"Club drug" is a general term for illicit synthetic drugs such as MDMA and GHB (gamma-hydroxybutyrate) that have become popular with teenagers and young adults that frequent nightclubs and raves. These drugs have become extremely common in Ohio and are posing a significant threat. Law enforcement in Ohio reports an increase in club drug availability, primarily in urban areas where rave activity is increasing. Given the popularity of raves in Ohio, the increases in the availability of club drugs may pose a greater immediate threat to adolescents and young adults than any other illegal drug.

There is a perception that many of these drugs are not harmful, like cocaine and heroin. However, there are documented cases in Ohio where young adults have either become seriously ill or died as a result of ingesting a club drug.

Pharmaceutical diversion is also a continuing problem throughout Ohio, although it may not receive as much attention as other illicit drug problems. Illegally obtained prescription drugs are readily available in most areas of Ohio, and most urban areas of southeastern Ohio report rampant prescription abuse. Law enforcement reports indicate that the illicit distribution of prescription drugs in Ohio is a lucrative business. The most commonly diverted pharmaceuticals in Ohio are Dilaudid, OxyContin, Percocet, Valium, and Vicodin.

The popularity of club drugs such as MDMA, GHB and GBL (gamma-butyrolactone), Rohypnol, ketamine, and LSD (lysergic acid diethylamide) has increased in Ohio. For some of these drugs, particularly MDMA, the surge in popularity is largely because their hallucinogenic and stimulant effects enhance the rave experience. Others, such as GHB and Rohypnol, are well-known "date rape" drugs. Although little information on the level of abuse is available, many users are experimenting with a variety of club drugs, other illicit drugs, and alcohol--an extremely dangerous combination.

MDMA is both a stimulant and a hallucinogen. The effects of MDMA usually last from 4 to 6 hours, although they vary by individual. If taken in tablet or capsule form, the onset of effects takes approximately 30-45 minutes; if snorted, smoked, or injected, effects are immediate. Physical reactions include increased heart rate, body temperature, and blood pressure, as well as nausea and cramping. Full effects usually are attained within an hour of ingestion and include feelings of well-being and euphoria--which contributes to MDMA's "hug drug" or "love drug" reputation--as well as anxiety and paranoia.

GHB and Rohypnol have gained a reputation as "date rape" drugs. When either of these drugs is mixed with alcohol, even in small amounts, the drinker loses consciousness for several hours. The manufacturer of Rohypnol now adds a blue dye, enabling detection in drinks and possibly contributing to a decrease in the popularity of Rohypnol and an increase in the use of GHB. Teenagers and young adults attending raves also take these drugs to lessen the "crash" associated with coming down from other drugs.

GHB, a powerful sedative and central nervous system depressant, has been approved in some countries for use as an anesthetic. It is unlawful to manufacture or market GHB in the United States, but recipes and "do-it-yourself" kits for its production are available on several Internet sites. GHB has become a significant problem, particularly on college campuses. There have been more than 5,700 overdoses and 58 deaths associated with GHB in the United States and Canada since 1990. In August 1998, an 18-year-old resident of Akron barely survived an incident where she drank a glass of water laced with GHB. The medical director of Ohio State University's emergency department said that about one patient a week is treated for GHB-related complications at the hospital. In April 2000, an Ohio State University honors student collapsed inside a fraternity house and later died after he had mixed GHB with alcohol.

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Ketamine is growing in popularity in Ohio as a club drug on the rave scene and in all-night dance clubs. Ketamine, also known as Special K, Vitamin K, or Kit-Kat, is a chemical derivative of PCP chiefly developed as a veterinary anesthetic. Ketamine can be used in its pharmaceutical liquid form or dried by evaporation or in a microwave oven to produce a white powder. In liquid form, ketamine has little to no smell and looks like water, but it has an unpleasant taste in both forms. Ketamine can be injected, smoked, swallowed, snorted, or mixed in either alcoholic or nonalcoholic drinks. Users normally prefer intramuscular injection because snorting powdered ketamine leads to an unpleasant burning sensation in the nasal passages. Although ketamine often is listed as one of the date rape drugs, DEA cites only one documented case in which it was used to commit a rape. Ketamine produces a hallucinogenic effect similar to LSD, but with less intensity and of shorter duration, lasting an hour or less. It often is used in conjunction with alcohol, cocaine, or marijuana. Dosage amounts vary widely according to the individual's total body weight and the desired result. Small doses of ketamine act as a mild sedative, while larger doses lead to unconsciousness. Through experimentation with increasing dosage amounts, users seek an intense psychedelic experience just short of unconsciousness. A typical dose for a 150-pound individual is about 100 milligrams when injected into a muscle, or 200 milligrams when snorted. Overdose deaths from ketamine use are extremely rare because lethal amounts are at least 20 to 30 times greater than standard dosages.

LSD was discovered in 1938 and is one of the most potent mood-altering drugs. Commonly known as "acid," it is sold on the street in tablet, capsule, and liquid form. It is odorless, colorless, and has a slightly bitter taste; it usually is taken orally. The effects of LSD often depend on the amount taken and the user's personality and surroundings. The user usually feels the first effects of the drug within 30 to 90 minutes of ingestion. Large doses produce delusions and visual hallucinations. Some fatal accidents have occurred during states of LSD intoxication.

Prescription medication is sometimes being substituted for illicit drugs when these substances are not available. In Richland County, crack cocaine users are using Vicodin when crack is not available. Federal investigators have noted areas of heavy OxyContin abuse in the United States, one of which is in Cincinnati. The other areas are southwestern Virginia; eastern Kentucky, rural Maine; Baltimore, Maryland; and Charleston, West Virginia. According to the Ohio BCI&I, OxyContin abuse first was noted in early 1999 in southeastern Ohio and, since then, is believed to be responsible for more than 15 deaths.

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Eleven of fifteen Ohio law enforcement agencies that responded to the 2000 National Drug Threat Survey indicated an increase in club drug activity in their areas. The increase in the availability and abuse of these drugs in northern Ohio is becoming a serious concern for law enforcement. Most law enforcement agencies in urban areas report an increase in MDMA and GHB availability. The Cincinnati, Cleveland, and Youngstown DEA Resident Offices report the availability of LSD in their areas. In Akron and Canton, distributors are able to obtain thousands of LSD dosage units at a time. An increase in rave activity in northeastern Ohio is providing adolescents and young adults with easy access to dangerous drugs. In 1999, the average price of a capful of liquid GHB in Ohio was $15; a gram of powdered GHB sold for $100.

The theft of ketamine from local veterinary offices in northern Ohio has increased. Ketamine has become popular with young adults in suburban areas and is readily available at local rave parties. In February 1998, the Ohio State Board of Pharmacy reported that complaints about the abuse of ketamine had increased. Thieves broke into the Delaware County Humane Society and stole ketamine hydrochloride from a locked box. What they might not have realized was that the drug was mixed with Xylazine, a tranquilizer used to sedate dogs and cats before they are euthanized.

Diverted pharmaceuticals are readily available throughout most areas of Ohio. In most urban areas, Dilaudid, OxyContin, Percocet, Tylenol with Codeine No. 3, Valium, and Vicodin are easily obtained. In Cuyahoga County, the Ohio BCI&I indicates that Adderall is being sold in local high schools. All 15 law enforcement agencies in Ohio that responded to the 2000 National Drug Threat Survey indicate that the availability of pharmaceuticals and the rate of pharmaceutical diversion remain high in their areas.

Forged prescriptions are commonly used to obtain pharmaceuticals. Pharmacists report that counterfeit prescriptions are being produced for Dilaudid, Percocet, Tylenol with Codeine No. 3, Valium, and Vicodin in north central Ohio. In 1997, the Cincinnati Police Department Pharmaceutical Diversion Squad investigated more than 500 prescription drug complaints and arrested 250 violators on felony prescription drug charges. Almost 30 percent of those arrested were healthcare professionals involved in distributing or abusing prescription drugs, and most were using diverted prescription drugs while working in a healthcare facility.

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Most of the MDMA available in the United States is produced in the Benelux region (a tripartite customs union formed in 1947 by Belgium, the Netherlands, and Luxembourg), although MDMA laboratories have been seized in other European countries, including Poland and the Czech Republic. Although domestic production of MDMA is seemingly small, the availability of production instructions on the Internet is cause for concern. A number of web sites contain formulas for home production, making it impossible to know the number of people who may be producing "homemade" MDMA from on-line recipes.

Lawful production of GHB occurs only in Europe. However, the widespread publication of recipes on the Internet and the ease with which precursor chemicals can be obtained make the production of GHB a potential problem. Only two chemicals, both of which are legal to possess, combined with other common items are needed to produce GHB. Combining GBL, a chemical found in industrial cleaners and sold as a dietary supplement, with either sodium hydroxide or potassium hydroxide produces GHB. Most illegally produced GHB is in liquid form; the powdered form is much more difficult to synthesize and usually results only from commercial production.

LSD is produced clandestinely in California by a few criminal organizations and is shipped to Ohio and throughout the country in liquid and blotter form. Production of LSD requires a significant background in chemistry as well as precursor chemicals that are difficult to obtain.

First produced in the 1960s, ketamine was used extensively during the Vietnam War as an anesthetic for battlefield surgery. Medically prescribed use for humans is now very limited because of the hallucinogenic side effects. The product is diverted from legitimate sources, with no reports of clandestine production. In 1999, the average price of one dosage unit of ketamine in Ohio was $25 and a gram of powdered ketamine was $130.

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Retail

Nightclubs and rave parties are the primary locations for the distribution of MDMA and other club drugs, although distribution increasingly is occurring outside these venues. Retail dealers typically are suburban teenagers, mostly Caucasians, who are involved in the rave scene. Sales usually occur between friends and acquaintances. Most law enforcement agencies in Ohio responding to the 2000 National Drug Threat Survey indicated that juveniles, mostly Caucasians from well-to-do families, are responsible for much of the distribution of club drugs in their areas, particularly at rave parties.

Those law enforcement agencies in Ohio that responded to the 2000 National Drug Threat Survey and listed pharmaceutical abuse and diversion as a concern indicated that local independent dealers are responsible for most distribution. In April 2000, a mother, son, and his stepbrother were arrested for what authorities called the largest known case of pharmaceutical diversion in Franklin County. The three were charged with distributing prescription drugs from two locations on the south side of Columbus. Authorities seized more than 21,000 pills and about $27,000. The group distributed an array of prescription drugs including Darvocet, Percocet, Percodan, phentermine, Ritalin, Tylenol with Codeine No. 3, Valium, and Vicodin.

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