1. Drugs of Abuse: Clinical Signs and symptoms
Sir Christian Kreipke, PhD, FRSC
Drugs of Abuse: Clinical Signs and symptoms

2. What is a drug of abuse
A substance which is chronically used without consultation with a trained professional
A non-controlled substance
A controlled substance which is utilized outside of the recommendation of a trained professional
A substance, either controlled or non-controlled, which causes a deviation from normal behavior
ETC, ETC, ETC

3. Why use a “Drug of abuse”
Peer pressure
Feels good
Looks cool
Necessary to begin and then gets out of hand
Accessible
Cheap escape to an otherwise contrary existence

4. Age of onset
Up to 50% of highschool-aged children have experimented with drugs of abuse
Up to 35% of middle-schoolers have gotten drunk
Up to 35% of those under the age of 18 are addicted to some drug of abuse
Up to 40% of adults over the age of 18 chronically abuse prescription drugs

5. Method of delivery
Oral
Snorting
Injecting
Topical application

6. consequences Legal troubles Interactions with non-drugs of abuse
Chronic physiological effects
Addiction
Comorbidity due to concentration deviations, poor quality control, etc
Financial ruin
Stigma

7. Common drugs of abuse Amphetamines Barbituates Cocaine Heroin
Methamphetamine
MDMA (ecstasy)
LSD
PCP
Alcohol
Marijuana
Prescription drugs
Etc.

8. Amphetamines Mode of delivery: oral or injection
Benefits: high without extreme low, apparent low addictive quality
Risks: potential for addiction; drug quality problems
Biology: selectively releases DA into the synaptic cleft

9. Barbituates Mode of delivery: oral
Benefits: calming low; apparent metabolism booster
Risk: temperature regulation imbalance; chronic fatigue; addiction; severe dehydration; depression
Biology: catch-all for DA, 5HT, and endocrine system

10. Cocaine Method of delivery: oral, snorting, injection
Benefits: great high
Risks: great low, highly addictive; quick sensitization requiring repetitive and frequent use; drug quality issues
Biology: selectively releases DA and reverses DA transporter (DAT)

11. Heroin Mode of delivery: most common is injection
Benefits: extreme initial high
Risks: “benefit” is transient and unpredictable; highly addictive; live destroyer; extreme low; very difficult to break the habit; expensive
Biology: causes neuronal death

12. Methamphetamine Mode of delivery: injected, oral, snorted
Benefits: mellow high; cheap
Risks: phenotypic signs (meth mouth); highly addictive; difficult to kick the habit; brain death
Biology: kills dopamine cells in VTA and SNc; cleaves DA terminals in STR

13. MDMA (ecstasy) Common mode of delivery: oral
Benefits: transient increase in sensory perception, particularly with pleasurable sensations
Risks: drug quality and concentration variability; effects are addictive; difficult to detect
Biology: selectively releases 5HT and blocks reuptake

14. LSD Mode of delivery: oral, topical Benefits: creative high
Risks: highly addictive; individual tolerance highly variable; negative flashbacks; overdose
Biology: initially releases 5HT, with delays GLU release and eventual GLU cell death

15. PCP Mode of delivery: oral or snorted
Benefits: extreme high; escape from reality
Risks: highly addictive; irreversible modification of brain physiology
Biology: inhibits NMDA receptors which initially shuts down GLU system then leads to increased mGLUr activation

16. Alcohol Mode of delivery: oral Benefits: socially accepted; buzz
risks: readily available, yet legally tightly controlled; individual tolerance hard to determine; false sense of security and confidence; impaired brain processing; addiction possible with varying genetics
Biology: blocks muscarinic receptors; selectively inhibits GLU in cerebellum and PFC; neural death

17. Marijuana Mode of delivery: oral Benefits: mellow high
Risks: unpredictable paranoia; possible addiction
Biology: binds cannabanoid receptors

18. Prescription drugs Mode of delivery: various
Benefits: readily available; potential various benefits
Risks: overdose; obtuse effects
Biology: varied

19. ETC.
Many other drugs that are household products or “home chemistry set made” that vary in quality, effect, danger, etc.