Drugs of Abuse

Drugs with Abuse Potential

Socially acceptable (licit) – alcohol , caffeine , nicotine

Opioid analgesics- morphine , heroin
Sedative / hypnotics
Hallucinogens

Inhalants

Club drugs / designer drugs

 Stimulants – cocaine & amphetamines
 Cannabis
 Anabolic steroids
 Antihistamines
Classification

 Depressants
 Opioids
 Stimulants
 hallucinogens
Depressants

 Depressants are category of drugs that include alcohol, sedatives

It is said that depressants inhibit the stress hormones. A person who is having difficult
dealing with stress and is exposed to depressants is likely to find them rewarding.
Alcohol, heroin
Alcohol

Chemical term that covers a class of substances

 Isopropyl alcohol (rubbing alcohol)
 Methanol (used for industrial & automotive purposes)
 Ethanol- essential ingredient in beverage alcohol; also found in many
medications
Alcohol content

Wine 10 – 14% by volume

Wine coolers 4 – 7 %
Alize ® 16 %
Heineken ® 5%
Red Stripe ® 4.7 %
Red Stripe Light ® 3.6 %
Vodka 50% , cognac 40%
Smirnoff Ice 5.6%
Guinness 6.5 %
Typical servings`````````

 Containthe same amount of alcohol (13.6 grams)

although the specific servings vary in terms of volume
 One 5 oz glass of table wine(12 % alcohol) ,one 3 oz glass
of fortified wine (18% alcohol), one 12 oz can / bottle of
beer or one “ shot glass “ with 1.5 oz of whiskey contain
the same amount of alcohol
Typical servings of alcohol
Alcohol- Low to moderate doses

 Dilation of blood vessels in skin

 Water loss through increased urination
 Induces sleep
 Accumulation of fat in liver – fatty liver
 Gastritis
Alcohol-Long term, heavy use

 Brain damage – alcoholic dementia

 Wernicke’s encephalopathy
 Korsakoff’s psychosis
 Peripheral neuropathy
 Cardiomyopathy
Alcohol-Long term, heavy use

 Gastritis, pancreatitis, peptic ulcer

 Alcoholic liver disease – fatty liver, alcoholic hepatitis, cirrhosis
 Cancer
 Foetal alcohol syndrome
Stimulants

 Cocaine, caffeine, amphetamines , nicotine

These substances stimulate the central nervous system. In moderation they enhance
mood, increase alertness and relieve fatigue .
More powerful stimulants produces sudden sensation known as ‘rush’
Abuse associated with binge use.
all other interests become secondary to re-creating the initial euphoric rush.
Cocaine
Coca is a flowering bush or shrub (Erythroxylon coca) that in cultivation stands three
to six feet high and yields at most four ounces of waxy, elliptical leaves that are about
1 percent cocaine by weight. Conversion into cocaine hydrochloride— powdered
cocaine—requires several steps. Immediately after being harvested, the leaves are
pulverized, soaked, and shaken in a mixture of alcohol and benzene (a coal tar
derivative) for about three days. After the liquid has been drained, sulfuric or
hydrochloric acid, depending on the alkaloid content of the leaves, is added, and the
solution is again shaken. Sodium carbonate is added, forming a precipitate, which is
washed with kerosene and chilled, leaving behind crystals of crude cocaine known as
coca paste, which is allowed to dry.
 Effects
Cocaine typically enters the bloodstream by being snorted into the nostrils through a
straw or rolled paper or from a “coke spoon.” “Because cocaine is a vasoconstrictor,
it inhibits its own absorption, and the time it takes to reach peak concentration gets
longer as the dose gets larger” (Karch 1996: 19).
Crack:
Crack, the drug abuser’s answer to fast food, became popular among young men and
women during the 1980s.
Drug is cheap
Versions of crack may contain any combination of freebase residue, concentrated
caffeine, or different amphetamines.
Patterns of cocaine use

Cocaine hydrochloride – snorting (intranasal), smoking, intravenous (including

being mixed with heroin (‘speedball’ or ‘snowball’)), ingestion, application to
genitalia
Crack cocaine – inhalation of vapour from heated foil or pipe
Freebasing
Coca leaves – chewed/ ingested  
Crack

 is usu. made by mixing 2 parts cocaine HCl w 1 part baking soda (sodium
bicarbonate) in about 20 ml H2O
 solution then heated gently until white precipitates form
 heating halted when precipitation stops
 precipitate filtered & retained; may then be washed w water
Crack cocaine

 product then dried for 24 hours under heat-lamp.

 Crack then cut or broken into small 'rocks' weighing a few tenths of a gram.
 can be smoked in crack pipes, or heated on foil & vapour inhaled
Freebase cocaine

 Changes cocaine hydrochloride into smokeable & more potent form

 Make cocaine hydrochloride alkaline by adding a base , then extracting cocaine
base from mixture using organic solvent
 Solvent must be evaporated before being smoked
EFFECTS OF LONG TERM USE

 BINGES FOLLOWED BY CRASHES

 FORMICATION
 SLEEP DISORDERS-insomnia followed by exhaustion
 EATING DISORDERS – appetite suppression alternating w
intense hunger
 SEXUAL DYSFUNCTION – impotence
 NEUROLOGICAL EFFECTS-cerebral atrophy
EFFECTS OF LONG TERM USE

 CARDIOVASCULAR – high blood pressure, arrhythmias

 INFECTIONS
 MISCARRIAGES
 PREMATURE DELIVERY
 LOW BIRTH WEIGHT BABIES
EFFECTS OF LONG TERM USE of
COCAINE

 CARDIOVASCULAR SYMPTOMS – high blood press, irregular heart beat

 INFECTIONS
 MISCARRIAGES
 PREMATURE DELIVERY
 LOW BIRTH WEIGHT BABIES
Amphetamine

 Unlike cocaine, amphetamines are products of the laboratory—they are synthetic

drugs. Although their chemical structures are distinctly different (Snyder 1986)
and amphetamine has no anesthetic properties, the effects of cocaine and
amphetamines are similar.
 The high from amphetamine lasts hours, rather than the fraction of an hour for
cocaine.
 Methamphetamine is known by many street names, such as “speed,” “crank, “go,”
“crystal,” “crystal meth,” and “poor man’s cocaine.” It can be used by all of the
common routes of illicit drug administration (inhalation, intranasal snorting,
intravenous injection, or orally) but must be purified before it can be smoked. Ice
is a purified form that is frequently sold as large crystals (rocks) that are smoked.
Like rock salt in size and appearance, ice produces a high that is reputed to last
from seven to twenty-four hours. Because of its purity, ice exaggerates all of the
effects of methamphetamine. Overdoses are more common with ice because it is
difficult for smokers to control the amount being inhaled. The substance could
easily substitute for crack.
 Nicotine
Nicotine is one of more than 4,000 chemicals found in the smoke from tobacco;
smokeless tobacco also contains a high level of nicotine (National Institute on Drug
Abuse 1998b).

Nicotine is absorbed through the skin and mucosal lining of the mouth and nose by
inhalation into the lungs (National Institute on Drug Abuse 2001d).
 E smoking: Resembling a normal cigarette, electronic cigarettes use a battery-
powered device to deliver a smokeless and odorless dose of nicotine. When the
user inhales, a sensor heats a cartridge that dispenses nicotine and produces
imitation smoke using propylene glycol, a product used to create smoke or fog in
theatrical productions
 Hookah: The use of water pipes, popular in the Middle East, has become part of
the college scene. Flavored and sweetened tobacco is heated over charcoal and
then cooled as it passes through a bowl of water. While many enthusiasts believe
that it is safer than smoking cigarettes, in fact the hookah may expose users to
more toxic materials than do cigarettes: “Each puff has as much as 100 times the
smoke as a puff from a cigarette” and smokers are also inhaling fumes from the
charcoal (“Despite Dangers, Hookahs Gain Favor” 2008: 6).
Hallucinogens

 hallucination as a “Perception of visual, auditory, tactile, olfactory, or gustatory

experiences without an external stimulus and with a compelling sense of their
reality.” “A hallucinogen is a drug that changes a person’s state of awareness by
modifying sensory inputs, loosening cognitive and creative restraints, and
providing access to material normally hidden in memory or material of an
unconscious nature” (Jacob and Shulgin 1994: 74).
 Autonomic hyperactivity results in distortions of the perception of objective
reality. These include: • Depersonalization: “Out-of-body” experiences or
misperceptions of reality • Synesthesia: “Seeing” sound and “hearing” visual
input • Hallucinations: Perceiving sounds, odors, tactile sensations, or visual
images that arise from within the person, not the environment
 LSD:
Lysergic acid diethylamide was synthesized in 1938
LSD has a slightly bitter taste and is usually taken by mouth. Commonly referred to
as “acid,” LSD is sold on the street in tablet, capsules and, occasionally, liquid form.
LSD is often added to absorbent paper (“blotter acid”) and divided into small
decorated squares, each square representing one dose. It may be mixed with any
number of substances, sugar, or gelatin sheets (“window panes”). It takes only 0.01
milligram for LSD to have an effect.
 Mushrooms:
Psilocybe mushrooms have also been used for centuries in Native American religious
ceremonies. The sacred or magic mushroom is typically eaten. Its active ingredients
—psilocybin and psilocyn—are chemically similar to LSD and can be produced
synthetically
Designer & club drugs

Manufactured by chemically altering

controlled substances
Designer & club drugs

 Hallucinogens - MDMA –
methylenedioxymethamphetamine- ecstasy
 methamphetamine
 Ketamine
 Date rape drugs – gamma – hydroxybutyrate ( GHB )
& Flunitrazepam ( Rohypnol )
 inhalants
Hallucinogens - MDMA – ecstasy

 synthetic drug that has hallucinogenic & stimulant properties

 @ low doses – hallucinogenic effects predominate
 @ higher doses – amphetamine like effects experienced
 taken orally as a capsule or tablet
Hallucinogens - MDMA – ecstasy

 Amphetamine like effects of MDMA result in  alertness & energy

 This allows prolonged dancing & rave participation – but unduly taxes metabolic ,
cardiac & muscle reserves
 Leads to malignant hyperthermia , rhabdomyolysis , kidney failure , hypertension,
tachycardia, arrhythmias, anxiety, psychosis, death
Ecstasy

 othereffects - nausea, chills, sweating, teeth clenching,

muscle cramping, blurred vision
Cannabis sativa
Cannabis sativa

 Historicalperspective
 Main psychoactive ingredient is delta – 9 –
THC ( tetrahydrocannabinol )
 Does not fit neatly in descriptions
Cannabis- short term use – low to moderate
doses
 Disinhibition & talkativeness
 Relaxation & drowsiness (contrast w LSD)
 Distortions of perception, time, body image & distance
 Impairment short term memory, ability to perform complex tasks
Cannabis- short term use – low to moderate
doses
 Reddening of eyes
 Fall in b.p
 Bronchodilatiation
 Increased appetite
Cannabis- short term use – higher doses

 True hallucinations
 Delusions
 Depersonalization
Cannabis

@ very high doses --- acute toxic psychosis characterized by hallucinations ,

paranoid delusions, disorientation , intense feelings of depersonalization, severe
agitation , loss of insight
Cannabis - long term use

 Amotivational syndrome ???? Manifestation of chronic intoxication

 Other effects – respiratory system – bronchitis , asthma , lung cancer

Cannabis- short term use – higher doses

 Synesthesias
 Pseudo-hallucinations
 Impaired judgment
 Reaction time slowed
Detection times

Marijuana is detectable
 in urine for 48-72 hours after single use
 up to 30 days after heavy use and/or in users with high body fat