Drugs of Abuse: Synthetic Hallucinogens

THE TERM HALLUCINOGEN IS SAID TO be an inaccurate ;ane; generally applied to a group of drugs that produce visual illusions, sensory distortions, perceived ability to "hear" light and "see" sounds, depersonalisation and derealisation.

To some researchers, the suitable terms that seems best to describe this group of drugs are illusiongenic, psychedelic, mysticomimetic or entactogens (to touch within).

Our previous article highlighted the hallucinogen LSD. This article will look at drugs such as Ecstasy.

Amphetamine was first synthesised in 1887 and was used to treat a range of medical conditions. Since then, a large number of hallucinogenic amphetamine analogues have been synthesised.

The most commonly available in the 1960s and 1970s were DOM (2,5 diemthoxy-4-methylamphetamine) and MDA (love drug or 3,4-methylene-dioxyamphetamine). It is from these compounds that MDMA, alias Ecstasy (3,4-methylenedioxymethamphetamine), has been derived from.

Less commonly available hallucinogenic amphetamine derivatives include DMA (2,5-dimethoxyamphetamine), 2,4- DMA, DOB (4-bromo-DMA), DPO (propyl-DMA), PMA (p-methoxyamphetamine).

These drugs are used ro seek a state of traquil euphoria and emotional empathy between users. Ecstasy for example, has amphetamine-like stimulant properties, seemingly giving abusers boundless energy, although these effects are less potent than those of amphetamine itself. When taken orally, often in the form of white or off-white tablets, abusers will experience a "fight-or-flight" type of reaction and some individuals may feel sick or suffer a headache. A typical dose of Ecstasy for a first-time user would be 75 mg, but the development of tolerance to the drug results in higher doses to achieve the same effect.

The abuse potential for all hallucinogenic amphetamine derivatives is high, and chemical dependency is the most serious threat of these drugs. Users come to depend upon the perceived feelings of peace, insight, openness and self-awareness they experience from these amphetamine derivatives. They term Ecstasy a "consciousness-effective" drug.

With prolonged use, these drugs can cause serious adverse effects. Among the indentified effects seen are chronic exhaustion and fatigue which may persist for several days after a single dose, jaundice and hepatotoxicity, weight loss, flashback effects, depression and psychosis.

Because these drugs are sympathomimetic (stimulates the sympathetic nervous system), they should definitely not be used by anyone with high blood pressure, heart disease or diabetes. Breastfeeding mothers and women who're pregnant or think they're pregnant should not take this drugs. Users should not attempt to dive a car or use machinary even though they think they are perfectly capable of doing so.

Several all-day long panic and anxiety attacks have been attributed to DOM. This drug is usually taken orally, sometimes "snorted," and rarely, injected intravenously. Because they're produced in illegal laboratories, the are seldom pure, and the dose in a tablet/capsule or on a piece of impregnated paper may be expected to vary quite considerably.

Phencyclidines were first tested in the 1950s as anaesthetics, but because of side-effects of confusion and delirium, its development for human use was discontinued. It became commercially available for use in veterinary medicine in the 1960s under the trade name Sernylan.

More commonly known as PCP, it is sold under at least 50 other names that reflect the range of its bizzare and volatile effects; Angel Dust, Crystal, Supergrass, Kill Weed, Embalming Fluid and Rocket Fuel. Often, it is also misrepresented as mescaline, LSD or THC.

In its pure form, PCP is a white crystalline powder that readily dissolves in water. Most PCPs now contain contaminants, a result of manufacturing processes, causing its colour to rainge from tan to brown, and its consistency, from a powder to a gummy mass.

Although sold in the form of tablets, capsules, powders and liquids, it can also come in a leafy material, such as parsley, mint, oregano or marijuana and smoked.

When ingested, it can be a depressant, stimulant, hallucinogen, convulsant or anaesthetic. Regarded by some experts as the single most dangerous drug on the illicit market today, PCP can affect people so that they will never be normal agains.

Angel dust is a mixture of mint leaves, parsley or low-grade marijuana laced with PCP. A small packet, weighing about 1.5g, can be turned into five or ten cigarettes, and only one such cigarettes ia all that is needed to induce a dreamy state that lasts up to eight hours.

Because PCP is available in liquid form, it can be soaked into marijuana joints. With a low to moderate dose (5 mg to 10 mg), PCP users can show agitation, excitement, gross incoordination of movements, a spaced-out floating euphoria, an inability to speak, excessive sweating and loss of pain sensation leading to stupor, vomiting, hypersalivation, repetitive motor movements and coma.

Mentally, this dose is sufficient to produce distorted images, extreme feelings of apathy, depersonalisation and drowsiness. Drowsy and intoxicated users may inexplicably turn violent and irritional, inflicting physical harm on themselves and others.

Overdosage with PCP can produce coma, high blood pressure, muscular rigidity and convulsions. Life support systems and intensive medical management are required to keep the person alive. There is specific antidote for PCP; the physician can only treat the symptoms, for example by giving diazepam to control convulsions.

Tolerance to PCP develops, and ever larger doses are required to achieve its desired effects. PCP depresses respiration and reduces heart rate, and if combined with alcohol, it can trigger an overdosage reaction as alcohol is also a depressant.

PCP is as variable in its effects as it is in its appearance. A moderate amount often produces a sense of detachment, distance and estrangement in its user. Numbness, slurred speech an a loss of coordination may be accompanied by a sense of strength, involuntary eye movements and an exaggerated gait.

Auditory hallucinations, visual distortions (similar to when looking at yourself in a fun-house mirror) and severe mood disorders may also occur, producing in some people acute anxiety and a feeling of impending doom. In others, there may be paranoia and they may exhibit violent hostility.

PCP is unique among common drugs of abuse in its power to produce psychoses indistinguishable from schizophrenia. Although such extreme psychotic reactions are usually associated with repeated use of the drug, they have been known to occur in some cases after only one dose.

Methaqualone us chemically distinct from barbiturates, and possesses a greater variety of actions. It has antispasmodic, anticonvulsant, local anaesthetic and antitussive activity.

Through its general depressant effect on the central nervous system. it reduces heart rate and respiration and results in the loss of muscular coordination.

Five years after its introduction, it had become widely abused by drug takers, who called it the "love drug."

Methaqualone's explosive invasion of the drug culture stemmed in part from the popular view amonfg users that it was a powerful aphrodisiac. But, as with alcohol, this effect can be explained by the release inhibitions, inducing feelings of relaxation, confidence and euphoria. Abusers term this as a "high," but they are actually experiencing central nervous system depression.

Tolerance of a serious addiction to methaqualone can develop after a month's regular use. Regular use of 75 mg a day can easily increase to 750 mg a day; some abusers take 2,000 mg a day.

Abrupt withdrawal is characteristerised by severe grand mal seizures and is life-threatening. Hence, detoxification is best carried out in a hospital. Since methaqualone and alcohol are metabolised by tge same liver enzymes, the danger of overdosage from a combination of these two is very real.

Dimethyltryptamine (DMT) is a synthetic compound chemicallt related to a compound isolated from hallucinogenic snuffs (cohoba) used by natives of the Carribean and South America.

It may be inhaled, smoked, injected or ingested. A uniquely rapid-acting psychedelic, DMT produces effects within second after it enters the bloodstream, its effects last for approximately one to two hours.

Another similar compound is 5-methoxy-N,N-dimethyltryptamine, which is excreted from the skin of the Bufo alvarius. The hallucinogenic coumpound is continuously excreted from the skin when the frog is agitated.

Under normal circumstances, an addicted user would lick the compound off from the frog's skin. The psychic and physciologic effects of DMT closely parallel those of LSD except for the duration of action, which is shorter in DMT.

In conclusion, the abuse potential hallucinogens is high, as is the potential for chemical dependence on them. It must always be remembered that most adverse effects are related to the mind-altering effects of the drug.

One such effect is "bad trips," which may involve prolonged panic attacks, acute depression and frightening illusions. Besides this, psychosis and flashbacks can develop, even after only a single dose.

These problems may persist for years after exposure but tend to dimish in itensity and frequency with time. Sometimes, flashbacks are bought on by abuse of other drugs, for example, alcohol and cannabis, or by physical or emotional stress.

The writer is a pharmacist and Head of the Toxicology Laboratory at the National Poison Centre, Universiti Sains Malaysia.