drug abuse

Question 1

mode of action of cocaine?

Answer 1

Monoamine reuptake inhibitor – dopamine,serotonin,noradrenaline increase

Question 2

how quickly does cocaine affect people

Answer 2

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)

Question 3

cocaine effects

Answer 3

stimulant and euphoriant

Anaesthetic effect

Hypersensitive

increased alertness and energy

increased confidence and impaired judgement

lessens appetite and desire for sleep

If mixed with alcohol - cocaethylene

Question 4

cocaine health problems

Answer 4

damage to nose and airways

convulsions with respiratory failure

cardiac arrhythmia’s and MI

hypertension and CVA

toxic confusion

paranoid psychosis

Question 5

cocaine withdrawal effects?

Answer 5

Depression 
Irritability
Agitation
Craving
Hyperphagia
Hypersomnia

Broadly opposite of drug effect

Question 6

describe amphetamine?

Answer 6

Generally amphetamine sulphate

Sniffed, swallowed or injected

Effects similar to cocaine but longer lasting

Toxic confusion occasionally with convulsions and death
Amphetamine psychosis in heavy chronic use

Question 7

example of opiates

Answer 7

Opium

Morphine

Heroin (diamorphine)

Methadone

Codeine and dihydrocodeine

Question 8

how is heroine available as?

Answer 8

diamorphine or as diamorphine hydrochloride

Question 9

mode of action of heroine?

Answer 9

Opiod agonist

Acts via mu (principally)

Acts principally via Mu ,Delta and Kappa receptors
Kappa and Delta – analgesia

Mu – mood effects, analgesia and euphoria

Half life of 30mins – multiple administrations needed if dependant ( increased risk) - subjective effect of approx. 4hrs

Question 10

Heroine effects?

Answer 10

Analgesia

Emotional analgesia

Nausea initially

Euphoria

Pin point pupils

Itching/sweating

Constipation

Decreased libido/menstrual irregularities

Reduced cough reflex

Question 11

effects of heroine overdoes

Answer 11

Respiratory depression

Snoring indicates risk

Bradycardia

Hypotension

Death

Risk increased if mixed with other respiratory depressants – alcohol, benzodiazepines etc

Naloxone – opiate antagonist

National Naloxone Programme

Question 12

short term side effects of opitaes

Answer 12

nausea/vomiting and headache

Question 13

medium term effects of opiates

Answer 13

phlebitis

endocarditis

Injection injuries/ consequences (BBVs)
Anorexia

Constipation

Question 14

longer term affects of opiates

Answer 14

tolerance

Withdrawal

Social and health problems

Question 15

describe opiates withdrawal syndrome

Answer 15

craving

insomnia

yawning

muscle pain and cramps
increased salivary, nasal and lacrimal secretions

dilated pupils

piloerection (hence ‘cold turkey’)

Question 16

examples of Benxodiazepines?

Answer 16

Diazepam (Valium)
Nitrazepam
Temazepam
Alprazolam (Xanax)
Lorazepam
Etizolam    etc   etc

Question 17

what is ecstasy?

Answer 17

MDMA/ Mandy

Question 18

what is found in ecstasy tabs/ Mandy/mdma?

Answer 18

contain no MDMA

instead nil active , LSD, amphetamine , ketamine

Question 19

how does mandy make u feel?

Answer 19

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

Question 20

Mandy effects?

Answer 20

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

Question 21

psychoactive parts of weed?

Answer 21

tetrahydrocannabino

Question 22

Cannabis - psychological effects

Answer 22

relaxing or stimulating, euphoriant , increases sociability and hilarity, increases appetite, changes in time perception, synaesthesia

in higher dose - anxiety , panic , persecutory ideation, hallucinatory activity

Question 23

Cannabis - ill effects

Answer 23

respiratory problems as with tobacco

toxic confusion

exacerbation of major mental illness

cannabis psychosis

Question 24

examples of anabolic steroids

Answer 24

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

Testosterone

Question 25

what are anabolic steroids for?

Answer 25

used as antidepressent

Use rapidly expanded in sports requiring muscle mass and strength

Also used to enhance appearance -increase muscle mass and reduce body fat

Question 26

signs of anabolic steroid use

Answer 26

muscle hypertrophy from steroid use is particularly marked in the upper body in the pectoralis, deltoid, trapezius, and biceps

Question 27

steroid side effects?

Answer 27

Skin – acne, stretch marks, baldness

Feminisation in males with hypogonadism and gynaecomastia (occasioning use of anti-oestrogens)

Virilisation in women including hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning

Question 28

ill effects of steroids?

Answer 28

Cardiovascular – increased cholesterol and hypertension

Growth deficits due to premature closure of epiphyses

Liver Disease – cholestatic jaundice, liver tumours

Question 29

psychological ill effects of steroid?

Answer 29

Irritability and anger – ‘roid rage’

Hypomania and mania

Depression and suicidality on withdrawal

Question 30

treatment of drug addictions?

Answer 30

need to think:
What drug
What combinations
Harmful/hazardous use?
Dependency?
Risk

Biopychosocial treatment packages

Strong emphasis on risk reduction

Abstinence vs Harm reduction debates

Treatment is effective