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Cannabis and Club Drugs

for Health Care Providers

Cannabis and Club Drugs

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Illicit DrugEffectsNotes
Cannabis (marijuana)

Also known as chronic, pot, weed, grass, Mary Jane, spliff, ganja, hash, skunk, puff, herb, and many other names
Intoxicant, stimulant, psychedelic (mild hallucinogenic), relaxant Both physical and psychological dependence are possible. A chronic heavy user can appear apathetic and unmotivated, and may perform poorly at work or school.

Other health risks include those associated with impaired judgment and coordination, increased incidence of respiratory infections, as well as toxicities from adulterants (eg, formaldehyde).

Note: Programs that authorize medical use of marijuana exist in a number of states and the District of Columbia, and VHA patients may access these programs through non-VHA providers. For patients who do participate in a marijuana program, VA providers should assess for misuse, adverse effects, and withdrawal. Participation in state-approved marijuana programs cannot in itself be a cause for denial of access to most VA clinical programs.

MDMA

Also known as ecstasy, E, X, XTC, rolls, beans, Adam

Stimulant, hallucinogenic amphetamine

MDMA is one of the most popular recreational psychoactive drugs, most commonly sold in the form of "ecstasy" tablets. It is known for its empathogenic, euphoric, and stimulant effects.

Physical effects are similar to those of amphetamines.

Between 300 and 400 deaths have been reported from MDMA use and overheating.

Concurrent use with amphetamines, cocaine, or alcohol increases the risk of overheating.

RTV increases MDMA levels 5- to 10-fold and can increase the risk of fatal heatstroke and dehydration.

Flunitrazepam (Rohypnol)

Also known as roofies, "date-rape" drug

Benzodiazepine sedative-hypnotic

Flunitrazepam has been used in many "date rapes" in the United States, with cases also reported in Europe and Australia.

10 times more potent in sedative-hypnotic effects than diazepam.

Causes paralysis, unconsciousness, and short-term amnesia.

Onset occurs within 10 minutes after being taken; the effects peak in 8 hours and last 12 hours.

Mixing with alcohol at higher doses can lead to unconsciousness for several days.

Gamma-hydroxybutyrate (GHB)

Also known as liquid ecstasy, GBL (a pro-drug), BDO, GBH, Blue Nitro, Midnight Blue, RenewTrient, Reviarent, SomatoPro, Serenity, Enliven

Sedative depressant, anesthetic

GHB is popular on the rave scene. It has effects of alcohol-like intoxication and sexual disinhibition.

Higher doses can lead to disorientation, blurred vision, nausea, vomiting, impaired physical coordination, and muscle spasms.

Onset occurs within minutes; overdose can lead to unconsciousness within 30 minutes. The risk of coma and death is potentiated by concurrent alcohol use.

RTV increases GHB levels, leading to increased risk of seizures, respiratory depression, and loss of consciousness.

Ketamine hydrochloride

Also known as K, Special K, Dorothy, cat tranquilizer, tekno, green

Dissociative anesthetic, hallucinogenic (same class as phencyclidine, or PCP)

Ketamine was developed as a veterinary and human anesthetic, but it has become popular in club and rave scenes.

Initial effects are of stimulation and euphoria, followed by sedation and hallucination (out-of-body sensations). Physical effects include nausea and vomiting, slurred speech, lack of coordination, and numbness.

Physical risks include injury resulting from the anesthetic effects. Overdoses can lead to respiratory compromise.

Used chronically, ketamine can increase the risk of drug-induced hepatitis.

From Substance Use
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009