What Are NBOMes?
The term NBOMe refers to several closely similar synthetically produced hallucinogenic drugs that go by the street name N-bomb (and others). According to sources, such as the United States Drug Enforcement Administration (DEA), NBOMe drugs are synthetically produced hallucinogenic drugs (e.g., 25I-NBOMe, 25C-NBOMe, and 25B-NBOMe) and go by the names N-bombs, 251, or smiles. The drugs are marketed as legal substitutes for the hallucinogenic drugs LSD or mescaline, and are also sometimes referred to as legal acid.
Believed to be developed in 2003 by a German chemist, these drugs are extremely powerful enhancers of the neurotransmitter serotonin. Their development was originally designed to be used to trace the function of serotonin in the brain using neural imaging, such as positron emission tomography (often abbreviated as PET scans); however, their use results in the experience of very vivid hallucinogenic events. LSD is a particularly powerful hallucinogen but these drugs are even more powerful than LSD. This resulted in these drugs achieving some popularity in the drug market.
NBOMes are generally sold as powders, in liquid form, on blotted paper much in the same way that LSD is marketed, or put into something that can be eaten. After these drugs were initially developed, there was some confusion as to whether they should be listed as controlled substances; however, today, the DEA lists them as Schedule I controlled substances, indicating that they have no medicinal value, are highly prone to abuse, and are highly susceptible to result in the development of physical or psychological dependence. These drugs would most likely be classified as designer drugs, and as a result, they have an air of novelty or sophistication about them.
Effects of Taking N-bombs
NBOMes are taken in extremely small doses, and the effects can be quite subjective. The drugs appear to have the effects of hallucinogens and stimulants, such as amphetamines. The effects are reported to last 6-10 hours and are dose-related. Reported effects include:
- A number of varied physical effects that include stimulation, numbness, shakiness, bruxism (grinding teeth), nausea, vomiting, difficulty with urination, vasoconstriction, increased heart rate, increased blood pressure, dilated pupils, and insomnia
- A number of varied cognitive and perceptual effects that can consist of euphoria, a perception of being weightless, feelings of increased sociability or empathy, thought acceleration or thought suppression depending on the dose, distortions in the perception of time such that time appears accelerated or extremely slow, hallucinations that are mostly visual and auditory but can occur in any sensory modality, enhancement of sensory experiences, dissociative experiences (the perception that one is leaving their body or that things aren’t real), and delusions
- In some cases, extreme panic, memory loss, and even severe depression and suicidality
In addition, there are reports that individuals taking too much of these drugs can experience extreme respiratory suppression, heart attack, and seizures. Numerous fatalities have also been reported. There are other reports of individuals having nonfatal complications and requiring hospitalization following use of these drugs.
Because these drugs result in a distortion of reality for individuals who take them, there is always the potential that users will either accidentally harm themselves or hurt themselves due to poor judgment. For example, there was a case of an individual jumping to his death under the influence of the drug because he thought he could fly.
A review reported in the journal Psychosomatics in 2015 reported that the typical profile of a person who abuses NBOMe drugs and experiences adverse effects is a young male who is a regular user of cannabis products and other drugs. The effects begin shortly after the person takes the drugs and may consist of confusion, agitation, and perceptual experiences. Issues with respiratory suppression, accelerated heartbeat, and even seizures may take place. It appears that the highest risk group for abuse of these drugs are young males between the ages of 15 and 25.
The abuse of NBOMes appears to be very restricted. Often, individuals who use these drugs believe they are taking some other drug, such as LSD. Because these drugs are considered illegal for personal use and can only be acquired with specific permissions from government sources, anyone who is in possession of these drugs can be arrested. Thus, any personal use of this class of drugs could be classified as abuse given their legal status.
According to the American Psychiatric Association, the physical signs of hallucinogen intoxication typically include several features that can be recognized by others:
- Dilated pupils
- Irregular heartbeat
- Heart palpitations
- Problems with balance and coordination
- Visual problems, such as complaining of blurred vision
A person who is suspected of abusing these drugs would demonstrate at least two of these physical symptoms. These drugs are not normally considered to be drugs that are commonly abused; however, nearly any substance can be a substance of abuse.
If a person continually abuses NBOMes, addiction can form. Specific criteria for hallucinogen use disorders follow:
- The person often takes greater amounts of the drug or for longer periods of time than they had originally intended when they started using it.
- The person repeatedly craves the drug.
- The person spends a great deal of time and energy trying to obtain the drug, using it, or recovering from using it.
Even though the person experiences a number of difficulties associated with their use, they continue taking NBOMes. Some of these difficulties could include:
- Negative ramifications related to one’s job
- Withdrawing from personal activities
- Family tension and strife
- Issues with other personal relationships
- Financial issues
- Withdrawing from familiar friends, family, peers, etc.
- The person often uses a drug in situations where it can be dangerous to do so.
- Even though the person has expressed a desire to either cut down or stop using the drug, they are unable to do so.
- The person continues to use the drug despite knowledge that it is causing them emotional, psychological, or physical damage.
- The person’s drug use results in them not fulfilling important personal obligations.
- The person needs more of the drug to get the same effects that they once got at much lower amounts (the development of tolerance).
A person displaying two or more of the above symptoms should be assessed for the possibility of a hallucinogen use disorder. The use of NBOMes does not appear to be associated with the development of physical dependence even though tolerance may develop.
In some cases, chronic hallucinogen use is associated with an extremely rare condition known as hallucinogen persistent perception disorder where individuals experience the effects of being on the hallucinogen when they have not taken the drug (sometimes referred to as flashbacks). It does not appear that there any reliable recorded cases of this disorder appearing in individuals who use NBOMes.
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Help for NBOMe abuse and treatment for hallucinogen use disorder is available via professional substance use disorder treatment programs. Individuals who use these types of drugs often have a number of other co-occurring issues that include a need to escape reality for some reason. The person with the abuse issue should be able to explore the reasons for their abuse of these particular drugs in a protected environment (professional therapy environment) and learn how to fulfill these needs without abusing potentially dangerous substances. They will also identify and adjust any irrational beliefs associated with their drug abuse. This often takes quite a bit of intensive work.
In some cases, the person may initially need to be isolated from potential environmental sources of stress, and an inpatient treatment program for the initial part of treatment may be required. Since there is no evidence that these drugs produce serious physical dependence, the person most likely would not need to go through withdrawal management program. Any needed medical treatment for any other psychiatric conditions, such as depression, anxiety, or other conditions, should be instituted along with the substance use disorder treatment.
Treatment for any type of substance use disorder should be viewed as a long-term commitment. The person with a substance use disorder should complete a formal treatment program that includes therapy specifically designed to address their substance use issues. This therapy can be performed in either individual or group sessions. In cases where there are family issues, family therapy can be an excellent form of treatment, although the individual would still need to participate in individual treatment sessions for substance abuse.
People with substance use disorders need to develop long-term aftercare programs once the initial treatment programs have run their course and they have been drug-free for some time. There are several good sources of long-term aftercare support measures that include 12-Step groups, community support groups, and other types of social support groups that are not technically defined as therapy groups because they are not run by a licensed, professional therapist. These groups offer a number of advantages and can help an individual to develop a positive peer group to maintain their recovery on a long-term basis.