PCP

PCP (phencyclidine), known on the street as 'angel dust,' is a dissociative drug originally developed as an anesthetic but abandoned for human medical use because of severe side effects. It produces a sense of detachment from reality and the body, along with distorted perceptions, and at higher doses it can cause profound disorientation, agitation, and unpredictable — sometimes violent — behavior. It comes as a powder, tablet, or liquid and is swallowed, snorted, smoked (often by dipping a cigarette or cannabis joint), or injected. PCP is considered a particularly hazardous drug because its effects are dose-dependent and unpredictable, it can cause serious psychiatric and medical emergencies, and people under its influence may be a danger to themselves or others.

PCP is a dissociative anesthetic that works mainly by blocking the NMDA glutamate receptor, interrupting the normal flow of information through the brain and producing the characteristic sense of detachment from one's body and surroundings, distorted perception, and, at higher doses, a trance-like or catatonic state. It also affects dopamine and other systems, which contributes to its stimulant-like agitation and its potential to produce psychosis-like states. Because the relationship between dose and effect is steep and unpredictable, relatively small differences in amount can produce very different — and far more dangerous — states. Repeated use can produce tolerance and a pattern of compulsive use in some people.

At lower doses PCP produces a sense of detachment, euphoria or numbness, distorted perceptions of sight and sound, and a feeling of being separated from one's body, along with physical signs like a blank stare, rapid involuntary eye movements, slurred speech, and loss of coordination. As the dose rises, effects can include severe disorientation, anxiety, paranoia, hallucinations, and agitation that can escalate to aggressive or violent behavior. High doses can cause dangerously high blood pressure, very high body temperature, seizures, muscle rigidity, a catatonic state, and unconsciousness. People on PCP may have reduced sensitivity to pain, which can lead to serious injury. Effects can be prolonged and unpredictable, and some people experience lingering psychiatric effects.

PCP is dangerous in several distinct ways. Behaviorally, it can cause severe agitation, paranoia, and unpredictable or violent behavior, and its pain-blunting effect means people can injure themselves badly without realizing it — making it a risk to the user and to others. Medically, high doses can cause a hypertensive crisis, dangerously high body temperature, seizures, muscle breakdown (rhabdomyolysis) that can damage the kidneys, coma, and death. The dose-effect relationship is steep and unpredictable, so escalation is especially risky, and combining PCP with alcohol or other depressants increases the danger of sedation and unconsciousness. There is no specific antidote; management is emergency medical and psychiatric care, ideally in a calm, low-stimulation environment. Severe agitation, very high temperature, chest pain, seizures, or unconsciousness are medical emergencies — call 911. For poisoning guidance call Poison Control at 1-800-222-1222; for substance-use or mental-health support the SAMHSA National Helpline is 1-800-662-4357.

distortion of sight/sound, detachment, numbness, slurred speech, loss of coordination, sense of strength/invulnerability; hallucinations at high dose

impaired memory/thinking, speech difficulties, suicidal thoughts, anxiety, depression, social withdrawal; dependence + withdrawal

smoked 2–5 min / oral 30–60 min

4–8 hr

subjective effects 24–48 hr

agitation, psychosis, bizarre behavior, raised BP/HR/temp

none (1950s vet anesthetic, discontinued)

developed 1950s as IV vet anesthetic; human trials ~1960 discontinued (postoperative delirium); peaked as abuse drug 1970s

NFLIS >104,000 reports since 1997 (~2,300 in 2024)