Leonard is a graduate of the Kennedy School of Goverment at Harvard, and holds degrees in public policy and chemistry. He was appointed as research assoicate in neurobiology at Harvard Medical School, and was a Fellow in drug policy with Harvard's Interfaculty Initiative on Drugs and Addictions, as part of Harvard's Program on Mind, Brain and Behavior.

The Future and Emerging Drugs Study: A Working group on Drug Design and Policy Implications
(College on Problems of Drug Dependency, 1999 Annual Meeting, Acapulco, Mexico)

The Future and Emerging Drugs study (FEDS) is an interactive forum (in progress) of the principal figures worldwide who influence drug development and regulation, and consists of experts in disciplines ranging from medicinal chemistry and pharmacology to law and public policy. The establishment of this group is based on awareness of recent progress in drug design, whereby classical synthesis has been superceded by techniques allowing millions of variants to be rapidly prepared and characterized,leading to marked increases in selectivity and potency as well as entirely new classes of psychoactive compounds. The current pharmacopeia inevitably will be largely replaced as a results of such advancements. Structures with novel efects upon personality, memory and learning, addictive behavior, and human performance will evolve as a consequence of this acceleration in drug design. FEDS affiliates recognize the need for discussion of the impact that future compounds will have upon the social fabric, attempt to identify new drugs of interest, predict the effects from their distribution and use, and exchange ideas concerning reorganization in regulation and policy required by novel properties.'

Substance Abuse in the Former Soviet Union: Evaluation of Current Indicators and Policies
(College on Problems of Drug Dependency, 1999 Annual Meeting, Acapulco, Mexico)

Since 1991, Russia appears, based on widespread and virtually unanimous anecdotal reports, to have experienced sustantial increases in substance abuse, both of alcohol and a variety of illicit substances. However, the former Soviet Union lacks a system of drug abuse indicators (surveys, arrestee urinalysis, compilations of emergecy room and medical examiner reports) that would document this increase and reveal its details. Various organizations, national and international-level administrative agencies and individual reseachers, have produced estimates concerning drug abuse and it sequelae in Russia. We collate and compare those estimates, and discuss the bureaucratic and methodological sources of the conflicts among them. This process generates all-source estimates of the prevalence of alcoholism and other forms of drug dependency, the associated morbidity and mortality, the physical and economic dimensions of the licit and illicit drug markets, and measures of official and unofficial activity to reduce substance abouse and the damage it causes, including arrest and treatment episodes.

What Should State Do about Drug Problems in Russia?: Development of a System for Monitoring Trafficking and Use.
(Policy Analysis Exercise, Kennedy School of Government, Harvard University, Cambridge, MA (1996))
Harvard University Hollis Catalog Number 006937456

An outbreak in use of the potent synthetic opiod trimethylfentanyl (TMF) occured in Moscow in the early nineties, resulting in at least 300 deaths and with the incidence of deaths alleged by some treatment providers to be significantly higher. A system is proposed for improving detection and reporting of TMF in emergency room settings and in forensic laboratories, in an effort to contain the outbreak and reduce lethality among users. A series of interviews was conducted among diverse respondents, including physicians, addiction specialists, emergency room presonnel, Moscow police, MVD officials, the users themselves, and the families of overdose victims. Notably, the Russian population in the wake of the economic reforms effectively was naive to chronic opiate use and - particularly - synthetic opiods of this potency, as opposed to more commonly used and less harmful drugs.

Raves, Youth and Drugs
(Proceedings of the 56th Annual Meeiting of the College of Drug Dependence, National Instiutute on Drug Abuse, Monograph Series 153)

Background: In the past few years 'raves' - huge all-night 'trance-dances' with primarily youthful participants - have spread throughout the world. Fifteen fatalities in the United Kingdom from hypothermia associated with use of 3,4-methylenedioxymethamphetamine (MDMA) at raves, and reported binge use of MDMA, provide for concern. This exploratory study was conducted in late 1993 and 1994 in San Francisco and New York.

Methods: Participant observation of twelve raves, a convenience sample survey of ravegoers, rave organizers, law enforcement, treatment personnel, disk jockeys and rave vendors.

Results: Ravegoers tend to be young (median age 18), and more diverse, ethnically and socioeconomically, than the traditional picture of psychedelic users. Use and initiation of LSD, MDMA, and other drugs were frequent. In a random sample (N = 385) of our survey, 79 percent reported initiating at least one illicit drug at a rave and 66 percent reported drug use at the last rave attended. LSD use was far more common in New York, while MDMA was more widely used in San Francisco. Some methamphetamine use was noted in San Francisco; small minorities of New York ravegoers used PCP, cocaine and heroin. Drug combinations and newer compounds (e.g. 2-CB and GHB) were reported in both cities. Few actual adverse drug effects were observed or reported, but many ravegoers reported dysphoria in connection with what they believe to be adulterated MDMA. Alcohol use and aggression were much less prevalent that at other events with youthful audiences, and anti-alcohol sentiments were expressed by many ravegoers. Although music was loud enough to threaten significant hearing damage, nearly all ravegoers and rave organizers seemed unaware of this danger.

Discussion: Widespread ignorance and misnformation about drugs, combined with great demand for accurate information, make rave attendees attractive targets for harm reduction efforts. The concentration of youthful drug use and initiation and the introduction of new drugs and drug combinations suggest the valule of raves as research sites. In particular, whether or not the reported dysphoria among MDMA users results from neurochemcial changes rather than adulteration deserves investigation.

Affiliation: Division on Addictions, Harvard Medical School, 220 Longwood Drive, Building B-2, Room 231, Boston, MA 02115

Methcathinone (1)
Science & Justice, Journal of the Forensic Science Society, California Association of Criminalists, July-September, 1995.

Methcathinone ("cat"), a novel amphetamine analogue, is being observed in emergency room admissions in the midwestern United States. As a strong euphoriant and stimulant with a short duration of action, methcathinone abuse is growing and represents a potentially severe public health problem. Reportedly the drug of choice in the Russian "speed" culture, some reporters suggest this amphetamine analogue potentially could supplant methamphetamine due to its extremely facile synthesis and the ready availability of chemical precursors. Chemcal syntheses currently are being discussed on the internet. We will present information on the chemistry, pharmacology and toxicology of methcathinone. Historical details of the pharmacoepidemiology of this substance will be described, from its widespread abuse in Russia to the seizures of the first clandestine laboratories in the United States leading to the classification of methcathinone as a Schedule I drug by DEA. Subjective effects of methcathinone include increased alertness, euphoria and heightened libido. Heavy or repeated use may result in agitation and symptoms of psychosis. Clinicians should be cognizant of this new stimulant of abuse.

William L. Pickard, University of California, Berkeley

Methcathinone (2)
Methcathinone - A Potent New Drug of Abuse
College on Problems of Drug Dependency Annual Meeting (Palm Beach, Florida, 1994)

Methcathinone ("cat") is a novel psychomotor stimulant which appeared in the Former Soviet Union in 1982 and rapidly spread. It is the drug of choice in the Russian "speed" culture, and reportedly is the mose widely abused illicit drug in Russia except for heroin. Methcathinone is chemically related to methamphetamine (being the beta-carbonyl derivative) and cathinone from the khat plant (being the N-methyl derivative). It was apparently unknown as an illicit drug in the United States prior to 1989, when it was synthesized in a clandestine laboratory in rural Michigan. More recently, methcathinone use has been associated with emergency room admissions in the midwestern United States and it has been classified as a Schedule I drug by the Drug Enforement Administration. Subjective effects of methcathinone include increased alertness, euphoria, and libido. Heavy or repeated use may result in agitation and symptoms of psychosis. We performed an exhaustive electronic search of the text databases of all U.S. newspapers over the last seven years and have found that new media accounts of the properties of methcathinone have varied considerably, with significant exaggeration of its properties. Nonetheless, federal agencies continue in their concern that that this amphetamine analogue potentially could supplant methamphetamine and cocaine due to its extremely facile synthesis and reported subjective preference in drug users for methcathinone over methamphetamine and cocaine. Chemical syntheses currently are being discussed on the internet, making methcathinone the first indicator that synthetic data for a newly scheduled drug may be rapidly disseminated worldwide in an uncontrolled manner, in contrast to the historically slower and more controlled routes of journal and book publications. Additionally, we note that the pharmacoepidemiology of methcathinone in the U.S. can be traced to a single individual and site. This situation provides an opportunity to study the mechanisms involved in the potential spread of other novel drugs of abuse which may occur in the future.

We are beginning a project to monitor new psychoactive compounds with potential addiction liability. We encourage concerned researchers and clinicians to contact our group with comments and suggestions for identifying unscheduled drugs which may achieve social use.

Affiliation of authors:
Kennedy School, Harvard University; University of California, Berkeley and San Francisco and Department of Veterans Affairs Medical Center, San Francisco; Harvard Medical School, Division on Addictions, 220 Longwood Drive, Building B-2, Room 231, Boston, MA 02115; Haight Ashbury Free Clinics, San Francisco.

A Word of Caution on Bremelanotide