Confronted with the rising popularity of new synthetic drugs, Congress is responding in a reflexive prohibitionist manner. Last month, bills aimed at banning the substances moved forward in Congress, despite the protests of advocates and businessmen that lawmakers are simply repeating the mistakes of drug prohibition.

The bills are aimed at two distinct classes of designer drugs -- synthetic cannabinoids or fake marijuana sold under names such as Spice and K2, and the synthetic methcathinone derivatives mephedrone and MDVP commonly sold as "bath salts" under names such as Ivory Wave that produce a high likened to those of cocaine, methamphetamine, or ecstasy.

A number of states have moved against fake weed or bath salts or both. In action earlier this year, the DEA imposed a temporary emergency ban on fake weed, but it has not moved yet against bath salts. Now, Congress is poised to get in on the action.

H.R. 1254, the Synthetic Drug Control Act of 2011 and its Senate companion bill, S. 605 would make both fake marijuana and bath salts Schedule I controlled substances, like LSD, heroin, and marijuana. They also attempt to block new designer drugs by banning whole classes of similar chemical compounds. And they seek to expand the period for which the DEA can impose an emergency ban on a new drug, which the agency did earlier this year with synthetic cannabinoids. That bill was moving in House committees last week. 

Two other bills that would do essentially the same thing have also been filed in the Senate. They are S. 409, introduced by Sen. Charles Schumer (D-NY) and S. 839, sponsored by Sen. Amy Klobuchar (D-MN). These bills, though, are aimed only at bath salts. (An additional House bill, H.R. 1571, identified by the Library of Congress legislative tracking system as related to S. 409, has not moved out of committee.)

The bath salts drugs have been associated with spectacular bad reactions, including increased blood pressure, increased heart rate, agitation, hallucinations, extreme paranoia and delusions, and some reports of violent behavior. Fake weed has been associated with less dangerous bad reactions, including confusion, nausea and panic attacks.

The American Association of Poison Control Centers warned in May that it had seen a nine-fold increase in bath salts-related calls over the previous year, and that was with less than half the year gone. Last year, centers reported 302 calls; as of May of this year, they had received more than 2,200 calls.

That would clearly seem to suggest that use of bath salts is on the rise, but what it means beyond that is not so clear. Without a handle on actual use levels, it is difficult to determine how frequent such adverse reactions are, or how they compare to reported adverse events with other drugs.

Still, Mark Ryan, director of the Louisiana Poison Center, said the substances are the worst he has seen in 20 years at the poison center. "These products create a very severe paranoia that we believe could cause users to harm themselves or others," he said.

Oddly enough, for drugs that are touted as being so horrible, evidence from Britain suggests that somebody likes them quite a bit. According to a report last month in the Guardian, which cited recently released scientific research, "Mephedrone is more popular among UK clubbers than ecstasy despite being banned."

"The legal status wasn't considered important," said Fiona Measham, a criminology lecturer who led the research. "Among the people we spoke to, I was surprised how much they liked it, how much they enjoyed it. They wanted to take more and were prepared to seek it out and buy it on the illegal market."

But Congress isn't paying attention to foreign researchers. In a statement typical of congressional discourse on the issue, in a hearing last week, Rep. Charles Dent (R-PA), the sponsor of HB 1254, first listed a number of anecdotal scare stories, then proceeded to warn his colleagues that the drugs were not innocent. "These substances are marketed with innocent sounding names," he said, "but these labels are total misnomers designed to facilitate their legal sale. These drugs have no legitimate medicinal or industrial purposes."

"We are in a new era of drugs," said Sen. Diane Feinstein (D-CA), as she prepared to deal with them with the same tired approach Congress has taken with other drugs -- by banning them.

There is a better way, said reform advocates and representative of trade groups.

"Lawmakers are poised to repeat mistakes from the past by creating ineffective laws that will criminalize more people and drive these substances into the illicit market," said Grant Smith, federal policy coordinator with the Drug Policy Alliance. "History has clearly shown that prohibiting a drug makes it more dangerous, not less. Instead of more failed drug prohibition, Congress would be much more successful with an approach that restricts how these drugs are marketed, provides comprehensive drug education, and has strict age controls. To best reduce the harms of these drugs, Congress should instead support rigorous scientific study to better understand what is in these products, and establish a robust system of regulation and control of the synthetic drug market."

"This application of the law is irresponsible," said Daniel Francis, executive director of the Retail Compliance Association, which represents retail outlets that sell (or sold) K2 as he addressed HB 1264. "It is the most irresponsible thing a lawmaker can do, an act of prohibition. I hope they wear the responsibility of the consequences of these acts on their minds forever. This law will force even less understood compounds into the market."

"This legislation comes at a time when Washington is seeking to reduce federal spending. Yet, enforcing a federal ban on synthetic drugs isn't going to be cheap and we already know from marijuana prohibition that this approach won't work," said Smith. "The irony is that the only reason that people use synthetic marijuana is because the real thing is illegal. But passage of this legislation will only further escalate the war on drugs, send more people to jail, exacerbate health harms, and ignore four decades of comprehensive research and review that confirms the war on drugs approach has failed," he added.

"The bill covers some potential ingredients in herbal incense products, by no means all, and these ingredients are invisible, no one, no police officer, or retailer can tell what is in the product, if it is legal or not, and this law provides no direction whatsoever in how one is to determine this," pointed out Francis.

The Retail Compliance Association, which sent a letter of concern to Congress about the issue in April, expects that its efforts to block passage of HB 1264 this year will be in vain. But that doesn't mean it is rolling over and playing dead. Instead, the group said it is forming a coalition to file a legal challenge to the bill "immediately after it passes."

It has taken decades to get past the hysteria and fear-mongering surrounding traditional drugs, and that is a task that is by no means completed. It would be nice if we didn't have to go through the same sort of rigmarole with these new designer drugs, but we do. At least this time around, there are people around from the beginning who and willing to stand and fight.

Although new synthetics are coming to market faster than governments can ban them, a number of states have moved in recent weeks to criminalize their possession and distribution. In Florida, Louisiana, Minnesota, Pennsylvania, and Wisconsin, state governments have enacted bans on synthetic cannabinoids ("fake pot") or synthetic stimulants ("bath salts"), or both. In South Dakota, they took a slightly different path to arrive at the same end.

Synthetic cannabinoids are marketed as "incense" under a variety of names, including Spice and K-2. They are currently the subject of a one-year emergency ban by the DEA, which is set to expire at the end of February. "Bath salts" are made from methcathinone analogues, typically mephedrone and MDPV, and produce a high likened to cocaine, methamphetamines, and ecstasy. The DEA lists them as a "drug of concern," but has yet to act against them.  They are sold under names like Bliss, Ivory Wave, and the less mellow-sounding Charley Sheene and Drone.

In Florida, Gov. Rick Scott (R) signed into law House Bill 1039 on May 31. It criminalizes the possession of "bath salts" by making them a Schedule I controlled substance. The new law makes permanent an emergency ban on the drugs that went into effect in January.

In Louisiana, the legislature has passed House Bill 12, which bans both synthetic marijuana and "bath salts." Gov. Bobby Jindal, who in January issued an executive emergency ban on the synthetic stimulants and who made this bill part of his legislative agenda, is expected to sign it shortly. Under the bill, both fake pot and "bath salts" will be classified as Schedule I drugs and their possession or distribution will be punished accordingly. This bill is set to go into effect July 15.

In Minnesota, Gov. Mark Dayton (D) has signed into law HF0057, which criminalizes bath salts, fake pot, and 2-CE, as well as any substances that are "substantially similar" in chemical structure and pharmacological effects to illegal drugs. That law goes into effect Friday. Although all of the substances are placed on Schedule I of the controlled substances list, possession of fake pot is a misdemeanor and sale of fake pot is a gross misdemeanor. Possession or sale of bath salts or 2-CE is a felony.

In Minnesota, at least, retailers are fighting back. Three of them filed suit in Hennepin County (Minneapolis) District Court Monday charging that the law is too vague and broad and is not backed by scientific proof. They also argue that the law provides no criteria for determining if a substance is "substantially similar" to an illegal drug and that the ban infringes on individuals' right to privacy and pursuit of happiness.

Consumers and retailers won't know "if they're committing a crime or not," said attorney Marc Kurzman, who is representing the stores. "You shouldn’t have to get the answer by being charged and going through criminal trials," he said. 

In Pennsylvania, Gov. Tom Corbett (R) last week signed into law Senate Bill 1006, which bans the possession, sale, and use of fake pot, "bath salts," and, for good measure, the psychedelic designer drug 2-CE and salvia divinorum. Possession of the proscribed substances can earn you a year in prison, while sales or possession with intent can get you five years. The law will go into effect in late August, 60 days after it was signed into law.

"If left unchecked, synthetic drugs could have developed into the most dangerous drug crisis since methamphetamine labs found their way into our state,'' Corbett said in a press release announcing his signature. "This ban on synthetic drugs sends a strong message that Pennsylvania will not tolerate the use of these chemicals."

In South Dakota, Gov. Dennis Daugaard (R) back in March signed into law Senate Bill 34, which will go into effect Friday. In deals with the fake pot and "bath salts" "threat" not by criminalizing them, but by making it a crime to use, possess, manufacture, or distribute them -- or any other substance -- to get high. In South Dakota, it is already a crime to have ingested an illegal drug; now, it will be a crime to ingest legal substances if it is for the purpose of intoxication.

In Wisconsin, Gov. Scott Walker (R) last week signed into law Senate Bill 54 criminalizing the sale, manufacture, and possession of synthetic cannabinoids and synthetic stimulants. Possession of synthetic cannabinoids is now punishable by up to six months in jail for a first offense and three years in prison for a second offense, while manufacture or distribution garners up to six years in prison. Possession of synthetic stimulants now garners up to a year in jail for a first offense, while distribution of manufacture earns a number of years in prison, depending on the quantity involved.

"By classifying dangerous synthetic narcotics as illegal in the state of Wisconsin we are giving law enforcement the ability to take these destructive substances off of our streets and out of our neighborhoods," Gov. Walker said in a signing statement.

For a master list of states that have banned or are considering banning or otherwise controlling mephedrone and MDPV ("bath salts"), go here. For a master list of states that have banned or are considering banning or otherwise controlling fake pot, go here.

The government of New Zealand plans to regulate and restrict access to legal synthetic cannabinoids, government spokesmen said last week. Under the plan, synthetic cannabinoids could not be sold to people under 18, and they would face regulation of their packaging, marketing, and sales.

The government is following the advice of the Expert Advisory Committee on Drugs, which reviews controlled drugs and other psychoactive substances and recommends how such substances should be classified. The committee found no basis for banning fake pot, but said it was unacceptable for the products to be available without regulation.

Products containing synthetic cannabinoids have appeared in markets worldwide in recent years, typically sold as "incense" under brand names including Spice and K2. A number of European governments have responded by banning the substances, as has the US DEA, which imposed an emergency ban earlier this year.

Americans states have responded similarly, with more than a dozen of them imposing bans before the DEA acted, and moves are afoot in other state legislatures this year to enact more bans. California, however, responded similarly to what is proposed in New Zealand, banning it only for minors.

Under the New Zealand proposal, in addition to the ban on minors, sales would be banned in places where minors gather and there would be restrictions on advertising. Fake pot products would have to be sold in child-resistant containers and would have to be labeled with the synthetic cannabinoids they contain.

Moving synthetic cannabinoids from an unregulated substance to a restricted substance under the Misuse of Drugs Amendment Act of 2005 will require parliamentary approval.

More than eight out of 10 of the world's inhabitants have little or no access to opioid pain medications, the International Narcotics Control Board (INCB) said Wednesday. The finding came as the INCB released both its Annual Report 2010 and a special report on the global availability of pain medications.

People in many countries in Africa, Asia, and parts of the Americas had little or no access to opioid pain medications and psychotropic substances for medical purposes, the INCB found. Opioids include both narcotics, such as morphine and oxycodone, and synthetic opiates, such as fentanyl. Psychotropic medicines include depressants, antidepressants, and antipsychotics.

"Ninety percent of the licit drugs are consumed by 10% of the world's population in the United States, Australia, Canada, New Zealand and some European countries," Hamid Ghodse, the INCB's president, said in a briefing on the release of the reports. "It has to be recognized that the availability of narcotics and psychotropic medicines is indispensable to medical practice," Ghodse told reporters.

The US is by far the world's leading consumer of opioid pain medications. According to INCB figures, for every pain pill consumed per capita in Asia, Africa, or Latin America, 50 are consumed in Europe, and 300 in North America. The US alone, with 5% of the world population, consumed 56% of the world's pain pills. [Editor's Note: This does not mean that US patients who need opioids can always get prescriptions for them.]

The special report on the availability of pain medicines found that while the global supply of raw opium for licit needs is adequate, there are a number of obstacles blocking their availability in large parts of the world. The INCB identified the obstacles in descending order as concerns about addiction, reluctance to stock or prescribe, lack of training of professionals, restrictive laws, administrative problems, cost, distribution problems, lack of supply, and absence of policies around the prescribing of the drugs for pain treatment.

Lack of supply was near the bottom of the list. The INCB said opiate raw materials, including opium, poppy straw, and poppy straw concentrate were sufficient to outstrip consumption. "There is no problem whatsoever with the availability of raw materials," Ghodse said.

Ghodse called on governments to analyze the problem, identify barriers to adequate availability, and take action to reduce or remove them. The report called on governments to collect data on licit drug requirements, legislation, education and training, national drug control systems, and steps to combat misuse.

For the INCB, the flip side of barriers to adequate pain pill access in large swathes of the world is excess availability, which it said can lead to abuse and drug dependence. While the number of single doses of opioid pain medications consumed has increased four-fold in the last 20 years, driven largely by increases in synthetic opioid production, consumption in the US, for example, has increased six-fold. The US now sees more people dying of prescription drug overdoses than from illegal drugs.

"In countries with excessive availability, the non-medical use of pain relievers, tranquillizers, stimulants or sedatives has become the fastest growing drug problem," the report said.

That is a theme repeated from last year's INCB report, when the monitoring body reported that the abuse of prescription drugs was increasingly markedly worldwide. More people were taking prescription drugs for non-medical reasons than were using heroin, cocaine, and ecstasy combined, that report said.

Another major theme for the INCB in this year's report was increasing concern over the emergence of new synthetic drugs, or what it called designer drugs. The INCB said the development of such drugs is escalating so rapidly that governments need to adopt generic bans on new substances.

The report cited 4-methyl-methcathinone, or mephedrone, which has effects similar to cocaine or amphetamines and is being marketed as bath salts under names like Ivory Wave. The drug is currently the cause of ongoing concern in the US, where it has been banned in at least four states, and in Europe, where it has been banned by the European Union.

"Mephedrone has now become a problem drug of abuse in Europe, North America, Southeast Asia and in Australia and New Zealand," the INCB report said. But mephedrone is just "one example of a large number of designer drugs that are being abused."

The European Union, for example, is monitoring 15 other methcathinone analogues alone, while Japan recently placed 51 designer drugs under control. The INCB is recommending generic bans on such substances.

"Given the health risks posed by the abuse of designer drugs, we urge governments to adopt national control measures to prevent the manufacture, trafficking in and abuse of these substances," said Ghodse.

The INCB's schizophrenic report -- increase access to licit opioid pain medications, continue to ban new drugs -- reflects its bifurcated mission. At the same time it is charged with ensuring an adequate supply of medicines to the world, it is also charged with preventing non-medical use and diversion.