 Oct. 19, 2002 |
| ASSEMBLY EDITION • SAN DIEGO |
"Club drugs" represent a unique form of substance abuse: the use of products that amplify euphoria associated with all-night, nonstop partying. "Raves," as these mass gatherings were called when first popularized in England in the 1980s, attracted hundreds and even thousands of partygoers to warehouses and stadiums.
Beginning after midnight, dancing to 140 to 200 beats per minute of techno music, and stimulated by strobe and laser lights, partygoers often resorted to "pharmaco assistance" to go all night, said Mark Stephens, M.D., associate professor of family medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.
Bona fide raves are no longer common, but smaller versions can be found around U.S. college campuses and even high schools, Stephens said in his Dialogue lecture yesterday on "Club Drugs: What's the Rave About?"
While marijuana is far and away the most common drug of abuse in the United States, and cocaine, heroin and methamphetamines are far greater health threats than club drugs, Stephens limited his remarks to the four drugs most popular within the clubbing community.
Street names for club drugs
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• Methylenedioxymethamphetamine -- MDMA or Ecstasy: At $20 to $40 a dose, MDMA dominates the club-drug market. It produces an amphetamine "rush" with hallucinations. Besides sympathomimetic effects, users can suffer malignant hyperthermia, seizures, myocardial infarction, hypertension, stroke, dehydration and -- oddly enough -- bruxism. In murine models, MDMA causes neuronal damage. Because of its amphetamine component, MDMA will "pop" on the standard National Institute on Drug Abuse five-drug screen, Stephens said. This tests for cocaine and other opiates, amphetamines, benzodiazepines, phencyclidines including PCP and ketamine, and cannabinoids.
•Gamma-hydroxybutyrate -- GHB: This drug has overtaken flunitrazepam (Rohypnol) as the date-rape drug, Stephens said. A central nervous system depressant, GHB can cause respiratory depression, somnolence, coma and death.
GHB is not detectable on a routine drug screen nor on standard toxicology screens, and it requires specific chromatographic analysis.
•Ketamine: This veterinary dissociative anesthetic is similar to PCP and has similar physical effects including delirium, amnesia, impaired motor function and respiratory impairment. It is not detectable on a routine toxicology screen.
• Flunitrazepam: It's dropping quickly in popularity since manufacturers began adding a dye-marker so individuals can identify drinks that have been tampered with. The drug, 10 times stronger than diazepam, is detectable on drug screens. In forensic cases, the metabolite 7-amino-flunitrazepam should be screened for using gas chromatography or mass spectrometry.
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Copyright © 2002 by
American Academy of Family Physicians.