CNS Depressants & Cannabis Flashcards
CNS Depressants
- Benzodiazepines
- GHB
- Inhalants
- Cannabis & Cannabis Use Disorder
- Opiates/heroin (Pharm 445)
- Alcohol (Pharm 445)
Benzodiazepines
Party drugs, date rape drugs
* Pre-party to reduce
alcohol needs
(caloric intake, $$)
* Flunitrazepam
(Rohypnol), midazolam,
temazepam
* Most frequent misused
drugs resulting in ER visits
* Dangerous in combination
with alcohol
* Withdrawal: hallucinations
and seizures are common;
risk of death
GHB (gammahydroxybutyrate)
- “G”, or “liquid X”; similar structure to GABA
- Clear liquid or powder, often homemade or herbal
- Party and date rape drug
- Reinforcing effects: relaxation, sociable
- Narrow dosing range, inconsistent concentration of
products from batch to batch - ADR: ↓resp, seizures, vomiting, sleep disturbances,
dizziness - Withdrawal: agitation, mental status changes, ↑HR,
↑BP, sweating, tremor
Group: Inhalants
- Solvents, gasses, nitrites
- e.g. gasoline, cleaning fluid, paint thinner,
aerosols sprays, model glue, shoe polish, nail
polish remover, marking pens, whip cream
cannisters - Sniffing a rag (huffing), container or
bag/balloon with substance inside (bagging). - Easily accessible, cheap, inconspicuous
- Intense, short duration effects
Group: Inhalants
- Stimulation, disinhibition,
headache, nausea or
vomiting, slurred speech,
loss of motor coordination,
wheezing/cramps, muscle
weakness, depression,
memory impairment,
irreversible damage to
cardiovascular and nervous
systems, unconsciousness;
sudden death - MOST TOXIC DRUGS OF
ABUSE – DAMAGE +++
CANNABIS USE
PREVALENCE
OF USE
- Cannabis use for non-medical purposes: used for a
wide range of non-medical purposes such as socially for
enjoyment, pleasure, amusement, spiritual, lifestyle, etc. - Cannabis use for medical purposes: used to treat a
disease/disorder or to improve symptoms associated
with a disease/disorder
CANNABIS
- Cannabis plant produces >80-100
cannabinoids and ~300 non-cannabinoid
chemicals - Most common: delta-9-tetrahydrocannabinol
(THC) and cannabidiol (CBD) - THC: psychoactive/”high”
- CBD: anti-psychoactive effect that can
counteract THC; may reduce anxiety
associated with THC; other potential benefits
CANNABIS
Marijuana: dried leaves, flowers, seeds, and
stems of the cannabis plant (5-20% THC)
* Hashish: derived from the dried resin of
the flowering tops of mature and
unpollinated female cannabis plants (20-60%
THC)
- Routes: smoked, PO
- Use: Cannabis can be hand rolled into joints, smoked in pipe
or water pipes (bongs), vaping, can be ingested by adding to
foods. Hash resin/oil is commonly added to cigarettes or
food - Pharmacology: initial effects in minutes, lasts 2-4 hours
with impairment up to 24 hours (slower in PO/oils)
CANNABIS fx
Reinforcing effects: initial “high”,
generally depressant effects, but at
increased doses can be
hallucinogenic.
Therapeutic uses: analgesia, antinauseant, muscle relaxant, decreases
intraocular pressure,
insomnia/anxiety (preliminary)
Drug testing: Can appear in drug
screening up to 4-5 weeks in
chronic users
CANNABIS
Acute intoxication:
- EENT: red eyes, dry mouth and throat, impaired balance and coordination, over-talkative
- CNS: euphoria, calm, distorted sensory perception, impaired learning, memory, anxiety,
panic attacks, psychosis, ↓ judgement, ↓ attention span - CV: ↑ heart rate
- Resp: cough
- Musc: slowed reaction time, general relaxation
- GI: ↑appetite “munchies”
CANNABIS
Chronic Use/misuse
EENT: mouth/throat cancer
* CNS: amotivational syndrome, anxiety, depression, psychosis, ↓
attention, reduced communication and social skills
* Resp: chronic cough, frequent respiratory infections,
permanent lung damage, lung cancer
* Musc: weight gain
* GI: increased appetite
* GU: amenorrhea, ↓ testosterone, infertility
CANNABIS
AND
DRIVING
- 6-11 % of fatal accident victims are positive for THC
- THC
- Decreases reaction time
- Decreases visual search frequency
- Decreased attention
- Decreases perception to changes in speed and direction
of self and others - Drivers are often aware of perceived impairment (vs.
alcohol) and typically underestimate abilities
CANNABIS AND
LUNG CANCER?
Use of 1-3 joints causes same amount of lung damage
as 5-15 cigarettes
Many of the carcinogens present in tobacco smoke are
also present in smoke from cannabis. (e.g. tar, carbon
monoxide, hydrogen cyanide and nitrosamines)
Cannabis smoking causes inflammation and cell damage,
and has been associated with pre-cancerous changes in
lung tissue.
Cannabis has been shown to cause immune system
dysfunction, possibly predisposing individuals to cancer.
Safer options: edibles, vaping (dry safer than oil)
LOWER RISK CANNABIS USE
- Abstain from all cannabis use
- Avoid cannabis use before 16 years, and ideally after mid-20s.
- Use low THC cannabis products; high CBD:THC ratios are safer
- Avoid the use of synthetic cannabinoids
- Avoid smoking combusted cannabis (i.e. vaporizing and edibles are safer)
- Avoid deep inhalation and breath-holding when smoking cannabis
- Daily or near-daily cannabis use is associated with more adverse outcomes
- Avoid driving while impaired from cannabis use
- Avoid cannabis use in those at higher risk of, or with family history of,
psychosis and SUD, as well as in pregnancy. - Avoid combination of high-risk behaviors listed above.
CANNABIS
Tolerance
withdrawal
Tolerance
* Common in chronic use
Withdrawal
* Sleep disturbances, irritability, sweating, anxiety, upset stomach, loss of appetite, craving
