Warning to clubbers over dangers of 'safe' alternative to ecstasy
Friday, 27 April 2007
Print
Email
A teenage clubber who collapsed after taking a new dance-scene drug, which has been marketed as a "safe" alternative to ecstasy, is lucky to have survived, doctors report today.
The 18-year-old girl had taken the drug, benzylpiperazine, or BZP, at a London nightclub on a bank holiday weekend last May.
Shortly after swallowing five tablets, she collapsed and suffered a seizure lasting 10 minutes. She was taken by ambulance to hospital where she was given emergency treatment. Her pupils were dilated, her heart was racing at 156 beats per minute and her body temperature and blood pressure had plummeted.
She was given a high dose of tranquillisers to calm her racing pulse and a blood sample was taken for toxicological testing. After 12 hours under observation she made a full recovery and was discharged.
She was one of seven patients admitted to the same hospital emergency department with similar symptoms that night.
Writing in The Lancet, specialists say the case highlights the dangers of the drug, which is becoming increasingly popular among clubbers but whose effects many doctors are unfamiliar with.
They warned colleagues to watch out for other young people suffering adverse reactions to the drug, which was legally available over the counter in the UK until last month.
The active ingredient in BZP is piperazine, which was developed in the Fifties as a worming medicine for veterinary use.
It has a similar chemical structure to amphetamine, a stimulant, and has become an increasingly popular alternative to ecstasy and amphetamines, being sold under names such as Pep Twisted, Legal E, Nemesis and Euphoria.
Last month, Britain's Medicines and Healthcare products Regulatory Agency (MHRA), made the unlicensed sale of the drug illegal.
David Wood, together with colleagues from the poisons unit at Guy's and St Thomas' Hospital, says manufacturers of the drugs claim that 20 million pills containing piperazines have been consumed in New Zealand with no deaths or significant harm.
Doctors are sceptical about these claims, however, because a study in New Zealand found that 80 people had been treated in emergency departments for symptoms similar to those caused by amphetamines, including nausea, vomiting, rapid heartbeat anxiety and agitation.
In 15 cases, the drug users suffered seizures after eight hours and three patients had repeated seizures which doctors said were life-threatening.
The authors pointed out that urine-testing kits designed to detect recreational drugs may miss piperazine. Doctors could be lulled into a false sense of security by the lack of cases in which harm was attributed to the drug, because it had not been identified or had been wrongly identified.
"Clinicians should be aware of the potential presenting features of piperazine toxicity, particularly because commercially available urine toxicological screening kits for drugs of abuse may not detect piperazines," they wrote.
In an accompanying commentary in The Lancet, Dr Roland Staack, from Ludwig-Maximilians University in Munich, said the low number of reported cases of piperazine poisoning may be due to confusion with amphetamines.
"Piperazines and amphetamines are similarly marketed, consumed by the same population, and show similar pharmacological symptoms," he said. "Therefore a piperazine poisoning can easily be wrongly diagnosed as an amphetamine poisoning."
