MDMA: also known as Ecstasy, E, X (or for those keeners…3,4-methylenedioxymethamphetamine)

One of the most commonly used substances in the club scene, primarily for its stimulatory effects, euphoric properties and emotional openness. MDMA is usually taken in pill form but can be mixed with a variety of other substances.  Not surprisingly as it is mostly a stimulant, signs of intoxication are dilated pupils, tachycardia, hyperthermia, sweating, tremor and decreased LOA.  As far as medical cautions dehydration is the key component of a bad night on MDMA.

FUN FACT: Patients who are also on SSRIs/SNRIs/MAOIs run the risk of serotonin syndrome – beware of extreme hyperthermia and seizures.

KETAMINE: also known as K, Ketalar, Special K

Although classically used as a horse tranquilizer, ketamine has become a staple in the club scene for its dissociative properties.  Most commonly found in a powder form, it can be snorted, ingested and injected.  In small doses it causes relaxation and auditory/visual sensations.  In larger doses (aka a K hole) patients can become catatonic and even progress to apnea.  These patients need to be monitored very closely with special attention to their airway.  Luckily these symptoms are self-limited (~20-30minutes) as ketamine has a short half-life.

FUN FACT: Contrary to popular belief giving someone who is in a k-hole sugar will NOT make them come out of it any sooner.

GHB: also known as Gamma Hydroxy Butyrate, G, Liquid E, Liquid X

In it’s pure form it is a clear, colourless, salty liquid but can be coloured or made into a powder.  It is used for its euphoric properties BUT due its small therapeutic index the amount patients need to get their ideal high isn’t that much less than they need before they black out.  Watch for altered LOA, bradycardia, bradypnea, hypotension and seizures.  GHB can also be used maliciously for the means of sexual assault.

FUN FACT:  Prior to 2000 GHB was legally sold in Canada at health food stores as a sleeping aid.
Brodie Nolan is a 4th year medical student at the University of Toronto. Brodie has 6 years of experience as an Emergency Medical Responder, and has interests in both pre-hospital care research and Emergency Medicine.