Phencyclidine or phenylcyclohexyl piperidine (PCP), also known as angel dust among other names, is a dissociative anesthetic mainly used recreationally for its significant mind-altering effects. PCP may cause hallucinations, distorted perceptions of sounds, and violent behavior. As a recreational drug, it is typically smoked, but may be taken by mouth, snorted, or injected. It may also be mixed with cannabis or tobacco. Adverse effects may include seizures, coma, addiction, and an increased risk of suicide. Flashbacks may occur despite stopping usage. Chemically, PCP is a member of the arylcyclohexylamine class, and pharmacologically, it is a dissociative anesthetic. PCP works primarily as an NMDA receptor antagonist. PCP is most commonly used in the United States. While usage peaked in the US in the 1970s, between 2005 and 2011 an increase in visits to emergency departments as a result of the drug occurred. As of 2017 in the United States, about 1% of people in 12th grade reported using PCP in the prior year while 2.9% of those over the age of 25 reported using it at some point in their lives. Phencyclidine is used for its ability to induce a dissociative state. Behavioral effects can vary by dosage. Low doses produce a numbness in the extremities and intoxication, characterized by staggering, unsteady gait, slurred speech, bloodshot eyes, and loss of balance. Moderate doses (5–10 mg intranasal, or 0.01–0.02 mg/kg intramuscular or intravenous) will produce analgesia and anesthesia. High doses may lead to convulsions. The drug is often illegally produced under poorly controlled conditions; this means that users may be unaware of the actual dose they are taking. Psychological effects include severe changes in , loss of ego boundaries, paranoia, and depersonalization. Psychosis, agitation and dysphoria, hallucinations, blurred vision, euphoria, and suicidal impulses are also reported, as well as occasional aggressive behavior. Like many other drugs, PCP has been known to alter mood states in an unpredictable fashion, causing some individuals to become detached, and others to become animated.