Download Mark Palla Street Drugs

Street Drugs:
From Marijuana to Nutmeg
Mark Palla
NREMT-P
Brown University EMS
Common Drugs of abuse today:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Alcohol
Tobacco
Prescription drugs
Methamphetamine
Marijuana
MDMA
Crack Cocaine
Steroids
Inhalants
Alcohol
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Points to remember:
1.
2.
3.
Holiday Heart syndrome
.4 or higher involves the brain stem
Do not forget about DKA
Prescription drugs
1. Narcotics: Oxycontin, Vicoden, Percocet
-Euphoric, sedating affects
2. Depressants: Xanax, Valium and Librium
-also for the sedating affects
3. Stimulants: Ritalin, Dexedrine, and Meridia
-used for the energizing and euphoric
affects.
Drugs we are familiar with:
Marijuana
Cocaine
PCP
Methamphetamines
Alcohol
Heroin
GHB
To drugs we are not that familiar
with:
„DMX
„Nutmeg
Amphetamines
Amphetamines
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Street Names: Bennies, black beauties, bumble bees, co-pilots,
Crank, Cross tops, Crystal meth, Dexies, Footballs, Hearts, Hot
Ice, Ice, L.A. glass, Meth, MDMA, Pep pills, Speed, Uppers
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Toxicology Detection: 48 to 72 hours
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Psychological Effects: A low dose can cause alertness,
euphoria, increased motor performance and energy, as well as
irritability, restlessness, and panic. High doses can cause brief
psychosis, increased aggressiveness, and antisocial behaviors
Amphetamines
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Physical Effects: Body becomes ready for
"fight or flight"; can cause stroke, heart attack,
or kidney failure
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Withdrawal Symptoms: Confusion, apathy,
irritability, depression, increased appetite and
need for sleep
Marijuana
Marijuana
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Street Names: Hash Oil, Pot, Refer, Weed
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Toxicology Detection: Occasional use, 1-3
days: Weekly use, persistently positive test:
Heavy use, even 1 month after cessation
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Psychological Effects: Mild euphoria and
relaxation, impaired motor control and memory,
sometimes panic and paranoia.
Marijuana
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Physical Effects: Higher blood pressure and
pulse, increased appetite (munchies), dry
(cotton) mouth, dizziness and nausea. Males
have low sperm counts, females have irregular
menstrual cycles
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Withdrawal Symptoms: Insomnia, loss of
appetite and weight, irritability, and rebound in
REM sleep
Marijuana
Points to remember:
„ THC binds to the cannabinoid
receptors in cells and specifically the
brain cells responsible for pleasure and
motor coordination.
„Side effects: ↑HR and blood
pressure. Leading to a 4x increase in
Heart attack incidence after the first
hour of smoking.
Marijuana
„Addition
of other illicit drugs with
marijuana:
„PCP- super joints (aggression)
„Alcohol
Cocaine
Cocaine
„
Street Names: Crack, blow, aspirin, super C, Devil’s
dandruff, etc.
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Toxicology Detection: 48 to 72 hours
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Psychological Effects: Varies with dose and tolerance,
but increased energy, alertness, and euphoria, as well as
irritability and insomnia. High doses can cause
psychosis, paranoia, and aggressive and antisocial
behavior
Cocaine
„
Physical Effects: High blood pressure and
pulse, increased risk for seizures, strokes, heart
attacks, and death
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Withdrawal Symptoms: Intense physical
cravings, irritability, depression, paranoia, and
suicidal ideation, sometimes delusions and
hallucinations
Cocaine
Points to remember:
„Cocaine MI. The MI of the young.
GHB
GHB
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It is classified as a sedative-hypnotic, and was
originally developed as a sleep-aid.
A similar drug, "GBL," is often sold under
different names and turns into GHB in the
body, having the same effect.
GHB
„
At lower doses GHB has a euphoric effect
similar to alcohol, and can make the user feel
relaxed, happy and sociable.
GHB
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Higher doses can make the user feel dizzy and
sleepy, and can sometimes cause vomiting,
muscle spasms, and loss of consciousness.
Overdoses will always cause loss of
consciousness (temporary coma), and will slow
down breathing. Sometimes, and particularly if
mixed with alcohol, GHB can slow breathing
down to a dangerously low rate, which has
caused a number of deaths.
Benzodiazepines
Benzodiazepines
„
Street Names: Rohypnol, Roofies,
Flunitrazepam, Ruffies, Roches, R-2, Valium)
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Toxicology Detection: 7 to 30 days
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Psychological Effects: Aggressiveness, high
energy, increased disinhibition, may be used
prior to "slam dancing" or "Date Rape"
Benzodiazepines
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Physical Effects: Drowsiness, loss of memory,
consciousness, and motor control; headaches,
dizziness, and nightmares afterwards
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Withdrawal Symptoms: Withdrawal is lifethreatening due to risk of seizures
LSD
LSD
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Street Names: Acid, Bartman, Bart Simpson,
microdots, gelatin chips, windowpanes/blotter,
paper/blotter
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Toxicology Detection: 30 hours
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Psychological Effects: Hallucinations, distortion of
time and space, good trips with pleasant affect, bad
trips with paranoia, panic, and agitation
LSD
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Physical Effects: Subtle changes in body
temperature, blood pressure, and pulse, as well
as sweating, chills, headache, and nausea
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Withdrawal Symptoms: None
Opiates
Opiates
„
Street Names: Codeine, China White, Ddarvon,
Darvocet, Demerol, dilaudid, heroin, methadone,
Morphine, Percocet, Percodan, Talwin, Vicodin
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Toxicology Detection: Sometimes 2 to 4 days
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Psychological Effects: Pain relief, sleepiness, euphoria
(on the "nod")
Opiates
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Physical Effects: Decreased respiration and
motor control, nausea. China White is especially
potent
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Withdrawal Symptoms: 1 to 3 weeks, physical
craving, anxiety, loss of appetite and weight,
fatigue, nausea and diarrhea, not life-threatening
PCP
PCP
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„
Phencyclidine
Known as: angel dust, ozone, or wack or Killer
Joints, supergrass, or rocket fuel when combined
with marijuana
„
was developed in the 1950s as an intravenous
anesthetic. Use of PCP in humans was discontinued
in 1965, because it was found that patients often
became agitated, delusional, and irrational while
recovering from its anesthetic effects
PCP
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Many PCP users are brought to emergency
rooms because of PCP's unpleasant
psychological effects or because of overdoses.
In a hospital or detention setting, they often
become violent or suicidal, and are very
dangerous to themselves and to others. They
should be kept in a calm setting and should not
be left alone
PCP
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At low to moderate doses, physiological effects of PCP
include:
An increase in breathing rate,
Pronounced rise in blood pressure and pulse rate.
Flushing and profuse sweating occur.
Generalized numbness of the extremities and muscular
uncoordination also may occur.
Psychological effects include distinct changes in body
awareness, similar to those associated with alcohol
intoxication
PCP
„
At high doses:
„
We have a BIG problem!!!
Ketamine
Ketamine
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Also known as Special K
Was originally created for use as a human
anesthetic, and is still used as a general
anesthetic for children, persons of poor health,
and in veterinary medicine.
Belongs to a class of drugs called "disasociative
anesthetics," which separate perception from
sensation
Ketamine
„
Effects:
At lower doses it has a mild, dreamy feeling similar
to nitrous oxide. Users report feeling floaty and
slightly outside their body. Numbness in the
extremities is also common.
„ Higher doses produce a hallucinogenic (trippy)
effect, and may cause the user to feel very far away
from their body.
„
Ketamine
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This experience is often referred to as entering a
"K-hole" and has been compared to a near
death experience with sensations of rising above
one's body. Many users find the experience
spiritually significant , while others find it
frightening.
While in a K-hole it is very difficult to move.
People usually remain seated or lying down
during the experience.
Ketamine
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Most people snort small lines or "bumps" for a mild,
dreamy effect. The effect comes on within about 5 to
10 minutes.
100mg is usually enough to enter a K-hole.
If liquid is injected into the muscle, less is needed to
enter a K-hole. Effects can be felt within four minutes.
(Ketamine is never injected into the vein).
If swallowed, the effects come on in 10 - 20 minutes.
Some people become nauseous after taking ketamine.
Ketamine
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While low doses of Ketamine can increase heartrate, at higher doses it depresses consciousness
and breathing and is extremely dangerous to
combine with downers like alcohol, Valium or
GHB.
Barbiturates
Barbiturates
„
Street Names: Amytal, Downers, Nembutal,
Phenobarbital, Reds, Red birds, Red devils,
Seconal, Tuninal, Yellowjackets
„
Toxicology Detection: Slowly, about half is
metabolized within 48 hours
Phenobarbital may be detected 4 weeks later
Barbiturates
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Psychological Effects: Like alcohol inebriation, but
with greater euphoria and disinhibition. Higher doses
can lead to memory loss, greater impairment in
judgment, paranoia and suicidal ideation
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Physical Effects: Sleepiness, slurred speech, decreased
respiration, and can lead to death. Tolerance develops
quickly, and danger of an overdose, especially when
taken with another drug, is significant
Barbiturates
„
Physical Effects: Sleepiness, slurred speech,
decreased respiration, and can lead to death.
Tolerance develops quickly, and danger of an
overdose, especially when taken with another
drug, is significant
Other Hallucinogens
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Mescaline
Mushrooms
Nutmeg
Nutmeg
The recipes:
1. 2-3 heaping teaspoons in a cup of coffee.
2. 2 tablespoons in a cup of mik.
3. Snorted (the wrong way to go)
Nutmeg
Course of action:
„First hour users feel “stoned”
„T+4-6 hours the memory problems
begin
„T+9 Concentration problems begin
„T+10 coordination problems begin
„T+12 visual problems begin
Nutmeg
„Users
indicate that effects are still
present T-24-36 hours later.
„Problems users experience is the lack
of “instant gratification”.
„They tend to use excessive amounts
to try to reach the “high” earlier.
„Then the hit the “tequila” wall.
Mushrooms
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
Mushrooms
„Similar
affect as LSD
„Dreamlike states, hallucinations
„Bad trips: paranoia, anxiety, etc
„Shorter
“trips” (less than 4 hours)
„Inexperienced users eat wrong
mushrooms
Dextromethorphan
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
DMX/DXM
„1.0-2.5
mg/kg: first plateau. User
experiences “stoned” behaviors
„2.5-7.5 mg/kg: second plateau. User
experiences hallucinations and motor
coordination problems.
„7.5-15 mg/kg: third plateau. User
experiences true sensory impairment.
Users become delusional and may even
recall suppressed memories.
DMX/DXM
„Fourth
Plateau: greater than
30mg/kg: Users lose all contact with
external senses. No ability to respond
to stimuli. Often found choking on
their own vomit. Gravely impaired.
GBH
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Candy
RaverCaps
Cherry
MethEasy lay
Everclear
Fantasy
GBH
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GG-riffic
Gamma Oh
GBH
GBL
Georgia home boy
GHB
Goop
GBH
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Great hormones at bedtime
Grievous bodily harm
Jib
Liquid
E-Liquid
Ecstasy
Liquid
X-Organic
Quaalude
GBH
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Salty
Water
Scoop
SleepSleep-500
Soap
Somatomax
Vita-G
Water