Post on 17-Dec-2015
Raves, Club Drugs, and Drugs of Abuse
Dr. Milton H. Cambridge
Demand Reduction Outreach and Prevention Coordinator
Raves
• Early 80’s subculture in England
• Clandestine or commercialized
• Loud “techno” music/dancing
• Lights and visual stimuli
• Promoted as Alcohol Free
• Club drugs bought, sold, consumed
• Unique costumes or themes
Environment
• All night event• Clandestine – warehouses, deserts, woods, etc.• Commercialized – established clubs• Hot• Loud• Crowded• Dancing• Criminal element often present
Promotions• 14-25 year olds targeted group
• Alcohol-free events
• Appearance of not promoting drug use
• Websites, posters, word of mouth
• Paraphernalia – available on internet
• Spiritual or cultural stimulation/ enhancement– One website “rated” the social and sexual
performance, hangover, and spiritual effects of drugs – no mention of dangers
Rave Paraphernalia
• Water bottles• Light sticks• Pacifers• Bags of small candy/breath mints• Eye-drop bottles• Dust & surgical masks/Vick’s Vapo-Rub• Caffeinated beverages• OTC stimulants
Dangers
• Dehydration• Hyperthermia (high body temperature)
– Caused by drugs, heat, and dehydration
• Drug use (intentional or unintentional)• Crime (sexual & physical assault, homicide,
robbery, property damage, etc.)• Crowds• Hearing loss over long periods of exposure• Lack of compliance with safety regulations
Club Drugs and Trend Drugs
• Ketamine• Rohypnol• Viagra• Oxycodone• PCP• Heroin• Inhalants• Marijuana• Dextromethorphan
• Ecstasy– Ecstasy + Viagra
– Ecstasy + Prozac
– Ecstasy + Ketamine
– Ecstasy + LSD
• Methamphetamine• PMA• 4-MTA• GHB• LSD
3,4-Methylenedioxymethamphetamine
• E, XTC, X, rolling, tachas, snackies, speedies• Stimulant and hallucinogenic properties• Effects: increased stimuli & sensations• Signs: euphoria, involuntary teeth grinding • Causes memory loss, brain damage, “Alzheimer’s”• OD: hyperthermia, teeth clenching, seizures,
unconsciousness, heart failure, heat stroke• Route: ingested, snorted, injected• Onset/Duration: 30-60 minutes/4-6 hours
Total Ecstasy ED Mentions
0
1,000
2,000
3,000
4,000
5,000
6,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Ecstasy ED Mentionsper 100,000 pop.
0
1
2
3
4
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Methamphetamine• Speed, ice, crystal, crank, batu, christmas trees,
pink, elbows, Ozs, cinnamon, blade• Schedule II, stimulant for ADD, narcolepsy• Signs: tachycardia, hypertension, hyperthermia,
violent behavior• OD: agitation, hostility, hallucinations, seizures,
hyperthermia, death• Chronic use causes paranoia, hallucinations,
picking at the skin, violent & erratic behavior• Route: ingested, smoked, snorted, injected• Onset/Duration: depends on route/6-8 hours
Yaba• Methamphetamine + caffeine• Crazy medicine, Hitler’s drug, Nazi speed• Red, orange, or green small pills, most
commonly with “WY” stamped on them• Originated in Thailand• Signs: tachycardia, dehydration, paranoia,
sweating, insomnia, irritability, hallucinations, depression
• Route: Oral, inhalation, injection• Onset/Duration: depends on route/6-8 hours
Paramethoxyamphetamine
• PMA, 4-MA, death, Mitsubishi double stack• Synthetic hallucinogen• Signs: tachycardia, hypertension, dyspnea,
hyperthermia, nystagmus, muscle spasms, visual hallucinations
• OD: dysrhythmias, pulmonary edema, renal failure, vomiting, seizures, coma (60mg), extreme hyperthermia (>108 hours after death)
• Onset/duration: depends on route• Route: ingested, inhaled, injected• Esp. hazardous with other amphetamines, alcohol,
cocaine, prozac
4-Methylthioamphetamine • 4-MTA, MTA, flatliners, golden eagle• Resembles amphetamine, developed as an anti-
depressant, releases serotonin• Effects: Stimulant/euphoric effects• Signs: restlessness, muscle twitches, involuntary
muscle contractions, tremors, seizures, coma• Duration: up to 12 hours• Route: ingested• Unknown toxicity & side effects• Sold as ecstasy
4-Methylthioamphetamine
Methamphetamine ED Mentions
0
5,000
10,000
15,000
20,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Amphetamines ED Mentions
0
5,000
10,000
15,000
20,000
25,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Amphetamines ED Mentionsper 100,000 pop.
0
10
20
30
40
50
60
70
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
GHB• Gamma Hydroxybutyrate, C4H8O3
• Georgia Home Boy, Grievous Bodily Harm, liquid X, goop
• Made from sodium / potassium hydrochloride & gamma-butylrolactone (GBL)
• Signs: drowsiness, dizziness, nausea, vomiting, status seizures, respiratory depression/cheyne-stokes, coma
• OD: unconsciousness, muscle stiffness, seizures, severe respiratory depression, coma
• Route: ingested (liquid)
• Onset/Duration: 10-20 minutes/2-4 hours
• If made incorrectly, can burn mouth & esophagus
GHB/GBL ED Mentions
0
1000
2000
3000
4000
5000
6000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
LSD
• D-lysergic acid diethylamide• Acid, cid, blotter acid, “candy flipping”• Most powerful hallucinogen known• Put in gel wraps, breath fresheners, “Smartie”
candies, blotters, sugar cubes • Signs: hallucinations, tachycardia, hypertension,
dilated pupils, hyperthermia, nausea, vomiting• OD: exaggerated signs as above, death is rare• Route: ingested, snorted, injected• Onset/duration: 20-90 minutes/6-12 hours
LSD ED Mentions
0.0
1,000.0
2,000.0
3,000.0
4,000.0
5,000.0
6,000.0
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
LSD ED Mentionsper 100,000 pop.
0
1
2
3
4
5
6
7
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Ketamine Hydrochloride• Special K, K, Ket Kat, Cat Valium• Dissociative anesthetic• Signs: hallucinations, vomiting, hypertension,
bradycardia, irrational behavior, seizures, respiratory depression, unconsciousness, hypoxia.
• Long-term side effects of regular use unknown• Onset/duration: 15 sec-5 mins/30-60 mins• Route: Oral, snorted, injected• 4/21/02 – DEA seized 3,998 vials (Missouri)
Ketamine ED Mentions
0
100
200
300
400
500
600
700
800
1994 1995 1996 1997 1998 1999 2000 2001 2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Flunitrazepam (Rohypnol)
• Roofies, Mexican valium, roach-2, rope, rib• Sedative, prevents seizures (not in the U.S.)• Signs: “drunkenness,” unsteadiness, slurred speech,
drowsiness, amnesia• OD: CNS depression, bradycardia, coma, death• Used in the commission of “date rapes”• Onset/duration: rapid onset/8 hours or more• Route: dissolved in water, alcohol, other liquids; can
be snorted
Rohypnol ED Mentions
0
10
20
30
40
50
60
70
80
1995 1996 1997 1998 1999 2000 2001 2002
Sildenafil (Viagra®)
• Trail mix, sextasy, hammerheading
• Treatment of impotence
• Used to counter sexual dysfunction caused by ecstasy
• Dangerous with nitrates (amyl nitrate) or nitrites (heart medication)
• >4 hours can cause anatomical damage
Oxycodone (Oxycontin®)• Oxys, oxycotton, OCs, killer, blue, valerie, rush• Analgesic, equally potent as morphine• Effects: Euphoria• Signs: euphoria, pinpoint pupils, dizziness,
confusion, decreased breathing and heart rate• OD: respiratory depression, pinpoint pupils, coma,
seizures• Onset/duration: depends on route/8-12 hours• Route: snorted, ingested, injected• Narcan will reverse effects
Oxycodone ED Mentions*
0
5,000
10,000
15,000
20,000
25,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
* Includes mentions for oxycodone, acetaminophen-oxycodone and aspirin-oxycodone
Cocaine• Powder: blow, coke, snow, yao, DP, perico, p-packs• Crack: rock, bullets, ma’a, monkey nut, yam, CDs• Most powerful natural stimulant• Effects: Stimulant• Signs: dysrhythmias, chest pain, increased heart and respiratory
rates, hypertension, dilated pupils, restlessness, blurred vision, dizziness, seizures
• “Crack Lung”: chest pain, cough w/hemoptysis, dyspnea, bronchospasm, pruritis.
• OD: hyperthermia, hallucinations, seizures, respiratory failure, death
• Onset/duration: 4-6 secs/depends on amount• Route: injected, snorted, smoked
Cocaine ED Mentions
0
50,000
100,000
150,000
200,000
250,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Cocaine ED Mentionsper 100,000 pop.
0
50
100
150
200
250
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
• Embalming fluid, rocket fuel, elephant, hog
• Veterinary analgesic
• Signs: delirium, violent & erratic behavior, hypertension, tachycardia, rapid & shallow breathing, sweating, flushed skin
• OD: bizarre, violent and self-destructive behavior, feelings of invulnerability
• Onset/duration: depends on route/4-8 hours
• Route: injected, snorted, smoked
Phenyl Cyclohexyl Piperidine (PCP)
PCP ED Mentions
0100020003000400050006000700080009000
1994 1995 1996 1997 1998 1999 2000 2001
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
PCP ED Mentionsper 100,000 pop.
0
5
10
15
20
25
30
35
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Heroin
• 747, bart simpson, dinosaur, homicide, Monica Lewinski, Bin Laden, Jerry Springer
• Developed as an alternate to morphine• Signs: respiratory depression, constricted
pupils, nausea & vomiting, warm flushed skin, and dry mouth. User goes “on the nod”
• OD: severe respiratory depression, apnea, coma, death
• Onset/duration: 1 min/several hours• Route: ingested, injected, snorted, smoked
Heroin ED Mentions
0
20,000
40,000
60,000
80,000
100,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Heroin ED Mentionsper 100,000 pop.
050
100150200250300350400450
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Inhalants
• Bagging, huffing• Petroleum or chemical product with strong fumes• Signs: euphoria followed by depression, stimulation,
distortions in time & space, headache, nausea & vomiting, slurred speech, loss of motor coordination, wheezing, dyspnea
• OD: coma, apnea, heart failure, death• Onset/duration: instantaneous/short duration• 2% of 4th and 12th graders used monthly (1998)• 2% of 8th graders used at least once (1999)
Inhalant ED Mentions
0
500
1000
1500
2000
1995 1996 1997 1998 1999 2000 2001 2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Top 10 Inhalants 1995 – 2002
0
50
100
150
200
250
Glu
e
Nitr
ous
Ox*
Paint
Thi
nner
Tolue
ne G
lue+
Aeros
ols+
+
Carb
Clean
er+
Butan
e+
Tolue
ne
Ethyl
ene
Gly
col
Nai
l Pol
ish
Remov
er
Paint (1,762), but no ED Mentions 2001, 2002 *No ED mentions 2001, 2002+No ED mentions 2002++No ED mentions 2001
Marijuana
• delta-9-tetrahydrocannabinol (THC)• Triple a, crank, schwagg, kryptonite, spliff, hydro,
LG, chiefing • THC concentration: 1970, <1%; 2002, >6%
– Sensamilla rose from 6%-13%; as high as 33%
• Signs: dizziness; trouble walking; silly and giggly; red, bloodshot eyes; impaired memory; distinctive odor on clothes, hair, skin
• Onset/duration: 3-4 minutes/2-3 hours• Route: smoked, eaten
Marijuana ED Mentions
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Marijuana ED Mentionsper 100,000 pop.
0
20
40
60
80
100
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
Dextromethorphan• DXM, DM, Robo, Velvet, Rojo• Dosages: 100-1500 mg or 1.5 mg/kg – 30 mg/kg• Effects: hallucinations, dissociative effect• Signs: drowsiness, fatigue, dizziness, nystagmus, decreased
LOC, hyperthermia, “drunk” and “stoned” appearance• OD: slurred speech, lethargy, sweating, weak pulses,
hypotension, nausea/vomiting, CNS• Onset/duration: depends on route/6 hours• Route: Oral, inhaled• Often sold as or mistaken for ecstasy• Can cause false positive for PCP• 1,467 tablets seized in raid, Albany, NY
Dextromethorphan ED Mentions
0
10
20
30
40
50
60
70
80
1995 1996 1997 1998 1999 2000 2001 2002
5-MeO-DiPT• 5-Methoxy-di-isopropyl-tryptamine• Foxy, Methoxy Foxy• Tryptamine hallucinogenic• Effects: euphoria, increased stimuli, increased sexual
and emotional feelings• Signs: auditory hallucinations, visual distortion, jaw
clenching, diarrhea, nausea, severe anxiety• Onset/duration: 20-60 mins/14 hours• Route: ingested, snorted
Alpha-methyltryptamine• AMT, IT-290• Hallucinogen• Capsule with orange, yellow, or off-white powder• Effects: stimulation, mood elevation, hallucinations• Signs: increased energy, empathy, visual patterns,
nausea, vomiting, headaches, teeth clenching, blurred vision, anxiety
• Onset/duration: 10 secs-2 hours/14 hours• Route: ingested, smoked• Long term effects unknown
Benzylpiperazine, Trifluromethylphenalpiperazine
• BZP, legal E, Legal X, A2, often sold as ecstasy• Stimulant with amphetamine- and ecstasy-like
properties & effects• Signs: tachycardia, hypertension, hyperthermia• Causes hallucinations, seizures, and respiratory
depression at high doses• MSDS: dyspnea, delayed pulmonary edema, chemical
burns to respiratory tract on inhalation • Onset/duration: depends on route/6-8 hours• Route: oral (tablets/pill) or smoked (freebase)• Labeled industrial or commercial bottles
Useful Websites
www.monitoringthefuture.org
www.streetdrugs.org
www.treas.gov/usss
www.dea.gov
www.drugabusestatistics.samshsa.gov
www.inhalants.org
www.drugabuse.gov
www.health.org
www.nida.nih.gov
www.clubdrugs.org
www.projectghb.org
www.stopdrugs.org
www.adhl.org
www.teenchallenge.com
www.samsha.gov
www.familyawareness.org