| Table 1. Features Of Partisan Web Sites As Of May 24, 2001.* | |||
| Name (URL) | Features | Examples Of Text From Site | Comments |
|---|---|---|---|
| The Vaults of Erowid (http://www.erowid.org) |
Describes the illicit use of over 200 substances in over 4000 pages, is visited more than 160,000 times per day, and describes detailed protocols for the use of illicit substances. | "And if you're really concerned ... most or all of the serotonin system reduction may be prevented by taking Prozac (fluoxetine) 0-6 hours after taking MDMA. One might speculate that other SSRI drugs (Zoloft, Paxil) may work too. Note, however, that some people report that Prozac taken before or in the early part of an MDMA session lessons some of the desirable effects of the MDMA." | The combined use of SSRIs monoamine oxidase inhibitors with drugs
possessing serotonergic activity such as MDMA has led to serotonin syndrome
in selected patients.3 For a large number of illicit substances, Erowid offers pharmacokinetic data in both tabular and graphical form, so that potential users can predict their own dose - response curves for a particular substance. Furthermore, the first-person descriptions of the effects of illicit substances ("trip reports") frequently list the dose and body weight of the reporter so that the observed clinical effects can be reproduced or avoided. |
| Dancesafe (http://www.dancesafe.org) |
Promotes "non-abstentionist" drug-related health and safety
information; provides "services [to] help people use as safely as possible"; offers
to test pills, free of charge, to identify those that do not contain ecstasy; and contains
a table that compares the risks associated with daily activities with the risks associated
with use of illicit substances. |
"High pressure levels in the [nitrous oxide] tank can shoot the gas
out at a dangerously fast speed and damage the lungs. It is safer to inhale from a balloon than
from a tank." "Many tablets sold on the illicit market as 'ecstasy' actually contain substances far more dangerous than MDMA." States that the risk of using "amphetamines, GHB, and cocaine" is comparable to the risk associated with "travel by airplane." |
Nitrous oxide inhaled from a secondary source was the cause of deaths of college
students in the Boston area.4 Dancesafe proposes that the majority of medical emergencies attributed to amphetamines are instead due to dextromethorphan. The two substances have distinct toxicities and clinical presentations.5 The Web site also states that the level of risk from the use of nitrouse oxide is comparable to the risk of "spontaneous combustion." |
| Ecstasy.org (http://www.ecstasy.org) |
Contains a question-and-answer section with replies from "experts," some of whom are physicians. | "I would like to know if it is safe to mix Ecstasy and Viagra? Expert Reply: I understand that there have now been two cases reported to Pfizer, the manufacturer of Viagra, of priapism associated with the use of Viagra together with ecstasy. The mechanism may be that inhibitors of the drug metabolizing enzyme system P450-34A are known to increase the concentration of sildenafil. …I can see why some users might want to try taking E[cstasy] and Viagra together. [I]f you must, try half a dose of each. … |
Ecstasy.org is on of several partisan Web sites to apply toxicogenomic principles to the use of illicit drugs. Other drug - drug effects commonly mentioned are the interactions of CYP3A4 inhibitors (such as HIV-protease inhibitors) with MDMA (ecstasy) and of monoamine oxidase inhibitors with MDMA.6 |
| Ecstasy info (http://come.to/ecstasy) |
Offers a direct entry into chat rooms in which the use of illicit drugs such as MDMA is discussed. | "Drink lots of water to replenish body fluids." | Because it is an amphetamine with serotonergic activity, MDMA suppresses both appetite and thirst. To prevent dehydration, several partisan sites suggest ingestion of water. This practice carries the risk of water intoxication and hyponatremia leading to seizures, cerebral edema, and death.7 |
| The Shroomery (http:// www.shroomery.org ) |
Proposes several "cures" for Amanita phalloides poisoning, which arises from the ingestion of misidentified mushrooms. | "Liver-damaging substances such as carbon tetrachloride can be used to stop uptake of phallotoxins, but the "cure" is not much better than the affliction." | Carbon tetrachloride is a known cause of fulminant hepatic necrosis.8 |
| The Lycaeum (http:// www. lycaeum.org ) |
Hosts several Web sites, including those of Rhodium (an underground chemist), Beehive (a compendium of syntheses for illicit substances), and GHB FAQ. | "If [taking GHB] makes you feel anxious some Clonazerpam (1-2mg) will help. (If you can still keep it in by that time … better take some before.) You may also best sleep for awhile (to find yourself waking up … refreshed!)." | The combination of two sedative - hypnotic agents - clonazepam and GHB - carries a risk of severe respiratory depression and loss of airway protective reflexes.9 |
| GHB FAQ (http:// users.lycaeum.org/ ~ghpfaq/contents.html ) |
Offers a brief form designed to be printed and carried to the site of drug use that describes the dose, effects, and management of overdose of GHB; the site also describes the dosing protocols for the use of GHB in the treatment of other clinical conditions, such as the alcohol withdrawal syndrome. | "Users wishing to employ GHB for immediate detox can follow the model of the experiment above. Begin with 50 mg/kg GHB 3 times each day, and reduce by 30% each day after the third. This should be done during a dedicated recovery period. … It is vital to have another person assisting in this process, who can absolutely ensure that the suspect does not drink." | Prolonged or excessive use of GHB itself is capable of producing a withdrawal syndrome similar to the alcohol withdrawal syndrome.10 |
| *MDMA denotes methylenedioxymethamphetamine, SSRI selective serotonin-reuptake inhibitor, GHB g-hydroxybutyric acid, and HIV immunodeficiency virus. | |||