Detail:

        Phencyclidine (PCP), also known as angel dust among other names, is a drug used for its mind altering effects. PCP may cause hallucinations, distorted perceptions of sounds, and violent behavior. As a recreational drug, it is typically smoked, but may be taken by mouth, snorted, or injected. It may also be mixed with cannabis or tobacco.

Adverse effects may include seizures, coma, addiction, and an increased risk of suicide.Flashbacks may occur despite stopping usage.Chemically, PCP is a member of the arylcyclohexylamine class, and pharmacologically, it is a dissociative anesthetic. PCP works primarily as an NMDA receptor antagonist.

        PCP is most commonly used in the United States. While usage peaked there in the 1970s, between 2005 and 2011 an increase in visits to emergency departments as a result of the drug occurred. As of 2017 in the United States about 1% of people in grade twelve reported using PCP in the prior year while 2.9% of those over the age of 25 reported using it at some point in their life.

        PCP was initially made in 1926 and brought to market as an anesthetic medication in the 1950s. Its use in humans was disallowed in the United States in 1965 due to the high rates of side effects while its use in other animals was disallowed in 1978. Moreover, ketamine was discovered and was better tolerated as an anesthetic. PCP is currently illegal in the United States where it is classified as a schedule II drug. A number of derivatives of PCP have been sold for recreational and non-medical use.

Effects:

        Behavioral effects can vary by dosage. Low doses produce a numbness in the extremities and intoxication, characterized by staggering, unsteady gait, slurred speech, bloodshot eyes, and loss of balance. Moderate doses (5–10 mg intranasal, or 0.01–0.02 mg/kg intramuscular or intravenous) will produce analgesia and anesthesia. High doses may lead to convulsions. The drug is often illegally produced under poorly-controlled conditions; this means that users may be unaware of the actual dose they are taking.

        Psychological effects include severe changes in body image, loss of ego boundaries, paranoia, and depersonalization. Hallucinations, euphoria, and suicidal impulses are also reported, as well as occasional aggressive behavior. Like many other drugs, PCP has been known to alter mood states in an unpredictable fashion, causing some individuals to become detached, and others to become animated. PCP may induce feelings of strength, power, and invulnerability as well as a numbing effect on the mind.

        Studies by the Drug Abuse Warning Network in the 1970s show that media reports of PCP-induced violence are greatly exaggerated and that incidents of violence are unusual and often limited to individuals with reputations for aggression regardless of drug use. Although uncommon, events of PCP-intoxicated individuals acting in an unpredictable fashion, possibly driven by their delusions or hallucinations, have been publicized.[citation needed] One example is the case of Big Lurch, a former rapper with a history of violent crime, who was convicted of murdering and cannibalizing his roommate while under the influence of PCP. Other commonly cited types of incidents include inflicting property damage and self-mutilation of various types, such as pulling one's own teeth. These effects were not noted in its medicinal use in the 1950s and 1960s however, and reports of physical violence on PCP have often been shown to be unfounded.

Recreational doses of the drug also occasionally appear to induce a psychotic state that resembles a schizophrenic episode, sometimes lasting for months at a time. Users generally report feeling detached from reality.

        Symptoms are summarized by the mnemonic device RED DANES: rage, erythema (redness of skin), dilated pupils, delusions, amnesia, nystagmus (oscillation of the eyeball when moving laterally), excitation, and skin dryness.

Addiction:

        PCP is self-administered and induces ΔFosB expression in the D1-type medium spiny neurons of the nucleus accumbens, and accordingly, excessive PCP use is known to cause addiction. PCP's rewarding and reinforcing effects are at least partly mediated by blocking the NMDA receptors in the glutamatergic inputs to D1-type medium spiny neurons in the nucleus accumbens. PCP has been shown to produce conditioned place aversion and conditioned place preference in animal studies.

Methods of administration:

        PCP comes in both powder and liquid forms (PCP base is dissolved most often in ether), but typically it is sprayed onto leafy material such as cannabis, mint, oregano, tobacco, parsley, or ginger leaves, then smoked.

        PCP can be ingested through smoking. "Fry" is a street term for marijuana or tobacco cigarettes that are dipped in PCP and then dried.

        PCP hydrochloride can be insufflated (snorted), depending upon the purity.

        The free base is quite hydrophobic and may be absorbed through skin and mucus membranes (often inadvertently).

Management of intoxication:

        Management of PCP intoxication mostly consists of supportive care – controlling breathing, circulation, and body temperature – and, in the early stages, treating psychiatric symptoms.Benzodiazepines, such as lorazepam, are the drugs of choice to control agitation and seizures (when present). Typical antipsychotics such as phenothiazines and haloperidol have been used to control psychotic symptoms, but may produce many undesirable side effects – such as dystonia – and their use is therefore no longer preferred; phenothiazines are particularly risky, as they may lower the seizure threshold, worsen hyperthermia, and boost the anticholinergic effects of PCP. If an antipsychotic is given, intramuscular haloperidol has been recommended.

        Forced acid diuresis (with ammonium chloride or, more safely, ascorbic acid) may increase clearance of PCP from the body, and was somewhat controversially recommended in the past as a decontamination measure. However, it is now known that only around 10% of a dose of PCP is removed by the kidneys, which would make increased urinary clearance of little consequence; furthermore, urinary acidification is dangerous, as it may induce acidosis and worsen rhabdomyolysis (muscle breakdown), which is not an unusual manifestation of PCP toxicity.

Analogues:

        Possible analogues of PCP

        Fewer than 30 different analogues of PCP were reported as being used on the street during the 1970s and 1980s, mainly in the United States. The best known of these are rolicyclidine (PCPy or 1-(1-phenylcyclohexyl)pyrrolidine); eticyclidine (PCE or N-ethyl-1-phenylcyclohexylamine); and tenocyclidine (TCP or 1-(1-(2-thienyl)cyclohexyl)piperidine). Only of a few of these compounds were widely used.

        The generalized structural motif required for PCP-like activity is derived from structure-activity relationship studies of PCP derivatives, and summarized in the illustration (right). All of these derivatives are likely to share some of their psychoactive effects with PCP itself, although a range of potencies and varying mixtures of anesthetic, dissociative and stimulant effects are known, depending on the particular drug and its substituents. In some countries such as the United States, Australia, and New Zealand, all of these compounds would be considered controlled substance analogues of PCP, and are hence illegal drugs if sold for human consumption, even though many of them have never been made or tested.

        Other analogues of PCP include 3-HO-PCP, 3-MeO-PCMo, and 3-MeO-PCP.

Usage:

        PCP began to emerge as a recreational drug in major cities in the United States in 1960s. In 1978, People magazine and Mike Wallace of 60 Minutes called PCP the country's "number one" drug problem. Although recreational use of the drug had always been relatively low, it began declining significantly in the 1980s. In surveys, the number of high school students admitting to trying PCP at least once fell from 13% in 1979 to less than 3% in 1990.

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