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(c) McGraw-Hill 2011

(c) McGraw-Hill 2011

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  • Image source: Spike Mafford/Getty Images (ephedra) (Image Ch06_19MaHuang) Image source: McGraw-Hill Companies, Inc./Gary He, photographer (cocaine user) (Image Ch06_15SnortCocaine) Image source: Drug Enforcement Administration (cocaine bricks) (Image Ch06_18CocaineBricks)
  • Image sources: Drug Enforcement Administration (Image Ch06_23MethamphetaminePipe) The McGraw-Hill Companies, Inc./ Suzie Ross, photographer
  • Image source: US Central Intelligence Agency, Coca Fact Paper (Images Ch06_02CocaField; Ch06_03CocaBush) Image source: US Drug Enforcement Administration (Image Ch06_04CocaLeaves)
  • Image sources: US Central Intelligence Agency, Coca Fact Paper (Image Ch06_05CocaMarket)
  • Image source: National Library of Medicine, National Institutes of Health (Image Ch06_06CocaWine)
  • Image source: National Library of Medicine, National Institutes of Health (Image Ch06_07CocaineDrops)
  • Image source: US Central Intelligence Agency (Image Ch06_08DryingCocaLeaves)
  • Image source: Library of Congress Prints and Photographs Division (Image Ch06_09Freud) Image source: Joshua Ets-Hokin/Getty Images (Image Ch06_10SherlockHolmes)
  • Image source: Royalty-Free/Corbis (Image Ch06_13PowderedCocaine)
  • Image source: US Drug Enforcement Administration (Image Ch06_14FreebaseCocaine) Image source: US Drug Enforcement Administration (Image Ch06_12CrackCocaine)
  • Figure 6.1 from text
  • Image source: McGraw-Hill Companies, Inc./Gary He, photographer (Ch06_15SnortCocaine)
  • Image source: S. Meltzer/PhotoLink/Getty Images (Image Ch06_16CocaineInfant)
  • Image source: U.S. Immigration and Customs Enforcement (top) (Image Ch06_17CocaineSeizure); Drug Enforcement Administration (bottom) (Image Ch-6_18CocaineBricks) Top: The cocaine seized in this raid was hidden within wooden pallets of an empty shipping container.
  • Image source: Spike Mafford/Getty Images (Image Ch06_19MaHuang)
  • Image source: Drug Enforcement Administration (Image Ch06_20Dexedrine)
  • Image source: U.S. Immigration and Customs Enforcement (Image Ch06_21MethLab)
  • Image source: Drug Enforcement Administration (Image Ch06_22MethamphetamineIce)
  • Figure 6.2 from text
  • Figure 6.3 from text
  • Image source: Photodisc/PunchStock (Image Ch06_26ADHD)
  • Figure 6.4 from text
  • Image source: Spike Mafford/Getty Images (ephedra) (Image Ch06_19MaHuang) Image source: McGraw-Hill Companies, Inc./Gary He, photographer (cocaine user) (Image Ch06_15SnortCocaine) Image source: Drug Enforcement Administration (cocaine bricks) (Image Ch06_18CocaineBricks)

Hart13 ppt ch06 Hart13 ppt ch06 Presentation Transcript

  • Chapter 6 Stimulants© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Stimulants  Stimulants are substances that keep a person going mentally and physically  Cocaine and amphetamine are restricted stimulants  Caffeine and nicotine are readily available stimulants© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Coca is a bush that grows in the Andes and produces cocaine  Coca has been harvested for thousands of years and actively cultivated for over 800 years© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Natives of the Andes chewed coca leaves to give them greater strength and endurance  The coca leaf was an important part of Inca culture  Used in religious ceremonies and as currency Coca leaf market© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Coca wine: Angelo Mariani  Used coca leaf extract in many products including lozenges, tea, and, especially, wine© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Coca extract was later used in the United States in early versions of Coca-Cola and in many patent medicines© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Local anesthesia: Dr. W. S. Halsted  Experimented with ability of cocaine to produce local anesthesia  Delivered via newly developed hypodermic syringe  Cocaine was isolated before 1860  Processing 500 kilograms of coca leaves yields 1 kilogram of cocaine Drying coca leaves© 2011 McGraw-Hill Higher Education. All rights reserved.
  • History of Cocaine  Early psychiatric uses: Sigmund Freud  Studied use of cocaine as a treatment for depression and morphine dependence  Later opposed use of the drug after nursing a friend through cocaine psychosis© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Early Legal Control  46 states passed laws to regulate cocaine between 1887 and 1914  Press and politicians made unsubstantiated claims about cocaine use among southern blacks:  Widespread  Associated with increased violent crime  Negative publicity about cocaine influenced the passage of the 1914 Harrison Act© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Forms of Cocaine  Coca paste  Crude extract created during the manufacture of cocaine  Can be mixed with tobacco and smoked  Cocaine hydrochloride  Most common form of pure cocaine  Stable water-soluble salt© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Forms of Cocaine  Freebase  Prepared as a chemical base  Can be heated and the vapors inhaled  Crack or rock  Lumps of dried, smokable cocaine  Prepared by mixing cocaine with water and baking soda© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Contemporary Legal Controls on Cocaine  Cocaine use began to increase again at the end of the 1960s  Prior to 1985, the major form of the drug available was cocaine hydrochloride, which was snorted  Cocaine was relatively expensive and its use was associated with status, wealth, and fame  Then an inexpensive ($5 to $10 a hit) form of smokable cocaine became available—crack  Smoked cocaine has a greater abuse potential than snorted cocaine© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Contemporary Legal Controls on Cocaine  Media and politicians focused on crack use among urban blacks  Associated with violence and dependency  Anti-Drug Abuse Acts of 1986 and 1988  Penalties for sale of crack cocaine significantly more severe than penalties associated with powder cocaine  Tougher penalties for first-time users of crack  Concerns about federal cocaine sentencing policy  Does it overstate the seriousness of most crack cocaine offenses?  Does it disproportionately affect the black community?© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Mechanism of Action  Chemical structure does not tell us how or why cocaine affects the brain  Cocaine blocks reuptake of dopamine, serotonin, and norepinephrine© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Cocaine Administration  Chewing or sucking coca leaves  Slow absorption and onset of effects  “Snorting” through nasal mucous membranes  Rapid absorption and onset of effects  Injected intravenously  Rapid and brief effects  Smoked  Rapid and brief effects© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Cocaine Elimination  Cocaine is metabolized by enzymes in the blood and liver  Cocaine has a half-life of about one hour  Major metabolites (detected by drug screens) have a half-life of eight hours© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Potential Beneficial Uses  Local anesthetic properties of cocaine were discovered in 1860, but the drug was not used medically until 1884  Synthesized drugs have largely replaced cocaine for medical use  Cocaine remains in use for surgery in the nasal, laryngeal, and esophageal regions© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Causes for Concern: Acute Toxicity  Acute cocaine toxicity causes profound CNS stimulation, which can lead to respiratory or cardiac arrest  Significant individual variation in the uptake and metabolism of cocaine  Difficult to estimate the size of a lethal dose  Rare, severe, and unpredictable reactions can cause cardiac failure  Cocaine combined with alcohol can cause the formation of the toxic chemical cocaethylene© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Causes for Concern: Chronic Toxicity  Risks of regularly snorting cocaine  Damage to the nasal septum  Paranoid psychosis  Damage to the heart muscle© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Causes for Concern: Chronic Toxicity  Dependence occurs in some users  Animal and human studies have shown that cocaine is a powerfully reinforcing drug  Some people experience withdrawal symptoms© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Causes for Concern  Cocaine use during pregnancy  Increased risk of miscarriage and torn placenta  Long-term effects of prenatal cocaine exposure still under study Infant exposed to cocaine being monitored in ICU© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Supply of Illicit Cocaine  Readily available in all major U.S. cities  Street cocaine averages about 50-75 percent pure  Most illicit cocaine comes from Peru, Bolivia, and Columbia Seized cocaine© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Cocaine: Current Use and Future Trends  2006 surveys indicate that about 2 percent of adults currently use cocaine  Down from a high of 7 to 9 percent in the 1980s  Usage rates of cocaine and amphetamine tend to cycle in opposition to each other© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamines: History  The Chinese used a medicinal tea made from ma huang (Ephedra)  Active ingredient = ephedrine  Ephedrine is a sympathomimetic drug  Stimulates the sympathetic branch of the autonomic nervous system© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamines: History  New synthesized chemical similar to ephedrine, called amphetamine, was patented in 1932  Amphetamine was used medically  Asthma  Narcolepsy  Hyperactivity in children  Appetite suppressant  Stimulant© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamines: History  Use by soldiers in World War II to fight fatigue  1960s  Amphetamine + heroin injected together = speedball  Most street amphetamines came from prescriptions  “Speed scene” = a time and place in which people used and became dependent on intravenous amphetamine  Amphetamines became more tightly controlled  Many look-alikes appeared  Some users switched back to cocaine  Illicit manufacture of methamphetamine grew© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamines: History  Limited amphetamine availability increased the number of illicit laboratories making methamphetamine  Manufacture of methamphetamine is dangerous and associated with toxic fumes and residue Materials from a garage meth lab© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamines: History  Methamphetamine hydrochloride crystals  Ice or crystal meth  Smokable  Methamphetamine abuse began in the western United States and then spread east; it is also now considered a “club drug”© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamine Pharmacology  Chemical structure of amphetamine is similar to the catecholamine neurotransmitters  The structure of methamphetamine allows it to more easily cross the blood-brain barrier  Ephedrine and PPA are less able to cross the barrier and so produce more peripheral than central nervous system effects  Causes increased activity of monoamine neurotransmitters (dopamine, norepinephrine, serotonin) by stimulating their release© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Molecular Structure© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Amphetamine Absorption and Elimination  Peak effects  1.5 hours after oral ingestion  5-20 minutes after intranasal administration  5-10 minutes following intravenous injection or smoking  Half-life  5-12 hours  Rapid tolerance (tachyphylaxis) can occur after high doses© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Beneficial Uses  Previous use for depression to temporarily elevate mood  Adjunctive therapy- a treatment used together with primary treatment.  The benefit of amphetamines is that their effects occur rapidly compared with standard antidepressant medications.© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Beneficial Uses  Weight control  Widely use to reduce food intake and body weight  Effect is real but small  Combination of fenfluramine and phentermine was associated with heart valve damage and lung disease in some people© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Beneficial Uses  Narcolepsy (uncontrolled daytime episodes of muscular weakness and falling asleep)  Stimulants used to keep patients awake during the day  Newer drug modafinil (Provigil) promotes wakefulness by increasing the activity of norepinephrine and dopamine  Low abuse potential  Doesn’t induce tolerance© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Beneficial Uses  Treatment of attention-deficit hyperactivity disorder (ADHD)  Characterized by problems with inattention, hyperactivity, and impulsivity  Stimulant medications can reverse catecholamine-associated deficits that may underlie ADHD  Due to side effects and concerns about the risk of abuse, other treatments for ADHD are being studied© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Beneficial Uses  “Smart pills”  At a low level of arousal, may improve performance  At a high level of arousal, may decrease performance, especially on complex or difficult tasks that require concentration  Athletics  Under some circumstances, may produce slight improvements in athletic performance© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Effects of Stimulants on Performance© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Acute Toxicity  Acute behavioral toxicity  Increases in feelings of power, suspicion, paranoia  Potential risk of violent behavior  Very high doses may destroy catecholamine neurons  Contaminants formed during the manufacture of illicit methamphetamine may have toxic effects on brain cells© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Chronic Toxicity from High-Dose Use  Paranoid psychosis  Two possible reasons for the psychosis  Heavy methamphetamine users have schizoid personalities.  Caused by sleep deprevation.  Higher risk among those who inject the drug© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Dependence Potential of Amphetamines  Often no obvious withdrawal symptoms  Produce psychological dependence  Capable of producing dependence as defined by DSM criteria  A potent reinforcer© 2011 McGraw-Hill Higher Education. All rights reserved.
  • Chapter 6 Stimulants© 2011 McGraw-Hill Higher Education. All rights reserved.