These drugs are taken by “drugheads” (a colorful term we have retained from the original authors of this book to describe individuals who use any agent that alters consciousness) and by many college and high school students for a way of socializing, for conformity, or for reasons that even they cannot ascertain.
The use of these drugs may be attended by a number of serious adverse reactions taking the form of acute panic attacks (“bad trip”), long-lasting psychotic states resembling paranoid schizophrenia, and flashbacks (spontaneous recurrences of the original LSD experience, sometimes precipitated by smoking marijuana and accompanied by panic attacks). Serious physical injury may follow upon impairment of the user’s critical faculties. Numerous claims have been made that LSD and related drugs are effective in the treatment of mental disease and a wide variety of social ills, and that they have the capacity to increase one’s intellectual performance, creativity, and self-understanding. To date, no acceptable studies validate any of these claims.
During the early 1970s, the abuse of phencyclidine (PCP) and its analogues was a significant problem. The popularity of these drugs has dropped, but some illicit use continues because they are relatively cheap, easily available, and quite potent. (Their manufacture as a veterinary anesthetic was stopped in 1979.) Phencyclidine is taken in the form of a granular powder, frequently mixed with other drugs, and is smoked or snorted. It is usually classified as a hallucinogen, although it also has stimulant and depressant properties. The effects of intoxication are like those of LSD and other hallucinogens, and resemble those of an acute schizophrenic episode, which may last several days to a week or longer. After the ingestion of a large amount (10 mg or more) of phencyclidine, it is present in the blood and urine for only a few hours sometimes making its detection difficult.
Toxicity from the illicit use of “ecstasy” (methylene-dioxymethamphetamine [MDMA]) during parties (“raves”) has increased as a result of its ill-founded reputation for safety. It appears to cause a release of both serotonin and dopamine in the brain and produces an elated state similar to the effects of cocaine. Seizures, cerebral hemorrhages, and psychosis have been reported in previously healthy individuals (Verebey et al).
The most important diseases in this category are tetanus, botulism, and diphtheria. Each is caused by an extraordinarily powerful bacterial toxin that acts primarily on the nervous system.
The cause of this disease is the anaerobic, spore-forming rod Clostridium tetani. The organisms are found in the feces of some humans and many animals, particularly horses, from which they readily contaminate the soil. The spores may remain dormant for many months or years, but when they are introduced into a wound, especially if a foreign body or purulent bacteria are present, they are converted into their vegetative forms, which produce the exotoxin tetanospasmin. In developing countries, tetanus is still a common disease, particularly in newborns, in whom the spores are introduced via the umbilical cord (tetanus neonatorum). In the United States, the incidence rate of tetanus is about 1 per million people per year. Injection of contaminated heroin is a significant cause. Approximately 67 percent of all injuries leading to tetanus occur from deep scratches and puncture wounds in the home, and approximately 20 percent from deep scratches and puncture wounds in gardens and on farms.