‘Club drugs’ which include Ecstasy, gamma-hydroxybutyrate (GHB), ketamine, and Rohypnol (flunitrazepam) have become popular with participants in ‘raves’, because they are perceived to enhance energy, endurance, sociability and sexual arousal.
These drugs vary in their pharmacologic properties, physiological and psychological effects, and potential consequences. The use of club drugs by young people has increased in the last decade, and continue to get modified and evolve, making them very difficult to monitor.
Further, these drugs are not picked up by routine drugs screening procedures, thereby making these popular with the criminals. India, which is in a phase of social transition, also faces this rising menace. Despite the nature and extent of this problem, this area has been under-researched.
Data from India are sparse barring a few newspaper and police reports. Keeping abreast of current trends in club drug use prepares the clinician to recognize the clinical effects of club drug use, to manage club drug related emergencies, and to generate social awareness.
‘Raves’ are parties with loud, electronic “techno-rock” music, laser light shows, and all-night dancing held in clandestine locations, including warehouses, nightclubs, and farm field . These first became popular in Great Britain in the late 1980s.
The underground or noncommercial music featured at raves which is produced by computers and include little or no vocals is distinct from the music played at conventional nightclubs. Following bans in some countries the rave parties moved in to legitimate nightclubs.
A raver is a person who has an exciting and uninhibited social life and regularly goes to raves. Not all ravers use drugs; however, many illicit drugs are available at raves and are used liberally to enhance the “vibe” The words like ‘rave drugs’, ‘club drugs’ and ‘party drugs’ have been used interchangeably in the literature.
The U.S. National Institute on Drug Abuse (NIDA) in its “Community Alert on Club Drugs,” defined “club drugs” as Ecstasy (3,4-methylenedioxymethamphetamine, or MDMA), gamma hydroxybutyrate (GHB), ketamine, Rohypnol (flunitrazepam), methamphetamine, and lysergic acid diethylamide (LSD)
. On the other hand, the U.S. Office of National Drug Control Policy identifies four specific club drugs: MDMA, GHB, ketamine, and Rohypnol.
Methamphetamine and LSD have been inconsistently included in the category of the club drugs. In addition, these two drugs have a longer history of misuse in comparison to the other four which came to the scene much later (MDMA being first reported in 1985).
In this review the term ‘club drugs’ will be used in reference to Ecstasy, GHB, ketamine, and Rohypnol to avoid further confusion. These drugs are being used in an expanding variety of venues by groups who differ in terms of age, gender, sexual orientation, and race/ethnicity Each of these drugs has very different pharmacologic properties, physiological and psychological effects, and potential consequences
. Despite evidence that suggests an increase in the population level use of these drugs, research on the population prevalence of their use is limited. For Ecstasy the prevalence has been estimated between 0.9 per cent in France to 19.7 per cent in Australia.
The others are much less prevalent – 0.9-4.7 and 0.7-2.6 per cent for GHB and ketamine respectively, depending upon the population and age group studied One study reported 20 per cent of American youths aged 16-23 having ever used one or more of these club drugs. Further, polysubstance abuse is common among users of club drugs, often used in combination, particularly with marijuana or alcohol
It has been found that, club drug use is common among youths in treatment for substance abuse and has spread beyond the rave culture.
A study assessing the pattern of club drug initiation among gay and bisexual men suggests that the sequencing of club drug use may be better explained by socialization processes in the gay community than by Gateway Theory, which has been traditionally used to explain patterns of drug use in the population