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.
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Community Drug Alert Bulletin
A number of our Nation's best monitoring mechanisms are detecting alarming
increases in the popularity of some very dangerous substances known
collectively as "club drugs." This term refers to drugs being used by young
adults at all-night dance parties such as "raves" or "trances," dance clubs,
and bars. MDMA (Ecstasy), GHB, Rohypnol, ketamine, methamphetamine, and LSD
are some of the club or party drugs gaining popularity. NIDA-supported
research has shown that use of club drugs can cause serious health problems
and, in some cases, even death. Used in combination with alcohol, these
drugs can be even more dangerous. Thus, we are issuing this alert to aid
communities in identifying and responding to this threat to the health and
safety of their young people.
"Club drug" is a vague term that refers to a wide variety of drugs.
Uncertainties about the drug sources, pharmacological agents, chemicals used
to manufacture them, and possible contaminants make it difficult to
determine toxicity, consequences, and symptoms that might be expected in a
particular community. The information in this alert will be useful,
whatever the local situation.
No club drug is benign. Chronic abuse of MDMA, for example, appears to
produce long-term damage to serotonin-containing neurons in the brain.
Given the important role that the neurotransmitter serotonin plays in
regulating emotion, memory, sleep, pain, and higher order cognitive
processes, it is likely that MDMA use can cause a variety of behavioral and
cognitive consequences as well as impairing memory.
Because some club drugs are colorless, tasteless, and odorless, they can be
added unobtrusively to beverages by individuals who want to intoxicate or
sedate others. In recent years, there has been an increase in reports of
club drugs used to commit sexual assaults - yet another reason why NIDA is
alerting you to these escalating trends.
What follows is an overview of the scientific data we have on several of the
most prevalent club drugs. Because many of these drug-use trends are still
emerging, some of the data presented here are preliminary. However, we feel
obliged to share what we know now, to provide whatever help we can to you
and your community as you anticipate or respond to club drug-related
problems. We also will be increasing our research efforts on club drugs to
better understand how they act on the brain and how they produce their
behavioral effects. And we will facilitate the development of treatment and
prevention strategies targeted to the populations that abuse club drugs. As
new research emerges, NIDA will continue to disseminate findings to you
quickly. Toward this end, we are establishing a web site to provide
scientific information about club drugs - www.clubdrugs.org. We hope this
information will be helpful as you combat drug use in your own community.
Alan I. Leshner, Ph.D.
Some Facts About Club Drugs
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
*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
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
- GHB is usually abused either for its intoxicating/sedative/euphoriant
properties or for its growth hormone-releasing effects, which can build
- 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
- 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
- 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,
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
- 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
- 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.
Lysergic Acid Diethylamide (LSD)
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,
- 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 called
*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.
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