The Dope on Dope: A Basic Primer in Drug Pharmacology

1. The Dope on Dope: A Basic Primer in Drug Pharmacology John D. King, MDiv, LAC Personal Performance Training Ft. Walton Beach, FL

2. Why this information? No one asked you to be a pharmacologist, nor should you be expected to be one. Yet, you are called on to work with clients who do engage in a wide variety of chemical substances. It behooves us to at least have a working knowledge of the drugs of abuse that are being used in our communities. Knowledge can mean a lot when trying to build rapport and it also helps to guide a client through the misinformation many abusers have about the very substances they use.

3. But first � � proof positive that drug abuse has been around for ages.

5. The Major Classes of Controlled Substances Depressants � induces sleep, relaxation Narcotics � relieves pain, induces stupor Stimulants � relieves fatigue, enhances alertness Hallucinogens � alters sensory perception Toxicants / Inhalants � CNS depression Steroids � enhances physical performance Since there are hundreds of examples, and we have limited time, I will review only a few of each

6. What we will review Each class and examples in each class The action of drug or what the taker seeks in taking them Dependence risk (physical vs. psychological) Dangers inherent and negative side effects Prevalence of use

7. The Narcotics From the Greek narcos � to sleep, stupor. Term is often misused. Several sub-groups of narcotics: Natural origin Semi-synthetic Synthetic

8. 19th Century America: A Drug Addict�s Paradise

11. Narcotics Data: Action sought: although an analgesic, most want the stuporous effect Dependence risk: both physical and psychological Dangers / side effects: nausea, infection, overdose, respiratory / cardiac arrest, venal collapse, death from overdose, delayed attention to legitimate physical illness. Prevalence of use: est 100,000 to 200,000 heroin users in 2007 and est 1-4 million illicit narcotics Rx users.

12. Nature�s Own Narcotics It all starts with the opium poppy (Papaver somniferum), which has been around for over 7000 years. Narcotics of natural origin found in the poppy: Opium (oldest form used) Morphine (most prevalent alkaloid) Codeine (most widely used in the world) Thebaine (primarily used to produce oxycodone and similar derivatives)

13. Semi-synthetics Heroin Developed in 1874 � as a curative for morphine addiction Harrison Narcotics Act Its action Usually cut From 1% to 70% Legal in some countries

14. More Semi-synthetics Dilaudid - marketed in tablets (2, 4, and 8 mg), suppositories, oral solutions, and injectable formulations analgesic potency two to eight times that of morphine, but it is shorter acting and produces more sedation than morphine Oxycodone (Oxycotin) derivative of thebaine Hydrocodone � (Lortab, Vicodin) � equivalent to morphine in potency

15. Synthetic Narcotics Meperidine (demerol) Darvon Fentanyl Methadone Analogues � keeping ahead of the authorities (e.g. -been over 15 for Fentanyl)

16. Depressants Alcohol (C2H5OH) � the most widely used of all Barbiturates (short to long acting) � Seconal, Nembutal, Tuinal .. And many more. Benzodiazepines � a million of them (Valium, Librium, Xanax) for anxiety, insomnia, anticonvulsants. Rohypnol (roofies) � date rape drug GHB � gamma hydroxybutyric acid Chloral Hydrate

18. Depressant Data: Action sought: sedation, anxiety and stress relief, convulsion control. Dependence risk: both physical and psychological Dangers / side effects: nausea, respiratory / cardiac arrest, impaired physical performance, death from overdose. Prevalence of use: est 150 million users of alcohol, plus 15 million abusers of legal Rx drugs. 15 million alcoholics.

19. The Stimulants Caffeine � most widely used in the world Nicotine � 2nd most widely used Coffee and a cigarette combination? Cocaine Amphetamines Methcathinone Methylphenidate

21. Stimulant Data: Action sought: excitation, perceived energy boost, extended wakefulness, some mild hallucination, relief of fatigue and minor anesthesia Dependence risk: both physical and psychological Dangers / side effects: paranoia, loss of sleep, cardiac arrest, dizziness, tremor, headache, flushed skin, chest pain with palpitations, excessive sweating, vomiting, abdominal cramps, agitation, hostility, panic, aggression, and suicidal or homicidal tendencies. Prevalence of use: estimated 2 million cocaine and amphetamine users in the US

23. Cocaine The most potent stimulant of natural origin Extracted from the coca plant Chew, brew, snort, inject Isolated in 1880�s for its local anesthetic quality Cocaine hydrochloride Free-base Crack A highly seductive drug High usually followed by dysphoric crash 2nd most used after marijuana in the US. (5/80 ratio)

24. Amphetamines First used in the 1930�s as anti-fatigue, hunger suppression, antidepressant � (benzedrine, dexedrine) Methamphetamine - injected or smoked. Aka - Ice, Crystal Meth Most clandestine labs Methcathinone (Cat) Anorectic � a slew of diet drugs (Didrex, Bontril) Khat � saw this in India

25. The Hallucinogens Sensory deprivation � enhancement � dysfunction All five senses can be involved Primary types: Marijuana LSD Psilocybin Peyote / Mescaline A raft of others

26. Hallucinogen Data: Action sought: sensory distortion, out of body experience, mood change, relaxation, Dependence risk: both physical and psychological Dangers / side effects: paranoia, elevated heart rate, increased blood pressure, and dilated pupils. Grandiose feelings can lead to dangerous activity or decisions. Fearful experiences leading to agitation and fear of the experience being real. Prevalence of use: estimated 25 million users of marijuana in the US and another .5 - 1 million users of other hallucinogens

27. Marijuana Cannabis sativa 1st cultivated for fibers (Washington) Cannabinoids (THC) Smoked, chewed, eaten Marinol � medical use Potency has skyrocketed in 30 years (1% to over 20%)

28. LSD Lysergic acid diethylamide (LSD) is the most potent hallucinogen known to science 1938 Dr. Albert Hoffman Very potent in pure form Alters sensory perception Not much use until late 50�s and into 60�s for study of mental illness The late Dr. Timothy Leary

29. Psilocybin Found in the wild throughout the Americas as well as cultivated (basements, caves) One of the tryptamines � naturally occuring but can be synthesized Potency varies by variety and cultivation

30. Peyote and Mescaline Small cactus that contains the chemical mescaline Used by some Native American tribes in religious ceremonies (movie: Altered States) The buttons are dried and eaten or made into a type of tea or tonic. Has been synthesized, too.

31. Hallucinogens � Analogue Heaven Of all the classes, this one seems to bring about the most chemically altered analogues Never ending battle to keep up with those in the illicit drug enterprise business. Examples are: MDMA (Ecstasy) PCP (Angel Dust) Ketamine (Special K)

32. The Toxicants / Inhalants Includes a wide variety of volatile substances: Glue / gasoline / hairspray Toluene Butyl nitrate White Out Nitrous oxide Freon Magic Markers?

33. Toxicant / Inhalant Data: Action sought: euphoria, disorientation, dizziness Dependence risk: psychological Dangers / side effects: suffocation, kidney abnormalities, liver damage, headaches, nausea, slurred speech, and loss of motor coordination, bronchial damage, and risk of explosion and burns. Mental effects may include fear, anxiety, depression and memory loss. Prevalence of use: estimated 1 million users, mostly adolescents. In 2005 national survey 25 million said they had used inhalants sometime in their life.

34. The Steroids Used for performance enhancement and weight gain Natural: testosterone Synthetics / anabolics: Boldenone Methenolone Nandrolone

35. Steroid Data: Action sought: muscle enhancement, increased size and strength of muscles, improve endurance, and decrease recovery time between workouts Dependence risk: psychological Dangers / side effects: Elevated blood pressure and cholesterol levels, severe acne, premature balding, reduced sexual function, and testicular atrophy. In males, abnormal breast development. In females, a masculinizing effect, resulting in more body hair, a deeper voice, smaller breasts, and fewer menstrual cycles. Several of these effects are irreversible. In adolescents, abuse of these agents may prematurely stop the lengthening of bones, resulting in stunted growth. Also reported: psychotic reactions, manic episodes, feelings of anger or hostility, aggression, and violent behavior (roid rage). Prevalence of use: estimated 1-3 million users in US.

36. Some good online sources that provide detailed, accurate, and routinely updated information: http://www.drugabuse.gov/DrugPages/DrugsofAbuse.html http://www.usdoj.gov/dea/pubs/abuse/chart.html http://www.drugabuse.gov/PDF/PrescriptionDrugs.pdf

37. Thank you! John D. King Personal Performance Training Ft. Walton Beach, FL