Final Exam Flashcards
Pure Food and Drug Act
1906
Opium Exclusion Act
1909
Harrison Narcotic Act
1914
Prohibition of Alcohol
1920
Cannabis Statue Act
1937
Controlled Substance Act
1970
5 Schedules (I, II, III, IV, V)
Based on:
Potential for Abuse
Current accepted medical issues
Potential for physical and/or psychological dependence
Drug Dependence
When an individual becomes strongly attached to a drug
Dependency
Is subdivided into physiological and psychological
Physiological dependence
When there is a need by the body to have the drug present
The body accepts it into its makeup
A person experiences sickness if they stop taking the drug-withdrawal
Think caffeine, nicotine, codeine
Psychological Dependence
When a person develops an uncontrollable “craving” (mental or emotional) for a drug
May be more difficult to overcome
No sickness if they stop taking the drug
CRS
Colorado Revised Statuses
Schedule I
(worst)
High potential for abuse
No Current medical use in treatment in the USA
Lack accepted safety for use under medical supervision
LSD, MDMA, Psilocyn Mushrooms, Heroin, BZP
Schedule II
High Potential for use
Has current accepted medical use in treatment in the USA with severe restrictions
Abuse may lead to severe physical and/or psychological dependence
Morphine, Opium, Cocaine, Methamphetamine, PCP
Schedule III
Has potential for abuse less than those in sch. I and II
Has current medical use in the USA
Abuse may lead to low to moderate physical dependence or high psychological dependence
Amobarbital, Phenobarbital, anabolic steroids, ketamine
Schedule IV
Has low potential for abuse
Has current medical use in the USA
Abuse may cause limited (moderate) physical and/or psychological dependence
diazepam (valium) most benzondiazepines
Schedule V
Low potential for abuse
Current accepted medical use in the USA
Abuse may lead to limited physical and/or psychological dependency relative to substances in sch. IV
Various codeine solutions (not more than 200 mg/100 mL)
Penalties
2 classes of offenses
3 classes of misdemeanor offenses
6 classes of felonies
Drugs of Abuse
Stimulants Depressants/Hypnotics Hallucinogens Narcotics/Opioids Steroids
Stimulants
Amphetamine Methamphetamine Cocaine/Crack Benzylpiperazine Caffeine Ephedrine/pseudoephedrine
Stimulants
Amphetamine Methamphetamine Cocaine/Crack Benzylpiperazine Caffeine Ephedrine/pseudoephedrine
Amphetamine/Metamphetamine
created in 1887 trying to synthesize ephedrine to help with asthma
Effects of Amphetamine
Impaired speech, dizziness, insomnia, uncontrollable movements, psychotic episodes, impotence, dry, itch dry skill, increased aggressiveness, paranoia, headache, dry mouth, increased heart rate, increased breathing rate, increased blood pressure, rise in body temperature, fever and sweating
Cocaine
Schedule II
History: American Indians for thousands of years, Spanish conquerors, American companies 1890’s provided workers with cocaine for better production
Effect: Rush, Euphoria
Pharmacology: Cocaine is both a central nervous system stimulant and topical anesthetic
Class: CNS Stimulant
Cocaine
Varies with dose and tolerance of the user.
Increases alertness, wakefulness, elevates the mood, mild to high degree of euphoria, decreases fatigue, increases energy, insomnia restlessness
With high doses may exhibit a pattern of psychosis with confused and disorganized behavior, irritability, fear, paranoia, hallucinations, may become extremely antisocial and aggressive
BZP (benzylpiperazine)
Stimulant which gained popularity in the early 2000’s as a legal alternative to amphetamine, methamphetamine, and MDMA
Very similar to amphetamine and that clinicals would be ill-advised
200 BZP added to sch. 1
Stimulants with hallucinogenic properties
Depressants/ Hypnotics
Alcohol Barbiturates Benzodiazepines Opiates GHB/ GBL Rohypnol/Flunitrazepam Ketamine
Depressants/ Hynotics
There are numerous CNS depressants; most act on the brain by affecting the neurotransmitter gammaaminobutyric acid (GABA)
Neurotransmitters are brain chemicals that facilitate communication between brain cells
GABA
works by decreasing brain activity
Although the different classes of CNS depressants work in unique ways- it is through their ability to increase GABA activity that they produce a drowsy or calming effect
Classes of Depressants
Sedative
Hypnotic
Narcotic
Tranquilizer
Sedative
Used to decrease activity
hypnotic
induce sleep or are used to help you sleep or used for surgery to put you to sleep
Narcotic
used to treat pain
Tranquilizer
a drug that calms and relieves anxiety
Depressants/ Hypnotics
Alcohol Barbiturates Benzodiazepines Opiates GBH/ GBL Ketamine
Alcohol
Fermented Beverages
Barbituates
Phenolbarbital, amobarbital
Benzodiazepines
diazepam (valium)
alprazolam (xanax)
flunitrazepam (rohypnol)
Opiates
Heroin, Morphine, Fentanyl
Barbituates and benzodiazepines
Barbituates were widely available on the street in the 1970s and ’80s, though less so in the ’90s and ’00s.
Benzodiazepines were developed to replace barbiturates, though they still share many of the undesirable side effects
Barbituates and benzodiazepines
Tranquillizers and barbiturates have two major effects:
Sedative (decrease anxiety)
Hypnotic (which help sleep)
Barbituates and benzodiazepines
These are abused because: many depressants have both effects: sedative effect at low doses and a hypnotic effect at high doses
Barbituates and benzodiazepines
Benzodiazepines such as diazepam (valium) and alprazolam (xanax), are prescribed to treat anxiety, acute stress reactions, and panic attacks
The more sedating benzodiazepines, such as triazolam (halcion) and estazolam (ProSom) are prescribed for short-term treatment of sleep disorders.
Usually benzodiazepines are not prescribed for long-term use
Narcotics/ Opiates/ Heroin
Used for centuries for medical and recreational uses. Assyrians and Sumerians used over 4000 years ago. The drug in 1811 was named after the Greek god of dreams, Morpheus, by Dr. F.W.A. Serturner, a German pharmacist
Schedule II (heroin sch I)
Effects; hypnotic/ depressant
Narcotics/ OPiates/ Heroin
All starts with Opium
Opium- Morphine- Heroin
Codeine
Fentanyl
Potency
Heroin 10x stronger than opium
Heroin 5x stronger than morphine
Fentanyl 100x stronger than morphine
The Golden Triangle
1995
Region of southwest Asia leads opium production
Aug. 2007
Afghanistan accounts for 95% of the world’s opium poppy. Afghanistan is now providing close to 95% of the world’s heroin
Burma
Drug Trafficking routes from Burma to Laos to southern China, Cambodia and Vietnam
Ketamine
Created in 1962, patented 1966 as a anesthetic in humans and animals
Effects: K-hole, K-land/ hallucinations
Pharmacology: Dissociative anesthetic (stimulant, depressant, hallucinogenic, analgesic)- amnesia
Schedule: III
Ketamine
Euphoria Sense of calm and serenity Enhanced sense of connection with beings or objects Distortion or loss of sensory perceptions (common) Closed- and open-eye visuals (common) Dissociation of mind from body Analgesia, numbness Ataxia (loss of motor coordination) Significant change in perception of time Slurred Speech Confusion, disorientation Shifts in perception of reality "K-hole"; intense mind-body dissociation, out-of-body experiences, highly realistic visuals
GHB (gamma- hydroxy butyrate)
Naturally occurs in body- abuse began in late 80’s by bodybuilders. Helps in the production of growth hormones.
Schedule: I
Effects: depressant, amnesia- “date-rape”
Other 1,4-butanediol
GHB
affects the release of dopamine in the brain, usually causing effects ranging from relaxation to sleep at low doses
GHB
Overall the effect is extremely similar to alcohol with the duration slightly longer.
The unpleasant and dangerous overdose effect of possibly causing temporarily unrousable sleep (coma) is very high.
Some people find GHB to be useful for treating insomnia, others use it as part of the process of breaking alcohol addiction.
Many people who try GHB don’t like its somewhat drowsy, slightly dizzy, alcohol-like character
GHB Low Dose
A low does of GHB (usually from 0.5-1.5 grams) often causes effects similar to those 1-3 drinks of alcohol.
Users feel mild relaxation
Increased sociability, slightly decreased motor skills, mild dizziness, and other effects similar to mild alcohol intoxication.
Even at low doses it is improper and dangerous for GHB users to drive or operate heavy machinery.
GHB Medium Dose
Usually from (1-2.5 grams) increases the relaxing effects and physical disequilibrium experienced.
Some people report an increased appreciation for music, dancing, or talking.
Some slurring of speech, silliness, and slight incoherency are also common.
Others report increased feeling or nausea and grogginess.
GHB Heavy Dose
2.5 grams can increase feeling of disequilibrium in many people to the point of feeling ill.
Many people accidentally move from medium to over dose, only passing through heavy dose for a few minutes.
People report how difficult find one’s personal dose range can be to achieve these effects.
An extra quarter (0.25 gram) can be the difference between euphoria and vomiting.
GHB Overdose
The overdose range for the GHB can be as little as 2 grams based on body weight and individual sensitivity.
One major problem with GHB as an underground recreational substance is that can be difficult to manage the various non-standard preparations available to the uninformed buyer.
Another major problem is that users often mix GHB with alcohol, which drastically increases the chance of vomiting and unconsciousness.
The strong drowsy feeling followed by an temporarily unarousable sleep (coma) for 1-4 hours.
Some overdoses of GHB mixing vomiting with unconsciousness- which is an extremely dangerous combination for obvious reasons.
An overdose can consist of mid to extreme nausea and dizziness and vomiting. Thus- date rape
Rohypnol/Flunitrazepam
Flunitrazepam is benzodiazepine used a sleep medication favored for its rapid onset and long duration.
Flunitrazepam has a half-life of over 14 hours resulting in a very long duration of effects.
It received a lot of attention as a “date-rape drug” in the US in the 1990s. Started as sleep aid- legal in some countries.
Pharmacology: depressant sedative, benzodiazepine
Schedule: IV
Effects: sedative- amnesia
Date Rape Drugs
All drugs can be “date-rape” drugs
Stereotypical Date-rape are:
Rohypnol (flunitrazepam)
GHB (gamma hydroxy butyrate)
Ketamine
Date Rape Drugs
All: Are sedatives/ depressants Have short-term memory loss side effect Will make people sick Are easy to overdose in Can and DOES cause coma or death Are available and easy to administer
Hallucinogens
Marijuana LSD Psilocyn/ Psilocybin Mushrooms MDMA (ecstacy) Peyote
LSD
LSD is best known and most researched psychedelic
It is the standard against which all other psychedelics are compared.
It is active at extremely low doses and is most commonly available on blotter or in liquid form.
With regard to uncertain strengths, the strength of hist these days is low, 100 micrograms or so. One should be careful and assume that the smallest square in a tiling of a sheet is a dose, even if a printed pattern covers several.
Psilocyn/ Psilocybin Mushrooms
There are more than 180 species of mushrooms which contain psilocybin or psilocin.
They have a long history of use in Mexico and are currently one of the most popular and commonly available natural psychedelics.
3,4 Methylenedioxymethamphetamine (MDMA)
Created in 1914 by Merck as a precursor for other therapeutic drugs.
MDMA is synthetic psychoactive drug that is chemically similarly to the stimulant methamphetamine and the hallucinogen mescaline. MDMA produces feeling of increased energy, euphoria, emotional warmth and distortions in time, perception, and tactile experiences.
MDMA
In high doses, MDMA can interfere with the body’s ability to regulate temperature, which can result in liver, kidney, cardiovascular system failure, or death.
MDMA can interfere with its own metabolism (breakdown within the body); therefore, potentially harmful levels can be reached by repeated MDMA administration within short periods of time.
Although the combination of MDMA with one or more of these drugs may be inherently dangerous, users who combine these with additional substances such as marijuana and alcohol may be putting themselves at even higher risk for adverse health conditions.
Synthetic Hallucinogens
MDA 2C-B DOB/DOC MDE FOXY AMT DMT 5-Meo-DALT 4-FMC 4-MFC FA MDPPP MDPV Methylone PVP
New Drugs
Bath Salts: 24 listed and controlled as of 8-1-12
Analogs are defined as being: structurally similar to a sch. I or II controlled substance and having similar physiological effects
Hazards to new synthetics
No Valid research that shows long-term effects
Chemicals being sold are often misrepresented
A lot of “imitation” drugs on the market (LSD)
A lot of mixing with alcohol and/or other drugs
Most of the chemicals are highly toxic
Most submissions we see are not pure-they are a mix of chemicals. Many contain multiple controlled substances
Teens have a false sense of security: being told the chemicals “aren’t illegal” or “if they were bad for you it would be illegal”
The people doing these drugs are guinea pigs
The substances generally have unpredictable reactions. If a substance “seems alright” one time- next time is may be another chemical
Bath Salts
Although bath salts initially seemed to be analogs, derivatives, or synthetically modified versions or Cathinone or Methcathinone- now the chemicals vary from cathinone to synthetic cannabinoids, to completely new synthetic chemicals
Salvia Divincrum
Is a sprawling perennial herb found in the Sierra Mazatec region of Mexico.
It’s leaves contain the extremely potent Salvinorin A. It has a history of buccal use as a divinatory psychedelic, and has been widely available since the mid 1900’s primarily as a smoked herb. Its effects are consisted unpleasant by many people.
New Drugs- Bath Salts
Muscle tension and aching Jaw Tension Increased perspiration Gastrointestinal discomfort, nausea and vomiting Dizziness, confusions paranoia, fear Hear racing, heart palpitations
New Drugs of Abuse
Aside from PCP and Amphetamine- we still see plenty of the “traditional” drugs
Cocaine, Marijuana, methamphetamine, heroin, LSD, Psilocyn
However, there is a resurgence of many of the “old” designer drugs
Drugs-relatively new (still out there)
Date Rape: ketamine, GHB, rohypnol Prescription pills abuse: oxycodone, alprazolam, ritilan MDMA/MDA- substitutes and combinations Benzylpiperazine (BZP 2004) Salvia Divinorum
Non-controlled drugs of Abuse
Cold Medications
Inhalants
Triple C
Ephedrine Guifenessin Triprolidine Chlorpheniramine DXM is a widely available over-the-counter cough suppressant. When taken far above its standard medical dosage, it is a strong dissociative and primarily by teens.
