Drugs of Abuse
Kimberly Hoffmann PharmD, BCPP, BCGP
Clinical Professor of Pharmacy Practice
Thomas J. Long School of Pharmacy and Health Sciences at
the University of the Pacific; Stockton, California.
firstname.lastname@example.org or email@example.com
There are no Conflicts
of Interest to Declare
for this Presentation
Goal of this Presentation
•The goal of this presentation is to inform
pharmacists of the widespread abuse of
medications in the world today, to update
them on new forms of substance
dependence, so they will be able to
recognize the problem and help the
patient obtain proper treatment.
Define drug abuse and be able to recognize key
factors in drug dependence.
Identify the biological, social, and environmental
causes of drug use.
Discuss the consequences of drug abuse, and the role
it plays over a lifetime (comorbidities)
Outline the different classes of drugs of abuse
concentrating on the newer medications being
Describe updated scientific information regarding
cannabinoids and their use in different populations.
Recognize new strategies to prevent drug abuse and
the consequences of use for patients.
Not in MY Neighborhood!Not in MY Neighborhood!
• In 2013, an estimated 24.6 million persons in the United
States aged 12 years or older (9.4% OF THE US
population) were classified as having abused or been
dependent on substances subject to addiction during the
National Institute for Drug Abuse, 2013.
WHAT IS THE ECONOMIC COST OF DRUG ABUSE IN THE
Abuse of tobacco, alcohol, and illicit drugs is costly to our
Nation, exacting more than $740 billion annually in costs
related to crime, lost work productivity and health care.¹
National Drug Intelligence Center. National Drug Threat Assessment. Washington,
DC: United States Department of Justice; 2011.
National Overdose Deaths—Number of Deaths from Prescription Drugs. The
figure above is a bar chart showing the total number of US overdose
deaths involving prescription drugs from 2001 to 2013. The chart is
overlayed by a line graph showing the number of deaths by females and
males. From 2001 to 2013 there was a 2.5-fold increase in the total
number of deaths. Prescription Drugs include: anti-depressants,
barbiturates, benzodiazepines and opioids. National Overdose Deaths—
Number of Deaths from Prescription Drugs. The figure above is a bar chart
showing the total number of US overdose deaths involving prescription
drugs from 2001 to 2013. The chart is overlayed by a line graph showing
the number of deaths
National Overdose Deaths—Number of Deaths from
Prescription Drugs. The figure above is a bar chart showing the total
number of US overdose deaths involving prescription drugs from
2001 to 2013. The chart is over layed by a line graph showing the
number of deaths by females and males. From 2001 to 2013 there
was a 2.5-fold increase in the total number of deaths. Prescription
Drugs include: anti-depressants, barbiturates, benzodiazepines and
What is Drug or Substance
The Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5), no longer uses the
terms substance abuse and substance dependence,
rather it refers to substance use disorders,
Substance use disorders occur when the recurrent
use of alcohol and/or drugs causes clinically and
functionally significant impairment, such as health
problems, disability, and failure to meet major
responsibilities at work, school, or home. According
to the DSM-5, a diagnosis of substance use disorder
is based on evidence of impaired control, social
impairment, risky use, and pharmacological criteria.
Drug Abuse vs. Drug
Definition of Dependence Syndrome:
The Tenth Revision of the International Classification of Diseases
and Health Problems (ICD-10) defines the dependence syndrome as
being a cluster of physiological, behavioural, and cognitive
phenomena in which the use of a substance or a class of substances
takes on a much higher priority for a given individual than other
behaviours that once had greater value. A central descriptive
characteristic of the dependence syndrome is the desire (often
strong, sometimes overpowering) to take the psychoactive drugs
(which may or not have been medically prescribed), alcohol, or
tobacco. There may be evidence that return to substance use after
a period of abstinence leads to a more rapid reappearance of other
features of the syndrome than occurs with nondependent
What Causes Substance
Misuse?Biology. The genes that people are born with
account for about half of a person's risk for
addiction. Gender, ethnicity, and the presence of
other mental disorders may also influence risk for
drug use and addiction.
Environmental and social causes: A person’s
environment includes many different influences,
from family and friends to economic status and
general quality of life. Factors such as peer
pressure, physical and sexual abuse, early
exposure to drugs, stress, and parental guidance
can greatly affect a person’s likelihood of drug use
What Causes Substance
Age: Although taking drugs at any age can lead to
addiction, the earlier that drug use begins, the
more likely it will progress to addiction. This is
particularly problematic for teens. Because areas
in their brains that control decision-making,
judgment, and self-control are still developing,
teens may be especially prone to risky behaviors,
including trying drugs.
Consequences of Drug Misuse
oShort-term effects can range from changes in appetite,
wakefulness, heart rate, blood pressure, and/or mood to
heart attack, stroke, psychosis, overdose, and even death.
These health effects may occur after just one use.
oLonger-term effects can include heart or lung disease,
cancer, mental illness, HIV/AIDS, hepatitis, and others. Long-
term drug use can also lead to addiction. Drug addiction is a
brain disorder. Not everyone who uses drugs will become
addicted, but for some, drug use can change how certain
brain circuits work. These brain changes interfere with how
people experience normal pleasures in life such as food and
sex, their ability to control their stress level, their decision-
making, their ability to learn and remember, etc. These
changes make it much more difficult for someone to stop
taking the drug even when it’s having negative effects on
their life and they want to quit.
NIDA. Health Consequences of Drug Misuse. National Institute on Drug Abuse website.
https://www.drugabuse.gov/related-topics/health-consequences-drug-misuse. March 23, 2017.
Accessed February 18, 2018.
Kids and Drugs
- your medicine cabinet
- Grandma’s purse
- siblings (sharing and stealing)
- OTC preparations (DXM, cough and cold preps)
oCost- the lower the better!
Adults in General:
Have Greater Accessibility to Drugs
- Internet (No physical needed!)
- Canada, Mexico, Great Britain, India etc
- Mail order prescriptions :Less familiarity
between Doctors and patients
Have a wider variety of drugs
available to them on the market
The Neurobiology of Addiction
• Above the hindbrain is the mesencephalon or
midbrain, which contains two important regions
for substance abuse:
1. Ventral Tegmental Area (VTA): which is has many
dopaminergic cell bodies that project to the limbic
system and forebrain.
2. Nucleus Accumbens: spiny neurons in this area
receive input from both the dopaminergic neurons
of the VTA and the glutamatergic neurons of the
hippocampus, amygdala, and medial prefrontal
cortex. The end result is the release of dopamine.
More to the Story…..
• Dopamine is not the only neurotransmitter
involved with substance dependence. Many
others play a role such as:
Males vs. Females
oMales start using drugs at an earlier age.
oMales abuse drugs more often and in larger
oMales are more likely to abuse alcohol and tobacco.
oClose to 12 percent of American males age 12 and
older were currently using illegal drugs, compared
with just over 7.3 percent of females in the same
age group. Multi-drug use was also more common in
males than in females.
oFemales abuse benzodiazepines more often than
o Global Burden:
In 2012, 3.3 million deaths, or 5.9 percent of all global deaths (7.6
percent for men and 4.0 percent for women), were attributable to
o Alcohol contributes to over 200 diseases and injury-related health
conditions, most notably alcohol dependence, liver cirrhosis,
cancers, and injuries.
o In 2013, 86.8 percent of people ages 18 or older reported that
they drank alcohol at some point in their lifetime; 70.7
percent reported that they drank in the past year; 56.4
percent reported that they drank in the past month.
Prevalence of Drinking: According to the 2013
National Survey on Drug Use and Health (NSDUH),
35.1 percent of 15year-olds report that they have had
at least 1 drink in their lives.17
About 8.7 million people
ages 12–20 (22.7 percent of this age group) reported
drinking alcohol in the past month (23 percent of
males and 22.5 percent of females).
Consequences of Underage Alcohol Use:Research
indicates that alcohol use during the teenage years
could interfere with normal adolescent brain
development and increase the risk of developing an
AUD. In addition, underage drinking contributes to a
range of acute consequences, including injuries, sexual
assaults, and even deaths—including those from car
National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Alert, No. 67 “Underage Drinking,” 2006. Available at:
Alcohol Toxicity is on the
In addition to alcoholic dementia, seizures,cirrhosis of the
liver and Werneke-Korsakoff syndrome…..we now have drugs
which are much more powerful and are metabolized by the
Cytochrome P450 system producing more Drug-Drug
Interactions and additive effects with alcohol.
Benzodiazepines, opiates, stimulants, barbiturates, muscle
relaxants, and anticonvulsants are all known to be very toxic
when combined with alcohol
• Increases the inhibitory activity mediated
by GABA-A receptors and decreases
excitatory activity mediated by glutamate
• Reinforcing effects probably due to
increased firing rate of the dopaminergic
neurons of the VTA and the dopamine
release into the nucleus accumbens.
(Benzodiazepines and Barbiturates)
Both types of drugs work on the GABA-A receptor
complex and have very strong reinforcing effects.
Many legal cases involving benzodiazepine use and
driving. The new “drugged-driving” scenario.
Tolerance develops to certain aspects of
benzodiazepines leading people to believe they are
oNew “Z” hypnotics……thought to be the safe
dependence….is that really the case?
oZolpidem….a new way to hallucinate?
-night eating, driving, crazy sex?
oWhat happens when you take four times the
Potent agonist of nicotinic receptors of the
cholinergic nervous system. Promotes dopamine
synthesis by increasing tyrosine hydroxylase
expression thru activation of somatodendritic
acetylcholine receptors in the niagrostriatal and
mesolimbic dopamine pathways.
Potential for dependence surpasses all other
psychoactive substances. (most like stimulants)
Statistics for Nicotine Use in
For people aged 18 years and older:
Tobacco use remains the single largest preventable cause of
death and disease in the United States. Cigarette smoking kills
more than 480,000 Americans each year, with more than 41,000
of these deaths from exposure to secondhand smoke. In
addition, smoking-related illness in the United States costs more
than $300 billion a year, including nearly $170 billion in direct
medical care for adults and $156 billion in lost productivity.
In 2016, an estimated 15.5% (37.8 million) of U.S. adults were
current* cigarette smokers. Of these, 76.1% smoked every day.
arette-smoking-in-united-states.htm-accessed February 18, 2018
Statistics for Nicotine Use in
For Children under age 18:
Cigarette smoking during childhood and adolescence causes
significant health problems among young people, including an
increase in the number and severity of respiratory illnesses,
decreased physical fitness and potential effects on lung growth and
Most importantly, this is when an addiction to smoking takes hold,
often lasting into and sometimes throughout adulthood. Among
adults who have ever smoked daily, 87 percent had tried their first
cigarette by the time they were 18 years of age, and 95 percent had
by age 21
In 2015, 9.3 percent of high school students reported smoking
cigarettes in the last 30 days, down 74 percent from 36.4 percent in
1997 when rates peaked after increasing throughout the first half of
What is this New Craze called
Vaping?E-cigarettes come in many shapes and sizes. Most have a
battery, a heating element, and a place to hold a liquid.
E-cigarettes produce an aerosol by heating a liquid that
usually contains nicotine—the addictive drug in regular
cigarettes, cigars, and other tobacco products—flavorings,
and other chemicals that help to make the aerosol. Users
inhale this aerosol into their lungs. Bystanders can also
breathe in this aerosol when the user exhales into the air.
E-cigarettes are known by many different names. They
are sometimes called “e-cigs,” “e-hookahs,” “mods,”
“vape pens,” “vapes,” “tank systems,” and “electronic
nicotine delivery systems (ENDS).”
Using an e-cigarette is sometimes called “vaping.”
E-cigarettes can be used to deliver marijuana and other
Types of e-cigarettes:
In the United States, youth are more likely than adults to use e-
In 2016, more than 2 million U.S. middle and high school students
used e-cigarettes in the past 30 days, including 4.3% of middle
school students and 11.3% of high school students.
“The Opioid Crisis”
Opioids encompasses both the naturally occurring
opiates such as heroin and morphine and the synthetic
and semi-synthetic preparations.
3 receptor classes in the brain for opioids:mu, delta and
Mu agonists have reinforcing properties.
Delta agonists and endogenous enkephalins seem to
produce reward, but at a lesser extent than mu agonists.
Kappa receptors appear to have an opposing effect on
reward, and are hypothesized to work with mu receptors
in keeping a balance or control of mesolimbic
Opioid Tolerance and
oWithdrawal from opioids is extremely
uncomfortable as is characterized by: watery
eyes, runny nose, yawning, sweating,
restlessness, irritability, tremor, nausea,
vomiting, diarrhea, increased blood pressure and
heart rate, chills cramps and muscle aches.
“I wasn’t taking the drugs to get high anymore, I
was taking the drugs to avoid withdrawal”.
Current Pharmacologic Treatment of
o Methadone-unusual pharmacokinetics
o Often patients still abusing other substances
o Buprenorphine (Buprenex®, Suboxone®, Subutex®)
combined with naloxone to discourage diversion. 3 times
per week, expensive
o Ofirmev™ is a new IV formulation of acetaminophen
designed for it’s synergistic effects with opioids in post
operative pain and in cancer patients. It is now being
used in emergency departments with drug seekers.
o Caldolor™ is a new formulation of ibuprofen in sterile
water for injection.
Can be injected, snorted or even smoked.
Black tar heroin is made primarily in Mexico. Names:
Negro: the Spanish word for black Piedra: the Spanish word
for stone Chiva: a Spanish word for a young goat, Nut Job ,
Muck, Frown, Slab
Historically, NYC is the city with the highest rate of heroin
Now that the governmental agencies are discouraging
healthcare professionals from prescribing opioids, the
number of heroin users is rising dramatically.
o Opioids are commonly crushed and snorted for a rush.
o Upon examination, look for constricted “pinpoint pupils”
o Hydrocodone/APAP (Norco™)-abuse at epidemic proportions.
This drug is now a “Schedule II” drug. Mixing with alcohol gives
intensified effect. Snorting may cause perforation of nasal
septum. Names: "vics", "tabs", "hydros“ or “Watsons”
o Oxycodone (Oxycontin™)-abuse at epidemic proportions. Sells
for at least $1.00 per mg on the street. Snorting becoming
very common. Names: Cotton, Hillbilly Heroin, Kicker, OCs, Ox,
Os, Oxy, Pills, 40, 40-Bar,80.
Other Opioids (continued)
Fentanyl (synthetic opioid)
o20 times more powerful than morphine
oUse is on the rise with teens. Many deaths
oSnorting, chewing patches etc
oSmoking out of lightbulbs
o100mcg patch sells for approximately $15.00
on the street Names: Apache, China girl,
China white, Dance fever, friend, Goodfella,
jackpot, murder 8, TNT, Perc-O-Pop, Lollipop,
Fentanyl in Healthcare today
o60% of all deaths in the US due to overdose are caused by
oNever prescribe Fentanyl to a patient who
is opiate naïve.
oFentanyl is not prescribed in Emergency Departments anymore.
oUsed primarily in surgery and hospice care.
oFentanyl is sometimes the substance used to lace fake Xanax.
oFentanyl is often stolen from hospice patients.
• Tylenol #3-still going strong. $5.00 for 2
tablets on high school campuses. Snorting.
Some people mixing tylenol# 3 with snuff
or spit tobacco and snorting. Gives both a
calming effect while nicotine is
stimulating. Street names: T-threes,
Captain Cody, schoolboy.
oAimed at our children
• Cheap high; sold for $2.00-$10.00
• Mixture of small amounts (2-8%) heroin and the
rest is Tylenol-
• Crushed into powder and snorted through
hollowed-out ballpoint pens.
oMimics the “speedball” (heroin and cocaine)
Opiates (con’t) Tramadol
(Ultram™)Now a Controlled Substance.
Many reports of dependence and
withdrawal of the mu receptor type.
Often crushed and snorted or diluted
with liquid and injected.
Drug inhibits the synaptic reuptake of
both serotonin and norepinephrine
Cases of serotonin serum sickness have
been reported in patients with
concomitant use of serotonergic
Increases risk of seizures
Newest Approaches to Decreasing
Education of the Patient:
1. The Pain will not completely disappear.
2. Educating Patients on Hyper-analgesia
3. Referring patient to Cognitive Behavioral
5. Using ice machines after surgery
6. Using heat to alleviate pain.
Newest Approaches to Decreasing
Opioid Use (con’t)
7. A transcutaneous electrical nerve stimulation (TENS)
unit is a device that sends small electrical currents to
targeted body parts. These currents are used to relieve
pain. Some TENS units are designed for use in a hospital or
healthcare facility. Others are safe to use at home. TENS
therapy subdues hyperalgesia, which is a high sensitivity to
pain. The pain may be located anywhere on the body.
8. Trigger Point Injections using anesthetics
9. Reducing doses of pain medications and replacing with
medications in lesser controlled category.
National Institutes of Health
Wednesday, October 21, 2015 “Prevalence of Marijuana Use
Among U.S. Adults Doubles Over Past
Surveys show 9.5 percent of Americans use marijuana; 30
percent of users meet criteria for a disorder.
o Long-term effects:
Marijuana also affects brain development. When marijuana users
begin using as teenagers, the drug may reduce thinking,
memory, and learning functions and affect how the brain builds
connections between the areas necessary for these functions.
Two studies involving adolescents showed an eight point
decrease in IQ for adolescents who used daily marijuana.
Cannabis derivatives are the most widely used
illicit drugs in the world.
New studies have shown the damage to the
lining of the lung is much worse than by cigarette
Works on the endocannabinoid system. Three
receptor ligands (cannabinoid agonists) have been
Euphoric effects thought to be from THC-9
acting on the mesolimbic dopamine reward system
Street names: weed, MJ, pot, maryjane, hooch)
Powerful stimulant which is snorted, smoked,
ingested or injected (sympathomimetic)
In the brain, cocaine acts as a monoamine
transporter blocker for dopamine, serotonin and
Cocaine also facilitates serotonin transmission in
the nucleus accumbens-may account for more
Withdrawal not as severe as with opioids
Street names: coke, snow, crack, rock
Crack cocaine, crack or rock is a solid form of cocaine
which is smoked. It is a freebase form of cocaine that
can be made using baking soda (sodium bicarbonate)
or sodium hydroxide, in a process to convert cocaine
hydrochloride (powder cocaine) into
methylbenzoylecgonine (freebase cocaine).
Crack cocaine is used by the African American
community at a very high rate.
Long term use results in cognitive deficits.
Executive functioning: decision-making and
EEG abnormalities detected in people
recovering from cocaine dependence
Anti-cocaine antibodies being developed for use
peripherally to prevent cocaine from entering
The cocaine vaccine IPC-010 (TA-CD) is being
tested on rats
Both remedies have high variability, and
thought to work best with highly motivated
This group includes both delta and levo
amphetamines, ephedrine, methamphetamine,
methylphenidate, and (-)cathinone (Khat:
leaves/bud of East African plant-chewed or brewed
as tea). Used excessively in somalia.
Only prescribed for medical use of ADHD,
narcolepsy, weight loss
Methylphenidate is crushed and snorted
Ritalin and Adderall are the new “Dexedrine” of the 50’s
White college age males biggest abusers of stimulants.
People using to stay awake and study
Teens stealing siblings ADHD meds for a “high”
School teachers and counselors “dipping in” to the
Street names: meth, crank, crystal, ice
Smoked, snorted, ingested, injected
Crossing the country at an alarming rate
Stimulates release of dopamine from nerve terminals via
dopamine transporter-dopamine is released independently
of neuronal excitation-this contrasts cocaine which blocks
reuptake in the synapse only.
New pseudoephedrine legislation has helped.
Majority of meth now imported from Mexico.
This has driven the price upward.
Fewer children able to afford.
Damage to dopaminergic neurons is severe-
regeneration after 14 months of abstinence, but
chemical transmission is still affected.
Ecstasy….”The Love Drug”
Street names: XTC, E, Adam, cloud 9, herbal bliss
Most worrisome: youth do not perceive this drug
Club drug, used at rave parties
Classified as a psycho-stimulant, but is also a
hallucinogen in very high doses.
New pharmacological class: entactogens-means
“entering into contact with yourself”
Abuse of this drug is spreading across the world. In
Asian countries, more ecstasy is consumed than
heroin and cocaine combined. In Australia, 90% of
all users inject the drug. In the US, the drug is
primarily ingested or smoke, but maybe snorted or
Most effects are serotonergic, but dopamine and
NE are also released.
Ecstasy is neurotoxic
Neurotoxicity is dose and frequency related-It is
Severe reductions in serotonin and its
transporters and neurons.
Impairment in regulation of body temperature
Impairments in memory, decision-making, and
Increased psychiatric symptoms such as:
depression, panic attacks and paranoia.
Scarcity of research-very little known regarding
mechanism of action
Most popular with children and adolescents due
Glue-sniffing, white-out, glade air freshener,
paint stripper, nail polish remover, sharpies,
whipped cream or anything “under the sink”
Dizziness, disorientation, and euphoria with
excitation minutes after inhalation.
Withdrawal of these substances often results in
convulsions. Damage is often severe.
Psychiatric and neurologic problems are often
irreversible, and include: severe paranoia,
hallucinations, delusions, temporal lobe
epilepsy, and lower IQ.
Very popular with the youth of today
LSD, ecstasy, ketamine, PCP and Salvia
Divinorum- perceived as harmless. Cannabis is
really a hallucinogen.
These drugs produce distortions of the senses.
Produces elevated heart rate and body
temperature, unstable motor coordination and
oDrug Class: Hallucinogen, dissociative anesthetic,
oLiquid form used to dip “joints” into=Angel Dust
oMedical and Recreational Uses: Formerly used as a
surgical anesthetic, however, there is no current
legitimate medical use in humans. Used as a
veterinary anesthetic or tranquilizer. Recreationally
used as a psychedelic and hallucinogen.
Used to be purchased in smoke shops legally.
Now illegal, but flourishing on the streets.
Lasting effects including Psychotic symptoms
Extremely addictive (psychologically)
Causes extreme violence in some people.
o The term “bath salts” refers to an emerging family of drugs
containing one or more synthetic chemicals related to cathinone,
an amphetamine-like stimulant found naturally in the khat plant.
o Reports of severe intoxication and dangerous health effects
associated with use of bath salts have made these drugs a
serious and growing public health and safety issue. The
synthetic cathinones in bath salts can produce euphoria and
increased sociability and sex drive, but some users experience
paranoia, agitation, and hallucinatory delirium; some even
display psychotic and violent behavior, and deaths have been
reported in several instances.
Street names: special K, Kit kat, Cat Valium, K,
Purple, jet, etc…..
Used in veterinary medicine and in conscious
sedation in Emergency Depts.
Effects are subjective-some feel euphoric and
happy, and some have a “bad trip” referred to as a
Dissociative (like LSD)-can be injected, inhaled,
mixed with ecstasy and smoked.
• Mitragyna speciosa, commonly known as kratom, grows naturally in
Thailand, Malaysia, Indonesia and Papua New Guinea.
• Serious concerns exist regarding the toxicity of kratom in multiple
organ systems. Consumption of kratom can lead to a number of
health impacts including, respiratory depression, vomiting,
nervousness, weight loss and constipation.
• Kratom has been indicated to have both narcotic and stimulant-like
effects and withdrawal symptoms may include hostility, aggression,
excessive tearing, aching of muscles and bones and jerky limb
• This drug has been sold in California as a natural botanical cure for
• The FDA and CA Dept. of Public health have placed an embargo on
its import and sales.
What is Krokodil
Desomorphine, known by thestreet name krokodil, is an
opioid derivative of codeine Like heroin and other opioids it
has a sedative and analgesic effect, is highly addictive, and
Those who inject these caustic agents into their veins can
develop extreme skin ulcerations, infections, and gangrene- a
discolored (green, black) scale-like skin that resembles a
crocodile, hence the street name “krokodil”.
The drug has been noted to be fast-acting and eight to ten
times more potent than morphine. However, the half-life is
short, and euphoric effects may last less than two hours. Due
to the short “high”, many users find themselves in a rapid
repetition of drug synthesis to avoid withdrawal symptoms
that are typical of heroin.
Side Effects of Krokodil
Reported Blood vessel damage
Open ulcers, gangrene, phlebitis
Skin and soft tissue infections
Side Effects of Krokadil (con’t)
• Rotting gums/tooth loss
• Bone infections (osteomyelitis)
• Speech and motor skills impairment
• Memory loss and impaired concentration
• Liver and kidney damage
Miscellaneous Drugs of
•Ibuprofen in albuterol metered dose inhalers. (HFA
won’t work!)Albuterol helped open the airways.
•Seroquel crushed and snorted “S, Quel”
•Wellbutrin crushed and snorted for a rush
•Dextromethorphan “DXM, Robo-tripping, skittling,
triple C”- dissociative effects in high doses. Abused by
teens. Available in powder form on the internet.
With alcohol, deaths have been reported.
Activity: Post Presentation
1. What neurotransmitter is thought to be predominant in the
reinforcing effects of substance abuse?
2. Which gender is found to become dependent on
sedative/hypnotics at a rate of
4:1 over the other gender?
Post Presentation Questions:
3. Which prescription narcotic is 20 times more powerful
than morphine and is being abused at an alarming rate
among teens and other youth?
4. Of the following illicit drugs, which one is the most widely
abused in the world?
B. cannabinoid derivatives
Post Presentation Questions:
5. What is the name of the new practice among teens
where many types of prescription medications are
ingested at the same time to see what feeling will
6. Why do youth typically abuse dextromethorphan,
alcohol, acetaminophen derivatives and
A. less addictive
B. more easily obtained
C. no hangovers
D. no legal consequences if caught
Post Presentation Questions:
7. Which area of the midbrain receives input from the
hippocampus, amygdala and medial prefrontal cortex which
results in the release of dopamine?
A. nucleus accumbens
B. pituitary gland
D. chemoreceptor trigger zone
8. Which medication has a potential for dependence which
surpasses all other psychoactive substances?