Search Results for: Liquid Ecstasy

List of Street Names for Drugs

People actively abusing legal or illicit substances can get pretty creative when it comes to devising a list of slang terms—ranging from avoiding detection from law enforcement to ensuring privacy in written and verbal communication. If you suspect someone you love is abusing drugs, watch for repeated use of odd, unrecognized, or seemingly slang terms.

Examples of these are included below for many of the more commonly abused substances.

list of street slang for drugs

Popular Slang Terms by Drugs

Slang, jargon, and street terms are constantly evolving.

What is used today may become obsolete tomorrow. Constant changes in the vernacular serve to help drug users evade detection of their substance use by others.

Unfortunately, some terms seem completely unrelated to the substances in any way, making them harder to identify.

Many slang terms are derived from:


  • The color, shape, or consistency of the drug
  • The effects the drug provides
  • Abbreviated forms of the name
  • Expanded forms of the name
  • The people that commonly use the drug

Below is a list of frequently used substances and their commonly used street names 1, 2, 3.


Alcohol

Alcohol

Alcohol—This is the most commonly used substance by adults. Slang terms may refer to the brand or variety of alcohol or may be more general. Non brand-specific street names include:

  • Booze
  • Juice
  • Hooch
  • Sauce
  • Rotgut

Cocaine

Slang for Cocaine

Cocaine—This white powder substance is commonly abused for its euphoric stimulant effects. Some street names include:

  • Blow
  • Bump
  • C
  • Charlie
  • Coke
  • Snow
  • Toot
  • Coca
  • Soda Cot

Crack

Crack Cocaine—The yellowish rock known as “crack” is a version of cocaine that is smoked to produce an intense, immediate, and short-lasting high. It will share some street names with the powder form, as well as specific names like:

  • Candy
  • Flake
  • Rock

Dimethyltryptamine

Dimethyltryptamine—A hallucinogenic substance derived from plants in South America, it is known for its short but intense effects. It is often referred to as:

  • DMT
  • Dimitri
  • Businessman’s Trip.

Gamma-Hydroxybutyric Acid (GHB)

Gamma-Hydroxybutyric Acid (GHB)This medication is used to treat narcolepsy but may be abused for its ability to induce euphoria. It is sometimes used as a date rape drug. Slang for GHB includes:

  • G
  • Georgia Home Boy
  • Goop
  • Grievous Bodily Harm
  • Liquid Ecstasy
  • Liquid X
  • Soap
  • Scoop

Heroin

Heroin Abuse

Heroin—This substance, which is essentially a modified form of the morphine alkaloid derived from opium poppies, can be consumed numerous ways (e.g., snorting, smoking, or injection) leading to an intense and addictive high. Common street names include:

  • Brown Sugar
  • China White
  • Chiva
  • Dope
  • H
  • Hell Dust
  • Horse
  • Junk
  • Negra
  • Skag
  • Skunk
  • Smack
  • Tar
  • Thunder
  • White Horse
  • Heroin w/ OTC Cold Meds & Antihistamine: Cheese

Inhalants

street terms for inhalants

Inhalants—A group of abused substances that comprises a wide range of solvents, glues, and other volatile products often found around the home. Inhalants give off fumes or vapors, which are then inhaled by the user, providing them with a short-lived but dangerous high. Depending on the type, they may be referred to as:

  • Dusters
  • Gluey
  • Huff
  • Laughing Gas
  • Poppers
  • Rush
  • Snappers
  • Whippets

Ketamine

Ketamine Club Drug

Ketamine—This dissociative drug is mainly used in veterinary medicine and results in feelings of detachment from reality. It is often called:

  • Cat Tranquilizer
  • Cat Valium
  • Jet K
  • K
  • Kit Kat
  • Purple
  • Special K
  • Vitamin K.

Khat

Khat—This plant grown in Africa and the Middle East can be chewed to produce a sense of euphoria and increased energy. Commonly referred to as:

  • Abyssinian Tea
  • African Salad
  • Catha
  • Chat
  • Cat
  • Oat

Lysergic Acid Diethylamide

LSD Street Terms

Lysergic Acid Diethylamide (LSD)—This hallucinogenic substance distorts reality and can produce drug-induced psychosis. Profoundly negative effects are often referred to as “bad trips.” Street names include:

  • Acid
  • Blotters
  • Blue Heaven
  • Cubes
  • Dots
  • Mellow Yellow
  • Microdot
  • Window Pane
  • Yellow Sunshine

marijuana

Marijuana Use

Marijuana—This psychoactive drug substance with the active ingredient delta-9-tetrahydrocannabinol (THC) is used frequently with increased legal status. It is referred to by numerous street names, including:

  • Aunt Mary
  • Blunt
  • Bud
  • Chronic
  • Dope
  • Ganja
  • Grass
  • Green
  • Herb
  • Hydro
  • Indo
  • Joint
  • Kif
  • Mary Jane
  • Pot
  • Reefer
  • Sense
  • Sinsemilla
  • Skunk
  • Smoke
  • Trees
  • Weed

Hashish

Hashish—A concentrated form of delta-9-tetrahydrocannabinol (THC) produced from the same plants that produce marijuana, it is available as an oily substances or a hard resin. It may be called:

  • Boom
  • Dabs
  • Gangster
  • Hash
  • Hemp

3,4-methylenedioxy-methamphetamine (MDMA)

3,4-methylenedioxy-methamphetamine (MDMA)This stimulant substance has combined effects of increasing energy/alertness as well as creating hallucinogenic effects. Commonly called “ecstasy” but may be also be referred to as:

  • Adam
  • Beans
  • Clarity
  • Disco Biscuit
  • E
  • Eve
  • Molly
  • Lover’s Speed
  • Peace
  • STP
  • X
  • XTC
  • Uppers

Mescaline

Mescaline—Found in varieties of cacti, this substance induces perceptual disturbances and pleasurable mood changes. Slang names include:

  • Peyote
  • Buttons
  • Cactus
  • Mesc

Methamphetamine

Meth Street Slang

Methamphetamine—This powerful stimulant increases energy and activity levels while decreasing the need for sleep. This substance is associated with poor decision-making, violence, and dangerous, erratic behaviors. Users are often called “tweakers,” while the substance is commonly called:

  • Batu
  • Bikers’ Coffee
  • Black Beauties
  • Chalk
  • Chicken Feed
  • Crank
  • Crystal
  • Fire
  • Glass
  • Go Fast
  • Ice
  • Meth
  • Methlies Quick
  • Shards
  • Speed
  • Stove Top
  • Tina
  • Trash
  • Tweak
  • Whiz
  • Yellow barn

Dextromethorphan

cough syrup abuse

Dextromethorphan—Found in certain over-the-counter cough and cold medicines, this substance produces hallucinations and paranoia when taken in large doses. Street names include:

  • CCC
  • Dex
  • Poor man’s PCP
  • Robotripping
  • Robo
  • Skittles
  • Triple C
  • Velvet

Phencyclidine (PCP)

Phencyclidine(PCP)—Previously used as a surgical anesthetic, PCP can create a sense of profound dissociation and can sometimes elicit psychotic symptoms such as delusions and hallucinations. Users may refer to it as:

  • Angel Dust
  • Boat
  • Hog
  • Love Boat
  • Peace Pill
  • Sherm
  • Mixed with marijuana: Zombie Weed.

Psilocybin

Magic Mushrooms Use

Psilocybin—Grown in North and South America, these mushrooms can trigger hallucinations, the inability to track time, and an altered sense of reality. They may be called:

  • Little Smoke
  • Magic Mushrooms
  • Purple Passion
  • Shrooms

Salvia

Salvia—A naturally-occurring herb that is native to Mexico, this substance results in feelings of separation from the body and confusion. Salvia’s street names include:

  • Magic Mint
  • Maria Pastora
  • Sally-D
  • Shepherdess’s Herb
  • Diviner’s Sage.

Steroids

Steroids—Legally available to treat hormone deficits, anabolic steroids are abused by those looking to add muscle mass or aid recovery following exercise. Commonly referred to as:

  • Arnolds
  • Juice
  • Gym Candy
  • Pumpers
  • Roids
  • Stackers
  • Weight Gainers

Synthetic Cannabinoids

synthetic marijuana names

Synthetic Cannabinoids—A combination of herbs with chemicals added to produce a “high,” this “synthetic marijuana” can be more potent and more problematic than marijuana.

  • K2
  • Spice
  • Black Mamba
  • Bliss
  • Bombay Blue
  • Fake Weed
  • Fire
  • Genie
  • Moon Rocks
  • Smacked
  • Yucatan
  • Zohai

Synthetic Cathinones (Bath Salts)

Synthetic Cathinones (Bath Salts)—These substances are man-made chemicals that are related to the natural substances found in khat. They can produce a strong sense of euphoria as well as dangerous and erratic behaviors. Bath salts are generally referred to by their many brand names, including:

  • Bloom
  • Cloud Nine
  • Cosmic Blast
  • Flakka
  • Ivory Wave
  • Lunar Wave
  • Scarface
  • Vanilla Sky
  • White Lightning.

Prescription Drugs


Prescription Opioids (Painkillers)

This segment covers a large amount of substances with tremendous variability. Some of the terms will be used interchangeably or called “pain pills” or “painkillers” in a generic sense. Though this group produces similar effects of decreased perceptions of pain and a pleasurable “high,” the strength and specific effects may vary somewhat. Prescription narcotics include:


Codeine

Codeine:

  • Captain Cody
  • Cody
  • Schoolboy
  • Codeine syrup mixed with alcohol: Lean, Sizzurp and Purple Drank
  • Codeine mixed with the sedative glutethimide: Doors and Fours, Loads, Pancakes and Syrup


Fentanyl

Fentanyl Street Words

Fentanyl:

  • Apache
  • China Girl
  • China White
  • Dance Fever
  • Friend
  • Goodfella
  • Jackpot
  • Murder 8
  • Tango and Cash
  • TNT


Hydrocodone

opiate painkillers

Hydrocodone(Norco, Vicodin, Lorcet, and Lortab) :

  • Hydro
  • Narco
  • Vickies
  • Vike
  • Watson-387


Hydromorphone

Hydromorphone (Dilaudid):

  • D
  • Dillies
  • Dust
  • Footballs
  • Juice
  • Smack


Meperidine

Meperidine (Demerol):

  • Demmies
  • Pain killer


Methadone

Methadone Pill Use

Methadone:

  • Amidone
  • Fizzies
  • Wafer
  • Methadone mixed with MDMA: Chocolate Chip Cookies


Morphine

Morphine:

  • Dreamer
  • Emsel
  • First Fine
  • God’s Drug
  • Hows
  • M
  • M.S
  • Miss Emma
  • Mister Blue
  • Monkey
  • Morf
  • Morpho
  • Unkie
  • White Stuff


Oxycodone

Oxycodone Street Jargon Terms

Oxycodone

  • Hillbilly Heroin
  • Kicker
  • O.C
  • Oxycet
  • Oxycotton
  • Oxy
  • Percs
  • Roxy


Oxymorphone

Oxymorphone (Opana):

  • Biscuits
  • Blue Heaven
  • Blues
  • Mrs. O
  • O bomb
  • Octagons
  • Stop signs

Prescription Sedatives

This group of substances calm the body and mind and trigger relaxation and drowsiness. There are numerous types of sedatives.


Barbiturates

Barbiturates like pentobarbital and phenobarbital:

  • Barbs
  • Block Busters
  • Christmas Trees
  • Goof Balls
  • Phennies
  • Pinks
  • Red Birds
  • Red Devils
  • Reds
  • Reds and Blues
  • Tooies
  • Yellow Jackets
  • Yellows


Benzodiazepines

Benzodiazepines like Xanax, Valium, Ativan, and Klonopin:

  • Benzos
  • Blue V
  • Candy
  • Downers
  • Sleeping Pills
  • Tranks
  • Rohypnol: Roofies,Roofinol, Rope, Rophies


Sleeping Pills

Prescription sleep aids like Ambien, Lunesta and Sonata:

  • Forget-me Pill
  • Mexican Valium
  • R2
  • Roche

Prescription Stimulants

This group of substances are commonly used to treat physical and mental health conditions like attention-deficit/hyperactivity disorder (ADHD) and narcolepsy.


Amphetamines

Amphetamine like Adderall or Benzedrine:

  • Bennies
  • Black Beauties
  • Crosses
  • Hearts
  • LA Turnaround
  • Speed
  • Truck Drivers
  • Uppers


Methylphenidate

Methylphenidate (Concerta, Ritalin)

  • JIF
  • MPH
  • R-ball
  • Skippy
  • The Smart Drug
  • Vitamin R

Helping Your Loved One


Identifying and learning more about the substances that your loved one is abusing can be a great step towards their recovery from drug abuse. If you know or suspect a drug problem, you may wish to consult with an addiction or substance use professional to learn more about your next steps in the process.

If you are seeking more information about treatment options that might be appropriate for your loved one, consider calling 1-888-744-0069Who Answers?.

Sources:

  1. National Institute on Drug Abuse. (2016). Commonly Abused Drug Charts.
  2. Drug Enforcement Administration. (2011). Drugs of Abuse: A DEA Resource Guide.
  3. National Institute on Drug Abuse for Teens. (2016). Drug Facts: Alcohol.

The Use and Abuse of Date Rape Drugs

 

Although Bill Cosby has been making headlines for his alleged use of date rape drugs, sexual assault cases involving these substances have been a problem in the U.S. for decades and continue to be a growing trend. What’s more, many young adults and teenagers are now recreationally abusing these drugs as a way to get high.

Defining Date Rape

Date rape drugs are typically used in the commission of a sexual assault. Although there are different definitions for the term “sexual assault,” it is widely accepted that these assaults occur when anyone is forced (without giving consent) to participate in or witness sexual activities. Examples can include:

  • Rape or attempted rape
  • Touching someone else’s body or your own
  • Having someone watch or photograph you in a sexual manner
  • Being exposed to someone else’s body
  • Spiking Food and Beverages

Most date rape victims are unaware that their food or drink has been “spiked.” That’s because the drugs are generally added while the intended victim has looked away or stepped out of the room. The good news is that, in many instances, people are able to spot these questionable substances before ingesting them.

Abusing Date Rape Drugs

Let’s take a look at some common date rape drugs that are being abused recreationally:

  • Flunitrazepam: (Street names: Rohypnol, roofies) Rohypnol is used as a date rape drug, to help “come down” after a sleepless drug binge and to increase the effects of other drugs. It’s tasteless and odorless; it also dissolves quickly in carbonated beverages. It comes in a small, white, round tablet and is usually taken orally, but can be ground up and snorted.
  • Gamma Hydroxybutyric Acid:(Street names: GHB, liquid ecstasy, blue nitro, cherry meth, easy lay) GHB is a narcotic sedative that comes in liquid, powder and pill forms. It is currently abused by teens and young adults at bars, parties, clubs and raves. Date rape victims become incapacitated due to the sedative effects of GHB, plus they are unable to fight off sexual attackers.
  • Ketamine:(Street name: Special K) Ketamine is used in powder or liquid forms for anesthetic purposes. Thanks to its detached, dreamlike effects, this drug is widely abused and utilized to facilitate sexual assaults.

Be Prepared and Educate Yourself

Luckily, there are ways that you can protect yourself from date rape drugs. Don’t leave your drink unattended and never accept a beverage from anyone besides a bartender or server. If possible, try to attend parties with a group of friends so you can watch each other’s drinks and leave as a group.

People who abuse date rape drugs often say the effects are “paralyzing.” The symptoms kick in approximately twenty to thirty minutes after taking the drug and may last for up to twelve hours. Users can become so incapacitated that they collapse to the floor, eyes wide open, able to observe events but completely unable to move. Overdose symptoms are likely with higher doses and lack of tolerance, requiring immediate and professional medical attention.

Learn more about the physical and mental effects of date rape drugs.

The Scary Facts About Designer Drugs and Legal Highs

Read Time: 30 minutes

Introduction

What Are Designer Drugs and Legal Highs?

The terms “designer drugs” and “legal highs” are used to refer to substances such as synthetic marijuana and “bath salts” that are engineered in a laboratory to recreate or simulate the effects of traditional illicit drugs such as amphetamines, ecstasy, lysergic acid diethylamide (LSD), marijuana, ketamine, and others. Because their chemical structures are different from the drugs they are intended to mimic, designer drugs frequently escape regulation, making them easier to obtain by users.

Although encompassing a wide variety of substances with many different effects, designer drugs share a few general characteristics including:

  • Opaque or misleading labeling information.
  • Inconsistent ingredients and dosages from batch to batch.
  • A lack of scientific or medical data on their safety profile and health risks.
  • Ceaseless tinkering with molecular structure, or chemical components to stay ahead of the law.

Why Are Designer Drugs Popular?

The recent surge in popularity of designer drugs is partly due to aggressive online marketing as well as several misperceptions about these substances. Some mistaken beliefs about these drugs are:1,2

  • There are no legal consequences for using them.
  • Drug screening tests are unable to detect them.
  • They are relatively safe when compared to illicit drugs.

Some people are attracted by the implication that, in contrast to illicit drugs, there are no criminal risks for using these substances. However, there has been a significant legislative effort in the US and other countries over the last 5 years to close the legal loopholes exploited by the makers of designer drugs, and the legal status of specific chemicals can change very quickly.1

Designer drugs can also be an attractive choice for individuals concerned about being screened for drug use because of the belief that these compounds are undetectable by drug tests.3 Although there is usually a lag after new designer drugs become available before drug testing is adjusted to detect them, drug test manufacturers have become much more vigilant in trying to keep pace with the proliferation of new substances,4, and there is no longer any guarantee of avoiding detection.

Finally, studies have shown that there is a perception among the general public that “legal highs” are safer than illicit drugs simply because they are legal.5 This is a dangerous misconception, because almost none of these compounds have been tested for safety in humans, and many have been reported to cause dangerous, even deadly, effects in some users. For this reason, some researchers and medical experts take issue with the term “legal high,” and they instead encourage the use of terms like “novel psychoactive substances” (NPS) or “novel psychoactive drugs”.1

Why Are These Drugs Legal?

Designer drugs are so numerous that they are difficult to categorize, although 2 classes—synthetic cannabinoids (marijuana substitutes) and synthetic cathinones (amphetamine and ecstasy substitutes)—are the most common. It is this overwhelming, constantly evolving variety that makes regulating these chemicals so difficult.

In 2009, there were 2 synthetic cannabinoids and 4 synthetic cathinones identified in the US. This number rose to 54 different synthetic cannabinoids and 31 synthetic cathinones by 2012. Worldwide, there were 348 known designer drugs being sold to drug users in 2013 according to the United Nations.6

Since most of these designer drugs are chemically different from the illicit drugs they are mimicking, they are frequently not covered by drug laws. New rules and regulations must be written to prohibit each new drug, or related group of drugs. This has led to a cat-and-mouse game in which no sooner have governments prohibited the latest batch of legal highs than illicit chemists produce new compounds not covered by the laws.7

It is important for people to know the facts about so-called “legal highs” in order to make informed decisions about their use. The following pages will briefly describe the effects and dangers of several large classes of designer drugs:

  • Synthetic cannabinoids.
  • Synthetic cathinones.
  • Designer hallucinogens.
  • Other legal highs that are substitutes for ketamine and opiates.

Synthetic Cannabinoids (Marijuana Substitutes)

What Are Synthetic Cannabinoids?

Synthetic cannabinoids are substances created in a laboratory that mimic the high caused by smoking or otherwise ingesting the marijuana (cannabis) plant. They are available in 2 main forms:

  • Sprayed on dried plant material to be smoked.
  • In a liquid that can be used in e-cigarettes and other types of vaporizers.

Synthetic cannabinoids first became available in Europe in the early 2000s as herbal mixtures that were labeled “incense” or “potpourri” and sold in head shops and convenience stores. Internet posts by users reported cannabis-like effects when these products were smoked.

It was initially thought that these effects were due to the bioactive herbs in the mixes, including Leonotis leonurus (Lion’s Tail) and Pedicularis densiflora (Indian Warrior), which do contain psychoactive chemicals. However, laboratory testing soon showed that synthetic cannabinoids had been sprayed on the plant material and were responsible for the highs produced by these herbal mixes.8

Common Street Names for Synthetic Cannabinoids

As of 2013, there were more than 100 different synthetic cannabinoids identified by the United Nations Office of Drug Control being sold to drug users.9 The technical names for these chemical substances are strings of letters and numbers such as JWH-018 and WIN55-212-2 that are confusing and difficult to remember.

Because of this, as well as the fact that the drug packaging never specifies the precise chemical composition, the drugs’ technical names are not well known to people outside of scientific and legal professions. Instead, synthetic cannabinoids are frequently referred to by street names such as “herbal incense”, “synthetic marijuana”, or “fake weed”.10

They are also known by the hundreds of brand names under which they are sold, including:

  • Spice.
  • K2.
  • Joker.
  • Black Mamba.
  • Kush.
  • Kronic.

Are Synthetic Cannabinoids Legal?

The legal status of synthetic cannabinoids is murky and constantly changing. Although synthetic cannabinoids have been around for over 20 years, it was only recently that they became a concern as recreational drugs.

In the U.S., the first report of products laced with synthetic cannabinoids occurred in 2008 when U.S. Customs and Border Protection seized a shipment of “Spice” for analysis in Dayton, Ohio.11 Because most synthetic cannabinoids are chemically distinct from delta-9-tetrahydrocannabinol (THC), the most important psychoactive ingredient in marijuana, the chemicals found in Spice were not covered by existing drug-control laws.12

Researchers originally developed synthetic cannabinoids to study the effects of marijuana on the brain,13 and the few scientists who were aware that these compounds existed considered them tools, not potential drugs of abuse. As a result, the authorities were unprepared for the rapid rise in popularity of synthetic cannabinoids—it would be several years before any federal or state regulations for drugs were in place.

As word spread about the intoxicating effects of herbal incense and potpourri mixes, their popularity increased rapidly, and websites marketing and selling synthetic cannabinoids proliferated. In 2010, the state of Kansas and the US military banned several specific compounds found in Spice and K2.14

In 2011, the Drug Enforcement Administration (DEA) placed a specific synthetic cannabinoid, called JWH-018, and 4 related drugs under Schedule I control. This rule made it illegal to manufacture or possess these compounds or any product that contained them.12

Although specific chemicals found in the original Spice formulations are now illegal, and new rules are being issued regularly to update the list of prohibited ingredients, the number of synthetic cannabinoids available is exploding. Only 2 new synthetic cannabinoids were found in 2009; in contrast, a total of 51 were identified in 2012.11

Each of these new compounds, if its chemical structure is sufficiently different from previously banned substances, requires a new rule to be issued before it can be declared illegal. Therefore, manufacturers in China and elsewhere are constantly tweaking and changing these drugs in order to stay one step ahead of the law and sell their products without repercussions.

Recent Research on Synthetic Cannabinoids

Marijuana is by far the most popular illicit drug in the United States, with 115 million Americans aged 12 or older having used it at least once in their lives.15 It is, therefore, unsurprising that marijuana substitutes enjoy a high level of popularity as well.

Besides the greater ease of obtaining synthetic cannabinoids due to their ambiguous legal status, these products are also less likely to be discovered by standard drug screening and may be perceived as safer due to their unregulated availability. Some recent statistics about synthetic cannabinoids include:

  • The Monitoring the Future survey on adolescent drug use revealed that in 2011, the year that synthetic cannabis was banned by the DEA, 11.4% of US12th graders had used the drug in the previous year. This made it the 2nd most popular illicit drug among this age group behind marijuana.16
  • The number of emergency room visits that involved synthetic cannabinoids increased from 11,406 in 2010 to 28,531 in 2011.17
  • According to the United Nations Office on Drugs and Crime, over 50% of all new designer drugs identified between 2009 and 2013 were synthetic cannabinoids.9
  • In the US, the largest group of synthetic cannabinoid users is composed of men aged 13-59 years who have a history of marijuana and other drug use.13

Natural cannabinoids, such as THC, and synthetic cannabinoids both cause their mental and physical effects primarily by binding to cannabinoid receptor 1 (CB1) on nerve cells in the brain and body. The major difference between THC and the chemicals found in herbal incense is how strongly they bind these CB receptors.18

For those synthetic cannabinoids that have been tested, the results have shown them to be between 2 to 100 times more potent than THC.13 The fact that the specific cannabinoids used in the earliest Spice products, such as JWH-018 and WIN55-212-2, were the ones that had been shown by scientists to bind CB1 receptors the best suggests that illegal drug manufacturers were searching scientific journals for information to help them decide which compounds to make and sell.19

Because of this greater potency, or increased binding affinity at the CB receptors, synthetic cannabinoids produce effects similar to marijuana, but with much greater intensity. Marijuana also contains cannabidiol, an ingredient that reduces anxiety, while synthetic cannabis products do not.20 This lack of built-in anxiolytic, or anxiety-quelling properties may help explain why Spice use sometimes leads to agitation, aggression, and anxiety more often than marijuana.21

What Are the Effects of Synthetic Cannabinoids?

Because there are so many different types of synthetic cannabinoids, and because none of them have ever been tested in controlled, clinical trials, it is difficult to know precisely how they will affect people after short- and long-term use. Indeed, because labels on products like Spice do not disclose their chemical ingredients or dosage, users are invariably taking a chance with their health whenever they use these drugs.

By using data from animal studies and individual case reports of human users, however, some general conclusions can be drawn regarding the use of synthetic cannabinoids. Many of these effects are similar to those caused by ingesting or smoking marijuana:8

  • Euphoric high.
  • Increased relaxation.
  • Conjunctival injection (red eyes).

In addition to these effects, there are dangerous side effects specific to synthetic cannabinoids. These are largely due to the comparatively high potency of these substances, and are possibly manifestations of other unstudied chemical differences between the synthetics and standard marijuana. These effects are primarily responsible for the many emergency department visits due to Spice use and include:12

  • Increased blood pressure.
  • Extreme anxiety and agitation.
  • Nausea and vomiting.

Serious Complications From Synthetic Cannabinoid Use

The lack of clinical trial data about synthetic cannabinoids and their short history of abuse mean that determining long-term effects is difficult. Although most side effects subsided after 1-2 days, some more serious effects have been reported, including:13

  • Heart attack.
  • Ischemic stroke.
  • Acute kidney injury.

Dangerous psychiatric effects have been reported as well, including episodes lasting for weeks or months:13 

  • Thought disorder.
  • Suicidal thoughts.

Dependence and Addiction

Finally, addiction to synthetic cannabinoids has been reported after a prolonged period of regular use and is characterized by withdrawal symptoms similar to marijuana including:22,23

  • Disturbed sleep and vivid dreams.
  • Anxiety.
  • Cravings.
  • Nausea.
  • Muscle twitching and cramping.
  • Chills.

Synthetic Cathinones (Stimulant Substitutes)

What Are Synthetic Cathinones?

Synthetic cathinones, commonly known as “bath salts,” are chemical derivatives of cathinone, a stimulant found in the khat plant (Catha edulis).24 These substances have fallen under recent scrutiny, as many of the designer drugs available today are synthetic cathinones—including some of the most popular legal highs.

Synthetic cathinones are sold as substitutes for illicit psychostimulants such as methamphetamine, cocaine, and ecstasy. Like synthetic cannabinoids and other common legal highs, synthetic cathinones are sold online, in head shops, and in convenience stores. These drugs are available in powder or crystalline form and can be eaten, insufflated (snorted), or injected.

Some of the more common synthetic cathinones include:

  • Methylenedioxypyrovalerone (MDPV).
  • Mephedrone.
  • Methylone.
  • ?- pyrrolidinopentiophenone (?-PVP).

In total, there are over 50 different synthetic cathinones that have been identified by law enforcement and health agencies around the world.

Common Street Names for Synthetic Cathinones

Synthetic cathinones are sold in packaging intended to avoid drug control laws by being labeled as “bath salts”—the most common street name for these chemicals. Other terms used on the labels to obscure the purpose of these substances include “plant food” and “jewelry cleaner”.24

Synthetic cathinones can also be found on the online market, and otherwise sold under dozens of brand names, including:

  • Cloud Nine.
  • Ivory Wave.
  • Vanilla Sky.

Finally, there are a number of street names for particularly popular and widely available synthetic cathinones. These names serve as much more memorable and marketable substitutes for the complex chemical names of these drugs:

  • Mephedrone—“Meph,” “Meow-meow,” “M-Cat,” “MMC Hammer,” “Bubbles”.
  • ?-PVP—“Flakka,” “Gravel”.

Are Synthetic Cathinones Legal?

Like other “legal highs”, the legality of synthetic cathinones is constantly changing. When they first appeared in the US a decade ago, neither the manufacturing of, nor the possession of, synthetic cathinones was illegal unless they were not intended for human consumption.25 This is the reason all legal highs are prominently labelled “not for human consumption” even though that is their only intended purpose.

After the emergence of mephedrone, MDPV, and methylone as recreational drugs, the DEA enacted temporary bans in 2011, prohibiting the manufacture, sale, or possession of these drugs. The Synthetic Drug Abuse Prevention Act of 2012 made the bans on mephedrone and MDPV permanent, and the Synthetic Cathinones Control Act of 2013 permanently prohibited methylone and 14 other synthetic cathinones.26

The problem, as with many designer drugs, is that as quickly as the authorities outlaw specific cathinones, clandestine chemists and laboratories continue to create new drugs with chemical structures that are not covered by current legislation.

As of December 2013, the United Nations Office of Drug Control reported that 54 different synthetic cathinones were being sold around the world.9 Over 80% of those substances had been identified after July 2012, indicating an explosion of new cathinones just as the new prohibition laws passed in the U.S.

Recent Research on Synthetic Cathinones

Synthetic cathinones have been around for a long time. The first research paper describing mephedrone appeared in 1929, and MDPV was first created in 1967. Recreational use of these stimulants, however, was not known until they were “rediscovered” in the early 2000s and promoted as legal substitutes for ecstasy.27

Most of what is known about how synthetic cathinones work has been gleaned from laboratory and animal studies. This is due to the fact that these drugs were never tested in controlled human trials before they appeared on the market.

Experiments in human cells have shown that synthetic cathinones work by influencing the levels of the monoamine neurotransmitters—an important group of brain-signaling molecules that includes dopamine, serotonin, and norepinephrine.28  Studies in mice and rats have shown that the way a particular cathinone affects the balance of these neurotransmitters determines whether they have effects that mimic MDMA, methamphetamine, or cocaine.29

Examples of each type include:

  • MDMA-like: mephedrone, methylone.
  • Methamphetamine-like: cathinone, methcathinone.
  • Cocaine-like: pyrovalerone, MDPV.

There is a lot of concern about how widespread synthetic cathinone is among the general public, but reliable data are difficult to obtain. Some important statistics about these drugs include:

  • The Monitoring the Future survey on adolescent drug use has shown that the use of “bath salts” among US 12th graders has declined from 1.3% in 2012 to 0.9% in 2014. This decline coincided with an increase in the number of high school seniors who perceive using bath salts to be dangerous, from 39% in 2012 to 49% in 2014.16
  • NMS Labs, a private drug testing company, reported that in 2014, the top 3 cathinones detected in the bio-samples they screened were: ?-PVP, ethylone, and methylone.30
  • Poison control center calls involving bath salts increased from 302 in 2010 to 6,136 in 2012.27

What Are the Effects of Synthetic Cathinones?

The effects of synthetic cathinones vary among the different drugs in this class but are broadly similar to other psychostimulants such as cocaine, methamphetamine, and MDMA. The intended effects sought by users include.27

  • Euphoric high.
  • Raised levels of energy and alertness.
  • Heightened sense of empathy and openness.
  • Increased libido.

The negative effect profile also overlaps with other, more commonly abused stimulants and includes signs and symptoms such as:

  • Jaw clenching.
  • Dilated pupils; sensitivity to light.
  • Reduced appetite.
  • Increased body temperature and sweating.
  • Rapid heart beat.
  • Agitation and aggression.
  • Anxiety and panic attacks.

Serious Complications

Most of the negative side effects listed above are relatively mild and generally resolve themselves within hours or days after taking bath salts. There are also more dangerous, even lethal, consequences reported in those who use these drugs, such as:29

  • Heart attack.
  • Liver failure.
  • Respiratory arrest.
  • Suicidal thoughts and self-harming behaviors.
  • Long-term cognitive impairment.

Dependence and Addiction

It is important to note that there is no reason to believe that synthetic cathinones are less dangerous than the illicit stimulants they mimic. Just as methamphetamine and cocaine can produce dependence and addiction in individuals who abuse them, so can cathinones.

In some instances, the designer substitute may be more dangerous than the original drug. Ecstasy tablets, for example, often contain the cathinone mephedrone instead of MDMA because both drugs produce similar effects in users. Mephedrone, however, also induces strong drug cravings in people—a key characteristic of an addictive drug—while MDMA does not.31

Finally, although many cases of human dependence on synthetic cathinones have been reported, animal experiments have helped to shed more light on their true addictive potential. Two recent studies showed that rats exerted more effort to get MDPV and ?-PVP (flakka) than they did for methamphetamine—one of the more highly addictive recreational drugs known.32

These results indicate that synthetic cathinones—far from being safe alternatives to cocaine and other drugs—may be even more dangerous and addictive.

Designer Hallucinogens (Psychedelic Substitutes)

What Are Designer Hallucinogens?

Hallucinogens, also known as psychedelics, are drugs that change an individual’s perception of their surrounding environment. The physical sensations—such as sight, sound, and touch—may be experienced as unreal, dreamlike, or even frightening.33 Hallucinogens may also distort:

  • The perception of time.
  • The notion of self (ego).
  • The ability to think rationally.

The original hallucinogenic drugs were derived from plants and fungi or their extracts. Some of these botanically derived substances include psilocybin, which is found in over 200 species of mushrooms, and mescaline, which is derived from the peyote cactus. The original man-made hallucinogenic drug was lysergic acid diethylamide (LSD) in 1938. Since that time, chemists such as David Nichols and Alexander Shulgin (known as the “godfather of ecstasy”) have created hundreds of similar drugs—each with their own range of hallucinogenic effects.

There are 3 main subgroups of hallucinogens:

  • Phenethylamines (mescaline).
  • Tryptamines (psilocybin).
  • Lysergamines (LSD).

Despite their distinct chemical structures, drugs from all three of these groups act on the brain via their interaction with various serotonin (5-HT) receptors—ultimately eliciting quite similar and characteristic effects.34

Common Street Names for Designer Hallucinogens

There are a huge number of different designer hallucinogens available under various names. However, in the past several years, 2 drugs and their derivatives in particular have grabbed the attention of medical and legal professionals with their widespread proliferation on the illicit drug scene.

The first of these is a drug that has the technical name 1-(8-bromobenzo[1,2-b;4,5-b’]difuran-4-yl)-2-aminopropane hydrochloride. This chemical is popularly known as bromo-dragonFLY because its chemical structure resembles an insect. It was first created in 1998 at Purdue University in the laboratory of David Nichols as a tool for brain research. This drug is also called:38

  • ABDF.
  • FLY.
  • DOB-Dragonfly.
  • Spamfly.
  • Placid.
  • B-fly.

The second currently widespread group of designer hallucinogens consists of 2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine and its derivatives, better known as 25C-NBOMe, 25B-NBOMe, and 25I-NBOMe. These drugs are sold on the street as N-bomb, smiles, 25C, 25B, and 25I. Some of these drugs—with reportedly lethal toxicities—are being sold as LSD to unsuspecting users.35

Are Designer Hallucinogens Legal?

Like other “legal highs,” designer hallucinogens fall into a complex and constantly changing legal grey area. Even though these drugs produce similar effects in users, they have very different chemical structures, which means that existing laws and regulations may not cover them. Further confusing the issue, individual states and the federal government can have different laws in place, making possession of some of these chemicals legal in one place, but subject to stiff penalties in another.

Take, for example, the NBOMe group of compounds—made illegal under an emergency ruling by the DEA in late 2013 following the deaths of 19 people from these drugs in the previous year. The drugs were promptly classified under schedule I of the Controlled Substances Act, placing them under the most stringent prohibition with drugs such as heroin and ecstasy.36 However, such emergency controls are in effect for only 2 years, leaving the future legal status of these drugs uncertain.

Recent Research on Designer Hallucinogens

Although synthetic hallucinogens are similar to previously known hallucinogens in that they primarily target 5-HT receptors in the brain, much remains unknown about these compounds, as little scientific study has been conducted on them. None of the designer hallucinogens have undergone controlled human trials, but a small number of animal and human studies have started to shed some light on these drugs.

Experimenters using rats to test bromo-dragonFLY found that it may be as potent as LSD, a drug with an effective dose in humans as low as 30 micrograms—an alarmingly miniscule amount considering its powerful effects.37 Additionally, users have reported that the onset of bromo-dragonFLY effects can be delayed by as much as 6 hours and then last as long as 2 to 3 days.38

An Internet survey of nearly 450 users revealed that NBOMe drugs produced more “negative” effects than either LSD or psilocybin.3 These negative effects include potentially life-threatening toxic reactions , as well as self-harming behaviors.

Such reactions may be especially dangerous in users who mistakenly believe they are taking LSD instead of NBOMes.35 When taken by mouth using blotter paper, NBOMes cause numbness of the tongue and mouth.36 This numbness can serve as a warning sign to those who believe they’ve taken LSD that they’ve taken something else entirely.

What Are the Effects of Designer Hallucinogens?

Designer hallucinogens produce effects similar to other, more conventional psychedelic drugs such as psilocybin and LSD although, depending on the exact drug taken, the duration of these effects can vary considerably. Some of these include:3,33,36

  • Introspection.
  • Euphoria.
  • Acceleration of thought.
  • Time distortion.
  • Increased empathy.
  • Increased energy.
  • Agitation.
  • Severe confusion.
  • Rapid heart rate.
  • Nausea.

Despite these similarities, there are some distinctions between conventional psychedelics and synthetic hallucinogens. Unlike typical hallucinogens, users of NBOMes have reported depersonalization, or the loss of the sense of self,3 an effect more often reported in dissociative drugs, such as ketamine.

Serious Complications

Although there is little experimental data about the toxic effects of synthetic hallucinogens, many severe reactions in users have been reported in the medical literature. Some of the most common of these include:3,38

  • Seizures.
  • Raised body temperature.
  • Kidney failure.
  • Psychosis.
  • Self-harming behavior.
  • Death.

Dependence and Addiction

Though in existence for many years, conventional hallucinogens have not been reported to produce withdrawal symptoms and they are typically seen as having minimal addictive potential, unlike other drugs of abuse.39 This is likely because their effects decline rapidly with frequent use, and they have little effect in the ventral tegmental area of the brain (the “reward center”).7

These facts make it unlikely that synthetic hallucinogens will elicit a progression towards chemical dependence and addiction. These drugs do have some effects and toxicities that distinguish them from conventional psychedelics, however, so it is possible that there is a danger of addiction from using them.

It’s also important to note that while hallucinogens have been shown to have relatively less addictive potential than some of the more classically thought of “drugs of abuse,” such as cocaine and heroin, people may still begin to manifest signs of compulsive drug seeking and using behavior with these substances—compulsions that can have a detrimental impact on an individual’s overall quality of life. One more fact to consider: users of synthetics will also often use them in combination with other more addictive substances and may ultimately be compounding the associated problems of another substance use disorder.

Other Popular Legal Highs—Kratom and Methoxetamine (Opiate and Ketamine Substitutes)

What Are Kratom and Methoxetamine?

Kratom

The term “kratom” technically refers to a group of plants distantly related to coffee and gardenia plants, but in the West, “kratom” is used for one particular, Southeast Asian species of plant—Mitragyna speciosa.

Kratom has a history of use in Thailand and neighboring countries going back hundreds of years, either by eating the leaves or using them to make a tea, and it is used as a stimulant, a painkiller, and a remedy for opiate withdrawal. This plant has now emerged in the United States as a legal high available as chopped leaves for brewing tea or compressed into tablets. It is promoted on various websites as an herbal remedy for pain and self-management of opiate withdrawal.40

Methoxetamine

Methoxetamine is a dissociative drug or dissociative anesthetic, which are a group of drugs that are similar to hallucinogens because they can alter perceptions and cause visual and auditory hallucinations. Dissociative drugs differ from so-called “psychedelic” hallucinogens like LSD and peyote by causing a distinct feeling of detachment, or dissociation, from oneself and the environment.33

Dissociative drugs such as phencyclidine (PCP) and ketamine were originally developed as anesthetics. Historically, recreational abuse of these substances has been commonplace. Consequently, there is a demonstrated demand for ketamine-like designer drugs—like methoxetamine—that are unregulated and perhaps easier to obtain from the illicit market.

Common Street Names for Kratom and Methoxetamine

Kratom

Because kratom is not a controlled substance in the U.S. and is sought by users for specific purposes like pain management, it is most often marketed under this name. Alternative street names listed by the DEA are:41

  • Thang.
  • Kakuam.
  • Thom.
  • Ketum.
  • Biak.

Methoxetamine

Now one of the most widely available designer dissociative drugs, an underground chemist in the United Kingdom claims to have created methoxetamine while trying to develop a safer alternative to ketamine.42 Common street names for this drug include:43

  • MXE.
  • Mexxy.
  • Kmax.
  • Legal ketamine.
  • Roflcoptr.

Brand names of legal highs containing this drug are:

  • Kwasqik.
  • Hypnotic.
  • Panoramix.
  • Lotus.

Are Kratom and Methoxetamine Legal?

As with other classes of designer drugs, the legality of kratom and methoxetamine is highly dependent on specific national or state laws, and legal status can change very quickly as governments and regulatory agencies seek to keep up with the proliferation of these substances.

Kratom is not a controlled substance in the U.S., and so is not subject to drug laws. However, the U.S. Food and Drug Administration (FDA) issued an import alert for kratom directing shipments to be seized due to health risks to users.44

The United Kingdom banned methoxetamine in February 2013. It currently remains unregulated in the U.S., though it is illegal to manufacture, sell, or purchase it for human consumption.7

Recent Research on Kratom and Methoxetamine

Kratom

Pharmacological studies on kratom have shown that there are more than 20 biologically active chemicals in this plant. Several of these bind opioid receptors in the brain, which may explain kratom’s reputed ability to ease opioid withdrawal.40

Methoxetamine has been shown to act in a similar way to other dissociative drugs like PCP and ketamine by blocking NMDA receptors in the brain to produce its effects.45 In a survey of people attending gay-friendly nightclubs in Britain in 2011, 6.4% of those who had ever used “legal highs” reported using methoxetamine at least once,43 and a drug testing company reported that in 2014 methoxetamine was detected in 6% of the samples testing positive for designer drugs.30

What Are the Effects of Kratom and Methoxetamine?

Kratom

Though few scientific studies have been conducted regarding the effects of this plant, user reports confirm that it produces an unusual mix of stimulant and opioid-like effects, though effects depend both on the individual user and the dose taken.40

Low doses produce stimulant effects like increased alertness and energy, though not as strong as amphetamines, while pain reduction, and sedation predominate at higher doses. These effects are reported to be either positive and euphoric, or unpleasant, depending on the individual.

Negative side effects reported in users of kratom include:46

  • Anxiety and irritability.
  • Aggression.
  • Nausea.
  • Constipation.
  • Itching.

Methoxetamine

The self-reported effects of methoxetamine vary significantly, with descriptions from users ranging from “euphoric” to “worst fear” to “near-death experience”.42 In general, the common effects of dissociative drugs include:33

  • Numbness.
  • Disorientation and confusion.
  • Nausea and vomiting.
  • Changes in sensory perceptions.
  • Hallucinations.
  • Feelings of detachment from self and environment.
  • Increase in body temperature and heart rate.
  • Memory loss.

At high doses, or when mixed with other drugs, dangerous and sometimes deadly side effects may occur including:

  • Intense fright or fear.
  • Panic attacks.
  • Cardiac arrhythmias.
  • Seizures.
  • Aggression.
  • Psychosis.
  • Respiratory distress.
  • Death.

There may also be risks from long-term use of these drugs. Regular users of ketamine are known to be at risk of ulcerative cystitis of the bladder, abdominal pain, memory decline, and psychosis.7

Dependence and Addiction

Kratom

The fact that kratom contains opioid-binding chemicals and has opioid-like effects raises the possibility that it may share opioid drugs’ characteristic of being highly addictive.

In Southeast Asia, where there is a much longer history of kratom use, tolerance and addiction are well known and have led to the plant being outlawed in many of these countries.46 More recently reports have surfaced in the West of individuals showing compulsive, heavy use of kratom and tolerance to its effects, suggesting that this drug has a significant potential to cause addiction.40

Methoxetamined

Ketamine and PCP are known to produce dependence and addiction among users. Individuals who use ketamine frequently report binging on the drug, or being unable to stop using it until it is gone.7 Many users of methoxetamine report similar binging experiences, as well feeling a desire to use the drug again as soon as possible.42 Based on this evidence, it is reasonable to consider that the designer dissociative drugs have a similar, significant potential for addiction.

The Rise of “Legal Highs” Online

One major reason for the proliferation of designer drugs and legal highs over the last decade has been their easy availability in retail outlets such as gas stations, head shops, convenience stores, and adult stores; however, the exploitation of the Internet by both sellers and users has arguably been the most important factor behind the rise of these drugs.

Internet sales have become such an important source of drugs, both legal and illegal, that specific federal penalties now exist for drug violations involving this medium.

Among drug consumers, the Internet offers a way to share knowledge and experiences about newly emerging designer drugs, and several surveys have shown that the Internet is the most popular source of information about recreational drugs. Because of this, awareness and demand for new legal highs can spread widely and rapidly. Unfortunately, like Wikipedia and other repositories of crowd-sourced information, this information is often biased and potentially inaccurate.47

Online retail websites have taken advantage of consumer interest in these drugs. It has been found that merely having a readily available and easy-to-use website can instill feelings of safety and trust in potential consumers.48 Additional strategies used by such sites to promote sales include:47

  • Appealing branding and names for products (“Spice”, “Vanilla Sky”, etc.).
  • Periodic discounts and special offers.
  • Use of mainstream payment and shipping methods.
  • Privacy protecting software.

The Internet makes designer drugs easily available and gives the sale of untested and unregulated drugs a veneer of legality and legitimacy, and there are many challenges for regulators in confronting this problem. Websites make identification of drug suppliers difficult and are scattered across international borders. A study in 2014 found 31 unique websites selling “bath salts”. The top 3 countries hosting these sites were the U.S., Germany, and the United Kingdom.48 Faced with these numbers and conflicting laws in differing jurisdictions, these websites are likely to continue selling their questionable products for the foreseeable future.

Warning Signs of Designer Drug Use

Traditional drug testing is of limited use when it comes to designer drugs. The constant influx of novel substances into the market means testing technology always lags behind the most recent crop of designer drugs, and the sheer number of compounds available makes it impossible to devise a test that detects them all. Indeed, the ability to defeat drug testing is one of the most commonly reported reasons that people give for using designer drugs, especially those being supervised by the legal system, like parolees, and members of the military.3

Because drug testing is of limited use, designer drug abuse may first be detected as part of a routine physical and mental status examination. Symptomatology may be used to help support existing clinical suspicion, with signs that include:

  • Raised body temperature.
  • Siezures.
  • Red eyes.
  • Hallucinations.

Other signs indicating possible designer drug use include:

  • The presence of paraphernalia (like pipes or rolling papers).
  • Perfume or cologne (to mask the smell of smoke).
  • Foil packaging for products labelled “not for human consumption”.3

Additionally, heavy designer drug users may start to show signs of substance dependence or addiction. These can include:

  • Sudden change in friends.
  • Loss of interest in previously enjoyable activities.
  • Money problems.
  • Becoming angry when asked about drug use.
  • Difficulties at school or work.

Although labeled “legal,” these drugs are still dangerous. Toxic side effects caused by designer drug use may ultimately require hospitalization or treatment, and addiction to a “legal high” can be just as devastating to a person’s life as being hooked on an illicit drug.

Treatment for Designer Drug Abuse and Addiction

Acute Intoxication

As discussed above, there have been many reports of medical complications in association with designer drug intoxication. Most physical toxic effects of these drugs generally wane within a few days as the drugs leave the user’s body.3

Although temporary, some of these physical effects can be dangerous—or even life-threatening. When in doubt, it will be important to seek medical attention for the affected individual to ensure their safety.

Of the drugs discussed, physical toxicities are most common in situations involving synthetic cannabinoid and cathinone use, and can bring about symptoms such as:13,27

  • Nausea and vomiting.
  • Shortness of breath.
  • Blood pressure instability.
  • Heart rate instability.
  • Sweating and chills.
  • Chest pains.
  • Muscle twitches and spasms.
  • Body temperature fluctuations.

Designer drug use can have serious mental health ramifications—ranging from the short-term (during the acute intoxication phase) through to more serious and long-lasting impact, even when the drug is not being used. A few of these problematic psychiatric effects include:

Sometimes, as with physical toxicities, time is the most important treatment, and keeping users in a safe, quiet environment with medical observation is sufficient. However, in more severe cases, medical intervention with sedative, anti-anxiety, and antipsychotic drugs may be required.3 For the most severe cases, prolonged inpatient treatment is sometimes necessary.

Withdrawal

As with most other drugs of abuse, the sudden discontinuation of designer drugs after a period of regular, heavy use often produces symptoms of withdrawal. Inpatient treatment at a detoxification facility can assist users through this difficult withdrawal period by offering observation and support by medical staff.

Withdrawal from synthetic cannabinoids may result in physical symptoms similar to that experienced by withdrawing marijuana users—such as headaches and vomiting. These symptoms are not life-threatening and can be treated with anti-nausea medications and intravenous fluids.3

Withdrawal from all classes of designer drugs can elicit psychological symptoms seen to arise throughout the detoxification process of many different types of drugs including:

Addiction

Addiction is a disease in which a person compulsively uses a substance despite negative impacts on their life such as losing a job, being arrested, or becoming estranged from friends and family. People who have a designer drug addiction face the same barriers to becoming well as individuals addicted to conventional drugs, including:

  • Difficulty being honest with themselves or others about their problem.
  • Lack of motivation to do something about their addiction.
  • Difficulty overcoming the addiction without outside help.

The treatment of designer drug addiction presents unique difficulties for physicians and mental health professionals for several reasons:3

  • The heterogeneous family of designer drugs encompasses substances with vastly different physical and mental effects, including cannabinoids, stimulants, and hallucinogens.
  • Each individual designer drug has existed for only short periods of time—a few years on average—and has been used by relatively small numbers of people, so there are very little data about the best treatment strategies for each substance.
  • The use of designer drugs is highest among young people and people who use multiple different drugs—both of these groups tend to have less successful outcomes in drug treatment programs than other patients.
  • Many designer drug users have an intermittent, rather than continuous, pattern of use, so they may be less likely to recognize their drug use as a problem.

There are no medications available to treat designer drug addictions, but the most effective treatments are likely to be similar to those used for other types of drug addiction. Treatment of club drug addiction could provide a good template for addressing the needs of a young population using many different drugs.49

Common interventions used in many inpatient and outpatient drug treatment facilities include:

  • Cognitive-behavioral therapy.
  • Group and individual counseling; support group participation.
  • Education—which can include learning new coping mechanisms, as well as relapse prevention strategies.

Following successful completion of a drug treatment program, sober living facilities and peer support (12-Step) groups can continue as effective aftercare measures to help those recovering from designer drug addictions to maintain abstinence and rebuild their lives.

Designer drugs are a relatively new and dangerous phenomenon in society. It is critically important to spread awareness of the dangers of these substances in order allow people make informed decisions about using them, and help those who have developed addictions to get the help they need.

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  29. Karila, L., Megarbane, B., Cottencin, O., & Lejoyeux, M. (2015). Synthetic Cathinones: A New Public Health Problem. Curr Neuropharmacol, 13(1), 12-20.
  30. NMS Labs. (2015). Designer Drugs: The Trends Report.
  31. Brunt, T. M., Poortman, A., Niesink, R. J., & van den Brink, W. (2011). Instability of the ecstasy market and a new kid on the block: mephedrone. J Psychopharmacol, 25(11), 1543-1547.
  32. Aarde, S. M., Huang, P. K., Creehan, K. M., Dickerson, T. J., & Taffe, M. A. (2013). The novel recreational drug 3,4-methylenedioxypyrovalerone (MDPV) is a potent psychomotor stimulant: self-administration and locomotor activity in rats. Neuropharmacology, 71, 130-140.
  33. National Institute on Drug Abuse. (2015). Hallucinogens and Dissociative Drugs.
  34. Nichols, D. E. (2004). Hallucinogens. Pharmacol Ther, 101(2), 131-181.
  35. Suzuki, J., Poklis, J. L., & Poklis, A. (2014). “My friend said it was good LSD”: a suicide attempt following analytically confirmed 25I-NBOMe ingestion. J Psychoactive Drugs, 46(5), 379-382.
  36. Bersani, F. S., Corazza, O., Albano, G., Valeriani, G., Santacroce, R., Bolzan Mariotti Posocco, F., (…) Schifano, F. (2014). 25C-NBOMe: preliminary data on pharmacology, psychoactive effects, and toxicity of a new potent and dangerous hallucinogenic drug. Biomed Res Int, 2014, 734749.
  37. Monte, A. P., Marona-Lewicka, D., Parker, M. A., Wainscott, D. B., Nelson, D. L., & Nichols, D. E. (1996). Dihydrobenzofuran Analogues of Hallucinogens. 3. Models of 4-Substituted (2,5-Dimethoxyphenyl)alkylamine Derivatives with Rigidified Methoxy Groups. J Med Chem, 39(15), 2953-2961.
  38. Coppola, M., & Mondola, R. (2012). Bromo-DragonFly: Chemistry, Pharmacology and Toxicology of a Benzodifuran Derivative Producing LSD-Like Effects. Journal of Addiction Research & Therapy, 3(4), 133.
  39. Luscher, C., & Ungless, M. A. (2006). The mechanistic classification of addictive drugs. PLoS Med, 3(11), e437.
  40. Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. J Am Osteopath Assoc, 112(12), 792-799.
  41. Drug Enforcement Administration. (2013). KRATOM (Mitragyna speciosa korth).
  42. Kjellgren, A., & Jonsson, K. (2013). Methoxetamine (MXE) — A Phenomenological Study of Experiences Induced by a “Legal High” from the Internet. J Psychoactive Drugs, 45(3), 276-286.
  43. Zawilska, J. B. (2014). Methoxetamine–a novel recreational drug with potent hallucinogenic properties. Toxicol Lett, 230(3), 402-407.
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  45. Roth, B. L., Gibbons, S., Arunotayanun, W., Huang, X. P., Setola, V., Treble, R., & Iversen, L. (2013). The ketamine analogue methoxetamine and 3- and 4-methoxy analogues of phencyclidine are high affinity and selective ligands for the glutamate NMDA receptor. PLoS One, 8(3), e59334.
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  47. Corazza, O., Valeriani, G., Bersani, F. S., Corkery, J., Martinotti, G., Bersani, G., & Schifano, F. (2014). “Spice,” “kryptonite,” “black mamba”: an overview of brand names and marketing strategies of novel psychoactive substances on the web. J Psychoactive Drugs, 46(4), 287-294.
  48. Meyers, K., Kaynak, O., Bresani, E., Curtis, B., McNamara, A., Brownfield, K., & Kirby, K. C. (2015). The availability and depiction of synthetic cathinones (bath salts) on the Internet: Do online suppliers employ features to maximize purchases? Int J Drug Policy, 26(7), 670-674.
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Drug Guide for Parents

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 1:

  • 27 million people in the U.S. over age 12 abused illicit drugs during the last month.
  • Nearly 140 million people over age 12 reported using alcohol in the last month.

If you have concerns that your child is abusing substances, you may already be looking for signs of substance abuse like 2:

  • Changes in attendance or performance at work or school.
  • Spending time with new people that use drugs or alcohol.
  • Stealing or selling items to acquire more money.
  • Odd behaviors such as wearing sunglasses inside or long sleeves on a hot day.
  • A decline in physical appearance and hygiene.

These general signs are only the beginning, however. Each substance of abuse has a number of characteristic

These general signs are only the beginning, however. Each substance of abuse has a number of characteristic effects, appearances, smells, and associated paraphernalia that will help you accurately distinguish one drug from another.


Alcohol

Alcohol is the most widely used substance of abuse.

Teenage Alcohol Abuse

What alcohol is: Any beverage that contains the active ingredient ethyl alcohol (also known as ethanol) is commonly referred to as alcohol 4.

Alcohol is the most widely used substance of abuse. Millions of adults have had a drink in the last month, and according to the National Institute on Drug Abuse (NIDA), 58% of high school seniors have abused alcohol in the last year 3.

Adolescents are most likely to begin using alcohol with malt beverages (e.g., coolers, hard lemonades and iced teas, canned ‘rita’ drinks, ‘ice’ drinks) due to their sweeter, more appealing tastes 5.

What alcohol does: Alcohol is a central nervous system (CNS) depressant. Use can produce effects like 5:

  • Feelings of calm and relaxation.
  • Rapidly changing moods.
  • Decreased inhibition.

Someone currently intoxicated from alcohol will show some telltale signs of alcohol abuse including 5:

  • Impaired motor coordination.
  • Slurred speech.

Physical items to note: Paraphernalia to look out for include 5:

  • Empty bottles.
  • Shot glasses.
  • Funnel attached to a long tube (beer bong).
  • Clothing or merchandise advertising alcohol.

What alcohol smells like: Typically, you can smell the alcohol itself on the drinker’s breath; however, as much as 5% of alcohol consumed is excreted from the body in the saliva, urine, or sweat 4. Since alcohol is unchanged in these excretions, someone’s urine or breath might smell of alcohol. Their body odor might also smell of alcohol.

Some alcohol products have no taste, no smell, and no color. Alcohol that doesn’t smell —generally called grain alcohol—can be relatively challenging to identify and more dangerous to consume due to its strength (in many locations, it can be purchased as strong as a 95% alcohol by volume, or 190 proof product) 6.


Marijuana

Teenager Rolling Marijuana Joint

What marijuana is: Marijuana is a psychoactive drug that comes from the leaves, stems, seeds, and flowers of the hemp plant and contains the active chemical THC (tetrahydrocannabinol). Marijuana – sometimes referred to as weed, pot, or grass – is the most widely used illicit substance and second only to alcohol in popularity 1,5. NIDA reports that nearly 35% of 12th graders have used marijuana in the last year 3.

What weed looks like: The marijuana leaf is green and has a distinctive, symmetrical, 5-point shape. The drug is commonly found as a green, brown, or gray mixture of shredded plants. Marijuana resembles other plants that look like weed, including tobacco 5, 8. It is commonly smoked after having been rolled into a cigarette (joint), but it is also sometimes mixed into foods or brewed into a tea 8.

What marijuana does: When consumed, the effects of marijuana will include 5,7,8:

  • Increased hunger.
  • Increased relaxation.
  • Decreased motivation.

Someone currently intoxicated on the substance will display signs such as:

  • Red and bloodshot eyes.
  • Lack of coordination.
  • Acting silly or laughing often.

Physical items to note: Many items are associated with marijuana use, including 5:

  • Rolling papers.
  • Hollow cigar wrappers.
  • Pipes.
  • Bongs.
  • Tweezers or clips (roach clips) to hold a joint.
  • Eye drops to reduce redness.
  • Clothing or jewelry displaying marijuana leaves.

What marijuana smells like: Marijuana smoke will leave a strong odor on someone’s clothes or in the location in which they consumed the weed. The slang term, “skunk,” reflects its strong, unpleasant scent. Marijuana odor can also smell like burning rope or alfalfa 2. Some users will attempt to mask the smell of weed with incense or air fresheners 5.


Heroin

Heroin

What heroin is: Heroin is an illicit opioid drug synthesized from the opiate morphine. Heroin is a potent narcotic and is capable of rapidly producing a strong, addictive high. SAMHSA survey data indicated that in 2015, 400,000 people reported using heroin in the last month 1.

What heroin does: Heroin acts quickly on the brain to produce a sedating and powerfully euphoric high. The effects of heroin use include 5,8:

  • A surge of euphoria called a “rush.”
  • A state of being partially awake and partially asleep—what is sometimes colloquially referred to as “the nods.”
  • Feeling of heaviness in the arms and legs.

Someone abusing heroin may present with a number of signs that include 5,7:

  • Small pupils.
  • Needle marks on arms.
  • Nausea and vomiting.

What heroin looks like: There are a number of forms of heroin available on the street. Frequently, heroin looks like powder that appears in a variety of colors like white, yellow, and brown 5. These powder variations are common on the East Coast 8. Powder heroin can be compacted into pill form or packaged into a balloon 5.

Black tar heroin is another variation commonly found in the western U.S. It is a black, sticky substance that appears like dark pieces of wax 8.

Physical items to note: Heroin use involves a large amount of paraphernalia that differs by method of use. Someone injecting heroin will sometimes have kits that include 2,5:

  • Lighters.
  • Spoons.
  • Syringes.
  • Medicine droppers.
  • String, belt, or elastic cord to tie off the arm.

Other heroin paraphernalia includes 5:

  • Balloons.
  • Needles.
  • Aluminum foil.

What heroin smells like: In its most common forms (white or light brown), heroin has no smell 2. Often, darker brown powder and black tar heroin, however, will smell like vinegar 11. If the substance is smoked, you may notice the black tar heroin smoke smell maintains the vinegar scent.

It’s never too early to find help for your child.
If your child is using drugs, call 1-888-744-0069Who Answers? and find a program now.

Cocaine

Cocaine

What cocaine is: Cocaine is a powerful and addictive substance made from the coca plant. Cocaine is abused by snorting, smoking, or injecting it. This stimulant substance is frequently consumed in binges 8.

What cocaine does: When ingested, cocaine will produce effects that are influenced by the methods of use. Smoking or injecting will result in very rapid, intense effects. Snorting will be slightly slower and less intense but longer-lasting. The effects of cocaine include 8:

  • Excitement.
  • Higher self-esteem.
  • Euphoric rush.

Someone abusing or currently intoxicated on the drug will show signs like 7:

  • Larger pupils.
  • Increased alertness.
  • Insomnia.
  • Erratic or aggressive behavior.

What cocaine looks like: Cocaine is typically found as a white powder. Pure cocaine might be mixed with other substances that change the color from a bright white to a duller variation 8.

What cocaine smells like: There is no noticeable odor to pure or unadulterated cocaine 2.

What crack cocaine is: Cocaine base (or “crack”) is smoked, which creates effects that are very intense but short in duration 8.

What crack cocaine does: Crack cocaine’s effects will be felt just seconds after the substance is smoked. These effects will be similar to those produced by powder cocaine but will be even more intense and come on more quickly 8.

Similarly, many of the signs of crack cocaine abuse will overlap with those of powdered cocaine but differ in intensity. A notable exception will be the “crash” into depression and exhaustion that follows a long binge on crack 8.

What crack looks like: Crack cocaine looks like chunks of a white substance. The pieces will be irregularly shaped and come in many different sizes. Pieces of crack are sometimes called “rocks” due to their size and shape 8.

What crack cocaine smells like: The smell associated with crack will be of smoke or a general burning smell, since the drug is smoked with a small pipe 5.

Physical items to note: Items associated with drugs like crack include 5:

  • Small spoon-shaped tools to sniff.
  • Rolled up dollar bills.
  • Straws.
  • Razor blades to make lines to snort.
  • Small pipe for smoking.
  • Bags, bottles, or vials to hold or transport the drug.


Methamphetamine

Meth in powder form

What methamphetamine is: Methamphetamine is available as a prescription medication called Desoxyn, but it has very limited medical use 8. Illicit meth is extremely potent and is frequently made with pseudoephedrine, an ingredient in cold medicines, and numerous toxins 14. SAMHSA reports that there are about 570,000 people that are currently abusing methamphetamine 1.

What meth does: As a central nervous system (CNS) stimulant, meth is a highly addictive drug that speeds up the body and mind and produces feelings of wakefulness and long periods of energy 8. Meth users will typically go on “runs” because the high caused by the drug is so powerful and rewarding it reduces the desire to eat or sleep 5,8. Other effects of meth will include 5:

  • A rush of euphoria.
  • Mood changes.
  • Heightened libido.

As use continues, the signs of meth abuse will be more prevalent. Methamphetamine can be swallowed, snorted, smoked, or injected. Someone smoking meth may display 5:

  • Restlessness and anxiety.
  • Jerky or spastic movements.
  • Changes in physical appearance like sores on the face and arms or dental decay.

What meth looks like: Meth is seen in many forms including pills, powder, and crystals. The prescription form of methamphetamine, Desoxyn, is a pill, while illicit meth is frequently encountered as a white or off-white powder 8.

What crystal meth is: A variation of methamphetamine is called crystal meth. Crystal meth is named for the larger crystals that are produced when crystal meth is made. Crystal meth is frequently made in homemade “meth labs” using cold medicines for the main ingredient. This form is typically smoked 8.

The effects of crystal meth use will be consistent with powder methamphetamine effects as long as the substances are consumed in the same manner, just as the signs of crystal meth abuse will be similar to other stimulants and include 8:

  • Extreme weight loss.
  • Memory loss.
  • Overheating.

What crystal meth looks like: Crystal meth looks like crystals of different colors including clear, white, yellow, blue, and pink 5,8. The crystals will vary in size, shape, and clarity.

What a meth lab looks like: Meth labs are usually very dangerous, as toxic chemicals are use in the production of meth. Meth labs will be identifiable by the various items required to make crystal meth, including14:

  • Baking dishes.
  • Plastic soda bottles.
  • Funnels.
  • Gloves.
  • Coffee filters.
  • Gas tanks.

Windows may be covered with sheets to conceal the activity inside 14.

What a meth lab smells like: One of the best indicators of a meth lab is the smell from the chemical fumes. You can expect a meth lab to produce an overwhelming smell of chemicals. You might smell 14:

  • Paint thinner.
  • Vinegar.
  • Ammonia/cat urine.
  • Ether.

Strong chemical smells may be retained on the skin or clothing of those who have been in the lab.

Physical items to note: While many items are used to make meth, the paraphernalia needed to consume it will depend largely on the route of administration and included 5:

  • Glass pipes.
  • Metal spoons.
  • Lighters.
  • Syringes
  • Foil shaped into bowls.
  • Razor blades.
  • Straws.


Prescription Painkillers (Opioids)

Painkillers are abused by more than 4 million people in the U.S.

Prescription Painkillers

What prescription painkillers are: Painkillers, or narcotics, are a group of prescription medications designed to relieve pain. These medications are all opioids, which means that, like heroin, they are related to or derived from the opium poppy 8. Opioid painkillers include 7:

  • Fentanyl.
  • Hydrocodone – Vicodin.
  • Oxycodone – OxyContin, Percocet.

These medications are found as pills, tablets, capsules, patches, lozenges, and liquids 7.

What painkillers do: Aside from their ability to relieve pain, prescription opioids can produce a profound sense of well-being. The effects of painkiller use include 8:

  • Reduced perceptions of pain.
  • Drowsiness.
  • A euphoric high.

Painkillers are abused by more than 4 million people in the U.S. 1. Abuse of these medications may lead to opioid addiction and painkiller overdose 7.

You can identify someone under the influence of these medications from signs like 8:

  • Pinpoint pupils.
  • Depressed breathing.
  • Slowed movements.

What prescription opioids look like: The appearance of prescription pain medication will vary greatly depending on the particular substance, brand, dose, and route of administration.

Two of the most widely abused pain medications among high school students are OxyContin and Vicodin 3:

  • OxyContin tablets are round and are manufactured in a variety of colors with “OP” or “OC” stamped on one side and numbers (e.g., 10, 20, 40) stamped on the other side, which corresponds to the dose in milligrams 9.
  • Vicodin tablets are white ovals scored down the middle with “Vicodin” stamped on them 10.

Physical items to note: In addition to being taken orally, many of these medications are abused through nasal insufflation (snorting), or injection 8. Less commonly, they are abused via smoking. Those who abuse these drugs via these alternate routes may possess paraphernalia that corresponds with their preferred method(s) of use.


Benzodiazepines

Benzodiazepines

What benzodiazepines are: Benzodiazepines (benzos) are a group of substances typically prescribed for the treatment of anxiety and panic disorders. They fit into a large group of drugs referred to as sedatives, tranquilizers, or depressants 7.

What benzodiazepines do: Many parents know a lot about the usual drugs of abuse like painkillers, weed, and heroin, but may be left wondering ‘what do benzos like Xanax do?’ As CNS depressants, Xanax and other benzodiazepines work to slow down brain activity to produce a calming effect. Benzo users may experience 8:

  • Feelings of euphoria.
  • Sedation.
  • Slowed breathing.

If someone you love is abusing benzos, you may notice 7:
  • Poor concentration and attention.
  • Slurred speech.
  • Confusion.

These signs may be challenging to differentiate from alcohol abuse.

What benzodiazepines look like: There are many variations of benzos based on their brand name and chemical composition. They are found in pill, capsule, and liquid form 7.

Popular benzos include Xanax (alprazolam), Ativan (lorazepam), and Valium (diazepam):

  • Xanax pills are ovals (football shaped) with “Xanax” and the dose on one side. The other side is scored down the middle. Colors of Xanax will change according to dose. For example, blue football Xanax are the 1 mg version. 12.
  • Ativan looks like small white pentagons.
  • Valium looks like round tablets with “V”s cut out 12.

It is important to note, though, that generic versions of benzos will come in a variety of shapes, colors, and sizes.

Physical items to note: When abused, benzodiazepines are consumed orally or snorted 8. Paraphernalia might include devices to crush and snort the pills like straws or mirrors.

Worried about your child?
Don’t wait to get help. Call 1-888-744-0069Who Answers? now.

Sleeping Pills

Sleeping Pills

What sleeping pills are: “Sleeping pill” is a general term that relates to non-benzodiazepine medications that help someone fall or stay asleep. Sleep aids slow down brain activity to foster relaxation and alleviate insomnia. They include 7:

  • Lunesta.
  • Sonata.
  • Ambien.

What sleeping pills do: Sometimes called “z-drugs” for their chemical names and ability to induce sleep, drugs like Ambien will induce effects like 7,13:

  • Reduced anxiety.
  • Increased drowsiness.
  • Slowed movement.

Signs of prescription sleeping pill abuse are similar across all of the drugs in the class, which include effects similar to those of alcohol intoxication and 7:

  • Slurred speech.
  • Confusion.
  • Poor concentration.

Someone on sleep aids may perform complex behaviors like eating, having sex, or driving while sleeping 13. This can be extremely dangerous for both the user and those around them.

What sleeping pills look like: Since they all have similar effects, accurately identifying the medication by appearance will allow you to differentiate between sleeping pills, benzodiazepines, and alcohol use.

  • Ambien looks like a long oval tablet. One side will have “AMB” followed by the dose stamped into the tablet. The reverse will have a 4-digit number in large font stamped into it. Ambien is found in colors like white and dark pink 12.
  • Lunesta is a round tablet that is either blue or white in color. Lunesta will be blank on one side with a stamp on the back beginning with “S19”
  • Sonata is a two-tone capsule that is either green/dark green or dark green/white, depending on the dose. The name of the drug and the specific dose will be printed in black 18.

Physical items to note: Sleeping pills like Ambien are meant to be consumed orally; however, abusers may also snort the pills. Check for pill bottles and tools used to crush and snort drugs.


Prescription Stimulants

Prescription Stimulants

What prescription stimulants are: Prescription stimulants are medications widely used to treat symptoms of attention-deficit/ hyperactivity disorder (ADHD) and narcolepsy.

There are two main types of prescription stimulants 15:

  • Amphetamines like Adderall, Dexedrine, and Vyvanse.
  • Methylphenidate — brand names: Ritalin and Concerta.

What prescription stimulants do: Despite the differences in name, all prescription stimulants will speed up the processes in the body and brain. Some effects of stimulant drugs include 15:
  • Increased sense of alertness and energy.
  • Hypertension (raised blood pressure).
  • Tachycardia (raised heart rate).

These drugs carry a strong risk of addiction when the medications are misused. Signs of stimulant abuse include 15:
  • Suppressed appetite/weight loss.
  • More frequent and intense anger.
  • Paranoid thoughts or behaviors.

What prescription stimulants look like: Prescription stimulants will all vary in their appearance based on the specific drug and dose.

Dexedrine looks like a two-part capsule that is brown on one side and clear on the other with orange spheres inside. “SB” and the corresponding dose will be printed on the capsule.

Adderall XR will be easier to identify than the standard Adderall. Despite a variety of colors based on the dose, all Adderall XR will appear as a capsule with the name and dose printed on it. Adderall will be a round tablet with “AD” stamped on one side and the dose on the other 19.

Ritalin looks like a white, round tablet with “CIBA” stamped on one side 3,16. The other side is partially scored with a number stamped in the middle 16.

Physical items to note: Since these products are only available with a prescription, any possession without a prescription is a signal of abuse. Also check for tools used to crush and snort the medication.


MDMA/Ecstasy

Ecstasy at Clubs

What MDMA/ecstasy is: Commonly used in dance clubs and parties, ecstasy is a methylated amphetamine substance with both stimulant and hallucinogenic properties 8. Although sometimes used interchangeably, the chemical MDMA is the primary psychoactive substance in ecstasy. Ecstasy may contain other stimulant or hallucinogenic substances as well.

What MDMA/ecstasy does: The effects of ecstasy use include 5:

  • Changed perceptions of colors, touch, and sounds.
  • A feeling of euphoria.
  • A strong need to be physically close to others.

If you child is abusing MDMA, they may demonstrate signs and symptoms like 5:
  • Dilated pupils.
  • Excessive thirst and sweatiness.
  • Being overly alert.

What MDMA/ecstasy looks like: Although the drug can be smoked and injected, ecstasy is most often snorted or swallowed. In some cases, ecstasy tablets may look like brightly colored candies with logos or designs stamped into the sides, possibly with shapes like 4-leaf clovers or words like “SEX” on them8.

Physical items to note: People abusing ecstasy/MDMA may have accessories like 5:

  • Lollipops and pacifiers to counteract the drug’s teeth-grinding effect.
  • Glow sticks.
  • Candies or mints to hide the ecstasy pills amongst.


Inhalants

Inhalants are noteworthy because they are more frequently abused by younger teens, particularly because they are commonly accessible around the house.

Inhalants

What inhalants are: Inhalants encompass a wide variety of products that give off chemical fumes can be inhaled for the purpose of getting high 8. As a class of drugs, inhalants are noteworthy because they are more frequently abused by younger teens (particularly because they are commonly accessible around the house).

What inhalants do: When breathed in, the effects of inhalants will include 5:

  • Euphoria.
  • Numbness.
  • Lightheadedness.

If you child is currently intoxicated, you can look for signs like 5:
  • Watery eyes.
  • Runny nose.
  • Appearing sleepy or disoriented.

What inhalants look like: Many items can be used as inhalants, including 5:
  • Paint.
  • Aerosol cans.
  • Gasoline.

What inhalants smell like: Smell will be a major indicator of inhalant use. The products themselves will have a range of strong, chemical scents, but so will your child. Their skin and clothing will retain the pungent smell long after the substance has been inhaled 5.

Physical items to note: In order to sniff inhalants, your child may use paraphernalia like 5:

  • Old rags.
  • Paper or plastic bags.
  • Balloons.

Their use of inhalants may also be seen from stains on their face, hands, or clothing 5.

As a parent, your goal is to do all you can to prevent or detect substance abuse in your child and other loved ones. If you suspect that anyone you care about has an issue with alcohol or other drugs, call or encourage them to call 1-888-744-0069Who Answers? today to begin the process of addiction treatment. Treatment can help to end use and avoid future risks associated with substance use.


References:

  1. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  2. Oklahoma Bureau of Narcotics and Drugs Control. (n.d.). Drug Abuse and Misuse.
  3. National Institute on Drug Abuse. (2016). Monitoring the Future Study: Trends in Prevalence of Various Drugs.
  4. Department of Health and Aging: Australian Government. (2004). Alcohol and Other Drugs: A Handbook for Health Professionals.
  5. The National Child Traumatic Stress Network. (n.d.). Recognizing Drug Use in Adolescents: A Quick Guide for Caregivers and Adults.
  6. Johns Hopkins University. (2014). JHU Expert Calls Grain Alcohol ‘Incredibly Dangerous’ as Md. Lawmakers Mull Ban.
  7. National Institute on Drug Abuse. (2016). Commonly Abused Drugs Charts.
  8. Drug Enforcement Administration. (2011). Drugs of Abuse.
  9. Drug Enforcement Administration. (n.d.). Image Gallery: OxyContin.
  10. Drug Enforcement Administration. (n.d.). Image Gallery: Narcotics.
  11. Department of Justice. (n.d.). Opioid Fact Sheet.
  12. Drug Enforcement Administration. (n.d.). Image Gallery: Depressants.
  13. Weaver, M. F. (2015). Prescription Sedative Misuse and Abuse. The Yale Journal of Biology and Medicine, 88(3), 247–256.
  14. North Carolina Department of Justice. (n.d.). Signs of a Meth Lab.
  15. National Institute on Drug Abuse for Teens. (2016). Prescription Stimulant Medications (Amphetamines).
  16. Drug Enforcement Administration. (n.d.). Image Gallery: Amphetamines/ Stimulants.
  17. Drugs.com: Pill Identifier. (n.d.). Lunesta.
  18. Drugs.com: Pill Identifier. (n.d.). Sonata.
  19. Drugs.com: Pill Identifier. (n.d.). Adderall.

Effects of Peyote Abuse

Peyote (or mescaline) belongs to a class of drugs known as hallucinogens.

Mescaline is the active hallucinogenic ingredient in peyote, which is a small, spineless cactus 1. The top, or crown, of the peyote cactus has circular-shaped buttons that are cut off and ingested in a variety of ways, such as by chewing them, soaking them in water to produce a psychoactive liquid, grinding them into a fine powder that can be swallowed in capsules, or smoking them with marijuana or tobacco 1. Mescaline can be synthetically derived as well 1. Common street names for peyote or mescaline include “cactus,” “mesc,” “peyote,” and “buttons” 1,2.

Peyote has long been used in religious rituals to connect users with a spiritual entity or deity by detaching them from reality and inducing visions 3. Current users of peyote may do so in a more social or recreational manner, using mescaline to relax, enjoy themselves, or achieve enlightenment 3.

In the United States, peyote and mescaline are listed by the Drug Enforcement Administration (DEA) as Schedule I drugs, meaning they have no currently accepted medical use, a high potential for abuse, and are considered unsafe for use, even under medical supervision 1.


Effects of Peyote on the Brain

Persistent Psychosis

The long-term effects of peyote on the brain are not well-known and are generally rare; however, chronic users may experience persistent psychosis or a condition known as Hallucinogen Persisting Perception Disorder (HPPD) 2,6.

Persistent psychosis is an ongoing series of psychological symptoms, including mood swings, visual disturbances, paranoia, and disorganized thoughts 2.

HPPD occurs after hallucinogen use has stopped, and involves the continued re-experiencing of peyote effects, such as hallucinations, flashes of color, more intense colors, or trails of images around objects in motion 6. These symptoms can cause significant impairment and distress in a user’s life, interfering with functioning at work, school, or in social settings 6.

Peyote has various short-term effects on the brain, similar to the effects of other hallucinogenic drugs, such as LSD or psilocybin (“magic mushrooms”) 1. Peyote is thought to elicit its effects by disrupting neurotransmitter transmission in the parts of the brain that affect mood, thought, and perception 2,4. These effects on the brain can include 1,2:

  • Altered body image or sense of self.
  • Altered perception of time and space.
  • Euphoria.
  • Feelings of anxiety or panic.
  • Feeling relaxed or detached from surroundings.
  • Hallucinations, which can affect any of the senses – visual, auditory, etc.
  • Illusions.
  • Increased intensity of emotions and sensations.
  • Mood swings 5.
  • Paranoia.
  • Spiritual experiences.
  • Synesthesia, or a mix-up of senses, such as hearing colors or seeing sounds.
  • Temporary psychosis.

Drug use often precipitates the development of tolerance, where the brain becomes desensitized to the effects of the drug. This leads to the person requiring more of the drug to attain the desired effects. There is some evidence that hallucinogens, such as peyote, can produce tolerance 2. Another phenomenon, known as cross-tolerance, occurs with many hallucinogenic drugs 2. Taking specific hallucinogens can increase one’s tolerance to different, chemically-similar hallucinogens, such as LSD, mushrooms, and peyote since they work on the same areas of the brain 2.


Effects of Peyote on the Body

Peyote also has a strong effect on the body, similar to other hallucinogenic drugs. These physical effects may include 1,2,4:

  • Dilated pupils.
  • Dry mouth.
  • Flushed skin.
  • Increase in body temperature, which can lead to excessive sweating.
  • Headaches.
  • Increased energy levels.
  • Increase heart rate.
  • Increased blood pressure.
  • Muscle weakness.
  • Impaired motor skills and coordination.
  • Loss of appetite.
  • Nausea or vomiting.
  • Sleep difficulties.

The long-term effects of peyote use on the body are not well-known and require more research. This drug should never be used during pregnancy, as peyote has been linked to abnormalities in developing fetuses 4.


How Long Do Peyote Effects Last?

Peyote, like many other hallucinogens, is a relatively long-acting drug. The effects of peyote can start to be felt between 20 to 90 minutes after ingestion, and can last for up to 12 hours 2,4. Ingesting peyote is known as a “trip,” and the overall experience can be highly unpredictable.

Woman with a bad Peyote trip

The experience and intensity of peyote’s effects are highly impacted by various factors, including the amount of peyote consumed, as well as the user’s 4:

  • Mood.
  • Personality.
  • Surroundings.
  • Expectations of peyote trip.

A good trip can provide enjoyable sensations, mental stimulation, and a feeling of heightened insight, while a “bad trip” can cause horrifying thoughts and emotions, such as anxiety, despair, or fear of loss of control, madness, or death 4.


How Many People Use Peyote?

While substance use in America is monitored through the use of regular surveys, hallucinogens are studied as a class, making it somewhat difficult to tease out data specific to the substance. The category of hallucinogens includes LSD, PCP, peyote, mescaline, psilocybin mushrooms, and MDMA 7.

The following 2014 statistics associated with hallucinogen use were reported 7:

  • Approximately 1.2 million Americans aged 12 or older reported current use of hallucinogens.
  • 322,000 more men than women reported past month hallucinogen use.
  • More than 930,000 people aged 12 or older tried hallucinogens for the first time.
  • About 136,000 Americans between the ages of 12 and 17 reported using hallucinogens.
  • About 502,000 Americans between the ages of 18 and 25 were current hallucinogen users.
  • An estimated 535,000 Americans aged 26 or older reported current hallucinogen use.

References:

  1. Drug Enforcement Administration. (2015). Peyote and mescaline.
  2. National Institute on Drug Abuse. (2016). DrugFacts: Hallucinogens.
  3. National Institute on Drug Abuse. (2015). Why Do People Take Hallucinogenic or Dissociative Drugs?
  4. National Institute on Drug Abuse. (2015). How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT, and Ayahuasca) Affect the Brain and Body?
  5. National Institute on Drug Abuse. (2015). Hallucinogens and dissociative drugs.
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: results from the 2014 national survey on drug use and health. HHS Publication No. SMA 15-4927, NSDUH Series H-50.

What Are Hallucinogens?

Hallucinogens are drugs that alter the user’s thinking processes and perception in a manner that leads to significant distortions of reality 1. These drugs affect one’s perception far differently than many other types of drugs do. To many, the influence of these drugs represents experiences of new and even expanded consciousness and, indeed, some individuals experience synesthesia (mixed sensory experiences, such as seeing sounds or hearing colors). Other common effects produced by these drugs include hallucinations, an altered sense of time, and dissociative experiences (e.g., not feeling connected to one’s body or reality).

Most hallucinogens are classified by the United States Drug Enforcement Administration (DEA) as Schedule I controlled substances, meaning they have no known medicinal uses and have a high potential for abuse and physical or psychological dependence 2. Hundreds of compounds are classified as hallucinogens.

Some of the more common hallucinogens include:

Ketamine is a Schedule III drug and PCP is a Schedule II, due to their previous medical uses, but they are serious drugs of concern nonetheless 2.

While these are not typically major drugs of abuse, in 2014 an estimated 1.2 million individuals over the age of 12 reported using hallucinogens 3. They have been used for a variety of purposes, including religious, stress-relief, recreational, or to reach enlightenment or understanding. These drugs, although not considered to be classically addictive, can lead to severe consequences and impairments.


Types of Hallucinogens

Hallucinogens can be classified into two subcategories: the classic hallucinogens and the dissociative drugs. Classic hallucinogens typically produce visual and auditory hallucinations and may result in an altered sense of time and heightened sensory experiences. Dissociative drugs produce feelings of detachment, such as derealization (the feeling that one is detached from reality or that things are not real) and depersonalization (the feeling that one is detached from one’s own physical body) 4,5.

The classic hallucinogens discussed in this article include:

  • LSD.
  • Psilocybin.
  • Peyote.
  • DMT.

The dissociative drugs discussed in this article include:

  • PCP
  • Ketamine.


LSD

LSD (lysergic acid diethylamide) is a synthetic drug that in small amounts can produce very powerful visual hallucinations and mood alterations 6. LSD was developed in 1938 by chemist Albert Hofmann, who was conducting research with ergot, a fungus, to develop its potential as a circulatory stimulant 7. The fungus had no practical uses for this purpose and it was shelved. Five years later, Hoffman began working with it again and, after accidentally absorbing it through his fingertips, he experienced the drug’s hallucinogenic effects. After experimenting with his colleagues, the drug was marketed as a potential benefit to patients in psychotherapy 7,8.

Most individuals using LSD typically feel euphoric, experience visual hallucinations, and often have very intense moods; however, so-called “bad trips” can occur in individuals, resulting in extreme anxiety (including panic attacks) and significant depression.6,7.

LSD is typically taken as a capsule , liquid, or “blotter paper” that has been dosed with LSD liquid 6. It’s commonly referred to as acid, dots, blotter acid, window pane, and mellow yellow 6. Though a standard dose averages in the mere micro-milligram range, the effects can last up to 12 hours 7,9. LSD was a very popular drug in the 1960s and early 1970s, and its use was partly responsible for the drug culture of that time. LSD faded in popularity over the years, but it may be making a mild comeback. In 2013, 229,000 individuals over the age of 12 admitted to current usage of LSD 10.

LSD use does not appear to result in physical dependence, although tolerance can develop 5. Other potential effects of LSD include 9:

man taking lsd
  • Increased body temperature, heart rate, and blood pressure.
  • Profound sweating.
  • Dizziness.
  • Loss of appetite.
  • Dry mouth.
  • Tremors.
  • Numbness.
  • Impulsiveness.
  • Mood swings.
  • Hallucinations.
  • Distorted thinking.

Long-term LSD use, in rare cases, can lead to Hallucinogen Persisting Perception Disorder, or chronic flashbacks of experiences while on LSD 5. These flashbacks can cause significant impairment or distress in the user’s life and can last for years 5.


Psilocybin

Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) is a hallucinogenic substance that is found in more than 200 types of mushrooms 11,12. These mushrooms are typically found in certain regions of South America, Mexico, and the United States 12. Common street names for mushrooms that contain psilocybin include magic mushrooms, mushrooms, and shrooms 12. The mushrooms are typically eaten, and they are also commonly brewed as a tea 12.

A few effects of eating mushrooms include 9, 12:

  • Relaxation.
  • Spiritual experiences.
  • Hallucinations.
  • Panic.
  • Paranoia.
  • Psychosis.
  • Nausea.
  • Vomiting.

One risk associated with psilocybin use is that of poisoning. Users may misidentify the mushrooms and accidentally ingest poisonous mushrooms, which can result in death 9, 12.


Get help for hallucinogen abuse today

Peyote

Peyote is a small cactus containing the active ingredient, mescaline 13. Mescaline comes from the small protrusions (“buttons”) on the cactus but can also be produced artificially 13. Peyote may be one of the oldest known hallucinogenic drugs. It was used in Mexico by the Aztecs and by certain groups of Native Americans. These groups used it for hallucinogenic and medicinal purposes. Some Native American churches still have the legal right to use peyote in religious services despite its classification by the DEA 14. Others have used mescaline, as well as other hallucinogens, to enhance creativity and promote appreciation of beauty and art 14.

Typically, the peyote cactus buttons are eaten or soaked in water 13. They can also be ground and put in a capsule or smoked with tobacco or marijuana 13. Users tend to experience the psychoactive effects of mescaline within one to two hours after ingestion, and its effects can last up to 12 hours 9. These effects include 9,13:

  • Increased heart rate and body temperature.
  • Vomiting.
  • Flushed skin.
  • Extreme sweating.
  • Coordination problems.
  • Hallucinations.
  • Altered perception and body image.
  • Anxiety.

It’s not likely that individuals using peyote or mescaline will become addicted, but tolerance, as well as cross-tolerance to other hallucinogens, can develop 9. Regular use does not appear to result in the development of physical dependence and withdrawal symptoms are uncommon 9.


DMT

What is Ayahuasca? 

Ayahuasca is a hallucinogenic tea that is usually brewed with a DMT-containing plant. It’s primarily used in South America for religious or healing purposes 15.

DMT (N,N-Dimethyltryptamine) , or “Dimitri,” is a hallucinogenic chemical that occurs naturally in some Amazonian plants, but can also be artificially synthesized. When made in a laboratory, DMT looks like a white, crystalline powder and is most often smoked. The worldwide use of DMT is increasing, as it has a large number of new users compared to other drugs 16.

Small amounts of DMT may occur naturally in the human brain. These trace quantities of DMT are hypothesized to be involved in people’s reports of certain unusual events, such as near-death encounters, mystical experiences, or alien abductions 15.

Unlike many other hallucinogens with relatively long duration of effects, DMT produces an intense but short-lived intoxication 16. Overall, users have not reported many negative adverse or “comedown” effects 15.

The effects of DMT may include 9:

  • Hallucinations.
  • Body and spatial distortions.
  • Changes in awareness and perception.
  • Increased heart rate and blood pressure.
  • Agitation.
  • Severe vomiting (due to ayahuasca tea).

Long-term DMT use doesn’t appear to cause tolerance and there is little evidence surrounding the long-term effects of ayahuasca use. The tea doesn’t appear to cause any lasting physical or mental health problems 15.


PCP

Phencyclidine (PCP) was initially developed as a general anesthetic, but because its use is associated with serious side effects, the dissociative drug is no longer used medicinally. It’s still legal for use in animals but is rarely used in veterinary settings. Pure PCP is white and crystalline in appearance but additives may give it a tan or brown color 17. PCP is commonly taken orally in tablet or capsule form, smoked, snorted as a powder, or injected 17. Street names for PCP include angel dust, animal tranquilizer, and rocket fuel 17. At least 14 types of PCP were sold on the street between the late 1960s and 1990s 18 and many illegal samples contain PCC, a toxic chemical which releases cyanide and can cause poisoning 17.

Although the prevalence of PCP addiction or PCP use disorder is unknown, about 2.5% of the population has reported using PCP at least once in their lives 5.

The effects of PCP vary depending on the dose, but in general, the user will feel effects within 1-5 minutes if the hallucinogen is injected or smoked and within about 30 minutes if taken orally or snorted 17. Intoxication typically lasts about 4-6 hours, and effects may include 5, 17:

vial of pcp
  • Euphoria.
  • Feelings of invulnerability and strength.
  • Disorientation.
  • Distorted sensory perception.
  • Disordered thoughts.
  • Hallucinations and illusions.
  • Violent or bizarre behaviors.
  • Severe anxiety.
  • Amnesia.
  • Paranoia.
  • Numbness or diminished response to pain.
  • Seizures.

The effects of the drug are often enhanced when PCP is mixed with others substances, such as alcohol, stimulants such as cocaine, or depressants including narcotic medications. Mixing PCP with alcohol or other drugs can increase the risk of adverse effects and overdose.

PCP intoxication increases the risk of injuries from assaults, accidents, or falls 5. Chronic PCP use can lead to impairments in cognition, speech, and memory, and these deficits may last for months 5. It’s not uncommon for long-term PCP users to also experience 5, 17:

  • Heart attacks.
  • Respiratory issues.
  • Intracranial hemorrhage (bleeding inside the skull).
  • Rhabdomyolosis (the breakdown of muscle tissue, which can lead to kidney failure).
  • Depression.

Chronic PCP users may develop tolerance and require higher doses of the drug in order to experience desired effects 5. This can be dangerous since higher doses can cause seizures and coma 5.


Ketamine

Ketamine was designed as an anesthetic for both animal and human use, particularly in trauma or emergency situations. Nowadays, ketamine is abused for its dissociative effects and its popularity as a “club drug” is increasing, particularly among young adults and teens 18,20.

Ketamine is usually in a clear liquid or a white powder, the latter of which is placed in plastic bags, capsules, or glass vials 20. The drug can be snorted, smoked, injected, or mixed into drinks 20. It is often used in conjunction with cocaine, methamphetamine, amphetamine, or MDMA (Ecstasy) 20. Users will take ketamine repeatedly in a short period of time to prevent a “come-down” and maintain the psychoactive effects 21.

The “K-Hole”

Ketamine users can reach a level of intoxication known as a “K-hole,” which can be subjectively characterized as an out-of-body or near-death experience, although sometimes with a spiritual component 20,21.

Other slang phrases associated with ketamine intoxication, include “K-land,” which occurs at low doses and is a mellow experience, “Baby food,” in which the person is in a blissful, unmoving state, and “God,” in which the user encounters a higher power 21.

Street names for ketamine include 20:

  • Special K.
  • K.
  • Cat tranquilizer.
  • Kit kat.

The effects of ketamine occur rapidly and may include 20, 21, 22:

  • Sedation.
  • Numbness.
  • Hallucinations.
  • Delirium.
  • Psychosis.
  • Paranoia.
  • Disorientation.
  • Feelings of detachment.
  • Depression.
  • Agitation.
  • Amnesia.
  • Cognitive impairments.
  • Nausea.
  • Muscle stiffness.
  • Heart palpitations.
  • Dizziness.
  • Seizures.

Tolerance to ketamine use develops rapidly and there is evidence of physical dependence in chronic users 21. There are documented cases of withdrawal symptoms in some individuals, but insufficient research exists to support a ketamine withdrawal syndrome 21.


Are Hallucinogens Addictive?

Many people equate the term addiction with the experience of withdrawal symptoms, even though the two are separate issues. Hallucinogen users don’t tend to experience withdrawal symptoms with the cessation of use, due to the fact that these drugs don’t have a high potential for physical dependence. And although hallucinogens aren’t classically addictive, individuals can still suffer from problematic use that impairs their daily lives. Because of the ambiguity surrounding the term “addiction,” it is no longer used clinically in the diagnostic process 5.

Instead, the term substance use disorder is used to signify a psychiatric/psychological disorder that occurs in individuals who experience negative ramifications and issues controlling the use of drugs. The American Psychiatric Association lists specific diagnostic criteria for a hallucinogen use disorder, which encompasses both hallucinogen abuse and negative consequences of use.

Individuals who use these substances for non-medicinal purposes, have issues controlling their use, and experience negative consequences as a result of their use may be diagnosed with a hallucinogen use disorder or phencyclidine use disorder in the case of PCP use.


Find Treatment

If you or someone you love is abusing hallucinogens or other drugs, call 1-888-744-0069Who Answers? to speak to a treatment support specialist about various recovery options.


References

  1. National Institute on Drug Abuse. (2015). Hallucinogens and dissociative drugs.
  2. United States Drug Enforcement Agency. (N. D.). Drug scheduling.
  3. Substance Abuse and Health Care Services Administration. (2015). Behavioral trends in the United States: Results from the 2014 national survey on drug use and health.
  4. Vollenweider, F. X., & Geyer, M. A. (2001). A systems model of altered consciousness: Integrating natural and drug-induced psychoses. Brain Research Bulletin, 56(5), 495-507.
  5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  6. United States Drug Enforcement Agency. (N. D.). Drug fact sheet: LSD.
  7. Lee, M. A., & Shlain, B. (1992). Acid dreams: The complete social history of LSD: The CIA, the sixties, and beyond. New York: Grove Press.
  8. Passie, T., Halpern, J. H., Stichtenoth, D. O., Emrich, H. M., & Hintzen, A. (2008). The pharmacology of lysergic acid diethylamide: a review. CNS Neuroscience & Therapeutics, 14(4), 295-314.
  9. National Institute on Drug Abuse. (2015). How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT, and Ayahuasca) Affect the Brain and Body?
  10. National Institute on Drug Abuse (2015). How Widespread Is the Abuse of Hallucinogens and Dissociative Drugs?
  11. Passie, T., Seifert, J., Schneider, U., & Emrich, H. M. (2002). The pharmacology of psilocybin. Addiction Biology7(4), 357-364.
  12. National Drug Intelligence Center. (N. D). Psilocybin: Fast facts.
  13. United States Drug Enforcement Administration. (N. D.). Drug fact sheet: Peyote.
  14. Korsmeyer, P., & Kranzler, H. R. (2009). Encyclopedia of drugs, alcohol & addictive behavior. New York: Macmillan.
  15. National Institute on Drug Abuse. (2015). Common Hallucinations and Dissociative Drugs.
  16. Winstock, A.R., Kaar, S., Borschmann, R. (2014). Dimethyltryptamine (DMT): prevalence, user characteristics and abuse liability in a large global sample. Journal of Psychopharmacology, 21 (1), 49-54.
  17. National Highway Traffic Safety Administration. (N. D). Phencyclidine.
  18. Morris, H., & Wallach, J. (2014). From PCP to MXE: A comprehensive review of the non?medical use of dissociative drugs. Drug testing and analysis6(7-8), 614-632.
  19. Freese, T. E., Miotto, K., & Reback, C. J. (2002). The effects and consequences of selected club drugs. Journal of Substance Abuse Treatment23(2), 151-156.
  20. United States Drug Enforcement Administration. (N. D.). Drug facts: Ketamine.
  21. Maxwell, J. C. (2015). Implications of Research for Treatment: Ketamine. The Center for Excellence in Drug Epidemiology, 1-4.
  22. National Highway Traffic Safety Administration. Drugs and Human Performance FACT SHEETS – Ketamine.

Date Rape Drugs: It’s Not Just Roofies Anymore

Rape is a serious criminal act, with the potential for severe and lasting repercussions on the victim’s life. Rape involves sexually taking advantage of another person without their consent, and this includes having sex with a person who is incoherent or unconscious. Some perpetrators attempt to facilitate their assault by using substances that incapacitate their victims to varying degrees.

“Date rape” is a term that refers to a person forcing someone that they are socially, romantically, or casually involved with to have sex without consent. Often, this type of rape is conceptualized as a predator first drugging the victim and, next, sexually assaulting them. While this is sometimes the case, date rape more often involves the perpetrator taking advantage of their victim’s chosen insobriety. Perhaps they were out celebrating with friends and had a little too much to drink, or unknowingly mixed certain drugs, rendering themselves incapacitated. In either scenario, the rapist takes advantage of this too-intoxicated state and forever alters the victim’s life.

Regardless of whether the victim chose to ingest a substance or they were unknowingly drugged, it is vital to remember that rape is never the victim’s fault. Consent must be clear, and a lack of a stated “no” or “stop” does not constitute consent. A person who is not sober cannot consent to sex!

Nearly half of all sexual assaults involve alcohol 1, 2, 3, but prevalence estimates for other sedative substances are not well known due to the shorter period of time that these drugs remain in the body. Some substances that are used to incapacitate people are well-known, such as Rohypnol (flunitrazepam), GHB, and ketamine, while others are not as widely recognized (clonazepam, etizolam, and other new substances). It is important to know the potential effects that these substances can have in order to recognize a risky situation and get out.


The Dangers You Know

Some substances used for date rape are relatively well-known. These include:

  • Rohypnol (“roofies”).
  • Ketamine (“special K”).
  • Gamma-Hydroxybutyrate (“GHB”).

These drugs all have similar depressant effects, but each one will affect a person a little differently, especially when combined with alcohol, which is commonly how these drugs are given to a victim (e.g., slipped into a drink).

Rohypnol

Woman dizzy from drinking

Rohypnol (generic name: flunitrazepam) is often referred to by street names such as:

  • Roofies.
  • The Forget Pill.
  • Circles.
  • La Rocha.

Rohypnol is a powerful benzodiazepine that is prescribed in certain countries to treat insomnia 4. In the US, however, this drug is illegal due to its powerful effects and reputation as a date rape drug.

Rohypnol pills are tasteless, odorless, and colorless 4, 5 and easily dissolve in liquid, making it easy for perpetrators to discreetly incapacitate potential victims. Newer versions of the drug have a blue center that can turn a light-colored drink blue, but generic versions may still be colorless in liquids, making them dangerously disguisable.

Taken alone, Rohypnol produces feelings of 4:

  • Sedation.
  • Lessened anxiety.
  • Eased muscle tension.

Effects can begin as early as 30 minutes after ingestion, peaking within 2 hours 5. Even a dose as low as 1 mg can exert its effects for up to 8 hours 5.

When consumed with alcohol, Rohypnol’s effects are enhanced to dangerous levels. Both substances have sedative effects that compound when taken together. Signs of being roofied include extreme drowsiness and even amnesia, meaning the person will not remember what happened during the time they were under the influence, depending on the amount consumed 4.

Ketamine

Ketamine is a potent dissociative anesthetic medication with some hallucinogenic effects 6. It can be obtained in clear liquid and white powder form, both of which mix easily with drinks, though they both have an extreme bitter taste.

The powder may even be cut with other powder substances such as cocaine, MDMA, or amphetamine for snorting and may be added to joints or cigarettes to drug a person without their knowledge. Ketamine is often referred to by the following names:

  • Special K.
  • Vitamin K.
  • Kitty.
  • Kit Kat.
  • Cat Valium.

Ketamine’s effects come on quickly, usually felt within 1-30 minutes of ingestion and lasting about an hour 7. Depending on the dose, effects may range from sedation and pain relief to amnesia and dissociation, wherein the person feels removed from or out of control of her own body 6.

These strong effects contribute to its involvement in date rape, as higher doses of ketamine may render a person unconscious or unable to move.

Gamma-Hydroxybutyric Acid (GHB)

GHB is short for gamma-Hydroxybutyric acid, a central nervous system (CNS) depressant. Xyrem (sodium oxybate) – a prescription drug used to treat a condition known as cataplexy, as well as to manage the excessive daytime sleepiness associated with narcolepsy – is a branded, pharmaceutical form of GHB.

GHB commonly goes by the following names:

  • G.
  • Liquid X.
  • Goop.
  • Scoop.

GHB is produced naturally in the body in small amounts, but it can also be synthesized in a lab 8. Manmade GHB is commonly found online and on the streets and is regularly adulterated with various caustic chemicals used at some point during the process of its illicit production, including sodium hydroxide (e.g., lye – found in some drain cleaners). GHB is sought out by recreational users for its CNS depressant effects (i.e., a sedative, relaxing high that can leave a person drowsy, confused, and amnesic 8.)

GHB is found in both a powder and liquid form, and both dissolve easily in liquid. It is colorless, odorless, and has a slight salty taste that can be masked easily by strong flavors 8. Effects can come on within 10 to 20 minutes, lasting up to 4 hours 9. When combined with alcohol, the depressant effects are enhanced, leading to extreme sedation and memory problems, ultimately leaving a person vulnerable to assault.

What About Alcohol?

Alcohol is a drug that has widespread, prevalent use. Many people enjoy its inhibition-lowering effects, but unfortunately, some people use it to take advantage of others. Almost half of all sexual assaults involve alcohol consumption by either the rapist or the victim 1, 2, 3, but this is not an excuse.

Remember, an intoxicated person cannot consent to sex.


Lesser-Known Dangers

Some substances that predators utilize are not as widely recognized. Etizolam, Clonazepam, and other research chemicals have been increasingly found in cases of rape.

Etizolam

Etizolam (aka “etizzy”) is a tasteless medication related to benzodiazepines that is not approved for medical use in the US. The drug can be obtained in both pill and powder form, and it produces depressant effects including 10:

  • Sedation.
  • Muscle relaxation.
  • Memory loss.

In animal studies it has been found to be up to 10 times more potent than Valium 10. Similar to “roofies,” ketamine, and GHB, etizolam’s effects are enhanced when combined with alcohol, leading to its growing reputation as a date rape drug.

Clonazepam

Clonazepam (trade name: Klonopin) is a benzodiazepine medication, similar to Rohypnol. It is commonly referred to by the names “KPin” or “Pin”).

Clonazepam dissolves very quickly in liquid, and has little to no taste—in fact, it might even taste slightly sweet, which can be easily masked by other strong flavors. Effects include:

  • Extreme drowsiness.
  • Problems with memory.
  • Blurred vision.
  • Loss of coordination.

All of the effects listed above are heightened by co-consumption with alcohol, making it a dangerous substance in the hands of a would-be rapist 11.

“Research Chemicals”

Many substances with similar effects to these date rape drugs are being developed every day. These drugs, sometimes labeled “research chemicals,” are constantly evolving and changing formulations to escape regulation.

These drugs vary widely in formulation but most will produce confusion, disorientation, and memory problems in the drugged individual.


Staying Safe

Rape is never the victim’s fault—the fault lies solely with the perpetrator. However, there are some precautions you can take that may help you stay safe and avoid being drugged:

  • Be aware of the people in the room. This includes being aware of other potential victims and anyone who appears incoherent or unaware of her surroundings. If anyone seems suspicious or predatory, steer clear and pay attention to how close they get to people and drinks. If you find yourself feeling suddenly and severely intoxicated, ask for help from a friend in getting home safely. Likewise, offer help to those who appear to be severely intoxicated and at-risk.
  • Keep track of what substances you and others are using. Along similar lines, avoid taking substances (including drinks) from a person that you do not know. While we do not endorse the illicit use of recreational drugs, if you do find yourself in a situation where drugs have been obtained from someone you don’t k now, you may consider using a testing kit to check the ingredients and ensure that they aren’t lying about what they’re giving you. Certain substance combinations can be especially debilitating, such as benzodiazepines and alcohol, cocaine and ketamine, and many other drug blends with interactive effects. While the best prevention method is not to take any drugs, using a testing kit can help you avoid dangerous drug mixtures and adulterated substances.
  • Always watch your drink! It can be dangerously easy for a predator to slip a drug into someone else’s drink—it only takes one moment of distraction. Even though it can be inconvenient, keeping your drink in hand or in sight is the best way to ensure that nothing goes into it. In addition, never take a drink from a stranger unless you watched it be prepared and brought to you. If someone offers to buy you a drink and you accept, go with them to the bar and grab it yourself rather than trust them to bring it back to you.

Credit: JoeySalads

If you see a person in a dangerous situation, especially if you see someone being drugged, taken advantage of, or assaulted, step in and help them. This can include taking immediate action or even calling for help from police and others nearby. Everyone has to work together to prevent rape, and looking out for one another is the best way to foster a network of safety.


What to Do if You Think You’ve Been Drugged

First take a moment to remind yourself that no matter what happened, it is not your fault.

If you are out on the town and suddenly feel significantly more intoxicated than you believe you should—especially if you’ve been hanging around or talking to a new person—you may want to take cautionary steps to ensure your own safety. If you know that something is not right, tell someone—your friends, the bartender, a bouncer—or even just call a cab to take you home. If you’ve been drugged, you need to get to a safe place as soon as possible or try to make sure someone is looking out for you.

If you do not remember what happened the night before and you suspect that someone may have raped you, first take a moment to remind yourself that no matter what happened, it is not your fault.

Fuzzy memory of the night before and extreme hangover symptoms may indicate that you were drugged. Here are some things that you can ask yourself to give you a better idea of whether or not you were drugged:

  • Do I feel like something happened but I can’t remember?
  • Are there any marks on my body that might indicate sexual assault such as bruises?
  • Are my clothes disheveled?
  • Does it seem like I was feeling stronger effects than would be expected?
  • Was there anyone that gave me an odd or uncomfortable feeling?

A victim of drugged rape may not be aware of what happened until many hours afterward 12. Because many of these drugs process through the body within this timeframe, there may be no way of knowing that drugs were involved. Regardless of whether the substance is cleared from the body or not, it is vital to get care right away by going to a hospital or rape crisis center. If you can, have a trusted friend or family member drive you and bring a change of clothes to the hospital/center because they will take the ones that you woke up in for evidence.

In order to preserve as much potential evidence as possible, do not urinate, shower, wash your hands, brush your teeth, eat, or drink before you go to a hospital or crisis center. This period of time is going to be difficult, as the doctors have to make sure to get all possible evidence they can.

Therapist comforting woman

From the hospital or crisis center, call the police. They will have you run through your memory of what happened, and may want to collect further evidence from the area where you believe the assault happened—even a drinking glass or bodily fluids on the bed can help further the investigation. Be sure to tell the police everything you can, remembering that nothing you did justifies sexual assault.

Once you are out of the hospital, seek comforting support. Counseling and therapy are invaluable resources for those coping with sexual assault. Calling a crisis center or hotline can help you connect with someone who knows how to help victims of rape cope with all the emotions and changes that come from such an experience. The National Sexual Assault Hotline at 1-800-656-HOPE is a great resource for those recovering from sexual assault.

Healing yourself after rape is never easy, but taking all possible steps to ensure that your rapist is caught and convicted and that you have the love, support, and skills training that you need will help you to heal.


Sources:

  1. Abbey, A., Zawacki, T., Buck, P. O., Clinton, A. M., & McAuslan, P. (2004). Sexual assault and alcohol consumption: What do we know about their relationship and what types of research are still needed? Aggression and Violent Behavior, 9. 271–303.
  2. Seto, M. C. & Barbaree, H. E. (1995). The role of alcohol in sexual aggression. Clinical Psychology Review, 15. 545– 66.
  3. Testa M. The impact of men’s alcohol consumption on perpetration of sexual aggression. Clinical Psychology Review. 2002; 22:1239–1263.
  4. Drug Enforcement Administration. Drug Fact Sheet: Rohypnol.
  5. Centre for Addiction and Mental Health. (2003). Do You Know: Rohypnol.
  6. Drug Enforcement Administration. Drug Fact Sheet: Ketamine.
  7. Centre for Addiction and Mental Health. (2012). Do You Know: Ketamine.
  8. Drug Enforcement Administration. Drug Fact Sheet: GHB.
  9. Centre for Addiction and Mental Health. (2003). Do You Know: GHB.
  10. U.S. Department of Justice. (2014). Etizolam. Drug Enforcement Administration: Office of Diversion Control.
  11. U.S. National Library of Medicine. (2010). Clonazepam. National Institute of Health.
  12. Office on Women’s Health. (2012). Date Rape Drugs Fact Sheet. U.S. Department of Health and Human Services.

Risk of Counterfeit and Laced Drugs

Selling counterfeit drugsResults from the 2014 National Survey on Drug Use and Health found that approximately 27 million people aged 12 or older were current illicit drug users. That figure amounts to 1 in every 10 people having used illegal drugs in the past month. With a growing number of people buying and using drugs comes an increase in demand on the illicit drug market. With illegal drug manufacturing in full swing, it can be difficult or even impossible to know what exactly you’re getting.

Drug dealers and online drug retailers may cut, lace, or mix drugs with other substances or adulterants during the production process to increase bulk and dilute purity-keeping costs down and profits up.

Furthermore, some prescription drug users are buying their pills from disreputable online sources and unwittingly receiving fake drugs as a result.

Unknown Purity

When you purchase a drug from a dealer or from the Internet, it is difficult to know:

  • How the drug was produced.
  • Whether the drug was mixed with other substances or adulterants.
  • The environment in which the drug was made.
  • Whether the drug is contaminated.

This dangerous combination of unknowns adds up to enormous unpredictability in drug purity and composition, as well as the effects the substance will produce. Additionally, if you take drugs that are diluted or fake, you may take more to feel the desired effects, which increases your risk of overdose.

The popular party drug, “Molly,” is marketed to consumers as pure ecstasy (MDMA). However, drugs such as Molly are often cut or laced with other substances. When one study looked at hair samples of nightclub/festival-attending young adults in New York City who reported lifetime Molly/MDMA/ecstasy use, they found that only half of the hair samples contained MDMA. Approximately 49%, however, tested positive for butylone and 10% tested positive for methylone, both of which are synthetic cathinones (or “bath salts”). The hair samples showed that 4 of 10 people who reported never having used bath salts or other novel psychoactive substances had, in fact, ingested them.

In the Netherlands, PMMA (paramethoxymethamphetamine)a very potent stimulant designer drug, was being sold under the guise of MDMA. Four people in the UK were thought to have died from taking the drugs (NIDA, 2016).

Impure or counterfeit products are difficult to identify, but their use can result in dire health consequences, including death.

Harm Reduction: Drug Purity Testing Kits

Drug impurities are so common that some companies have created drug-testing kits. These kits allow users to test the purity of their drugs on their own. There are a range of kits available on the market, including:

  • EZ Test.
  • Dancesafe.

The kits do not identify the various ingredients but rather proclaim to indicate the presence or absence of MDMA. The kits are still relatively new, and some argue they are dangerously unreliable. For example, Dr. Adam Winstock of the Global Drug Survey argues that testing kits are not suited to give a 100% accurate reading. Rebecca Murray of the University of Florida in Gainesville told New Scientist that the kits will “create a false sense of security.” The only truly reliable way to test drug purity is via lab testing.


Cutting Drugs with Other Substances

Cocaine powder after falling on the ground

Below are some of the more commonly encountered cutting agents found in popularly abused drugs.

Cocaine may contain:

  • Lidocaine: a local anesthetic with numbing qualities similar to cocaine but none of its stimulant effects.
  • Phenacetin: an analgesic and antipyretic drug similar to acetaminophen; banned by the FDA in 1983 because it increased the risk of certain cancers.
  • Levamisole: an anti-parasitic used on dogs and cattle.

Ecstasy may contain:

  • PMMA or PMA: an illegal psychoactive chemical that can cause eath in high doses.
  • Amphetamines: stimulants that produce effects that resemble those of ecstasy.
  • Synthetic cathinones (including methylone and butylone): drugs that possess amphetamine-like properties.

Other adulterants such as lead, caffeine, and sugar are often added to various drugs. These substances are legal, cheap, and more readily available than other drugs.

Heroin may contain:

  • Phenobarbital: a barbiturate sedative. Inclusion of large doses of this substance can cause severe and sometimes fatal adverse effects such as profound respiratory depression.
  • Quinine: an antimalarial medication that can cause renal failure and visual disturbances. Mimics the “rush” felt by injecting heroin.
  • Clenbuterol: a decongestant and bronchodilator used to manage reactive airway diseases; numerous toxicities (neural, cardiovascular, thyroid, etc.) in high doses.
  • Scopolamine: an anticholinergic medication used to treat motion sickness. It is not easily detectable and can cause sleepiness and euphoria.
  • Fentanyl: an extremely potent opioid painkiller.

Fentanyl: Rise of the Hidden Killer

One of the deadliest drug combinations is heroin and fentanyl. Fentanyl itself is an extremely powerful opioid — 80-100 times stronger than morphine and 25-50 times stronger than heroin.

Recently, emergency departments have seen a surge in the number of visits resulting from heroin cut with fentanyl. According to the Centers for Disease Control (CDC), in Florida, Maryland, Maine, Ohio, Philadelphia and Pennsylvania, public health departments have reported dramatic increases in fentanyl-related seizures and deaths. In 2013, there were 92 unintentional deaths involving fentanyl in Ohio. By 2014, that number rose to 514, representing nearly a 500% increase. In 2016, NIDA issued a warning because fake medications disguised as Norco, Percocet, and Xanax actually contained fentanyl.

The combination of heroin and fentanyl can cause people to stop breathing. The DEA reported that in other parts of the world, labs are manufacturing fentanyl and smuggling them into the U.S. via drug cartels.


Counterfeit Prescription Drugs

Fake or adulterated prescription pills pose a slew of dangers that are impossible to predict.

The World Health Organization (WHO) estimates that 1% of prescription medicines in developed countries are fake. Many counterfeit drugs are sold online, and the FDA warns buyers about the dangers of purchasing prescription medication over the Internet.

Although a website may look legitimate, you do not know where the drugs are coming from or in what conditions they are manufactured. The FDA cites an incident in which people ordered drugs like Ambien, Xanax, Lexapro, and Ativan over the Internet and instead received powerful anti-psychotics. As a result, a number of unsuspecting individuals needed emergency medical treatment.

Furthermore, WHO warns that fake drugs can be difficult to identify – which is the point. Fake drugs usually look like the actual product. The consumption of counterfeit drugs poses a number of health risks because they may contain the wrong ingredient or inaccurate amounts of the ingredients.

Counterfeit prescription drugs may be:

  • Contaminated with adulterants.
  • Packaged in a way that looks convincingly real.
  • Much cheaper than normal.
  • Made with the wrong ingredients.

Fake or adulterated prescription pills pose a slew of dangers that are impossible to predict.


Who’s at Risk?

Blurry image of People in city
Individuals purchasing drugs on the street – whether prescription or illicit – are at serious risk of ingesting impure and adulterated drugs. Many sellers will alter their products for convenience or to cut cost and make more money, or simply because they are attempting to produce the drugs without the proper chemical materials, equipment, or expertise.

Many people who may have purchased drugs in person, however, are now turning to the Internet as a place to buy their desired substances, and this can be risky as well. The Internet is introducing a new way to purchase drugs, and in a recent survey of 100,000 drug buyers, people felt that buying drugs online was safer than buying off the street. Other factors such as low purity product and variable product purity also contributed to their desire to buy online vs. on the street (GDS, 2015).

However, the online availability of a drug does not ensure its safety. Certain websites will sell drugs of questionable legality such as “research chemicals,” with varying ingredients and simply label it “not for human consumption.” Other websites will sell medications with supposed “cyber doctors” who will allow you to buy a drug after filling out a questionnaire.

Any time you take a drug in the absence of a legitimate prescription from a doctor, your health is at risk.

More recently, festivals and concerts have become epicenters of the problem. Individuals are taking drugs from friends or strangers without knowing what is in the drug, resulting in unwanted drug interactions. In fact, substance use and sales of adulterated drugs at music festivals has become such a widespread problem that this documentary was created to raise awareness of the issue.


Prevention

It is nearly impossible to avoid the risk of impurities when purchasing recreational drugs off the street or off the Internet. For those who are abusing illicit drugs, the best means of avoiding potential harm is to get help to stop using. For information on treatment programs, call us at 1-888-744-0069Who Answers?.

If you are looking for prescription medications (and you have a legitimate prescription), make sure to get your medication from a reputable source, such as a trusted doctor. If you have to shop online, the FDA says that consumers should know how to distinguish between safe, legal sources and questionable websites and know how to buy real medicines safely.

The FDA recommends the following strategies to prevent buying impure or counterfeit drugs:

  • Do not purchase prescriptions online without a legitimate prescription.
  • Only visit state-licensed pharmacy websites.
  • Make sure that the pharmacy is located in the United States.
  • Don’t buy from websites that will sell you medications without a prescription.
  • Do not buy from websites that use “cyber doctors” who will give a “prescription” after answering only an online questionnaire.
  • Don’t give any personal information unless you are sure the site will keep your information private.*
  • Use sites that have a licensed pharmacist to answer your questions.

* Be aware that some illegal sites may not protect your personal information such as your name, social security number, credit card information, or medical history. Take your time to protect yourself by looking for the National Association of Boards of Pharmacy’s (NABP) Verified Pharmacy Practice Sites (VIPPS) Seal on the website. The seal indicates that it is a safe Internet pharmacy and meets state licensure requirements.

If you or a loved one is dependent on recreational, prescription, and/or illicit drugs, consider treatment. Research shows that substance dependence is treatable.

Don’t wait to get the help you deserve. You can lead a healthy life that does not include using any type of drug. Give us a call today to learn more about available recovery options and resources. We can help you find a program that will meet your needs.


Sources:

PCP History and Statistics

Silhouette of smoker

“Angel Dust”, “Animal Trank”, “Rocket Fuel” – these are only some of the street names used to reference the drug PCP (Phencyclidine), an infamous hallucinogenic (more specifically a dissociative drug), often sought for it’s ability to create the delusion of supreme strength, euphoria, and enhanced sexual and social abilities.

The National Drug Intelligence Center has estimated that in the US, more than 6 million people 12 years and older have tried PCP at one time in their life.

In a 2013 report, SAMHSA reported that overall emergency room visits related to PCP increased more than 400% between 2005 and 2011.

Today PCP is most commonly found laced with other drugs – specifically marijuana – where the drug was found in 24% of street marijuana samples.

History of PCP

PCP dust

The abbreviated term ‘PCP’ originates from the chemical name—phencyclidine or, more specifically Phenylcylohexyl piperidine. It’s been claimed that the drug’s street name “the peace pill” also contributed to the abbreviation PCP.

PCP was originally marketed as an anesthetic pharmaceutical in the 1950s by Parke, Davis and Company. At that time, the trade name for the drug was Sernyl, and in 1957 it was recommended for and later used in clinical trials on humans. Initially, PCP was used as a surgical anesthetic and later began to be utilized by veterinarians as an animal tranquilizer.

In the beginning, PCP was widely embraced by the medical community because the drug was able to provide effective anesthesia without negative effects to the heart and lungs. However, because of its adverse side effects, including post-operative psychosis, severe anxiety and dysphoria (feeling of unease or general dissatisfaction), the drug was discontinued in 1965. By 1967, the use of PCP was restricted to “veterinary use only” and rapidly gained popularity as an effective animal tranquilizer.

PCP entered the street scene in the 1960s in Haight Ashbury, San Francisco—a district known for being central to the hippie movement, as well as for its culture of psychedelic drug use. PCP is used for its mind-altering effects and can be snorted, swallowed, or smoked. Smoking PCP is the most common method, according to the Drug Enforcement Administration (DEA).

The sale of PCP became illegal in the United States in 1978Today, PCP in classified as a Schedule II substance; drugs under this classification have a high probability for abuse as well as the possibility that the user may become physically or psychologically dependent.

Street Names

Straight PCP

  • Angel dust.
  • Amoeba.
  • Amp.
  • Animal trank.
  • Belladonna.
  • Peace pills.
  • Rocket fuel.
  • Embalming fluid.

Marijuana or Tobacco Cigarettes/PCP Combination

  • Wet.
  • Killer joint.
  • Crystal supergrass.
  • Fry.

PCP and MDMA

  • Elephant flipping.
  • Pikachu.

Statistics on Illicit Use

  • According to the National Survey on Drug Use and Health, 6.1 million individuals in the United States, ages 12+ reported lifetime use of PCP (DHHS, 2011)—that’s 2.4% of all people in this demographic.
  • PCP is predominately used by high school students and young adults (DEA, 2013).
  • There has been a significant increase from an estimated 37,266 to 53,542 PCP related hospital visits between 2008 and 2010 (DEA, 2013).
  • The Drug Abuse Warning Network (DAWN) reported that PCP was most prevalent among African American males ages 21-24.
  • PCP-related emergency room visits increased 400% between 2005 and 2011, with increases seen in both genders.
  • In 2011, males accounted for 69% of PCP-related ER visits, with the largest age group being 24-35 (SAMHSA, 2013).

The Effects of PCP

Classified as a hallucinogen (DEA, 2013), PCP is a glutamatergic NMDA receptor blocker that binds to sites in the brain’s cortex and limbic structures—effecting dopamine, norepinephrine and serotonin release and reuptake (Brenner, et. al, 2014) and inducing a dissociative anesthetic state, which can entail:

  • Sight and sound distortion.
  • Detachment.
  • Sedation.
  • Amnesia.

PCP effects are dose-dependent and also vary by administration route. When smoked, PCP produces effects within 2-5 minutes, and within 30-60 minutes when swallowed. Intoxication can last from 4-8 hours, with some users experience effects for 24-48 hours.

Depressed man holding his head

Low to moderate amounts (1-5 mg), PCP users experience:

  • Feelings of detachment.
  • Slurred speech.
  • Numbness.
  • Loss of coordination, coupled with a sense of strength and invulnerability.

In higher doses, PCP produces:

  • Hallucinations.
  • Catatonic posturing.

Physiologic effects include:

  • Increased blood pressure.
  • Rapid heart rate.
  • Raised temperature.
  • Shallow breathing.

Chronic PCP use can result in:

  • Physical dependence.
  • Cognitive and memory impairment.
  • Speech impairment.
  • Anxiety.
  • Depression,
  • Suicidality.

PCP users may present with disorganized thought processes—including delirium, amnesia, paranoia, and dysphoria.

If you or someone you love is using PCP, it’s important to seek help right away. This powerful drug can have major, devastating effects. Call 1-888-744-0069Who Answers? to speak to someone who can help you find a treatment provider.

The PCP Market

PCP is a water- or alcohol-soluble white crystalline powder when in its pure form. PCP may also be found in other forms including liquid, tablets, or capsules.

It has been reported that the spike in PCP-related cases being reported do not involve pure PCP, but rather PCP mixed with other substances ranging from tobacco, marijuana, and various synthetic drugs including MDMA (Ecstasy). PCP has even been reported being sold disguised as entirely different substances altogether—including the drugs LSD, meth, and even marijuana.

According to the DEA, PCP is sold anywhere from $5-$15 per tablet, $20-$30 per powder gram, and $200-$300 per liquid ounce.

PCP is manufactured relatively inexpensively in clandestine laboratories, primarily in Southern California. Additionally, pharmaceutical-grade PCP is diverted to the illicit market, as the drug is still being manufactured and used in veterinary medicine.

Is PCP Illegal?

In 1978, PCP was changed from a Schedule III to Schedule II drug by the DEA under the Controlled Substances Act. Schedule II drugs, which include cocaine and methamphetamine, are considered to have a high potential for abuse and may lead to dependence (NDIC, 2003).

Legal Penalties
  • Penalty for possession is typically charged under state law, although one can be charged under federal statute for possession of large quantities, manufacture, or distribution across state lines.
  • If convicted in Federal court for possession of 100-999 grams, an individual can be sentenced anywhere from 5-40 years in prison, and may be fined up to $2,000,000.
  • If a crime results in death or serious injury, the sanction can be increased to 20 years to life imprisonment.
  • If convicted of a 2nd offense, sanctions may include 10 years to lifetime imprisonment, a fine up to $4,000,000, or both. If the crime results in death or serious injury, the penalty is life imprisonment.

Is PCP Dangerous?

PCP can be extremely dangerous. Aside from the severe side effects the user is likely to experience, as well as the alarming risk of self-injury, high doses of PCP may actually cause death.

The primary cause of PCP-related fatality was attributed to behavioral disturbances during intoxication that lead to self-injurious behavior and impaired judgment, including self-inflicted injury, extreme physical exertion, or injuries sustained while resisting physical restraints.

Deaths resulting from direct effects of PCP intoxication included:

  • Hyperthermia.
  • Acute renal failure.
  • Rhabdomyolysis (muscle cell death, with breakdown products released into bloodstream).
  • Disseminated intravascular coagulation (blood clotting proteins become overactive).
PCP ED VIsits_DAWN Report

Image Credit: Samhsa DAWN Report, 2013

PCP is one of the scariest and most dangerous illicit drugs. If you have a problem with PCP use, or have someone close to you who does, don’t wait until it’s too late to get help. Dial 1-888-744-0069Who Answers? for more information about your drug abuse treatment options – call today, and get your life back on track.


 

Sources:

  1. Bey, T., & Patel, A. (2007). Phencyclidine Intoxication and Adverse Effects: A Clinical and Pharmacological Review of an Illicit Drug. The California Journal of Emergency Medicine8(1), 9–14.
  2. California Narcotic Officers’ Association (n.d.). THE PCP STORY. Retrieved September 9, 2015, from https://www.cnoa.org/documents/NPCP.pdf
  3. Phencyclidine (PCP). (2013, October 29). Retrieved September 9, 2015, from http://www.cesar.umd.edu/cesar/drugs/pcp.asp
  4. Narconon News (2009). The History of Drug Abuse and Addiction in America part 6 PCP Retrieved from: http://news.narconon.org/history-drug-addiction-pcp-america/http://news.narconon.org/history-drug-addiction-pcp-america/
  5. National Drug Intelligence Center (2013). PCP Fast Facts. Retrieved from: http://www.justice.gov/archive/ndic/pubs4/4440/http://www.justice.gov/archive/ndic/pubs4/4440/
  6. Brenner, S, Corden, T.E., Dribben, W.H., Windle, M.L., & Tucker, J.R. (2014). PCP Toxicity
  7. Department of Health & Human Services (The DAWN Report: Club Drugs, 2002 Update. U.S. Department of Health and Human Services. July 2004. Available at
  8. http://dawninfo.samhsa.gov/old_dawn/pubs_94_02/shortreports/files/DAWN_tdr_club_drugs02.pdf.
  9. Department of Health & Human Services (2011). National Survey on Drug Use and Health Summary: Report of Findings. DHHS. Retrieved from: http://archive.samhsa.gov/data/NSDUH/2k11Results/NSDUHresults2011.htm
  10. Drug Enforcement Agency (2013). Phencyclidine. Drug Enforcement Administration Office of Diversion Control Drug & Chemical Evaluation Section. Retrieved from: http://www.deadiversion.usdoj.gov/drug_chem_info/pcp.pdf
  11. England, D. (n.d.) PCP Possession and Penalties. Criminal Defense Lawyer. NOLO. Retrieved from: http://www.criminaldefenselawyer.com/resources/pcp-possession-and-penalties.htm
  12. Medscape. Retrieved from: http://emedicine.medscape.com/article/1010821-medication
  13. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The DAWN Report: Emergency Department Visits Involving Phencyclidine (PCP). Rockville, MD. Retrieved from: http://www.samhsa.gov/data/sites/default/files/DAWN143/DAWN143/sr143-emergency-phencyclidine-2013.htm

The Effects of PCP Use

drugabuse-shutterstock183268427-man_holding_white_pills-feature_image

What Is PCP?

PCP abbreviation for the powerful, dissociative sedative drug phencyclidine. PCP is found sold on the street in many forms including:

  • White powder.
  • Crystal.
  • Capsules.
  • Tablets.
  • Liquid.

The tablets can be found in multiple colors and, like many illicit substances, are distributed in difficult to determine doses–frequently mixed with other intoxicating substances. The various forms can be swallowed, snorted, or smoked either alone or in combination with other drugs like tobacco, marijuana, and MDMA.

Where Did PCP Come From?

The history of this chemical substance dates back to the 1920s when it was initially developed. In the 1950s, PCP was administered intravenously, as a surgical anesthetic. Due to a number of unwanted side effects, it fell out of favor as a substance with practical medical use. Today, pharmaceutical PCP is only rarely as a veterinary tranquilizer. Currently, the drug continues to be manufactured in small amounts for research and testing, but the majority of the drug is manufactured illegally.

Learn more at our article, PCP History and Statistics.

 


Short-Term Effects

The short-term effects of PCP vary depending on the particular dose taken as well as the route of administration used. As an example – when the drug is smoked – the effects will begin in as few as 2 minutes.

Swallowing the drug slows the absorption and results in the onset of effects delayed until about 30 – 60 minutes.

In either case, the effects may last for as few as 4 hours and as many as 48 hours depending on the amount used.

Like its chemical cousin, ketamine, PCP is a dissociative sedative-anesthetic drug. It has hallucinogenic properties, however–meaning that it is known to produce visual and auditory distortions, as well as perceptual changes. PCP’s dissociative effects can result in an individual feeling detached from themselves or the world around them. While under the influence of PCP, someone might feel temporarily divorced from reality, or that their body is not their own.

Dosage and PCP’s Effects

A low dose of PCP between 1 and 5 mg will lead to symptoms including:

  • Numbness and relaxation.
  • A sense of well-being and euphoria.
  • Problems concentrating.
  • Slurred speech.
  • Loss of motor coordination.
  • Misperceptions of abilities including strength, speed, and invulnerability.
  • Odd, erratic, or unexpected behaviors.

Someone witnessing the effects of PCP use may observe the person staring blankly or showing rapid eye movements. In some cases, the person using PCP will be perfectly still for long periods without responding to stimulation.

A higher dose of PCP can lead to other effects including:

  • Seeing things that are not present.
  • Hearing things that are not there.
  • Delusions of grandeur with inflated sense of importance.
  • Higher blood pressure and heart rate.
  • Breathing problems.
  • Raised body temperature.
  • Anxiety, panic, and feeling extreme worry.


Long-Term Effects

With excessive use of PCP over an extended period of time, the negative effects of PCP become more troublesome, and may persist for periods even when the drug isn’t actively being taken.

They can begin negatively impacting the mental and physical health of the PCP user. These effects include:

drugabuse-shutterstock297080372-woman_depressed

  • Impaired memory.
  • Thinking problems and impaired decision-making abilities.
  • Speech problems.
  • Severe depression with suicidal thoughts.
  • Higher anxiety, paranoia, and isolation.
  • Extreme weight loss.
  • “Flashback” phenomena.
  • Continuous hallucinations and delusional thinking even when not using the substance.

These long-term effects can be quite dangerous; case studies indicate that some of these reported symptoms may persist for as long as a year following last use of PCP.


Is PCP Harmful?

While under the influence of PCP, people are more likely to act aggressively or violently against others or themselves.

Perhaps deservedly so, PCP has developed a very negative reputation based on reports of what can happen to those under the influence of the drug. People are more likely to act aggressively or violently against others or themselves. The incidence of such behaviors may be more common in people with a history of mental health issues.

People using PCP often overestimate their abilities or think themselves impervious to harm, which can lead to accidental injuries and death. For example, someone will think they can cross a street quickly enough to avoid the traffic, only to be hit by a car.

While using PCP, people may misinterpret and distort calm situations as confrontational and respond with violence, and since they are perceiving pain inaccurately, the violence could end with serious physical injuries.

Another level of danger from PCP is that the substance is easily mixed with other drugs like marijuana or tobacco. In powder form, PCP can be used to “lace” marijuana or tobacco prior to being smoked. Similarly, a cigarette can be dipped into liquid PCP to produce a more covert way of using the drug.

Some people – intent on purchasing ecstasy or MDMA – are deceived, and instead given pills that combine PCP and other substances including ketamine, caffeine, or methamphetamine.


Dependence

Like many drugs with sedating or tranquilizing properties, PCP can be an addictive substance. People that use PCP consistently will begin craving the drug and will likely engage in risky, dangerous, or illegal behaviors to acquire and use more of the substance.

Physiologic dependency becomes an issue with extended PCP use. When dependency develops, the user’s body has grown accustomed to the effects of the drug, and will function or will be perceived by the dependent individual to function sub-optimally without it.


PCP Addiction Treatment

There are a number of options that can benefit someone struggling with an addiction to PCP. Seeking professional advice is always the appropriate course of action if you, or someone you know, is negatively impacted by abuse of PCP.

Depending on your situation, a range of treatments can be helpful including:

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  • Inpatient detoxification or rehabilitation services. After the immediate presence and influence of the drug relinquishes its hold, inpatient or residential programs continue seamless transition into a mode of intensive therapy. Furthermore, the inpatient environment allows individuals to focus sole attention towards their recoveries–free of the distractions and temptations they might contend with in their native environment. A combination of individual and group therapies will aid in this process. During your stay, you may see a doctor that can prescribe helpful medication to manage withdrawal symptoms to increase your chance of success.
  • Outpatient drug and alcohol or mental health treatment. If the inpatient path is not best for you, you can find benefit in the outpatient setting. As opposed to inpatient, where you will stay at the treatment facility, outpatient services permit you to sleep at home. Programs will vary with options ranging from intensive, all-day programs to weekly hour-long appointments.

Whatever your situation, be sure to follow the treatment recommendations of the professionals to help ensure that you get the level of care that fits with your needs.


Sources:

  1. Drug Enforcement Administration. (2013). Phencyclidine.
  2. National Institute on Drug Abuse. (2014). Hallucinogens.