Although alcohol and marijuana are the most common drugs of abuse by adolescents, there is another class of drugs being used by this age group with increasing frequency, known as “club drugs.” Named after the locations of their frequent use (night clubs and raves), club drugs range from stimulants to depressants to hallucinogens.

Commonly used club drug stimulants include 3, 4-methylenedioxy- methamphetamine (MDMA), also known as ecstasy, XTC, and X; and methamphetamine, also known as speed, crank, and crystal. MDMA, a selective serotonergic neurotoxin taken orally, also has hallucinogenic properties. Its effects can be felt within 30 minutes of ingestion and last for up to 8 hours. An overdose could result in sympathetic hyperactivity, abnormal behavior, and fever, which is the main source of the more serious complications, including acute renal failure, seizures, and coma. Management of MDMA overdose includes a cooling blanket for hyperthermia, adequate control of hypertension, and benzodiazepines for agitation and seizures.

Methamphetamine, the N-methyl homolog of amphetamine, acts by increasing the release of and inhibiting the breakdown of catecholamines. It can be smoked, snorted, injected, or taken orally, and its rate of effect is directly related to its method of intake. The side effects of methamphetamine relate to its stimulant effect on peripheral alpha- and beta-receptors and include fever, tachypnea, hypertension, insomnia, anorexia, paranoia, and psychosis. Management of amphetamine overdose includes a cooling blanket for hyperthermia, adequate control of hypertension, and haloperidol for the psychosis.