Club drugs: is it all ecstasy?

Substance use in the club scene of Rome: a pilot study

Objective. Over the last few years, a wide number of unregulated substances have been marketed on the Web and in smart and head shops; they are usually advertised as legal alternatives to commonly known drugs and are defined as “smart drugs,” “legal highs,” and “novel psychoactive substances” (NPS). Aim of our work is to describe use habits and distribution of NPS in a population of young adults in Rome club scene. Methods. A self-administered questionnaire was proposed to subjects over 18 years of age at the entrance of 5 nightclubs in Rome. Socioeconomic characteristics and substance use were investigated. Results. Preliminary results give evidence that 78% of respondents have a lifetime history of NPS use. In addition, 56% of the sample has consumed illicit drugs in the past and 39% has used psychoactive substances in the 12 hours preceding the questionnaire administration. Conclusions. A significant proportion of subjects report use of novel psychoactive substances; traditional illicit drugs consumption, particularly cocaine, appears to be very high as well in the club scene. These data highlight a serious public health challenge, since pharmacological, toxicological, and psychopathological effects linked to interactions among all these substances may be unpredictable and sometimes fatal in vulnerable individuals.

Teenage toxins: recreational poisoning in the adolescent

Adolescents are experimenting with recreational drugs on a regular basis, particularly at social gatherings such as parties, raves and mass events. A combination of reduced fluid intake, physical activity and drug-induced hyperthermia leads to complications such as heat stroke, delirium and potentially death. The clinician needs to be aware of the variety of pharmacologically active substances available in the recreational marketplace in order to diagnose and manage these patients. Recreational misadventure, because of incorrect dosage or mixing multiple substances, is a common reason for teenagers presenting to hospital with toxidromes. Death from club drug overdose is more likely to be associated with suicidal intent, related risky behaviour and trauma, as well as the inherent toxicity of the drug itself. Although many teenagers are concerned about 'drink spiking' with club drugs, the most common agent causing drink spiking incidents is ethanol.

Club drug use among youths in treatment for substance abuse

We describe lifetime rates of club drug use among 782 youths in treatment for substance abuse. Rates (%) for youths under eighteen (N = 486) were methylenedioxymethamphetamine (MDMA), 32.3; gamma-hydroxybutyrate (GHB), 7.0; lysergic acid diethylamide (LSD), 48.6; ketamine, 18.3; and methamphetamine, 30.2. For youths 18-32 (N = 289) rates (%) were MDMA, 37.0; GHB, 13.1; LSD, 42.9; ketamine, 17.0; and methamphetamine, 31.5. Older youths reported significantly more use of GHB than younger youths (p < .01). Youths reported using club drugs frequently outside of rave settings. Club drug use is common among youths in treatment for substance abuse and has spread beyond the rave culture.

The adolescent and substance use, an approach to office management

Adolescence is a period of transition. During this time young people explore many options in an attempt to define who they are. Substance use or abuse is an area of experimentation that creates anxiety for everyone involved and in which, as a health care provider, a physician may be asked to intervene. This article provides general principles regarding substance use, information about commonly used drugs, and recommendations on the diagnosis and management of this problem in an office setting.