PROGRAMS YOU SHOULD KNOW ABOUT:
Phencyclidine (PCP)
Phencyclidine (PCP) is classified as a schedule II drug. PCP was first manufactured in 1926 and was marketed and used as an anesthetic medication. Because of side effects and the availability of better alternative medication, its use was discontinued. PCP derivatives have been sold for recreational and non-medical use. PCP usually comes as a white powder, which can be dissolved in alcohol or water. It can be bought as a powder or liquid.
Pharmacology
PCP is a dissociative anesthetic. (Journey 2020) It can be smoked, snorted, eaten, or injected. (Glantz 1993, Journey 2020) Effects are mildly stimulant and cause hypertension, tachycardia, bronchodilation, and agitation. (Journey 2020) It can also cause sedation. (Journey 2020) Higher doses cause ataxia, hypersalivation, and hallucinations, (Glantz 1993) or even seizure, coma, and death (Journey 2020). Half-life is estimated at 21 hours. PCP is fat soluble and can be released days to months after use. (Journey 2020)
Treatment
Little is known about treating PCP use disorder.
Pregnancy
There is very little recent research focusing on PCP in pregnant humans. Even in older studies, sample sizes are small and control for complicating factors is scarce. Neonatal treatments in the 1980s were very different from today, and in many cases included interventions which we now know to be harmful. (Strauss 1981, Howard 1986) Evidence in this section should be interpreted with caution.
Fetus
PCP crosses the placenta. (Glantz 1993, Golden 1987) There is no evidence of a link with congenital anomalies, fetal loss, or preterm labor. (Glantz 1993) Infants in larger studies do not show any consistent effects. (Glantz 1993, Rahbar 1993, Wachsman 1989)
Lactation
PCP is present in the milk of people who use it, (Howard 1998, LactMed, Reece-Stretman 2015) but infant effects are unknown (LactMed).
Development
Chasnoff finds no differences in measurements or developmental scores, despite lack of control for maternal health and socioeconomic status. (Chasnoff 1983) PCP is present in the milk of people who use it, (Howard 1998, LactMed, Reece-Stretman 2015) but infant effects are unknown (LactMed).
Overdose
Higher doses can cause seizures, coma, or death. (Journey 2020) PCP overdose is a medical emergency.
Withdrawal
There is no evidence of dependence or withdrawal from PCP.
References:
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Chasnoff, I. J., Burns, W. J., Hatcher, R. P., & Burns, K. A. (1983). Phencyclidine: effects on the fetus and neonate. Developmental pharmacology and therapeutics, 6(6), 404–408. https://doi.org/10.1159/000457343
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Glantz JC, Woods JR Jr. Cocaine, heroin, and phencyclidine: obstetric perspectives. Clin Obstet Gynecol. 1993 Jun;36(2):279-301. doi: 10.1097/00003081-199306000-00009.
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Golden, N. L., Kuhnert, B. R., Sokol, R. J., Martier, S., & Williams, T. (1987). Neonatal manifestations of maternal phencyclidine exposure. Journal of perinatal medicine, 15(2), 185–191. https://doi.org/10.1515/jpme.1987.15.2.185
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Howard, C. R., & Lawrence, R. A. (1998). Breast-feeding and drug exposure. Obstetrics and gynecology clinics of North America, 25(1), 195–217. https://doi.org/10.1016/s0889-8545(05)70365-x
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Howard, J., Kropenske, V., & Tyler, R. (1986). The long-term effects on neurodevelopment in infants exposed prenatally to PCP. NIDA research monograph, 64, 237–251.
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Journey, J. D., & Bentley, T. P. (2020). Phencyclidine Toxicity. In StatPearls. StatPearls Publishing.
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LactMed Phencyclidine. (2018). In Drugs and Lactation Database (LactMed). National Library of Medicine (US).
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Rahbar, F., Fomufod, A., White, D., & Westney, L. S. (1993). Impact of intrauterine exposure to phencyclidine (PCP) and cocaine on neonates. Journal of the National Medical Association, 85(5), 349–352.
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Reece-Stretman, S. & Marinelli, K. A. (2015). ABM clinical protocol #21: Guidelines for breastfeeding and substance use or substance use disorder, revised 2015. Breastfeeding medicine. 10(3). 135-141.
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Strauss, A. A., Modaniou, H. D., & Bosu, S. K. (1981). Neonatal manifestations of maternal phencyclidine (PCP) abuse. Pediatrics, 68(4), 550–552.
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Wachsman, L., Schuetz, S., Chan, L. S., & Wingert, W. A. (1989). What happens to babies exposed to phencyclidine (PCP) in utero?. The American journal of drug and alcohol abuse, 15(1), 31–39. https://doi.org/10.3109/00952998908993397
