Drugs, Science & Society

Physiology of Drug Abuse

DRUG ADDICTION IS A COMPLEX ILLNESS

Positron Emission Tomography (PET)

Your Brain on Drugs

1-2 Min

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6-7

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9-10

10-20

20-30

Your Brain After Drugs

The Memory of Drugs

Amygdala not lit up
Anterior

Amygdala activated

Posterior

Nature Video

Cocaine Video

control

on cocaine

Categories of Drugs

Categories of Drugs
Stimulants - uppers - stimulate the central nervous system - amphetamines, amyl nitrite, cocaine, crack, ecstasy Depressants - downers - depress the central nervous system - alcohol, barbiturates, benzodiazepines Analgesics - powerful painkillers - from opium poppy or synthetically produced Hallucinogens - psychedelics - dramatically alter perception - LSD, psilocyn, psilocybin, cannabis, ecstasy

CLUB DRUGS

Club Drugs
ECSTASY
Drug Class: CNS stimulant, hallucinogen Other names: MDMA, XTC, X, E, Adam, Clarity, Essence, Stacy, Lovers Speed Developed in WWI but became illegal in 1985 Today: a designer drug White form, crystalline powder + buffed & pressed = pills Usual dose: 1 to 2 mg/kg body weight Ingested orally, placed under the tongue, added to juice or carbonated beverage, snorted or injected

Club Drugs
ECSTASY
Candyflipping combined used of ecstasy and LSD Stacking taking 3 E tablets at once, mixing it with other drugs How Ecstasy Works Half-life is 6 hours Onset action vary from person to person Serotonin and dopamine released into the brain perception of pain, body temperature overheat without feeling any discomfort

Club Drugs
ECSTASY
The E Rush Instantaneous rush 30-45 sec, lasting to 15-30 mins Sudden clarity, intensification of perceptions Inner sensation of happiness, sense of loving booster dose hope to prolong the sensations tolerance: desired effects; in adverse effects bubble bursting anxiety, paranoia, nausea, panic 30 mins3 hrs after initial rush: plateau phase of > intense feelings trance-like movements long lasting ecstatic trance-dancing

Club Drugs
ECSTASY
The After Rush coming down: 3 6 hrs after initial ingestion feelings of disappointments: anxiety, depression sluggishness & residual effects: lasts up to several days 6-7 hours to fall asleep after returning to normal Tuesday blues from depletion of serotonin Long term effects still uncertain BUT subsequent depression may occur due to short-circuit of serotonin pathway & serotonin shortage

Club Drugs
ECSTASY
Adverse Effects addiction to concurrently used substance anorexia, nausea, vomiting, insomnia visual blurring, confusion jaw-clenching, teeth grinding, muscle spasms dehydration, electrolyte imbalances heat exhaustion and injury (Saturday night fever) acute renal failure, hepatic toxicity tachychardia, fatigue, convulsions coma, death

ecstasy

Stacy

lovers speed

E
xtc
Essence

Club Drugs
HERBAL ECSTASY
Other names: Ma huang, ephedra, Cloud 9, Herbal Bliss, Rave Energy Combination of stimulants to stimulate effects of XTC Common use: stimulant or weight loss agent Available: many health food stores or by mail order Present in food supplements: Metabolift or Metabolife 356 In US: No regulation from US-FDA Found in many OTC cold preparations Adverse Effects Tachycardia, hypertension, stroke, seizure, heart attack, death

Club Drugs
METHAMPHETAMINE
other names: Ice, speed, tweak, crank , glass, shabu white powder or clear, crystal rock release large amounts of dopamine = highly addictive stimulant enhance mood and body movement taken orally, intranasally, intravenously, rectally Desired effects smoking, intravenous: intense, very pleasurable sensation intranasal and oral: high feeling 3 5 mins (intranasal); 15-20 mins (oral); can last: 24 hours

Club Drugs
METHAMPHETAMINE
Adverse effects wide variety or physical and psychological effects wakefulness, increased physical activity (hyper, alertness) appetite headache, sensation of hair standing on end dry mouth, tremors, tachycardia, hypertension, palpitations stroke, seizures euphoria, irritability, insomnia, anxiety hallucinations, paranoia, psychosis, death degeneration of neurons underlying cause of Parkinsons disease

Methamphetamine Speed
shabu

ICE

Drug OPIUM

Street Names black stuff, chandu

Effects Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes Loss of concentration and memory, heart rate increases, poor balance & coordination, anxiety or panic, depression, confusion Ice has a strong effect on the nervous system and is highly addictive. Loss of weight, impotency, severe convulsions (fits), hallucinations, liver & kidney damage, damage to the heart, stroke & death. Blood pressure and increase in pulse rate, false feelings of confidence & closeness with others, dehydration, convulsions, vomiting & anxiety. Hallucination, Altered sensation, mood and consciousness, Affected judgment and co-ordination, distorted hearing, touch, smell, taste and visual sensation, nausea and vomiting, memory loss Increased heart beat, dehydration, paranoid feeling, sweating, insomnia, irritability, depression

MORPHINE

M, white stuff, white powder

HEROIN

White, junk, powder, putih, medicine marijuana, ganja, pot, grass, joints Ice, glass, crystal, quartz, icecream, hirropon, shabu

CANNABIS originated from the hemp plant, Cannabis Sativa METHAMPHETAMINE HYDROCHLORIDE

METHYLENEDIOCYMETHAMPHETAMINE (MDMA) KETAMINE

Ecstasy, Pink or Pink Lady, Snow White, Playboy, Apple, XTC Also known as "K", Special K, Vitamin K, Ket, Kit kat Methamphetamine tablet, crazy horse, mad medicine

YABA

Cocaine Powder Cracked cocaine

cocaine

Amphetamines in various capsules

Barbiturate Pills

Benzodiazepine Pills

Marijuana leaves

seeds In joint rolling

In plastic bag

In block

Cannabis

Codeine in various form

Coca leaves and powder

Hashish Oil

Downers (various)

Depressant Pills

LSD in Blotter Paper

LSD in forms

Heroin in plastic Heroin in various forms with balloons

Heroin in off white powder form

Ketamine - special

Ketamine

Morphine Methadone

Morphine in various forms

Opium

Opium pod & derivatives

oxycontin

Drug User Paraphernalia

Drug User Paraphernalia

Drug Laboratory

Identification of a Drug User

Identification of a Drug User

excitable, hostile, violent, destructive behavior, outbreaks of temper unsteadiness, clumsiness slurred speech, talking to oneself in a state of confusion dreamy, hallucinations lack of personal hygiene loss of concentration or attention loss of interest in personal care & appearance, food, family activity social withdrawal sudden decline in attendance or performance in school frequent job hopping frequents places like storage rooms, toilets, isolated corners sores on nose & mouth (glue sniffers), runny nose, bloodshot eyes smell solvents on breath, clothes, hair (glue sniffers)

Drug Abuse is a preventable behavior

and

Drug Addiction is a treatable disease

Prevention Programs should . . . . Reduce Risk Factors

y ineffective parenting y chaotic home environment y lack of mutual attachments/nurturing y inappropriate behavior in the classroom y failure in school performance y poor social coping skills y affiliations with deviant peers y perceptions of approval of drug-using behaviors in school, peer, and community environments

Prevention Programs should . . . .

Enhance Protective Factors
y strong family bonds y parental monitoring y parental involvement y success in school performance y prosocial institutions y conventional norms about drug use

Prevention Programs should . . . . . .Target all Forms of Drug Use

. . . and be Culturally Sensitive

Prevention Programs should . . . . Include Interactive Skills-Based Training

y Resist drugs y Strengthen personal commitments against drug use y Increase social competency y Reinforce attitudes against drug use

Prevention Programs should . . . . Be Family-focused

y Provides greater impact than parent-only or childonly programs y Family: included at each stage of development y Involve effective parenting skills

Prevention Programs should . . . . Involve Communities and Schools

y Media campaigns and policy changes y Strengthen norms against drug use y Address specific nature of local drug problem

Components of Comprehensive Drug Addiction Treatment

Matching Patients to Individual Needs

y No single treatment is appropriate for all individuals y Effective treatment attends to multiple needs of the individual, not just his/her drug use y Treatment must address medical, psychological, social, vocational, and legal problems

Duration of Treatment
y Depends on patient problems/needs y Less than 90 days is of limited/no effectiveness for residential/outpatient setting y A minimum of 12 months is required for methadone maintenance y Longer treatment is often indicated

Medical Detoxification
y Detoxification safely manages the physical symptoms of withdrawal y Only first stage of addiction treatment y Alone, does little to change long-term drug use

Self-Help and Drug Addiction Treatment

y Complements and extends treatment efforts y Most commonly used models include 12-Step (AA, NA) and Smart Recovery y Most treatment programs encourage self-help participation during/after treatment

Counseling and Other Behavioral Therapies

Medications for Drug Addiction

y Methadone y LAAM y Naltrexone y Nicotine Replacement y patches y gum y buproprion

Motivation to Enter and/or Sustain Treatment

y Effective treatment need not be voluntary y Sanctions/enticements (family, employer, criminal justice system) can increase treatment entry/retention y Treatment outcomes are similar for those who enter treatment under legal pressure vs voluntary

HIV/AIDS, Hepatitis and Other Infectious Diseases

y Drug treatment is disease prevention y Drug treatment reduces likelihood of HIV infection by 6 fold in injecting drug users y Drug treatment presents opportunities for screening, counseling, and referral

Effectiveness of Treatment
y Goal of treatment is to return to productive functioning y Treatment reduced drug use by 40-60% y Treatment reduces crime by 40-60% y Treatment increases employment prospects by 40% y Drug treatment is as successful as treatment of diabetes, asthma, and hypertension

Cost-Effectiveness of Drug Treatment

y Treatment is less expensive than not treating or incarceration y Savings can exceed costs by 12:1 when health care costs are included y Reduced interpersonal conflicts y Improved workplace productivity y Fewer drug-related accidents

The Philippine Drug Scene

The Philippine Drug Scene

RA 9165 Comprehensive Dangerous Act of 2002 signed June 7, 2002 stiffer penalties for illegal drug possession and pushing RA 7624 Integrated Drug Prevention Control in the Intermediate & Secondary Curricula signed July 22, 1991 Drug users: 300% annually 2001: 2 million Filipinos are drug dependents 1.2 million are 15 17 years old Growing number of executives hooked on drugs Growing problem: production of shabu in the country Philippines: serves as a transit point strategic location

The Philippine Drug Scene

Shabu favored drug; mass appeal, poor mans cocaine, most popular drug of abuse XTC rich mans hug drug previously: designer drug among the rich kids now: caught on by the middle class originally expensive; but now, affordable before: only in bars and dance clubs now: streets, malls, schools, internet chat rooms popular among kids: easy to use, looks like any other pill, take it like ordinary medicine, no incriminating evidence E sold now: diluted E, mixed E, homemade E

The Philippine Drug Scene

Phil. Drug Enforcement Agency (PDEA) closely monitoring production of E also: use and trafficking of E recent Drug Act 2002: life imprisonment to death for people caught with more than 10g of E choice of drug users: shabu info from: drugs addicts in the rehab centers 2001: Revenue from sales of illegal drug trade expected to hit 300 billion pesos (50% national budget in 2001)

Is it worth the risk?

t he n d