PCP (Angel Dust)

What is PCP?

PCP is phencyclidine, a dissociative drug that was originally used as an intravenous anesthetic for surgery in the 1960s. The drug was valuable because it could provide pain relief and amnesia with minimal depression of the cardiovascular and respiratory systems.^[1] However, some patients dosed with phencyclidine, especially young males, were found to become delirious, delusional, agitated, and even violent after operations.^[2] With ketamine offering similar advantages as an anesthetic and fewer side effects, phencyclidine was banned for human use in 1967.^[1][4]

However, phencyclidine’s mind-altering, hallucinogenic effects made it of interest to recreational drug users, who began siphoning it off veterinary supplies, which remained legal until 1978, and manufacturing it underground.^[5] Illicit use of the drug originated in the late 1960s amidst the hippie movement in San Francisco, where it was known as the “peace pill,” before spreading nationally in the 1970s.^[6]

Recreational use of PCP subsided after the 1980s but reappeared in the late 2000s, with emergency room visits associated with the drug rising by more than 400% between 2005 and 2011.^[7] The DEA reports that its use is most common among young adults and high school students.^[8] In 2022, 1.2% of 12th graders reported having used PCP in the previous year, according to the University of Michigan’s Monitoring the Future survey.^[9]

PCP is currently a Schedule II controlled substance in the United States, as a drug with a high potential for abuse and a risk of “severe psychological or physical dependence.” ^[8][10] Use, possession, sale, distribution, and manufacturing of PCP are illegal.

How is PCP abused?

PCP is most commonly encountered as a bitter, white or yellow crystalline powder, hence the nickname angel dust. That powder can be snorted or sprinkled onto tobacco, cannabis, or even mint, parsley, or oregano, rolled into a cigarette, and smoked.^[4]

PCP can also easily be dissolved into water and or alcohol. That liquid can be swallowed or used to saturate a cigarette of tobacco or cannabis, known as a dipper.^[8] Liquid PCP can also be injected, which is the most dangerous way of consuming it. Injecting PCP comes with all the attendant risks of injecting drugs, such as bloodborne pathogens like HIV and hepatitis C, infections and abscesses, and overdose.^[11]

PCP is sometimes also encountered pressed into pills, as it was consumed in the 1960s.

What class of drugs is PCP?

PCP is a dissociative, a type of hallucinogen that both distorts the senses like other psychedelic drugs but also produces feelings of detachment—dissociation—from the environment and self, sometimes along with hallucinations. Some dissociatives still are used medically for anesthesia and are referred to as dissociative anesthetics.^[12]

In addition to PCP, dissociative drugs include:^[12]

• Ketamine: a drug still used in surgery and recently explored for pain relief and to treat depression
• Nitrous oxide: a gas used for pain relief, often during oral surgery or childbirth; known as laughing gas or whippets
• High doses of dextromethorphan (DXM): a cough suppressant found in cold and cough medicines, recreationally known as lean or dank

Dissociative drugs produce their effects by blocking the activity of the NMDA receptor, producing analgesia (pain relief), anesthesia (loss of sensation), memory deficits, hallucinations, paranoid delusions, mood changes, confusion, and agitation.^[2]

The effects of PCP abuse

Short-term effects of PCP

PCP may produce:^[6][11]

• Dissociation: feeling disconnected from reality, your body, and your physical environment; some people describe this as feeling dreamy, floaty, or numb.
• Euphoria
• Relaxation
• Disinhibition
• Pain relief
• Memory loss
• Loss of motor control
• Muscle rigidity
• Catatonic posturing: strange body positions, often seen in schizophrenia
• Bizarre movements
• Involuntary rapid eye movements
• Sensory distortion
• Hallucinations: feeling and seeing things that aren't real
• Feelings of strength and invulnerability
• Paranoid delusions
• Psychosis
• Mania
• Aggression
• Agitation
• Suicidal impulses

The last five effects aren’t commonly seen with other dissociative drugs but appear at high doses of PCP (5 to 10mg) and make the drug particularly dangerous.^[6][13]

In fact, PCP is sometimes used in psychiatric research as an animal model of schizophrenia. While many other drugs induce hallucinations and paranoia (the positive symptoms of schizophrenia), PCP is unique in its ability to replicate the negative symptoms, including catatonic posturing, bizarre movements, depression, anhedonia, self-neglect and social withdrawal, and its cognitive deficits (difficulties with working memory, attention, and executive function).^[2][14]

In overdose, PCP can cause elevated blood pressure, fast and elevated heart rate, exaggerated muscle tone, bizarre movements, decreased respiration, seizures, coma, and death.^[15]

However, most deaths associated with PCP are a result of its triggering of bizarre and violent behavior, combined with numbness to pain. People on PCP have been reported to have walked into traffic, jumped from buildings, and removed their own teeth or eyes.

PCP is also reported to cause superhuman strength. Stories of “dusted” criminals picking up vehicles and fighting off dozens of cops are urban legends, but PCP does numb users' ability to sense pain. People high on PCP may feel invulnerable and engage in activities that would otherwise hurt them.

How long do the effects of PCP last?

The acute effects of PCP typically last four to eight hours.^[6] Some people report a “hangover” or “come down” lasting for 24 hours or longer after use, featuring dizziness, numbness, and lethargy.^[15]

In some people, especially those with pre-existing mental health conditions or vulnerabilities, a dose of PCP can trigger more long-lasting psychosis, persisting for days or weeks.^[13] In chronic users, PCP abuse can ultimately develop into true schizophrenia.^[16][17]

Is PCP addictive?

Assessments of PCP’s addictiveness vary, but it’s thought to be more addictive than other hallucinogens and dissociative drugs.^[6] Chronic users often engage in compulsive reducing, sometimes taking repeated hits for periods of two to three days, during which time they remain sleepless.^[17]

Withdrawal symptoms from PCP have also been reported:^[13][18]

• Anxiety
• Irritability
• Restlessness
• Disturbances of thought and sleep
• Lack of energy
• Tremor
• Diarrhea
• Long-term depression and inability to experience pleasure (anhedonia)

Treatment for PCP addiction

Treatment for PCP addiction is best undertaken at a residential rehab facility or outpatient treatment center.

Addiction treatment for PCP may include:

• Medical detox, to treat acute withdrawal symptoms.
• Psychological therapies to help break your psychological dependence on PCP and address any underlying problems or mental health conditions that predisposed you to abuse the drug.
• Support groups such as Narcotics Anonymous (NA)
• Medication to treat the lasting mental health effects of PCP abuse, such as antidepressants and antipsychotics