Rave Drugs: Designer Drugs With a Price

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Rave DrugsDesigner Drugs With a Price

• Travis R. Welch, NREMT, PA-S

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The Rave scene began as a subculture in England
circa 1980, and has since migrated into
mainstream culture throughout the United States.

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Rave Culture In The United States Is
Characterized By

• 2 Types of Raves
• secretive warehouses, deserts, woods, etc.
• commercialized typically held in established
  clubs
  
• Extremely loud techno music/dancing
• Lighting and visual stimuli lasers, video
  screens, etc...
  
• 14-25 age group
• Alcohol-free environment
• Escapist culture
• All-night events
• Designer drugs bought, sold, consumed

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Rave Paraphernalia

• Water bottles
• Light sticks
• Pacifiers
• Bags of small candies/brearespiratione-drop
  bottles
  
• Dust masks/Vicks Vapo-Rub
• Caffeinated beverages/over the counter stimulants

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Rave Paraphernalia Defined

• Water bottles -- Ecstasy the most widely used
  drug associated with raves causes dehydration and
  increases body temperature.
  
• Light sticks -- These are used to enhance the
  visual experience while on the drugs (individuals
  see trails of light)
  
• Pacifiers -- Rave drugs tend to cause the user to
  grind their teeth, the pacifier prevents this.
  
  
• Bags of small candies and breath mints -- The
  drugs intended for sale are often stored in these
  bags.
  
• Eye drop bottles -- These are used to store the
  liquid form of the drugs.
  
• Dust mask and Vicks Vapo-Rub -- These are
  combined to enhance the effects of the designer
  drugs. The Vicks is placed under the nose the
  the mask is used to keep the rub from
  dissipating.
• Caffeinated beverages/stimulants -- These help
  with exhaustion caused by the dancing and
  stimulant effect of the drugs.

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Some Designer Drugs Affiliated With Raves

• Ecstasy
• LSD
• Ketamine
• GHB
• Rohypnol
• Nitrous Oxide

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As with all drugs, the amount used combined with
the mental/physical state of the user and the
setting in which it is consumed, will determine
the effect of the chemical. The higher the dose
the more pronounced and more prolonged the
effects.
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ECSTASY(MDMA) (Methylenedioxymethamphetamine)

• Street names E, X, XTC, rolling, clarity,
  essence, Adam, go, disco biscuit, crystal, hug
  drug
  
• Over-sensitivity to sensory stimuli
• Overall feeling of euphoria
• Dehydration/hyperthermic
• Insomnia
• Hallucinogenic
• Stimulant
• Appetite suppressant
• Dilated pupils

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Ecstasy (MDMA)

• MDMA is marketed as a "feel good" drug. Devotees
  say it produces profoundly positive feelings,
  empathy for others, elimination of anxiety, and
  extreme relaxation--hence the name "hug drug."
  MDMA is also said to suppress the need to eat,
  drink, or sleep, enabling club scene users to
  endure all-night and sometimes two, or three-day
  parties.
• MDMA is taken orally, usually in tablet or
  capsule form. Its effects last approximately four
  to six hours.
  
• Source Strategic Domestic Unit DEA

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Ecstasy (MDMA) Overdose

• Hypertension, Tachycardia
• Muscle Cramping
• Faintness
• Panic attacks
• LOC
• Seizures

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Reported Ecstasy After-effects

• Anxiety
• Paranoia
• Depression

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Ecstasy (MDMA)

• Ecstasy causes long-lasting damage to brain areas
  that are critical for thought and memory.
  
• Source The Journal of Neuroscience (June 14,
  1999)
  
• The proportion of eighth graders reporting any
  use of Ecstasy in the prior 12 months rose from
  1.7 percent in 1999 to 3.1 percent in 2000. Among
  10th-graders, the use of Ecstasy rose from 4.4
  percent to 5.4 percent, and among 12th graders
  from 5.6 percent to 8.2 percent. Ecstasy then,
  would be used by more American teen-agers today
  than is Cocaine.
• Source University of Michigan (December 14, 2000)

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LSD (Lysergic Acid Diethylamide)

• Street names sold under more than 80 names
  acid, blotter, cid, doses, trips, hits, tabs,
  dope
  
• Distorted and intensified sensory input
• Powerful hallucinogenic
• Delusions/paranoia
• Strong effect on mood and emotion
• Dilated pupils
• Raised body temp., heartbeat, blood pressure
• Facial flushing/profuse perspiration
• Blurred vision
• Dizziness and nausea
• Synesthesia- hearing colors or seeing sounds

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KETAMINE (Ketamine Hydrochloride)

• Street names special K, K, kit kat, cat valium,
  jet, super acid, honey oil, green, super C
  
• Powerful anesthetic (Used in widely in veterinary
  medicine)
  
• Overtly hallucinatory
• Muscle relaxation to complete muscle loss
  (including muscles of respiration)
  
• Mild sedative effects to loss of consciousness
• Hypnotic
• Partial amnesia
• Detached, distant, and estranged from
  surroundings
  
• Described as similar to drunkenness only
  stronger
  

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GHB(Gamma-Hydroxybutyrate)

• Street names liquid X, liquid E, G, Georgia home
  boy, goop, gamma-oh, grievous bodily harm
  
• Powerful sedative
• Produces euphoric and psychedelic hallucinatory
  states
  
• Stimulates muscle growth
• Adverse effects drowsiness, nausea, vomiting,
  dizziness, severe respiratory depression,
  unconsciousness, seizures, coma, death
  
• Induces a reduced level of consciousness
• Memory loss

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ROHYPNOL (Flunitrazepam)

• Street names roofies, R-2, Mexican valium,
  rophies, rope, roaches, forget me drug, circles
  
• Powerful anesthetic
• Sedation to loss of consciousness
• Muscle relaxation to complete loss of muscle
  control
  
• Reduction in anxiety
• Prevention of convulsions
• Partial amnesia
• Adverse effects drowsiness, dizziness, loss of
  motor control, lack of coordination, slurred
  speech, confusion, respiratory depression
  
• Impairs cognitive and psychomotor functions
• Alcohol and Rohypnol potentiate each others
  toxicity

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Another concern

• GHB, ROHYPNOL, KETAMINE have sedative and
  amnesia-causing affects that lead them to being
  abused as date-rape drugs which has a plethora
  of consequences.
• These substances can lead to LOC that can lead to
  aspiration, respiratory depression, or DEATH

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NITROUS OXIDE(N2O)

• Disorientation
• Fixated vision
• Throbbing or pulsating auditory hallucinations
• Similarly pulsating visual hallucination
• Increased pain threshold
• Deeper mental connections
• Weak anaesthetic
• Bacteriostatic (stops bacteria growth)
• Light use is not necessarily hazardous

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Emergency Medical Treatment

• Is the scene secured?
• Be aware of possibility of sudden changes of mood
  or hallucinations!
  
• Aggressive airway management as needed.
• Monitor patient frequently and be prepared to
  treat for shock, or cardiopulmonary collapse.
  
• Determine substance taken if possible, and
  transport substance with patient to ER if
  possible.

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Emergency Medical Treatment (Summary)

• Treat patient symptomatically.
• A thorough history and patient assessment (and
  frequent reassessment) will be key to the
  management of these patients!!!
  

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Other considerations

• These drugs are often produced in clandestine
  labs, similar to those used to manufacture
  methampethamine, so the purity of the tablets are
  questionable at best.
• The presence of other chemicals opens the door
  for a plethora of medical conditions and
  complications.
  
• If lab is encountered, proceed as with a
  clandestine methampethamine lab and consider
  responder PPE and Pt decon procedures

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Questions???