HIGHER AND HIGHER DRUG COCKTAILS

Pleasures, Risks And Reasons

(New York City)-Dormil is HIV positive. Each day he takes four different AIDS
medications, including AZT. For recreation, he goes to dance clubs
where he gets high on a nocturnal medley of Ecstasy, Special K, and
crystal methamphetamine. Fidgeting in his seat at a Chelsea coffee shop, he
claims he consumes only modest amounts of illegal narcotics, though his
friends say otherwise. From the outside at least, he appears hale and hearty.

"My doctor tells me not to do party drugs, but they haven't affected
my health in any way," professes the department-store clerk, who gets
a thorough medical checkup every three months. "It's therapeutic. It's
a stress-reliever. It allows me to accept the fact of my disease and
go forward with my life."

Dormil (not his real name) believes his positive attitude is why he
has so many good trips. He talks of his own polydrug experience as
"blissful," "healing," and "like a workout for the mind." But he
admits that other users are less responsible than he claims to be. He
tells of Viagra sex parties where-besides Bob Dole's favorite
tablet, purchased over the Internet- other substances on offer
included Ecstasy and crystal meth.

"The idea is that the Viagra pumps blood into your penis, the Ecstasy
makes you feel all sensual and tingly, and the crystal meth makes you
fuck all night," he explains. What is supposed to be an erotic recipe
sounds more like a prescription for a heart attack.

This weekend, and every weekend on dance floors across the city,
thousands of teeth-grinding subjects like Dormil engage in an
underground research project. Amid flashing lights and pounding music,
untutored freelance pharmacologists conduct experiments on their own
bodies to determine what happens when one consumes a bewildering array
of pills and powders in the confined and humid setting of a nightclub.
The results are not always pretty.

Earlier this year, a fragile teenager named Jimmy Lyons died at the
Tunnel disco from a popular drug cocktail combining the animal
anesthetic ketamine, better known as Special K, with the amphetamine
derivative MDMA, a/k/a Ecstasy. The subsequent closing of the Tunnel
and Sound Factory (both venues have since reopened) frightened club
owners and promoters all over town.

Security guards conduct humiliating body searches of patrons, who by
now are used to having their privacy routinely violated. These days,
it's not uncommon to find some burly bouncer peering over the stall
while you're trying to use the toilet. Hastily tacked up signs now
appear on bathroom walls: "Do not smoke pot and Special K. It puts you
in K-hole" and "The management has absolutely zero tolerance for . . .
drugs [that] induce coma and cardiac arrest." One club even went so
far as to hire a private ambulance on Saturday nights, in case
customers overdose. The paranoia is further exacerbated by persistent
rumors that the Drug Enforcement Agency has snitches planted in all
the major hot spots.

But dancehalls are not the only locations where people
OD. Thirty-seven-year-old Anne Marie Capati suffered a stroke last year at
a Crunch fitness center on Lafayette Street. Her family alleges in a
lawsuit that she was killed by nutritional supplements recommended by
her trainer. (Crunch says the trainer denies giving her supplements.)
Capati's death- no less tragic than Jimmy Lyons's- was widely
covered in the local media. But her demise has inspired no moral
crusade to shut down gymnasiums.

Despite the ongoing crackdown on clubland, thrill-hungry nightcrawlers
still continue to experiment with an alphabet soup of chemicals: MDMA,
MDA, GHB, Special K, LSD, 2CB, as well as old standbys like crystal
meth and cocaine. (See sidebar glossary.) Add alcohol and nicotine, as
well as various prescription medications ranging from antidepressants
to protease inhibitors- not to mention the anabolic steroids
commonplace among disco denizens- and you have a volatile mixture of
unpredictable chemical cross-reactions that turns many clubgoers into
dancing drug stores. Or burned-out zombies.

"It's crazy," says one veteran dealer, who is in the process of
quitting the business. "The entire New York club scene revolves around
drug cocktails. I've lost count of the number of people I've seen
collapse on their faces after mixing GHB with alcohol. It's rare that
people go out and do one thing anymore- they have to mix two or
three things at once to get that extra boost. One addiction feeds the
other."

Hedonism has a dark side. "People want to go out and get fucked up
because they're not happy," the anonymous dealer continues. "They're
trying to escape for the night. They don't want to be where they are.
And if they are there, they don't want to have to remember it."

But polydrug use doesn't have to be synonymous with immoderation. Some
club patrons go to great lengths to figure out what each drug does
individually and in combination. Besides, you can snort yourself into
oblivion using just a single substance such as cocaine. It would be
naive to deny, though, that once you've enjoyed MDMA, for instance,
there's not a natural curiosity to try other chemicals. In many ways,
Ecstasy is the gateway drug of the '90s. When the supply is scarce or
adulterated, clubgoers try replacement substances.

"I've seen people do E and when the E doesn't work, they do K and GHB,
and drink. And then they fall on the floor in convulsions," said one
bartender who has worked at some of the druggiest hot spots in New
York. "It's very scary. It's to do with how bad the person's reality
is, and how bad they want to escape from it."

Disco polypharmacy involves risk. Nobody knows how safe some of these
mixtures really are. Some say that not necessarily all combinations
are bad for you- for instance, partygoers claim that swallowing
Ecstasy followed by LSD (known as "candy flipping") can be extremely
therapeutic. "I've interviewed a lot of people about the practice . .
. and I have had no reports of any adverse physical or psychological
effects from the combination, other than the limited adverse effects
that can be caused by taking each drug separately," says Dr. Katherine
Bonson, a psychopharmacologist at the National Institute of Mental
Health. But other combos- say, the mix of alcohol, GHB, and ketamine
referred to as a "Special K-lude"- appear more fraught with peril.

Still, finding out authoritatively which blends are chancey is
difficult because of the paucity of reliable scientific research. What
happens, for instance, when you take AIDS medications with MDMA, a
common combo in gay clubs? How important is individual genetics in
determining how a person metabolizes various drugs? Why can one person
die from combining E and K, while a hundred others will swear it's one
of the most life-affirming highs available, particularly when you
sniff K after ingesting the E? Conclusive answers are not easy to
find. For one thing, pharmaceutical companies don't test products for
bad reactions with illegal substances.

Chemist and author Dr. Alex "Sasha" Shulgin, who wrote the drug bibles
PIHKAL (Phenethylamines I Have Known and Loved) and TIHKAL
(Tryptamines I Have Known and Loved) and rediscovered MDMA in the
early '70s, points out that "There's been precious little clinical
study done on these drugs individually, and in combination, virtually
nothing- because of the 'War on Drugs,' no one in a position of
authority will approve it. In our day and age, there's no way you can
set up a study of the physical-pharmacological action of something
that's illegal."

Filling the knowledge gap left by authorities are the inevitable
rumors- urban myths about how MDMA drains your spinal fluid, or how
acid is cut with rat poison. Of course, there's always the Internet,
which features acres of information about illegal pharmaceuticals. But
figuring out how much of that info is reliable is frustrating.

"Because it's so difficult to do above-ground research, there's been
this flourishing of semi-informed underground research," says Rick
Doblin, founder of MAPS (the Multi- Disciplinary Association for
Psychedelic Studies), which in 1996 conducted a chemical analysis of
Ecstasy samples taken from clubs and raves, and found that roughly
half the hits contained no MDMA whatsoever. The good news (available
on Doblin's Web site, www.maps.org) is that the stuff the bogus E was
cut with- Sudafed, caffeine, cough suppresant, chalk- isn't that
harmful.

Dr. Bonson is another source of dependable data. For the last five
years, she has conducted an ongoing nonclinical Internet survey (at
her e-mail address, kbonson@codon.nih.gov) of people who mix illegal
with prescription drugs, focusing on the interaction between
hallucinogens and antidepressants.

"If you were on Prozac, or other SSRIs [Seratonin Selective Re-Uptake
Inhibitors], what happened was there was a diminishment of response to
drugs like LSD and MDMA," she reveals. "That's in contrast to people
taking Lithium or a tricyclic antidepressant, who had a much greater
response to the hallucinogens, to the point where some lapsed into an
unpleasant fugue state where they didn't know where they were."

But the most hazardous concoction she found was Ecstasy and MAO
inhibitors like Nardil. "The combinations," she warns, "can produce an
extremely dangerous increase in blood pressure known as hypertensive
crisis. Which can lead to death."

Alex Shulgin spearheaded the current polydrug boom with his pioneering
work in the '60s on the synthesis of new psychoactive substances,
which he tested on himself. He and his wife, Ann, also a researcher,
submit that drug combinations interact in two different ways:
potentiation and synergism. Potentiation is when one drug increases
the activity of another; synergism is when each drugs enhances the
activity of each other.

As an example of synergism, the Shulgins cite what they regard as the
benign practice of taking MDMA followed a couple hours later by other
psychedelics like ketamine or 2CB. "The best effect is when coming
down off the MDMA, take a lower dose of 2CB," advises Ann. In this
way, Ecstasy boosts the action of the 2CB.

By contrast, as an example of potentiation, the Shulgins refer to the
popular clubland combo of alcohol and the liquid steroid GHB. Both
drugs are depressants which slow down the nervous system. When taken
together, the alcohol greatly increases the GHB's potential for
inducing a coma.

Like a Boy Scout, Dexter (not his real name) always comes prepared. A
self-described high-school nerd who, with aid of gyms and chemicals,
blossomed into a sex magnet, he takes his drugs seriously. A typical
Saturday night for the thirtysomething software executive begins
around 8 p.m. with a hearty meal, to sustain him for the night ahead.
Around midnight, back at his apartment, he takes a hit of Ecstasy. He
also consumes Ammodium AD (because MDMA gives him diarrhea), followed
by Carbo-Force, a liquid carbohydrate supplement.

Ten minutes before the Ecstasy is due to hit, he heads out, drinking a
bottle of water in the taxi en route to the club, hiding a milliliter
measure in his shoe. Once in the club, he buys more water. With the E
kicking in, he and his friends head onto the dance floor, where they
do their first bump of Special K for the night, followed later by GHB
specially made up for them by a chemist acquaintance. (They avoid such
physically addictive substances as heroin, cocaine, and crystal meth.)
"I use the Ecstasy as the base drug, and then afterward use the K as a
temporary effect to heighten the E experience," Dexter says. "I find
that drugs are a lot more effective in a group situation where
everybody is high. The ritual get-together enhances the drugs. It's
more a social thing than a drug thing."

Because of the crackdown in clubland, customers increasingly take the
drugs before entering clubs, or smuggle them past security, rather
than buying from house dealers. "The drugs are very impure in the
clubs at the moment," says one dope peddler. "Everybody goes, 'Oh,
this is the best from Amsterdam.' They don't have a clue. It's
probably from somebody's bathtub in South Jersey. In a club, how can
you check?"

As a result, club-kid chemists now synthesize their own connoisseur
brands at home- for instance Chanel No. 9, an expensive mix of
cocaine, MDMA, and Special K. "The high is intense and powerful,"
reports one user. "As you come down from the coke, you feel the
tingling relaxation of the Ecstasy, followed by the intermittent
euphoria brought on by the K. It then becomes like a rollercoaster,
repeating in waves up and down for hours."

Clubland features more blends than Starbucks. But combining one drug
with another is not confined to dance floors. Pharmaceutical companies
are the biggest polydrug peddlers on the block: cough and cold
medicines such as Nyquil P.M. are usually drug mixtures, and the
current mania for so called "lifestyle drugs" only adds more to the
mix. The psychedlic tea "ayahuasca," which pop stars like Sting rave
about, is an ancient polydrug example- two rain-forest plants are
combined; one contains an MAO inhibitor, which deactivates stomach
enzymes that would otherwise nullify the effect of the main
ingredient, the powerful hallucinogen DMT.

In the modern world, from Prozac to MTV, from special-effects
blockbusters to those cruel silver machines found in gymnasiums,
society seems rife with mood-altering simulators and stimulators
designed to enervate, sedate, or change some aspect of personality or
biology. There are plenty of technologies available that allow you to
achieve multiple highs without hard drugs. Normal folks relaxing at
home, sipping a glass of red wine then drinking a cup of coffee while
flicking through TV channels, rely as much on polydrugs as the
nocturnal freaks of clubland. Bombarded by fast-cut images and
free-floating visuals, the trippy, media-saturated fabric of everyday
life encourages all of us to explore different forms of reality
concurrently.

"The whole culture tends towards blending," claims Rick Doblin. "You
want multiple things happening simultaneously. I don't think that's
inherently a bad thing."

(end of article)

Sidebar----
DOING POLYDRUGS SAFELY

Given that, among young hipsters, the desire to get high is perennial
no matter how harsh the season, what should the disco polydrug user
watch out for, other than the law? The Voice does not endorse illegal
drug use, but experts and experienced clubbers we talked to offer the
following advice:

* Avoid taking different drugs that do the same thing8B like piling
stimulants on top of stimulants.

* Don't mix psychedelics and booze.

* If you're unhappy or depressed, don't get high.

* Be conscious of your surroundings. In a club, the ambient
temperature of the room, the proximity of the bodies, and the
disorienting visual and sonic assault can fuse to create a potentially
hazardous environment for the unwary user.

* Make sure you're in the company of responsible friends who will come
to your aid if anything goes wrong.

* Rely on the power of your imagination as much as the potency of
chemicals.

* If you're doing a new drug for the first time, try it by itself
before combining it with other substances.

* And, as Ann Shulgin counsels: "Make sure you stay hydrated and don't
overdo things. Watch out for heavy sweats, chills, and vertigo. . . .
Most of all, be conservative."

* Plus, get plenty of rest afterward.

Second Sidebar-----
POLYDRUG GLOSSARY

Crystal Methamphetamine: highly addictive, turbo-charged amphetamine
that increases energy levels, enabling users to party for nights on
end. Done in excess, can cause diarrhea, paranoia, hallucinations, and
liver damage.

Ecstasy (MDMA): euphoric, empathy-inducing amphetamine derivative
that Rick Doblin calls "the universal solvent" because it goes well
with a cornucopia of other drugs.

Ephedrine: the speedy substance that may have killed Anne Marie Capati.
Frequently found in over-the-counter drugs like Sudafed.

GHB (gamma hydroxybutrate): salty-tasting steroid that, before it was
banned, used to be sold over the counter in health stores. Because it
comes in concentrated liquid form, there's a fine line between a
heavenly high and a deadly dose.

LSD (acid): powerful hallucinogen that causes mind-bending visions,
sometimes pleasant, other times not.

MAO inhibitors: Monoamine oxidase is an enzyme that metabolizes
neurochemicals in the brain; MAO inhibitors are antidepressants that
prevent the enzyme's activity, allowing neurochemicals to continue
working.

Special K (ketamine): animal tranquilizer (used by veterinarians) that
doctors classify as a "disassociative anesthetic," since your mind
feels detached from your body. Depending on the dose, ketamine induces
everything from pleasant weightlessness to a full-fledged out-of-body
or near-death experience.

2CB: Mild psychedelic sometimes sold as Ecstasy.