Alcohol - sbirt.pitt.edu · References Ciccarone, D. (2011). Stimulant Abuse: Pharmacology,...

Alcohol

Short-Term Effects

What is Alcohol and How Does It Work?

Street Names: Booze, Sauce, Suds, Alc.

Alcohol is a depressant.

Long-Term Effects

How is it taken?

Signs Someone Could Be Misusing

Drinks like beer, malt liquor, wine, and hard liquor contain alcohol.

It can be taken orally.

High blood pressure,

Irregular heartbeat,

Heart muscle disease,

Increased risk of pneumonia

and other infections,

Nerve disorders

(Burning/stabbing/tingling),

Flushed face,

Reddened conjunctivae,

Anxiety, Depression, Sleep Disorder,

Headache, Memory loss,

Slower reaction time, Stroke,

Liver disease, Digestive disorder,

Gastrointestinal inflammation

and bleeding,

Inflamed pancreas,

Men: Impotence,

Women: Early menopause,

Absence of a menstrual period,

Spontaneous abortion,

Cancer: Mouth, Throat, Liver,

Breast, Pancreatic,

Other: Vitamin deficiency,

Bone damage, Gout,

Spider veins, Death

Intoxication

Physiological:

Slurred speech, Involuntary eye movement, Lost

control of bodily movement, Warm feeling, Dilated

pupils, Reddened conjunctivae, Flushed face

Psychological:

Reduced anxiety, Euphoria/dysphoria, Increased

confidence, Assertiveness, Emotions

Other Functional Effects:

Impaired judgement, Motor skills, Reaction

time, Reduced attention span

Overdose

Physiological: Loss of the ability to create new memories,

Involuntary eye movement, Nausea, Vomiting,

Respiratory depression, Insufficient blood in the

arteries, Gag reflex suppression, Fainting, Seizures,

Unconsciousness, Death

Increased chances of getting hurt

Memory blackout

Anxiety and/or depression

Irritability

Restlessness

Reduced reaction time

Copyright 2018, University of Pittsburgh. All Rights Reserved.

References

Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide. Retrieved from https://www.dea.go v/pr/multimedia-library/publications/d rug_of _abuse.pdf

Douaihy, A. & Daley, D., (Eds.). (2013). Pittsburgh Pocket Psychiatry Series: Substance Use Disorders. New York, NY: Oxford Universi ty Press.

Koob, G. F., Arends, M. A., & Moal, M. L. (2014). Drugs, addiction, and the brain(1st ed.). Oxford: Academic Press, an imprint of Elsevier.

National Institute on Alcohol Abuse and Alcoholism. (2018). Alcohol Use Disorder. Retrieved from https://www.niaaa.nih.go v/al cohol-health /overview- alcohol-consumption/alcohol-use-disorders

NIAAA. (2015). Alcohol Overdose: The Dangers of Drinking Too Much. https://pubs.niaaa.nih.gov/publications/alcoholoverdosef actsheet/o verdosefact .htm

Ries, R.K., Fiellin, D.A., Miller, S.C., &Saitz, R. (2011). Principles of Addiction Medicine (4th Ed). Philadelphia, PA: Lippincott Williams & Wilkins

SAMHSA. (2016). Results from the 2015 National Survey on Drug Use and Health (NSDUH): Summary of National Findings. Office of Applied Studies. Rockville, MD.

Babor et al., 2016

https://www.dea.gov/pr/multimedia-library/publications/drug_of_abuse.pdf



https://pubs.niaaa.nih.gov/publications/alcoholoverdosefactsheet/overdosefact.htm

Alcohol

Contraindications

Pharmacology

Street Names: Booze, Sauce, Suds, Alc

GABA receptor agonist; NMDA receptor antagonist

Other: Vitamin deficiency, osteoporosis,

gout, telangiectasia, death

Health Consequences

Physiological: Slurred speech, nystagmus, ataxia, warm feeling, mydriasis, reddened

conjunctivae, flushed face

Psychological: Reduced anxiety, euphoria/dysphoria, increased confidence, assertiveness,

and emotions

Executive function: Impaired judgement, motor skills, and reaction time, reduced attention

span

Physiological: Anterograde amnesia (“blacking out”), nystagmus, nausea, vomiting, respiratory depression, hypoxia, hypothermia, gag reflex suppression, syncope, seizures,

unconsciousness, death

Physiological: Tremor, insomnia, anorexia, nausea, headache, tachycardia, hypertension,

hyperthermia

Psychological: Anxiety, dysphoria

Rare cases: Delirium tremens, seizures, hallucinations

Onset: 6-24 hours (may present before blood alcohol is zero); Duration: 24-48 hours

Intoxication

Overdose

Withdrawal


Peripheral Neuropathy

(Burning/stabbing/tingling)

Increased risk of pneumonia

and other infections

Cirrhosis, liver disease

Women: Amenorrhea, early

menopause, spontaneous abortion

Men: Impotence

Peripheral Neuropathy

Anxiety, depression, sleep disorder, headache,

memory loss, slower reaction time, stroke Flushed face, reddened conjunctivae

Hypertension, arrhythmia,

cardiomyopathy

GI inflammation and bleeding,

GERD, ulcers, pancreatitis

Cancer: Mouth, throat, liver, breast,

pancreatic

References Douaihy, A. & Daley, D., (Eds.). (2013). Pittsburgh Pocket Psychiatry Series: Substance Use Disorders. New York, NY: Oxford Universi ty Press.


NIAAA. (2015). Alcohol Overdose: The Dangers of Drinking Too Much. https://pubs.niaaa.nih.gov/publications/alcoholoverdosefactsheet/overdosefact.htm



Babor et al., 2016


https://pubs.niaaa.nih.gov/publications/alcoholoverdosefactsheet/overdosefact.htm

Benzodiazepines

Short-Term Effects

What are Benzodiazepines and How Do They Work?

Street Names: Xanies, Downers, Tranks, Benzos.

Benzodiazepines are prescription depressants

that are normally used to treat anxiety and insomnia.

Long-Term Effects

How are they taken?


Benzodiazepines are tablets or an injectable syrup.

They can be taken orally, injected, or crushed and snorted.

Increased risk of lost

cognitive functioning

and Alzheimer’s, Loss of the ability

to create new memories,

Learning impairments,

Emotional lability,

Physical harm

resulting from falls,

Overdose death

when used with

other substances,

especially opioids

Intoxication

Physiological:

Slurred speech, Lost control of bodily

movement, Loss of the ability to create new

memories, Dizziness, Sleepiness


Poor concentration, Confusion

Overdose

Physiological:

Acute state of confusion, Stupor, Suspension

of breathing, Coma, Death

Loss of memories

Aggressive behavior

Irritability

Dilated pupils

Vivid or disturbing dreams

Shallow respiration

Clammy skin


References


Longo, L.P., & Johnson, B. (2000). Addiction: Part 1. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61: 2121-2128.

http://www.aafp.org/afp/2000/0401/p2121.html







Benzodiazepines

Contraindications

Pharmacology

Street Names: Xanies, Downers, Tranks, Benzos

GABA receptor agonists

Other: Physical harm resulting from falls,

overdose death when used with other

substances – especially opioids

Anterograde amnesia, learning

impairments, emotional lability

Possible increased risk of

developing dementia

and Alzheimer's

Health Consequences

Physiological: Slurred speech, ataxia, anterograde amnesia, dizziness, drowsiness

Executive function: Poor concentration, confusion

Physiological: Delirium, stupor, apnea, coma, death

Physiological: Tremor, headache, nausea, anorexia, insomnia, tachycardia, hypertension,

seizure with rapid withdrawal

Psychological: Anxiety, irritability, psychosis

Executive function: Impaired concentration

Intoxication

Overdose

Withdrawal

Commonly misused: Xanax® (alprazolam), Klonopin® (clonazepam), Valium® (diazepam)

Benzodiazepines can be taken injected.


References Longo, L.P., & Johnson, B. (2000). Addiction: Part 1. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61: 2121-2128. http://www.aafp.org/afp/2000/0401/p2121.html





Cocaine

Short-Term Effects

What is Cocaine and How Does It Work?

Street Names: Coke, Crack, Snow, Bump, Toot.

Cocaine is a stimulant.

Long-Term Effects

How is it taken?


Cocaine can come in a variety of forms: Powder (cocaine),

chunks (freebase or crack-cocaine), salt crystals (cocaine hydrochloride).

It can be injected, snorted, or smoked.

Chest pain, Irregular heartbeat,

Ischemic heart disease,

Heart attack,

Deep vein thrombosis,

High blood pressure,

Pulmonary edema, Asthma,

Nasal and oral lesions,

Sense of smell dysfunction,

Septal perforation

Headaches, Seizures,

Insomnia,

Nerve cell damage,

Central nervous system damage,

Stroke

Malnutrition,

Increased risk of

infection and cancer,

Death,

Men: Impotence

Women: Infertility

Intoxication: Duration of 20-45 minutes

Physiological:

Increased heart rate and blood pressure,

Dilated pupils, Brisk reflexes, Muscle

spasms, Impotence

Psychological:

Euphoria, Anorexia, Anxiety, Paranoia

Overdose

Physiological:

High blood pressure, Constricted blood

vessels, Fast heart rate, Heart attack, Stroke,

Seizure, Death

Psychological:

Extreme paranoia, Hallucinations

Intense euphoric effect

Increased alertness and excitation

Restlessness

Irritability

Anxiety

Paranoia


References

Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Primary Care, 3 8(1), 41–58.

http://doi.org/10.1016/j.pop.2010.11.004

Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide. Retrieved from https://www.dea.gov/pr/mult imedia-lib rary/public ations/drug_of _abuse.pdf



Shappell, C.M., Crieger, T.A., & Warden, D.L. (1997). Medical complications of cocaine abuse: Substance Abuse Update. Elsevier, 2(2): 34 -38.

http://www.griegermd .com/grieger%20articles%20and%20chapters/M edical%20Complic ations%20Cocain e%20Abuse.pdf


http://doi.org/10.1016/j.pop.2010.11.004




http://www.griegermd.com/grieger articles and chapters/Medical Complications Cocaine Abuse.pdf

Cocaine

Contraindications

Pharmacology

Street Names: Coke, Crack, Snow, Bump, Toot

Inhibits monoamine reuptake transporters causing increased levels of dopamine, norepinephrine and serotonin.

Other: Malnutrition, increased risk of infection

and cancer, death

Headaches, seizures, insomnia

demyelination, central nervous

system atrophy, stroke

Angina, arrhythmias, coronary artery disease,

myocardial infarction, deep vein thrombosis,

hypertension

Men: Impotence

Women: Infertility

Pulmonary edema, asthma

Nasal and oral lesions, olfaction

dysfunction, septal perforation

Health Consequences

Physiological: Increased HR and BP, mydriasis, brisk reflexes, muscle spasms, impotence

Psychological: Euphoria, anorexia, agitation, paranoia

Duration: 20-45 minutes

Physiological: Hypertension, vasoconstriction, tachycardia, myocardial infarction, stroke,

seizure, death

Physiological: Polyphagia, insomnia, cravings, myalgia, tremor, fatigue

Psychological: Dysphoria, depression, anxiety, irritability

Executive function: Difficulty concentrating

Intoxication

Overdose

Withdrawal

Common Forms of Cocaine: Cocaine (powder), freebase cocaine, crack-cocaine, cocaine hydrochloride

Cocaine can be smoked, snorted, or injected.


References Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Primar y Care, 38(1), 41–58. http://doi.org/10.1016/j.pop.2010.11.004



Shappell, C.M., Crieger, T.A., & Warden, D.L. (1997). Medical complications of cocaine abuse: Substance Abuse Update. Elsevie r, 2(2): 34-38.

http://www.griegermd.com/grieger%20articles%20and%20chapters/Medical%20Complications%20Cocaine%20Abuse.pdf



http://doi.org/10.1016/j.pop.2010.11.004

http://www.griegermd.com/grieger articles and chapters/Medical Complications Cocaine Abuse.pdf

DMT (N,N-dimethyltryptamine)

Pharmacology

Street Names: Dimitri, DMT, Businessman's Trip

Endogenous sigma-1 receptor agonist; some effect on serotonergic (5-HT) receptors.

Hypertension, tachycardia

Seizures, dizziness

Health Consequences

Physiological: Relaxed feeling, increased BP, mydriasis, nausea

Psychological: Hallucinations, bodily dissociation, anxiety, depression, paranoia, and/or

suicidal or homicidal ideation

High doses: Coma and respiratory arrest

Withdrawal signs and symptoms have not been observed in association with DMT.

Intoxication

Overdose

Withdrawal

DMT was first found in Amazonian hallucinogenic plant mixtures that were being used as snuff.


Rhabdomyolysis,

acute renal failure

References NIDA. (2017). Drug Facts. https://www.drugabuse.gov/publications/finder/t/160/DrugFacts



https://www.drugabuse.gov/publications/finder/t/160/DrugFacts

DXM (Dextromethorphan)

Pharmacology

Street Names: Lean, syrup, purple drank, robo-tripping

At therapeutic doses - sigma-1 agonist; At high doses - NDMA antagonist

Cognitive dysfunction,

amnesia, serotonin

syndrome, insomnia, vertigo

Health Consequences

Stage 1(1.5-2.5 mg/kg): Increased alertness, restlessness, visual/auditory sensitization,

generalized euphoria

Stage 2 (2.5-7.5 mg/kg): Auditory/visual sensations, then periods of deprivations, imbalance,

hallucinations, increased energy/excitability

Stage 3 (7.5-15 mg/kg): Visual/auditory sensations, periods of semi-consciousness, delayed

reaction/response time, impaired cognitive ability, mania, partial dissociation

Stage 4 (>15 mg/kg): Complete dissociation, hallucinations, ataxia

Physiological: Tachycardia, hypertension, syncope, seizure, respiratory depression, stupor,

coma, death

Physiological: Craving, insomnia

Psychological: Dysphoria

Intoxication

Overdose

Withdrawal

DXM can be taken orally or injected.


Constipation

Other: Death

References Brick, J. (2012). Handbook of the medical consequences of alcohol and drug abuse (2nd ed.). New York: Routledge.

Burns, J. M., & Boyer, E. W. (2013). Antitussives and substance abuse. Substance Abuse and Rehabilitation, 4, 75-82. doi:10.2147/SAR.S36761

Romanelli, F., & Smith, K. M. (2009). Dextromethorphan abuse: Clinical effects and management. Journal of the American Pharmacists Association, 49(2), E20-E27. doi:10.1331/japha.2009.08091


Gamma-Hydroxybutyric Acid (GHB)

/ Rohypnol®(flunitrazepam)

Contraindications

Pharmacology

Street Names: Roofies, roofenol, liquid X, Mexican Valium, date rape drug

GABA receptor agonists

Other: Death

Anterograde amnesia,

emotional lability Anxiety, depression, seizures

Health Consequences

Physiological: Slurred speech, ataxia, anterograde amnesia, dizziness, nausea, drowsiness

Psychological: Euphoria, hallucinations

Executive function: Confusion, poor concentration

Physiological: Respiratory depression, coma, death

Physiological: Nausea, abdominal cramps, headache, insomnia, tremor, seizures, delirium

Psychological: Anxiety, depression, agitation, hallucinations

Intoxication

Overdose

Withdrawal


References

GHB Drug: Effects, Hazards & Methods of Abuse. (2017). Retriev ed October 04, 2017, from https://www.drugs.com/illicit/ghb.html Rohypnol: Effects, Hazards & Methods of Abuse. (2017). Retriev ed October 04, 2017, from https://www.drugs.com/illicit/rohypnol.html

Drugs.com, 2017

Treatment for Rohpynol Withdraw al, 2017


https://www.drugs.com/illicit/ghb.html

https://www.drugs.com/illicit/ghb.html

Heroin

Short-Term Effects

What is Heroin and How Does It Work?

Street Names: Big H, Black Tar, Chiva, Hell Dust, Horse, Negra, Smack, Thunder

Heroin is s a highly addictive depressant and it is a rapidly acting opioid.

Long-Term Effects

How is it taken?


Heroin can come in several forms: primarily white powder from Mexico and South America; and

“black tar” and brown powder from Mexico. It can be taken injected, smoked, or snorted.



Inner heart infection,

Infection,

Fluid in the lungs,

Blood clot in the lungs,

Asthma, Seizures,

Rapid destruction of

skeletal muscle,

Kidney inflammation,

Renal disease,

Serotonin syndrome,

Suppressed gag reflex,

Men: Impotence

Women: absence of

Menstrual periods

Malnutrition,

Ion imbalance, Death

Intoxication

Physiological:

Absence of sense of pain, Constriction of the

pupil, Sleepiness, Slow heart rate,

Unresponsive state, Nausea, Vomiting, Low

blood pressure, Reduced body temperature

, Relaxed state (“nodding”) Psychological:

Euphoria

Overdose

Physiological:

Constriction of the pupil, Slow heart rate,

Unresponsive state, Low blood pressure,

Blue/grey lips, fingertips, and/or skin,

Coma, Death

Classic triad:

Pinpoint pupils, Unconsciousness,

Respiratory depression

Euphoria or “rush”


Nausea

Warm flushing of the skin

Sleepiness

Constricted pupils


References

Douaihy, A. & Daley, D., (Eds.). (2013). Pittsburgh Pocket Psychiatry Series: Substance Use Disorders. New York, NY: Oxford Universi ty Press.


Gowing, L., Ali, R., & White, J. M. (2009). Buprenorphine for the management of opioid withdrawal. Cochrane Database of Systematic Reviews, (3), cd002025. doi:10.1002/14651858.cd002025.pub4



University of Michigan. (2015, October 26). Introduction to Psychology. Retrieved October 04, 2017, from http://open.lib.umn.edu/intropsyc/chapter/5-2-altering-consciousness-with-psychoactive-

drugs/

Yaksh, T. L., & Wallace, M. S. (2011). Chapter 18: Opioids, Analgesia, and Pain Management. In L. L. Brunton, B. A. Chabner, & B. C. Knollman (Eds.), Goodman & Gilman's: The Pharmacological Basis

of Therapeutics(12th ed.). New York, NY: McGraw-Hill. Retrieved September 5, 2017, from http://accessmedicine.mhmedical.com/content.aspx?bookid=1613§ionid=102158872




http://open.lib.umn.edu/intropsyc/chapter/5-2-altering-consciousness-with-psychoactive-drugs/













Inhalants

Contraindications

Pharmacology

Street Names: Poppers, Duster, Laughing Gas, Whippits

Varies depending on inhalant composition; highly lipid soluble (easily cross blood-brain barrier), onset is rapid

Other: Lead poisoning,

anorexia/malnutrition, peripheral

neuropathy, sudden death

Chronic headache,

dementia, impaired

concentration and

memory, depression

Perioral dermatitis

Health Consequences

Physiological: Euphoria (“rush”) followed by lightheadedness and perceptual changes (effects only last a few minutes), somnolence, slurred speech, nystagmus, headache, nausea,

diarrhea, coughing, sneezing

Physiological: Seizure, cardiac arrest, coma, sudden death

Physiological: Fatigue, tremor, headache, cravings

Psychological: Depressed mood, anxiety, irritability

Intoxication

Overdose

Withdrawal

Commonly forms: Inhalants are inhaled volatile compounds found in glue, fuel, paint, and aerosol propellants.


Renal failure

Bone marrow suppression

References NIDA. (2017). Drug Facts. https://www.drugabuse.gov/publications/finder/t/160/DrugFacts



Ketamine

Contraindications

Pharmacology

Street Names: Special K, Vitamin K

NMDA antagonist

Rhabdomyolysis, end-

organ kidney damage

Health Consequences

Physiological: Slurred speech, ataxia, dizziness, apnea, increased HR and BP

Psychological: Hallucinations, bodily dissociation

Physiological: Tachycardia, hypertension, stupor, respiratory depression, coma, death

Physiological: Insomnia, tachycardia, hypertension, headache, hypersensitivity to stimuli,

disordered perceptions

Psychological: Dysphoria, severe anxiety, psychosis

Intoxication

Overdose

Withdrawal


Apathy, impaired

memory and cognition,

depression,

schizophrenia, delusion

LUTS (Lower Urinary Tract Symptoms)

Other: Death

References


Kalsi, S. S., Wood, D. M., & Dargan, P. I. (2011). The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerging Health Threats Journal, 4, doi: 10.3402/ehtj.v4i0.7107


LSD (Lysergic Acid Diethylamide)

Contraindications

Pharmacology

Street Names: Acid, Sunshine, Elvis, Lucy in the Sky

Most significant effects as a 5-HT2aR agonist

Personality changes, emotional

lability, flashbacks, anxiety,

depression, insomnia

Risk of developing

depersonalization/derealization

syndrome or post-hallucinogen

perceptual disorder

Health Consequences

Physiological: Audio-visual synesthesia, perceptual distortions, mydriasis, increased HR, BP,

and temperature

Psychological: Emotional lability, confusion, anxiety, paranoia, panic attacks, suicidal or

homicidal ideation, euphoria, closeness to others, hallucinations,

depersonalization/derealization

Executive function: Impaired judgement

Duration: 8-12 hours

Little evidence of overdose

Doses 1,000x higher than street doses: hyperthermia

Withdrawal signs and symptoms have not been observed in association with LSD.

Intoxication

Overdose

Withdrawal

LSD is synthesized from lysergic acid, which is found in the ergot fungus that grows on grains.

LSD can be taken orally.


References

Abraham, H. D., & Aldridge, A. M. (1993). Adverse consequences of lysergic acid diethylamide. Addiction, 88(10), 1327 -1334. doi:10.1111/j.1360-0443.1993.tb02018.x

Gable, R.S. (2004). Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction, 99(6): 686 -696. doi: 10.1111/j.1360-0443.2004.00744.x

NIDA. (2017). Drug Facts. https://www.drugabuse.go v/public ations/finder/t/160/DrugFacts



Schmid, Y., Enzler, F., Gasser, P., Grouzmann, E., Preller, K. H., Vollenweider, F. X., . . . Liechti, M. E. (2015). Acute Effects of Lysergic Acid Diethylamide in Healthy Subjects. Biological Psychiatry,

78(8), 544-553. doi:10.1016/j.biopsych.2014.11.015



Marijuana

Contraindications

Pharmacology

Street Names: Weed, Bud, Green, Grass, Ganja, Pot, Mary Jane

The psychoactive drug in marijuana, tetrahydrocannabinol (THC), is a cannabinoid receptor (CB 1 and CB2) agonist.

Other: Increased risk of hepatitis C

disease progression, infection

Reduced brain volume,

sleep disturbances Poor oral health

Health Consequences

Physiological: Polyphagia, reddened conjunctivae, xerostomia, heightened sensitivity,

increased HR and BP, orthostatic hypotension, postural syncope, distorted perception of

colors, sounds, space, and time

Psychological: Euphoria, decreased anxiety (some users may experience increased anxiety

and paranoia)

Executive function: Impaired concentration, memory, and motor function

No evidence

Physiological: Restlessness, insomnia, anorexia, tremor, headache, cough

Psychological: Anxiety, depressed mood, irritability

Intoxication

Overdose

Withdrawal

Most marijuana comes from the Cannabis sativa plant.

Marijuana can be smoked, vaporized and inhaled, or eaten.


Bladder cancer

Cough, respiratory cancer,

chronic inflammation

References Ashton, C.H. (2001). Pharmacology and effects of cannabis: a brief review. British Journal of Psychiatry, 178(2): 101-106. doi: 10.1192/bjp.178.2.101


Nierenberg, C. (2015, June 15). Marijuana 'Dabbing' Is 'Exploding onto the Drug-Use Scene'. Retrieved October 04, 2017, from https://www.livescience.com/51202-marijuana-dabbing-trend.html



Stokes, P. R., Egerton, A., Watson, B., Reid, A., Lappin, J., Howes, O. D., . . . Lingford-Hughes, A. R. (2011). History of cannabis use is not associated with alterations in striatal dopamine D2/D3 receptor availabi lity. Journal of

Psychopharmacology, 26(1), 144-149. doi:10.1177/0269881111414090


https://www.livescience.com/51202-marijuana-dabbing-trend.html







MDMA (Methylenedioxymethamphetamine)

Short-Term Effects

What is MDMA and How Does It Work?

Street Names: Ecstasy, X, Molly.

MDMA is structurally related to methamphetamine and mescaline, and thus exhibits both

hallucinogenic and stimulant properties.

Long-Term Effects

How is It taken?


MDMA is distributed in tablets, capsules, powder, and liquid forms.

They can be taken orally, smoked, or crushed and snorted.


Bleeding, Heart attack,

Rapid heartbeat,

Nervous system disease,

Degeneration,

Liver failure,

Long-term damage

affecting thought,

memory, and pleasure,

Chemical-driven

liver damage,

Kidney failure

Rapid destruction

of skeletal muscle,

Severe dehydration,

Low sodium levels

in the blood,

Malnutrition

Intoxication

Physiological:

Increased heart rate, blood pressure, energy,

warmth, and relaxation, Heightened perceptions

of sound, color, and touch, Jaw clenching, Muscle

tension, Tremor, Insomnia, Eating disorder,

Headache, Nausea, Sweating, Chills, Blurred

vision

Psychological:

Euphoria, Anxiety, Paranoia

Overdose

Physiological:

Elevated body temperature, Fast heartbeat, High

blood pressure, Bleeding, Muscle cramping,

Faintness, Seizures

Psychological:

Panic attacks

Anxiety and depression

Confusion

Paranoia

Sleep problems

Drug craving

Faintness


References


Green, A. R., Mechan, A. O., Elliot, J. M., O'Shea, E., & Colado, M. I. (2003). The Pharmacology and Clinical Pharmacology of 3,4-Methylenedioxymethamphetamine (MDMA,

"Ecstasy"). Pharmacological Reviews,55(3), 463-508. doi:10.1124/pr.55.3.3

Kalant, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ: Canadian Medical Association Journa l, 165(7), 917–928.






MDMA (Methylenedioxymethamphetamine)

Contraindications

Pharmacology

Street Names: Ecstasy, X, Molly

Inhibitor of monoamine transporters, causing increased serotonin, norepinephrine, and dopamine concentrations; 5-HT agonist

Other: Severe dehydration,

hyponatremia, malnutrition

Demyelination, degeneration;

Long-term damage affecting

thought, memory, and pleasure

Rhabdomyolysis, kidney failure

Health Consequences

Physiological: Increased HR, BP, energy, warmth, and relaxation, heightened perceptions of sound, color, and touch, jaw clenching, muscle tension, tremor, insomnia, anorexia,

headache, nausea, diaphoresis, chills, blurred vision Psychological: Euphoria, anxiety, paranoia

Physiological: Hyperthermia, tachycardia, hypertension, hemorrhages, muscle cramping,

faintness, seizures

Psychological: Panic attacks

Physiological: Fatigue, anorexia

Psychological: Depression

Intoxication

Overdose

Withdrawal


Hepatotoxicity, liver failure Arrhythmias, hemorrhage, cardiac arrest,

myocardial infarction, Long QT Syndrome

References

Green, A. R., Mechan, A. O., Elliot, J. M., O'Shea, E., & Colado, M. I. (2003). The Pharmacology and Clinical Pharmacology of 3,4-Methylenedioxymethamphetamine (MDMA,

"Ecstasy"). Pharmacological Reviews,55(3), 463-508. doi:10.1124/pr.55.3.3

Kalant, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ: Canadian Medical Association Journa l, 165(7), 917–928.




Mescaline

Contraindications

Pharmacology

Street Names: Peyote, Cactus, Buttons

5-HT receptors agonist

Nausea, vomiting, diarrhea

Health Consequences

Physiological: Audio-visual synesthesia, altered perception of space and time, increased

body temperature, headache, myasthenia, nausea, mydriasis

Psychological: Hallucinations, euphoria

Low to moderate doses: Increased HR and BP

High doses: Decreased BP, bradycardia, and respiratory depression

Onset: 30 minutes


Overdose Death for Mescaline is rare.

Withdrawal signs and symptoms have not been observed in association with Mescaline.

Intoxication

Overdose

Withdrawal


Rare cases of anxiety, paranoia and

emotional lability

References

Brick, J. (2012). Handbook of the medical consequences of alcohol and drug abuse (2nd ed.). New York: Routledge.

Halpern, J. H., Sherwood, A. R., Hudson, J. I., Yurgelun-Todd, D., & Pope, H. G. (2005). Psychological and cognitive effects of long-term peyote use among Native Americans. Biological

psychiatry, 58(8), 624-631. doi: 10.1016/j.biopsych.2005.06.038



Methamphetamine

Short-Term Effects

What is Methamphetamine and How Does It Work?

Street Names: Meth, Speed, Crank, Ice, Crystal.

Methamphetamine is a stimulant similar to cocaine.

Long-Term Effects

How is it taken?


“Meth” can come in a variety of forms: tablets, capsules, powder, or crystal. It can be injected, snorted, smoked, or swallowed.

Rapid tooth decay, oral lesion

Chest pain

Irregular heartbeat

Heart attack

High blood pressure

Brain damage

Men: Impotence

Women: Infertility

Malnutrition

Death

Intoxication: Duration of 8-12 Hours

Physiological:

Increased energy, alertness, heart rate,

blood pressure, and body temperature

Psychological:

Intensive excitement or happiness

(euphoria), anorexia, paranoia


Confusion, aggressive/violent behavior

Overdose

Physiological:

Stroke, kidney failure, heart attack, chest

pain, tremors, elevated body temperature,

high blood pressure, rapid heart rate,

seizures, delirium, death

Psychological:

Extreme paranoia, hallucinations

Picking at skin or hair

Dilated pupils

Rapid eye movement

Reduced appetite

Sleep loss

Sudden outbursts or extreme mood swings


References

Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Primary Care, 3 8(1), 41–58.

http://doi.org/10.1016/j.pop.2010.11.004

Darke, S., Kaye, S., Mcketin, R., & Duflou, J. (2008). Major physical and psychological harms of methamphetamine use. Drug and Alcohol Review, 27(3), 253-262. doi:10.1080/09595230801923702

Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide. Retrieved from https://www.dea.gov/pr/mult imedia-lib rary/public ations/drug_of _abuse.pdf



Scott, J. C., Woods, S. P., Matt, G. E., Meyer, R. A., Heaton, R. K., Atkinson, J. H., & Grant, I. (2007). Neurocognitive Eff ects of Methamphetamine: A Critical Review and Meta-

analysis. Neuropsychology Review,17(3), 275-297. doi:10.1007/s11065-007-9031-0


http://doi.org/10.1016/j.pop.2010.11.004




Methamphetamine

Contraindications

Pharmacology

Street Names: Meth, Speed, Crank, Ice, Crystal

Taken up by monoamine reuptake transporters causing the release of dopamine, norepinephrine and serotonin.

Other: Malnutrition, infections, cancers, death

Rapid tooth decay, oral lesions

Angina, arrhythmias, coronary artery disease,

myocardial infarction, deep vein thrombosis,

hypertension

Men: Impotence

Women: Infertility

Pulmonary hypertension

Brain damage, psychosis, insomnia,

demyelination, central nervous

system atrophy, stroke

Health Consequences

Physiological: Increased energy, alertness, HR, BP, and body temperature

Psychological: Euphoria, anorexia, paranoia

Executive function: Confusion, aggressive/violent behavior


Physiological: Stroke, renal failure, myocardial infarction, chest pain, tremors, hyperthermia,

hypertension, tachycardia, seizures, delirium, death

Psychological: Extreme paranoia, hallucinations

Physiological: Fatigue, craving

Psychological: Dysphoria, depression, irritability, anxiety

Executive function: Poor concentration

Intoxication

Overdose

Withdrawal

“Meth” can come in a variety of forms, including tablets, capsules, powder, or crystal.

It can be injected, snorted, smoked, or swallowed.


References Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Primary Care, 3 8(1), 41–58. http://doi.org/10.1016/j.pop.2010.11.004

Darke, S., Kaye, S., Mcketin, R., & Duflou, J. (2008). Major physical and psychological harms of methamphetamine use. Drug and Alcohol Review, 27(3), 253-262. doi:10.1080/09595230801923702



Scott, J. C., Woods, S. P., Matt, G. E., Meyer, R. A., Heaton, R. K., Atkinson, J. H., & Grant, I. (2007). Neurocognitive Effects of Methamphetamine: A Critical Review and Meta-analysis. Neuropsychology Review,17(3), 275-297.

doi:10.1007/s11065-007-9031-0

Substance Abuse and Mental Health Services Administration. (2016). Results from the 2015 National Survey on Drug Use and Health (NSDUH): Summary of National Findings. Office of Applied Studies. Rockville, MD.


http://doi.org/10.1016/j.pop.2010.11.004

Nicotine

Contraindications

Pharmacology

Street Names: Smokes, Cigs, Chew, Dip

Nicotinic cholinergic receptor agonist, releasing large levels of dopamine among other neurotransmitters

Other: Increased risk of diabetes,

infections, and cancers, death

Cataracts Stroke

Health Consequences

Physiological: Rush of pleasure and energy (“buzz”), relaxation, dizziness, headache, increased HR and BP

Stage 1: Tachycardia, hypertension, tachypnea, diaphoresis, tremor, nausea, ataxia, seizure

Stage 2: Bradycardia, hypotension, respiratory depression, possible coma and death

Physiological: Restlessness, polyphagia, cravings, constipation, bradycardia

Psychological: Irritability, anxiety, depression

Executive function: Decreased concentration

Onset: 6-12 hours; Peak:1-3 days; Taper: 7-30 days; Duration: Occasional lifelong cravings

Intoxication

Overdose

Withdrawal

Commonly misused: Cigarettes, cigars, hookah, chewing tobacco, e-cigarettes, snuff

Nicotine can be smoked or chewed.


Gingivitis, periodontitis,

tooth loss, oral and

esophageal cancer

COPD, bronchitis,

emphysema, pneumonia,

lung cancer

Coronary artery disease,

cardiovascular disease,

deep vein thrombosis

Men: Impotence

Women: Infertility, birth defects

References Benowitz, N.L. (2008). Clinical Pharmacology of Nicotine: Implications for Understanding, Preventing, and Treating tobacco Addiction. Clinical Pharmacology & Therapeutics, 83(4): 531-541. doi: 10.1038/clpt.2008.3

CDC. (2016, December 01). Smokeless Tobacco: Health Effects. Retrieved September 28, 2017, from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/health_effects/index.htm

CDC. (2017, May 15). Smoking & Tobacco Use. Retrieved September 28, 2017, from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm


NIDA. (2012, July). What Are the Medical Consequences of Tobacco Use? Retrieved September 28, 2017, from https://www.drugabuse.gov/publications/research-reports/tobacco/what-are-medical-consequences-tobacco-use


Schep, L. J., Slaughter, R. J., & Beasley, D. M. (2009). Nicotinic plant poisoning. Clinical Toxicology, 47(8), 771-781. doi:10.1080/15563650903252186


https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/health_effects/index.htm

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

https://www.drugabuse.gov/publications/research-reports/tobacco/what-are-medical-consequences-tobacco-use













Opiates/Opioids

Short-Term Effects

What are Opiates/Opioids and How Do They Work?

Street Names: Oxy, Vikes, Percs.

Opiates/Opioids are prescription depressants. Natural opiates are derived from the resin of

opium, Opioids are artificially made to mimic opiate actions.

Long-Term Effects

How are they taken?


Opiates/Opioids can come in a variety of forms: pills, liquids, or suckers to take by mouth, and in

shot, skin patch, and suppository form.

They can be taken orally, injected, or snorted.



Inner heart infection,

Infection,

Fluid in the lungs,

Blood clot in the lungs,

Asthma, Seizures,

Rapid destruction of

skeletal muscle,

Kidney inflammation,

Renal disease,

Serotonin syndrome,

Suppressed gag reflex,

Men: Impotence

Women: absence of

Menstrual periods

Malnutrition,

Ion imbalance, Death

Intoxication

Physiological:

Absence of sense of pain, Constriction of the

pupil, Sleepiness, Slow heart rate,

Unresponsive state, Nausea, Vomiting, Low

blood pressure, Reduced body temperature

, Relaxed state (“nodding”) Psychological:

Euphoria

Overdose

Physiological:

Constriction of the pupil, Slow heart rate,

Unresponsive state, Low blood pressure,

Blue/grey lips, fingertips, and/or skin,

Coma, Death

Classic triad:

Pinpoint pupils, Unconsciousness,


Euphoria

Relaxed state

Shallow breathing

cold and clammy skin

Sleepiness

Pinpoint pupils







University of Michigan. (2015, October 26). Introduction to Psychology. Retrieved October 04, 2017, from http://open.lib.umn.edu/intropsyc/chapter/5-2-altering-consciousness-with-psychoactive-

drugs/

Yaksh, T. L., & Wallace, M. S. (2011). Chapter 18: Opioids, Analgesia, and Pain Management. In L. L. Brunton, B. A. Chabner, & B. C. Knollman (Eds.), Goodman & Gilman's: The Pharmacological Basis

of Therapeutics(12th ed.). New York, NY: McGraw-Hill. Retrieved September 5, 2017, from http://accessmedicine.mhmedical.com/content.aspx?bookid=1613§ionid=102158872

















Opiates/Opioids

Pharmacology

Street Names: Oxy, Vikes, Percs

Most are µ-opioid receptor agonists, and mimic endorphin activity.

Other: malnutrition, ion

imbalance, death

Suppressed gag reflex Serotonin syndrome, seizures

Health Consequences

Physiological: Analgesia, miosis, somnolence, bradycardia, stupor, nausea, vomiting,

hypotension, hypothermia, relaxed state (known as “nodding”) Psychological: Euphoria

Heroin high: “Rush” lasting a few minutes after injection and an extended “high”(extreme calm) lasting a few hours before withdrawal symptoms

Physiological: Miosis, bradycardia, stupor, hypotension, blue/grey lips, fingertips, and/or

skin, coma, death

Classic triad: Pinpoint pupils, unconsciousness, respiratory depression

Physiological: Tachycardia, hypertension, hyperthermia, chills, diaphoresis, yawning,

tremor, myalgia, nausea, vomiting, abdominal cramps, diarrhea, rhinorrhea, fatigue,

insomnia, lacrimation

Psychological: Irritability, anxiety, dysphoria

Acute onset: 4-12 hours; Peak onset: 2-4 days; Peak symptoms: Dysphoric state, abnormal

physiological functioning, malaise, and intense, sporadic cravings that can continue for

months

Intoxication

Overdose

Withdrawal

Commonly misused: Codeine, Fentanyl, Heroin, Hydrocodone, Hydromorphone, Methadone, Morphine,

Oxycodone, Oxymorphone.

Opiates / Opioids can be taken orally or injected.


Infection, pulmonary edema,

pulmonary embolism, asthma

Rhabdomyolysis,

glomerulonephritis,

renal disease

Coronary artery disease,

arrhythmias, endocarditis

Men: Impotence

Women: Amenorrhea





University of Michigan. (2015, October 26). Introduction to Psychology. Retrieved October 04, 2017, from http://open.lib.umn.edu/intropsyc/chapter/5-2-altering-consciousness-with-psychoactive-drugs/

Yaksh, T. L., & Wallace, M. S. (2011). Chapter 18: Opioids, Analgesia, and Pain Management. In L. L. Brunton, B. A. Chabner, & B. C. Knollman (Eds.), Goodman & Gilman's: The Pharmacological Basis of Therapeutics(12th ed.). New

York, NY: McGraw-Hill. Retrieved September 5, 2017, from http://accessmedicine.mhmedical.com/content.aspx?bookid=1613§ionid=102158872















Phencyclidine (PCP)

Short-Term Effects

What is PCP and How Does It Work?

Street Names: Angel Dust, Hog

PCP is a synthetically produced hallucinogen.

Long-Term Effects

How is It taken?


Liquid PCP is often sprayed on cannabis or tobacco, and it could also be taken in pill form.

PCP can be taken orally, smoked, snorted or injected.

Profuse discharge of blood,

Impaired memory,

Paranoia,

Sleeplessness,

Violent behavior,

Seizures,

Rapid destruction

of skeletal muscle,

Acute renal failure,

Death

Intoxication

Physiological:

Excessive production of saliva, Sweating,

Increased heart rate and blood pressure

Psychological:

Hallucinations, Delusions, Social

disinterest, Confusion, Psychosis,

Dissociation of body and reality

Overdose

Physiological:

High blood pressure, Fast resting heart

rate, Elevated body temperature, Seizures,

Respiratory arrest, State of near-

unconsciousness, Coma, Death

State of intense happiness

Anxiety

Memory loss

Lost control of movement

Hallucinations

Nausea


References



National Institute on Drug Abuse. (2015). Hallucinogens and dissociative drugs. Retrieved from https://d14rmgtrwzf5a.cloudfront.net/sites/d efault/files/hallucinogensrrs4.pdf


https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/hallucinogensrrs4.pdf

Phencyclidine (PCP)

Contraindications

Pharmacology

Street Names: Angel Dust, Hog

NMDA (N-methyl-D-aspartate) antagonist

Rhabdomyolysis, acute

renal failure

Health Consequences

Physiological: Hypersalivation, diaphoresis, increased HR and BP

Psychological: Hallucinations, delusions, asociality, confusion, psychosis, dissociation of

body and reality

Physiological: Hypertension, tachycardia, hyperthermia, seizures, respiratory arrest, stupor,

coma, death

Physiological: Tremor, hypersomnolence

Psychological: Depression, anxiety, irritability

Intoxication

Overdose

Withdrawal


Hemorrhage, impaired memory,

paranoia, insomnia, violent

behavior, seizures

Other: Death

References





Psilocybin

Contraindications

Pharmacology

Street Names: Shrooms, Magic Mushrooms

Mixed 5-HT and sigma-1 receptor agonist

Rhabdomyolysis, acute

renal failure

Health Consequences

Physiological: Increased HR and BP, altered perceptions of time, space, and self, anterograde

amnesia, nausea

Psychological: Hallucinations, euphoria, anxiety, depression, paranoia, suicidal or homicidal

ideation

Duration: 6 hours; Onset: 20 minutes

Overdose is extremely rare in association with Psilocybin.

Withdrawal signs and symptoms have not been observed in association with DMT.

Intoxication

Overdose

Withdrawal


Drowsiness, flashbacks,

impaired memory

References


Griffiths, R. R., Richards, W. A., McCann, U., & Jesse, R. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and

spiritual significance. Psychopharmacology, 187(3), 268-283. doi: 10.1007/s00213-006-0457-5 NIDA. (2017). Drug Facts. https://www.drugabuse.gov/publications/finder/t/160/DrugFacts



Prescription (Rx) Stimulants

Contraindications

Pharmacology

Street Names: Addies, Uppers, Pep Pills, Skippy

Taken up by monoamine reuptake transporters causing the release of dopamine, norepinephrine and serotonin.

Other: Other: Malnutrition,

weight loss, death

Arrhythmias, myocardial

infarction, deep vein

thrombosis, hypertension

Anxiety, depression,

insomnia, stroke

Health Consequences

Physiological: Increased alertness, energy, HR, BP, and body temperature, headache,

insomnia, xerostomia, anorexia

Executive function: Increased focus

Physiological: Hyperthermia, hypertension, tachycardia, mydriasis, tremors, seizure,

myocardial infarction, stroke, rhabdomyolysis, death

Executive function: Hallucinations

Physiological: Extreme fatigue, disturbed sleep patterns

Psychological: Irritability, depression, anxiety

Intoxication

Overdose

Withdrawal

Commonly misused: Adderall®, Ritalin®, Dexedrine®

Prescription (Rx) Stimulants can be taken orally and intranasally.


References Adderall ® [package insert] Greenville, NC: DSM Pharmaceuticals Inc; 2006

Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Primary Care, 3 8(1), 41–58. http://doi.org/10.1016/j.pop.2010.11.004




Date post:	30-Oct-2019
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

Alcohol - sbirt.pitt.edu · References Ciccarone, D. (2011). Stimulant Abuse: Pharmacology,...

Documents