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Chapter 14. Hallucinogens and Club Drugs

Michael F. Weaver, M.D.; Sidney H. Schnoll, M.D., Ph.D.
DOI: 10.1176/appi.books.9781585623440.347400

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Excerpt

Drugs considered hallucinogens are a diverse group of compounds (Table 14–1) including lysergic acid diethylamide (LSD), designer drugs, and many others that produce perceptual distortions (rarely complete hallucinations). Phencyclidine (PCP) and ketamine are dissociative anesthetics that produce perceptual distortions similar to hallucinogens, resulting in their being classified as hallucinogens. Designer drugs are synthetic compounds that are chemically related to stimulants, often with additions to the phenyl ring of amphetamine that cause them to have hallucinogen properties. These ring substitutions, such as are found in methylenedioxymethamphetamine (MDMA; "ecstasy"), can produce perceptual distortions.

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Table Reference Number
TABLE 14–1. Hallucinogens
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TABLE 14–2. Club drugs identified by the National Institute on Drug Abuse
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TABLE 14–3. Additional club drugs
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TABLE 14–4. Hallucinogen intoxication
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TABLE 14–5. Stimulant intoxication
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TABLE 14–6. -Hydroxybutyrate intoxication
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There are many different types of hallucinogens, derived from different sources. Lysergic acid diethylamide (LSD) is the prototypical hallucinogen and is the most commonly abused.

Hallucinogens cause perceptual distortions more than hallucinations, and "bad trips" do not often require medical treatment.

Club drugs identified by the National Institute on Drug Abuse are LSD, ketamine, methamphetamine, methylenedioxymethamphetamine (MDMA), -hydroxybutyrate (GHB), and flunitrazepam. Other club drugs may include prescription opioids, benzodiazepines, and over-the-counter cold preparations.

Intoxication or overdose from certain club drugs (GHB, opioids, benzodiazepines), especially in combination, may result in serious medical consequences and death.

Treatment of hallucinogen and/or club drug abuse involves components such as individual counseling, support groups, and 12-step self-help group attendance.

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Sample questions:
1.
Drugs considered to be hallucinogens are a diverse group of compounds that have a variety of street names. What is the chemical name for the hallucinogen that goes by the street name "angel dust?"
2.
The National Institute on Drug Abuse has identified six drugs as club drugs. What is the street name for methylenedioxymethamphetamine?
3.
You are called to evaluate a patient in the emergency room for possible hallucinogen intoxication. Which of the following acute physiological effects would usually not be seen in hallucinogen intoxication?
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