The term club drugs is neither a pharmacological nor medical classification, but rather a cultural one referring to a chemically and psychoactively diverse group of drugs used and abused on the club and rave scenes of the late twentieth and early twenty-first centuries. Due to the ever-changing and novelty seeking nature of the youth-culture that spawned the term, no list of club drugs is likely to be complete, though most lists include MDMA, GHB, ketamine, rohypnol, methamphetamine, and LSD. One might add that changes in the youth culture may also render the club drugs obsolete as a useful grouping, as the cultural moment that brought them to the fore has largely passed. Further, use of the drug most commonly identified with the club drug class, MDMA, declined substantially in the late 1990s and early twenty-first century. Nonetheless, these drugs, together or apart, continue to be used and abused, particularly by young people with an experimental attitude towards drug use. A more useful name for the class might be novelty drugs owing to the fact that most users are attracted to these drugs by their actual or relative novelty compared to other drugs with more established reputations.
Whether the time of club drugs as cultural phenomena has passed or not, it is important that the cultural memory of their impact is not lost. Many young people faced with the choice to use drugs in 2008 were old enough to recall the cocaine epidemic of the 1980s, which in itself was in part a product of the loss of cultural memory of the cocaine epidemic of the 1930s. Like cocaine in its heyday, many club drug users took to these drugs because they seemed more benign than cocaine or heroin, the dangers of which were well known both to clinicians and the wider public. Lacking direct experience of the negative consequences of the use of these drugs led to a much more casual approach to their use than would have been the case with a hard drug such as heroin. Page 314 | Top of ArticleMDMA was not used recreationally until the 1980s, so information on the clinical consequences of its use and abuse was lacking both publicly and within the research community. Two decades later, due to research and clinical experience, the adverse consequences of MDMA use and abuse were more widely known. The lesson here is that experimenting with drugs is precisely that, an experiment, and often one whose result is more negative than anticipated.
MDMA is a psychoactive drug that emerged as a recreational drug in the mid-1980s, though it was first synthesized decades earlier. It is an amphetamine- derived hallucinogen, sometimes described as an empathogen or entactogen due to the enhanced feelings of emotional and physical closeness to others it generates in many users. Although it had a reputation as a benign so-called love drug, MDMA contributed to hundreds of deaths in its short time as an abused drug. It has been linked to seizures as well as kidney and cardiovascular failure. MDMA has produced long-term neurotoxicity in animals and a number of frequent human users have exhibited long lasting cognitive and emotional deficits.
Both rohypnol and GHB gained notoriety as date-rape drugs due to their criminally abused propensity for impairing memory and inducing unconsciousness. Again, both were fairly new to the world of recreational drug use, although rohypnol belongs to the same class of drugs, the benzodiazepines, as Valium, a drug with a well-known history of abuse. GHB, by contrast, is produced naturally in the human brain at low concentrations and may be involved in the regulation of sleep architecture. These drugs are especially dangerous when used with alcohol, which exacerbates their depressant effects often leading to stupor, respiratory depression, and in some cases coma and death. Like alcohol, GHB and rohypnol seem to cause an increase in violent behavior in some users. Another similarity to alcohol is the relative ease with which use of these drugs can result in overdose, dependency, and severe withdrawal syndromes. These drugs have been linked to such a disproportionate number of negative events that as of 2008 many countries had opted to increase restrictions on their use.
Methamphetamine has a long and well-documented history of abuse and toxic effects. Its appearance on the club scene seems to be linked to its low cost and the negative perception of cocaine as an alternative psychostimulant. Methamphetamine is substantially more toxic to the brain and liver than cocaine but it shares some of cocaine's potentially lethal effects on the cardiovascular system. Amphetamine use has also been linked to toxic psychosis.
Ketamine is a dissociative anesthetic formerly used in humans but subsequently largely restricted to veterinary use. Ketamine shares its major site of action with phencyclidine (PCP) and, like the latter drug, can produce many of the symptoms of psychosis in humans, including hallucinations and indifference to pain or death. Given that chronic PCP use has been associated with the development of long-term psychosis, it seems likely that this may prove to be a risk with ketamine as well. Ketamine is thought to have few other toxic effects, and some studies have demonstrated its potential as an acute antidepressant when used in low doses.
LSD is another drug with a well-known history of misuse and abuse. Its dangers lie in its hallucinogenic properties, which may cause users to physically harm themselves or others. LSD also seems to aggravate depression and psychosis. Outside its intense psychological effects LSD has few, if any, physiological side effects even when taken at doses well in excess of those used recreationally.
Club drugs are hardly risk-free, as has been made abundantly clear by many hospital admissions as well as basic and clinical research. A particularly risky and difficult-to-analyze aspect of the club drug phenomena is that most club drug users use several of these drugs as well as tobacco and alcohol. With such a variety of drugs being abused by individual users, toxic and other dangerous results are far more likely to occur and be less predictable in terms of long-term consequences.
See also Amphetamine; Hallucinogens; Lysergic Acid Diethylamide (LSD) and Psychedelics; MDMA; Methamphetamine; Phencyclidine (PCP); Psychomotor Stimulant.
Club Drugs. National Institute on Drug Abuse (NIDA). Available from http://www.nida.nih.gov/ .
Fritz, J. (1999). Rave culture, an insider's overview. Victoria, BC: Smallfry Press.
Knowles, C. R. (2001). Up all night: A closer look at club drugs and rave culture. North Springfield, VT: Red House Press.
RICHARD G. HUNTER