SMASHED AND STONED

When I was drunk I smoked some pot, and then sounds echoed and my vision
blurred. Is this a normal reaction to mixing the two?

Dear Buzzed,

I went out the other night to a party, and had about four beers and half a
glass of wine within about three and a half hours. I noticed I was getting
a little more drunk than usual, but didn't think much more about it.
Afterward, I took a few hits of a joint. Ten to 20 minutes later, sounds
began to echo and I couldn't really see straight or clearly. Soon after, I
was vomiting and on the verge of passing out. When I managed to get home, I
did pass out, and could barely move the few times I was awoken by my
boyfriend. The next day, I felt somewhat shaky but not really hung over.

I have never been affected in this way by the combination of alcohol and
pot. From the severity of my reaction, does it sound like I may have been
slipped something, or does it sound like I'd taken leave of my intelligence
for the evening?

Wondering

Dear Wondering,

It sounds to us like you got much more than you bargained for. As you
probably know, lots of people combine the use of marijuana and alcohol, and
we certainly don't hear reports of such powerful effects. (However, if
we've missed something, we hope our readers will tell us!) We think you
were right to suspect that you were given an additional drug -- more about
that shortly.

Research shows that combining alcohol and THC, the active ingredient in
pot, impairs a person more than either substance does alone. One's physical
performance, like driving a car, is particularly affected, and the effects
appear to be additive. For example, if you drink an amount of alcohol that
impairs your reaction time by 10 percent, and if you then smoke enough pot
to impair your reaction time by 10 percent, your total impairment will be
20 percent. This information is important for people who smoke pot while
having a couple of drinks and think that they are below the legal limit for
driving while intoxicated. Although their blood alcohol levels won't be
higher from smoking, they will be much more impaired than if they had just
been drinking.

So, what could you have ingested that would produce such a striking
reaction? Our best bet is that there was something in the alcoholic drinks
besides alcohol. Based on your symptoms, it could well have been GHB (gamma
hydroxybutyrate), which is clear and colorless and is easily added to
drinks without the consumer being able to detect it. We talked about its
effects in a recent column, so here we'll only say that it is profoundly
sedative and makes you throw up. Because it also can produce amnesia, it
has been used as a date-rape drug.

Another possibility is that there was something added to the marijuana. For
years there have been reports that marijuana is sometimes laced with
embalming fluid (mostly formaldehyde) and PCP (aka phencyclidine or angel
dust). The embalming fluid smells quite distinctive, and unless you noticed
something odd about the joint, it is unlikely that was the problem. On the
other hand, PCP could have been there and you never would have known it.

PCP is a very complex drug that is a close relative of the anesthetic
ketamine. Originally designed to be an anesthetic that would suppress
consciousness without affecting respiration and cardiovascular functions,
PCP proved to be unsuitable clinically. It can produce schizophrenia-like
symptoms, hallucinations and dissociative feelings. Some people react to it
by becoming virtually paralyzed (catatonia). Your symptoms don't sound
exactly like this, but you can never predict how a particular individual
will respond to a drug, especially when other drugs are present. It's
impossible to point to hard data on the subject because there are no
controlled studies of mixing PCP or GHB with alcohol and marijuana.

You also might want to reconsider whether your experience had anything to
do with a drug. It's natural and appropriate to believe that this change in
your brain function was caused by using these drugs, but sometimes
coincidences do occur, and some underlying condition like epileptic
seizures can be precipitated by the modest use of a drug.

So our advice is twofold: First, if you experience anything like this
again, or any other unexpected changes in the way you feel, see your doctor
right away; and second, always be aware that the recreational drug you take
may not be quite what you expected.

Buzzed appears every week in Salon Health. If you have a question, send it
to us at buzzed@salon.com.

About the writer Cynthia Kuhn, Ph.D., is a professor of pharmacology at
Duke University Medical School and heads the Pharmacological Sciences
Training Program at Duke. She is coauthor of "Buzzed: The Straight Facts
About the Most Used and Abused Drugs From Alcohol to Ecstasy" and of the
forthcoming book "Pumped: Straight Facts for Athletes About Drugs,
Supplements and Training."

Wilkie Wilson, Ph.D., is a professor of pharmacology at Duke University
Medical School. He studies how drugs affect the brain, particularly the
processes of learning and memory. He is also coauthor of "Buzzed" and of
the forthcoming book "Pumped."