raves, club drugs, and drugs of abuse dr. milton h. cambridge demand reduction outreach and...
TRANSCRIPT
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Raves, Club Drugs, and Drugs of Abuse
Dr. Milton H. Cambridge
Demand Reduction Outreach and Prevention Coordinator
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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
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Environment
• All night event• Clandestine – warehouses, deserts, woods, etc.• Commercialized – established clubs• Hot• Loud• Crowded• Dancing• Criminal element often present
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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
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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
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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
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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
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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
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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
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Ecstasy ED Mentionsper 100,000 pop.
0
1
2
3
4
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
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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
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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
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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
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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
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4-Methylthioamphetamine
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Methamphetamine ED Mentions
0
5,000
10,000
15,000
20,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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Amphetamines ED Mentions
0
5,000
10,000
15,000
20,000
25,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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GHB/GBL ED Mentions
0
1000
2000
3000
4000
5000
6000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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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
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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)
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Ketamine ED Mentions
0
100
200
300
400
500
600
700
800
1994 1995 1996 1997 1998 1999 2000 2001 2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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Rohypnol ED Mentions
0
10
20
30
40
50
60
70
80
1995 1996 1997 1998 1999 2000 2001 2002
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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
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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
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Oxycodone ED Mentions*
0
5,000
10,000
15,000
20,000
25,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
* Includes mentions for oxycodone, acetaminophen-oxycodone and aspirin-oxycodone
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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
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Cocaine ED Mentions
0
50,000
100,000
150,000
200,000
250,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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Cocaine ED Mentionsper 100,000 pop.
0
50
100
150
200
250
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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• 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)
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PCP ED Mentions
0100020003000400050006000700080009000
1994 1995 1996 1997 1998 1999 2000 2001
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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Heroin ED Mentions
0
20,000
40,000
60,000
80,000
100,000
1994
1995
1996
1997
1998
1999
2000
2001
2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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Heroin ED Mentionsper 100,000 pop.
050
100150200250300350400450
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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)
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Inhalant ED Mentions
0
500
1000
1500
2000
1995 1996 1997 1998 1999 2000 2001 2002
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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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
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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
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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Marijuana ED Mentionsper 100,000 pop.
0
20
40
60
80
100
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
Washington DC
Source: Substance Abuse and Mental Health Services
Administration, Drug Abuse Warning Network
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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
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Dextromethorphan ED Mentions
0
10
20
30
40
50
60
70
80
1995 1996 1997 1998 1999 2000 2001 2002
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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
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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
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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
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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