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Preclinical Abuse Liability Evaluation in Drug Control

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<strong>Precl<strong>in</strong>ical</strong> <strong>Abuse</strong> <strong>Liability</strong><br />

<strong>Evaluation</strong> <strong>in</strong> <strong>Drug</strong> <strong>Control</strong><br />

Srihari R. Tella, Ph.D.<br />

Pharmacologist<br />

<strong>Drug</strong> and Chemical <strong>Evaluation</strong> Section<br />

Office of Diversion <strong>Control</strong><br />

<strong>Drug</strong> Enforcement Adm<strong>in</strong>istration, Wash<strong>in</strong>gton DC<br />

Tel: 202-307-7183; Fax: 202-353-1263<br />

email: Srihari.R.Tella@usdoj.gov


<strong>Drug</strong> and Chemical<br />

<strong>Evaluation</strong> Section (ODE)<br />

<strong>Drug</strong> Schedul<strong>in</strong>g (Domestic and<br />

International)<br />

Quotas for Schedule I and II Substances<br />

Exempt Products<br />

Review Schedule I Researcher license<br />

applications<br />

United Nations Treaty Activities


Designer <strong>Drug</strong>s<br />

Background<br />

Applicable current laws<br />

Recently controlled drugs<br />

Currently encountered drugs<br />

Data used


Designer <strong>Drug</strong>s -<br />

Background<br />

Popular name for <strong>Control</strong>led Substance<br />

Analogs<br />

Orig<strong>in</strong> – Clandest<strong>in</strong>e laboratories<br />

“<strong>Drug</strong> Culture” <strong>in</strong> early 1960s was led by<br />

LSD made <strong>in</strong> Clandest<strong>in</strong>e laboratories.<br />

Mescal<strong>in</strong>e analogs (“alphabet soup”) –<br />

MDA, MMDA, DOM, TMA, PMA & DMA.<br />

Analogs of methaqualone, PCP and<br />

amphetam<strong>in</strong>es <strong>in</strong> 1970s


Advent of Designer <strong>Drug</strong>s<br />

Potent fentanyl analogues from 1979<br />

Alpha-methylfentanyl – <strong>Control</strong>led <strong>in</strong> 1981<br />

Many other fentanyls soon appeared<br />

Over 100 deaths due to fentanyls<br />

In 1982 – MPPP (meperid<strong>in</strong>e analog) under<br />

the street name “new hero<strong>in</strong>” – Neurotoxicity<br />

(Park<strong>in</strong>son’s”) due to by-product MPTP<br />

In 1980s – MDMA was another popular drug


Amendments to the<br />

<strong>Control</strong>led Substances Act<br />

(CSA 1970)<br />

Comprehensive Crime <strong>Control</strong><br />

Act of 1984 (Temporary<br />

Schedul<strong>in</strong>g)<br />

Anti-<strong>Drug</strong> <strong>Abuse</strong> Act of 1986<br />

(Analogue Statute)


Temporary Schedul<strong>in</strong>g<br />

(Comprehensive Crime <strong>Control</strong> Act of 1984)<br />

Actual abuse and imm<strong>in</strong>ent hazard to<br />

public health/safety risks<br />

As set forth under 21 U.S.C 811(h),<br />

follow<strong>in</strong>g three factors under the CSA (21<br />

U.S.C. 811(c)) are to be considered <strong>in</strong> the<br />

evaluation<br />

4.Its history and current pattern of abuse<br />

5.The scope, duration, and significance of<br />

abuse<br />

6.What, if any risk to the public health


Temporary Schedul<strong>in</strong>g<br />

(Comprehensive Crime <strong>Control</strong> Act of 1984)<br />

Lawfully marketed and IND drugs<br />

excluded<br />

DHHS notified but approval not required<br />

Schedule I (CI) status - 1 year + 6 months<br />

extension<br />

Initiation of full review <strong>in</strong>clud<strong>in</strong>g<br />

precl<strong>in</strong>ical abuse liability assessment


Temporary scheduled<br />

drugs (1985-2005)<br />

Number of <strong>Drug</strong>s<br />

Scheduled<br />

14<br />

12<br />

10<br />

8<br />

6<br />

4<br />

2<br />

12<br />

1<br />

3<br />

1<br />

Total drugs = 26<br />

2 1 1<br />

3 2<br />

0<br />

1985<br />

1987<br />

1989<br />

1991<br />

1993<br />

1995<br />

Year<br />

1997<br />

1999<br />

2001<br />

2003


Analogue Enforcement Act<br />

Anti-<strong>Drug</strong> <strong>Abuse</strong> of Act of 1986<br />

As set forth under 21 U.S.C 802 (32 (A)),<br />

<strong>Control</strong>led Substance Analogue means a<br />

substance with<br />

1. Chemical structure substantially similar<br />

to that of a CI or CII substance;<br />

2. Pharmacological effects substantially<br />

similar to that of a CI or CII substance; or<br />

3. Represented or <strong>in</strong>tended to produce a<br />

similar effect as a CI or CII substance


Analogue Enforcement Act<br />

Anti-<strong>Drug</strong> <strong>Abuse</strong> of Act of 1986<br />

Analogues are treated as CI substances<br />

only if they are <strong>in</strong>tended for human use<br />

Analogues need not be clandest<strong>in</strong>ely<br />

produced nor derived from a CI or CII<br />

substance<br />

Crim<strong>in</strong>al, not regulatory controls of CI<br />

substances<br />

Prosecution on case by case basis<br />

Prosecution require expert testimony


Analogue Enforcement Act<br />

Anti-<strong>Drug</strong> <strong>Abuse</strong> of Act of 1986<br />

Analogue does not <strong>in</strong>clude<br />

A controlled substance<br />

Any lawfully marketed substance<br />

With respect only to an <strong>in</strong>vestigational<br />

new drug (IND) holder, any substance<br />

with a currently active IND status


Recent Temporary<br />

Schedul<strong>in</strong>g Actions<br />

Tryptam<strong>in</strong>es (<strong>in</strong> 2003)<br />

Alpha-methyltryptam<strong>in</strong>e (AMT)<br />

5-Methoxy-N,N-diisopropyltryptam<strong>in</strong>e (5-MeO-<br />

DIPT)<br />

Piperaz<strong>in</strong>es (<strong>in</strong> 2002)<br />

Benzylpiperaz<strong>in</strong>e (BZP)<br />

1-[3-(trifluro-methyl)phenyl]piperaz<strong>in</strong>e (TFMPP)<br />

Phenethylam<strong>in</strong>es (<strong>in</strong> 2002)<br />

2,5-Dimethoxy-4(n)-propylthiolphenylethylam<strong>in</strong>e<br />

(2C-T-7)


Currently Encountered<br />

Tryptam<strong>in</strong>es<br />

CH 3 O<br />

H<br />

N<br />

NH 2<br />

CH 3<br />

5-Methoxy-alphamethyltryptam<strong>in</strong>e (5-MeO<br />

MeO-AMT)*#<br />

CH 3 O<br />

5<br />

H<br />

N<br />

H 3 C H CH 3<br />

H<br />

N H<br />

H<br />

5-Methoxy-N-methyl<br />

H<br />

N<br />

H 3 C<br />

N<br />

CH 3 O<br />

CH 3<br />

CH 3<br />

CH 3<br />

N,N-Diisopropyltryptam<strong>in</strong>e (DIPT)*<br />

5<br />

CH 3 O<br />

5-Methoxy-N,N-diethyltryptam<strong>in</strong>e (5-MeO<br />

MeO-DET) DET)*<br />

methyl-N-isopropyltryptam<strong>in</strong>e (5-MeO<br />

MeO-MIPT) MIPT)*<br />

* These are positively identified by the Lab analysis.<br />

#One death associated with its abuse<br />

H<br />

N<br />

H 3 C<br />

H<br />

N<br />

N CH 3<br />

5-Methoxy-N,N-dimethyltryptam<strong>in</strong>e (5-MeO<br />

MeO-DMT) DMT)*#<br />

CH 3<br />

N<br />

CH 3


Currently Encountered<br />

Tryptam<strong>in</strong>es<br />

H<br />

N<br />

H<br />

N<br />

CH 3<br />

H<br />

C<br />

H<br />

C CH 3<br />

H<br />

4<br />

O<br />

H<br />

N<br />

H 3 C H CH 3<br />

H<br />

N H<br />

H<br />

CH 3<br />

N,N-Dipropyltryptam<strong>in</strong>e (DPT)*<br />

4-Methoxy-N-methyl-N-isopropyltryptam<strong>in</strong>e (4-MeO<br />

MeO-MIPT) MIPT)*<br />

H<br />

H<br />

H<br />

H<br />

N<br />

H H C<br />

H<br />

H<br />

CH<br />

N 3<br />

C<br />

C<br />

C H<br />

CH<br />

H 3<br />

N<br />

H<br />

H<br />

N<br />

CH3<br />

H H<br />

H<br />

H<br />

N-Methyltryptam<strong>in</strong>e (NMT)*<br />

N-methyl-N-isopropyltryptam<strong>in</strong>e (MIPT)*<br />

4-Hydroxy-N,N-diisopropyltryptam<strong>in</strong>e (4-OH<br />

OH-DIPT)<br />

*<br />

* These are positively identified by the Lab analysis.<br />

#One death associated with its abuse<br />

4<br />

OH<br />

H<br />

N<br />

CH 3<br />

H 3 C H CH 3<br />

N H<br />

CH 3


Currently Encountered<br />

Tryptam<strong>in</strong>es<br />

Cases (#)<br />

60<br />

50<br />

40<br />

30<br />

20<br />

10<br />

0<br />

54 52<br />

25<br />

6 4 3 1 1 1 1<br />

5-MeO-DMT<br />

5-MeO-AMT<br />

DPT<br />

5-MeO-MIPT<br />

NMT<br />

DIPT<br />

MIPT<br />

4-OH-DIPT<br />

4-MeO-MIPT<br />

5-MeO-DET


Currently Encountered<br />

Phenethylam<strong>in</strong>es<br />

O C H 3<br />

OCH 3<br />

N H 2<br />

NH 2<br />

I<br />

Cl<br />

O C H 3<br />

2,5-Dimethoxy<br />

Dimethoxy-4-iodophenethylam<strong>in</strong>e iodophenethylam<strong>in</strong>e (2C-I)<br />

I)*#<br />

CH 3 CH 2<br />

H<br />

CH 3 O<br />

OCH 3<br />

C<br />

H<br />

C<br />

H<br />

NH 2<br />

2,5-Dimethoxy<br />

Dimethoxy-4-ethylphenethylam<strong>in</strong>e ethylphenethylam<strong>in</strong>e (2C-E)<br />

E)*<br />

H<br />

H<br />

H<br />

H 3<br />

C<br />

C H 3<br />

O<br />

S<br />

OCH 3<br />

2,5-Dimethoxy<br />

Dimethoxy-4-chloro-<br />

phenethylam<strong>in</strong>e (2C-C)<br />

C) *<br />

O C H 3<br />

2,5-Dimethoxy<br />

Dimethoxy-4-ethylthioethylthio<br />

phenethylam<strong>in</strong>e (2C-T-2)<br />

2)*<br />

•These are positively identified by the Lab analysis.<br />

•## One death associated with its abuse.<br />

N H 2


Currently Encountered<br />

Phenethylam<strong>in</strong>es<br />

CH 3 O<br />

NH 2<br />

H3C<br />

CH 3 O<br />

NH 2<br />

FH 2 C S<br />

OCH 3<br />

2,5-Dimethoxy<br />

Dimethoxy-4-(2-fluoroethylthio)<br />

phenethylam<strong>in</strong>e (2C-T-21)<br />

21)@<br />

H 3 C<br />

S<br />

OCH 3<br />

2,5-Dimethoxy<br />

Dimethoxy-4-(i) (i)-propylthio<br />

phenethylam<strong>in</strong>e (2C-T-4)<br />

4)*<br />

H 3 CO<br />

NH 2<br />

Cl<br />

NH 2<br />

H 3 CO<br />

3,4-Dimethoxy<br />

Dimethoxy-phenethylam<strong>in</strong>e (3,4-DMPEA)<br />

H 3 CO<br />

OCH 3<br />

4,5-Dimethoxy<br />

Dimethoxy-2-chlorophenethylam<strong>in</strong>e*<br />

•These are positively identified by the Lab analysis.<br />

•@Possibly one death


Currently Encountered<br />

Phenethylam<strong>in</strong>es<br />

30<br />

25<br />

29<br />

2C-I<br />

2C-T-2<br />

20<br />

15<br />

10<br />

5<br />

0<br />

8<br />

3 3 3<br />

1 1 1<br />

2C-C<br />

2C-E<br />

3,4-DMPEA<br />

2C-T-21<br />

2C-T-4<br />

2Cl-4,5-DMPEA


Currently Encountered<br />

Designer <strong>Drug</strong>s<br />

Scope and magnitude of the problem –<br />

Internet; thousands of customers<br />

July 2004 - DEA shut down five websites<br />

under “Operation Web Tryp”<br />

Some purchases (Over 1 year 3 months<br />

period) found <strong>in</strong> a seized computer used by<br />

an website operator<br />

<br />

<br />

<br />

5-MeO-DMT<br />

– 679 orders for 824 gms<br />

5-MeO-DIPT<br />

– 536 orders for 642 gms<br />

5-MeO-AMT<br />

– 347 orders for 414 gms etc..


Adm<strong>in</strong>istrative Schedul<strong>in</strong>g<br />

- Designer <strong>Drug</strong>s<br />

Time w<strong>in</strong>dow of 18 months follow<strong>in</strong>g<br />

temporary schedul<strong>in</strong>g<br />

Need for pharmacology evaluation<br />

NIDA/CPDD support - Chemical synthesis<br />

and precl<strong>in</strong>ical abuse liability assessment<br />

Pharmacology tests - 5-MeO-AMT, DIPT,<br />

5-MeO-DET, 4-OH4<br />

OH-DIPT, 5-MeO5<br />

MeO-MIPTMIPT<br />

Chemical synthesis - 2C-I I and 2C-T-2


Adm<strong>in</strong>istrative Schedul<strong>in</strong>g<br />

- Designer <strong>Drug</strong>s<br />

<strong>Precl<strong>in</strong>ical</strong> studies<br />

Receptor b<strong>in</strong>d<strong>in</strong>g and functional assays (e.g. 5-5<br />

HT2A, 5-HT1A, 5<br />

DAT, NET, 5-HTT, 5<br />

monoam<strong>in</strong>e uptake <strong>in</strong>hibition)<br />

Locomotor activity <strong>in</strong> mice<br />

<strong>Drug</strong> discrim<strong>in</strong>ation <strong>in</strong> rats (Tra<strong>in</strong><strong>in</strong>g drugs:<br />

LSD, DOM, MDMA, DMT, methamphetam<strong>in</strong>e,<br />

or coca<strong>in</strong>e)<br />

Self-adm<strong>in</strong>istration


Contact Information<br />

Srihari R. Tella, Ph.D.<br />

Pharmacologist<br />

<strong>Drug</strong> and Chemical <strong>Evaluation</strong> Section<br />

Office of Diversion <strong>Control</strong><br />

<strong>Drug</strong> Enforcement Adm<strong>in</strong>istration<br />

Wash<strong>in</strong>gton DC<br />

Tel: 202-307-7183<br />

Fax: 202-353-1263<br />

email: Srihari.R.Tella@usdoj.gov

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