1. DRUGS OF ADDICTION Ken Roy, MD Addiction Recovery Resources of New Orleans Tulane Department of Psychiatry River Oaks Hospital 504-780-2766 www.arrno.org

2. Why are Drugs Addicting? Cause pleasure In our pleasure and reward system

3. The Unfortunate Truth After tonight you will know more than your doctor knows about drugs of addiction This is your disease, and your responsibility to get and stay well Everyone will need medical care in recovery You cannot trust that your doctor knows what to do to keep you in recovery

4. Why This is an “Easy Study” We have very few “natural” neuro- transmitters that make us feel good All of the plant derived and synthetically compounded chemical that fit on the same receptor as a “natural” chemical form a CLASS of addicting drugs

5. How Easy It Is Only three major Classes Sedative Hypnotics Stimulants Opiates And a “wastebasket” Class Hallucinogens

6. Classes All drugs in a Class are: Cross addicting Cross tolerant Cross relapsing Drugs in a Class result in similar: Intoxication Detoxification Overdose

7. Sedative Hypnotics GABA Alcohol Benzodiazepines Valium, Ativan, Xanax, Rohypnol, Restoril Barbiturates Good old Barbs + Fiorinal, Esgic, etc. Other sleepers Quaalude, Doriden, Placidyl, Ambien Miscellaneous GHB, Soma

8. Stimulants Noradrenalin Cocaine + Crack Cocaine Amphetamines Good old speed + Crystal = Crank + Ice MDA, MDMA, Adderall Ritalin, Cylert Decongestants OTC Diet Pills

9. Opiates Endorphins Injectable Morphine, Heroin, Demerol, Dilaudid, Stadol, Nubain, Buprenorphine Oral medications #2-4, Vicodin, Lorcet, Lortab, Norco, Percodan, OxyContin, Ultram, Darvon Methadone

10. HallucinogensVarious LSD, Psilocybin, Mescaline Indirectly affect Dopamine through Serotonin Marijuana Has it’s own neurotransmitter PCP, Ketamine General anesthetics in high doses

11. Drugs of Abuse Medications Benadryl, Elavil, Seroquel, Prednisone Inhalants Glue, paint, whiteout, toluene, gasoline, N 2 O Caffeine

12. Cross Addiction Between Classes Occasionally occurs, based on availability or change in preference Most often use results in relapse to original drug of choice Connects through the Locus Ceruleus A small area in the brain that produces all of the brain adrenalin, or Norepinephrine

13. Take Home Messages Use of any addicting drug during or before recovery produces addict thinking Most addicting drugs are prescribed medications There is a chance of switching addictions to another class There is a greater danger of relapse to the original drug of choice.

14. If You Have to Use Have a plan to become abstinent again Have a safety net Someone who will pull you back, no matter what Build your spiritual “Bank Account” By frequent meeting attendance – for the foreseeable future