Transcript Amphetamines Megan Trimble 3/28/06

Amphetamines
The Use and Abuse of Designer Drugs
Megan Trimble
Doctor of Pharmacy candidate
March 2006
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What are Amphetamines?
The term “amphetamines” refers to a class
of drugs.
World War II
– Stimulants for soldiers and prisoners (1)
http://images.google.com/imgres?imgurl=http://www.modafinil.com/article/modsold.jpg&imgrefurl=http://www.modafinil.com/a
rticle/soldiers.html. Accessed 29 April 2006.
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Amphetamine-like Drugs
Most commonly abused by college
students:
– Methamphetamine
Results in CNS excitation
– In other words, it “revs up” your brain
– Chemical responsible for these effects: Dopamine
– MDMA
Serotonin, not dopamine, is the chemical
responsible for the effects felt from using MDMA
“Designer” amphetamines (1)
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“Designer Drugs”
What is Methamphetamine?
– Street names:
“meth” “speed” “chalk”
“ice” “crystal” “glass” (1,2)
What is MDMA?
– Street names:
http://www.teens.drugabuse.gov/facts/facts_xtc1.asp. Accessed April 6, 2006.
“ecstasy” “E” “Adam” “XTC” “M&M” (1)
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Amphetamines Forms
Methamphetamine
MDMA
– Crystalline powder
– Tablets
White, odorless
Tastes bitter
This form is referred to as
“speed” or “meth”
Colorful and branded
Prevalent at “rave”
and club scenes (1)
– Smoked form
Referred to as “ice”
“crystal” “glass” (2)
– Injection (needle use)
(3)
http://www.michigan.gov/images/ravdrug_8430_7.jpg Accessed March 29, 2006
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Why Do People Use
Amphetamines?
Methamphetamine
– Increased energy &
alertness
– Improve mood
A false feeling of
being happier
– Decrease appetite
(1)
MDMA
– Euphoria
– Heightened
awareness
– Inner peace
– Ease of socializing
(3)
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Methamphetamine is one of the most widely used
and abused drugs, in college age students, today
Graph: Amphetamine use/abuse vs.
Methamphetamine (2)
http://www.nida.nih.gov/ResearchReports/Methamph/methamph2.html#what. Accessed April 6, 2006.
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Mild Effects of Amphetamines
Cognitive effects
– Initial “rush” or
energy high
– Confusion
– Poor concentration
– Memory problem
(especially MDMA)
Systemic effects
– Restlessness
– Movement delays
– Sleep disturbances
– Thirst
– Nausea/vomiting
– Chills/Sweating
involuntarily
– Agitation
– Aggression (1,2,4)
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Severe Effects of Amphetamines
(Including Overdosing)
Convulsions/seizures
Increase heart rate
High blood pressure
Panic Attacks
Hallucinations
Unconsciousness
Damaged blood vessels (1, 2, 4)
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Life Threatening Effects of
Amphetamines (from abuse)
Hyperthermia
Hyponatremia (Large free water intake due to
physical activity causes a drop in sodium levels)
(1)
Kidney failure
Intracerebral hemorrhage
Heart failure
Muscle breakdown
Fetal death (1,5,6)
http://www.drugabuse.gov/pubs/teaching/teaching4/Teaching3.html. Accessed April 6, 2006.
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Chronic Amphetamine Abuse
The use of amphetamines such as “meth” and
“ecstasy” can lead to abuse dependence or
death
– Tolerance develops
– “Speed run”
Defining the term: The more of this drug you consume, the
higher you want get and the harder it is to do so. The user
takes increasing amounts without sleeping which can result
in being beyond high, for days at a time
Many side effects are still seen/experienced
many years after being drug free (1)
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Post-Abuse Effects
Repeating the same tasks over and over again
Clenching/grinding of teeth
Loss of memory
Permanent brain damage
– Long term psychosis effect
– Increased risk of developing Schizophrenia later in life
(1)
MDMA use results in brain damage that can be
evident 6-7 years later
– Can occur even if you only use MDMA for a couple of
days in your life (7)
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Amphetamine Pharmacology
Stimulant (methamphetamine and MDMA)
Hallucinogenic (MDMA)
Release of neurotransmitters in brain
– Dopamine
– Norepinephrine
– Serotonin
Dopamine and norepinephrine are primarily altered/effected
in the brain
Serotonin is released with use of higher doses of MDMA
(ecstasy)
The extent to which these chemicals effect the brain is
dependent on how much abuse is taking place; permanent
brain damage can occur as a result (1)
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What is Dopamine?
In the brain, dopamine is a significant role player in regulating
and controlling your pleasure level. Dopamine is produced
(made) in nerve cells. (2)
Dopamine is released from the end of specific nerves in your brain, in an
excessive amount, when methamphetamine is used and abused.
http://www.nida.nih.gov/ResearchReports/Methamph/methamph3.html#short. Accessed April 6, 2006
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What is Serotonin?
Serotonin is involved in brain
regulation
– Mood, emotions, sleep
– Appetite, aggression, perceptions (6)
Body craves more serotonin
in order to compensate for the
excess released from the brain
(5)
http://www.drugabuse.gov/pubs/teaching/teaching4/teaching.htm Accessed April 6,2006.
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Serotonin
http://www.drugabuse.gov/ResearchReports/MDMA/MDMA3.html#effects. Accessed April 29, 2006.
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Routes of Administration
(Ways to use amphetamines)
Methamphemines
– Oral (ingested)
– Parenteral
(injected)
– Inhalation
(snorting)
– Smoked and
resmoked (1,2)
MDMA
– Oral
Tablet
Capsule
Pill (1,7)
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Duration of Time
Using amphetamine-like drugs effect the
body for a long period of time
– Methamphetamine
24 hours +
Repetitive use due to tolerance
– Accumulation occurs and the duration of
effect on the body is prolonged (1)
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Elimination from Body
Renal Elimination (Kidneys)
– Amphetamines
30 %
– Methamphetamines
40-50%
– MDMA
65%
Hepatic Elimination (liver) (1)
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Risks of “Designer Drugs”
Lead poisoning (methamphetamine
abusers) (2)
– Contamination from making and using on the
street
Fetal Complications due to use and abuse
during pregnancy
– Deformities
– Death
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Risks from Injection
Using and sharing needles increases the risk of
contracting severe and life threatening diseases
– HIV
– Hepatitis B and C
The risk of HIV is not only increased by injection
but also from the enhanced sexual feelings that
arise from using these drugs
– Amphetamine use can increase your libido or alter
your perception in engaging in sexual activity
– Rough sex is common with use which can lead to
tears and abrasions resulting in bleeding (2)
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Summary
Why do people use and abuse amphetaminelike drugs (“designer drugs)?
– Stress release
– Ease of communication with peers
Feelings of fitting in/socializing
– Elevates mood
– Decreases anxiety due to school, work and personal
relations
Acceptance
– Unwanted withdrawal symptoms (don’t want to feel
bad)
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Summary
Amphetamine-like substances such as “meth” and
“ecstasy” are highly abusive drugs among college
students today. These highly addictive drugs may seem
appealing due to their short term, feel good, highs. But
the high is just that – short term. The after effects not
only cause tremendous emotional instability but also
cause negative, physical effects as well. Amphetamines
harm your entire body; the brain, heart, liver, kidneys and
blood vessels are among the many systems of your body
that deteriorate and shut down, leading to a possible
cause of death. Not only can death occur, but the risks of
acquiring HIV, hepatitis, and other serious diseases are
significantly increased.
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References
(1) Goldfrank’s Toxicologic Emergencies. 7th ed. c2002. The McGraw-Hill
Companies, Inc. “Chapter 68 Amphetamines” March 26th 2006 [Date accessed].
Available from STAT!Ref [database on the Internet]
(2) “Methamphetamine Abuse and Addiction.” [about 6 screens] National Institute On
Drug Abuse. [internet website] c2005. National Institute of Health. [in association with]
6 April 2006 [date accessed] <http://www.nida.nih.gov/ResearchReports/Methamph>
(3) “Infofacts:Methamphetamine.” [about 4 screens] National Institute On Drug Abuse.
[internet website] c2005. National Institute of Health. [in association with] 6 April 2006
[date accessed] <http://www.nida.nih.gov/Infofacts/clubdrugs.html>
(4) “MDMA Abuse and Addiction.” [about 3 screens] National Institute On Drug Abuse.
[internet website] c2005. National Institute of Health. [in association with] 6 April 2006
[date accessed] <http://www.drugabuse.gov/ResearchReports/MDMA/MDMA
3.html#effects>
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References Continued
(5) “The Neurobiology of Ecstasy (MDMA).” [about 5 screens] National Institute On
Drug Abuse. [internet website] c2005. National Institure of Health. [inassociation with]
6 April 2006 [date accessed] <www.drugabuse.gov/pubs/teaching/teaching
4/teaching.html>
(6) “Infofacts:MDMA(Ecstasy).” [about 2 screens] National Institute On Drug Abuse.
[internet website] c2005. National Institute of Health. [in association with] 6 April 2006
[date accessed] <http://www.drugabuse.gov/Infofacts/ecstasy>
(7) “Ecstasy.” [about 2 screens] National Institute On Drug Abuse For Teens. [internet
website] c2003. National Institute of Health. [in association with] 6 April 2006 [date
accessed] <http://www.teens.drugabuse.gov/facts/facts_xtc/.asp>
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