addictions psychiatry Flashcards
what is cocaine
Most potent natural stimulant
Extracted from leaves of coca plant
First isolated in 1880s
Formerly used in eye nose and throat surgery
Leaves chewed or brewed
Cocaine hydrochloride snorted or injected
Cocaine freebase of crack cocaine smoked
side effects of cocaine
depends on dose and rate of entry to the brain
smoking - almost immediate
injecting - 15 to 30 secs
snorting - 3 to 5 mins
the effects of crack smoking are very intense but quickly over ( 15 mins)
stimulant and euphoriant
increased alertness and energy
increased confidence and impaired judgement
lessens appetite and desire for sleep
risks of cocaine use
damage to nose and airways
convulsions with respiratory failure
cardiac arrhythmia’s and MI
hypertension and CVA
toxic confusion
paranoid psychosis
cocaine withdrawal symptoms
Depression
Irritability
Agitation
Craving
Hyperphagia
Hypersomnia
what is amphetamine
Generally amphetamine sulphate
Sniffed, swallowed or injected
Effects similar to cocaine but longer lasting
side effects of amphetamine use
Toxic confusion occasionally with convulsions and death
Amphetamine psychosis in heavy chronic use
what is heroine
First synthesised from morphine in 1874
Addictive potential unrecognised for years
Available as diamorphine or as diamorphine hydrochloride
May be presented as powder or as an almost tar like substance
Purity varies from 1%- 98% with average of 35% in US
what methods are there for taking heroine
Also known as H ,gear, smack or brown
Taken by - Snorting
- Smoking(chasing the dragon)
- Injection
Smoking is safest, injecting the most dangerous method of use
side effects of heroine use
Analgesia
Drowsiness
Mood change
Cough reflex and respiratory depression
Sensitisation labyrinth with nausea and vomiting
Lower body temp
Pupil constriction
Constipation
First - Medium and chronic use symptoms from heroine use
First time - nausea/vomiting and headache
Medium term - phlebitis
- Anorexia
- Constipation
Longer term - tolerance
- Withdrawal
- Social and health problems
heroine withdrawal symptoms
Respiratory arrest
Pinpoint pupils
Snoring
Bradycardia and hypotension
Reduced consciousness
craving
insomnia
yawning
muscle pain and cramps
increased salivary, nasal and lacrimal secretions
dilated pupils
piloerection (hence ‘cold turkey’)
what is methadone
decriminalises drug use
allows normalisation of lifestyle
reduces iv misuse
leakage on to the illicit market
what is ecstasy
3,4-methylenedioxymethamphetamine
almost always used orally ; £10-£15 /tab.
relaxed euphoric state without hallucinations
half of all ‘ecstasy tabs.’ contain no MDMA
instead nil active , LSD, amphetamine , ketamine
what effects do people get when taking ecstasy
likened to mixture of LSD and amphetamine
euphoria followed by feeling of calm
increased sociability
inability to distinguish between what is and isn’t desirable
effects after 20 mins lasting 2-4 hours
side effects of ecstasy use
Nausea and dry mouth
increased blood pressure and temperature
in clubs users risk dehydration
large doses can cause anxiety and panic
drug induced psychosis
? liver and brain cell damage
what is cannabis
most commonly used illicit drug
tetrahydrocannabinol is the psychoactive agent
presented as marijuana , hashish (cannabis resin) or as hash oil (produced by extracting cannabinoids from plant material with a solvent)
skunk (sensimilla) has high THC content
what methods of taking cannabis are there
Usually sold by the ounce
£12-15 per eighth/oz for resin to £25 per eighth for marijuana
can be eaten but usually smoked ( joints spliffs or blunts)
short term side effects of cannabis
relaxing or stimulating, euphoriant , increases sociability and hilarity, increases appetite, changes in time perception, synaesthesia
in higher dose - anxiety , panic , persecutory ideation, hallucinatory activity
cannabis withdrawal effects
respiratory problems as with tobacco
toxic confusion
exacerbation of major mental illness
? cannabis psychosis
what are anabolic steroids
Anabolic steroids or steroids for brevity
Family of drugs comprising testosterone and many synthetic analogues
legitimately prescribed in hypogonadism, muscular dystrophy, various anaemias, wasting in AIDS
what are side effects of taking anabolic steroids
Skin – acne, stretch marks, baldness
Feminization in males with hypogonadism and gynaecomastia (occasioning use of anti-oestrogens)
Virilisation in women including hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning
Cardiovascular – increased cholesterol and hypertension
Growth deficits due to premature closure of epiphyses
what are withdrawal effects of anabolic steroids
Liver Disease – cholestatic jaundice, liver tumours
Irritability and anger – ‘roid rage’
Hypomania and mania
Depression and suicidality on withdrawal
what are examples of opiates
Opium
Morphine
Heroin (diamorphine)
Methadone
Codeine and dihydrocodeine
effects of opiates summarised
Intense but transient feeling of pleasure
- “A rush”
- Almost orgasmic
- Physical and emotional anaesthetic
