, Pennsylvania, USA, provided a summary of the current evidence on designer drug use among adolescents to help educate psychiatric nurses on the high incidence and dangers of these substances and what signs and symptoms to be aware of for suspected use, as well as the role they should play in changing health care policies.

Based on a systematic review of emerging drugs of abuse (Nelson ME et al. Emerg Med Clin North Am. 2014), Ms Drobile-Landis first provided a brief description and accompanying signs and symptoms of 2 commonly used designer drugs among adolescents: synthetic cannabinoids and synthetic cathinoids (bath salts).

First approved in 1985 for the treatment of nausea, synthetic cannabinoids are commonly known as spice, K2, spice gold, or fake weed. Signs and symptoms include anxiety, agitation, confusion, insomnia, hypertension, short-term memory loss, seizure and convulsions, shortness of breath, and psychosis and paranoia.

Existing in a natural form in the leaves of the Khat plant, synthetic cathinones are commonly known as bath salts, vanilla sky, ivory wave, meow meow, and cloud 9. Signs and symptoms include hyperthermia, blurry vision, tachycardia, psychosis, hypertension, agitation, seizure and convulsions, and acute renal failure.

Along with recognizing the signs and symptoms of these substances and providing supportive treatment, Ms Drobile-Landis emphasized the need for nurses to educate adolescents about the dangers of these substances, and the need for abstinence and breaking with maladaptive patterns that lead to their use.

US poison control centers received 2251 calls in 2012 related to bath salts through September 10 [Gershman JA, Fass AD. P T. 2012]. Ms Drobile-Landis highlighted efforts over the past several years to ban or regulate these substances in the United Kingdom and the United States. A UK study showed about 1800 queries relating to cathinones over 1 year leading up to the UK ban [James D et al. Emerg Med J. 2011], but a survey showed mephedrone was still in demand following the ban [Winstock A et al. Lancet. 2010].

Emphasizing the active role that nurses need to take in educating patients about these substances as well as helping to change policy on their use, Ms Drobile-Landis encouraged nurses to report suspected use of these substances to their local poison control center to help identify the extent of the problem and receive guidance on how to manage the problem. She also highlighted that in patients suspected of severe substance use, outside laboratory tests using liquid chromatography and mass spectrometry should be considered.