PHARM - Drug Assignments (Test 3) Flashcards
Common streetnames for crack/cocaine
- snow
- Devil’s dandruff
- Hannah montana
- blow
- soft white
- hard white
- yayo
- 8ball
- star-spangled powder
- rock
- nose beeres
What’s the difference between crack and cocaine?
- crack is a derivative of cocaine - achieved through a cooking process
- crack: rock form
- cocaine: powder form
What does crack look like?
- rock form; ranging in colour from clear white to off white, varied in shape and size
- At its natural form, it comes from a plant (chewable)a
What does cocaine look like?
- white powder - looks similar to baking soda and other white powders
- can look flaky depending ona additives
- In the market today, it is a fine white powder
How is crack cocaine used?
- Crack: smoked (crackpipe)
-
Cocaine: snorted, injected, smoked (rare)
- may be swallowed to boost high
How is cocaine manufactured?
1) Cocaine comes from dried leaves of coca plant Erythroxylum
2) Leaves are mulched & binding agent like cement is sprinkled over it
3) Mixed with gasoline, ammonia, sulfuric acid, sodium permanganate, caustic soda and others to produce a paste
4) Paste is extracted and heated until most of the water is evaporated
5) Crushed and sold, may be mixed with other stuff then grinded it to turn into a powder
How is cocaine manufactured?
made by cooking cocaine powder with baking soda (sodium bicarbonate) then breaking it into small pieces called rocks (name comes from the fact that it cracckles when heated and smoked)
Benefits of cocaine?
- local anesthestic
- vasoconstrictive properties
- ^ both used for head and neck surgeries
- in coca cola as a “tonic” back in the day
Retail value of crack and cocaine
Crack:
- 0.1g (rock): $10-25
- 0.1 - 0.25g: $40
Cocaine: 1/8th oz/3.5 g (8 ball): $120-150+
Demographics use for crack/cocaine
- 58% of crack/cocaine use is male
- highest use if 20-24 age group
- use in Canadian population is ~2%
Effects of crack/ccoaine on body, and time it takes for the drug to kick in via intranasal (snorting), injection, and smoking.
Intranasal/snorting: takes effect within a few minutes, lasts 15-30 min
Injection: produces a rush felt in 30-45 secs, lasts 10-20 mins
Smoking: causes high within seconds, last only 5-10 mins
Effects: cocaine binds to dopamine transporter, blocking the removal of dopamine from synapse so it accumulates in the synapse to produce an amplified signal to receiving neurons - causes “euphoria”
Short term effects of crack/cocaine
- Short acting stimulant
- Euphoric “high” feeling - can induce hallucinations, huge mood swings, panic, and paranoia
- Restlessness & aggression, violence
- Dry mouth, loss of appetite, sweating, increased HR
- Long “low crash” follows - associated with strong cravings & depressive episodes
- May also experience tremors, vertigo, and muscle twitches
Long term effects of crack/cocaine
- Increased anxiety, nervousness and psychosis
- Breathing problems and lung damage: “Crack Lung”
- Difficulty sleeping, weight loss
- Nose Bleeds
- damage the nasal septum (sinus infections and loss of smell)
- Infections with injections (used needles) or with impurities of the drug
- Debt & difficult social relationships
Withdrawal symptoms of crack/cocaine
- Significant fatigue and depression
- Agitation
- Intense cravings
- Anxiety
- Nausea
- Insomnia & nightmares
- Hallucinations
- Excessive sweating
Long term use of crack cocaine can dause dangers to the body including:
- Can cause blood vessels to thicken and constrict, reducing flow of oxygen to the heart
- Can cause heart muscle to work harder (risk of heart attack and stroke)
- Raises BP which can weaken blood vessels in the brain to bursta
Overdose of crack/cocaine leads to:
- Seizures and heart failure
- Weak breathing and/or respiratory arrest
- Also mixing cocaine with other substances such as alcohol, fentanyl, and heroin increases dangers and risk of overdose
CBT
- Psychotherapy approach to help with substance abuse
- Helps with identifying negative and self-deprecating thoughts and aims to improve self-control, form good coping strategies, increased awareness
- Includes:
- Functional analysis: identifying thoughts and feelings and circumstances leading to substance use + consequences of behaviour; provides insight to better understand a person’s history and relate tx around these issues
- Skills training: developing coping skills, providing education, substituting habits with positive action plans
MDMA stands for
methylenedioxymethamphetamine
Street names for MDMA
- ecstasy
- molly
- Adam
- XTC
- Scooby snacks
- Lover’s speed
- Bean
- Candy
- X
What is MDMA?
- dissociative hallucinogenic drug
- works as a stimulant and hallucinogen (alters senses and perceptions)
How is MDMA made and where does it come from?
- most ingredients in MDMA come from China because most of it is legal there
- most of the MDMA seized in the US is synthesized in Canada and to a lesser extent, The Netherlands
- Ingredients:
- isolate Safrole Oil
- convert safrole to MDP2P (oxygen is added to catalyze the reaction)
- reductively aminate MDP2P to MDMA
- Crystallize the MDMA oil (filtered and further processed to be compressed into tablets)
What does MDMA look like?
- many shapes, sizes and colous (varies due to different ingredients used to bind the crystalline powder into pill/tab)
- triangular MDMA marked with an “X”
- speckled ecstasy tablet with a fish imprint
- off-white ecstast tablet with Crows foot symbol
- Blue ecstasy tablet with butterfly imprint
True or false. MDMA initially comes in a white powder but is never sold as a powder
True. It is mostly sold as a chalky tablet or pill
How is MDMA taken?
orally, intranasally, IV
Who uses MDMA?
- adolescents and YA in nightlife and festival settings
- predominantly used in 18-25 y.o.
- sexual orientation influences MDMA use
- gay/bisexual men and women were more likely to use MDMA then their heterosexual counterparts
Effects of MDMA on body and how long this takes to kick in
- effecs usually take ~45 min of taking a single dose
-
Effects:
- enhanced sense of wellbeing, pleasure and self confidence
- increased extroversion and energy
- emotional closeness
- empathy towards others
- enhanced sensory perception (hallmark of MDMA use)
Clinical signs/indicators to look for in individuals who use MDMA
- dilated pupils
- reduced pain sensation
- elevated body temp
- long periods of wakefulness
How does MDMA affect chemicals in the body?
How addictive is MDMA?
How significant is the withdrawal from MDMA?
- MDMA produces adaptations in the 5HT and dopamine systems that are associated with substance use/abuse disorder (blocking reuptake of these substances)
- no research on how addictive MDMA is but it may affect many of the same NTs as other addictive substances
- Withdrawal: nothing formally recognized when MDMA is stopped but often assocaited with varying distress psychological and emotional symptoms
Short term effects of MDMA
release of dopamine, NE, and 5HT (blocks their reuptake)
Long term effects of MDMA
- heart arrhythmias
- heart damage
- irritability
- depression
- impulsivity
- impaired attention and memory
Leading cause of ecstast-related deaths is _____________.
hyperthermia
often taken at raves/nightclubs and dancing (which all cause increased risk to become hyperthermic, dehydrated) - eventually leads to organ dysfunction
What is re-upping? Why do MDMA users do this?
- aka double stack
- users of MDMA may continue to take more to return to euphoric effects once peak effects start to wear off
- avoids the crash (which causes feelings of anxiety, depression, fatigue, irritability, and agitation form body’s lack of producing hormones)
Overdosing on MDMA may lead to
- heart arrhythmias
- body temp dysregulation
- hyperterhmia
- hyperthermia-related rhabdomyolysis & kidney injury
- seiures
Benefits of MDMA
- suppresses area of the brain responsible for anxiety and fear which can be beneficial in therapeutic applications
- tx of social anxiety who are on autism spectrum
- produces empathetic and pro-social feelings in those who could otherwise suffer from social anxiety (not associated with autism spectrum)
- produce feelings of calmness and trust
- alcohol addiction
- PTSD
MDMA is a schedule _____ drug, and access by therapists is ________.
I; limited (very restricted access by therapists)
price of 1 MDMA tablet
$15-25
cheaper than alternative therapies for severe PTSD that may take longer and need more drugs/professional assistance
Street names for heroin
- dope
- smack
- H
- junk
- skag
- snow horse
- china hite
- brown
- beast
- hero
How is heroin used?
- injection (most common)
- sniffed/snorted
- smoked (“chasing the dragon”)
- gumming/chewing
- suppository
- speedball
What is heroin?
- semi-synthetic opioid
- comes from opium poppies
- morphine is a natural opioid that is harvested from the opium plant
- heroin is made from morphine and then chemically processed
- has multiple cutting agents: baking soda, sugar, starch, crushed OTC painkillers, powedered milk, laundry detergent, caffeine, rat poison
S/S of heroin
- dry mouth
- pinpoint pupils
- decreased bowel movement
- decreased HR
- decreased breathing
- flushed skin
- hypotension
- muscle spasms
Short term effects of heroin use
- “Flash effect” - surge of euphoria, dry mouth, warm flushing of the skin, heavy feeling in arms/legs, N/V, severe itching, clouded mental functioning and going “on the nod”
- back and forth state of being conscious and subconscious
Long term effects of heroin use
- insomnia
- collapsed veins (from injection)
- damaged tissue inside nose (for sniffing/snorting)
- infection of heart lining and valves
- abscesses
- constipation and stomach
- liver and kidney disease
- lung complications
- mental disorders
- sexual dysfunction for men/irregular menstrual cycle for women
When can heroin addiction start? What are S/S of heroin withdrawal?
- Addiction can start within 2-3 weeks
- Withdrawal can start wtihin 6-12 hours of last use
- S/S:
- restlessness
- severe muscle and bone pain
- sleep problems
- diarrhea and vomiting
- cold flashes with goosebumps
- uncontrollable leg movements
- severe heroins cravings
What does heroin overdose look like?
- face becomes pale/clammy
- blue lips and fingernails
- extreme drowsiness
- slow or halted breathing
- pinpoint pupils
- body goes limp
- may lead to coma or death
Treatment for overdose of heroin
- use of naloxone
- preventative measures: clean supplies or clean injection sites, don’t use alone
- long term - recovery programs and treatment options like methadone
