Quiz 2-Drug Education

Psilocybin Mushrooms

"Magic mushrooms" Hallucinogenic effects similar to LSD but not to the same degree Used for centuries by Native American cultures Usually ingested, but may be dried & smoked

psychedelics

"mind viewing" drugs

Narcotic Addiction Treatment (1)

Drug Therapy -Methadone -LAAM (levo-alpha-acetylmethadol) -naltrexone

Barbiturates

-History (Bayer: urea + malonic acid) opiates, bromides,chloral hydrate & paraldehyde, alcohol, barbital Used in U.S. since the early 1900's to relieve anxiety & induce sleep Used illicitly to "come down" from the effects of stimulants Pentobarbital (Seconal): 2-3 hours 15 min. time of onset Amobarbital (Amytal): 5-6 hours 30 mins. Time of onset Phenobarbital (Luminal) 6-10 hours Luminal---one of several brand names 1 hr. time of onset

Methadone Deaths Rising

-Methadone is now the fastest growing cause of narcotic deaths. More than twice as many deaths of heroin. surpassing the tolls of oxycotin and vicodin

Why are depressants misused and abused?

-Pleasure increases, pain decreases -needs for depressants: anxiety and insomnia -# 1 prescription drug is tranquilizers

LSD Acid experience

-Usually is unpredictable and varied from individual to individual -Extremely emotional (intense laughing or crying) -Tactile sensitivity increases -Hallucinations -Visual effects (ever-changing colors, shapes, or objects) -Synesthesia (crossing of sense responses) -Time & space perception changed -Sounds & sights may flash on & off tripping thought processes that have been long forgotten

Factors Influencing Effects of Opiates

-amount taken -user's past experiences -circumstances in which the drug is taken (setting) -the psychological frame of mind of the user (mindset)

Psychological Effects of PCP

-anxiety/ agitation -body image distortion -euphoria -depersonalization -distorted thought process -hallucinations (rare)

Legal Sedatives-Hypnotics

-barbiturates (sleeping pills) -benzodiazepines (tranquilizers)

"bad trips"

-caused by hallucinogens -bad psychological reaction to LSD and similar drugs -scary sensations that can last a few minutes or several hours -may be mildly frightening or terrifying -user experiences panic, confusion, anxiety. helplessness, loss of control

Lysergic Acid Diethylamide (LSD)

-discovered by Dr. Albert Hofmann -used in late 50's and early 60's for medical purposes (psychotherapy) and military and intelligence experiment -bad trips and chromosome issues caused a decrease in LSD but replaced by PCP -returned in the 90's

Effects of Hallucinogens

-disorientation -paranoid delusion -anxiety -panic -confusion -hallucinations -euphoria -increased pulse rate -unpredictable violent behavior; effects can last 12 hours

Other effects of sedatives/ hypnotics -large doses

-drowsiness -decreased respiration -in large doses, cessation of breathing (coma, death) Risk of death increases when barbiturates are combined with alcohol or other depressants synergistic effect

LSD Recreational Use

-experiments by psychologist Timothy Leary and Dr. Richard Alpert on Harvard graduate students.

Reasons for abusing depressants

-instant high -deal with stress and anxiety -substitute -counteracting stimulant effects -others (rave, party)

Pharmacology of LSD

-latency period: 45 minutes for oral intake -5 minutes for intraethical injection -oral dosage: 100 micrograms sequence of absorption: oral intake, blood absorption, 1% reach brain (highest in pituitary gland, hypothalamus, limbic system, and auditory and visual reflex areas) -effects last 10-16 hours

Opiates

-narcotics: "numbness" -produce feelings of well-being and euphoria -powerfully addictive and have high potential for abuse -derived from the pod of the poppy seed (ex. morphine, codeine, opium, and derivatives such as heroin) -synthetic or manufactured opiates: demerol, oxycotin, and methadone

pharmacology of LSD

-odorless, colorless, tasteless, and most potent hallucinogens known -acts on serotonin receptors (indole structure) -tolerance develops very quickly -cross tolerance develops among LSD, mescaline, and psilocybin -ingredients: lysergic acid, diethylamine, and trifluoracetic acid

flashbacks from effects of hallucinogens

-person experiences drugs's effects, without having to take the drug again -stress, driving alone at night, right before falling asleep, marijuana or other drug use more likely to trigger LSD flashbacks

Misuse and Abuse of MDMA

-promote euphoria, feelings of closeness, empathy, sexuality and to reduce inhibitions -considered a "party drug" and obtained of "rave" or "techno" parties

Effects of opiates

-resembles effects of endogenous opioids (endorphin) -affect the limbic system to produce increased feelings of pleasure, relaxation, and contentment -act on the brainstem to depress coughing and slow breathing -block messages from the spinal cord

more about Lysergic Acid Diethylamide (LSD)

-schedule 1 drug -most potent of the hallucinogens -has same basic structure as serotonin -metabolized by the liver -tolerance builds up quickly but no evidence it causes physical addiction

Pharmacology of PCP

1 gram PCP can make 18-24 street joints of 5-10 mg of standard dosage Its effects from smoking (5-10mg) take place within 2-5 min. peak in 15-30 min. & last for 4-6 hrs.

Psilocybin

Effects are similar to LSD and mescaline and cross-tolerance exists among the three Effects depend on dose Up to 4 mg causes relaxation and changes of some body sensations Higher doses cause changes of perceptual and body-image with hallucinations in some individuals Sympathetic arousal symptoms May only be active after converted to psilocin

Other PCP-Like Drugs

Examples: Ketamine, dextromethorphan, and nitrous oxide Cause different degrees of depressive and dissociative effects

Opiates Withdrawal: Heroin, Morphine, Methadone

Heroin: 4 hours Morphine: 6 hours Methadone: 12-24 hours

Narcotic Withdrawal Symptoms (later phase)

Hot or cold flashes; aching bones & muscles; loss of appetite Insomnia; raised BP; increased temp., pulse & respiratory rate; restlessness; nausea Curled up, fetal position; vomiting; diarrhea; weight loss

Effects of Sedatives and Hypnotics

Alcohol-like intoxication Impaired judgment & coordination Depression Tolerance Physical & psychological dependence

Opium War

banned the use, sale, and import in China but British smuggled opium through East India Company

Anti-cholinergic

blocking the passage of nerve impulse through parasympathetic nerves or an agent that blocks the parasympathetic nerves

physical effects associated with hallucinogens

increased heart rate and blood pressure sleeplessness and tremors lack of muscular coordination sparse, mangled, and incoherent speech decreased awareness of touch and pain that can result in self-inflicted injuries convulsions coma heart and lung failure

Vietnam War

increased the use of opium and resulted in significant increase of abuse and demand for drugs.

Effects of High Dose of PCP (12-15mg)

Alternating periods of sleep & waking Convulsion Comatose up to 12 hours Decreased respiratory rate/depth, BP, & urine output Arrhythmia Respiratory arrest Death

MDMA effects

A synthetic psychoactive drug chemically similar to methamphetamine and mescaline. A Schedule I drug that is misused for energizing effect as well as distortions in time & perception and enhanced tactile experiences

Psilocybin & Psilocin

A tryptamines (monoamine alkaloid) that can be obtained naturally or produced synthetically. At doses of 10-20 mg, the drugs produce muscle relaxation, dilation of pupils, vivid visual & auditory distortions, & emotional disturbances. The effects last about 8 hours.

Long Term Effects of Ecstasy

About 60% of individuals report withdrawal symptoms including fatigue, loss of appetite, depressed feelings, and trouble concentrating. Studies in primates showed long-term damage to neurons that are involved in mood, thinking, and judgment. (Exposure to only 4 days has been shown to cause damage to serotonin nerve terminals 6 to 7 years later.)

Belladonna ("Deadly Nightshade")

Active ingredient is atropine Name Atropa belladonna comes from two major historical uses As a deadly poison: Atropos, one of the Three Fates in Greek mythology, was responsible for cutting the thread of life 14 berries contain a lethal dose of atropine As a beauty aid: Belladonna, or "beautiful woman" Extract of the plant dilates the eyes, which is thought to improve appearance

Narcotic Withdrawal Symptoms (beginning phase)

An increase in drug craving & anxiety Yawning; perspiration; runny nose Pupil dilation; goose bumps; muscle tremors or twitches

Long term effects of opiates (1)

Appear after repeated use over a period of time abscesses and infection at injection sites Hepatitis B & C, and HIV infection resulting from sharing infected injecting drug equipment (can occur at first use)

What was the first barbiturate developed?

Barbital -synthesized from chemicals in urine -effective in inducing sleep

Anticholinergic Hallucinogens Effects

Block production of mucus in the nose and throat and prevent salivation Mouth becomes dry and perspiration stops Temperature can increase to fever levels Heart rate increases Eyes dilate, resulting in an inability to focus on nearby objects At high doses, behavior pattern resembles toxic psychosis (delirium, mental confusion, loss of attention, drowsiness, loss of memory for recent events)

Other facts about PCP

By 1960, PCP had been characterized as An excellent anesthetic for monkeys A medically safe but psychologically troublesome anesthetic for humans A hallucinogen different from LSD and mescaline, with profound effects on body perception Currently, PCP is licensed for use as an animal anesthetic

Mescaline

Can be extracted from peyote or produced synthetically. The hallucinogenic dose is about 0.3 to 0.5 grams and lasts about 12 hours. It usually produces rich visual hallucinations. A Schedule I drug

Other facts about PCP (ctd)

Commonly referred to as "angel dust" Schedule III drug, later became Schedule II. Not a "true" hallucinogen due to pharmacology -- also relieves pain & acts as a stimulant Rarely produces visual hallucinations

Mandrake (Mandragora officinarum)

Contains all three anticholinergic hallucinogen alkaloids Close association with love and lovemaking going back to Genesis The root is forked and can be said to resemble a human body Long thought to be endowed with magical and medical properties

Henbane (Hyoscyamus niger)

Contains scopolamine and l-hyoscyamine Long known and used as a poison Shakespeare's Hamlet

Medical uses (II)

Cough suppressant Decrease activity in the cough control center in the medulla oblongata Sedative (cancer treatment)

Reasons for LSD abuse

Creativity Spiritual search Pleasure & excitement

DOM (STP)

DOM 2,5-dimethoxy-4-methylamphetamine Earlier street name was STP ("serenity, tranquility, peace") Effects similar to mescaline and LSD

Danger of LSD abuse

Deceit Bad trips and flashbacks Best solution for bad trips is to talk the patient back into a calm state with a quite and comfortable environment. No direct death has been reported

Depressants

Depress the CNS Produce a calming effect or sleep Commonly referred to as "downers" Many are highly addictive E.g sleeping pills

Short term effects of opiates (II)

Immediately after injection, the user feels a surge of pleasure (rush) which quickly leads to a state of gratification (high) The body feels warm, the limbs very heavy, and the mouth becomes dry The user may go "on the nod"-- an alternate wakeful and dreamy/sleepy state

Short Term Effects of MDMA

In high doses, MDMA can interfere with body' ability to regulate temperature, occasionally can lead to a sharp increase in body temperature and result in liver, kidney, and cardiovascular system failure, and death. MDMA can interfere body metabolism and may lead to harmful levels within short intervals by repeated use. Increase in BP, HR & muscle tension. Teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Where does the majority of legal heroin come from?

India

Long term effects of opiates (2)

Inflammation of the brain (meningitis) due to germs from contaminated needle (can occur at first use) Various types of pneumonia

Routes of Opium Administration

Ingested orally pharmaceuticals: tablets, capsules & syrups Smoked (inhalation) Snorted Injected

PCP (Phencyclidine)

Initially appeared to be a good anesthetic It does not depress blood circulation or respiration or produce heart rate irregularities as some anesthetics do Mechanism of action of PCP PCP alters many neurotransmitter systems Sigma receptor may be selective for PCP and similar drugs

Risk of Ecstasy Misuse and Abuse

It can cause brain cell death, memory loss and potentially irreversible brain damage. A series of studies over the past 5 years at UF has shown that using MDMA and other forms of mathamphetamine can lead to the same type of brain damage that occurs when a person endures a sharp blow to the brain (i.e., a kick in the head).

Ecstasy (MDMA) effects

It's a psychedelic mathamphetamine that has gained popularity over the past 20 years. It produces strong feelings of comfort, empathy and connections to others. It most frequently comes in tablet form. Its use is closely tied to dance club scene.

First Aid for Opium overdose

Keep patients awake Maintain an open airway Give mouth-to-mouth resuscitation if needed Place unconscious patient on side Monitor vital signs (breathing, pulse, temp.) Call for help or transport to medical facilities

Ketamine (Special K or super K)

Ketamine is a rapidly acting anesthetic. Its pharmacological profile is essentially the same as PCP. Ketamine has both analgesic and amnesic effects and is associated with less confusion, irrationality, and violent behavior than PCP. It is primarily used in veterinary medicine, but it has some utility for emergency surgery in humans. On the street, it is usually distributed as a powder obtained by removing the liquid products. It can be taken orally, snorted, or injected. It is also sprinkled on marijuana or tobacco and smoked. After oral or intranasal administration, effects are evident in 10-15 minutes and are over in about an hour. Low doses produce vertigo, ataxia, slurred speech, slow reaction time, and euphoria. High doses can cause amnesia, or coma.

Narcotic Addiction Treatment (IV)

LAAM (Levo-Alpha-Acetyl-Methadol) works in the same way as methadone longer duration than methadone; taken 3 times a week easy on the patients allows more patients to be seen

Peyote

Peyote (from the Aztec peyotl) is a small, spineless, carrot-shaped cactus, Lophophora williamsii Lemaire Mostly subterranean, with only the pincushion-like top appearing above ground Long pre-Columbian history of use among Mexican Indians, who used the plant ceremonially

What is the most common illicit drug?

Marijuana

Narcotic Addiction Treatment (III)

Methadone administered orally at clinic or doctor's office short-duration of action; taken daily has been in use for more than 30 years

Narcotic Addiction Treatment (II)

Methadone detoxification programs maintenance programs (700 U.S. programs, 100,000 patients ) eliminates craving, diminishes w/d symptoms, & blocks heroin from reaching the receptors The treatment program needs to be monitored closely because it can produce euphoric effects. It is also a physical dependent drug

Sedatives- Hypnotics

Mild CNS depressant effects Include those drugs used to reduce nervous tension & induce sleep Produce sedation in small doses, sleep in larger doses, & anesthesia or coma in higher doses

Narcotic Addiction Treatment (V)

Naltrexone (Revia, Trexan) "narcotic antagonist" (also anti-alcoholism) does not eliminate craving generally, seen as short-term intervention

Anticholinergic Hallucinogens

Naturally occurring agents in this group come from the potato family Effects come from three pharmacologically active alkaloids that are central and peripheral cholinergic (parasympathetic nervous system) blocking agents Atropine (dl-hyoscyamine) Scopolamine (l-hyoscine) l-hyoscyamine Many used as poisons in addition to being used for their hallucinogenic effects

Physiological Effects of PCP (ctd.)

Nystagmus (involuntary rapid movement of eyeballs) Depressed light reflex Blurred vision Diminished pain & temp sensations Ataxia (loss of muscle coordination) Tremors & muscle weakness Slurred speech Drowsiness Increased respiratory rate/depth (low dose) Increased pulse rate, BP, urine output, body temp (hot hog) (low dose) Nausea & vomiting

Possible Desired Sedatives/ Hypnotics Effects

Reduced anxiety Decreased inhibitions Increased self confidence Decreased criticism Elevated mood

Facts about PCP III

Originally developed as an anesthetic in the 1950 but taken off the market White crystal-like powder, tablet, capsule May be smoked, ingested orally, snorted, or injected Causes altered perceptions of body image

Medical Intervention

Overdose "narcotic antagonists" - drugs that antagonize or counteract the effects of narcotics Narcan (Naloxone) - used in hospital ERs Withdrawal symptoms Methadone (Dolophine) Clonidine

Phencyclidine (PCP)

PCP is a tranquilizer anesthetic with hallucinogenic properties First used as veterinary drugs in late 50' under the name of "Sernylan" Mixed with marijuana as "killer weed" Misused in late 60's as 'PeaCe Pill" on the street and became popular to replace LSD in 70's & 80's Other street names: angel dust, crystal, super grass, elephant tranquilizer

Medical Use of Opium

Pain relief -visceral pain -pain may still be felt, but the emotional reaction is reduced intestinal disorders -GI system (ex. counteract diarrhea and cause H2O to be absorbed from intestinal material)

Other Ecstasy effects

Prior to the scheduling of MDMA (Schedule I), some psychiatrists used it in practice because it was viewed as having a special ability to promote empathy, aiding in therapy Effects Heightened sense of "closeness" with others Increased heart rate Increased blood pressure Euphoria Increased sociability Other autonomic effects

Narcotic Treatment (VI)

Psychotherapy/Counseling Inpatient Outpatient Individual & Group Support/Self-help groups Narcotics Anonymous (NA)

Mescaline Pharmacology

Rapidly absorbed if taken orally Half-life is about 6 hours Effects Low dose effects are primarily euphoric Higher doses cause the full set of hallucinogenic effects Most mescaline is excreted unchanged Psychoeffective dose causes sympathetic arousal LD50 is about 10 to 30 times the dose needed to cause behavioral effects Tolerance develops more slowly to mescaline than to LSD Cross-tolerance between LSD and mescaline

Medical Uses of Sedatives-Hypnotics

Sedative; tranquilizing Hypnotic; sleep-inducing Anti-convulsant; seizure control Anesthetic; pain reliever (short-acting barbiturates)

Commonly Used and Abused Depressants

Sedatives/Hypnotics Barbiturates (sleeping pills, anti-seizure drugs) Benzodiazepines (tranquilizers) Rohypnol Gamma Hydroxy-Butyric Acid (GHB) Ketamine (Special K) Inhalants

Symptoms of Narcotic overdose

Shallow breathing Slowed pulse Clammy skin Pulmonary edema Respiratory arrest Convulsions Coma; possible death

Belladonna effects

Some users report the sensation of flying Use of belladonna may have been tied to some early descriptions of witchcraft and the activities of witches

3,4-MethyleneDioxyMethAmphetamine (MDMA)

Street/Slang Names Ecstasy XTC X E Adams Beans Hug Drug Disco Biscuit Go Lover's Speed Molly

Mescaline (3,4,5- Trimethoxyphenetylamine)

The primary active ingredient in peyote, a small spineless, carrot-shaped cactus Used for centuries by Native Americans in religious ceremonies -- the only use currently allowed by U.S. law Usually ingested orally but may be dried & smoked

Short term affects from opiates (I)

Those that occur rapidly after a single dose and disappear within hours or days depress the activities of the CNS affect the higher centers of the brain affect the lower brain stem which controls vomiting & nausea depress the part of the brain stem which controls cough

LIfe of a Heroin User

Three to four injections needed daily to prevent withdrawal Expensive habit (cost of drugs and paraphernalia) Risk of overdose due to variable potency of different batches Health problems associated with injection habit Skin infections Blood-borne infections Masking of early symptoms of illness Some users "mature out"

Dimethyltryptamine (DMT)

Worldwide, an important naturally occurring hallucinogen found in many plants DMT is the active agent in Cohoba snuff, used in some South American and Caribbean Indian hunting rituals Usually snuffed, smoked, or taken by injection Ineffective when taken orally Effects are very brief

Harrison Narcotic Act 1914

controlled the use, sale, and import of opium, resulted in decrease of abuse

psychotomimetics

drugs produce effects that mimic psychosis

phantastica

drugs that create a world of fantasy

What are the most popular pain relievers?

hydrocodone and oxycotin

Hallucinogens

mind-altering (psychedelic) drugs that interfere with normal perceptions, sensations, comprehension, self-awareness, and emotions, create hallucinations -Drugs used to produce an altered state of consciousness (alpha, beta, theta, delta waves)

codeine

natural alkaloid (.5x opium)

morphine

natural alkaloid (10 x opium)

Major Methods of Use of Sedatives

oral (pills) intravenously (injection)

Dilaudid

semi-synthetic (3-4x morphine)

heroin

semi-synthetic (3x morphine)

methadone

synthetic (morphine)

Physical effects of LSD

tingling in hands and feet -feeling of numbness -nausea -anorexia -flushed appearance -sensation of chillness -mydriasis -high blood pressure, high heart rate, high body temp., and high blood sugar