Club Drugs
MDMA (Ecstasy), Rohypnol, GHB, and Ketamine are among the
drugs used by teens and young adults who are part of a nightclub,
bar, rave, or trance scene. Raves and trance events are generally
night-long dances, often held in warehouses. Many who attend
raves and trances do not use drugs, but those who do may be
attracted to the generally low cost, seemingly increased stamina,
and intoxicating highs that are said to deepen the rave or
trance experience.
Current science, however, is showing change to critical parts
of the brain from use of these drugs. Also, in high doses
most of these drugs can cause a sharp increase in body temperature
(malignant hyperthermia) leading to muscle breakdown and kidney
and cardiovascular system failure.
MDMA (Ecstasy)
MDMA is a synthetic, psychoactive drug with both stimulant
(amphetamine-like) and hallucinogenic (LSD-like) properties.
Street names for MDMA include Ecstasy, Adam, XTC, hug, beans,
and love drug. Its chemical structure (3-4 methylenedioxymethamphetamine,
"MDMA") is similar to methamphetamine, methylenedioxyamphetamine
(MDA), and mescaline - these are synthetic drugs known to
cause brain damage. MDMA usually is taken in pill form, but
some users snort it, inject it, or use it in suppository form.
Many problems MDMA users encounter are similar to those found
with the use of amphetamines and cocaine. Psychological difficulties
can include confusion, depression, sleep problems, severe
anxiety, and paranoia. Physical problems can include muscle
tension, involuntary teeth clenching, nausea, blurred vision,
faintness, and chills or sweating. Use of the drug has also
been associated with increases in heart rate and blood pressure,
which are special risks for people with circulatory or heart
disease. Recent research also links MDMA use to long-term
damage to those parts of the brain critical to thought, memory,
and pleasure.
MDMA use is increasing in most metropolitan areas of the
United States.* In Boston and New York City, it appears to
be spreading beyond the club scene to the streets. Content
of the MDMA pills also varies widely, and may include caffeine,
dextromethorphan, heroin, and mescaline. In some areas of
the country, the MDMA-like substance paramethoxyamphetamine
(PMA) has been involved in the deaths of people who mistakenly
thought they were taking true MDMA. The deaths were due to
complications from hyperthermia.
In a 5-year retrospective of emergency room mentions of club
drugs,** the Substance Abuse and Mental Health Services Administration
reports that emergency room mentions involving MDMA increased
from 250 in 1994 to 2,850 in 1999.
Rohypnol, GHB, and Ketamine
GHB, Rohypnol, and ketamine are predominantly central nervous
system depressants. Because they are often colorless, tasteless,
and odorless, they can be added to beverages and ingested
unknowingly.
These drugs emerged a few years ago as "date rape"
drugs. Because of concern about their abuse, Congress passed
the "Drug-Induced Rape Prevention and Punishment Act
of 1996" in October 1996. This legislation increased
Federal penalties for use of any controlled substance to aid
in sexual assault.
GHB
Since about 1990, GHB (gamma hydroxybutyrate) has been abused
in the U.S. for euphoric, sedative, and anabolic (body building)
effects. It is a central nervous system depressant that was
widely available over-the-counter in health food stores during
the 1980s and until 1992. It was purchased largely by body
builders to aid fat reduction and muscle building. Street
names include Liquid Ecstasy, Soap, Easy Lay, and Georgia
Home Boy. Even though GHB may be difficult to distinguish
from water, it has appeared in law enforcement indicators,
including seizures of large amounts in Minneapolis/St. Paul
and Phoenix.*
Coma and seizures can occur following abuse of GHB and, when
combined with methamphetamine, there appears to be an increased
risk of seizure. Combining use with other drugs such as alcohol
can result in nausea and difficulty breathing. GHB may also
produce withdrawal effects, including insomnia, anxiety, tremors,
and sweating.
GHB and two of its precursors, gamma butyrolactone (GBL)
and 1,4 butanediol (BD) have been involved in poisonings,
overdoses, date rapes, and deaths. These products, obtainable
over the internet and sometimes still sold in health food
stores, are also available at some gyms, raves, nightclubs,
gay male parties, college campuses, and the street. They are
commonly mixed with alcohol (which may cause unconsciousness),
have a short duration of action, and are not easily detectable
on routine hospital toxicology screens.*
GHB emergency room mentions increased from 55 in 1994 to
2,973 in 1999.** In 1999, GHB accounted for 32 percent of
illicit drug-related poison center calls in Boston. In Chicago
and San Francisco, GHB use is reportedly low compared with
MDMA, although GHB overdoses seem frequent compared with overdoses
related to other club drugs.
Rohypnol
Rohypnol, a trade name for flunitrazepam, has been of particular
concern for the last few years because of its abuse in date
rape. It belongs to a class of drugs knows as benzodiazepines.
When mixed with alcohol, Rohypnol can incapacitate victims
and prevent them from resisting sexual assault. It can produce
"anterograde amnesia," which means individuals may
not remember events they experienced while under the effects
of the drugs. Also, Rohypnol may be lethal when mixed with
alcohol and/or other depressants.
Rohypnol is not approved for use in the United States, and
its importation is banned. Illicit use of Rohypnol started
appearing in the United States in the early 1990s, where it
became known as "rophies," "roofies,"
"roach," and "rope." Emergency room mentions
of Rohypnol were 13 in 1994 and increased to 624 in 1998;
they decreased to 540 in 1999.**
Abuse of two other similar drugs appears to be replacing
Rohypnol abuse in Miami, Texas, and Boston. These are clonazepam,
marketed in the U.S. as Klonopin and in Mexico as Rivotril,
and alprazolam (marketed as Xanax). Rohypnol, however, continues
to be a problem among treatment admissions in Texas, particularly
among young Hispanic males along the Mexican border.
Ketamine
Ketamine is an anesthetic that has been approved for both
human and animal use in medical settings since 1970; about
90 percent of the ketamine legally sold is intended for veterinary
use. It can be injected or snorted. Ketamine is also known
as "Special K" or "vitamin K".
Certain doses of ketamine can cause dream-like states and
hallucinations, and it has become common in club and rave
scenes and has been used as a date rape drug.
At high doses, ketamine can cause delirium, amnesia, impaired
motor function, high blood pressure, depression, and potentially
fatal respiratory problems.
Emergency room mentions of ketamine rose from 19 in 1994
to 396 in 1999.** Recent use has been reported more frequently
among white youth in many cities, including Atlanta, Baltimore,
Boston, Chicago, Minneapolis/St. Paul, Newark, New York City,
Phoenix, San Diego, Texas, and Washington, DC.*
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See also NIDA's Community Alert Bulletin on Club Drugs, available
on NIDA's website at www.clubdrugs.org and also from the National
Clearinghouse for Alcohol and Drug Information (NCADI) at
1-800-729-6686.
* The information in this fact sheet is taken primarily from
the June 2000 Highlights and Executive Summary, Epidemiologic
Trends in Drug Abuse, a summary of the proceedings of the
June 2000 meeting of NIDA's Community Epidemiology Work Group
(CEWG). CEWG is a NIDA-sponsored network of researchers from
21 major U.S. metropolitan areas and selected foreign countries
who meet semiannually to discuss the current epidemiology
of drug abuse.
** These data are from The DAWN Report, December 2000, by
the Substance Abuse and Mental Health Services Administration
(SAMHSA). The report is available online at www.samhsa.gov
or by calling 1-800-729-6686.
Source: National Institute on Drug Abuse
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