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Research Chemicals – Use Among High-Risk Youth and how to obtain
31
Jul
Jul
Research Chemicals”: Tryptamine and Phenethylamine Use Among High-Risk Youth
Research Chemicals such as Tryptamines and phenethylamines are two broad categories of psychoactive substances with a long history of licit and illicit use. Profiles of users of recently emerging tryptamines and phenethylamines are nonexistent, however, since surveillance studies do not query the use of these substances. This manuscript describes the types, modes of administration, onset of use, and context of use of a variety of lesser known tryptamines and phenethylamines among a sample of high-risk youth. Findings are based upon in-depth interviews with 42 youth recruited in public settings in Los Angles during 2005 and 2006 as part of larger study examining health risks associated with injecting ketamine. Youth reported that their use of tryptamines and phenethylamines was infrequent, spontaneous, and predominately occurred at music venues, such as festivals, concerts, or raves. Several purchased a variety of these “research chemicals” from the Internet and used them in private locations. While many described positive experiences, reports of short-term negative health outcomes included nausea, vomiting, diarrhea, disorientations, and frightening hallucinations. These findings, based upon pilot study data, move toward an epidemiology of tryptamine and phenethylamine use among high-risk youth.
Keywords: hallucinogen, high-risk youth, injection drug user, phenethylamine, tryptamine
Research Chemicals – Introduction
Tryptamines and phenethylamines are two broad categories of psychoactive substances that produce a range of hallucinogenic effects. More commonly known tryptamines, such as LSD, Ibogaine, and psilocybin (“magic mushrooms”), and ordinary phenethylamines, including mescaline and MDMA (“ecstasy”), have been widely researched (see Griffiths, Richards, McCann, and Jesse, 2006; Kalant, 2001; Nichols, 2004; Sewell, Halpern, and Pope, 2006; Vastag, 2005). However, little is known about less common tryptamines, such as DMT, AMT, and 5-MEO-DiPT (“Foxy”), or phenethylamines, such as 2C-B (“Nexus”), 2C-E, and 2C-T-7 (“Blue Mystic”). This study describes the types and contexts of use among these lesser known tryptamines and phenethylamines among a sample of high-risk youth.
Tryptamines and phenethylamines have a long history of licit use for spiritual and medicinal purposes and illicit use for recreational purposes (Halpern, 2004; McKenna, 2004; cf. Jacob and Presti, 2005). More recently, tryptamines and phenethylamines, such as DMT, 2C-B, and 5-MEO-DIPT have been consumed by young people in club and rave environments (Measham, 2004; Sanders, 2006; cf. Yacoubian et al., 2004), and traces of these substances have been found in pills sold as “ecstasy” in the United States, the UK, and elsewhere (Australian Bureau of Criminal Intelligence [ABCI], 2002; Carmo et al., 2005; Drug Enforcement Administration [DEA], 2003, 2005; Laks et al., 2004; Winstock, Wolff, and Ramsey, 2001). The Internet has also facilitated the illicit use of tryptamines and phenethylamines in recent years. Various Web sites now offer information about where to find plants that naturally contain a tryptamine or phenethylamine and how to extract these drugs from plants (see Halpern, 2004). Tryptamines and phenethylamines can be ordered over the Internet through companies selling them as “research chemicals” (McCandless, 2004; cf. Halpern and Pope, 2001; Kikura-Hanajiri, Hayashi, Saisho, and Goda, 2005).
Despite increased access at raves and on the Internet, tryptamines and phenethylamines are not included in drug monitoring surveys and, therefore, surveillance data do not exist. A handful of clinical accounts, however, have emerged in recent years, each concerned with individual cases of one type of tryptamine or phenethylamine (e.g., Carmo et al., 2005; Muller, 2004; Tanaka, Kamata, Katagi, Tsuchihashi, and Honda, 2006; Wilson, McGeorge, Smolinske, and Meatherall, 2005). Moreover, international concern over tryptamines and phenethylamines has increased. In Great Britain, for instance, most tryptamines and phenethylamines were outlawed in 2002 and are now considered Class A (Schedule I) substances (see McCandless, 2004). In the United States, the DEA classified some tryptamines and phenethylamines as Schedule I substances but not others. For instance, while it remains illegal to possess DMT or 2C-B, possession of their chemical cousins, 5-MeO-DMT or 2C-I, continues to be legal. Under the Analogue Statue of the Controlled Substance Act, however, it is illegal to traffic any substances chemically analogous to scheduled tryptamines and phenethylamines. Due to the increasing availability of these substances on the Internet, the DEA launched Operation Web Tryp in 2004, which targets individuals and companies illegally selling tryptamines and phenethylamines. Despite the increasing restrictions on access and manufacture, many of the tryptamines and phenethylamines discussed here remain legal to use and posses.
Methods
The use of 4-AcO-DET crystals and phenethylamines among high-risk youth was discovered during a two-phase, three-city study examining health risks associated with injecting ketamine (see Lankenau, 2006; Lankenau et al., 2007; Lankenau and Sanders, 2007). Ketamine is a dissociative anesthetic that has emerged as a drug commonly used in the dance/rave scene (Jansen, 2001) and among subgroups of young IDUs (Lankenau et al., 2007). Phase one comprised a cross-sectional, ethnographic survey of young IDUs recruited in New York, New Orleans, and Los Angeles. Phase two consisted of a two-year longitudinal study of young IDUs recruited in Los Angeles during Phase one. Data described in this manuscript are largely based upon respondents recruited in Los Angeles; therefore, the discussion of methods primarily focuses on the Los Angeles site (see Lankenau et al., 2007, for a discussion of three-site methodology).
Phase One
Data collection began with a community assessment process (CAP; Clatts, Rees Davis, and Atillasoy, 1995) by two trained ethnographers in Los Angeles to determine the locations of groups of young people who injected ketamine. Ethnographers interviewed key informants, such as directors of homeless shelters, health clinic staff, needle exchange coordinators, or outreach workers. Based upon the CAP, ethnographers recruited young ketamine injectors using a combination of chain referral sampling (Biernacki and Waldorf, 1981; Penrod, Preston, Cain, and Starks, 2003) and targeted sampling (Watters and Biernacki, 1989). Guided by this sampling methodology, ethnographers entered three neighborhoods in Los Angeles reported to contain populations of young people and IDUs, observed the activities in the area, engaged young people in informal conservations, and screened individuals who might meet the enrollment criteria. Recruitment and observations occurred during an 18-month period during 2005 and 2006.
Young people were eligible for study enrollment if they were between the ages of 16 and 28 and had injected ketamine at least once within the past two years. These criteria were selected to enroll a sample of young IDUs who could describe recent ketamine injection events. A series of screening questions focusing on health behaviors, recent drug use, and history of homelessness were asked in order to hide the true enrollment criteria. Before beginning an interview, individuals signed informed consent documents approved by an Institutional Review Board at Childrens Hospital Los Angeles. Each interview lasted between 60 and 90 minutes and was conducted in the vicinity of recruitment locations, either in private areas of restaurants, parks, or in the ethnographer’s offices. Subjects received a $20 cash payment after the interview, as well as referral information for local needle exchanges, health clinics, homeless shelters, and other service organizations for high-risk youth populations.
Phase Two
Ketamine injectors recruited in Los Angeles during phase one were eligible for enrollment into the phase two longitudinal study. All IDUs consented for participation in a series of seven follow-up interviews occurring approximately every 3–4 months. During the cross-sectional baseline interviews in Los Angeles, locator information, such as telephone numbers and e-mail addresses, were collected from each participant. Additionally, ethnographers provided each participant with a toll-free telephone number that connected directly to an ethnographer’s cell phone. Respondents who traveled outside of Los Angeles following baseline were interviewed over the telephone, and payments were sent via Western Union. Cash incentives increased for each interview by $5, so that participants earned $25 for the first follow-up, $30 for the second follow-up, and so on. Subjects were consented at each follow-up interview to detail any changes to the study design and to remind them of their rights as human subjects.
Research Chemicals Measures and Analyses
The phase one interview guide, which was administered to all subjects recruited in New York, New Orleans, and Los Angeles, contained eight domains or modules and captured data on demographics, drug using histories, recent drug use, and risk behaviors. The phase two interview guides, which were utilized only in Los Angeles, followed up on key risk behaviors, such as changes in homeless status, injection drug using behaviors, criminal justice involvement, and drug using behaviors. Additionally, new modules were included in each subsequent interview to probe important areas that emerged during earlier interviews, such as use of tryptamines and phenethylamines.
Interview guides, which contained both structured, close-ended questions and probing, qualitative questions, were administered on laptop computers using Questionnaire Development Software, and interviews were recorded with digital recorders. Open-ended, qualitative questions were analyzed using ATLAS ti., and closed-ended quantitative questions were analyzed using SPSS and SAS.
Discussions of tryptamines and phenethylamines were first encountered during phase one interviews in New York. After being read an extensive list probing for overall substance use, youths were then asked, “Have you used any other drugs?” Ethnographers in Los Angeles and New Orleans later discovered during phase one interviews that some youth mentioned using these same drugs. Tryptamines and phenethylamines use, however, was most extensively probed during the first follow-up interview in Los Angeles when youth were asked about the types, administrations, frequencies, locations, and experiences regarding their tryptamine and/or phenethylamine use. We report findings based upon data collected in Los Angeles since descriptions of tryptamine and phenethylamine use were most complete at this site.
Results
Research Chemicals Sample Characteristics
The Los Angeles sample consisted largely of young White men, with a median age of 22, with histories of homelessness, incarceration, and drug treatment (see Table 1). Out of these youth, 42 mentioned using at least one tryptamine and/or phenethylamine in their lifetime. Youth who had used a tryptamine and/or phenethylamine were likely to report being male, White, heterosexual, and a “traveler.” Travelers are nomadic, predominantly homeless youth who travel around the country for various reasons (see Des Jarlais, Perlis, and Settembrino, 2004; Hathazi, Lankenau, Sanders, and Jackson-Bloom, 2005; Hyde, 2005).
Table 1
Selected demographic characteristics
| Los Angeles (n = 101) | Tryp/phen users (n = 42) | |
|---|---|---|
| Median age | 22 | 22 |
| Male | 64.7% | 69.0% |
| Race and ethnicity | ||
| White/Caucasian | 73.5% | 88.1% |
| Black/African American | 1% | — |
| Hispanic/Latino | 5.9% | 2.4% |
| Asian or Pacific Islander | 1% | — |
| Native American | 1% | — |
| Multiracial background | 14.9% | 9.5% |
| Sexual identity | ||
| Heterosexual | 75.2% | 83.3% |
| Gay/lesbian | 2.0% | 2.4% |
| Bisexual | 19.8% | 9.5% |
| Other/undecided | 3.0% | 4.8% |
| High school graduate/GED | 60.4% | 61.9% |
| Homeless | 94.1% | 95.2% |
| Homeless traveler | 68.3% | 81.0% |
| Ever homeless | 100% | 100% |
| Employed full/part time | 12.9% | 11.9% |
| History of drug treatment | 58.4% | 61.9% |
| History of mental health care | 75.2% | 71.4% |
| Ever arrested | 94.1% | 95.2% |
| Ever in jail | 88.1% | 92.9% |
| Ever in prison | 14.9% | 19% |
| Tested for HIV | 94.1% | 90.5% |
| HIV positive | — | — |
| Tested for HCV | 87.1% | 83.3% |
| HCV positive | 24.8% | 28.6% |
The sample also has an extensive history of drug use (see Table 2). Categorizing these youth as “heroin users,” “cocaine users,” or “ketamine users,” however, would be inaccurate. Rather, these youth could be more accurately described as “polydrug users” who regularly used two or more drugs simultaneously or over a short period of time (e.g., over the course of a day; see Lankenau and Clatts, 2005; Sanders, 2006). Youth who used a tryptamine and/or phenethylamine had an overall earlier mean age of initiating most other illicit substances, including common tryptamines, such as LSD and psilocybin mushrooms, and a common phenethylamine, ecstasy. Moreover, tryptamine and phenethylamine users were more likely to have ever used other drugs, including LSD, ecstasy, and psilocybin mushrooms, but also many others, such as PCP, GHB, cocaine, crystal methamphetamine, and a range of prescription drugs non-medically.
