Amphetamines

1. Amphetamines Dr. M. Maneesh Kumar Reddy Assistant professor Chalapathi Institute Of Pharmaceutical Sciences, Lam

2. What are Amphetamines? • The term “amphetamines” refers to a class of drugs. • World War II • Stimulants for soldiers and prisoners (1) http://images.google.com/imgres?imgurl=http://www.modafinil.com/article/modsold.jpg&imgrefurl=http://www.modafinil.com/article/soldiers.html. Accessed 29 April 2006.

3. Amphetamine-like Drugs • Most commonly abused by college students: • Methamphetamine • Results in CNS excitation • In other words, it “revs up” your brain • Chemical responsible for these effects: Dopamine • MDMA • Serotonin, not dopamine, is the chemical responsible for the effects felt from using MDMA • “Designer” amphetamines (1)

4. “Designer Drugs” • What is Methamphetamine? • Street names: • “meth” “speed” “chalk” • “ice” “crystal” “glass” (1,2) • What is MDMA? • Street names: • “ecstasy” “E” “Adam” “XTC” “M&M” (1) http://www.teens.drugabuse.gov/facts/facts_xtc1.asp. Accessed April 6, 2006.

5. Methamphetamine Crystalline powder White, odorless Tastes bitter This form is referred to as “speed” or “meth” Smoked form Referred to as “ice” “crystal” “glass” (2) Injection (needle use) (3) MDMA Tablets Colorful and branded Prevalent at “rave” and club scenes (1) Amphetamines Forms http://www.michigan.gov/images/ravdrug_8430_7.jpg Accessed March 29, 2006

6. Methamphetamine Increased energy & alertness Improve mood A false feeling of being happier Decrease appetite (1) MDMA Euphoria Heightened awareness Inner peace Ease of socializing (3) Why Do People Use Amphetamines?

7. Graph: Amphetamine use/abuse vs. Methamphetamine (2) Methamphetamine is one of the most widely used and abused drugs, in college age students, today http://www.nida.nih.gov/ResearchReports/Methamph/methamph2.html#what. Accessed April 6, 2006.

8. Cognitive effects Initial “rush” or energy high Confusion Poor concentration Memory problem (especially MDMA) Systemic effects Restlessness Movement delays Sleep disturbances Thirst Nausea/vomiting Chills/Sweating involuntarily Agitation Aggression (1,2,4) Mild Effects of Amphetamines

9. Severe Effects of Amphetamines (Including Overdosing) • Convulsions/seizures • Increase heart rate • High blood pressure • Panic Attacks • Hallucinations • Unconsciousness • Damaged blood vessels (1, 2, 4)

10. Life Threatening Effects of Amphetamines (from abuse) • Hyperthermia • Hyponatremia (Large free water intake due to physical activity causes a drop in sodium levels) (1) • Kidney failure • Intracerebral hemorrhage • Heart failure • Muscle breakdown • Fetal death (1,5,6) http://www.drugabuse.gov/pubs/teaching/teaching4/Teaching3.html. Accessed April 6, 2006.

11. Chronic Amphetamine Abuse • The use of amphetamines such as “meth” and “ecstasy” can lead to abuse dependence or death • Tolerance develops • “Speed run” • Defining the term: The more of this drug you consume, the higher you want get and the harder it is to do so. The user takes increasing amounts without sleeping which can result in being beyond high, for days at a time • Many side effects are still seen/experienced many years after being drug free (1)

12. Post-Abuse Effects • Repeating the same tasks over and over again • Clenching/grinding of teeth • Loss of memory • Permanent brain damage • Long term psychosis effect • Increased risk of developing Schizophrenia later in life (1) • MDMA use results in brain damage that can be evident 6-7 years later • Can occur even if you only use MDMA for a couple of days in your life (7)

13. Amphetamine Pharmacology • Stimulant (methamphetamine and MDMA) • Hallucinogenic (MDMA) • Release of neurotransmitters in brain • Dopamine • Norepinephrine • Serotonin • Dopamine and norepinephrine are primarily altered/effected in the brain • Serotonin is released with use of higher doses of MDMA (ecstasy) • The extent to which these chemicals effect the brain is dependent on how much abuse is taking place; permanent brain damage can occur as a result (1)

14. In the brain, dopamine is a significant role player in regulating and controlling your pleasure level. Dopamine is produced (made) in nerve cells. (2) Dopamine is released from the end of specific nerves in your brain, in an excessive amount, when methamphetamine is used and abused. What is Dopamine? http://www.nida.nih.gov/ResearchReports/Methamph/methamph3.html#short. Accessed April 6, 2006

15. What is Serotonin? • Serotonin is involved in brain regulation • Mood, emotions, sleep • Appetite, aggression, perceptions (6) • Body craves more serotonin in order to compensate for the excess released from the brain (5) http://www.drugabuse.gov/pubs/teaching/teaching4/teaching.htm Accessed April 6,2006.

16. Serotonin http://www.drugabuse.gov/ResearchReports/MDMA/MDMA3.html#effects. Accessed April 29, 2006.

17. Methamphemines Oral (ingested) Parenteral (injected) Inhalation (snorting) Smoked and resmoked (1,2) MDMA Oral Tablet Capsule Pill (1,7) Routes of Administration(Ways to use amphetamines)

18. Duration of Time • Using amphetamine-like drugs effect the body for a long period of time • Methamphetamine • 24 hours + • Repetitive use due to tolerance • Accumulation occurs and the duration of effect on the body is prolonged (1)

19. Elimination from Body • Renal Elimination (Kidneys) • Amphetamines • 30 % • Methamphetamines • 40-50% • MDMA • 65% • Hepatic Elimination (liver) (1)

20. Risks of “Designer Drugs” • Lead poisoning (methamphetamine abusers) (2) • Contamination from making and using on the street • Fetal Complications due to use and abuse during pregnancy • Deformities • Death

21. Risks from Injection • Using and sharing needles increases the risk of contracting severe and life threatening diseases • HIV • Hepatitis B and C • The risk of HIV is not only increased by injection but also from the enhanced sexual feelings that arise from using these drugs • Amphetamine use can increase your libido or alter your perception in engaging in sexual activity • Rough sex is common with use which can lead to tears and abrasions resulting in bleeding (2)

22. Summary • Why do people use and abuse amphetamine-like drugs (“designer drugs)? • Stress release • Ease of communication with peers • Feelings of fitting in/socializing • Elevates mood • Decreases anxiety due to school, work and personal relations • Acceptance • Unwanted withdrawal symptoms (don’t want to feel bad)

23. Summary • Amphetamine-like substances such as “meth” and “ecstasy” are highly abusive drugs among college students today. These highly addictive drugs may seem appealing due to their short term, feel good, highs. But the high is just that – short term. The after effects not only cause tremendous emotional instability but also cause negative, physical effects as well. Amphetamines harm your entire body; the brain, heart, liver, kidneys and blood vessels are among the many systems of your body that deteriorate and shut down, leading to a possible cause of death. Not only can death occur, but the risks of acquiring HIV, hepatitis, and other serious diseases are significantly increased.