For the “Abuse Folio” section of the August, 1983 issue of High Times, Dr. David E. Smith and Rick Seymour of the Haight-Ashbury Free Medical Clinic wrote about PCP, with the usual disclaimer that they did not advocate the use of any psychoactive substances.
“PCP eats your head.” “It’s the devil’s drug.” Everything bad you ever heard about LSD is really true about PCP. PCP can cause combativeness. catatonia, convulsions and coma. Its use can produce irrational or destructive behavior. It can precipitate psychotic behavior, as well as cause toxic psychosis with long-term abuse. Long-term depression can also occur with chronic abuse. PCP causes permanent brain damage.
Nature and Use
Phencyclidine (PCP) is a dissociative anesthetic with a wide range of effects on the central nervous system. These include mind-body disassociation, anesthesia, psychomotor stimulation and the effects generally associated with hallucinogenic drugs.(1) Normally, these effects persist for about one to two hours after ingestion of the drug. PCP was first synthesized in 1958 and tested as a human anesthetic. Side effects, such as postoperative excitation, fearful delusions or psychotic behavior made this use impractical. As Sernylan®, the drug was used by veterinarians to anesthetize large primates.
PCP first emerged as a street drug in 1967 in San Francisco. Called the PeaCe Pill, the drug was not well accepted at that time. For about 10 years afterward, PCP appeared primarily as an active ingredient in drugs of deception. PCP can be snorted, swallowed, smoked or injected, and is peddled like many other drugs, to the young and non-street-wise under various names such as Krystal, “THC” or Superweed. In the late 1970s, PCP emerged as a drug of choice and the horrors of PCP became an overnight media “event.” As two medical researchers put it, “…PCP is the ideal American-television dramatic drug because it fits so many violent stereotypes.”(2)
The unpredictable behavior of PCP abusers can be frightening and dangerous. Equally frightening is the potential for overreaction by law enforcement and treatment people when confronted by PCP psychosis. Fortunately for all concerned, use of this drug is on the decline, though it lingers on among the very poor where it continues to be used at low dosage for intoxication.
Adverse Effects of PCP
Our clinical findings show four different types of PCP intoxication:
- Acute Toxicity, occurring as a direct result of PCP intoxication, can involve combativeness, catatonia, convulsions and coma, and may occur within minutes or hours of ingestion. Hypertensive crises severe enough to be fatal are rare but have been recorded. Mind-body detachment and “moon walking,” where the user looks like he’s trying to walk on the moon in a space suit, are common. At high doses, grand mal seizures and coma require hospitalization. Acute toxicity can last from a few minutes to 24 hours.
- Toxic Pyschosis may follow repeated high-dose PCP abuse and represents a break from reality that can last from 24 hours to seven days or more. Symptoms include impaired judgment, paranoid delusions with agitation, auditory and visual hallucinations, and behavior that is destructive to self or others.
- PCP-Precipitated Psychotic Episodes can follow single-dose administration of PCP and can last a month or longer. They can occur even after one use of PCP, and probably involve the triggering of an underlying psychological condition. The symptoms are like those of schizophrenia, with paranoid features and thought-disorder of varying intensity.
- PCP-Induced Depression may follow any of the other three stages and can last from one day to several months. Usually, this is a result of chronic PCP abuse; it appears to be a physically based cerebral dysfunction, manifesting a depression that can lead to suicide attempts, the abuse of other drugs in attempts to self-medicate the depression, and the resumption of PCP use.(3)
One of the greatest concerns with PCP abuse is the violent reaction that involves irrational and destructive behavior. Bizarre violent reactions to the drug have occurred with some individuals, and although these have been overemphasized in the media, they are among the adverse effects of PCP.
Being a dissociative anesthetic, PCP renders a user’s body completely insensible to pain during the period of intoxication. This has special dangers, since people in this state are likely to burn or bruise themselves badly by accident, or even break bones in their feet or hands, without being aware of the pain until the drug wears off. By that time, infection may have set in, or the broken bones may have become compound fractures, causing extensive internal damage and bleeding.
The “flashback” phenomenon with PCP is also a very real hazard. Days or even weeks after the dose wears off, with no warning, the user may suddenly develop all the symptoms of acute PCP intoxication for an hour or so. This appears to be due to the drug’s very slow rate of elimination from the body, which causes it to recirculate periodically through the bloodstream for days or weeks after ingestion. Since PCP is highly attracted to acidic fluids, it can periodically reenter the user’s acidic spinal fluid, reenter the brain and cause another PCP trip.
Unconscious users need to be taken to a drug or poison control center, or an emergency room, for stabilization of respiratory and cardiovascular systems and to deal with possible convulsions. Conscious users may still need medical intervention, especially if they may harm themselves or others. Reduction of external stimulation can help. Vitamin C or cranberry juice can be used to help eliminate PCP through acidification of urine and enhanced excretion.
Patients should be warned that dangerous consequences such as severe depression can occur with the combining of tricyclic antidepressants (Elavil, Triavil) and PCP, alcohol or other psychoactive drugs. This depression is associated with impaired memory which gradually recovers with time and abstinence from PCP.
- Smith, David E., M.D., “Editor’s Note,” PCP: Problems and Prevention, Selected Proceedings of the National PCP Conference 1979, eds., Smith, D.E., Wesson, D.R., Buxton, M.E., Seymour, R.B., Bishop, M.P., Zerkin, E.L., Journal of Psychedelic Drugs, vol. 12, nos. 3-4, July-December 1980.
- Morgan, John P., M.D., and Kagan, Doreen, M.S., “The Dusting of America: The Image of Phencyclidine (PCP) in the Popular Media,” ibid.
- Smith, David E., M.D., “A Clinical Approach to the Treatment of PCP Abuse,” PCP (Phencyclidine): Historical and Current Perspectives, ed., Domino, E.F., NPP Books, Ann Arbor, 1981.