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AmphetaminesAmphetamines

The Use and Abuse of Designer DrugsThe Use and Abuse of Designer DrugsMegan TrimbleMegan Trimble

Doctor of Pharmacy candidateDoctor of Pharmacy candidateMarch 2006March 2006

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What are Amphetamines?What are Amphetamines?

The term “amphetamines” refers to a class The term “amphetamines” refers to a class of drugs.of drugs.

World War IIWorld War II– Stimulants for soldiers and prisoners (1)Stimulants for soldiers and prisoners (1)

http://images.google.com/imgres?imgurl=http://www.modafinil.com/article/modsold.jpg&imgrefurl=http://www.modafinil.com/article/soldiers.html. Accessed 29 April 2006.

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Amphetamine-like DrugsAmphetamine-like Drugs

Most commonly abused by college Most commonly abused by college students:students:– MethamphetamineMethamphetamine

Results in CNS excitationResults in CNS excitation– In other words, it “revs up” your brainIn other words, it “revs up” your brain– Chemical responsible for these effects: DopamineChemical responsible for these effects: Dopamine

– MDMAMDMASerotonin, not dopamine, is the chemical Serotonin, not dopamine, is the chemical responsible for the effects felt from using MDMAresponsible for the effects felt from using MDMA

““Designer” amphetamines (1)Designer” amphetamines (1)

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““Designer Drugs”Designer Drugs”

What is Methamphetamine?What is Methamphetamine?– Street names:Street names:

““meth” “speed” “chalk” meth” “speed” “chalk”

““ice” “crystal” “glass” (1,2)ice” “crystal” “glass” (1,2)

What is MDMA?What is MDMA?– Street names:Street names:

““ecstasy” “E” “Adam” “XTC” “M&M” (1)ecstasy” “E” “Adam” “XTC” “M&M” (1)

http://www.teens.drugabuse.gov/facts/facts_xtc1.asp. Accessed April 6, 2006.

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Amphetamines FormsAmphetamines Forms

MethamphetamineMethamphetamine– Crystalline powderCrystalline powder

White, odorlessWhite, odorless

Tastes bitterTastes bitter

This form is referred to as This form is referred to as “speed” or “meth”“speed” or “meth”

– Smoked formSmoked formReferred to as “ice” Referred to as “ice” “crystal” “glass” (2)“crystal” “glass” (2)

– Injection (needle use) Injection (needle use) (3)(3)

MDMAMDMA– TabletsTablets

Colorful and brandedColorful and branded

Prevalent at “rave” Prevalent at “rave” and club scenes (1)and club scenes (1)

http://www.michigan.gov/images/ravdrug_8430_7.jpg Accessed March 29, 2006

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Why Do People Use Why Do People Use Amphetamines?Amphetamines?

MethamphetamineMethamphetamine– Increased energy & Increased energy &

alertness alertness – Improve moodImprove mood

A false feeling of A false feeling of being happierbeing happier

– Decrease appetite Decrease appetite (1)(1)

MDMAMDMA– EuphoriaEuphoria– Heightened Heightened

awarenessawareness– Inner peaceInner peace– Ease of socializing Ease of socializing

(3)(3)

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Methamphetamine is one of the most widely used Methamphetamine is one of the most widely used and abused drugs, in college age students, todayand abused drugs, in college age students, today

Graph: Amphetamine use/abuse vs. Graph: Amphetamine use/abuse vs. Methamphetamine (2)Methamphetamine (2)

http://www.nida.nih.gov/ResearchReports/Methamph/methamph2.html#what. Accessed April 6, 2006.

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Mild Effects of AmphetaminesMild Effects of Amphetamines

Cognitive effectsCognitive effects– Initial “rush” or Initial “rush” or

energy highenergy high– ConfusionConfusion– Poor concentrationPoor concentration– Memory problem Memory problem

(especially MDMA)(especially MDMA)

Systemic effectsSystemic effects– RestlessnessRestlessness– Movement delaysMovement delays– Sleep disturbancesSleep disturbances– ThirstThirst– Nausea/vomitingNausea/vomiting– Chills/Sweating Chills/Sweating

involuntarily involuntarily – AgitationAgitation– Aggression (1,2,4)Aggression (1,2,4)

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Severe Effects of Amphetamines Severe Effects of Amphetamines (Including Overdosing)(Including Overdosing)

Convulsions/seizuresConvulsions/seizures

Increase heart rateIncrease heart rate

High blood pressureHigh blood pressure

Panic AttacksPanic Attacks

HallucinationsHallucinations

UnconsciousnessUnconsciousness

Damaged blood vessels (1, 2, 4)Damaged blood vessels (1, 2, 4)

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Life Threatening Effects of Life Threatening Effects of Amphetamines Amphetamines (from abuse)(from abuse)

HyperthermiaHyperthermia

Hyponatremia (Large free water intake due to Hyponatremia (Large free water intake due to physical activity causes a drop in sodium levels) physical activity causes a drop in sodium levels) (1)(1)

Kidney failureKidney failure

Intracerebral hemorrhageIntracerebral hemorrhage

Heart failureHeart failure

Muscle breakdownMuscle breakdown

Fetal death (1,5,6)Fetal death (1,5,6)http://www.drugabuse.gov/pubs/teaching/teaching4/Teaching3.html. Accessed April 6, 2006.

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Chronic Amphetamine AbuseChronic Amphetamine Abuse

The use of amphetamines such as “meth” and The use of amphetamines such as “meth” and “ecstasy” can lead to abuse dependence or “ecstasy” can lead to abuse dependence or deathdeath– Tolerance developsTolerance develops– ““Speed run” Speed run”

Defining the term: The more of this drug you consume, the Defining the term: The more of this drug you consume, the higher you want get and the harder it is to do so. The user higher you want get and the harder it is to do so. The user takes increasing amounts without sleeping which can result takes increasing amounts without sleeping which can result in being beyond high, for days at a timein being beyond high, for days at a time

Many side effects are still seen/experienced Many side effects are still seen/experienced many years after being drug free (1)many years after being drug free (1)

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Post-Abuse EffectsPost-Abuse Effects

Repeating the same tasks over and over againRepeating the same tasks over and over againClenching/grinding of teethClenching/grinding of teethLoss of memoryLoss of memoryPermanent brain damagePermanent brain damage– Long term psychosis effectLong term psychosis effect– Increased risk of developing Schizophrenia later in life Increased risk of developing Schizophrenia later in life

(1)(1)

MDMA use results in brain damage that can be MDMA use results in brain damage that can be evident 6-7 years laterevident 6-7 years later– Can occur even if you only use MDMA for a couple of Can occur even if you only use MDMA for a couple of

days in your life (7)days in your life (7)

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Amphetamine PharmacologyAmphetamine Pharmacology

Stimulant (methamphetamine and MDMA)Stimulant (methamphetamine and MDMA)Hallucinogenic (MDMA)Hallucinogenic (MDMA)Release of neurotransmitters in brainRelease of neurotransmitters in brain– DopamineDopamine– NorepinephrineNorepinephrine– SerotoninSerotonin

Dopamine and norepinephrine are primarily altered/effected in Dopamine and norepinephrine are primarily altered/effected in the brainthe brainSerotonin is released with use of higher doses of MDMA Serotonin is released with use of higher doses of MDMA (ecstasy) (ecstasy) The extent to which these chemicals effect the brain is The extent to which these chemicals effect the brain is dependent on how much abuse is taking place; permanent dependent on how much abuse is taking place; permanent brain damage can occur as a result (1)brain damage can occur as a result (1)

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What is Dopamine?What is Dopamine?In the brain, dopamine is a significant role player in regulating In the brain, dopamine is a significant role player in regulating

and controlling your pleasure level. Dopamine is produced and controlling your pleasure level. Dopamine is produced (made) in nerve cells. (2)(made) in nerve cells. (2)

Dopamine is released from the end of specific nerves in your brain, in an Dopamine is released from the end of specific nerves in your brain, in an excessive amount, when methamphetamine is used and abused.excessive amount, when methamphetamine is used and abused.

http://www.nida.nih.gov/ResearchReports/Methamph/methamph3.html#short. Accessed April 6, 2006

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What is Serotonin?What is Serotonin?

Serotonin is involved in brain Serotonin is involved in brain

regulationregulation– Mood, emotions, sleepMood, emotions, sleep– Appetite, aggression, perceptions (6)Appetite, aggression, perceptions (6)

Body craves more serotonin Body craves more serotonin

in order to compensate for thein order to compensate for the

excess released from the brain excess released from the brain

(5) (5) http://www.drugabuse.gov/pubs/teaching/teaching4/teaching.htm Accessed April 6,2006.

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SerotoninSerotonin

http://www.drugabuse.gov/ResearchReports/MDMA/MDMA3.html#effects. Accessed April 29, 2006.

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Routes of AdministrationRoutes of Administration(Ways to use amphetamines)(Ways to use amphetamines)

MethampheminesMethamphemines– Oral (ingested)Oral (ingested)– Parenteral Parenteral

(injected)(injected)– Inhalation Inhalation

(snorting)(snorting)– Smoked and Smoked and

resmoked (1,2)resmoked (1,2)

MDMAMDMA– Oral Oral

TabletTablet

CapsuleCapsule

Pill (1,7)Pill (1,7)

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Duration of TimeDuration of Time

Using amphetamine-like drugs effect the Using amphetamine-like drugs effect the body for a long period of timebody for a long period of time– MethamphetamineMethamphetamine

24 hours + 24 hours +

Repetitive use due to toleranceRepetitive use due to tolerance– Accumulation occurs and the duration of Accumulation occurs and the duration of

effect on the body is prolonged (1)effect on the body is prolonged (1)

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Elimination from BodyElimination from Body

Renal Elimination (Kidneys)Renal Elimination (Kidneys)– AmphetaminesAmphetamines

30 %30 %

– MethamphetaminesMethamphetamines40-50%40-50%

– MDMAMDMA65% 65%

Hepatic Elimination (liver) (1)Hepatic Elimination (liver) (1)

2020

Risks of “Designer Drugs”Risks of “Designer Drugs”

Lead poisoning (methamphetamine Lead poisoning (methamphetamine abusers) (2)abusers) (2)– Contamination from making and using on the Contamination from making and using on the

streetstreet

Fetal Complications due to use and abuse Fetal Complications due to use and abuse during pregnancyduring pregnancy– DeformitiesDeformities– DeathDeath

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Risks from InjectionRisks from Injection

Using and sharing needles increases the risk of Using and sharing needles increases the risk of contracting severe and life threatening diseasescontracting severe and life threatening diseases– HIVHIV– Hepatitis B and CHepatitis B and C

The risk of HIV is not only increased by injection The risk of HIV is not only increased by injection but also from the enhanced sexual feelings that but also from the enhanced sexual feelings that arise from using these drugsarise from using these drugs– Amphetamine use can increase your libido or alter your Amphetamine use can increase your libido or alter your

perception in engaging in sexual activityperception in engaging in sexual activity– Rough sex is common with use which can lead to tears Rough sex is common with use which can lead to tears

and abrasions resulting in bleeding (2)and abrasions resulting in bleeding (2)

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SummarySummary

Why do people use and abuse amphetamine-Why do people use and abuse amphetamine-like drugs (“designer drugs)?like drugs (“designer drugs)?– Stress releaseStress release– Ease of communication with peersEase of communication with peers

Feelings of fitting in/socializingFeelings of fitting in/socializing

– Elevates moodElevates mood– Decreases anxiety due to school, work and personal Decreases anxiety due to school, work and personal

relationsrelationsAcceptanceAcceptance

– Unwanted withdrawal symptoms (don’t want to feel Unwanted withdrawal symptoms (don’t want to feel bad) bad)

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SummarySummary

Amphetamine-like substances such as “meth” and Amphetamine-like substances such as “meth” and “ecstasy” are highly abusive drugs among college “ecstasy” are highly abusive drugs among college students today. These highly addictive drugs may seem students today. These highly addictive drugs may seem appealing due to their short term, feel good, highs. But appealing due to their short term, feel good, highs. But the high is just that – short term. The after effects not the high is just that – short term. The after effects not only cause tremendous emotional instability but also only cause tremendous emotional instability but also cause negative, physical effects as well. Amphetamines cause negative, physical effects as well. Amphetamines harm your entire body; the brain, heart, liver, kidneys harm your entire body; the brain, heart, liver, kidneys and blood vessels are among the many systems of your and blood vessels are among the many systems of your body that deteriorate and shut down, leading to a body that deteriorate and shut down, leading to a possible cause of death. Not only can death occur, but possible cause of death. Not only can death occur, but the risks of acquiring HIV, hepatitis, and other serious the risks of acquiring HIV, hepatitis, and other serious diseases are significantly increased. diseases are significantly increased.

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ReferencesReferences

(1) Goldfrank’s Toxicologic Emergencies. 7th ed. c2002. The McGraw-Hill (1) Goldfrank’s Toxicologic Emergencies. 7th ed. c2002. The McGraw-Hill Companies, Inc. “Chapter 68 Amphetamines” March 26th 2006 [Date accessed]. Companies, Inc. “Chapter 68 Amphetamines” March 26th 2006 [Date accessed]. Available from STAT!Ref [database on the Internet]Available from STAT!Ref [database on the Internet]

(2) “Methamphetamine Abuse and Addiction.” [about 6 screens] (2) “Methamphetamine Abuse and Addiction.” [about 6 screens] National Institute On National Institute On Drug AbuseDrug Abuse. [internet website] c2005. National Institute of Health. [in association with] . [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [date accessed] <http://www.nida.nih.gov/ResearchReports/Methamph>6 April 2006 [date accessed] <http://www.nida.nih.gov/ResearchReports/Methamph>

(3) “Infofacts:Methamphetamine.” [about 4 screens] (3) “Infofacts:Methamphetamine.” [about 4 screens] National Institute On Drug AbuseNational Institute On Drug Abuse. . [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [date accessed] <http://www.nida.nih.gov/Infofacts/clubdrugs.html>[date accessed] <http://www.nida.nih.gov/Infofacts/clubdrugs.html>

(4) “MDMA Abuse and Addiction.” [about 3 screens] (4) “MDMA Abuse and Addiction.” [about 3 screens] National Institute On Drug National Institute On Drug AbuseAbuse. [internet website] c2005. National Institute of Health. [in association with] 6 . [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [date accessed] April 2006 [date accessed] <http://www.drugabuse.gov/ResearchReports/MDMA/MDMA 3.html#effects><http://www.drugabuse.gov/ResearchReports/MDMA/MDMA 3.html#effects>

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References ContinuedReferences Continued

(5) “The Neurobiology of Ecstasy (MDMA).” [about 5 screens] (5) “The Neurobiology of Ecstasy (MDMA).” [about 5 screens] National Institute On National Institute On Drug AbuseDrug Abuse. [internet website] c2005. National Institure of Health. [inassociation with] . [internet website] c2005. National Institure of Health. [inassociation with] 6 April 2006 [date accessed] <www.drugabuse.gov/pubs/teaching/teaching 6 April 2006 [date accessed] <www.drugabuse.gov/pubs/teaching/teaching

4/teaching.html>4/teaching.html>

(6) “Infofacts:MDMA(Ecstasy).” [about 2 screens] (6) “Infofacts:MDMA(Ecstasy).” [about 2 screens] National Institute On Drug AbuseNational Institute On Drug Abuse. . [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [internet website] c2005. National Institute of Health. [in association with] 6 April 2006 [date accessed] <http://www.drugabuse.gov/Infofacts/ecstasy>[date accessed] <http://www.drugabuse.gov/Infofacts/ecstasy>

(7) “Ecstasy.” [about 2 screens] (7) “Ecstasy.” [about 2 screens] National Institute On Drug Abuse For TeensNational Institute On Drug Abuse For Teens. [internet . [internet website] c2003. National Institute of Health. [in association with] 6 April 2006 [date website] c2003. National Institute of Health. [in association with] 6 April 2006 [date accessed] <http://www.teens.drugabuse.gov/facts/facts_xtc/.asp>accessed] <http://www.teens.drugabuse.gov/facts/facts_xtc/.asp>