Phencyclidine Dependence

Treatment


Phillip W. Long, M.D.
1990

Contents


Medical Treatment

Basic Principles

Acute adverse reactions generally require pharmacological treatment to control symptoms.

Hospitalization

Acute PCP intoxication can lead to death due to hyperpyrexia and other autonomic instability, thus hospitalization is preferred. Intravenous benzodiazepines are an effective treatment for such patients.

Antianxiety Drugs

Diazepam is often effective in reducing agitation, and frequently encountered muscle spasm.

Antipsychotic Drugs

A patient with violent PCP-induced delusions may require haloperidol (Haldol) 1 to 4 mg IM or PO every 2 to 4 hours until the patient is calm.

Phenothiazines are contraindictated for the first week after PCP ingestion (because PCP is somewhat anticholinergic, and because PCP is often contaminated with belladonna alkaloids).

Other Drugs

A hypotensive drug, such as phentolamine, may occasionally be needed.

Phencyclidine elimination should be enhanced by ammonium chloride in the acute stage and by ascorbic acid or cranberry juice later on.

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Psychosocial Treatment

Basic Principles

If a user is to remain drug-free, follow-up treatment, usually with psychiatric help and resort to community resources, is vital.

Life-style changes such as avoiding people, places, and things related to PCP use should be encouraged.

Initial psychosocial treatment should focus on confronting denial, teaching the disease concept of addictions, fostering an identification as a recovering person, recognition of the negative consequences of PCP abuse, avoiding situational and intrapsychic cues that stimulate craving, and formulation of support plans.

Drug urine tests should be used to ensure compliance. Urine testing for PCP can remain positive for 7 days and false negatives can occur.

Psychotherapy

It is likely that some heavy PCP drug users, like other heavy drug users, suffer from chronic anxiety, depression, or feelings of inadequacy. In these cases, the drug abuse is a symptom rather than the central problem. These cases can benefit from psychotherapy.

Psychotherapy is useful when it focuses on the reasons for the patient's drug abuse. The drug abuse itself - past, present, and future consequences - must be given firm emphasis. Involving an interested and cooperative parent or spouse in conjoint therapy is often very beneficial.

Narcotics Anonymous

PCP drug users may benefit from Narcotics Anonymous.

N.A. meetings provide members with acceptance, understanding, forgiveness, confrontation, and a means for positive identification. New N.A. members are asked to admit to a problem, give up a sense of personal control over the disease, do a personal assessment, make amends, and help others. Telephone numbers are exchanged, and new members pick "sponsors" (more experienced members who guide them through their recovery).

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