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Hallucinogens. Hallucinogens. Where do they come from? Organic and synthesized origins History plants used in religious ceremonies and as part of indian rituals LSD discovered in 1938; Hoffman absorbed it became widely recognized and used in 1960s
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Hallucinogens Where do they come from? Organic and synthesized origins History plants used in religious ceremonies and as part of indian rituals LSD discovered in 1938; Hoffman absorbed it became widely recognized and used in 1960s e.g., cultish subculture: T. Leary--turn on, tune in, drop out reemergence of LSD in rave subculture in 1990s uses of LSD, X in psychotherapy
Hallucinogens Types 1. Serotonergic hallucinogens (Phantastica) chem similar to _______________ 2. Methylated amphetamines (Phantastica) chem similar to ________________________...alterations in mood without much change in senses 3. Anticholinergic - (Deliriants) _________________ receptor sites central mechanism found in plants: belladonna, mandrake, jimson weed can produce trance or dream-like states 4. Dissociative anesthetics (Deliriants) can remain conscious in surgery; causes euphoria, numbness, aggressive behavior, and tactile sense disturbances
Lysergic acid diethylamide (LSD) Ergot fungus Psilocybin (mushrooms) mushrooms Dimethyltryptamine (DMT) Virola trees Mescaline Peyote cactus Harmaline, Harmine Ayahuasca vine Ergine, Isoergine morning glory Lysergic Acid Amide morning glory Serotonergic Hallucinogens
MDMA (Ecstacy) synthetic MDA (Love Drug) synthetic DOM (STP) serenity, tranquility, pax? Methylated Amphetamines
Atropine belladonna plant Scopolamine roots of mandrake, herbane Hyoscyamine roots of mandrake, herbane Ibogaine Iboga plant Acetylcholinergic Hallucinogens
Phencyclidine (PCP, Angel Dust) synthetic Ketamine PCP-like drug Dissociative Anesthetic Hallucinogens
Methylenedioxymethamphetamine • “MDMA” for short • MDMA is a synthetic norepinephrine-related hallucinogenic drugIt is popularly called: Ecstasy X Adam Lover’s Speed XTC E Clarity (among other names)
History • First synthesized in Germany in 1914 • First used in the 1970s in the U.S. as an adjunct to psychotherapy • to enhance empathy, introspection, communication • to induce positive mood states & feelings of intimacy and tranquility • At the same time animal studies showed it produced permanent brain damage • Popular with young people since the late 1980s
History • Not to be confused with “Herbal ecstasy” containing ephedrine and other herbs • Reputed to be a safe “recreational” or “therapeutic” drug in a dose of 1 to 2 mg. • Deaths have been attributed to the use of MDMA – why?
History • In 1989 the Drug Enforcement Administration placed MDMA on the Schedule I drug list • Interestingly, the Multidisciplinary Association for Psychedelic Study continues to lobby to legalize MDMA for research • Has undeserved reputation as being totally safe, but research lacking
Methods of Use • Distributed in tablet form for oral ingestion • In New York, 100 mg. tablet costs approx. $20 • Many “rave-goers” report experimenting with “stacking” -- • taking 3 or more tablets at once and/or • mixing MDMA with herbal ecstasy, LSD, alcohol, marijuana, and other drugs of abuse
Signs and Symptoms ofMDMA Intoxication: Most Common Symptoms and Signs: • Muscle tension and aches • jaw clenching • sweating • fatigue • difficulty concentrating & retaining newly learned material • Confusion or delirium even weeks after drug use Occasional Symptoms: • Intense dysphoria (depression, anxiety)
Common Serious Adverse Effects of MDMA Serious Illness and Death have occurred from: • ___________________________________ • ___________________________________ • ___________________________________ • ___________________________________ • ___________________________________ • ___________________________________ • ___________________________________
Brain on Ecstasy • The brain scan on the right belongs to an individual who used Ecstasy many times, but had not used any drugs in the last 3 weeks before the scan. • The bright red spots on the left “normal” brain scan are serotonin receptor sites. • Whereas, the dark spots at the top of the right scan are serotonin receptor sites which are not active
What are Raves? • Clandestine dance parties (location usually kept quiet until 1-2 days before event) • Held at abandoned warehouses, other locations • Advertised by flyers or word of mouth
What are they like? • Loud, repetitive, synthesized electronic music at 80-120 beats per minute mixed by disk jockeys • Only laser lights illuminate the darkened building • Vigorous, all night dancing
Raves • Rave attendees are usually high school and college students (some junior high students) • Because alcohol may not be served at some raves, water and power drinks are served to help to replenish fluid losses from vigorous dancing and MDMA use • Carnival-like atmosphere with sales of: • drug paraphernalia and drugs • brightly-colored nitrous oxide filled balloons • baby bottles and pacifiers (used to help mediate adverse effects of jaw-clenching)
Raves • PLUR Philosophy (Peace, love, unity, and respect)plus the focus on drugs (ecstasy, LSD, GHB, speed & pot) has earned ravers the name “techno-hippies” • According to rave-goers, PLUR is what Raves are all about. Quote from a rave attendee:“We have unconditionally-accepting ‘freaks are us’ love.”
Screening & Emergency Treatment of Acute Toxicity • MDMA can be detected by drug screening for amphetamines • but test sensitivity is reduced by about 50% • Treatment: • Rapid Cooling • Rehydration • Monitoring electrolytes • Monitoring organ function
Risk Factors of MDMA Usage Adolescents who have aggregates of the following: • Have close friends who use drugs • Frequently attend raves • Early use of nicotine • Frequent use of marijuana • May have interpersonal issues with parents and authority figures
Diagnosis and Treatment • The diagnosis is complicated by comorbidity • Least intrusive method is outpatient after-school drug treatment and education • Most drug treatment programs recommend: • abstinence from drugs and alcohol • severing ties with drug-using friends • Self-help groups • Unscheduled monitoring by urine toxicology tests