Club Drugs Flashcards
d-Methamphetamine
Large crystals of pure D-isomer are often smoked, much like CRACK snorted and IV use to Long duration of action Similar "runs" then crash New "high-tech" drug Longer acting than CRACK Effective weight reduction
Psychiatric Complications d-Meth
Acute anxiety Acute paranoid psychosis Chronic schizophreniform psychosis Possible induction of panic attacks not due to latent psychosis
MDMA vs Molly
Molly more a pure form than MDMA
devoid of adulterants and is claimed to be safer and non-addictive
Molly is the powder form so it can be snorted
MDMA is typically sold as a pressed pill and is swallowed
MDMA Effects
Induced altered state of conciousness
Patients receptive to psychotherapy
Facilitates communication skills and heightens empathy– spiritual pursuit
Adjunct to insight oriented psychotherapy
No memory deficits
Neuropsychological test performance is impaired with chronic use
MDMA Abuse Liability
MDMA is self administered by rhesus monkeys and baboons
MDMA shared discriminative stimulus effects with amphetamine
MDMA is reinforcing in human volunteers
MDMA USE Profile
Oral dose of 100-200 mg
Smoked, snorted, or injected
Stacking or piggybacking- taking 3 or more tablets at a time
Used at parties often with other drugs
MDMA mechanism of action
Binds to 5-HT transporters in plasma membrane and secretory vesicle
Enter the vesicle and causes massive release of serotonin
Extra serotonin binds to receptors
Half life of 8-9 hours
Next day “pleasant”effects due to its MDA metabolite that exerts LSD like effects
Effects of MDMA on serotonin
Once effects wane, users tempted to take another dose, but serotonin levels are low
Serotonin dip that may last days to weeks- depressed mood
Prolonged use will cause a depletion in serotonin
Continued use will also cause a down regulation of serotonin receptors
Likely cause of depression in MDMA users
MDMA and other drugs
Some obtain Prozac to deal with depression
others get ritalin to increase concentration
Mix of drugs is dangerous
Tolerance develops to its effects with prolonged use
Toxicity- MDMA
Psychiatric Toxicity Induction of panic disorder Long-lasting neuropsychiatric syndromes Psychosis, visual illusions and hallucinations Flashbacks Neurotoxicity Cerebral infarcts Subarachnoid hemorrhage Hyponatremia with stupor
General Toxicity MDMA
Sympathomimetic reactions
hyperreflexia, hyperthermia and rhabdomyolysis
Kidney failure, seizures, coma and death
Hyperthermia secondary to neurotransmitter depletion
Fatal or near fatal reactions
Mechanism of Toxicity MDMA
Mechanism unclear– first thought to be hypersensitivity reaction
Recognized as due to overdose
MDMA is metabolized to MDA, more potent neurotoxin
Neuronal Damage MDMA
Can damage neurons that make serotonin
Damage is long lasting (6 years)
Neuronal damage persists long after effets have worn off
Nerve fibers regrow in some brain areas, but make abnormal connection, and some do not regrow
Rohypnol
Roofies
Sedation, amnesia, muscle relaxation, slowed relexes
Often used in combination with ethanol, marihuana or cocaine to produce a very rapid and dramatic high
Used as a parachute with heroine and cocaine users when coming off the high
Inexpensive on the street, sold in bubble packets
Gamma hydroxybutyrate
GHB does not act directly on GABA receptors
May inhibit release of dopamine, resulting in stored levels that are released later
Stimulates GH release and PRL rises