ADDICTION

Presented by:
 Omar Abouelgheit 87116
 Maryem Sami 87105
 Mostafa Elsayed 97526
 Amal Husein 86937
 Yassmin Yasser 86947
 Rana Reda 97537
 Habiba Mohamed 87117
 Alaa Ahmed 92296
 Sohaila Ashraf 87114
 Kareem Ahmed 97506
 Mohab Alaaeldin 87093

Supervised by: Dr Ghada Salah

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Table of content:

Introduction

Cannabis

Cocaine

Hallucinogens

Inhalants

Reference

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Introduction:
Addiction is defined as a chronic, relapsing disorder characterized by
compulsive drug seeking and use despite adverse consequences. It is considered a
brain disorder, because it involves functional changes to brain circuits involved in
reward, stress, and self-control. Those changes may last a long time after a person has
stopped taking drugs.
Addiction is a lot like other diseases, such as heart disease. Both disrupt the
normal, healthy functioning of an organ in the body, both have serious harmful
effects, and both are, in many cases, preventable and treatable. If left untreated, they
can last a lifetime and may lead to death.

 There are 2 types of addiction:

Behavioral addiction: Person becomes dependent on the pleasurable feelings that
come as a result of certain behaviors and begins to compulsively act on that behavior.
These behaviors include: Food addiction, internet addiction or gambling addiction.
Physical addiction: The ones that are generally better known. These are addictions to
substances that are ingested or otherwise put into a person’s body. They include:
Alcohol, Tobacco, opioids, cocaine, marijuana, hallucinogens and inhalants.
In this research we are going to discuss some types of drugs and substances
which cause addiction. They are classified into:
Central Nervous System (CNS) Depressants: Drugs that include sedatives,
tranquilizers, and hypnotics. Which slow down the operations of the brain and the
body as they act on the brain by increasing activity of gamma-aminobutyric acid
(GABA), a chemical that inhibits brain activity. They include:
 Opioids
 Cannabis
 Benzodiazepines
 Analgesics
 Alcohol
Central Nervous System (CNS) Stimulants: Drugs that increase activity of the
central nervous system and the body. They include:
 Nicotine
 Cocaine
 Amphetamine
Hallucinogens: a diverse group of drugs that alter a person’s awareness of their
surroundings as well as their own thoughts and feelings. They are commonly split into
two categories:
 Classic hallucinogens (such as LSD)
 Dissociative drugs (such as PCP)
Inhalants: substances that people typically take by inhaling. They include:
 Solvents
 Aerosol sprays
 Gases , Nitrites
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  Addictive drugs can also be distinguished as three groups:
Drugs that bind to G-protein coupled receptor (GPCR). They include:
 Opioids
 Cannabinoids
 Gamma-hydroxy butyrate (GHB)
Drugs that interact with inotropic receptors or ion channels. They include:
 Nicotine
 Alcohol
 Benzodiazepines
Drugs that target monoamine transporters. They include:
 Cocaine
 Amphetamine

CANNABIS
CHEMISTRY: Tetrahydrocannabinol.
KINETICS:
 Absorption: Oral or by Inhalation.
 Distribution: Cross blood brain barrier.
 Metabolism: CYP2C and CYP3A in the liver.
 Excretion: 70% in feaces and about 20% in urine.

MECHANISM OF ACTION:
11-OH-THC (11-Hydroxy-tetrahydrocannabinol)
which is psychoactive metabolite of THC responsible
for stimulation of brain dopamine (DA) signaling in
the nucleus accumbens which is a mechanism
believed to underlie the rewarding effects of drugs
and to trigger the neuroadaptations that result in
addiction.

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EFFECT: The effects of Cannabis (THC) include:
 Euphoria
 Tachycardia
 Impaired body movement
 Impaired memory,
 Altered senses and vision
 Delusions and hallucinations (high doses only)

SIGNS AND SYMPTOMS:

 Bloodshot eyes
 Lack of motivation and weight gain
 Nervous or paranoid behavior
 Dry mouth (xerostomia)
 Anxiety Distorted perception
 Sleepiness Feeling

Related Disorders: Several studies have linked marijuana use to increased risk for
psychiatric disorders, including schizophrenia, depression, anxiety, and substance use
disorders.

Withdrawal symptoms: Smoking marijuana a handful of times may not be

enough to cause symptoms, but for people who smoke marijuana regularly, it may be
a different story. Withdrawing from regular marijuana use can lead to symptoms that
include:
 Mood changes, depression and irritability
 Sleep difficulties, including insomnia
 Headaches and loss of focus
 Sweating including cold sweats
These symptoms can range from mild to more severe, and they vary from person to
person. These symptoms may not be severe or dangerous, but they can be unpleasant.
The longer we used marijuana, the more likely we are to experience withdrawal
symptoms.

COCAINE
CHEMISTRY: methyl ester of benzoylecgonine. (Natural ester).
KINETICS:
 Absorption: Oral, Intra venous and intra nasal.
 Distribution: Cross blood brain barrier by passive diffusion.
 Metabolism: Liver.
 Excretion: Renal.

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MECHANISM OF ACTION:
In the normal neural communication
process, dopamine is released by a neuron into
the synapse, where it can bind to dopamine
receptors on neighboring neurons. Normally,
dopamine is then recycled back into the
transmitting neuron by a specialized protein
called the dopamine transporter. If cocaine is
present, it attaches to the dopamine
transporter and blocks the normal recycling
process, resulting in a buildup (accumulation)
of dopamine in the synapse, which contributes
to the pleasurable effects of cocaine.

EFFECT OF COCAINE:
Cocaine travels through the bloodstream leading to damage in the whole body.
These damages can include: Hypertension, Heart attack, Cardiac arrhythmias,
Strokes, Seizures, Permanent damage to the lungs, Perforation of the nasal cavities,
Ulcers, Perforation of the stomach and intestines, Rhabdomyolysis, Serious skin
infections and abscesses and also Death.

SIGNS AND SYMPTOMS

It varies from one individual to the next depending upon length of addiction,
frequency of use, and level of physical dependency.
 Anxiety
 Euphoria
 Paranoia
 Increased energy and alertness
 Violent behaviors
 Irritability
 Damage to nasal passages and loss of
smell
 Dilated pupils, Vasoconstriction of blood
vessels of brain and heart
 Difficulties in swallowing and
hoarseness
 Delusions and hallucinations

DISORDERS:
The most common disorders that co-occur with cocaine addiction include the
following:
 Depressive disorders
 Bipolar disorder
 Schizophrenia
 Antisocial personality disorder
 ADHD
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WITHDRAWAL SYMPTOMS:
 Exhaustion and fatigue
 Anhedonia (the inability to feel pleasure)
 Challenges in concentration
 Depression, Anxiety
 All-over body aches and tremors.
 It can also lead to Suicidal thoughts.

HALLUCINOGENS
(LSD)
CHEMISTRY: LSD Lysergic acid diethylamide
LSD was first synthesized by Swiss chemist from lysergic acid which is a chemical
derived from the hydrolysis of ergotamine that is alkaloid found in ergot (fundus that
infect grains). LSD is semi-synthetic drug; odorless, colorless, and tasteless as well.

KINETICS:
 Absorption: orally as capsules or tablets.
 Distribution: Pass blood brain barrier, act on both CNS and autonomic.
 Metabolism: liver.
 Excretion: In urine.

MECHANISM OF ACTION:
LSD works by stimulating the raphae nuclei.
This section of brain uses serotonin, which
LSD chemically resembles, and is responsible
for regulating incoming sensory information
and outgoing muscular impulses. Researchers
hypothesize that LSD increases the sensitivity
of this brain region and allow more
information to flow to higher brain regions,
including those responsible for vision and
emotion. Users may experience therefore
heightened sensitivity to environmental stimuli
which can lead to distortion in perception
(depth, touch, color, sound, and balance).

EFFECT OF LSD:
DOSE LSD is taken in micrograms, usually 50 to 300 micrograms.
Depending on dose, effect may last from 6 to 12 hours; the plasma half-life is about
two and a half hours. If LSD is taken continuously over long period, increased dosage
would be required to achieve desired effect. However, because LSD is so powerful,
most users do not take it frequently.

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EFFECT Panic reactions (bad trips) may be sufficiently severe to require
medical support. Patients usually recover within few hours but occasionally
hallucinations last up to 48 hours and psychotic states for 3-4 days. The effect is
greatly affected by individuals' mental state and the surroundings in which the drug is
taken. Sensory disturbances are known as flashbacks sometimes occur. Serious side
effects often attributed to LSD such as irrational acts leading to suicide or accidental
deaths, are extremely rare. Deaths attributed to LSD overdose are virtually unknown.
Symptoms of bad trips are: Extreme anxiety and panic, paranoia, delusions,
disorientation, fear of losing personal identity or dying, violent behavior and suicidal
thoughts.

SIGNS AND SYMPTOMS:

 Impulsive behavior
 Quickly shifting mood and emotions
 Hallucinations
 Altered perception
 Hypertension
 Rapid heart rate
 Dizziness
 Dry mouth (xerostomia)
 Tremor

DISORDERS:
 Schizophrenia
 Long term psychosis
 HPPD (hallucinogen persisting perception disorder)

WITHDRAWAL SYMPTOMS:
Dependence is typically psychologically not physical.
 General discomfort
 Restlessness
 Anxiety and insomnia
 Depression


INHALANTS
(Difluoroethane)
Inhalants are various products easily bought and found in the home or
workplace such as: spray paints, markers, gas dusters, glues, and cleaning fluids. They
contain dangerous substances that have psychoactive (mind-altering) properties when
inhaled.

CHEMISTRY: C2H4F2 , 1,1-Difluoroethane.

KINETICS:
 Absorption: Inhalation.
 Distribution: Lungs, blood and cross blood brain barrier.
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  Metabolism: by liver into fluorinated compound.
 Excretion: by kidney through urine.

MECHANISM OF ACTION:
Stimulate the gamma-aminobutyric acid
(GABA) and the glycine a1 receptors, as well
as inhibit the N -methyl-D -aspartate (NMDA)
receptor, leading to inhibition in the CNS
Mechanisms include induced changes in
neuronal cell membranes. GABA is
responsible for helping to regulate feelings or
stress and anxiety by inhibiting the nerve
impulses carrying those feelings to the brain.

EFFECT:
Systemically: Effects of difluoroethane inhalation include loss of consciousness,
frostbite at mucosal surfaces, rhabdomyolysis, and global myocardial hypokinesis. At
the cardiac myocyte, fluorinated hydrocarbons alter potassium and calcium currents,
leading to dysrhythmias and prolonged atrial refractory time. These effects cause
cardiac injury after acute or chronic use.

On bone: prolonged DFE inhalation. DFE is metabolized into a fluorinated

compound that accumulates and leaches calcium from bone, altering its structure.
This can manifest as bony deformities with diffuse periosteal reaction and elevated
serum fluoride levels. Furthermore, the elevated C-telopeptide level seen in this case
may suggest increased bone turnover.

SIGNS AND SYMPTOMS:

 Hearing loss
 Frequent headaches
 Impaired cognition
 Difficulty concentrating
 Memory problems
 Issues with motor skills and coordination
 Chemical or paint stains, especially on the
hands or face
 Missing household products that could be used
as inhalants
 A noticeable amount of related paraphernalia
 Constant chemical smell on their person
 Blistered skin where the inhalant may have
broken the skin.

WITHDRAWAL SYMPTOMS:
Withdrawal symptoms can include tremors, diaphoresis, nausea, vomiting,
depression, anxiety, irritability, psychosis, and hallucinations. Symptoms typically
start within 24 to 48 hours of cessation and last for 3 to 7 days. 5 Psychotic symptoms
often abate quickly; however, anxiety and insomnia can persist for weeks.
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CASE PRESENTATION: sudden sniffing death syndrome
 A 20-year-old man was found dead on the floor next to a computer, with a
nearly full can of "CRC Duster" dust remover located next to the deceased on
the floor, and an empty can of the same product on the computer desk.
Toxicologic evaluation using either gas chromatography/mass spectrometry
(GC/MS) or gas chromatography/flame ionization detector (GC/FID) method
identified the active ingredient 1,1-difluoroethane (Freon 152a) in all tissues
analyzed. Tissue distribution studies revealed highest concentration in central
blood, lung, and liver. It is believed that the 1,1-difluoroethane inhalation was
the cause of death.

 A case series addressed deaths within a California county which occurred

while the decedents were intoxicated with difluoroethane. Cases included loss
of consciousness while driving resulting in fatal motor vehicle collisions,
death by suicide, and incidental death in otherwise healthy individuals likely
involving sudden cardiac compromise.

 A case of a 39-year-old white female who suffered from “huffing”-related

overdose from 1,1-difluoroethane (DFE) has been described. general state of
intoxication similar to that produced by alcohol or marijuana. The effects
usually last for only 15–30 minutes but can be sustained by continuous or
repeated use. The decedent’s blood was positive for DFE (52 mcg/mL) and
mitragynine (18ng/mL). In consideration of the investigation, postmortem
examination, and postmortem toxicology, the cause of death was certified as
DFE toxicity and the manner of death was certified as an accident.

TREATMENT:
People who become addicted to inhalants use the same treatment as any other
addictive drug which is mainly focused on psychiatric treatment such as cognitive
behavioral therapy , family therapy .In some cases there will be a permanent damage
to some organs and therefore a specific treatment is prescribed such as in severe
kidney damage, dialysis is necessary. And in severe lung damage, mechanical
ventilation is required.

REFERENCE:
https://nida.nih.gov
https://www.emcdda.europa.eu/
https://www.optionsbehavioralhealthsystem.com/
https://pubchem.ncbi.nlm.nih.gov
https://ncbi.nlm.nih.gov
https://www.sciencedirectcom
https://www.researchgate.net

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