Ecstasy, Herbal 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. Recent hard science, however, is showing serious damage to several parts of the brain from use of these drugs.
Many users tend to experiment with a variety of club drugs in combination. Also, combinations of any of these drugs with alcohol can lead to unexpected adverse reactions and death.
Club drugs are an increasing challenge for treatment programs. Many teens and young adults enter treatment with a number of these drugs and alcohol, rather than a single drug, as their primary problem.
Club drug use appears to be increasing in many cities around the country,* with Atlanta, Seattle, Chicago, Detroit, Miami, and Newark reporting widespread use at rave and club scenes. A recently completed survey in the Seattle area found that 20 percent of young, gay men reported using Ecstasy. GHB is the drug of choice among white, gay males in New Orleans' French Quarter and is popular among high school and college students. Ecstasy
MDMA, called "Adam," "Ecstasy," or "XTC," on the street, is a synthetic, psychoactive drug with hallucinogenic and amphetamine-like properties.
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, a special risk for people with circulatory or heart disease. Recent research also links Ecstasy use to long-term damage to those parts of the brain critical to thought, memory, and pleasure.
Rohypnol, GHB, and Ketamine
Rohypnol, GHB, and Ketamine are predominantly central nervous system depressants. Because they are often colorless, tasteless, and odorless, they can be easily added to beverages and ingested unknowingly. These drugs have emerged as the so called "date rape" drugs.
Because of concern about these abused sedative-hypnotics, 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.
Rohypnol, a trade name for flunitrazepam, has been of particular concern for the last few years because of its abuse in date rape. When mixed with alcohol, Rohypnol can incapacitate a victim and prevent them from resisting sexual assault. Also, Rohypnol may be lethal when mixed with alcohol and/or other depressants.
In addition to sedative-hypnotic effects including muscle relaxation and amnesia, Rohypnol it can produce physical and psychological dependence. In Miami - one of the earliest sites of Rohypnol abuse - poison control centers report an increase in withdrawal seizures among people addicted to Rohypnol.
Rohypnol is not approved for use in the United States and its importation is banned. Illicit use of Rohypnol began in Europe in the 1970s and started appearing in the United States in the early 1990s, where it became known as "rophies," "roofies," "roach," and "rope."
Another very similar drug is now being sold as "roofies" in Miami, Minnesota, and Texas. This is clonazepam, marketed in the U.S. as Klonopin and in Mexico as Rivotril. It is sometimes abused to enhance the effects of heroin and other opiates. Based on emergency room admission information, Boston, San Francisco, Phoenix, and Seattle appear to have the highest use rates of clonazepam.
Since about 1990, GHB (gamma hydroxy-butyrate) 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, purchased largely by body builders to aid fat reduction and muscle building. As with Rohypnol and clonazepam, GHB has been associated with sexual assault in cities throughout the country.
GHB has not been sold over-the-counter in the U.S. since 1992. However products containing gamma butyrolactone (GBL), a chemical that is converted by the body into GHB, are used in a number of dietary supplements in health food stores and gymnasiums.
Reports from Detroit indicate liquid GHB is being used in nightclubs for effects similar to those of Rohypnol. It is also common in the club scene in Phoenix, Honolulu, and Texas, where it is known as "liquid ecstacy," "somatomax," "scoop," "Georgia Home Boy," or "grievous bodily harm." In Miami, poison control center calls have reflected problems associated with increased GHB use, including loss of consciousness. In New York City, there have been reports of GHB use among those in the fashion industry. GHB is one of the most popular manufactured drugs in Atlanta. It is available in some gyms and reputed to be widely accessible at some gay male party venues.
A Poison Control Center in Denver reports that in 1998, 33 calls involved GHB, and almost half of these cases were considered life threatening. GHB accounts for an increasing number of sexual assault cases in Los Angeles and overdose deaths involving drug combinations.
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.
Ketamine is another central nervous system depressant abused as a "date rape" drug. Ketamine, or "Special K," is a rapid-acting general anaesthetic. It has sedative-hypnotic, analgesic, and hallucinogenic properties. It is marketed in the U.S. and a number of foreign countries for use as a general anesthetic in both human and veterinary medical practice.
It is similar to phencyclidine (PCP), although ketamine has a more rapid onset and is less potent. Depending on the dose, ketamine induces everything from feelings of pleasant weightlessness to full-fledged out-of-body or near-death experiences. Ketamine is reportedly used as an alternative to cocaine and is generally snorted.
Ketamine abuse has been reported in many cities around the country. It has been reportedly stolen from veterinary supply sources in Minnesota, Louisiana, and Michigan. In Miami, ketamine has been diverted from shipments intended for other countries. Ketamine is widely available in New York City where it sells for about $20 a dosage unit. A small but stable market for ketamine has been established in suburban areas outside Baltimore. Three ketamine deaths were reported in New Orleans in 1998, and the Detroit Poison Control Center reported six ketamine contacts in early 1999.
* The information in this fact sheet is taken primarily from the June 1999 Advance Report, Epidemiologic Trends in Drug Abuse, a summary of the proceedings of the June 1999 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.
NOTE: See also NIDA' Community Alert Bulletin on Club Drugs, available on NIDA's website at http://www.clubdrugs.org/ and also from CSAP's National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686.
Information and educational materials on Rohypnol and GHB directed toward college students are available from the Rape Treatment Center at Santa Monica-UCLA Medical Center at 1-800-END-RAPE (1-800-363-7273).
|Ecstasy Causes Long-Term Memory Damage|
|A new study by Dutch researchers shows that
use of ecstasy causes long-term damage to memory function, Reuters
reported Oct. 14.
Previous research determined that ecstasy caused temporary injury to brain cells. But after examining memory tests and brain scans of 22 ecstasy users, researchers from the Academic Medical Center in Amsterdam found long-term memory deficiencies and changes in certain brain cells.
In particular, study participants had damage to the cortical neurons, which are linked to memory function. These brain cells suffered a decreased density of receptors for the neurotransmitter serotonin, which transports messages between cells and affects mood.
Scans and memory tests performed on former ecstasy users found that the damage may be irreversible. "We identified that ecstasy use is associated not only with short-term consequences on memory but with long-term consequences as well," said study author Liesbeth Reneman.
The study is published in the October issue of the Archives of General Psychiatry.
Uncertainties about the sources, chemicals, and possible contaminants used to manufacture many club drugs, make it extremely difficult to determine toxicity and resulting medical consequences.
Slang or Street Names: Ecstasy, XTC, X, Adam, Clarity, Lover's Speed
MDMA was developed and patented in the early 1900's as a chemical precursor in the synthesis of pharmaceuticals. Chemically, MDMA is similar to the stimulant amphetamine and the hallucinogen mescaline. MDMA can produce both stimulant and psychedelic effects.
|Methylenedioxyamphetamine (MDA) and methylenedioxyethylamphetamine (MDEA)
are drugs chemically similar to MDMA.||MDMA is taken orally, usually in a tablet or a capsule. MDMA's effects
last approximately 3 to 6 hours, though confusion, depression, sleep
problems, anxiety, and paranoia have been reported to occur even weeks after
the drug is taken.||MDMA can produce a significant increase in heart rate and blood pressure
and a sense of alertness like that associated with amphetamine use.||The stimulant effects of MDMA, which enable users to dance for extended
periods, may also lead to dehydration, hypertension, and heart or kidney
MDMA can be extremely dangerous in high doses. It can cause a marked increase in body temperature (malignant hyperthermia) leading to the muscle breakdown and kidney and cardiovascular system failure reported in some fatal cases at raves. MDMA use may also lead to heart attacks, strokes, and seizures in some users.
MDMA is neurotoxic. Chronic use of MDMA was found, first in laboratory animals and more recently in humans, to produce long-lasting, perhaps permanent, damage to the neurons that release serotonin, and consequent memory impairment.
*MDMA use has been reported across the country, including many of the 21 cities that comprise NIDA's Community Epidemiology Work Group (CEWG), a network of researchers that provide ongoing community-level surveillance of drug abuse. CEWG cities in which MDMA use has been reported inlcude: Chicago, Denver, Miami, Atlanta, New Orleans, San Francisco, Austin, Seattle, Boston, Detroit, New York, St. Louis, Dallas, and Washington, D.C.
Slang or Street Names: Grievous Bodily Harm, G, Liquid Ecstasy, Georgia Home Boy
GHB can be produced in clear liquid, white powder, tablet, and capsule forms, and it is often used in combination with alcohol, making it even more dangerous. GHB has been increasingly involved in poisonings, overdoses, "date rapes," and fatalities. The drug is used predominantly by adolescents and young adults, often when they attend nightclubs and raves. GHB is often manufactured in homes with recipes and ingredients found and purchased on the Internet.
|GHB is usually abused either for its intoxicating/sedative/euphoriant
properties or for its growth hormone-releasing effects, which can build
muscles.||Some individuals are synthesizing GHB in home laboratories. Ingredients in
GHB, gamma-butyrolactone (GBL) and 1,4-butanediol, can also be converted by
the body into GHB. These ingredients are found in a number of dietary
supplements available in health food stores and gymnasiums to induce sleep,
build muscles, and enhance sexual performance.||GHB is a central nervous system depressant that can relax or sedate the
body. At higher doses it can slow breathing and heart rate to dangerous
levels.||GHB's intoxicating effects begin 10 to 20 minutes after the drug is taken.
The effects typically last up to 4 hours, depending on the dosage. At lower
doses, GHB can relieve anxiety and produce relaxation; however, as the dose
increases, the sedative effects may result in sleep and eventual coma or
death.||Overdose of GHB can occur rather quickly, and the signs are similar to
those of other sedatives: drowsiness, nausea, vomiting, headache, loss of
consciousness, loss of reflexes, impaired breathing, and ultimately death.||GHB is cleared from the body relatively quickly, so it is sometimes
difficult to detect in emergency rooms and other treatment facilities.|
*CEWG cities in which GHB use has been reported include: Detroit, Phoenix, Honolulu, Miami, New York , Atlanta, Minneapolis/St. Paul, Dallas, Seattle, San Francisco, San Diego, New Orleans, Newark, Los Angeles, Baltimore, Boston, and Denver.
Slang or Street Names: Special K, K, Vitamin K, Cat Valiums
Ketamine is an injectable anesthetic that has been approved for both human and animal use in medical settings since 1970. About 90 percent of the ketamine legally sold today is intended for veterinary use.
|Ketamine gained popularity for abuse in the 1980s, when it was realized
that large doses cause reactions similar to those associated with use of
phencyclidine (PCP), such as dream-like states and hallucinations.||Ketamine is produced in liquid form or as a white powder that is often
snorted or smoked with marijuana or tobacco products. In some cities
(Boston, New Orleans, and Minneapolis/St. Paul, for example), ketamine is
reportedly being injected intramuscularly.||At higher doses, ketamine can cause delirium, amnesia, impaired motor
function, high blood pressure, depression, and potentially fatal respiratory
problems.||Low-dose intoxication from ketamine results in impaired attention,
learning ability, and memory.|
*CEWG cities in which Ketamine use has been reported include: Seattle, Miami, New York, Chicago, Minneapolis/St. Paul, Newark, Boston, Detroit, New Orleans, and San Diego.
Slang or Street Names: Roofies, Rophies, Roche, Forget-me Pill
Rohypnol® (flunitrazepam) belongs to the class of drugs known as benzodiazepines (such as Valium®, Halcion®, Xanax®, and Versed®). It is not approved for prescription use in the United States, although it is approved in Europe and is used in more than 60 countries as a treatment for insomnia, as a sedative, and as a presurgery anesthetic.
|Rohypnol is tasteless and odorless, and it dissolves easily in carbonated
beverages. The sedative and toxic effects of Rohypnol are aggravated by
concurrent use of alcohol. Even without alcohol, a dose of Rohypnol as small
as 1 mg can impair a victim for 8 to 12 hours.||Rohypnol is usually taken orally, although there are reports that it can
be ground up and snorted.||The drug can cause profound "anterograde amnesia"; that is,
individuals may not remember events they experienced while under the effects
of the drug. This may be why one of the street names for||Rohypnol is "the forget-me pill" and it has been reportedly used
in sexual assaults.||Other adverse effects associated with Rohypnol include decreased blood
pressure, drowsiness, visual disturbances, dizziness, confusion,
gastrointestinal disturbances, and urinary retention.|
*CEWG cities in which Rohypnol use has been reported include: Miami, Houston, and along the Texas-Mexico border.
Slang or Street Names: Speed, Ice, Chalk, Meth, Crystal, Crank, Fire, Glass
Methamphetamine is a toxic, addictive stimulant that affects many areas of the central nervous system. The drug is often made in clandestine laboratories from relatively inexpensive over-the-counter ingredients. It is being used by diverse groups, including young adults who attend raves, in many regions of the country.
Available in many forms, methamphetamine can be smoked, snorted, injected, or orally ingested.
|Methamphetamine is a white, odorless, bitter-tasting crystalline powder
that easily dissolves in beverages.||Methamphetamine is not sold in the same way as many other illicit drugs;
it is typically sold through networks, not on the street.||Methamphetamine use is associated with serious health consequences,
including memory loss, aggression, violence, psychotic behavior, and
potential cardiac and neurological damage.||Methamphetamine abusers typically display signs of agitation, excited
speech, decreased appetite, and increased physical activity levels.||Methamphetamine is neurotoxic. Methamphetamine abusers may have
significant reductions in dopamine transporters.||Methamphetamine use can contribute to higher rates of transmission of
infectious diseases, especially hepatitis and HIV/AIDS.|
*CEWG cities in which Methamphetamine use has been reported include: San Diego, San Francisco, Phoenix, Atlanta, St. Louis, Denver, Honolulu, Los Angeles, Minneapolis/St. Paul, Philadelphia, Seattle, Dallas, and many rural regions of the country.
Slang or Street Names: Acid, Boomers, Yellow Sunshines
LSD is a hallucinogen. It induces abnormalities in sensory perceptions. The effects of LSD are unpredictable depending on the amount taken, on the surroundings in which the drug is used, and on the user's personality, mood, and expectations.
|LSD is typically taken by mouth. It is sold in tablet, capsule, and liquid
forms as well as in pieces of blotter paper that have absorbed the drug.||Typically an LSD user feels the effects of the drug 30 to 90 minutes after
taking it. The physical effects include dilated pupils, higher body
temperature, increased heart rate and blood pressure, sweating, loss of
appetite, sleeplessness, dry mouth, and tremors.||LSD users report numbness, weakness, or trembling, and nausea is common.||There are two long-term disorders associated with LSD, persistent
psychosis and hallucinogen persisting perception disorder (which used to be
*CEWG cities in which LSD use has been reported include: Boston, Detroit, Seattle, Chicago, Denver, New Orleans, San Francisco, Atlanta, and Phoenix.
*Information from NIDA's Community Epidemiology Work Group (CEWG), a network of epidemiologists and researchers from 21 U.S. metropolitan areas who monitor drug use trends.
This publication may be reprinted without permission.
For free publications contact the National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686
More information on Club Drugs