Transcript indiv_drugs_f14

Individual Drug Info
Fall 2014
Similar Properties Across Drugs
Withdrawal (physical dependence)
 Psychological dependence
 Tolerance
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Differences
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Forms
Availability
DEA Schedule
Effects
◦ Acute
◦ Chronic
◦ Overdose
Photo, originally taken by Thoric, available to
use in the public domain
How does marijuana affect anxiety and depression?
Does marijuana affect respiratory function? Especially during
exercise?
Is marijuana more destructive to your brain than alcohol?
Cannabis - marijuana
Cannabis
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Cannabis sativa
◦ Different
subspecies/varietals used
for clothing vs drug use
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Active ingredient: THC
THC is a cannabinoid
◦ Interacts with cannabinoid
receptors in brain
◦ Many other cannabinoids exist,
but not thought to cause
psychoactive reactions
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DEA: Schedule I
Despite state regulations,
marijuana still federally illegal
Medical cannabis
(10/30/14), source: procon.org)
Alaska (98)
Maine (99)
New Jersey (10)
Arizona (10)
Maryland (14)
New Mexico (07)
California (96)
Massachusetts (12)
New York (14)
Colorado (00)
Michigan (08)
Oregon (98)
Connecticut (12)
Minnesota (14)
Rhode Island (06)
Delaware (11)
Montana (04)
Vermont (04)
Hawaii (00)
Nevada (00)
Washington (98)
Illinois (13)
New Hampshire
(13)
Washington, DC
(10)
Recreational Cannabis
Washington (2013)
 Colorado (2013)
 Washington, DC (2014)
 Alaska (2014)
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Cannabis
Acute effects
THC acts on cannabinoid receptors, increases dopamine, serotonin
Increases appetite
ASAP Science:Your Brain on Marijuana (via YouTube)
Overdose generally doesn’t occur
◦ Large amount required
◦ Smoking a lot may induce sleepiness
◦ Eating too much may trigger nausea, vomiting
◦ Q13 News story, Michigan
Mixing any chemical substances can potentially cause a problem
Alcohol vs Cannabis
More research on alcohol
 Age dependent
 Amount of alcohol/amount of cannabis
 Mixing substances
 Alcohol interferes with neurogenesis of
brain cells (Gary L.Wenk, Psychology Today, 2010)
 Cannabis: 2014 study showing regular use
impacted decision-making and judgment
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(Published online before print November 10, 2014, doi: 10.1073/pnas.1415297111. PNAS November 10, 2014)
Depression and Anxiety
Many use marijuana to ease mood
 Regular use may trigger, or worsen, either condition,
especially in younger people
 2013 Imperial College study showed lower dopamine
levels in regular users, which may lead to more anxiety
 Marijuana, conversely, may help those with PostTraumatic Stress Disorder
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◦ Memory inhibition
Cannabis
Chronic effects
 Respiratory distress
 Mood swings
 Impaired memory (potential hippocampus
damage)
 Earlier research
 2011 NIMH/NIDA study
◦ Daily use may reduce brain receptor number
◦ Receptors regenerated with cessation
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Society of Nuclear Medicine. "Chronic marijuana smoking affects brain chemistry, molecular imaging shows."
ScienceDaily. ScienceDaily, 13 June 2011. <www.sciencedaily.com/releases/2011/06/110606131705.htm>.
Marijuana & Respiratory Function
During Exercise
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Acute effect: any smoke
can interfere with oxygen
binding to red blood cells
Acute: marijuana can
disrupt coordination,
balance, reaction time
Acute: increase heart rate
and blood pressure
Acute: stored THC in fat
could be released into
bloodstream during
exercise
Chronic: depends on how
frequently one smokes,
type of exercise
What is DMT?
How does DMT work as a psychoactive drug?
Dimethyltryptamine
(DMT)
Dimethyltryptamine
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Chemical structure
Hallucinogenic ingredient
Present in a variety of
plants
Occurs naturally in the
body
Schedule I substance
Image source: Wikimedia Commons
Dimethyltryptamine
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Often consumed via
beverage: ayahuasca tea
◦ Requires MAO-I (specific
vine)
◦ Ceremonial purposes
◦ Ashland, OR Brazilian church
lawsuit
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Can be injected, inhaled,
smoked
Dimethyltryptamine Effects
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Hallucinogenic visualizations
Mood change
Time distortion
Dissociation
Muscle twitching, coordination difficulties
Nausea, vomiting
Shorter-lasting effects than other hallucinogens
◦ “businessman’s trip” per DEA
◦ 30-60 minutes
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Video Clip - The Spirit Molecule, Part 1 (YouTube)
Video Clip – London Real (34:00+ = trip described)
Source: Arch Gen Pesychiatry. 1994 Feb;51(2):98-108.
Learn the effects of acid
Are there different types?
LSD
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LSD
Albert Hoffman: “Last Friday,
April 16,1943, I was forced to
interrupt my work in the
laboratory in the middle of the
afternoon and proceed home,
being affected by a remarkable
restlessness, combined with a
slight dizziness. At home I lay
down and sank into a not
unpleasant intoxicated-like
condition, characterized by an
extremely stimulated imagination.
In a dreamlike state, with eyes
closed (I found the daylight to be
unpleasantly glaring), I perceived
an uninterrupted stream of
fantastic pictures, extraordinary
shapes with intense,
kaleidoscopic play of colors. After
some two hours this condition
faded away.”
LSD
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Schedule I hallucinogen synthesized in
1930s
• Manufacturing secretive: Nick Sand (National
Geographic, 3:39)
• “Types”
• Same basic chemical structure
• Illegal, so cannot guarantee contents, care of
product
• Light and air may degrade drug
• Dosage measured in micrograms (very small)
LSD Forms
Crystal can be crushed,
mixed with other materials
into tablets: microdots
 Gelatin squares
 Converted to liquid paper
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◦ Dosed onto sugar cubes
◦ Placed on candy (gummy
bears - Lake Tahoe, 2011,
e.g.)
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Usually taken orally
◦ Can be inhaled, injected,
applied transdermally
LSD Acute Effects
• Duration of “trip” = several hours in length
• Visual hallucinations (images, color, light)
• Altered perception of senses
• “Seeing sounds, hearing colors”
• Color, size of objects
• Altered perception of time, depth
• Potential anxiety/panic
• Experiences can vary widely
• Serotonin receptors may be excited or inhibited
• LSD experimentation on British soldiers (YouTube.com)
• Overdose thought to be rare, but some individuals may not
respond well, or may experience problems if drug is different
than LSD
LSD
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Chronic effects may involve flashbacks
◦ Sudden onset of abnormal perceptions
◦ Hallucinogen Persisting Perception Disorder
 Visual images remain longer than in consciousness
 Dr. Henry Abraham (Tufts University) blog
LSD Research
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US Food and Drug Administration allowed
LSD research
Recent study sponsored by Multidisciplinary
Association for Psychedelic Studies, carried
out by Swiss physician Peter Gasser
◦ Information published 2014
◦ 12 patients with terminal illness, end-of-life anxiety
◦ Took two doses of LSD with talk therapy, across eight
weeks
◦ Those with larger dose reported improvement
Which Drugs are Most Dangerous?
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Largely depends on availability
◦ Most emergency department (ED) visits:
alcohol (DAWN, 2011)
◦ Half + of 2.5 million ED visits: illicit substances
Which Drugs are Most Dangerous?
Cocaine – 505,224
Combinations – 10,388
Marijuana – 455,668
Inhalants – 10,032
Heroin – 258,482
Unclassified hallucinogens – 8,043
Amphetamine/meth. – 159,840
LSD – 4,819
PCP – 75,538
GHB – 2,406
Synthetic cannabinoids – 28,531
Ketamine – 1,550
MDMA – 22,498
How does Ecstasy prove to help people with PTSD?
What exactly is Molly & why does it kill people?
How do you overdose Ecstasy? Molly?
MDMA
3,4-methylenedioxy-N-methylamphetamine
MDMA
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Molly, Ecstasy, Thizz
Synthetic drug
Stimulant and
hallucinogenic
properties
MDMA
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Acute effects on the brain
◦ Increased serotonin release
◦ Increased dopamine release
◦ Increased norepinephrine release
◦ Effects will vary since formula is not standardized or regulated
◦ Effects will vary based on the synthetic nature of substance
◦ MDMA-assisted therapy (Multidisciplinary Association for
Psychedelic Studies, video; 0-2:00; 14 subjects, per website)
◦ More on MDMA therapy for PTSD (The Verge via YouTube,
MAPS research through 7:00)
MDMA
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Chronic effects are controversial, per Carl Hart, Columbia
University (YouTube)
◦ Well-circulated animal studies showing neuron damage
Emergency Department Visits
Synthetics are currently popular
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2C-I, MDMA, bath salts, synthetic cannabis
Lower price (think about economy’s influence)
Drug popularity changes with time (synthetics were popular in
1970s)
Health-related issues will subsequently ebb and flow as drugs move
in and out of favor
That acknowledged, some can be devastating: Krokodil (CBS, 2013)
Which drugs are the most popular? (by
country here)
Mushrooms
mushrooms
Psilocybin/psilocin are two
active psyhoacticve
substances found in “magic
mushrooms”
Couple dozen species
 Taken orally
 Recognized for centuries
Probably used in religious rites
 Hallucinogen
 Schedule I
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mushrooms
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Acute effects:
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Relaxation
Altered perception of reality
Altered perception of time
Sense of connection to others/universe
Visual hallucinations (images, color, light)
Potential for anxiety and subsequent panic, heart rate & blood
pressure increase
Chronic effects:
◦ A “bad trip” may trigger fear
◦ Hallucinogens may exacerbate mental illness
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Being investigated as treatment for OCD, depression,
smoking cessation
◦ Johns Hopkins Psilocybin Cancer Project (via YouTube, 0:30-4:03)
Dextroamphetamine
(Adderall)
About Adderall
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Stimulant
Works on dopamine and
norepinephrine
Used as prescription for
ADHD, narcolepsy
Some abuse Adderall for
its performance-related
effects
60 Minutes program, April
2010
Schedule II
Adderall Availability
Readily available across U.S.
 $5-10 per pill
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Adderall Prescriptions, by Year (U.S.
Department of Justice)
10000
9000
8000
7000
6000
5000
4000
3000
2000
1000
0
Number
2003
2004
2005
2006
2007
Adderall Effects
Increased alertness
 Euphoria
 Self-assuredness
 Increased heart rate, blood pressure
 Emotional changes
 Weight loss
 Stomach discomfort (nausea, cramps)
 Long-term effects are not yet known
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Adderall Forms
Tablet (5-30mg)
 Time release capsule
(10-25mg)
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Adderall Overdose
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According to Dailymed (National Library of Medicine),
traditional symptoms can develop: anxiety,
confusion, restlessness
4-iodo-2,5-dimethoxyphenethylamine
2C-I
2C-I
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“Smiles”
Synthetic substance
Usually inhaled or
taken orally; may
also be taken via
blotter paper
Stimulant &
hallucinogenic
properties
Schedule I
2C-I
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Impacts dopamine &
serotonin
Onset of effects may not
be immediate, triggering
overdose
Little information on
brain impact
Additives, chemical
changes make drug
unpredictable, similar to
bath salts
Methamphetamine
Methamphetamine
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Famous/notorious for laboratory production, short-term dopamine
effects & long-term effects
Stimulant (blood pressure, heart rate, alertness)
DEA: Schedule II substance (Desoxyn: ADD, narcolepsy, weight
control)
Methamphetamine acute effects
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Intense high/euphoria
◦ May last up to 12 hours (longer than cocaine)
◦ Meth Inside and Out video describing effects
Energetic, talkative, excitable
 Insomnia
 Increased heart rate, blood pressure
 Sweating
 Dry mouth
 Jaw clenching
 Nausea, vomiting
 Comparison: meth vs cocaine,Brookhaven National
Laboratory, 2008
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Methamphetamine chronic effects
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Chronic users may experience hallucinations, rage, paranoia, heart “meth
mouth;” damage to dopamine-, serotonin-containing nerve cells
◦ Crank Bugs (Meth Project)
◦ Meth Mouth (Meth Project)
◦ Ashley’s Story (Meth Project)
◦ Research supports both brain damage as well as lack of brain damage
Methamphetamine Chronic
Effects
Before & After Photos
Before and After Photos
3 Years and 5 months after starting meth
Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm
Before and After
17 months after starting meth
Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm
Before and After
3 months later
Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm
Heroin
Heroin
Narcotic
 Synthesized from morphine in late 1800’s
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Morphine synthesized from opium poppy
Heroin 10x more powerful than morphine
Was thought to be less addictive
After many people became addicted, heroin was
outlawed in 1920’s
◦ Drug Ads (wings.buffalo.edu)
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Schedule I