Rapid sedation, fluid resuscitation, and reduction of hyperthermia are the foundation of excited delirium treatment. If autonomic hyperactivity secondary to abnormal dopamine processing is to blame for the clinical presentation of excited delirium, then rapid sedation of the patient and attenuation of catecholamines is the goal. Benzodiazepines, neuroleptics, or both in combination are commonly used to treat agitated patients.
Does Drug Use Cause Dilated Pupils?
If the police catch people supplying illegal drugs in a home, club, bar or hostel, they can potentially prosecute the landlord, club owner or any other person concerned in the management of the premises. For example, 2CB and 2CT-7 have been sold as white powders or small 5mg pills. Consumers in turn began to ask their dealers for tusi tailored to their personal preferences, notes Quintero. They phone the supplier and say, ‘look, I want a more downer tusi,’ or one that is more stimulating or even a psychedelic one,” he told InSight Crime. In October 2014, a struggle 2c deug for control over tusi sales in Cali led to an internal purge in the Urabeños crime group that murdered eight people.
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2C-B is not inherently addictive — however, people can form addictions to any mind-altering substance, including 2C-B. The main risk of this compound is adulteration (mixing or swapping other substances into 2C-B tablets or powder). With that said, there is a serious lack of research available on the safety of 2C-B. Due to the heavily restricted status of this substance, it’s unlikely we’re going to see this research anytime in the near future. The more 2C-B you take, the further the experience diverges from MDMA. High doses are very psychedelic and can make being at public events very uncomfortable — unlike MDMA.
Mixing drugs is always risky but some mixtures are more dangerous than others. 2C-B is controlled in Australia and on the list of substances subject to import and export controls (Appendix B). It was placed on Schedule One of the Drugs Misuse and Trafficking Act when it first came to notice in 1994, when in a showcase legal battle chemist R. Alexander Shulgin came to Australia to testify on behalf of the defense, to no avail. 2C-B is a scheduled drug in most jurisdictions.57 The following is a partial list of territories where the substance has been scheduled. Donate today to empower research and analysis about organized crime in Latin America and the Caribbean, from the ground up.
Hyperthermia (temperature ≥40 °C) can be treated with sedation and rapid cooling. Controlling excessive muscle activity is important in treating hyperthermia 54. For severely hyperthermic patients, sedation, intubation and extended paralysis with rocuronium or veronium may be necessary 54. Use of these non-depolarizing agents and intubation with mechanical ventilation can be supplemented with external cooling 54. Antipyretics have no place in the treatment of drug-induced hyperthermia as they work by lowering the hypothalamic set point in febrile patients.
Burnett et al. suggest ketamine as an alternative chemical restraint agent for patients in excited delirium, and they are not alone in this suggestion 52, 53. Benefits of ketamine include rapid onset, predictable ability to induce a dissociated state, and lack of cardiovascular or respiratory depression. However, ketamine may result in airway compromise, including laryngospasm and hypoxia, or have stimulatory cardiovascular effects resulting in increased tachycardia and hypertension. The 2Cs are just one of the designer drug classes currently being promoted and disseminated on the internet and at raves. The phenethylamine-based structure is actually shared among amphetamines, catecholamines, cathinones, and many other drugs. The terminology “2Cs” is in reference to an acronym invented by Alexander Shulgin to describe the two carbons between the amino group and the benzene ring in the chemical structure (Fig. 1) 3, 4.
Ring-substituted phenethylamines, commonly known as 2Cs, are designer drugs that are emerging as new drugs of abuse. Currently, the amount of published literature concerning 2Cs is limited. There are a few 2Cs that have been studied, i.e., 2C-T-7, 2C-B, and 2C-E, so information about the pharmacology, pharmacokinetics, and pharmacodynamics, while low in volume, is becoming available. A syndrome consistent with excited delirium including severe agitation, aggression, violence, seizures, and hyperthermia is consistently depicted in lethal 2C cases.
The Post-Millennial Drug
Dr. Paloma Lehfeldt, MD, MA, is deeply committed to advancing plant medicine and advocating for the integration of psychedelics into mental health care. With over fifteen years of experience in research, community outreach, and education, she brings her expertise to her work with Supermind.co. Additionally, Paloma volunteers her time to support various nonprofit boards dedicated to empowering women and people of color in the field of plant medicine.
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- There have been reports of 2C-B triggering a false-positive on amphetamine tests, but this is very rare.
- The drug may cause an individual’s surroundings to seem distorted, or the person may see or hear things that don’t exist.
- Like with most psychedelic drugs, quitting 2C-B cold turkey can be challenging.
- Polydrug use is a term for the use of more than one drug or type of drug at the same time or one after another.
- In smaller doses these effects are limited, but higher doses of 2C-B produce intense changes in sensory perception.
We’re running a continual survey on the use of 2C-B to better understand the effects and use patterns surrounding this unique psychedelic substance. Microdosing is the process of taking very small, sub-perceptual doses of a substance. They’re used to increase focus and concentration, improve empathy and connectedness with others, and help achieve a higher level of productivity.
However, the depth and intensity of 2C-E also comes with potential challenges. Drugs in the 2C family are often referred to as designer drugs because they’re made in clandestine labs. A person may experience stimulating effects, hallucinogenic effects or a combination of the two. Despite established efficacy of benzodiazepines and neuroleptics, they have a slow onset of action via the intramuscular (IM) route. Excited delirium patients may not have this amount of time to spare.
- Most people take 2C-B orally and experience a burning sensation when ingesting the drug.
- 2C-E, like many psychedelics, can have both positive and negative effects.
- 2C-B is often sold as a bright pink powder that is snorted known as tusi or pink cocaine.
- On the contrary, it was growing so much that in 2013, Colombia’s police director responded to the seizure of a few thousand alleged 2C-B capsules by claiming the drug was replacing cocaine.
- Most of them were banned in the 1990s and subsequently fell into obscurity, but 2C-B survived, carving out a niche for itself in European discos.
- Users experience light trails, geometric patterns, and objects that appear to merge together.
A normal pill come-up takes about 45 to 75 minutes, while the peak lasts two to four hours and the comedown one to two. Unlike MDMA, it doesn’t deplete serotonin, the chemical in our bodies that tells us to be happy. Instead, it mimics it – in the same way as certain antidepressants – meaning sad thoughts and exhaustion after use, along with long-term damage to brain cells (neurotoxicity), aren’t as likely. In 1985, it became a short-lived substitute for ecstasy in the US when MDMA was criminalised, and for a time was sold in Dutch smart shops under the name Nexus.
2C-B is a Schedule I drug with no accepted medical drug use and a high potential for addiction. Possession of 2C-B is punishable by up to 7 years in prison, a fine, or both. When MDMA was outlawed in 1985, 2C-B became the street drug of choice for its euphoric and psychedelic effects. Studies show that most people who use these drugs are young adults who frequently attend raves.
In August 2007, 2C-B, along with many other psychologically active substances,62 was added to Ley 20.000, known as the Ley de Drogas es.
Most of them were banned in the 1990s and subsequently fell into obscurity, but 2C-B survived, carving out a niche for itself in European discos. There is little information available about the pharmacology of hallucinogenic 2Cs. It has been shown that 2Cs have an affinity for 5-HT2 and alpha-adrenergic receptors, but these compounds can be either agonists or antagonists, which is dependent on the specific receptor subtype 12–14.
This is likely one of the main mechanisms involved with the substance’s stimulating effects. Compared to other 2C-x drugs, 2C-B is the second most potent agonist of serotonin receptors only to 2C-I. Mixing 2CB with other psychedelics like LSD, mescaline, or magic mushrooms can lead to much stronger hallucinations. 2C-B is often compared to LSD because the visual effects of these two drugs are very similar. Users experience light trails, geometric patterns, and objects that appear to merge together.