SOC 204 Goldberg Ch 11 & 12 Week 6
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This document provides information about stimulants and cocaine. It discusses the history of cocaine use, how it works in the body, forms of cocaine, effects, risks, legal issues and debates around stimulant use to treat ADHD. It also covers amphetamines, including their history, pharmacology, effects, risks and debates around their medical use and treatment of ADHD. Methamphetamine is also discussed.
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SOC 204 Goldberg Ch 11 & 12 Week 6
- 1. Chapter 11 Stimulants Goldberg SOC 204 DRUGS & SOCIETY
- 2. Historically, cocaine was used as an anesthetic. A. True B. False True False 0%0%
- 3. Stimulants Modify (stimulate) a person’s Activity level Mood Central nervous system Increased heart rate Increased respiration Increased blood pressure Dilated pupils https://ww w.youtube. com/watc h?v=R3GYI -Kpf5M
- 4. History of Cocaine Bush that grows in the Andes Natives chewed the leaves for endurance
- 5. Cocoa wine Coca-Cola Patent medicines
- 7. Cocaine accounts for more ER visits than any other illegal drug. A. True B. False True False 0%0%
- 8. Local anesthesia: Dr. W. S. Halsted Early psychiatric uses: Sigmund Freud Used to alleviate fatigue, depression, opiate addiction Later opposed this use History
- 9. 46 states passed laws to regulate cocaine between 1887 and 1914 Negative publicity about cocaine influenced the passage of the 1914 Harrison Act Anti-Drug Abuse Acts of 1986 and 1988 Legal Control
- 10. The majority of powder cocaine users who enter treatment are white, and the majority of crack cocaine users who enter treatment are black. A. True B. False True False 0%0%
- 11. Processing 500 kilograms of coca leaves yields 1 kilogram of cocaine Forms of Cocaine
- 12. Coca paste Cocaine hydrochloride Freebase Crack or rock
- 14. Cocaine blocks reuptake of dopamine, serotonin, and norepinephrine Mechanism of Action
- 15. The depressant effects of alcohol reduce the stimulating effects of cocaine, making serious side effects less likely to occur. A. True B. False True False 0%0%
- 16. Routes: Topical, snorting, IV, smoking 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 Administration/Elimination
- 17. Anesthetic properties Acute toxicity Damage to nasal septum Paranoid psychosis Damage to heart muscle Dependence Some withdrawal Use during pregnancy Benefits/Concerns
- 18. Ancient Chinese used ephedra Chemical version in 1932 – amphetamine Used in WWII to fight fatigue 1960’s Tighter control Amphetamines
- 20. After Mexico, the largest producer of methamphetamine is Canada, because pseudoephedrine is not regulated there. A. True B. False True False 0%0%
- 21. Chemical structure is similar to catecholamine neurotransmitters (adrenaline, noradrenaline) Methamphetamine and amphetamine both cross blood brain barrier Increases activity of monoamine neurotransmitters by stimulating their release (dopamine, norepinephrine, serotonin) Pharmacology
- 22. Peak effects 1.5 hours oral 5-20 min snorting 5-10 min smoking Half-life is 5-12 hours Rapid tolerance Absorption/Elimination
- 23. Boys are more than twice as likely as girls to be identified with ADHD. A. True B. False True False 0%0%
- 25. ADHD is limited to teenagers and children. Very few adults have this disorder. A. True B. False True False 0%0%
- 26. Acute behavioral toxicity High doses may destroy catecholamine neurons Contaminants Paranoid psychosis No withdrawal Powerful psychological dependence https://www.youtube.com/watch?v=FTGm43yY pT Q https://www.youtube.com/watch?v=0kq7zj8Kd _Q Risks
- 27. Methamphetamine
- 28. Do you think that using stimulants to treat ADD or ADHD is a good thing? A. Yes B. No Yes No 50%50% Response
- 29. Most commonly prescribed drugs for ADHD Ritalin and other stimulants enhance the functioning of the reticular activating system, which helps children focus attention and filter out extraneous stimuli Side effects include insomnia, weight loss, headaches, irritability, nausea, and dizziness Ritalin, Adderall
- 30. Caffeine Humor http://www.youtub e.com/watch?v=Tq FRP5lXTmE Videos
- 31. Do you think of caffeine as a drug? A. Yes B. No C. Not sure Yes No Notsure 0% 0%0% Why or why not?
- 32. Sources of caffeine Coffee Tea Soda Chocolate Energy drinks Over-the-counter medications NoDoz Vivarin Anacin Excedrin Midol Diurex Caffeine
- 33. What do you consider an acceptable level of caffeine intake? A. None B. One beverage a day C. 2-5 beverages a day D. Any level is ok NoneOne beverage a day2-5 beveragesa day Anylevelisok 0% 0%0%0%
- 34. Peak blood levels reached 30 minutes after oral intake Half-life is about 3 hours Low-grade tolerance does develop Pharmacology
- 35. 200 mg Increased arousal Mood-elevating effects 500 mg Increased heart rate & respiration Paradoxical effect on blood vessels: dilation Constriction of blood vessels in the brain = headache relief Increased basal metabolic rate (10%) in chronic users Works on the neurotransmitter adenosine (inhibitory) Blocks receptors Mechanism of Action
- 36. Behavioral Stimulation Headache Hyperactivity Does not sober one up Concerns Panic attacks 1980s thought to have a link to cancer, since disproven Reproduction Heart disease (large amounts) Caffeinism Effects
- 37. Should there be an age limit on caffeine consumption? A. Yes B. No Yes No 0%0%
- 38. Considerations What age? Infants Toddlers School age Teenage What products? Energy drinks Soda Coffee Tea/iced tea Hot chocolate Chocolate
- 39. Your brain on coffee http://www.youtube.com/watch?v=hbuCmO8Bwhs&noredirect=1 http://www.youtube.com/watch?v=gfntvRGwpvs Children and Caffeine http://guardianlv.com/2014/02/caffeine-is-a-drug-for-kids-video/ Videos
- 40. How much caffeine do you consume? 1981 FDA: limit of 6 mg of caffeine per ounce No labeling required Wrap-up Item Amount of Item Amount of Caffeine Jolt soft drink 12 ounces 71.2 mg Mountain Dew 12 ounces 55.0 mg Coca-Cola 12 ounces 34.0 mg Diet Coke 12 ounces 45.0 mg Pepsi 12 ounces 38.0 mg 7-Up 12 ounces 0 mg Brewed coffee (drip method) 5 ounces 115 mg Espresso 1 shot 64 mg Tea 5 ounces 40 mg Iced tea 12 ounces 70 mg Dark chocolate 1 ounce 20 mg Milk chocolate 1 ounce 6 mg Cocoa beverage 5 ounces 4 mg Chocolate milk beverage 8 ounces 5 mg Cold relief medication 1 tablet 30 mg Midol 1 tablet 32 mg Excedrin 1 tablet 65 mg Monster Energy Drink 16 ounces 160 mg Red Bull 8 ounces 60 mg
- 41. Under what circumstances should a person consider reducing caffeine intake? A. When they are cranky without it B. When they have health complications C. When they obsess about it D. Can’t think of a time I’d give it up! W hen theyare cranky w ... W hen theyhavehealth ... W hen theyobsessaboutit Can’tthinkofa tim e I’d g... 0% 0%0%0%
- 42. Goldberg Chapter 12 Marijuana SOC 204 DRUGS & SOCIETY
- 43. The word canvas is derived from the word cannabis and many famous paintings are on marijuana fibers. A. True B. False True False 0%0%
- 45. Cannabis sativa Cannabis indica Cannabis ruderalis Cannabis
- 46. The early colonial settlers planted marijuana because they recognized its medicinal value. A. True B. False True False 0%0%
- 47. 1. Charas, also known as hashish 2. Ganja, also known as sinsemilla From Spanish sin semilla, “without seeds” 3. Bhang Preparations
- 49. The use of marijuana by high school students has increased in the last five years while alcohol consumption has decreased. A. True B. False True False 0%0%
- 50. 1900s little use or interest 1926 newspaper articles linked marijuana to crime 1936 all state had laws regulating use Early perceptions Marijuana Tax Act Declared unconstitutional in 1969 Reefer Madness http://digital.films.com/PortalViewVideo.aspx?xtid=5863&loid=12178&psid=0&sid=0&State=&title=Alter ed%20States:%20A%20History%20of%20Drug%20Use%20in%20America&IsSearch=Y&parentSeriesID = History
- 51. The federal government owns a farm in Mississippi where it grows marijuana to be used for research purposes. A. True B. False True False 0%0%
- 52. Mouse Party http://digital.films.com/PortalViewVideo.aspx?xtid=39495&loid=70444&psid=0&si d=0&State=&title=Marijuana&IsSearch=Y&parentSeriesID=# Pharmacology
- 53. Review: The neurotransmitter affected by THC: A. Dopamine B. Serotonin C. Cannabinoids D. GABA Dopam ine Serotonin Cannabinoids GABA 0% 0%0%0% Response
- 54. Most young people who try marijuana for the first time do so during the winter months. A. True B. False True False 0%0%
- 57. Anandamide THC binds to two receptors CB1 Primarily in brain CB2 Primarily outside brain in immune cells Mechanism of Action
- 59. Cardiovascular Pulmonary Reddening of eyes Dryness of mouth/throat http://digital.films.com/Por talVi ewVideo.aspx?xtid=39495 Physiological Effects
- 60. Marijuana arrests account for over half of all drug abuse arrests. A. True B. False True False 0%0%
- 61. Abuse potential Effects: Euphoria, mellow-ness, hunger Cognitive Effects Food Intake Verbal Behavior Psychological Effects
- 62. The federal government allows the medical use of marijuana only to treat the side effects of chemotherapy on cancer patients. A. True B. False True False 0%0%
- 63. Declined even before Marijuana Tax Act Dropped from National Formulary & US Pharmacopia 1941 Uses: Anticonvulsant Headaches Glaucoma Reduces nausea Increases appetite https://www.youtube.com/watch?v=qQzyfYfq1WY Medical Uses
- 64. EC Review: The neurotransmitter directly affected by THC is: A. Anandamide B. GABA C. Serotonin D. Dopamine Anandam ide GABA Serotonin Dopam ine 0% 0%0%0% Response
- 65. EC Review: Medical uses for marijuana do not include: A. To increase appetite B. To control convulsions C. To fight infection D. To reduce nausea To increase appetite To controlconvulsionsTo fightinfectionTo reducenausea 0% 0%0%0% Response http://www.drugabuse.gov/publications/drugfacts/marijuana- medicine
- 66. DSM-5 – no listing for cannabis withdrawal Abstinence syndrome Tolerance Abuse Potential Abuse & Dependence http://digital.films.com/PortalViewVideo.aspx? xtid=36368&loid=37683&psid=0&sid=0&Stat e=&title=Cannabis:%20Satanic%20Herb%20or %20Healing%20Potion?&IsSearch=Y&parentS eriesID=
- 67. EC: Do marijuana users experience withdrawal? A. Yes B. No C. No, but they do experience mild symptoms when they abstain Yes No No,butthey do experi... 0% 0%0% Response
- 68. EC: Does tolerance develop with marijuana use? A. No B. Yes, rapidly and immediately C. Yes, with regular use D. Yes, but unevenly, (not to all effects) No Yes,rapidlyand im m edia... Yes,with regularuse Yes,butunevenly,(notto... 0% 0%0%0% Response
- 69. Public opinion polls reveal that the majority of Americans favor legalizing marijuana. A. True B. False True False 0%0% http://www.gallup.com/poll/165539/first-time- americans-favor-legalizing-marijuana.aspx
- 70. Acute No recorded human overdoses Chronic Lungs Anxiety Reproductive Effects Immune System Effects Toxicity
- 71. Amotivational Syndrome Marijuana Madness h ttp://dig ital .fi lms.com/PortalViewVideo.aspx?xti d=36368&loid=37683&psi d=0&si d=0&State=&title=Ca n nabi s:%20Satanic%20Herb%20or%20Healing%20Potion?&IsSearch=Y&parentSeriesID=# Driving Ability Toxicity
- 72. EC: The negative effects of marijuana include: A. Increased violence B. Problems with memory C. Problems with learning D. Respiratory problems Increased violence Problem sw ith m em ory Problem sw ith learning Respiratory problem s 0% 0%0%0% Response
- 73. Opinion: Do you believe amotivational syndrome occurs in marijuana users? A. Yes B. No Yes No 0%0% Response
- 74. Decriminalization of marijuana Legalization for medical use Legalization for recreational use Federal scheduling reform Attitudes of Society
- 75. Opinion: I think legalization of marijuana was a good idea. A. Yes B. No Yes No 0%0% Response
Editor's Notes
- Stimulants modify a person’s activity level, mood, and central nervous system Some stimulants, such as cocaine and methamphetamines, are illegal Others, such as amphetamines, require a prescription Legal stimulants such as caffeine and nicotine are among the most widely used drugs in the world
- 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 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 Cocaine comes from the leaves of the coca plant, Erythroxylon coca Natives of the Andes Mountains chew coca leaves to relieve fatigue, for spiritual reasons, or to enhance well-being Colombia is the largest producer of cocaine Bolivia and Peru account for a small percentage of cocaine production
- Coca wine: Angelo Mariani Used coca leaf extract in many products including lozenges, tea, and, especially, wine Coca extract was later used in the United States in early versions of Coca-Cola and in many patent medicines
- 1800s
- 420,000 in 2009 Powder cocaine accounts for three times as many ER visits Chart shows numbers USING each drug http://www.drugabuse.gov/publications/drugfacts/nationwide-trends
- 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 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 Cocaine was isolated from coca leaves by the German scientist Niemann around 1859 Freud recommended cocaine to alleviate opiate addiction, depression, and fatigue Cocaine was originally included in Coca-Cola The Harrison Narcotic Act of 1914 designated cocaine as a narcotic
- 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 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 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?
- True but not by much. 48% of powder cocaine users are white, 53% of crack users are black
- 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 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
- 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 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 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 Cocaine is an odorless, crystalline, white powder that produces intense euphoria, alertness, and energy Cocaine may be used in a Brompton’s cocktail, which is used to manage cancer pain Cocaine is used in surgical procedures on the facial areaCrack is usually smoked, but it can also be injected Because it comes in small units, the cost is low The euphoria is brief (about 10 to 20 minutes), and the desire to repeat usage is high Crack use is a problem among impoverished, inner-city adolescents Many addicts exchange sex for crack Rates of AIDS are high In 1984, laws mandated harsher penalties for individuals arrested for crack cocaine than for powder cocaine In 2010, the United States Sentencing Commission reversed that law The law was viewed as racially discriminating – 85% of offenders are African American, only 5% are White
- Chemical structure does not tell us how or why cocaine affects the brain Cocaine blocks reuptake of dopamine, serotonin, and norepinephrine Physical effects Elevated blood pressure Excessive perspiration Nausea, vomiting, abdominal pain Headache Tightened muscles Slower digestion Anorexia Nutritional deficiencies Rapid pulse Faster breathing rate Increased body temp Urge to urinate, defecate, belch Inflammation of trachea and bronchi Hoarseness or laryngitis Wheezing and coughing Coughing up pus, mucus, blood Seizures Hallucinations Physical effects of cocaine depend on how the drug enters the body The speedball, an injected mixture of cocaine and heroin, carries a higher risk of dependency and overdose Smoked cocaine can affect the heart to the point of congestive heart failure and death Injected cocaine has been linked to inflammation of the heart lining and liver PSYCHOLOGICAL EFFECTS Talkativeness Mood swings Hallucinations Repetitive behaviors Extreme depression Neglect of personal hygiene Rage and violent behavior Delusions Distorted perceptions Depersonalization Suicidal ideation Paranoia
- 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 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 Injected cocaine reaches the brain the fastest, and euphoria is rapid and intense Snorted cocaine is absorbed into the bloodstream through the nasal mucous membranes Crack cocaine is made by heating cocaine after mixing it with baking soda and water Freebase cocaine is separated from its hydrochloride salt by heating, using a volatile chemical such as ether Cocaine use increased again in the 1970s, accompanied by an increase in cocaine-related deaths In the 1980s celebrity users made cocaine glamorous In 2010, an estimated 1.5 million Americans aged 12 and older were cocaine users
- ACUTE: 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 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 CHRONIC: Risks of regularly snorting cocaine Damage to the nasal septum Paranoid psychosis Damage to the heart muscle Dependence occurs in some users Animal and human studies have shown that cocaine is a powerfully reinforcing drug Some people experience withdrawal symptoms Cocaine use during pregnancy Increased risk of miscarriage and torn placenta Long-term effects of prenatal cocaine exposure still under study DEPENDENCE Cocaine users build up tolerance to the drug, but not to the health risks Withdrawal symptoms include depression, lack of energy, poor appetite, restlessness, and agitation Scientists are working on a vaccine for preventing addiction to cocaine and other drugs WITHDRAWAL Intense craving, agitation, anorexia, and deep depression –the desire for cocaine may increase Withdrawal, during which the person is incapable of feeling normal pleasure, but depression moderates and sleeping becomes easier Extinction, during which improvement is considerable, but periods of depression and craving can occur The African hallucinogen ibogaine is a controversial drug given to cocaine addicts Propranolol eases withdrawal symptoms, making it easier for cocaine addicts to remain in treatment Disulfiram, a drug used to treat alcoholism, has also shown potential as a treatment for cocaine addicts Typically cocaine addicts are given antidepressants to lessen withdrawal symptoms DEATH Cocaine can cause irregular heartbeat (cardiac arrhythmias), high blood pressure, chest pains and heart attacks Coronary artery disease leading to death is relatively common in cocaine users Some fatalities result from uncontrolled seizures, strokes, or paralysis of breathing muscles People who inject cocaine are in danger of contracting HIV and other potentially fatal infections PREGNANCY 1 out of every 25 women use an illegal drug while pregnant Cocaine constricts blood vessels and reduces blood flow and oxygen to the fetus Cocaine can cause detachment of the placenta, as well as premature labor Cocaine may reduce immunity in the fetus, increasing the risk of HIV infection Prenatal exposure to cocaine delays growth and language development Some babies have neurological problems, perhaps caused by strokes before birth Babies have higher rates of congenital heart defects, lower birth weights, seizures, and are at risk for sudden infant death Babies tend to be born with smaller heads, and are more prone to urinary tract problems
- 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 New synthesized chemical similar to ephedrine, called amphetamine, was patented in 1932 Amphetamine was used medically Asthma Narcolepsy Hyperactivity in children Appetite suppressant Stimulant 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 Limited amphetamine availability increased the number of illicit laboratories making methamphetamine Manufacture of methamphetamine is dangerous and associated with toxic fumes and residue 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” Amphetamines were developed as inhalers to treat asthma, sold under the name Benzedrine Amphetamines were used for treating depression, for increasing work capacity, and for treating narcolepsy It then was used to suppress appetite and ward off fatigue In the late 1930s, it was given to hyperactive children In the 1940s, Japan and Sweden had severe problems with amphetamine abuse In the 1930s, people in the US could legally obtain amphetamines In 1970, they represented about 8% of prescriptions
- Countries in SE Asia are the second largest producers. Canada contributes very little.
- 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 Amphetamines can be administered by ingestion, injection, snorting, or inhalation Tolerance develops quickly – many users increase the dosage or go on binges to maintain their high Amphetamines are sympathomimetic drugs – their effects are similar to those in people who are emotionally aroused Their chemical structure is similar to that of the neurotransmitters norepinephrine and dopamine The half-life is 10 to 12 hours, and they are not totally eliminated from the body for about two days Amphetamines are removed from the body in two ways: They are excreted through urine after being transformed by liver enzymes They are deactivated and removed by adding molecules to the amphetamine compound
- 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
- For every 4 girls with ADHD, 10 boys are diagnosed.
- 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. 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 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 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 “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
- 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 Paranoid psychosis Two possible reasons for the psychosis Heavy methamphetamine users have schizoid personalities. Caused by sleep deprivation. Higher risk among those who inject the drug Often no obvious withdrawal symptoms Produce psychological dependence Capable of producing dependence as defined by DSM criteria A potent reinforcer Physical Psychological effects include paranoia, violence, restlessness, agitation, hallucinations, confusion, and anxiety Physical effects are tremors, tinnitus (ringing in ears), dry mouth, excessive perspiration, increased blood pressure, poor coordination, and convulsions Amphetamines are especially harmful to the cardiovascular system and can cause cardiac arrest Most people who are dependent on amphetamines experience withdrawal, continue using them despite problems, cannot stop, develop tolerance, and give up other activities to use amphetamines Stimulants can improve mental and physical performance for simple tasks – but not for tasks requiring complex thinking, such as problem-solving and decision-making High doses negatively affect judgment and decision-making skills, and can cause severe behavioral problems Gross motor skills improve; fine motor skills are impaired Amphetamine psychosis – marked by paranoia, aggressiveness, fearfulness, disordered thinking, mania, and hallucinations – is a significant problem related to chronic use
- Catecholamine: Pronounced cat·e·chol·amine. An amine derived from the amino acid tyrosine -- examples include epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine -- that act as hormones or neurotransmitters. The Chemical Difference amphetamine/methamphetamine The main difference between amphetamine and methamphetamine involves a bit of chemistry. The easiest way to explain this is as follows. Both drugs are stimulants of the central nervous system. However, amphetamine is chemically phenylethylamine, while methamphetamine is referred to as N-methylamphetamine. These drugs are processed differently in the user's body due to the chemical makeup is different. Methamphetamine breaks down into amphetamine when it is metabolized. This means that the meth turns into amphetamine in the user's body and is excreted as amphetamine. Methamphetamine is a derivative of amphetamine. It was developed in the 1950's and was prescribed to people with depression, alcoholism, Parkinson's, and obesity. The public caught onto methamphetamine rather quickly and began to use it to stay alert and/or lose weight. Eventually it began to be heavily used by people, especially those working in the trucking industry. In 2000, a study was done and approximately 5% of people in the USA had used methamphetamines or were still using; this number is thought to be much greater. Methamphetamines (speed) are more potent forms of amphetamine “Speed freaks” go on binges, shooting up every few hours over a five- or six-day period before crashing Many users take methamphetamines in conjunction with other drugs such as cocaine and marijuana Speed Ice Crystal Meth Chicken powder Go-fast Glass Crank Christy Crystal-meth Chalk Peanut butter-crank Shabu-shabu Zip In the US, methamphetamines have become the number-one drug problem in rural areas Types of harm associated with meth labs: Physical injury from explosions, fires, chemical burns, and toxic fumes Environmental hazards Child endangerment EFFECTS Slurred speech Loss of appetite Excitement Increased blood pressure and heart rate Irregular heartbeat Pounding heart Severe chest pain Hot flashes Excessive perspiration Anxiety Tremors Confusion Insomnia Convulsions Memory loss Violent behavior Elevated body temp Paranoia Auditory hallucinations Death
- Ritalin (methylphenidate) and Adderall are the most prescribed drugs for ADHD Ritalin and other stimulants enhance the functioning of the reticular activating system, which helps children focus attention and filter out extraneous stimuli Side effects include insomnia, weight loss, headaches, irritability, nausea, and dizziness
- Most widely used psychoactive drug Some people regularly consume much more Can cause dependence and interfere with functioning Belongs to a class of chemicals known as xanthines Three plants containing xanthines have been used by humans for thousands of years: Coffee—from the Middle East Tea—first grown in China Cacao—from the Americas All three played important cultural and economic roles Coffee originated in Ethiopia Legend of its discovery by an Ethiopian goat herder, Kaldi, who noticed unusually boisterous activity in his goats after they consumed the berries The practice then spread to Egypt and other Arabic countries by the 1400s, throughout the middle east by the 1500s and into Europe in the 1600s. Coffeehouses spread: a location to relax, learn the news of the day, seal bargains, and listen and learn from literary and political figures England 1674: “The Women’s Petition Against Coffee” argued against the use of coffee on the grounds that it made men impotent Coffee consumption in the United States Use increased following taxation of tea and the American Revolution Use also increased during and after Prohibition Per capita U.S. coffee consumption Peaked in 1946 Declined as soft drink consumption increased Current = about 25 gallons of coffee per year Originally: people chewed on coffee beans or put raw beans in hot water Roasting improves the flavor, aroma, and color of the drink made from the beans Coffeehouses and individuals originally roasted and ground their own beans 1790: Commercial roasting 1900: Vacuum packing for long-term storage of ground coffee Introduced into the East Indies and then Latin America About half of American coffee comes from Latin America, the rest from Vietnam, Indonesia, and Thailand Over $5 billion was imported to the US in 2008 Variations in coffee characteristics Different varieties of the coffee shrubs caffea arabica- milder flavor, take longer to develop after planting and require a near tropical climate to grow. caffea robusta- stronger and more bitter flavor and a higher caffine content, used in less expensive blends and to make instant coffee. Different growing and processing conditions Decaffeinated coffee Soaking unroasted beans in an organic solvent removes the caffeine Alternative Swiss water process not widely used It removes more of the coffee’s flavor Caffeine removed from coffee is used in the manufacture of soft drinks The caffeine content of coffee depends on how it is prepared Type Average caffeine content Brewed, drip (5 oz) 115 Brewed, percolator (5 oz) 80 Instant (5 oz) 65 Decaffeinated, brewed (5 oz) 3 Decaffeinated, instant (5 oz) 2 Tea (Camellia sinensis) originated in China Legend of its creation by Daruma, the founder of Zen Buddhism, who cut off his eyelids to remain awake while meditating A new plant grew from the spot where his eyelids touched the earth, with leaves that made a brew that would keep a person awake AD 350: Chinese manuscript describes many medicinal uses AD 780: Nonmedical cultivation and use of tea 1610: Dutch delivered tea to Europe English East India Company Concentrated on importing spices, so the first tea was taken to England by the Dutch. As demand grew, the company expanded its imports from China. Most tea sold in coffeehouses In Britain, major marketing campaigns promoted the switch from coffee to tea After the American Revolution, to be a tea drinker was to be loyal to the Crown Tea and the American Revolution American colonists were big tea drinkers Anger over a tax on tea that they had not helped formulate “Taxation without representation” Legal tea sales dropped due to a boycott Illegal smuggling of tea increased Tea and the American Revolution A special arrangement was made for the English East India Company, angering American merchants The result was “The Boston Tea Party” of 1773 Annual per capita tea consumption 4.5 pounds in the United Kingdom 1/2 pound in the United States Tea starts its life on a four- to five-foot bush high in the mountains of China, Sri Lanka, India or Indonesia. Bushes are regularly pruned to aid in harvesting new growth Tea leaves are picked by hand, about every 6 to 10 days Preparation: tea leaves are Dried Rolled to crush the cells in the leaves Placed in a cool, damp place for fermentation (oxidation) Black tea is fully oxidized leaves Green tea is nonoxidized leaves Oolong tea is greenish-brown and consists of partially oxidized leaves Iced tea accounts for 75 percent of all tea consumed in the U.S. Flavored teas are mixtures of tea and mint, spices, or other flavors Herbal teas contain a mix of plant leaves and flowers but no actual tea (see right) Caffeine Pound for pound, tea has more caffeine than coffee BUT 1 pound of tea leaves = 200 cups of tea 1 pound of coffee = 50 to 60 cups of coffee Tea has about 40 to 60 mg of caffeine per cup depending on the type and strength of the brew Theophylline Tea contains a very small amount of theophylline In high doses, theophylline is used as an asthma medication Chocolate originated in Mesoamerica Legend: Cacao tree was a gift to humans from paradise from the Aztec god Quetzalcoatl Linnaeus named the cacao tree Theobroma, meaning “food of the gods” Aztecs cultivated cacao widely, and the cacao bean was an important part of their economy and culture Chocolatl—from the Mayan words choc (“warm”) and latl (“beverage”)—was a thick, bitter liquid flavored with vanilla Cortez introduced chocolate into Europe Chocolate drinking spread slowly Chocolate was often sold alongside coffee and tea in established coffeehouses Prior to 1828, the traditional Aztec process was still used Cacao pods were dried in the sun, then roasted to remove the husk Kernels were ground to obtain a thick liquid (baking chocolate) 1828: Dutch patent issued for a process that removes about two-thirds of the fat (cocoa butter) and produces a powder 1876: Milk chocolate introduced by the Swiss Theobromine Chocolate contains the unique xanthine theobromine It acts in a parallel fashion to caffeine, but it is much less potent in its CNS effects Caffeine An average cup of cocoa contains about 4 mg of caffeine Soft Drinks: Coca-Cola Developed as a nerve tonic in the late 1800s; ingredients included: Caramel Fruit flavoring Phosphoric acid Caffeine A secret mixture called Merchandise No. 5 Named for two flavoring agents: coca leaves and cola (kola) nuts Up until 1906, the beverage did contain a small amount of cocaine Other soft drinks All types of soft drinks are popular U.S. per capita soft drink consumption is about 50 gallons per year Energy drinks Over-the-counter medications Caffeine is the world’s most frequently consumed stimulant Tea contains caffeine and theophylline, a stimulant from the same chemical family as caffeine Products containing caffeine include gum, mints, beer, candy, sunflower seeds, many prescription medicines, and chocolate Another stimulant in chocolate, theobromine, is related chemically to caffeine but is less powerful High-Caffeine energy drinks The FDA does not regulate caffeine in food and drinks –however, it suggests that a safe level is 72 mg per 12 ounces Many beverages such as Red Bull, Monster, and Rock Star exceed that level To counter the sedating effects of alcohol, some individuals alternate with these high-energy drinks when drinking alcohol DECAF Caffeine is displaced from the coffee bean using a hot water solution – then is taken out of the water an organic solvent The original solvent, trichloroethylene, is potentially carcinogenic – it was replaced by methylene chloride, which also might contribute to cancer Decaffeinated coffee still has some caffeine: 5 mg to 32 mg per 10 to 12 ounces (compared to 100mg)
- Three key xanthines Caffeine Theophylline Theobromine Time course Rapid absorption if taken orally Peak levels reached in 30 minutes Half-life is about 3 hours Dependence Reinforcing properties Withdrawal symptoms include headache and fatigue Mechanism of action Xanthines block inhibitory receptors for adenosine, thereby having a stimulant effect Physiological effects Stimulates the CNS and skeletal muscles Causes sleep disturbances Elevates mood Constricts blood vessels in the brain May explain the ability of caffeine to reduce migraine headaches Stimulation Caffeine partially offsets the effects of fatigue on both mental and physical tasks, but it may not improve performance in well-rested individuals High caffeine consumption among college students is associated with lower academic performance Headache treatment: Helps relieve both migraine and nonmigraine headaches Hyperactivity treatment: High doses may decrease hyperactivity Sobering up? Caffeine does not lower blood alcohol concentration and will not help a person sober up Caffeine acts as an antagonist to receptors for the inhibitory neurotransmitter adenosine Peak effects occur 30 to 45 minutes after consumption Caffeine use by well-conditioned athletes has been found to improve endurance on a short-term basis Extreme caffeine intake has been linked to a low blood sugar condition called hypoglycemia Caffeine is a xanthine – stimulants that improve work capacity, alertness, motor performance, and curb fatigue Caffeine may delay the progression of Alzheimer’s disease; help asthmatics breathe easier; and may reduce risk of type 2 diabetes in younger and middle-aged women Caffeine taken on an empty stomach releases stomach acids and digestive enzymes, causing an upset stomach Side effects include nervousness, anxiety, insomnia, heartburn, and symptoms of premenstrual syndrome Caffeine has been implicated in cardiovascular conditions from heart disease to hypertension Caffeine might contribute to breast lumps, breast tenderness, and cysts Caffeinated coffee decreases the likelihood of certain cancers
- Mechanism of action Xanthines block inhibitory receptors for adenosine, thereby having a stimulant effect Physiological effects Stimulates the CNS and skeletal muscles Causes sleep disturbances Elevates mood Constricts blood vessels in the brain May explain the ability of caffeine to reduce migraine headaches Stimulation Caffeine partially offsets the effects of fatigue on both mental and physical tasks, but it may not improve performance in well-rested individuals High caffeine consumption among college students is associated with lower academic performance Headache treatment: Helps relieve both migraine and nonmigraine headaches Hyperactivity treatment: High doses may decrease hyperactivity Sobering up? Caffeine does not lower blood alcohol concentration and will not help a person sober up
- There is no clear evidence that moderate caffeine consumption is dangerous Cancer: Caffeine is not a risk factor in human cancer Reproductive effects: High consumption of caffeine reduces a woman’s chances of becoming pregnant and slows the growth of the fetus Research is mixed on whether caffeine increases the risk of miscarriage Heart disease: High intake of caffeine may increase the risk of heart attack, particularly in people with other risk factors Caffeinism (excessive use of caffeine) Toxicity is relatively low It would require about 100 cups of coffee to receive a fatal dose from oral caffeine Unpleasant symptoms do occur: Nervousness Irritability Tremors Muscle twitching Insomnia Flushed appearance Elevated temperature Palpitations Heart arrhythmias Gastrointestinal disturbances At moderate levels, caffeine increases blood pressure, body temperature, blood sugar levels, metabolism, urination, and hand tremors, and decreases appetite and coordination In large amounts, it causes nausea, diarrhea, shaking, headache, and nervousness At worst, caffeine can cause convulsions, respiratory failure, and, if one drinks 70 to 100 cups of coffee, death Caffeine users need the drug to achieve alertness and to eliminate withdrawal symptoms Withdrawal symptoms appear in people who consume 2½ cups of coffee or more daily Withdrawal symptoms include headache, depression, lethargy, lower energy level, drowsiness, and irritability Excessive caffeine consumption resulting in caffeine dependency is called caffeinism More than one-half of moderate coffee drinkers who stop drinking it experience moderate to severe headaches Caffeinism is marked by irritability, depression, insomnia, headaches and morning lethargy About one-fourth of users experience withdrawal symptoms when they discontinue drinking caffeine
- Cannabis sativa Most widespread; used primarily to make rope Has a tall, woody stem and can reach a height of 20 feet Cannabis indica Grown for its psychoactive properties Grows to a height of 3 to 4 feet Cannabis ruderalis Found mainly in northern Europe and Asia Has a short growing season and low potency The primary mood-altering, psychoactive agent in marijuana is delta-9-tetrahydrocannabinol, or THC Several factors influence THC levels: The plant’s sex Soil and climate conditions The part of the plant that is used How the plant is harvested, prepared, and stored Female plants produce more resin and flowers, which contain higher THC concentrations Marijuana is a preparation of leafy material from the Cannabis plant that is smoked Marijuana is classified separately because its effects are varied and complex Sedation Pain relief Hallucinations (in large doses) Effects it produces in most users are sufficiently different from the effects of depressants, narcotics, and hallucinogens to merit its separate classification Cannabis sativa Originated in Asia but now grown worldwide Grown primarily for its fibers, from which hemp rope is made Grows as a weed in the U.S. and Canada A lanky plant up to 18 feet high Cannabis indica Grown for its psychoactive resins Cultivated in many areas of the world A compact plant 2 to 3 feet high Potency varies depending on plant genetics and environmental conditions Cannabis ruderalis Grown primarily in Russia The cannabis plant can be grown almost anywhere Production is especially high in Colombia and Mexico Other countries in Latin America, and in Asia and the Caribbean, also produce marijuana Lebanon, Morocco, Pakistan, and Thailand are particularly known for producing much marijuana Indoor cultivation of marijuana makes it easier to avoid federal, state, and local law enforcement Indoor cultivation has allowed for production of marijuana with a higher THC content The profits of indoor cultivation are higher because marijuana plants can be harvested four to six times per year
- Not used for medicinal purposes until early 1990s.
- Ganja, consisting of the top leaves and flowers of the female cannabis plant, is considered the best quality marijuana Bhang consists of the lower leaves, stems, and seeds of the cannabis plant and is regarded as poor quality marijuana Sinsemilla (“without seeds”) is derived from the unfertilized female cannabis plant, and has higher THC levels Two other forms are hashish (charas) and hash oil These forms of marijuana have a higher THC content than Cannabis sativa Hashish, taken from the resin of the cannabis plant, is usually smoked in a pipe Hash oil is made by boiling resin in alcohol, and has a THC content of 60% – it is mixed with tobacco and smoked Hashish Consists of pure resin that has been carefully removed from the surface of leaves and stems May be less than pure depending on how carefully the resin has been separated from the plant material Rare in the U.S. Average THC content of U.S. hashish ranges from 3 to 8 percent A few batches have tested as high as 20 percent THC Production methods Traditional production involves manual scraping of exuded resin from the plant More efficient recent production method involves boiling the plants in alcohol and evaporating the resulting liquid down to thick, dark hash oil Potency of hash oil varies but can contain more than 50 percent THC Sinsemilla Consists of dried flowering tops of plants with pistillate flowers (female plants) Male plants are removed from the fields before the female plants are pollinated Female plants don’t put their energy into seed production, thus increasing their potency Average THC content of U.S. sinsemilla samples is about 7 to 12 percent Bhang Consists of the remainder of the Cannabis plant after the top has been picked Plant material is dried, ground into a powder, and mixed into drinks or candies Rare in the U.S., but about equivalent to low-grade marijuana consisting of leaves Average THC content of less than 1 percent Potency varies widely Low-grade products (less than 1 percent THC) High-grade sinsemilla (9 percent or more THC) Typical range of potency is 2 to 8 percent THC Proportion of confiscated marijuana samples of higher-potency has increased since the 1980s but is still only about 15 percent
- Annual marijuana use increased from 22% to 25% in 2011, while annual alcohol use decreased 51% in 2006 to 45% in 2011. from Goldberg NEED TO FACT CHECK…TWO TEXTS SAY TWO DIFFERENT THINGS>>>>>>>> http://www.drugabuse.gov/publications/drugfacts/nationwide-trends Marijuana use: 7.3% from 5.8% Marijuana use has increased since 2007. In 2012, there were 18.9 million current (past-month) users—about 7.3 percent of people aged 12 or older—up from 14.4 million (5.8 percent) in 2007. Alcohol use: Drinking by underage persons (ages 12–20) has declined. Current alcohol use by this age group declined from 28.8 to 24.3 percent between 2002 and 2012, while binge drinking declined from 19.3 to 15.3 percent and the rate of heavy drinking went from 6.2 to 4.3 percent.
- Marijuana (cannabis) is one of the world’s oldest known drugs Early settlers in Jamestown, Virginia, planted marijuana (hemp) for its fiber, which also was used during World War II People started smoking it for its euphoric effect during the 1920s, coinciding with alcohol prohibition Marijuana use was banned after the Marijuana Tax Act was enacted in 1937 Earliest mention: Chinese pharmacy book (2737 BC) Social use of the plant had spread to the Muslim world and North Africa by AD 1000 “Hashishiyya” religious cult carried out political murders Story of cult spread in works by Marco Polo (1299) and Boccaccio (1350s) Origin of the term assassin Hashish use mentioned frequently in The Arabian Nights Early 1900s: Little public interest or use 1926: Series of newspaper articles linked marijuana and crime Other reports by police and in popular literature followed 1936: All states had laws regulating the use, sale, and/or possession of marijuana Most early regulation efforts Based on concerns about use and resultant behavior Not based on direct evidence linking marijuana use with crime or violence Contributing factors to “pyramid of prejudice” against marijuana Marijuana use associated with lower-class groups and recent immigrants Regular references made in popular literature to the murdering cult of assassins as suggestive of the characteristics of the drug Shaky factual ground of the stories Individuals in the legends did NOT commit murder under the influence of hashish but rather received hashish as a reward for their actions MARIJUANA TAX ACT Act followed the regulation-by-taxation theme of the 1914 Harrison Act Grower, distributor, seller, and buyer were taxed Administratively almost impossible to deal in Cannabis Bureau of Narcotics uniform law specifically named Cannabis sativa Current federal and uniform laws refer more generally to the genus Cannabis State laws made possession and use of Cannabis illegal per se 1969: U.S. Supreme Court declared the Marijuana Tax Act unconstitutional AFTER MARIJUANA TAX ACT Cost of marijuana increased significantly Reports continued to be published that marijuana use had less serious effects than commonly believed BUT Substantial disagreement over the interpretation of research findings 1950s and ‘60s Little scientific research done on Cannabis Use of Cannabis continued to increase A common symbol of youthful rejection of authority Identification with a new era of personal freedom Usage rose around 1980, declined until the mid-1990s, and then peaked in the late 1990s, although never reaching the levels in the 1970s. Worldwide, marijuana is the fourth most commonly used drug, after nicotine, caffeine, and alcohol Marijuana is the most common illegal drug in the US, with an annual prevalence of 13.7% The most important reasons that students significantly increased use of marijuana relate to reduced perception of risk and less disapproval of its use
- Chemistry of Cannabis is complex and unique Active agent contains no nitrogen and thus is not an alkaloid like other psychoactive plant materials Cannabinoids are 66 chemicals unique to the Cannabis plant Delta-9-tetrahydrocannabinol (THC) Isolated and synthesized in 1964 The most pharmacologically active cannabinoid There may be several other active agents in Cannabis Smoked marijuana THC is absorbed rapidly by the blood and travels to the brain and then the rest of the body Within 30 minutes, most THC is gone from the brain Peak psychological and cardiovascular effects occur together within 5 to 10 minutes Oral THC THC is absorbed more slowly and the liver transforms it into 11-hydroxy-delta-9-THC Less THC reaches the brain Peak effects occur about 90 minutes following ingestion Metabolites have different half-lives After one week, 25 to 30 percent of the THC and its metabolites might remain in the body Two or three weeks may be required to completely eliminate a large dose of THC and its metabolites High lipid solubility of THC and its metabolites Selectively taken up and stored in fatty tissue, to be released slowly No easy way to monitor THC and metabolite levels and relate them to effects Long-lasting low concentrations of THC and metabolites may have effects on the brain and other organs that have not yet been determined Marijuana contains more than 500 chemicals – 60 are unique to the cannabis plant (cannabinoids) Marijuana smoke contains 70% more carcinogenic benzopyrene and 50% more tar than tobacco smoke Marijuana releases five times as much tar into the lungs as cigarettes Marijuana can be smoked or ingested Smoked THC is three times more potent than ingested THC If ingested, marijuana’s actions last longer Most smokers roll marijuana into a cigarette – an alternative is to roll it into a blunt, a type of cigar in which some of the tobacco is removed and replaced with marijuana When marijuana is smoked, THC reaches the brain within a few seconds – peak effects are felt in about 30 minutes When smoked, about half of the THC is absorbed by way of the lungs into the bloodstream If ingested, the effects may not be felt for a couple of hours because less THC is absorbed Marijuana is fat soluble, and its metabolites can remain in the fatty tissue of heavy users for two to three weeks after use In studies, pharmacological tolerance was more likely to develop among daily users One indication of tolerance is that heavy users are still capable of doing cognitive tasks Many users claim they get high from decreasing doses, though no evidence of reverse tolerance exists Frequent users also experience less loss of memory, coordination, and concentration
- June & July – lack of supervision.
- Anandamide Endogenous substance isolated from brain tissue with marijuana-like effects From ananda, Sanskrit for “bliss” THC and other cannabinoids bind to two receptors CB1 receptor CB2 receptor CB1 receptor found primarily in the brain but also unusually widespread throughout the body Potential actions of cannabinoids are widespread High density of CB1 receptors in specific brain regions Basal ganglia (movement coordination) Cerebellum (fine body movement coordination) Hippocampus (memory storage) Cerebral cortex (higher cognitive functions) Nucleus accumbens (reward) CB2 receptor found mainly outside the brain in immune cells Potential role of cannabinoids in the modulation of the immune system Rimonabant, a selective CB1 receptor antagonist, is being tested Shows promise in reducing food intake and helping people quit smoking Concerns raised over use of the drug due to concerns about side effects such as depression and anxiety When marijuana is smoked, THC reaches the brain within a few seconds – peak effects are felt in about 30 minutes When smoked, about half of the THC is absorbed by way of the lungs into the bloodstream If ingested, the effects may not be felt for a couple of hours because less THC is absorbed Marijuana is fat soluble, and its metabolites can remain in the fatty tissue of heavy users for two to three weeks after use
- Cardiovascular effects Increased heart rate occurs after smoking marijuana and ingesting oral THC Time course differs substantially following the two different methods of administration Research findings on the effects of cannabinoids on blood pressure have been mixed Cardiovascular risks of marijuana use haven’t been shown in young, healthy users People with cardiovascular disease should probably avoid marijuana and oral THC due to effects on heart rate Pulmonary effects Bronchodilation is seen following acute exposure to marijuana Heavy marijuana smoking over a long period could lead to clinically significant impairment of pulmonary function Reddening of the eyes Dryness of the mouth and throat
- 52%
- Abuse potential has been shown Studies show both animals and humans will self-administer the drug Marijuana cigarettes with higher THC content are preferred Oral THC does not have high abuse potential, likely due to its different time course Less rapid onset of effects is usually associated with reduced risk of abuse Effects include euphoria, “high,” mellowness, hunger, and stimulation Peak effects occur within 5 to 10 minutes and last for about two hours Oral THC has similar effects but a different time course Magnitude of effects is greater with increasing THC concentrations Regular marijuana smokers can recognize the effects and distinguish between real and placebo marijuana cigarettes Infrequent smokers Experience similar but more intense effects compared with experienced smokers due to lower tolerance At high THC concentrations, may report negative effects such as mild paranoia and hallucinations Acute administration of marijuana to infrequent users disrupts cognitive performance Slowed cognitive processing Impaired short-term memory Impaired inhibitory control Loss of sustained concentration or vigilance Impaired visuospatial processing Acute administration of marijuana to frequent users Causes less dramatic effects, implying they are tolerant to some (but not all) cognitive effects Slowed cognitive processing consistently seen Impairment during certain workplace tasks and the operation of machinery and automobiles can have significant effects Effects on long-term cognitive functioning are more difficult to predict Studies have had divergent findings and interpretations Current evidence suggests that after abstaining for more than a month, regular marijuana use produces few effects on cognition Additional (and better) research may change current thinking Food intake: Marijuana and oral THC significantly increase total daily calorie intake Clinical use of cannabis-based drugs for appetite stimulation Unclear if average chronic marijuana users are overweight Verbal behavior: Verbal exchanges decrease, nonverbal social interactions increase Marijuana increases the release of dopamine, a neurotransmitter involved in the experience of euphoria Numerous studies support the connection between marijuana use and mental illness Detrimental psychological reactions to marijuana are unusual, although high doses can induce anxiety, delusions, disorientation, hallucinations, and paranoia Marijuana alters perceptions of time and space Mood changes are marked by anxiety, sadness, laughter, and paranoia Some people experience panic reactions, which tend to be temporary and triggered by a feeling of not being in control One reported cognitive effect of marijuana is impairment of short-term memory Learning and remembering new information become more arduous when using marijuana Heavy users were impaired in skills involving expression but not in vocabulary, mathematics, and reading comprehension Cognitive deficits persist up to 28 days after a person last smoked marijuana
- U.S. medical use declined even before the 1937 Marijuana Tax Act New and better drugs were developed to treat most illnesses Variability of product (also a problem for research) Active ingredient insoluble in water (can’t be injected) Oral dose has delayed onset of action 1941: Cannabis dropped from The National Formulary and The U.S. Pharmacopoeia Renewed interest in potential medical uses led to a review of older reports May be effective as an anticonvulsant in some cases when preferred medication is ineffective May relieve tension and migraine headaches Reduces fluid pressure in the eyes May be useful in glaucoma patients Limited program in which NIDA supplied medical-grade marijuana cigarettes to certain patients on a “compassionate use” protocol Reduces severe nausea caused by certain drugs used to treat cancer 1985: Oral TCH (dronabinol; brand name Marinol) licensed for sale to cancer patients experiencing nausea from chemotherapy 1993: Approved to stimulate appetite in AIDS patients State and federal action 1996: Arizona and California ballot initiatives pass Physicians can recommend marijuana Patients can use marijuana if recommended Currently, 14 states have some form of similar legislation State and federal action U.S. government announced plans to prevent medical marijuana use Closure of Cannabis buyers’ clubs Revocation of the DEA registration of any physician who advised a patient to use marijuana Prosecution of physicians and patients 2005: U.S. Supreme Court ruled that patients could be prosecuted for possessing marijuana even if their physicians recommended its use for a serious illness In 2009, US Attorney General Eric Holder said that the government would end its raids on state-approved marijuana dispensaries. Findings from Institute of Medicine report Marijuana is a relatively safe and effective medicine for patients suffering from certain chronic conditions More research is needed on marijuana and synthetic cannabinoids An effective inhaler should be developed to solve the problem of poor oral absorption of THC Compassionate use of smoked marijuana cigarettes should be allowed for no more than six months in certain patients with debilitating, intractable pain or vomiting under certain conditions In the late 1800s, marijuana was used medically to treat convulsions, chronic cough, sleeplessness, gastrointestinal disorders, gonorrhea, and pain Recently, marijuana has been used for treating glaucoma, asthma, nausea and vomiting during cancer chemotherapy, and pain associated with multiple sclerosis It also has been used to alleviate withdrawal symptoms related to barbiturates, narcotics, and alcohol Glaucoma Marijuana reduces pressure behind the eye Nausea and Vomiting Marijuana is an effective anti-emetic to counteract nausea and vomiting associated with chemotherapy for cancer Marinol (THC formulated in sesame oil) Cesamet (a synthetic cannabinoid) More than 40% of oncologists recommended marijuana to their cancer patients to control nausea and vomiting Asthma THC dilates the bronchial tubes Additional Medical Uses Appetite stimulant Pain relief Muscle relaxant Recommended for epilepsy, insomnia, rheumatoid arthritis, chronic pain conditions, premenstrual syndrome and menstrual cramps
- DSM-IV: No listing of cannabis withdrawal, BUT Research suggests an abstinence syndrome does exist Not life threatening but unpleasant Symptoms Negative mood states–anxiety, irritability Disrupted sleep Decreased food intake Aggressive behavior (in some cases) Begins about 1 day after the last dose Lasts 4 to 12 days Tolerance to many marijuana effects develops after regular use of high levels Tolerance may not develop uniformly to all effects Marijuana has abuse potential A significant minority of current marijuana users may be abusing or dependent on the drug Although most experts agree that physical dependence on marijuana does not occur – it might depend on how dependency is defined One-fourth of adolescents who use marijuana frequently meet the criteria for marijuana abuse or dependency 60% of regular marijuana smokers experienced significant withdrawal symptoms, including irritability, nausea, vomiting, diarrhea, sweating, anxiety, and insomnia Marijuana can result in psychological dependence If dependency develops, it is more likely to be motivated by psychosocial than by physiological factors The perceived need for the drug is believed to be responsible for compulsive use and dependency Factors influencing effects of marijuana: Whether it is smoked or ingested Dosage THC content Interval between puffs Depth of inhalation Length of time in one’s lungs Set and setting Previous experiences
- Acute physiological effects Increased heart rate, possibly risky for someone with preexisting cardiovascular disease No human overdose deaths have been reported Chronic lung exposure from marijuana smoking Daily smoking impairs air flow in and out of the lungs Long-term implications for health are unclear Marijuana smoke contains many—but not all—the chemicals found in tobacco smoke Tar Carbon monoxide Hydrogen cyanide Nitrosamines Benzopyrene Carcinogen found in higher levels in marijuana cigarettes than in tobacco cigarettes Marijuana cigarettes are not filtered Chronic lung exposure from marijuana smoking Smoking behavior among regular marijuana users Smoke fewer marijuana cigarettes than tobacco users smoke standard cigarettes Hold smoke deep in their lungs longer than do cigarette smokers No direct evidence that marijuana smoking causes lung cancer More time may be required to show the link Anxiety Characterized by fear of loss of control and fear that things won’t return to normal Some people require a medical sedative or tranquilizer but the best method to remind a person everything will go back to normal is a “talking down.” Reproductive effects Reduced testosterone levels in men Diminished sperm counts and abnormal sperm in men A growing number of studies show that marijuana use by pregnant mothers does not appear to be associated with low birth weight or premature birth. The amounts of marijuana used by the women in these studies were relatively low. Immune system effects Findings have been mixed Some evidence that marijuana use reduces immunity to infection Mortality data do NOT show a relationship between marijuana use and overall death rate In a study of first-year college students, over 9% had a cannabis use disorder that resulted in concentration problems or missing a number of classes Adolescents who smoked at least once a week had increased thoughts of suicide, felt more lonely and unloved, and were more likely to run away from home, cut classes, or steal Marijuana impairs perceptual and motor skills and the ability to stay awake – skills necessary for driving Appetite Marijuana users consistently report increase in appetite The Respiratory System THC acts as a bronchodilator Smoke contains many respiratory irritants and carcinogens One marijuana cigarette equals 20 regular cigarettes in terms of bronchial damage Marijuana contains 20 times as much ammonia and 5 times as much hydrogen cyanide as tobacco smoke The Immune System Studies with animals demonstrate that marijuana affects the immune system adversely The Reproductive System In males, marijuana decreases testosterone levels, sperm count, and libido In women, it may inhibit ovulation The Brain Chronic marijuana users experience cognitive deficits Marijuana reduces acetylcholine in the hippocampus, the portion of the brain that affects memory Marijuana affects the activity of the neurotransmitters norepinephrine and dopamine Anticholinergic drugs such as marijuana are related to schizophrenia
- Amotivational syndrome Concern has been expressed about the effect of regular marijuana use on behavior and motivation. Laboratory data do not support the hypothesis that frequent marijuana smokers exhibit diminished motivation. Heavy marijuana users reportedly are unable to concentrate and are unmotivated, apathetic, lacking ambition, and not achievement-oriented (amotivational syndrome) Amotivational syndrome is more likely to develop in adolescents than in older people However, people who smoke a great deal might also be predisposed to these problems initially Marijuana Madness Some researchers are collecting data that they claim shows that marijuana causes psychosis Some studies have found a correlation between marijuana use and psychotic symptoms. Participants admitted to having at least one psychotic symptoms. It is possible the people had psychotic symptoms prior to using marijuana. Since marijuana users typically use other psychoactive drugs, it is difficult to disentangle the influence of other drug use on the psychotic symptoms There is evidence that marijuana can increase the liklihood of psychotic episodes in individuals with a history of psychiatric problems. Driving ability: Research findings mixed Laboratory studies of computer-controlled driving simulations Marijuana produces significant impairment Epidemiological studies Little evidence that drivers who use marijuana alone are more likely to be involved in an accident Effects may be more severe in infrequent users
- In 1972, the Presidential Commission on Marijuana and Drug Abuse recommended the decriminalization of marijuana 11 states decriminalized marijuana, making possession a minor offense punishable by a $100 fine In 2008, Michigan became the 13th state to approve the medical use of marijuana An argument against marijuana is that it is a gateway drug, leading to the use of more dangerous drugs However, most marijuana smokers do not proceed to use other drugs Steppingstone theory Hypothesis that use of soft drugs such as marijuana and alcohol leads to use of harder drugs such as heroin and cocaine Which is the greater problem—marijuana or laws against marijuana? The National Organization for the Reform of Marijuana Laws (NORML) contends that the quality of marijuana would be controlled more effectively if it were legal Legalization of marijuana is compared to tobacco and alcohol, which have known medical and social consequences In 2011, the Dutch government reversed its tolerance policies and reclassified marijuana so that it is now comparable to cocaine and Ecstasy The Dutch government believe that better control over marijuana use reduces the risks It is estimated that 13% of Dutch high school students have used marijuana, compared to 28% of American students Marijuana has a long history of medical use and is reasonably safe Opponents believe that if marijuana were available for medical use, its nonmedical use would increase dramatically In states that legalized medical marijuana, rates of marijuana use, abuse, and dependence are higher One concern is that medical marijuana may be illegally diverted for substance abuse In November 1996, California voters eliminated state penalties for medical uses of marijuana Fifteen states, including the District of Columbia, have now passed medical marijuana laws The Institute of Medicine (IOM) found that marijuana has “potential for therapeutic use” In 2006, the FDA reaffirmed that marijuana should remain a Schedule I drug, and has no currently accepted medical use Drug reform advocates: Treating drug offenders is much cheaper than incarcerating them Legalizing marijuana and other drugs would stem the rise in violence and criminal activity Opponents of drug reform: Marijuana is unhealthy and the only viable option is elimination of its use Advertising and marketing would increase drug problems dramatically Hassan, an Arabian politico who lived during the Middle Ages, and his cult, purportedly used hashish in preparation for aggressive acts against others Legalization might reduce criminal and violent behavior, but interpersonal and intrapersonal problems might escalate When alcohol was prohibited, organized crime increased – legalization would remove much of the profit motive Marijuana has become the single most important drug issue in the United States. Today 14 states have legalized medical marijuana and a dozen others will consider this in late 2010 In the 1960s and 1970s, there was a shift in attitude about marijuana Marijuana was found to be pretty innocuous Young people found out the government had been lying about drugs and it led to broad rejections of government information. Seniors who smoked marijuana peaked at 60% in the 1970s. Changing attitudes toward decriminalization 1972 report recommended decriminalizing possession of small amounts for personal use and casual distribution of small amounts without monetary profit Beginning in 1973, several states altered laws Possession of small amounts of marijuana became a civil offense rather than a criminal offense Changing marijuana possession from a felony to a misdemeanor saved money on court costs, juries, and jails Usage rates went up, but not substantially In 2009, the AMA called upon the Federal government to rethink its classification of marijuana as a Schedule I drug. Changing attitudes toward decriminalization There are four factors toward the recent push Increasing amount of scientific evidence that marijuana is not as toxic as once thought While the economy in 2007 was crashing, billions of dollars were spent to stop illicit drug use. A growing number of Americans believe the government could tax the growth, transportation and sale of marijuana if it were legal. Reports of violence in Mexico due to the illicit drug trade.