Phencyclidine-Has The “Dust” Been Stirred Up?

Phencyclidine-Has The “Dust” Been Stirred Up?

Phencyclidine (PCP) or 1-(1-phenylcyclohexyl)piperidine), a dissociative drug known by the street name “Angel Dust”, was first synthesized by Parke, Davis and Company in 1926 for use in general anesthesia both in human and veterinary medicine.1 By the mid 1960’s its use was abandoned when patients in clinical studies experienced various negative side effects. Two of these negative side effects, delusions and hallucinations, lead to PCP’s desirability as a drug of abuse. Severe anxiety and agitation were also seen in the clinical studies and in illicit use of PCP. Although PCP is an NMDA receptor antagonist and that typically would mediate excitation, the compound “unexpectedly produces substantial cortical activation in humans”4. This heightened state has resulted in erratic violent behavior, some of which is more myth than fact including removing limbs with super human strength.5 It also influences the actions of the neurotransmitter dopamine resulting in euphoria, another desired effect with illicit use of the drug.2

Abuse of PCP declined in the very late 1970s through the early 1980s when the use of other drugs such as crack cocaine became more popular. During the 1980s teenagers in various areas of the United States (Baltimore, Chicago, Detroit, Los Angeles, New Orleans, New York City, San Diego, San Francisco, St. Louis, and Washington, DC), began to abuse PCP again leading to another influx in abuse.3 Although the decline in abuse of PCP was seen during the late 1980s and 1990s, recently emergency departments (ED) are seeing resurgence in use. In a report by the Drug Abuse Warning Network (The DAWN Report: Emergency Department Visits Involving Phencyclidine), researchers found “the estimated number of PCP-related ED visits increased more than 400% between 2005 and 2011 (from 14,825 to 75,538 visits); more recently, the number of these visits doubled between 2009 and 2011 (from 36,719 to 75,538)”3. This is staggering when compared to MDMA (street name “Ecstasy”) which increased 100% (from 11,287 to 22,498 visits) and LSD (street name “Acid”) related ED visits was up 141% (from 2,001 to 4,819 visits).3

What are the demographics of PCP users now? During the examined time period (2005-2011) young adults (aged 25 to 34) saw the largest increase at 518% (from 5,556 visits to 34,329) and both genders saw a rise in use with males increasing from 10,721 to 51,906 visits and females from 4,007 to 23,598 visits.3 PCP is considered one of the most dangerous hallucinogens as its use results in violent behavior and it is this behavior that “new” users may be unaware of.2 Concomitant use of other drugs with PCP is also an issue. Awareness and education of the dangers of PCP use/abuse will need to be addressed. Health care providers (especially new ones) will need to be educated on how to recognize the signs and symptoms of PCP intoxication to ensure that individuals receive appropriate care.

References:

  1. Center for Substance Abuse Research. Drug Information: PCP. (November 21, 2013) <http://www.cesar.umd.edu/cesar/drugs/pcp.pdf>
  2. U.S. Department of Justice, Drug Enforcement Administration. (2003). PCP: The threat remains. Microgram Bulletin, 36(8), 181-190.
  3. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (November 12, 2013). The DAWN Report: Emergency Department Visits Involving Phencyclidine (PCP). Rockville, MD.  (November 21, 2013)<http://www.samhsa.gov/data/2K13/DAWN143/sr143-emergency-phencyclidine-2013.pdf>
  4. Hirsch, JC; Crepel, F (1991). “Blockage of NMDA receptors unmasks a long-term depression in synaptic efficacy in rat profrontal neurons in vitro”. Exp Brain Res 85 (3): 621–624. doi:10.1007/BF00231747.
  5. Spiegel, C. Effects of PCP: Myth Vs. Reality: Stories abound about the drug imbuing people with superhuman strength. But some researchers say those claims are overrated. Much about the drug remains a mystery. Los Angeles Times. June 17, 1991 (November 21, 2013) <http://articles.latimes.com/1991-06-17/news/mn-625_1_drug-abuse>

 

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