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Individual Drug Info

This article explores the distinction between physical and psychological dependence on drugs, the factors that contribute to addiction, and the available treatment options. It also provides information on the most addictive drugs and their effects on the body and mind.

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Individual Drug Info

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  1. Individual Drug Info Winter 2018

  2. Similar Properties Across Drugs Student Question: What is the difference between physical and psychological dependence? • Physical dependence • Psychological dependence • Student Question: Which drug is the most addictive? • Depends on who you ask • Depends on the individual and that person’s reasons for taking the drug • Depends on what substance(s) is/are readily available • Tolerance Not everyone who takes psychoactive substances becomes dependent on them, but we cannot predict who will and who won’t

  3. Differences • Forms • Availability • DEA Schedule • Effects • Acute • Chronic • Overdose • Photo, originally taken by Thoric, available to use in the public domain

  4. LSD

  5. LSD • Albert Hoffman: “Last Friday, April 16,1943, I was forced to interrupt my work in the laboratory in the middle of the afternoon and proceed home, being affected by a remarkable restlessness, combined with a slight dizziness. At home I lay down and sank into a not unpleasant intoxicated-like condition, characterized by an extremely stimulated imagination. In a dreamlike state, with eyes closed (I found the daylight to be unpleasantly glaring), I perceived an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors. After some two hours this condition faded away.”

  6. LSD • Schedule I hallucinogen synthesized in 1930s • Manufacturing secretive: Nick Sand (National Geographic, via YouTube, 3:39) • Student Question: Are there different types? • Same basic chemical structure • Illegal, so cannot guarantee contents, care of product • Light and air may degrade drug • Dosage measured in micrograms (very small) • “Microdosing” – small portion of normal dose to reduce disruptive effects, increase desirable effects • BBC – People Who Take LSD With Breakfast (via YouTube) (0-4:48)

  7. LSD Forms • Crystal can be crushed, mixed with other materials into tablets: microdots • Gelatin squares • Converted to liquid paper • Dosed onto sugar cubes • Placed on candy (gummy bears - Lake Tahoe, 2011, e.g.) • Usually taken orally • Can be inhaled, injected, applied transdermally

  8. LSD Acute Effects • Duration of “trip” = several hours in length • Visual hallucinations (images, color, light) • Altered perception of senses • “Seeing sounds, hearing colors” • Color, size of objects • Altered perception of time, depth • Potential anxiety/panic • Experiences can vary widely • Serotonin receptors may be excited or inhibited • Brain imaging on LSD (CNN, 2016) • LSD experimentation on British soldiers (YouTube.com) • Overdose thought to be rare, but some individuals may not respond well, or may experience problems if drug is different than LSD

  9. LSD • Chronic effects may involve flashbacks • Sudden onset of abnormal perceptions • Hallucinogen Persisting Perception Disorder • Visual images remain longer than in consciousness • Dr. Henry Abraham (Tufts University) blog

  10. LSD Research • Research on hallucinogenics as treatment for end-of-life anxiety CBS News interview video (February 2017) • Study sponsored by Multidisciplinary Association for Psychedelic Studies, carried out by Swiss physician Peter Gasser (no video; article) • Information published 2014 • 12 patients with terminal illness, end-of-life anxiety • Took two doses of LSD with talk therapy, across eight weeks • Those with larger dose reported improvement • Future research? Difficult-to-treat depression, alcoholism

  11. Heroin

  12. Heroin – Scope of Use • According to SAMHSA, average age at first use is 24.5 years (2013) • At left: numbers reporting heroin use in past year and past month, persons aged 12y+ • Per SAMHSA, number reporting dependence: 517,000 (2013) National Survey on Drug Use and Health, 2013, via SAMHSA

  13. Heroin – Current Concern • Narcotic • Schedule I • In the news because of overdoses • Much higher death rates per 100,000 of population • Added substances (e.g. Fentanyl) in products contribute to deaths

  14. Cannabis - marijuana Student Question: How does weed affect people? In what states is weed legal? How does marijuana affect anxiety and depression? Does marijuana affect respiratory function? Especially during exercise? Is marijuana more destructive to your brain than alcohol?

  15. Cannabis • Cannabis sativa • Different subspecies/varietals used for clothing vs drug use • Active ingredient: THC • THC is a cannabinoid • Interacts with cannabinoid receptors in brain • Many other cannabinoids exist, but not thought to cause psychoactive reactions • DEA: Schedule I • Despite state regulations, marijuana still federally illegal

  16. Medical cannabis source: procon.org, 12/28/16

  17. Recreational Cannabis • Washington (2013) • Colorado (2013) • Washington, DC (2014) • Oregon (2014) • Alaska (2014) • Maine (2016) • Massachusetts (2016) • California (2016) • Nevada (2016) • Map (governing.com) • Student Question: If weed can be used for medical purposes, then why is it illegal in different states? • Good question • Long-standing influences from culture, government

  18. Cannabis Acute effects • THC acts on cannabinoid receptors, increases dopamine, serotonin • Increases appetite • ASAP Science: Your Brain on Marijuana (via YouTube) • Infamous call in Michigan (full call here) • Student Question: Are blunts much worse for health than bongs, joints, and other forms of smoking? • Possibly (more smoke since more product; depends on inhalation, frequency, amount of time passing when one smokes

  19. Depression and Anxiety • Many use marijuana to ease mood • Regular use may trigger, or worsen, either condition, especially in younger people • 2013 Imperial College study showed lower dopamine levels in regular users, which may lead to more anxiety • Marijuana, conversely, may help those with Post-Traumatic Stress Disorder • Memory inhibition

  20. Student Question: What are the negative side effects of smoking weed other than it being bad for your lungs? Can weed kill? Chronic effects • Respiratory distress • Mood swings • Impaired memory (potential hippocampus damage) • Earlier research • 2011 NIMH/NIDA study • Daily use may reduce brain receptor number • Receptors regenerated with cessation • Society of Nuclear Medicine. "Chronic marijuana smoking affects brain chemistry, molecular imaging shows." ScienceDaily. ScienceDaily, 13 June 2011. <www.sciencedaily.com/releases/2011/06/110606131705.htm>.

  21. Marijuana & Respiratory Function During Exercise • Acute effect: any smoke can interfere with oxygen binding to red blood cells • Acute: marijuana can disrupt coordination, balance, reaction time • Acute: increase heart rate and blood pressure • Acute: stored THC in fat could be released into bloodstream during exercise • Chronic: depends on how frequently one smokes, type of exercise

  22. Marijuana & Driving? • Legal limit is 5 nanograms • Medical patients may have higher levels (tolerance) • If driving dangerously, can be pulled over, regardless of drug influence • Local driving test

  23. Dimethyltryptamine (DMT) What is DMT? How does DMT work as a psychoactive drug?

  24. Dimethyltryptamine • Chemical structure • Hallucinogenic ingredient • Present in a variety of plants • Occurs naturally in the body • Schedule I substance Image source: Wikimedia Commons

  25. Dimethyltryptamine • Often consumed via beverage: ayahuasca tea • Requires MAO-I (specific vine) • Ceremonial purposes • Ashland, OR Brazilian church lawsuit • Can be injected, inhaled, smoked

  26. Dimethyltryptamine Effects • Hallucinogenic visualizations • Mood change • Time distortion • Dissociation • Muscle twitching, coordination difficulties • Nausea, vomiting • Shorter-lasting effects than other hallucinogens • “businessman’s trip” per DEA • 30-60 minutes • Video Clip - The Spirit Molecule, Part 1 (YouTube, 1:44) • Video Clip – London Real (34:00+ = trip described) Source: Arch Gen Pesychiatry. 1994 Feb;51(2):98-108.

  27. Mushrooms

  28. Mushrooms • Psilocybin/psilocin are two active psyhoacticve substances found in “magic mushrooms” Most from psilocybe genus, couple dozen species • Taken orally • Recognized for centuries Probably used in religious rites • Hallucinogen • Schedule I

  29. Mushrooms • Dose • Varies • Fresh vs dried • User • Trip desired • ~1 mushroom or less for new user

  30. Mushrooms • Acute effects: • Relaxation • Altered perception of reality • Altered perception of time • Sense of connection to others/universe • Visual hallucinations (images, color, light) • Potential for anxiety and subsequent panic, heart rate & blood pressure increase • Chronic effects: • A “bad trip” may trigger fear • Hallucinogens may exacerbate mental illness

  31. Mushrooms • Student Question: How do they interact with antidepressants? • According to 2006 publication of Australian Pharmacist: • Information on LSD only (hallucinogens impact serotonin) • Taking anti-depressants may increase or decrease hallucinogen’s effects • Avoid stopping SSRI medications • Flu-like symptoms • Headache • Mood changes • Irony? Treatment investigations: OCD, depression, smoking cessation • In depression, psilocybin may “turn off” parts of the brain that are overactive among individuals who are depressed (Discovery, 1/2012) • Johns Hopkins Psilocybin Cancer Project (via YouTube, 0:30-4:03)

  32. Methamphetamine Chronic Effects Before & After Photos

  33. Before and After Photos 3 Years and 5 months after starting meth Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm

  34. Before and After 17 months after starting meth Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm

  35. Before and After 3 months later Meth Awareness Prevention Project: http://www.mappsd.org/Faces%20of%20Meth.htm

  36. Student Question: Which Drugs are Most Dangerous? • Largely depends on availability • Carl Hart, Columbia University, on drug abuse (0-2:40) • Most emergency department (ED) visits: alcohol (DAWN, 2011) • Half + of 2.5 million ED visits: illicit substances

  37. Student Question: Is Heroin or Meth More Addictive? • Depends on availability, mode, reasons for use • 2008 study by Hser et. Al.: • Researchers examined data from five studies • Assessed 10-year drug behaviors among 629 heroin users, 694 cocaine users, 474 meth users • Heroin users: used 13-18 days per month • Cocaine: used 8-11 days per month • Meth: 12 days per month • Groups – “consistently high use,” “increasing use,” “decreasing use,” “moderate use,” “low use” • Heroin over-represented in “consistently high use,” under-represented in “low use” • 2011 study by Novak et. Al. – injection users were more likely to abuse and become dependent

  38. Student Questions • “Why do we focus more on jailing addicts than recovery options? What helps people quit these substances? Are there any positive uses that have been proven and could be used under a doctor’s watch?” • History, government, culture • Cocaine, opium available in 1800s, early 1900s • Harrison Act in early 1900s regulated these substances – taxing • Those who did not pay the tax were in legal trouble (tax evasion) • Alcohol prohibited (prohibition later appealed) • Heroin Act, Narcotic Drug Import & Export Act • 1970 Drug Abuse Prevention & Control Act • NIDA Principles of Effective Treatment

  39. Student Question (continued) • WHO ATLAS on Substance Abuse (2010) • Alcohol main problem • Other drug issue is cocaine • 39 deaths per 100,000 (35 due to alcohol) • Not enough government resources • Africa – out of pocket treatment costs • Beds: 1.7 per 100,000 • Many other issues

  40. Methamphetamine

  41. Methamphetamine • Famous/notorious for laboratory production, short-term dopamine effects & long-term effects • Stimulant (blood pressure, heart rate, alertness) • DEA: Schedule II substance (Desoxyn: ADD, narcolepsy, weight control)

  42. Methamphetamine acute effects • Intense high/euphoria • May last up to 12 hours (longer than cocaine) • Meth Inside and Out video describing effects • Energetic, talkative, excitable • Insomnia • Increased heart rate, blood pressure • Sweating • Dry mouth • Jaw clenching • Nausea, vomiting • Comparison: meth vscocaine,Brookhaven National Laboratory, 2008

  43. Methamphetamine chronic effects • Chronic users may experience hallucinations, rage, paranoia, heart “meth mouth;”damage to dopamine-, serotonin-containing nerve cells • Crank Bugs (Meth Project) • Meth Mouth (Meth Project) • Ashley’s Story (Meth Project) • Research supports both brain damage as well as lack of brain damage

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