quiz 2

Categories of Psychoactive Substances

1. Stimulants 2. Depressants 3. Opioids (Narcotics) 4. Hallucinogens/Psychedelics 5. PCP & Ketamine (Dissociatives) 6. Marijuana

Major Depressants

Alcohol Barbiturates Benzodiazepines (Valium, Xanax, Rohypnol ) GHB Inhalants

Cocaine

Although coca contains many different naturally occurring psychoactive drugs, cocaine hydrochloride (cocaine) is the most important in terms of its psychoactive effects -Cocaine is still used today in ear, eye, nose and throat operations as a topical anesthetic and used in about 200,000 operations every year. -Like other strong stimulants, the potential for psychological dependence and craving for cocaine is high if the drug is used more than occasionally. Cocaine use, especially heavy use may lead to paranoia, hallucinations, depression and death via heart attack.

Alcohol

Behavioral effects of alcohol (and many other drugs) are in part a due to their ability to lower social inhibitions and allow individuals to "cut-loose" or misbehave with the knowledge that, if necessary, they can always excuse this behavior later as a result of their drinking. -Alcohol has a very high level of both chronic and acute toxicity and is widely used. The result is that the number of deaths attributed to alcohol is at least twenty-five times the number attributed to all illegal drugs combined (Delirium Tremens DTs) -heavy alcohol use can cause physical damage including cirrhosis to liver (leading killer of men age 25-65) heart disease, cancer, and brain damage

Fentanyl

Fentanyl is a synthetic opioid derived from morphine that is 50-100 times stronger than morphine, is commonly used in ER and hospital settings as a pain killer. It is most notable currently bc it's often used by dealers to lace heroin -is roughly 50 to 100 times stronger, or more potent than morphine, or 17-34 times as potent as heroin,

Methamphetamine (type of amphetamine)

In a recreational context methamphetamine is rarely taken orally (as Benzedrine and Dexedrine typically are), but rather snorted, smoked or injected, which intensifies its effects. Although similar to the other amphetamines, the effects of meth may be more intense due to its potency. - "Street meth" also contains a variety of other ingredients, many of which are poisonous, complicating comparisons with pharmaceutical-grade methamphetamine. -Like the use of other powerful stimulants amphetamine use, especially heavy use, may lead to paranoia, hallucinations, depression and death via heart attack -with frequent and/or high-dose use may display high levels of nervousness, paranoia, irritability, confusion, insomnia, schizophrenia-like symptoms and possibly hallucinations or delusional symptoms. High doses over a long period of time may also cause brain damage. -10-14 hours per dose

3. Opioids/Narcotics

Opioids are all products and derivatives of opium (a milky extract contained in the seedpod of certain poppy plants that grow in regions of the world) - Opioids have depressant effects (this is part of what makes them very dangerous) but they also produce a strong euphoric effect (this is primarily why they are so addictive) and these drugs are among the best analgesics, or pain-killers, known to man. -subclass of opiods are the "opiates" -natural psychoactive substances found in opium -narrow therapeutic ratio *The opioids are among the most addictive drugs known and result in tens of thousands of lethal overdoses annually. Opioid overdose kills more people than car crashes.

Cocaine 2 (power cocaine vs crack cocaine)

Power cocaine (powder) cannot be smoked because the combustion destroys the drug -treating crack cocaine more severely than powder cocaine in drug legislation *Policy was passed which in effect made the penalties 100 times tougher for crack than powder cocaine. This was called the 100 to 1 rule as it took 5 grams of crack (an amount that would commonly be held by users, not dealers) to trigger a federal mandatory minimum sentence of 5 years in prison... but it required 500 grams of powder cocaine (an amount that would only be possessed by a dealer, and likely a pretty "big fish" dealer) to trigger the same 5 year mandatory minimum sentence. This had massive implications for drug incarcerations, especially in the poor, African-American community.

ecstasy

The chemical name of what is commonly called "ecstasy" is 3-4 methy-lenedioxy-methamphetamine, so as noted the "MA" in MDMA stands for Methamphetamine. -Ecstasy has been referred to as a "hallucinogenic amphetamine" because it has effects similar to both mescaline and the amphetamines although it does not have as strong a stimulatory effect as other amphetamines. -Use may cause muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, and sweating and dehydration. Depression may result from use, particularly heavy use ('Terrible Tuesday's'). Little is known about long-term effects. Dehydration (severe) and adulterants (below) and are the primary acute risks. *the average ecstasy tablet available today contains 125mg of MDMA, more than 5 times the average dose in 2009

Ritalin, Adderall & Other ADD Prescription Drugs

When abused/used heavily the risks of Ritalin/Concerta, Adderall/Vyvanse are similar to cocaine/amphetamines (Adderall and Vyvanse contain amphetamines, Ritalin and Concerta contain methylphenidate, which is a derivative of the amphetamines). -twenty percent, or one in five college students had consumed Ritalin without a prescription,

Barbiturates

also called sedatives, tranquilizers or downers, these drugs were widely used through the 1950s but are not commonly used today. -overdose potential of barbiturates is compounded by the fact that when they are combined with alcohol or another depressant such as Valium the effects are combined -Today, because of their overdose danger, the barbiturates been largely replaced by the benzodiazepines (e.g. Xanax, Valium, Klonopin), which have similar effects but are much safer (not safe) with respect to lethal overdose potential.

Bath Salts

they are a variety of products that contain one or more of three chemicals: mephedrone, methylone, or MDPV (methylenedioxypyrovalerone), or derivatives of these chemicals -The bath salts have stimulant and hallucinogenic properties, with users reporting effects that are similar to cocaine, methamphetamine, LSD, and ecstasy -Street chemists are continually making new derivatives of the primary chemicals associated with bath salts, called analogs or analog drugs, and until these new drugs are identified, it is impossible to test for and difficult to legislate against them (e.g. MDVP may be illegal but a derivative may not). -may include agitation, delusions, hallucinations, psychosis, hypertension, agitation, tachycardia, chest pain, seizures, and headaches

Why are these substances so commonly used by children?

they are commonly used by children because of access. The inhalants are often the only (or one of the only) intoxicating substances available at very young ages. -"grownups tend to regard glue, gasoline, paint thinner, and the rest as cheap highs—easy to obtain and not very good" -The use of inhalants by kids is particularly concerning because many inhalants are highly toxic and can be lethal to users.

Amphetamines

As compared to cocaine, amphetamines are more toxic, more difficult to metabolize, and their effects last longer—but as a consequence of their longer duration of effect users are less likely to dose repeatedly in a short period of time in order to maintain their high (as many do with cocaine *The first amphetamine, Benzedrine was synthesized in Germany in 1887. Other forms of amphetamines include Dexedrine, which is twice as strong as Benzedrine, and methamphetamine, developed by a Japanese chemist in 1919, which is twice as strong as Dexedrine -These drugs are synthesized from ephedrine, a synthetic chemical derived from the ephedra plant and adrenaline *first medical application of the amphetamines was the treatment of narcolepsy, a condition which causes victims to suddenly fall asleep -Amphetamines were and ARE also used to treat attention deficit hyperactivity disorder (ADHD) and sometimes for weight control. Commonly prescribed in the past for depression and similar conditions.

2. Depressants

Depressants are substances that reduce the energy level of the nervous system, dampen sensitivity to external stimulation and, in high enough doses, induce sleep. -These drugs are also called sedative-hypnotics because they sedate users at low doses and can induce sleep (i.e. hypnotize) at high doses. *depressant drugs are more dangerous than the stimulants. These drugs can kill people via several physiological mechanisms but most commonly the use of these drugs can shut down breathing.

Herion

Heroin is the trade name given to the drug (diacetyl morphine) when it was marketed by Bayer laboratories in 1898 as a painkiller and cough suppressant. It is very similar to morphine- was made to be less addicting -high overdose rate is associated w/heroin results from narrow TR and disparity in purity of drug available on streets -heroin has extremely high dependence potential, both physical and psychological/craving. -in terms of chronic toxicity the effects of heroin are surprisingly benign compared to other hard drugs. there is no scientific evidence that indicates any (direct) serious long-term consequences of heroin to any tissue or organ system. However, there are substantial indirect risks, such as HIV/AIDS and hepatitis infection, associated with injecting these drugs, and due to the fact that heroin addicts rarely live lifestyles that are conducive to self-care. -A harm reduction strategy adopted in some cities to control some of the negative consequences associated with heroin use are 'safe injection sites.'

Kratom

Kratom is a drug with an unusual combination of opioid-like and stimulant-like effects. It is derived from a tree native to Southeast Asia, where the drug has been used for centuries. Kratom was traditionally taken by chewing the leaves of the kratom tree, but it can also be taken as a tea or, more typical now, in powder form mixed into a drink or via capsules. Kratom is illegal in many countries, has been listed on the DEA's "drugs of concern" for several years and is banned in some U.S. states and localities. But kratom remains legal in many places in the United States and can be bought online and in many convenience marts and drug-paraphernalia shops. hundreds of thousands of people now use kratom as an analgesic and/or substitute for traditional opioids

Benzodiazepines (xanax, rohypnol, GHB)

Like the barbiturates, the benzodiazepines are also commonly referred to as sedatives, tranquilizers or downers, and were developed in the 1950s to offer a safer alternative to the barbiturates. XANAX—Initially developed and marketed as a less addicting substitute for Valium, research now indicates that Xanax and similar drugs have a similar addiction potential and along w/ Valium & certain narcotic-based pain-killers, one of the most prescribed and widely abused prescription drugs. ROHYPNOL-roughly 10 times as strong as Valium & it has also been called a "rape drug." This is because, especially when combined with alcohol, rohypnol can cause paralysis, extreme sedation, unconsciousness and anterograde amnesia (date rape drug/roofies) GHB- also can be used as a rape drug because, in addition to causing euphoria and reducing inhibitions, at higher doses it can cause heavy sedation and sometimes sleep. -overdose of GHB is especially likely if it is combined w/alcohol or other drugs, can depress the respiration to the point that coma or death result

What was going during the mid-1800's that would involve the need for morphine?

Major factor involved in the increased use of morphine at this time was several large military conflicts in the second half of the 19th century, including the American Civil War. -Other factor leading to the spread of morphine use and addiction was the invention of the hypodermic syringe by Dr. Alexander Wood in 1853. The development of the syringe allowed morphine to be injected, which not only generated a much stronger effect than ingestion, but it also allowed the drug to take effect much faster. *Recreational morphine use became more widespread in the late 1800s and early 1900s—but at this time most users of narcotic drugs were women. Because of addiction problems with morphine, chemists altered morphine and produced a new drug they hoped would be less addicting. This was what led to the creation of heroin.*

Major Opioids

Morphine Heroin Codeine Fentanyl Oxycodone, Hydrocodone & Hydromorphone Kratom

Morphine

Raw opium contains over 40 pharmacologically active alkaloids, but the two most important of these are morphine (which constitutes 4 to 20 percent of dried opium) and codeine (1 to 5 percent of dried opium). -extremely valuable for the treatment of severe pain

1. Stimulants

The use of stimulants makes people feel more alert and energetic. They produce these effects by causing nerve fibers in the brain to release adrenaline (also called epinephrine) and other neurotransmitters that have similar effects -stimulants don't "create" energy out of nothing, they simply force the body to use up some of its reserves of chemical energy, energy that must be replenished later.

Tobacco

Tobacco is consumed many ways, smoking being the most typical and generally the most harmful. -in the case of tobacco the primary psychoactive drug is nicotine. -nicotine, is one of the most toxic and addicting of all known drugs *Considering both physical dependence and craving associated with nicotine, many researchers go so far as to say that smoking tobacco is more "addicting" than any other drug—including heroin, meth and cocaine -In the U.S. alone smoking is responsible for roughly 400,000 premature deaths per year and globally it is estimated that six million people die from smoking-related diseases annually.

Oxycodone, Hydrocodone & Hydromorphone

are derived from different sources but all are opiods, these drugs, especially oxycodone and hydrocodone are heavily abused in the form of prescription painkillers. Oxycodone: OxyContin, Percodan, Percocet Hydrocodone: Vicodin, Lortab Hydromorphone: Dilaudid -Oxycodone is another semi-synthetic opioid. It is actually synthesized from thebaine. Thebaine is a present in raw opium but it does not have psychoactive properties of its own. It only becomes psychoactive when it is altered by chemists who make oxycodone with it. -OxyContin is at least equivalent to morphine in its analgesic effect, and it is reportedly as strong as or even stronger than morphine in terms of its psychoactive effects. This is particularly the case when users engage in the common practice of crushing OxyContin pills into a powder and snorting or injecting them, circumventing the intent of the medication to be released in a sustained manner over 12 hour *Americans represent less than 5% of the global population but consume more than 80% of the global opioid supply and 99% of the hydrocodone supply.

Inhalants

class of drugs based on their method of administration—they are generally either liquids that vaporize at room temperature or gasses that are inhaled by users or aerosol propellants that users expel from containers and then inhaled -has been estimated that more than 1,000 common household products are inhaled or "huffed" for their psychoactive effects. TYPES OF INHALANTS 1)Volatile Solvents - liquids that vaporize at room temperature (e.g. gasoline, glue, paint thinner). 2)Aerosol Sprays -sprays containing propellants and solvents (e.g. spray paint, hair spray). 3)Gases - gases under pressure (butane lighters, refrigerants). 4)Nitrites—inhalants similar in effect to anesthetics. Many are sold in head shops as "liquid incense." -nitrites are a different group of inhalants that have effects somewhat similar to anesthetics.

Codeine

codeine is a psychoactive element present in opium but it is weaker than morphine in terms of its psychoactive and physical effects. -by far the most widely used narcotic in the world and it is available over-the-counter in numerous countries including Canada and Mexico. -though it has psychoactive effects similar to morphine if taken in sufficient quantities, the levels of codeine contained in medications such as Tylenol #3 are low enough that the person may (likely will) overdose and poison themselves on the acetaminophen contained in the drug before achieving the desired euphoric effects of codeine. -desomorphine, street name 'Krokodil,' (because of it's effects on people's skin) can be produced by using codeine based medications and combining it with other iodine and phosphorous.

Major Stimulants

coffee tobacco cocaine amphetamines bath salts ritalin/adderall/other add prescription drugs ecstasy

Route of administration

refers to the manner in which the drug is taken into the body. The route of administration may substantially affect the experience of taking the drug including the potency of effect, associated reward and likelihood of repetitive dosing. Types of Administration -smoking/inhalation -injection -snorting -contact - ingestion (module 2.10)

Caffeine

the most widely used drug in the world -While caffeine is not regarded as a psychoactive drug by many people, it is in fact a drug *Caffeine can result in physical dependence The heavy or excessive use of caffeine is sometimes referred to as "Caffeinism" -Caffeinism is a condition involves symptoms such as restlessness, nervousness, insomnia, rapid heartbeat, muscle twitching and flushing. *Death by caffeine overdose is possible, though extremely rare.