Confuse-Ant ® Drugs Part 2

1. Confuse-Ant® Drugs Part 2 Kim Edward Light, Ph.D. Professor, College of Pharmacy University of Arkansas for Medical Sciences

2. Objectives • Identify and discuss the tryptamine-like hallucinogenic agents • Identify and discuss the dissociative anesthetic agents • Identify and discuss other agents in this category (GHB, solvents, nitrites).

3. Lysergic Acid Diethylamide (LSD) • Ergot fungus growing on wheat and rye • Dr. Albert Hoffman 1938 Sandoz Labs • Oral, inhalational, injection, transdermal • Effective dose 25-250 mg • Tablet, capsule, liquid • Blotter paper, window pane, microdot

4. LSD - Effects • Dilated pupils – mydriasis • Numbness, weakness, tingling, nausea • Body temperature • Heart rate & Blood pressure • Sweating, • Loss of appetite, dry mouth, tremors, sleepiness

5. LSD - Actions • Slang/Street Names: acid, boomers, yellow sunshine, microdot, window pane • Onset 20-30 minutes oral • Effects peak at 2-4 hrs • Duration 6-8 hours • Residual & Flashbacks

6. Hallucinations • Hallucinations of increased color perception, altered mental status & thought disorders • Impaired depth, time and space perception • Temporary psychosis delusions trance-like state, body-image changes • Feel several emotions at once or swing rapidly from one to the next

7. LSD – Problems • Effects often unpredictable and depend on • Dose ingested • User’s personality and mood • Surroundings and expectations • Toxic fatalities are rare, however fatal accidents, suicides violent/bizarre behavior common • Sustained feelings of anxiety or depression

8. LSD bad trips • Severe terrifying thoughts and feelings • Fear of losing control, despair, paranoia • Tachycardia, hypertension, elevated body temp, sweating, body tremors, speech difficulties • Prolonged mania, panic, long-lasting psychosis, severe depression

9. LSD – ER Visits • ER visits mentioning LSD have declined • Greater availability of ecstasy and others

10. Psilocybin mushrooms • Magic mushrooms – many species • Cultivated indoor or outdoor • Brown or tan in color with golden crown • Bruise and turn blue when handled • Part of religious practices native cultures • Orally ingested 1-5 g dry mushroom or 10-50 gm wet

11. Psilocybin • Onset in 20-60 minutes • Duration 3-6 hours • Muscle relaxation • Dilation of pupils (mydriasis) • Visual and auditory hallucinations • Emotional disturbances

12. Psilocybin - Effects • Anxious energy • Contentment • Mental stimulation • Feelings of insight • Spiritual awareness • Realization about past experiences • Open and closed-eye visions

13. Tryptamines • DMT – dimethyltryptamine • DET – diethyltryptamine • AET – alpha-ethyltryptamine • “Foxy-Methoxy” (N,N-diisopropyl-5-methoxytryptamine) DMT

14. Tryptamines • Bufotenine – skin glands of one type of Bufo toads DMT

15. Phencyclidine - PCP Dissociative Anesthetic Agent • Developed in 1959 as an anesthetic agent - discontinued in 1965 • Street drug presence in late 1960s • Street names: • angel dust, ozone, rocket fuel, elephant tranquilizer, hog, embalming fluid, crystal, horse tranquilizer, tic tac, and many others. • Popularity highly variable

16. PCP • Synthetic, clear yellowish liquid or white crystalline powder mixed with dyes or sold as tabs caps or colored powders • Added to marijuana, or tobacco and sold as: sherms, killer joints, super weed, killer weed, krystal joint, wet, fry, amp, illy, blunts. • “Embalming fluid” or “formaldehyde” coated on marijuana or tobacco

17. PCPCharacteristics • Low dose = 3-5 mg • Common dose = 5-10 mg • High dose > 10 mg • Onset 1-5 minutes – smoked • Peak effects 15-30 minutes • Duration – 4-6 hours • Lingering – 24-48 hours

18. PCP - Actions • Euphoria, calmness, lethargy, • Feelings of invulnerability, • Disorientation, drowsiness, sedation • Disordered thinking, • Body awareness distortions, • Altered sensory perceptions, • Flushing grimacing facial expressions • Consciousness anesthesia

19. PCP - Toxicity • Seizures, coma, death • Mimic schizophrenia • Perceptual distancing from environment • Catatonia • Anger, rage, selective amnesia

20. PCP - Consequences • Long term use • Memory loss • Difficulties with speech and thinking • Depression • Mood disorders • Sedative effects • Potentiated by alcohol, benzodiazepines • Accidental overdose, coma

21. PCP – ER Visits • ER visits for overdose or dysphoria • Violence or suicidal actions • Keep calm but not alone • Sensory deprivation asfar as possible • Inexpensive and easy to synthesize

22. KetamineSpecial K, K, Vitamin K, Cat Dissociative Anesthetic Agent • An injectable anesthetic, human and animal use since 1970. • Gained popularity in the 1980s, • Large doses similar to PCP • Snorted or smoked with marijuana or tobacco

23. Ketamine • Some experience dreams 24 hrs after use

24. Ketamine – Low Doses • Low-dose • Impaired attention and memory • Decreased awareness of environment • Drowsy, sedated, uncommunicative • Invulnerability, disoriented, easily distracted

25. Ketamine – High Doses • Higher doses • Psychomotor impairment, hypertension • Potentially fatal respiratory problems • Vivid dreams & hallucinations • Insensitivity to pain • Cataplexy • Anxiety, paranoia, delirium, flashbacks • Cognitive impairment & out-of-body experiences

26. Ketamine – ER Visits • ER episodes highly variable • Not a reflection of safety

27. GHBgamma-hydroxy butyrate • Slang/Street Names • Grievous Bodily Harm, G, Liquid Ecstasy, Georgia Home Boy • Clear liquid or white powder, tablet, capsules • Colorless and nearly tasteless • One of the “Club Drugs”

28. GHB - Characteristics • Chemicals such as gamma-butyrolactone (GBL)and 1, 4-butanediol are converted by the body into GHB. • Onset in 10 to 20 minutes • Duration up to 4 hours • Cleared from the body relatively quickly

29. GHB - Actions • CNS depression • Disordered thinking and confusion • Amnesia • Slower breathing and heart rate • Volatile overdose • Coma and death

30. GHB – ER Visits

31. Dextromethorphan • Street Names • DXM, DM, CCC, Triple C, Candy, Robo, Velvet, Rojo • Cough suppressant at normal doses • High and very high doses • Similar to PCP or ketamine • Gastrointestinal distress • Itching skin • Combination product OTC

32. Inhalants • Organic solvents or petroleum distillates • Glue, toluene, xylene, hair spray, lighter fluid, gasoline, paint remover and other paint products, permanent markers, typewriter correction fluid, etc. • Rapid and short duration

33. Nitrites • “Poppers” “snappers” • Various alkyl nitrites – isobutyl nitrite, butyl nitrite, cyclohexyl nitrite, amyl nitrite • Onset in seconds, duration a few minutes • Dizzy, disorientated, increased heart rate

34. Nitrous Oxide • “Whippets” or laughing gas • Analgesic gas used in some medical procedures • Also a useful propellant for various food products • Dreamy, floating, giddiness • Careful monitoring and oxygen • Automobile racing to increase power

35. Summary • Discussed the tryptamine-like hallucinogenic agents • The dissociative anesthetic agents • PCP, • Ketamine • Discussed several miscellaneous agents such as GHB, solvents, and nitrites.