By Isabel Burk, M.S., CPP, CHES for GuidanceChannel.com
In the 1980s the term club drugs was coined to label the drugs most often used at social sites such as late night dance clubs and raves. The drugs would typically be stimulants or hallucinogens, used by older teens and young adults to keep up their energy for partying all night. The term itself implies cachet, as if usage of these drugs constitutes entrée into a club, appealing to young people on several levels.
These exotic-sounding drugs burst into our national consciousness, prompting increased media coverage, increased abuse and increased parental concern. The increased attention spurred demand, which led to imitation drugs, lowered prices and widening availability. In turn, use of club drugs spread from the late night city club scene to wider availability at social venues and finally to gatherings at private homes, even in rural areas. Club drugs are used almost exclusively at night and on weekends, but the demographics and dangers have changed, as younger teens have easier access and more money to try drugs.
The US Substance Abuse and Mental Health Services Administration currently lists Ecstasy, LSD, GHB and Ketamine in the club drug category. (The Drug Abuse Warning Network Report, July, 2004) Their effects couldn`t be more dissimilar, but they are included in this category because they are often found on the club or social scene.
How widespread is the issue? The National Survey on Drug Use and Health reports that in 2002, 1.1 million people over the age of 12 tried Ecstasy for the first time, of which one third (371,000) were under age 18. Good news: new users decreased from the 1.8 million who first tried the drug in 2001. Bad news: mean age of first time users declined from 21.7 years to 20.7 years, the lowest mean age of initiation of Ecstasy recorded since the survey first reported Ecstasy use in 1976, revealing the ever younger age of beginners.
First time use of LSD is way down, too, dropping to 170,000 new users under 18 years old in 2002, almost half of the number who tried LSD in 2001. Again, mean age of first time users dropped for the third year in a row, to 17.1 years, the lowest mean age since the survey began in 1965.
The combination of stimulant, euphoric and psychedelic properties makes Ecstasy dangerous, but these same properties are desirable to youth. The small pastel colored tablets frequently sport cartoons stamped into the top, appealing to younger prospects as well. Fifteen percent of high school students and 15% of college students reported having used it at some time in their lives (University of Michigan Monitoring the Future/NIDA, 2001, 2003). Effects commence in about 30 minutes, can last 4-6 hours, and include increased energy, distortion of time and perception, muscle tension and/or spasms, increased blood pressure, increased heart rate, faster respiration, increased body temperature, and more. Ecstasy promotes Seratonin, the "feel good" brain neurotransmitter, so users get a powerful surge of euphoria. Dangers include problems with heat exhaustion, heart disturbances and stroke; in 2002, more than 4000 people ended up in the emergency room with Ecstasy-related problems. And after the drug effects wear off, users can experience disturbances with mood and memory that may linger.
Some Ecstasy users smoke marijuana, drink alcohol or use other drugs in an effort to modulate the intense effects of the drug. These polydrug users face increased risks of drug interactions and other unwanted effects. In fact, many users who buy club drugs may be unwittingly ingesting a variety of drugs. Drug trafficking has become more hazardous and expensive as a result of post-9/11 security measures, so the price of pure Ecstasy has increased, spurring adulteration and/or use of substitutes that mimic its effects.
Although Ecstasy grabbed the headlines, LSD use has held steady for half a dozen years, finally showing a definite decline in usage in 2003 among school-age youth as well as college students. Still, 14-15% prevalence confirms the continuing challenge of LSD. Onset of effects within 30 minutes and duration of effects up to 8 hours combines to make LSD a serious risk to health and safety, changing sensorial perception and interpretation, increasing heart rate, blood pressure and body temperature. LSD often enters the bloodstream via paper tabs rubbed on the skin as well as in liquid form. These tabs are commonly decorated with brightly colored images. In 2002, almost 900 emergency room visits were precipitated by LSD use, overwhelmingly by the young (76% were under age 26) and male (87% of patients were male).
Gamma hydroxybutyrate(GHB) morphed from an underground drug for bodybuilders to a predatory drug for potential rapists or robbers, and now includes users who want to modulate other drugs` effects. For decades, bodybuilders looked to GHB to put themselves into a deep sleep, thinking their bodies would secrete additional human growth hormone to make them stronger with bigger muscles.
At small doses, GHB reduces social inhibitions, similar to alcohol, and an increased libido. At higher doses, GHB`s pronounced sedative effects plus intoxication and mild euphoria are the desired counterpoint for those already under the influence of Ecstasy or stimulants. Effects are felt within 15 minutes of ingestion, lasting up to four hours.
Predators also rely on this combination of effects to disable victims. The odorless, colorless, almost tasteless powder is mixed into liquid (usually water) for drinking. Unwitting victims may not even notice the slightly thick consistency or slightly salty/bitter taste especially if they are already high from alcohol or other drugs. This used to be called "date rape" but is now termed "drug facilitated rape," a more accurate label.
It is possible to formulate GHB from inexpensive ingredients following recipes found on the internet. As with any illicit substance, GHB can contain dangerous substances introduced during development or trafficking, posing additional dangers to users.
Rates of prevalence of GHB abuse in the mainstream population have remained steady at under 2% for high school students since 2000, the first year NIDA included questions about GHB on its Monitoring the Future survey. But GHB dangers persist. In 2002, more than 3000 patients arrived in emergency rooms as a result of GHB complications. Doctors found multiple drugs in more than 2500 of these people, which can be deliberate (drinking while using drugs, for example) or inadvertent (purchasing adulterated drugs or being drugged without your knowledge.)
However, no reliable data exists to determine the prevalence of involuntary (predatory) incidents. Urine tests on victims may fail to find GHB because it clears the system rapidly. In fact, victims may not understand what happened to them, coming back to themselves hours later with fuzzy memories and woozy, disoriented feelings, and may never seek medical assistance at all.
A legal drug used for anesthetic or sedative purposes, Ketamine Hydrochloride, has been on the club drug scene for about a decade. Best known as "Special K" or "Vitamin K" when abused, this prescription drug (Ketalar®, Ketaset®) is legally used for pediatric anesthesia or by veterinarians for sedation of small animals. Ketamine can be swallowed, snorted, smoked or injected. So why would it be used in a social setting? First, perception that a legal drug might be safer and more potent than a street drug. Second, the unusual combination of effects: visual/auditory hallucinations and dissociation, resulting in users’ feeling detached from their body and senses, floating. And, as with most drugs, the thrilling feeling of taking risks.
The drug works quickly, as most anesthetics do, with effects in about 10-15 minutes, lasting up to about 90 minutes. Ketamine also facilitates rape, as it is somewhat easy to administer to an unsuspecting person, rendering the victim helpless for more than an hour.
The 2002 emergency room report listed 260 visits related to Ketamine, a significant decrease from the 679 reported cases in 2001. More than 68% of patients were under age 26, Only 20% of emergency room patients had a single drug in their body, with 80% having ingested multiple drugs.
Club drugs present unique challenges for prevention. Their wider availability, perceived prestige, and association with social/party behaviors appeal to an even younger target audience. Reinforcement of healthy family values, coupled with increased vigilance by parents, maintain positive expectations and guiding principles for youth. More than ever, parents need to become familiar with the local social scene, know the whereabouts of their children, and supervise gatherings. Settings and conditions of drug abuse continue to change, so we need to continue to learn and share knowledge about trends and risks in our neighborhood and community.
Parents can form informal networks to exchange information, discuss issues and work with community officials on drug prevention issues.
Since club drugs appear in headlines frequently, parents can use the news as an opportunity to open a conversation, discussing safety issues and family rules. Discuss the unglamorous side of club drugs: emergency room visits, victimization, etc. Note that drugs of abuse may pose significant danger when taken by a person with a medical condition, either exacerbating health issues or by interacting with prescription medications.
Club drugs will undoubtedly be a continuing threat, so we must keep ourselves positive and informed, in order to protect all our youth.
References
National Survey on Drug Use and Health, 2003
The Drug Abuse Warning Network Report, Club Drugs 2002 Update
Monitoring the Future 2003 from the National Institute on Drug Abuse
