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Revision as of 08:18, 5 November 2012
The examples and perspective in this article may not represent a worldwide view of the subject. (December 2010) |
Designer drugs are drugs that are created (or marketed, if they had already existed) to avoid the provisions of existing drug laws, usually by preparing analogs or derivatives of existing drugs by modifying their chemical structure to varying degrees,[1] or less commonly by finding drugs with entirely different chemical structures that produce similar subjective effects to illegal recreational drugs; they are usually sold on the grey market because there are little to no regulations when it comes to these substances.
History
The examples and perspective in this article may not represent a worldwide view of the subject. (May 2010) |
United States
1920s–1930s
Following the passage of the second International Opium Convention in 1925, which specifically banned morphine, the diacetyl ester of morphine, heroin, and a number of alternative esters of morphine quickly started to be manufactured and sold. The most notable of these were dibenzoylmorphine and acetylpropionylmorphine, which have virtually identical effects to heroin but were not covered by the Opium Convention. This then led the Health Committee of the League of Nations to pass several resolutions attempting to bring these new drugs under control, ultimately leading in 1930 to the first broad analogues provisions extending legal control to all esters of morphine, oxycodone, and hydromorphone.[2] Another early example of what could loosely be termed designer drug use, was during the Prohibition era in the 1930s, when diethyl ether was sold and used as an alternative to illegal alcoholic beverages in a number of countries.[3]
1960s–1970s
During the 1960s and 1970s, a number of new synthetic hallucinogens were introduced, with a notable example being the sale of highly potent tablets of DOM in San Francisco in 1967.[4] There was little scope to prosecute people over drug analogues at this time, with new compounds instead being added to the controlled drug schedules one by one as they became a problem, but one significant court case from this period was in 1973, when Tim Scully and Nicholas Sand were prosecuted for making the acetyl amide of LSD, known as ALD-52. At this time ALD-52 was not a controlled drug, but they were convicted on the grounds that in order to make ALD-52, they would have had to be in possession of LSD, which was illegal. The late 1970s also saw the introduction of various analogues of phencyclidine (PCP) to the illicit market.
1980s-early 1990s
The modern use of the term designer drug was coined in the 1980s to refer to various synthetic opioid drugs, based mostly on the fentanyl molecule (such as α-methylfentanyl).[5] The term gained widespread popularity when MDMA (ecstasy) experienced a popularity boom in the mid 1980s. When the term was coined in the 1980s, a wide range of narcotics were being sold as heroin on the black market. Many were based on fentanyl or meperidine. One, MPPP, was found in some cases to contain an impurity called MPTP, which caused brain damage that could result in a syndrome identical to full-blown Parkinson's disease, from only a single dose.[6] Other problems were highly potent fentanyl analogues, which were sold as China White, that caused many accidental overdoses.[7]
Because the government was powerless to prosecute people for these drugs until after they had been marketed successfully, laws were passed to give the DEA power to emergency schedule chemicals for a year, with an optional 6-month extension, while gathering evidence to justify permanent scheduling, as well as the analogue laws mentioned previously. Emergency-scheduling power was used for the first time for MDMA. In this case, the DEA scheduled MDMA as a Schedule I drug and retained this classification after review, even though their own judge ruled that MDMA should be classified Schedule III on the basis of its demonstrated uses in medicine.[8] The emergency scheduling power has subsequently been used for a variety of other drugs including 2C-B, AMT, and BZP. In 2004, a piperazine drug, TFMPP, became the first drug that had been emergency-scheduled to be denied permanent scheduling and revert to legal status.
The late 1980s and early 1990s also saw the re-emergence of methamphetamine in the United States as a widespread public health issue, leading to increasing controls on precursor chemicals in an attempt to cut down on domestic manufacture of the drug. This led to several alternative stimulant drugs emerging, the most notable ones being methcathinone and 4-methylaminorex, but, despite attracting enough attention from authorities to provoke legal scheduling of these compounds, their distribution was relatively limited in extent and methamphetamine continued to dominate the illicit synthetic stimulant market overall.[9]
Late 1990s-2004
In the late 1990s and early 2000s, there was a huge explosion in designer drugs being sold over the internet.[10][11][12] The term and concept of "research chemicals" was coined by some marketers of designer drugs (in particular, of psychedelic drugs in the tryptamine and phenethylamine family). The idea was that, by selling the chemicals as for "scientific research" rather than human consumption, the intent clause of the U.S. analogue drug laws would be avoided. Nonetheless, the DEA raided multiple suppliers, first JLF Primary Materials, and then multiple vendors (such as RAC Research) several years later in Operation Web Tryp. This process was accelerated greatly when vendors began advertising via search engines like Google by linking their sites to searches on key words such as chemical names and terms like psychedelic or hallucinogen. Widespread discussion of consumptive use and the sources for the chemicals in public forums also drew the attention of the media and authorities.
In 2004, the US Drug Enforcement Administration raided and shut down several Internet-based research chemical vendors in an operation called Web Tryp. With help from the authorities in India and China, two chemical manufacturers were also closed. Many other internet-based vendors promptly stopped doing business, even though their products were still legal throughout much of the world.
Most substances that were sold as "research chemicals" in this period of time are hallucinogens and bear a chemical resemblance to drugs such as psilocybin and mescaline. As with other hallucinogens, these substances are often taken for the purposes of facilitating spiritual processes, mental reflection or recreation. Some research chemicals on the market were not psychoactive, but can be used as precursors in the synthesis of other potentially psychoactive substances, for example, 2C-H, which could be used to make 2C-B and 2C-I among others. Extensive surveys of structural variations have been conducted by pharmaceutical corporations, universities and independent researchers over the last century, from which some of the presently available research chemicals derive. One particularly notable researcher is Dr. Alexander Shulgin, who presented syntheses and pharmacological explorations of hundreds of substances in the books TiHKAL and PiHKAL (co-authored with Ann Shulgin), and has served as an expert witness for the defense in several court cases against manufacturers of psychoactive drugs.
The majority of chemical suppliers sold research chemicals in bulk form as powder, not as pills, as selling in pill form would invalidate the claims that they were being sold for non-consumptive research. Active dosages vary widely from substance to substance, ranging from sub-microgram levels to hundreds of milligrams, but while it is critical for the end user to weigh doses with a precision scale, instead of guessing ("eyeballing"), many users did not do this and this led to many emergency room visits and several deaths, which were a prominent factor leading to the emergency scheduling of several substances and eventually Operation Web Tryp. Some compounds such as 2C-B and 5-Meo-DiPT did eventually increase in popularity to the point that they were sold in pill form to reach a wider market, and acquired popular street names ("Nexus" and "Foxy," respectively). Once a chemical reaches this kind of popularity, it is usually just a matter of time before it is added to the list of scheduled (i.e., illegal) drugs.
The late 1990s and early 2000s also saw the first widespread use of novel anabolic steroids by athletes in competition. Steroids had been banned by the International Olympic Committee since 1976, but due to the large number of different anabolic agents available for human and veterinary use, the ability of laboratories to test for all available drugs had always lagged behind the ability of athletes to find new compounds to use. The introduction of increasingly formalised testing procedures, especially with the creation of the World Anti-Doping Agency in 1999, made it much more difficult for athletes to get away with using these drugs without detection, which then led to the synthesis of novel and potent anabolic steroid drugs such as tetrahydrogestrinone (THG), which were not detectable by the standard tests.[13]
2005–2011
While through recent history most designer drugs had been either opioids, hallucinogens, or anabolic steroids, the range of possible compounds is limited only by the scientific and patent literature, and recent years have been characterised by a broadening of the range of compounds sold as designer drugs. These have included a wide variety of designer stimulants such as geranamine, mephedrone, MDPV and desoxypipradrol, several designer sedatives such as methylmethaqualone and premazepam, and designer analogues of sildenafil (Viagra), which have been reported as active compounds in "herbal" aphrodisiac products.[14][15] Designer cannabinoids are another recent development, with two compounds JWH-018 and (C8)-CP 47,497 initially found in December 2008 as active components of "herbal smoking blends" sold as legal alternatives to marijuana,[16] and subsequently a growing range of synthetic cannabinoid agonists have continued to appear, including by 2010 novel compounds such as RCS-4, RCS-8, and AB-001, which had never been reported in the literature, and appear to have been invented by designer drug manufacturers themselves. Another novel development is the use of research ligands for cosmetic rather than strictly recreational purposes, such as grey-market internet sales of the non-approved alpha-melanocyte-stimulating hormone tanning drugs known as melanotan peptides.[17]
“...what is new is the wide range of substances now being explored, the aggressive marketing of products that have been intentionally mislabelled, the growing use of the internet, and the speed at which the market reacts to control measures.”
Safety
The safety of research chemicals is untested and little if any research has been done on the toxicology or pharmacology of most of these drugs. Few, if any, human or animal studies have been done. Many research compounds have produced unexpected side-effects and adverse incidents due to the lack of screening for off-target effects prior to marketing.
Law
Due to the recent development of many designer drugs, laws banning or regulating their use have not been developed yet, and in recent cases novel drugs have appeared directly in response to legislative action, to replace a similar compound that had recently been banned.[20] Many of the chemicals fall under the various drug analogue legislations in certain countries, but most countries have no general analogue act or equivalent legislation and so novel compounds may fall outside of the law after only minor structural modifications.
In the United States, the Controlled Substances Act was amended by the Controlled Substance Analogue Enforcement of 1986, which attempted to ban designer drugs pre-emptively by making it illegal to manufacture, sell, or possess chemicals that were substantially similar in chemistry and pharmacology to Schedule I or Schedule II drugs.
Other countries have dealt with the issue differently. In some, the new drugs are banned as they become a concern, as in Germany, Canada, the United Kingdom, and Sweden. In Sweden, the police and customs from April 2011 may also seize drugs that are not on the list of drugs covered by the anti-drug laws if the police suspect that the purpose of the holding is related to drug abuse. Following a decision by a prosecutor, the police may destroy the seized drugs.[21]
Some countries, such as Australia, have gone the opposite direction and enacted sweeping bans based on chemical structure only, making chemicals illegal even before they are created — if a theoretical chemical fits a set of rules regarding substitutions and alterations of an already-banned drug, it too is banned. The controlled substance analogue law under both Australian Federal law and that of some individual states such as New South Wales is so broad that it would cover millions of compounds that have never been made, simply on the basis that they bear a vague resemblance to one of the drugs on the illegal list. However, it would still not cover drugs that have no structural similarity to any controlled drug, even if they produced similar effects.[22][23]
This section needs expansion. You can help by adding to it. (June 2008) |
Common Names
In the UK to avoid being controlled by the Medicines Act, designer drugs such as mephedrone have been described as "bath salts" or "plant food", despite the compounds having no history of being used for these purposes.[24][25][26]
In the USA, similar descriptions have been used to describe mephedrone as well as methylone and methylenedioxypyrovalerone (MDPV).[27][28] Combined with labeling that they are "not for human consumption", these descriptions are an attempt to skirt the Federal Analog Act which forbids drugs that are “substantially similar” to already classified drugs from being sold for human use.[29]
List
Some research chemicals are structural analogues of tryptamines or phenethylamines but there are also many other completely unrelated chemicals that can be considered part of the group. Psychoactivity or other pharmaceutical properties of these compounds might not be predictable based strictly upon structural examination. Many of the substances have common effects whilst structurally different and vice versa due to SAR paradox. As a result of no real official naming for some of these compounds, as well as regional naming, this can all lead to potentially hazardous mix ups for users.[30]
- α-methylfentanyl or "China White" on the heroin market
- parafluorofentanyl
- 3-methylfentanyl, extremely potent opioid, allegedly used as a chemical weapon by the Russian military in the Moscow theater hostage crisis
- MPPP, especially infamous due to an impurity in some batches called MPTP, which caused permanent Parkinsonism with a single use[31][32]
- 4'-Nitromethopholine
- O-Desmethyltramadol
- Nortilidine
- 4,4-Diphenyl-6-(pyrrolidin-1-yl)-heptan-3-one, the pyrrolidine analogue of dipipanone and phenadoxone.
- Lysergamide-based
- ALD-52, N-acetyllysergic acid diethylamide, famously believed to have been the active ingredient in the "Orange Sunshine" acid of the 1960s
- ETH-LAD, which has been sold by some research chemical suppliers.
- AL-LAD, which has been sold by some research chemical suppliers.
- PRO-LAD, which has been sold by some research chemical suppliers.
- LSB
- LSZ
- Tryptamine-based
- 4-Acetoxy-DiPT, N,N-diisopropyl-4-acetoxytryptamine
- 4-Acetoxy-DMT, 4-acetoxy-dimethyltryptamine
- 4-HO-MET, 4-hydroxy-N-methyl-N-ethyltryptamine
- 4-HO-MiPT, 4-hydroxy-N-methyl-N-isopropyltryptamine
- 5-MeO-AMT, 5-methoxy-alpha-methyltryptamine
- 5-MeO-DiPT, 5-methoxy-di-isopropyltryptamine (also known as "Foxy" or "Foxy Methoxy")
- 5-MeO-MiPT, 5-methoxy-methylisopropyltryptamine
- DiPT, N,N-diisopropyl-tryptamine
- DPT, N,N-dipropyltryptamine
- 5-MeO-DALT (N-allyl-N-[2-(5-methoxy-1H-indol-3-yl)ethyl]prop-2-en-1-amine)
- Phenethylamine-based
- 2C-C, 2,5-dimethoxy-4-chlorophenethylamine
- 2C-D, 2,5-dimethoxy-4-methyl-phenethylamine
- 2C-E, 2,5-dimethoxy-4-ethyl-phenethylamine
- 2C-G, 3,4-dimethyl-2,5-dimethoxyphenethylamine
- 2C-I, 2,5-dimethoxy-4-iodophenethylamine
- 2C-T-2, 2,5-dimethoxy-4-ethylthiophenethylamine
- 2C-T-4, 2,5-dimethyoxy-4-(i)-propylthiophenethylamine
- 2C-T-7, 2,5-dimethoxy-4-(n)-propylthiophenethylamine
- 2C-T-21, 2,5-dimethoxy-4-(2-fluoroethylthio)phenethylamine
- 2CB-FLY
- Bromodragonfly
- DOB, 2,5-dimethoxy-4-bromoamphetamine
- DOC, 2,5-dimethoxy-4-chloroamphetamine
- DOI, 2,5-dimethoxy-4-iodoamphetamine
- DOM, 2,5-dimethoxy-4-methylamphetamine
- TMA-2, 2,4,5-Trimethoxyamphetamine
- TMA-6, 2,4,6-Trimethoxyamphetamine
- NBOMe-2C-C, 25C-NBOMe, "Pandora"
- NBOMe-2C-I, 25I-NBOMe, "Solaris"
- NBOMe-2C-D, 25D-NBOMe, "Divination"
- 3-MeO-PCP
- 4-MeO-PCP [33]
- Dizocilpine (MK-801; (+)-5-methyl-10,11- dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine)
- Eticyclidine (PCE; CI-400; N-ethyl-1-phenylcyclohexylamine)
- Methoxetamine (2-(3-methoxyphenyl)-2-(ethylamino)cyclohexanone)
- PCPr (N-propyl-1-phenylcyclohexylamine)
- Rolicyclidine (PCPy; 1-(1-phenylcyclohexyl)pyrrolidine)
- Tenocyclidine (TCP; 1-(1-(2-Thienyl)cyclohexyl)piperidine)
- 3-MeO-PCE (2-(3-methoxyphenyl)-2-(ethylamino)cyclohexane)
- Ethylketamine (2-(2-chlorophenyl)-2-(ethylamino)cyclohexanone)
- Methoxyketamine (2-(2-methoxyphenyl)-2-(methylamino)cyclohexanone)
Piperazine-based
- BZP, 1-benzylpiperazine
- mCPP, 1-(3-chlorophenyl)piperazine
- MeOPP, 1-(4-methoxyphenyl)piperazine
- pFPP, 1-(4-fluorophenyl)piperazine
- TFMPP, 3-trifluoromethylphenylpiperazine, has the unique distinction of being the only drug in the USA to be emergency scheduled into Schedule I and then allowed to become legal because the DEA was unable to justify permanent scheduling
- 4-MTA, 4-Methylthioamphetamine
- 5-Me-MDA
- 5-APB, 5-(2-aminopropyl)benzofuran
- 6-APB, 6-(2-aminopropyl)benzofuran
- AET, α-ethyltryptamine
- Butylone, β-keto-N-methylbenzodioxolylpropylamine
- Ethylone, 3,4-methylenedioxy-N-ethylcathinone
- IAP
- MBDB
- MDAT (5,6,7,8-tetrahydrobenzo[f][1,3]benzodioxol-7-amine)
- MDEA, 3,4-methylenedioxy-N-ethylamphetamine
- Methylone, 3,4-methylenedioxy-N-methylcathinone
- MMA, 3-Methoxy-4-methylamphetamine
- PMA, a highly dangerous amphetamine derivative responsible for many accidental deaths
- PMMA, similar to PMA
- PMEA, also similar to PMA
- α-Pyrrolidinopropiophenone (α-PPP)
- 2-Fluoroamphetamine
- 3-Fluoroamphetamine
- 4-Fluoroamphetamine
- 4-Methylaminorex (4-MAR)
- Buphedrone
- Camfetamine (N-methyl homologue of Fencamfamine)
- Desoxypipradrol
- Dimethocaine
- Diphenylprolinol
- Ethcathinone
- Ethylphenidate
- Flephedrone (4-FMC), and its 3-fluoro isomer 3-FMC
- Geranamine
- MDPV, Methylenedioxypyrovalerone, commonly known by its street name "bath salts"
- Mephedrone, 4-methylmethcathinone
- Methedrone
- Methiopropamine
- Naphyrone
- Pentedrone
- Pentylone
- 1,4-Butanediol, another GHB analogue
- 2-Methyl-2-butanol, a more potent analogue of ethanol
- GBL, gamma-butyrolactone, both a precursor to and substitute for GHB
- GHV, gamma-hydroxyvaleric acid (4-methyl-GHB)
- GVL, gamma-valerolactone
- Methylmethaqualone, an analogue of the sedative methaqualone
- Mebroqualone
- Benzylbutylbarbiturate
- Phenazepam, a benzodiazepine that was not listed by the Convention on Psychotropic Substances and so is not regulated internationally
- Premazepam
- Etizolam
Benzoylindoles
Naphthoylindoles
- AM-1220
- AM-1221
- AM-1235
- AM-2201
- AM-2232
- JWH-007
- JWH-015
- JWH-018
- JWH-019
- JWH-073
- JWH-081
- JWH-098
- JWH-116
- JWH-122
- JWH-149
- JWH-182
- JWH-193
- JWH-198
- JWH-200
- JWH-210
- JWH-398
- JWH-424
- MAM-2201
Nonclassical cannabinoids
- CP 47,497 and its (C8) homologue cannabicyclohexanol
- CP 55,940
- HU-308
Phenylacetylindoles
Adamantoylindoles
- Madol (sometimes referred to as "DMT")
- Methasterone
- Norbolethone
- Prostanozol
- THG, "The Clear"
Erectile dysfunction
- Aildenafil
- Mycoxafloppin
- Acetildenafil
- Aminotadalafil
- Gendenafil
- Homosildenafil
- Hydroxyacetildenafil
- Hydroxyhomosildenafil
- Hydroxythiohomosildenafil
- Nitrosoprodenafil[34]
- Piperidino-acetildenafil
- Piperidino-vardenafil
- Sulfoaildenafil
- Thiosildenafil
See also
- cf. Drug design
- Controlled Substances Act
- Controlled Substance Analogue Enforcement of 1986
- JLF
- Operation Web Tryp
- Pharmaceutical company
External links
- Substances and classifications table (31/10/2008) – European Legal Database on Drugs raport on all substances controlled in at least one EU country in XLS format
- Research Chemical FAQ on Erowid
- A comprehensive guide to CNS compounds and products
References
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- ^ "Esters of Morphine". UNODC Bulletin on Narcotics (2): 36–38. 1953.
- ^ Brecher, Edward M. (1972). The Consumers Union Report on Licit and Illicit Drugs. Consumer Reports Magazine.
- ^ Snyder, SH; Faillace, L; Hollister, L (1967). "2,5-dimethoxy-4-methyl-amphetamine (STP): A new hallucinogenic drug". Science. 158 (3801): 669–70. doi:10.1126/science.158.3801.669. PMID 4860952.
- ^ Donald A. Cooper. Future Synthetic Drugs of Abuse. Drug Enforcement Administration, McLean, Virginia
- ^ Fahn, Stanley (1996). "The Case of the Frozen Addicts: How the Solution of an Extraordinary Medical Mystery Spawned a Revolution in the Understanding and Treatment of Parkinson's Disease". The New England Journal of Medicine. 335 (26): 2002. doi:10.1056/NEJM199612263352618.
- ^ Henderson GL (1988). "Designer Drugs: Past History and Future Prospects". Journal of Forensic Sciences. 33 (2): 569–575. PMID 3286815.
- ^ TheDEA.org: The History of MDMA
- ^ Philip Jenkins. Synthetic Panics: The Symbolic Politics of Designer Drugs. NYU Press 1999. ISBN 978-0-8147-4244-0
- ^ Cole, MD; Lea, C; Oxley, N (2002). "4-Bromo-2,5-dimethoxyphenethylamine (2C-B): A review of the public domain literature". Science & justice : journal of the Forensic Science Society. 42 (4): 223–4. doi:10.1016/S1355-0306(02)71832-7. PMID 12632938.
- ^ De Boer, D; Bosman, I (2004). "A new trend in drugs-of-abuse; the 2C-series of phenethylamine designer drugs". Pharmacy world & science : PWS. 26 (2): 110–3. PMID 15085947.
- ^ Uchiyama, N; Kikura-Hanajiri, R; Kawahara, N; Goda, Y (2008). "Analysis of designer drugs detected in the products purchased in fiscal year 2006". Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan. 128 (10): 1499–505. PMID 18827471.
- ^ Malvey, TC; Armsey Td, 2nd (2005). "Tetrahydrogestrinone: The discovery of a designer steroid". Current sports medicine reports. 4 (4): 227–30. PMID 16004834.
{{cite journal}}
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- ^ Venhuis, Bastiaan J.; Blok-Tip, Leonore; De Kaste, Dries (2008). "Designer drugs in herbal aphrodisiacs". Forensic Science International. 177 (2–3): e25–7. doi:10.1016/j.forsciint.2007.11.007. PMID 18178354.
- ^ Spice enthält chemischen Wirkstoff (German)
- ^ Evans-Brown, M.; Dawson, R. T; Chandler, M.; McVeigh, J. (2009). "Use of melanotan I and II in the general population". BMJ. 338: b566. doi:10.1136/bmj.b566. PMID 19224885.
- ^ "EU struggles to curb hard drugs". BBC News. 5 November 2009.
- ^ 2009 Annual report: the state of the drugs problem in Europe. EMCDDA, Lisbon, November 2009.
- ^ Lindigkeit, R; Boehme, A; Eiserloh, I; Luebbecke, M; Wiggermann, M; Ernst, L; Beuerle, T (2009). "Spice: A never ending story?". Forensic Science International. 191 (1–3): 58–63. doi:10.1016/j.forsciint.2009.06.008. PMID 19589652.
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- ^ Commonwealth Criminal Code Act 1995 s 314.1(2)
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- ^ "Police warning over 'bubble' drug". BBC News. 20 November 2009. Retrieved 2009-11-27.
- ^ Reed, Jim (13 January 2010). "Clubbers are 'turning to new legal high mephedrone'". BBC News. Retrieved 2010-07-04.
- ^ Victoria Cumbow (2011-02-06). "Synthetic form of cocaine and methamphetamine being packaged as bath salts". The Huntsville Times. Retrieved 2011-02-10.
- ^ "Reports: Miami 'zombie' attacker may have been using '[[Bath salts (drug)|bath salts]]'". CNN. May 29, 2012.
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- ^ Davis, Glenn C.; Williams, Adrian C.; Markey, Sanford P.; Ebert, Michael H.; Caine, Eric D.; Reichert, Cheryl M.; Kopin, Irwin J. (1979). "Chronic Parkinsonism secondary to intravenous injection of meperidine analogues". Psychiatry Research. 1 (3): 249–54. doi:10.1016/0165-1781(79)90006-4. PMID 298352.
{{cite journal}}
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ignored (help) - ^ Wallis, Claudia (2001-06-24). "Surprising Clue to Parkinson's - TIME". Time. Retrieved 2010-05-01.
- ^ King LA. New drugs coming our way - what are they and how do we detect them? EMCDDA Conference, Lisbon, 6–8 May 2009
- ^ Venhuis BJ, Zomer G, Hamzink M, Meiring HD, Aubin Y, de Kaste D. The identification of a nitrosated prodrug of the PDE-5 inhibitor aildenafil in a dietary supplement: a Viagra with a pop. Journal of Pharmaceutical and Biomedical Analysis. 2011 Mar 25;54(4):735-41. PMID 21145686