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Uppers Downers & All Arounders Uppers/Stimulants Chapter 3

Mar 31, 2015



  • Slide 1

Uppers Downers & All Arounders Uppers/Stimulants Chapter 3 Slide 2 Uppers/Stimulants In 1999 about 1.7 million Americans used amphetamines for nonmedical reasons, 4.2 million used cocaine, 68 million smoked cigarettes, 200 million drank coffee, tea, caffeinated soft drinks or an over-the-counter medication containing caffeine. (p. 83). Slide 3 General Classification Most people use stimulants in the form of: Diet aids Drugs to control hyperactivity Coffee & Tea Cigarettes Caffeinated solf drinks Stimulants are found in plants and in synthetic form Slide 4 General Effects Stimulants force the release of the energy chemicals (epinephrine and norepinephrine along with dopamine and serotonin) Infuses the body with large amounts of extra energy before the body needs it With heavy use the bodys energy supply is depleted leading to crash, withdrawal and depression Crash and withdrawal occurs when energy supplies become depleted and body is left without reserves Slide 5 General Effects All Stimulants activate chemical and electrical activity in central nervous system Increases Heart rate Blood pressure Respiration Effects include Activeness Restlessness Medical uses include treatment of obesity, narcolepsy and Attention-deficit/hyperactivity Disorder Slide 6 General Effects Reward/reinforcement center is artificially over- stimulated Rush of pleasure and strong sense of wellbeing Often accompanied by no basic need for hunger, thirst or sex Weight loss: stimulants fool the body into thinking it has satisfied hunger without eating Cardiovascular side effects include constricted blood vessels, high blood pressure and sometimes arrhythmia Chronic use weakens blood vessels and risk of stroke Slide 7 General Effects Emotional & mental effects: Initial release causes increase of confidence and euphoria As use continues feeling of euphoria turn to irritability, paranoia, aggressiveness, depression Tolerance & Addiction liability Increases as body loses its ability to synthesize drugs Can also develop with methamphetamine congeners, caffeine, nicotine and other mild stimulants Slide 8 COCAINE Cocaine epidemics seem to occur every few generations Hardcore use still strong in 2000s Cocaine is extracted from coca plant 97% grown in South America Colombian drug Cartels control cultivation and production 2/3 of smuggling handled by drug artels in Mexico U.S. consumes 70% of worlds cocaine trade Slide 9 COCAINE: Routes of Administration Chewing Leaf: Historically Native cultures Drinking: Started in 1880s in wine, coca cola, and patent medicine. Widely prescribed to womem Injecting: Started after the invention of hypodermic needle in 1853 Intravenous use takes 15-30 seconds Subcutaneous/intramuscular takes 3-5 minutes Snorting: Self-limiting method The more snorted, the less absorption due to constriction of capillaries in the nose Destructive to nasal passages Slide 10 COCAINE: Routes of Administration Mucosal & contact absorption Can be absorbed through mucosal tissue in nose, mouth, rectum & vagina Delivery method is also used for dental work, minor surgeries Smoking: First introduced in 1914, but high temperature was needed to keep cocaine cigarettes going Mid-1970s, cocaine hydrochloride was chemically altered into freebase Fastest form to reach brain Highly addictive Slide 11 COCAINE: Physical and Mental Effects Metabolism: Quickly metabolized and disappears faster than methamphetamine Medical Use: Only naturally occurring local anesthetic Used to numb nasal passages, eyes, throat, and chronic sores Neurochemistry & Central Nervous System Forces relase of norepinephrine, epinephrine and dopamine Blocks re-absorption so more intense stimulation Blocks 60-70% of dopamine reuptake Too much dopamine can over stimulate brains fright center causing paranoia. Excessive use causes insomnia, agitation and severe depression Slide 12 COCAINE: Physical and Mental Effects Sexual Effects: At low doses cocaine increases desire for sex and delay ejaculation As use continues sexual dysfunction occurs Aggression, violence & cocaethylene Increases aggression & violence by disrupting inhibitory and fright centers of the brain Cocathylene (metabolite when cocaine & alcohol is combined) induces greater agitation, euphoria and violence Can also induce cardiac conduction abnormalities Slide 13 COCAINE: Physical and Mental Effects Cardiovascular Effects Can damage circulatory system Raise blood pressure Cause stroke (bursting of blood vessels in brain) Cause heart damage Neonatal Effects: Transmitted within seconds to fetus Increases chances for miscarriage, stroke, SIDS, respiratory ailments, mental delays & other abnormalities Proper pre-natal and post natal treatment can hel cocaine babies Slide 14 COCAINE: Physical and Mental Effects Tolerance: To the euphoric effect can begin to develop after first injection or smoking session Withdrawal, Craving & relapse: Major effects include anhedonia, lack of energy and intense craving Typical cycle of compulsive use: Bingeing to crashing to detox to resolutions of abstinence or treatment and relapsing 2-4 weeks later. Slide 15 COCAINE: Physical and Mental Effects Overdose: Can be caused by as little as 1/50 gram Overwhelmingly intense stimulation Injury to heart and blood vessels More often not fataljust feels that way Severe reaction through in verse tolerance or kindling Miscellaneous Effects: Formication (itching from imaginary bugs) Dental erosion Seizures Gastrointestinal complications Cocaine Psychosis: Paranoid psychosis/schizophrenia caused by excess dopamine Can also activate genetic predisposition to schizophrenia Slide 16 COCAINE: Other Problems with Use Polydrug Use Alcohol, valium, heroin to take the edge off Adulteration & Contamination Cocaine at street level is almost always cut When injected, bacteria and viruses contaminate drugs and needles Hepatitis C rate for IV drug users is between 50% and 90% Compulsion Use for euphoria, boredom, peer pressure, curiosity, self-medication, escape from personal problems Slide 17 Slide 18 SMOKABLE COCAINE (CRACK & FREEBASE) Pharmacology of smokable Cocaine Began around 1981 Crack epidemic in 1986 Chemically crack is the same as freebase Delivered to the brain faster Ether converts cocaine to freebase Baking soda converts cocaine to crack Effects and Side Effects More intense than snorting or injecting Rush or euphoria last 5 20 minutes Replaced by the feeling of irritability and other negative emotions Always used in a binge pattern Chronic use include paranoia, intense cravings, depression, cocaine psychosis, high-risk sexual activity Slide 19 SMOKABLE COCAINE (CRACK & FREEBASE) Respiratory Effects Breathing problems Severe fever Chest pains Coughs Crack lung Hemorrhage Respiratory failure & death Aggravated by cigarette smoking Polydrug use Increases the potential for abuse of depressants Slide 20 SMOKABLE COCAINE (CRACK & FREEBASE) Overdose Mild-rapid heart beat Hyperventilation Fear of dying Kills several thousand a year due to Cardiac arrest Seizure Stroke Respiratory failure Severe hypothermia Consequences of Crack use Economic Social: abuse, family, legal, formation of sex trade Cocaine vs Amphetamines Cocaines duration is 40 minutes/ Meth is 4-6 hours Meth is cheaper Slide 21 Amphetamines Slide 22 Classification: Sympathomimetic agent Stimulate the release of sympathic neurotransmitters Activates the sympathetic nervous system that controls the fight or flight response Stimulates the reward/information center Street names: crank, ice, shabu, glass, clear History of Use First synthesized in 1887 Medically used in 1930s Treats narcolepsy & depression Used by students and truck drivers to stay awake Widely used in pill form during WW II Slide 23 Amphetamines History of Use Japanese epidemic continued after WW II 1970 6-8% of American population used prescribed amphetamines for weight loss Street speed chemists increased production of crank and crystal in late 1980s Ice highly potent smokable form used in 1990s and common use in Hawaii Recent development of ya ba in Thailand Slide 24 Amphetamines (Effects) Routes of Administration Snorting Intravenous Smoking Oral Neurochemistry Like cocaine, amphetamines increase levels of catecholamines by stimulating their release and blocking reuptake Unlike cocaine, amphetamines block metabolism Long term use alters the ability to produce vital neurotransmitters causing depression and taking mor to stay normal Slide 25 Amphetamines (Effects) Physical Effects Small to moderate doses cause Increased heart rate Raised body temperature Rapid respiration Higher blood pressure Extra energy Dilation of bronchial vessels Appetite suppression Meth users go on binges for 3, 4 or 10 days Long term use can cause sleep deprivation Heart & blood toxicity Severe malnutrition Bad or rotten teeth Tolerance is more pronounced Slide 26 Amphetamines (Effects) Mental & Emotional Effects Mild to intense euphoria / sense of wellbeing Prolong use leads to Irritability Paranoia Anxiety Confusion Poor judgement Hallucinations Delusions Can result in violent, suicidal & homicidal thoughts Antisocial behaviors Slide 27 Amphetamines (Effects) With abstinence, disturbed mental states such as amphetamine psychosis or depression can stop for some people Amphetamines release neurotransmitter that mimics sexual gratification Effects of Ice is greater on the brain than the respiratory and pulmonary system Results in more overdoses Greater mental side effects Longer detoxification Slide 28 Slide 29 Amphetamine Congeners/Lookalikes Methylphenidate (Ritalin) Most widely used Prescribed as mood elevator, narcolepsy and to treat Attention-deficit/hyperactivity disorder Diet Pills Only recommended for short-term use Careful monitoring by physician Long-term use associated with abuse Lookalikes Prescription