PCP Overdose Signs and Treatment

Hallucinogenic drugs affect an individual’s perceptions in a different manner than other drugs affect perception of the environment. Hallucinogenic drugs produce experiences that are not consistent with reality, such as hallucinations (seeing, hearing, feeling, smelling, or even tasting things that are not really there), synesthesias (having mixed perceptual experiences, such as believing that one can see sound or hear colors), and the development of delusional behaviors. The dissociative aspect of PCP also represents an alteration in perception, such that one begins to feel that they are not real, that they are leaving their body, or that things around them are not real.

PCP use peaked in the 1970s and 1980s, according to the DEA. Even so, PCP is still a significant drug of abuse and classified as a Schedule II controlled substance, designating that its distribution is tightly controlled due to its potential to be abused and the extreme effects the drug produces. The drug can be snorted, injected, or smoked in cigarettes or cannabis products.

PCP Overdose

The National Institute on Drug Abuse (NIDA) states that the effects of PCP are dependent on the dose one takes.

• Lower doses of PCP are the typical doses on the street, and they are usually between 1 mg and 6 mg. At these doses, the effects are similar to alcohol intoxication.
• Moderate doses of PCP of between 6 mg and 10 mg. They produce significant psychosis, hyperactivity, and issues with irregular heartbeat, high blood pressure, muscle rigidity, and elevated temperature rates.
• Very large doses exacerbate the above effects, and they are also likely to produce comatose states, catatonia, and seizures. Extremely large doses, above 200 mg, can be fatal.

Anyone who suspects that someone has overdosed on PCP should immediately contact emergency medical services by calling 911. If a person has no medical training, they should not attempt to get the individual any fluids or medications. One should attempt to control the individual by limiting any environmental stimulation, talking to them, and behaving in a calm and controlled manner until help can arrive. Eliminating environmental stimulation may include trying to block bright lights, minimizing noise, not touching the person, and moving slowly and deliberately. Do not approach someone who is extremely agitated; instead, keep your distance and monitor them until help arrives.

Treatment for PCP Overdose

A PCP overdose can be associated with numerous irreversible effects that can result in damage to numerous areas of the brain. The damage that occurs in these areas is often associated with reduced or blocked oxygen flow due to coma and decreased breathing, as a result of hyperthermia, or as a result of seizure activity. Areas that use high levels of oxygen in their normal functioning are particularly vulnerable. This includes damage to the frontal and temporal areas of the brain that are involved in attention, problem-solving, and learning and memory. Other areas of the brain that may be damaged as a result of a PCP overdose include the cerebellum, a structure at the posterior portion of the brain that is involved in movement and certain aspects of thinking and reasoning.

Some individuals may continue to display psychotic behaviors for a significant length of time following an overdose of PCP. These individuals may need long-term treatment for this behavior.  Individuals who continue to display psychotic behaviors after a PCP overdose and had no prior history of psychosis may have damaged certain areas of the brain that are involved in perception and reasoning. Other organs, such as the heart, liver, and kidneys, can also suffer irreversible damage as a result of reduced blood flow and oxygen.

Follow-up care typically includes referring the individual for substance use disorder treatment, continued outpatient therapy, the use of benzodiazepines to avoid seizures, and the continued use of antipsychotic medications as needed. Because an individual who has overdosed on PCP is at extreme risk for even more severe and potentially permanent effects if they continue to use the drug, it is extremely important that every effort be made to involve them in a formal substance use disorder treatment program. This includes helping the individual avoid use of other drugs of abuse as the damage that may have occurred as a result of a PCP overdose may leave them very vulnerable to future damage from other substances.