Club drugs have become the drugs of choice at all night dance parties. These dance parties are often referred to as raves or trances and are generally frequented by young adults. These dance parties are held at clubs, bars and hotels. These high energy parties frequently involve loud rock music and flashing neon or laser lights. These all night parties frequented by ravers are almost always associated with the use of club drugs.
The use of club drugs has increased significantly over the past 2 decades. The danger of mixing alcohol and club drugs also has the potential to cause serious intoxication and fatalities are not unheard of.
MDMA, GHB, Rohypnol, Ketamine, Methamphetamine, and LSD are the most common club drugs used at these parties. One reason for their increased use is the easy availability, low cost and their intoxicating effects produced. Because the majority of the club drugs are colorless, tasteless and odorless, they can easily be added inconspicuously to beverages by persons who want to intoxicate or sedate others individuals.
Because of the tendency of club drugs to sedate others, the subject of date rape has become a recent concern. Date rapes have been on the rise and often involve friends and associates. These drugs have the potential to cause retrograde amnesia and thus the victims usually are unable to remember or have any memory of the event. These drugs also have the ability to decrease a person’s inhibition and alter the mental capacity of individuals. These factors make it easy to date rape friends or acquaintances.
Due to the increased demands for these drugs and the potential to make money, many individuals intentionally manufacture them under less than ideal conditions. Thus possible contamination and impurities are always a concern for users.
The most widely used club drug is MDMA (Ecstasy). MDMA was developed and marketed in the early 1990s as an appetite suppressant, although it has never been clinically used in humans. The drug bears a strong resemblance to amphetamine like drugs. When ingested, it can produce brain stimulation with a dominance of hallucinogens and psychedelic effects. Over the past decade the use of the drug has slightly declined among older individuals but the use of MDMA is still on the increase by teenagers and college students.
MDMA has dual properties acting as a brain stimulant and also has the ability to generate hallucinogenic effects. Ecstasy is an available as a pill/capsule which is easily concealed. Its duration of action is known to last at least 4-8 hours. In a few people it can cause idiosyncratic reactions like depression, insomnia and severe anxiety for long periods, ranging from a few days to weeks. Other common side effects of ecstasy include panic attacks, syncope, coma, seizures, chills, diaphoresis, muscle cramps and blurred vision. Deaths have been known to occur especially when the drug is combined with alcohol or other club drugs. MDMA is known to cause malignant hyperthermia which is fatal if not treated.
MDMA use enables the individual to be awake for extended periods, but this may lead to dehydration, heart or kidney failure due to lack of appetite and physical over activity. MDMA is neurotoxic agent and its affects to the brain are permanent if used chronically.
Gamma Hydroxyl Butyrate (GHB)
GHB (liquid ecstasy) is a strong sedative and often used as “date rape” drug. The drug is available as a clear liquid, powder, capsule or pill and is easily dissolved in alcohol or soft drinks. Once ingested, the drug rapidly takes effect and the sedative effects can last up to 4-6 hours. Prolonged loss of consciousness, breathing difficulties, seizures, coma and even death has been reported with the drug.
The drug is used predominantly by adolescents and young adults during all night parties. The drug is often manufactured at home by obtaining ingredients purchased from local food stores, pharmacies and the internet. The drug has the potential to be a strong sedative and also has euphoric effects. Also noticed over the past decade is that GHB can release anabolic hormones which can increase muscle size. Some claim that GHB is also a potent aphrodisiac like chemical.
Because GHB is a central nervous system depressant, it can also lead to increased lethargy, coma and even death. Overdose with GHB are not rare especially when it is ingested with alcohol or other CNS suppressant drugs. The drug is rapidly excreted from the body and often escapes detection in the body when patients are admitted to hospital.
Rohypnol (flunitrazepam) is also known as Rophies. It belongs to the benzodiazepine class of drugs (such as valium) and acts like a sedative. It is not approved for clinical use in the USA, but is approved as a sedative in Europe. Because of its ability to cause antegrade/retrograde amnesia, it is often used in anesthesia.
The drug is tasteless and odorless and is easily dissolved in both nonalcoholic and alcoholic beverages, thus making it a popular “date rape” drug. The drug is very potent and has a prolonged action which can last up to 12 hours. When combined with alcohol, it is known to cause mental confusion and lethargy. Drowsiness, dizziness, mental slowing lethargy and constipation can result with the use of rohypnol. Deaths have been reported with the drug when combined with alcohol.
Methamphetamine (speed) is a brain stimulant that causes delusions of grandeur, hyperexcitation, irritability, anxiety, and panic. The drug is frequently manufactured in clandestine factories using impure and cheap ingredients. The drug may be ingested, inhaled or even smoked. It is associated with a number of serious side effects which include mental confusion, extreme aggression, paranoia, psychotic ideations and damage to the heart. It has a great potential to be addictive. It is available as a pill, capsule or powder; the drug can be ingested, snorted, injected or smoked. Its actions may last up to 24 hours. When first ingested, it always produces an intense rush and a feeling of extreme confidence and euphoria.
Overdose with the drug can cause extreme agitation, slurred speech, fever, hallucinations, seizures and death. Methamphetamine is known to cause irreversible damage to the heart, kidney, lung and liver. When the drug is injected, the spread of HIV has been known to occur, especially in those sharing needles.
LSD (acid) is a chemical with hallucinogenic properties and has the ability to generate extra sensory perceptions. The effects of LSD are highly unpredictable. Different individuals experience different perceptions, depending on their pre morbid personality.
LSD is available as a clear liquid, tablet, capsule, or the drug may be leached on to pieces of paper which can be swallowed. The effects of LSD are apparent within 20-40 minutes after ingestion and can cause a mild increase in heart rate, blood pressure, diaphoresis and a loss of appetite. Dry mouth and restlessness are also common features.
Overdose can cause dramatic visual flashbacks, psychotic ideations and delusions of grandeur. Extrasensory perceptions such as sound and colors are amplified. Some individuals may experience severe reactions such as frightening vivid imaginations and this is referred to as a “bad trip”. Bad trip reactions can often last from 12-24 hours. Those who use LSD chronically are prone to developing psychotic ideations and recurrent hallucinations.
Ketamine is a general anesthetic used in clinical medicine. It is widely used in animal medicine also and has properties similar to the hallucinogen, Phencyclidine. The agent has the ability to cause dissociative anesthesia and is available as a liquid or powder.
After anesthesia with ketamine, patients have reported hallucinations and dream like states. Illicit use is common with this agent that can be inhaled, injected or even smoked with marijuana or cigarettes. The drug can increase blood pressure and may even cause difficulty in breathing. Deaths have been reported with this drug. Prolonged use of ketamine often leads to mental confusion, impaired learning and loss of memory.
Club drugs are illegal drugs which are widely used at all night parties. Almost all of them have the potential to cause serious health problems and death is always a concern. The drugs have the potential to cause addiction with serious consequences. Club drugs are frequently used as “date rape" drugs and thus all friends' acquaintances and associates “beware”.
- Anglin D, Spears KL, Hutson HR. Flunitrazepam and its involvement in date or acquaintance rape. Acad Emerg Med. Apr 1997;4(4):323-6.
- Arria AM, Yacoubian GS, Fost E, Wish ED. The pediatric forum: ecstasy use among club rave attendees. Arch Pediatr Adolesc Med. Mar 2002; 156(3):295-6.
- Bialer PA. Designer drugs in the general hospital. Psychiatr Clin North Am. Mar 2002; 25(1):231-43.
- Ellenhorn MJ, Barceloux DG, eds. Amphetamines and designer drugs. In: Ellenhorn's Medical Toxicology. 2nd ed. Baltimore, Md: Lippincott Williams & Wilkins; 1997:340-48.
- Klein-Schwartz W. Abuse and toxicity of methylphenidate. Curr Opin Pediatr. Apr 2002; 14(2):219-23.
- Koesters SC, Rogers PD, Rajasingham CR. MDMA ('ecstasy') and other 'club drugs'. The new epidemic. Pediatr Clin North Am. Apr 2002; 49(2):415-33.
- 12. Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002:2119-2215.
- Smith KM, Larive LL, Romanelli F. Club drugs: methylenedioxymethamphetamine, flunitrazepam, ketamine
- Weiner AL. Emerging drugs of abuse in Connecticut. Conn Med. Jan 2000; 64(1):19-23.
- Hydrochloride, and gamma-hydroxybutyrate. Am J Health Syst Pharm. Jun 1 2002; 59(11):1067-76.