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PHENCYCLIDINE DEPENDENCE
 

Prediction: Episodic/Chronic For Years

      Occupational-Economic:
  • Works poorly with others (bizarre behavior on "bad trip") occupational failure; legal problems
  • Impaired cognitive functioning (learning, judgment) this impairment can last for months
  • Irrationality (eccentricity, delusions, hallucinations) can trigger psychosis
      Social:
  • Antagonism (hostility)
  • Detachment (suspiciousness, social withdrawal)
  • Marital/child abuse/neglect
      Medical:
  • Denial of addiction; injury/death due to erratic behavior during a "bad trip"

SYNOPSIS

Dependence Syndrome Due To Use Of Phencyclidine F19 - ICD10 Description, World Health Organization
Repeated use of phencyclidine that typically includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, and increased tolerance.
Phencyclidine Use Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with phencyclidine use disorder needs to meet all of the following criteria:

  • A pattern of phencyclidine (or a pharmacologically similar substance) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

    • Phencyclidine is often taken in larger amounts or over a longer period than was intended.

    • There is a persistent desire or unsuccessful efforts to cut down or control phencyclidine use.

    • A great deal of time is spent in activities necessary to obtain phencyclidine, use phencyclidine, or recover from its effects.

    • Craving, or a strong desire or urge to use phencyclidine.

    • Recurrent phencyclidine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to hallucinogen use; phencyclidine-related absences, suspensions, or expulsions from school; neglect of children or household).

    • Continued phencyclidine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of phencyclidine (e.g., arguments with a spouse about consequences of intoxication; physical fights).

    • Important social, occupational, or recreational activities are given up or reduced because of phencyclidine.

    • Recurrent phencyclidine use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by phencyclidine).

    • Phencyclidine use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by phencyclidine.

    • Tolerance, as defined by either of the following:

      • A need for markedly increased amounts of phencyclidine to achieve intoxication or desired effect.

      • A markedly diminished effect with continued use of the same amount of phencyclidine.

      Note: Withdrawal symptoms and signs are not established for phencyclidine, and so this criterion does not apply.

    • Specify if:

      • In early remission: After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met for at least 3 months but for less than 12 months (with the exception that the criterion, "Craving, or a strong desire or urge to use phencyclidine," may be met).

      • In sustained remission: After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met at any time during a period of 12 months or longer (with the exception that the criterion, "Craving, or a strong desire or urge to use the hallucinogen," may be met).

    • Specify if:

      • In a controlled environment: This additional specifier is used if the individual is in an environment where access to phencyclidine is restricted.

Phencyclidine dependence is compulsive use of phencyclidine (PCP or angel dust) leading to clinically significant impairment or distress. PCP is an illegal recreational dissociative drug. The physical signs of PCP intoxication are: numbness in the extremities, staggering, unsteady gait, slurred speech, bloodshot eyes, and loss of balance. Higher doses produce analgesia, anesthesia and convulsions. The psychological symptoms of PCP intoxication are: severe changes in body image, loss of ego boundaries, paranoia, depersonalization, hallucinations, euphoria, suicidal impulses and aggressive behavior. PCP may induce feelings of strength, power, and invulnerability as well as a numbing effect on the mind. Occasionally, this leads to bizarre acts of violence, such as in the case of Big Lurch, a former rapper who claimed his room mate was the devil and ate part of her lung.

Ineffective Therapies

Management of PCP intoxication mostly consists of supportive care and treatment of anxiety or agitation with lorazepam, and treatment of psychosis with atypical antipsychotic medication. The effectiveness of treatment for phencyclidine dependence is unknown due to lack of randomized, controlled clinical trials.

It is possible to stop using phencyclidine. To do this you must: (1) totally divorce yourself from drug-using or drug-supplying people, (2) not use alcohol or any other illegal drug, (3) keep socially active and help others, (4) talk to other people who have successfully stayed off drugs, (5) devote yourself to important activities that gives meaning and purpose to life (e.g., family, friends, sports, work, helping others, church etc.). Therapists know that these 5 steps work, but our therapies are often ineffective in motivating patients to complete these essential steps to recovery.

Top 20 Most Harmful Drugs In Britain In 2008

Professor David Nutt published in the Lancet the following rating of Britain's most dangerous drugs. They are listed in descending order from the most harmful.

1. Heroin

Class A drug. Originally used as a painkiller and derived from the opium poppy. There were 897 deaths recorded from heroin and morphine use in 2008 in England and Wales, according to the Office of National Statistics (ONS). There were around 13,000 seizures, amounting to 1.6m tonnes of heroin.

2. Cocaine

Class A. Stimulant produced from the South American coca leaf. Accounted for 235 deaths -- a sharp rise on the previous year's fatalities. Nearly 25,000 seizures were made, amounting to 2.9 tonnes of the drug.

3. Barbituates

Class B. Synthetic sedatives used for anaesthetic purposes. Blamed for 13 deaths.

4. Street methadone

Class A. A synthetic opioid, commonly used as a substitute for treating heroin patients. Accounted for 378 deaths and there were more than 1,000 seizures of the drug.

5. Alcohol

Subject to increasing concern from the medical profession about its damage to health. According to the ONS, there were 8,724 alcohol deaths in the UK in 2007. Other sources claim the true figure is far higher.

6. Ketamine

Class C. A hallucinogenic dance drug for clubbers. There were 23 ketamine-related deaths in the UK between 1993 and 2006. Last year there were 1,266 seizures.

7. Benzodiazepines

Class C. A hypnotic relaxant used to treat anxiety and insomnia. Includes drugs such as diazepam, temazepam and nitrazepam. Caused 230 deaths and 1.8m doses were confiscated in more than 4,000 seizure operations.

8. Amphetamine

Class B. A psychostimulant that combats fatigue and suppresses hunger. Associated with 99 deaths, although this tally includes some ecstasy deaths. Nearly 8,000 seizures, adding up to almost three tonnes of confiscated amphetamines.

9. Tobacco

A stimulant that is highly addictive due to its nicotine content. More than 100,000 people a year die from smoking and tobacco-related diseases, including cancer, respiratory diseases and heart disease.

10. Buprenorphine

An opiate used for pain control, and sometimes as a substitute to wean addicts off heroin. Said to have caused 43 deaths in the UK between 1980 and 2002.

11. Cannabis

Class B. A psychoactive drug recently appearing in stronger forms such as "skunk". [Since this video was made; there is now conclusive proof that cannabis causes a 6.7 fold increase in the risk of developing schizophrenia.] Caused 19 deaths and there were 186,000 seizures, netting 65 tonnes of the drug and 640,000 cannabis plants.

12. Solvents

Fumes inhaled to produce a sense of intoxication. Usually abused by teenagers. Derived from commonly available products such as glue and aerosol sprays. Causes around 50 deaths a year.

13. 4-MTA

Class A. Originally designed for laboratory research. Releases serotonin in the body. Only four deaths reported in the UK between 1997 and 2004.

14. LSD

Class A. Hallucinogenic drug originally synthesised by a German chemist in 1938. Very few deaths recorded.

15. Methylphenidate

Class B drug. Brand name of Ritalin. A psychostimulant sometimes used in the treatment of attention deficit disorders.

16. Anabolic steroids

Class C. Used to develop muscles, notably in competitive sports. Also alleged to induce aggression. Have been blamed for causing deaths among bodybuilders. More than 800 seizures.

17. GHB

Class C drug. A clear liquid dance drug said to induce euphoria, also described as a date rape drug. Can trigger comas and suppress breathing. Caused 20 deaths and 47 seizures were recorded.

18. Ecstasy

Class A. Psychoactive dance drug. Caused 44 deaths, with around 5,000 seizures made.

19. Alykl nitrites

Known as "poppers". Inhaled for their role as a muscle relaxant and supposed sexual stimulant. Reduce blood pressure, which can cause fainting and in some cases death.

20. Khat

A psychoactive plant, the leaves of which are chewed in east Africa and Yemen. Also known as qat. Produces mild psychological dependence. Its derivatives, cathinone and cathine, are Class C drugs in the UK.

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