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DRUGS OF ABUSE
Recreational Drugs:
1. Rewarding Subjective Effect
2. Improve Sexual, Athletic, Artistic Performance
3. Therapeutic Benefit
DRUG ABUSE
1. Defined by Society
2. Interference With “Normal” Functions
Multiple Simultaneous Variables Affecting Onset and Continuation of Drug Abuse and Addiction
Agent (drug)AvailabilityCostPurity/potencyMode of administration
Chewing (absorption via oral mucous membranes)GastrointestinalIntranasalSubcutaneous and IntramuscularIntravenousInhalation
Speed of onset and termination of effects Pharmacokinetics: Combination of agent and host
Host (user)Heredity
Innate tolerance Speed of developing acquired tolerance Likelihood of experiencing intoxication as pleasure
Psychiatric symptomsPrior experiences/expectationsPropensity for risk-taking behavior
EnvironmentSocial settingCommunity attitudes
Peer influence, role modelsAvailability of other reinforcers (sources of pleasure or recreationEmployment or educational opportunities
Pharmacological PhenomenaTolerance
Many clandestine “labs” are small enough to fit on a kitchen cabinet
PSYCHOTOMIMETIC DRUGS
Induce Altered States of Consciousness
- Mechanism Includes NE, DA, & 5-HT Receptors
- Interact with Receptors to Alter Consciousness
LSD
1. Perceptual Changes – “Hallucinations”
2. Affective Changes – “Mood Swings”
3. Cognitive Changes – “Logic Variations”
4. Revelations – “Special Insights”
LSD EFFECTS
1. Visual Hallucinations – auditory rare.
2. Anxiety to euphoria swings.
3. Consciousness retained.
4. Autonomic nervous system activation –
pupil dilation, sweating, tachycardia.
LSD Mechanism
1. Agonist and antagonist on 5-HT
receptors.
2. 5HT2 on post-synaptic side and 5-HT1
on both pre and post synaptic neurons.
3. Raphe nuclei – sleep is 5-HT1A to
decrease function of 5-HT neuron.
4. Agonist effects on 5-HT1A auto receptors to decrease release of 5-HT.
Collage of LSD blotter paper.
Psilocybin Mushroom
The Peyote Cactus
Amphetamine Mechanism
1. Release NE from Brain Neurons
2. Paranoia Effect – DA Release Leading to
Schizophrenia-like Psychosis.
3. Similar Action – Mescaline, Dimethoxy-
methylamphetamine and Methoxy-
amphetamine
Amphetamine1. Management of ADD.
2. Large doses increase euphoria, self confidence, ability to concentrate through mesolimbic and mesocortical dopamine system.
3. Large doses can also cause paranoia and a deep depression through release of epinephrine, dopamine and norepinephrine from brain neurons.
4. E.R. – Seizures, cardiac arrhythmias and severe anxiety.
“Ice”, so-named because of its appearance, is a smokeable form of methamphetamine.
Clandestinely manufactured MDA tablet
COCAINE
1. Derived from “Coca Leaves”
2. Intense Euphoria, Increases Self-Confidence, Increased Energy
3. Blocks Neuronal Transport System for NE Uptake
4. Extremely Reinforcing – “5-HT Related”?
Cocaine Administration
1. “Snorting” – Nasal Mucosa
2. Rapid Absorption
3. I.V. Bolus
4. Tobacco or Free Base, “Crack”
5. Short Acting – 30-60 Minutes.
6. No Physical Dependence. Strong Psychological Dependence
Flower of the coca plant, Erythroxylum
Cocaine is extracted from the coca leaf after the leaves are picked and dried.
Crack, the smokeable form of cocaine provides an immediate “rush”.
Cocaine Use
1. Local Anesthetic
- “Vasoconstrictor” Nose, Throat Surgery
2. “Hospice Mix”
- To counteract mental clouding
effects of morphine
Cocaine Withdrawal Symptoms and Signs
1. Dysphoria, depression
2. Sleepiness, fatigue
3. Cocaine craving
4. Bradycardia
PCP
1. “Angel Dust” – Phencyclidine is related to Ketamine “Special K”.
2. Induces Euphoria and Auditory Hallucinations.
3. Used as “Adulterant”.
PCP is most commonly sold as a power (left), or liquid (center), and applied to a leafy material such as oregano (right) which is then smoked.
PCP MECHANISM1. Psychotomimetic effects by acting at NMDA
glutamate receptor subtype as a non-competitive antagonist.
2. Open channel blocker where it blocks the NMDA – glutamate subtype channel
3. Physiological effects – hypertension, convulsions, respiratory system. Protect from self-inflicted harm.
4. E.R. – Stabilize cardiovascular and respiratory system. Protect from self-inflicted harm.
The flowering of Cannabis Sativa
Marijuana buds are hung out to dry
Marijuana is still rolled into cigarettes and smoked
Hallowed out cigars packed with marijuana are called blunts, and are gaining in popularity.
THC
1. Fat Soluble
2. Slow Excretion
3. Chronic Use – “Motivational Syndrome”
4. Immune System Compromised
Marijuana Withdrawal Syndrome
1. Restlessness
2. Irritability
3. Mild agitation
4. Insomnia
5. Sleep EEG disturbance
6. Nausea, cramping
THC IN MEDICINE
1. Antiemetic – Cancer Patients
2. Decrease Intraocular Pressure