21317.3 Psychoactive Drugs and Their Abuse
oxycontin. It is prescribed as a pain killer. An example of its abuse was associated
with a certain radio talk show host. Oxycontin is a hydrochloride (HCl addition)
derivative of oxycodone, whose structure is shown along with those of morphine and
heroin in Fig. 17.11. Its similarity to heroin and morphine is obvious.
Fentanyl, a synthetic chemical compound, was discovered to be about 100 times
as potent as morphine or heroin. Its chemical structure shown in Fig. 17.11 indicates
that it can also be classified as an alkaloid. This compound has been widely used as
an anesthetic in surgical procedures, as the physiological effects are much shorter-
acting than morphine. And it gives a “high” like heroin, though short-lived.
To add this group or that to fentanyl by chemical reactions, i.e., making deriva-
tives is what chemists are good at. Unless a chemical compound is specifically clas-
sified as “Schedule I controlled substance”, it is legal. All the fentanyl analogs,
when appeared in 1970s and early 1980s, were legal. Some of the fentanyl analogs
that have appeared on streets are shown in Fig. 17.11; these drugs were called
“designer drugs”. Some of them are easy to make, but some are more difficult.
Particularly 3-methyl fentanyl (see the structure in Fig. 17.11) is very difficult to
make, but it was produced very cleanly. Apparently a first-class synthetic chemist
was behind all the fentanyl analogs. The drug was first used to dope racehorses.
Some narcotics are quite species-specific, and fentanyl turned out to act as a stimu-
lant in horses. As 3-methyl fentanyl is called a perfect heroin substitute, these ana-
logs are potent narcotics. They have caused several hundred death of human beings
by overdoses.
Another chemical, meperidine, was synthesized and patented in 1939 and was
sold under the trade name of “Demerol”. An analog of meperidine, MPPP was tried
as a substitute for meperidine and was demonstrated to be more effective than mep-
eridine, but was never commercialized. The structures of meperidine and MPPP are
shown in Fig. 17.11. MPPP looks easy to synthesize. Some underground chemist(s)
tried to synthesize MPPP according to a published procedure. The synthesis requires
a specific reaction condition. If it is carried out under slightly different conditions,
the synthetic procedure tends to produce a different compound, MPTP (1-methyl-4-
phenyl-1,2,5,6-tetrahydropyridine). The product was sold on the street as synthetic
heroin, and later shown indeed to be contaminated with MPTP (the structure of
which is also shown in Fig. 17.11). People who used this staff were stricken with
symptoms similar to those of Parkinson’s disease. Fortunately for the medical com-
munities, this provided an opportunity for further understanding of Parkinson’s dis-
ease, now that a specific compound was serendipitously discovered that caused the
disease. Research led to a discovery that MPTP is further converted by an enzyme
(called monoamine oxidase, MOA) to MPP
+
(1-methyl-4-phenyl-pyridinium ion,
see Fig. 17.11 for the structure), and that the latter is the specific toxin for dopamin-
ergic neurons. MPP
+
destroys such neurons. More than 80% of the dopaminergic
cells must be destroyed for the symptoms of the disease to appear. People under
normal circumstances lose several percent (5–8%) of the dopaminergic cells per
decades; hence ordinarily people would die before the symptoms show up. MPP
+
and perhaps some other compounds similar to it (that occur in the environment)
speed up the loss of the dopaminergic neurons, resulting in Parkinson’s disease.