SUBSTANCE ABUSE DRUGS

SUBSTANCE ABUSE DRUGS Sultana Poonja University of the Sciences in Philadelphia, Philadelphia College of Pharmacy Doctor of Pharmacy Candidate February 2005 PP495 Project in Pharmacy Instructor: Grace Earl, Pharm.D.

Use of this Presentation • This presentation may be used for educational purposes. • Please obtain permission by using contact information on the next page

Acknowledgement • Contact Grace Earl, Pharm.D. at g.earl@usip.edu • Instructor: Grace Earl, Pharm.D., Assistant Professor, University of the Sciences in Philadelphia, Philadelphia College of Pharmacy, Box 8, 600 South 43rd Street, Philadelphia, PA 19104

Reviewed by • Laura Mandos, Pharm.D. • Associate Professor • University of the Sciences in Philadelphia • Philadelphia College of Pharmacy and Science

Purpose of this Presentation • This presentation was designed to be used for educational purposes. • The information describes general information on drugs and substances that are abused. • Each section gives information on pharmacology, explanation of methods used to administer substances, symptoms, statististics.

DEA DEFINITIONS • I highest potential abuse, unpredictable, psychological & physical dependence, death, NO medical use • II high potential abuse, severe psychological/physical dependence, medical use accepted with restrictions • III medium potential abuse, moderate or low physical, high psychological dependence, accepted medical use • IV low potential abuse, limited physical/psychological dependence, accepted medical use • V lowest potential abuse, limited physical / psychological dependence, accepted medical use

Featured Illicit Drugs • Gamma Hydroxybutyrate (GHB) • Flunitrazepam (Rohypnol) • Amphetamines (Ecstasy) • Cocaine • Marijuana • Lysergic Acid Diethyl-amide (LSD) • Volatile Inhalants • Heroin • Oxycodone • Ketamine • Dextromethorphan

Gamma Hydroxybutyrate (GHB) Definition • Central Nervous System depressant. • A sedative-hypnotic, was originally developed as a sleep-aid. • A similar drug, “GBL,” turns into GHB in the body, having the same effect. • DEA SCHEDULE I • No known medical use.

GBH Grievous Bodily Harm “G” Liquid Ecstasy Easy Lay Energy Drink Liquid E GHB STREET NAMES

GHB DOSAGE FORMS • A teaspoon or capful →normal dose. • Proper dose is unknown. A teaspoon could also be an overdose.

LOW DOSES Euphoric effect~ (alcohol) Relax Happy Sociable HIGH DOSES Dizziness Sleepiness Vomiting Muscle spasms Loss of consciousness GHB POSSIBLE EFFECTS

GHB OVERDOSE EFFECTS • Cause loss of consciousness (temporary coma) • Slow breathing. • With alcohol, slows breathing to a dangerously low rate, which causes deaths. • Overdose occurs because the onset is delayed for up to two hours.

GHB APPEARANCE • Powder and capsule form. • A clear liquid form that is colorless and odorless. (most common) • Produced as a white crystalline powder. • Slightly salty to the taste, and sold in small bottles.

GHB 2002 STATISTICS1 • 5 fatal cases reported • Ages: 19-36 years of age • 2 of the 5 cases were single ingestions. • 3 cases were multiple ingestions (GHB with other substance abuse drugs. • Acute type ingestions

FLUNITRAZEPAM (ROHYPNOL) • Definition • Brand for flunitrazepam, a benzodiazepine drug, family of Valium & Xanax. • “Date rape” drug • DEA SCHEDULE IV • Not approved in the U.S. , used in the rest of the world as a tranquilizer, insomnia treatment & a sedative prior to surgery. • No statistical data reported.

Roofies Rophies Lunch Money (referring to the drug's low price on the street) Pappas or Potatoes (refers to mental capacity of someone under the influence of the drug) Mind-Erasers Mexican Valium ROHYPNOL STREET NAMES

ROHYPNOL DOSAGE FORMS • Orally in pill form, crushed and snorted. • Ingested orally, usually with alcohol or other drugs, including heroin. • 1 and 2 milligram dose

ROHYPNOLPOSSIBLE EFFECTS WITHOUT ALCOHOL • Disorientation and confusion • Drowsiness • Dizziness • Slurred speech • Impaired judgement • Lack of coordination (difficulty walking) • Amnesia (impairs memory of events)

ROHYPNOL POSSIBLE EFFECTS WITH ALCOHOL • Low blood pressure • Difficulty breathing • Death • Coma

ROHYPNOL EFFECTS OF OVERDOSE • Rapid mood swings • Violent outbursts of temper • Can be life-threatening when mixed with alcohol • Development of physical and psychological dependence

ROHYPNOL APPEARANCE • White & round pill, smaller than a dime. • Pills may be ground up or crushed into a powder. • Liquid form. • Dropped into a drink, it may dissolve & become "invisible." • Currently supplied with a 1-milligram dose in an olive green, oblong tablet, imprinted with the number 542.

AMPHETAMINES (ECSTASY) DEFINITION • A MDMA/3,4-Methylenedioxymethamphetamine. Belongs to “entactogens,” drug family, meaning “touching within.” • Other drugs: MDA,MDE and MBDB. • DEA SCHEDULE I • Appearance : N/A • No Medical Use http://www.usdoj.gov/dea/photo_library.html accessed May 6, 2005

AMPHETAMINES (ECSTASY) http://www.usdoj.gov/dea/photo_library.html accessed May 6, 2005

E X XTC Adam Clarity Lover’s Speed ECSTASY STREET NAMES

ECSTASY DOSAGE FORMS • Tablet or capsule. • Usual dose is 100-125 mg • Black market "ecstasy" tablets vary widely in strength, and often contain other drugs.

ECSTASY POSSIBLE EFFECTS • MDMA is a "mood elevator" • Relax, euphoric state. • It does NOT produce hallucinations. • Increased chances of dehydration, hypertension, & heart or kidney failure • Increased body temperature leads to death.

ECSTASY EFFECTS OF OVERDOSE • Linked to neurotoxic damage in laboratory animals. • It is still unknown whether such damage occurs in humans or, if it does, whether this has any long-term, negative consequences.

ECSTASY 2002 STATISTICS 1 • 9 fatal cases • 1 of the 9 cases was by inhalation. • The 8 cases were by ingestion with multiple means such as cocaine, LSD, marijuana, ethanol, propranolol, benzodiazepine, etc. • Acute type ingestions/inhalations. • 3 of the cases were suicides.

LYSERGIC ACID DIETHYL AMIDE (LSD) DEFINITION • A hallucinogenic or psychedelic drug. • Found absorbed into tiny pieces of paper called “blotter”. • Found as a pure liquid or absorbed into a sugar cube. • LSD costs about $5 for a "hit." • DEA SCHEDULE I

LSD http://www.usdoj.gov/dea/photo_library.html accessed May 6, 2005

Acid- (battery, black, blotter, blue, lime, paper, vodka) Electric Kool-Aid Mind detergent Caps (blue, brown, green, pink, purple, yellow) Sunshine (black, California, Hawaiian, Yellow) Crystal tea LSD STREET NAMES

LSD DOSAGE FORMS • The form or derivative found in the seeds of the morning glory family plant. • Four to eight of these seeds are equal to 10,000 micrograms of LSD • Believed to be the ingredient in the parasitic fungus Claviceps purpurea and in the Convolvulaceae plant family, both of which were used in religious rites

LSD POSSIBLE EFFECTS DESCRIBED AS A TRIP WITH 4 PHASES:

ONSET Approximately 30 minutes after ingestion, colors appear sharper, moving objects leave "trails" behind them, and flat surfaces may appear to "breathe."

THE PLATEAU Over the second hour, the effects become more intense. Imaginary visions can appear from nowhere--from shapes in smoke, to lines on the palms of the hand.

PEAK Time is slowed almost to a standstill. Users may feel like they are in a different world, or a movie. For some this is profound and mystical, but it can be very frightening for others.

COMEDOWN Five or 6 hours after taking the drug the sensations begin to subside, then after 8 hours the trip is usually over. The residual effects may last until after sleep

LSD OVERDOSE EFFECTS • Longer, more intense “trip” episodes • Psychosis • Possible death

LSD APPEARANCE • Powder, tablet, capsule • Sugar cube • Drop of LSD solution evaporated on filter or blotting paper. • Incorporated into a square of gelatin ("windowpane")

LSDMEDICAL USES • Once proposed as an analgesic in terminal patients. • An aid in psychotherapy • An adjunct to the treatment of alcoholism, opioid addiction, sexual abnormalities, autism, and sociopathy.

LSD 2002 STATISTICS 1 • Only one fatal case was reported. • Age of the person was 16 years old • Acute type • Usage way was unknown • Used in abuse

MARIJUANA DEFINITION • Cannabis, an ancient hallucinogenic drug derived from hemp plant • Can grow wild almost everywhere • Consists of dried, chopped, plant parts. • THC: active ingredient to cause damage. • Other types: Hashish, Bhang, Ganja, & Sinsemilla • Dea Schedule I

MARIJUANA http://www.usdoj.gov/dea/photo_library.html accessed May 6, 2005

Pot Grass Weed Mary Jane Dope Reefer Skunk Boom MARIJUANA STREET NAMES

MARIJUANA DOSAGE FORMS • Smoked as a cigarette or joint, or in a pipe or bong. • Appeared in "blunts" =>cigars that have been emptied of tobacco and re-filled with marijuana, sometimes in combination with another drug, such as crack

MARIJUANA POSSIBLE EFFECTS • Affects learning & social behavior • Affects memory & concentration • Drowsiness • Some experience insomnia • Feeling unmotivated • Feeling giddy • Uneasiness & anxiety • Thirst & hunger • Smoke can affect breathing

MARIJUANA OVERDOSE EFFECTS • Impairs memory and may cause delusions, hallucinations and disorientation. • There is NO documented case worldwide of a fatal overdose from taking marijuana.

MARIJUANA APPEARANCE & MEDICAL USES • It is a plant that is crushed into powder form to be able to sniff. • Legally there are no medical uses in America for marijuana. However, it has been used for patients who have AIDS & cancer because it helps them to control pain & nausea & other symptoms. Further research is needed for this drug to be legalized as a medicinal use. • No statistics reported

COCAINE DEFINTION • A powerful addictive stimulant directly affecting the brain. • The pure chemical, cocaine HCL, has been an abused substance for more than 100 years, & coca leaves, the source of cocaine, have been ingested for 1000 years. • DEA SCHEDULE II

COCAINE http://www.usdoj.gov/dea/photo_library.html accessed May 6, 2005

SUBSTANCE ABUSE DRUGS