Phencyclidine Use Disorder
Overview
Phencyclidine is known as a dissociative anesthetic or mind-altering substance. It is a Schedule II drug, which is illegal in the United States. Consuming PCP can cause altered perceptions, induce hallucinations,1 and drastically change a person’s consciousness and sensory experiences. It may also cause aggressive behavior, making it difficult for an individual to carry out daily activities.
Because of its effects, phencyclidine (PCP) may be misused as a recreational drug, sometimes referred to as “angel dust.” Using this drug recreationally can lead to PCP use disorder and other serious complications. PCP use disorder can affect people of different backgrounds and age groups, with the potential for dependence, addiction, withdrawal, and overdose. Misconceptions surrounding the condition may lead to social stigma,2 which can further complicate the lives of those affected.
High doses of PCP are linked to psychosis3 or intoxication. In addition, long-term use of PCP may have serious effects on mental health, including depression. Individuals with PCP use disorder often benefit from treatment in the form of therapy or prescription medications to manage symptoms and recover.
Symptoms
PCP use disorder may be identified through specific symptoms. A person who misuses PCP may show specific behavioral, cognitive, and physical symptoms, which may warrant the benefit of intervention and treatment. These symptoms may vary in severity and frequency, depending on the individual. Some of the most common symptoms include the following:
Behavioral symptoms
Below are some common behavioral symptoms of PCP use disorder:
- Neglected responsibilities at work, school, or home
- Interpersonal challenges, such as conflicts or arguments with loved ones
- Decreased interest in previously enjoyed activities
- Continued use despite adverse effects, such as health problems or legal troubles
- Difficulty controlling use and failed attempts to reduce or stop drug use
- High-risk behavior, such as driving under the influence
Cognitive symptoms
Cognitive symptoms of this disorder may include the following:
- Memory loss
- Impaired concentration
- Poor judgment
- Disorientation or confusion
- Difficulty thinking or speaking
- Hallucinations
- Delusions
- Depersonalization
- Paranoia
- Difficulty problem-solving
Physical symptoms
PCP use disorder can cause the following physical symptoms:
- Dizziness
- Numbness
- Slurred speech
- Rapid and involuntary eye movements
- Nausea or vomiting
- Profuse sweating
- Increased heart rate and blood pressure
In addition to the symptoms listed above, higher doses of PCP can lead to symptoms of overdose. Severe effects of a PCP overdose may include muscle rigidity, severe agitation, seizures, and coma.
Withdrawal symptoms may occur upon suddenly stopping the use of PCP. These symptoms can include intense cravings, headaches, anxiety, and sweating. In addition, long-term use of PCP can lead to hallucinogen-induced persisting perceptual disorder (HPPD) and toxic psychosis, which can cause hostility and other dangerous behaviors.
Awareness of these symptoms may help individuals and treatment providers identify PCP use disorder as early as possible. Once diagnosed, early intervention and treatment may prevent long-term health problems and improve the chances of recovery4 for those with phencyclidine use disorders.
Causes
There is no single cause that may lead to the development of PCP use disorder. However, several factors may contribute to the development of substance use disorders,5 including genetic, environmental, and individual risk factors.
Research suggests that individuals with a family history of substance use disorders are more likely to develop a substance use condition themselves. Additionally, some people may inherit genes that make them more susceptible to the addictive effects of PCP and other drugs.
Environmental factors may also contribute to the development of PCP use disorder. Exposure to PCP, especially in places with easy access, may increase the risk of substance misuse and dependence. Peer pressure, having friends or acquaintances who use PCP, and social environments that encourage drug use may also increase the risk of developing the disorder.
Individual risk factors for developing PCP use disorder might include:
- A history of mental health disorders, such as depression, anxiety, or schizophrenia, which may lead individuals to self-medicate with PCP to relieve symptoms
- A history of other substance use disorders, as those with a history of addiction to other substances may be more prone to develop an addiction to PCP
- Exposure to trauma or highly stressful situations, which may cause some individuals to seek escape through the dissociative and hallucinogenic effects of PCP
Knowing the various causes and risk factors linked to substance use disorders like PCP use disorder may help individuals find treatment. Recognizing potential risk factors may also help people get treatment early before serious complications arise.
Treatments
There are various treatments for PCP use disorder, depending on the severity of the condition and symptoms experienced. Treatment may also depend on the individual's overall condition, their medical conditions, and other treatments they use.
Common treatments may include therapy, medication, and self-care strategies to support recovery. A supervised, in-patient environment may be valuable to safely treat individuals with severe addiction or co-occurring mental health conditions.
Therapy
Various forms of therapy may be helpful in treating PCP use disorder and the factors behind it, including but not limited to the following modalities:
- Cognitive-behavioral therapy (CBT): CBT helps individuals recognize and alter their thought patterns and behaviors related to drug use. They can also learn coping skills to manage causes of use and cravings.
- Contingency management (CM): CM therapy uses rewards and incentives to encourage positive behavior changes, such as staying drug-free or attending therapy sessions consistently.
- Group and family therapy: These forms of therapy provide a supportive space where individuals can share their experiences and work through challenges together. Family therapy may help resolve underlying conflicts and improve communication within the family unit.
Medication
While there are currently no approved medications specifically for treating PCP use disorder, certain medications may be used to manage toxicity, withdrawal symptoms, or co-occurring mental health conditions. The medication used may depend on whether the substance is mixed with other drugs, such as embalming fluid, which may sometimes be added to the tip of cigars or cigarettes laced with PCP. It can be crucial to tell your doctor all of the substances you consumed to avoid harmful interactions.
Examples of medications used in treatment may include:
- Benzodiazepines: These medications may help reduce anxiety, agitation, and seizures during PCP intoxication.
- Antipsychotics: Antipsychotic medications may be used in PCP-intoxicated individuals with PCP-induced psychosis.
Medication should only be used under the supervision of a healthcare professional as part of a comprehensive treatment plan. Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
Other treatment options
In addition to therapy and medication, other treatment options may be beneficial for those experiencing PCP use disorder, especially when it comes to an overdose. Key steps to manage PCP toxicity involve supporting basic life functions like airway, breathing, and circulation.
In severe cases, healthcare providers might use a tube to help the individual breathe (intubation). While methods to clean out the stomach may be unneeded, activated charcoal can be used if a significant quantity of PCP or another harmful substance is ingested.
Self-care
Specific self-care strategies may promote overall health during recovery from PCP use disorder:
- Exercise: Regularly exercising may reduce cravings, boost mood, and improve overall physical and mental health.
- Sleep: Sleep can be crucial to healing and recovery, as it allows the body and mind to rest and rejuvenate.
- Nutrition: Eating a balanced diet and staying hydrated can support overall health and manage mood during withdrawal and recovery.
- Stress management: Developing effective stress-management techniques, such as mindfulness, meditation, or yoga, may help individuals cope with challenging events and prevent relapse.
Treating PCP use disorder often requires a well-rounded approach, including therapy, medication, and self-care strategies. Combining these elements and tailoring them to each person's needs may improve the chances of successful recovery.
Resources
Individuals with PCP use disorder can often find support and guidance from resources made for people with mental health challenges. Finding accessible therapy can be challenging. In these cases, online therapy platforms like BetterHelp may offer convenient access to professional therapists who can assist individuals on their recovery journey. An online platform can connect individuals with licensed mental health professionals experienced in treating substance use disorders.
In addition to therapy, several mental health organizations and support groups are dedicated to helping individuals with substance use disorders. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA) are organizations that provide information about various treatment methods, recovery programs, and resources for individuals struggling with substance use disorders. They focus on educating individuals, families, and communities about the complexities of drug misuse and mental health.
Local support groups may also be valuable resources for individuals with PCP use disorder. These groups provide a safe space to share their experiences, learn from others, and cope with various challenges. StartYourRecovery.org can allow individuals to search for local support groups and other community-based organizations based on their zip code.
For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).
Research
Researchers have explored the causes of drug misuse and potential treatments for PCP use disorder. One study evaluated how PCP may cause psychosis and be misused. It found that PCP disrupts the communication between specific brain cells in an area of the brain called the hippocampal CA1. In addition, PCP was found to overstimulate a process related to the creation of specific proteins, leading to cognitive function challenges.
Another study looked at how a drug called Lu AF35700 could correct changes in brain activity caused by PCP. The results showed that Lu AF35700 could successfully counteract the modifications induced by PCP, particularly in areas of the brain called thalamocortical networks. The study also found that two types of dopamine receptors in the brain, D1-R and D2-R, play a role in this process.
A drug called haloperidol, which works on D2-R, and a combination of haloperidol and another drug called SCH-23390, which works on D1-R, may also reverse the effects of PCP. These findings suggest that treatments that target both dopamine receptors could reverse some changes caused by PCP.
Statistics
Below are several statistics on PCP use disorder:
- Approximately 6.3 million people (2.4% of the population) aged 12 or older have used PCP in their lifetime, and roughly 120,000 individuals (less than 0.1% of the population) have used it in the past year.
- According to one report from SAMHSA, of the 75,538 emergency department (ED) visits involving PCP usage, approximately 69% were made by males, with nearly half (45%) of all PCP-related visits accounted for by patients aged 25 to 34, and patients aged 18 to 24 and 35 to 44 each contributing to 19% of the visits.
- Nearly 225,000 individuals aged 12 to 17 and 777,000 individuals aged 18 to 25 have used PCP at least once. In addition, over 3% of high school seniors in the United States have used PCP at least once in their lifetime, with over 1% having used the drug in the past year.
- Around 50% of people with a history of a mental health condition during their lives are also diagnosed with a substance use disorder like PCP use disorder.
- One study found that internet-based therapy for substance use disorders could be more effective than in-person options and was more convenient and cost-effective for clients.