When the drug of choice is a drug of confusion: embalming fluid use in inner city Hartford, CT

Illy: clinical and public health implications of a street drug

We conducted a prospective, observational study of patients presenting to an emergency department with suspected use of a street drug known as "illy" to identify the active ingredient in "illy" and describe the clinical presentation and outcomes associated with its use. Vital signs, mental status, restraint use, and urine toxicology (UT) results were recorded. Patients were interviewed about drug use patterns and co-ingestants. Fifty-nine patients (89.9% males) with a mean age of 22 years (SD +/- 4.37) were enrolled over a 34-month period. UT was obtained in 61% of patients; of these 91.7% tested positive for phencyclidine (PCP). Seventy-eight percent of patients were discharged, (15.3%) required psychiatric evaluation; 3 were admitted, one died in the ED. Patients reported concurrent drug use (54%) and at-risk drinking (50%). PCP is likely the active component of "illy". Most patients require observation and supportive care only, however major complications including death may occur.

Behavioral effects of orally administered glycine in socially housed monkeys chronically treated with phencyclidine

RATIONALE

Schizophrenia is a major mental disorder. Dissociative anesthetics such as phencyclidine (PCP) produce a syndrome in humans that is clinically indistinguishable from schizophrenia by blocking neurotransmission at N-methyl-D-aspartate (NMDA)-type glutamate receptors. NMDA receptors in brain are modulated by the amino acid glycine (GLY), which reverses neurochemical and behavioral effects of PCP in rodents. The present study investigates GLY effects on PCP-induced behavior in primates.

OBJECTIVES

In primates, PCP induces characteristic behavioral symptoms that can be used to model positive and negative symptoms of schizophrenia. This study investigated the effects of GLY treatment in ten socially housed monkeys receiving chronically infused PCP.

METHODS

Ten monkeys received escalating then stable doses of continuously infused PCP through a series of subcutaneously implanted osmotic minipumps. During a segment of the highest PCP dose period, monkeys were concurrently treated with glycine (2 g kg(-1) day(-1) bid p.o.). Behavioral observations were recorded during baseline and treatment periods.

RESULTS

Chronic PCP treatment was associated with a progressive decrease in stereotyped pacing and a progressive increase in scanning behavior. Eight of ten animals had one or more episodes of extreme motoric and physiological responses precipitated by stressful events. GLY treatment significantly reversed the effects of PCP on stereotyped pacing but had no effect on scanning.

CONCLUSIONS

The results support GLY treatment as beneficial for negative symptoms of schizophrenia. Although further validation is needed, the results also indicate that chronic PCP in primates may be an appropriate model system for development of drugs targeting positive and negative symptoms of schizophrenia.