Phencyclidine (PCP) Drug Use: DSM-5 Criteria and SAMHSA Guidelines for Hallucinogen Use

Course Summary

Phencyclidine (PCP) is a dissociative anesthetic. Animal and human studies showed that PCP was an effective anesthetic and analgesic. There are multiple mechanisms of action of PCP that are responsible for its clinical effects. Phencyclidine mainly works as an NMDA receptor antagonist. Phencyclidine can also inhibit the reuptake of the biogenic amines dopamine, norepinephrine, and serotonin. Phencyclidine causes significant adverse effects, including delirium, depersonalization, dysphoria, and hallucinations. Consequently, PCP is no longer used in humans as an anesthetic, but phencyclidine continues to be used as an illicit drug. Although PCP is far less popular now than it was, people continue to misuse it. Phencyclidine intoxication can lead to PCP substance use disorder, and it can cause serious, long-lasting morbidities. There is pharmacologic treatment for perceptual disorders caused by PCP use e.g., clonidine, benzodiazepines, atypical antipsychotics, and others. The Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Improvement Protocol (TIP) Series, No. 42 (2020) discusses the guiding principles of effective substance use treatment for the management of co-occurring mental health and substance use disorders. Motivational enhancement strategies and patient education on integrated community treatment are recommended for successful recovery.