Other Dangerous Drugs

Other dangerous drugs--including the stimulant MDMA, the hallucinogens LSD and ketamine, the depressant GHB, and diverted pharmaceuticals such as OxyContin, Ritalin, and Vicodin--constitute a significant and increasing threat to Maryland. According to law enforcement sources, teenagers and young adults are the principal abusers of most of the drugs in this category, except diverted pharmaceuticals. MDMA, primarily abused at nightclubs and raves, is the most frequently abused and widely available club drug in Maryland. The abuse of LSD is limited, but the drug is readily available in some parts of the state. GHB is readily available throughout central Maryland, and the drug is frequently abused at raves. Independent dealers, primarily Caucasians, are the dominant distributors of stimulants, hallucinogens, and depressants in the state. Diverted pharmaceuticals are a serious but often unrecognized threat throughout the state.

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Stimulants

MDMA. The increasing availability and abuse of MDMA (3,4-methylenedioxymethamphetamine), particularly among teenagers and young adults, pose a growing threat to Maryland. Also known as Adam, ecstasy, XTC, E, and X, MDMA is a stimulant and low-level hallucinogen. MDMA was patented in 1914 in Germany where it was sometimes given to psychiatric patients to assist in psychotherapy. This practice was never approved by the American Psychological Association or the Food and Drug Administration. Abusers claim that MDMA, sometimes called the hug drug, helps them be more "in touch" with others and "opens channels of communication." However, abuse of the drug can cause psychological problems similar to those associated with methamphetamine and cocaine abuse including confusion, depression, sleeplessness, anxiety, and paranoia. The physical effects can include muscle tension, involuntary teeth clenching, blurred vision, and increased heart rate and blood pressure. MDMA abuse can also cause a marked increase in body temperature leading to muscle breakdown, kidney failure, cardiovascular system failure, stroke, or seizure as reported in some fatal cases. Research suggests that MDMA abuse may result in long-term and sometimes permanent damage to parts of the brain that are critical to thought and memory.

MDMA abuse is increasing in Maryland, especially among high school and college students and young adults. MDMA has emerged as the most popular club drug in Maryland and, according to substance abuse professionals and juvenile offenders interviewed by the Maryland Drug Early Warning System Drug Scan in 2000 and 2001, MDMA abuse has spread beyond the rave subculture to other social venues such as after school activities, dances, and parties. The 2001 Maryland Adolescent Survey reports that while the number of sixth and twelfth grade students who reported having used MDMA in the past 30 days decreased from 1998 to 2001, rates of MDMA abuse among eighth, tenth, and twelfth grade students increased. In 2000 the Center for Substance Abuse Research conducted a personal drug use survey of 114 rave attendees as they were exiting clubs in Baltimore between 1 a.m. and 4 a.m. The individuals surveyed were approximately 20 years of age, 61 percent were male, and 89 percent were Caucasian. This survey reports that 60 percent had abused MDMA in the past 90 days, and 90 percent had abused MDMA at least once during their lifetime.

MDMA abuse is of increasing concern in several counties. The Maryland Drug Early Warning System Drug Scan reported MDMA as an emerging threat in 18 of Maryland's 23 counties in 2000 and in 22 counties and the city of Baltimore in 2001. The Baltimore County Police Department reported that MDMA is available throughout the county. The DEA Baltimore District Office reports MDMA is gaining in popularity on the Eastern Shore, particularly among young adults. The Maryland Governor's Office of Crime Control and Prevention has launched a statewide awareness campaign to educate the public about the dangers associated with MDMA. MDMA-related deaths in Maryland increased from two in 1998 to four in 1999 to nine in 2000.

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Investigations and seizures by Maryland law enforcement agencies indicate an increase in the availability of MDMA. The number of MDMA investigations by the Maryland State Police increased from 59 in FY1999 to 128 in FY2000. Baltimore County Police reported 123 investigations that yielded 4,624 dosage units of MDMA in 2000. In 2000 the Anne Arundel County Police Department reported the seizure of 1,414 dosage units in 35 investigations, and the Montgomery County Police Department reported 58 investigations resulting in the seizure of 9,093 dosage units. The Prince George's County Police Department reported 21 investigations resulting in the seizure of 1,539 dosage units in 2000. Arrests for MDMA by the Maryland State Police, Drug Enforcement Command increased from 4 in 1998 to 67 in 2001. The Maryland State Police reported that the number of MDMA samples sent to the state crime laboratory for analysis quadrupled from 1998 through 1999. The Maryland State Police also reported that statewide MDMA prices ranged from $10 to $30 per dosage unit and $500 to $1,000 per 100 dosage units in 2000. The average price of MDMA in the Baltimore area was $20 to $25 per dosage unit in 2000.

Most MDMA is produced outside the state. Laboratories in the Netherlands and Belgium produce at least 80 percent of the MDMA consumed worldwide. In 2000 a package containing 5,000 dosage units was sent to Maryland from the Netherlands. There have been some attempts to produce MDMA in Maryland. For example, in 2000 a Baltimore police officer who was arrested for distributing MDMA had also been attempting to create his own MDMA laboratory and purchase a pill press. Taped conversations revealed his plans to produce the drug; however, the laboratory was never located.

MDMA is transported into Maryland primarily from New York via package delivery services. Local independent dealers, particularly Caucasians, are the dominant transporters of MDMA into the state. They make purchases of 12 to 40 dosage units and transport them by private vehicle or package delivery services. In 2001 a Dorchester County man was arrested for receiving 29 MDMA tablets sent from Florida via a package delivery service.

MDMA abusers buy the drug primarily from relatives and friends at raves, nightclubs, and on college and high school campuses. According to the Center for Substance Abuse Research survey of 114 ravers during the summer and fall of 2000, 53 percent of those surveyed obtained the drug from family or friends, 24 percent from street dealers, and 18 percent from individuals at clubs or raves.

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Hallucinogens

LSD. The distribution and abuse of LSD (lysergic acid diethylamide) constitute a low threat to Maryland. LSD, also known as acid, boomer, and yellow sunshine, is a hallucinogen that induces abnormalities in sensory perceptions. The effects of LSD are unpredictable depending upon the amount taken, the environment in which it is abused, and the abuser's personality, mood, and expectations. Abusers may feel the effects for up to 12 hours. The physical effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, nausea, numbness, weakness, insomnia, dry mouth, and tremors. Two long-term disorders associated with LSD are persistent psychosis and hallucinogen persisting perception disorder (flashbacks). LSD typically is taken orally.

LSD is available in a variety of forms including powder or liquid, tablets or capsules, on pieces of blotter paper, and on small candies. It is abused primarily at raves, bars, and nightclubs in large cities and college towns in Maryland. Most abusers are teenagers and young adults. Some abusers conceal liquid LSD in breath mint vials or eyedrop bottles. In 1998 liquid LSD was seized in Prince George's County where it is reported by police to be readily available from local independent dealers at rave parties. According to DEA, in 2001 the average price of LSD in the state was approximately $4 per dosage unit and $300 per sheet (100 dosage units).

The Maryland Drug Early Warning System Drug Scan reports that LSD was available and abused in six counties in 2000. Approximately 9 percent of twelfth grade students surveyed in the 2001 Maryland Adolescent Survey reported having abused LSD within the past year. The 2001 Maryland Adolescent Survey reports that the percentage of sixth, eighth, tenth, and twelfth grade students who reported having abused LSD in the past 30 days decreased from 1996 to 2001. The most significant decreases were among tenth grade students (from 5.8 percent in 1996 to 3.7 percent in 2001) and twelfth grade students (from 5.6 percent in 1996 to 3.7 percent in 2001).

Most LSD available in the state is produced in California and transported into Maryland directly from California or transported to major East Coast cities such as Washington, D.C., New York City, and Philadelphia. Retail distributors in Maryland travel to those cities primarily in private vehicles or buses to purchase quantities for personal use and further distribution. College and high school students, primarily Caucasians, are the dominant retail distributors of the drug. In response to the NDIC National Drug Threat Survey 2001, the Caroline County Sheriff's Office reported a 200 percent increase in LSD seizures, largely due to one major seizure in 2000. In that case, the suspect, a U.S. citizen, was arrested for transporting 250 dosage units of LSD to beach resorts on the western shore of Maryland. The liquid LSD, which was dyed with blue food coloring and packaged in a windshield washer fluid container, reportedly had been transported across the Mexican border from Tijuana.

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Ketamine. The abuse of ketamine is increasing in Maryland. Ketamine, also known as K, special K, vitamin K, and cat valium, is an injectable anesthetic that has been approved for both human and animal use. Ketamine is sold commercially and is produced in liquid, powder, and pill forms. The liquid form typically is injected intramuscularly. Powdered ketamine often is snorted or smoked with marijuana or tobacco products and may be mistaken for cocaine or methamphetamine.

Low-dose intoxication from ketamine may result in impaired attention, learning disability, memory dissociation--which includes out-of-body and near-death experiences--and hallucinations. High doses of ketamine can cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems. Ketamine gained popularity among abusers in the 1980s when it was discovered that large doses caused reactions similar to those experienced with PCP abuse. Ketamine abusers in the United States and the United Kingdom have reported incidents similar to bad LSD trips. Some abusers have attempted to fly or have jumped from moving vehicles.

Caucasian teenagers and young adults from middle- and upper-class socioeconomic backgrounds are the primary abusers of ketamine. The Drug Early Warning System reports that in November 2000 ketamine was still abused at raves and its popularity was increasing in other social venues as well, such as after school activities, dances, and parties. The Maryland Drug Early Warning System Drug Scan reports that ketamine was available and abused in five counties in 2000. There were two seizures of ketamine in Maryland reported by EPIC in 2000; in both cases the drug was transported via package delivery services. In 1998 Maryland law enforcement officials seized approximately 3,060 milliliters of liquid ketamine and an undisclosed amount in powdered form. In Anne Arundel, Frederick, and Washington Counties, a number of ketamine-related burglaries of veterinarian offices and animal clinics have been reported. The Maryland State Police reported that ketamine sold statewide for $20 per dosage unit and $100 to $150 per gram in powdered form in 2000. Respondents to the NDIC National Drug Threat Survey 2001 reported that ketamine was available throughout Maryland.

Depressants

GHB. The abuse of GHB (gamma-hydroxybutyrate) poses a low threat to Maryland. GHB, also known as liquid MDMA, scoop, grievous bodily harm, and Georgia homeboy, is a depressant that is produced by the body and is necessary for full functioning of the brain and central nervous system. Synthetic GHB is odorless, colorless, and practically undetectable if mixed with a beverage. Medical and law enforcement experts report that abusers can lose consciousness within 20 minutes of ingesting GHB and that traces of the drug usually disappear from the body within 12 hours. The drug has been increasingly involved in poisonings, overdoses, sexual assaults, and fatalities. GHB overdoses can occur quickly; some effects include drowsiness, nausea, vomiting, loss of consciousness, impaired breathing, and death. Abusers can also experience insomnia, anxiety, tremors, and sweating.

White, middle- and upper-class suburban teenagers abuse GHB in various parts of the state. GHB abuse initially was reported in 1998 in Frederick and Queen Anne's Counties; both areas have active rave scenes. The drug is now available throughout central Maryland. There were 23 GHB overdoses reported to the Maryland Poison Center in 1999. The Maryland Drug Early Warning System reported GHB abuse or overdoses in 12 of 23 counties and the city of Baltimore in 1999. GHB usually is sold in liquid or powdered form for $10 to $20 per dose at the retail level. Respondents to the NDIC National Drug Threat Survey 2001 reported that GHB is available, but they had no information on seizures, arrests, or investigations. Respondents reported that Caucasians are the dominant transporters and distributors of the drug.

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Diverted Pharmaceuticals

Diversion of pharmaceuticals is a low but increasing threat to Maryland. Pharmaceutical diversion in Maryland primarily is accomplished through prescription forgery and a practice known as "doctor shopping," in which abusers who may or may not have a legitimate ailment visit numerous physicians to obtain drugs in excess of what should legitimately be prescribed. Theft of controlled substances and indiscriminate prescribing and dispensing by practitioners and pharmacists also occur. Most violators who forge prescriptions maintain records to avoid returning to the same pharmacy too soon with the same prescription. The diverted substance of choice varies depending on the part of the state; however, most law enforcement agencies report problems with the diversion of OxyContin, Ritalin, and Vicodin.

OxyContin. The abuse of OxyContin is becoming an increasing problem throughout Maryland. The diversion of the powerful painkiller was first reported in Baltimore in 2000. The Maryland Drug Early Warning System identified oxycodone, the active ingredient in OxyContin, as a chief emerging drug of abuse in 2000. DEA reports that nearly 85 percent of arrests in 1999 for writing false prescriptions in Maryland involved oxycodone products, including OxyContin. Reports from the city of Baltimore and Baltimore and Harford Counties indicate that OxyContin is growing in popularity among teenagers.

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OxyContin provides effects similar to heroin and is readily accessible to abusers. OxyContin tablets are designed to be swallowed whole. Some abusers chew the tablets to destroy the controlled-release coating; others crush them and snort the powder or dissolve the powder in water and inject the solution. Snorting and injecting lead to the rapid release and absorption of oxycodone. OxyContin is sometimes referred to as poor man's heroin despite the high price it commands at the illicit retail level.

OxyContin is distributed illegally on the street or via the Internet. OxyContin purchased by prescription in a retail pharmacy costs approximately $4 for a 40-milligram tablet or $400 for a 100-tablet bottle. Retail prices for OxyContin sold illicitly vary depending on geographic location but generally average $40 per 40-milligram tablet. Thus, a 100-tablet bottle of 40-milligram tablets can be sold illegally for $4,000. OxyContin abuse has led to an increase in thefts and robberies at pharmacies as well as incidents of healthcare fraud.

Ritalin. The abuse of Ritalin (methylphenidate) in Maryland is increasing. Ritalin, an amphetamine-like central nervous system stimulant with properties that are very similar to cocaine, is currently a Schedule II controlled substance. The potential for diversion is high because two to four million children and one million adults nationwide are prescribed Ritalin legally. Ritalin can be ingested orally but many abusers crush the pills and snort or inject the powder believing that the stimulant effect will be enhanced.

Vicodin. A controlled narcotic used as a pain reliever or cough suppressant, Vicodin is a brand name for hydrocodone. Hydrocodone abuse can cause both physical and psychological dependence. The Montgomery County Police Department, Pharmaceutical Diversion Unit, reports that Vicodin is the number one diverted pharmaceutical in the county, and it is being obtained primarily by prescription forgery. In 1999 the Montgomery County Police Department seized 4,000 dosage units of Vicodin during investigations and arrests.

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