LETTERS

miliar

primary

alienation

dent

are increased.

way

toward

The

of

the

An open

bridging

scene

Peopk

of assistance, professional

sources

between

these

mind

and

cognitive

of the therapeutic lower

the and

distance and the community

and

cultural

transaction

socioeconomic

of resi-

dence

of opiates,

will go a long

iolytic

agents.

chasms.

analyzed

flexibility

is indeed

status

resent

a urinalysis

showed

trace

amounts

methadone, A sample

as pure

of barbiturates

of crystal

THC

removal

In addition

of

coat and profeswho wish to work

to analgesia,

cyclidine

can

in

image

body

cause and

blood

object

size,

toxic

states

can

develop

complement

his

to play and a stage

performance.

Stepping

out

of

mg of the

setting

character

causes

cognitive dissonance and creates resistances that hamper therapeutic efforts. My appreciation of the paper by Drs. Tseng and McDermott

stems from my heightened awareness of the vital necessity for understanding the cultures of the people who use the CMHC. Their concepts provide a frame of reference that orients one to synergistic

action

rather

than

competitiveness

or

rejection.

This

can only contribute to more effective delivery of mental services to all of the community, whether urban or rural.

health

M. Los

FLORENCE

DOUGLAS,

Angeles.

icity

the

are

alert

to the

marijuana.

In fact,

phencyclidine

can

be

with

of the is ac-

We

inhaled

4.

or

Rainey

JM

Jr.

hope

the

We have recently seen sis that, to our knowledge,

rect inhalation

an example is the first

of the crystalline

of a phencyclidine case reported

THC,”

report. split

single

A 26-year-old it into

dose each

not maintain occasionally

man

14 approximately

day for 5 days.

purchased equal

a gram doses,

He quit hisjob

his balance, spent his days heard laughter when no

Although

it had been

to pinprick

over

10

in con-

JM

suspect

most

or

community

and widespread ( I).

of

these

misdiagnosed

as

will

become

use of phencyclidine:

RENCES

MK:

Prevalence

of phencyclidine 1974 or phencyclidine

in street

Jr.

Crowder

230:824,

1974

MK:

Ketamine

BD, Rosenbaum drug-Sernyl.

81:363-369,

AMA

(ltr

G, et al: Study of a new Archives of Neurology

to ed). schizoand

1959

Reed D, Cravey RH, cyclidine. International

Sedgwick Association

PR:

A fatal case involving of Forensic Toxicologists

phenBul-

7, 1972, p 7 JOHN

M.

RAINEY,

K.

MILES

M.D., Detroit,

JR.,

PH.D.

Mich. M.D. Tenn.

CROWOER,

Nashville,

di-

Smoking

and Mental

Health

form.

listening one in

of “crystal and

because

inhaled

a

he could

to music, the room

and was

denied visual, gustatory, or olfactory hallucinations. When asked what he was thinking, he replied, “nothing,” with a burst of laughter and a flattened, attenuated smile. I-Ic could not understand proverbs but was oriented to time, place, and person. However, he was unable to put his actions in a satisfactory temporal sequence, giving the impression he was floatinsensitive

result

psycho-

following



was

hyper-

of 7 to

(actually

laughing. He became frightened because he felt numb, plastic. and was “dripping all over the walls and melting into the furnitune. He was afraid of other people who were in the room but

ing in time.

dis-

N EngI J Med 290:466467.

Luby ED, Cohen phrenomimetic

SIR:

Case

may

agents

medical

caline, psibocybin, cocaine, MDA, THC, and other more attractive drugs, or may be mixed with these agents (I, 2). In one series (1) PCP was detected in 184 of237 street drug samples, and

in our area are purchasing “crystal THC” for $1.50 to $2.00 a pill or $65 a gram.

or violent injection

We

to other

Crowder

preparations.

letin. June

“snorted,” ingested orally, or injected intravenously. It is sprayed on marijuana, parsley, oregano, or other plant leaves and sold as “angel dust,” and, in powder form, is marketed as PCP or “peace pills” (I). It is also frequently sold as LSD, mes-

drug users pencyclidine)

time

amounts

described.

potential of abuse

drug

Psychiatry

or without

smoked,

have

REFE

3.

Journal, Louis R. Hott, M.D., noted that tually phencyclidine smoked in crystal form,

we

M.D. Calif

1974 issue “angel dust”

phen-

alterations

auditory and olfactory or hyperactivity. Pro-

intravenous

Larger

attributed

toxic

it is a major

JAMA

in the December

one (3).

2. Rainey

to the editor

(3).

nystagmus. ataxia,

by semicoma

following

drug

being

schizophrenia

Dust”

In a letter

SIR:

characterized

pure

like

cases

drug on “Angel

was

vulsions, and impurities produced during an improperly controbbed synthesis can cause abdominal cramps, hematemesis, coma, and death (4). This drug is so easily synthesized by amateurs and so widely distributed and sold that there must be many cases of PCP tox-

I.

More

anx-

locally

depersonalization,

activity

The absence of these props health specialist. In short,

and

pressure,

longed

to

obtained

anesthesia,

increased

sential impairs

has a role he is expected

no cvi-

or various

phencyclidine.

tortion, disordered thought processes, hallucinations, delirium, and catalepsy

the therapist

EDITOR

but

phenothiazines,

with them. The community resident knows that powerful people (healers, physicians, etc.) have certain “props” which are an espart of therapeutic activities. the credibility of the mental

THE

important.

the

symbols of authority (for example, the white sional appearance and attitude) by therapists

sense

TO

12 hours the right

since his last dose, forearm

and

he

displayed

a 3 beat per second vertical and horizontal nystagmus with fast upward and lateral components and a slow return. There were no detectable needle marks on his arms, hands, legs, or feet, and

It has been over

10 years

since

the Surgeon

General

first

alerted the country to the serious dangers of tobacco smoking. Since that time, tobacco smoking has been consistently and convincingly implicated in the development of many crippling diseases. Recent research has also revealed that the damaging effects of tobacco smoke are not confined to the user but are inflicted on those in his vicinity as well.

Most in

of the public

a cooperative

and to encourage personnel, who

effort its

have

and almost to

limit

elimination.

observed

all physicians the

increase However,

that

have

responded

of tobacco

smoking

many

smoking

mental

seems

health

to have

a

calming effect on their patients, have been reluctant to discourage the practice for fear of subjecting patients to added stress. This reluctance has led to the common experience of the typical mental health center being a place where both therapists and patients “smoke like crazy.” Although it is to our credit that we try to reduce stress for our patients, it is also true that the gains in physical and emotional health from giving up smoking far outweigh the hardships in-

volved

in the transition

AmJ

period.

Psychiatry

Furthermore,

/32:8,

August

it does

1975

not

make

879

Letter: More on "angel dust".

LETTERS miliar primary alienation dent are increased. way toward The of the An open bridging scene Peopk of assistance, professional s...
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