Pubdate: Thu, 22 Jul 1999 Source: Village Voice (NY) Copyright: 1999 VV Publishing Corporation Contact: 36 Cooper Square, New York, NY 10003 Feedback: http://www.villagevoice.com/aboutus/contact.shtml Website: http://www.villagevoice.com/ Author: Frank Owen with additional reporting by Steph Watts HIGHER AND HIGHER DRUG COCKTAILS Pleasures, Risks And Reasons (New York City)-Dormil is HIV positive. Each day he takes four different AIDS medications, including AZT. For recreation, he goes to dance clubs where he gets high on a nocturnal medley of Ecstasy, Special K, and crystal methamphetamine. Fidgeting in his seat at a Chelsea coffee shop, he claims he consumes only modest amounts of illegal narcotics, though his friends say otherwise. From the outside at least, he appears hale and hearty. "My doctor tells me not to do party drugs, but they haven't affected my health in any way," professes the department-store clerk, who gets a thorough medical checkup every three months. "It's therapeutic. It's a stress-reliever. It allows me to accept the fact of my disease and go forward with my life." Dormil (not his real name) believes his positive attitude is why he has so many good trips. He talks of his own polydrug experience as "blissful," "healing," and "like a workout for the mind." But he admits that other users are less responsible than he claims to be. He tells of Viagra sex parties where-besides Bob Dole's favorite tablet, purchased over the Internet- other substances on offer included Ecstasy and crystal meth. "The idea is that the Viagra pumps blood into your penis, the Ecstasy makes you feel all sensual and tingly, and the crystal meth makes you fuck all night," he explains. What is supposed to be an erotic recipe sounds more like a prescription for a heart attack. This weekend, and every weekend on dance floors across the city, thousands of teeth-grinding subjects like Dormil engage in an underground research project. Amid flashing lights and pounding music, untutored freelance pharmacologists conduct experiments on their own bodies to determine what happens when one consumes a bewildering array of pills and powders in the confined and humid setting of a nightclub. The results are not always pretty. Earlier this year, a fragile teenager named Jimmy Lyons died at the Tunnel disco from a popular drug cocktail combining the animal anesthetic ketamine, better known as Special K, with the amphetamine derivative MDMA, a/k/a Ecstasy. The subsequent closing of the Tunnel and Sound Factory (both venues have since reopened) frightened club owners and promoters all over town. Security guards conduct humiliating body searches of patrons, who by now are used to having their privacy routinely violated. These days, it's not uncommon to find some burly bouncer peering over the stall while you're trying to use the toilet. Hastily tacked up signs now appear on bathroom walls: "Do not smoke pot and Special K. It puts you in K-hole" and "The management has absolutely zero tolerance for . . . drugs [that] induce coma and cardiac arrest." One club even went so far as to hire a private ambulance on Saturday nights, in case customers overdose. The paranoia is further exacerbated by persistent rumors that the Drug Enforcement Agency has snitches planted in all the major hot spots. But dancehalls are not the only locations where people OD. Thirty-seven-year-old Anne Marie Capati suffered a stroke last year at a Crunch fitness center on Lafayette Street. Her family alleges in a lawsuit that she was killed by nutritional supplements recommended by her trainer. (Crunch says the trainer denies giving her supplements.) Capati's death- no less tragic than Jimmy Lyons's- was widely covered in the local media. But her demise has inspired no moral crusade to shut down gymnasiums. Despite the ongoing crackdown on clubland, thrill-hungry nightcrawlers still continue to experiment with an alphabet soup of chemicals: MDMA, MDA, GHB, Special K, LSD, 2CB, as well as old standbys like crystal meth and cocaine. (See sidebar glossary.) Add alcohol and nicotine, as well as various prescription medications ranging from antidepressants to protease inhibitors- not to mention the anabolic steroids commonplace among disco denizens- and you have a volatile mixture of unpredictable chemical cross-reactions that turns many clubgoers into dancing drug stores. Or burned-out zombies. "It's crazy," says one veteran dealer, who is in the process of quitting the business. "The entire New York club scene revolves around drug cocktails. I've lost count of the number of people I've seen collapse on their faces after mixing GHB with alcohol. It's rare that people go out and do one thing anymore- they have to mix two or three things at once to get that extra boost. One addiction feeds the other." Hedonism has a dark side. "People want to go out and get fucked up because they're not happy," the anonymous dealer continues. "They're trying to escape for the night. They don't want to be where they are. And if they are there, they don't want to have to remember it." But polydrug use doesn't have to be synonymous with immoderation. Some club patrons go to great lengths to figure out what each drug does individually and in combination. Besides, you can snort yourself into oblivion using just a single substance such as cocaine. It would be naive to deny, though, that once you've enjoyed MDMA, for instance, there's not a natural curiosity to try other chemicals. In many ways, Ecstasy is the gateway drug of the '90s. When the supply is scarce or adulterated, clubgoers try replacement substances. "I've seen people do E and when the E doesn't work, they do K and GHB, and drink. And then they fall on the floor in convulsions," said one bartender who has worked at some of the druggiest hot spots in New York. "It's very scary. It's to do with how bad the person's reality is, and how bad they want to escape from it." Disco polypharmacy involves risk. Nobody knows how safe some of these mixtures really are. Some say that not necessarily all combinations are bad for you- for instance, partygoers claim that swallowing Ecstasy followed by LSD (known as "candy flipping") can be extremely therapeutic. "I've interviewed a lot of people about the practice . . . and I have had no reports of any adverse physical or psychological effects from the combination, other than the limited adverse effects that can be caused by taking each drug separately," says Dr. Katherine Bonson, a psychopharmacologist at the National Institute of Mental Health. But other combos- say, the mix of alcohol, GHB, and ketamine referred to as a "Special K-lude"- appear more fraught with peril. Still, finding out authoritatively which blends are chancey is difficult because of the paucity of reliable scientific research. What happens, for instance, when you take AIDS medications with MDMA, a common combo in gay clubs? How important is individual genetics in determining how a person metabolizes various drugs? Why can one person die from combining E and K, while a hundred others will swear it's one of the most life-affirming highs available, particularly when you sniff K after ingesting the E? Conclusive answers are not easy to find. For one thing, pharmaceutical companies don't test products for bad reactions with illegal substances. Chemist and author Dr. Alex "Sasha" Shulgin, who wrote the drug bibles PIHKAL (Phenethylamines I Have Known and Loved) and TIHKAL (Tryptamines I Have Known and Loved) and rediscovered MDMA in the early '70s, points out that "There's been precious little clinical study done on these drugs individually, and in combination, virtually nothing- because of the 'War on Drugs,' no one in a position of authority will approve it. In our day and age, there's no way you can set up a study of the physical-pharmacological action of something that's illegal." Filling the knowledge gap left by authorities are the inevitable rumors- urban myths about how MDMA drains your spinal fluid, or how acid is cut with rat poison. Of course, there's always the Internet, which features acres of information about illegal pharmaceuticals. But figuring out how much of that info is reliable is frustrating. "Because it's so difficult to do above-ground research, there's been this flourishing of semi-informed underground research," says Rick Doblin, founder of MAPS (the Multi- Disciplinary Association for Psychedelic Studies), which in 1996 conducted a chemical analysis of Ecstasy samples taken from clubs and raves, and found that roughly half the hits contained no MDMA whatsoever. The good news (available on Doblin's Web site, www.maps.org) is that the stuff the bogus E was cut with- Sudafed, caffeine, cough suppresant, chalk- isn't that harmful. Dr. Bonson is another source of dependable data. For the last five years, she has conducted an ongoing nonclinical Internet survey (at her e-mail address, of people who mix illegal with prescription drugs, focusing on the interaction between hallucinogens and antidepressants. "If you were on Prozac, or other SSRIs [Seratonin Selective Re-Uptake Inhibitors], what happened was there was a diminishment of response to drugs like LSD and MDMA," she reveals. "That's in contrast to people taking Lithium or a tricyclic antidepressant, who had a much greater response to the hallucinogens, to the point where some lapsed into an unpleasant fugue state where they didn't know where they were." But the most hazardous concoction she found was Ecstasy and MAO inhibitors like Nardil. "The combinations," she warns, "can produce an extremely dangerous increase in blood pressure known as hypertensive crisis. Which can lead to death." Alex Shulgin spearheaded the current polydrug boom with his pioneering work in the '60s on the synthesis of new psychoactive substances, which he tested on himself. He and his wife, Ann, also a researcher, submit that drug combinations interact in two different ways: potentiation and synergism. Potentiation is when one drug increases the activity of another; synergism is when each drugs enhances the activity of each other. As an example of synergism, the Shulgins cite what they regard as the benign practice of taking MDMA followed a couple hours later by other psychedelics like ketamine or 2CB. "The best effect is when coming down off the MDMA, take a lower dose of 2CB," advises Ann. In this way, Ecstasy boosts the action of the 2CB. By contrast, as an example of potentiation, the Shulgins refer to the popular clubland combo of alcohol and the liquid steroid GHB. Both drugs are depressants which slow down the nervous system. When taken together, the alcohol greatly increases the GHB's potential for inducing a coma. Like a Boy Scout, Dexter (not his real name) always comes prepared. A self-described high-school nerd who, with aid of gyms and chemicals, blossomed into a sex magnet, he takes his drugs seriously. A typical Saturday night for the thirtysomething software executive begins around 8 p.m. with a hearty meal, to sustain him for the night ahead. Around midnight, back at his apartment, he takes a hit of Ecstasy. He also consumes Ammodium AD (because MDMA gives him diarrhea), followed by Carbo-Force, a liquid carbohydrate supplement. Ten minutes before the Ecstasy is due to hit, he heads out, drinking a bottle of water in the taxi en route to the club, hiding a milliliter measure in his shoe. Once in the club, he buys more water. With the E kicking in, he and his friends head onto the dance floor, where they do their first bump of Special K for the night, followed later by GHB specially made up for them by a chemist acquaintance. (They avoid such physically addictive substances as heroin, cocaine, and crystal meth.) "I use the Ecstasy as the base drug, and then afterward use the K as a temporary effect to heighten the E experience," Dexter says. "I find that drugs are a lot more effective in a group situation where everybody is high. The ritual get-together enhances the drugs. It's more a social thing than a drug thing." Because of the crackdown in clubland, customers increasingly take the drugs before entering clubs, or smuggle them past security, rather than buying from house dealers. "The drugs are very impure in the clubs at the moment," says one dope peddler. "Everybody goes, 'Oh, this is the best from Amsterdam.' They don't have a clue. It's probably from somebody's bathtub in South Jersey. In a club, how can you check?" As a result, club-kid chemists now synthesize their own connoisseur brands at home- for instance Chanel No. 9, an expensive mix of cocaine, MDMA, and Special K. "The high is intense and powerful," reports one user. "As you come down from the coke, you feel the tingling relaxation of the Ecstasy, followed by the intermittent euphoria brought on by the K. It then becomes like a rollercoaster, repeating in waves up and down for hours." Clubland features more blends than Starbucks. But combining one drug with another is not confined to dance floors. Pharmaceutical companies are the biggest polydrug peddlers on the block: cough and cold medicines such as Nyquil P.M. are usually drug mixtures, and the current mania for so called "lifestyle drugs" only adds more to the mix. The psychedlic tea "ayahuasca," which pop stars like Sting rave about, is an ancient polydrug example- two rain-forest plants are combined; one contains an MAO inhibitor, which deactivates stomach enzymes that would otherwise nullify the effect of the main ingredient, the powerful hallucinogen DMT. In the modern world, from Prozac to MTV, from special-effects blockbusters to those cruel silver machines found in gymnasiums, society seems rife with mood-altering simulators and stimulators designed to enervate, sedate, or change some aspect of personality or biology. There are plenty of technologies available that allow you to achieve multiple highs without hard drugs. Normal folks relaxing at home, sipping a glass of red wine then drinking a cup of coffee while flicking through TV channels, rely as much on polydrugs as the nocturnal freaks of clubland. Bombarded by fast-cut images and free-floating visuals, the trippy, media-saturated fabric of everyday life encourages all of us to explore different forms of reality concurrently. "The whole culture tends towards blending," claims Rick Doblin. "You want multiple things happening simultaneously. I don't think that's inherently a bad thing." (end of article) - ---Sidebar---- DOING POLYDRUGS SAFELY Given that, among young hipsters, the desire to get high is perennial no matter how harsh the season, what should the disco polydrug user watch out for, other than the law? The Voice does not endorse illegal drug use, but experts and experienced clubbers we talked to offer the following advice: * Avoid taking different drugs that do the same thing8B like piling stimulants on top of stimulants. * Don't mix psychedelics and booze. * If you're unhappy or depressed, don't get high. * Be conscious of your surroundings. In a club, the ambient temperature of the room, the proximity of the bodies, and the disorienting visual and sonic assault can fuse to create a potentially hazardous environment for the unwary user. * Make sure you're in the company of responsible friends who will come to your aid if anything goes wrong. * Rely on the power of your imagination as much as the potency of chemicals. * If you're doing a new drug for the first time, try it by itself before combining it with other substances. * And, as Ann Shulgin counsels: "Make sure you stay hydrated and don't overdo things. Watch out for heavy sweats, chills, and vertigo. . . . Most of all, be conservative." * Plus, get plenty of rest afterward. - ---Second Sidebar----- POLYDRUG GLOSSARY Crystal Methamphetamine: highly addictive, turbo-charged amphetamine that increases energy levels, enabling users to party for nights on end. Done in excess, can cause diarrhea, paranoia, hallucinations, and liver damage. Ecstasy (MDMA): euphoric, empathy-inducing amphetamine derivative that Rick Doblin calls "the universal solvent" because it goes well with a cornucopia of other drugs. Ephedrine: the speedy substance that may have killed Anne Marie Capati. Frequently found in over-the-counter drugs like Sudafed. GHB (gamma hydroxybutrate): salty-tasting steroid that, before it was banned, used to be sold over the counter in health stores. Because it comes in concentrated liquid form, there's a fine line between a heavenly high and a deadly dose. LSD (acid): powerful hallucinogen that causes mind-bending visions, sometimes pleasant, other times not. MAO inhibitors: Monoamine oxidase is an enzyme that metabolizes neurochemicals in the brain; MAO inhibitors are antidepressants that prevent the enzyme's activity, allowing neurochemicals to continue working. Special K (ketamine): animal tranquilizer (used by veterinarians) that doctors classify as a "disassociative anesthetic," since your mind feels detached from your body. Depending on the dose, ketamine induces everything from pleasant weightlessness to a full-fledged out-of-body or near-death experience. 2CB: Mild psychedelic sometimes sold as Ecstasy. - --- MAP posted-by: manemez j lovitto