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α-PiHP (α-pyrrolidinoisohexanophenone) is a synthetic stimulant of the substituted cathinone class. It is a positional isomer of α-PHP, distinguished by a branched rather than linear side chain.[1] α-PiHP is a selective dopamine and norepinephrine reuptake inhibitor, producing its effects by prolonging monoamine signaling in the brain's reward and arousal circuits.[2]

Open Beta

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Threshold
< 5 mg
Light
5 – 15 mg
Common
15 – 25 mg
Strong
25 – 40 mg
Heavy
40+ mg
12340 h1 h2 h
1Onset
0s–5m2Come-up
5m–15m3Peak
30m–1h4Resolution
1h–2hAftereffects3h–8h
Total2h–4h
Builduprapid
Full reset5 days
Cross-tol.
α-PVP, α-PHP, MDPV +3 more
Absolute5 entries
Cardiovascular diseasePsychotic spectrum disordersBipolar disorderPregnancy and lactationMAO inhibitor therapy
Relative4 entries
Seizure disordersSevere anxiety disordersRenal impairmentHyperthyroidism
Dosage varies by body weight, tolerance & metabolism · Not medical advice · Terms

α-PiHP first appeared on research chemical markets in China in 2016, designed as a replacement for α-PVP and α-PHP as those compounds were scheduled.[3] By 2022 it ranked among the top five synthetic cathinones seized by weight across Europe.[4] It was placed into Schedule II of the 1971 Convention on Psychotropic Substances in March 2023 and is now controlled in most major jurisdictions.[5]

Subjective effects include psychomotor stimulation, euphoria, wakefulness, and focused energy. The experience is narrowly dopaminergic — intense physical and psychological activation without the empathogenic warmth of serotonergically active compounds, producing a compulsive high that drives repeated administration.[6] Anxiety, paranoia, tachycardia, and compulsive redosing urges are characteristic unsought effects.[1]

α-PiHP carries high psychological dependence liability and dose-dependent cardiovascular toxicity, with no established lethal threshold.[7][8] Sustained blood pressure elevation exceeds that of equi-dose cocaine,[9] and fatal cardiac arrest has been documented;[10] polydrug use is present in nearly all recorded fatalities, compounding attribution. No clinical trials have been conducted; the current understanding rests on forensic case series, one naturalistic pharmacokinetic study, and in vitro data.

History[edit]

Discovery

The original synthesis of α-PiHP is undocumented in the scientific literature. The compound was designed as a structural variant of α-PHP — itself a successor to α-PVP and MDPV — engineered to exploit regulatory gaps as predecessor pyrovalerone cathinones were sequentially scheduled.[11] It was first identified in seized material in China in 2016, with Hungary reporting an independent detection that same year and a formal notification to the EMCDDA Early Warning System following from Slovenia in December 2016.[3]

Market trajectory

α-PiHP's spread exemplifies the sequential replacement pattern of synthetic cathinone markets: each new compound fills the niche left by its newly scheduled predecessor.[11] By 2022 it ranked among the top five synthetic cathinones seized by weight across Europe.[4] In the United Kingdom, it has been identified as a component of "monkey dust" — mixed pyrovalerone street preparations associated with severe intoxication presentations in North Staffordshire.[12]

International scheduling

The WHO Expert Committee on Drug Dependence evaluated α-PiHP at its 45th meeting in October 2022, concluding that it inhibits dopamine and norepinephrine uptake more potently than methcathinone, cocaine, and methamphetamine.[5] It was placed into Schedule II of the 1971 Convention in March 2023.[1] The European Union adopted Union-wide control measures the same month, and the United States added a specific Schedule I listing in December 2023.[13]

Chemistry[edit]

Structural class

α-PiHP belongs to the pyrovalerone subclass of substituted cathinones — synthetic compounds built on a phenethylamine backbone with a β-keto group and a nitrogen incorporated into a pyrrolidine ring. The parent scaffold is shared with α-PVP, α-PHP, and MDPV.

α-PiHP is a positional isomer of α-PHP: both share the same molecular formula and a six-carbon side chain, but α-PiHP carries a branched (isobutyl) chain where α-PHP carries a straight (n-butyl) chain.[1] This single structural difference produces measurable pharmacokinetic differences while preserving the core mechanism of action.[4]

Molecular properties

IUPAC name4-methyl-1-phenyl-2-(pyrrolidin-1-yl)pentan-1-one
Molecular formulaC₁₆H₂₃NO
Molecular weight245.36 g/mol

The molecule features a phenyl ring bearing a cathinone motif (α-aminoketone), with the nitrogen incorporated into a five-membered pyrrolidine ring and the aliphatic chain extending as a 2-methylpropyl (isobutyl) group.[14]

Stereochemistry

α-PiHP contains one chirality center at the carbon adjacent to the carbonyl. Market samples are presumed racemic mixture. No studies have determined whether individual enantiomers differ in potency, selectivity, or toxicity.inferred

For structurally related pyrovalerone cathinones, the S-enantiomer generally shows greater DAT inhibition, but this has not been confirmed for α-PiHP.

Physical properties

In salt form, α-PiHP appears as a white to off-white crystalline powder.[15] No published data on melting point, solubility, or degradation pathways were identified. In vitro studies indicate moderate metabolic resistance — approximately 65% of the parent compound remained intact after five hours of incubation with human liver microsomes.[16]

Pharmacology[edit]

Mechanism of action

α-PiHP blocks the DAT (DAT) and NET (NET), preventing these neurotransmitters from being cleared from the synapse after release. It is a pure reuptake inhibitor — it does not force stored neurotransmitters out of nerve terminals the way amphetamine and methcathinone do.[2] This distinction matters: reuptake inhibitors amplify naturally occurring signals, while releasers generate a flood of neurotransmitter regardless of ongoing neural activity.

The WHO Expert Committee on Drug Dependence concluded that α-PiHP inhibits dopamine and norepinephrine uptake more potently than methcathinone, cocaine, and methamphetamine.[5] Serotonin transporter activity is negligible — a trait shared across the pyrovalerone cathinone class.[2]

This high selectivity for dopamine over serotonin predicts strong reinforcement and correspondingly high abuse liability.[7][17] In animal studies, α-PiHP produces locomotor activation comparable to cocaine and methamphetamine, though it requires higher doses than α-PVP to achieve the same effect — a difference attributed to lower peak brain concentrations rather than weaker target binding.[4]

Pharmacokinetics

The first human pharmacokinetic data came from a 2025 observational study in which 17 adults self-administered α-PiHP intranasally at 15–25 mg, with cocaine (75–90 mg) as a within-subjects comparator.[9] Peak concentrations in oral fluid were reached within approximately 20 minutes. The plasma half-life was approximately 1.1 hours. Less than 1% of the administered dose was excreted unchanged in urine, indicating extensive metabolism.

Cardiovascular effects — elevated heart rate and blood pressure — were more sustained than those produced by cocaine at the comparator dose.[9]

Metabolism

Ten urinary metabolites have been identified in human users.[3] The major metabolic pathways are reduction of the β-ketone group and hydroxylation of the aliphatic side chain. The hydroxylation metabolite serves as a diagnostic marker distinguishing α-PiHP from α-PHP in urine testing.[16]

In postmortem tissue, the hydroxylated metabolite (OH-α-PiHP) co-occurs with the parent compound across all major organs.[18] The specific liver enzymes responsible for α-PiHP metabolism have not been identified, though structural analogy to related compounds suggests CYP3A4 and CYP2C19 as probable primary metabolizers.inferred

Neuroscience[edit]

Where it acts

α-PiHP's selective blockade of the dopamine and norepinephrine transporters concentrates its effects in two neural systems. In the mesolimbic pathway — projections from the ventral tegmental area to the nucleus accumbens — elevated synaptic dopamine drives the intense but narrow reward signal that defines the experience.[7] The absence of SERT engagement means this reinforcement lacks the prosocial or empathogenic modulation seen with MDMA-like compounds.

In the locus coeruleus–cortical arousal system, elevated norepinephrine drives the wakefulness, psychomotor activation, and sympathomimetic effects — rapid heart rate, blood pressure elevation, pupil dilation — that dominate the physical experience.[9][10]

Why it matters

The distinction between "wanting" (dopamine-driven incentive salience) and "liking" (opioid-mediated hedonic pleasure) is central to understanding α-PiHP's abuse pattern. Selective dopamine reuptake inhibitors preferentially amplify wanting — the compulsive drive to obtain the drug — which persists after subjective pleasure fades.[6] This framework explains the compulsive redosing characteristic of pyrovalerone binges.

At high doses and during prolonged use, excessive dopamine activation in mesolimbic circuits produces stimulant psychosis — hallucinations, persecutory delusions, and paranoia consistent with forensic reports of delirium and violent behavior.[1][19][17]

Subjective Effects[edit]

Summary

The α-PiHP experience is narrowly stimulant — focused activation and euphoria without the empathogenic or prosocial warmth of serotonergically active substances. The quality of the high shifts markedly with dose: lower doses produce alert, energized focus; higher doses intensify physical activation and introduce paranoid ideation. Set and setting modulate the anxiogenic dimension substantially — the same pharmacological arousal that reads as productive energy in a calm environment can register as agitation and paranoia in overstimulating or unfamiliar surroundings.[1]

The closest experiential comparator is α-PVP, which shares the reuptake-inhibitor-only mechanism but produces greater intensity per milligram due to higher peak brain concentrations.[4] Compared to cocaine, α-PiHP at recreational intranasal doses produces broadly similar stimulation but with more sustained cardiovascular effects and a qualitatively less serotonergically modulated character.[9]

Effect Grid

Dose Level:
Description

Clear stimulant effects dominate — pronounced cognitive euphoria, marked wakefulness, and appetite suppression. Focus enhancement and motivation enhancement are prominent. Thought acceleration is obvious, and users may experience increased sociability, though without the empathogenic warmth of serotonergic stimulants due to α-PiHP's negligible SERT activity.

Physically, heart rate and blood pressure are noticeably elevated — blood pressure elevation is more sustained than with comparable cocaine doses. Excessive sweating, dry mouth, and mild bruxism may occur. Restlessness becomes apparent. Pupil dilation is likely.

The compulsive redosing urge emerges at this tier and can intensify as peak effects begin to fade. This is the range studied in the De la Rosa 2025 human observational study (15–25 mg insufflated). Sleep will be impossible for several hours.

Modeled from the effect's dose-dependence curve — not per-substance measurements.

Perception(6)likelihood · intensity
Dreaming suppression
possible
Light sensitivity
possible
Visual processing acceleration
possible
Auditory hallucinations
v.rare
External hallucinations
v.rare
Shadow people
v.rare

Shadow people

Body(19)likelihood · intensity
Stimulation
likely
Appetite suppression
likely
Pupil dilation
likely
Wakefulness
likely
Dry mouth
likely
Insomnia
likely
Physical fatigue
likely
Vasoconstriction!
likely
Motor control impairment!
possible

Wakefulness · Dry mouth · Insomnia · Physical fatigue · Restlessness · Body high · Dehydration sensation · Excessive sweating · Heart rate perception changes · Muscle tension · Bruxism · Sexual arousal enhancement · Trembling · Nausea

Restlessness · Body high · Dehydration sensation · Excessive sweating · Heart rate perception changes · Muscle tension · Bruxism · Sexual arousal enhancement · Trembling · Nausea

Thinking(15)likelihood · intensity
Cognitive euphoria
likely
Cognitive fatigue
likely
Compulsive redosing urge!
likely
Motivation suppression
likely
Thought acceleration
likely
Cognitive dysphoria
possible
Focus enhancement
possible
Information processing enhancement
possible
Decision impairment!
possible

Thought acceleration · Cognitive dysphoria · Focus enhancement · Information processing enhancement · Motivation enhancement · Analysis enhancement · Cognitive impairment · Thought disorganization · Thought loops · Confusion

Motivation enhancement · Analysis enhancement · Cognitive impairment · Thought disorganization · Thought loops · Confusion

Feeling(8)likelihood · intensity
Euphoria
likely
Anhedonia
possible
Anxiety
possible
Irritability
possible
Depression!
possible
Dysphoria
possible
Paranoia!
possible
Emotional lability
possible

Irritability · Dysphoria · Emotional lability

Self(6)likelihood · intensity
Craving
possible
Compulsive repetitive behavior!
possible
Disinhibition
possible
Sociability enhancement
possible
Sociability suppression
possible
Self-control suppression!
rare

Sociability suppression

Time(1)likelihood · intensity
Time alteration
possible
Awareness(1)likelihood · intensity
Reality testing impairment!
v.rare
Likelihood: how common this effect is at the selected dose level.This effect has safety implications — review before use.

Timeline

Safety[edit]

Harm
Acute toxicity
High
Chronic toxicity
Moderate
Withdrawal
Moderate
Tolerance buildup
rapid
Tolerance reset
5 days
Dependence
Physical
Negligible
Psychological
High
Compulsive redosing
High
Dose escalation
High
Cross-tol.
α-PVP · α-PHP · MDPV
Risk Shape
TOXPHYPSYWDRREDTOL

Toxicity

No lethal dose has been established in any species, and no therapeutic index can be calculated. Postmortem blood concentrations span a wide range with substantial overlap between non-fatal intoxication and fatal exposures, making it impossible to define a reliable toxic threshold.[8]safety citation needed

Acute toxicity

α-PiHP intoxication presents as a stimulant overdrive syndrome: rapid heart rate, elevated blood pressure, elevated body temperature, agitation, and sweating.[9][1] In the only human pharmacokinetic study, blood pressure elevation following intranasal α-PiHP (15–25 mg) was more sustained than following intranasal cocaine (75–90 mg).[9]

Heart and circulation

Cardiovascular failure is the primary lethal mechanism. Documented outcomes include sustained rapid heart rate and elevated blood pressure at recreational doses,[9] cardiac rhythm disturbances,[1] and sudden cardiac arrest — including a fatal case involving co-ingestion with tramadol.[10]

In a Finnish postmortem series covering synthetic cathinone-related deaths from 2018–2023, sudden cardiac death was the predominant cause.[20]

Dangerous overheating

Life-threatening hyperthermia has been documented following massive oral ingestion (approximately 5 grams). The case involved severe muscle breakdown and acute kidney injury from sustained muscular hyperactivity. The skeletal muscle relaxant dantrolene produced prompt temperature reduction.[21]

Fatal cases

Multiple fatalities have been documented, nearly always involving other substances. In the Finnish postmortem series, 82% of decedents were male with a median age of 35, and opioids, stimulants, or sedatives were co-detected in 69–92% of cases.[20] Only 1.7% of synthetic cathinone-related deaths in that series had a cathinone as the sole detected substance.

The first confirmed fatality primarily attributed to α-PiHP included comprehensive tissue distribution and detection of the hydroxylated metabolite across all major organs.[18]

Clinical management

No specific antidote exists.[22] Treatment follows standard stimulant overdose protocols: active cooling, intravenous fluids, and benzodiazepines for agitation.[22] Dantrolene may be considered for hyperthermia unresponsive to standard cooling.[21]

Psychological risks

At recreational doses, α-PiHP produces anxiety and paranoia consistent with the pharmacology of dopamine-selective stimulants.[1][19] At higher doses and during sustained binge use, psychotic features emerge: hallucinations, persecutory delusions, and severe agitation.[1][15] Forensic cases frequently document aggressive and violent behavior.[17]

Excited delirium — extreme agitation, elevated body temperature, unusual physical strength, and loss of pain sensitivity — has been documented for the pyrovalerone cathinone class and carries high mortality risk.[23]

No data exist on long-term psychiatric effects specific to α-PiHP. Class-level evidence suggests possible post-acute anxiety, depression, and anhedonia following chronic use.[6][19]

Tolerance and dependence

No α-PiHP-specific tolerance or dependence studies have been published.inferred The WHO assessed α-PiHP as having high abuse potential based on animal self-administration models and a pharmacological profile comparable to cocaine and methamphetamine.[5]

Class-level evidence from related pyrovalerone cathinones indicates rapid tolerance development during binge use, with escalating doses required to maintain euphoric effects.[6] Psychological dependence liability is high, driven by selective dopamine reinforcement via the mesolimbic pathway.[7]

Compulsive redosing is characteristic: the high dopamine-to-serotonin selectivity ratio drives intense but short-lived reward, promoting rapid re-administration.[6][19] Withdrawal is primarily psychological — cravings, anhedonia, fatigue, and low mood — rather than the physiological withdrawal seen with opioids or benzodiazepines.[6]

Drug interactions

No controlled interaction studies exist. The following are documented through co-occurrence in fatal or severe cases, or inferred from mechanism.

Opioids

Co-administration with opioids is present in the majority of α-PiHP-related fatalities.[20] The stimulant component masks progressive respiratory depression from the opioid, while both compounds add cardiovascular stress.safety citation needed

Tramadol

A fatal case documented cardiac arrest with α-PiHP and tramadol at toxic concentration.[10] Tramadol adds further monoamine reuptake inhibitor, lowers the seizure threshold, and may prolong the QT interval.

Benzodiazepines

Frequently co-detected in intoxication cases.[17][20] Benzodiazepines may suppress agitation without addressing cardiovascular toxicity, creating a false sense of stability.

MAO inhibitors

No published case reports were identified. The mechanistic basis is established: blocked monoamine breakdown combined with blocked reuptake produces dangerous accumulation of dopamine and norepinephrine, risking hypertensive crisis.safety citation needed

Other stimulants

Multi-cathinone use (e.g., α-PiHP with α-PHP or MDPHP) is documented in forensic series.[17][8] Cardiovascular load is additive to synergistic.

Alcohol

Co-detected in death series.[20] Adds impairment of judgment, decision-making, and temperature regulation.

Pregabalin

Co-detected in German forensic cases.[17] May add central nervous system depression and worsen the post-acute low.

Contraindications

No substance-specific contraindication studies exist.inferred

Heart conditions: α-PiHP produces dose-dependent rapid heart rate and sustained blood pressure elevation.[9] Pre-existing coronary artery disease, rhythm disturbances, heart muscle disease, or uncontrolled blood pressure are absolute contraindications. Sudden cardiac arrest has been documented.[10][20]

Psychiatric disorders: Psychotic spectrum disorders, bipolar disorder, and severe anxiety disorders are absolute contraindications. α-PiHP precipitates hallucinations and delusions at high doses,[1] with specific risk for psychotic decompensation in predisposed individuals.

Seizure disorders: Stimulants lower seizure threshold. No α-PiHP-specific seizure cases are documented, but the class-level risk is established.safety citation needed

MAO inhibitor therapy: Concurrent use with any monoamine oxidase inhibitor is an absolute contraindication due to risk of hypertensive crisis.safety citation needed

Kidney impairment: α-PiHP-induced muscle breakdown and acute kidney injury are documented.[21] Pre-existing kidney disease increases vulnerability.

Pregnancy and lactation: No reproductive toxicity data exist. Stimulants pose risks to fetal cardiovascular development and placental blood flow.safety citation needed

Harm Reduction[edit]

Forms & Identification

Reagent ResultsNot recorded+ add reagent results
AppearanceNot recorded+ add appearance
Red FlagsNot recorded+ add red flags

α-PiHP is nearly indistinguishable from α-PHP by appearance — both circulate as white to off-white crystalline powders. Specialized mass spectrometric methods were developed specifically because standard testing cannot reliably differentiate the two isomers.[16] Reagent testing can confirm the presence of a cathinone but cannot distinguish between specific pyrovalerone analogs.

Given the documented prevalence of mixed pyrovalerone street preparations — including "monkey dust" blends in the UK[12] — any powder sold as α-PiHP may contain other active cathinones, and dosing decisions should account for this uncertainty.

Guidelines

  • Test all material with reagent kits to confirm cathinone class; understand that specific identity cannot be verified without laboratory analysis
  • Start with the lowest reported active dose via the intended route; do not redose within 90 minutes regardless of perceived lack of effect
  • Weigh doses with a milligram-precision scale — never estimate by eye
  • Avoid vaporization and intranasal routes if unable to resist compulsive redosing; oral administration's slower onset reduces but does not eliminate this risk
  • Set a firm time limit and dose cap before the session; communicate both to a sitter or trusted contact
  • Remove additional supply from immediate access once the session begins
  • Stay hydrated but do not over-hydrate; eat a light meal beforehand
  • Monitor heart rate if possible; rest and seek help if sustained rapid heartbeat exceeds personal baseline by 50% or more

Set & Setting

The anxiogenic dimension of α-PiHP is highly sensitive to environment. The same pharmacological arousal that registers as focused energy in a calm, familiar setting can present as paranoia and agitation in unfamiliar or overstimulating contexts. A quiet, controlled environment with trusted company reduces the risk of anxiety spiraling into panic.

Solitary use increases vulnerability to compulsive redosing cycles and delays recognition of medical emergencies.

Aftercare & integration. The comedown from α-PiHP is characterized by fatigue, low mood, irritability, and difficulty sleeping despite physical exhaustion. These effects reflect temporary dopamine depletion and typically resolve within 24–72 hours.

Prioritize sleep — use a dark, quiet room and avoid screens. Eat nutrient-dense food even if appetite is suppressed. Stay hydrated. Avoid caffeine and other stimulants during recovery. Light physical exercise can help restore baseline mood, but the cardiovascular system needs rest after sustained stimulant-driven elevation.

If anxiety, paranoia, or low mood persist beyond 72 hours, or if psychotic symptoms occurred during use, consult a healthcare provider. Repeated binge-crash cycles escalate rapidly with pyrovalerone cathinones.

Recovery & Support

α-PiHP carries high psychological dependence liability. The compulsive redosing pattern characteristic of pyrovalerone cathinones means problematic use can develop rapidly, often within weeks of regular use.

Stimulant-specific recovery resources include SMART Recovery (evidence-based self-management), Crystal Meth Anonymous (applicable to cathinone stimulant patterns), and local addiction services accessible through national helplines. No pharmacological treatment specific to cathinone dependence exists, but behavioral therapies — particularly contingency management and cognitive behavioral therapy — have demonstrated effectiveness for stimulant use disorders.

Reaching out to a healthcare provider, counselor, or peer support group is a concrete first step.

Recovery resources, crisis lines, and support pathways → View all

Emergency Response

Recognizing an emergency: chest pain or pressure, seizure, loss of consciousness, body temperature hot to the touch through clothing, severe confusion, or extreme agitation that cannot be talked down — any of these signals a medical emergency, not a difficult experience.

Immediate steps:

  • 1. Call emergency services immediately
  • 2. Move the person to a cool environment and remove excess clothing
  • 3. If unconscious but breathing, place in the recovery position (on their side, airway clear)
  • 4. Do not restrain unless there is immediate danger of self-harm or harm to others
  • 5. Do not induce vomiting
  • 6. Apply cool (not ice-cold) water to the neck, armpits, and groin if overheating is suspected
  • 7. Stay with the person until help arrives

What to tell the dispatcher: The substance name (α-PiHP, a synthetic cathinone), the amount taken if known, the time of last dose, the route of administration, and current symptoms. Good Samaritan laws in many jurisdictions protect people who call for help during a drug emergency.

No reversal agent exists for α-PiHP or any synthetic cathinone.

references

  1. [1] 
    ^abcdefghijklmnoDinis P, Franco J, Margalho C (2024) α-Pyrrolidinohexanophenone (α-PHP) and α-Pyrrolidinoisohexanophenone (α-PiHP): A Review — Life doi:10.3390/life14040429
  2. [2] 
    ^abcKolaczynska KE, Thomann J, Hoener MC, Liechti ME (2021) The Pharmacological Profile of Second Generation Pyrovalerone Cathinones and Related Cathinone Derivative. — International journal of molecular sciences doi:10.3390/ijms22158277
  3. [3] 
    ^abcKemenes K, Hidvegi E, Szabo L, Kerner A, Suvegh G (2023) Metabolism of the Synthetic Cathinone Alpha-Pyrrolidinoisohexanophenone in Humans Using UHPLC-MS-QToF — Journal of Analytical Toxicology doi:10.1093/jat/bkac085
  4. [4] 
    ^abcdeBaarset AM, Steinsland S, Nerem E, Andersen JM, Baumann MH, Bogen IL (2025) Pharmacological effects and pharmacokinetics of the novel synthetic cathinone α-pyrrolidinoisohexanophenone (α-PiHP) compared with α-pyrrolidinovalerophenone (α-PVP) in mice — Neurotoxicology doi:10.1016/j.neuro.2025.05.005
  5. [5] 
    ^abcdeWorld Health Organization Expert Committee on Drug Dependence (2022) WHO Expert Committee on Drug Dependence Forty-Fifth Report: recommendation on alpha-PiHP Link
  6. [6] 
    ^abcdefWeinstein A, Rosca P, Fattore L, London ED (2017) Synthetic Cathinone and Cannabinoid Designer Drugs Pose a Major Risk for Public Health — Frontiers in Psychiatry doi:10.3389/fpsyt.2017.00156