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'Trail Mix' Brings Dangerous High

Experts warn of health risks in popular dance club drug cocktail

MONDAY, July 30, 2001 (HealthDayNews) -- Party lovers are falling to a new low in health safety in order to stay high longer at trendy all-night dance clubs, Harvard researchers say.

They're creating a concoction called "trail mix" -- a blend of ecstasy and other potent drugs like cocaine, ketamine and methamphetamine -- and it's a bad idea, the scientists claim.

The new drug mixture is finding its way into the gay dance club scene in cities that range from New York City and Boston to Los Angeles and Miami. The use of "trail mix" has already been reported in heterosexual clubs.

"This is not a craze, it's not even common, but it's emerging," says Patricia Case, a Harvard Medical School urban health expert who's supervising a study on drug use at gay clubs.

Case and her colleagues interviewed 100 people who frequent clubs in New York and Boston. The information for Miami and Los Angeles came from other reports. She presented her findings recently at the first International Conference on Ecstasy in Bethesda, Md.

Although the club drug ecstasy is normally taken in pill form, it's crushed to make "trail mix." Ketamine, a veterinary tranquilizer, is most commonly added, but the mixture can also include methamphetamine, known as "crystal meth," or cocaine, or both stimulants. In some instances, Viagra is added for improved sexual function.

"There's no set formula. People are just making these mixes to their own tastes," Case says. "But if you offered 'trail mix' to someone on the dance floor, they would commonly understand -- at least in New York -- that it at least had ecstasy and ketamine in it."

The appeal of "trail mix" is its ability to lengthen the hallucinogenic high of ecstasy on the dance floor, Case says.

"The ketamine mellows out and extends the ecstasy high. If you go to a dance party that lasts for two days, you might not want to go up and down in six hours. The ketamine addition to ecstasy can help stretch it out," she says.

But ketamine -- also know as "K" or "Special K" -- is trouble on its own. People who take too much of the drug can end up in a vacant, sedated state known as the "K-hole," Case says.

The idea of mixing drugs is hardly new.

"It's a variation on the theme of combining cocaine and alcohol," says Dr. Charles Moore, a recovery program director with the Kaiser Permanente Health Plan. "Cocaine gives a stimulating effect, while alcohol tends to produce a sedation and a calming. If you get too much of one, you can try to match it with the other."

The health effects of "trail mix" aren't clear, Case says.

"The only thing that concerns me is that the stimulant effects of the drugs involved in 'trail mix' -- like methamphetamine and ecstasy -- may override the ketamine," she adds.

Another possible effect is an increase in the potency of the drugs as the body gets overwhelmed and can't process them quickly, says Dr. Una McCann, an associate professor of psychiatry at Johns Hopkins School of Medicine.

"You're overwhelming the liver's ability to metabolize the drugs," she says, and that could explain why "trail mix" appears to lengthen the high that people get.

While the use of "trail mix" may be on the rise, McCann says ecstasy and ketamine make strange partners.

"People on ecstasy initially feel a rush, a speedy kind of feeling. They experience closeness with others, empathy and feeling at one with the universe," McCann says. "Ketamine makes people want to be by themselves. It's a very introspective drug."

What To Do

Illegal drug use can be dangerous, and mixing drugs can spell extra trouble. Remember that when someone puts a pill in your hand in a dance club, there's no way to know where it came from or what is in it.

It's not clear how "trail mix" will affect people who are on AIDS drugs. Read this advice on recreational drug use by AIDS patients.

Learn more about ecstasy from the U.S. Drug Enforcement Administration.

SOURCES: Interviews with Patricia Case, Sc.D., instructor, social medicine, Harvard Medical School, Boston; Una McCann, M.D., associate professor, psychiatry, Johns Hopkins School of Medicine, Baltimore; Charles Moore, M.D., medical director, chemical dependency recovery program, Kaiser Permanente Health Plan, Sacramento, Calif.; July 19, 2001, presentation, first International Conference on Ecstasy, Bethesda, Md.
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