““Newer Drugs of Abuse: Newer Drugs of Abuse: Identifying Drugs of Choice Identifying Drugs of Choice for Adolescents and Young for Adolescents and Young Adults to Help Students Adults to Help Students Become Drug-Free Become Drug-Free

Employees.”Employees.”

Cardwell C. Nuckols, MA, PhDCardwell C. Nuckols, MA, PhD

cnuckols@elitecorp.orgcnuckols@elitecorp.org

Partnership For Drug Partnership For Drug Free America, 17Free America, 17thth Annual SurveyAnnual Survey 1 in 5 teens had abused prescription 1 in 5 teens had abused prescription

painkillerspainkillers– HydrocodoneHydrocodone– OxycodoneOxycodone

Increase in prescription Increase in prescription psychostimulant usepsychostimulant use

9% had used cough syrup or other OTC 9% had used cough syrup or other OTC products to get highproducts to get high

http://www.msnbc.msn.com/id/7582787http://www.msnbc.msn.com/id/7582787

The Rat BrainThe Rat Brain

What “turns on” the dopamine in a What “turns on” the dopamine in a rats brain…..rats brain…..– SEX-200% increase in dopamineSEX-200% increase in dopamine– COCAINE-300% increase in dopamineCOCAINE-300% increase in dopamine– METHAMPHETAMINE-1100% increase METHAMPHETAMINE-1100% increase

in dopaminein dopamine This explains why rats will kill This explains why rats will kill

themselves to get more drug-themselves to get more drug-especially methamphetamineespecially methamphetamine

MarijuanaMarijuana

Brain cannabinoid receptorBrain cannabinoid receptor– CB1CB1

Endogenous CannabinoidsEndogenous Cannabinoids– N-arachidonoylethanolamine N-arachidonoylethanolamine

(Anandamide)(Anandamide)– 2-arachidonylglycerol2-arachidonylglycerol

AnandamideAnandamide

Sanskrit ananda means “bliss”Sanskrit ananda means “bliss” Chemical messenger involved in mood, Chemical messenger involved in mood,

memory, pain perception and appetitememory, pain perception and appetite Natural molecular keyNatural molecular key THC fits same receptorTHC fits same receptor Anandamide is fragile and breaks Anandamide is fragile and breaks

down quicklydown quickly– No intense high like THCNo intense high like THC

ChocolateChocolate

AnandamideAnandamide

Seems to play role in making and Seems to play role in making and breaking of short term memorybreaking of short term memory

Induces forgetfulnessInduces forgetfulness– Substances that keep anandamide Substances that keep anandamide

from bonding may be used to treat from bonding may be used to treat memory lossmemory loss

Pigs treated with anandamide walk Pigs treated with anandamide walk less and lay down more-”calm”less and lay down more-”calm”

Classification of Classification of SubstancesSubstances Stimulant drugsStimulant drugs OpioidsOpioids MarijuanaMarijuana DepressantsDepressants ArylcyclohexylaminesArylcyclohexylamines HallucinogensHallucinogens Others- Club Drugs, OTC, InhalantsOthers- Club Drugs, OTC, Inhalants

Stimulant DrugsStimulant Drugs

MethamphetamineMethamphetamine CocaineCocaine NicotineNicotine CaffeineCaffeine Routes of AdministrationRoutes of Administration

– OralOral– IVIV– PulmonaryPulmonary

Stimulant ToxicityStimulant Toxicity

Increased levels of Increased levels of Norepinephrine and DopamineNorepinephrine and Dopamine– Hyper-arousalHyper-arousal– PleasurePleasure– ParanoiaParanoia

Increased levels of SerotoninIncreased levels of Serotonin– Reduced hungerReduced hunger– Difficulty sleepingDifficulty sleeping

OpioidsOpioids NaturalNatural

– MorphineMorphine– CodeineCodeine

Semi-syntheticSemi-synthetic– HeroinHeroin– OxycodoneOxycodone

TyloxTylox PercodanPercodan OxyContinOxyContin

OpioidsOpioids Semi-syntheticSemi-synthetic

– OxymorphoneOxymorphone DilaudidDilaudid

– HydrocodoneHydrocodone VicodinVicodin LortabLortab

SyntheticsSynthetics– MethadoneMethadone– Propoxyphene (Darvon)Propoxyphene (Darvon)– LomotilLomotil

Toxic EffectsToxic Effects

Nausea and VomitingNausea and Vomiting Pinpoint pupilsPinpoint pupils ConstipationConstipation ItchingItching Depressed respirationDepressed respiration Possible overdose deathPossible overdose death

CannabisCannabis

MarijuanaMarijuana HashishHashish Hash oilHash oil THCTHC Routes of administrationRoutes of administration

– PulmonaryPulmonary– OralOral

Increased potencyIncreased potency

HallucinogensHallucinogens

Lysergic Acid Diethylamide (LSD)Lysergic Acid Diethylamide (LSD)– ““Acid”Acid”– ““Microdot”Microdot”

Peyote (Mescaline)Peyote (Mescaline)– ““Buttons”Buttons”

Psilocybe (Psilocybin)Psilocybe (Psilocybin)– ““Magic Mushrooms”Magic Mushrooms”– ““Scrooms”Scrooms”

Tryptamine derivativesTryptamine derivatives– ““Foxy Methoxy”Foxy Methoxy”– ““DMT”DMT”

Club DrugsClub Drugs

Oral administrationOral administration MDMAMDMA

– 3,4-3,4-methylenedioxymethylenedioxymethamphetaminemethamphetamine

– ““Ecstasy”Ecstasy”– ““XTC”XTC”

Club DrugsClub Drugs

GHBGHB– Gamma-hydroxybutyrateGamma-hydroxybutyrate– ““Georgia Home Boy”Georgia Home Boy”– ““Grievous Bodily Harm”Grievous Bodily Harm”

RohypnolRohypnol– ““Coma caps”Coma caps”– ““Roofies”Roofies”

MDMA ToxicityMDMA Toxicity

DehydrationDehydration HyperthermiaHyperthermia Increased ANS functioningIncreased ANS functioning

– SeizuresSeizures Heart and kidney failureHeart and kidney failure ““Stacking and combining”Stacking and combining” Serotonin damageSerotonin damage

GHB ToxicityGHB Toxicity

Low doseLow dose– Reduces anxietyReduces anxiety– Acts as a depressantActs as a depressant– Affectionate and sensual responseAffectionate and sensual response– Slurred speechSlurred speech– EnergeticEnergetic– Playful Playful

GHB ToxicityGHB Toxicity

High doseHigh dose– Sleep producingSleep producing– ComaComa

OverdoseOverdose– Nausea and vomitingNausea and vomiting– Like other CNS depressant drugs Like other CNS depressant drugs

(alcohol,heroin)(alcohol,heroin)– Seizure activitySeizure activity

RohypnolRohypnol

BenzodiazepineBenzodiazepine Anterograde amnesiaAnterograde amnesia

– ““The forget-me pill”The forget-me pill” 10 times more powerful than 10 times more powerful than

ValiumValium FlunitrazepamFlunitrazepam

InhalantsInhalants

Volatile gases and solventsVolatile gases and solvents AerosolsAerosols NitratesNitrates Anesthetic gasesAnesthetic gases ChemicalsChemicals Routes of administrationRoutes of administration

– ““Huffing”Huffing”– ““Sniffing”Sniffing”

Volatile Gases and Volatile Gases and SolventsSolvents GasolineGasoline ButaneButane FreonFreon Lighter fluidLighter fluid Nail polish removerNail polish remover

AerosolsAerosols

Cooking spray(PAM)Cooking spray(PAM) Spray paintSpray paint

– Gold paint(copper)Gold paint(copper) Hair sprayHair spray

NitratesNitrates

Butyl NitrateButyl Nitrate– Rush Rush – Locker RoomLocker Room

Amyl NitrateAmyl Nitrate– ““Poppers”Poppers”– ““Snappers”Snappers”

Anesthetic Gases and Anesthetic Gases and ChemicalsChemicals Anesthetic gasesAnesthetic gases

– Nitrous OxideNitrous Oxide ChemicalsChemicals

– TolueneToluene– AcetoneAcetone– BenzeneBenzene

Toxic EffectsToxic Effects

Nausea,vomiting and headachesNausea,vomiting and headaches StuporStupor Mood changesMood changes Aggressive,violent behaviorAggressive,violent behavior Inflammation around nose and Inflammation around nose and

mouthmouth Slurred speechSlurred speech Lack of muscular controlLack of muscular control

OverdoseOverdose

SuffocationSuffocation Heart attackHeart attack ComaComa DeathDeath

Over the Counter Over the Counter MedicationsMedications Phenylpropanolamine (PPA)Phenylpropanolamine (PPA) DipenhydramineDipenhydramine Ephedrine (Ephedra)Ephedrine (Ephedra) ExampleExample

– NyquilNyquil

PhenylpropanolaminePhenylpropanolamine

Medical usesMedical uses– Decrease congestionDecrease congestion– Suppress allergic reactionsSuppress allergic reactions– Decrease appetiteDecrease appetite– Trade namesTrade names

ContacContac SinutabSinutab

Phenylpropanolamine Phenylpropanolamine ToxicityToxicity

Hypertensive crisisHypertensive crisis SeizuresSeizures PsychiatricPsychiatric

– Paranoid PsychosisParanoid Psychosis– Visual and auditory hallucinationsVisual and auditory hallucinations– Suicidal behaviorSuicidal behavior

DiphenhydramineDiphenhydramine

Medical usesMedical uses– Reduces allergic reactionsReduces allergic reactions– Motion sicknessMotion sickness– Induces sleepInduces sleep

Trade namesTrade names– BenadrylBenadryl– SominexSominex– NytolNytol

Diphenhydramine Diphenhydramine ToxicityToxicity

ConvulsionsConvulsions Red faceRed face HallucinationsHallucinations ComaComa

Ephedrine(Ephedra)Ephedrine(Ephedra)

Medical usesMedical uses– AsthmaAsthma– Decongestant Decongestant – Suppresses allergic reactionSuppresses allergic reaction

Trade namesTrade names– BronkaidBronkaid– NyquilNyquil– TedralTedral

Ephedrine ToxicityEphedrine Toxicity

Severe anxietySevere anxiety ConfusionConfusion DeliriumDelirium Muscle tremorsMuscle tremors Irregular heart rateIrregular heart rate

NyquilNyquil

AlcoholAlcohol Dextromethorphan (cough Dextromethorphan (cough

suppressant)suppressant) Pseudoephedrine (decongestant)Pseudoephedrine (decongestant) Doxylamine succinate Doxylamine succinate

(antihistamine)(antihistamine) Acetaminophen (pain/fever)Acetaminophen (pain/fever)

THANK YOUTHANK YOU

THERE IS NO COMPLETELY THERE IS NO COMPLETELY SAFE DRUG. TOO MUCH OF SAFE DRUG. TOO MUCH OF ANY SUBSTANCE-ANY SUBSTANCE-INCLUDING WATER-CAN BE INCLUDING WATER-CAN BE HARMFUL.HARMFUL.