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Club drugs often are adulterated or misrepresented.Any club drug overdose should therefore be suspected as polydrug use with the actual substance and dose unknown.Persons who have adverse reactions to these club drugs are likely to consult a family physician.

The primary management is supportive care, with symptomatic control of excess central nervous system stimulation or depression.

There are no specific antidotes except for flunitrazepam, a benzodiazepine that responds to flumazenil.

Special care must be taken for immediate control of hyperthermia, hypertension, rhabdomyolysis, and serotonin syndrome.

Severe drug reactions can occur even with a small dose and may require critical care.

Club drug overdose usually resolves with full recovery within seven hours. Although alcohol remains the primary “social lubricant,” it has been joined by many newer psychoactive drugs that are used to intensify social ex-eriences.

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