Download Common Drugs Cocaine - Cuyahoga County Medical Examiner

Common Drugs
Cocaine
Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine is not a new drug. In
fact, it is one of the oldest known drugs. The pure chemical, cocaine hydrochloride, has been an abused
substance for more than 100 years, and coca leaves, the source of cocaine, have been ingested for
thousands of years.
Pure cocaine was first extracted from the leaf of the Erythroxylon coca bush, which grows primarily in
Peru and Bolivia, in the mid-19th century. In the early 1900s, it became the main stimulant drug used in
most of the tonics/elixirs that were developed to treat a wide variety of illnesses.
Cocaine abuse has a long history and is rooted into the drug culture in the U.S. It is an intense euphoric
drug with strong addictive potential. With the increase in purity, the advent of the free-base form of the
cocaine ("crack"), and its easy availability on the street, cocaine continues to burden both the law
enforcement and health care systems in America.
The powdered, hydrochloride salt form of cocaine can be snorted or dissolved in water and injected.
Crack is cocaine that has not been neutralized by an acid to make the hydrochloride salt. This form of
cocaine comes in a rock crystal that can be heated and its vapors smoked. The term “crack” refers to the
crackling sound heard when it is heated.
Today, cocaine is a Schedule II drug under the Controlled Substances Act of 1970, meaning that it has
high potential for abuse, but can be administered by a doctor for legitimate medical uses, such as local
anesthesia for some eye, ear, and throat surgeries.
Heroin
Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the
opiates. Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod
of certain varieties of poppy plants. It is typically sold as a white or brownish powder or as the black sticky
substance known on the streets as “black tar heroin.” Although purer heroin is becoming more common,
most street heroin is “cut” with other drugs or with substances such as sugar, starch, powdered milk, or
quinine. Street heroin can also be cut with strychnine, fentanyl or other poisons. Because heroin abusers
do not know the actual strength of the drug or its true contents, they are at risk of overdose or death.
Heroin also poses special problems because of the transmission of HIV and other diseases that can
occur from sharing needles or other injection equipment.
First synthesized from morphine in 1874, heroin was not extensively used in medicine until the early
1900s. Commercial production of the new pain remedy was first started in 1898. It initially received
widespread acceptance from the medical profession, and physicians remained unaware of its addiction
potential for years. The first comprehensive control of heroin occurred with the Harrison Narcotic Act of
1914. Today, heroin is an illicit substance having no medical utility in the United States.
Heroin can be injected, smoked, or sniffed/snorted. Injection is the most efficient way to administer lowpurity heroin. The availability of high-purity heroin, however and the fear of infection by sharing needles
has made snorting and smoking the drug more common.
Today, heroin is an illicit substance having no medical utility in the United States. It is in Schedule I of the
CSA.
Hydrocodone
Hydrocodone is an antitussive (cough suppressant) and analgesic agent for the treatment of moderate to
moderately severe pain. Studies indicate that hydrocodone is as effective, or more effective, than codeine
for cough suppression and nearly equipotent to morphine for pain relief.
Hydrocodone is the most frequently prescribed opiate in the United States with nearly 130 million
prescriptions for hydrocodone-containing products dispensed in 2006. There are several hundred brand
name and generic hydrocodone products marketed. All are combination products and the most frequently
prescribed combination is hydrocodone and acetaminophen (Vicodin®, Lortab®, Lorcet®).
Hydrocodone diversion and abuse has been escalating in recent years. In 2006, hydrocodone was the
most frequently encountered opioid pharmaceutical in drug evidence submitted to the National Forensic
Laboratory Information System (NFLIS) with 25,136 exhibits; the System to Retrieve Investigational Drug
Evidence (STRIDE) analyzed 654 exhibits in 2006. In the 2005 Drug Abuse Warning Network (DAWN)
combination products were associated with more emergency room visits than any other pharmaceutical
opioid with an estimated 51,225 emergency room visits. Poison control data, medical examiners’ reports,
and treatment center data all indicate that the abuse of hydrocodone is associated with significant public
health risks, including a substantial number of deaths.
When the CSA was enacted in 1971, hydrocodone as a substance by itself was placed in schedule II
while products, containing hydrocodone in specified amounts and in combination with other active
ingredients, were placed in schedule III and V. At that time, hydrocodone was primarily utilized as a
cough suppressant with limited prescriptions. Today, hydrocodone products are increasingly utilized for
pain management and are the most frequently dispensed opioid pharmaceuticals in the United States.
Marijuana (Marihuana)
Marijuana is the most commonly abused illicit drug in the United States. A dry, shredded green/brown mix
of flowers, stems, seeds, and leaves of the plant Cannabis sativa, it usually is smoked as a cigarette
(joint, nail), or in a pipe (bong). It also is smoked in blunts, which are cigars that have been emptied of
tobacco and refilled with marijuana, often in combination with another drug. It might also be mixed in food
or brewed as a tea. As a more concentrated, resinous form it is called hashish and, as a sticky black
liquid, hash oil. Marijuana smoke has a pungent and distinctive, usually sweet-and-sour odor.
The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol). The membranes of certain
nerve cells in the brain contain protein receptors that bind to THC. Once securely in place, THC kicks off
a series of cellular reactions that ultimately lead to the high that users experience when they smoke
marijuana.
Marijuana is a Schedule I substance under the Controlled Substances Act (CSA). Schedule I drugs are
classified as having a high potential for abuse, no currently accepted medical use in treatment in the
United States, and a lack of accepted safety for use of the drug or other substance under medical
supervision.
MDMA (Ecstasy)
MDMA (3,4-methylenedioxymethamphetamine) is a synthetic, psychoactive drug chemically similar to the
stimulant methamphetamine and the hallucinogen mescaline. MDMA is an illegal drug that acts as both a
stimulant and psychedelic, producing an energizing effect, as well as distortions in time and perception
and enhanced enjoyment from tactile experiences.
Adolescents and young adults use it to promote euphoria, feelings of closeness, empathy, sexuality and
to reduce inhibitions. It is considered a "party drug" and obtained at "rave" or "techno" parties. However,
its abuse has expanded, to include other settings outside of the rave scenes, such as a college campus.
Although MDMA is known universally among users as ecstasy, researchers have determined that many
ecstasy tablets contain not only MDMA but also a number of other drugs or drug combinations that can
be harmful as well. Adulterants found in MDMA tablets purchased on the street include
methamphetamine, caffeine, the over-the-counter cough suppressant dextromethorphan, the diet drug
ephedrine, and cocaine. Also, as with many other drugs of abuse, MDMA is rarely used alone. It is not
uncommon for users to mix MDMA with other substances, such as alcohol and marijuana.
In the 1980s, MDMA gained popularity as a drug of abuse resulting in its final placement in Schedule I of
the Controlled Substances Act (CSA).
OxyCotin®
OxyContin® is a prescription painkiller used for moderate to high pain relief associated with injuries,
bursitis, dislocations, fractures, neuralgia, arthritis, lower back pain, and pain associated with cancer.
OxyContin® contains oxycodone, the medication's active ingredient, in a timed-release tablet. Oxycodone
products have been illicitly abused for the past 30 years.
Oxycodone is a Schedule II narcotic analgesic and is widely used in clinical medicine. It is marketed
either alone as controlled release (OxyContin®) and immediate release formulations (OxyIR®,
OxyFast®), or in combination with other nonnarcotic analgesics such as aspirin (Percodan®) or
acetaminophen (Percocet®). The introduction in 1996 of OxyContin®, commonly known on the street as
OC, OX, Oxy, Oxycotton, Hillbilly heroin, and kicker, led to a marked escalation of its abuse as reported
by drug abuse treatment centers, law enforcement personnel, and health care professionals. Although the
diversion and abuse of OxyContin® appeared initially in the eastern US, it has now spread to the western
US including Alaska and Hawaii. Oxycodone-related adverse health effects increased markedly in recent
years. In 2004, Food and Drug Administration (FDA) approved for marketing generic forms of controlled
release oxycodone products.
Oxycodone products are in Schedule II of the federal Controlled Substances Act of 1970.
*All information and images are from the DEA website listed under Drug Information.
Methodologies
The Drug Chemistry Section uses an array of color tests as well are GC/MS or FTIR to establish the
presence of a controlled substance or to confirm the lack there of.