epidemiology of common club drugs - hkma.org · to australia, india, belgium, egypt and canada....
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Epidemiology ofCommon Club Drugs
Dr. Char-Nie CHEN
What are Club Drugs?
Rave Culture (1)(Dr. Erica Weir, 2000, p. 1844)
A subculture of youth who, in reactionto the materialism of the "me"generation, have embraced a partyetiquette of peace, love, unity andrespect - "PLUR”Began in UK & US in mid-1980s & thento Australia, India, Belgium, Egypt andCanada
Rave Culture (2)(Dr. Erica Weir, 2000, p. 1844)
Up to 20,000 youths dance vigorouslyand continuously all night to repetitiveelectronic music by celebrated DJsRavers seek sensory amplification andeuphoric transcendence through acombination of marathon trancedancing, liberal drug use and hypnoticmusic
Common Club Drugsin Hong Kong
3,4-methylene-dioxy-meth-amphetamine (MDMA)
Meth-amphetamine (Desoxyn; speed; ice)
Ketamine (Ketajet)
Other Club Drugs
Lysergic acid diethyl-amide(LSD) Gamma-hydroxy-butyrate(GHB) Flunitrazepam (Rohypnol)
Meth-amphetamines
Amphetamines (1)1887 - Amphetamine was synthesized1910 - Patented as anorectics in Germany1932 - S.K.F. produced Benzedrine inhaler1937 - Narcolepsy (and many others)1940s - German, Japanese, & British
soldiers in WW II1950s - American soldiers in Korean War
Amphetamines (2)1958 - P.H. Connell: Amphetamine psychosis1960s - Japanese Bohryokudan Triad and
amphetamine sales1968 - BMA Working Party: No place for
depression1970 - FDA: Narcolepsy, ADHD, short-term weight
reduction1971 - Withdrawn from market1980s - Ice developed in Hawaii for smoking
4 kinds of amphetamines?(Kovar, K-A et al., 1996)
Psycho-stimulants: central stimulationAmphetamine & methamphetamine Entactogens: insight enhancementMDMA, MDA, MDE, MMDA, MBDB Methoxy-phenethylamine hallucinogens:Mescaline, etc. Methoxy-amphetamine hallucinogens:TMA, DMA, PMA, DOET, DOB, DOM / STP
Amphetamines Dextro-amphetamine Amphetamine sulfate Biphetamine Meth-amphetamine HCl Meth-amphetamine
Methamphetamines(Speed, ice)
Methamphetamine HCl (Speed)for oral, snorting & injection -‘Flash house’ Methamphetamine (free base)- ‘ice’ - for smoking & injection Listed as Schedule II in USA
Annual Proportion of Methamphetamine UseHong Kong 1993-2000 (CRDA, 2000)
0
5
10
15
20
25
93 94 95 96 97 98 99 00
NA <21y NA >21y
PA <21y PA >21y
% NA=Newly-reported abusers; PA=Previously-reported abusers
Weighted EDs & Unweighted MEsMethamphetamines USA (DAWN, 2000)
0
20004000
60008000
10000
1200014000
1600018000
20000
1994 1995 1996 1997 1998 1999
0
100
200
300
400
500
600
700EDsMEs
Calendar Years
EDs (No.) MEs (No.)
3,4-methylene-dioxy-meth-amphetamine
(MDMA)
MDMA (Ecstasy, Fing頭丸頭丸頭丸頭丸)1912 - Synthesized by Merck1950s - Intensive study by American CIA1960s - Used in the Haight-Ashbury district of San
Francisco (the Hippie Movement)1978-85 - Alexander Shulgin introduced to
psychotherapists as adjunct to psychotherapy:Entactogen
1983 - Used in rave parties, night clubs & discos1985 - American DEA: Public hearing1986 - Listed as Schedule I Controlled Substance
in USA
Annual Proportion of MDMA UseHong Kong 1993-2000 (CRDA, 2000)
-20-10
010203040506070
93 94 95 96 97 98 99 00
NA <21y NA >21y
PA <21y PA >21y
% NA=Newly-reported abusers; PA=Previously-reported abusers
Weighted EDs & Unweighted MEsMDMA USA (DAWN, 2000)
0
500
1000
1500
2000
2500
3000
1994 1995 1996 1997 1998 1999
0
12
34
5
67
89
10
EDsMEs
Calendar Years
EDs (No.) MEs (No.)
Ketamine 氯胺酮 (K仔)
1962 - Synthesized (an analog ofPhencyclidine)1965 - Replaced phencyclidine as asurgical anaesthetic both in humansand in animals1970 - Listed in Schedule III in USA1980s - Abuse began
Phencyclidine ㆝使塵
1957 - Synthesized in Parke-Davis Lab(Sernyl)1957/65 - Used as I.V. surgicalanaesthetic, but 10-20% had CNCdepression (Sernylan)1967 - Widespread abuse as ‘peaCe’ pillsin San Francisco, but many bad trips1970 - Listed as a Schedule II in USA1979 - All legal manufacture ceased
Ketamine Abuse in HK (CRDA Report, 46th)
1.11.11.11.1 0.20.20.20.2 0.30.30.30.3 0000
44.344.344.344.3
22.722.722.722.7
12.212.212.212.21111
0000
10101010
20202020
30303030
40404040
50505050
1999 2000
N <21yN <21yN <21yN <21y P <21yP <21yP <21yP <21y
N >21yN >21yN >21yN >21y P >21yP >21yP >21yP >21y
%
Annual Proportion of Ketamine UseHong Kong 1993-2000 (CRDA, 2000)
-20
-10
0
10
20
30
40
50
93 94 95 96 97 98 99 00
NA <21y NA >21y
PA <21y PA >21y
% NA=Newly-reported abusers; PA=Previously-reported abusers
Weighted EDs & Unweighted MEsKetamine USA (DAWN, 2000)
0
50
100
150
200
250
300
350
400
450
1994 1995 1996 1997 1998 1999
0
2
4
6
8
10
12
14
16
18
EDsMEs
Calendar Years
EDs (No.) MEs (No.)
Annual Proportion of Heroin UseHong Kong 1993-2000 (CRDA, 2000)
0
20
40
60
80
100
93 94 95 96 97 98 99 00
NA <21y NA >21y
PA <21y PA >21y
% NA=Newly-reported abusers; PA=Previously-reported abusers
0
20
40
60
80
100
93 94 95 96 97 98 99 000
20
40
60
80
100
93 94 95 96 97 98 99 00
0
20
40
60
80
100
93 94 95 96 97 98 99 000
20
40
60
80
100
93 94 95 96 97 98 99 00
MDMA Ketamine
Methamphetamine
Heroin
NA <21y NA >21y NA >21y (CRDA, 2000)NA <21y
DeathExamined by
Medical Examiners
1
6
8
3
9
0
2
4
6
8
10
12
14
16
1994 1995 1996 1997 1998
4
7
9
16
10
0
2
4
6
8
10
12
14
16
1994 1995 1996 1997 1998
KetamineMDMA
507 487 484
622
501
0
100
200
300
400
500
600
700
1994 1995 1996 1997 1998
Methamphetamine
Ratio of EDs/MEs(DAWN, 2000)
1994
1995
1996
1997
1998
Total No. of Deaths in 1994-98
Ketamine 5:1 21:1 9:1 20:1 21:1 46
MDMA 250:1 70:1 40:1 212:1 127:1 27
Math-amphet-amine
35:1
33:1
23:1
28:1
23:1
2,601
Note: ME = Medical Examiners' cases, which are voluntary reports;ED = Emergency Department mentions, which are weighted data.
Poly-Drug Abuse
Proportion of Poly-drug UseHong Kong 1991-2000 (CRDA, 2001)
05
1015202530354045
91 92 93 94 95 96 97 98 99 00
NA <21y NA >21y
PA <21y PA >21y
%
Proportion of Poly-drug EpisodesUSA 1999 (DAWN, 2000)
51
78 81
0
20
40
60
80
100
M etham p M DM A Ketam ine
%
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