Drugs of Abuse
                                ==============
                                4/6/95 Ed Krenzelok
þ See also Herbal Teas and Remedies:
  <P-Herbal.TXT>

þ Kava-Kava
 - used as intoxicant
 - may stimulate benzodiazepine receptors
 - California Highway Patrol has been instructed to suspect this in DWI cases
   but with negative EtOH tests.
 - urine tests available
   (WMS 1997 Annual Scientific Assembly workshop, Robert S. McCaleb,
   President, Herb Research Foundation, Boulder Colorado, www.herbs.org.)

þ St. Johnswort
 - serotonin uptake inhibition effects
 - not well studied

þ FenFen
 - combination of:
  + St. Johnswort
  + ephedra extract
 - "an upper and an antidepressant together"

þ what gets abused?
 - drugs that are available, cheap, mood altering

þ Poison Center data
 - interpret with caution, slanted to those who _call_ poison centers
   (underrepresents many patients who are DOA, or just in ED)

þ Solvent Abuse ("sniffing")
 - incident of disadvantaged youth who inhaled toluene-containing raft cement
   halfway down Grand Canyon, ran around the camp, then arrested, vomited,
   aspirated, died
 - leading cause of death in adolescents
 - many different fluids
 - sensitizes myocardium, leads to ventricular fibrillation

þ Dextromthorphan (drugstore wine, robowing)
 - Waynesboro, PA  and Salt Lake City
 - main problem is other combinations with decongestants, acetaminophen
 - 4-20 oz. at a time

þ Ketamine (special K, purple, mauve, het, green)
 - developed as an alternative to PCP
 - often mix with B12
 - smoked

þ Ethanol and Gelatin ()
 - making ethanol-soaked Jello
 - sugar covers the ethanol taste, so may ingestic toxic doses leading to
   death
 - young children (e.g., 2-year olds) may become profoundly hypoglycemic

þ Benzedrex Inhalers
 - used to have amphetamine until 1950s
 - propylhexedrine = has 10% of amphetamine's CNS effects
 - OTC
 - pulmonary granulomas and cardiomegaly