MISUSE & ABUSE OF CNS

STIMULANTS by zohra

• TOPIC NAME

What are drugs?

Drugs are substances that • change a person's physical or mental state.• The vast majority of drugs are used to treat

medical conditions, both physical and mental.

• Some, however, are used outside the medical setting for their effects on the mind.

• These are referred to as recreational drugs

WHY DO PEOPLE USE PSYCHOACTIVE DRUGS?

People use drugs for many reasons—• for fun or excitement; • to feel good, better or different • to counteract negative feelings• because they are bored or curious• because their friends or family do it• because they have a dependence on the drug.• Often people who use drugs associate with other

people who use drugs. It is not always clear which comes first— the friends or the drugs.

DRUG DEPENDENCE• Drug dependence may occur when a person continues to use drugs— legal or illegal—

even though their drug use causes them significant problems. It is regarded by many as a medical condition or a disorder not directly under the control of the individual. The term 'addict', with its negative implications, is not used any longer.

• In general, drug dependence may be diagnosed if a person:• spends a significant amount of time obtaining the drug, using it, and/or recovering

from its effects• develops a tolerance to the drug .• continues using the drug even though they know it is causing them psychological

and/or physical harm• wants to cut down or control their drug use (and perhaps makes repeated

unsuccessful attempts to do so)• takes more of the substance, or uses it for longer, than they intend• reduces, or gives up entirely, important social, recreational and/or work activities

because of their drug use• suffers symptoms of withdrawal when they stop using the drug

withdrawal

•When a person who has been using a drug stops taking it, or reduces the dose, they may experience a physical and/or psychological reaction. This is called withdrawal. Because the dependent person has become tolerant to the drug's effects, they have been taking the drug just to feel normal. When they stop taking the drug, they may experience the opposite to the highs the drug originally gave them.•Withdrawal can be very unpleasant, producing symptoms such as tremors, sweating and vomiting, as well as extreme craving.

Stimulant drugs

• Drugs that are classed as stimulants include:• Caffeine• Nicotine• Cocaine• Amphetamines

What are stimulants?

• As the name suggests, stimulants increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration.

• Stimulants historically were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments.

• SHORT-TERM EFFECTSThe short-term effects of stimulants include exhaustion, apathy and depression—the “down” that follows the “up.” It is this immediate and lasting exhaustion that quickly leads the stimulant user to want the drug again. Soon he is not trying to get “high,” he is only trying to get “well”—to feel any energy at all.• LONG-TERM EFFECTSStimulants can be addictive. Repeated high doses of some stimulants over a short period can lead to feelings of hostility or paranoia. Such doses may also result in dangerously high body temperatures and an irregular heartbeat.

How do stimulants affect the brain and body?

• Stimulants act in the brain similarly to a family of key brain neurotransmitters called monoamines, which include norepinephrine and dopamine.

• Stimulants enhance the effects of these chemicals in the brain.

• The associated increase in dopamine can induce a feeling of euphoria when stimulants are taken nonmedically.

• Stimulants also increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up breathing passages.

consequences of stimulant abuse

Physiological it is possible for individuals to become dependent upon or addicted to

stimulants. Withdrawal symptoms associated with discontinuing stimulant use include

fatigue, depression disturbance of sleep patterns. Repeated abuse of some stimulants (sometimes within a short period)

can lead to feelings of hostility or paranoia, even psychosis taking high doses of a stimulant may result in dangerously high body

temperature an irregular heartbeat. There is also the potential for cardiovascular failure or seizures.

Psychoactive that increase activity in the brain These drugs can temporarily elevate

alertness mood awareness can be addicting.

Caffeine is the most commonly used mood-altering drug in the world. Caffeine is a stimulant that speeds up your central nervous system, and

is the world’s most popular drug.• Caffeine occurs naturally• in products such as coffee, tea, chocolate• and cola soft drinks and is added to a• variety of prescription and over-the-counter medications, including

cough, cold and pain remedies.

Street Names:

• Legal crack • Bubbly • Happy in a bottle

• Caffeine was first isolated from coffee in 1819. It is also found in tea; in cacao pods, and hence in cocoa and chocolate products; in kola nuts, used in the preparation of cola drinks; in the ilex plant, from whose leaves the popular South American beverage yerba mate is prepared; and in guarana seeds, an ingredient in some soft drinks.

What does caffeine look like?In its pure form, caffeine is a white, bitter-tasting powder

Oral and Intravenous Routes of Administration of Caffeine

Caffeine is a stimulant and can be addictive

In North America, more than 80 per cent of adults regularly consume caffeine. Worldwide per-capita caffeine consumption (including that of children) is estimated to be 70 mg per day, equivalent to approximately one cup of coffee.

In Canada, coffee consumption increased from 96 litres per person in 1990 to 101 litres per person in 2000.

Consumption of tea has also increased, up from 42 litres per person in 1990 to 70 litres per person in 2000

IN PAKISTAN

Statistics: Statistics 7.6 million (approximately 31%) of U.S. teenagers say they drink energy drinks. In 2006, $2.3 billion was spent by teens and young adults on energy drinks

• How long does the feeling last?• When taken in beverage form, caffeine begins to take effect within five

minutes, and reaches its peak effect in about 30 minutes. It takes about four hours for half of a given dose of caffeine to be metabolized by the body.

• Normally, almost all ingested caffeine is metabolized,• and there is no day-to-day accumulation of the drug in the body.

Structurally, caffeine closely resembles a molecule that’s naturally present in our brain, called adenosine (which is a byproduct of many cellular processes, including cellular respiration)—so much so, in fact, that caffeine can fit neatly into our brain cells’ receptors for adenosine, effectively blocking them off. Normally, the adenosine produced over time locks into these receptors and produces a feeling of tiredness.

When caffeine molecules are blocking those receptors, they prevent this from occurring, thereby generating a sense of alertness and energy for a few hours. Additionally, some of the brain’s own natural stimulants (such as dopamine) work more effectively when the adenosine receptors are blocked, and all the surplus adenosine floating around in the brain cues the adrenal glands to secrete adrenaline, another stimulant.

Mechanism of action

Absorbed in the stomach and the intestine Stimulates brain activity Physiologic effects: Increase blood pressure Increase pulse Increase stomach acid production Fat stores break down Fatty acids released into blood stream

Soon after you drink (or eat) something containing caffeine, it’s absorbed through the small intestine and dissolved into the bloodstream. Because the chemical is both water- and fat-soluble (meaning that it can dissolve in water-based solutions—think blood—as well as fat-based substances, such as our cell membranes), it’s able to penetrate the blood-brain barrier and enter the brain.

CAFFIENE TOLERANCEIn people who take advantage of this process on a daily basis (i.e. coffee/tea, soda or energy drink addicts), the brain’s chemistry and physical characteristics actually change over time as a result. The most notable change is that brain cells grow more adenosine receptors, which is the brain’s attempt to maintain equilibrium in the face of a constant onslaught of caffeine, with its adenosine receptors so regularly plugged (studies indicate that the brain also responds by decreasing the number of receptors for norepinephrine, a stimulant). This explains why regular coffee drinkers build up a tolerance over time—because you have more adenosine receptors, it takes more caffeine to block a significant proportion of them and achieve the desired effect.

HEALTH EFFECTS OF CAFFIENE Too much caffeine can lead to

cardiovascular problems. When you consume caffeine your blood pressure and heart rate will rise. Additionally, over time, an overuse of caffeine can lead to heart disease.

Caffeine can lead to the increased risk of gastrointestinal problems such as ulcers.

• Since caffeine stimulates stress hormones,

this can lead to increased anxiety, insomnia, and tension.

Suddenly giving up caffeine entirely can trigger a range of withdrawal effects. The principle is that your brain is used to operating in one set of conditions (with an artificially-inflated number of adenosine receptors, and a decreased number of norepinephrine receptors) that depend upon regular ingestion of caffeine. Suddenly, without the drug, the altered brain chemistry causes all sorts of problems, including the dreaded caffeine withdrawal headache.

If you become addicted to caffeine, it will be difficult to cut this out of your diet. When you finally decide to do so, you may experience symptoms associated with withdrawal. This includes irritability, headaches, and more.

Withdrawal symptoms: • Headache Tiredness • Mood swings • Jittery feeling • Difficulty concentrating

WITHDRAWL EFFECTS

PREVENT WITHDRAWAL SYMPTOMS

Taper your caffeine intake

Eat small, frequent meals

Exercise Get enough sleep

The Academy of Nutrition and Dietetics gives these tips for cutting down on caffeine:

• Mix decaffeinated coffee in with regular coffee

• Drink a latte with more low-fat milk than coffee

• Brew tea for less time• Pick soft drinks without caffeine

ANXIETY AND CAFFEINE• Studies have shown that high dietary doses of caffeine

(200 mg or more) increase anxiety ratings and induce panic attacks in the general population. Individuals with panic and anxiety disorders are especially sensitive to the effects of caffeine. Although highly anxious individuals tend to be more likely to limit their caffeine use, not all individuals with anxiety problems naturally avoid caffeine, and some may fail to recognize the role that caffeine is playing in their anxiety symptoms.

SLEEP AND CAFFEINE • Caffeine administered immediately prior to bedtime or throughout

the day has been shown to delay sleep onset, reduce total sleep time, alter the normal stages of sleep, and decrease the reported quality of sleep. There is some evidence to

• suggest that caffeine taken early in the day also negatively affects nighttime sleep. Caffeine-induced sleep disturbance is greatest among individuals who are not regular caffeine users. Although there is evidence for some tolerance to the sleep disrupting effects of caffeine, complete tolerance may not occur and thus habitual caffeine consumers are still vulnerable to caffeine-induced sleep problems.

CAFFEINE ADDICTION (i.e. CAFFEINE DEPENDENCE)• Although caffeine does not produce with life-threatening

health risks commonly associated with the use of classic drugs of addiction such as cocaine, heroin and nicotine, some caffeine users report becoming "addicted" to caffeine in the sense that they report an inability to quit or to cut down their caffeine use,

• they continue to use caffeine despite having medical or psychological problems made worse by caffeine and they continue to use caffeine to avoid experiencing caffeine withdrawal symptoms.

DIAGNOSIS• Caffeine dependence (ICD-10 diagnosis and DSM-IV criteria for substance

dependence applied to caffeine). • Substance dependence is characterized by a cluster of cognitive, behavioral and

physiological symptoms indicating that the individual continues use of the substance despite significant substancerelated problems (American Psychiatric Association). The clinical diagnosis of substance dependence encompasses several features which may or may not include physical dependence (i.e., withdrawal). The World Heath Organization (ICD-10) recognizes a diagnosis of substance dependence due to caffeine.

• Despite the fact that DSM-IV uses very similar criteria for making a diagnosis of substance dependence, caffeine dependence is not presently included in DSM-IV. The rationale presented for excluding substance dependence on caffeine as a DSM-IV diagnosis was that although it had been established that caffeine produces physical dependence, there was insufficient information pertaining to other features of dependence such as such as inability to stop use and use despite harm.

A restrictive set of four of the seven DSM-IV criteria that seemed most appropriate to problematic caffeine use were assessed ,

(1. continued use despite knowledge of a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance;

2. persistent desire or unsuccessful efforts to cut down or control substance use; 3. characteristic withdrawal syndrome or use of the substance to relieve or avoid

withdrawal symptoms; 4. tolerance as defined by a need for markedly increased amounts of the

substance to achieve desired effect, or markedly diminished effect with continued use of same amount of substance).

Interestingly, among those who met criteria for caffeine dependence, caffeine intake ranged from 129 mg to 2548 mg and the preferred caffeine vehicle was equally divided between coffee and soft drinks. Using the same four criteria, another study identified adolescents who fulfilled diagnostic criteria for caffeine dependence. These studies, which represent a series of case reports, demonstrate that a clinically meaningful caffeine dependence syndrome does exist. The most commonly reported symptom (56%) was persistent desire or unsuccessful efforts to cut down or control caffeine use.

Nicotine is an alkaloid present in Nicotiana Tabacum, a member of the Nightshade family

Nicotine is the addictive substance in tobacco smoke

It is CNS stimulant drug

EFFECTS ON BODY

PHYSICALLY

Psychologically

• Nicotine, the primary alkaloid in tobacco products binds stereo-selectively to nicotinic-cholinergic receptors on autonomic ganglia, the adrenal medulla, neuromuscular junctions and in the brain. Nicotine exerts two effects, a stimulant effect exerted at the locus ceruleus and a reward effect in the limbic system. Itranvenous administration of nicotine causes release of acetylcholine, norepinephrine, dopamine, serotonine, vasopressin, beta-endorphin and ACTH. Nicotine is a highly addictive substance. Nicotine also induces peripheral vasoconstriction, tachycardia and elevated blood pressure

ADDICTION OF NICOTINE

Nicotine reaches the brain within 20 seconds and  and creates a dependency so that smokers become addicted 

People who smoke more than 20 cigarettes/day and have their first cigarette within 30 minutes of waking indicates high nicotine dependence

Causes a release of adrenaline from the adrenal glands providing a ‘hit’ or ‘kick’ from each puff of a cigarette

Dependence develops fairly rapidly often within 60 days of regular use

Withdrawal syndrome occurs when blood levels fall sharply

Severity of dependence depends more on the difficulty the person has in quitting smoking than on the amount and pattern of smoking

Chronic disease it can be progressive, relapsing and fatal

STEPS TO OVERCOME ADDICTION

Combination of counseling and pharmacotherapy is more effective than either option alone

The more intense the intervention, the better the outcome of abstinence

Pharmacologic Options

Two categories of pharmaceutical options:Nicotine replacement therapy (NRT)Non-nicotine replacement therapy

Nicotine Replacement Therapy (NRT):Nicotine Patch Nicotine Lozenges Nicotine Gum Nicotine Inhalers

Non-nicotine Therapy

Bupropion Hydrochloride (Zyban)Also marketed as the anti-depressant medication

WellbutrinPresumed to alleviate cravings associated with nicotine

withdrawal affecting noradrenaline and dopamineVarenicline Tartrate (Champix)

Targets nicotinic acetylcholine receptors to decrease cravings and withdrawal

Clonidine & NortriptylineSecond-line medications used in smoking cessation

All of these medications require a prescription

Non-prescripti

on available over-the-counter

WITHDRAWL SYMPTOMS

Irritability Anxiety Headache Restlessness Coughing Nausea Insomnia Dizziness Depression Difficulty concentrating Physical and psychological dependency

Interesting facts Alzheimer's Disease

The first neurons lost to Alzheimers are cholinergic neurons

Patients showed increased capacity for learning verbal material when exposed to nicotine

Symptoms reduced inADHDTourette's Syndrome

Nicotine patches that slowly deliver nicotine were used

Glutamate Increases learning and memory Enhances connections between sets of

neurons

Nicotine is also suspected as the reason for the lower incidence of Parkinson's Disease among smokers. And for those who have it, nicotine appears to reduce the associated symptoms

Evidence shows that around 50% of those who start smoking in the adolescent years continue to smoke for 15 to 20 years.

Research on nicotine

• Probably 2nd most commonly used drug in US

• Cigarette smoking accounts for 90% of lung cancer cases in the U.S., and about 38,000 deaths per year can be attributed to secondhand smoke

• Most cigarettes in the U.S. market today contain 10 milligrams (mg) or more of nicotine

In 1989, the Surgeon General issued a report that cigarettes and other forms of tobacco, which contain nicotine (such as cigars, pipe tobacco and chewing tobacco) are addictive. The report also determined that smoking was a major cause of stroke as well as the third leading cause of death in the U.S

Approximately three quarters (74.1%) of female university students in Egypt reported preferring smoking tobacco via a water pipe to smoking cigarettes because they believed it to be less harmful

Drug abuses• A maladapted pattern of use of a substance• Excessive use from a harmful drug ( over use)• Psychoactive drugs or performance

enhancing drugs for a non therapeutic or non medical effect

Drug misuses • A term used commonly for prescription

medications with clinical efficacy but abuse potential & known adverse effects linked to improper use such as psychiatric medications with sedative, anxiolytic, analgesic or stimulant properties

• Usage of drug to treat symptoms that it is either not prescribed for or not effective against

Effect of nicotine in cigarette smoke

Misuses of nicotine• Nicotine can be a stimulant or it can be a depressant

depending entirely upon the mood of the user. Normally nicotine is absorbed by the lungs when cigarette or cigar smoke is inhaled but it can also be absorbed through most all of the membranes of the body.

• Then in 1964 the Surgeon General issued a report telling us that cigarette smoking and (presumably) cigar smoking was linked to lung cancer. That's when the anti-smoking campaign began in earnest.

Abuses of nicotine• Nicotine is rapidly absorbed in the

bloodstream• It immediately stimulates the adrenal glands

to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate.

• For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction—a condition of compulsive drug seeking and use, even in the face of negative consequences.

• When an addicted user tries to quit, he or she experiences withdrawal symptoms including:

• Irritability• Attention difficulties• Sleep disturbances• Increased appetite• Powerful cravings for tobacco

Side effects due to misuse & abuse of

nicotine

Other effects

• Increased risk of cancer• Stroke• Heart attack• Chronic bronchitis and emphysema• Vascular disease• Leukemia• Miscarriage ( in pregnancy)

• Hallucinogens are substances that alter sensory processing in the brain,

causing perceptual disturbances,changes in thought processing, and

depersonalization

• Hallucinogens are a type of drug that changes a person’s perception of reality. Also known as ‘psychedelic drugs’, hallucinogens make a person see, feel and hear things that aren’t real, or distort their interpretation of what’s going on around them. Some are quick acting, others take longer to take effect. Being under the influence of a hallucinogen is commonly called ‘tripping’.

• Some hallucinogens are synthetically manufactured, like LSD (lysergic acid diethylamide), PCP (phencyclidine, or ‘angel dust’) and ketamine. Others are naturally occurring compounds found in particular plants. For instance, the peyote cactus produces the hallucinogen mescaline, while psilocybin is found in certain mushrooms, known as ‘magic mushrooms’.

It is also called as

• Psychedelics: substances that expand or heighten perception and consciousness.

• Psychotomimetic: substances that mimic psychosis.

• Psychotogenic: substances that produce psychosis.

TYPESHallucinogens come in a number of different forms. For example:• LSD is a powerful drug – typically, small squares of blotting paper or gelatine are

soaked in LSD, which are then swallowed, although it may also come in tablets or capsules.

• PCP usually comes in the form of pills, capsules or powders of various colours. It is usually swallowed, sniffed or injected, but is sometimes smoked.

• Ketamine can be made into tablets or pills, or dissolved in liquid. It is usually swallowed, snorted or injected.

• Magic mushrooms can be cooked, boiled into a drink or eaten raw.• Mescaline can appear as a white powder while dried, ground peyote buttons are

usually found as capsules. It is usually swallowed, but can be chewed or smoked.• Some depressant and stimulant drugs also have a hallucinogenic effect in high

doses, including cannabis and ecstasy. Since a person’s sense of distance, time and objective reality are warped when under the influence of hallucinogens, serious injury and accidental death are real risks.

• Synthetic hallucinogensIn recent years, a wide range of synthetic products, claiming to have similar effects to hallucinogens, have also been available in Australia. The active ingredient in these products can potentially be a number of chemicals, such as 2C-B or NBOMe, but it is difficult to know what exactly they contain, and as a result, they can have more unpredictable effects and are potentially more harmful than hallucinogens.

How hallucinogens work

Hallucinogens target specific centres of the brain to alter the interpretations of sensory input. For instance, a person might be looking at a blank wall, but their hallucinating brain will interpret the blank wall as moving and swirling, or perhaps covered in insects.

Effects of hallucinogens

The effects of hallucinogens depend on the type of drug, the strength of the dose, the physiology of the person taking them and their state of mind.

Generally, some of the common effects of hallucinogens include:• hallucinations of sight, sound, taste and touch• a blurring of the senses, such as sounds being ‘felt’ or colours being ‘heard’• feeling detached from the body• distortions of time, direction and distance• relaxation• accelerated heart rate• dilated pupils• nausea and loss of appetite

• Short-Term Effects Hallucinogens affect all of senses, but in particular vision and hearing. You may see and hear things differently than they are (for example, colours may seem brighter and richer, and sounds sharper), and you may even have visions of things that aren’t there at all (hallucinations). You might experience synesthesia, which means you believe you can “hear colours,” or “see sounds.”

• These drugs also alter your sense of time and space.• Hallucinogens may also give you a feeling of relaxed well-being,

happiness, love for those around you, and may make you feel as though you have great insight into the world, your life, and yourself

• Some people experience the hallucination of spiders or insects crawling all over their skin, and others have described their altered perceptions as feeling they were “going crazy.”

• The effects of hallucinogens are very unpredictable, and can vary each time you take a hallucinogen, so you never know what kind of experience you’ll have.

• The effects depend on how much of a drug you take, your size and weight, whether you’re mixing a hallucinogen with other drugs or alcohol, as well as your state of mind and your expectations of the experience.

• It’s also possible to experience a “bad trip,” in which the entire time you’re high, you feel an intense sense of panic and fear. After a bad trip, the anxiety and paranoia can stay with you for days, weeks, and even months.

• Hallucinogens may also give you a loss of appetite, a loss of coordination, paranoia, confusion, anxiety, chills, numbness, and muscle weakness.

• FACT SHEET Hallucinogens 2006 2 2 Hallucinogens can also make you feel like you’re observing yourself from a distance. This means that when you take a hallucinogen, you’re less able to make conscious and informed decisions about any risky activity, including sex. Because LSD is illegally prepared in labs, it’s impossible to know what you’re really taking, and how much. This makes your experience that much harder to predict.

• Psilocybin also comes with risks—many mushrooms are poisonous, and can be deadly. It’s illegal to possess or sell LSD or psilocybin in Canada. Punishment can come in the form of a minimum $1000 fine, and/or a prison sentence.

• Long-Term Effects Regular LSD use may give you flashbacks, which can cause you problems years later.

• A flashback is when, days, weeks, or even years later, you re-experience the effects of LSD, usually for one or two minutes. You may hallucinate again, or may have your vision and thought processes temporarily altered.

• Flashbacks are often triggered by stress, fatigue, or other drug use. It is believed that LSD can do long-term damage to your memory and ability to concentrate. Addiction LSD and psilocybin are not physically addictive, and come with no physical withdrawal symptoms. However, it is possible to become psychologically dependent on either of these drugs—you may feel the urge always use hallucinogens in certain situations, which may mean you become compulsive and obsessed with taking the drug, placing it above other things in your life that are important to you.

Technically, you don’t develop a tolerance to hallucinogens, meaning that you would need to take more and more of the drug to continue feeling the effects. Rather, if you take LSD or psilocybin a few days in a row, the drug stops having any effect whatsoever. But when you stop using the drug for a week or so, your resistance to the drug subsides, and you will feel the full effects of the drug the next time you take it. Reducing the Risks

If someone is experiencing a “bad trip,” don’t leave them alone. Make sure they are safe and comfortable, and that they’re not able to hurt themselves.

It is very dangerous to drive after taking a hallucinogen. Don’t inject LSD. Any needle use greatly increases the chance of acquiring HIV or

other diseases. Bet You Didn’t Know Over the last hundred years or so, some psychologists and therapists have believed hallucinogens to be a possible treatment for psychiatric disorders. However, no study has shown that there is a medical use for these drugs. In fact, it’s quite the opposite: regular use of LSD has been linked to chronic depression

Psilocybin has been known to cause severe stomach pain, and sometimes nausea and vomiting.

In high doses, LSD can cause seizures. It’s very dangerous to take hallucinogens when taking other drugs, including

alcohol. Combining them with another drug makes it that much harder to know what kind of physical and psychological effects your body and mind will experience.

There are no reported deaths from the direct effects of LSD or psilocybin. However, the total lack of perception of the world around you can lead to

very risky behaviour. Many fatalities have been reported of people who were high on LSD and had

an accident. People who take LSD sometimes become suicidal. Because your sense of sight and your perception are so impaired, it’s very dangerous to drive after using a hallucinogen.

Signs of Hallucinogen Use, Addiction and Dependence

• People intoxicated by hallucinogens show many different signs of being high. When someone is under the influence of hallucinogens, they are considered to be on a “trip” and have a “psychedelic experience” such as seeing people as warped, feeling disconnected or detached from their body, sights and sounds being distorted, and moving shapes. This “trip” can be a bad or good experience depending on various factors. Some of these factors are:

• State of mind• Previous experiences• Anxiety• Mood• Physical environment• Dose strength

• The user can display several of the following signs of a hallucinogenic state:• Dilated pupils• Rapid eye movement• Anxiety• Increase or loss of appetite• Feelings of being invulnerable• Euphoria• Increased heart rate• Distorted perceptions• Depression• Weight loss• Changes in personality• Speech difficulty

Physical Hallucinogen Withdrawal Symptoms

• According to the Institute for Substance Abuse Treatment Evaluation, hallucinogens work by stimulating neurotransmitter production in the brain. Neurotransmitter chemicals, such as glutamate, serotonin, norepinephrine and dopamine act as chemical messengers, enabling the various regions of the brain to communicate with one another. Neurotransmitter chemicals also regulate central nervous system functions.

• With regular drug use, hallucinogen effects disrupt the brain’s natural chemical balance, which in turn impairs its ability to regulate bodily functions in a normal fashion. Once brain chemical imbalances reach a certain point, physical hallucinogen withdrawal symptoms develop.

• In addition to triggering neurotransmitter secretions, hallucinogens also cause damage to the brain cells that secrete these chemicals. This damage weakens the cells’ ability to produce neurotransmitter supplies. When this happens, a person has to keep taking larger doses of hallucinogens in order to experience the desired drug effects.

Physical hallucinogen withdrawal symptoms to watch out for include –

Stiff muscles Seizure episodes Extreme changes in body temperature Rapid heart rates Tremors Over time, the brain’s tolerance for hallucinogens

continues to increase. As tolerance levels rise, physical withdrawal symptoms happen on a more frequent basis and also increase in intensity

Behavior-Based Hallucinogen Withdrawal Symptoms

• Hallucinogen withdrawal symptoms not only affect the body’s ability to function, but also the mind. Behavior-based withdrawal symptoms develop once the drug’s effects start to impair the brain’s cognitive and emotion-based functions, according to Bryn Mawr College.

• The hallucinations brought on by hallucinogens originate from the cognitive and emotion-based regions of the brain. The neurotransmitter chemical surges that bring on these effects can leave behind some pretty distressing aftereffects once a person stops using these drugs.

Behavior-based withdrawal symptoms most often experienced include – Panic attacks Psychotic-like behavior displays Violent tendencies Extreme and frequent mood swings Speech difficulties During the withdrawal period, it’s difficult to function normally in everyday

life so be prepared to take time off from work until withdrawal runs its course. In cases of chronic hallucinogen use, these symptoms can persist for months and even years after stopping drug use, so it may be a good idea to seek out professional treatment help rather than trying to go it alone.

Ultimately, hallucinogen withdrawal symptoms worsen in severity the longer a person has engaged in drug use. Frequency of use and dosage amounts normally ingested also influence how intense your withdrawal period will be.

lsd

COMMON NAMES:• Acid, Battery Acid, Pane, Brown Bombers,

Coffee, Crystal Tea, Dots, Golden Dragon, Haze, Looney Toons, Microdot, Lucy, Paper Acid, Pearly Gates, Pink Panther, Rainbow, Superman, White Lightening, Window Glass, Yin Yang, Zen, Yellow Sunshine, Sugar Cubes, & others.

Derived from ergot alkaloids of the rye fungus. Colorless, odorless, bitter taste. Most potent mood & perception altering drug

known to man. (can cause effects at 25 μg = in weight to a few grains of salt).

Can be synthesized in 1 week Was used to treat alcoholism, paranoia,

schizophrenia, and autism.

pharmacokinetics Administered orally, smoked, snorted, or injected. Doses 25-300 μg. (lethal dose = 14,000 μg) Microdots: tablet form, Window panes: LSD in gelatin, Blotter acid:

liquid added to paper, Sugar cubes: LSD in sugar cubes. Absorbed within 1 hour. Effects last 6-12 hours. Diffuses across all barriers in body Metabolized in liver and excreted in urine No physical/physiological dependence Few if any withdrawal symptoms Tolerance and cross-tolerance to other hallucinogens does occur.

(is lost within days after cessation of use).

pharmacodynamic

Binds to 5-HT2 serotonin receptorsEffects due to disruption of raphe nuclei

(pons/medulla), which filters incoming sensory stimuli, creating surge of sensory information and overload of brain circuits.

Effects cerebral cortex (involved in mood, cognition, and perception) & locus ceruleus (receives sensory info)

LSD in high concentrations in iris of eye.

effects

Dilation of pupils, dizziness, dreamy detached feelings, changes in time perception, color/smells/sounds intensified, increase heart rate & blood pressure, sweating, dry mouth, hallucinations.

At High doses causes nausea, tremors, & confusion.Moods typically depends on mood prior to use,

causing those to become intensified.However, moods can change quickly from euphoria

to terror and panic.

Long term effects

1. Psychosis = dramatic mood swings2. HPPD (Hallucinogen Persisting Perception

Disorder) = also called Flashbacks. Former users experience spontaneous/repeated/continuous sensory distortions (seeing false motions or trails, etc.)

2 Types of Emotional Responses to LSD:

Ecstatic-Transcendental Reactions: users become talkative, euphoric, ideas seem to have great importance.

Panic & Psychotic-like Reactions: users experience intense anxiety & fear, lose control of thoughts & emotions, become paniced.

Known as a Bad Trip Can result in accidents or accidental suicides due to

individual attempting to flee panic and terror they are experiencing.

Lsd drug forms

DMT

• Short-acting serotonin agonist (30 min)= Called “businessman’s lunch break drug”

• Produces LSD-like effects • snorted or smoked

• Can’t be taken orally, because acid in stomach destroys drug before absorption can occur.

• Metabolized by MAO (monoamine oxidase)• Found in Leguminous trees & shrubs in West Indies

and South America• Dose 60-150 mg

• Dimethyltryptamine (DMT) • - A short-acting hallucinogen • - It is inhaled and similar action as psilocybin. • - High doses can be quite intoxicating.• - Can also cause unpleasant reactions/\.

legality

• it is illegal to have DMT or other plants that contain DMT, such as the chacruna plant

• DMT has a high potential for abuse and there is no medical use of DMT in treatments in the U.S

• DMT lacks the accepted safety requirements for use under medical supervision.

pharmacodynamics

• Anatomical: • Resembles LSD, but mimics sympathetic reflex symptoms like

dilated pupils, heightened blood pressure, and increased pulse rate are more common and more intense.

• Action in the brain:• DMT much like LSD has it’s effect on the serotonergic system.

Binding the 5HT2a & 5HT2c receptor cites. • Endogenous Neurochemical:• DMT is one the only endogenous psychedelic known, meaning

is produced within the body. While it’s role in the brain is unknown , it has been speculated that DMT is released by the pineal gland.

Effects of dmt

* Intense visuals* Altered concept of time* Stomach discomfort* Overwhelming fear* Lung irritation* Increased heart rate* Increased body temperature

Dangers of DMT

Using DMT can be a serious health risk that results in death. Users can go into a state of unconsciousness or a drug induced coma. Often, unconscious users will begin to vomit resulting in choking and death.

PCP (Phencyclidine)

Common names: Angel Dust, Peace Pill, Hog, Lovely, Wack, Ozone, Dust, Embalming Fluid, Rocket Fuel; Supergrass and Killer Joints are names that

refer to PCP combined with marijuana.

State: PCP is a white crystalline powder that readily dissolves in

water or alcohol and has a distinctive bitter chemical taste. Available forms: It is available in a variety of tablets, capsules, and colored

powders, which are either taken orally or by insufflation ("snorted"). The liquid form of PCP is actually PCP base dissolved most often in ether, a highly flammable solvent. For smoking, PCP is typically sprayed onto leafy material such as mint, parsley, oregano, or marijuana. PCP may also be injected.

A moderate amount of PCP often causes users to feel detached, distant, and estranged from their surroundings. Numbness of the extremities, slurred speech, and loss of coordination may be accompanied by a sense of strength and invulnerability. A blank stare, rapid and involuntary eye movements, and an exaggerated gait are among the more observable effects. Auditory hallucinations, image distortion, severe mood disorders, and amnesia may also occur. In some users, PCP may cause acute anxiety and a feeling of impending doom; in others, paranoia and violent hostility, and in some, it may produce a psychoses indistinguishable from schizophrenia. Many believe PCP to be one of the most dangerous drugs of abuse.

Physiological effects of PCP include a slight increase in breathing rate and a more pronounced rise in blood pressure and pulse rate. Respiration becomes shallow, and flushing and profuse sweating.

At high doses of PCP, there is a drop in blood pressure, pulse rate, and respiration. This may be accompanied by nausea, vomiting, blurred vision, flicking up and down of the eyes, drooling, loss of balance, and dizziness. High doses of PCP can also cause seizures, coma, and death (though death more often results from accidental injury or suicide during PCP intoxication). Psychological effects at high doses include illusions and hallucinations.

Effects of PCP Use:

Pharmacological effect:

Statistics and Trends

National Survey on Drug Use and Health: Trends in Prevalence of Various Drugs for Ages 12 or Older, Ages 12 to 17, Ages 18 to 25, and Ages 26 or Older; 2013 (in percent)*

Drug Time Period Ages 12 or Older

Ages 12 to 17

Ages 18 to 25

Ages 26 or Older

PCP

Lifetime 2.50 [0.20] 0.90 3.00

Past Year [0.00] 0.10 [0.10] 0.00

Past Month 0.00 0.00 0.00 0.00

PCP Health Hazards:

PCP is addictive and its use often leads to psychological dependence, craving, and compulsive PCP-seeking behavior. Users of PCP report memory loss, difficulties with speech and learning, depression, and weight loss. These symptoms can persist up to a year after cessation of PCP use. PCP has sedative effects, and interactions with other central nervous system depressants, such as alcohol and benzodiazepines, can lead to coma or accidental overdose. Use of PCP among adolescents may interfere with hormones related to normal growth and development. Many PCP users are brought to emergency rooms because of PCP's unpleasant psychological effects or because of overdoses. In a hospital or detention setting, they often become violent or suicidal, and are very dangerous to themselves and to others. They should be kept in a calm setting and should not be left alone.

psilocybin

psilocybinPsilocybin is the psychoactive component of

mushroomsClassified in the tryptamine family because of

the indole ringOther tryptamines; DMT, Melatonin,

Serotonin, tryptophan and LSD-25

Psilocybin is converted to the psychoactive metabolite Psilocin.

Psilocin is a partial agonist at the 5-HT2A serotonin receptor in the brain

Psilocin is also an agonist 5-HT1A and 5-HT2C receptors

Duration (orally ingested)Total duration: ~4-7hrsOnset: 15-60minPlateu: 2nd to 4th hours

After effects:Headache In general, no physiological hangover/ day after effects

Sensory effects

• Visual Hallucinations (VUS subscale)– Visionary restructuralization

• Illusions/ hallucinations• synaesthetic phenomena• Enhancement of percepts

– Contour distortion– Increased sensitivity to light– Closed eye visuals

• Auditory hallucinations• Alterations in perception of time and space• Sensation of buzzing in the peripheral limbs• Recollective/ analytical stage• Attribution of salience to random objects/ events

Psilocybin-induced psychosis provides clues as to the physiological mechanisms of Schizophrenia

• “Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action” Vollenweider et al. 1998

– Administered psilocybin to three groups who were pre-treated with 5-HT2 antagonist ketanserin, 5-HT/ D2 antagonist risperidone, or D2 antagonist haloperidol

Results: – Pre-treatment with either ketanserin or risperidone dose-dependently blocked

psilocybin-induced psychosis on APZ-OAV scale– Pre-treatment with haloperidol only reduced the effect of psilocybin on the

OSE subscale, no influence on psilocybin-induced visual hallucinations• Haloperidol uniformly increased the AIA scores in all of the subjects treated with

psilocybin– Also found that Psilocybin increased the RT on memory-guided delayed

response task during peak effects of drug (evidence of impairment of working memory)

Effect on brain

Treatment of hallocinogen

s

Hallucinogen Addiction Treatment

• Doctors usually base the diagnosis on symptoms. Tests are not available to confirm the use of many of these drugs.

• Most users do not seek treatment. A quiet, dark room and calm, nonthreatening talk can help users who are having a bad trip. They need reassurance that the effects are caused by the drug and will end. If anxiety is severe, benzodiazepines (sedatives), such as lorazepam, may help. People who experience a prolonged psychosis may need mental health treatment.

overview