Club Drugs

Ecstasy/MDNA, Ketamine, Rohypnol, GHB

Club Drug Review

In recent years, certain drugs have emerged and become popular among teens and young adults at dance clubs and "raves." These drugs, collectively termed "club drugs," include MDMA/Ecstasy methylenedioxymethamphetamine), Rohypnol (flunitrazepam), GHB (gamma hydroxybutyrate), and ketamine (ketamine hydrochloride).

MDMA is a synthetic, psychoactive drug chemically similar to the stimulant methamphetamine and the hallucinogen mescaline.

The tasteless and odorless depressants Rohypnol and GHB are often used in the commission of sexual abuse due to their ability to sedate and intoxicate unsuspecting victims. Rohypnol, a sedative/tranquilizer, is legally available for prescription in over 50 countries outside of the U.S. and is widely available in Mexico, Colombia, and Europe. Although usually taken orally in pill form, reports have shown that some users grind Rohypnol into a powder and snort the drug.

GHB, available in an odorless, colorless liquid form or as a white powder material, is taken orally, and is frequently combined with alcohol. In addition to being used to incapacitate individuals for the commission of sexual abuse/rape, GHB is also sometimes used by body builders for its alleged anabolic effects.

The abuse of ketamine, a tranquilizer most often used on animals, became popular in the 1980s, when it was realized that large doses cause reactions similar to those associated with the use of PCP, such as dream-like states and hallucinations. The liquid form of ketamine can be injected, consumed in drinks, or added to smokable materials. The powder form can also be added to drinks, smoked, or dissolved and then injected.6 In some cases, ketamine is being injected intramuscularly.

Health Effects of Club Drugs

In high doses, MDMA can interfere with the body's ability to regulate temperature, sometimes leading to a sharp increase in body temperature (hyperthermia), resulting in liver, kidney, and cardiovascular system failure, and death. MDMA users also risk increases in heart rate and blood pressure, and symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating. Psychological effects of MDMA use can include confusion, depression, sleep problems, drug craving, and severe anxiety. Additionally, these problems can occur during as well as sometimes days or weeks after using the drug.

Rohypnol, GHB, and ketamine are all central nervous system depressants. Lower doses of Rohypnol can cause muscle relaxation and can produce general sedative and hypnotic effects. In higher doses, Rohypnol causes a loss of muscle control, loss of consciousness, and partial amnesia. When combined with alcohol, the toxic effects of Rohypnol can be aggravated.
GHB has been shown to produce drowsiness, nausea, unconsciousness, seizures, severe respiratory depression, and coma. Additionally, GHB has increasingly become involved in poisonings, overdoses, date rapes, and fatalities.

The use of ketamine produces effects similar to PCP and LSD, causing distorted perceptions of sight and sound and making the user feel disconnected and out of control. The overt hallucinatory effects of ketamine are relatively short, lasting approximately one hour or less. However, the user's senses, judgement, and coordination may be affected for up to 24 hours after the initial use of the drug. Use of this drug can also bring about respiratory depression, heart rate abnormalities, and a withdrawal syndrome.

Of an estimated 106 million emergency department (ED) visits in the
U.S. during 2004, the Drug Abuse Warning Network (DAWN) estimates that 1,997,993 were drug-related. DAWN data indicate that MDMA was involved in 8,621 ED visits; GHB was involved in 2,340 visits; rohypnol was involved in 473 visits; and ketamine was involved in 227 visits.

Club Drug Detox and Club Drug Withdrawal

Most people who experiment with club drugs such as Ecstasy, MDMA, Rophynol and others and do not dose on a regular basis, generally do not develop club drug dependence or a physical dependency. That being said, it does not mean that the club drug user has not begun to develop a psychological dependency and may experience club drug withdrawal symptoms when they discontinue club drug use. To err on the side of caution, the user should contact a drug rehab program or addiction treatment center for an evaluation. Quality addiction treatment programs, such as Lakeview, offer drug rehab services ranging from medical detox, inpatient drug rehab or outpatient addiction treatment services.

For the person taking club drugs on a regular basis, club drug withdrawal can be very challenging from a medical perspective and psychological standpoint. When trying to detox on their own, many people end up self medicating with alcohol, barbituates or tranquilizers to offset the side effects of club drug withdrawal. The solution is to seek admission to an effective, medically driven, club drug detox program. Club drug detox can last anywhere from three to ten days depending on the combination of drugs and alcohol the person is taking, frequency and amount of use, medical problems and a variety of other factors. 

Medications will be prescribed to manage and sometimes eliminate club drug withdrawal symptoms, while the staff in club drug detox support you through the emotional ups and downs associated with club drug withdrawal. All club drug detox programs should ideally be located within a drug rehab or addiction treatment program. Detox is only the initial step to recovery and many individuals require the addiction treatment services offered by a drug rehab program. There is a much better continuity of care provided when the patient can transfer from one level of addiction treatment care to another. Within the confines of the same drug rehab facility.

Extent of Club Drug Use

According to the 2005 National Survey on Drug Use and Health (NSDUH), an estimated 11.5 million Americans aged 12 or older tried MDMA at least once in their lifetimes, representing 4.7% of the U.S. population in that age group. The number of past year MDMA users in 2005 was approximately 1.9 million (0.8% of the population aged 12 or older) and the number of past month MDMA users was 502,000 (0.2%).

Among 12–17 year olds surveyed as part of the 2005 NSDUH, 0.3% reported past month MDMA use. Additional NSDUH results indicate that 0.8% of 18–25 year olds and 0.1% of those aged 26 or older reported past month use of MDMA.

There were 615,000 individuals who first used MDMA in the year prior to the date of the NSDUH interview. This is a significant reduction from 1.2 million past year initiates in 2002.
Among students surveyed as part of the 2005 study, Monitoring the Future, 2.8% of eighth graders, 4.0% of tenth graders, and 5.4% of twelfth graders reported lifetime use of MDMA. In 2004, these percentages were 2.8%, 4.3%, and 7.5%, respectively.

Percent of Students Reporting MDMA Use, 2004–2005
Forty percent of eighth graders, 51.4% of tenth graders, and 60.1% of twelfth graders surveyed in 2005 reported that trying MDMA once or twice was a "great risk."

Percent of Students Reporting Risk of Using MDMA, 2005
Approximately 1.1% of eighth graders and 1.0% of tenth graders surveyed in 2005 reported lifetime use of Rohypnol (twelfth grade data are not available for Rohypnol).

Percent of Students Reporting Rohypnol Use, 2004–2005
Additional Monitoring the Future results for 2005 indicate that 0.5% of eighth graders, 0.8% of tenth graders, and 1.1% of twelfth graders reported past year use of GHB. Data showing past month and lifetime use of GHB and ketamine were not captured in the study.

The Youth Risk Behavior Surveillance study by the Centers for Disease Control and Prevention surveys high school students on several risk factors including drug and alcohol use. Results of the 2005 survey indicate that 6.3% of high school students reported using MDMA at some point in their lifetimes. This is down from 11.1% in 2003

Production & Trafficking

Since 2004, Canada-based Asian criminal groups (primarily ethnic Vietnamese and Chinese) have been expanding MDMA distribution and have significantly elevated MDMA availability. DEA System To Retrieve Information From Drug Evidence (STRIDE) data for 2003 to 2005 indicate that MDMA is readily available in most areas of the United States.

The amount of MDMA seized by federal law enforcement agencies has increased 186% from approximately 1.92 million dosage units seized in 2004 to nearly 5.5 million dosage units in 2005. Across the U.S., there were 14 MDMA lab seizures reported to the National Clandestine Laboratory Seizure System in 2005.

Distribution of GHB has declined to relatively low levels, and notwithstanding the possibility of sporadic, localized outbreaks, a significant national resurgence of this drug appears unlikely in the near term. During 2005, authorities reported 2 GHB lab seizures in the U.S. This is down from 12 lab seizures in 2004