DRUGS OF ABUSE Recreational Drugs: 1.Rewarding Subjective Effect 2.Improve Sexual, Athletic, Artistic Performance 3.Therapeutic Benefit

DRUG ABUSE 1.Defined by Society 2.Interference With “Normal” Functions

Multiple Simultaneous Variables Affecting Onset and Continuation of Drug Abuse and Addiction Agent (drug) Availability Cost Purity/potency Mode of administration Chewing (absorption via oral mucous membranes) Gastrointestinal Intranasal Subcutaneous and Intramuscular Intravenous Inhalation Speed of onset and termination of effects Pharmacokinetics: Combination of agent and host Host (user ) Heredity Innate tolerance Speed of developing acquired tolerance Likelihood of experiencing intoxication as pleasure Psychiatric symptoms Prior experiences/expectations Propensity for risk-taking behavior Environment Social setting Community attitudes Peer influence, role models Availability of other reinforcers (sources of pleasure or recreation Employment or educational opportunities Pharmacological Phenomena Tolerance

Many clandestine “labs” are small enough to fit on a kitchen cabinet

PSYCHOTOMIMETIC DRUGS Induce Altered States of Consciousness - Mechanism Includes NE, DA, & 5-HT Receptors - Interact with Receptors to Alter Consciousness

LSD 1. Perceptual Changes – “Hallucinations” 2. Affective Changes – “Mood Swings” 3. Cognitive Changes – “Logic Variations” 4. Revelations – “Special Insights”

LSD EFFECTS 1. Visual Hallucinations – auditory rare. 2. Anxiety to euphoria swings. 3. Consciousness retained. 4. Autonomic nervous system activation – pupil dilation, sweating, tachycardia.

LSD Mechanism 1.Agonist and antagonist on 5-HT receptors. 2.5HT 2 on post-synaptic side and 5-HT 1 on both pre and post synaptic neurons. 3. Raphe nuclei – sleep is 5-HT 1A to decrease function of 5-HT neuron. 4.Agonist effects on 5-HT 1A auto receptors to decrease release of 5-HT.

Collage of LSD blotter paper.

Psilocybin Mushroom

The Peyote Cactus

Amphetamine Mechanism 1. Release NE from Brain Neurons 2. Paranoia Effect – DA Release Leading to Schizophrenia-like Psychosis. 3. Similar Action – Mescaline, Dimethoxy- methylamphetamine and Methoxy- amphetamine

Amphetamine 1.Management of ADD. 2.Large doses increase euphoria, self confidence, ability to concentrate through mesolimbic and mesocortical dopamine system. 3.Large doses can also cause paranoia and a deep depression through release of epinephrine, dopamine and norepinephrine from brain neurons. 4.E.R. – Seizures, cardiac arrhythmias and severe anxiety.

“Ice”, so-named because of its appearance, is a smokeable form of methamphetamine.

Clandestinely manufactured MDA tablet

COCAINE 1.Derived from “Coca Leaves” 2.Intense Euphoria, Increases Self- Confidence, Increased Energy 3.Blocks Neuronal Transport System for NE Uptake 4.Extremely Reinforcing – “5-HT Related”?

Cocaine Administration 1.“Snorting” – Nasal Mucosa 2.Rapid Absorption 3.I.V. Bolus 4.Tobacco or Free Base, “Crack” 5.Short Acting – Minutes. 6.No Physical Dependence. Strong Psychological Dependence

Flower of the coca plant, Erythroxylum

Cocaine is extracted from the coca leaf after the leaves are picked and dried.

Crack, the smokeable form of cocaine provides an immediate “rush”.

Cocaine Use 1.Local Anesthetic - “Vasoconstrictor” Nose, Throat Surgery 2.“Hospice Mix” - To counteract mental clouding effects of morphine

Cocaine Withdrawal Symptoms and Signs 1.Dysphoria, depression 2.Sleepiness, fatigue 3.Cocaine craving 4.Bradycardia

PCP 1.“Angel Dust” – Phencyclidine is related to Ketamine “Special K”. 2.Induces Euphoria and Auditory Hallucinations. 3.Used as “Adulterant”.

PCP is most commonly sold as a power (left), or liquid (center), and applied to a leafy material such as oregano (right) which is then smoked.

PCP MECHANISM 1.Psychotomimetic effects by acting at NMDA glutamate receptor subtype as a non-competitive antagonist. 2.Open channel blocker where it blocks the NMDA – glutamate subtype channel 3.Physiological effects – hypertension, convulsions, respiratory system. Protect from self-inflicted harm. 4.E.R. – Stabilize cardiovascular and respiratory system. Protect from self-inflicted harm.

The flowering of Cannabis Sativa

Marijuana buds are hung out to dry

Marijuana is still rolled into cigarettes and smoked

Hallowed out cigars packed with marijuana are called blunts, and are gaining in popularity.

THC 1.Fat Soluble 2.Slow Excretion 3.Chronic Use – “Motivational Syndrome” 4.Immune System Compromised

Marijuana Withdrawal Syndrome 1.Restlessness 2.Irritability 3.Mild agitation 4.Insomnia 5.Sleep EEG disturbance 6.Nausea, cramping

THC IN MEDICINE 1. Antiemetic – Cancer Patients 2. Decrease Intraocular Pressure