Scopolamine is an FDA-approved medication used medically to treat post-operative nausea, vomiting, and motion sickness. [1][2] Less commonly, this drug is used recreationally, as well as criminally, in the form of a powder known as Devil’s Breath to render victims temporarily defenseless against robberies, assaults, or other crimes. [3][4]
- Scopolamine is a medication that is FDA-approved to treat post-operative nausea and vomiting and motion sickness.
- This drug is extracted from certain nightshade plants like Jimsonweed, Angel’s trumpet, and henbane, and works by lowering levels of acetylcholine.
- A powdered form of this drug called Devil’s Breath has been used by criminals to temporarily incapacitate victims, usually in connection with assaults and robberies.
Scopolamine: What it is and how it works
Scopolamine is a medication most commonly used to treat nausea and vomiting, but it is also sometimes used recreationally for psychedelic effects that occur at higher doses. This medicine is an anticholinergic drug that works on M-1 muscarinic acetylcholine receptors and H1 histamine receptors to reduce symptoms of nausea. [1][2]
Scopolamine is an alkaloid derived naturally from extracts of certain nightshade plants. It is an extremely potent drug that can be safe and effective when used medically in prescribed doses, but can also be toxic and even fatal when used at higher doses. [2]
In addition to suppressing nausea, this drug also has psychoactive effects. At lower doses, this drug commonly causes sedation and disorientation. At higher doses, it can make people feel agitated, restless, paranoid, more prone to hallucinations and delusions, and more suggestible and compliant. [1][3]
Origins
Scopolamine is often derived from the plants Datura stramonium (Jimsonweed), Scopolia carniolica, Brugmansia (angel's trumpet), and Hyoscyamus niger (henbane). These plants produce toxic compounds called belladonna alkaloids as a protective mechanism. Medically, these compounds can block acetylcholine in the nervous system, which helps to suppress nausea and GI spasms linked to vomiting. [2]
Devil’s Breath and criminal uses
This drug also has a history of being used by criminals to temporarily disorient unsuspecting victims. There have been several reported instances of criminals blowing powdered scopolamine (aka Devil’s Breath) into a person’s face or spiking beverages in order to rob, assault, or otherwise take advantage of them. [4]
When administered this way, it causes a person to become disoriented, confused, and very compliant with requests and suggestions from others. The drug can cause short-term amnesia, which criminals can also use to their advantage. Because of these unusual side effects, criminals have used Devil’s Breath to convince people to hand over large amounts of money willingly, often without remembering doing so later on. [3]
Medical uses
Scopolamine is an FDA-approved medication indicated for post-operative nausea and vomiting, as well as motion sickness. Scopolamine is sometimes used as an off-label treatment for intestinal spasms, chemotherapy-induced nausea, asthma attacks, depression, smoking cessation, and excessive sweating. [1][2]
Scopolamine transdermal patches
When used medically, scopolamine is most commonly prescribed as a transdermal patch that releases small amounts of the medicine over the course of several hours. Transdermal patches are usually placed directly behind the ear where the skin is thinnest, allowing for easier absorption. [1]
Recreational uses
Because of the unpleasant side effects and the lack of euphoric effects, recreational use is uncommon. Still, there have been isolated reports of people abusing the drug recreationally for its hallucinogenic effects. Because these hallucinogenic effects are more common at high doses, recreational use is very dangerous and increases the risk of accidental overdose. [2][3]
Scopolamine side effects
When used medically and in prescribed doses, the side effects are typically mild and temporary. The most common include:
- Dry mouth
- Blurred vision
- Dilated pupils
- Drowsiness
- Skin irritation where the patch is applied
- Flushed skin
- Tachycardia (fast heart rate)
Less commonly (and more often in older adults, at higher doses, or with misuse), scopolamine can cause more serious effects:
- Confusion and disorientation
- Agitation
- Paranoia
- Hallucinations or psychosis
- Short-term memory loss
- Unusual compliance or suggestibility
- Hyperthermia (dangerous overheating)
Scopolamine long-term effects
When used short-term after surgeries or to treat occasional or acute nausea related to motion sickness or medication side effects, long-term side effects are atypical. There is insufficient research on the adverse effects of long-term recreational use of this drug. [1][2]
How scopolamine affects the brain
Scopolamine blocks muscarinic receptors in the brain, preventing acetylcholine from binding to them. Acetylcholine is still present; it simply can't do its normal job. Because acetylcholine is involved in learning, memory, and concentration, blocking it impairs the ability to think, make decisions, focus, and remember events. These effects are temporary and wear off as the drug is metabolized. [2]
Scopolamine effects and timeline
The therapeutic effects of scopolamine include relief from nausea, vomiting, and associated gastrointestinal spasms. In addition, many people experience side effects like sedation, blurred vision, dry mouth, and flushed skin. At higher doses, it’s possible to experience confusion, increased compliance, temporary amnesia, restlessness, agitation, paranoia, and psychosis. [1][2]
The timeline of effects depends on the method of administration.
- When given in a transdermal patch, the effects onset more slowly over the course of 4 hours, and peak within 24 hours. The patch is designed as an extended-release formulation which continues to deliver the medication for 3 days. [2]
- When inhaled as Devil’s Breath, the effects are reported to onset much more quickly, but there is no conclusive research to provide specific information on the onset and duration of effects.
Signs of intoxication
The signs of intoxication vary depending on the dose taken and an individual’s response, but can include: [1][2]
- Confusion and disorientation.
- Memory problems.
- Agitation or restlessness.
- Slurred speech.
- Paranoia or psychosis.
- Dilated pupils.
- Sweating or overheating.
- Blurred vision or dizziness.
- Flushing of the skin.
- Impaired judgment.
Scopolamine overdose
Consuming too much scopolamine can result in an overdose, which can be life-threatening and requires immediate medical intervention. In children, doses of 10 mg can be fatal. The signs of overdose can include: [1][2]
- Overheating.
- Severe delirium or psychosis.
- High blood pressure.
- Tachycardia or irregular heart rate.
- Respiratory problems.
- Coma.
- Seizures.
How to help someone spiked with scopolamine
If someone has overdosed or been exposed to non-medical scopolamine, seek immediate medical attention from a hospital or emergency room. If the person is non-responsive, is struggling to breathe, or showing other signs of acute medical distress, call 911 immediately. In non-life-threatening situations, consider calling poison control at 1-800-222-1222 or contacting their medical provider for advice and follow-up care.
Scopolamine withdrawal and timeline
There have been some documented reports of scopolamine withdrawal, and the FDA now reports that these symptoms can begin within 24 hours of removing the transdermal patch and may last a week or longer. [5]
Withdrawals have been more commonly reported when the patch has been used long-term, and more research is needed to better understand how long it takes to form a dependence and who is most at risk. Currently, this drug is not a controlled substance, and evidence of withdrawal related to recreational use is scarce.
Withdrawal from scopolamine patches can involve the following symptoms: [5]
- Dizziness and problems with balance.
- Nausea and vomiting.
- Abdominal cramps.
- Sweating.
- Headaches.
- Confusion and agitation.
- Muscle weakness.
- Slow heart rate (bradycardia).
- Low blood pressure (hypotension).
Scopolamine dependence and treatment
There have been some reports of dependence, but the evidence is limited and does not indicate that recreational use of this drug is common or widespread. This medication is primarily used medicinally on a short-term basis to treat nausea and vomiting related to operations or surgeries. [1][2]
When used therapeutically, doses are controlled to prevent significant psychoactive effects. However, at high doses, scopolamine can have psychedelic effects, and some individuals have abused the drug recreationally as a hallucinogen. Recreational use is dangerous, especially when used frequently and at high doses, and can have life-threatening consequences. [3]
Treatment for scopolamine dependence
There are effective treatments for individuals struggling to overcome a substance use problem, including inpatient, residential, and outpatient options. In treatment, it’s possible to learn new, healthier ways of coping without drugs or alcohol, and begin the process of rebuilding areas of your life damaged by addiction.
For many, the first step towards recovery involves scheduling a substance use evaluation. During this evaluation, a licensed clinician will ask questions to better understand your treatment needs and goals and will make individualized recommendations for treatment.
Final thoughts
Scopolamine is an FDA-approved medicine that can treat post-operative nausea and vomiting, as well as motion sickness. Normally, this medication is given as a transdermal patch worn behind the ear that slowly releases medication over the course of 3 days. When used short-term and as prescribed, it does not carry a significant risk for abuse, dependence, or overdose. [1][2]
While uncommon, there have been some reports of recreational abuse, as well as instances where a powdered form of this drug, known as Devil’s Breath, has been used to temporarily incapacitate victims, usually in connection with robberies. When inhaled, this powder can cause people to become sedated, suggestible, and confused, and can also lead to short-term amnesia. [3][4]
When consumed in large doses, this drug can lead to a number of serious adverse effects including confusion, psychosis, overheating, and dangerous changes in heart rate and blood pressure. There have also been reports of overdose, which can be fatal in some instances. Less is known about dependence potential, although long-term use can result in temporary symptoms of withdrawal. [5]
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