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Understanding the Substances

Drink Check™ Screens For

GHB — Gamma-Hydroxybutyrate /

Gamma-Hydroxybutyric Acid

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Abbreviation: GHB
Drug Class: Central Nervous System Depressant

 

What is GHB?

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Gamma-hydroxybutyrate, commonly known as GHB, is a powerful central nervous system depressant. A pharmaceutical form of GHB, sodium oxybate, has legitimate medical uses under carefully controlled conditions. Illicit GHB may appear as a clear liquid, powder, or other preparation.

GHB has been associated with drug-facilitated sexual assault because it can cause significant sedation and impairment. The DEA identifies GHB as a depressant.

Possible Effects

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Effects may include:

  • Relaxation or euphoria

  • Drowsiness

  • Dizziness

  • Confusion

  • Reduced inhibitions

  • Impaired coordination

  • Nausea or vomiting

  • Memory loss or amnesia

  • Loss of consciousness

At higher exposures, GHB can cause severe central nervous system and respiratory depression. Combining GHB with alcohol or other depressants can substantially increase the danger.

 

 

Why Drink Awareness Matters

  

Someone exposed to GHB may appear much more intoxicated than expected for the amount of alcohol they consumed. Memory gaps, sudden profound sleepiness, poor coordination, or loss of consciousness should be taken seriously.

If someone becomes unconscious, cannot be awakened, has abnormal or slowed breathing, or develops seizures, call 911 immediately.

Fentanyl     Fentanyl

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Abbreviation: FYL or FENT, depending upon the test manufacturer
Drug Class: Synthetic Opioid

 

What is Fentanyl?

 

Fentanyl is a very powerful synthetic opioid. Pharmaceutical fentanyl is used medically for severe pain and anesthesia. Illegally manufactured fentanyl is also found in the illicit drug supply.

The DEA reports that fentanyl is approximately 50 times more potent than heroin and 100 times more potent than morphine as an analgesic.

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Possible Effects

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Fentanyl exposure may cause:

  • Extreme sleepiness

  • Sedation

  • Confusion

  • Dizziness

  • Nausea or vomiting

  • Pinpoint pupils

  • Slowed or stopped breathing

  • Loss of consciousness

 

The greatest immediate danger is respiratory depression.

 

 

Signs of a Possible Opioid Overdose

Watch for:

  • Person cannot be awakened

  • Very slow, irregular, or stopped breathing

  • Pinpoint pupils

  • Limp body

  • Pale, gray, or bluish skin, lips, or fingernails

  • Gurgling, choking, or unusual snoring sounds

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What to Do

Call 911 immediately.

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If naloxone/Narcan® is available, administer it according to the product directions. Naloxone can reverse an opioid overdose, including one caused by fentanyl, and may be lifesaving.

Ketamine — Ketamine

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Abbreviation: KET
Drug Class: Dissociative Anesthetic

 

What is Ketamine?

 

Ketamine is a medication used medically as an anesthetic and has other legitimate clinical applications. It is classified as a dissociative anesthetic because it can cause a person to feel detached from their body, surroundings, pain, or environment.

 

The DEA notes that ketamine can cause sedation, immobility, pain relief, perceptual changes, and amnesia and has also been used in drug-facilitated sexual assault.

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Possible Effects

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Effects may include:

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  • Dizziness

  • Confusion

  • Disorientation

  • Slurred speech

  • Poor coordination

  • Sedation

  • Altered perception

  • Hallucinations

  • Feeling detached from reality

  • Difficulty moving

  • Memory loss

  • Unconsciousness

 

At high concentrations, severe exposure can result in respiratory problems, seizures, coma, and other medical emergencies.

 

 

Why Drink Awareness Matters

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Unexpected ketamine exposure may leave someone conscious but severely disoriented or unable to control their movements. A person may also have difficulty remembering events that occurred while under its effects.

Sudden confusion, profound weakness, inability to walk normally, altered consciousness, or difficulty breathing requires immediate medical evaluation.

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Cocaine — Cocaine

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Abbreviation: COC


Drug Class: Stimulant

 

 

What is Cocaine?

 

Cocaine is a powerful central nervous system stimulant derived from coca leaves. It produces intense stimulation and has a high potential for addiction.

Unlike sedating substances traditionally associated with drink tampering, cocaine stimulates the body's cardiovascular and nervous systems.

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Possible Effects

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Cocaine may cause:

  • Increased alertness or energy

  • Restlessness

  • Anxiety

  • Agitation

  • Paranoia

  • Dilated pupils

  • Increased heart rate

  • Increased blood pressure

  • Sweating

  • Tremors

 

Serious reactions can include:

  • Irregular heartbeat

  • Chest pain

  • Seizures

  • Stroke

  • Cardiac arrest

 

Unexpected stimulant symptoms following consumption of a beverage should not be ignored.

Methamphetamine — Methamphetamine

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Abbreviation: METH or MET


Drug Class: Stimulant

 

 

What is Methamphetamine?

 

Methamphetamine is a potent stimulant that accelerates activity in the brain and body. Although a prescription form exists for limited medical indications, illicit methamphetamine is commonly known as meth, crystal meth, ice, or crystal.

The DEA describes methamphetamine as highly addictive and notes that it can significantly increase heart rate, blood pressure, breathing rate, and body temperature.

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Possible Effects

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Effects may include:

  • Unusual energy

  • Agitation

  • Restlessness

  • Rapid heartbeat

  • Elevated blood pressure

  • Increased body temperature

  • Sweating

  • Anxiety

  • Paranoia

  • Tremors

  • Confusion

 

Severe toxicity may cause:

  • Seizures

  • Dangerous overheating

  • Stroke

  • Heart attack

  • Cardiovascular collapse

 

Sudden severe agitation, chest pain, seizures, extreme overheating, or altered mental status requires emergency medical attention.

MDMA — 3,4-Methylenedioxymethamphetamine

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Abbreviation: MDMA

Common Names: Ecstasy, Molly


Drug Class: Stimulant with Hallucinogenic/Entactogenic Effects

 

 

What is MDMA?

 

MDMA is a synthetic psychoactive substance that has both stimulant and perception-altering effects. It is frequently known as Ecstasy or Molly.

The DEA describes MDMA as producing increased energy as well as changes in perception, mood, and tactile sensations. Products sold illicitly as Ecstasy or Molly may also contain other substances.

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Possible Effects

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MDMA may cause:

  • Increased energy

  • Euphoria

  • Increased feelings of closeness or emotional openness

  • Reduced inhibitions

  • Altered perception

  • Dilated pupils

  • Increased heart rate

  • Increased blood pressure

  • Jaw clenching

  • Sweating

  • Nausea

  • Confusion

 

Serious reactions may include dangerous increases in body temperature, cardiovascular problems, severe agitation, seizures, or altered consciousness.

Unexpected behavioral or physical changes after consuming a beverage should be taken seriously.

Diphenhydramine — DPH

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Abbreviation: DPH
Common Brand Name: Benadryl®
Drug Class: First-Generation Antihistamine

 

 

What is Diphenhydramine?

 

Diphenhydramine is a widely available antihistamine commonly used for allergies and in some nighttime sleep products.

Although it is an over-the-counter medication, it can produce significant sedation. Alcohol can increase the drowsiness caused by diphenhydramine.

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Possible Effects

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Diphenhydramine may cause:

  • Drowsiness

  • Dizziness

  • Slower reaction time

  • Impaired coordination

  • Dry mouth

  • Blurred vision

  • Confusion

 

Large amounts may cause:

  • Severe confusion

  • Agitation

  • Hallucinations

  • Rapid heartbeat

  • Delirium

  • Seizures

  • Coma

 

Diphenhydramine overdose can become a medical emergency.

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Why Drink Awareness Matters

Because diphenhydramine is sedating, unexpected exposure—particularly when combined with alcohol or other depressants—may increase impairment and reduce someone's ability to safely respond to their environment.

Dextromethorphan — DXM

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Abbreviation: DXM

Drug Class: Cough Suppressant / Dissociative at High Exposure

 

 

What is DXM?

 

Dextromethorphan is a cough suppressant found in many over-the-counter cough and cold medications. The DEA reports that DXM is contained in more than 120 over-the-counter cold medications, either alone or combined with other medications.

When taken in amounts greater than recommended, DXM may produce significant changes in perception and consciousness.

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Possible Effects

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Effects can include:

  • Dizziness

  • Drowsiness

  • Nausea

  • Poor coordination

  • Confusion

  • Altered perception

  • Disorientation

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At higher exposures, effects may become more severe and can include dissociation, hallucinations, significant impairment, or dangerous toxicity—particularly when combined with other substances.

 

Unexpected neurologic or behavioral symptoms following a beverage should receive medical attention.

Scopolamine — Scopolamine

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Abbreviation: SCOP
Drug Class: Anticholinergic

 

 

What is Scopolamine?

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Scopolamine is a legitimate prescription medication commonly used to prevent motion sickness and postoperative nausea and vomiting.

However, excessive or unintended exposure can produce significant effects on the brain and nervous system.

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Possible Effects

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Scopolamine toxicity can cause:

  • Dry mouth

  • Blurred vision

  • Dilated pupils

  • Rapid heartbeat

  • Confusion

  • Disorientation

  • Agitation

  • Hallucinations

  • Severe drowsiness

  • Memory problems

  • Difficulty speaking

  • Urinary retention

 

More severe toxicity may cause seizures, profound altered mental status, or coma.

 

Why Drink Awareness Matters

 

Scopolamine has received attention because significant exposure can produce confusion, impaired judgment, memory disturbances, and altered consciousness.

 

It is important, however, not to describe every case of suspected drink tampering as scopolamine exposure. Only appropriate toxicology testing can establish what substance, if any, was present.

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Benzodiazepines — BZO / BZD

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Abbreviation: BZO or BZD

Drug Class: Central Nervous System Depressants

 

 

What is Benzodiazepines?

 

Benzodiazepines are medications used to treat conditions such as anxiety, insomnia, seizures, and for procedural sedation.

 

Examples include:

  • Alprazolam — Xanax®

  • Diazepam — Valium®

  • Lorazepam — Ativan®

  • Clonazepam — Klonopin®

  • Midazolam — Versed®

  • Temazepam — Restoril®

  • Flunitrazepam — Rohypnol®

 

Benzodiazepines slow activity in the central nervous system. They may cause sedation, impaired coordination, and memory loss.

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Possible Effects

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Effects may include:

  • Drowsiness

  • Relaxation

  • Dizziness

  • Slurred speech

  • Poor coordination

  • Impaired judgment

  • Confusion

  • Memory loss or amnesia

 

Large amounts or combinations with alcohol, opioids, or other depressants can cause:

  • Extreme sedation

  • Respiratory depression

  • Loss of consciousness

  • Coma

  • Death

Rohypnol® — Flunitrazepam

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Drug Class: Benzodiazepine

 

Rohypnol® is the trade name for flunitrazepam, a benzodiazepine and central nervous system depressant.

​Rohypnol is not approved by the FDA for medical use in the United States. The DEA notes that it has been misused to incapacitate people targeted for sexual assault.

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​Possible Effects

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Rohypnol may cause:

  • Profound drowsiness

  • Muscle relaxation

  • Impaired judgment

  • Poor coordination

  • Reduced inhibitions

  • Confusion

  • Memory loss

  • Loss of consciousness

Combining a benzodiazepine with alcohol or an opioid can greatly increase central nervous system and respiratory depression.

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