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Benzylpiperazine

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Benzylpiperazine



 
 
Benzylpiperazine (with trade names such as "A2", "Benny Bear", "Benny", "Frenzy" and "Nemesis", commonly referred to as BZP) is a recreational drug with euphoric
Euphoria (emotion)

Euphoria is medically recognized as an emotional and mental state defined as a sense of great happiness and quality_of_life. Technically, euphoria is an affect , but the term is often colloquially used to define emotion as an intense, Wiktionary:transcendent happiness combined with an overwhelming sense of well-being....
, stimulant
Stimulant

Stimulant drugs are drugs that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often prescription medicines or illegal drugs....
 properties. Its dopamine and serotonin agonist mechanism of action
Mechanism of action

In pharmacology, the term mechanism of action refers to the specific biochemical interaction through which a Medication substance produces its pharmacological effect....
 is believed to be similar to MDMA and the effects produced by BZP are comparable to those produced by amphetamine
Amphetamine

Amphetamine and related drugs such as methamphetamine are a group of drugs that act by increasing levels of norepinephrine, serotonin, and dopamine in the brain....
. Adverse effects have been reported following its use including acute psychosis
Psychosis

Psychosis , with adjective psychotic, literally means abnormal condition of the mind, and is a generic psychiatry term for a mental state often described as involving a "loss of contact with reality"....
, renal toxicity, and seizures.






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Benzylpiperazine (with trade names such as "A2", "Benny Bear", "Benny", "Frenzy" and "Nemesis", commonly referred to as BZP) is a recreational drug with euphoric
Euphoria (emotion)

Euphoria is medically recognized as an emotional and mental state defined as a sense of great happiness and quality_of_life. Technically, euphoria is an affect , but the term is often colloquially used to define emotion as an intense, Wiktionary:transcendent happiness combined with an overwhelming sense of well-being....
, stimulant
Stimulant

Stimulant drugs are drugs that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often prescription medicines or illegal drugs....
 properties. Its dopamine and serotonin agonist mechanism of action
Mechanism of action

In pharmacology, the term mechanism of action refers to the specific biochemical interaction through which a Medication substance produces its pharmacological effect....
 is believed to be similar to MDMA and the effects produced by BZP are comparable to those produced by amphetamine
Amphetamine

Amphetamine and related drugs such as methamphetamine are a group of drugs that act by increasing levels of norepinephrine, serotonin, and dopamine in the brain....
. Adverse effects have been reported following its use including acute psychosis
Psychosis

Psychosis , with adjective psychotic, literally means abnormal condition of the mind, and is a generic psychiatry term for a mental state often described as involving a "loss of contact with reality"....
, renal toxicity, and seizures. It does not appear to be very addictive and no deaths have been reported following a sole ingestion of BZP, although there have been at least two deaths from the combination of BZP and MDMA. Its sale is banned in a few countries, including the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
, Australia
Australia

Australia, officially the Commonwealth of Australia, is a country in the southern hemisphere comprising the Australia of the world's smallest continent, the major island of Tasmania, and numerous list of islands of Australia in the Indian Ocean and Pacific Oceans....
, New Zealand
New Zealand

New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses , and numerous Islands of New Zealand, most notably Stewart Island/Rakiura and the Chatham Islands....
 and in parts of Europe
Europe

Europe is, conventionally, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally divided from Asia to its east by the water divide of the Ural Mountains, the Ural , the Caspian Sea, and by the Caucasus Mountains to the southeast....
. However, its legal status
Legal status

In law legal status refers to the concept of individuals having a particular place in society, relative to the law, as it determines the laws which affect them....
 is currently less restrictive in some other countries such as Ireland
Republic of Ireland

Ireland is an Island country in north-western Europe. The modern Sovereignty state occupies about five-sixths of the island of Ireland, which was partitioned by the British on 3 May 1921....
 and Canada
Canada

Canada is a country occupying most of northern North America, extending from the Atlantic Ocean in the east to the Pacific Ocean in the west and northward into the Arctic Ocean....
, although investigations and regulations are pending under European Union
European Union

The European Union is an economic and political union of 27 European Union member state, located primarily in Europe. It was established by the Treaty of Maastricht on 1 November 1993 upon the foundations of the pre-existing European Economic Community....
 laws.

History


Development history

It is often claimed that BZP was originally synthesized as a potential antihelminthic (anti-parasitic) agent for use in farm animals. However, there are some references to BZP in medical literature that predate interest in piperazine
Piperazine

Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
s as anthelmintics. Even so, the majority of the early work with the piperazines were investigations into their potential use as anthelmintics with the earliest clinical trial
Clinical trial

In health care, clinical trials are conducted to allow safety and efficacy data to be collected for new drugs or devices. These trials can only take place once satisfactory information has been gathered on the quality of the product and its non-clinical safety, and Institutional review board approval is granted in the country where the trial...
s in the literature relating to piperazine being articles in the British Medical Journal
British Medical Journal

BMJ is an open access medical journal. It is among the most influential and widely read Peer review general academic journals in the field of medicine in the world....
 in the 1950s. It was discovered that BZP had side effect
Adverse drug reaction

An adverse drug reaction or adverse drug event is an expression that describes the unwanted, negative consequences associated with the use of given medications....
s and was largely abandoned as a worm treatment. It next appears in the literature in the 1970s when it was investigated as a potential antidepressant
Antidepressant

An antidepressant is a psychiatric medication used for alleviating major depressive disorder or dysthymia. Drug groups known as MAOIs, tricyclics, and second-generation antidepressants such as SSRIs, and serotonin-norepinephrine reuptake inhibitors are particularly associated with the term....
 medication, but rejected when research reported that BZP had amphetamine-like effects and was liable to abuse. The study suggested that BZP “should be placed under statutory control similar to those regulating the use of amphetamine.”

Recreational history

In the early 1990s
1990s

The 1990s or Nineties was the decade that ran from January 1, 1990 to December 31, 1999. During this time, the widespread adoption of personal computers, the Internet, and the increased economic productivity led to the equity market booms around the world, and caused an influx of wealth to the United States, Canada, Europe, and Asia....
, the United States Drug Enforcement Administration
Drug Enforcement Administration

The Drug Enforcement Administration is a United States Department of Justice law enforcement agency tasked with combating War on Drugs Not only is the DEA the lead agency for domestic enforcement of the drug policy of the United States , it also has sole responsibility for coordinating and pursuing U.S....
 noted the drug was being used recreationally in California
California

California is a U.S. state on the West Coast of the United States of the United States, along the Pacific Ocean. It is bordered by Oregon to the north, Nevada to the east, Arizona to the southeast, and to the south the Mexico state of Baja California....
. It also reported that BZP was being used as an adulterant
Adulterant

Adulterants are chemical substances which should not be contained within other substances for legal or other reasons. Adulterants may be intentionally added to substances to reduce manufacturing costs, or for some deceptive or malicious purpose....
 in illicit drugs
Illegal drug trade

The illegal drug trade or drug trafficking is a global black market consisting of the cultivation, manufacture, distribution and sale of Law controlled drugs....
. Not long after, there was an explosion in the drug's use worldwide — a situation which was soon followed by legislative control in many countries. Since 1999, benzylpiperazine use grew sharply in New Zealand, where there was initially a complete lack of regulation. The New Zealand government attempted to ban the product as of December 18, 2007, but the necessary second reading of the bill did not happen in time for the law to be passed. It was so widely used that an estimated 5 million pills were sold in New Zealand in 2007. Piperazine-based stimulants began to appear in Europe in 2000 but remained virtually unavailable in the rest of the world until recently. In early 2006, pills containing the active ingredients BZP and TFMPP began to appear in the city of Vancouver
Vancouver

Vancouver is a coastal city and major seaport located in the Lower Mainland of southwestern British Columbia, Canada. It is the largest city in British Columbia and the second largest metropolitan area in the Pacific Northwest region....
, Canada, where they first gained popularity with late night party-goers as a safer alternative to many of the illicit street drugs commonly available there. In 2007 piperazine based party-pill formulations started to become widely available nationwide which has caused concern with local authorities such as Health Canada and subsequently BZP has gained much media attention in 2008. As of May 2008 piperazines such as BZP and TFMPP have been under evaluation by Health Canada in order to determine whether or not party-pills pose a significant health risk to individuals. At this time no official decision has been made regarding these specific piperazines becoming restricted substances, or if they should be banned altogether in Canada. In the United States, it is still used as an adulterant in ecstasy mimic tablets.

Production and distribution

Bzp Brands
BZP is a piperazine derivative which comes as either the hydrochloride salt or a free base
Freebase (chemistry)

Freebase or free base refers to the standalone neutral, Base form of an amine, as opposed to its water-soluble Salt . The amine is usually an alkaloid natural product....
. The hydrochloride salt is a white solid while the base form is a slightly yellowish-green liquid. BZP base is corrosive and causes burns.

In countries where its purchase is legal, BZP products are often produced in small specialist laboratories. The raw materials can be purchased from various chemical supply agencies and formed into tablets or capsules using relatively cheap production techniques. The resulting product can be marketed at extremely high markup
Markup (business)

Markup is the difference between the cost of a Good or Service and its selling price. A markup is added on to the total cost incurred by the producer of a good or service in order to create a Profit ....
, so end-user prices can be as high as 300 times the bulk cost of raw ingredients.

BZP is often marketed ostensibly as a "dietary supplement" to avoid meeting stricter laws that apply to medicines and drugs, despite the fact that BZP has no dietary value. As of late 2005, the Misuse of Drugs Act ensured it can no longer be classified or marketed as a dietary supplement
Dietary supplement

A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to provide nutrients, such as vitamins, Dietary minerals, fatty acids or amino acids, that are missing or are not consumed in sufficient quantity in a person's diet ....
 in New Zealand. Some retailers claim that BZP is a "natural" product, describing it as a "pepper extract" or "herbal high," when in fact the drug is entirely synthetic
Chemical synthesis

In chemistry, chemical synthesis is purposeful execution of chemical reactions in order to get a product , or several products. This happens by physics and chemical manipulations usually involving one or more reactions....
, and has not been found to occur naturally.

Pharmacodynamics

BZP has been shown to have a mixed mechanism of action, acting on the serotonergic
Serotonin

Serotonin is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system and enterochromaffin cells in the gastrointestinal tract of animals including humans....
 and dopamine
Dopamine

Dopamine is a neurotransmitter occurring in a wide variety of animals, including both vertebrates and invertebrates. In the human brain, this phenethylamine functions as a neurotransmitter, activating the five types of dopamine receptors ? D1, D2, D3, D4 and D5, and their variants....
rgic receptor systems in a similar fashion to MDMA. BZP has amphetamine-like actions on the serotonin reuptake transporter
Monoamine transporter

Monoamine transporters are structures in nerve cell cell membranes that function as neurotransmitter transporters transferring monoamine neurotransmitters in or out of cell s....
, which increase serotonin concentrations in the extracellular fluid
Extracellular fluid

Extracellular fluid usually denotes all body fluid outside of cells. The remainder is called intracellular fluid.In some animals, including mammals, the extracellular fluid can be divided into two major subcompartments, interstitial fluid and blood plasma....
s surrounding the cell
Cell (biology)

The cell is the structural and functional unit of all known Life organisms. It is the smallest unit of an organism that is classified as living, and is often called the building bricks of life....
 and thereby increasing activation of the surrounding serotonin receptors. BZP has a lower potency effect on the noradrenaline reuptake transporter
Monoamine transporter

Monoamine transporters are structures in nerve cell cell membranes that function as neurotransmitter transporters transferring monoamine neurotransmitters in or out of cell s....
 and the dopamine reuptake transporter
Monoamine transporter

Monoamine transporters are structures in nerve cell cell membranes that function as neurotransmitter transporters transferring monoamine neurotransmitters in or out of cell s....
. BZP has a high affinity action at the alpha2-adrenoreceptor, it is an antagonist at the receptor, like yohimbine
Yohimbine

Yohimbine, also known under the antiquated names quebrachin, aphrodin, corynine, yohimvetol, and hydroergotocin, is a purported aphrodisiac....
, which inhibits negative feedback, causing an increase in released noradrenaline.

BZP also acts as a non-selective serotonin receptor agonist
Agonist

An agonist is a term used to describe a type of Ligand or drug that binds and alters the activity of a Receptor . The ability to alter the activity of a receptor, also known as the agonist's efficacy is a property that distinguishes it from receptor antagonist, a type of receptor ligand which also binds a receptor but which does not alter t...
 on a wide variety of serotonin receptors; binding to 5HT2A receptors may explain its mild hallucinogenic effects at high doses, while partial agonist or antagonist effects at the 5HT2B receptors may explain some of BZPs peripheral side effects, as this receptor is expressed very densely in the gut, and binding to 5HT3 receptors may explain the common side effect of headaches, as this receptor is known to be involved in the development of migraine
Migraine

Migraine is a neurology syndrome characterized by altered bodily perceptions, headaches, and nausea. Physiologically, the migraine headache is a neurological condition more common to women than to men....
 headaches.

There is still much that is not known about the pharmacokinetics of benzylpiperazine. Its metabolism is mainly through the enzymes CYP2D6
CYP2D6

Cytochrome P450 2D6 , a member of the cytochrome P450 mixed-function oxidase system, is one of the most important enzymes involved in the metabolism of xenobiotics in the body....
 and COMT.

Effects


The effects of BZP are largely similar to amphetamine
Amphetamine

Amphetamine and related drugs such as methamphetamine are a group of drugs that act by increasing levels of norepinephrine, serotonin, and dopamine in the brain....
s, with one study finding that former amphetamine addicts were unable to distinguish between dextroamphetamine
Dextroamphetamine

Dextroamphetamine is a psychostimulant which is known to produce increased wakefulness and focus in association with decreased fatigue and appetite....
 and BZP administered intravenously. Users report alertness, euphoria and a general feeling of well being. The perception of certain sensations such as taste, colour or music may be subjectively enhanced. The average duration is longer than that of dextroamphetamine, typically lasting 4-6 hours with reports as long as 8 hours depending on the dose. A recent study has shown that mixtures of BZP with other piperazine drugs such as TFMPP
Trifluoromethylphenylpiperazine

3-Trifluoromethylphenylpiperazine is a piperazine-based drug. It is not used medicinally, but has been sold as a recreational drug used as a "legal alternative" to illicit drugs such as LSD and MDMA....
 share certain pharmacodynamic traits with MDMA.

Subjective effects


Upon ingestion of between 50 mg and 200 mg of BZP, the user may experience any or all of the following:

Coming up:
  • Actual and perceived changes in body temperature
    Thermoregulation

    Thermoregulation is the ability of an organism to keep its core temperature within certain boundaries, even when the surrounding temperature is very different....
  • Slight nausea
    Nausea

    Nausea is the sensation of unease and discomfort in the stomach with an urge to vomit....
  • Flushing
    Flushing (physiology)

    For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiology conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, generally restricted to the face or cheeks, and generally assumed to reflect embarrassment....
  • Mild xerostomia
    Xerostomia

    Xerostomia is the medical term for a dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, or doughmouth....
     (dry mouth)
  • Rapid mood elevation
  • Mild jaw clenching/bruxism
    Bruxism

    Bruxism is the grinding of the teeth, and is typically accompanied by the clenching of the jaw. It is an oral Parafunctional habit that occurs in most humans at some time in their lives....
  • Increased heart rate
  • Enhanced sociability
  • Repetitive thought patterns
  • Dilation
    Dilation

    Dilation or dilatation may refer to:In physiology:* Pupillary response, dilation of the pupil of the eye* Cervical dilation, the widening of the cervix in childbirth, miscarriage etc....
     of pupil
    Pupil

    The pupil is the sphere that is located in the center of the Iris of the eye and that controls the amount of light that enters the eye. It appears black because most of the light entering the pupil is absorbed by the biological tissue inside the eye....
    s (see photo)
  • Decreased appetite
    Appetite

    The appetite is the desire to eating food, felt as hunger. Appetite exists in all higher lifeforms, and serves to regulate adequate energy intake to maintain metabolism needs....
  • Slight urinary incontinence
    Urinary incontinence

    Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life....
    , often described as "leaking" a small amount of urine
    Urine

    Urine is a liquid waste product of the body secreted by the kidneys by a process of filtration from blood called urination and excreted through the urethra....
     after urinating (not due to loss of bladder
    Urinary bladder

    In anatomy, the urinary bladder is a solid, muscle, and distensible organ that sits on the pelvic floor in mammals. It is the organ that collects urine excreted by the kidneys prior to disposal by urination....
     control)
  • "Rushing" sensation
  • Enhanced appreciation of music
  • Skin tingling
  • Feelings of euphoria
    Euphoria (emotion)

    Euphoria is medically recognized as an emotional and mental state defined as a sense of great happiness and quality_of_life. Technically, euphoria is an affect , but the term is often colloquially used to define emotion as an intense, Wiktionary:transcendent happiness combined with an overwhelming sense of well-being....
    , wonder, amazement, well-being, energy and elation
  • Increased desire to move, also slight increase in stereotypy
    Stereotypy

    A stereotypy is a repetitive or ritualistic movement, posture, or utterance, found in patients with mental retardation, autism spectrum disorders, tardive dyskinesia and stereotypic movement disorder....


Coming down:
  • Mild headache
    Headache

    In medicine a headache or wiktionary:cephalalgia is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies....
  • Nausea
  • Hangover
    Hangover

    A hangover describes the sum of unpleasant physiological effects following heavy consumption of drugs, particularly alcoholic beverages. The most commonly reported characteristics of a hangover include headache, nausea, sensitivity to photophobia and phonophobia, lethargy, dysphoria, and thirst....
    -like symptoms (common with high doses)
  • Fatigue
    Fatigue (physical)

    Fatigue is a weariness caused by exertion. It can describe a range of afflictions, varying from a general state of wikt:lethargy to a specific work-induced burning sensation within one's muscles....
  • Increased hunger (and sometimes thirst)
  • Insomnia
    Insomnia

    Insomnia is a symptom of a sleep disorder characterized by persistent difficulty falling sleep or staying asleep despite the opportunity. Insomnia is a symptom, not a stand-alone diagnosis or a disease....
  • Confusion
    ConFusion

    ConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association....
  • Loss of appetite
    Anorexia (symptom)

    Anorexia is the decreased sensation of appetite. While the term in non-scientific publications is often used interchangeably with anorexia nervosa, many possible causes exist for a decreased appetite, some of which may be harmless, while others indicate a serious clinical condition, or pose a significant risk....


Tolerance

Research into BZP's tolerance is sparse. Anecdotal evidence
Anecdotal evidence

The expression anecdotal evidence has two distinct meanings. Evidence in the form of an anecdote or hearsay is called anecdotal if there is doubt about its veracity: the evidence itself is considered untrustworthy or untrue....
 from online sources claim tolerance to the central action of BZP will develop quickly. Due to tiredness associated with the body's recovery from stimulants, such as BZP, it is uncommon for users to be able to sustain a week-long intake.

Toxic effects

As with most sympathomimetic stimulant
Stimulant

Stimulant drugs are drugs that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often prescription medicines or illegal drugs....
s there appear to be significant side effects associated with BZP use. BZP reportedly produces insomnia and a mild to severe hangover
Hangover

A hangover describes the sum of unpleasant physiological effects following heavy consumption of drugs, particularly alcoholic beverages. The most commonly reported characteristics of a hangover include headache, nausea, sensitivity to photophobia and phonophobia, lethargy, dysphoria, and thirst....
 after the drug effect wears off, however, some manufacturers in New Zealand have started including recovery pills which contain 5-HTP
5-Hydroxytryptophan

5-Hydroxytryptophan or 5-HTP is a naturally occurring amino acid, a precursor to the neurotransmitter serotonin and an intermediate in tryptophan metabolism....
 and vitamins which allegedly ease these hangovers.

The major side effects include dilated pupils, blurred vision, dryness of the mouth, extreme alertness, pruritus, confusion
ConFusion

ConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association....
, agitation
Agitation

Agitation may refer to:* emotional state of excitement or restlessness** psychomotor agitation, an extreme form of the above, which can be a side effect of antipsychotic medication...
, tremor, extrapyramidal symptoms (dystonia
Dystonia

Dystonia is a neurology movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. The disorder may be Heredity or caused by other factors such as Birth trauma or other physical trauma, infection, poisoning or reaction to Medication....
, akathisia
Akathisia

Akathisia, or acathisia, is a syndrome characterized by unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless, hence its origin in Ancient Greek a , [without, not] + ????s?? , [sitting]....
), headache
Headache

In medicine a headache or wiktionary:cephalalgia is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies....
, dizziness
Dizziness

Dizziness describes a number of subjective symptoms, which the patient may describe as feelings of lightheadedness, floating, wooziness, giddiness, confusion, disorientation or loss of balance....
, anxiety, insomnia
Insomnia

Insomnia is a symptom of a sleep disorder characterized by persistent difficulty falling sleep or staying asleep despite the opportunity. Insomnia is a symptom, not a stand-alone diagnosis or a disease....
, vomiting
Vomiting

Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Undesired vomiting may result from many causes, ranging from gastritis or poisoning to brain tumors, or elevated intracranial pressure....
, chest pain
Chest pain

In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the chest pain is non-cardiac in origin this is often a diagnosis of exclusion made after ruling out more serious causes of pain....
, hallucination
Hallucination

A hallucination, in the broadest sense, is a perception in the absence of a stimulus . In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space....
s, paresthesia
Paresthesia

Paresthesia is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a human limb being "asleep" ....
, tachycardia
Tachycardia

The word tachycardia comes from the Greek words tachys and kardia .Tachycardia typically refers to a heartrate that exceeds the range of the normal resting heartrate, based upon age:...
, hypertension
Hypertension

Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated....
, palpitation
Palpitation

A palpitation is an abnormal awareness of the heart rate of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. It should not be confused with ectopic beat....
s, collapse, hyperventilation
Hyperventilation

In medicine, hyperventilation is the state of breathing faster and/or deeper than necessary, bringing about lightheadedness and other undesirable symptoms often associated with panic attacks....
, sweating, hyperthermia
Hyperthermia

Hyperthermia, in its advanced state referred to as heat stroke or sunstroke, is an acute condition which occurs when the body produces or absorbs more heat than it can dissipate....
, and problems with urine retention. The more severe toxic effects include psychosis or adverse psychiatric events, renal toxicity, respiratory failure
Respiratory failure

The term respiratory failure, in medicine, is used to describe inadequate gas exchange by the respiratory system, with the result that arterial oxygen and/or carbon dioxide levels cannot be maintained within their normal ranges....
, and seizure
Seizure

An epileptic seizure is a transient symptom of abnormal, excessive or synchronous neuronal activity in the brain. It can manifest as an alteration in mental state, tonic or clonic movements, convulsions, and various other psychic symptoms ....
.

Christchurch study
The majority of the toxic effects information came from a study conducted between 1 April 2005 to 1 September 2005. The study recorded all presentations associated with party pill use at the Emergency Department
Emergency department

The emergency department , sometimes termed the emergency room , emergency ward , accident & emergency department or casualty department is a hospital or primary care department that provides initial treatment to patients with a broad spectrum of illnesses and injury, some of which may be Medical emergency and requiri...
 of Christchurch
Christchurch

Christchurch is the largest city in the South Island of New Zealand, and the country's second-largest Urban areas of New Zealand. It is midway down the South Island's east coast, just north of Banks Peninsula which itself, since 2006, lies within the formal limits of Christchurch....
 Hospital, New Zealand by recording them on a prospective data collection form. The aim was to study the patterns of human toxicity related to the use of benzylpiperazine-based 'party pills'. 61 patients presented on 80 occasions. Patients with mild to moderate toxicity experienced symptoms such as insomnia, anxiety, nausea, vomiting, palpitations, dystonia, and urinary retention. Significantly, fourteen toxic seizures were recorded with two patients suffering life-threatening toxicity
Toxicity

Toxicity is the degree to which a substance is able to damage an exposed organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a substructure of the organism, such as a cell or an organ , such as the liver ....
 with status epilepticus
Status epilepticus

Status epilepticus refers to a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 30 minutes , or recurrent seizures without regaining consciousness between seizures for greater than 30 minutes....
 and severe respiratory and metabolic acidosis
Metabolic acidosis

In medicine, metabolic acidosis is a process which if unchecked leads to acidemia, i.e. blood pH is low due to increased production of hydrogen by the body or the inability of the body to form bicarbonate in the kidney....
. It was concluded that BZP appears to induce toxic seizures in neurologically normal subjects. The results of this study and others like it showed that BZP can cause unpredictable and serious toxicity in some individuals, but the data and dosage collection were reliant on self reporting by drug users, which may result in under-reporting, and there were complicating factors like the frequent presence of alcohol and other drugs.

Attributed deaths

According to party pill manufacturer Matt Bowden, over 20 million pills containing BZP have been consumed in New Zealand with no available record attributing deaths or lasting injuries to a single ingestion of BZP. Additionally, a retrospective study carried out at an Auckland
Auckland

The Auckland metropolitan area or Greater Auckland, in the North Island of New Zealand, is the largest and most populous urban areas of New Zealand with over 1.3 million residents, percent of the country's population....
 emergency department found that BZP presentations only made a minor contribution to their overdose database with most cases not producing any significant toxicity. Several cases where BZP individually or combined with alcohol or other medicines or illicit drugs resulting in complications exist. One such example is the well publicised case of a combination of BZP and MDMA by a 23 year old from Greymouth, New Zealand
Greymouth

Greymouth is the largest town in the West Coast, New Zealand List of regions in New Zealand on the South Island of New Zealand, and the seat of the Grey District Council....
. Ben Rodham, a DJ, ingested a combination of BZP and MDMA in February 2007, which nearly resulted in his death. Rodham was put into an induced coma
Induced coma

A barbiturate-induced coma, or barb coma, is a temporary coma brought on by a controlled dose of a barbiturate drug, usually pentobarbital or thiopental....
 in an effort to prevent him from dying. He later recovered.

After many millions of doses consumed worldwide, two deaths have been officially recorded in correlation with the use of BZP, although no causal relationship has been proven. In the first case in Zurich in 2001 a 23-year-old took two BZP tablets as well as ecstasy (MDMA) and drank more than 10 litres of water in a 15-hour period, subsequently dying of cerebral edema
Cerebral edema

Cerebral edema is an excess accumulation of water in the intracellular and/or extracellular spaces of the brain....
 due to hyponatremia
Hyponatremia

Hyponatremia is an electrolyte disturbance in which the sodium concentration in the blood plasma is too low .Severe or rapidly progressing hyponatremia can result in swelling of the brain , and the symptoms of hyponatremia are mainly neurology....
 resulting from water intoxication
Water intoxication

Water intoxication is a potential fatal disturbance in brain functions that results when the normal balance of electrolytes in the body is pushed outside of safe limits by over-consumption of water....
. In the second case a male 25 year old New Zealander ingested alcohol alongside BZP and MDMA. The cause of death of this individual has not been released. It is uncertain what role the BZP may have had in these deaths; death from hyponatremia is a well known consequence of drinking too much fluid after consuming MDMA, it is likely that the additional hyponatremic effects from the BZP may have increased the hyponatremic effects from the MDMA, to the point that death resulted.

Addictive effects


One in every 45 (2.2%) last-year users of BZP in New Zealand is classed as dependent upon it, although 97.9% of users said that "it would not be difficult to stop using legal party pills", and 45.2% of people who reported using both BZP and illegal drugs such as methamphetamine
Methamphetamine

is a stimulant and sympathomimetics psychoactive drug. It is a member of the family of phenylethylamines. The levorotary levomethamphetamine is an over-the-counter drug and used in Vicks Inhalers for nasal decongestion and does not possess the Central nervous system activity of dextro or racemic methamphetamine....
 reported that they used BZP so that they did not have to use methamphetamine, which was perceived as more harmful. Still, most of the people who use BZP, even though they say it is quite easy to stop, do not want to, and continue to use the drug, feeling that it helps them to reach higher levels of mood, sociability, and energy. Studies undertaken on animals have indicated that BZP can substitute for methamphetamine in addicted rats, although it is ten times less potent and produces correspondingly weaker addictive effects.

Legal issues

The drug was classified as a Schedule I controlled substance in the United States in 2002, following a report by the DEA
Drug Enforcement Administration

The Drug Enforcement Administration is a United States Department of Justice law enforcement agency tasked with combating War on Drugs Not only is the DEA the lead agency for domestic enforcement of the drug policy of the United States , it also has sole responsibility for coordinating and pursuing U.S....
 which incorrectly stated that BZP was 10 to 20 times more potent than amphetamine, when in fact BZP is ten times less potent than dexamphetamine. The DEA subsequently admitted this mistake, but nevertheless retained the Schedule 1 classification. BZP is banned in all Australian states. Victoria, the last state in which it was legal, changed its classification on September 1 2006. This is the date BZP and piperazine analogs become illegal in the federal schedules which are now enacted by all Australian states and territories. BZP is also a banned substance in Japan, along with TFMPP. Both Australia and Japan admit that their scheduling decisions were made primarily in response to the Schedule 1 classification given to BZP in the USA, although some instances of BZP use had been reported by law enforcement authorities in both countries. BZP is also banned in Greece
Greece

Greece , officially the Hellenic Republic , is a country in southeastern Europe, situated on the southern end of the Balkans. It has borders with Albania, Bulgaria and the former Yugoslav Republic of Macedonia to the north, and Turkey to the east....
, Italy
Italy

Italy , officially the Italian Republic , is a country located on the Italian Peninsula in Southern Europe and on the two largest islands in the Mediterranean Sea, Sicily and Sardinia....
, Malta
Malta

Malta , officially the Republic of Malta , is a densely populated developed country European microstates microstate in the European Union....
, Denmark
Denmark

Denmark is a Scandinavian country in northern Europe and the senior member of the Kingdom of Denmark. It is the southernmost of the Nordic countries....
 and Sweden
Sweden

Sweden , officially the Kingdom of Sweden , is a Nordic countries on the Scandinavian Peninsula in Northern Europe. Sweden has land borders with Norway to the west and Finland to the northeast, and it is connected to Denmark by the ?resund Bridge in the south....
.

Piperazine
Piperazine

Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
 and salts of piperazine
Piperazine

Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
 are classified as Prescription Only Medicines in the UK. Any products containing salts of piperazine
Piperazine

Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
 would be licensable under the Medicines Act and consequently anyone manufacturing and supplying it legally must hold the relevant licenses to do so. BZP is not a salt of piperazine
Piperazine

Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
, but mislabelling of BZP products as containing "piperazine blend" have resulted in some prosecutions of suppliers in the UK by the Medicines and Healthcare Products Regulatory Agency, though to this date there has not been a successful prosecution in the UK for the sale of BZP, so its legal status remains uncertain. Although sale is regulated, possession of BZP is still legal.

For now, BZP and other analogous piperazines are legal and uncontrolled in many countries such as Canada
Canada

Canada is a country occupying most of northern North America, extending from the Atlantic Ocean in the east to the Pacific Ocean in the west and northward into the Arctic Ocean....
 and Ireland
Ireland

Ireland is the List of islands by area in Europe, and the twentieth-largest island in the world. It lies to the north-west of continental Europe and is surrounded by hundreds of islands and islet....
. They are not controlled under any UN convention, so the compounds themselves are legal throughout most of the world, although in most countries their use is restricted to pharmaceutical manufacturing and recreational use is unknown.

Benzylpiperazine is, however, to be the subject of a European Monitoring Centre for Drugs and Drug Addiction
European Monitoring Centre for Drugs and Drug Addiction

The European Monitoring Centre for Drugs and Drug Addiction is an agency of the European Union. Established in 1993, the EMCDDA is located in Lisbon, Portugal....
 (EMCDDA) risk assessment, the results of which will determine what, if any, control will placed on BZP throughout the European Union
European Union

The European Union is an economic and political union of 27 European Union member state, located primarily in Europe. It was established by the Treaty of Maastricht on 1 November 1993 upon the foundations of the pre-existing European Economic Community....
. The risk assessment
Risk assessment

Risk assessment is a step in a risk management process. Risk assessment is the determination of quantitative or qualitative value of risk related to a concrete situation and a recognized threat ....
 comes about as the result of a joint Europol – EMCDDA report which concluded that BZP needs to be looked at in more detail. The results were published in June 2007. The report concluded that the use of BZP can lead to medical problems even if the long effects are still unknown. Taking this concession as a basis, the European Commission has decided to ask the Council to place BZP under control of the UN Convention on Psychotropic Substances. On 4 March 2008, the EU requested countries to place BZP under control within a year and France complied on May 20th.

Based on the recommendation of the EACD, the New Zealand government has passed legislation which placed BZP, along with the other piperazine derivatives TFMPP, mCPP, pFPP, MeOPP and MBZP, into Class C of the New Zealand Misuse of Drugs Act 1975. A ban was intended to come into effect in New Zealand on December 18th 2007, but the law change did not go through until the following year, and the sale of BZP and the other listed piperazines became illegal in New Zealand as of 1st of April 2008. An amnesty for possession and usage of these drugs will remain until October 2008, at which point they will become completely illegal.

See also


  • Benzedrine
    Benzedrine

    Benzedrine is the trade name of the racemic mixture of amphetamine . It was marketed under this brandname in the United States by GlaxoSmithKline in the form of inhalers, starting in 1928....
  • TFMPP
  • mCPP
    1-(3-Chlorophenyl)piperazine

    1-piperazine is a piperazine-based 5-HT Receptor agonist. In the mid-2000s, it has shown up in legal alternatives to illegal stimulants in New Zealand, and pills sold as ecstasy in Europe and the United States....
  • MeOPP
    MeOPP

    4-methoxyphenylpiperazine is a piperazine derivative with stimulant effects which has been sold as an ingredient in "Party pills", initially in New Zealand and subsequently in other countries around the world....
  • pFPP
    PFPP

    Parafluorophenylpiperazine is a piperazine derivative with mildly hallucinogenic and euphoric effects which has been sold as an ingredient in legal recreational drugs known as "Party pills", initially in New Zealand and subsequently in other countries around the world....
  • MBZP
    1-Methyl-4-benzylpiperazine

    MBZP is a stimulant drug which is a derivative of benzylpiperazine. MBZP has been sold as an ingredient in legal recreational drugs known as "Party pills", initially in New Zealand and subsequently in other countries around the world....
  • MDBZP
    Methylenedioxybenzylpiperazine

    MDBZP or 1-piperazine is a piperazine derivative related to the stimulant drug benzylpiperazine. In the book PIHKAL it is speculated that MDBZP might have effects similar to the drug MDMA because of the presence of the 3,4-methylenedioxy group on the benzene ring, however once the compound was tested in humans this theory was shown to be inc...
  • 2C-B-BZP
    2C-B-BZP

    2C-B-BZP is a research chemical and stimulant of the Piperazine....
  • DBZP
    Dibenzylpiperazine

    Dibenzylpiperazine is a piperazine derivative often found as an impurity in the recreational stimulant drug benzylpiperazine .Presence of DBZP is a marker for low quality or badly made BZP....
  • Party pills
    Party pills

    Party pills, also known as "herbal highs", "pep pills" "dance pills" and "natural power", is a colloquialism for a type of recreational drug whose main ingredient was originally benzylpiperazine , but has now expanded to a wide range of compounds with a variety of effects....
  • Piperazine
    Piperazine

    Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a salt taste....
  • Drug abuse
    Drug abuse

    Drug abuse has a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect....
  • Recreational drugs


Footnotes


External links