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Chapter 3 Drug Specific Information Drugs on the Street Where You Live Chapter Objectives Define and apply the following terms: physical dependence, withdrawal, psychological dependence, routes of administration, set and setting, tolerance, cross-tolerance, synergism, antagonism. Define and outline the various aspects of the behavioral definition of addiction. Explain the difference between psychoactive and nonpsychoactive drugs. Chapter Objectives Outline some updated information on crystal methamphetamine, Rohypnol, LSD, heroin, marijuana, inhalants, and MDMA (Ecstasy). Outline the basic classification system of drugs. Classify the drugs in the narcotic analgesics category. Discuss the central nervous system depressants. Classify the central nervous system stimulants. Chapter Objectives Classify the drugs in the hallucinogens category. Classify the drugs in the cannabis sativa category. Classify the various inhalants and their available forms. Explain the problems in classifying phencyclidine. Explain the various uses of drugs in sports and athletics. Drugs in Our Society Drug revolution of the 60s and 70s revolted against – Protestant work ethic – moral and sexual values – societal values in general Symbolized the conflict in Vietnam and the stress of the draft. Drugs in Our Society In the 1980s, cocaine use had a major impact through the deaths of media personalities and on the middle- to upper-class population. In the late 1980s to early 1990s, designer drugs came on the scene. – – – – – “ice” methamphetamines Rohypnol ecstasy purer heroin Classification of Drugs Non Psychoactive Drugs – Substances that do not directly affect the brain when taken in normal doses . • vitamins • antibiotics • topical skin preparations Psychoactive Drugs Substances that affect brain functions, mood, and behavior and are subdivided primarily on the basis of physiological and psychological effects. – – – – – – – Narcotic analgesics central nervous system depressants central nervous system stimulants hallucinogens cannabis sativa: marijuana and hashish inhalants: volatile solvents phencyclidine (PCP) Narcotic Analgesics “Narcotic” comes from the Greek term “narcosis”, which means “to numb”. Narcotic analgesics come from the poppy plant. These include: – morphine – codeine – heroin “Narcotic” has been inappropriately applied to marijuana, cocaine, and hallucinogens as an emotional-laden moral response. Central Nervous System Depressants Drugs that are used as sedatives or hypnotics. – alcohol – barbiturates – tranquilizers Alcohol Acts as a depressant on the central nervous system. Is the most widely used psychoactive drug known (other than tobacco products). Has major effects on the brain, peripheral nerves, GI tract, heart and blood vessels, and the lungs. Time is the only method of “sobering-up”. Barbiturates Prescribed to induce sleep and relax the nervous system. Affect areas of the brain that are related to sleep more than other sedative hypnotics. Usually taken orally and are readily absorbed. Some nonbarbiturates have a barbiturate-like action. – chloral hydrate – methaqualone – flurazapame (Dalmane) – glutethimide (Doriden) – ethchlorvynol (Placidyl) CNS Stimulants - Tranquilizers Minor tranquilizers act primarily as antianxiety agents. Major tranquilizers act primarily as antipsychotic agents. Can be taken orally or as an injectable. There is a crosstolerance and high addiction potential to minor tranquilizers by about 5% of the population - those people are alcoholics and addicts of other drugs. Amphetamines Prescribed primarily for narcolepsy, hyperkinetic syndrome in children, certain mental conditions, and short-term weight control. Can be taken orally or injected intravenously. Prolonged use leads to dehydration, weight loss, vitamin deficiency, reduced immune system, liver and cardiovascular disease, hypertensive disorders, and psychiatric problems. Cocaine Has gained popularity in a wide variety of drug forms, including crack cocaine. Can be inhaled, injected or smoked (including freebase smoking). Is short-acting; after the euphoria, psychological depression, nervousness, fatigue, and irritability set in. Cocaine is the most addicting drug known today. Tobacco Is the most widely abused drug. Single-leading cause of preventable death in this country. Diseases related to smoking tobacco. – heart disease – peripheral vascular disease – cerebrovascular disease – cancer – chronic obstructive lung disease Hallucinogens “Hallucinogen” is derived from the Latin term “hallucinari”, which means to wander in the mind. Defined as: – psychedelic • alters consciousness – psychotomimetic • mimics psychosis – psychotogenic • produces psychosis LSD Is the most potent drug by weight, and is the most thoroughly researched. Is often impregnated in sugar pills, blotter paper, or small gelatin squares for ingestion. Can produce profound effects on thinking, selfawareness, and emotions. Physical dependence is unlikely, however psychological dependence is common in long-term users. Cannabis Sativa (Marijuana) Cannabis refers to any product of the plant Canabis sativa. Can be smoked in hand-rolled cigarettes or joints. Higher-potency marijuana is usually smoked in a water pipe. Effects include exhilaration, relaxation, heart rate increase, drowsiness, dry mouth and throat, bloodshot eyes, impaired short-term memory, altered states of time and space, and dilated pupils. Inhalants Various solvents, aerosols, and other gases are inhaled to get high. Available forms of inhalants include: – glue, model cement, fingernail polish removers, various cosmetics, cleaning solvents, gasoline, paint, paint thinner, lighter fluids, antifreeze, aerosol cans, white correction fluid. Effects include: – a feeling of well-being, reduction of inhibitions, dizziness, illusions, giddiness, time and space distortions, feeling of floating, and an elevated mood. Inhalants Adverse effects include: – confusion, drunkenness, slurred speech, numbness, runny nose, tears, headache, incoordination, nausea, vomiting, confusion, panic, irritation, tension, hyperactivity, aggressiveness, drowsiness, stupor, respiratory depression, unconsciousness, difficulty breathing, ulcers around mouth and nose, weight loss, nutritional disorders, death. Phencyclidine (PCP) Cannot be properly classified as a hallucinogen, stimulant, or a depressant, causing it to be listed in a separate drug category. Can be smoked or ingested, and occasionally is injectable. Effects include: – euphoria, auditory/visual/time disturbances, loss of muscle control, delusions, tranquilization, inebriation, dissociation, changes in body imagery, perceptual distortions, feelings of apathy and estrangement, drowsiness, inability to verbalize, difficulty thinking, poor concentration, preoccupation with death. Phencyclidine (PCP) Because PCP produces a loss of feeling, accidents causing injury are common. High or consistent doses have led to incidents of violence. – Police have reported PCP users breaking out of steel handcuffs, failing to stop an attack despite being shot several times, or bleeding to death because of an inability to feel the injury. Adverse reactions may include: – paranoia, agitation, withdrawn or isolated feeling, bizarre delusions, increased heart rate/blood pressure, sweating, salivation, flushing, nystagmus (jerky eye movements). Phencyclidine (PCP) Does not appear to be physically addictive, although tolerance may develop. When smoked, users may become very psychologically dependent. Athletes and Drugs - Caffeine Caffeine present in two and a half cups of coffee may increase endurance, but does not improve performance during maximal short-term bursts of exercise. Caffeine increases urine output, causing potential implications for the athletes’ hydration status. Athletes and Drugs - Caffeine Adverse effects are dose-related and may include: – headaches, tremors, nausea, irregular heartbeat, restlessness, anxiety, insomnia. Withdrawal symptoms may include: – headaches, drowsiness, lethargy, irritability, depression. Athletes and Drugs - Tobacco While the percentage of smokers among athletes has declined, the use of chewing tobacco remains high. The Surgeon General has concluded that chewing tobacco is related to oral cancer, gum recession, and nicotine dependence. Nicotine does not heighten energy or strength! Athletes and Drugs - Amphetamines These drugs have an appetite-suppressing effect attractive to athletes for whom keeping a certain weight is critical. – – – – jockeys gymnasts wrestlers boxers Athletes and Drugs - Amphetamines Most people agree that amphetamines improve alertness. However . . . Amphetamines do NOT prevent fatigue, but mask fatigues which can lead to disaster! Athletes and Drugs - Amphetamines By diminishing pain thresholds, athletes are allowed to continue to compete despite injury, potentially causing more damage. There is an added potential for injury to others in contact sports because of the increase in aggressiveness caused by amphetamine use. Athletes and Drugs - Steroids Androgenic steroids – Include testosterone. Primarily develop and maintain male sex characteristics. Anabolic steroids – Are synthetic derivatives of testosterone developed in an attempt to minimize testosterone’s androgenic or masculinizing effects on the individual while promoting protein synthesis and muscular growth. Athletes and Drugs - Steroids Major effects of steroid use: – significant increases in strength – increases in lean body mass – increased ability to perform high-intensity training sessions Athletes and Drugs - Steroids Adverse effects of steroid use: – heart disease, elevated blood pressure, reduction of high density lipoproteins that aid in removing cholesterol, stunted growth. – Adverse effects on men: • liver and kidney damage, breast development, acne, baldness, cysts, shrinking of the testicles, sterility, reduced sex drive, headaches, nausea, dizziness. – Adverse effects on women: • infertility, clitoral enlargement, breast atrophy, menstrual irregularities, male pattern baldness, voice change. Athletes and Drugs - Steroids Evidence is emerging that the most significant effect of steroid use is psychological. – Aggressiveness, mood swings, depression, delusions, loss of control, continued use despite known adverse consequences, tolerance, withdrawal. These effects suggest that both physical and psychological dependence may occur. Athletes and Other Drugs/Alcohol Professional athletes may seek both relief from the pressures of athletic competition and the accompanying lifestyle, as well as enhancement of performance by using alcohol or other drugs. Alcohol/drug problems are still enabled and/or denied at many levels of athletic competitions. Additional efforts are needed to resolve the issue of alcohol/drug abuse and addiction at all levels of athletics.