Treatment for PCP Abuse and Addiction


Phencyclidine, more commonly known as PCP, is a member of the group of drugs called hallucinogens. It was developed in the 1950s as an intravenous anesthetic, but its use was discontinued after patients experienced a delirium with hallucinations after surgery.1

It emerged as a drug of abuse during the late 1960s then saw a decline of use during the 1970s with popularity rising again in specific metropolitan areas of the United States during the 1980s.1 It’s popularity has since waned, with only 56 people reporting use in the past year, although 2.4% of Americans having used PCP in their lifetime.2

PCP is a white crystalline powder that will dissolve in water or alcohol. It’s most commonly sprayed over a leafy material (e.g., marijuana, tobacco, or parsley) and smoked, but may also be injected, snorted as a powder, or swallowed in the form of a tablet or capsule.1,3

Street names for PCP include angel dust, boat, hog, love boat, ozone, rocket fuel, shermans, wack, crystal, and embalming fluid. The combination of PCP and marijuana may be called killer joints, super grass, fry, lovelies, wets, and waters; a dipperis a joint or cigarette that has been dipped into liquid PCP.1,4

Some tablets of MDMA (ecstasy, Molly) have been found to contain small amounts of PCP.1

Effects of PCP

PCP is a dissociative drug that induces distortions of sight and sound that affect the way a person perceives reality, producing a feeling of being disconnected from one’s environment.1,4,5 It’s effects are similar to those produced by another dissociative drug, ketamine, although PCP is more potent, longer acting, and more likely to produce seizures.6

The intoxicating effects of PCP vary depending upon the route of administration and the dose taken. When smoked, effects are produced within 2 to 5 minutes. When swallowed, effects are produced in about 30 to 60 minutes. The intoxicating effects typically last anywhere from 4 to 8 hours, but some users report experiencing subjective effects from 24 to 48 hours after use.1

Effects of a low to moderate dose (1–7 mg) of PCP include:1,6

  • Feeling of detachment from surroundings and self.
  • Numbness and a blank stare on the face.
  • Slurred speech.
  • Loss of coordination.
  • A sense of strength and invulnerability.
  • Involuntary eye movements.

Physiological effects of PCP include:1

  • Increased blood pressure.
  • Rapid and shallow breathing.
  • Elevated heart rate.
  • Elevated temperature.

Higher doses (7-10 mg) of PCP will produce a confused state that includes hallucinations.1,6 Doses around 17.5 mg can produce a state of agitation with higher doses inducing a coma-like state of severe rigidity and catonia.6 A dose of 120 mg or higher may cause death.6

Dangers of PCP Use

Chronic and repeated abuse of PCP may result in a confused delirium or psychosis that includes:1,6

  • Impaired memory and thinking.
  • Persistent speech difficulties.
  • Agitation and violent behavior.
  • Suicidal thoughts.
  • Anxiety, depression, and social withdrawal.

Users in this state may pose a danger to themselves or others. In a report on PCP-related visits to the emergency room during 2011, approximately plus75,538 emergency room visits were related to PCP – 72 percent of those involved other drugs, including heroin, cocaine, marijuana and prescription pain relievers, benzodiazepines and other anti-anxiety and insomnia medications.7

A person who takes continual doses of PCP may develop dependency and experience withdrawal symptoms following cessation:6

  • Teeth clenching and grinding.
  • Rapid and involuntary eye movements.
  • Sleepiness/drowsiness.
  • Diarrhea.
  • Goose bumps (i.e., bristling of hair follicles where hair stands on end).
  • Muscle tremors.
  • Seizures.

Individuals under the influence of PCP may be brought to the emergency room for overdose or because of extreme psychological effects from the drug. Some In fact, deaths related to PCP are most often the result of suicide while under the influence or injuries due to an accident.

Treatment for PCP Dependence

If individuals are brought to an emergency department for an acute adverse reaction or potential overdose, they must be medically stabilized—and sometimes physically restrained—before beginning any other type of treatment for dependence. Multiple medical interventions, from reducing fever to lowering high blood pressure to ensuring proper breathing may be necessary. Benzodiazepines may help with sedation in order to reduce the effects of psychosis. The individual may also be placed in a quiet, dimly lit environment.

Once stabilized, the focus should be shifted to treating the PCP addiction.8 Individuals should be assessed for any co-occurring mental health conditions, such as anxiety or depression.

Inpatient or outpatient behavioral therapy will focus on identifying maladaptive behaviors and changing said behaviors. Lifestyle changes, such as avoiding situations in which PCP use is likely, and the development of new coping skills, such as meditation or relaxation techniques to use when the individual feels a craving for PCP, may also be introduced.6,8

After individuals are released from inpatient care, ongoing treatment is needed. Since PCP can be detected in urine for around seven days, drug testing can be helpful in monitoring compliance.6 In addition, clients may participate in ongoing individual counseling as well as group therapy sessions and any alternative therapies that were found to be beneficial during inpatient treatment, such as art therapy or equine-assisted therapy.

Mutual-help groups may also offer individuals many benefits both during and after inpatient or outpatient treatment. These groups can provide a much-needed support system to help maintain positive change and sustain recovery.

References

  1. Diversion Control Division. Drug Enforcement Agency. (2019). Phencyclidine.
  2. Center for Behavioral Health Statistics and Quality. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables.Substance Abuse and Mental Health Services Administration, Rockville, MD.
  3. National Institute on Drug Abuse. (2015). Common Hallucinogens and Dissociative Drugs.
  4. National Institute on Drug Abuse. (2019). Commonly Abused Drugs: PCP.
  5. National Institute on Drug Abuse. (2015). What are Hallucinogens and Dissociative Drugs?
  6. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  7. Substance Abuse and Mental Health Services Administration. (2013). The DAWN Report: Emergency Department Visits Involving Phencyclidine (PCP).
  8. Journey, J. D., & Bentley, T. P. (2019). StatPearls: Phencyclidine (PCP) Intoxication.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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