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12DESIGNER DRUGSOne thing is unique about designer/club drugs—theyare all purely synthetic and made by chemical reactions inlaboratories, often in garages or basements in residentialneighborhoods. By contrast, other well-known illegal drugscome from natural sources such as plants. For example,cocaine is made from the coca plant, heroin is made from theopium poppy, marijuana comes from the cannabis plant,nicotine comes from tobacco leaves, etc. Thus, unlike illegaldrugs that require significant interstate and internationaltrafficking of the plant products (for example, from SouthAmerica, Europe, or the Middle East) before it gets to theuser, the route from designer drug maker to designer druguser could be as short as a few city blocks.DRUGS AND THE BRAINDesigner drugs are mind-altering and can produce hallucinations.For these reasons, they are often called “psychoactive” or“psychedelic.” Designer drugs produce their effects by alteringthe way nerve cells (neurons) in the brain communicate witheach other (Figure 1.1).Under normal circumstances, neurons carry electricalsignals along wire-like nerve fibers called axons. At the endof each axon is a mushroom-shaped nerve ending calleda synaptic terminal. When the electrical signal from theaxon reaches the synaptic terminal, it causes chemicalmessengers (called neurotransmitters) to be released andsecreted onto nearby neurons. This junction between asynaptic terminal and a nearby neuron is called a synapse.There are literally trillions of synapses in the brain, andeach neuron can have as many as 100,000 different synapseson it. After neurotransmitters are released, they diffuseaway from the synaptic terminal into the synapse andencounter proteins (called receptors) on the nearby neuronsthat are designed to recognize specific neurotransmitters(Figure 1.2). These receptors can cause the nearby nerve cell