Adolescents who use MDMA/ecstasy and other hallucinogens, as well as adults who have recently used ecstasy, have a higher prevalence of other substance use disorders compared with nonhallucinogen substance users. Individuals who use hallucinogens exhibit eleva- tions of nonsubstance mental disorders (especially anxiety, depressive, and bipolar disor- ders), particularly with use of ecstasy and salvia. Rates of antisocial personality disorder (but not conduct disorder) are significantly elevated among individuals with other hallucinogen use disorder, as are rates of adult antisocial behavior. However, it is unclear whether the mental illnesses may be precursors to rather than consequences of other hallucinogen use disorder (see the section ”Risk and Prognostic Factors” for this disorder). Both adults and adolescents who use ecstasy are more likely than other drug users to be polydrug users and to have other drug use disorders.
A. Recent use of phencyclidine (or a pharmacologically similar substance).
B. Clinically significant problematic behavioral changes (e.g., belligerence, assaultive- ness, impulsiveness. unpredictability, psychomotor agitation, impaired judgment) that developed during. or shortly after, phencyclidine use.
C. Within 1 hour, two (or more) of the following signs or symptoms:
Note: When the drug is smoked, "snorted," or used intravenously, the onset may be particularly rapid.
1. Vertical or horizontal nystagmus.
2. Hypertension or tachycardia.
Numbness or diminished responsiveness to pain.
Ataxia.
Dysarthria.
Muscle rigidity.
Seizures or coma.
Hyperacusis.
D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.
Coding note: The |CD-9-CM code is 292.89. The |CD-10-CM code depends on whether there is a comorbid phencyclidine use disorder. If a mild phencyclidine use disorder is co- morbid, the |CD-10-CM code is F16.129, and if a moderate or severe phencyclidine use disorder is comorbid, the |CD-10-CM code is F16.229. If there is no comorbid phencycli- dine use disorder, then the |CD-10-CM code is F16.929.
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Note: In addition to the section ”Functional Consequences of Phencyclidine Intoxication,” see the corresponding section in phencyclidine use disorder.
Phencyclidine intoxication reﬂects the clinically significant behavioral changes that occur shortly after ingestion of this substance (or a pharmacologically similar substance). The most common clinical presentations of phencyclidine intoxication include disorientation, confusion without hallucinations, hallucinations or delusions, a catatonic-like syndrome, and coma of varying severity. The intoxication typically lasts for several hours but, de- pending on the type of clinical presentation and whether other drugs besides phencycli- dine were consumed, may last for several days or longer.
Use of phencyclidine or related substances may be taken as an estimate of the prevalence of intoxication. Approximately 2.5% of the population reports having ever used phency- clidine. Among high school students, 2.3% of 12th graders report ever using phencycli- dine, with 57% having used in the past 12 months. This represents an increase from prior to 2011. Past—year use of ketamine, which is assessed separately from other substances, has remained stable over time, with about 1.7% of 12th graders reporting use.