I am horribly sick. How sick am I? I slogged down to CVS and had so little energy left I said fuck it and bought NyQuil. (Well, CVS generic NyQuil-equivalent. They make the caplets minty. Why do they do this? It's thoroughly disgusting.) I never do this. I am the group's casual drugstore oh-hey-what-does-this-do-really? pharmacologist. I can organize the contents of everyone's medicine cabinet by drug family, and I can tell you what your girlfriend's roommate probably has if you tell me what kind of mystery pills you found lying around the house. I buy all of my anti-snot drugs separately, in their own boxes, so that I can mix and match, and also avoid the phenylephrine that's in everything since for some reason we think this'll make meth extinct, which is actually such shitty decongestant it performed worse than placebo in at least one study.

So the fact that I paid money for a semi-random collection of stuff in a flavored tablet just because it had cough suppressant and an antihistamine in it and I didn't want to think any more should tell you just how I'm feeling. It also reminds me that I promised David I'd ramble about the thing he sent me, where some dude took what was apparently every drug he could get his hands on and then drew pictures of himself while high.

Do not do this. No, I mean really -- do not do this. You will have an incredibly shitty time. Most of these are not recreational drugs. Yeah, yeah, safety, side-effects, long-term blah blah blah, whatever, but a lot of these aren't considered abusable because they aren't any fun. 'Hey, this might kill you,' doesn't really discourage anyone who's that bored and that determined to take the risk, but please believe me when I say that this dude must be some sort of dedicated self-loathing masochist, because anti-psychotics are not entertaining in the slightest, regardless of dose. This is, in fact, why a lot of people who are prescribed them in an attempt to stave off legit psychosis quit taking them. They don't enjoy psychosis, but they enjoy Risperdal even less.

Here's a rundown of the random pills his jackass friends apparently gave him.

Abilify / Geodon / Risperdal / Seroquel / Trazodone / Zyprexa / Haldol

These are all anti-psychotics of various different classes. None of them are recreational. Their primary known MO is to kill off dopamine activity in the brain, sometimes resulting in a slew of Parkinson-like iatrogenic problems in vivo, which is another good reason people hate taking them. A lot of them are structurally related to sedating antihistamines, and common side effects include dry mouth, clumsiness, sleeping 12 hours a day, and being unable to complete a goddamn thought. Slightly more alarming is the sometimes enormous and often unstoppable weight gain seen with these medications, and also the prospect of tardive dyskinesia, which is a thoroughly unpleasant condition involving unsuppressable mouth and facial tics, inability to initiate speech, and shuffling along like an exhausted zombie all the time.

Aside from how unfun they are to take, I would also question where he was getting them. Anti-psychotics are not handed out willy-nilly. They aren't diverted from pharmacies, because no one in their right mind (and, frankly, most people in their wrong one) would think they had any street value. They are used to control the hallucinations of schizophrenia, outright psychosis, and severe paranoia disorders, and for mood control in bipolar I. If he's experimenting with these pills, it means whoever they originally belonged to isn't taking them.

Albuterol

A non-steroidal bronchodilator. Given that this was apparently given with a Valium IV and combined with O2, it probably wasn't intentional -- this is standard ER treatment for an acute asthma attack. Probably an opportunistic work.

Ativan / Xanax / Klonopin / Valium

These are all sedatives of the benzodiazepine class. They vary in the immediacy and duration of effects, Xanax being firstest and fastest, then Ativan, Klonopin, and Valium. Although effective as anxiolytics and hypnotics, they're used sparingly in psychiatry these days, due to addiction problems and the fact that, while opiate withdrawl will make you want to die, benzo detox can potentially actually kill you. As single-dose medications, they're also given to patients who are about to undergo anaesthesia or procedures that tend to freak people out like MRIs and dental surgery and the like. Their general mechanism of action is to disinhibit the production of GABA, which is a substance that quells excitation in the nervous system, producing euphoria and a general lack of motivation or attention span until such point as they knock you into dreamland.

Note that the last work says "Ativan / Haloperidol". I would bet this is the last one for a reason. Lorazepam and haloperidol is the kind of combo the ER staff give you when they want you to go the fuck to sleep, ideally within the next couple of minutes. You can inject it intramuscularly (i.e., wherever you can get a needle on a flailing patient) and it acts very quickly. This is the sort of thing more decorously called "temporary chemical restraints", particularly when given to someone who is having a violent psychotic episode and needs to be subdued before they hurt themselves or others.

Absinthe / Pruno

Real absinthe has wormwood in it. Theoretically this is poisonous, and was once thought to cause hallucinations and particularly nasty side effects in drinkers of the stuff; this was disproved about fifteen years ago, which probably explains why the stuff isn't viciously illegal in the US anymore. There's some amount of thujone, but not enough to do anything. Primarily what's in absinthe is a metric fuckton of alcohol. Pruno is prison wine, typically made by mixing dried fruit -- hence the name -- with yeast and other things, and letting the disgusting mess ferment under the bed for a while. It apparently makes Everclear-laden fraternity punch taste like most delicate champagne.

Adderall / Crystal meth

Dextroamphetamines and methamphetamines. I'm pretty sure we all know how these work by now. You stay very very awake until it wears off, then you become a bitchy mess. Pharmacologically they induce wakefulness by increasing dopamine, particularly to the frontal lobes, which is why they also make you concentrate like a motherfucker.

Ambien

Ambien, otherwise known as zolpidem, is the drug industry's attempt to make something that puts you to sleep as well as a benzo without being horrifyingly abusable like a benzo. They failed. Rather than encourage production of GABA, the z-drugs (there are others in this family, including Lunesta) potentiate it, which is to say they make what you have work better. Since the unpleasant rebound effects of benzo withdrawl is pretty much due to your system having adapted to taking it, and the z-drugs just cause your system to ramp down GABA production instead of downregulating the receptors, it's becoming kind of obvious that they do the same damn thing as benzos, only slower, and with more delirium and hallucinating involved. Ambien is considered to have recreational potential, although it beats me how, since one of the outstanding features of the stuff is that you don't retain any memory of the mad shit you do after taking it. Even those who take the responsible-person dose of the stuff in a genuine attempt to sleep sometimes wake up to their roommates asking them why they were making a peanut butter and remote control sandwich naked at four in the morning.

"Bath Salts"

Fuck only knows what this actually was. Typically "bath salts" means synthetic cathinones, but other things have been found labelled thus. Cathinones are broadly part of the class that includes ephedra and amphetamines, and the original natural kind are present in khat, a plant chewed for a faintly euphoric, energetic high, mostly in the Arab world, including northern Africa. There are a bazillion variations of the stuff, everyone is making them very quickly illegal, and they're fairly dangerous when ingested by, say, an amateur artist who apparently doesn't have any idea what the hell he is doing. Cathinone triggers a deluge of basically all the important brain chemicals, and if you are taking absolutely anything else at the time, it's pretty easy to get yourself into quite a state, if not into a hospital bed.

Buspar / Zoloft

Buspar and Zoloft are anxiolytics and antidepressants. Buspar's method of action is "suspected to differ from SSRI medications", which means nobody knows how the fuck it does whatever it does. It's a serotonin agonist and dopamine antagonist, which, oversimplifying wildly, should generally make your mood lift but flatten terribly. Zoloft is a selective serotonin reuptake inhibitor, which in case you were still wondering about that, means that it discourages the brain from vacuuming up any loose serotonin without touching anything else. (Theoretically. Nobody is terribly clear on any of this. Nor is anyone clear on why SSRIs sometimes make people less depressed, and also sometimes make people more depressed, on top of which they may make people more or less anxious. Brains are complicated.) Neither is of these is considered to have any abuse potential -- Buspar is used for generalized anxiety disorder, but it doesn't seem to be GABAergic and isn't known to give the euphoric effects of benzos. Beyond me why he bothered. Taking a bunch of SSRIs at once isn't recreational, although if you're ambitious enough about it you can land yourself in hot water with serotonin syndrome.

Butalbital

Butalbital is a barbiturate, which was the class of hypnotic sedatives widely in use before they noticed the things were addictive and dangerous, whereupon they hastily invented this new class of wonder drugs called benzodiazepines to fix that! Really the only thing they managed to fix was the outright toxicity; benzos are surprisingly difficult to OD on without also snorking down other depressants, but barbiturates could kill you outright. (Marilyn Monroe officially died of an overdose of a different one, Nembutal.) They typically aren't used alone as sedatives anymore, but barbiturates are sometimes present in some combo medications like muscle relaxers and migraine treatments.

Cephalexin

This is a cephalosporin antibiotic. The class is not known for any psychotropic or neurological side-effects. Any "trip" he experienced was the result of psyching himself out.

Cocaine / Ritalin

Cocaine and Ritalin are broadly in the same class of dopamine and norepinephrine reuptake inhibitors. (Explains a lot about why ADHD kids sometimes self-medicate with coke, doesn't it?) Cocaine, a naturally-occurring alkaloid, also inhibits reuptake of serotonin. Ritalin (methydiphenidate, a synthetic drug) is longer-acting and less toxic, with dangerous overdoses being rare and mostly multi-drug attempts at self-harm; you can OD on cocaine, and death of acute cocaine intoxication is frequently from heart attack or stroke, due to the boost in blood pressure. Both of them produce a distinct lifting of mood, particularly in those who don't have narcolepsy or ADHD to begin with, and a fairly unpleasant crash afterwards, as all the fun chemicals drain out of your brain at the same time. Apart from the acute OD risks of cocaine, there are some studies indicating that occasional use of either doesn't have much in the way of repercussions, but chronic use of either has been known to result in a chemical psychosis in susceptible individuals.

Cough Syrup (DXM) / Nitrous Oxide (NO2) / PCP

Both DXM and NO2 are mildly hallucinogenic dissociatives. Nitrous is widely used for twilight anaesthesia when full sedation isn't an option, particularly in dental work where the scopolamine normally used for twilight would have unacceptable side effects. It's also odorless and tasteless and cheap and therefore used as a propellant in whipped cream, which is the pretext by which most recreational uses get a hold of it. Over the counter "cough syrup" in the US contains dextromethorphan hydrobromide, a non-narcotic antitussive. It happens to be an enantiomer of one of the synthetic opioids, although due to the mirror-image shape it doesn't have an opioid mechanism of action. I can tell you from personal experience that the "cough syrup" picture looks approximately right; one of the more curious effects of the drug is to divorce you from your physical corpus in such a way that you end up seeing a somewhat distorted, eye-heavy reflection in the mirror, as if it doesn't belong to you.

Phencyclidine is also a hallucinogenic dissociative, but the resemblance pretty much stops there. PCP is an NMDA receptor antagonist, like DXM and ketamine, but it also exhibits significant D2 receptor agonist activity -- in layman's terms, it does the exact opposite of what the anti-psychotics above do, and tends to make people paranoid and generally whacko. It was once used as an anaesthetic, as ketamine still is in pediatric and veterinary practice (we got a ketamine'd cat back from the spay/neuter clinic once still tripping balls -- only cat we ever had who thought that was fun), which means people on PCP also tend to not be dissuaded by pain.

Dilaudid / Morphine / Hydrocodone / Oxycodone / Lortab / Percocet

A variety of opioids. Morphine is actually the great-granddaddy of the class, being derived straight from opium poppies; the others were synthesized from it and related compounds in various different ways. Some of these are the same, there -- Dilaudid is dihydromorphinone, but Percocet is oxycodone + APAP, and Lortab is an alternate name for Vicodin, which is hydrocodone + APAP. The APAP (acetaminophen to Americans; paracetamol to most others) is mostly in there to punish you for trying to get high on the stuff by killing your liver. It is possible to separate the two out, as was once discovered by a friend who was allergic to Tylenol, when she discovered her dentist had given her Vicodin instead of Vicoprofen by mistake and she had no one less-high to drive her back out to correct the error. Common stuff both to use and to abuse.

Huffing

Sniffing paint/computer duster/lighter fluid/whatever to get high is called huffing, and one of the mechanisms of action is hypoxia. This is as idiotic as you think it is. Other effects depend on what you're huffing, but in general, gasoline and derivatives are intoxicating much like alcohol, "canned air" (computer dusting gas) varies, but is usually a compound that ends in scary things like -fluoroethane, and are otherwise used as ozone-eating refrigerants.

Marijuana / Brownies / Hash / Butane Honey Oil

Various methods of extracting and ingesting the natural cannabinoids from marijuana. Anyone who has gone to college or watched a Cheech & Chong movie has a pretty good idea of what they do. Marijuana itself has an extremely low toxicity -- the LD50 for marijuana is so high you'd stand an equal chance of dying if that much weed fell on your head -- but there's some risk associated with the prep of things like honey oil, which poses about the kind of danger you'd expect when stoners play with butane.

Mushrooms / DMT

Psilocybin and dimethyltryptamine are both psychoactive hallucinogens in the tryptamine class. Other tryptamines include the endogenous neurotransmitters serotonin and melatonin, and synthetic migraine medications like sumatriptan. These things make us see weird shit when we take a lot of them because [insert reasons here when science catches up]. It's fairly difficult to injure yourself with shrooms or DMT directly, but given that the effects are unpredictable at best (and not necessarily entheogenic), smart people take this stuff in a nice place with nice people who are not knocking back mushroom tea, just in case.

Nicotine

Nicotine is a stimulant poison developed by plants in order to get rid of pests. It works as an acetylcholine receptor agonist -- just to give everyone some perspective, acetylcholine is one of the main neurotransmitters in the human body, an agonist is something that activates a receptor without the normal chemical needing to be in place, and the main use of an acetylcholine receptor antaognist is and always has been killing stuff. Nicotine is still used as an insecticide, and other classes of compounds that work via the same mechanism include the organophosphates, both the ones used for bug murder and the ones used as nerve gas. Just in case you needed more motivation to quit smoking.

Salvia divinorum

The genus Salvia is what's commonly known as the sage family; Salvia divinorum, or diviner's sage, is a variety smoked to produce intense but short-lived hallucinations. The effects are often compared to LSD, in that they're reported to be vivid, colorful, and have a sort of cosmic quality to them; but while LSD gives you plenty of time to prepare while you wait for it to come on and lasts many hours, salvia tends to hit you like a brick and then vanish into the night. The drawing is noted to be before/after, because the whole experience typically takes less than five minutes and you pretty much lose all radio contact with your limbs during, although some emotional after effects may persist for a while. Users are often left impressed with the strange profundity of whatever they saw, and the stuff is not recommended for idiots or anyone otherwise experiencing psychological problems.

Comments

  1. I am actually really impressed that he managed to do anything after taking Abilify, because its effects on me, for the first week I'm taking it, is always to turn me into a complete zombie. I mean, I literally do not remember anything that happened for seven days two weeks ago. I know the days happened because today's date matches. But holy cow.

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