M.D., Ph.D. in Pharmacology
Director of research and professor in the Faculty of Medicine
Universidad de los Andes
In films and literature, we have seen human beings who wander around unconsciously, they walk slowly, their movements are clumsy, and they appear to be in a troubled state. They talk incoherently, seem to not be aware of what they are doing, and can even cause others harm. These ‘people’ are called zombies and their affliction has been blamed on magic, infections, radiation, or other phenomena. We have seen them in films such as The Return of the Living Dead or in the series such as The Walking Dead.
However, over recent years, zombies have gone from fiction to becoming real people who the media has shown either causing physical damage or fear in the community. These real-life zombies are not the result of magic, but instead the product of abusing substances known colloquially as zombie drugs or scientifically as synthetic drugs.
The most infamous image we have seen was of a man in an agitated state eating body parts of the victim he attacked after having taken Flakka (a zombie drug) in Florida, U.S.A. There have also been reports of the drug in Colombia, and recently we heard of parties in the Coffee Growing region where young people became erratic and uncontrolled after having taken zombie drugs.
The manufacture and distribution of these drugs is not regulated, and this means that it is very difficult to identify the substance responsible for intoxication and to predict the effects that these drugs have on the organism. They were generally designed in legal scientific laboratories to study the effects that different neurotransmitters had on neurons and the central nervous system. However, the manufacturing methods were described in the scientific literature, which allowed these compounds to be made in a less-controlled and more artisan manner.
To pass the security measures, these synthetic drugs are mixed with vegetable products (generally inert) and are sold as ‘incense’ to smoke or to be used in hookah pipes. Some of these substances can also be ingested by being injected.
Zombie drugs are very addictive, and they can cause severe intoxications as the content of the drug is highly variable and because of the extreme potency of the compounds. For example, a synthetic cannabinoid named after the AK-47 assault rifle, which contains the AMB-FUBINACA molecule, can be up to two hundred times more potent than regular marihuana. So, a very low dose of AMB-FUBINACA is needed to achieve similar effects to marijuana on the central nervous system.
Synthetic drugs have an effect on the central nervous system, and they can be divided into various groups including: cathinone-like stimulants that are known colloquially as ‘bath salts’ (Flakka), synthetic opioids that are similar to morphine (Krokodil), and cannabinoids (AK-47).
The stimulants are generally alkaloids derived from plants such as Catha edulis, or they contain molecules similar to MDMA (ecstasy). They increase the levels of neurotransmitters such as dopamine and norepinephrine on the central nervous system, and their effects on the organism are comparable with those reported with the use of ecstasy, amphetamine, and cocaine. The effects include a sensation of euphoria, psychomotor agitation, convulsions, paranoia, hallucinations, and attacks of rage. When the subjects are under the effects of the drug, they may destroy objects or harm people around them. Also, the people who consume these drugs can have heart, muscle, and liver problems, which can lead to death.
Synthetic cannabinoids behave similarly to marihuana. In general, they depress the functions of the central nervous system, and they can distort the perception of reality. In some people, the psychotic symptoms have lasted up to five months. These cannabinoids also have severe adverse effects such as anxiety (which can result in suicides), convulsions, hypertension, kidney damage, and heart problems (that can end in a heart attack and then death).
Given the variety of zombie drugs available and the high doses to which people can be exposed, healthcare workers are finding it a challenge to tackle medical emergencies and confirm the exact cause of the intoxication. Treatment for intoxication with these substances focuses on controlling the complications of the patients, many of whom are treated in intensive care.
The low cost of producing synthetic drugs as well as the low-level of control and monitoring to counter their production and distribution mean that the use of zombie drugs is emerging as an important public health issue.