stimulants amphetamine and cocaine. change in brain activity amphetamine amphetamine synthetic amine...
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StimulantsStimulants
Amphetamine and CocaineAmphetamine and Cocaine
Change in Brain ActivityChange in Brain Activity AmphetAmphetamineamine Synthetic amineSynthetic amine Activate dopamine Activate dopamine
in reward circuitsin reward circuits Other amines Other amines
involved in moodinvolved in mood Activates fight or Activates fight or
flightflight Sympathetic NSSympathetic NS Emergency reactionEmergency reaction Stress responseStress response
EphedraEphedra
Natural source Natural source of ephedrineof ephedrine
StimulantStimulant Source for Source for
amphetamineamphetamine
AmphetamineAmphetamine
First produced in First produced in 19371937
Used in WWII by Used in WWII by Germans, British Germans, British and Japaneseand Japanese
United States United States started using started using amphetamine amphetamine during the Korean during the Korean WarWar
Post-war JapanPost-war Japan Huge stockpiles of Huge stockpiles of
amphetamine after waramphetamine after war Sold without prescriptionSold without prescription Advertised for “elimination Advertised for “elimination
of drowsiness and repletion of drowsiness and repletion of the spirit.of the spirit.
By 1948, one million By 1948, one million dependent Japanesedependent Japanese
Tight controls imposed in Tight controls imposed in 1954.1954.
By 1958, problem greatly By 1958, problem greatly reducedreduced
Korean War VetsKorean War Vets
Returned to USReturned to US Entered college on Entered college on
GI BillGI Bill Study for examsStudy for exams Remember Remember
stimulant used stimulant used during warduring war
Available in RxAvailable in Rx Sought another Sought another
routeroute
Vets found supply sourceVets found supply source
Long distance truck Long distance truck drivers had been drivers had been using amphetamine.using amphetamine.
Became main Became main source for college source for college vets.vets.
Also supplied to Also supplied to high achievers in high achievers in entertainment and entertainment and business.business.
Weight ControlWeight Control
Amphetamines as Amphetamines as very popular for very popular for weight control and weight control and relief from relief from boredom.boredom.
During 1960’s, During 1960’s, 99% of 99% of amphetamine Rx amphetamine Rx written for weight written for weight loss.loss.
Amphetamine EpidemicAmphetamine Epidemic
In 1967, 31 million prescriptions In 1967, 31 million prescriptions written for weight control.written for weight control.
In 1966, 25 tons of legally In 1966, 25 tons of legally manufactured amphetamine was manufactured amphetamine was diverted to illegal sale.diverted to illegal sale.
90% of legal manufactured drug 90% of legal manufactured drug never made it to market.never made it to market.
In 1970, FDA put the breaks on.In 1970, FDA put the breaks on.
1970 FDA guidelines1970 FDA guidelines
Amphetamine could only be Amphetamine could only be prescribed for three conditions:prescribed for three conditions:
1) nacrolepsy1) nacrolepsy 2) short term weight loss2) short term weight loss 3) hyperkinesis3) hyperkinesis
NacrolepsyNacrolepsy
Sleep seizureSleep seizure Sudden onset Sudden onset Inappropriate timesInappropriate times Loss of muscle toneLoss of muscle tone HallucinationsHallucinations Enter REM sleepEnter REM sleep DreamingDreaming Muscle paralysisMuscle paralysis
Weight ReductionWeight Reduction More the 50% of US More the 50% of US
adults overweight.adults overweight. Major health problem.Major health problem. Heart disease, Heart disease,
diabetes.diabetes. Huge market in diet Huge market in diet
aids.aids. 95% of pounds lost are 95% of pounds lost are
regained.regained. Need permanent Need permanent
change in lifestyle, change in lifestyle, including regular including regular exercise.exercise.
Amphetamine for weight Amphetamine for weight lossloss
Effective for two weeks.Effective for two weeks. Lose weight, gain energy, good mood.Lose weight, gain energy, good mood. Tolerance develops.Tolerance develops. Need to increase dose.Need to increase dose. Shop for doctors; multiple perscriptions.Shop for doctors; multiple perscriptions. Get amphetamine from black market.Get amphetamine from black market. Or weight comes back, energy and mood Or weight comes back, energy and mood
sag.sag. True with all stimulant weight loss True with all stimulant weight loss
agents.agents.
Diet Pills not a solutionDiet Pills not a solution
Don’t learn anything about nutrition.Don’t learn anything about nutrition. Don’t change exercise habits.Don’t change exercise habits. Many make take pills for energy and Many make take pills for energy and
euphoria.euphoria. Tolerance leads to high doses.Tolerance leads to high doses. Start to develop symptoms of psychosis.Start to develop symptoms of psychosis. Movie: Movie: Requiem for a DreamRequiem for a Dream Woman wants to lose weight to get on TV Woman wants to lose weight to get on TV
quiz show. Keeps increasing dosage until quiz show. Keeps increasing dosage until she has psychotic break.she has psychotic break.
HyperkinesisHyperkinesis
HyperactivityHyperactivity Restless, Restless,
distractible, mood distractible, mood swings, act out, not swings, act out, not doing well in school.doing well in school.
90% boys90% boys Most identified in Most identified in
early gradesearly grades Parents and teachersParents and teachers Rx: RitalinRx: Ritalin
RitalinRitalin
Mild stimulant.Mild stimulant. How could a stimulant calm a child?How could a stimulant calm a child? Wouldn’t you expect them to be Wouldn’t you expect them to be
more active and distractible?more active and distractible? Early theories: differences in brain Early theories: differences in brain
structure and function.structure and function. Paradoxical effect in children with Paradoxical effect in children with
hyperactivity.hyperactivity.
Attention Deficit Attention Deficit DisorderDisorder
Loss of attention leads to distractibility and Loss of attention leads to distractibility and restlessnessrestlessness
Take kids to see cartoon. Hypnotic stillness.Take kids to see cartoon. Hypnotic stillness. Take kids to see romantic comedy. Suddenly Take kids to see romantic comedy. Suddenly
hyperactivehyperactive
Action of RitalinAction of Ritalin
Increase attention.Increase attention. Increase inhibition (improve brake Increase inhibition (improve brake
linings on the brain).linings on the brain). Reduce hyperactivity.Reduce hyperactivity. Acts the same in adults.Acts the same in adults. Small dose helps concentration, Small dose helps concentration,
alertness.alertness. Higher doses become too hyper, lose Higher doses become too hyper, lose
concentration. concentration.
Concerns with RitalinConcerns with Ritalin Loss of attention could be do to other Loss of attention could be do to other
problems.problems. Solve primary cause: family problems.Solve primary cause: family problems. Long term effects of the drug are unknown.Long term effects of the drug are unknown. Chemical solutions not the best.Chemical solutions not the best. Retrain the brain through neural feedback.Retrain the brain through neural feedback. Teachers forbidden to suggest use of Teachers forbidden to suggest use of
Ritalin to parents.Ritalin to parents. Child needs a full exam by a professional.Child needs a full exam by a professional.
Other meds for ADDOther meds for ADD Adderall Adderall DexedrineDexedrine Cylert (pemoline)Cylert (pemoline) All stimulantsAll stimulants All act on All act on
dopaminedopamine Fewer side effectsFewer side effects Longer lastingLonger lasting Antidepressants Antidepressants
such as Effexorsuch as Effexor
CocaineCocaine
Action on the brain very similar to Action on the brain very similar to amphetamine.amphetamine.
History of stimulant use. History of stimulant use. Alternating use of amphetamine and Alternating use of amphetamine and
cocaine.cocaine. Develop new forms of each.Develop new forms of each. More addictive and dangerous.More addictive and dangerous.
Coca PlantCoca Plant
Rich historyRich history Used by native Used by native
peoples in peoples in Peru, Bolivia Peru, Bolivia and Columbiaand Columbia
Coca leaves chewedCoca leaves chewed
Combat fatigueCombat fatigue Slow and Slow and
steadysteady No RushNo Rush Part of native Part of native
religion and religion and folklorefolklore
Spanish invadersSpanish invaders
Spanish overseers Spanish overseers used natives as used natives as slaves.slaves.
Priests opposed Priests opposed coca use.coca use.
Natives weren’t able Natives weren’t able to work as intensely.to work as intensely.
Priest allowed use Priest allowed use but destroyed native but destroyed native culture.culture.
Coca’s use continues Coca’s use continues todaytoday
Coca traded around the Coca traded around the worldworld
Coca WineCoca Wine
Most popular Most popular form in form in Europe.Europe.
For For “neuralgia, “neuralgia, sleeplessness sleeplessness (?), (?), despondencydespondency
Mariani WineMariani Wine
Most popular in Most popular in 1800’s1800’s
Angelo MarianiAngelo Mariani Famous endorsers:Famous endorsers:
Thomas EdisonThomas Edison
Jules VerneJules Verne
Pope Leo XIIIPope Leo XIII
Vin MarianiVin Mariani
““Fortifies and Fortifies and refreshes body refreshes body and brainand brain
Restores health Restores health and vitality.”and vitality.”
Patent medicinesPatent medicines
Freud and KollerFreud and Koller
Medical usesMedical uses Experiments with Experiments with
friend Carl Kollerfriend Carl Koller Noticed relieved pain.Noticed relieved pain. Koller used it to Koller used it to
deaden the cornea deaden the cornea before eye surgerybefore eye surgery
Father of local Father of local anesthesiaanesthesia
Koller’s legacyKoller’s legacy
Local anestheticsLocal anesthetics LidocaineLidocaine ProcaineProcaine NovacaineNovacaine All based on All based on
cocainecocaine Nerve blocksNerve blocks Stop transmission Stop transmission
of neural pain of neural pain messagesmessages
Freud’s cocaine Freud’s cocaine prescriptionsprescriptions
Freud searching for Freud searching for another use.another use.
Relieve morphine Relieve morphine addiction.addiction.
Rx for colleague, Rx for colleague, Fleisch.Fleisch.
Morphine addiction Morphine addiction transferred into first transferred into first cocaine addiction.cocaine addiction.
Tolerance and Tolerance and psychosis.psychosis.
Dr. J.C. PembertonDr. J.C. Pemberton
Formulated his own Formulated his own nerve tonic in 1886.nerve tonic in 1886.
Used extracts from Used extracts from coca and cola plants coca and cola plants to produce patent to produce patent medicine.medicine.
““Cure for all Cure for all nervous afflictions”nervous afflictions”
Coca-ColaCoca-Cola ““Relieves mental and Relieves mental and
physical exhaustion”physical exhaustion” ““Cures headache”Cures headache” New idea:New idea: AT ALL SODA AT ALL SODA
FOUNTAINSFOUNTAINS Formulation had to be Formulation had to be
changed after 1906 changed after 1906 with the Pure Food with the Pure Food and Drug Actand Drug Act
Cocaine illegalCocaine illegal
1914 Harrison 1914 Harrison Narcotic ActNarcotic Act
““Narcotic” as Narcotic” as dangerous drugdangerous drug
Political pressure Political pressure to include to include cocaine with cocaine with opiates.opiates.
Media hype about Media hype about rape and murder.rape and murder.
Cocaine remained Cocaine remained popularpopular
Cole Porter 1934 lyric:Cole Porter 1934 lyric: ““I get no kick from cocaineI get no kick from cocaine
I'm sure that if I took even one sniffI'm sure that if I took even one sniffIt would bore me terrifically tooIt would bore me terrifically tooYet I get a kick out of you”Yet I get a kick out of you”
New lyric:New lyric:
“ “I get perfume from Spain”I get perfume from Spain”
Safe drug?Safe drug?
1970’s cocaine returned as rich person’s 1970’s cocaine returned as rich person’s drugdrug
Advertised as safeAdvertised as safe In 1980, Scientific American reported that In 1980, Scientific American reported that
“cocaine was addictive as potato chips”“cocaine was addictive as potato chips” Few ill effects (?)Few ill effects (?) No tolerance(?), no addiction(?)No tolerance(?), no addiction(?) Soon, we learned these beliefs were Soon, we learned these beliefs were
WRONG.WRONG.
Cocaine is addictiveCocaine is addictive
Most common route was snortingMost common route was snorting Effect lasts 20-30 minutesEffect lasts 20-30 minutes EuphoriaEuphoria One NYC user: “It makes you shiver in One NYC user: “It makes you shiver in
tune with the raw volcanic energy of tune with the raw volcanic energy of NY. It blends your senses til you see NY. It blends your senses til you see the city as an epileptic rainbow, the city as an epileptic rainbow, trembling at the speed of light.”trembling at the speed of light.”
Likened to the pleasure of orgasm Likened to the pleasure of orgasm
Higher dosesHigher doses
ParanoiaParanoia HallucinationsHallucinations Symptoms of psychosisSymptoms of psychosis Depression as an after-effectDepression as an after-effect Strong psychological dependencStrong psychological dependenc Tolerance with chronic useTolerance with chronic use High cost as use acceleratesHigh cost as use accelerates
New forms: FreebaseNew forms: Freebase
Cocaine water Cocaine water soluble but not soluble but not smokeable.smokeable.
FreebasingFreebasing Cocaine is treated Cocaine is treated
with ether with ether (flammable)(flammable)
Product can then be Product can then be smokedsmoked
Smoke reaches lungs Smoke reaches lungs and brain fasterand brain faster
New forms: CrackNew forms: Crack
Another Another smokeable formsmokeable form
Treat cocaine Treat cocaine with chemicalswith chemicals
Cheaper per Cheaper per dosedose
More doses to More doses to maintain highmaintain high
More addictiveMore addictive
MethamphetamineMethamphetamine
Use patterns cycling Use patterns cycling back to back to amphetamine.amphetamine.
““ice or crystal meth”ice or crystal meth” Easy to manufactureEasy to manufacture Start with ephedrineStart with ephedrine ToleranceTolerance AddictiveAddictive Scourge of rural Scourge of rural
AmericaAmerica