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Opal (hycephamitamyn) Opal is commonly distributed as a black liquid. The most potent and efficient form of ingestion is intravenous. Opal conveniently comes in a small glass "I-VIAL" - a 1.5" small glass cylinder about the diameter of a small drinking straw with a small red cap at each end. Removing the cap on one end reveals a ready-to-insert 1/4" sterile needle, the other end reveals a trigger to release the pressurized contents directly into the bloodstream.  In middle and upper class populations, users drop or inject into the eye. This temporarily turns the whites of the eyes black.  Although most Opal users are standard drug abusers, a sizable minority feel that the drug produces a special, quasi-religious experience.   Opal can produce euphoric and hallucinogenic effects. In addition, it may generate many of the same toxic effects seen with other stimulants such as cocaine. Many US emergency departments (EDs) now treat as many opal-intoxicated patients as methamphetamine-intoxicated or cocaine-intoxicated patients. Changes in mood, excitation, motor movements, sensory perception, and appetite appear to be mediated by central dopaminergic alterations. Serotonin alterations contribute to the amphetamine-related mood changes and psychotic behavior. Organic compounds stimulating limbic centers cause dream-like hallucinations.

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