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Raves & Party Drugs:
Is It All Ecstasy?
Pierre-Paul Tellier, MD
Associate Professor
Family Medicine
Director Student Health
McGill University
Marie-Elaine Delvin, BSc N
Nursing Coordinator
Student Health
McGill University
Table of Contents
Section 1: Description of Party Drugs.
1) Ecstasty – MDMA
2) GHB
3) Ketamine
4) Cocaine
5) Methamphetamines
6) Stimulants
7) Designer Drugs
8) Hallucinogens
9) Marijuana
10) Depressants/Tranquilizers
11) Inhalants
12) Others
Section 2: Annotated Bibliography
Section 3: Useful Websites
Section 4: Educational Resources
Section 1:
Description of Party Drugs
Party Drugs – Major Drugs of Use
Ecstasy – MDMA – 3,4 methylene-dioxy-N-methylamphetamine
Names: X, E, XTC, Adam
Desired effect: “strengthens” the ego, softens defensiveness and gently removes obstacles to communications (1)
History/Pharmacology: amphetamine analog first synthesized in Germany by Merck in 1912. Human
experimentation has only been traced back to early 1970s (4 ). It was criminalized in the USA 1985 (4.) Most of
what is sold as ecstasy is not MDMA. It may be MDA, MDEA, LSD, amphetamines, caffeine, heroin, “China
White”, lactose. Therefore a trip may last from six to 24 hours. May be taken in combination with amphetamines
or LSD (candyflipping) as well as cocaine and for coming down, cannabis
or alcohol and sometimes Ketamine or GHB. The stimulant effects of MDMA may mask the sedative effects of
alcohol or opiates thus leading to overdose of the latter. Alcohol by increasing diuresis may increase the risk of
dehydration.
Presentation: a white crystalline powder which maybe buffered and pressed into pills (1)
Dose/absorption/metabolism: The average dose is between 125mg to 180mg depending on weight of the person. It
may be taken orally, placed under the tongue or in juice or carbonated liquid, may be taken nasally. It causes the
release of serotonin and dopamine in the brain. Serotonin is released normally to create the mood for situations such
as being in love, and dopamine is released to suppress pain in situation where we are hurt but have to carry on.
Some of the neurotransmitters released by MDMA help control the regulation of body temperatures and thus allow
us to overheat without discomfort. (5) MDMA is metabolized in the liver in large part into MDA which in turn is
excreted in the urine. The half life of MDMA is six hours. Response is idiosyncratic, different individuals will
respond differently some being very sensitive others less so. The intensity of the responds may be due to variations
in metabolism or to psychological factors. Booster dose often taken at about an hour to prolong the experience
Stages of a typical session:
Coming on: the transition to a peak of an MDMA experience happens very rapidly – about 30 to 45 seconds
after the substance is taken on an empty stomach. The duration of the “rush” is between 15 to 30 minutes,
followed by a gradual descent back to normal consciousness. There dawns a sudden clarity and
intensification of experiencing. Outwardly, everything seems brighter and crisper. Inwardly, there is a
feeling of ecstasy and utter happiness. Everything is perfect just as it is; everybody is lovable just as they
are. This is when the booster dose is usually taken. Booster doses increase the negative effects of coming
down and this seems to worsen with increase use. “Bubble Bursting” occurs when there is a build up of
psychic tension, trepidation, stomach tightness, panic and/or mild nausea instead of the described rush.
Plateau: one half hour to 3 hours after the initial effect, leveling off of experience after the initial rush, less
intense feelings than during coming on period, coordination or movements are not impaired. During this
time some young people find various forms of movements extremely pleasurable which lead to long-lasting
ecstatic states achieved through “trance dancing”.
Coming down: 3 to 6 hours after initial effect, psychological effects shuts, can take up to 6 to 7 hours to fall
asleep and there can be disappointment and other negative emotions at this time. (1)
There are some residual effects for one to two days after, usually sluggishness.
Psychological effects: It produces empathy, openness, peace and caring. It caused altered time perception
(speeded up or slowed down), increased ability to interact with or be open with others, decreased defensiveness,
decreased fear, (5) It does not cause hallucinations in normal doses and does not disrupt “ego-integrity”, coordination
remains intact and no disorganization of the thought process occurs. (1) Ecstasy makes sexual experiences more
sensual, affect capacity to obtain an erection and to reach orgasm for both men and women. Other effects can
include confusion, depression, sleep problems, drug craving, severe anxiety, paranoia, psychotic episodes.
Judgment is impaired, problems with arithmetic and there are conflicting reports of memory loss. (5) Long term it
may lead to depletion or decrease in serotonin production in the brain which may be linked to depression and
memory impairment. (29) The use of MDMA is usually followed by a state of depression a few days later,
“Tuesday Blues”. This is accompanied by impaired attentional function. (44)
Physical effects: mild rise in blood pressure and heart rate for up to 11/2 hours, talkativeness, jaw-clenching,
nystagmus, muscle tension, nausea, decrease appetite. Occasionally, also reported, difficulty in walking, chills,
sweating, biting the inside of the cheek, headache, fainting, and vomiting. (1). There is also decrease appetite, more
long term, weight loss and in women irregular periods and amenorhea. Ecstasy may inhibit orgasm and prevent
erection in some men. Intoxication with MDMA may lead to hyperthermia, malignant hyperthermia,
rhabdomyelisis, disseminated intravascular coagulopathy, acute renal failure, seizures, arrhythmias, intracranial
hemorrhage, brain infarction and death (3) (35). In cases of intoxication intubation may be difficult because of
trismus thus resulting in the need for tracheostomy. (35) Many of these side effects are described as part of the
Serotonin syndrome.(55) Some cases of jaundice and hepatomegaly have been linked to the use of MDMA. ( 53)
Dehydration may be indicated by failure to sweat, heat cramps in the legs, arms and back, giddyness, headache,
fatigue, vomiting, fainting, suddenly feeling tired and irritable, urinating small amounts but having urgency,
concentrated urine. (51)
Long term impact: difficult to determine. Known to cause destruction of some neurons but the significance of this is
unknown. Saunders in his book published in 1995 reviewed the literature and concluded that there is no indication
that this neurotoxicity leads to behavioral changes or functional changes (5.) However more recent studies indicate
some impairment of memory secondary to chronic MDMA use. (88,89,95)
Contraindications: heart disease, hypertension, epilepsy, MAO inhibitors (including harmaline and ayahuasca
hallucinogenic plants which are MAOIs (73)), pregnancy, hyperthyroidism, diabetes mellitus, hypoglycemia,
glaucoma, diminished liver functions. (1)
Interactions between ritonavir and MDMA may lead to a two to three fold increase in amphetamine levels because
enzymes that metabolize amphetamines are inhibited by ritonavir. Theoretically there is the same effect with other
protease inhibitors such as indinavir, saquinavir and nelfinavir. (65) Other drugs that inhibit these same enzymes
include codeine and dextrometorphan.
Synergies: synergistics with most psychedelics, e.g. LSD and 2 – CB, may be dangerous when taken with cocaine.
Effects are diminished by alcohol or marijuana (1).
MDA 3,4-methylenedioxyamphetamine (29)
Name: Love pill, love drug, speed for lovers
Psychological/Physical effects: Similar to above but more toxic and stimulating
Has greater hallucinogenic effects.
May cause cardiac arrhythmias. (56)
Destroys serotonin-producing neurons, which play a direct role in regulating aggression, mood, sexual activity, sleep
and sensitivity to pain. It is probably this action on the serotonin system which gives MDA its purported properties
of heightened sexual experience, tranquility, and conviviality. (4)
GHB – Gamma Hydroxybutyrate (10)
Names: Liquid Ecstasy, Easy lay, grievous bodily harm, cherry meth, gook, gamma 10, liquid X, liquid G, liquid E.
Desired effects: Used to produce euphoria, disinhibition, sexual enhancing effects without an appreciable
hangover (57)
History/pharmacology: Developed as an adjunct to anaesthesia, however, there were problems in that patient’s
reaction were unpredictable. A given dose in one patient could completely anaesthetize him whereas the same dose
may have very little effect on another. GHB mediates sleep cycles, temperature regulation, cerebral glucose
metabolism and blood flow, memory and emotional control. (59)
Made a Schedule 1 drug in 2000.
Presentation: orally as a capsule or as a powder which may be dissolved in liquid. Usually sold as a salty, clear
liquid in small bottles and taken by the capful. The concentration may vary and the amount taken at one time also,
therefore reaction is unpredictable.
Absorption and metabolism: When taken orally the onset of action is within 15 minutes to an hour and lasts from one
to three hours. The elimination half-life is 27 minutes and the primary route of elimination is expired breath as
carbon dioxide. (59) While the patient is intoxicated with GHB and apneic he or she may have episodes of violent
agitation so physical stimulation must be kept at minimum. ( 58) As the patient recovers they have an emergence
phenomenon which is characterized by myoclonic jerking, transient confusion, and combativeness. Emergence and
recovery of consciousness usually occur rapidly. (57) The effect is potentiated by alcohol. Used as a intoxicating
agent or to come down from ephedrine, ecstasy, speed or cocaine.
Psychological/physical effects: delusions, depression, altered mental status.(57) Physical effects include
mydriasis, or miosis, inconsistent pupil response, visual disturbances, myoclonus, agitation, bradycardia,
hypotension, nausea, vomiting, vertigo, respiratory distress, transient metabolic acidosis, loss of airway reflexes,
loss of consciousness, amnesia, coma (3). Mentally altered mental status (57)
Contraindications: Severe illness of any kind, seizures, heart problems, bradycardia, hypertension,
hyperprolactinemia, cushing’s syndrome
Potentiation: by alcohol, ketamine, benzodiazepines, major tranquilizers, opiates and derivatives, anticonvulsants
and over-the-counter cold medicine and sleep medication. All these can potentiate the effects and lead to further
respiratory depression. Methamphetamines can increase chance of seizures.
GBL Gamma butyrolactone
Names: Blue nitro, Gamma-G, renewtrient, reviverent, GHR
History/pharmacology: Like for GHB thought to help build muscle mass (3) an organic solvent used for
cleaning circuit boards, stripping paint and flavoring soy products.
May be made into GHB with home kits by mixing with sodium hydroxide or is metabolized in the liver to GHB (3)
Psychological/Physical effects: As per GHB but slower in onset and longer in duration. Side effects:
respiratory depression and cardiac dysrythmia (3)
Similar products to GBL are 1,4 butanediol found in Thunder Nectar, Revitalize Plus, Serenity, Enliven, GHRE,
SomatoPro, NRG3 and Weight Belt Clearner. Other precursors to GHB also include tetramethylene glycol, 2(3H)furanone di-hydro
Ketamine (10)(22)(23)
Names: Special K, Vitamin K, New Ecstasy, Psychedelic Heroin, Ketalar, ketaject, super K
Desired effects: relaxed feeling with hallucinations and visual distortions
History/pharmacology: An anaesthetic agent used primarily in veterinary medicine and pediatrics.
May be mixed with several other drugs including:: heroin, cocaine and ecstasy
The mode of use is orally or intravenously as a liquid, white powder that is snorted, taken orally or smoked with
marijuana or tobacco. This powder can be made from the liquid by gentle boiling on a stove or in the microwave.
Ketamine can also be injected intramuscularly and intravenously. The effects may be wide ranging and variable
with the same amount. Intramuscularly the effect is felt within two minutes, orally in 15-20 minutes and less if on
an empty stomach, nasally 5-10 minutes. When taken intranasally the dose will be repeated every 5 minutes until
desired effect. If the person enters a “k-hole” they may be semi-conscious for up to an hour, after that the effect
will continue for 2-3 hours with some residual symptoms for up to 24 hours. “CK” is a combination of Ketamine
and cocaine. Dangerous interactions can occur with alcohol, barbiturates, valium because they are all respiratory
depressant.
Psychological/physical effects: hallucinations and visual distortions ( K-land)
Low dose produce a floppy relaxed feeling, higher doses produces dissociation, near death experience and insights
(K-Hole), loss of sense of time, and identity, depression, recurrent flashbacks, delirium, amnesia, impaired motor
function, high blood pressure, increased heart rate and cardiac output, respiratory problems, bronchodilation,
pupillary dilation, nausea. The user may become cold from inactivity. It stops the user from feeling pain leading to
the user to cause unwitting injuries to him or herself (50)
Neuroleptic drugs are ineffective in controlling unpleasant mental side effects once they have started. (54)
Long term effects: not determined but may cause some brain damage all studies indicating this until now have been
done on animals. These effects may be compounded by yohimbine, major tranquilizers and anticholinergics. Other
authors claim that ketamine is protective against brain damage (85)
The risk of seizures may be compounded when other substances including some antibiotcs, e.g. ofloxacin,
anticholinergics, antipsychotics, bupropion (wellbutrin and Zyban), caffeine, GHB. (84)
Contraindications: Cardiovascular accidents, hypertension, cardiac problems
Potentiation: other depressants such as alcohol, barbiturates, valium, GHB, opiates
Methamphetamines (5) (9) (16)
Names: Ice, crystal meth, speed, tweak, crank, glass
Desired effect: Acts to release high levels of the neurotransmitter dopamine which stimulates brain cells,
enhancing mood and body movement.
History/Pharmacology:
Dose/absorption/metabolism
White powder which when heated gives off a vapor which is inhaled, can also be taken orally, intranasally rectally or
intravenously. After smoking or using intravenously the users experience a “rush” which is an intense, extremely
pleasurable sensation lasting a few minutes. Intransal and oral use does not produce this “rush” but produces a
“high”. Snorting produces effects withing 3 to 5 minutes, oral ingestion within 15- 20 minutes. (48) Lasts up to 24
hours.
Psychological/physical effects: wakefulness, increased physical activity, decreased appetite, euphoria,
irritability, insomnia, confusion, hallucinations, anxiety, paranoia, psychosis which may be long lasting,
aggressiveness. Physical effects include headaches, pallor, mydriasis, sensation of piloerection in the head,
coldness of the upper and lower extremities due to vasoconstriction, increased viscosity of saliva, a dry mouth,
hyperreflexia, tremors, increased heart rate and blood pressure, chest pain, palpitations, atrial and ventricular
arrhythmias, cardiomyopathy, irreversible damage to blood vessels in the brain producing strokes, increased
respirations, respiratory problems such as dyspnea and wheezing, irregular heartbeat, extreme anorexia, hypethermia,
convulsions, and death. (16)(47) (56) A rebound phenomenon develops accompanied by weakness, fatigue and
depression. (56) Increases and decreases in sexual desire and activity have been reported. (68)
Is addictive.
Methamphetamine has been shown by Chicago researchers to cause degeneration of neurons containing the
neurotransmitter dopamine. Damage of these neurons is the underlying cause of the motor disturbances seen in
Parkinson’s disease.
Strong relationship between use of methamphetamines and HIV in gay males. (47)
Contraindications: As per MDMA, heart disease, hypertension, epilepsy, MAO inhibitors (including
harmaline and ayahuasca hallucinogenic plants which are MAOIs (73)), pregnancy, hyperthyroidism, diabetes
mellitus, hypoglycemia, glaucoma, diminished liver functions. (1)
Interactions between ritonavir and methamphetamines leading to a two to three fold increase in amphetamine levels
because enzymes that metabolize amphetamines are inhibited by ritonavir. Theoretically there is the same effect
with other protease inhibitors such as indinavir, saquinavir and nelfinavir. (65)
Agitation should be controlled using haloperidol, diazepam can be used to control behavioural and seizures
Hypertension is best managed using IV labetolol and esmolol (68)
Amphetamines (5)
Names: Speed, whizz, billy
Desired effects: emotional disinhibition, increased self-worth, reduction of communication barriers, feeling of
greater energy, euphoria,
History/Pharmacology: Method of ingestion snorted, dabbed with a finger onto the gums, added to a drink or
injected. Duration is 8 hours
Psysical/psychological effects: emotional disinhibition, increased self-worth, reduction of communication
barriers, feeling of greater energy, euphoria, psychosis, paranoia, lack of appetite. Overdose results in feeling
irritable and violent.
Physical effects include: dry mouth, nausea, vomiting, difficult micturition, sweating, reduced need to sleep, visual
and auditory hallucinations, formication, restlessness, irritability, nervousness, clouding of consciousness, increase
blood pressure, heart rate and body temperature, chest pain, dysrythmia, seizures, stroke and death ( 64) . Pulmonary
edema can result from smoking of amphetamines. Cause the release of neurotransmitters which cause the body to
overheat without discomfort (5)
Dependence is an issue.
Long term use: neurotoxicity, paranoid psychoses, cardiac and circulatory failure, cerebral hemorrhage, stroke
Contraindications:
Interactions between ritonavir and amphetamines leading to a two to three fold increase in
amphetamine levels because enzymes that metabolize amphetamines are inhibited by ritonavir. Theoretically there
is the same effect with other protease inhibitors such as indinavir, saquinavir and nelfinavir. (65)
Physical dangers as per MDMA and is addictive
Cocaine (5) (7) (8) (20)
Names: Coke, charlie, snow
Desired effect: Induces state of intense euphoria and alertness, increased confidence and strength, heightened
sexual feelings, indifference to concerns and cares. This rapidly changes to despondency, dejection and despair,
which is obviously less desirable.
History/Pharmacology: A stimulant as well as a local anesthetic with potent vasoconstrictor properties.
Can be taken orally, intranasally, intravenously, smoking or inhalation of coca paste, cocaine freebase or “crack”
cocaine (freebase prepared with sodium bicarbonate). When injected in combination with heroin it is called a
“speedball.” Onset is very rapid when smoking or when taken intravenously longer when intranasaly. When snorted
up a nostril duration of effect is half an hour. Cocaine is metabolized by plasma and hepatic esterases, hepatic
damage may lead to higher plasma concentration. The metabolites are excreted in the urine. Cocaine exerts its
effect predominately through CNS excitation, producing a hyperandrenergic state. It inhibits the re-uptake of
nerepinephrine and dopamine from both central and peripheral neurons, and it interacts with the serotonergic system.
(38)
It is of ten combined with many other drugs. When combined with alcohol a metabolite is produced called
cocaethylene. This can lengthen the cocaine-induced euphoria and reduce the unpleasant symptoms of withdrawal,
but increases the possibility of sudden death from cardiovascular, complications, hepatotoxicity, and behaviors
leading to injury.
Psychological/Physical effects:
Psychological: euphoria or affective blunting, changes in sociability, hypervigilance, interpersonal sensitivity,
anxiety, tension, anger, stereotyped behaviors, impaired judgment, impaired social or occupational functioning,
insomnia, labile affect, hallucinations, psychosis.
Physical: tachycardia or bradycardia, pupillary dilatation, nose bleeds, constricted peripheral blood vessels, elevated
or lowered blood pressure, increased temperature, nausea or vomiting, evidence of weight loss, psychomotor
agitation or retardation, muscular weakness, respiratory depression, chest pain, cardiac arrythmias, myocardial
infarction, (43) confusion, dyskinesia, dystonia, coma. In diabetics there is a higher incidence of diabetic
ketoacidosis. Seizure can occur depending on the reports in 1% to 29% of users. Seizures may be more frequent in
people who smoke and inject cocaine. (38) Myocardial infarcts have been reported in cocaine users. The majority
of case reports suggest that the person will present with chest pain. This pain occurs shortly after intake of cocaine.
The pathophysiology of MIs in this population is not entirely clear but may include vasospasm, enhanced
thrombogenicity and platelets aggregation, accelerated atherogenesis in chronic users, increased oxygen demands
and direct myocardial toxicity. Smoking appears to compound these problems. Some cocaine users with MIs may
not demonstrate ECG changes. Management of chest pains in cocaine users should therefore be very conservative
and should include appropriate laboratory analysis, a patient should not be discharged based on the absent of ECG
changes. The patient with an MI should have intravenous access, O2, Apirin, nitroglycerin, thrombolytic agents
when indicated, beta-adrenergics blockade should be avoided since it may compound the vasoconstrictive effects of
cocaine so use calcium channel blockers, and “ caines” for arrythmias should be used judiciously since they may also
compound the cocaine effects. (43) Pneumothorax has also been described and is believed to be due to direct
traumatic effect of the powder. (45) Other vascular problems may include mesenteric ischemia, renal infarction.
Dependence is a problem.
There are also effects which are the result of long term use.
Contraindications: Drug interactions: mono-amine oxidase, tricyclic antidepressants, alpha-methyldopa,
reserpine. The effects of these drugs are potentiated and can cause an adrenergic crisis. Serotonin syndrome when
cocaine is taken with SSRIs (69)
Crack cocaine(5)
Names: Rocks, freebase
Smoked high lasts 10 minutes
Crack lung: a syndrome usually occurring 1-48 hours after heavy cocaine smoking, represents a hypersensitivity
pneumonitis. It consists of the constellation of chest pain, cough with hemoptysis,
Marijuana (17)
Names: pot, herb, weed, boom, mary jane, gangster,
Desired effects: euphoria, laughter, relaxation, time distortion, auditory and visual enhancement
History/pharmacology: Mode of use: smoking, cigarettes, pipe or cigar, eaten or brewed in a tea.
May be mixed with several other drugs purposely or not including crack cocaine, PCP
May be combined with PCP in embalming fluid-soaked marijuana see PCP
Psychological/physical effects:
Phsychological: Low doses: euphoria, laughter, relaxation, time distortion, auditory and visual enhancement,
problems with memory and learning, distorted perception, difficulty thinking and problem-solving, loss of
coordination, High dose: mood fluctuations, depersonalization, hallucinations, toxic doses: anxiety and panic
attacks, delusions, paranoia, psychosis.
Physical: increased appetite, dry mouth, decreased nausea, injected conjunctiva, normal to dilated pupils.
Cardiovascular reaction include increase heart rate. The increase in heart rate and blood pressure and the potential
for heart attack is greatly enhance when combined with cocaine. The effects of these drugs combine on the
circulatory system is greater than when each is used alone. Neurologic findings include normal to increased reflexes,
drowsiness, impaired coordination, tracking and reaction times. Long term use may have effects on learning,
respiratory system, decrease sperm count, gynecomastia and cause amotivational syndrome. (86)
Designer drugs (5), (9)
Originally used to mean compounds that were designed to have the same effect as illicit drugs without being illicit
themselves. However, the term is often used to mean new drugs which have been designed to have particular
effects. (5)
They can be derivatives of amphetamines, phencyclidine, tryptamines, meperidine and fentanyl
Neurotoxins may be formed if the drugs are not manufactured properly leading to problems such as parkinsonism
“designer drug disaster”
Usually they are very strong thus precise dosing is difficult and overdosage can be easy and fatal
Amphetamine derivatives:
Methamphetamine
Dexedrine (dexamphetamine sulfate (5)
Dexys
Tablets with similar effects to amphetamines
Physical effects: high blood pressure
Contraindications: MAO inhibitors, heart disease, hypertension
MDMA See Ectstasy
MDA 3,4-methylenedioxyamphetamine (29)
Love pill, love drug, speed for lovers
Similar to MDMA but more toxic and stimulating
Has greater hallucinogenic effects.
May cause cardiac arrhythmias. (56)
Destroys serotonin-producing neurons, which play a direct role in regulating aggression, mood, sexual activity, sleep
and sensitivity to pain. It is probably this action on the serotonin system which gives MDA its purported properties
of heightened sexual experience, tranquility, and conviviality. (4)
MDE N-ethyl-methylendioxyamphetamine (29)
Eve
Similar to MDMA, different effect, turns subject inwards.
2 – CB (24) (27)
Name: Nexus, N, 4-bromo-2, 5-dimethoxyphenethylamine, phenethylamine analog of DOB (2,5-dimethoxy-4bromoamphetamine,
Mode of use: taken orally the onset is in 45-75 minutes, duration 4-8 hours. May be taken in combination with
MDMA to enhance effects.
Effects: visual hallucination, dissociation, increase body awareness, including skin sensitivity, heightened smell,
taste and sexual stimulation. Increased production of mucus at bottom of trachea leading to coughing. Taking large
doses can lead to panic attacks, nausea, muscle clenching, claustrophobia, trembling, cramps, shallow breathing.
DOB (2,5-dimethoxy-4-bromoamphetamine) (24)
Mode of use: a liquid usually sold in impregnated blotter paper (56)
Duration of effect 18-30 hours
Effects: hallucinations, dissociation
2 – CD 2,5-dimethoxy-4-methylphenethylamine (24)
Duration : 4-6 hours
Effects: Hallucinations
DOM 2,5-dimethoxy-4-methylamphetamine (24)
Duration 14-20 hours
Effect: hallucination, muscle tremors, facial flushing, minor sensory amplification
Tryptamine Derivatives(9)
DMT, DET, DPT
Names: happy pill, love pill
Mode of use: capsules orally
Effects: euphoria, dysphoria, hallucinations, visual distortions, everestimation of one’s own capacities, aggression,
disorientation, motor activity, restlessness, hypersensitivity, fall in blood pressure
Meperidine Derivatives(9)
MPPP, PEPTP
Effects as for morphine and heroin
Fentanyl Derivatives(9) (25)
Short acting analgesic used in induction during anaesthesia.
Derivatives of this compound are called designer drugs. They are extremely potent and have a quick onset. Onset
1-4 minutes, duration 30 to 90 minutes
Effects: respiratory depression, sudden death.
Names : China white, persian white
Mode of use: snorting or IV
Stimulants
This category of drugs are used to give more energy and will allow the partygoer to dance all
night. The side effect profile is similar. Many create dependence.
Amphetamine Derivatives:
These include amphetamine, methamphetamine, dexedrine, MDMA ( Ecstasy), MDA (Love Drug), MDE
(Eve), 2CB, DOM, DOB, 2CD. All of these are previously described in Ecstasy and Designer Drugs.
Methcathinone
Cat, Khat, dqat
A herb (Catha Edulis) that is chewed
Effects: amphetamine like high
Cocaine:
See Cocaine
Ephedrine compounds:
Herbal ecstasy (10)
Ma Hwang of Ephedra or pseudo ephedrine and caffeine (kola nut)
Found in Chinese herbal medication, nutritional supplements, including “Metabolife 356” (3)
300 mg of Ephedra equals 30mg of ephedrine (3)
The amount of caffeine and ephedrine vary widely in the pills
Side effects; Hypertension or hypertensive emergencies (3), seizures, heart attacks, stroke, death
Medication to use: Benzodiazipines for hypertension, nitroprusside for hypertensive crises
Ephedrine
Found in sudafed (pseudoephedrine) and other over the counter medication
Taken orally and effects last 3-4 hours
3 tablets has a similar effect to caffeine or speed
Overdose may cause restlessness, muscle spasms, racing heart, dry throat, cold extremeties
Contraindication for people with cardiac problems
Ritalin (methylphenidate) (14)
Stimulant with effects similar but less potent than amphetamines and more potent than caffeine. It is most potent
when snorted or injected.
May be mixed with heroin or with both cocaine and heroin
Mode of use: pills taken orally or crushed and inhaled or disolved in water for intravenous use.
Effects: nervousness, insomnia, loss of appetite, nausea, vomiting, dizziness, palpitations, headaches, changes in
heart rate and blood pressure ( usually elevation), skin rashes, itching, abdominal pain, weight loss, digestive
problems, toxic psychosis, psychotic episodes, dependence, depression on withdrawal. High doses will cause loss
of appetite, tremors, muscle twitching, fevers, convulsions, headache (severe), irregular heartbeat and respiration,
anxiety, restlessness, paranoia, hallucinations, delusions, excessive repetition of movements and meaningless tasks,
and formication. Death is also possible. Problems can also result from fillers used in the manufacture of pills when
injected or snorted. (63)
Caffeine
Drank as a liquid, pills
Effects: Increased heart rate and blood pressure, and temperature, nervousness, insomnia, decrease appetite,
increased secretion of stomach acid, hand tremor, impaired fine motor movement, headaches, delirium. This
compound is also a diuretic.
Stay awake pills is used by about 20% of the high school seniors and college-age young adults.
Smart Alternatives ( 83)
Comes in bottles, cans, powders or capsules, they contain natural substances, mostly herbal, and vitamins
They generally boost energy levels, increase stamina, refresh, quench thirst, and aid concentration. If isotonic help
replaced fluid lost by sweating and the sugar content helps as well. Most products will contain stimulants.
If taken in too large quantities can result in nausea, loss of appetite, insomnia, increased heart rate, visual and sensory
impairment and discomfort in the bladder and urinary tract.
Most are contraindicated in people who have heart or kidney problems, high/low blood pressure, asthma and
diabetes. Should not be mixed with alcohol.
Common ingredients may include: caffeine, guarana, stimulant similar to caffeine, Ma-Huang, contains epedrine,
ginseng, amino acids, taurine, sugars, tryptophan, vitamins usually high doses of C and Bs
Examples include: Stackers which contains ephedra and caffeine
Go-go drinks: which contain ginseng, yohimbine, guarana ( being marketed as Viagra for women)
Hallucinogens
These compounds are used to produce hallucinations.
The dose is often difficult to titrate and the effects unreliable.
MDMA, MDA, MDE, etc
See Designer Drugs and Ecstasy
Ketamine:
See Ketamine
Dextromethorphan DXM
Names: DMX, Robo, X, DM, DXM
Desired effects: can cause euphoria and mild hallucinations.
History/Pharmacology: Doses ranging from 300 to 18,000mg can cause euphoria and mild hallucinations.
Therapeutic doses 60mg/day in adults and 10-20mg/day in 12 year old. Doses of 20-30 mg/kg can cause seizures
(3)
Physical side effects: lethargy, dizziness, drowsiness, ataxia, lateral nystagmus, mydriasis, palpitations, nausea,
seizures (3)
Medication to use: Naloxone
LSD (9) (10) (18)
Names: Acid, A, microdots, strawberry, trips, 25+, pink Jesus, morning glory, pink dots, the chief, purple wedges
Desired effects: Visual and auditory hallucinations
History/Pharmacology: Liquid taken on blotters, sugar cubes, gelatin sheets
Begin to feel effects in 30 to 90 minutes of ingestion and the “high” may last up to 12 hours. The high can be widely
unpredictable depending on the individual, the environment, etc. The strength is unpredictable and the amount
difficult to titrate since the LSD may be very potent so the duration and intensity of the effects is difficult to predict.
(52)
Physical/psychological effects:
Causes visual and auditory hallucinations, distortions
Low doses enhance sound and lights
Higher doses strong emotional and visual effects
Euphoria, depression, acute panic reactions, visuospatial disorientation
Dilated pupils, increased body temperature, increased heart rate and blood pressure rates, loss of appetite,
sleeplessness, dry mouth, tremors, increased perspiration.
Phencyclidine (9) (15)
Names: PCP, PeaCe pill, rocket fuel, magic dust, DOA, elephant tranquilizer, angel dust, ozone, wack,
Desired effect: euphoria and hallucinations.
History/Pharmacology: Originally an intravenous anesthetic.
Hallucinogenic, anesthetic, stimulant
Mode of use: capsules or tablets orally, occasionally injection as a liquid, powder sniffed or smoked. Onset of
effects is within 2 to 5 minutes with a peak at 15 minutes. The duration of the effects may last from 3 to 18 hours.
PCP is primarily metabolized in the liver. Predominantly affects the central nervous system and the proposed
mechanisms of action include reuptake inhibition of dopamine, norepinephrine, serotonin and GABA. It also acts
directly on blood vessels leading to vasospam (66)
Psychological/Physical effects: Small doses: disinhibition, euphoria, dysphoria and depression, miosis with
nystagmus, slight increase in breathing rate, rise in blood pressure and pulse rate, shallow respiration, flushing,
profuse sweating, generalized numbness of the extremities and incoordination. Larger doses adverse effects on
concentration, psychosis, agitation, hallucinations, paranoia, catatonia, drop in blood pressure, pulse rate, and
respiration, nausea, vomiting, blurred vision, vertical nistagmus, drooling, loss of balance, dizziness, hyperthermia,
seizure, coma and death often resulting from seizures and apnea. Death is a result of accidental overdose or suicide
attempts. Speech is sparse and garbled.
Depending on the dose some of the above may last for days
In adolescents may interfere with hormones related to normal growth and development as well as learning process.
Inability to feel pain which may lead to bodily harm
Hypoglycemia occurs in twenty percent.
Embalming fluid-soaked marijuana (happy sticks, sherm, wet, sheba, takow, illie, dank, therm, clickums, clickers,
hydro, fry, whack, loveboat, boat) believed to contain PCP. Psychosis has been reported with the use of this
combination. (37)
Serum glucose should be determined and treated if present
Chemical and physical restraints may be needed, IV benzodiazepines may be used of IM lorazepam or midazolam.
Hydration is important (67)
Psilocybin (6) (9)
Magic mushrooms, liberty caps, mushies, shrooms
Eaten, stewed and strained then drunk as tea.
May be PCP or LSD
Effects: mild euphoria, strong visual and auditory hallucinations affecting user’s sense of time and space, dysphoria,
paranoia
Hallucinogenic plants: (6)
Peyote cactus: contains mescaline, cacti are cut up and simmered and the juice is drank may last up to 12 hours
San Pedro cactus: contain mescaline, as per peyote but more is needed, can cause nausea and retching
Salvia: available in California, hallucinogenic, smoked in a water pipe cause mild hallucinogenic episodes lasting
up to 30 minutes, longer and milder if leaves are chewed and held against the cheek.
Ayahuasca: also known as caapi, natema, yage. Mixture derived from two plants, the climbing jagube vine which
contains the drug harmaline and leaves from pychotria viridis which contains dimethyl tryptamine (DMT) a powerful
psychedelic. Causes nausea and retching.
Morning glory: seed of some stains contain a close variant of LSD, stomach cramps and nausea likely. Other side
effects include convulsion and gangrene. Commercially available seeds from nursery doused with pesticide. “Gordo
juice” combination of morning glory seeds and fruit juice. (62)
Hawaii Baby Woodrose: seeds contain LSD relatives.
Jimson weed, Angel’s trumpet: a wild poisonous weed can cause death (62)
Tryptamines (9)
See designer drugs.
Nutmeg
Hallucigenic
10-20 grams of fresh nutmeg (2 to 9 whole netmegs).
Mode of use: orally, onset of symptoms withing 3-6 hrs and these resolve within 24 hours.
Effects: nausea, vomiting, dry mouth, abdominal pain, cold extremities, palpitations, weak pulse, shallow
respirations.
Agitation, feeling of impending doom, visual hallucinations,
Depressants/Tranquilizers
These are varied, most can cause dependence. They include alcohol which is the most widely used drug by young
people. Benzodiazepines are also commonly used to come down from stimulants. They are not described here
except for Rohypnol. Others include opiods and their derivatives.
GHB/GBL
Previously described
Ketamine
Previously described
Temazepam
Jellies, wobbly eggs
Capsules or tablets normally swallowed, but may be melted and injected and cause thrombophlebitis when it
solidifies.
Muscle relaxant, sleeping pill
Propoxyphene (9)
A weak narcotic analgesic
Mode of use: orally
Effects: mild euphoria, drowsiness, abdominal pain, delusions, numbness, coma, spasms, pulmonary edema, heart
problems
Methadone (9)
Heroin substitute
Mode of use: Oral, subcutaneous, intramuscular, rectal
Effects: sedation, mood swings, miosis, changes in cognitive and sensory functional ability, central respiratory
depression, nausea, vomiting, headaches, dizziness.
Heroin (9)
Modes of use: intravenously, intramuscularly, subcutaneously (skin-popping), with cocaine IV mixed together
“speed balling”, cocaine in one arm heroin in the other (stereo shooting) , smoking heroin-treated cigarettes,
inhaling the fumes (chasing the dragon), sniffing
Effects: euphoria followed by sedation, slowed comprehension, impaired mentation, decreased reflexes, decreased
temperature, miosis, nausea, vomiting, muscle pain, lacrimation, rhinorrhea, yawning, fever, insomnia, respiratory
paralysis, pulmonary edema, decreased blood pressure, arrythmias, circulatory collapse. Cases of status asthmaticus
have been reported in asthmatics who snorted or smoked heroin. (49)(86) Complications from IV administration
including endocarditis, cellulitis, track marks, phlebitis, pulmonary emboli, hepatitis, HIV.
Morphine
Codeine
Meperidines (9)
MPPP, PEPTP
Effects as for morphine and heroin
Fentanyls (9) (25)
Short acting analgesic used in induction during anaesthesia.
Derivatives of this compound are called designer drugs. They are extremely potent and have a quick onset. Onset
1-4 minutes, duration 30 to 90 minutes
Effects: respiratory depression, sudden death.
Names : China white, persian white
Mode of use: snorting or IV
Rohypnol (flunitrazepam) (10)
Names: roach, Roche, roofies, Run-Trip-and-Fall, R-2, Mexican Valium, Ropynol, Rib, Rope
A benzodiazepine ten times stronger than Valium. A white tablet taken orally effects may last up to eight hours.
The reaction to this substance varies from individual to individual. In some states clonazepam is sold as Roofies
(13)
Effects: sleepy, slurred speech, impaired judgment, difficulty walking, deep sedation, respiratory distress, blackouts
lasting up to 24 hours. It may have paradoxical effects and cause aggressiveness
Combination with alcohol may be lethal.
Inhalants
Long lists of substances
Mode of use: inhaled through nose or mouth
Effects: Most are CNS depressants. Much like alcohol initially stimulated, less inhibited, confusion, perceptual
distortion and hallucinations often leading to aggressive behavior, ataxia, dysarthria, convulsions, cardiac arrythmias,
(in the presence of hypoxia volatile substances are believed to sensitize the myocardium to the action of adrenaline)
(42) unconsciousness, heart failure and death. Suffocation can occur by displacing oxygen in the lungs and then in
the CNS. Specific problems from various products such toluene, benzenes, nitrous oxide. Long term effects can
include lung tissue damage, brain cell destruction leading to neurological impairments such as mood swings,
hostility, confusion, depression, memory loss, paranoia. Damage to brain cells can also lead to loss of coordination,
balance and muscle control. Inhalants can also damage vital organs such as the liver damage leading to cirrhosis
and chronic hepatitis, kidneys, blood and bone marrow. (60)
Poppers
Sniffed or breathed in open mouth
Often used with ecstasy
Iso-butyl nitrate
Strong rushes of euphoria
Side effects: black outs, (hypotensive episodes) headache, nausea, heart attacks
Contraindications: heart problems, viagra
Amyl nitrates
Similar to above
More widely uses in gay population for sex to relax anus while maintaining an erection
Others
Various substances used by partygoers that may affect the individuals reactions to other drugs.
Anabolic Steroids (11)
Many partiers may be on anabolic steroids the effects of which is unknown when used in combination with other
drugs. Different anabolic steroids may have different side effect profiles. The reaction to each may also be
idiosyncratic
Mode of use: orally, injection
Effects: increases lean muscle mass, strength, ability to train longer, liver tumors, jaundice, fluid retention, high
blood pressure, acne and trembling. Hemoconcentration has been described in some users with potential resulting
strokes and transient ischemic attacks. Other effects may include: shrinking of testicles, reduced sperm count,
infertility, baldness, gynecomastia, low HDL (41) . In adolescents may halt growth through premature skeletal
maturation and accelerated pubertal changes. In women: growth of facial hair, changes or cessation of menstrual
cycle, enlargment of clitoris, deepened voice.
Aggression and other psychiatric side effects, wild mood swings, delusions, irritability, mania, hypomania,
depression , psychosis. (41) Long term use can lead to cardiomegally, hypertension, atherosclerosis, elevated
cholesterol levels, prostatic enlargement, sexual dysfunction, sterility, baldness, gynecomastia, testicular atrophy,
liver damage, kidney damage and kidney stones. In women long term effects may include menstrual irregularities,
deepening of the voice, fetal damage, baldness, hair growth on other parts of the body, sexual dysfunction, sterility,
reduction of breasts, and genital swelling. (61)
Interactions: one animal study has reported potentiation of the effect on blood pressure when anabolic steroids and
cocaine is used. Since some individual may suffer from hemoconcentration then the use of ecstasy,
methamphetamine and other stimulants which lead to hyperthermia and risk of dehydration may increase the risk for
clotting problems. (36)
Creatine
Amino acid compound used by body builders with hopes of improving muscle mass, strength, and recovery time.
Anecdotal adverse effects include dehydration, heat-related illnesses, reduced blood volume, and electrolyte
imbalance. Some party goers may take creatine and question arise as to whether adverse effects of some drugs,
amphetamine derivatives, can be compounded in these individuals.
Sildenafil citrate (Viagra) (66)
Oral therapy for erectile dysfunction taken at times by party goers who have done MDMA or other drugs
Mode of use: Usually this is taken orally but it has been reported that some party goer will ground the pills and snort
it with cocaine and ketamine. When taken orally it is absorbed rapidly and has a half life of four hours. It is
metabolized in the liver to an other active metabolite.
Effects: erection after stimulation, decreased blood pressure, color vision problems due to inhibition of enzymes in
the retina. Other adverse effects include flushing, headaches, dyspepsia, nasal congestion, diarrhea, dizziness, rash.
Contraindication: the use of poppers in combination with viagra will cause a hypotensive crisis and possible
myocardial infarction.
Smart Alternatives ( 83)
Comes in bottles, cans, powders or capsules, they contain natural substances, mostly herbal, and vitamins
They generally boost energy levels, increase stamina, refresh, quench thirst, and aid concentration. If isotonic help
replaced fluid lost by sweating and the sugar content helps as well. Most products will contain stimulants.
If taken in too large quantities can result in nausea, loss of appetite, insomnia, increased heart rate, visual and sensory
impairment and discomfort in the bladder and urinary tract.
Most are contraindicated in people who have heart or kidney problems, high/low blood pressure, asthma and
diabetes. Should not be mixed with alcohol.
Common ingredients may include: caffeine, guarana, stimulant similar to caffeine, Ma-Huang, contains epedrine,
ginseng, amino acids, taurine, sugars, tryptophan, vitamins usually high doses of C and Bs
Examples include: Stackers which contains ephedra and caffeine
Go-go drinks: which contain ginseng, yohimbine, guarana ( being marketed as Viagra for women)
Section 2:
Annotated Bibliography
Annotated Bibliography/Reference List
Raves, Party Drugs and Related Articles
1 - Eisner Bruce. Ecstasy – The MDMA Story, Ronin Publishing, Berkeley, CA, 1989
Book on MDMA
2 - Strathdee, S.A. et al. HIV Infection and Risk Behaviours Among Young Gay and Bisexual Men in Vancouver.
Can. Med. Assoc. Journ., Vol. 162, 2000, pp 21-25
Prospective cohort study involving gay and bisexual men aged 18-30
3 - McFee, R.B. et al. Ecstasy – A Drug on the Rise. SAM Newsletter, Vol. 10, No. 2, 1999. P. 6
Brief summary of various forms of substances which come under the name of ecstasy. Report of a small clinic
studies on usage.
4 – Beck, J, Rosenbaum, M. Pursuit of Ecstasy – The MDMA Experience, State University of New York Press,
Albany 1994
Book on Ecstasy, somewhat useful.
5 – Saunders, Nicholas. Ecstasy and the Dance Culture. Nicholas Saunders, London, 1995
Good book on ecstasy, raves with a results of various studies done in England.
6 – Castaneda, R., Time Out, Time Out Magazine Ltd, London, Oct 21-28, 1998
Good summary of plants with hallucigenic properties.
7 – Diagnostic and Statistical Manual on Mental Disorders, 4 th Ed.: DSM-IV, Washington, DC: American
Psychiatric Association, 1994.
8 – Mendelson, J.H., Mello, N.K. Management of Cocaine Abuse and Dependence. NEJM, vol. 334, 1996, pp. 965972.
Good summary article on cocaine.
9 – Drugs of Abuse: Boehringer-Mannheim 1998. http://www.boehringer-mannheim.com/rapids/drugsabuse
Site has moved to Roche search in diagnostics. Good information.
10 – Club Drugs: Just the Facts Texas Commission on Alcohol and Drug Abuse, Jan 7, 1999.
http://www.tcada.state.tx.us/research/facts/clubdrugs.html
11 – Steroids (Anabolic) NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human
Services, NIH, March 4, 1999. http://www.nida.nih.gov/infofax/steroids.html
12 – High School and Youth Trends – Monitoring the Future Study (MTF) NIDA Infofax, National Institute on Drug
Abuse, US Department of Health and Human Services, NIH, March 4, 1999.
http://www.nida.nih.gov/infofax/HSYouthtrends.html
13 – Rohypnol and GHB NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human
Services, NIH, August 13, 1999. http://www.nida.nih.gov/infofax/rohypnolghb.html
14 – Ritalin NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human Services, NIH,
March 4, 1999. http://www.nida.nih.gov/infofax/ritalin.html
15 – PCP (Phencyclidine) NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human
Services, NIH, March 4, 1999. http://www.nida.nih.gov/infofax/pcp.html
16 – Methamphetamine ) NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human
Services, NIH, March 4, 1999. http://www.nida.nih.gov/infofax/methamphetamine.html
17 – Marijuana NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human Services,
NIH, March 4, 1999. http://www.nida.nih.gov/infofax/marijuana.html
18 – LSD NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human Services, NIH,
March 4, 1999. http://www.nida.nih.gov/infofax/lsd.html
19 – Inhalants: NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human Services,
NIH, March 4, 1999. http://www.nida.nih.gov/infofax/inhalants.html
20 – Crack and Cocaine : NIDA Infofax, National Institute on Drug Abuse, US Department of Health and Human
Services, NIH, March 4, 1999. http://www.nida.nih.gov/infofax/cocaine.html
21 – Release Drugs and Dance Survey – An Insight Into the Culture. Release, London 1997
Report on work done by this organization, good summary on raves.
22 – Ketamine Hydrochloride FAQ Hyperreal Organization, 1994.
http://www.hyperreal.org/drugs/psychedelics/dissociative/faq.ketamine
23 – Ketamine FAQ The Vaults of Erowid, 1999. http://www.erowid.org/chemicals/ketamine/ketamine_faq
24 – 2C-B FAQ The Vaults of Erowid, 1999. http://www.erowid.org/chemicals/2cb/2cb_faq
25 – Designer Drugs Drug Abuse USA 1997
http://www.drug-abuse.com/information/designerdrugs/designerdrugs1.html
26 – The Official alt.rave FAQ Hyperreak.org, 1994. http://.hyperreal.or/raves/altravefaq.html
27 – Frequently Asked Questions About Raves and Techno Music version 3.0 Brown, M, Behlendorf, B. 1995,
http://www.hyperreal.org/~mike/pub/altravefaq.html
28 – Future Synthetic Drugs of Abuse. Cooper, D. A. Hyperreal.org http://hyperreal.org/drugs/misc/future.html
29 – MDMA Frequently Asked Questions Document. Behlendorf, B., Hyperreal.org, 1994
http://www.hyperreal.org/drugs/mdma/faq-mdma
30 – Woody, G.E. et al. Non-injection Substance Use Correlates with Risky Sex Among Men Having Sex with Men:
data from HIVNET. Drug and Alcohol Dependence, Vol. 53, 1999, pp 197-205
Reports on a relatively large survey done in major US cities. Links risky sex with inhalants, stimulants,
hallucinogens and alcohol use.
31 – Strathdee, S.A. et al. Determinants of Sexual Risk-Taking Among Young HIV-Negative Gay and Bisexual Men.
Journal of Acquired Immuno Deficiency Syndromes and Human Retrovirology, Bol 19, 1998, pp 61-66
32 – Warner, E.A. et al. Diabetic Ketoacidocis Associated With Cocaine Use. Arch Internal Medicine, Vol 158,
1998, pp 1799-1802
Report of a series of cases of DKA in diabetic cocaine user compared to non users
33 – Aarons G.A. Adolescent Alcohol and Drug Abuse and Health. Journal of Adolescent Health Care, Vol 24,
1999, pp 412-421.
Study on the prevalence of health problems in adolescent using drugs as compared to non-users.
34 – Adlaf, E.M., Smart, R.G. Party Subculture or Dens of Doom? An Epidemiological Study of Rave Attendance
and Drug Use Patterns Among Adolescent Students. Journal of Psychoactive Drugs, Vol 29, 1997, pp. 193-197
Study perform in Ontario on high school students looking at the prevalence of party attendance and characteristics of
party goers.
35 – Arimany, J., et al. Intentional Overdose and Death With 3,4-Methylenedioxyethamphetamine (MDEA; “Eve”)
The American Journal of Forensic Medicine and Pathology, Vol 19, 1998, pp 148-151
A case report on a patient who possibly committed suicide using EVE
36 – Rockhold, R.W. Cardiovascular Toxicity of Anabolic Steroids. Annual Review Pharmacology and
Toxicology, Vol. 33, 1993, pp 497-520.
Review article on the above subject
37 – Holland, J.A, et al. Embalming Fluid-Soaked Marijuana: New High or New Guise for PCP? Journal of
Psychoactive Drugs, Vol. 30, 1998, pp215-219.
Case report and review of literature on this topic.
38 – Winbery, S. et al. Multiple Cocaine-Induced Seizures and Corresponding Cocaine and Metabolite
Concentration. American Journal of Emergency Medicine, Vol 16, 1998, pp. 529-533.
39 – Schuster, P., et al. Is the Use of Ecstasy and Hallucinogens Increasing? Results from a Community Study.
European Addiction Research, Vol. 4, 1998, pp. 15-82.
40 – Alter, M.J. et al. The Prevalence of Hepatitis C Virus Infection in the United States, 1988 through 1994. NEJM,
Vol 341, 1999, pp. 556-562.
41 – Pope, H. G., Katz, D.L. Psychiatric and Medical Effects of Anabolic-Androgenic Steroid Use – A Controlled
Study of 160 Athletes. Arch Gen Psychiatry, Vol 51, 1994, pp. 375-382.
42 – Chalmers, E.M. Volatile Substance Abuse. The Medical Journal of Australia. Vol. 154, 1991, 269-274
Good review article on the subject.
43 – Hollander, J.E., Hoffman, R., S.. Cocaine-Induced Myocardial Infarction: An Analysis and Review of the
Literature. The Journal of Emergency Medicine, Vol 10, 1992, pp. 169-177.
Good review article on the subject.
44 – Curran, H.V., Ross, R.A.. Mood and Cognitive Effects of ± 3,4-methylenedioxymenthamphetamine (MDMA,
‘ecstasy’): week-end ‘high’ Followed by Mid-week Low. Addiction, Vol 92, 1997, pp 821-831.
45 – Torre, M, Barberis, M.. Spontaneous Pneumothorax in Cocaine Sniffers. American Journal of Emergency
Medicine, Vol. 16, 1998, pp. 546-549.
46 – Perkonigg, A. et al. Prevalence of Use, Abuse, and Dependence of Illicit Drugs Among Adolescents and Young
Adults in a Community Sample. European Addiction and Research, Vol. 4, 1998, pp. 58-66.
47 – Gorman, M. Speed Use and HIV Transmission. 1996. http://www.tweaker.org/science.html
48 – Methamphetamine: Abuse and Addiction – How is methamphetamine used? National Institute on Drug Abuse,
1996. http://www.nida.nih.gov/researchreports/methamph/methamph3.html
49 – Cygan, J. et al. Inhaled Heroin-Induced Status Asthmaticus – Five Cases and a Review of the Literature. Chest,
Vol 117, pp. 272-275.
50 – Bell, V. Ketamine. Drugs, Solvents and Intoxicants – Ketamine. 1995
http://area51.upsu.plym.ac.uk/~harl/ketamine.html
51 - Bell, V. Ecstasy . Drugs, Solvents and Intoxicants – Ecstasy. 1995
http://area51.upsu.plym.ac.uk/~harl/ecstasy.html
52 - Bell, V. LSD. Drugs, Solvents and Intoxicants – LSD. 1995 http://area51.upsu.plym.ac.uk/~harl/lsd.html
53 – Henry, J.A., Jeffreys, K.J., Dawling, S. Toxicity and Deaths from 3,4-methylenedioxymethamphetamine
(“ecstasy). Lancet, Vol. 340, 1992, pp. 384-387.
54 – Øye, I. Ketamine Analgesia, NMDA Receptors and the Gates of Perception. Acta Anaesthesiologica
Scandinavia, Vol. 42, 1998, pp. 747-749.
55 – Mueller, P.D., Korey, W.S. Death by “Ecstasy”: The Serotoning Syndrome? Annals of Emergency Medicine
Vol. 32, 1998, pp. 377-380
56 – Cho, A. K., Segal D. S. Amphetamines and Its Analogs. Academic Press, London, 1994.
Pharmacologically oriented book on amphetamines.
57 – Chin, R.L. et al. Clinical Course of Gamma-Hydroxybutyrate Overdose. Annals of Emergency Medicine, Vol.
31, 1998, pp 716-722.
58 – Li, J. et al. A Tale of Novel Intoxication: Seven Cases of Gamma-Hydroxybutyric Acid Overdose. Anna.ls of
Emergency Medicine, Vol. 31, 1998, pp. 723-728.
59 – Li, J., et al. A Tale of Novel Intoxication: A Review of the Effects of Gamma-Hydroxybutyric Acid With
Recommendations for Management. Annals of Emergency Medicine, Vol. 31, 1998, pp. 729-736.
60 – Inhalants: Just the Facts Texas Commission on Alcohol and Drug Abuse, Aug 30, 1999.
http://www.tcada.state.tx.us/research/facts/inhalants.html
61 - Steroids: Just the Facts Texas Commission on Alcohol and Drug Abuse, Aug, 30, 1999.
http://www.tcada.state.tx.us/research/facts/steroids.html
62 - Hallucinogens: Just the Facts Texas Commission on Alcohol and Drug Abuse, Aug 30, 1999.
http://www.tcada.state.tx.us/research/facts/hallufacts.html
63 – Bailey, W.J. FactLine on Non-Medicinal Use of Ritalin (methyphenidate) Indiana Prevention Resource Center,
1995. http://www.drugs.indiana.edu/publications/iprc/factline/ritalin.html
64 – Handly, N., Toxicity, Amphetamine. Emedicine, 1998, http://www.emedicine.com/emerg/topic23.htm
65 – King, E. Recreational Dangers – Understanding Possible Interactions Between Prescribed and Illegal Drugs.
AIDS Treatment Update, Issue 51, 1997 http://www.aegis.com/hivinfoweb/library/misc/atu051a.html
66 – Viagra (Sildenafil citrate) Product monograph, Pfizer, 1998, http://www.viagra.com/hcp/prod_info_temp.html
67 – Graham, S. Toxicity, Phencyclidine. Emedicine, 1999. http://www.emedicine.com/emerg/topic420,htm
68 – Darlet, R. Toxicity, Methamphetamines. Emedicine, 1999, http://www.emedicine.com/emerg/topic859.htm
69 – Bad trips – Dealing With One. Ravesafe Information on dealing with a Bad Trip.
http://www.ravesafe.org.za/bad-trip.htm
70 – Adlaf, E. M., Ivis, F.J. Recent Findings from the Ontario Student Drug Use Survey. CMAJ, Vol. 159, 1998,
pp. 451-454
71 – High School and Youth Trends – Monitoring the Future Study (MTF) NIDA Infofax 1999,
http://165.112.78.61/infofax/HSYouthtrends.html
72 – Ecstasy NIDA Infofax, 1999, http://165.112.78.61/infofax/ecstasy.html
73 – Ecstasy Dancesafe http://www.harmreduction.net/dancesafe/ehealth.html
74 – Monks, G. Axis & Bloomsbury Clinics, Gay Men’s Drug Use Surveys, London (1998) Private communication.
75 – Critchlow Leigh, B. The Relationship of Substance Use During Sex to High-Risk Sexual Behavior Journal of
Sex Research, Vol. 27, 1990, pp.199-213
76 - Barrett, D.C., Bolan, G., Douglas, Jr., J.M. Redefining Gay Male Anal Intercourse Behaviors: Implications for
HIV Prevention and Research. Journal of Sex Research, Vol. 35, 1998, pp. 381-389
77 – Paul, J. P. et al. Correlates of Sexual Risk-Taking Among Gay Male Substance Abusers. Addiction, Vol. 89,
1994, pp.. 971-983.
78 – de Wit, J.B.F., van Griensven, G.J.P. Time from Safer to Unsafe Sexual Behaviour among Homosexual Men.
AIDS, Vol. 8, 1994, 123-126.
79 – Lemp, G.F. et al. Seroprevalence of HIV and Risk Behaviors Among Young Homosexual and Bisexual Men The San Francisco/Berkeley Young Men’s Survey. JAMA, Vol. 272, 1994, pp.449-454.
80 – Ostrow, D.G. et al. Recreational Drug Use and Sexual Behavior Change in a Cohort of Homosexual Men.
AIDS, Vol. 4, 1990, pp. 759-765.
81 – Ruiz, J., et al. Risks Factors for Human Immunodeficiency Virus Infection and Unprotected Anal Intercourse
Among Young Men Who Have Sex With Men. Sexually Transmitted Diseases, Vol. 25, 1998, pp. 100-107
82 – Siegel, K, et al. Factors Distinguishing Homosexual Males Practicing Risky and Safer Sex. Soc. Sci. Med.
Vol. 28, 1989, pp. 561-569.
83 – “Smart” alternatives. RaveSafe Infornation on “Smart” Alternatives
http://www.pcb.co.za/users/ravesafe/smart.htm
84 – White, W. E. This is Your Brain on Dissociatives: The Bad News is Finally In. 1998,
http://www.frognet.net/~dxm/olney.html
85 – Jansen, K.L.R. Using Ketamine to Induce the Near-Death Experience:Mechanism of Action and Therapeutic
Potential.
86 – Schwartz, B, Alderman, E.M. Substance of A buse. Pediatrics in Review, Vol. 18, 1997, pp. 204-215
Tables on each commonly used substance, effects, management of problems. Ecstasy, Ketamine, GHB not included
P-P Tellier, MD, March 2000
Section 3:
Useful Websites
Useful Web Sites
1 – Addiction Research Foundation: Information on drug and alcohol with information on
adolescent drug use including statistics.
http://www.arf.com/
2 – The Vaults of Erowid: Good source of information on most drugs used and plants.
http://www.erowid.org/index.shtml
3 – Ravesafe Drug: Information on raves and drugs.
http://www.pcb.co.za/users/ravesafe/home.htm
4 – The Lycaeum: Information on drugs
http://www.lycaeum.org/
5 – The Realm of Techno: Site devoted to raves and techno music
http://www.whizzbomb.com/techno.html
6 – Boehringer-Mannheim: German pharmaceutical company now own by Roche. Provides
information on drugs and drug testing
http://www.boehringer-mannheim.com/rapid/drugsabuse/DrugsAbuse_EN.html
7 – Center for Addiction Research and Mental Health: Canadian organization provides good
information on addiction.
http://www.camh.net/
8 – Dancesafe: Rave and party drug information, based on the West Coast
http://www.dancesafe.org/index.html
9 – Do It Now Foundation Online: Drug information
http://wwwdoitnow.org/
10 – Drug Abuse USA Information: Information on drugs, follow just say no philosophy.
http://www.drug-abuse.com/information/
11 – Drugs, Solvants and Intoxicants: Information source from United Kingdom
http://www.area51.upsu.plym.ac.uk/~harl/index.html
12 – eMedicine On Line: Medical page on emergency medicine, excellent articles on emergency
management of drug overdoses.
http://www.emedicine.com/emerg
13 – NIDA – Club Drugs Home Page: Home page for club drug initiative, may be interesting for
Americans wanting to get funding for research.
http://165.112.78.57/
14 – NIDA – National Institute on Drug Abuse: Information on all aspects of substance use
including reference material and studies.
http://www.nida.nih.com/NIDAHome2.html
15 – Indiana Prevention Resource Center: Another source of information
http://www.drugs.indiana.edu/
16 – The CRISSY Campaign Analysis: Gay site providing information on methamphetamines
http://www.tweaker.org/index2.html
17 – Texas Commission on Alcohol and Drug Abuse: Information on drugs
http://www.tcada.state.tx.us/research/facts
18 – Hearing Education and Awareness for Rockers
http://www.hearnet.com
P-P Tellier, MD, March 2000
Section 4:
Educational Resources
Educational Resources:
1. Bad Boys Montreal
“Please, Party & play safely!”
Gives detail on the drugs GHB, Special K, Crystal, Ecstasy, and Cocaine. This
includes a description of what the drug are, the effects, and dangers involved. There
are also helpful notes on what to do before and after certain drugs, the effects when
coming down, and specific instructions if you are HIV positive. Includes reference
numbers for Drug and AIDS helplines in Montreal.
Web Site: www.bbcm.org
E-mail: [email protected]
Address: P.O. Box 1253
Station V
Montreal, Quebec
H3B 3K9
2.
Camden and Islington Community Health Services NHS Trust
“Positive about Drugs 2: The Essential Information Guide for HIV + Gay Men Who
Use Drugs”
A colourful booklet divided into four sections: Section 1 includes Drug Profiles, containing
general drug information. If you’re looking for something on how drugs affect you, the law or
safer drug use, you’ll find it there. Section 2 looks at Drugs and the Immune system, looking
at the effects of drugs on the immune system – whether you’re HIV or not. Section 3
examines the issue of how illicit drugs interact with HIV treatment medicines and the notion
of maintaining “compliance” to HIV drug regimes. Section 4 provides a further list of
services for more information. Primarily English.
“Clued Up: A Handbook of drugs and services for gay men”.
The handbook is divided into a Ten-point plan for safer drug use, an A-Z of drugs, Safer
injecting, Drugs and the Law, Drugs and Holidays, Drugs and Sex, Further information and
support, and other drug resources for gay men to look out for.
“In Gear: A Guide to Safer Steroid Use for Men”
This Guide is divided into understanding how steroids work, the diet and work-out, how
steroids are taken, oral vs. injectables, the truth about side effects: physical problems, mental
health problems, steroids and other drugs, injecting advice, other fitness drugs, steroids and
HIV, Steroids and Sex, Steroids and the Law, and where to get further help.
“Sexual Chemistry: Sex, drugs, and Gay men”.
This booklet explores the social context of drugs and sex, drugs and sexual health, drugs and
sexual behavior, how to keep safe, and information on further support. Includes sections on
Viagra, and HIV.
Postcards available:
“Control Freak”
Briefly describes how drugs can make you lose control. Additional support numbers listed.
“ Time Gentlemen, please!”
Briefly explores the effects of heavy drinking for gay men, and provides suggestions on how
to limit your intake. Additional support numbers listed.
“Brian drain”
Brief alert on drugs and mental health problems. Additional support numbers listed.
“Shaken or Stirred”
Briefly describes the dangers of mixing different drugs, and drugs with alcohol. Additional
support numbers listed.
Websites: www.candihps.com/pinkpages
www.cluedup.demon.co.uk
www.isdd.co.uk
E-mail: [email protected]
Address: St.Pancras Hospital,
4 St. Pancras Way
London, UK
NW1 0PE
3.
ETR Associates
“Designer Drugs”
Short Synopsis of Designer Drugs, includes where Designer Drugs come from, how to identify a Designer Drug,
and the risks of Designer Drugs. Specific Drugs included: MDMA (Ecstasy), “China White”, and Rohypnol.
Web Site: www.etr.org
Address: P.O. Box 1830
Santa Cruz, CA
95061-1830
4. Harmony
“ GHB”
An informative description of what is GHB, the Effects of GHB, and smart facts to
know if you Use GHB (i.e. mixing GHB with other substances).
E-mail: [email protected]
5. Santa Monica-UCLA Medical Center: Rape Treatment Center
“Rapists are using a new weapon to overpower their victims”
A concise pamphlet discussing the silent and invisible drugs Rohypnol and GHB.
Topics include how rapist use the drugs, what exactly are Rohypnol and GHB, the
effects of these drugs and special sections on what to do if it happens to you, and
prevention efforts.
Address: 1250 Sixteenth Street
Santa Monica, CA
90404
#(310) 319-4000
6. Youth Support
“Youth support Guide to Drugs”
Not another boring pamphlet telling you don’t do drugs. It is designed to give you a
clear understanding of a variety of illegal and legal drugs, their effects both short and
long term and their potential dangers, targeted for adolescents.
Address: 13 Crescent Road
London, UK
BR3 2NF
# 01816506296
Fax: 01816593309
McGill University: March, 2000.