Chapter 6

1. Chapter 6 Stimulants

2. Stimulants are substances that cause the user to feel pleasant effects, such as an increase in energy, due to the ability of the drugs to release dopamine. • Stimulants increase alertness, excitation, and euphoria, and are referred to as uppers.

3. History of Cocaine • Cocaine can be traced back to Coca. It has been used as a stimulant for thousands of years. • Natives of the Andes mountains chewed coca leafs which gave them energy to run and carry things long distances.

4. History of Cocaine • Coca Wine • Angelo Mariani • Lozenges, tea, wine, Coca-Cola • Local Anesthesia • Hypodermic syringe • Dr. W.S. Halsted • Early Psychiatric uses • Sigmund Freud • Treatment for depression and morphine depression

5. Early Legal Control • From 1887 to 1914, 46 states passed laws to regulate cocaine • Press and politicians associated cocaine with black urbanites of New York • Major influence on the passage of the Harrison Act

6. Cocaine Administration • Orally • Chewing of the coca leaf • Inhaled into the nasal passages • “Snorting” • Injected intravenously • Hypodermic needle • Smoked • Freebasing • Crack

7. Contemporary Legal Controls on Cocaine • End of the 1960s cocaine use began to increase again • Many raved about the benefits of cocaine • Until 1985 it was the drug of choice, due to the high cost, for those with extra income • Then an inexpensive ($5 to $10 a hit) form that could be smoked became available

8. Contemporary Legal Controls on Cocaine • Again, the media and politicians going after blacks urbanites • The Anti-drug Abuse Act of 1986 was passed • The Anti-drug Abuse Act of 1988 added tougher penalties for first-time users • Concerns about racial profiling

9. Figure 6.1 Cocaine

10. Mechanism of Action • Chemical structure does not tell us how or why it works • Cocaine blocks reuptake of many neurotransmitters • Absorption and Elimination • Chewing or sucking provides a slow absorption and onset of effects • Snorting is absorbed rapidly and reaches the brain quickly • Intravenous use delivers a high concentration to the brain producing a rapid and brief effect • Crack is less invasive than intravenous use and the onset of effects is just as fast

11. Cause for Concern • Acute Toxicity • Chronic Toxicity • Dependence Potential

12. 3 Main Stages of Cocaine Withdrawal • The “crash,” the initial abstinence phase consisting of depression, agitation, suicidal thoughts, and fatigue • Withdrawal, including mood swings, craving, anhedonia, and obsession with drug seeking • Extinction, when normal pleasure returns, which cues trigger craving and mood swings

13. Amphetamines • History • Ephedrine • Sympathomimetic drug • Patented in 1932 • Wartime use • Used by American soldiers in WWII to fight fatigue • Speed Scene • Amphetamines are often used with other combinations of drugs called ‘speedballs’ • Illegal methamphetamine • Most common and heavily-used amphetamine

14. Amphetamines • Causes alertness • Can cause anxiety, severe apprehension or panic • Potent effects on dopamine in the reward center of the brain • Behavioral stereotyping

15. How Stimulants are Taken • Amphetamines can be taken: • Orally • Intravenously • Speed freak • Smoking • Ice

16. Approved Uses of Amphetamines Athletics Weight reduction Hyperkinetic behavior Narcolepsy “Smart Pills”

17. Side Effects of Therapeutic Doses • Agitation, anxiety, panic • Irregular heartbeat, increased blood pressure, and heart attack or stroke • Intense and high-dose abuse can cause severe psychotic behavior, stereotyping, seizures, and severe cardiovascular side effects, as noted above

18. Summary of the Effects of Amphetamines Body • Increase heartbeat • Increase blood pressure • Decreased appetite • Increased breathing rate • Inability to sleep • Sweating • Dry mouth • Muscle twitching • Convulsions • Fever • Cheat pain • Irregular heartbeat • Death due to overdose Mind Decrease fatigue Increased confidence Increased feeling of alertness Restlessness, talkativeness Increased irritability Fearfulness, apprehension Distrust of people Behavioral stereotyping Hallucination Psychosis

19. Current Misuse • Decline in abuse in the late ‘80s and early ‘90s • In 1993, the declines were replaced by an alarming increase • Increase in use of methamphetamine led to the “National Methamphetamine Strategy” in 1996 • “Speed” • Due to the ease of production, meth-amphetamine is often made in makeshift labs in homes or garages

20. Cause for Concern • Acute Toxicity • Chronic Toxicity • Dependence Potential