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Uppers Downers & All Arounders. Uppers/Stimulants Chapter 3. Uppers/Stimulants. In 1999 about 1.7 million Americans used amphetamines for nonmedical reasons, 4.2 million used cocaine, 68 million smoked cigarettes,

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uppers downers all arounders

Uppers Downers & All Arounders


Chapter 3

uppers stimulants
  • In 1999 about
  • 1.7 million Americans used amphetamines for nonmedical reasons,
  • 4.2 million used cocaine,
  • 68 million smoked cigarettes,
  • 200 million drank coffee, tea, caffeinated soft drinks or an over-the-counter medication containing caffeine. (p. 83).
general classification
General Classification
  • Most people use stimulants in the form of:
    • Diet aids
    • Drugs to control hyperactivity
    • Coffee & Tea
    • Cigarettes
    • Caffeinated solf drinks
  • Stimulants are found in plants and in synthetic form
general effects
General Effects
  • Stimulants force the release of the energy chemicals (epinephrine and norepinephrine along with dopamine and serotonin)
  • Infuses the body with large amounts of extra energy before the body needs it
  • With heavy use the body’s energy supply is depleted leading to crash, withdrawal and depression
  • Crash and withdrawal occurs when energy supplies become depleted and body is left without reserves
general effects5
General Effects
  • All Stimulants activate chemical and electrical activity in central nervous system
    • Increases
      • Heart rate
      • Blood pressure
      • Respiration
    • Effects include
      • Activeness
      • Restlessness
    • Medical uses include treatment of obesity, narcolepsy and Attention-deficit/hyperactivity Disorder
general effects6
General Effects
  • Reward/reinforcement center is artificially over-stimulated
    • Rush of pleasure and strong sense of wellbeing
    • Often accompanied by no basic need for hunger, thirst or sex
  • Weight loss: stimulants fool the body into thinking it has satisfied hunger without eating
  • Cardiovascular side effects include constricted blood vessels, high blood pressure and sometimes arrhythmia
    • Chronic use weakens blood vessels and risk of stroke
general effects7
General Effects
  • Emotional & mental effects:
    • Initial release causes increase of confidence and euphoria
    • As use continues feeling of euphoria turn to irritability, paranoia, aggressiveness, depression
  • Tolerance & Addiction liability
    • Increases as body loses its ability to synthesize drugs
    • Can also develop with methamphetamine congeners, caffeine, nicotine and other mild stimulants
  • Cocaine epidemics seem to occur every few generations
  • Hardcore use still strong in 2000’s
  • Cocaine is extracted from coca plant
    • 97% grown in South America
    • Colombian drug Cartels control cultivation and production
    • 2/3 of smuggling handled by drug artels in Mexico
    • U.S. consumes 70% of world’s cocaine trade
cocaine routes of administration
COCAINE: Routes of Administration
  • Chewing Leaf: Historically Native cultures
  • Drinking: Started in 1880’s in wine, coca cola, and patent medicine. Widely prescribed to womem
  • Injecting: Started after the invention of hypodermic needle in 1853
    • Intravenous use takes 15-30 seconds
    • Subcutaneous/intramuscular takes 3-5 minutes
  • Snorting: Self-limiting method
    • The more snorted, the less absorption due to constriction of capillaries in the nose
    • Destructive to nasal passages
cocaine routes of administration10
COCAINE: Routes of Administration
  • Mucosal & contact absorption
    • Can be absorbed through mucosal tissue in nose, mouth, rectum & vagina
    • Delivery method is also used for dental work, minor surgeries
  • Smoking:
    • First introduced in 1914, but high temperature was needed to keep cocaine cigarettes going
    • Mid-1970’s, cocaine hydrochloride was chemically altered into freebase
    • Fastest form to reach brain… Highly addictive
cocaine physical and mental effects
COCAINE: Physical and Mental Effects
  • Metabolism: Quickly metabolized and disappears faster than methamphetamine
  • Medical Use: Only naturally occurring local anesthetic
    • Used to numb nasal passages, eyes, throat, and chronic sores
  • Neurochemistry & Central Nervous System
    • Forces relase of norepinephrine, epinephrine and dopamine
    • Blocks re-absorption so more intense stimulation
    • Blocks 60-70% of dopamine reuptake
    • Too much dopamine can over stimulate brain’s fright center causing paranoia.
    • Excessive use causes insomnia, agitation and severe depression
cocaine physical and mental effects12
COCAINE: Physical and Mental Effects
  • Sexual Effects:
    • At low doses cocaine increases desire for sex and delay ejaculation
    • As use continues sexual dysfunction occurs
  • Aggression, violence & cocaethylene
    • Increases aggression & violence by disrupting inhibitory and fright centers of the brain
    • Cocathylene (metabolite when cocaine & alcohol is combined) induces greater agitation, euphoria and violence
      • Can also induce cardiac conduction abnormalities
cocaine physical and mental effects13
COCAINE: Physical and Mental Effects
  • Cardiovascular Effects
    • Can damage circulatory system
    • Raise blood pressure
    • Cause stroke (bursting of blood vessels in brain)
    • Cause heart damage
  • Neonatal Effects:
    • Transmitted within seconds to fetus
    • Increases chances for miscarriage, stroke, SIDS, respiratory ailments, mental delays & other abnormalities
    • Proper pre-natal and post natal treatment can hel cocaine babies
cocaine physical and mental effects14
COCAINE: Physical and Mental Effects
  • Tolerance: To the euphoric effect can begin to develop after first injection or smoking session
  • Withdrawal, Craving & relapse:
    • Major effects include anhedonia, lack of energy and intense craving
    • Typical cycle of compulsive use:
      • Bingeing to crashing to detox to resolutions of abstinence or treatment and relapsing 2-4 weeks later.
cocaine physical and mental effects15
COCAINE: Physical and Mental Effects
  • Overdose:
    • Can be caused by as little as 1/50 gram
    • Overwhelmingly intense stimulation
    • Injury to heart and blood vessels
    • More often not fatal…just feels that way
    • Severe reaction through in verse tolerance or kindling
  • Miscellaneous Effects:
    • Formication (itching from imaginary bugs)
    • Dental erosion
    • Seizures
    • Gastrointestinal complications
  • Cocaine Psychosis:
    • Paranoid psychosis/schizophrenia caused by excess dopamine
    • Can also activate genetic predisposition to schizophrenia
cocaine other problems with use
COCAINE: Other Problems with Use
  • Polydrug Use
    • Alcohol, valium, heroin to take the edge off
  • Adulteration & Contamination
    • Cocaine at street level is almost always cut
    • When injected, bacteria and viruses contaminate drugs and needles
    • Hepatitis C rate for IV drug users is between 50% and 90%
  • Compulsion
    • Use for euphoria, boredom, peer pressure, curiosity, self-medication, escape from personal problems
smokable cocaine crack freebase
  • Pharmacology of smokable Cocaine
    • Began around 1981
    • Crack epidemic in 1986
    • Chemically crack is the same as freebase
    • Delivered to the brain faster
    • Ether converts cocaine to freebase
    • Baking soda converts cocaine to crack
  • Effects and Side Effects
    • More intense than snorting or injecting
    • Rush or euphoria last 5 – 20 minutes
    • Replaced by the feeling of irritability and other negative emotions
    • Always used in a binge pattern
    • Chronic use include paranoia, intense cravings, depression, cocaine psychosis, high-risk sexual activity
smokable cocaine crack freebase19
  • Respiratory Effects
    • Breathing problems
    • Severe fever
    • Chest pains
    • Coughs
    • Crack lung
    • Hemorrhage
    • Respiratory failure & death
    • Aggravated by cigarette smoking
  • Polydrug use
    • Increases the potential for abuse of depressants
smokable cocaine crack freebase20
  • Overdose
    • Mild-rapid heart beat
    • Hyperventilation
    • Fear of dying
    • Kills several thousand a year due to
      • Cardiac arrest
      • Seizure
      • Stroke
      • Respiratory failure
      • Severe hypothermia
  • Consequences of Crack use
    • Economic
    • Social: abuse, family, legal, formation of sex trade
  • Cocaine vs Amphetamines
    • Cocaine’s duration is 40 minutes/ Meth is 4-6 hours
    • Meth is cheaper
  • Classification: “Sympathomimetic agent”
    • Stimulate the release of sympathic neurotransmitters
    • Activates the sympathetic nervous system that controls the fight or flight response
    • Stimulates the reward/information center
    • Street names: crank, ice, shabu, glass, clear
  • History of Use
    • First synthesized in 1887
    • Medically used in 1930s
    • Treats narcolepsy & depression
    • Used by students and truck drivers to stay awake
    • Widely used in pill form during WW II
  • History of Use
    • Japanese epidemic continued after WW II
    • 1970 6-8% of American population used prescribed amphetamines for weight loss
    • Street speed chemists increased production of crank and crystal in late 1980s
    • Ice highly potent smokable form used in 1990’s and common use in Hawaii
    • Recent development of “ya ba” in Thailand
amphetamines effects
Amphetamines (Effects)
  • Routes of Administration
    • Snorting
    • Intravenous
    • Smoking
    • Oral
  • Neurochemistry
    • Like cocaine, amphetamines increase levels of catecholamines by stimulating their release and blocking reuptake
    • Unlike cocaine, amphetamines block metabolism
    • Long term use alters the ability to produce vital neurotransmitters causing depression and taking mor to stay normal
amphetamines effects25
Amphetamines (Effects)
  • Physical Effects
    • Small to moderate doses cause
      • Increased heart rate
      • Raised body temperature
      • Rapid respiration
      • Higher blood pressure
      • Extra energy
      • Dilation of bronchial vessels
      • Appetite suppression
    • Meth users go on binges for 3, 4 or 10 days
      • Long term use can cause sleep deprivation
      • Heart & blood toxicity
      • Severe malnutrition
      • Bad or rotten teeth
      • Tolerance is more pronounced
amphetamines effects26
Amphetamines (Effects)
  • Mental & Emotional Effects
    • Mild to intense euphoria / sense of wellbeing
    • Prolong use leads to
      • Irritability
      • Paranoia
      • Anxiety
      • Confusion
      • Poor judgement
      • Hallucinations
      • Delusions
      • Can result in violent, suicidal & homicidal thoughts
      • Antisocial behaviors
amphetamines effects27
Amphetamines (Effects)
    • With abstinence, disturbed mental states such as amphetamine psychosis or depression can stop for some people
    • Amphetamines release neurotransmitter that mimics sexual gratification
  • Effects of Ice is greater on the brain than the respiratory and pulmonary system
    • Results in more overdoses
    • Greater mental side effects
    • Longer detoxification
amphetamine congeners lookalikes
Amphetamine Congeners/Lookalikes
  • Methylphenidate (Ritalin)
    • Most widely used
    • Prescribed as mood elevator, narcolepsy and to treat Attention-deficit/hyperactivity disorder
  • Diet Pills
    • Only recommended for short-term use
    • Careful monitoring by physician
    • Long-term use associated with abuse
  • Lookalikes
    • Prescription drugs that contain ephedrine and pseudoephedrine (anti-asthmatics)
    • Decongestants
    • Caffeine
    • Ephedra & ephedrine
miscellaneous plant stimulants
Miscellaneous Plant Stimulants
  • Khat & methcathione
    • Used in Arab and African countries
    • Produces amphetamine like highs
    • Insomnia, anorexia
    • Chronic abuse cause exhaustion, violence & depression
    • Methcathione: AKA ephedrone is synthesized in illegal labs in U.S.
      • Sold as a powerful alternative to methamphetamine
miscellaneous plant stimulants31
Miscellaneous Plant Stimulants
  • Betel Nuts (seed of betel palm)
    • Used by 200 million people in Arab world, India and Asia
    • Effects similar to nicotine
    • High doses can be toxic and produce psychological dependence
  • Yohimbine
    • Spicy extract from African yohimbe tree
    • Used in tea
    • Medicine
    • Aphodisiac
    • Produces mild euphoria and occassional hallucinations
miscellaneous plant stimulants32
Miscellaneous Plant Stimulants
  • Ephedra
    • Ephedra bush
    • Mild stimulant used as medicine, tea & tonic
    • Also used by athletes for energy boost
    • Banned in U.S. because of overdoses
    • This drug and synthetic version is main ingredients in methamphetamine & methcathione
    • Herbal Ecstasy and Herbal Nexus are two herbal products marketed as stimulants and as buffers for illegal drugs
      • Contains herbal forms of ephdrine, caffeine, herbs and vitamines
miscellaneous plant stimulants33
Miscellaneous Plant Stimulants
  • Caffeine
    • Most popular stimulant in the world
    • Found in teas, coffee, soft drinks, chocolate & hundreds of medications
  • History
    • Tea: drunk in China as early as 2700 B.C.
      • Introduced to Europe in 16th Century
    • Coffee: Cultivated in Ethiopia A.D. 650 and spread to Arabia then Europe
      • Classified as a drug and banned in many cultures
    • Cocoa: Mayan and Aztec royalty
      • Only small amount of caffeine in cocoa
miscellaneous plant stimulants34
Miscellaneous Plant Stimulants
  • Pharmacology
    • Classified as an akaloid of the chemical class called xanthines
    • Found in more than 60 plants
    • Takes 15-35 hours for 95% of the caffeine to be excrete by the body
  • Physical and Mental Effects
    • Mild stimulant
    • 5-7 cups of coffee can cause anxiety, insomnia, nervousness
    • Higher doses can cause muscle twitching, increased heart rate, palpatations
    • Letal at about 10 grams (100 cups of coffee)
miscellaneous plant stimulants35
Miscellaneous Plant Stimulants
  • Tolerance, withdrawal & addiction
    • Dosages vary depending on person
    • Symptom includes throbbing headache
    • Dependence can occur with 5 cups of coffee

10 cola drinks or 8 cups of tea

  • Nicotine
    • Cigarettes account for 90% of all tobacco use in U.S.
    • Discover in American and spread to Europe
    • Smokeless tobacco: moist snuff, powder snuff & loose-leaf
      • Absorbed by mucosal in the mouth and nise
nicotine tobacco
  • Pharmacology
    • Nicotine is the most important ingredient
    • Average cigarette contains 10 mg of nicotine
    • Central Nervous system stimulant that disrupts the balance of neurotransmitters
      • Dopamine
      • Endorphins
      • epinephrine,
      • Acetylcholine
      • Constricts blood vessels
      • Raises heart rate
      • Depresses appetite
      • Produces mild euphoria
      • Deadens senses
nicotine tobacco38
  • Two most important reasons people smoke tobacco is:
    • Weight loss
    • Craving
      • One must keep a certain level in blood stream to avoid withdrawal
  • Tolerance develops quickly
  • Withdrawal causes:
    • Headaches
    • Nervousness
    • Fatigue
    • Severe irritability
    • Intense craving
    • Poor concentration
    • Sense of relaxation from smoking a cigarette is actually a withdrawal symptom being subdued
nicotine tobacco39
  • Addiction
    • Tobacco is pure example of addiction process
      • 80% want to quit & 10% want to cut down
      • May have a genetic predisposition to nicotine addiction
  • Side Effects
    • Tobacco & smoke contain more than 4,000 other chemicals of which 400 are classified as toxic
    • 43 are known as carcinogens
nicotine tobacco40
  • 1997: 3.5 million premature deaths
  • In U.S. 392,000 die prematurely
  • 50,000 die of second hand smoke
  • Cardiovascular & Respiratory effects:
    • Plaque formation
    • Hardening of the arteries
    • Leading cause of heart attacks
    • Lung cancer
    • Men who smoke are 22 x’s more chance of cancer
    • Women 12 x’s more chance of cancer