In recent years, illicit drug manufacturers have been creating new and slightly different synthetic drugs that are similar to other illegal drugs. These are called novel psychoactive substances (NPS) or designer drugs. They are made in clandestine laboratories, often sold on the internet, passed off as “research chemicals,” and labeled as “not for human consumption.”
Since 2012, reports of a group of NPS phenethylamine drugs that are both stimulants and hallucinogens have progressively increased, the journal European Psychiatry publishes. This group of NPS includes 25i-NBOMe, 25C-NBOMe, and 25B-NBOMe, called “N-bombs,” which are often passed off as LSD or mescaline. Users are often unaware that the drug they are actually taking is not really pure LSD.
Since LSD is a Schedule I controlled substance by the Drug Enforcement Administration (DEA), this makes the drug illegal and therefore somewhat harder to obtain and dangerous to possess. These new synthetic drugs were able to fly under the radar, as they were not federally controlled or technically illegal. In 2013, however, the DEA recognized the danger that N-bomb drugs possess and temporarily placed them into Schedule I, a ruling that was finalized in October 2016. Today, 25i-NBOMe is considered an illegal drug with no accepted medicinal, or safe, use for humans.
Sold as liquids, powders, edibles (often laced into gummy bears), or soaked into blotter paper, 25i-NBOMe drugs act on the serotonin receptors in the brain, much in the same way other illegal hallucinogenic drugs like LSD do. They can cause extreme euphoria, or a high, as well as relaxation. They also can produce visual and auditory hallucinations, distort one’s sense of time, and alter sensory perceptions.
As a stimulant, 25i-NBOMe can cause excitement, an increased sex drive and sociability, elevated levels of empathy, and heightened senses. Even in relatively small doses, 25i-NBOMe can cause cardiac arrest, seizures, respiratory arrest, and death. The National Institute on Drug Abuse (NIDA) warns that there were 19 deaths reported between March 2012 and August 2013 involving ingestion of 25C-, 25B, or 25i-NBOMe.
An overdose on 25i-NBOMe can occur quickly. The drug is considered to be extremely potent, and even in low doses, it can rapidly cause a toxic buildup in the bloodstream. As 25i-NBOMe is more potent in lower doses than LSD, which it is often mistaken for, overdose can often be the result of someone not realizing that the drug is present. There are specific signs of a 25i-NBOMe overdose. Among them are:
A 25i-NBOMe overdose can be fatal and requires swift medical intervention to potentially reverse the effects. The DEA warns that there have been no studies regarding the safety of 25i-NBOMe for human consumption, and it can cause acute toxicity in very small doses.
Since these drugs have not been tested in humans and have not been on the market for very long, long-term side effects and health risks of N-bombs are not known. Hallucinogenic drugs like LSD can cause several long-ranging and irreversible health hazards, however. Since 25i-NBOMe acts on some of the same regions of the brain, it is possible that it may also have similar long-term risks.
Both LSD and 25i-NBOMe act on the 5H-T serotonin receptors in the brain as agonists. High levels of serotonin influence moods, thoughts, and memory formation. Repeated interaction of drugs on these receptors and chemical levels in the brain may cause lasting damage. NIDA warns that tolerance to LSD is possible, and a person may keep increasing the dosage to produce the same high or get the same trip. Escalating the dosage raises the risk for a potentially life-threatening overdose and also may lead to compulsive drug use and psychological dependence.
Hallucinogenic drug use can cause a person to experience “flashbacks” months or even years after taking one. A flashback can occur without warning. It involves reexperiencing the drug’s effects without taking it again.
Persistent psychosis and hallucinogen persisting perception disorder (HPPD) are additional possible long-term health risks of hallucinogenic drug use. Mood disturbances, paranoia, disorganized thoughts, and visual disturbances come with persistent psychosis while repeated hallucinations, neurological issues, and visual problems, like seeing halos around lights or trails behind moving objects, are symptoms of HPPD. Neither of these disorders is completely reversible, although medications and therapeutic measures may help to manage their symptoms.
Regular and repeated use of 25i-NBOMe may have lasting and unpleasant side effects. Long-term and potentially permanent damage to the brain is a potential risk of use.
Typically, 25i-NBOMe is taken sublingually, which means that a person will suck on a piece of blotter paper or something else laced with the drug. It’s less effective when swallowed, so it is not usually abused orally. It also may be snorted in powder form, inserted into the rectum, or more rarely injected.
On the street, 25i-NBOMe goes by many names.
While it is often passed off as other drugs, like LSD, mescaline, or even ecstasy, 25i-NBOMe can often be identified by its bitter taste. Mixing 25i-NBOMe is especially dangerous as the drug is already powerful on its own. Combining it with another substance can only heighten its effects and intensify the effects of the other drug or alcohol used. This exponentially increases the odds of a toxic interaction or overdose.
A 25i-NBOMe trip is often unpredictable. It may be either negative or positive; a person may never be sure exactly how it will feel before they take the drug. A trip can last between four and 10 hours, the Alcohol and Drug Foundation (ADF) reports. The crash from 25i-NBOMe may be unpleasant, as the drug wears off, leaving a person feeling fatigued, depressed, anxious, restless, mentally cloudy, and with low energy. Additional side effects of a 25i-NBOMe trip may occur. Among them are:
In general, hallucinogens are believed to be typically used by teens and young adults, often at all-night dance parties or raves, as club or party drugs. The World Health Organization (WHO) publishes that the average age of people studied who died from exposure to an N-bomb was 20 years old.
Abuse of 25i-NBOMe may be recognizable by extreme mood shifts and out-of-character behaviors as well as by odd sleeping patterns, a lot of time spent online, and suspicious packages coming in the mail. The drug is regularly laced onto colorful paper and may come in packaging labeled “not for human consumption.”
Taking 25i-NBOMe can make a person feel more social and less inhibited, which can potentially lead to bigger risk-taking endeavors and potential accidents or injuries as a result. Increased sex drive and heightened sensory perception can lead to unsafe sexual practices and raise the risk for unwanted pregnancy or the spread of sexually transmitted or infectious diseases. As a general rule, 25i-NBOMe does not affect appetite like other drugs do, but sleep disturbances and changes in sleep patterns are often signs of 25i-NBOMe use.
It is not fully understood whether or not 25i-NBOMe is addictive. Physically, it is unclear if regular use can lead to drug tolerance and chemical dependence; however, just like with other psychoactive drugs that influence mood, it is likely that psychological dependence can occur.
The pleasant side effects of 25i-NBOMe and negative ramifications of the crash can encourage a person to want to keep feeling the positive high. Repeated use of 25i-NBOMe may then become compulsive, and a person may struggle to control how often they take the drug.
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Social circles can change to include only others involved in drug use, and recreational activities are often given up to make room for more drug abuse. Difficult mood swings, increased secrecy, and preoccupation with the drug can impact interpersonal relationships, including those with family members. A person struggling with compulsive 25i-NBOMe use likely has less interest in keeping up with regular obligations. Abuse of 25i-NBOMe can have profound physical and emotional effects, but professional treatment can help.
Any use of 25i-NBOMe can be problematic and harmful, but a specialized drug abuse and addiction treatment program can help a person to stop such use. Drug use is often an attempt to escape reality and combat stress, providing an unhealthy outlet and a short-term solution with long-ranging hazards.
Comprehensive programming can help individuals determine the root cause of drug abuse and learn better ways for managing stress and coping with life’s troubles. While 25i-NBOMe may provide a temporary reprieve from the struggles of everyday life, those issues are still there after the trip is over, and the risks of taking the drug actually outweigh any potential benefit. A drug abuse treatment program can help to identify problems and improve self-esteem and methods for dealing with stressors. Behavioral therapies, group and individual counseling sessions, educational programs, and life skills training can all serve to improve quality of life and overall well-being.
Since 25i-NBOMe is not recognized as creating a significant physical dependence, a medical detox program is typically not required for physical stabilization before admission into a treatment program. NIDA publishes that there are more than 14,500 programs in the United States offering specialized services for the treatment of drug abuse and addiction. There are many different formats to choose from and many specialized programs to serve individual needs.
An outpatient program can provide services that can be tailored around a person’s existing schedule while an inpatient, or residential treatment program offers a highly structured environment with 24/7 care and support. Supportive care often includes 12-step programs and groups that can provide healthy peer interactions to serve as a source of encouragement in recovery. The key to a successful treatment program is to find one that provides a tailored treatment approach to suit the person in need.
(March 2016). 25I-NBOMe: The Legal LSD. European Psychiatry. Retrieved August 2018 from https://www.sciencedirect.com/science/article/pii/S0924933816000109
(October 2016). Final Rule: Placement of Three Synthetic Phenethylamines into Schedule I. Drug Enforcement Administration. Retrieved August 2018 from https://www.deadiversion.usdoj.gov/fed_regs/rules/2016/fr0927_2.htm
(September 2013). Emerging Trends. National Institute on Drug Abuse. Retrieved August 2018 from https://www.drugabuse.gov/emerging-trends/flakka-al
(November 2013). 25I-NBOMe, 25C-NBOMe, and 25B-NBOMe. Drug Enforcement Administration. Retrieved August 2018 from https://www.deadiversion.usdoj.gov/drug_chem_info/nbome.pdf
(February 2015). Hallucinogenic and Dissociative Drugs. National Institute on Drug Abuse. Retrieved August 2018 from https://www.drugabuse.gov/publications/hallucinogens-dissociative-drugs/how-do-hallucinogens-lsd-psilocybin-peyote-dmt-ayahuasca-affect-brain-body
NBOMes. Alcohol and Drug Foundation. Retrieved August 2018 from https://adf.org.au/drug-facts/nbomes/
(June 2014). 25I-NBOMe Critical Review Report. World Health Organization. Retrieved August 2018 from http://www.who.int/medicines/areas/quality_safety/4_19_review.pdf
(January 2018). Drug Addiction Treatment in the United States. National Institute on Drug Abuse. Retrieved August 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states