1. Psychoactive Substances Student Interests/Questions

2. Cocaine Extracted from coca plant CNN Interactive Stimulant Schedule II drug

3. Cocaine: Interesting Stuff In late 1800’s was prescribed by US physicians  Cough drops Cough drops Coca-Cola had cocaine removed in early 1900’s Coca-Cola Cocaine wine was availablewine

4. Cocaine Availability According to DEA, second most commonly used illegal substance South America is primary source  Other countries involved with transportation  Generally supervised via Colombia Most cocaine enters US via Mexico Price depends on purity (50-70%), form of cocaine

5. Cocaine Forms Powdered form  Snorted  Dissolved in water, injected  ($10-40K per kg) Processed in rock form  Smoked ($3-$50 per rock) The faster a drug can enter the brain, the more it will be abused The faster a drug can enter the brain, the more it will be abused

6. Cocaine Effects Increased heart rate, blood pressure, temperature Improved mood, well-being  Short-lived (few minutes to few hours) Increased sensation of energy Chronic users may experience bloody noses (damage to septum), brain adaptations to cocaine-induced dopamine effects

7. Cocaine Overdose Seizures Heart attack Stroke Kidney failure Death In 2002, hospitals reporting cocaine- mentioned ER cases: 199,198

8. Cocaine Withdrawal Withdrawal: Symptoms experienced by user when substance is not used Apathy Fatigue Depression/mood swings Cravings for drug Not as intense as withdrawal from heroin, alcohol

9. Cocaine Tolerance Tolerance: A need to increase the dosage of a substance to obtain the same effects Thought to increase with heavy use initially Tolerance may not continue to develop

10. Cocaine Dependence Dependence: Compulsion to take a substance despite adverse consequences Emphasis appears to be on psychological rather than physical dependence Rats and self-administrationadministration

11. Methamphetamine

12. About Methamphetamine Stimulant Limited medical use: narcolepsy, weight control Schedule II drug

13. Methamphetamine Availability Historically existed as independent laboratories DEA: In 2001, 12,715 labs reported Increasingly, methamphetamine is available via Mexican drug trafficking organizations $3,500-$23,000 per pound Purity has been reduced, perhaps due to regulation

14. Methamphetamine Forms Snorted, smoked, orally ingested, injected  Crystal meth typically smoked or ingested

15. Methamphetamine Effects Intense high/euphoria  May last up to 12 hours Increased blood pressure Increased sensation of energy, alertness Chronic users may experience hallucinations, rage, paranoia, heart lining inflammation, sores from “crank bugs”; damage to dopamine-, serotonin-containing nerve cells

16. Methamphetamine Overdose Dangerous increase in blood pressure Sweating Seeing spots (increased pressure in eye) Convulsions Heart attack Stroke In 2002, hospitals reporting methamphetamine- mentioned ER cases: 17,696

17. Methamphetamine Tolerance, Dependence With chronic use, tolerance develops  Higher dose  Increased frequency  Different administration Physical, Psychological dependence can develop

18. Methamphetamine Withdrawal Depression Fatigue Anxiety Paranoia Craving

19. Opium

20. About Opium Narcotic Produced from opium poppy Heroin originates from opium  Other narcotics (“opiates”) Used in Asia historically to stop diarrhea Schedule II

21. Opium Availability Asia has been primary producer Opium poppy growth occurs in South America Mexico grows little opium, but crop converted to heroin  Much of US heroin availability

22. Opium Forms Raw (pictured) for oral ingestion Prepared from raw form for smoking

23. Opium Effects Euphoria Analgesia Relaxation Nausea, vomiting, dizziness

24. Transformation: Opium to Heroin Opium poppies grown After blooming, seed pods form Sap from pods is extracted Farmer collects extract; entrance into black market Product refined into a morphine base (smokable) Heroin produced from morphine bricks

25. Heroin

26. About Heroin Narcotic Synthesized from morphine in late 1800’s  Morphine synthesized from opium poppy  Was thought to be less addictiveless addictive Schedule I

27. Heroin Availability Produced largely in Burma, Afghanistan Routes, methods of transportation depend on origin US heroin increasingly obtained from South America, Mexico Costs vary across US (Asian vs Mexican heroin)  $15K-$250K per kilogram

28. Heroin Forms Pure heroin is white Most is darker  Additives  Impurities Injection, smoking, snorting

29. Heroin Effects Euphoria Slow, shallow respiration Analgesia Stupor Long-term effects: collapsed veins, respiratory problems

30. Heroin Overdose Frequently occurs when mixing with other substances In 2001, hospitals reporting heroin- mentioned ER cases: 93,064

31. Heroin Tolerance, Dependence, Withdrawal With regular use, tolerance develops Dependence is both physical and psychological Withdrawal symptoms can be severe  Craving  Restlessness, insomnia  Pain  Diarrhea  Vomiting  Can be fatal among heavy users Methadone can be used to treat withdrawal

32. Rohypnol

33. About Rohypnol Depressant ‘Low-cost’  $5/tablet “Date Rape” drug More commonly seen in southern US Schedule III (some states Schedule I)

34. Rohypnol Effects Oral ingestion, snorting, injection Frequently combined with alcohol Muscle relaxation Drowsiness/loss of consciousness Memory impairment/amnesia Nightmares Confusion

35. Other “date rape” drugs…

36. GHB Depressant Schedule I Manufactured in clandestine labs in US  Contents can vary dramatically Ingestion: powder dissolved in liquid Effects similar to Rohypnol; hallucinations also occur

37. Ketamine Hallucinogen Schedule III Can be mixed in drinks, smoked, injected $25 per dose Changes in perception; dissociative effects; loss of coordination; numbness; analgesic

38. Ketamine, GHB Ketamine & GHB

39. LSD

40. About LSD Hallucinogen Synthesized in 1930’s; derived from a fungus Very small amounts are very potent  Dose = 20-80 micrograms Schedule I

41. About LSD Discovered by Albert HoffmanAlbert Hoffman “Last Friday, April 16,1943, I was forced to interrupt my work in the laboratory in the middle of the afternoon and proceed home, being affected by a remarkable restlessness, combined with a slight dizziness. At home I lay down and sank into a not unpleasant intoxicated-like condition, characterized by an extremely stimulated imagination. In a dreamlike state, with eyes closed (I found the daylight to be unpleasantly glaring), I perceived an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors. After some two hours this condition faded away.”

42. LSD Availability Available in all states  Raves/concerts Produced in the US  Chemists vs independent producers  Recipes available  Infrequent production cycles (USDOJ)  Few labs are discovered and seized  Kansas, 2000 (silo)  Distribution highly confidential

43. LSD Forms Initially produced in crystal form Crystal can be crushed, mixed with other materials into tablets: microdots Gelatin squares aka “window panes” Converted to liquid  Dosed onto blotter paperblotter paper  Dosed onto sugar cubes Usually taken orally  Can be inhaled, injected, applied transdermally

44. LSD Effects Increased heart rate, blood pressure, sweating Possible anxiety/panic Visual hallucinations (images, color, light) Altered perception of senses  “Seeing sounds, hearing colors”  Sound  Touch  Color, size of objects Altered perception of time, depth

45. LSD Effects Extreme mood changes Nausea Impaired judgment Experiences can vary widely  Expectations, surroundings, pre-existing mental conditions, presence of other substances LSD pathways unclear  serotonin

46. LSD Effects Long-term effects:  Flashbacks (days/months after dose)  Cause unknown; may be due to use of other substances  Hallucinogen Persisting Perception Disorder Hallucinogen Persisting Perception Disorder Recurring  Psychotic states among those with psychological disorders  Apathy

47. LSD Overdose Possible No reported deaths LSD implicated in accidental deaths, suicides, murders, self-inflicted wounds

48. LSD Tolerance, Dependence, Withdrawal Tolerance  Tolerance does develop  Can abate after a few days of disuse Dependence: Physical dependence is unlikely; psychological dependence can occur Withdrawal: No evidence

49. Hallucinogenic Mushrooms

50. About Mushrooms Psilocybin/psilocin are two active psychoactive substances found in “magic mushrooms”  Couple dozen species Recognized for centuries  Probably used in religious rites Hallucinogen Schedule I

51. Availability of Mushrooms Available across US, though primarily western and central states Independent growers may cultivate mushrooms from kits

52. Mushrooms: Forms Psyilocybin mushrooms pictured Other hallucinogenic mushrooms Oral ingestion

53. Effects of Mushrooms Relaxation Provides an altered perception of reality (typically shorter “trip” than LSD) Altered perception of time Sense of connection to others/universe Visual hallucinations (images, color, light)

54. Effects of Mushrooms Anxiety, mild increases in heart rate, blood pressure & breathing Thought to act on serotonin receptors Experiences can vary widely  Expectations, surroundings, pre-existing mental conditions, presence of other substances The wrong mushroom can be toxicwrong mushroom  "All mushrooms are edible, but some only once."-- Croatian Proverb

55. Effects of Mushrooms Long-term effects:  Since hallucinogenic usage usually not frequent, long-term effects seldom occur  May cause anxiety/panic attacks  Paranoid delusions  Psychosis among those with pre-existing psychological disorders

56. Mushrooms: Overdose, Tolerance, Dependence, Withdrawal Overdose: No known reports Tolerance:  Tolerance does develop  Can abate after a few days of disuse Dependence: physical dependence unlikely; psychological dependence can occur

57. PCP

58. About PCP Often considered hallucinogen  Has stimulant, narcotic qualities  “Designer drug” Investigated in 1950’s as anesthetic  Discontinued when side effects recognized Schedule II

59. PCP Availability Virtually all PCP is produced in clandestine laboratories in US  Per DEA, PCP production is centered in the Los Angeles area

60. PCP Forms In pure form, a powder dissolved in water Most manufacture cause change in color, consistency Tablets/capsules Applied to leaves and smoked

61. PCP Effects Detachment from surroundings Numbness Slurred speech Loss of coordination Sense of strength and vulnerability  Stereotypical scenario-jumping off building

62. PCP Effects Auditory hallucinations Mood changes  Includes rage; may lead to violence Amnesia Anxiety/paranoia Schizophrenia-like psychosis Long-term effects include depression, weight loss, memory loss

63. PCP Overdose Overdose can occur  Paranoia  Seizures  Coma  Death  PCP considered among the most dangerous of “hallucinogens”  In 1997 ~2500 ER hospitalizations

64. PCP Tolerance, Dependence, Withdrawal Tolerance:  Evidence of tolerance  Less research in this area vs. other drugs Dependence:  PCP may cause physical dependence  Psychological dependence can occur Withdrawal:  Twitches/tremors  Seizure susceptibility  Depression  Craving

65. Ecstasy

66. About Ecstasy Hallucinogen  Ecstasy also has stimulant properties  Is a methamphetamine  “Designer drug” MDMA synthesized in early 1900’s Popular at raves Schedule I

67. Ecstasy Availability Most produced outside US  Belgium, Netherlands Trafficked into US via organized crime  Shipment modes vary  Major gateways include Miami, NY, LA

68. Ecstasy Effects Changes in mood Changes in perception (music) Fosters feelings of empathy, intimacy Increased heart rate, blood pressure, temperature Anxiety

69. Ecstasy Effects Confusion Depression Sleeplessness Long-term effects:  Neural damage leading to mood disorders  Controversial  Memory impairment

70. Ecstasy Forms Most often available in pill form Capsule form Powdered  Dissolved in liquid, injected

71. Ecstasy Overdose May occur, especially when paired with rave environment  Physical activity  Heated room  Dehydration  Other psychoactive substances used Deaths have been reported Over 4,000 ER hospitalizations in 2002

72. Ecstasy Tolerance, Dependence, Withdrawal Tolerance:  Research suggests tolerance quickly develops Dependence:  With increasing dose, positive effects decline  For some, MDMA may be physically addictive  Baboons and rhesus monkeys have been shown to self-administer (Drugs and Human Behavior)  Psychological dependence possible Withdrawal:  May include depression, anxiety, craving