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