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Oct 5 stimulants

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Presentation on psychoactive drugs that excite or speed up neurotransmission in the brain.

Presentation on psychoactive drugs that excite or speed up neurotransmission in the brain.

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  • Three major groups of stimulants: Cocaine Amphetamines Cathinones – newest stimulants to appear on the drug scene in America All share one thing – high potential for abuse
  • Chemical uppers force the body to release its natural stimulants – neurotransmitters, Potentiate the actions, especially norepinephrine At low doses the behavioral response is like an exaggerated stress response Other actions include increased heart rate, etc. High dose and overstimulation may result in restlessness, irritability and insomnia Chemical uppers force the body to release its natural stimulants – neurotransmitters, Potentiate the actions, especially norepinephrine At low doses the behavioral response is like an exaggerated stress response Other actions include increased heart rate, etc. High dose and overstimulation may result in restlessness, irritability and insomnia Chemical uppers force the body to release its natural stimulants – neurotransmitters, Potentiate the actions, especially norepinephrine At low doses the behavioral response is like an exaggerated stress response Other actions include increased heart rate, etc. High dose and overstimulation may result in restlessness, irritability and insomnia Force body to release natural stimulants, especially norepinephrine, resulting in rush of energy and power throughout body
  • F Long term or excessive use depletes the body’s energy producing neurotransmitters, various body systems start to shut down, resulting in physical collapse and mental depression.
  • Localization of cocaine "binding sites" When a person smokes or snorts cocaine, it travels quickly to the brain. Although it reaches all areas of the brain, it concentrates in some specific areas. These are highlighted with the turquoise sprinkles; the VTA, the nucleus accumbens and the caudate nucleus (lighter turquoise since the caudate is inside the hemisphere). Point out that cocaine concentrates especially in the reward areas that you have just discussed. Cocaine accumulation in other areas such as the caudate nucleus can explain other effects such as increased stereotypical behaviors (pacing, nail-biting, scratching, etc..) – the VTA is the ventral tegmental area which is where the impulse starts Show the "big picture". As a result of cocaine's actions in the nucleus accumbens (point to the sprinkles of cocaine in the nuc. acc.), there are increased impulses leaving the nucleus accumbens to activate the reward system. Indicate that with continued use of cocaine, the body relies on this drug to maintain rewarding feelings. The person is no longer able to feel the positive reinforcement or pleasurable feelings of natural rewards (food, water, sex). They are basically “drowned out” by the stronger impulses coming from the drug effect itself.
  • ,
  • One other drug known as “cat” is short for methcathinone…it is homemade and is a powerful stimulant. Destructive side effects keep it from wide use So intense that your text says it must sometimes be mixed with alcohol or pot to offset stimulating effect.
  • Remains the primary target of the Drug War, until now…
  • Using the close-up view, explain what happens when dopamine binds to its receptor. When dopamine binds to its receptor, another protein called a G-protein (in pink) moves up close to the dopamine receptor. The G-protein signals an enzyme to produce cyclic adenosine monophosphate (cAMP) molecules (in green) inside the cell. [Sometimes the signal can decrease production of cAMP, depending on the kind of dopamine receptor and G-protein present.] Point to the dopamine receptor-G-protein/adenylate cyclase complex, and show how cAMP is generated when dopamine binds to its receptor. Indicate that cAMP (point to the cyclic-looking structures) controls many important functions in the cell including the ability of the cell to generate electrical impulses. Using the close-up view, explain what happens when dopamine binds to its receptor. When dopamine binds to its receptor, another protein called a G-protein (in pink) moves up close to the dopamine receptor. The G-protein signals an enzyme to produce cyclic adenosine monophosphate (cAMP) molecules (in green) inside the cell. [Sometimes the signal can decrease production of cAMP, depending on the kind of dopamine receptor and G-protein present.] Point to the dopamine receptor-G-protein/adenylate cyclase complex, and show how cAMP is generated when dopamine binds to its receptor. Indicate that cAMP (point to the cyclic-looking structures) controls many important functions in the cell including the ability of the cell to generate electrical impulses.
  • Chemical uppers force the body to release its natural stimulants – neurotransmitters, Potentiate the actions, especially norepinephrine At low doses the behavioral response is like an exaggerated stress response Other actions include increased heart rate, etc. High dose and overstimulation may result in restlessness, irritability and insomnia Long term or excessive use depletes the body’s energy producing neurotransmitters, various body systems start to shut down, resulting in physical collapse and mental depression.
  • Because cocaine constricts coronary arteries at the same time it raises blood pressure, it increases the likelihood that a cardiac event will occur. At the same time, it disturbs the electrical signals which stimulate heart beat. Needle use TB = this and other respiratory infections occur more frequently in cocaine users than any other drug group – effect on nasal tissues is one cause, but also a practice known as “shotgunning” – often used to increase “intimacy” or to hook new users – Accidental overdose most often linked to lower socioeconomic status of user – Asthma – severe constriction of airways is one of the sympathetic effects of cocaine – can be severe enough to cause epileptic seizures Aggression, anxiety, panic attacks, and depression are most common emotional problems associated with cocaine use.
  • Disulfiram (long used in treatment of alcoholism) has an inhibiting effect on the cAMP reaction that takes place when dopamine reuptake is blocked Selegeline is an MAO-B nhibitor, metabolises dopamine and phenylethylamine (the chocolate amphetamine) – is considered “neuroprotective” against oxidative damage by glutamate
  • Amphetamine is a general term used to describe these four closely-related drugs – Can be smoked, ingested orally, snorted, or injected (after being mixed with water) Similar effects – improve length of performance, reverse effects of fatigue, postpone sleep, Not really harmful if use is occasional or infrequent…although injected it can cause death by heart failure or stroke Tend to use in binges – days without food and possible dehydration May induce formication: sensation of “crank bugs” walking on skin amphetamine psychosis
  • Meth dramatically affects the brain, spinal cord, and spinal nerves, also known as the central nervous system. These changes have widespread effects. Many people are lured into using this drug for the initial good feelings it brings. Immediately after smoking or injecting, the meth user experiences an intense sensation, called a “rush” or “flash.” While that rush is described as pleasurable, it only lasts a few minutes. It is followed by a high that can last up to 6 to 8 hours. Some people start using meth to reduce fatigue and maintain productivity since meth makes users feel more alert and gives them feelings of increased strength. Some people hope it will increase sexual desire and activity. Others want to lose weight. Other typical psychological effects include: Feelings of invulnerability. Feelings of increased confidence and competence.
  • Whatever the reason for using the drug, the meth high is followed by a devastating low. In fact, the depression that follows meth use can be intolerable. This depression often contributes to an individual’s decision to start using meth again. As a result, users often follow a “binge and crash” pattern of use. That is, they continue taking the drug over several days to prolong the high and avoid that inevitable crash. The crash phase, called “tweaking,” often overwhelms the user with feelings of anxiety and emptiness. The reality of meth use is that at some point users may lose control of the drug and become addicted. And, whether addicted or not, meth users risk permanent brain damage.
  • In addition to depression, after the rush individuals typically experience a state of high agitation that can lead to violent behavior. As the drug leaves their systems, users can experience: Irritability/aggressiveness/frustration. Anxiety. Depression. Fatigue. Paranoia. Sometimes these feelings are so extreme they lead to thoughts of homicide or suicide. In addition, people who tweak may exhibit unpredictable and dangerous behavior. When they are startled, confused, or confronted by anyone — including law enforcement, medical personal, and even their own children — they can be violent. Hallucinations or delusions. Insects crawling on the skin, for example. Intense cravings for the drug. Can lead to the binge and crash pattern we discussed, as well as addiction.
  • Meth users face a variety of long-term consequences. Meth’s effect on the brain and the brain’s ability to recover are not entirely clear. However, brain damage can be seen months after a person quits using meth. Research is continuing, but studies have connected prolonged use of meth with symptoms similar to those of people with Parkinson’s disease. Another outcome may be brain damage similar to that caused by Alzheimer’s disease, stroke, and epilepsy. In addition to brain damage and memory loss, users can experience: Insomnia—can’t sleep. Decreased appetite and anorexia. Increased heart rate, blood pressure, and body temperature. Tremors or convulsions. Breathing problems. Lung, kidney, and liver damage. Increased risk of stroke due to irreversible damage to blood vessels in the brain. Increased risk of HIV/AIDS, hepatitis B and C, and other diseases for users who inject meth and share needles.
  • Given these negative effects, you may wonder who would use meth? Well, as with most drugs, it’s used by a broad range of people — every ethnicity, every income bracket, from all areas of the country. While anyone may use meth, some people more susceptible to use are: Students studying long hours. Youth partying all night. People trying to lose weight. Athletes, both in and out of school, seeking temporary bursts of energy and feelings of increased physical endurance. Men in some gay populations where meth is often used to boost sexual performance or alleviate depression. AIDS patients seeking temporary relief from fatigue and depression. They may not realize that meth damages their physical health and makes them more likely to neglect prescribed therapies. People manufacturing meth at home to make money, support their own addiction, or both.
  • While young people are mentioned previously, the impression may be that meth is most widely used by adults. However, during the meth teleconference, experts emphasized that the typical age when people first use meth is in their mid- to late-teens. It was also noted that meth use is increasing, and it is very easy to go from so-called casual use of meth to slip into addiction. Among high school seniors surveyed, almost 8 percent reported using meth at least once. According to the 2000 Monitoring the Future Survey, 8.8 million Americans reported using meth at least once. That’s more than double the number in 1994. Meth use is a national problem, and the dangers faced by those using meth are significant and must be addressed.
  • Let’s take a closer look at meth production. What is a “meth house” or a “meth lab” exactly? And what are some of the very real and literally volatile problems associated with having one in your neighborhood? First, it’s important to understand that meth, unlike many drugs, is made with relatively inexpensive, over-the-counter ingredients. Also, someone doesn’t need much space or special equipment. This makes it fairly simple to manufacture the drug at home and explains why labs can spring up almost anywhere. Manufacturing meth is referred to as “cooking,” a process that is extremely dangerous due to the unstable chemicals used and the toxic byproducts produced. Some of the chemicals used in cooking meth include sulfuric or hydrochloric acid, iodine, ether, and lye. Whether inhaled, ingested, or absorbed through the skin, these chemicals pose serious health hazards. These poisons are usually dumped on the ground or pollute our rivers. In addition, meth labs can and do explode unexpectedly and forcefully. All of these hazards mean that anyone in or near a meth lab is at risk, including police officers, firefighters, and emergency medical technicians who are called to these labs.
  • Meth poses tremendous risks for those around meth users as well. More and more, meth is a contributing factor in cases of domestic violence and child neglect. Meth also threatens the physical safety of children who live in meth labs as well as community members nearby. For instance: One in six meth labs explodes or catches fire each year. Every pound of meth produced generates 5 – 6 pounds of toxic waste. Property values decline and criminal activities escalate when a meth house comes into a neighborhood.
  • Although meth effects many non-users, children are especially vulnerable. When women use meth during pregnancy, it can lead to problems for the infant: Premature delivery — babies are born too early. Low birth weights. Abnormal reflexes and extreme irritability. Learning deficits related to verbal skills.
  • In addition, child protection services are reporting dramatically increased caseloads related to the manufacture and use of methamphetamine. Parents using or producing meth often: Fail to adequately supervise their children’s activities. Fail to obtain appropriate medical attention when necessary. Fail to either feed their children or provide them with proper nutrition.
  • In addition, users and people who tweak can be physically abusive to their children — just as they can be to anyone who bothers them while in withdrawal.

Oct 5 stimulants Oct 5 stimulants Presentation Transcript

  • Mouse Party
    • http://learn.genetics.utah.edu/units/addiction/drugs/mouse.cfm
  • The Stimulants Getting “Up” and “Turned On”
  • Two Major Stimulants top The NIDA 5: Amphetamines. Meth, MDMA: disrupt serotonin transmission Cocaine. Powder, crack: block dopamine transporter. (Marijuana. THC: binds to cannabinoid receptors . Opiates. Codeine/morphine: bind to opioid receptors. Phencyclidine. PCP: disrupts glutamate transmission . Beyond the NIDA five: Alcohol Nicotine Club drugs Steroids Emerging drugs (Khat, Salvia, energy drinks) Prescription medications
  • Social Pressure to Excel
    • “ The popularity of the stimulants is congruent with values in Western society.”
    • Ray. Drugs, Society and _ Human Behavior
  • Uppers: Natural and Synthetic
    • Plant-derived
    • Caffeine
    • Nicotine
    • Cocaine
    • Methcathinone
    • Ephedrine
    • Synthetic
    • Amphetamine
    • Methamphetamine
    • Percent of those ever using who become addicted
    Alcohol Cocaine Heroin Tobacco 35% 30 25 20 15 10 5 0 Schuh et al., Am J Ther. 1996 May;3(5):335-341
    • All stimulants increase activity and availability of monoamine neurotransmitters
      • neurotransmitters and neuromodulators that contain one amino group connected to an aromatic ring by a two-carbon chain (-CH2-CH2-).
      • all monoamines are derived from aromatic amino acids like phenylalanine , tyrosine , tryptophan , and the thyroid hormones by the action of aromatic amino acid decarboxylase enzymes .
        • Catecholamines
          • Dopamine
          • Norepinephrine (noradrenaline)
          • Epinephrine (adrenaline
        • Tryptamines :
          • Serotonin
          • Melatonin
    Note of interest : MAOI drugs inhibit the production of monoamine oxidase, enzymes that break down the monoamine nts…used to treat depression.
    • Direct effect on dopamine levels result from different mechanisms by which different stimulants increase availability of dopamine
      • Cocaine blocks reuptake of dopamine
      • Amphetamine stimulates release of dopamine
    • Complex effects produced by interactions with other monoamine neurotransmitters (norepinephrine, serotonin)
    Direct and Indirect Effects of Stimulants
  • Positive Reinforcement
    • Exaggerated “fight or flight” response
    • Neurotransmitters potentiated
      • Norepinephrine
      • Dopamine
      • Seratonin
    • Low doses mimic norepinephrine
      • Increased alertness, energy
      • Increased blood flow to muscles
      • Increased blood sugar and oxygen
  • Direct Action in Reward Pathway VTA Nucleus accumbens Caudate nucleus
  • Ability of Endogenous Reward System To Elevate Dopamine Significantly Less than that of the Stimulant Drugs Fiorino and Phillips, J. Neuroscience, 1997. DA Concentration (% Baseline) 0 1 2 3 4 5 hr Time After Amphetamine Sample Number 1 2 3 4 5 6 7 8 Female Present SEX AMPHETAMINE DA Concentration (% Baseline) 0 100 200 300 400 500 600 700 800 900 1000 1100 0 100 200 300 400 500 600 700 800 900 1000 1100
  • 0 100 200 300 400 500 600 700 800 900 1000 1100 0 1 2 3 4 5 Hrs. after amphetamine % of Basal Release (DA in Accumbens) AMPHETAMINE 0 100 150 200 250 0 1 2 3 4 5 Hrs. after morphine % of Basal Release MORPHINE 0 100 150 200 250 Hrs. after nicotine % of Basal Release NICOTINE Source: Di Chiara and Imperato Effects of Drugs on Dopamine Release 0 100 200 300 400 0 1 2 3 4 5 Hrs. after cocaine % of Basal Release COCAINE COCAINE 0 1 2 3
  • Positive feedback loop model of addiction Low Dopaminergic Function Drug Abuse/Addiction
  • The Xanthenes: Caffeine
    • Caffeine: Performance enhancement limited to simple tasks – not complex tasks requiring concentration and high-level thinking
    • Xanthenes produce a mildly stimulating effect by blocking receptors for adenosine , a neurotransmitter modulator (inhibits release of other neurotransmitters)
    • Chocolate also contains a xanthene - theobromine – almost no effect on CNS
  • Nicotine
    • Naturally occurring liquid alkaloid
    • When plant is heated, nicotine is released in smoke
    • Highly toxic - 60 mg is lethal dose
    • Cigarettes, cigars are effective delivery methods
    • Action in CNS is complex
      • Mimics acetylcholine
        • First stimulates, then blocks acetylcholine receptors
        • Also causes release of adrenaline (sympathomimetic )
  • Ephredrine
    • Originally derived from herbs classified as Ephedra
    • Used medically in asthma inhalers to dilate bronchial passages (sympathomimetic)
    • Called herbal ecstasy – sometimes marketed as “safe” alternative to MDMA
    • NOT REGULATED BY FDA when used as dietary supplement
    • Betel nuts and yohimbe are close relatives
  • From Ephedrine to Amphetamine
    • Amphetamine – synthesized to resemble ephedrine chemically
      • First patented use for amphetamine was Benzedrine inhaler (OTC )
    • Meth molecule is derived from altering amphetamine molecule
      • Methamphetamine – added methyl molecule to basic amphetamine
      • Ice – smokable form of methamphetamine
      • More rapid absorption, faster effect
    Amphetamine Methamphetamine
  • Cathinoids
    • Schedule 1 drugs: no known (or recognized) medical uses in U. S.
    • Alkaloids derived from khat – plant native to Africa/Arabian Peninsula
    • Effects similar to amphetamines and cocaine
    • Little known about long-term effects; still in early research
    • More widely used in Eastern Europe than in west, although this may be changing.
  • Antidepressants
      • Note: These drugs do not belong in the class of stimulants, but produce an excitatory effect similar to that of the stimulants by increasing availability of the monoamine neurotransmitters
    • MAOIa (monoamine oxidase inhibitors) – raise norepinephrine levels by blocking enzymatic breakdown
    • Tricyclic compounds – prevent reuptake of excitatory neurotansmitters
    • SSRIs such as Fluoxetine ( Prozac ) – blocks reuptake of seratonin and keeps it circulating at higher levels in the brain
  • Cocaine
    • Cocaine causes “ … exhilaration and lasting euphoria, which in no way differs from the normal euphoria of the healthy person...You perceive an increase of self-control and possess more vitality and capacity for work....In other words, you are simply normal, and it is soon hard to believe you are under the influence of any drug....Long intensive physical work is performed without any fatigue...This result is enjoyed without any of the unpleasant after-effects that follow exhilaration brought about by alcohol....Absolutely no craving for the further use of cocaine appears after the first, or even after repeated taking of the drug...”
    Sigmund Freud, circa 1884
  • OTC medicine Cocawine - beverage of choice of Pope Leo XIII In 1909, Ernest Shackleton took “Forced March” brand cocaine tablets to Antarctica , as did Captain Scott a year later on his ill-fated journey to the South Pole
    • Once used widely as an anesthetic
    • Still used as a local anesthetic for nasal, laryngeal and esophageal surgeries because of efficiency with which it’s absorbed into mucous membranes
    • Potential for misuse recognized early on -
      • Novacaine, zylocaine developed as safer topical anesthetics
      • Chemically similar, no CNS effects
    Schedule II
  • Cocaine Facts
    • Cocaine is a $35 billion illicit industry now surpassing coffee as Columbia’s #1 export
    • Only one in four addicts will be able to quit without help
    • Each day 5000 more people experiment with cocaine
    • Young single people are most frequent users of cocaine
    • Figure 6.1
    • Cocaine
  • Cocaine
    • Inhaled cocaine penetrates mucous membranes of nasal lining
    • enters bloodstream through many small capillaries
    • reaches brain in 3-5 minutes
    Most Common Route of Administration is “sniffing” or “snorting” – “doing a line”
  • Other Administration Routes
    • Oral ingestion (chewed leaves)
      • Oldest slowest form
      • 15-20 minutes
    • Injection
      • rush – 15 seconds)
      • Often combined with heroin or other injectable drug to “soften” crash
      • called “speedballing”
    • Smoking – soak cigarette or joint with vapors or use water pipe
      • “ Freebasing” - uses ether to produce vapors – highly flammable – very risky
      • “ Crack” - uses baking soda or ammonia –safer and cheaper – same results
  •  
  • Normal Action of Dopamine Dopamine molecules (pink) move toward special receptors on the adjoining neuron
  • Cocaine Mimics Dopamine… Dopamine activating receptors -cocaine enters synapse Dopamine displaced-Cocaine interferes with reuptake pump Result …an overload of excitation at the synapse
  • Chemical Action Triggered by Dopamine
  • Crack Cocaine - Drug of Choice in Rat Studies What makes it first choice for humans? Crack Cocaine Comparison drugs Rapid effect Slower onset Intense euphoria Less intense More “brain rewarding” – always first choice Chosen only if crack isn’t available Short duration with abrupt end of effect (rapid “let down”) Less intense “ let-down” No visible side-effects Side effects visible No odor - undetectable Tell-tale odor Can be smoked Cannot be smoked
  • Perfect Model of Positive Reinforcement
    • Exaggerated “fight or flight” response
    • Neurotransmitters released and potentiated as a result of stimulant administration
      • Norepinephrine
      • Dopamine
      • Seratonin
    • Low doses mimic norepinephrine
      • Increased alertness, energy
      • Increased blood flow to muscles
      • Increased blood sugar and oxygen
  •  
  • Faster RUSH = Higher RISK
    • A single dose of crack can cause stroke, heart attack, or cardiac arrest
    • B/c of speed with which it reaches heart/brain
  • Crack babies
    • In males, cocaine may attach to sperm causing damage to fetal cells
    • Increased incidence of miscarriage n female users
    • Increased incidence of premature labor and delivery
    • Pre-natal strokes due to fluctuations in blood pressure
    • Fetal addiction/withdrawal
    • Kidney and respiratory ailments
    • Increased risk of SIDS
  • Addiction Process
    • Cocaine, especially crack cocaine, can become addictive on the first use
    • Scientific studies with animals
      • Rats or monkeys hooked to intravenous source of drug
      • Will administer heroin indefinitely, but still eat and sleep
      • Will administer cocaine and do virtually nothing else
  • Addiction Process (cont.)
    • Continued self-administration
      • Stop eating and sleeping
      • Within days/weeks, lose up to 40% of their body weight
      • Within a month, are dead
    • Addiction “cues” in animals
      • Visible excitation at sight of lever for obtaining cocaine
  • Addiction Process in Humans?
    • Similarly, addiction cues have been observed in studies with humans
      • Racing heartbeat when shown items identified with taking cocaine
      • Intense cravings when reminded of use even after period of abstention
  • Acute Potential for harm
    • Cardiovascular toxicity
    • HIV/AIDS infection
    • Tuberculosis infection
    • Accidental overdose
    • Asthma attacks and seizures
    • Violent death
    • Severe emotional and behavioral problems
    • Adulterated drugs (“cutting”)
  • Here’s Why
    • Because cocaine constricts coronary arteries at the same time it raises blood pressure, it increases the likelihood that a cardiac event will occur. At the same time, it disturbs the electrical signals which stimulate heart beat.
    • Needle use
    • TB = this and other respiratory infections occur more frequently in cocaine users than any other drug group – effect on nasal tissues is one cause, but also a practice known as “shotgunning” – often used to increase “intimacy” or to hook new users –
    • Accidental overdose most often linked to lower socioeconomic status of user –
    • Asthma – severe constriction of airways is one of the sympathetic effects of cocaine – can be severe enough to cause epileptic seizures
    • Aggression, anxiety, panic attacks, and depression are most common emotional problems associated with cocaine use.
      • Psychological
      • Addiction
      • Irritability; mood disturbances
      • Restlessness
      • Paranoia
      • Auditory hallucinations
    • Physiological
      • Arrhythmias; heart attacks
      • Chest pain; respiratory failure
      • Increased risk for stroke
      • Seizures
      • Headaches
      • Abdominal pain, nausea
    Medical Complications (Long-Term Use)
    • The “crash,” the initial abstinence phase
      • depression
      • agitation
      • suicidal thoughts
      • fatigue
    • Withdrawal
      • mood swings,
      • craving
      • anhedonia (absence of emotional response, such as joy, affection)
      • obsession with drug seeking
    • Extinction - normal pleasure returns, which cues
      • trigger craving
      • mood swings
    3 Main Stages of Cocaine Withdrawal
  • Treatments
    • Treatment providers in most areas report cocaine as most common cited drug of abuse among clients
    • Majority of cocaine addicts seeking treatment are poly-drug users
    • Behavioral/cognitive (in-patient)
    • Pharmacological approaches
      • No medication specific to cocaine addiction
      • Disulfiram, Selegeline being tested, other antidepressants
    www. selegiline .com/
  • Amphetamines
  • Amphetamines
    • Amphetamine (Benzedrine)
    • Dextroamphetamine (Dexedrine)
    • Methamphetamine (“crystal meth” or “crank”)
      • Smokable form: “ice”)
      • Derivatives: Ritalin
    • No natural source (all synthetic)
  • Short-term Effects
    • Effects felt in 7-8 seconds when smoked
    • Toxic doses can cause convulsions, coma, death
    • Association with violence/crime
    • Effects last 4 to 14 hours
      • Intense physical and psychological exhilaration – high energy
      • Rapid depletion of stored energy, vitamins and minerals
      • Long-term health problems: delusions, hallucinations, paranoia, extreme agitation
  • Medical Uses
    • Anorectic – appetite suppressant
    • Narcolepsy
    • Attention-deficit-hyperactivity disorders in children
      • Dextroamphetamine
      • Ritalin (methylphenidate )
  • Current Misuse
    • Decline in abuse in the late ‘80s and early ‘90s
    • In 1993, the declines were replaced by an alarming increase
    • Increase in use of methamphetamine led to the “National Methamphetamine Strategy” in 1996
    • “ Speed”
    • Due to the ease of production, methamphetamine is often made in makeshift labs in homes or garages
  • Acute Effects of Amphetamine
    • Body
    • Increased/irregular heartbeat
    • Increased blood pressure
    • Decreased appetite
    • Increased breathing rate
    • Sleeplessness
    • Sweating
    • Dry mouth
    • Muscle twitching
    • Convulsions
    • Fever
    • Chest pain
    • Death due to overdose
    Mind
    • Decreased fatigue
    • Increased confidence
    • Increased feeling of alertness
    • Restlessness, talkativeness
    • Increased irritability
    • Fearfulness, apprehension
    • Distrust of people
    • Behavioral stereotyping
    • Hallucinations
    • Psychosis
  • Methamphetamine
    • The following slides are from a special presentation by US Health and Human Services Dept’s SAMHSA (Substance Abuse and Mental Health Services Administration) Division, in response to the growing problems with methamphetamine abuse.
    • Addiction
    • Psychosis/paranoia
    • Hallucinations
    • Anxiety
    • Depression
    • Anorexia/malnutrition
    • Aggression/violence
    LONG TERM EFFECTS OF METH USE
  • Natural Rewards Ability To Elevate Dopamine Pales Compared to Drugs’ Ability To Do So Fiorino and Phillips, J. Neuroscience, 1997. DA Concentration (% Baseline) 0 1 2 3 4 5 hr Time After Amphetamine Sample Number 1 2 3 4 5 6 7 8 Female Present SEX AMPHETAMINE DA Concentration (% Baseline) 0 100 200 300 400 500 600 700 800 900 1000 1100 0 100 200 300 400 500 600 700 800 900 1000 1100
  • The brains of people addicted to Methamphetamine are different from those of non-addicts
  • Dopamine Transporter ( 11 C-d-threo-MP) Brain Glucose Metabolism ( 18 FDG) Normal Meth Abuser BNL-UCLA-SUNY Stony Brook METH Decreases Brain Dopamine Transporters and Glucose Metabolism
  • Dopamine Transporters in Methamphetamine Abusers Methamphetamine abusers have significant reductions in dopamine transporters . BNL - UCLA - SUNY NIDA - ONDCP - DOE Motor Task Memory Task Normal Control Methamphetamine Abuser 7 8 9 10 11 12 13 1.0 1.2 1.4 1.6 1.8 2.0 Time Gait (seconds) 4 6 8 10 12 14 16 1.0 1.2 1.4 1.6 1.8 2.0 Delayed Recall (words remembered) Dopamine Transporter Bmax/Kd
  • How does Methamphetamine Impact the Spread and Course of HIV/AIDS?
    • Increases risky sexual behavior, especially among men who have sex with men (MSM)
    • It may reduce medication adherence to HAART
    • Increases replication of FIV in brain cells (the feline equivalent of HIV)
    • Meth. addiction increases the risk of HIV-related cognitive problems
  • The effects of meth
    • Dramatically affects the brain
    • Alertness/wakefulness
    • Feelings of increased strength/renewed energy
    • Intensified feelings of sexual desire
    • Feelings of invulnerability
    • Feelings of increased confidence/competence
  • What’s the downside?
    • Meth users suffer severe effects and
    • consequences:
    • Depression
    • Binge and crash pattern of use
    • Crash phase — “tweaking” — often includes feelings of anxiety and emptiness
    • Addiction
    • Brain damage
  • What comes after the “high”?
    • Irritability/aggressiveness/frustration
    • Anxiety
    • Depression
    • Fatigue
    • Paranoia
    • Hallucinations or delusions
    • Intense cravings for the drug
  • Long-term effects
    • Brain damage
    • Memory problems
    • Insomnia
    • Decreased appetite and anorexia
    • Increased heart rate and blood pressure
    • Breathing problems
    • Increased risk of stroke
    • Increased risk of HIV/AIDS, hepatitis B and C, and other diseases from shared needles.
  • Anyone can be a potential meth user Interstate truck drivers Restaurant, construction, and factory workers White-collar workers People with AIDS Students Youth at all-night parties People seeking weight loss People producing meth Athletes Gay men
  • Who uses meth?
    • Age of first use: teens
    • Easy to go from casual use to being addicted
    • In 1999, 7.9 percent of high school seniors reported taking meth at least once
    • (2000 Monitoring the Future Survey)
    • 8.8 million Americans reported using meth (2000 SAMHSA Household Survey)
  • Meth production and its effects
    • Over-the-counter ingredients
    • Easily made at home
    • Manufacturing = “cooking”
    • Dangerous chemicals and toxic residue
    • Labs can and do explode unexpectedly
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  • Non-users suffer too…
    • Domestic violence and child neglect
    • Threats to physical safety of community members:
      • One in six meth labs explodes or catches fire
      • Every pound of meth leaves behind 5–6 pounds of toxic waste
    • Property values decline, crime escalates
  • Meth and pregnancy
    • Consequences for Infants:
      • Premature delivery
      • Low birth weight
      • Abnormal reflexes and extreme irritability
      • Learning defects
    • Neglect—inadequate supervision
      • Daily activities
      • Health and hygiene
      • Malnutrition
    Meth—the impact on children
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