Sherm is a street term for a dangerous, illicit substance that poses severe risks to physical and mental health. This article defines the drug’s composition and delivery method, explains its complex mechanism of action in the brain, and outlines the significant, unpredictable health crisis it can cause.
Defining Sherm: Chemical Basis and Delivery
“Sherm” is a street name given to a cigarette, typically made of tobacco or marijuana, that has been dipped in or laced with a liquid solution of Phencyclidine (PCP). This highly potent chemical is the active component responsible for the drug’s mind-altering effects. The term “Sherm stick” is a common reference for such a laced cigarette, which is smoked to quickly absorb the substance into the bloodstream.
Phencyclidine is classified chemically as an arylcyclohexylamine. It was originally developed in the 1950s for use as a general anesthetic in human surgery. Its use in humans was discontinued shortly after its introduction due to an unacceptably high rate of severe psychological side effects, including agitation and dysphoria. Despite being withdrawn from medical practice, PCP remains a Schedule II substance under the Controlled Substances Act due to its high potential for abuse and physical or psychological dependence.
How Phencyclidine Acts on the Brain
Phencyclidine exerts its primary neurological effect by acting as a noncompetitive antagonist at the N-methyl-D-aspartate (NMDA) receptor, a major receptor for the excitatory neurotransmitter glutamate. By binding inside the ion channel of the NMDA receptor, PCP effectively blocks the flow of positive ions, disrupting the brain’s critical glutamatergic signaling pathways. This interference with glutamate transmission is the fundamental cause of the drug’s dissociative properties, creating a feeling of detachment from reality and the body.
PCP also affects other neurochemical systems in the brain. It is known to interact with dopamine D2 receptors and to inhibit the reuptake of dopamine, serotonin, and norepinephrine. This complex perturbation of neurotransmitters contributes to the severe and unpredictable psychoactive effects. The disruption of dopamine signaling is thought to play a role in the drug’s ability to induce psychosis that closely resembles symptoms of schizophrenia.
Immediate Behavioral and Physical Manifestations
Intoxication results in a wide and unpredictable range of acute behavioral and physical signs that can appear within minutes of smoking a Sherm stick. Psychologically, users often experience a profound sense of depersonalization, feeling disconnected from their own thoughts and body. This is frequently accompanied by a severe disturbance of perception, including hallucinations, paranoia, and acute psychosis.
Users may exhibit highly aggressive or violent behavior, which is often the most dangerous manifestation. The sense of invulnerability and altered pain perception caused by the drug can lead to bizarre and self-destructive actions, posing a threat to both the user and others. Physical signs of intoxication include involuntary, jerky movements of the eyeballs, known as nystagmus, a hallmark finding in emergency settings. The drug’s stimulating effects on the central nervous system also cause an elevated heart rate (tachycardia) and a significant rise in blood pressure (hypertension).
Acute Toxicity and Emergency Medical Intervention
High doses of Phencyclidine, often delivered through the unpredictable dosing of a Sherm stick, can quickly lead to life-threatening acute toxicity requiring immediate medical attention. One of the gravest medical risks is severe hyperthermia, an uncontrolled rise in body temperature often triggered by extreme agitation and muscle hyperactivity. This overheating can rapidly lead to organ damage and is a primary cause of death in severe intoxication cases.
Extreme muscle activity and agitation can also cause rhabdomyolysis, a condition where damaged skeletal muscle tissue breaks down and releases proteins into the bloodstream. These proteins can overwhelm the kidneys and cause acute kidney injury, adding another layer of severe systemic toxicity. Other critical complications include seizures, prolonged coma, and respiratory depression, which necessitate the immediate stabilization of the patient’s breathing and circulation.
There is no specific antidote for Phencyclidine toxicity; therefore, emergency treatment is primarily supportive and focused on managing symptoms and complications. Controlling severe agitation and violent behavior is achieved using sedating medications, with benzodiazepines being the preferred class of drug. Controlling the patient’s body temperature and managing their blood pressure are also critical interventions to prevent long-term organ damage and ensure survival.