PCP Phencyclidine Abuse: An Appraisal

327 Pages·2002·3.07 MB·English

PCP
Phencyclidine
Abuse:
An Appraisal
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • Public Health Service • Alcohol, Drug Abuse, and Mental Health Administration
Phencyclidine (PCP) Abuse:
An Appraisal
Editors:
Robert C. Petersen, Ph.D.
Richard C. Stillman, M.D.
NIDA Research Monograph 21
August 1978
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Alcohol, Drug Abuse, and Mental Health Administration
National Institute on Drug Abuse
5600 Fishers Lane
Rockville, Maryland 20857
NIDA Research Monographs are prepared by the research divisions of the
National Institute on Drug Abuse and published by its Office of Science. The
primary objective of the series is to provide critical reviews of research problem
areas and techniques, the content of state-of-the-art conferences, and integra-
tive research reviews Its dual publication emphasis is rapid and targeted dissem-
ination to the scientific and professional community.
Editorial Advisors
Martin W Adler, Ph.D.
Temple University, School of Medicine
Philadelphia, Pennsylvania
Sydney Archer, Ph.D.
Rensselaer Polytechnic Institute
Troy, New York
Richard E. Belleville, Ph.D.
NB Associates, Health Sciences
Rockville, Maryland
Gilbert J. Botvin, Ph.D.
Cornell University Medical College
New York, New York
Joseph V. Brady, Ph.D.
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Theodore J. Cicero, Ph.D.
Washington University School of Medicine
St. Louis, Missouri
Sidney Cohen, M.D.
Los Angeles, California
Reese T. Jones, M.D.
Langley Porter Neuropsychiatric Institute
San Francisco, California
Denise Kandel, Ph.D.
College of Physicians and Surgeons of Columbia University
New York, New York
Herbert Kleber, M.D.
Yale University School of Medicine
New Haven, Connecticut
NIDA Research Monograph Series
William Pollin, M.D.
DIRECTOR, NIDA
Jack Durell, M.D.
ASSOCIATE DIRECTOR FOR SCIENCE, NIDA
EDITOR-IN-CHIEF
Eleanor W. Waldrop
MANAGING EDITOR
Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857
Phencyclidine (PCP) Abuse:
An Appraisal
ACKNOWLEDGMENT
This monograph is based upon papers presented at a conference
which took place on February 27-28, 1978, at the Asilomar Confer-
ence Center, Pacific Grove, California. The conference was
conducted and reported by PLOG Research, Inc. , Reseda, California
under NIDA contract 271-77-3413.
The National Institute on Drug Abuse has obtained permission from
the copyright holders to reproduce certain previously published
material as noted in the text. Further reproduction of this
material is prohibited without specific permission of the copyright
holders. All other material in this volume except quoted passages
from copyrighted sources is in the public domain and may be used
or reproduced without permission from the Institute or the authors
Citation of the source is appreciated.
The U.S. Government does not endorse or favor any specific
commercial product or commodity . Trade or proprietary names
appearing in this publication arc used only because they are
considered essential in the context of the studies reported
herein.
Library of Congress catalog card number 78-600095
DHHS publication number (ADM) 85-728
Printed 1978 Reprinted 1983, 1985
NIDA Research Monographs are indexed in the Index Medicus. They
are selectively included in the coverage of American Statistics
Index, BioSciences Information Service, Chemical Abstracts,
Current Contents , Psychological Abstracts , and Psychopharmacology
Abstracts
iv
Foreword
Phencyclidine (PCP), or “angel dust” as it is more commonly known
to drug users, posed until recently a relatively modest problem.
While some illicit use occurred as early as the mid ‘6Os, the drug’s
initially poor street reputation seemed to make it decidedly unlikely
that it would ever become popular as a drug of choice.
More recent events have made it abundantly clear that our initial
optimism was poorly founded. A change in mode of use from oral
ingestion to smoking or snorting, which may enable the user to better
control aversive consequences of use, together with the ease with
which PCP can be synthesized, have markedly changed the phencyclidine
abuse picture.
In one year (from 1976 to 1977) the number who had used phencyclidine
as measured by NIDA’s National Drug Use Surveys nearly doubled in the
12 to 17 year age group. Among young adults between 18 and 25, the
number of PCP users increased nearly fifty percent in that same year.
Although the level of use detected was still modest, there is good
reason to believe that the standardized indicators of the extent of
PCP use and of its adverse consequences represent significant under-
estimates of the seriousness of the problem. Clinical reports have
also indicated that phencyclidine use can precipitate violent acting
out and seriously self-destructive behavior as well as psychotic
thinking and behavior.
Because of the relatively recent emergence of phencyclidine abuse as
a problem of widespread proportions, our knowledge remains fragmen-
tary. If the dimensions of the problem continue to be in doubt,
still more remains to be learned about the implications of use,
especially on a chronic basis. This volume represents an attempt to
bring together our present knowledge. It is based on a small working
conference of researchers and clinicians with extensive PCP experi-
ence which was held in late February of this year (1978). We hope
that it proves to be a useful compendium of information on the prob-
lem as well as a stimulus to further work to answer some of the
critical questions with which we are confronted. In addition,
because phencyclidine may well prove to be prototypic of a range of
easily synthesized psychoactive drugs susceptible to abuse, we hope
it will stimulate thinking about better ways both to anticipate newly
emerging drug problems and to cope with them.
The Editors
v
Contents
Foreword
The Editors . . . . . . . . . . . . . . . v
Chapter 1
Phencyclidine: An Overview
Robert C. Petersen and Richard C. Stillman . . . . 1
Chapter 2
Neurobiology of Phencyclidine--An Update
Edward F. Domino . . . . . . . . . . . . . 18
Chapter 3
Neurochemical Pharmacology of Phencyclidine
Kenneth M. Johnson . . . . . . . . . . . . 44
Chapter 4
The Behavioral Effects of Phencyclidine in Animals
Robert L. Ealster and Larry D. Chait . . . . . . 53
Chapter 5
Phencyclidine Use Among Youth: History, Epidemiology, and
Acute and Chronic Intoxication
Steven E. Lerner and R. Stanley Burns . . . . . . 66
Chapter 6
Phencyclidine and Ketamine Intoxication: A Study of
Four Populations of Recreational Users
Ronald K. Siegel . . . . . . . . . . . . . 119
Chapter 7
Epidemiology of Multiple Drug Use with Special Reference
to Phencyclidine
J. Fred E. Shick . . . . . . . . . . . . . 148
Chapter 8
Patterns of Phencyclidine Use
David B. Graeven . . . . . . . . . . . . . 176
Chapter 9
The Psychiatric Aspects of Chronic Phencyclidine Use: A
Study of Chronic PCP Users
Michael A. Fauman and Beverly J. Fauman . . . . . 183
vi
Chapter 10
Phenomenological Aspects of Phencyclidine Abuse Among
Ethnic Groups in Hawaii
Anthony J. Marsella and Russell D. Hicks . . . . 201
Chapter 11
The Pharmacokinetics of Phencyclidine in Overdosage and
Its Treatment
Alan K. Cone, Regine Aronow, and Joseph N. Miceli . . 210
Chapter 12
Clinical Observations During Phencyclidine Intoxication
and Treatment Based on Ion-Trapping
Regine Aronow, Joseph N. Miceli, and Alan K. Done . . 218
Chapter 13
The Diagnosis and Treatment of the PCP Abuse Syndrome
David E. Smith, Donald R. Wesson, Millicent E.
Buxton, Richard Seymour, and Honey M. Kramer . . . 229
Chapter 14
The Phencyclidine Psychosis: Phenomenology and Treatment
Paul V. Luisada . . . . . . . . . . . . . 241
Chapter 15
Long Term Treatment of Adolescent PCP Abusers
Gerald G. DeAngelis and Elliott Goldstein . . . . 254
Chapter 16
Phencyclidine, Criminal Behavior, and the Defense of
Diminished Capacity
Ronald K. Siegel . . . . . . . . . . . . . 272
Chapter 17
Control of Drug Self-Administration: The Role of
Aversive Consequences
Nancy K. Mello . . . . . . . . . . . . . 289
Conference Participants . . . . . . . . . . . . . 309
List of Monographs . . . . . . . . . . . . . . 311
vii

Chapter 1
Phencyclidine: An Overview
Robert C. Petersen, Ph.D., and Richard C. Stillman, M.D.
Although phencyclidine was first abused in oral form over a decade
ago, it is only in recent years as a smoked or snorted drug that
it has become a more serious problem involving significant numbers
of users. This overview is intended to review and summarize what
is presently known about the drug with special emphasis on the con-
tributions of the authors of this volume. By providing a relatively
brief integrated view of our current knowledge we hope to convey
the limitations of that knowledge and to encourage others to en-
large our presently modest understanding of the implications of
phencyclidine abuse.
THE MATERIAL
Phencyclidine,or PCP, one of the group of arylcyclohexylamines, is
in pharmaceutically pure form a white powder which readily dissolves
in water. In “street” form PCP is often adulterated and quite often
misrepresented as a variety of other drugs. It is highly variable
in appearance, being sold in liquid, powder, and tablet form, the
latter two in many colors. As a powder or liquid, it is often placed
on parsley or on other leaf mixtures to be smoked as cigarettes
(joints). When misrepresented, PCP is most commonly sold as THC
(the principal psychoactive ingredient in marihuana, which in reality
is not available on the street). But phencyclidine has also been
sold as cannabinol (another marihuana constituent), mescaline,
psylocybin, LSD, and even as amphetamine or cocaine. Because of
the variability in street names and its frequent misrepresentation,
the casual user may be unaware of what he or she has ingested or
may be mistaken about its true identity.
Some of the street names for phencyclidine include: angel dust,
dust, crystal, cyclones, embalming fluid, elephant or horse tran-
quilizer, killer weed, superweed, mintweed, mist, monkey dust,
Peace Pill, rocket fuel, goon, surfer, KW, and scuffle. The wide
range of regional names for this illicit drug, as well as variations
in its appearance, mean that the casual user may not be aware that
he or she has used PCP or may fail to report its use in surveys because
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