Download Narcotics

Narcotics
&
drugs of abuse
Introduction
Drugs are so commonly used and abused
in modern societies that virtually everyone
has some familiarity with the concept of
drug addiction and abuse.
drugs that affect behavior are particularly
likely to be taken in excess when the
behavioral effects are considered
pleasurable
Drugs of abuse
Is simply excessive use of a drug or use
of a drug for purposes for which it was not
medically intended.
Drug Categories for Substances of
Abuse
•
•
•
•
•
•
•
Narcotics
Depressants
Stimulants
Hallucinogen
Cannabis
Alcohol
Steroids
Narcotics
Drugs used medicinally to relieve pain
High potential for abuse
Cause relaxation with an immediate "rush"
Initial unpleasant effects - restlessness,
nausea
• Types:
Opium, Morphine, Codiene, Heroin,
Hydromorphone, Meperidine, Methadone.
Depressants
Drugs used medicinally to relieve anxiety,
irritability, tension
High potential for abuse, development of
tolerance
Produce state of intoxication similar to that of
alcohol
Combined with alcohol, increase effects,
multiply risks
• Types:
Barbiturates, Methaqualone, Tranquilizers,
Chloral hydrate, Glutethimide.
Stimulants
Drugs used to increase alertness, relieve
fatigue, feel stronger and more decisive;
used for euphoric effects or to counteract
the "down" felling of tranquilizers or
alcohol.
• Types:
Cocaine, Amphetamines,
Methamphetamine, Phenmetrazine,
Methylphenidate, Other stimulants, Ice.
Hallucinogens
Drugs that produce behavioral changes
that are often multiple and dramatic
No known medical use, but some block
sensation to pain and use may result in
self-inflicted injuries
"Designer Drugs", made to imitate certain
illegal drugs, are often many times
stronger than drugs they imitate
• Types:
PCP (angel dust, loveboat), LSD (acid,
green/red dragon), mescaline, peyote,
psilocybin, designer drugs (ecstasy-PCE).
Cannabis
Hemp plant from which marijuana and
hashish are produced;
Hashish consists of resinous secretions of
the cannabis plant;
Marijuana is a tobacco-like substance.
• Types:
marijuana, tetrahydrocannabinol, hashish,
hashish oil.
Alcohol
Liquid distilled product of fermented fruits,
grains and vegetables
Used as solvent, antiseptic and sedative
Moderate potential for abuse.
• Types:
ethyl alcohol, ethanol.
Steroids
Synthetic compounds available legally and
illegally
Drugs that are closely related to the male
sex hormone, testosterone
Moderate potential for abuse, particularly
among young males.
• Types:
dianabol, nandrolone.
Narcotics
• The term "narcotic," derived from the Greek word for
stupor, originally referred to a variety of substances
that dulled the senses and relieved pain. term
originally applied to all compounds that produce
insensibility to external stimuli through depression of
the central nervous system, but now applied
primarily to the drugs known as opiates—
compounds extracted from the opium poppy and
their chemical derivatives. Also classed as narcotics
are the opioids, chemical compounds that are
wholly synthesized, but which resemble the opiates
in their actions.
• Narcotics have a high potential for abuse. As
abused drugs they are sniffed, smoked, or selfadministered by the more direct routes of
subcutaneous (“skin-popping”) and intravenous
(“mainlining”) injection. Drug effects depend heavily
on the dose, route of administration, and previous
exposure to the drug. Aside from their medical use,
narcotics produce a general sense of well-being by
reducing tension, anxiety, and aggression. These
effects are helpful in a therapeutic setting but con
tribute to their abuse
Does using opiates cause dependence or
addiction?
• Yes. Dependence is likely, whether using
large amounts frequently or occasionally
over a long period of time. When a person
becomes dependent, finding and using the
drug often becomes the main focus in life.
As more and more of the drug are used
over time, larger amounts are needed to
get the same effects. This is called
tolerance. Withdrawal signs usually begin
shortly before the user’s body expects its
next dose of narcotics.
Types of narcotics
• Naturally occurring narcotics:
-Heroin
-Codeine
-Morphine
-Opium
• Synthetic narcotics/opiates:
-Neperidine (Demerol)
-Percodan
-Darvon
-lomotil
Street Names:
• Morphine: Morpho, Unkie, M, Miss
Emma, Hocus, dreamer.
• Codeine: Schoolboy
• Heroine: Snow, Stuff, Harry, H, White
Horse, Horse, Hard Stuff, White Stuff, Joy
Powder, Scag, Junk, brown sugar.
• Meperidine: Doctors
• Methadone: Dollies, Methadose, frizzies.
• Cocaine: coke, crank, crack, snow, zip.
Opium, narcotic drug
produced from the drying
resin of unripe capsules of
the opium poppy, Papaver
somniferum.
Today opium is sold on the
street as a powder or dark
brown solid and is smoked,
eaten, or injected.
Papaver somniferum
Heroin,
Of all illegal drugs, is responsible for the greatest
number of deaths. In its pure form, heroin is white
and has a bitter taste. Most street preparations of
heroin are diluted or “cut,” with other substances.
Illegal (street) heroin comes in different forms,
ranging in color from white to dark brown.
Heroin is usually “mainlined,” but it can be
inhaled or smoked. Heroin may cause
physical and psychological problems
such as nausea, panic, insomnia, and
tolerance. Its addictive properties
create a need for repeated use of the
drug (craving) and painful physical
withdrawal symptoms.
heroin
• Codeine is mostly produced
from morphine. Used for relief
of moderate pain, codeine may
be in the form of tablets or can
be combined with other
products, such as aspirin or
acetaminaphin (Tylenol 3).
Liquid codeine preparations
are used for the relief of
coughs. Codeine is also
manufactured to a lesser
extent in an injectable form for
the relief of pain. It is by far the
most widely used naturally
occurring narcotic in medical
treatment.
Codein tablet
Morphine the principal product of opium is one of
the most effective drugs known for the relief of pain.
Morphine is the active ingredient in most narcotics,
marketed in the form of white crystals, hypodermic
tablets, and injectable preparations. It is used legally
primarily in hospitals. Morphine is odorless, tastes
bitter, and darkens with age. It may be administered
subcutaneously, intramuscularly, or intravenously.
Tolerance and dependence develop rapidly. Only a
small part of the morphine obtained from opium is
used medically. Most is converted to codeine.
• Percodan is similar to codeine but is
usually mainlined. Percodan is much
more potent and has a higher dependence
potential than codeine.
• Dilaudid, a shorter acting and more
sedative drug than morphine, is usually 2
– 8 times the potency. Dilaudid is usually
marketed in tablet and injectable form and
is generally obtained through theft and
false prescriptions
Cocaine, alkaloid
obtained from leaves
of the coca plant and
used medically as a
local anesthetic. It is
also widely abused as
a drug.
Cocaine is classified
as a narcotic for legal
purposes by the
United States
government. It causes
strong psychological
dependence.
.
Coca plant
Crack cocaine
The plant
Cannabis sativa is
the
source of
both
marijuana
and hashish.
Both drugs are usually smoked. Their effects are
similar: a state of relaxation, accelerated heart rate,
perceived slowing of time, and a sense of heightened
hearing, taste, touch, and smell. These effects can
differ, however, depending on the amount of drug
consumed and the circumstances under which it is
taken.
Marijuana and hashish do not produce
psychological dependence except when
taken in large daily doses. The drugs can
be dangerous, however, especially when
smoked before driving.
Cannabis sativa
Marijuana cigarette
marijuana pipe
Drug dependance
Drug Dependence, psychological and sometimes
physical state characterized by a compulsion to use a
drug to experience psychological or physical effects.
Drug dependence takes several forms:
• Tolerance, a form of physical dependence, occurs when
the body becomes accustomed to a drug and requires
ever-increasing amounts of it to achieve the same
pharmacological effects.
• Habituation, a form of psychological dependence, is
characterized by the continued desire for a drug, even
after physical dependence is gone.
• Addiction is a severe craving for the substance and
interferes with a person’s ability to function normally. It
may also involve physical dependence.
The intensity and character of the physical
symptoms experienced during withdrawal
are directly related to the particular drug of
abuse, the total daily dose, the interval
between doses, the duration of use, and
the health and personality of the user.
Symptoms:
•
•
•
•
•
•
•
•
•
Abscesses at injection sites
Drowsiness, slowed pulse
Constricted pupils
respiratory depression
Nausea, vomiting and Constipation
Needle marks on extremities
Euphoria, lethargy and Lack of motivation
Flushing of skin on face, chest and neck
Except in cases of acute intoxication, there is no loss
of motor coordination or slurred speech as occurs with
many depressants.
Overdose Symptoms:
•
•
•
•
•
Shallow breathing
Slowed pulse, clammy skin
Pulmonary edema
Respiratory arrest, coma
Convulsions, possible death
Withdrawal Symptoms:
The withdrawal symptoms associated with
heroin/morphine addiction are usually experienced
shortly before the time of the next scheduled dose.
•
•
•
•
•
•
Runny nose, teary eyes and Excessive yawning
Restlessness, irritability, nausea and loss of appetite
Diarrhea, tremors and Goose bumps
Chills, shakes, flushing and excessive sweating
Muscle jerks, cramps, Nodding and sleep
Severe depression and vomiting are common. The heart rate
and blood pressure are elevated. And drug craving appear.
At any point during this process, a suitable narcotic
can be administered that will dramatically reverse the
withdrawal symptoms. Without intervention, the
syndrome will run its course, and most of the overt
physical symptoms will disappear within 7 to 10 days.
When an opiate-dependent person stops •
taking the drug, withdrawal usually begins
within 4-6 hours after the last dose. the
intesity of withdrawal symptoms depend
on amount of the drug taken, how often
and for how long. These symptoms for
most opiates are stronger approximately
24-72 hours after they begin and subside
with 7-10 days. sometimes symptoms
such as sleeplessness and drug craving
can last for months.
Treatment of opiate addiction
The basic appeoaches to drug abuse treatment
are:
• Detoxification. supervised withdrawal from drug
dependence, either with or without medication,
in a hospital or as an putpatient.
• Drug-free program, which emphasize various
forms of counseling as the main treatment.
• Methadone maintenance, which provides
methadone, (a substitute for heroin) to an
opiate-dependent person in a daily basis to help
them lead productive lives while still in
treatment.
Social issues
In a 1999 household survey by the Substance Abuse
and Mental Health Services Administration an
estimated 14.8 million people in the United States
classified themselves as current illicit drug users.
Among youths aged 12 to 17, close to 8 percent of
respondents were regular users of marijuana. The
percentage of youths in the same age range who used
cocaine at least once a month was 49.8 percent. The
survey also reported an estimated 1.6 million U.S.
residents used prescription drugs for nonmedical
purposes in 1998. The state with the highest rates of
dependence on illicit drugs was Alaska with 2.8
percent of its 12 and older population dependent on
illicit drugs and 7.3 percent dependent on illicit drugs
or alcohol.
International control of drugs
The purpose of the conventions is to provide
Governments with the necessary tools to
address drug production, trafficking and
abuse problems individually and
collectively. Each of the major conventions
relating to drug control now has over 140
signatories.
There are three major international drug control
treaties currently in force:
• 1961. The Single Convention on Narcotic Drugs
• 1971. The Convention on Psychotropic Substances
• 1988. The UN Convention Against Illicit Traffic in
Narcotic Drugs and Psychotropic Substances
• These three United Nations conventions embody the
efforts of the international community to cooperate in
the field of drug abuse control. They also contain the
principal objective of all previous international
conventions in this field, namely to restrict the use of
drugs to purely medical and scientific purposes. The
UN drug control conventions do not recognize a
distinction between licit and illicit drugs and describe
only the use as licit or illicit.
The provisions of these conventions, upon its
coming into force, shall, as between parties
hereto, terminate and replace the provisions of
the following treaties:
• International Opium Convention, signed at The
Hague on 23 January 1912;
• Agreement concerning the Manufacture of, Internal
Trade in and Use of Prepared Opium, signed at
Geneva on 11 February 1925;
• International Opium Convention, signed at Geneva
on 19 February 1925;
• Convention for Limiting the Manufacture and
Regulating the Distribution of Narcotic Drugs, signed
at Geneva on 13 July 1931;
• Agreement for the Control of Opium Smoking in the
Far East, signed at Bangkok on 27 November 1931;
• Protocol signed at Lake Success on 11 December
1946, amending the Agreements, Conventions and
Protocols on Narcotic Drugs concluded at The
Hague on 23 January 1912, at Geneva on 11
February 1925 and 19 Febryary 1925 and 13 July
1931, at Bangkok on 27 November 1931 and at
Geneva on 26 June 1936, except as it affects the
last-named convention;
• The Conventions and Agreements referred to in the
last paragraphs as amended by the Protocol of
1946;
• Protocol for Limiting and Regulating the
Cultivation of Poppy Plant, the Production of,
International Wholesale Trade in, and Use of
Opium, signed at New York on 23 June 1953,
should that Protocol have come into force.
• Protocol signed at Paris on 19 November 1948
Bringing under Intentional Control Drugs outside
the Scope of the Convention of 13 July 1931 for
Limiting the Manufacture and Regulation the
Distribution of Narcotic Drugs, as Amended by
the Protocol signed at Lake Success on 11
December 1946;
The objectives of these conventions
are:
• To gather all the existing multilateral treaties.
• To create a single unified body, which is the
INCB (International Narcotics Control Board).
• To limit the production of Narcotic plants.
Single Convention on Narcotic Drugs, 1961
The adoption of this Convention is regarded as a
milestone in the history of international drug control.
The Single Convention codified all existing multilateral
treaties on drug control and extended the existing
control systems to include the cultivation of plants that
were grown as the raw material of narcotic drugs. The
principal objectives of the Convention are to limit the
possession, use, trade in, distribution, import, export,
manufacture and production of drugs exclusively to
medical and scientific purposes and to address drug
trafficking through international cooperation to deter
and discourage drug traffickers. The Convention also
established the International Narcotics Control Board,
merging the Permanent Central Board and the Drug
Supervisory Board.
Yellow list
• This document contains the current list of
narcotic drugs under international control
and additional
• information to assist governments in filling
in the International Narcotics Control
Board questionnaires related
• to narcotic drugs, namely, form A, form B
and form C. It is divided into four parts:
•
Part 1 gives a list of narcotic drugs under
international control; it is subdivided into three
sections:
the first section listing those drugs included in
Schedule I of the 1961 Convention and/or Group I of
the 1931 Convention, the second section listing
those drugs in Schedule II of the 1961 Convention
and/or Group II of the 1931 Convention and the third
section listing those drugs in Schedule IV of the
1961 Convention and/or Group II of the 1931
Convention. The names and descriptions used are
those given in the 1961 Convention or in the official
notifications of the Secretary-General of the United
Nations. International non-proprietary names
recommended by the World Health Organization
are printed in bold type; in many cases the
chemical formula is given to facilitate identification.
• Part 2 lists the preparations of narcotic
drugs exempted from some provisions and
included in Schedule III of the 1961
Convention.
• Part 3 is a list in alphabetical order of the
names given to the narcotic drugs other
than the names listed in Part 1, and other
designations (mainly trade names) of
preparations containing narcotic drugs.
• Part 4 contains tables showing the pure
anhydrous drug content of esters, ethers and
salts of narcotic drugs listed in the Schedules
as well as the equivalents, in terms of the pure
anhydrous drug, of certain extracts and
tinctures.
Convention on Psychotropic
Substances 1971
This Convention establishes an
international control system for
psychotropic substances. It responded to
the diversification and expansion of the
spectrum of drugs of abuse and
introduced controls over a number of
synthetic drugs according to their abuse
potential on the one hand and their
therapeutic value on the other.
Green list
•
•
•
•
The Green List is divided into four parts:
Part one. Substances in Schedules I-IV of the
Convention on Psychotropic Substances of 1971;
Part two. Names, synonyms and trade names of
psychotropic substances, their salts and preparations
containing psychotropic substances under
international control;
Part three. Pure drug content of bases and salts of
psychotropic substances under international control;
Part four. Prohibition of and restrictions on export and
import pursuant to article 13 of the Convention on
Psychotropic Substances of 1971.
United Nations Convention against the Illicit
Traffic in Narcotic Drugs and Psychotropic
Substances, 1988
This Convention provides comprehensive
measures against drug trafficking, including
provisions against money laundering (practice
of engaging in financial transactions in order to
conceal the identity, source and/or destination
of money and is a main operation of
underground economy) and the diversion of
precursor chemicals. It provides for
international cooperation through, for example,
extradition of drug traffickers, controlled
deliveries and transfer of proceedings.
Red list
The list is comparable to the lists of narcotic
drugs and psychotropic substances under
international control, and the alphabetical
listings of other names and trade names of
narcotic drugs and psychotropic
substances, which are published by the
Board as the "Yellow List" and the "Green
List", respectively.
• Part One gives a list of those substances
scheduled in Tables I and II of the 1988
Convention. The list is divided into two sections,
the first listing those substances included in
Table I, and the second listing those substances
in Table II. English, French and Spanish names
as used in the respective versions of the Tables
of the 1988 Convention are given, as well as
Harmonized System (HS) codes and Chemical
Abstracts Service (CAS) registry numbers, to
facilitate rapid identification of all scheduled
substances. The full Chemical Abstracts Index
name of each substance is given also for
reference purposes.
• Part Two lists in alphabetical order the
chemical names, synonyms and trade names,
etc., of the substances included in Part One.
Although not explicitly stated in the 1988
Convention, it is understood that the name of
each of those substances, as given in the
Tables of the Convention, covers also all
isomeric forms of the substance. Consequently,
it should be noted that where a specific isomer
is listed in Part Two, for example l-ephedrine as
a synonym for ephedrine, this should not be
understood to mean that only the l-form of
ephedrine is controlled.
• Part Three provides a table of conversion
factors needed to convert quantities of
scheduled substances in their salt form
into quantities of pure anhydrous base.
• Part Four lists those Governments that
have requested pre-export notifications
pursuant to article 12, paragraph 10 (a), of
the 1988 Convention.
presented by:
• Nahid Osman
• Nuha Bashir
• Shaimaa Jabir
•
•
•
•
•
Marwa Nasr Alhadi
Afraa Altayyib
Dania Abdalla
Magboola Mohammed
Nusayba Sa’eed
Under the supervision of:
Dr. Ahmad El-jamal
Thanks