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Chapter 5

Drugs & Behaviour - Chapter Five - Stimulants.pdf

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PSYC 3030
Masood Kamlani

Page 1 of 8 Chapter Five: Cocaine, Amphetamines, and Related Stimulants Many drugs that are used for recreational and medical purposes are referred to as stimulants because they heighten mood, increase alertness and decrease fatigue. Controlled stimulants such as cocaine, amphetamines, methylphenidate (Ritalin) and related compounds are discussed in this chapter. We look at history of stimulant use, some of the effects of these drugs as we review their history and finally a more detailed pharmacology of these stimulants. [ PAGES 83 – 103 ] The Coca Leaf  Early use of cocaine has been traced to Bolivia, Ecuador, northern Argentina and Peru, where a low shrub called the coca bush or coca tree grows. From the leaves of this plant comes the powerful stimulant cocaine. Chewing coca leaves was a common thing back in the day  The coca leaf had important religious significance to the Inca people but was used for medicinal and work-related purposes as well  Until the 1800s, the coca plant was relatively unknown in Europe. European naturalists began to explore Peru and experiment with coca and the rise of scientific interest in coca became noticed  In 1850 European chemist Albert Niemann was able to isolate the far more potent active agent in the leaf which they called cocaine; the extraction lead to a new era in the history of stimulant drug use. Early Use of Cocaine  In the late 19 century the history of cocaine broadened they early use of cocaine for recreational, social, medical and psychological purposes  Sigmund Freud was first recognized for his writings on cocaine  Freud: advocated cocaine as a local aesthetic and as treatment for depression, indigestion, asthma, various neuroses, syphilis, morphine addiction and alcoholism. Freud also though cocaine was an aphrodisiac. Freud‟s influence prompted a major period of cocaine abuse  During this time cocaine was prescribed by physicians as a topical medication and application for eye surgery and dental work. It was also available in patent medicines  French chemist Angelo Mariani used an extract from coca leaves in various patented products used to cure common ailments; his most famous marketing of cocaine was sold as a popular wine: Mariani‟s Coca Wine  Dr. John Stith Pemberton invented Coca-Cola. This non-alcoholic beverage was advertised as containing the “tonic and nerve stimulant properties of the coca plant” – back when it was the real thing. The extract was later replaced with „caffeine‟ in 1903 after increasing discoveries of cocaine‟s hazards  Cocaine‟s popularity spread throughout Europe and North America through its public praise for its effects – this included literature: Sherlock Holmes and Dr. Jekyll and Mr. Hyde and others who provided testimonials  By the end of the 19 century many users has discovered firsthand the hazards of cocaine and with cocaine psychosis, overdose death and sever dependence becoming major problems. Popular sentiment turned against cocaine  Beliefs and attitudes changed. Violent acts committed under the influence of the drug was reported, which led to a swing of public opinion, the control of cocaine under the 1911 Opium and Other Drugs Act in Canada and the 1914 Harrison Narcotics Act in the US. Page 2 of 8 Cocaine Use and Canada  With the creation of drug policy cocaine use declined for the period of 1920-1960s  The implementation of the Opium and Other Drugs Act in Canada acted as the first dry prohibition with other drugs such as cannabis and alcohol  The act changed in 1929 to be called the Opium and Narcotic Drug Act, which became the instrument of drug policy for the next 40 years  In early 1970s, cocaine began to re-emerge but it was fairly difficult to obtain and was expensive. It became glamorized as the drug of movie stars and pro athletes and acquired a reputation as the “champagne” of the stimulants  In Canada large quantities of illicit cocaine were exported by South American Cartels though the US boarders by motorcycle gangs; by the 1980s the cocaine trade was the top organized crime in Canada  Cocaine is a Schedule I drug under the Controlled Drugs and Substances Act. In 2009, cocaine was made the subject of increased criminal sanctions in Canada for serious drug crimes Types of Cocaine and Routes of Administration  Cocaine use increased in the 1980s-1990s because the increased availability of cheaper cocaine  This led to changing patterns of use. Another factor was the practice of smoking cocaine, or cack. 1 2  Although freebasing cocaine seemed to emerge in the late 1970s crack burst upon the national scene in 1986  The form in which cocaine is administered is an important determinate of abuse liability  Street cocaine, which takes the form of a white powder, is produced by combining a paste made from coca leaves with a hydrochloric acid solution to form a salt – cocaine hydrochloride. Because it is a salt street cocaine is water soluble and can be injected or taken intranasal (sniffed or snorted)  Intranasal cocaine can produce intense effects but it causes construction of blood vessels in the nose its absorption is slowed. Overdose, psychosis and dependence are all possible consequences of intranasal cocaine but are less common than with injected cocaine  Freebasing: when the vaporized cocaine is inhaled, it is absorbed rapidly and completely in lung tissue and produces an intensely pleasurable high of very short duration flowed by a severe crash. To smoke cocaine, the hydrochloride salt must be separated from the cocaine base and this is where “freebase” and crack come in.  Freebase cocaine is made by mixing street cocaine with ether. Base cocaine is produced by dissolving the cocaine salt in an alkaline solution. When the water in the solution is boiled off what remains is a hard rock like substance called “crack” or “rock” cocaine  The name crack comes from the crackling sound made by the baking soda left in the compound when it is heated  Smoking crack results in rapid and concentrated delivery of cocaine to the brain and the intense „rush‟ is so pleasurable that addicts actually prefer it to comparable doses of injected cocaine. Users report a „crash‟ after 10 – 20 minutes and begin to crave another hit  Crack is cheaper and less dangerous to produce than other forms of freebase. It is also potent that it can be sold in small chucks. Because of the strong cravings a large market for crack developed overnight 1 2Freebasing: the term used to describe the practice of smoking cocaine by heating it until it vaporizes Crack: freebase cocaine produced by mixing cocaine salt with baking soda and water. The solution is then heated, resulting in brittle sheets of cocaine that are ‘cracked’ into small smoke-able chunks or ‘rocks’ Page 3 of 8  In Canada the first seizure of crack was made in Metropolitan Toronto in 1986  By the late 1980s overdoses were increasing other cocaine overdose emergencies, such as paranoid reactions, also increased  Dependence on cocaine came to be seen as one of the nation‟s major health problems with the introduction of crack  In Canada, crack use is a relatively neglected problem in comparison to injection drug use  2009 CADUMS reported that 15-24 year olds have used crack/cocaine during the past year  Because the allure of crack is so great it leads people to tragic levels of desperation and self-destruction  The „crack house‟ a place where crack is sold and smoked has become the den of iniquity  When addicts run out of money, sexual activities become the medium of exchange and then the transmission of HIV is an additional risk factor Types of Cocaine and Routes of Administration Cocaine Form Method Coca Leaf ----- Oral Coca Paste (Basuco) Cocaine Sulfate Smoke-able Street Cocaine Cocaine Hydrochloride Intranasal Injection Crack Freebase Cocaine Smoke-able The Amphetamines (ATSs)  With the Opium and Other Drugs Act cocaine use declined but other drugs entered the scene: Amphetamines (ATSs) th  ATSs are a class of drugs first synthesized in the late 19 century that includes amphetamine, dextroamphetamine, and methamphetamine (see table below)  Amphetamines have been used as a treatment for cold and sinus symptoms, obesity, narcolepsy and paradoxically, ADHD.  Amphetamines also have a high potential for abuse. But the drugs were not recognized as dangerous until the 1960s  Users experience a brief but intense “flash” or “rush” immediately after the drug is injected. The feeling is described as orgasmic in nature  Both cocaine and amphetamines suppress appetite and prevent sleep, people may go days without sleep, eating very little and administrating dose after dose  When dose levels of amphetamines get large enough, users develop fornication symptoms and paranoid delusions (called stimulant psychosis ) – paranoid state often led to violence; overdose deaths were rare. Binge users may crash and then awaken deeply depressed. Depression a common withdrawal symptom  Eventually user‟s physical and mental health deteriorates badly unless they can break the cycle  Limited medical uses in Canada for ATSs. Today ATSs are used in the treatment of narcolepsy, attention-deficit hyperactivity disorder (ADHD) , and Parkinson‟s Disease 3 Stimulant Psychosis: paranoid delusions and disorientation resembling the symptoms of paranoid schizophrenia, caused my 4rolonged use or overdose of cocaine and/or amphetamine Attention-Deficit Hyperactivity Disorder – ADHD: it is a behavioural disorder, more commonly diagnosed in children, characterized by inattention, disorganized thinking and failure to complete tasks Page 4 of 8 Amphetamine – Type Stimulants (ATSs) Generic Names Brand Names Slang Terms Form & Use Amphetamine Adderall, Benzedrine Bennies, white crosses Capsule or tablet, taken orally Dextroamphetamine Dexedrine, Biphetamine Black Beauties, Cadillac, Capsule or tablet, taken dexies orally, smoked or injected Methamphetamine Desoxyn Speed, Crank, ice, crystal, Powder, taken orally, meth snorted or injected Methylphenidate Ritalin Vitamin R Capsule or tablet, taken orally Methcathinone ----- Cat Whitish powder mixed with commercial products, smoked in crack pipe, snorted or orally with liquid The Re-Emergency of Methamphetamines  A more potent form of amphetamines began to appear on the street, called „ice,‟ „crystal,‟ „crank,‟ or „meth.‟  Illegal methamphetamine labs began to spring up with great frequency in the late 1990s  Crystal meth is the drug of choice in BC for youths  Several of the chemicals used to make meth are toxic, as are some of the by-products that can cause significant health hazards wherever they are dumped  Meth users are at risk for a number of health complications. Exposure to high doses poses a risk of seizures, convulsions, and cardiovascular collapse. Chronic users face additional problems: depression, “meth mouth,” (characterized by loss of teeth and deterioration) and long lasting damage to the brain  Higher crystal meth problem in areas of Canada where there are higher First Nation populations  Pseudoephedrine is a key chemical component most meth labs use. Is used in a wide variety of over the counter cold formulations and until recently was easily obtained This is Your Brain on Stimulants (BOX)  How Cocaine Produces Euphoria and Why People “Crash” A. In the normal functioning of the nervous system, neurotransmitters are released into the synaptic cleft by vesicles in terminal buttons of sending neurons. Many are taken up by receptor sites in receiving neurons B. In the process called the „reuptake‟, sending neurons typically reabsorb excess molecules of neurotransmitters
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