Chapter 6
over ______ prescriptions of ADHD meds in 2011 (_____ in sales)
- 10 million - $8 billion
cocaine epidemics?
- 1880s with Freud - 1980s
use of cocaine became widespread in the 1880s due to:
- Freud's promotion of it - easy availability in patent medicines - non-prescription sources
sympathomimetic effects of stimulants:
- HR, BP, respiratory rate go up - sweating increases - blood flood to muscle groups, brain, and internal organs increases - body temp elevates - pupils dilate - appetite suppression
health concerns related to meth:
- addiction - stimulant psychosis - use-associated violence - depression - "meth mouth" - formication syndrome related skin sores - short and long term brain changes
amphetamine epidemics?
- after WWII in 1945- 1960s - 1990s-early 2000s
approved stimulant meds for ADHD:
- amphetamine (Adderall), dextroamph, methamph, lisdexamfetamine - methylphenidate (Ritaline), dexmethlyphenidate
several factors contributed to the cocaine epidemic II:
- decrease in price - increased availability - development of crack
effects of stimulant drugs for ADHD:
- improve teacher/parent rating of performance - improve attention, time on task, and other measures of classroom performance - dec. disruptive behavior
concerns regarding ADHD stimulant use in kids:
- insomnia - loss of appetite - weight loss - growth delays*
coke, amphs, and amph-like stimulants can be administered:
- orally - intranasally - intravenously - inhaled
risk of overdosing on stimulant drugs; convulsions that result in:
- respiratory collapse - myocardial infarction due to coronary artery spasm - stroke
moderate doses of coke and amphs produce:
- sense of elation - inc. talkativeness and sociability - inc. alertness and arousal - enhanced performance on tasks involving physical endurance and strength
what does coke come from and where was it first found? how was it used?
- the coca leaf - Andean regions of Bolivia, Ecuador, northern Argentina, and Peru - they chewed the leaves
required registration and taxation of cocaine
1914 Harrison Narcotics Act
mephedrone was synthesized in ____
1920s
when did the "war on drugs start"?
1971
meth reappeared on the west coast and Hawaii in ____
1980s
when did the second cocaine epidemic begin?
1980s
meth was associated with motorcycle gangs in ______; mostly white males
1980s and 1990s
crack burst upon the national scene in ____
1986
why did meth kitchen labs come about?
1996 comprehensive meth control act
increased penalties for manufacture and trafficking of meth
1996 comprehensive methamphetamine control act
illegal meth labs began appearing in the ____
2000s
restricts sales of pseudo ephedrine and ephedrine
2006 combat meth epidemic act
_____% increase in stimulant use since 1990
500
a neurobehavioral disorder defined by persistent and maladaptive symptoms of hyperactivity/impulsivity and inattention
ADHD
concerns about meth resulted in the 1996______
Comprehensive Methanmphetamine Control Act
_____ is more potent than the other drugs in blocking reuptake of dopamine
MDPV
after the 2006 combat meth epidemic act, ____ cartels increased production of meth to meet demand
Mexican
____ tolerance can take place, even when the dose is being increased
acute
when the highly pleasurable effects of the initial dose of coke begin to wear off, users are prone to taking another dose. however, the second admin.- even when the same amt. is taken- generally prod. much less of a pleasurable high due to rapidly dev. _____ tolerance
acute
chronic use of stimulants can lead to two types of tolerance:
acute and protracted
a type of functional tolerance that occurs within a course of action of a single drug dose
acute tolerance
the amphetamines include:
amph, dextroamph, and methamaph.
_____ increase release of dopamine
amphetamines
psychotic state can be effectively treated with _____
antipsychotics
causing one to lose appetite; suppression of eating
appetite suppression
a psychoactive "designer drug" that is synthesized from various amphetamine-like chemicals and can be inhaled, swallowed, smoked, or injected
bath salts
more recently, meth is associated with:
clubbing; women and non-white population and very prevalent in gay men
works as an anesthetic today
cocaine
acute tolerance is particularly clear with______
cocaine (e.g., tolerance to the heart rate-increasing effects)
when you combine a paste made from coca leaves with a hydrochloric acid solution to form a salt: _____
cocaine hydrochloride (powder cocaine)
some controlled stimulants:
cocaine, amphetamines, methylphenidate, and methcathinone
______ has a high, quick peak and then crashes, _____ is a steady, moderate high
coke; meth
what led to the cocaine epidemic II?
concerns of dangers of amphetamine use led to reemergence of widespread cocaine use in the late 1980s
a freebase cocaine produced by mixing cocaine salt with baking soda and water; the solution is then heated, resulting in brittle sheets of cocaine that are "cracked" into small smokable chunks of "rocks"
crack
____ cocaine is much safer to make than ____ cocaine
crack; freebase
primary symptoms of dependence of stimulants:
depression, anxiety, changes in appetite, sleeping disturbance, and craving for the drug
amphs increase the release of _____
dopamine
long- term stimulant use leads to depletion of _____ and other neurotransmitters
dopamine
if you increase the dose of the drug, the reuptake of the monoamines goes ____
down
physiological effects are identical for coke, amph, and methylphenidate, except for _____
duration of action
freebase cocaine is made by mixing street powder cocaine with a highly flammable substance _____ (this separates the coke base from the salt)
ether
symptoms of itching and feeling as if insects were crawling under skin, caused by cocaine and amphetamine
formication syndrome
_____ is the term used to describe the practice of smoking cocaine, but cocaine is not burned like tobacco, it is heated until it vaporizes
freebase
protracted tolerance occurs with stimulants (e.g., _____)
heart rate-increasing effects of cocaine decrease across days
describe the early use of coke in Vienna:
in the 1880s, Freud advocated coke as local anesthetic and treatment for depression, indigestion, asthma, neuroses, syphilis, morphine addiction, and alcoholism
the first medical applications of amphs? and when?
in the 1920s to treat cold and sinus symptoms, obesity, narcolepsy, depression, ADHD, and morphine addiction
because it is a salt, street cocaine is water-soluble and can be _____ or taken _____
injected; intranasally (sniffed or snorted)
describe cocaine "speed freaks"
intense, short rush; repeated, frequent use with little sleep or eating
when were amphs first synthesized?
late 19th century
when did people start viewing coke negatively? this culminated into what Act?
late 19th-early 20th centuries; 1914 Harrison Narcotics Act
used as pest control in Israel in the 2000s and began being used recreationally in Israel ("plant food") and then Europe
mephedrone
chemicals in bathsalts:
mephedrone, methylone, and MDPV
_____ prescribing for heroin addiction treatment led to problematic use in the US in the 1960s
meth
some over-the-counter stimulants:
nicotine and caffeine
acute toxicity of bath salts:
panic attacks, hallucinations, hostility, self-mutilation, tachycardia, and elevated blood pressure
_____ tolerance means that the individual consumes greater amounts of a drug to achieve an effect that was once achieved with a lesser dose
protracted
______ tolerance pertains to the effects of a given dose of a drug when it is admin. more regularly or chronically
protracted
people who drink may show impairment in memory today after drinking 6 beers, when formerly they showed the same degree of impairment after drinking only one beer, this is an example of ____ tolerance
protracted
a type of functional tolerance that occurs over the course of over two or more drug administrations
protracted tolerance
high doses of stimulants can produce _____
psychotic state
characterized by paranoid delusions and compulsive, stereotyped behavior like rocking, hair pulling, chain smoking, or fiddling with things
psychotic state produced by high doses of stimulant drugs
why might smoking increase use compared to snorting?
rapid onset effects and greater peak effect
lab animals self-administering bath salts (and pretty much anything) compared to humans?
relatively the same
when you develop tolerance to the pleasurable effects of a drug, and the negative effects seem to increase
reverse tolerance
smoking or oral administration has greater effects on meth pharmacokinetics?
smoking
one problem with stimulants as study aid is_____
state-dependent learning
when learning under the influence of a drug is best recalled when one is in the same "state"
state-dependent learning
paranoid delusions and disorientation resembling the symptoms of paranoid schizo., caused by prolonged use or overdose of cocaine and/or amp.
stimulant psychosis
_____ were originally not considered to produce dependence
stimulants
loosely defined category of drugs that heighten mood, increase alertness, and decrease fatigue
stimulants
speed up performance on variety of cognitive tasks, but at cost of increased errors
stimulants and cognitive performance
stimulants are classic examples of _____ drugs
symphatomimetic drugs
mechanism of stimulant actions of coke, amphs, and bath salts:
they block the reuptake of monoamine neurotransmitters (dopamine, norepinephrine, and serotonin)
street cocaine takes the form of ___
white powder