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Club drugs

From: Exposure to Psychotropic Medications and Other Substances during Pregnancy and Lactation: A Handbook for Health Care Providers

On this page:

Examples

3,4 methylenedioxymethamphetamine (ecstasy/MDMA); flunitrazepam (Rohypnol); gamma-hydroxybutyrate (GHB); ketamine

Street names

Ecstasy/MDMA: E, XTC, Adam, the love drug

Flunitrazepam (Rohypnol): roofies, roachies, La Roche, rope, rophies, ruffies

GHB: G, liquid ecstasy, liquid x, grievous bodily harm

Ketamine: special K, K, ket, vitamin K, cat tranquilizers

In recent years, certain drugs have emerged and become popular among young adults at dance clubs and raves—large all-night dance parties attended mainly by youth. Of what have come to be collectively termed “club drugs,” MDMA is the most popular, and is often used concurrently with alcohol.

The only province-wide study that reports on ecstasy use in Canada is a 2005 Ontario student survey1 in which 4.4 per cent of all students (ranging from 0.6 per cent of Grade 7 to 9.8 per cent of Grade 11 students) reported ecstasy use, a significant increase from 1993, when 0.6 per cent of students surveyed reported use.

There are no Canadian reports or studies on the prevalence of other club drug use.

Summary and Recommendations

  • Since there is little information on the safety of club drugs, they should be avoided altogether during pregnancy and breastfeeding.

Fetal effects

Major malformations and spontaneous abortion

Of the few studies on the effects of club drugs, one prospective follow-up study of 136 babies exposed to MDMA in utero indicates that the drug may be associated with a significantly increased risk of congenital defects.2 Twelve (8.8 per cent) of the 136 babies in the study had congenital malformations; however, there was no pattern of defects. The study did not include a comparison group, nor did it control for other possible contributing factors.

Another study reported data on 42 women who took club drugs in early pregnancy. There were three elective pregnancy terminations and two spontaneous abortions in this group. Of the 39 live-born babies, including one set of triplets, one baby had a congenital cardiac malformation. However, some of the mothers had used other substances while pregnant that could have harmed the fetus.3

Another study found no increased risk for major malformations or spontaneous abortions.4

Finally, another study of 54 women who had used MDMA during pregnancy compared birth outcomes with 54 unexposed women. No differences were reported in major malformations or spontaneous abortions.5

While there are no reports of fetal effects specific to flunitrazepam, it is a benzodiazepine and so there may be an increased risk of malformations, including oral cleft (see Benzodiazepines section).

Neonatal effects

There are no reports of adverse neonatal effects in infants of mothers exposed to these drugs close to delivery.

The only published study on ketamine, when used as the sole anaesthetic during the induction-to-delivery period (i.e., in women at full term who are undergoing an elective caesarean section), reports that no adverse effects occurred in any of the exposed infants.6

Long-term effects on the child

There are no published studies of the long-term effects of club drug use during pregnancy.

Breastfeeding

There is no information on the effects of using any of these drugs while breastfeeding.

Withdrawal effects on the mother

Patterns of use of club drugs are generally different from those of other substances of abuse (i.e., use is not always daily or regular), and so physical dependence, tolerance and withdrawal are less likely.

Ecstacy: Physical withdrawal symptoms are not usually reported; however, after the drug’s effects wear off there have been reports of symptoms similar to a depressive episode.7

Flunitrazepam: See Benzodiazepines section.

GHB: Stopping regular use abruptly can result in anxiety, tremors, insomnia and other unpleasant, potentially dangerous side-effects, including paranoia with hallucinations and high blood pressure.8

Ketamine: Withdrawal effects have not been reported.

References

  1. Adlaf, E. & Paglia-Boak, A. (2005). Drug Use among Ontario Students, 1997–2005: 2005 Ontario Student Drug Use Survey (OSDUS)—Highlights (CAMH Research Document Series No. 17). Available: www.camh.net/News_events/News_releases_and_  media_advisories_and_backgrounders/osdus2005_highlights.html. Accessed June 29, 2007.
  2. McElhatton, P.R., Bateman, D.N., Evans, C., Pughe, K.R. & Thomas, S.H. (1999). Congenital anomalies after prenatal ecstasy exposure. Lancet, 354 (9188), 1441–1442.
  3. van Tonningen-van Driel, M.M., Garbis-Berkvens, J.M. & Reuvers-Lodewijks, W.E. (1999). Pregnancy outcome after ecstasy use: 43 cases followed by the Teratology Information Service of the National Institute for Public Health and Environment (RIVM). Nederlands Tijdschrift Voor Geneeskunde, 143 (1), 27–31.
  4. Smith, L.M., LaGasse, L.L., Derauf, C., Grant, P., Shah, R., Arria, A. et al. (2006). The infant development, environment, and lifestyle study: Effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics, 118 (3), 1149–1156.
  5. Sarkar, M. (2006, June). Pregnancy Outcome of Women Exposed to MDMA. Abstract presented at the meeting of the Organization of Teratology Information Services, Tucson, AZ.
  6. Baraka, A., Louis, F. & Dalleh, R. (1990). Maternal awareness and neonatal outcome after ketamine induction of anaesthesia for caesarean section. Canadian Journal of Anaesthesia, 37 (6), 641–644.
  7. Huxster, J.K., Pirona, A. & Morgan, M.J. (2006). The sub-acute effects of recreational ecstasy (MDMA) use: A controlled study in humans. Journal of Psychopharmacology. 20 (2), 281–290.
  8. Gonzalez, A. & Nutt, D.J. (2005). Gamma hydroxy butyrate abuse and dependency. Journal of Psychopharmacology 9 (2), 195–204.

Exposure to Psychotropic Medications and Other Substances during Pregnancy and Lactation: A Handbook for Health Care Providers

General issues and background

Psychotropic medications and other substances: Properties, effects and recommendations

Resources

Index of drugs
Image of cover

Related Links