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DRUGS OF ABUSE
Recreational Drugs:
1. Rewarding Subjective Effect
2. Improve Sexual, Athletic, Artistic Performance
3. Therapeutic Benefit
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DRUG ABUSE
1. Defined by Society
2. Interference With “Normal” Functions
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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
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Many clandestine “labs” are small enough to fit on a kitchen cabinet
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PSYCHOTOMIMETIC DRUGS
Induce Altered States of Consciousness
- Mechanism Includes NE, DA, & 5-HT Receptors
- Interact with Receptors to Alter Consciousness
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LSD
1. Perceptual Changes – “Hallucinations”
2. Affective Changes – “Mood Swings”
3. Cognitive Changes – “Logic Variations”
4. Revelations – “Special Insights”
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LSD EFFECTS
1. Visual Hallucinations – auditory rare.
2. Anxiety to euphoria swings.
3. Consciousness retained.
4. Autonomic nervous system activation –
pupil dilation, sweating, tachycardia.
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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.
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Collage of LSD blotter paper.
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Psilocybin Mushroom
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The Peyote Cactus
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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
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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.
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“Ice”, so-named because of its appearance, is a smokeable form of methamphetamine.
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Clandestinely manufactured MDA tablet
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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”?
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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
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Flower of the coca plant, Erythroxylum
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Cocaine is extracted from the coca leaf after the leaves are picked and dried.
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Crack, the smokeable form of cocaine provides an immediate “rush”.
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Cocaine Use
1. Local Anesthetic
- “Vasoconstrictor” Nose, Throat Surgery
2. “Hospice Mix”
- To counteract mental clouding
effects of morphine
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Cocaine Withdrawal Symptoms and Signs
1. Dysphoria, depression
2. Sleepiness, fatigue
3. Cocaine craving
4. Bradycardia
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PCP
1. “Angel Dust” – Phencyclidine is related to Ketamine “Special K”.
2. Induces Euphoria and Auditory Hallucinations.
3. Used as “Adulterant”.
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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.
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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.
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The flowering of Cannabis Sativa
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Marijuana buds are hung out to dry
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Marijuana is still rolled into cigarettes and smoked
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Hallowed out cigars packed with marijuana are called blunts, and are gaining in popularity.
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THC
1. Fat Soluble
2. Slow Excretion
3. Chronic Use – “Motivational Syndrome”
4. Immune System Compromised
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Marijuana Withdrawal Syndrome
1. Restlessness
2. Irritability
3. Mild agitation
4. Insomnia
5. Sleep EEG disturbance
6. Nausea, cramping
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THC IN MEDICINE
1. Antiemetic – Cancer Patients
2. Decrease Intraocular Pressure
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