藥物濫用 Hallucinogens and Marijuana 賴滄海 教授

Learning Objectives- Hallucinogens Major hallucinogens Major hallucinogens Describe the major types of hallucinogens Describe the major types of hallucinogens Describe the effects that environment and personality have on the individuals response to hallucinogens Describe the effects that environment and personality have on the individuals response to hallucinogens Describe the effects of hallucinogens Describe the effects of hallucinogens

Hallucinogens (Psychedelics) LSD (Lysergic Acid Diethylamide) LSD (Lysergic Acid Diethylamide) Mescaline （ Peyote ） Mescaline （ Peyote ） Psilocybin Psilocybin Tryptamines Tryptamines Dimethyltryptamine (DMT) Dimethyltryptamine (DMT) Foxy(5-methoxy-N,N- diisopropyltryptamine) Foxy(5-methoxy-N,N- diisopropyltryptamine) Nutmeg Nutmeg

Sensory and Psychological effects Altered senses (Synesthesia) Altered senses (Synesthesia) Loss of control Loss of control Self-reflection Self-reflection Loss of identity and cosmic merging Loss of identity and cosmic merging

Synesthesia A subjective sensation or image of a sense other than the one being stimulated, such as an auditory sensation caused by a visual stimulus A subjective sensation or image of a sense other than the one being stimulated, such as an auditory sensation caused by a visual stimulusFlashbacks Recurrences of earlier drug-induced sensory experiences in the absence of the drug Recurrences of earlier drug-induced sensory experiences in the absence of the drug

Mechanism of action Serotonin Serotonin Norepinephrine, dopamine, Norepinephrine, dopamine, acetylcholine and others acetylcholine and others

Physiological Effects of LSD Concentrated in the Hypothalamus, the limbic system, the auditory and visual reflex area. Concentrated in the Hypothalamus, the limbic system, the auditory and visual reflex area. Activates the sympathetic nervous system.( Increase body temperature, heart rate, blood pressure, sweats, dilated pupils). Activates the sympathetic nervous system.( Increase body temperature, heart rate, blood pressure, sweats, dilated pupils). Affect the parasympathetic nervous system (salivation and nausea). Affect the parasympathetic nervous system (salivation and nausea).

Tolerance to LSD developed very quickly due to changes in sensitivity of target cells Tolerance to LSD developed very quickly due to changes in sensitivity of target cells No withdrawal symptoms after stop use No withdrawal symptoms after stop use Had no effect on creativity Had no effect on creativity

Adverse Psychedelic Effects of LSD-”Freak out” Intense nightmarish experience Intense nightmarish experience Complete loss of emotional control Complete loss of emotional control Paranoid delusion Paranoid delusion Hallucinations, panic attacks Hallucinations, panic attacks Psychosis Psychosis No carcinogenic or mutagenic effects in human No carcinogenic or mutagenic effects in human

Non psychotic adverse reaction of LSD Tension, anxiety Tension, anxiety Fear Fear Depression Depression Despair Despair Altered perception Altered perception

Nutmeg--( 肉豆蔻 )

Phenethylamines Dimethoxy methylamphetamine ( DOM,STP ） Dimethoxy methylamphetamine ( DOM,STP ） MDA （ methylenedioxy amphetamine ） MDA （ methylenedioxy amphetamine ） MDMA （ methylenedioxy methamphetamine, MDMA （ methylenedioxy methamphetamine, Ecstasy, 搖頭丸） Ecstasy, 搖頭丸）

Entactogens Drugs that enhance the Drugs that enhance the sensation and pleasure of sensation and pleasure of touching touching

Anticholinergic Hallucinogens Atropa belladonna 顛茄 Atropa belladonna 顛茄 The deadly nightshade plant (Atropine) The deadly nightshade plant (Atropine) Mandragora officinarum 毒参茄 Mandragora officinarum 毒参茄 The mandrake （ hyocyamine, scopolamine, atropine and mandragorine ） The mandrake （ hyocyamine, scopolamine, atropine and mandragorine ） “And Shrieks like mandrakes torn out of the earth, that living mortals hearning them run mad.” Romeo and Juliet “And Shrieks like mandrakes torn out of the earth, that living mortals hearning them run mad.” Romeo and Juliet Hyoscyamus niger 茛菪（ㄍㄣˋ ㄉㄤˋ） Henbane （ hyocyamine and scopolamine ） Hyoscyamus niger 茛菪（ㄍㄣˋ ㄉㄤˋ） Henbane （ hyocyamine and scopolamine ） Datura stramonium 曼陀羅 Datura stramonium 曼陀羅 Jimson weed （ scopolamine ） Jimson weed （ scopolamine ）

Atropa belladonna -- 顛茄 The deadly nightshade plant

Mandragora officinarum- 毒参茄 The mandrake

Hyocyamus niger 茛菪 （ ㄍㄣˋ ㄉㄤˋ ） Henbane

Datura stramonium – 曼陀羅 Jimson weed

Other Hallucinogens PCP （ Angel dust ） PCP （ Angel dust ） Ketamine Ketamine Dextromethophan Dextromethophan Marijuana Marijuana Salvia divinorum Salvia divinorum

Salvia divinorum

Marijuana Learning objectives Statistics of Marijuana use Statistics of Marijuana use Effects of Marijuana use Effects of Marijuana use Medical use of Marijuana Medical use of Marijuana

Contradictory views Assassin of youth (USA) Assassin of youth (USA) Holy Plant (Jamaica) Holy Plant (Jamaica)

Major factors Affecting Marijuana Use 1. Perceived risk 2. Parental role model 3. Mass media 4. availability

Major Factors Affecting Marijuana Use 5. Peers 6. Structural factors-Ages gender 7. Social factors 8. Settings 9. Attitudinal factors

Effects of marijuana use The High Subjective Euphoric Effects Driving performance Critical thinking skills Amotivational Syndrome

Medical use of marijuana Reduction in intraocular （ eye ） pressure Reduction in intraocular （ eye ） pressure Anti asthmatic Anti asthmatic Muscle relaxant Muscle relaxant Anti depressant Anti depressant Analgesic Analgesic Appetite stimulant Appetite stimulant

Physiological effects of Marijuana use Damage to the lung Damage to the lung CNS （ Altered perceptions ） CNS （ Altered perceptions ） Respiratory System Respiratory System laryngitis, pharyngitis, bronchitis asthma-like conditions, cough, hoarseness, dry mouth laryngitis, pharyngitis, bronchitis asthma-like conditions, cough, hoarseness, dry mouth

Physiological effects of Marijuana use Cardiovascular Cardiovascular Vasodilation Vasodilation Binding to hemoglobin Binding to hemoglobin Reproductive System Reproductive System Decreased amount of testosteroneDecreased amount of testosterone Decreased number of sperm, blocks ovulationDecreased number of sperm, blocks ovulation

Inhalants Types of Inhalants Types of Inhalants Gasoline, freon, butane, propane, aerosol Gasoline, freon, butane, propane, aerosol toluene, Nitrous oxide, nitrites toluene, Nitrous oxide, nitrites

Danger of Inhalant Abuse 1. Direct physical damage to the heart, lung, liver and the brain 2. Choking on vomitus, asphyxiation, suffocation 3. Falls or accidents involving impaired driving under the influence of inhalants