Download Opiates

Drug Review
Winter 2011, Substance Abuse Counseling Class
Opiates
Derived from the poppy (Opium)
 Binds to natural opiate receptors
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Effects of opiates
Produces pleasant, dream-like state
 Suppresses pain
 Slows breathing
 Can produce euphoria
 Constipates
 (Impotence)
 Can stop breathing (cause death)
 Pin Point pupils
 Vomit
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Withdrawal
Diarrhea
 Flu-like symptoms
 Increased sensitivity to PAIN, sensitive
skin
 Dysphoria
 “Spiders in spine”
 Not deadly
 Hallucinations?
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Forms
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Heroin – CALL IT “HERRORON”
Oxycodone (Oxycontin) – Street value $1/mg.
◦ mash up and inject (banging)
◦ crush it and snort(start with this, move up to injection)
◦ set on tin foil, heat it, breathe smoke
Oxycontin is in an extended release form that won’t
get you high if you crush it.
 Immediate release is called “ROXY” – still valuable
 Hydrocodone – not much street value
 Fentanyl – patches – such out with needle & inject
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Treatment for Opiates
Typically, people receive some sort of
replacement therapy
 Methadone – slow action, one dose per
day. Less high, function more
 Suboxone (Buprenorphine + Naloxone) –
sublingual (Naloxone prevents injecting)
 Naloxone – blocks opiate receptors,
reverses opiate effects (oral version is
Naltrexone), treats overdose
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Hallucinogens
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3 kinds: LSD (peyote/Shrooms), Belladonna
Alkaloids (jimson weed wild in west, LOCO
weed), Dissociative Anthethetics PCP, Ketamine
Effects – perceptual disturbance; 4-6 hours
(longer lasting ones)
Risks: nausea, increase HR/BP, “bad trips” very
poor judgment. Flashbacks (unclear?)
Withdrawal: No clear withdrawal
You can overdose on PCP (maybe LSD?) – how
do you overdose?
It doesn’t appear to be addicted, you can build
tolerance, wait a week to get more bang for buck
Steroids
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Most used is Anabolic, naturally occurring as
testosterone (derived from this)
Injection (IM), oral, patch.
Effects: Increases muscle mass, body building. MUST
TAKE 10-100 times normal amount.
MUSCLE to fat? Seems to be a myth
Too much testosterone – can revert to female
hormones in mean, lead to breast growth. Females
get irreversible male characteristics
Not addictive per se (no high), but is reinforced due
to better muscle results (despite negative
consequences)
Roid rage? NIDA says it may be possible
Caffeine
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Caffeine “addictive” – doesn’t seem to be a “can’t live
without it” drug
Starbucks – 259mg, Redbull – 69mg, can of Coke – 29.5mg,
Diet Coke – 38.2 mg, Mtn Dew 48mg (darker coffee has less
caffeine)
There is withdrawal, but doesn’t seem to be tolerance
Receptors? Adenosine (which promotes sleep and reduces
arousal) is reduced
Headache? Vasoconstrictor normally, but expands vascular
areas when off of it
Deadly overdose? Rare, caffeine poisoning occurs first,
probably in concert with pre-existing health problems
Can have some other negative effects (don’t use in expectant
mothers, pregnant mothers)
Methamphetamine (usage)
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Powder than can be dissolved, can be in pills, can be
in rocks to be smoked (ice)
Made from repulsive ingredients (can be home-made)
prolonged sense of euphoria, as well as increased
energy, focus, confidence, sexual prowess and feelings
of desirability.
Binge/Crash pattern, continual use
HUGE rush, longer (2-8 hours, compared to 5-10
minutes for crack) – binds to more dopamine
receptors, causes greater release, longer time
Listlessness in withdrawal
Pockmarks on face, loss of teeth due to chemicals in
the meth
Inhalants
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Nitrates, anesthetics, solvents
Short high, repeated inhaling over hours (model
glue)
SOLVENTS BAD  can kill you (same day brain
damage could die 1st time, memory attention)
26% who die of inhalants die of trauma (like
setting on fire, other dangerous behavior)
Limited research because move into harder drugs
B12 deficiency, blocks red blood cells
Few seek treatment or are already using other
drugs by the time treatment sought.
Nitrous Oxide – laughing gas -- whippits
Rufies
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Rohypnol (Rufies – Flunitrazepam, @1972, 90’s here)
Snorted, smoked, mixed in drinks
Benzodiazepine (Like valium, tranquilizer)
Originally used for prolonged sedation, 24 hours, insomnia
inpatient medication
Date rape drug, used in sexual assault
Cheap, potent ($1-5). Looks like aspirin, fun high.
Lethal when mixed with other benzos/alcohol (suppresses
breathing, HR)
Tolerance (yes), withdrawal (presumably)
Drunkeness, memory loss, light-headedness, staggering
GHB – Gamma-hydroxybutric acid – aphrodesiac,
intoxication but no hangover – illegal, coma, death, seizures if
mixed
Methylphenidate
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ADHD, Narcolepsy
Strong stimulant, addictive, release DA, NE
Effective calming down kids with ADHD, stimulates non ADHD
individuals
Effects: what you might expect for stimulants (dizziness, lost of
appetite, euphoria, high energy, but extreme cases can lead to
psychotic symptoms, heart attack)
Increase attention, focus, stay awake, used in teen-agers and college
students
Crush and inject, but particles can cause vessel blockage
Withdrawal: depression, delusions, SI + attempts
Most ADHD medications are Ritalin in some form or another
(differences in timing of action) – 19% teenagers abusing some
prescription med
Buy from other kids
Adderall – Dextroamphetamine
Straterra – Atamoxitine – not stimulant per se
Cough syrup abuse
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Dextromethorphan – DXM in 100’s of OTC drugs (Robitussin,
Coricidin D)
1 in 10 abuse some form of cough medicine
Slang: DXM, Triple C’s, Skittles
Reduces cough, but high dose can cause hallucinations, memory
loss, Impaired vision, cause BP/HR to fluctuate, rapid breathing,
slurred speech, fever, coma
DXM  perceived as “safe” – parents ill-informed (not locked)
Signs: sudden changes in mood, sleep, school performance, friends
Cheap, easily available, now behind counter
Kids use facebook to network about drugs
Big concerns: OVERDOSE, IMPAIRMENT, MIXING WITH OTHER
DRUGS
How much to die, to feel impaired, average consumption? Drinking
whole bottles
Bath Salts and Herbals
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Fake bath salts, fertilizer, etc. AKA Cloud 9, Ivory Wave,
Hurricane Charlie – “Herbal Ecstacy”
Methadrone -> worse than cocaine in terms of craving
Buy in stores: Inject, snort, smoke
Paranoia, delusions, HI/SI (murder/self-harm)
SPICE and K2 – “Natural” product – synthetic (?) marijuana –
same high as MJ, but negative drug test (buy on internet and
head shop)
Nutmeg – contains chemical that induces eurphoric state
(need a lot) – severe hallucinations, nausea, vomitting
Soaking tampons in vodka and insert in nether regions
Morning glory seeds, crush seeds, soak water drink juice
Digital drugs – listen to downloads to “get high”
PCP
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Pseudohallucination and delusions
Taken for amphetamine effects and euphoria
Yellow oil, use as liquid or powder. Soak in
cigarette
$10-25 per cigarette for 4-6 hours of effects
Similar to Ketamine – NMDA receptor
antagonist, decrease in pain (was Terminator on
PCP?)
3 in one – like drunk, like amphetamine, like
hallucinogen
CAN BE DANGEROUS – give supportive care if
having bad trip, can have loss of breathing or
stroke
Schedule of drug
Schedule 1: high potential for abuse no
medical use
 Schedule 2: limited medical potential, high
potential for abuse
 Schedule 3: limited addiction potential,
high medical potential
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