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Overview
In recent years, certain drugs have emerged and become popular among teens and young adults at dance clubs and "raves." These drugs, collectively termed "club drugs," include MDMA/Ecstasy (methylenedioxymethamphetamine), Rohypnol (flunitrazepam), GHB (gamma hydroxybutyrate), and ketamine (ketamine hydrochloride).
Producing both stimulant and psychedelic effects, MDMA is often used at parties because it enables party-goers to dance and remain active for long periods of time. This substance is usually ingested in tablet form, but can also be crushed and snorted, injected, or used in suppository form.1
The tasteless and odorless depressants Rohypnol and GHB are often used in the commission of sexual assaults due to their ability to sedate and intoxicate unsuspecting victims. Rohypnol, a sedative/tranquilizer, is legally available for prescription in over 50 countries outside of the U.S. and is widely available in Mexico, Colombia, and Europe.2 Although usually taken orally in pill form, reports have shown that some users grind Rohypnol into a powder and snort the drug.3
GHB, available in an odorless, colorless liquid form or as a white powder material, is taken orally, and is frequently combined with alcohol. In addition to being used to incapacitate individuals for the commission of sexual assault/rape, GHB is also sometimes used by body builders for its alleged anabolic effects.4
The abuse of ketamine, a tranquilizer most often used on animals, became popular in the 1980s, when it was realized that large doses cause reactions similar to those associated with the use of PCP, such as dream-like states and hallucinations.5 The liquid form of ketamine can be injected, consumed in drinks, or added to smokable materials. The powder form can also be added to drinks, smoked, or dissolved and then injected.6 In some cases, ketamine is being injected intramuscularly.7
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Extent of Use
According to the 2003 National Survey on Drug Use and Health, an estimated 10.9 million Americans aged 12 or older tried MDMA at least once in their lifetimes, representing 4.6% of the U.S. population in that age group. The number of past year MDMA users in 2003 was 2.1 million (0.9% of the population aged 12 and older) and the number of past month MDMA users was 470,000 (0.2%). The past year and past month figures are down from 2002 when approximately 3.2 million (1.3% of the population aged 12 and older) reported past year MDMA use and 676,000 (0.3%) reported past month MDMA use.8
Among 12–17 year olds surveyed in 2003, 2.4% reported lifetime MDMA use, 1.3% reported past year MDMA use, and 0.4% reported past month MDMA use. Among 18–25 year olds surveyed in 2003, 14.8% reported lifetime MDMA use, 3.7% reported past year MDMA use, and 0.7% reported past month MDMA use.9
The Youth Risk Behavior Surveillance System (YRBSS) study by the Centers for Disease Control and Prevention (CDC) surveys high school students on several risk factors including drug and alcohol use. For the first time in 2003, the YRBSS collected data on lifetime use of MDMA. Results of the 2003 survey indicate that 11.1% of high school students reported using MDMA at some point in their lifetimes (11.6% of male students and 10.4% of female students). The 2003 lifetime MDMA figures broken down by grade are as follows: 10.9% for 9th graders, 9.0% for 10th graders, 11.4% for 11th graders, and 12.8% for 12th graders.10
According to the 2003 Monitoring the Future Study, 3.2% of eighth graders, 5.4% of tenth graders, and 8.3% of twelfth graders reported using MDMA at least once during their lifetimes. One percent of eighth graders and tenth graders reported using Rohypnol at least once during their lifetimes (twelfth grade data are not available). Lifetime use of GHB and ketamine was not captured in the survey.11
Percent of Students Reporting MDMA and Rohypnol Use, 2003
Data showing past year use of GHB and ketamine are captured in the Monitoring the Future Study. In 2003, 0.9% of eighth graders, 1.4% of tenth graders, and 1.4% of twelfth graders reported using GHB at least once in the past year.12
Percent of Students Reporting Past Year Use of GHB & Ketamine, 2003
Approximately 42% of eighth graders and nearly 50% of tenth graders surveyed in 2003 reported that using MDMA once or twice was a "great risk."13
Percent of Students Reporting Risk of Using MDMA, 2003
During 2003, 12.9% of college students and 15.3% of young adults (ages 19–28) reported using MDMA at least once during their lifetimes.14
Percent of College Students & Young Adults Using MDMA, 2003
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Health Effects
Using MDMA can cause serious psychological and physical damage. The possible psychological effects include confusion, depression, anxiety, and paranoia and may last weeks after ingesting the substance. Physically, a user may experience nausea, faintness, and significant increases in heart rate and blood pressure. MDMA use can cause hyperthermia, muscle breakdown, seizures, stroke, kidney and cardiovascular system failure, and may lead to death. Also, chronic use of MDMA has been found to produce long-lasting, possibly permanent, damage to the sections of the brain critical to thought and memory.15
Rohypnol, GHB, and ketamine are all central nervous system depressants. Lower doses of Rohypnol can cause muscle relaxation and can produce general sedative and hypnotic effects. In higher doses, Rohypnol causes a loss of muscle control, loss of consciousness, and partial amnesia. When combined with alcohol, the toxic effects of Rohypnol can be aggravated.16 The sedative effects of Rohypnol begin to appear approximately 15–20 minutes after the drug is ingested. The effects typically last from 4–6 hours after administration of the drug, but some cases have been reported in which the effects were experienced 12 or more hours after administration.17
GHB has been shown to produce drowsiness, nausea, unconsciousness, seizures, severe respiratory depression, and coma. Additionally, GHB has increasingly become involved in poisonings, overdoses, date rapes, and fatalities.18
The use of ketamine produces effects similar to PCP and LSD, causing distorted perceptions of sight and sound and making the user feel disconnected and out of control.19 The overt hallucinatory effects of ketamine are relatively short-acting, lasting approximately one hour or less. However, the user's senses, judgement, and coordination may be affected for up to 24 hours after the initial use of the drug.20 Use of this drug can also bring about respiratory depression, heart rate abnormalities, and a withdrawal syndrome.21
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Drug Episode: A drug-related
ED episode is an ED visit that
was induced by or related to the
use of drug(s).
Drug Mention: A drug mention
refers to a substance that was
recorded during an ED episode. Because up to 4 drugs can be reported for each drug abuse episode, there are more mentions than episodes.
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The number of emergency department (ED) MDMA mentions reported to the Drug Abuse Warning Network (DAWN) has increased from 421 in 1995 to 4,026 in 2002. During this same time period, the number of GHB mentions increased from 145 to 3,330. The number of ketamine ED mentions has increased from 81 in 1996 to 260 in 2002.22
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Arrests & Sentencing
The number of arrests by the Drug Enforcement Administration (DEA) for MDMA-related offenses have declined from 1,930 in 2001 to 1,346 in 2002. The proportion of MDMA-related arrests to all DEA arrests for any major drug decreased from 5.7 percent in 2001 to 4.7 percent in 2002.23
The Department of Justice reports that MDMA was involved in 153 Organized Crime Drug Enforcement Task Force (OCDETF) investigations during FY2002, a decrease from 188 in FY2001, but still higher than 107 such investigations in FY2000. The number of OCDETF indictments filed in which an MDMA trafficking offense was reported in the indictment has decreased from 212 in 2001 to 191 in 2002.24
According to DEA, the number of arrests for GHB-related offenses increased from 0 in 2002 to 9 in 2003. The number of GHB-related investigations by DEA also increased from 8 in 2002 to 19 in 2003. However, from FY 2002 to FY 2003 the number of OCDETF GHB- and GBL-related investigations and indictments decreased. The number of GHB- and GBL-related OCDETF investigations decreased from 18 in FY 2002 to 11 in FY 2003; the number of indictments decreased from 9 in FY 2002 to 2 in FY 2003.25
In response to the Ecstasy Anti-Proliferation Act of 2000, the U.S. Sentencing Commission increased the guideline sentence for trafficking MDMA. The new amendment, enacted on November 1, 2001, increases the sentence for trafficking 800 MDMA pills by 300%, from 15 months to 5 years. It also increases the penalty for trafficking 8,000 pills by nearly 200%, from 41 months to 10 years.26
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Production & Trafficking
MDMA is primarily manufactured in clandestine laboratories located in Europe, particularly the Netherlands and Belgium. From these labs, MDMA is transported to the U.S. and other countries using a variety of means, including commercial airlines, express mail services, and sea cargo. Currently, Los Angeles, Miami, and New York are the major gateway cities for the influx of MDMA from abroad.27
From 2001 to 2002, the amount of MDMA seized by Federal agencies decreased from 4,639,540 dosage units in 2001 to 3,495,960 dosage units in 2002. According to seizure data collected by the DEA's El Paso Intelligence Center (EPIC), the number of MDMA dosage units seized at U.S. points-of-entry (POEs) arriving from foreign source or transit countries decreased from 8,071,127 in 2000, to 6,699,882 in 2001, to 3,395,036 in 2002. EPIC reports that of the 3,395,036 MDMA tablets seized at POEs in 2002, approximately 3,229,311 were transported via commercial air carriers, 103,925 via private and commercial vehicles, and 61,800 via commercial maritime vessels.28
GHB, GHB kits, and recipes for making GHB can be found on the Internet.29 DEA El Paso Intelligence Center (EPIC) National Clandestine Laboratory Seizure System (NCLSS) data show that the number of reported GHB laboratory seizures is low and decreased from 13 in 2001 to 7 in 2002 to 2 in 2003. 30
Rohypnol, legally produced and sold in Latin America and Europe, is typically smuggled into the U.S. using mail or delivery services. States along the U.S. border with Mexico have the most significant activity related to Rohypnol being mailed or brought into the U.S. via couriers from Mexico.31 Since the mid-1990s, the number of Rohypnol seizures in the U.S. have decreased. In 1995, a high of 164,534 dosage units of Rohypnol were seized, while in 2000, less than 5,000 dosage units were seized.32
Legitimately used by veterinarians, ketamine is sometimes stolen from animal hospitals and veterinary clinics. DEA reporting also indicates that some of the ketamine available in the U.S. has been diverted from pharmacies in Mexico.33 Since first recorded in 1999, the number of ketamine seizures reported by the DEA have increased each year. Seizures of this drug have increased from 4,551 dosage units in 1999 to 1,154,463 in 2000. DEA data also indicate that 581,677 dosage units were seized from January to June 2001.34
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Legislation35
MDMA, GHB, Rohypnol, and ketamine have all been scheduled under the Controlled Substance Act (CSA), Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. The Schedules of the club drugs are as follows:
- MDMA—Schedule I as of 1998
- GHB—Schedule I as of 2000
- Rohypnol—Schedule IV as of 1984
- Ketamine—Schedule III as of 1999
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Street Terms36
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Other Links
In the Spotlight: Club Drugs
A comprehensive online resource providing data, publications, events, and other information related to club drugs.
ClubDrugs.Org
This NIDA site provides club drugs resources including publications, news, and data.
Gamma Hydroxybutyrate (GHB) Fact Sheet
This fact sheet provides an overview of GHB abuse, effects, scheduling, street terms, and its use in drug-facilitated rape.
MDMA (Ecstasy) Fact Sheet
This fact sheet provides a summary of data related to the club drug ecstasy. It includes information on ecstasy use, health effects, and related enforcement initiatives.
Pulse Check: Club Drugs Special Report
From the Mid-Year 2000 Pulse Check, this special report provides an overview club drugs abuse in U.S. cities.
Club Drugs Publications
A listing of club drug-related publications from various sources.
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Sources
1 National Institute on Drug Abuse, Infofax: Club Drugs, February 2000
2 Drug Enforcement Administration Web site, Drug Descriptions: Flunitrazepam (Rohypnol)
3 National Institute on Drug Abuse, Community Drug Alert Bulletin: Club Drugs, December 1999
4 Drug Enforcement Administration Web site, Drug Descriptions: Gamma Hydroxybutyric Acid (GHB)
5 National Institute on Drug Abuse, Community Drug Alert Bulletin: Club Drugs, December 1999
6 Drug Enforcement Administration, Club Drugs: An Update, September 2001
7 National Institute on Drug Abuse, Community Drug Alert Bulletin: Club Drugs, December 1999
8 Substance Abuse and Mental Health Services Administration, Results from the 2003 National Survey on Drug Use and Health: National Findings, September 2004
9 Ibid.
10 Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance—United States, 2003, May 2004
11 National Institute on Drug Abuse and University of Michigan, Monitoring the Future 2003 Data from In-School Surveys of 8th-, 10th-, and 12th-Grade Students, December 2003.
12 Ibid.
13 Ibid.
14 National Institute on Drug Abuse and University of Michigan, Monitoring the Future National Survey Results on Drug Use, 1975–2003, Volume II: College Students & Adults Ages 19–45 (PDF), 2004
15 National Institute on Drug Abuse, Infofax: MDMA (Ecstasy)
16 National Institute on Drug Abuse, Community Drug Alert Bulletin: Club Drugs, December 1999
17 Drug Enforcement Administration Web site, Drug Descriptions: Flunitrazepam (Rohypnol)
18 National Institute on Drug Abuse, Infofax: Club Drugs, February 2000
19 National Institute on Drug Abuse, Research Report: Hallucinogens and Dissociative Drugs, March 2001
20 Drug Enforcement Administration Web site, Drug Descriptions: Ketamine
21 National Institute on Drug Abuse, Research Report: Hallucinogens and Dissociative Drugs, March 2001
22 Substance Abuse and Mental Health Services Administration, Emergency Department Trends from the Drug Abuse Warning Network, Final Estimates 1995–2002, July 2003
23National Drug Intelligence Center, National Drug Threat Assessment, 2004, April 2004
24 Ibid.
25 National Drug Intelligence Center, Intelligence Bulletin: GHB Trafficking and Abuse, September 2004
26 U.S. Sentencing Commission, Congressional Testimony, Statement of Diana E. Murphy, Chair of the U.S. Sentence Commission, before the Senate Caucus on International Narcotics Control (PDF), March 21, 2001
27 Drug Enforcement Administration, Ecstasy: Rolling Across Europe, August 2001
28National Drug Intelligence Center, National Drug Threat Assessment, 2004, April 2004
29 Drug Enforcement Administration, Club Drugs: An Update, September 2001
30 National Drug Intelligence Center, Intelligence Bulletin: GHB Trafficking and Abuse, September 2004
31 Drug Enforcement Administration, Club Drugs: An Update, September 2001
32 National Drug Intelligence Center, National Drug Threat Assessment 2002, December 2001
33 Drug Enforcement Administration, Club Drugs: An Update, September 2001
34 National Drug Intelligence Center, National Drug Threat Assessment 2002, December 2001
35 Drug Enforcement Administration, Club Drugs: An Update, September 2001
36 Office of National Drug Control Policy, Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade
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Last Updated: September 27, 2004
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