1 . Rave parties, or raves, began in England in the
| A) | | 1960s. |
| B) | | 1970s. |
| C) | | 1980s. |
| D) | | 1990s. |
Rave parties, or raves, began in England in the 1980s and
spread to the United States in the early 1990s. These events are marathon dance parties held
in clandestine locations, including warehouses, nightclubs, and farm fields, accompanied by
extravagant light shows with themes emphasizing harmony, empathy, and a sense of belonging.
Club drugs are used to increase feelings of closeness with others and to heighten the
experience through sensory enhancement, visual distortion, and illusion [3]. Alcohol is generally not sold at raves, but
designer and other drugs are obtainable and affordable. Also, "power drinks" are often sold.
These drinks consist of fruit juice mixed with amino acid powders and B vitamins to replenish
fluids lost during strenuous marathon dancing [4].
2 . Which of the following statements regarding raves and club drugs is FALSE?
| A) | | Club drugs are used to increase feelings of closeness with others. |
| B) | | Alcohol is generally sold at raves to enhance the effects of club drugs. |
| C) | | "Power drinks" are often sold at raves to replenish fluids lost during strenuous marathon dancing. |
| D) | | Club drugs are used to heighten experiences through sensory enhancement, visual distortion, and illusion. |
Rave parties, or raves, began in England in the 1980s and
spread to the United States in the early 1990s. These events are marathon dance parties held
in clandestine locations, including warehouses, nightclubs, and farm fields, accompanied by
extravagant light shows with themes emphasizing harmony, empathy, and a sense of belonging.
Club drugs are used to increase feelings of closeness with others and to heighten the
experience through sensory enhancement, visual distortion, and illusion [3]. Alcohol is generally not sold at raves, but
designer and other drugs are obtainable and affordable. Also, "power drinks" are often sold.
These drinks consist of fruit juice mixed with amino acid powders and B vitamins to replenish
fluids lost during strenuous marathon dancing [4].
3 . According to the Youth Risk Behavior Survey 2019, approximately what percentage of high school students had used MDMA at least once during their lifetimes?
| A) | | 0.3% |
| B) | | 3.6% |
| C) | | 9.2% |
| D) | | 11.1% |
Club drug use may be described as a youth movement. While
college is frequently the time of first MDMA use, use in high school students has become more
common. The Youth Risk Behavior Survey 2019 reported that 3.6% of high school students
nationwide had used MDMA at least once during their lifetimes [5,41]. In 2020, a total of 1.8% of high school seniors had consumed MDMA during
the previous year, and approximately 0.3% admitted to being current users [40].
4 . Which of the following statements regarding MDMA use among high school students is FALSE?
| A) | | MDMA use peaked in 2001. |
| B) | | Approximately 0.39% admitted to being current users of MDMA. |
| C) | | MDMA use showed an upward trend among high school students in 2020. |
| D) | | The combined past-year rates of students in grades 12, 10, and 8 showed lower rates in 2020 than in 1996. |
In 2019, more than 24.3% of high school seniors stated that
MDMA was "fairly easy" or "very easy" to obtain. In 2001, this figure was as high as 61.5%
[40]. MDMA use peaked in 2001; in 2003, a
sharp drop was noted, probably related to the increased perception of risk [7,40]. The drop in past-year use of MDMA has continued through 2020. The
combined past-year rates of students in grades 12, 10, and 8 showed lower rates in 2020 than
in 1996, the first year MDMA use was measured [40].
5 . After oral ingestion, MDMA reaches peak plasma concentration within
| A) | | three to five minutes. |
| B) | | one to two hours. |
| C) | | two to four hours. |
| D) | | four to six hours. |
MDMA reaches peak plasma concentration within two to four
hours following oral ingestion. Its half-life is approximately eight hours, and metabolism
occurs primarily through the hepatic enzyme CYP2D6 [17,18].
6 . MDMA ingestion can trigger psychiatric disturbances, including
| A) | | depression. |
| B) | | panic attacks. |
| C) | | persisting perception disorder ("flashbacks"). |
| D) | | All of the above |
The alteration of perception initiated by MDMA use may be
experienced as dysphorogenic, and MDMA-naïve subjects have reported anxiety, mild
depersonalization or derealization, moderate thought disorder, and poor coordination. MDMA
ingestion can trigger psychiatric disturbances, including depression, panic attacks, and
persisting perception disorder ("flashbacks"). It has been proposed that these disturbances
are more likely to emerge in individuals with a vulnerability to mental illness [2]. Experienced MDMA users taking the drug
under controlled conditions have frequently reported impaired decision-making ability,
difficulty in concentrating, and decreased mathematics performance [8].
7 . Patients admitted to the emergency department for MDMA toxicity may present with which of the following?
| A) | | Lethargy |
| B) | | Tachycardia |
| C) | | Hypothermia |
| D) | | Hypernatremia |
Patients admitted to the emergency department for MDMA
toxicity typically present with agitation, anxiety, tachycardia, hypertension, or
hyperthermia. There is no antidote for MDMA toxicity; treatment is limited to supportive
care [9,20].
8 . Which of the following statements is TRUE regarding the pharmacology of gamma hydroxybutyrate (GHB)?
| A) | | GHB decreases brain dopamine, serotonin, and acetylcholine. |
| B) | | GHB decreases dopamine release and activates tyrosine hydroxylase. |
| C) | | GHB is involved in the regulation of GABA, serotonin, and acetylcholine. |
| D) | | All of the above |
GAMMA HYDROXYBUTYRATE (GHB)
GHB increases brain dopamine, serotonin, and acetylcholine
and interacts with the opioid system. It is involved in the regulation of GABA, serotonin,
and acetylcholine. GHB also disinhibits dopamine release and activates tyrosine hydroxylase,
which together act to increase the central dopamine levels associated with the reinforcing
effects of GHB [2].
9 . Which of the following is NOT an adverse effect of ketamine?
| A) | | Nausea |
| B) | | Hypermobility |
| C) | | Symptoms of schizophrenia |
| D) | | Abnormally low body temperature |
Low doses of ketamine are associated with feelings of
relaxation, while higher doses can produce dreamlike states, hallucinations, visual
distortions, and unpleasant sensations of near-death experience. Some common effects of
ketamine use are delirium, amnesia, and depression. Adverse effects include nausea,
immobility, abnormally low body temperature, anxiety, dissociation, depression, recurrent
flashbacks, impaired attention, learning disability, and symptoms of schizophrenia.
Cognitive dysfunction related to attention, learning, and memory can result from chronic
abuse [2].
10 . Due to its anterograde amnestic effects, which of the following club drugs is most commonly associated with drug-induced sexual assault?
| A) | | GHB |
| B) | | MDMA |
| C) | | Ketamine |
| D) | | Flunitrazepam |
CLUB DRUGS AND FACILITATION OF SEXUAL ASSAULT
Several club drugs have been implicated for use in sexual
assault because victims have difficulty resisting the attack due to the profoundly sedating
and intoxicating drug effects. GHB has effects that are similar to alcohol, and a combination
of alcohol and GHB puts a potential victim at heightened risk of loss of consciousness.
Flunitrazepam causes similar symptoms. Due to its anterograde amnestic effects (inability to
recall events taking place while under the influence of the drug), flunitrazepam is more
commonly used in drug-induced sexual assault [2,9]. The memory problems associated with
both drugs and the fact that GHB clears from the body within 12 hours make detection difficult
and increase the complexity of attempts to prosecute perpetrators utilizing these drugs [22]. In addition to GHB and flunitrazepam,
ketamine is being used increasingly as a "date rape drug" due to its dissociative effect [17].
