CMT8824 - CONCLUSIONS AND ADDENDUM
What have we learned to this point about involuntary DOA treatment?
There are roles for all parties involved in involuntary DOA treatment: the client, the clinician, the workplace and the court system.
There are special complications in providing involuntary treatment services to DOA clients, which can include managing both treatment and policing roles.
There are important knowledge bases that must be known by the treatment provider, including special issues related to confidentiality.
There is a five-stage model of therapeutic change related to DOA treatment that has important considerations for choices in timing and intervention on the part of the treatment provider.
Earlier in our training, we discussed the system of treatment as consisting of the client, the clinician and the referring party (the workplace or the court system). In an optimal situation, all of these parties would work together to produce a common result: the client achieving and maintaining sobriety.
In a very real way, the client's position within the five-stage model of change has a very important role in determining the effectiveness or failure of the decisions made by all parties involved in involuntary treatment. Analysis of this factor will help us to pull together much of the important information in this training.
Both the referring party and the treatment providers are in the position of needing to utilize their treatment and sanctioning capacities to help the client's success in overcoming his/her DOA problems. The mission, in other words, is to create systems of support that will be successful in creating sobriety.
The client's receptiveness to efforts to create change, however, is the single greatest determinant of the degree to which the systems of support will be successful in achieving sobriety. This is the factor of motivational congruence we discussed earlier in this training. This receptiveness, to a significant degree, will be based upon where the client resides in the stages of change.
Yet neither the court system nor the workplace has necessarily integrated this key knowledge element into their decisions about interventions and approaches to DOA abusers.
Many court systems and workplaces will utilize the same intervention approaches - regardless of what stage of change the offender or employee is at. The client may be referred to the same "one size fits all" treatment program - whether he/she is in the precontemplation stage or in the action stage. Clearly, this factor may explain to some degree the great variability in success rates that is found in mandated DOA treatment.
To reiterate a point made earlier in this training, a key element of the success of treatment approaches to mandated DOA clients is the flexibility of the program in providing a wide range of services - working with an understanding of our principle of motivational congruence.
One final note: the research shows whether a person comes to treatment on a voluntary or involuntary basis is not necessarily significant. What is significant is the skill of treatment personnel in assessing people’s motivation for change - including where they are in the stages of change - and utilizing in a flexible manner a range of knowledge and techniques to meet the client's needs.
For any clinician working with this population, whether in an assessment and referral role or in the role of primary clinician, it is important to remain aware of the changing landscape of substance misuse, and to remain current with the common substances that are being abused and leading to mandatory referral to substance abuse treatment.
Accordingly, as an addendum to this course, there will follow some summary sheets concerning the substances that are most frequently abused and that are currently most likely to lead to referrals for treatment through work or through the court system. These will be grouped according to chemical formulation and effects. This will include, whenever possible, the street names of the substances that are likely to be encountered, allowing the trainee to be able to talk more fluently with clients about the substances that led them to the need for treatment.
Marijuana Summary Page
Street names: Ganja, weed, Mary Jane, doobie, bud, bhang, chronic
What it is: Leafy, wild growing plant, common in tropical and temperate areas. Leaves and flowering tops prominently contain the active chemical THC—Delta-9 tetrahydrocannibinol, a mild, hallucinogenic with calming, sedative effects.
Appearance: Usually brown or green leaves, resembling chopped oregano.
Who uses it and how? Young white adult males are primary users. It is usually smoked, but is sometimes added to food (or baked) and eaten.
Effects: It has mild stimulant properties at the start of intoxication and can cause giddiness and euphoria. It then has sedative and tranquility producing effects. The active ingredient, THC, changes the way in which sensory information gets into and is acted upon by the neurons in a region of the brain called the hippocampus. This induces perceptual and sensory changes, sometimes mild hallucinations.
The Bad News: Memory problems, reduced concentration, decrease in reaction time, panic attacks, paranoia, respiratory problems, disruption in menstrual cycle, decreased sperm count, possible damage to the DNA of the body's germ cells. Withdrawal effects for long term users. Because THC is fat soluble, it has a long half-life, and can stay in the body up to 4 weeks. For this reason, it shows up frequently in random drug screens.
Salvia Summary Page
Street names: Magic Mint, Diviner's Sage, Sally D
What it is: An entheogenic - or mildly hallucinagenic - plant used traditionally in Mazatec rituals to increase spiritual awareness and facilitate shamanic visions.
Appearance: Salvia is a plant in the sage family with large green leaves, hollow square stems, and purple and white flowers.
Who uses it and How? A variety of "alternative" groups have used Salvia in attempts to reach a higher spiritual plane. Salvia use has begun to show up in the ranks of more traditional substance users as an alternative to other kinds of chemical highs, and users in junior high school have been noted as a point of concern. Salvia was originally chewed by the Mazatec Indians, or the leaves were crushed to extrude the leaf juices. More commonly, non-native users will smoke dried leaves, usually with a water pipe, since the burning temperature for the leaves is quite high.
Effects: Effects appear to be as a mild hallucinagen, and subtle mood enhancer. Users have reported visions, enhanced mood, and a sense of spiritual connectedness, as well as a sensation of motion and alterations in time sense.
The Bad News: To date, not enough research has been directed towards understanding the risks of this drug. Anecdotal reports suggest a state of inebriation may be reached that poses physical risks to the user, based on an induced delirium and difficulties with balance.
K2 (Spice) Summary Page
Street names: Spice, herbal incense, Genie, Zohai
What it is: Any of several products containing synthetic cannabis compounds, the most common of which are HU-210, JWH-018 and JWH-073, similar in chemical structure to THC, the psychoactive substance in marijuana, with similar psychoactive effects. The compound is reported to be 10 times stronger than THC in terms of psychoactive effects.
Appearance: K2 has typically been sold in packets of green herbs, where the psychoactive ingredient has been added to the herbs. It is often marketed and sold as “home incense,” although this is a cover for the real intent for its purchase.
Who uses it and how? K2 is used by people of all age groups who would otherwise use marijuana. Teenagers have been common purchasers in states where it has not been outlawed, because it can be purchased in stores as a legal product with no age restrictions attached. K2 is mixed with herbs and smoked like marijuana.
Effects: Similar to marijuana: relaxation, sleepiness and reduced blood pressure at lower doses; hallucinations at higher doses.
The Bad News: Because of the strength of the compounds in terms of psychoactive effects, there have been reported instances of delusions and agitation. Additionally, K2 has been reported to cause increased heart rate, vomiting, and, in some cases, seizures. However, it is not known whether the synthetic cannabis compounds are causing these problems by themselves, or whether there additional compounds were added to the herbs to prepare the product for the marketplace.
Extra information: Although similar in chemical structure to THC, K2 has not historically been detectable in traditional drug screenings. Therefore it has represented a loophole for marijuana users who are subject to workplace drug screens. However, there has recently been a new drug screening made available that will detect the presence of K2. It is being marketed to parents who want to check their teenagers for K2 use.
Opioids, Pain Killers, and Muscle Relaxers
Heroin Summary Page
Street names: Big H, Black tar, Brown sugar, Dope, Horse, Junk, Mud, Skag, Smack
What it is: Semi-synthetic opiate narcotic derived from the opium poppy and processed from morphine, a highly addictive, powerful and damaging drug.
Appearance: Most always in powder form, and recently has been found to be quite pure. Can be tarry and black.
Who uses it and how? An emerging number of young adults under 26 try and use it, and a surprising number of adults over 30 use it regularly. Purity has increased in recent years, so it can now be snorted. It is also melted into a liquid and injected. During the recent opioid epidemic, it is frequently used by persons who become addicted to painkillers, then turn to street heroin because it is cheaper or more readily available than the prescription medications.
Effects: Heroin excites the neurons that respond to our own endorphins - pleasure creating chemicals. It also stimulates dopamine containing neurons to fire and release their chemical into the pleasure center of the brain. It produces a deep relaxation, as well as a powerful sense of euphoria or well-being.
The Bad News: Very high overdose rate; in past 6 years emergency room visits for heroin up 2000%. Extremely addictive, with terrible withdrawal. Also leading cause of infectious diseases, including HIV/AIDS and Hepatitis B & C from infected needles.
OxyContin Summary Page
Street names: Killers, OC, OXY, Oxycotton
What it is: Oxycodone hydrochloride, a high-dose, 12-hour time release form of oxycodone, an opioid analgesic used for chronic pain.
Appearance: White tablets in four different milligram amounts: 10, 20, 40, & 80.
Who uses it and how? OxyContin users take off the sustained-release coating to get a rush of euphoria similar to heroin. Tablets are crushed for snorting, boiled for injection, or chewed. Primarily used by young adult white males for recreational purposes, or by all groups who become addicted to painkillers upon prescription for pain management.
Effects: Similar to other opioids, such as heroin. It produces a deep relaxation, sense of calm, and euphoria.
The Bad News: Constipation, nausea, dizziness, vomiting, headache, dry mouth, sweating, and weakness. Respiratory depression occurs, and, of course, can be fatal with high enough dose. Because it is an opioid, it can be very addictive. Additives can be very destructive to nasal tissues and veins when pills are snorted or injected.
Most Abused Pain Medications / Opioids
Listed in Order of Those Most Frequently Diverted for Recreational Use
Chemical Name: Hydrocodone
Of Note: Most commonly misused painkiller
Other brand names: Lortab, Hycodan, Anexsia, Tussionex, Tussend
Street names: Vike, Watson387
# of combination medications containing Hydrocodone: About 400
Percodan, Percoset, OxyContin
Chemical Name: Oxycodone
Of Note: Second most commonly misused painkiller
Other brand names: Dazidox, ETH-Oxydose, Endocodone, Oxy IR, Oxycontin, Oxyfast, Percolone, Roxicodone
Street names: Oxy, Cotton, Blue, 40, 80
# of combination medications containing Oxycodone: About 40
Chemical Name: Propoxyphene
Of Note: Third most commonly misused painkiller
Other brand names: PP-Cap
Street names: Pinks, Footballs, Pink footballs, Yellow footballs, N, 65s
# of combination medications containing Propoxyphene: About 10
Chemical Name: Hydromorphone
Of Note: Fourth commonly misused painkiller
Other brand names: Exalgo, Hydrostat, hydromorph contin,
Street names: Dust, Juice, Dillies, Smack, D, Drugstore heroin, Footballs
# of combination medications containing Propoxyphene: 1
Other commonly misused painkillers
Chemical Name: Buprenorphine
Other brand names: Subutex, Suboxone
Street names: Bupe, Subs
Chemical Name: 3-methylmorphine
Street names: T-Threes, School Boy, cough syrup
# of combination medications containing Codeine: Over 130
Chemical Name: Meperidine
Of Note: An analog is available on the streets as a white powder that is inhaled or injected, called synthetic heroin, or MPTP or MPPP
Other brand names: Mepergan
Street names: Demmies, Pethidine
Chemical Name: Dihydrocodeine
Other brand names: Parzone
Street names: DFs, Diffs
Chemical Name: Levorphanol
Other brand names: Levorphanol tartrate
Street names: Dans, Dance, Ds
Chemical Name Methadone:
Of Note: Methadone is being increasingly diverted for street use
Other brand names: Dolophine, Amidone
Street names: Fizzies, Amadone, Chocolate chip cookies
Chemical Name: Morphine
Of Note: Methadone is being increasingly diverted for street use
Other brand names: Oramorph, Duramorph, Roxanol, Kadian, Avinza, Kapanol
Street names: Duramorph, M, Miss Emma, Monkey, Roxanol, White stuff
Chemical Name: Oxymorphone
Other brand names: Opana ER
Street names: Blues, Biscuits, Blue heaven, New blues, Octagons, Pink, Pink lady, Pink heaven, Pink biscuits, Pink O, OM, Stop signs, Mrs. O, The O Bomb
Chemical Name: Opium
Other brand names: Camphorated Tincture of Opium
Street names: PG, PO, Big O, Aunti, Aunti Emma, Goric, Guma, Hop or Hops, Mira, Midnight oil, Pox, Skee, Toxy, Toys, Zero, Ope, O.P., Gondola, Gee, Dreams, Dream stick, Chinese tobacco, Black stuff, Poppy
Chemical Name: Butorphanol Tartrate
Of Note: Nasal spray application and veterinary tablets now being used as street drugs
Other brand names: None, only available as generic or in tablets for veterinary purposes
Street names: Torbo
Chemical Name: Fentanyl
Of Note: This medication is available in a lollypop, which on the street is called a percopop
Other brand names: Actiq, Durogesic, Fentora, Onsolis, Instanyl, Abstral, Leptanal, Fentaz
Street names: Apache, China girl, China white, Dance fever, Friend, Goodfella, Jackpot, Murder 8, TNT, Tango and Cash.
Chemical Name: Sufentanil
Of Note: Used intravenously only, but a patch is likely to be available soon
Other brand names: None
Street names: None
Chemical Name: Pentazocine
Of Note: Poor euphoriant, very little street use by itself, but is used in combination with the anti-histamine, trippelennamine, to produce a high
Other brand names: Fortral, Fortwin, Talacen
Street names: Yellow footballs, Ts
Alfentanil (Alfenta) Administered by injection only, rarely used as street drug
Other similar, non-narcotic substances used as street drugs
Chemical Name: Tramadol
Of Note: Non-narcotic painkiller
Other brand names: Ryzolt, Rybix
Street names: Ultras
Most Abused Barbiturate and Sedative Medications
Chemical Name: Secobarbitol
Street names: Reds, Red bullets, Red birds, Red devils, Lilly, F-40s, Pinks, Pink ladies, Seggy
Chemical Name: Pentobarbital
Street names: Nembies, Yellow jackets, Abbots, Mexican yellows
Chemical Name: Amobarbitol
Street names: Amys, Birds, Blue, Blues, Blue angels, Blue devils, Blue heaven, Blue heavens, Blue dolls, Blue birds, Blue bullets, Blue clouds
Chemical Name: Phenobarbital
Other names: Solfoton
Street names: Purple hearts, Goof balls
Less Frequently Abused Barbiturates
Chemical Name: Secobarbitol and amobarbitol combination
Street names: Rainbows, Reds and blues, Tooies, Double trouble, Gorilla pills, F-66s
Chemical Name: Butabarbitol Sodium
Other brand names: Sarisol No. 2, Butalan, Busodium
Street names: Doors and fours, Load, Pancakes (all with combination w/ codeine)
Chemical Name: Mephobarbital
Street names: Barbs, Reds, Red birds, Phennies, Tooies, Yellows, Yellow jackets
Chemical Name: Talbutal
Street names: None known
Most Abused Sedative Sleep Medications
Chemical Name: Zolpidem
Street names: Tic Tacs, A-minus, Zombie pills
Chemical Name: Zaleplon
Other brand names: Starnoc
Street names: Zimmers, Zimmies, Zim-zims
Other barbiturate-like sedatives include
Chemical Name: Glutethimide
Of Note: Doriden combined with codeine is known to be abused
Street names: Doors and fours, Load
Chemical Name: Methyprylon
Of Note: Infrequently prescribed
Chemical Name: Meprobramate
Of Note: Infrequently prescribed
Muscle Relaxers Being Abused
Chemical Name: Carisoprodol
Of Note: Soma is a muscle relaxer that is currently being abused
Other brand names: Parzone
Street names: Dans, Ds, Dance
Other muscle relaxers include:
Little evidence of widespread abuse noted in literature
Chemical Name: Cyclobenzaprine
Chemical Name: Dantrolene
Chemical Name: Metaxalone
Chemical Name: Baclofen
Chemical Name: Chlorzoxazone
Chemical Name: Methocarbamol
Chemical Name: Orphenadrine
Chemical Name: Tizanidine
Stimulants Being Abused
Methamphetamine Summary Page
Street names: Meth, Chalk, Crank, Fire, Croak, Crypto, Crystal, Glass, Speed, White Cross
What it is: A highly addictive central nervous system stimulant.
Appearance: An odorless, white or off-white, bitter tasting powder, though it is also found in pills, capsules and larger crystals.
Who uses it and how? Highest rate of use was among the 26 or older age group, but use noted in both younger and older groups, as well. It is frequently snorted but is also used orally, smoked, and injected.
Effects: It decreases the user's ability to remove dopamine from the intercellular space of the brain, thereby amplifying the effects of the dopamine. It also pushes dopamine out of little sacs in the brain called vesicles, increasing the amount of dopamine in circulation. Use generally increases the heart rate, blood pressure, body temperature, and rate of breathing of the user, accompanied by a sense of well being and euphoria.
The Bad News: Significant mood disturbance, paranoia, auditory and visual hallucinations, extreme anxiety, confusion, insomnia, aggression, erratic behavior, and homicidal or suicidal thoughts/plans. High addiction rate, very unpleasant withdrawal.
Cocaine Summary Page
Street names: Coke, Dust, Nose Candy, Snowbirds; Crack, Rock (freebase)
What it is: A stimulant chemically derived from the processed leaves of the Coca plant.
Appearance: White powder, or white or off-white crystals
Who uses it and how? Adults 18 to 30. Powder form more likely to be used in higher socioeconomic groups; crack tends to be in lower socioeconomic areas, although it is very prevalent in higher socioeconomic groups, as well. Powder usually snorted, crack is almost always smoked.
Effects: Cocaine blocks the re-absorption of dopamine in the synaptic cleft, particularly in the pleasure center of the brain, causing dopamine to stay in the synaptic cleft and create a highly pleasurable state. It also causes a short-term increase in energy.
The Bad News: Agitation, anxiety, paranoia, nausea/vomiting, violent behavior, kidney failure, seizure, stroke, and heart attack. Can produce death on first usage (Sudden Cocaine Death Syndrome). Cocaine is a very psychologically addictive and is often extremely difficult to terminate use. Strangely, a small percentage of users experience no tendency towards addiction whatsoever.
Ritalin Summary Page
Street names: Kibbles and Bits, Pineapple, Vitamin R, The Smart Drug, Rids, Pineapple, Skippy, Jif, Rball, Poor man’s cocaine, Coke junior
What it is: A mild amphetamine (methylphenidate) commonly prescribed for children and adults with significant focusing and attention management problems. Also prescribed for narcolepsy.
Appearance: Small, white tablet
Who uses it and how? Users crush the tablets and snort the powder, or dissolve it in water and "cook" it for injection. Adolescent and young adult use has been steadily increasing for the past few years. It is often sold in school by students to whom it has been prescribed for Attention Deficit Disorders.
Effects: Since it is a mild, central nervous system stimulant, the effect can be similar to very strong coffee at low dosages, but similar to cocaine when snorted or injected.
The Bad News: Even when taken according to the prescription directions, there is a risk of developing dependence and tolerance to the drug. Negative effects are similar to those of methamphetamine, including formication (sensation of bugs crawling under the skin).
Other Most Abused Stimulant Medications
Chemical Name: Combined dextroamphetamine and amphetamine
Of Note: The same chemical formulation is used in a weight control medication called Obetrol.
Street names: A Train, Addies, A Candy, A.D., A-Bombs, Amps, Beans, Black beauties, Fatty Addy, Study buddies, Ralls, Poopy, Blue buddies, Blue Betties, Blue boy, Jollies, Smurfs, Rinky dink, Diet Coke, Davies Team Blue
Chemical Name: Methylphenidate
Street names: Smart drug, Mind candy
Chemical Name: Dextroamphetamine
Of Note: The same chemical formulation is present in another medication called biphetamine.
Street names: Dexies, Bennies, Black beauties, Crosses, Hearts, Truck drivers, LA turnaround
Chemical Name: Methamphetamine
Of Note: Desoxyn is kept in very limited use, and methamphetamines are now in the street scene mostly from foreign and domestic meth labs.
Street names: Meth, speed
Other stimulant medications infrequently diverted
These medications are typically referred to on the street only by generic names for stimulants such as uppers or speed. Street names that exist are in parentheses.
Benzphetamines (For diet and weight loss)
Phendimetrazines (For diet and weight loss)
Preludin (Prellies, Bam)
Common Club Drugs of Abuse
Ecstasy (MDMA) Summary Page
Street names: Adam, Bean, E, Ecstasy, M, Roll, X, XTC
What it is: 3-4-methylenedioxymethamphetamine, a psychoactive (mind-altering) drug with hallucinogenic and amphetamine-like properties. Its chemical structure is similar to methamphetamine.
Appearance: Tablets, in a wide variety of sizes, shapes and colors, often with a variety of logos or insignias.
Who uses it and how? Older teens, college students use it at raves—all night dance parties—for enhancing mood, produces relaxation.
Effects: Ecstasy supercharges the brain's serotonin systems. This produces a sense of overall well being and a desire for emotional closeness. Used to be utilized to enhance relationships in therapy.
The Bad News: Confusion, severe anxiety, depression, paranoia, dehydration, exhaustion, psychotic episodes. With use, it causes depletion and exhaustion of the brain's serotonin systems, causing a period of depression and apathy that can last from a few days to a couple of weeks. Long term changes from serotonin exhaustion can include memory atrophy, as well as neuron and neurotransmitter permanent damage.
BZP or A2 Summary Page
Street names: A2, Frenzy, Nemesis, Herbal High
What it is: BZP (1-benzylpiperazine) is a type of synthetic alkaloid chemical called a piperazine in the same class of drugs as Viagra, but which does not have the same sexual effects. The naturally occurring chemical similar in structure is called piperine, and it was originally derived from the pepper plant. This gave this class of chemicals its name. BZP was first used as a worming treatment for internal parasites in cattle. It has a mild stimulant effect in stand alone form, but it is frequently mixed with other piperazines , it can produce more euphoric effects. While illegal in the United States since 2002, it is still legal in many other Western countries, including New Zealand which serves as an export country of origin for sales to other countries where it is still legal. BZP is the most usual active ingredient in a variety of substances sold in head shops and on the internet as “Herbal Highs.”
Appearance: BZP is sold in a variety of tablet and capsule forms. The tablets are often yellow, tan and pink in color, sometimes with the letter “A”, or with a bull’s head, a butterfly, a heart or spiders. It is also usually the active ingredient in drugs sold as “Herbal Highs”.
Who uses it and how? BZP is used in ways similar to Ecstasy and Molly, as a mild stimulant to increase a party or rave experience.
Effects: Like Ecstasy and Molly, BZP produces temporary increases in both dopamine and serotonin effects in the user, and this means it has a stimulant effect. It can also have euphoric and hallucinogenic effects, which are enhanced if BZP is used in conjunction with other similar chemicals. It produces approximately one-tenth the stimulant effects of dextroamphetamines. Effects last about 6-8 hours. A combination of BZP and TFMPP (Molly) produces effects almost identical to what is produced by taking Ecstasy.
The Bad News: There are reported instances in which renal toxicity has resulted from BZP use. Hyperthermia is another reported potential problem. Insomnia is a frequently reported side-effect, and BZP reportedly can cause a hangover. There is evidence that addiction and dependence to this drug can occur.
Extra information: The most common names for the Herbal High for which BZP is usually the active ingredient: Herbal E, Herbal X, Herbal Bliss, Rave Energy, Yohimbe, Ultimate XPhoria, Happy Caps, XPillz, Cloud9, and others. Both BZP and Molly will sometimes be added to pills that are marketed just as Ecstasy, so the user will be taking both MDMA and BZP. Additionally, BZP is at times the only active ingredient in pills marketed as Ecstasy, even though its effects are about one third as strong as those of Ecstasy, when taken at similar doses.
Chemically similar substances: There is a piperazine that is similar in structure and effects to BZP, called MDBP (1-(3,4-methylendioxybenzyl). It is not as frequently encountered on street scene.
Molly Summary Page
Street names: Molly (short for molecular), Legal E, Legal X
What it is: According to the DEA, Molly is a designer drug called 1-(3-Trifluoromethylphenyl) piperazine (TFMPP), a more intense form of the drug Ecstasy. Less reliably, users claim the drug to be simply the purest form of MDMA (3,4-Methylenedioxymethamphetamine - Ecstasy). Whereas most Ecstasy pills pair MDMA with other chemicals, such as speed or ephredra, Molly is supposed to contain only the active ingredient that causes the positive effects of Ecstasy. However, as is the case with many street drugs, the actual composition of what is sold as Molly may or may not contain other psychoactive chemicals.
Appearance: Molly is a beige-yellow to white powder, usually sold as a free powder, but sometimes sold in capsules.
Who uses it and how? Molly is used in ways similar to Ecstasy, distributed at rave clubs, taken to enhance party experiences. Users tend to be high school and college aged teenagers and young adults. Previously, users of Ecstasy and Molly used to be confined to urban areas, but there has been increased penetration of these drugs to more rural areas.
Effects: Like Ecstasy, Molly has a stimulant and euphoric effect. It has also been reported to create feelings of increased empathy, closeness and connection to other people, as well as a reduction in anxiety. As noted above, a combination of BZP and TFMPP (Molly) produces effects almost identical to what is produced by taking Ecstasy.
The Bad News: Like Ecstasy, Molly can produce increased heart rate, blood pressure and higher body temperature. Users frequently are not aware of becoming over-heated and dehydrated, and reports of serious hyperthermia (over-heating) have been made. At higher doses, Molly has been reported to cause hallucinogenic reactions. This has prompted some users to take larger amounts of the drug in order to seek out the hallucinogenic effects. At very high doses, it may cause kidney problems and cardiovascular problems. Like Ecstasy, Molly has neurotoxic effects, acting upon the serotonin systems in particular. It can cause damage to these systems, resulting in short-term or longer-term depression. Some reports also suggest that damage to these serotonin systems can create problems with learning and memory.
Chemically similar substances: There are two other piperazines that are similar in structure and effects to Molly, called mCCP (1-(3-chlorophenyl)) and MeOPP (1-(3-trifluoromethylphenyl)). Neither of these substances are as frequently noted on the street scene as Molly.
Less common Piperazines of note:
Tryptamines Summary Page
Street names AMT: Spirals
Street names 5-MeO-AMT: Alpha-o, Alpha
Street names DMT: DMT, spice, Dmitri
Street names 5-MeO-DMT: Dmitri
Street names DPT: DPT
Street names 5-MeO-DIPT: Foxy, Foxy methoxy
What it is: Any of several synthetic chemicals similar in structure and effects to the active ingredient of psilocybin mushrooms.
Appearance: The substances may be found in capsule, tablet or powder form, or may be prepared as a liquid that is impregnated onto sugar cubes, candies or blotter paper. As a powder, it is a white, clear crystal.
Who uses it and How? Users of these substances tend to be similar to those users of psilocybin mushrooms. 5-MeO-DMT, AMT and DPT are all active when ingested, but two other closely related tryptamines, DMT and 5-MeO-DPT need to be smoked or sniffed to have their active ingredients remain effective.
Effects: Effects appear to be as a mild hallucinogen with mild euphoric and empathy-enhancing effects. Users have reported auditory and visual hallucinations with use.
The Bad News: Tachycardia, hypertension, tremors confusion and seizures have been reported as side effects for these substances.
Extra information: There is currently no immunological screening test available that is successful in detecting these classes of substances, therefore they are not as easy to find in urine screenings.
Key Phenylethylamines Summary Page
Street names 2C-B: Nose Candy, Nexus, Venus, Bees, Erox, CB, bromo
Street names 2C-T-7: Triptasy, beautiful, Lucky 7
Street names 2C-T-2: NO STREET NAMES
What they are: Synthetically produced psychedelic drugs of the 2C family. 2C-B, like MDMA (Ecstasy), was originally used as an aid in psychotherapy during the 1970s, and marketed as an aphrodisiac in Germany under the trade name of Eros. It is similar in chemical structure to mescaline. It is now classified as a schedule I narcotic in the United States. 2C-T-2 and 2C-T-7 were later synthesized with similar chemical formulations.
Appearance: 2C-B is sold as either a white powder or pressed into white tablets or gel caps. There are also some reports of red tablets. 2C-T-2 and 2C-T-7 are also white powders in their composed form. They are also pressed into white tablets. 2C-T-7 has also been sold in a blue pill, under the name Blue Mystic, and as a red pill under the name of Red Raspberry. These substances can also be made into liquid preparations.
Who uses it and how? Originally used in Europe legally as an aid to therapy and a replacement for MDMA (Ecstasy), 2C-B made the jump to the club scene, and is reportedly used in lower doses as an aphrodisiac and in higher doses for a hallucinogenic high. 2C-T-2 and 2C-T-7 were developed later, and arose in Europe in the late 1990s. 2C-B is extremely popular in Japan, and has been noted by law enforcement authorities as a club drug in Denver and other big cities. Users will snort 2C-B as a white powder for a faster and more intense high or a shorter duration, or will swallow tablets for a milder and longer lasting high. 2C-B has sometimes been used concurrently with Ecstasy to improve orgasmic potential. Unlike MDMA, it does not appear to deplete brain serotonin concentrations.
Effects: It is reported that lower doses of 2C-B can produce aphrodisiac effects. At higher doses, all three drugs work as a hallucinogen, similar to their chemical cousin, Mescaline, with additional effects of enhanced visual and auditory perception. Users have reported hallucinations that increase and decrease in intensity over time, as well as an increase awareness of one's own body. There are also reports of an increase in imagination.
The Bad News: To date, not enough research exists to understand the risks of these drugs. There are reports of extremely frightening bad trips, as well as a decrease in the ability to communicate and decrease in coordination. There are no reports of fatalities due to overdose to date for either 2C-B or 2C-T-2, but there have been reported deaths with 2C-T-7. Minor increases in dosage can produce significant alterations in the degree of effects, and it is usually difficult or impossible to know what dosage may be present in any illegally procured pill. In some people, 2C-B and 2C-T-2 can produce nausea, chills, and extreme nervousness. 2C-T-2 can cause extreme warm flushes. Like MDMA, these drugs can affect the body's thermostat, and can lead to overheating.
MDPV (3,4-methylenedioxypyrovalerone) Summary Page
Street names: Bath salts, Super Coke, PV, Pee Vee, White Lightning , MDPK, Pixie Dust, Lovey Dovey, Aura, Ivory Wave, Ocean, Charge Plus, magic,, White Girl, Scarface, Hurricane Charlie, Bonzai Grow, Euphoria, Vanilla Sky, Blue Silk, Red Dove and White Dove
What it is: MDPV is designer drug from a category of drugs called cathinone derivatives, a group of stimulant medications. It is a norepinephrine-dopamine reuptake inhibitor (NDRI), similar in structure to a drug called pyrovalerone, which had been used as a stimulant medication to treat chronic fatigue syndrome in the 1960s, but withdrawn due to concerns about dependence.
Appearance: MDPV comes in a white to light brown lumpy powder.
Who uses it and how? Club drug and designer drug users who seek a stimulant drug like Ritalin at the lower end or cocaine or methamphetamine at the upper end. MDPV can be taken orally or sniffed like cocaine powder. It can also be smoked, taken rectally, or injected.
Effects: MDPV creates the same effects as Ritalin or Concerta, but with a potency and strength several times higher.
The Bad News: Like most stimulants, there is a considerable risk of dependence with MDPV, as well as a severe comedown syndrome after binge use. While there have been no reports of fatalities to date – except in combination with other substances – rapid heartbeat, blood pressure increases and vasoconstriction are concerns. Kidney damage is also reportedly a side effect of concern. Reportedly, panic attacks are common with this drug.
Less common Phenylethylamines of note:
4-MTA (5-methoxy- dimethyltryptamine)
It is our hope that this program has contributed to the trainee's body of knowledge in a way will aid in this process.
This completes our course material. We will have two additional sections prior to moving to our course test material. The first will be an addendum of materials supporting the information in this course. The second will be our course bibliography. All of this information is provided on pages that are easily printable.