Raves, Club Drugs, and Drugs of Abuse Dr. Milton H. Cambridge Demand Reduction Outreach and...

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



Amphetamines ED Mentions

0

5,000

10,000

15,000

20,000

25,000

1994

1995

1996

1997

1998

1999

2000

2001

2002



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



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



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



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



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



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



* 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



Cocaine ED Mentionsper 100,000 pop.

0

50

100

150

200

250

1995

1996

1997

1998

1999

2000

2001

2002

Baltimore

Washington DC



• 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



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



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



Heroin ED Mentionsper 100,000 pop.

050

100150200250300350400450

1995

1996

1997

1998

1999

2000

2001

2002

Baltimore

Washington DC



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



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



Marijuana ED Mentionsper 100,000 pop.

0

20

40

60

80

100

1995

1996

1997

1998

1999

2000

2001

2002

Baltimore

Washington DC



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

Raves, Club Drugs, and Drugs of Abuse Dr. Milton H. Cambridge Demand Reduction Outreach and...

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Transcript of Raves, Club Drugs, and Drugs of Abuse Dr. Milton H. Cambridge Demand Reduction Outreach and...