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CORK Bibliography: PCP (Phencyclidine)

63 citations. January 1996 to present

Prepared: March 2012

Bobo WV; Miller SC; Martin BD. The abuse liability of dextromethorphan among adolescents: A review. (review). Journal of Child & Adolescent Substance Abuse 14(4): 55-75, 2005. (108 refs.)

Dextromethorphan (DM) is a popular over-the-counter antitussive medication. Although adverse effects from appropriate use are rare, a specific toxidrome with significant psychomimetic effects occurs with ingestions in excess of those recommended. Both DM and its active metabolite, dextrorphan (DOR), share pharmacologic and neurobehavioral properties similar to opiates and phencyclidine (PCP). As Such, cases of recreational DM abuse and, rarely, dependence, have been reported, and some data Suggest that Such abuse is on the rise. DM may be considered by substance abusers, especially adolescents, to be a dissociative agent devoid of financial concerns, legal limitations, negative stigma, problems with access or adverse health consequences. However, DM's popularity among adolescent substance abusers is generally not matched by adequate health care provider awareness, pharmacological understanding or epidemiological characterization. In this review, we summarize the current understanding of DM's addiction medicine-based neuropharmacology and epidemiology, describe social characteristics more unique to DM as in agent of abuse, review treatment and prevention issues, and identify areas in need of further research.

Copyright 2005, Haworth Press, Inc.

Brault M; Dussault C; Bouchard J. The contribution of alcohol and other drugs among fatally injured drivers in Quebec: Final results. Glasgow: ICADTS, 2004. (9 refs.)

This study presents the final results regarding the contribution of alcohol and other drugs in fatal crashes in Quebec. The data comes from two sources. The first is coroner, forensic laboratory and police accident records matched for 859 fatally injured drivers between April 1999 and December 2002. Of these blood and urine samples were obtained in 63% of the cases. Second, two roadside surveys were conducted, representative of the driving population, distributed proportionally to number and time of fatal crashes per day. Almost 12,000 drivers participated; 97% providing a breath sample and 50% provided a urine sample. Among fatally injured drivers, drugs were found in the following percent of drivers: alcohol (35%), cannabis (18.5%), cocaine 7.6%, benzodiazepines, (9.7%), PCP (0.9%), opiates (1.7%), barbiturates (0.2%), and amphetamines (0.9%). Among the drivers participating in the road survey, the following drugs and percentage of drivers in which they were identified in urine samples is as follows: cannabis (6.7%), benzodiazepines (3.6%^), cocaine (1.1%), opiates (1.2%), barbiturates (0.5%), amphetamines (0.1%) and PCP (0.03%). The coroner and police accident report files remain to be matched and a case-control analysis be conducted. There is an accompanying PowerPoint presentation with 20 slides.

Copyright 2006, Project Cork

Brust JCM. Substance abuse and movement disorders. (review). Movement Disorders 25(13): 2010-2020, 2010 , 2010. (175 refs.)

An array of movement disorders is associated with ethanol, illicit drugs, and tobacco. Heavy ethanol users experience withdrawal tremor and, less often, withdrawal parkinsonism, chorea, and myoclonus. Asterixis is a feature of hepatic failure. On the other hand, ethanol can ameliorate essential tremor and myoclonus-dystonia. Among opioid drugs, meperidine can precipitate myoclonus. Severe parkinsonism affected users of a synthetic meperidine analog contaminated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Spongiform leukoencephalopathy, sometimes with chorea and myoclonus, occurred in inhalers of heroin vapor (chasing the dragon). Psychostimulants including cocaine acutely cause stereotypies and dyskinesias. Phencyclidine toxicity causes myoclonus. Tobacco use, on the other hand, protects against Parkinson's disease. Clinicians need to consider substance abuse in patients with unexplained movement disorders.

Copyright 2010, Movement Disorder Society

Carls KA; Ruehter VL. An evaluation of phencyclidine (PCP) psychosis: A retrospective analysis at a state facility. American Journal of Drug and Alcohol Abuse 32(4): 673-678, 2006. (13 refs.)

It has been reported in the literature that phencyclidine (PCP) psychosis recovery may take up to 4-6 weeks. This retrospective review sought to determine whether patients with a new onset of PCP psychosis have a longer hospitalization than those patients with new onset functional psychosis. The PCP arm (N = 20) was found to have a significantly shorter hospitalization than those with a new onset functional psychosis (N = 20)-mean 4.8 days (range 1-9) versus 13.6 days (range 3-41), p < .05. In addition, patients with psychosis related to PCP use were treated more aggressively with conventional antipsychotics than patients with a new onset functional psychosis at this facility.

2006, Marcel Dekker, Inc.

Dziegielewski SF; Bersch TA. LSD, ecstasy, and PCP. IN: Dziegielewski SF, ed. Understanding Substance Addictions: Assessment and Interventions. Chicago: Lyceum Books, 2005. pp. 208-224. (36 refs.)

This chapter discusses the most common psychedelic substances -- LSD, ecstasy, and PCP, all of which are classified as Schedule I by the Food and Drug Administration, meaning they have no medical uses. For each drug there is discussion of the prevalence, associated problems, and best practices in respect to interventions.

Copyright 2006, Project Cork

Goessaert AS; Pil K; Veramme J; Verstraete A. Analytical evaluation of a rapid on-site oral fluid drug test. Analytical and Bioanalytical Chemistry 396(7): 2461-2468, 2010. (12 refs.)

There is a need for a reliable rapid on-site oral fluid test that can be used in police controls to detect impaired drivers. We evaluated the Varian OralabA (R) 6 and collected two oral fluid samples from 250 subjects, one with the Varian OralabA (R) 6 and one with the StatSure (TM) SalivaaEuro cent Sampler (TM). The OralabA (R) 6 can detect six drug types: amphetamines, methamphetamine, cocaine, opiates, delta9-tetrahydrocannabinol (THC), and phencyclidine (PCP). On-site results were obtained within 10 to 15 min. The sample collected with StatSure (TM) was analyzed using liquid chromatography-tandem mass spectrometry after liquid-liquid extraction and these results were used as a reference to determine prevalence, sensitivity, and specificity. Two cut-off values were used in the evaluation. The Varian cut-off values were: amphetamine 50 ng/mL, cocaine 20 ng/mL, opiates 40 ng/mL, and THC 50 ng/mL. The DRUID cut-offs were: amphetamine 25 ng/mL, cocaine 20 ng/mL, opiates 20 ng/mL, and THC 1 ng/mL. Applying the first cut-offs, prevalence, sensitivity, and specificity were: amphetamine 10%, 76%, 100%; cocaine 23%, 34%, 100%; opiates 38%, 83%, 94%; and THC 18%, 41%, 99%. The DRUID cut-off values gave the following results: amphetamine 14%, 56%, 100%; cocaine 28%, 34%, 100%; opiates 49%, 68%, 98%, and THC 45%, 16%, 99%. The specificity of the OralabA (R) 6 is generally good. For both cut-offs, sensitivity was low for cocaine and THC. Therefore, the Varian OralabA (R) 6 test is not sensitive enough to be applied during roadside police controls.

Copyright 2010, Springer

Gouzoulis-Mayfrank E; Heekeren K; Neukirch A; Stoll M; Stock C; Obradovic M et al. Psychological effects of (S)-ketamine and N,N-dimethyltryptamine (DMT): A double-blind, cross-over study in healthy volunteers. Pharmacopsychiatry 38(6): 301-311, 2005. (81 refs.)

Introduction: Pharmacological challenges with hallucinogens are used as models for psychosis in experimental research. The state induced by glutamate antagonists such as phencyclidine (PCP) is often considered as a more appropriate model of psychosis than the state induced by serotonergic hallucinogens such as lysergic acid diethylamide (LSD), psilocybin and N,N-dimethyltryptamine (DMT). However, so far, the psychological profiles of the two types of hallucinogenic drugs have never been studied directly in an experimental within-subject design. Methods: Fifteen healthy volunteers were included in a double-blind, crossover study with two doses of the serotonin 5-HT2A agonist DMT and the glutamate N-methyl-d-aspartate (NMDA) antagonist (S)-ketamine. Results: Data are reported for nine subjects who completed both experimental days with both doses of the two drugs. The intensity of global psychological effects was similar for DMT and (S)-ketamine. However, phenomena resembling positive symptoms of schizophrenia, particularly positive formal thought disorder and inappropriate affect, were stronger after DMT. Phenomena resembling negative symptoms of schizophrenia, attention deficits, body perception disturbances and catatonia-like rnotor phenomena were stronger after (S)-ketamine. Discussion: The present study suggests that the NMDA antagonist model of psychosis is not overall superior to the serotonin 5-HT2A agonist model. Rather, the two classes of drugs tend to model different aspects or types of schizophrenia. The NMDA antagonist state may be an appropriate model for psychoses with prominent negative and possibly also catatonic features, while the 5-HT2A agonist state may be a better model for psychoses of the paranoid type.

Copyright 2005, Georg Thieme Verlag KG

Gonzalez-Maeso J; Sealfon SC. Psychedelics and schizophrenia. Trends in Neurosciences 32(4): 225-232, 2009. (86 refs.)

Research on psychedelics such as lysergic acid diethylamide (LSD) and dissociative drugs such as phencyclidine (PCP) and the symptoms, neurochemical abnormalities and treatment of schizophrenia have converged. The effects of hallucinogenic drugs resemble some of the core symptoms of schizophrenia. Some atypical antipsychotic drugs were identified by their high affinity for serotonin 5-HT2A receptors, which is also the target of LSD-like drugs. Several effects of PCP-like drugs are strongly affected by both 5-HT2A and metabotropic glutamate 2/3 receptor modulation. A serotonin-glutamate receptor complex in cortical pyramidal neurons has been identified that might be the target both of psychedelics and the atypical and glutamate classes of antipsychotic drugs. Recent results on the receptor, signaling and circuit mechanisms underlying the response to psychedelic and antipsychotic drugs might lead to unification of the serotonin and glutamate neurochemical hypotheses of schizophrenia.

Copyright 2009, Elsevier Science

Greydanus DE; Patel DR. The adolescent and substance abuse: Current concepts. Disease-a-Month 51(7): 392-431, 2005. (93 refs.)

This review addresses alcohol and other drug use among adolescents. The article addresses its etiology, adolescent development and how this is affected by and influences substance use. It also addresses factors which may be risk factors including the presence of psychiatric illness, environmental stresses and the widespread availability and access to drugs. The symptoms and stages of drug use and abuse are described. Specific attention is directed to alcohol, marijuana, nicotine, cocaine, opiates, amphetamines, methamphetamines, ecstasy, ketamine, the inhalants, gamma-hydroxybutyrate, barbiturates, PCP, as well as agents used to enhance athletic performance, including the anabolic steroids. There is also discussion of management and approaches to treatment. There are twenty-nine accompanying tables.

Copyright 2005, Mosby Inc.

Hoaken PNS; Stewart SH. Drugs of abuse and the elicitation of human aggressive behavior. (review). Addictive Behaviors 28(9): 1533-1554, 2003. (158 refs.)

The drug-violence relationship exists for several reasons, some direct (drugs pharmacologically inducing violence) and some indirect (violence occurring in order to attain drugs). Moreover, the nature of that relationship is often complex, with intoxication, neurotoxic, and withdrawal effects often being confused and/or confounded. This paper reviews the existing literature regarding the extent to which various drugs of abuse may be directly associated with heightened interpersonal violence. Alcohol is clearly the drug with the most evidence to support a direct intoxication-violence relationship. The literatures concerning benzodiazepines, opiates, psychostimulants, and phencyclidine (PCP) are idiosyncratic but suggest that personality factors may be as (or more) important than pharmacological ones. Cannabis reduces likelihood of violence during intoxication, but mounting evidence associates withdrawal with aggressivity. The literature on the relationship between steroids and aggression is largely confounded, and between 3,4-methylenedioxymethamphetamine (MDMA) and aggression insufficient to draw any reasonable conclusions. Conclusions and policy implications are briefly discussed.

Copyright 2003, Elsevier Ltd.

Holland JA; Nelson L; Ravikumar PR; Elwood WN. Embalming fluid-soaked marijuana: New high or new guise for PCP? Journal of Psychoactive Drugs 30(2): 215-219, 1998. (18 refs.)

A growing trend of smoking marijuana soaked in what is purported to be embalming fluid has been reported in the literature since the mid-1980s. This article describes several cases of intoxication, gives regional epidemiological data on this phenomenon, and includes current nomenclature. The authors also analyze a sample of fluid said to be embalming fluid and discover PCP (phencyclidine) and multiple congeners and by-products of PCP manufacture. The implications of this finding are discussed, and the hypothesis that most embalming fluid-soaked marijuana likely contains PCP is considered.

Copyright 1998, Haight-Ashbury Publications

Jenkins AJ. Drug contamination of US paper currency. Forensic Science International 121(3): 189-193, 2001. (14 refs.)

It is known that US paper currency in the general circulation is contaminated with cocaine. Several mechanisms have been offered to explain this finding, including contamination due to handling during drug deals and the use of rolled up bills for snorting. Drug is then transferred from one contaminated bill to others during counting in financial institutions. The possibility of contamination of currency with other drugs has not been reported. In this study, the author reports the analysis of 10 randomly collected US$ 1 bills from five cities, for cocaine, heroin, 6-acetylmorphine (6-AM), morphine, codeine, methamphetamine, amphetamine and phencyclidine (PCP). Bills were immersed in acetonitrile for 2 h prior to extraction and GC-MS analysis. Results showed that 92% of the bills were positive for cocaine with a mean amount of 28.75 +/- 139.07 Vg per bill, a median of 1.37 mug per bill, and a range of 0.01-922.72 etag per bill. Heroin was detected in seven bills in amounts ranging from 0.03 to 168.50 [tg per bill: 6-AM and morphine were detected in three bills; methamphetamine and amphetamine in three and one bills, respectively, and PCP was detected in two bills in amounts of 0.78 and 1.87 pg per bill. Codeine was not detected in any of the US$ 1 bills analyzed. This study demonstrated that although paper currency was most often contaminated with cocaine, other drugs of abuse may be detected and a posited in bills.

Copyright 2001, Elsevier Scientific Publishers Ireland, Ltd.

Jenkins AJ; Engelhart DA. Phencyclidine detection in nails. (letter). Journal of Analytical Toxicology 30(8): 643-644, 2006. (8 refs.)

Johnston LD; O'Malley PM; Bachman JG. Monitoring the Future: National Survey Results on Drug Use, 1975-2000. Volume I: Secondary school students. Bethesda MD: Department of Health and Human Services, 2001. (0 refs.)

This is the first of a two-volume monograph reporting the results of the 2000 national survey of drug use and related attitudes and beliefs among American eighth-, tenth-, and twelfth-grade students and college students. Drugs covered include marijuana, cigarettes, LSD, ecstasy (MDMA), amphetamines, methamphetamine, inhalants, cocaine, crack cocaine, PCP, heroin, and alcohol. Among the findings are that alcohol has been used by 52 percent of eighth graders, 71 percent of tenth graders, 80 percent of twelfth graders, and 87 percent of college students. Heavy drinking, defined as five or more drinks in a row at least once in the prior 2-week period, was reported by 14 % of eighth graders, 26% of tenth graders, 30% of twelfth graders, and 39% of college students. Alcohol use did not increase as other illicit drugs decreased among seniors from the late 1970s to the early 1990s, contrary to the "displacement hypothesis." Instead, alcohol and other illicit drug use by seniors have tended to move in the same direction. There is a substantial gender difference among high school seniors in the prevalence of heavy drinking occasions (24 percent for females versus 37 percent for males in 2000). However, this differential has been diminishing across time. Prevalences of monthly, daily, and heavy alcohol use declined from 1980 to 1993 for high school seniors and college students, but less among college students.

Copyright 2001, Project Cork

Kidwell DA; Holland JC; Athanaselis S. Testing for drugs of abuse in saliva and sweat. (review). Journal of Chromatography B 713(1): 111-135, 1998. (204 refs.)

The detection of marijuana, cocaine, opiates, amphetamines, benzodiazepines, barbiturates, PCP, alcohol and nicotine in saliva and sweat is reviewed, with emphasis on forensic applications. The short window of detection and lower levels of drugs present compared to levels found in urine limits the applications of sweat and saliva screening for drug use determination. However, these matrices may be applicable for use in driving while intoxicated and surveying populations far illicit drug use. Although not an illicit drug, the detection of ethanol is reviewed because of its importance in driving under the influence. Only with alcohol may saliva be used to estimate blood levels and the degree of impairment because of the problems with oral contamination and drug concentrations varying depending upon how the saliva is obtained. The detection of nicotine and cotinine (from smoking tobacco) is also covered because of its use in life insurance screening and surveying for passive exposure.

Copyright 1998, Elsevier Science BV

Kosten T; Owens M. Immunotherapies for substance abuse. IN: Dewey WL, ed. Problems of Drug Dependence 2003: Proceedings of the 65th Annual Scientific Meeting. Rockville MD: National Institute on Drug Abuse, 2004. pp. 31-33. (0 refs.)

Medications based on immunological therapies are currently in pre-clinical and human trials for cocaine, nicotine, methamphetamine, and phencyclidine (PCP). The purpose of this symposium is to show experimental data from animal and human models of clinical scenarios in which these new therapeutic approaches might prove useful. These modes include reduction of drug self-administration, treatment of excessive drug use, and prevention of brain or cardiac toxicity. As an example, pre-clinical behavioral studies in rats show active immunization against cocaine and nicotine, or passive administration with anti-methamphetamine monoclonal antibodies might be used to reduce drug self-administrant, even when the drug dowse appears to exceed the apparent antibody binding capacity. Experimental data is show about the use methamphetamine and phencyclidine monoclonal antibodies for the treatment of excessive drug use. Data is also presented on the immunization of rats with a nicotine conjugate vaccine for the passive transfer of nicotine-specific antibodies substantially reduce maternal nicotine distribution to the fetal brain and attenuates the acquisition of nicotine self-administration. Finally, results from human outpatient clinical trials of a cocaine vaccine, along with their urine toxicology results. These data show that more frequent vaccinations of humans can lead to higher antibody levels. excellent reductions in cocaine use with minimal side effects.

Public Domain

Kosten T; Owens SM. Immunotherapy for the treatment of drug abuse. (review). Pharmacology & Therapeutics 108(1): 76-85, 2005. (62 refs.)

Antibody therapy (as either active or passive immunization) is designed primarily to prevent drugs of abuse from entering the central nervous system (CNS). Antidrug antibodies reduce rush, euphoria, and drug distribution to the brain at doses that exceed the apparent binding capacity of the antibody. This is accomplished through a pharmacokinetic antagonism, which reduces the amount of drug in the brain, the rate of clearance across the blood-brain barrier, and the volume of drug distribution. Because the antibodies remain primarily in the circulatory system, they have no apparent central nervous system side effects. Active immunization with drug-protein conjugate vaccines has been tested for cocaine, heroin, methamphetamine, and nicotine in animal, with I cocaine and 3 nicotine vaccines in Phase 2 human trials. Passive immunization with high affinity monoclonal antibodies has been tested for cocaine, methamphetamine, nicotine, and phencyclidine (PCP) in preclinical animal models. Antibodies have 2 immediate clinical applications in drug abuse treatment: to treat drug overdose and to reduce relapse to drug use in addicted patients. The specificity of the therapies, the lack of addiction liability, minimal side effects, and long-lasting protection against drug use offer major therapeutic benefit over conventional small molecule agonists and antagonists. Immunotherapies can also be combined with other anti-addiction medications and enhance behavioral therapies. Current immunotherapies already show efficacy, but improved antigen design and antibody engineering promise highly specific and rapidly developed treatments for both existing and future addictions.

Copyright 2005, Elsevier Science Ltd.

Lankenau SE; Clatts MC. Patterns of polydrug use among ketamine injectors in New York City. Substance Use & Misuse 40(9-10): 1381-1397, 2005. (35 refs.)

Polydrug use is an important public health issue since it has been linked to significant adverse health outcomes. Recently, club drugs, including ketamine and other drugs used in dance/rave scenes, have been identified as key substances it? new types of polydrug using patterns. While seemingly a self-explanatory concept, "polydrug" use constitutes multiple drug using practices that may impact upon health risks. Ketamine, a club drug commonly administered intranasally among youth for its disassociative properties, has emerged as a drug increasingly prevalent among a new hidden population of injection drug users (IDUs). Using an ethno-epidemiological methodology, we interviewed 40 young (< 25 years old) ketamine injectors in New York during 2000-2002 to describe the potential health risks associated with ketamine and polydrug use. Findings indicate that ketamine was typically injected or sniffed in the context of a polydrug using event. Marijuana, alcohol, PCP, and speed were among the most commonly used drugs during recent ketamine using events. Polydrug using events were often quite variable regarding the sequencing of drug use, the drug combinations consumed, the forms of the drug utilized, and the modes of administrating the drug combinations. Future research should be directed towards developing a more comprehensive description of the risks associated with combining ketamine with other drugs, such as drug overdoses, the transmission of bloodborne pathogens, such as HIV and HCV, the short- and long-term effects of drug combinations on cognitive functioning, and other unanticipated consequences associated with polydrug use.

Copyright 2005, Marcel Dekker, Inc

Lejuez CW; Bornovalova MA; Reynolds EK; Daughters SB; Curtin JJ. Risk factors in the relationship between gender and crack/cocaine. Experimental and Clinical Psychopharmacology 15(2): 165-175, 2007. (66 refs.)

Female inner-city substance users evidence greater crack/cocaine use and are more likely to be dependent on this drug than on any other drug. Additionally, female inner-city substance users evidence greater crack/cocaine use and are more likely to be dependent on this drug than their male counterparts, despite no consistent difference demonstrated in use and dependence across other drugs. Because no published work has empirically examined the factors underlying this link between females and crack/cocaine, the current study examined the role of theoretically relevant personality and environmental variables. Among 152 (37% female) individuals in a residential substance-use treatment program, females evidenced greater use of crack/cocaine (current and lifetime heaviest) and were significantly more likely to evidence crack/cocaine dependence than their male counterparts. In contrast, no gender differences were found for any other substance across alcohol, cannabis, and hallucinogens (including PCP). Surprisingly, females were more impulsive than their male counterparts, with impulsivity serving as a risk factor in the relationship between gender and crack/cocaine dependence and lifetime heaviest use. Females also evidenced higher levels of negative emotionality and childhood abuse, but neither variable served as a risk factor in the relationship between gender and crack/cocaine dependence or use. Limitations and future directions are discussed, including the need for further exploration of impulsivity across its various dimensions as well as the inclusion of additional variables such as social context variables to account more fully for this complex link between gender and crack/cocaine.

Copyright 2007, American Psychological Association

Leukefeld C; Logan T; Farabee D; Watson D; Spalding H; Purvis R. Drug dependency and HIV testing among state prisoners. Population Research and Policy Review 18(1-2): 55-69, 1999. (16 refs.)

HIV and drug use are higher among prisoners than the general US population. This study examines drug dependency/use and differences between prisoners who volunteered for HIV testing and those who did not in a less densely populated state. It was hypothesized that prisoners who volunteered for an HIV test were engaged in more drug use and other risky behaviors than those who did not. Survey data were collected from 600 randomly selected inmates (567 males and 33 females) from 15 state prisons. Subjects were male (95%), white (63%), never married (43%), and 44% volunteered for an HIV test since entering prison. Ninety-two percent of inmates met DSM criteria for drug dependence in their lifetime. Those who volunteered for HIV testing were 2.6 times more likely to ever have used PCP; 1.5 times more likely to ever have used cocaine; 1.4 times more likely to ever have had a problem with drugs; 1.3 times more likely to have used opiates, and 1.6 times more likely to report having been sexually or physically abused. Implications for interventions are discussed.

Copyright 1999, Elsevier Scientific Publishing Co.

Li L; Smialek JE. Observations on drug abuse deaths in the State of Maryland. Journal of Forensic Sciences 41(1): 106-109, 1996. (16 refs.)

The problem of drug abuse in America encompasses all ages, economic, and ethnic groups. The Office of the Chief Medical Examiner (OCME) has recorded a continuous increase in drug abuse deaths in Maryland over the past seven years. This report focuses on the epidemiological characteristics and pathological findings of victims of fatal drug abuse in Maryland investigated by the OCME in 1992 and 1993. A retrospective study of OCME cases in 1992 and 1993 yielded a total of 605 deaths caused by drugs of abuse. 426 deaths were the result of narcotic drug use, 66 deaths due to cocaine, 102 deaths involved both narcotics and cocaine, 6 deaths were due to phencyclidine (PCP) and 5 involved both PCP and narcotic drugs. Drug abuse deaths most often involved individuals who were male (86%) and black (64%). Their ages ranged from 15 to 68 years with the majority (58%) of victims being in their 30s. Of the 605 drug deaths, 393 (65%) had a known history of drug abuse. 279 (46%) exhibited needle tracks, of which only 94 (16%) had identifiable fresh needle puncture marks. Drug paraphernalia (needles, syringes, etc.) was found at the scene in 22% of the cases. Twenty-nine (4.8%) cases showed complications of drug abuse which included pneumonia, endocarditis or myocarditis, pulmonary embolism, AIDS and intracerebral hemorrhage. 87 (14.4%) were positive for HIV antibodies, an incidence much higher than that identified in our general autopsy population (2.6%). Drugs of abuse were also found in a significant portion of the homicides examined at this office in 1992 and 1993. 323 of the 1265 homicide victims (25%) showed evidence of some form of illicit drug activity.

Copyright 1996, American Society for Testing and Materials

Marnell T, ed. Drug Identification Bible, Third Edition. Denver CO: Drug Identification Bible, 1997. (43 refs.)

This is a widely used reference volume that endeavors to answer the questions commonly asked by parents, educators, law enforcement personnel, "What does it look like?" and "What does it do?" It provides information on commonly abused prescription drugs as well as illicit drugs. It addresses the current "drug scene" using color photos, combined with information on street prices, purity, packaging, methods of use, and slang. Two sections are devoted to the identification of tablets and capsules. The section on controlled Prescription Drugs shows full color/actual size photos of over 700 drugs. The section on non-controlled and over-the-counter preparations lists markings and logo information on approximately 9,000 items. This material is organized for easy reference. The contents are organized as follows: (A) a reprinting of the Controlled Substance Act. (B) Prescription Drugs: markings and logos; photos of controlled prescription drugs; use/abuse (C) Illicit Drugs -- amphetamines, cocaine, designer drugs, heroin, legal highs, LSD, marijuana, PCP, psilocybin mushrooms, Rohypnol -- photos, description of use, and slang. The volume concludes with suggested readings; charts of drug detection limits and weight conversion; and an index of drug manufacturers.

Copyright 1998, Project Cork

Maurer HH. Chemistry, pharmacology, and metabolism of emerging drugs of abuse. (review). Therapeutic Drug Monitoring 32(5): 544-549, 2010 , 2010. (94 refs.)

In recent years, besides the classic designer drugs of the amphetamine type, a series of new drug classes appeared on the illicit drugs market. The chemistry, pharmacology, toxicology, metabolism, and toxicokinetics is discussed of 2,5-dimethoxy amphetamines, 2,5-dimethoxy phenethylamines, beta-keto-amphetamines, phencyclidine derivatives as well as of herbal drugs, ie, Kratom. They have gained popularity and notoriety as rave drugs. The metabolic pathways, the involvement of cytochrome P450 isoenzymes in the main pathways, and their roles in hepatic clearance are also summarized.

Copyright 2010, Lippincott, Williams & Wilkins

Maxwell JC. Substance abuse trends in Texas. IN: Community Epidemiology Work Group, eds. Epidemiologic Trends in Drug Abuse. Volume II: Proceedings of the Community Epidemiology Work Group. June 2000. Bethesda MD: National Institute on Drug Abuse, 2000. pp. 283-313. (0 refs.)

Alcohol is the primary drug of abuse in Texas in terms of dependence, deaths, treatment admissions, and arrests. Crack-cocaine continues as the number-one illicit drug among treatment admissions. The proportion of African-American crack admissions is declining, while the rate of white and Hispanic admissions increase. After marijuana, cocaine is the drug for which arrestees are most likely to test positive. Heroin overdose deaths increased between 1998 and 1999. The price of Mexican heroin remains steady. Among youth entering treatment, the proportion reporting marijuana as their primary drug is increasing. There is also discussion of methamphetamine -- more of which is arriving via Mexico -- GHB, ecstasy, LSD, PCP. [Note: There is mention of the practice of dipping marijuana joints into embalming fluid. Others have questioned whether this in fact occurs or whether this is an urban myth.]

Public Domain

McCann UD; Lowe KA; Ricaurte GA. Long-lasting effects of recreational drugs of abuse on the central nervous system. (review). The Neuroscientist 3(6): 399-411, 1997. (195 refs.)

Although a wealth of knowledge exists regarding the acute pharmacological effects of recreational drugs on the CNS, much less is known about the long-term toxic effects of recreational drugs on the CNS. Recent finding in nonhuman primates treated with amphetamine analogs, such as +/-3,4,-methylenedioxymethamphetamine (MDMA), indicate that these drugs can produce long-lasting, probably permanent, changes in brain serotonin innervation. Similarly, animals treated with phencyclidine (PCP) and related drugs develop neurodegenerative changes in selected brain regions. It seems clear, then, that some psychoactive drugs have the potential to produce persistent changes in CNS structure and, possibly function. The goal of this article is to summarize current knowledge regarding the long-term effects of several popular recreational drugs, including MDMA and related amphetamine analogs, cocaine, marijuana, alcohol, PCP, lysergic acid (LSD), and opiates. Gaps in the current knowledge base are identified, and areas ripe for future research are suggested.

Copyright 1997, Williams & Wilkins

Meng Y; Lichtman AH; Bridgen DT; Martin BR. Pharmacological potency and biodisposition of phencyclidine via inhalation exposure in mice. Drug and Alcohol Dependence 43(1/2): 13-22, 1996. (28 refs.)

The purpose of the present study was to characterize the pharmacological effects and biodisposition of phencyclidine (PCP) following inhalation exposure to mice. Results from these studies indicate that PCP was easily volatilized when heated in a glass pipe. Volatilization was efficient with no significant formation of pyrolytic products. Exposure to the volatilized PCP resulted in a dose-dependent impairment in motor performance in both the rotorod and inverted-screen tests. PCP was equally effective in disrupting performance on the inverted-screen and rotorod with ED(50) values corresponding to the volatilization of 10.7 and 13.2 mu mol, respectively. The time courses were comparable to those produced following intravenous (i.v.) administration of PCP. In order to determine the dose of drug absorbed by inhalation, mice were exposed Co [H-3]-PCP. The ED(50) values of PCP following i.v. administration were 4.1 and 6.2 mu mol/kg in the inverted screen and rotorod, respectively. The biodisposition of PCP following inhalation exposure was similar to that after i.v. injections. At doses that produced approximately 50% of the maximum motor impairment by either administration route, higher ratios of the total drug equivalents were found following i.v. injection than that after inhalation, with the brain/plasma ratios of 1.3 +/- 0.2 versus 0.58 +/- 0.02, and brain/body ratios of 0.59 +/- 0.06 versus 0.35 +/- 0.1 for i.v. and inhalation, respectively. However, the brain/plasma ratios of the concentrations of PCP were similar, 1.1 versus 0.9. The body concentration of PCP equivalents that produced 50% of the maximum effect after inhalation was 4.7 +/- 0.6 mu mol/kg. These results indicate that inhalation of PCP produces a similar pharmacological profile to that of i.v. administration and suggest that the drug is equipotent by these two administration routes. Moreover, these findings are consistent with the observation that smoking is becoming the most common route of administration among drug users.

Copyright 1996, Elsevier Scientific Publishers Ireland, Ltd.

Moeller MR; Kraemer T. Drugs of abuse monitoring in blood for control of driving under the influence of drugs. Therapeutic Drug Monitoring 24(2): 210-221, 2002. (81 refs.)

Driving under the influence of drugs is an issue of growing concern in the industrialized countries as a risk and a cause for road accidents. In forensic toxicology, the increasing number of samples for determination of drugs in blood is mainly due to zero-tolerance laws in several countries and well-trained police officers who can better recognize drivers under the influence of drugs of abuse. This review describes procedures for detection of the following drugs of abuse in whole blood, plasma, and serum: amphetamine, methamphetamine, 3,4-methylenedioxy methamphetamine (MDMA), N-ethyl- 3, 4-methylenedioxyamphetamine (MDEA), 3,4-methylenedioxyamphetamine (NIDA), cannabinoids (delta-9-tetrahydrocannabinol [THC], 11-hydroxy- delta-9-THC, 11-nor-9-carboxy-delta-9-THC), cocaine, benzoylecgonine, ecgonine methyl ester, cocaethylene, the opiates (heroin, 6- monoacetylmorphine, morphine, or codeine), and methadone as well as gamma-hydroxybutyric acid (GHB), lysergic acid diethylamide (LSD), phencyclidine (PCP), and psilocybin/psilocin. For many of the analytes, sensitive immunologic methods for screening are available. Gas chromatography-mass spectrometry (GC-MS) is still the state-of- the-art method for confirmatory analysis or for screening and confirmation in one step. Liquid chromatography-mass spectrometry (LC- MS) procedures for such purposes are also included in this review. Basic data about the biosample assayed, internal standard workup, GC or LC Column and mobile phase, detection mode, reference data, and validation data of each procedure are summarized in two tables.

Copyright 2002, Lippincott-Raven Publishers

Mokhlesi B; Garimella PS; Joffe A; Velho V. Street drug abuse leading to critical illness. (review). Intensive Care Medicine 30(8): 1526-1536, 2004. (133 refs.)

Critical care physicians are frequently confronted with intoxicated patients who have used street drugs. In the last decade there has been an upward trend in the use of these substances, particularly amongst adolescents and young adults in large urban areas. In excess quantities all street drugs can lead to critical illness. Early and appropriate medical attention by emergency medicine physicians and intensivists can improve outcomes. In this review article we intend to familiarize critical care physicians with the most common street drugs such as amphetamines, ecstasy, cocaine, gamma hydroxybutyrate, opioids, and phencyclidine.

Copyright 2004, Springer

Moore C; Negrusz A; Lewis D. Determination of drugs of abuse in meconium. (review). Journal of Chromatography B 713(1): 137-146, 1998. (36 refs.)

Fetal exposure to drugs has many adverse effects upon the neonate including low birthweight, small head size and an increased risk of miscarriage and death. Correct diagnosis of drug use during pregnancy is essential if the child is to receive specialized treatment and care, which will aid in learning and behavioral development. Diagnosis will also help in the prevention of subsequent drug-exposed children being born to the same mother. Meconium is the first fecal material excreted by the newborn and is an excellent depository for drugs to which the fetus has been exposed. Its analysis is widely accepted in the scientific and medical communities since it has several advantages over urinalysis, including providing a longer historical record of drug exposure and easier collection Various drugs and their metabolites have been detected in meconium, however, the metabolic profile of drugs in meconium differs from that of neonatal and/or maternal urine. This article addresses the determination of cocaine, amphetamines, opiates, cannabinoids, phencyclidine, nicotine and methadone in meconium using several analytical procedures including immunochemical and chromatographic methods.

Copyright 1998, Elsevier Science BV

Moore KA; Werner C; Zannelli RM; Levine B; Smith ML. Screening postmortem blood and tissues for nine cases of drugs of abuse using automated microplate immunoassay. Forensic Science International 106(2): 93-102, 1999. (17 refs.)

A commercially available enzyme-linked immunosorbant assay (ELISA) was evaluated as a screening procedure for the detection of nine classes of abused drugs in postmortem blood and tissue specimens. Specifically, postmortem blood, fluid and/or tissue homogenates were screened for amphetamine (AMP), methamphetamine (MET), barbiturates (BARB), benzodiazepines (BZD), cannabinoids (CNB), cocaine (benzoylecgonine; BE), morphine-specific (MOR), opiates (class; OPI), phencyclidine (PCP) and lysergic acid diethylamide (LSD) by ELISA and by coated tube radioimmunoassay (CTR) (BARB, BE, OPI, PCP, LSD) or double-antibody radioimmunoassay (DAR) (AMP/METH, BZD, CNB). Specimens that screened 'positive' by any method were confirmed and quantitated by gas chromatography/mass spectrometry (GC/MS). The only assay that appeared to perform less optimally than RIA was the MOR assay (five false negatives). However, this assay is very specific for free morphine while the GC/MS confirmation method provided a total morphine value. The OPI assay was more sensitive, producing fewer false negatives, and is recommended for broad class opiate screening. EIA is an adequate alternative to RIA for screening postmortem specimens, including blood and tissue, for nine major classes of drugs.

Copyright 1999, Elsevier Scientific Publishers Ireland, Ltd.

Moore NN; Bostwick JM. Ketamine dependence in anesthesia providers. Psychosomatics 40(4): 356-359, 1999. (32 refs.)

Ketamine is a compound similar to the street drug PCP. It was first synthesized in 1962, and first used in humans in 1970. It was designed as a dissociative anesthetic, but free from the violent, confused behavior patients emerging from PCP anesthetic often demonstrated. Although PCP had failed as an ansesthetic agent, it quickly became a popular street drug. Ketamine, in contrast was touted as comparatively 'gentle' and safe, reliable and filled an important niche in anesthesia because it did not increased cardiac drive and did not depress respiratory function. From it first used, according to patient accounts, it was recognized to cause dissociation, and there were reports of flashbacks. It too quickly became a popular street drug, valued by 'recreational' user for it hallucinogenic properties as well as feelings of arousal and euphoria. In 1979, the FDA warned of its abuse potential and considered making it a controlled substance. Two case of ketamine dependence among hospital personnel are reported here.

Copyright 1999, Academy of Psychosomatic Medicine

Morral AR; McCaffrey DF; Chien S. Measurement of adolescent drug use. Journal of Psychoactive Drugs 35(3): 301-309, 2003. (22 refs.)

There is widespread agreement that estimates of adolescent drug use prevalence from the National Household Survey of Drug Abuse (NHSDA) and Monitoring the Future (MTF) are subject to considerable measurement error. Nevertheless, some have suggested that trends over time in these prevalence estimates probably reflect true trends in drug use, since underreporting may be assumed to be constant over time. A recent National Research Council report criticizes this assumption on logical grounds. The present study examines adolescent drug use responses on the NHSDA and MTF for evidence of "drug omission," "jargon confusion" and "conceptual confusion," three types of misreporting expected to vary in magnitude with changes in drug use practices and changes in survey items. Results demonstrate that adolescent drug users are significantly more likely than adults to report use of drugs not listed in the NHSDA. Among adolescents who wrote in the "other" drugs they used, 66% and 86% of hallucinogen and inhalant, responses showed confusion over the meaning of the pharmacological terms used in the NHSDA. Almost 20% of MTF respondents who report lifetime use of Rohypnol or ecstasy, when specifically queried about these drugs, deny lifetime use of any substances in the drug classes intended to assess use of Rohypnol and ecstasy. MTF respondents reporting lifetime use of PCP underreport use of hallucinogens at rates that vary substantially over time, from a high of 45% (in 1986), to a low of just 8% (in 1998). The implications of these findings for adolescent drug use prevalence estimation and survey design are discussed.

Copyright 2003, Haight-Ashbury Publications

Nakahara Y; Takahashi K; Sakamoto T; Tanaka A; Hill VA; Baumgartner WA. Hair analysis for drugs of abuse. XVII. Simultaneous detection of PCP, PCHP, and PCPdiol in human hair for confirmation of PCP use. Journal of Analytical Toxicology 21(5): 356-362, 1997. (14 refs.)

This paper reports the simultaneous detection of phencyclidine (PCP) and its two major metabolites, 1-(1-phenylcyclohexyl)-4-hydroxypiperidine (PCHP) and trans-1(1-phenyl-4-hydroxycyclohexyl)-4-hydroxypiperdiine (t-PCPdiol) in human hair. The detection of these metabolites provides definitive evidence that a positive hair analysis result is due to active PCP use and not due to external contamination of the hair specimen. Methods of analysis are described.

Copyright 1997, Project Cork

Nelson LS; Holland JA; Ravikumar PR. Dangerous form of marijuana. (letter). Annals of Emergency Medicine 34(1): 115-116, 1999. (5 refs.)

with the use of marijuana cigarettes that are allegedly treated with "embalming fluid" to enhance their euphoric effects. Although undisclosed to most users, these cigarettes are adulterated with phencyclidine (PCP). Marijuana adulteration is not new, but the manner in which this agent is marketed is of great public health concern. The prerolled marijuana cigarettes are illicitly sold under regionally varying names including "Illy" in Connecticut, "Hydro" in New York City, "Wet" in Philadelphia, and "Fry" in Texas. Intoxication from these adulterated cigarettes produces disorganized thoughts, diminished attention, psychomotor agitation, and stimulation of the sympathetic nervous system, all of which are expected findings after PCP use. Patients are often sedate on presentation and become increasingly agitated during observation. Although several authors have attributed these findings to formaldehyde intoxication or an interaction between tetrahydrocannabinol and formaldehyde, they have also noted their similarity to PCP intoxication.[4] However, no laboratory analysis of patient's body fluids or the drug specimen for phencyclidine has been reported to date. Using gas chromatography/mass spectrometry analysis of the urine of a recent user, as well as that of the original "embalming fluid" preparation, we identified PCP and several of its congeners such as 1-piperidinocyclohexane carbonitrile (PCC) and phenylcyclohexane (PCH). Many of these PCP analogs are physiologically active, and the low sensitivity of the screening assay toward these agents may explain the high frequency of negative drug screen results in patients who are clinically intoxicated. Given the illicit nature of the product, it is not surprising that starting products for the synthesis of PCP (eg, bromobenzene and cyclohexanone) were also found. Embalming fluid, which contains the volatile solvent formalin (ie, formaldehyde in methanol), is merely a vehicle to aid in the uniform distribution of PCP. Although typically allowed to dry, smoking the cigarette while still wet may account for one appellation.

Copyright 1999, American College of Emergency Physicians. Used with permission

Nordt SP. "DXM": A new drug of abuse? (letter). Annals of Emergency Medicine 31(6): 794-795, 1998. (7 refs.)

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Emergency Department Trends from Drug Abuse Warning Network (DAWN), Preliminary Estimates, January-June 2002. DAWN series: D-22. Rockville MD: Substance Abuse and Mental Health Services Administration, 2002. (0 refs.)

This report includes data generated by the Drug Abuse Warning Network (DAWN). It includes major substance of abuse, by drug category and drug name. (alcohol in combination with other drugs, heroin, marijuana, methamphetamines, ketamine, LSD, PCP, club drugs, GHB, Data is presented in 210 tables and 4 figures. It includes preliminary estimates for January through June of 2002, annual estimates for 1994-2001, and semi-annual estimates for the second half of 1997 through June 2002. The estimates are for the coterminous U.S. and for 21 major metropolitan areas.

Public Domain

Ompad DC; Galea S; Fuller CM; Phelan D; Vlahov D. Club drug use among minority substance users in New York City. Journal of Psychoactive Drugs 36(3): 397-399, 2004. (7 refs.)

Surveillance data suggests that club drug use (Ecstasy, GHB, ketamine, LSD, methamphetamine, PCP and flunitrazepam) has been a predominantly White adolescent and young adult phenomenon in the United States. The authors investigated the use of club drugs among 323 streetrecruited minority substance users in northern New York City (66.3% were Hispanic, 23.8% were Black, and 9.9% were White/other race; median age = 32 years old). While Whites were more likely than others to have used club drugs, club drug use among Hispanics and Blacks was not uncommon; 45.3% Hispanics and 56.4% of Blacks reported a lifetime history of club drug use. PCP was the most commonly reported club drug used among all racial/ethnic groups. Further investigation of club drug use in minority populations is warranted.

Copyright 2004, Haight-Ashbury Publishing

Paule MG. Maternal drug abuse and adverse effects on neurobehavior of offspring. IN: Slikker W; Chang LW, eds. Handbook of Developmental Neurotoxicology. San Diego: Academic Press, Inc., 1998. pp. 617-629. (148 refs.)

This chapter focuses on prenatal drug exposure and illicit drug use during pregnancy, and the adverse consequences for the fetus. Following a brief mention of drug access to the developing embryo-fetus, attention is directed to the following drugs: marijuana, opiates, PCP (phencyclidine) and cocaine. The chapter also notes the problems related to study of illicit drug use during pregnancy, and the role of animal models.

Copyright 1998, Project Cork

Pestaner JP; Southall PE. Sudden death during arrest and phencyclidine intoxication. American Journal of Forensic Medicine and Pathology 24(2): 119-122, 2003. (34 refs.)

Deaths of individuals being arrested are important and complex medicolegal cases. Conclusions regarding the cause and manner of death for such cases must take into account multiple factors that may have played a role, as well as anticipate the forensic issues that will arise. In this article, we review the deaths of 2 individuals in which phencyclidine intoxication was a factor that contributed to death during arrest. Most cases of sudden death during arrest have involved cocaine intoxication; because phencyclidine's pharmacologic properties are quite different from those of cocaine, these cases allow for comparisons to those factors that may have greater importance.

Copyright 2003, Raven Press, Ltd

Peters RJ; Kelder SH; Meshack A; Yacoubian GS; McCrimmons D; Ellis A. Beliefs and social norms about cigarettes or marijuana sticks laced with embalming fluid and phencyclidine (PCP): Why youth use "Fry". Substance Use & Misuse 40(4): 563-571, 2005. (9 refs.)

Recent drug-use monitoring among Houston adolescents has detected a concoction of cigarettes or marijuana sticks laced with embalming fluid and PCP ("fry"). To shed light on this mixture, the current pilot study used a qualitative approach to investigate relevant beliefs and norms associated with fry initiation and perceived addiction among 38 youth who were attending outpatient and inpatient drug-user treatment programs in the spring of 2003. Respondents perceived that addiction to fry could occur as early as initial consumption, and the majority of participants indicated that their second fry event occurred either the same day as their initial use or the next day. In addition, fry use was perceived to have extremely dangerous consequences. Youth stated that users have impaired motor skills, hallucinations, long-term mental health problems, incoherent behavior, paranoia, and aggressive behaviors. Implications for these results are discussed.

Copyright 2005, Marcel Dekker, Inc

Peters RJ; Tortolero SR; Addy RC; Markham C; Yacoubian GS; Escobar-Chaves SL. Drug use among Texas alternative school students: Findings from Houston's Safer Choices 2 program. Journal of Psychoactive Drugs 35(3): 383-387, 2003. (16 refs.)

Self-report drug use data were collected from 494 alternative school students, grades seven through 12, surveyed through the Safer Choices 2 study in Houston, Texas. Data were collected between October 2000 and March 2001 via audio-enabled laptop computers equipped with headphones. Twenty-eight percent of the sample reported past-month marijuana use, and 10% reported past-month opiate/codeine use. Males were almost twice as likely as females to have used cocaine during the past month, and over four times as likely to have used opiates/codeine during the past month. Students 16 years and older and were twice as likely to have ever used cocaine and opiates/codeine than students under 16 years. Latinos were 10 times more likely than Blacks to have ever used cocaine; Blacks were twice as likely as Latinos to have used opiates/codeine during the past month. Males were twice as likely as females to have tried "fry," a new street drug made of tobacco or marijuana mixed with embalming fluid and PCP. These new drug trends are startling because they indicate a potential for long-term treatment services for abusers.

Copyright 2003, Haight-Ashbury Publications

Poulin C; Van Til L; Wilbur B; Clarke B; MacDonald CA; Barcelo A. Alcohol and other drug use among adolescent students in the Atlantic provinces. Canadian Journal of Public Health 90(1): 27-29, 1999. (16 refs.)

The objective of the study reported was to estimate the prevalence of alcohol and other drug use among students in junior and senior high school in the Atlantic region, and the specific prevalence in Nova Scotia, Newfoundland and Labrador, and Prince Edward Island. Characteristics of the sample are outlined and use within the past 12 months ascertained for the following substances: alcohol, cigarettes, marijuana, LSD, stimulants, other hallucinogens, tranquilizers, cocaine, steroids, inhalants, PCP, heroin and barbiturates. The results are summarized in three tables, that highlight the differences between provinces, the role of gender.

Copyright 1999, Canadian Public Health Association

Radovanovic Z; Pilcher CWT; Al-Nakib T; Shihab-Eldeen A. On substance abuse in Kuwait (1992-1997): Evidence from toxicological screening of patients. Journal of Substance Abuse 12(4): 363-371, 2000. (20 refs.)

Purpose: To assess preference for different psychoactive substances and time trends in Kuwait. Methods: Analysis of urine and blood samples of specimens sent by attending physicians to the only public health reference laboratory for toxicological screening in the country. Results: A total of 28,548 tests were performed on 3781 samples. Cannabinoids were positive in 40% of the tested samples, opiates in 24%, ethanol in 10%, and amphetamines in 5%. Elevated concentrations of methadone, cocaine, and phencyclidine did not exceed 0.1%. About 40% of samples was positive for benzodiazepines, but their therapeutic use obscures the informativeness of this finding. There was a significant increase in the proportion of positive results for ethanol, amphetamines, and benzodiazepines. Implications: It is high time to implement a modem and comprehensive preventive and control program. The tendency to blame the Iraqi invasion for drug addiction has hampered efforts to recognise and address the problem in its entirety.

Copyright 2000, Ablex Publishing Corp.

Rodefer JS; DeRoche KK; Lynch WA; Carroll ME. Feeding conditions alter the demand for phencyclidine and ethanol: A behavioral economic analysis. Experimental and Clinical Psychopharmacology 4(1): 61-67, 1996. (49 refs.)

This experiment examined the effects of feeding conditions on orally self-administered phencyclidine (PCP) or ethanol in rhesus monkeys using a behavioral economic analysis. Drug intake was measured as a function of drug cost, which was varied by changes in the fixed ratio (FR) schedule. The monkeys were trained to respond for PCP (0.25 mg/ml) or ethanol (8% wt/vol) with concurrent water available under FR 4-128 schedules. As the FR increased, drug intake decreased in a positively decelerating manner. Results suggest that food deprivation increased the reinforcement value of the drugs as significantly increasing consumption of both PCP and ethanol. In addition, ethanol and PCP deliveries showed proportionally greater increases due to food deprivation as FR increased. Together, these results suggest that food deprivation increases the reinforcing efficacy of drugs and this effect is enhanced as the cost (FR) of the drug increases.

Copyright 1996, American Psychological Association

Roettger ME; Swisher RR; Kuhl DC; Chavez J. Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: Evidence from longitudinal panels of males and females in the United States. Addiction 106(1): 121-132, 2011. (52 refs.)

Aims: One-eighth of young adults in the United States report that their biological father has ever been incarcerated (FEI). This study is the first to examine associations between FEI and trajectories of substance use during the transition from adolescence into young adulthood for the US population. Design: Using multi-level modeling techniques, trajectories of marijuana and other illegal drug use are examined, with FEI as the primary independent variable. Setting: Data are from the first three waves of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US adolescents beginning in 1995. Participants: Panels of 7157 males and 7997 females followed from adolescence (7th-12th grades) into early adulthood (ages 18-27 years). Measurements: Dependent variables included an ordinal measure of marijuana frequency of use in last thirty days, and a dichotomous measure for whether respondent had any use in the last thirty days of illegal drugs such crystal meth, cocaine, heroin, hallucinogens, PCP, LSD, speed, and ecstasy. Findings: Among males and females, respectively, FEI is associated with an increased frequency of marijuana use, and increased odds of any other illegal drug use. Interactions between FEI and age further reveal that FEI is associated with an accentuated trajectory (i.e. a steeper slope) of marijuana use, and an elevated risk (i.e. higher mean level) of other illegal drug use. Conclusions: Analysis provides some of the first evidence that paternal incarceration is significantly associated with drug use among U.S. males and females, even after controlling for a number of family background, parental, and individual characteristics.

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs

Schneider S; Kuffer P; Wennig R. Determination of lysergide (LSD) and phencyclidine in biosamples. (review). Journal of Chromatography B 713(1): 189-200, 1998. (75 refs.)

Lysergic acid diethylamide (LSD) is difficult to detect and to quantify in biosamples because of its very low active dose. Although there are a number of tests available, routine analysis of LSD is rarely performed. Immunoassays largely vary in their specificity and cross-reactivities with other molecules often make these tests unreliable. Because of its low concentration and the instability of the derivatives (e.g. trimethylsilyl-LSD), routine gas chromatography- mass spectrometry (GC-MS) detection and quantitation of LSD remains a difficult task. The most promising procedures for LSD determination seems to be liquid chromatography-MS analysis using electrospray ionisation and selected ion monitoring (SIM). Extraction, derivatization, GC or high-performance Liquid chromatography conditions and the different detection modes will be summarised. Phencyclidine (PCP) is an abused drug seldom found outside the United States. Well established detection and quantitation procedures include radioisotopic and nonradioisotopic immunoassays and GC-MS analysis using SIM mode with deuterated PCP as internal standard. Alternatively, GC with nitrogen-phosphorus detection or capillary electrophoresis has been used. Recent progress in PCP analysis will be summarised.

Copyright 1998, Elsevier Science BV

Schnoll SH; Weaver MF. Phencyclidine. IN: Galanter M; Kleber HD, eds. Textbook of Substance Abuse Treatment, Second Edition. Washington DC: American Psychiatric Press, 1999. pp. 205-214. (52 refs.)

This is one of 11 chapters, discussing treatment for specific drugs of abuse, in the third section, of a reference text on substance abuse.

Copyright 1999, Project Cork

Smith KM; Larive LL; Romanelli F. Club drugs: methylenedioxymethamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. American Journal of Health-System Pharmacy 59(11): 1067-1076, 2002. (97 refs.)

The abuse of methylene-dioxymethamphetamine (MDMA), flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate (GHB) is discussed. Club drugs are chemical substances used recreationally in social settings. Use is increasingly frequent among young people, especially during all-night dance parties. All four agents have been classified as controlled substances. MDMA ("ecstasy") is available as a tablet, a capsule, and a powder; formulations may contain many adulterants. MDMA increases the release of neurotransmitters. The desired effects are euphoria, a feeling of intimacy, altered visual perception, enhanced libido, and increased energy. The most common adverse effects are agitation, anxiety, tachycardia, and hypertension. More serious adverse effects include arrhythmias, hyperthermia, and rhabdomyolysis. Flunitrazepam is a potent benzodiazepine. At higher doses, the drug can cause lack of muscle control and loss of consciousness, Other adverse effects are hypotension, dizziness, confusion, and occasional aggression. Ketamine is a dissociative anesthetic used primarily in veterinary practice. It may be injected, swallowed, snorted, or smoked. Like phencyclidine, ketamine interacts with the N-methyl-D-aspartate channel. Analgesic effects occur at lower doses and amnestic effects at higher doses. Cardiovascular and respiratory toxicity may occur, as well as confusion, hostility, and delirium. GHB, a naturally occurring fatty acid derivative of gamma-aminobutyric acid, was introduced as a dietary supplement. Increasing doses progressively produce amnesia, drowsiness, dizziness, euphoria, seizures, coma, and death. Flunitrazepam, ketamine, and GHB have been used to facilitate sexual assault. Supportive care is indicated for most cases of club drug intoxication. The increasing abuse of MDMA, flunk trazepam, ketamine hydrochloride, and GHB, particularly by young people in social settings such as clubs, should put health care professionals on guard to recognize and manage serious reactions.

Copyright 2002, American Society of Health-System Pharmacists

Singer M; Mirhej G; Shaw S; Saleheen H; Vivian J; Hastings E et al. When the drug of choice is a drug of confusion: Embalming fluid use in inner city Hartford, CT. Journal of Ethnicity in Substance Abuse 4(2): 73-96, 2005. (20 refs.)

This paper examines the use of a new illicit drug -- embalming fluid mixtures -- in Hartford, CT based on a recent assessment of drug consumption in an outreach-recruited sample of 242 not-in-treatment active drug users. Sociodemographic, drug use, and health and social problems of drug users who do and do not use embalming fluid mixture are presented, revealing some notable differences between these two groups of street drug users. Despite regular consumption, we report that embalming fluid mixture users are often uncertain about what is in this new drug, despite experiencing often powerful effects. Urine toxicology findings from a subsample of individuals who used embalming fluid mixtures in the last 48 hours, reveal the frequent presence of phencyclidine (PCP) as well as other drugs. The public health implications of this new wave of PCP use are assessed.

Copyright 2005, Haworth Press

Stone AL; O'Brien MS; De la Torre A; Anthony JC. Who is becoming hallucinogen dependent soon after hallucinogen use starts? Drug and Alcohol Dependence 87(2/3): 153-163, 2007. (18 refs.)

This study, based upon epidemiological survey data from the United States (U.S.) National Household Surveys on Drug Abuse (NHSDA) from 2000 to 2001, presents new estimates for the risk of developing a hallucinogen dependence syndrome within 24 months after first use of any hallucinogen (median elapsed time similar to 12 months). Subgroup variations in risk of becoming hallucinogen dependent also are explored. Estimates are derived from the NHSDA representative samples of non-institutionalized U.S. residents ages 12 and older (n = 114,241). A total of 2035 respondents had used hallucinogens for the first time within 24 months prior to assessment. An estimated 2-3% of these recent-onset hallucinogen users had become dependent on hallucinogens, according to the NHSDA DSM-IV computerized diagnostic algorithm. Controlling for sociodemographic and other drug use covariates, very early first use of hallucinogens (age 10-11 years) is associated with increased risk of hallucinogen dependence (p < 0.01). Excess risk of developing hallucinogen dependence was found in association with recent-onset use of mescaline; excess risk also was found for recent-onset users of ecstasy and of PCP. This study's evidence is consistent with prior evidence on a tangible but quite infrequent dependence syndrome soon after the start of hallucinogen use; it offers leads that can be confirmed or disconfirmed in future investigations.

Copyright 2007, Elsevier Science

Strassman R. Hallucinogens. IN: Earleywine M, ed. Mind-Altering Drugs: The Science of Subjective Experience. New York: Oxford University Press, 2005. pp. 49-85. (164 refs.)

This chapter reviews the history of hallucinogen use. The author notes that both LSD and the neurotransmitter serotonin were discovered in the late 1940s, both of which enjoyed some basic pharmacological and physiological properties, and around the time the antipsychotic properties of chlorpromazine were recognized. These events are seen as marking the development of contemporary biological psychiatry and psychopharmacology. The hallucinogens were the object of considerable research and as an adjunct to psychotherapy. Concern about misuse and the social upheaval of the 1960s led to their being brought under the Controlled Substances Act. The chapter reviews nomenclature, chemistry and pharmacology, the role of set and setting, typical effects, and altered states of consciousness. The literature on adverse is reviewed. Also provided are a number of rating scales developed to assess the effects of hallucinogens.

Copyright 2007, Project Cork

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse: Population Estimates 1996. Rockville MD: Substance Abuse and Mental Health Services Administration, 1997. (6 refs.)

This volume, part of an ongoing series, reports the results of a national survey regularly conducted by SAMHSA [previously the National Institute on Drug Abuse (NIDA)] to ascertain the prevalence of use of different classes of drugs, and the nature of problems accompanying use. The work is presented primarily in tables, with brief summaries of the major findings and trends. Organized into three sections -- an introduction, a presentation of sample sizes and US population tables, and then estimates of prevalence of use and frequency of use by demographic characteristics for specific drug and drug classes, i.e. any illicit drug use, marijuana, cocaine, crack, inhalants, hallucinogens, any psychotherapeutics, stimulants, sedative, tranquilizers, analgesics, alcohol, cigarettes, smokeless tobacco, LSD, PCP, heroin, use of needles.

Copyright 1998, Project Cork

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse: Population Estimates 1997. Rockville MD: Substance Abuse and Mental Health Services Administration, 1998. (0 refs.)

This volume, part of an ongoing series, reports the results of a national survey regularly conducted by SAMHSA [previously the National Institute on Drug Abuse (NIDA)] to ascertain the prevalence of use of different classes of drugs, and the nature of problems accompanying use. The work is presented primarily in tables, with brief summaries of the major findings and trends. Organized into three sections -- an introduction, a presentation of sample sizes and US population tables, and then estimates of prevalence of use and frequency of use by demographic characteristics for specific drug and drug classes, i.e. any illicit drug use, marijuana, cocaine, crack, inhalants, hallucinogens, any psychotherapeutics, stimulants, sedative, tranquilizers, analgesics, alcohol, cigarettes, smokeless tobacco, LSD, PCP, heroin, use of needles.

Copyright 1999, Project Cork

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse: Population Estimates 1998. Rockville MD: Substance Abuse and Mental Health Services Administration, 1999. (0 refs.)

This volume, part of an ongoing series, reports the results of a national survey regularly conducted by SAMHSA [previously the National Institute on Drug Abuse (NIDA)] to ascertain the prevalence of use of different classes of drugs, and the nature of problems accompanying use. The work is presented primarily in tables, with brief summaries of the major findings and trends. Organized into three sections -- an introduction, a presentation of sample sizes and US population tables, and then estimates of prevalence of use and frequency of use by demographic characteristics for specific drug and drug classes, i.e. any illicit drug use, marijuana, cocaine, crack, inhalants, hallucinogens, any psychotherapeutics, stimulants, sedative, tranquilizers, analgesics, alcohol, cigarettes, smokeless tobacco, LSD, PCP, heroin, use of needles.

Copyright 1999, Project Cork

Swartz JA; Lurigio AJ. Psychiatric illness and comorbidity among adult male jail detainees in drug treatment. Psychiatric Services 50(12): 1628-1630, 1999. (10 refs.)

The prevalence of psychiatric disorders was examined in a sample of 204 pretrial jail detainees receiving standard drug treatment. More than half of the sample had at least one lifetime DSM-III-R axis I diagnosis, and the lifetime rates of serious mental illness were higher than reported prevalence rates for arrestees in general jail populations. Detainees with comorbid disorders were more likely than others to have more than one co-occurring psychiatric disorder, to have been arrested for property crimes, and to be dependent on alcohol, marijuana, or PCP. The findings argue for the expansion of integrated treatment services within criminal justice drug treatment settings.

Copyright 1999, American Psychiatric Association. Used with permission

Swartz MS; Swanson JW; Hannon MJ. Detection of illicit substance use among persons with schizophrenia by radioimmunoassay of hair. Psychiatric Services 54(6): 891-895, 2003. (25 refs.)

Objective: Illicit substance use is a potent risk factor for poor outcomes in schizophrenia, yet methods for detecting substance use consistently underestimate the problem. The purpose of this study was to assess whether use of a relatively new method of detection, radioimmunoassay of hair, improved detection and was acceptable to patients with serious mental illness. Methods: Persons already participating in a longitudinal naturalistic study of schizophrenia treatment were approached for participation in this study. The 203 persons who consented were interviewed and submitted urine and hair samples for laboratory measures of potential substances of abuse. Radioimmunoassay of hair was used to detect the use of amphetamines, cocaine, marijuana, opiates, and phencyclidine (PCP) in the preceding three months. Results: Of the 203 participants, only 33 (16.3 percent) self-reported illicit substance use, and only 25 (12.4 percent) had a positive urine test, but 63 (31.0 percent) had a positive hair assay. When all detection methods were combined-self-report, urine test, and hair assay-78 participants (38.4 percent) were classified as users in the preceding three months. Few of those asked to participate (20, or 9.9 percent) refused hair analysis. Conclusions: Radioimmunoassay of hair appears to be a promising method for improving assessment of illicit substance use among persons with schizophrenia. Most participants appeared to find hair analysis an acceptable procedure, although this conclusion warrants further study. The test's three-month window of detection may make it a valuable method for assessing and monitoring use over time.

Copyright 2003, American Psychiatric Association

Ubogu EE. Amaurosis fugax associated with phencyclidine inhalation. European Neurology 46(2): 98-99, 2001. (10 refs.)

Vollenweider FX. Advances and pathophysiological models of hallucinogenic drug actions in humans: A preamble to schizophrenia research. (review). Pharmacopsychiatry 31(Supplement): 92-103, 1998. (120 refs.)

Recent research into the pharmacological mechanism of hallucinogens (LSD, psilocybin) and dissociative anesthetics (PCP, ketamine) suggest that multiple neurotransmitter systems are involved in drug-induced and possibly also in naturally occurring psychoses. Specifically, animal models suggest that a dysbalance between serotonin, glutamate, and dopamine in the limbic cortico-striato- thalamic circuitry may be critical to psychotic symptom formation. To test this hypothesis, psychometric measures and metabolic PET investigations were performed (1) with FDG to elucidate the common neuronal substrates of different hallucinogens, (2) with specific receptor ligands before and after pretreatment with specific receptor antagonists to explore the putative interactions of hallucinogens with various neurotransmitter systems. Our data demonstrate that the neuronal substrate of normal and abnormal thought and behavior is associated with a distributed neuronal network and with multiple interactive neurotransmitter systems. The data also support the view that the hallucinogen challenge paradigm constitutes a powerful tool for elucidating the pathophysiology of neuropsychiatric disorders.

Copyright 1998, Georg Thieme Verlag Stuttgart

Weber AE; Boivin JF; Blais L; Haley N; Roy E. Predictors of initiation into prostitution among female street youths. Journal of Urban Health 81(4): 584-595, 2004. (39 refs.)

Prostitution among female street youths represents an important risk factor for several health problems. Little is known about the incidence and determinants of prostitution in this vulnerable population, and no data have been previously reported based on a longitudinal follow-up study. The objective of this study was to determine predictors of initiation into prostitution among female street youths. Female youths aged 14 to 25 years were enrolled in the Montreal Street Youth Cohort. They completed a baseline and at least one follow-up questionnaire between January 1995 and March 2000. Girls who reported never having engaged in prostitution at baseline were followed prospectively to estimate the incidence and predictors of prostitution. Of the 330 female street youths enrolled as of September 2000 in the cohort, 148 reported no history of involvement in prostitution at baseline and completed at least one follow-up questionnaire. Of these 148 girls, 33 became involved in prostitution over the course of the study (mean follow-up 2.4 years), resulting in an incidence rate of 11.1/100 person-years. Multivariate Cox regression analysis revealed having a female sex partner (adjusted hazard ratio [AHR] 3.8; 95% confidence interval [CI] 1.6-9.1) was an independent predictor of initiation into prostitution after controlling for having been on the street at age 15 years or younger (AHR 1.8, 95% CI 0.9-3.8), using acid or phencyclidine (PCP; AHR 2.0, 95% CI 0.9-4.6), using heroin (AHR 1.9, 95% CI 0.7-5.5), the use of drugs greater than twice per week (AHR 1.9, 95% Cl 0.9-4.2), and injection drug use (AHR 0.8, 95% CI 0.3-2.4). The incidence of prostitution in female street youths was elevated. Having a female sex partner was a strong predictor of initiating involvement in prostitution.

Copyright 2004, New York Academy of Sciences

Weddington WW. Drug addiction. IN: Jobe TH; Gaviria M; Kovilparambil A, eds. Clinical Neuropsychiatry. Oxford: Blackwell Science Publishers, 1997. pp. 194-203. (25 refs.)

This chapter reviews the neurophysiologic aspects of intoxication and withdrawal syndromes for drugs of abuse other than alcohol, caffeine, or nicotine. The chapter reviews the epidemiology of use and then proceeds to deal with intoxication that occurs with different classes of drugs, i.e., the stimulants, opiates, sedative, hypnotic and anxiolytics, cannabis, hallucinogens, PCP, and inhalants. It then proceeds to address withdrawal phenomenon associated with each of these drug classes. The are numerous charts and tables that set forth the criteria associated with intoxication and withdrawal for each of these.

Copyright 1997, Project Cork

Wynn GH; Cozza KL; Zapor MJ; Wortmann GW; Armstrong SC. Antiretrovirals. Part III: Antiretrovirals and drugs of abuse. Psychosomatics 46(1): 79-87, 2005. (72 refs.)

The third in a series reviewing the HIV/AIDS antiretroviral drugs, this report summarizes the interactions between antiretrovirals and common drugs of abuse. In an overview format for primary care physicians and psychiatrists, the metabolism and drug interactions in the context of antiretroviral therapy are presented for the following drugs of abuse: alcohol, benzodiazepines, cocaine, GHB (liquid X), ketamine (special K), LSD (acid), MDMA (Ecstasy), opiates, PCP (angel dust), and THC (marijuana).

Copyright 2005, American Psychiatric Association

Yacoubian GS. Correlates of benzodiazepine use among a sample of arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) program. Substance Use & Misuse 38(1): 127-139, 2003. (22 refs.)

While marijuana and cocaine are the two most prevalent drugs used among arrestee populations, benzodiazepine use has surpassed that of opiates in several jurisdictions across the United States. Despite this proliferation, few scholarly works have focused on benzodiazepine use among individuals under criminal, justice supervision. In the present study, chi-square statistics and logistic regression are utilized to identify significant associations between recent benzodiazepine use (as measured by urinalysis), demographic characteristics, and alcohol and other drug (AOD) use among a sample of 862 adult Philadelphia arrestees interviewed in 1997 through the Arrestee Drug Abuse Monitoring (ADAM) Program. Compared to nonusers, benzodiazepine-positive respondents were more likely to be White, to have used alcohol and barbiturates in the three days preceding the interview, and to have tested positive by urinalysis for marijuana, cocaine, opiates, and phencyclidine (PCP). Moreover, logistic regression identified that if an arrestee reported three-day barbiturate use, the odds ratio (OR) of recent benzodiazepine use was more than nine times higher than an arrestee who reported no three-day barbiturate use. Implications for drug surveillance are assessed in light of the current findings.

Copyright 2003, Marcel Dekker, Inc

Young SJ; Longstaffe S; Tenenbein M. Inhalant abuse and the abuse of other drugs. American Journal of Drug and Alcohol Abuse 25(2): 371-375, 1999. (14 refs.)

Aims: To examine the relationship between inhalant abuse and other substances of abuse. Design: Survey using a structured interview administered by a single trained interviewer. Setting: A juvenile detention facility. Participants: 209 children incarcerated at the facility over a 3-month period. Selection Procedure: Consecutive sample. Interventions: None. Measurements/Findings: The structured interview was adapted from the American Drug and Alcohol Survey, which has been extensively used to obtain substance abuse epidemiologic data. We collected information on inhalants, alcohol, marijuana, downers, pep pills, lysergic acid diethylamide (LSD), cocaine, designer drugs, phencyclidine (PCP), Talwin and Ritalin, speed, and narcotics. The chi-square or Fisher exact test were used when appropriate. Mean ages of initial experimentation were as follows: inhalants, 9.7 years; marijuana, 11.9 years; alcohol (inebriated), 12.0 years; cigarettes, 11.2 years; for the remaining substances of abuse, the mean age was 13.2-14.7 years. Thirty subjects had used inhalants. Significant relationships were found between inhalants and cocaine (p = .004), Talwin and Ritalin (p = .001), downers (p = .01), and narcotics (p = .003). Conclusions: For children incarcerated in a juvenile detention facility in our community, inhalant abuse is associated with the later use of other substances of abuse. If this finding is replicated in other populations, it underscores the need for effective preventive strategies.

Copyright 1999, Marcel Dekker, Inc. Used with permission