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![BASIC TREATMENT
Mainly supportive
ALS
Standard therapy for
respiratory problems (from
smoking)]
steroids very helpful for the
respiratory damage](https://image.slidesharecdn.com/streetdrugspart1-101110111433-phpapp02/85/Street-drugs-part-1-47-320.jpg)
Street drugs part 1
- 1. Street Drugs Part1 Street Drugs every medic should know
- 2.
- 3. Overview We will reviewsome common principles of caring for the “Pharmacologically gifted” We will discuss some of the “standard” street drugs that every paramedic should know. There is no way we can be all inclusive in an hour so bear with me. And if you think this is going to be boring…try researching it!
- 4. Drugs we willcover Street Opiates Hyper dynamic Drugs Meth and derivatives Cocaine LSD
- 5. The Opiates We willfocus on Heroin. There are others similar drugs in this class as well: Morphine Oxycontin Fentanyl Methadone
- 6. Background Heroin - Firstsynthesized from morphine (derived from the poppy plant) in 1874, was not extensively used in medicine until the beginning of this century. Commercial production of the new pain remedy was first started in 1898. While it received widespread acceptance from the medical profession, physicians remained unaware of its potential for addiction for years. It’s abuse was a major cause of the Harrison Narcotic Act of 1914.
- 7. Background One survey in1999 saw 2% of HS students had used heroin, most (1.1%) under the age of 16. Use is mainly growing in the 30- 40 age group (those w/ teenagers) There is some indication that heroin use is slowly increasing to levels seen in the 60’s and 70’s.
- 8. Background Pure heroin isa white powder with a bitter taste. Most illicit heroin is a powder form which may vary in color from white to dark brown because of impurities left from the manufacturing process or the presence of additives. Pure heroin is rarely sold on the street.. This heroin may be smoked. "black tar," has also become increasingly available in the western United States. It is often sold on the street in its tar-like state at purities ranging from twenty to eighty percent. This heroin is most frequently dissolved, diluted and injected.
- 9. Slang A "bag" --slangfor a single dosage unit of heroin--may contain 100 mg of powder, only a small portion of which is heroin. The remainder could be sugars, starch, powdered milk, or quinine. Traditionally the purity of heroin in a "bag" has ranged from one to ten percent. More recently, heroin purity has ranged from one to ninety-eight percent, with a national average of thirty-five percent. “ chippers" that being the term for non-addicts who use addictive drugs in a controlled fashion
- 10. Slang China White Red Rum Homicide,Polo, Super Buick (w/ Scopolamine or Coke) Dragon Black Tar Smack, Scag
- 11. Methods of use LowPurity: almost exclusively was injected either IV, SQ, or IM. Higher purity: snort or smoke the narcotic. Availability of high quality heroin is increasing.
- 12. Methods of use: Shooting: Skin Popping: MusclePopping: Chasing the dragon: Smoking Freebasing Dirty Hit:
- 13. Methods of use:Oxycontin / MS Contin Time released capsules, some may have more than 100 mg Often crushed and snorted, eliminating the “time release” May be crushed, diluted, and injected like traditional heroin
- 14. S/S OF ANOVERDOSE Pin Point Pupils Hypotension N/V Respiratory/CNS depression Aspiration and Hypoxia Hallucinations Other s/s? Think poly- pharm involvement Dirty Needles (“Diabetics”) Cotton balls, Cig Filters Spoons w/ residue The bottom of a soda pop can is commonly used as a "spoon" to dissolve the heroin in because it is curved inward like a spoon. The bottom is torn off of a can as close to the bottom as possible.
- 15. BASIC TREATMENT Ventilation/stimulation first Slowadmin of Narcan, just enough to make them breath Narcan 0.4 mg-2 mg traditional, may need higher doses High doses may be needed if drug is synthetic Watch for re-sedation due to Narcan’s short duration
- 16. FOCUSED TREATMENT Due tothe multiple drug combinations possible, full ALS is advised (unforeseen drug reactions-speed ball, homicide, etc)
- 17. Long Term problems HIV,HEP-A/B/C, BLOOD POISONING (Septicemia) “Cotton Fever” ENDOCARDITIS TETANUS NECROTIZING FASCIITIS (Flesh-Eating Disease) Associated w/ black tar WOUND BOTULISM TRACKING AND BRUISING CONSTIPATION, BOWEL OBSTRUCTION
- 18. Interactions Cocaine: AKA: Speedball Heroinis thought to mask/temper some of cocaine's nastier effects “Homicide”, “Super Buick” Heroin, coke, scopolamine- Causes tachycardia, anticholinergic toxicity (remove the heroin via Narcan and the adrenergic and anticholinergic effects combine uninhibited) This is why its very important to give just enough Narcan to regain respiratory function
- 19. Some weird thingsthat have been done with a Heroin OD by Junkies Injected someone with salt water. This is an old junky myth sometimes still used. Injected someone who overdosed on heroin with cocaine or speed, or vice versa. Another old myth. Narcan Used PTA of EMS- Narcan is becoming more and more common among junkies for “emergencies” (some trials are being done in Seattle and Europe) Put ice on their genitals (down their pants) .
- 20. Dependence, Detox, andWithdrawal medical detoxification is usually accomplished by giving decreasing doses of a long-acting opiate like methadone. While not truly physically addictive, Heroin withdrawal is clearly extremely uncomfortable and painful. The previously suppressed Locus Coeruleus is believed responsible for most of the clinical problems: anxiety, HTN, agitation
- 21. TAKE HOME INFORMATOIN Bewareof the curveballs (poly Pharm) Slow minimal Narcan administration
- 22.
- 23. Hyper-Dynamic Drugs Hyper-dynamic Drugs:Drugs with severe adrenergic properties… Meth Amphetamine Amphetamine, cocaine (in several forms) Other drugs that would be similar are Ecstasy, and PMA which are discussed elsewhere.,
- 24. Background- Meth andother Amphetamines “Meth" is methamphetamine, which is a type of amphetamine. The chemical Methamphetamine is composed of an amphetamine molecule with an additional methyl group attached to its nitrogen (amine group). For Methamphetamine, the methyl allows it a little better fat solubility and thus better penetration into the brain.
- 25. How Long hasMeth and other Amphetamines been around? Jan 18, 1887-Amphetamine was first synthesized by a German chemist 1919- Methamphetamine is first synthesized (in Japan) WWII -Both Amphetamine and Methamphetamine (by the Japanese mostly)are widely distributed to soldiers to help improve performance. This led to addiction problems in Japan after the war.
- 26. Background Methamphetamine is asynthetic stimulant commonly used as a recreational drug. It is legally prescribed as a treatment for ADD under the brand name Desoxyn, for both children and adults. On the street, it is generally found as an odorless, white or off-white, bitter-tasting powder, though it is also found in pills, capsules and larger crystals. Methamphetamine production is a relatively simple process, especially when compared to many other recreational drugs.
- 27. Slang Nazi method: amethod of quick cooking meth Methamphetamine: meth, crystal meth, speed, ice, crank, glass, uppers, yaba, shabu shabu, tweak, go-fast, Hitler's Drug, Crazy Medicine Speed : any amphetamine Jacked: on speed
- 28. Slang Bump: a snortedhit (average 2-4 “bumps”) An intentional binge: with some heavy users injection as much as a gram every 2-4 hours to keep things going What is the difference between crystal and crank? “Crystal" has seven letters, “Crank" only has five.
- 29. Methods of use Itis frequently snorted, but is also used orally, smoked, and injected. Oral use takes about half an hour to produce effects. When smoked, effects are almost instantaneous, and nearly as quick when snorted.
- 30. S/S OF ANOVERDOSE High last about 6-24 hours. 50% of meth is remains in body at 12 hours. Most effects are from the over stimulation of release of dopamine. Jaw clenching, Agitation, Paranoia HTN, Tachycardia Hyperthermia (lethal levels), DIC, Seizures Visual, Auditory and tactile hallucinations 'Amphetamine Psychosis‘ Serotonin Syndrome?
- 31.
- 32. FOCUSED TREATMENT Benzo’s forsedation and seizures 0.5-2mg Ativan 2.5-10 mg Valium Haldol also an option for just combativeness. Note: Unresponsive meth users should have a temp checked when feasible for early detection and intervention Active cooling for profound hyperthermia
- 33. Long term effects Methamphetamineis an anorexant, This is considered a benefit for many light users, but in regular or heavy users can lead to malnutrition. Methamphetamine is also believed to be neurotoxic.It’s use causes damage to the neurons in the dopamine portions of the brain. Some possible effect on the serotonin producing parts of the brain is also suspected. Lead Poisoning Psuedo-Parkinson's D/O
- 34. Interactions The most commonly(and ambiguously) documented warning of amphetamines (and ecstasy, PMA)is with the use of Monoamine Oxidase Inhibitors (MAOI’s) can be dangerous in combinations with MAOIs, at high doses, or at high frequencies of use. monoamine oxidase inhibitors (MAOIs) Until recently, it was believed that the metabolites of Parnate were Amphetamine and Methamphetamine, which would fit the definition of "sympathomimetic agonists" Recent research does not support the amphetamine metabolite theory. However, there is still a lot to learn about MAOI pharmacology.
- 35. Dependence, Detox, andWithdrawal Methamphetamine causes significant tolerance, as well as psychological dependence strong cravings for more meth, while at the same time being unable to reach a satisfactory high Withdrawal from high doses can produce severe depression, called the “Crash”
- 36.
- 37. Everybody loves cocaine “…Woeto you my Princess, when I come, I will kiss you quite red and feed you till you are plump. And if you are forward, you shall see who is the stronger, a gentle little girl who doesn't eat enough or a big wild man who has cocaine in his body." -- Sigmund Freud, On Coca
- 38. Background- Cocaine Cocaine isan alkaloid found in leaves of the South American shrub Erythroxylon coca . It is a powerfully reinforcing psychostimulant. The drug induces a sense of exhilaration in the user primarily by blocking the reuptake of the neurotransmitter dopamine in the midbrain. Doctors dispensed cocaine as an antidote to morphine addiction. Unfortunately, some of their patients made a habit of combining both.
- 39. Background Until 1916, onecould buy it at Harrods. Cocaine was widely used in tonics, toothache cures and patent medicines; and in chocolate cocaine tablets. Ryno's Hay Fever and Catarrh Remedy - "for when the nose is stuffed up, red and sore" - was 99.9 per cent pure cocaine. Prospective buyers were advised - in the words of pharmaceutical firm Parke-Davis - that cocaine "could make the coward brave, the silent eloquent, and render the sufferer insensitive to pain".
- 40. Background Cocaine Hydrochloride isavailable on the street generally at 30% to 40% purity and retails at prices ranging from $10.00 to $50.00 per quarter gram. Cocaine metabolites are excreted in the urine and can be detected for between 2 to 4 days after the drug has been consumed.
- 41. Slang rock cooked cocaine base, freebase fatbags cookies and kryptonite. coke crack dust snow blow flakes bloke
- 42.
- 43. Methods Freebasing: “freebase” eitherinjected or heated and its fumes inhaled through a pipe. Very Elaborate, very dangerous Smoked: Crack converted to smoke via direct flame Chasing the dragon –as for heroin Snorting:"snorted into the nose. This results in rapid inhalation of the powder and cutting agents. Cocaine is absorbed rapidly via the mucous membranes into the blood stream. Dabbing:a licked finger is coated with the powder and then placed on the tongue or gums is an alternative method.
- 44. Freebasers Hall ofFame Richard Pryor Sam Kinison Nikki Sixx
- 45. S/S OF ANOVERDOSE Tachycardia, cardiac Stimulation , MI HTN Nausea Tremors, insomnia, agitation Dilated pupils Headaches, blurred vision Seizures , Stroke cerebral vasoconstriction Twitching (tactile hallucinations) Fever, Hyperthermia Impotence cold sweats Fatigue (when Crashing) Sinus Problems (when snorting)
- 46. Acute S/S Pregnant cocaineusers may experience premature labor and abruptio placenta Just FYI: Cocaine has been reported to produce a prolonged and intense orgasm if taken prior to intercourse…in case you were wondering
- 47. BASIC TREATMENT Mainly supportive ALS Standardtherapy for respiratory problems (from smoking)] steroids very helpful for the respiratory damage
- 48. FOCUSED TREATMENT Treat CONFIRMEDMI’s per standard guidelines, thrombo’s with caution NTG’s OK ACLS –EP recommends spacing out EPI to 5-10 minutes in arrest Lidocaine with caution Mag for Dysrhythmias Haldol for combativeness Benzo’s for sedation and seizures, AND HTN 0.5-2mg Ativan 2.5-10 mg Valium Use anti-Hypertensives with caution as they may worsen coronary ischemia Alpha specific blockers for HTN (Regitine) Beta Blockers are falling out of favor (may leave alpha effects unopposed)
- 49. Long term effects MultipleRespiratory problems from smoking (COPD) Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures Sterile Infections MI’s, Cardiovascular Damage Constipation Vascular damage from HTN Irritability and increased risk of violence are found among heavy chronic users
- 50. Interactions-Alcohol When combined withalcohol, the cocaine alkaloid yields a further potently reinforcing compound, now known to be cocaethylene alcohol plus cocaine produces more stimulatory l behavior in mice than either drug alone The combination appears to exert more cardiovascular toxicity than either drug alone in humans. Alcohol appears to potentiate cocaine hepatotoxicity in both humans and mice.
- 51. Interactions- Heroin and Scopolamine AKA:Speedball Heroin is thought to mask/temper some of cocaine's nastier effects “Homicide”, “Super Buick” Heroin, coke, scopolamine- Causes tachycardia, anticholinergic toxicity (remove the heroin via Narcan and the adrenergic and anticholinergic effects combine uninhibited) This is why its very important to give just enough Narcan to regain respiratory function
- 52. Dependence, Detox, and withdrawal Sincecocaine withdrawal is generally mild, is mainly psychological in nature. Tolerance to Cocaine builds quickly, thus larger and larger doses are used. Treatment of withdrawal symptoms is generally not required. Depression, bradycardia, sleepiness, fatigue, cocaine craving
- 53. Take Home informationabout Hyper- dynamic Drugs PROTECT yourself Betablockers falling out of favor Benzos for HTN, sedation, SZ Adrenergic blockers with alpha effects as well as beta 1. Beware of the poly pharm OD Beware of the malignant hyperthermia
- 54.
- 55. “For about aweek I couldn't walk through the lobby of A-entry at the dorm without getting really scared, because of the goblin I saw there when I was tripping….” ( …User, circa.1971, )
- 56.
- 57. Background Discovered by Dr.Albert Hofmann in 1938 Extensive study, use, and abuse by the government in the late 40’s. 50’s, and 60’s. (OSS/CIA, US Navy) Some documented cases of CIA Operatives taking it to “Immunize” them selves to its effects in the 60’s. Now that’s job satisfaction!
- 58. Slang Many names referto the carrier or “brand”(image printed on blotter) Blotter, Sugar, Sugar Cube, “cid, Acid Bart Simpsons, Barrels, Tabs, Blotter, Heavenly blue, "L", Liquid, Liquid A, Lucy in the sky with diamonds, Microdots, Mind detergent, Orange cubes, Orange micro, Owsley, Paper acid, Sacrament, Sandoz, Sunshine, Tabs, Ticket, Twenty-five, Wedding bells, Windowpane, etc.
- 59. Slang Hit- Dose Body Kinks-Unexpected physical side effects I.e. nausea, jitters, etc Bad trip- A person on LSD who becomes depressed, agitated, or confused may experience these feelings in an overwhelming manner that grows on itself. LSD psychosis: The effects of LSD exacerbate pre-existing psychological problems for several days.
- 60. Methods Usually taken Sublinguallyor orally on paper (“Blotter”) The solution may also be injected s.c. or i.v.(RARE) The effect is identical with that of oral administration but sets in more rapidly. Usual dose is 50-200 mcg, with “Transcending doses” as high as 500 mcg
- 61. How does itwork? Similar to other drugs that give hallucinations: It affects the re-uptake of 5-HT similarly to SSRI (serotonin specific reuptake inhibiting) anti- depressants such as fluoxetine (Prozac), sertraline, and paroxetine Agonist (stimulation rather than blocking) properties at the 5-HT2 receptor have been found to fairly universally be associated with other psychedelic drugs such as psilocybin and mescaline, and somewhat in MDMA
- 62. S/S OF ANOVERDOSE Dilated Pupils Vivid Auditory, tactile, and visual perception Nausea Mild drops in B/P Hyperglycemia Piloerection (Goosebumps) Mild Hyperthermia Bradycardia May exacerbate pre-existing behavioral tendencies Mild stimulatory effects
- 63. After trip effects Insomnia(common) “Jitters” Flashbacks (inconstantly proven and disproven in literature)
- 64. BASIC TREATMENT Supportive Protect thepatient Calm low key, low light, environment Calm low key, low light environment Calm low key, low light environment Calm low key, low light environment Oh yes… Calm low key, low light environment
- 65. FOCUSED TREATMENT Benzo’s forsevere agitation (rare)
- 66. Dependence, Detox, andwithdrawal No documented physical or psychological dependence A rapid tolerance is built up (about 3-5 days) that just as rapidly disappears
- 67. Take Home Information Facilitatea low key trip, and all is well The patients respond to your actions as much as we respond to them Very little clinical problems from drug, just actions resulting from altered behavior
- 68.
Editor's Notes
- #8 Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 1994-1998.
- #9 "black tar," has also become increasingly available in the western United States. The color and consistency of black tar heroin results from the crude processing methods used to illicitly manufacture the substance in Mexico. Black tar heroin may be sticky, like roofing tar or hard like coal, and its color may vary from dark brown to black. It is often sold on the street in its tar-like state at purities ranging from twenty to eighty percent. This heroin is most frequently dissolved, diluted and injected. Red Rum Heroin - is a highly potent form of heroin that was recently responsible for the overdose death of a rock musician in New York. Red Rum and other brands like it, including Fire Express, Green Honey, and Laundromat, are much more potent than brands of heroin a decade ago. They are designed to deliver a strong high by snorting or smoking instead of injecting. According to New York City police, a sample of the Red Rum heroin tested at a purity level between 60 and 70 percent. Red Rum's origins are believed to be South American.
- #11 The typical heroin user today consumes more heroin than a typical user did just a decade ago, which is not surprising given the higher purity currently available at the street level. Until recently, heroin in the United States almost exclusively was injected either intravenously, subcutaneously (skin-popping), or intramuscularly. Injection is the most practical and efficient way to administer low-purity heroin. The availability of higher purity heroin has meant that users now can snort or smoke the narcotic. Evidence suggests that heroin snorting is widespread or increasing in those areas of the country where high-purity heroin is available, generally in the northeastern United States. This method of administration may be more appealing to new users because it eliminates both the fear of acquiring syringe-borne diseases such as HIV/AIDS and hepatitis, and the historical stigma attached to intravenous heroin use.
- #12 Howard Lotsof, a renowned researcher into ibogaine treatment of heroin addiction, has estimated that a "low end analgesic dose of heroin would be about 1mg." Most users start with doses much higher than this. Insufflated doses of heroin probably start at between 5 and 20mg of pure heroin and intravenous doses probably start between 5 and 10 mg. As usage increases, however, the doses get much higher. Dr Lotsof wrote "In close to twenty years of research and involvement with the treatment of opioid dependence with ibogaine the highest dose I personally saw used of heroin in Europe was 2 grams [per day], that is 2,000 mgs." 2 grams per day, however, is extremely high, much higher than most heroin addicts achieve. Heroin is very expensive and this dosage level would be fatal in most people who had not worked up their dosages slowly.When the Swiss government began allowing maintanence of heroin users, they were able to collect reliable data about exactly how much heroin was being used. The Swiss found that users offered unlimited quantities would, on average, max out at between 300 and 500 mg. of diacetylmorphine per day. One author writes "I've known people prescribed a full gram per day, but they were quite unusual, and such habits on the street are impossible except for relatively high level dealers. Remember, I'm talking about pure pharmaceutical or number 4 if on the street. There are certainly cases of pain patients receiving larger equivalent dosages of opioids, but I've never heard of one of these beating a 1000/1 ratio."The Swiss data was published in 1999 Prescription of Narcotics for Heroin Addicts: Main Results of the Swiss National Cohort StudyVolume One. Uchtenhagen, A;Dobler-Mikola, A.; Steffen, T; Gutzwiller, F.; Blattler, R; Pfeifer, S. Karger; Basel; 1999Page 20 states that the mean daily dose of heroin IV ( when used alone, without methadone on the side) was 491.7mg.Page 22 states "A stable dose was achieved after 6 months at most; beyond this point, almost no further increases in dose were required
- #13 A dirty hit can result in a fairly quick and intense reaction or might take days or weeks to produce an effect. Symptoms often include sweating, headache, fever, and trembling. While the effects of a dirty hit may pass by themselves, you should seek medical attention if they are particularly strong or persistent. Shooting: IV Injection Skin Pooping: SQ injection Muscle Pooping: IM Chasing the dragon: Smoking (it's put on aluminum foil and heated from the bottom and allowed to run down the foil if possible while inhaling the smoke…) freebasing Dirty Hit: The result of a dirty process usually resulting in an abscess, cellulites, etc
- #14 Big in Ky, Fl, A new formulation would make it "a lot more difficult to get a high" from OxyContin, said Robin Hogen, executive director of public affairs for Purdue Pharma of Norwalk, Connecticut. The painkiller has become a popular street drug, delivering an instant high when crushed or dissolved and ingested. Hogen said the new drug would have to pass through clinical trials required by the Food and Drug Administration, which means it might be two to three years before it could be prescribed by doctors. Among the hurdles, Hogen said, are efficacy trials that would show how well the new formula handles pain relief.
- #15 This is the key to the heroin high: Nothing matters, hot or cold, fun or boring, big or small. When one is high on smack, one looks at the outside world and has only one thought: Who gives a fuck? You feel as if you've been wrapped in the most pleasing, warm, and comfortable blanket in the world. At high doses, you fall in and out of consciousness, and getting this 'nod' is what the veteran user prays for every time he shoots up; to sleep the sleep of angels is the ultimate goal of the heroin addict. ..from erowid.com
- #18 BLOOD POISONING (Septicemia) Blood poisoning (septicemia) is a bacterial infection of the bloodstream that can be caused by injecting with contaminated water, re-using old cottons, or failing to clean the skin prior to injection. Early symptoms include chills, fever, and extreme fatigue. If you experience these symptoms, seek medical attention. Septicemia can be fatal! ENDOCARDITIS Endocarditis is an infection of the heart lining that is caused by bacteria, fungi, and other infection-causing microbes that enter the bloodstream during injection and build up around the valves of the heart, weakening them as well as other parts of the heart muscle. Endocarditis can eventually cause a heart murmur, as well as fever, chest pains, fainting spells, shortness of breath, and heart palpitations. It can be treated with antibiotics if detected early, but can be fatal if it goes untreated. TETANUS tetanus spores enter a wound and release tetanus bacteria, usually after a scab has already formed. The bacteria then enter the bloodstream and cause an infection, which is characterized by muscle spasms or rigidity, especially in the neck and jaw (tetanus is commonly called "lockjaw"). Tetanus is fatal if not treated. Tetanus spores live in the soil and on rust, which is why a tetanus shot is recommended if you step on an old nail or other rusty object. If your needle, syringe, or other injection equipment is contaminated with tetanus spores due to dirt or rust, you could infect yourself. Skin-poppers and muscle-poppers are particularly susceptible to tetanus infection and should always use new, sterile equipment. NECROTIZING FASCIITIS (Flesh-Eating Disease) Associated w/ black tar Necrotizing fasciitis is a bacterial infection commonly known as "flesh-eating disease" that enters the body through broken skin and then affects the surrounding tissue and nearby muscle. It can be transmitted by the exchange of blood during needle sharing, and has recently been traced to "black tar" heroin on the West Coast. Symptoms of necrotizing fasciitis include increasing redness and swelling and extreme pain at the wound or injection site accompanied by a fever. The flesh around the site of infection begins to decay and looks as if it had been "eaten" away. Since this infection is fatal, early treatment with antibiotics is crucial to survival, although even appropriate therapy does not prevent death in all cases. Wounds must be kept impeccably clean. WOUND BOTULISMWound botulism is caused by a bacteria that produces a toxin on the skin where a puncture would is made and that eventually stops your breathing by paralyzing your muscles. Recent cases have been associated with the subcutaneous injection of "black tar" heroin on the West Coast. The source of the botulism could be the drug itself, a cut in the drug, dirty injection equipment, or contamination during the preparation process. Wound botulism can be prevented in the same ways as necrotizing fasciitisby following excellent sterile technique when preparing and injecting your drugs. Symptoms of wound botulism include droopy eyelids, blurred or double vision, and a dry, sore throat which may progress into difficulty speaking and swallowing, a weakness of the neck, arms, and legs, and difficulty breathing.
- #19 Jimson weed is Datura Stramonium, a member of the nightshade family. The active chemicals in Jimson include atropine, scopolamine, and hyoscamine. The buzz from this family of psychotropic plants is more like a dilerium with very strong hallucinations than anything else. Jimson is very poisonous, the buzz couldn't really be described as recreational, and I wouldn't try it, myself. If you decide to experiment with it, be *extremely* careful, because just a little too much could kill you. I have tried smoking a small amount of Datura Inoxia, and the buzz is interesting, but not overly pleasant. It has been reported that Datura Inoxia has been added to marijuana for extra effects, but I don't have any firsthand knowledge of this combination, It's possible that Datura Stramonium could be used in the same way, but I haven't heard or read of anyone trying this. Scopolamine: “Twilight Sleep” Chemically related to Atropine, it is an anticholenergic (wich has some hallucinatory properties at high doses) Strong potentiation with some hallucination. Also a component in “Jimson weed” Stedman's medical dictionary describes overdose symptoms as: "Strange indescribable feelings with giddiness, yawning, staggering or falling on attempting to walk; dryness of mouth and throat, sense as of suffocation, swallowing difficult, voice husky; face at first pale later suffused with a scarlatiniform rash which extends to the body; pupils widely dilated; pulse, at first bounding and rapid, later becomes irregular and faint".
- #21 medical detoxification is usually accomplished by giving decreasing doses of a long-acting opiate like methadone. After a few weeks of this, the patient is usually opiate-free without having suffered any appreciable physical discomfort. Since a percentage of the methadone marketed for medical use finds its way into the streets, many addicts also detox themselves this way without formal medical help Still others detox 'cold turkey'--without any pharmacological help at all. They simply tell their friends they have the flu, go to bed, and suffer in relative silence. A substantial portion of the physical symptoms of this stage seem to depend on the activity (previously suppressed) of a part of the brainstem called the locus coeruleus. The is believed responsible for the brain's fear-alarm system, and such hyperactivity would be consistent with the marked anxiety, hypertension, and agitation withdrawing addicts report.
- #25 The "meth" comes from the chemical name "methyl". The chemical Methamphetamine is composed of an amphetamine molecule with an additional methyl group attached to its nitrogen (amine group). A methyl is one of the simplest atomic groups which can be added to a molecule: it is a single carbon atom with a set of (usually) 3 hydrogens.For many of the known psychoactives, adding a methyl group slightly alters the effects, duration, and/or potency. As you start to pay attention to other chemical names, you'll see "meth" show up in many names and this will almost always indicate that there is a methyl group on the molecule somewhere. For Methamphetamine, the methyl allows it a little better fat solubility and thus better penetration into the brain.
- #26 Jan 18, 1887-Amphetamine was first synthesized by German chemist L. Edeleano and originally named phenylisopropylamine 1932Amphetamines are first marketed as 'benzedrine' in an over-the-counter inhaler to treat congestion. 1937Amphetamine is first available in tablet form by prescription for use in the treatment of narcolepsy and ADHD (attention deficit hyperactivity disorder). WWII Both Amphetamine and Methamphetamine are widely distributed to soldiers to help improve performance. This led to addiction problems in Japan after the war. 1942Dextro-amphetamine and methamphetamine become commonly available. 1960'sMethamphetamine use rises in the United States. 1970Amphetamine becomes illegal with the passage of the 'U.S. Drug Abuse Regulation and Control Act of 1970'. [ Late 1980'sSmoked Methamphetamine becomes more popular
- #27 All of these substances are swallowed, snorted, smoked, and injected by users (in estimated order of frequency) and all can be dangerous in combinations with MAOIs, at high doses, or at high frequencies of use.monoamine oxidase inhibitors (MAOIs) Until recently, it was believed that the metabolites of Parnate were Amphetamine and Methamphetamine, which would fit the definition of "sympathomimetic agonists" Most research does not support the amphetamine metabolite theory. However, there is still a lot to learn about MAOI pharmacology.
- #29 "Crystal" has seven letters, "crank" only has five. A term once used mostly to distinguish down-and-dirty bootleg meth from its crystal-clean sibling, "crank" has become a generic nickname for all forms of speed. And that includes the tablets and capsules that find their way out of the local pharmacy and onto the street.
- #31 Chronic use can lead to what is called, resulting in paranoia, auditory and visual hallucinations, self-absorption, irritability, aggressive and erratic behavior, and picking at the skin. This can be magnified by lack of sleep which often accompanies heavy use of meth. Patients concomitantly ingesting dextromethoraphan, monoamine oxidase inhibitors, MDMA and other serotonergic agents may develop a "serotonin syndrome." Characterized by agitation, hyperthermia, altered muscle tone and seizures. Occurs within 2 hours of ingestion of offending agent and resolves 6 -24 hours after discontinuing the agent.
- #34 Repeated administration of methamphetamine damages cells in the somatosensory cortex: overlap with cytochrome, by O'Dell SJ, Marshall JFSynapse, Vol 37 (No 1) Jul 2000;32-7 Methamphetamine is also believed to be neurotoxic.It use causes damage to the neurons in the dopamine portions of the brain. : Up to 50% in relatively small doses over prolonged periods Lead Poisening had been documented in some chronic IV meth users, Meth is sometimes made with lead acetateLarge amounts of lead in can cause brain damage, mental retardation, behavior problems, anemia, liver and kidney damage, hearing loss, hyperactivity, developmental delays, other physical and mental problems, and in extreme cases, death. Chelation therapy is indicated in patients with blood lead levels between 45 and 70 mug/dL. clinical symptoms suggesting encephalopathy (eg, obtundation, headache, and persistent vomiting) Normally the brain's irreplaceable complement of 30-40 thousand odd dopaminergic cells tends to die off at around 13% per decade in adult life. This diminishes the quality and intensity of experience. It also saps what in more ontologically innocent times might have been called one's life-force. Eighty percent loss of dopamine neurons results in Parkinson's disease, often prefigured by depression.
- #36 Most pharmacological Detox is based on cocaine info, has met with little success in meth users. This combination can be particularly bad because the user is likely to have strong cravings for more meth, while at the same time being unable to reach a satisfactory high
- #40 Cocaine was soon sold over-the-counter. Until 1916, one could buy it at Harrods. Cocaine was widely used in tonics, toothache cures and patent medicines; and in chocolate cocaine tablets. Ryno's Hay Fever and Catarrh Remedy - "for when the nose is stuffed up, red and sore" - was 99.9 per cent pure cocaine. Prospective buyers were advised - in the words of pharmaceutical firm Parke-Davis - that cocaine "could make the coward brave, the silent eloquent, and render the sufferer insensitive to pain". Coca-cola was introduced in 1886 as "a valuable brain-tonic and cure for all nervous afflictions". Coca-cola was promoted as a temperance drink "offering the virtues of coca without the vices of alcohol". The new beverage was invigorating and popular. Until 1903, a typical serving contained around 60mg of cocaine. Sold today, it still contains an extract of coca-leaves. The Coca-Cola Company imports eight tons from South America each year. Nowadays the leaves are used only for flavoring since the drug has been removed.
- #41 The reinforcing effects of cocaine and cocaine analogs correlate best with their effectiveness in blocking the dopamine transporter (Ritz et al, 1987). This blockade is believed to produce increased dopaminergic stimulation at critical brain sites. However cocaine also blocks both norepinephrine (NE) and serotonin (5HT) reuptake and chronic use of cocaine produces changes in these systems as measured by reductions in the neurotransmitter metabolites MHPG (3-methoxy-4 hydroxyphenethyleneglycol and 5-HIAA (5-hydroxyindoleacetic acid). Thus neurotransmitters other than dopamine may be involved. It blocks re-uptake of 5-HT similarly to SSRI (serotonin specific reuptake inhibiting) anti-depressants such as fluoxetine (Prozac), sertraline, and paroxetine. Agonist (stimulation rather than blocking) properties at the 5-HT2 receptor have been found to fairly universally be associated with "classical" psychedelic drugs such as LSD, psilocybin and mescaline. It is possible that some of MDMA's "psychedelic" effect occurs because of interactions with this receptor. The alpha-2 adrenergic receptor may be associated with some of the carciovascular effects of MDMA. MDMA also releases dopamine which may be central to both its psychological action and to its neurotoxicity in animal studies. Pre- treatment of an animal with a drug which blocks dopamine release will also block MDMA neurotoxicity. In summary, MDMA effects 5-HT similarly to the way that amphetamines effect dopamine, by inhibiting the reuptake and causing the release of 5-HT. This effect is somewhat similar to the effect that SSRI anti-depressant drugs have. It also effects the 5-HT2 (psychedelic) and alpha-2 adrenergic (cardiovascular) receptor sites. Also, its effects on dopamine appear, at this point, to be involved both with its neurotoxicity and psychological effects.
- #43 Low-potency cocaine differs from regular cocaine powder and crack in terms of its purity level, and how fast and thoroughly it alters brain chemistry. According to Weil, the coca leaf chewed by peasant farmers in Bolivia and Peru is half of 1 percent pure cocaine. Similar concentrations sold in gum and lozenges overseas Freebasing is an especially dangerous means of abusing cocaine because of the high concentrations of cocaine it introduces into the bloodstream. These high doses can overtax the cardiovascular system. Reports of sudden death while freebasing are not uncommon. freebase: mix about 1 g of coke in 10 ml of water in a small vial. Slowly add drops of ammonia to the solution. A white milky precipitate will form. Stop adding ammonia when additional drops no longer result in precipitation. Add 5 ml of ethyl ether, close vial, and shake. The precipitate (freebase) will dissolve in the ether. Siphon off the ether with a pipette (ether and water don't mix), and slowly drip it on a plate. As the ether evaporates, white crystals will form. This is the evil freebase. Crush the crystals and put under a heat lamp for at least 24 hrs to let the solvent evaporate. mix 2 parts ok coke HCL for 1 part baking soda in 20 ml of water. Heat solution gently until white precipitates form, and stop heating when precipitation stops. Filter and keep precipitate. wash precipitate once with water (this procedure usually omitted in street product). Dry 24 hours under heat lamp. Voila. The product is much less pure (there is lots of baking soda left) but the procedure is safer.
- #44 By contrast, cocaine smuggled in by traffickers is 50 percent to 60 percent pure. The effect of crack is even more intense because it is smoked and its chemicals reach the brain in seconds. Cocaine inhaled through the nose takes 30 minutes to be fully effective. Orally ingested cocaine in lozenges or gum takes an hour, according to Kleber. Freebasing is an especially dangerous means of abusing cocaine because of the high concentrations of cocaine it introduces into the bloodstream. These high doses can overtax the cardiovascular system. Reports of sudden death while freebasing are not uncommon. freebase: mix about 1 g of coke in 10 ml of water in a small vial. Slowly add drops of ammonia to the solution. A white milky precipitate will form. Stop adding ammonia when additional drops no longer result in precipitation. Add 5 ml of ethyl ether, close vial, and shake. The precipitate (freebase) will dissolve in the ether. Siphon off the ether with a pipette (ether and water don't mix), and slowly drip it on a plate. As the ether evaporates, white crystals will form. This is the evil freebase. Crush the crystals and put under a heat lamp for at least 24 hrs to let the solvent evaporate. mix 2 parts ok coke HCL for 1 part baking soda in 20 ml of water. Heat solution gently until white precipitates form, and stop heating when precipitation stops. Filter and keep precipitate. wash precipitate once with water (this procedure usually omitted in street product). Dry 24 hours under heat lamp. Voila. The product is much less pure (there is lots of baking soda left) but the procedure is safer.
- #45 Because cocaine hydrochloride will decompose if smoked directly, the hydrochloride must be converted back to a relatively pure base state (freebasing) before it is suitable for smoking. Freebasing was introduced as a way to smoke cocaine during the late seventies. The base is produced form the hydrochloride using volatile chemicals (generally ether) and elaborate paraphernalia such as acetylene or butane torches. The process is dangerous and cumbersome and has resulted in numerous explosions and burns to individuals. Unlike cocaine base manufactured in the traditional freebase process, crack (which is an off-white color resembling coagulated soap powder) is manufactured by converting hydrochloride back to base, primarily by using baking soda and water. Ammonia can also be substituted for the baking soda. This method of preparation does not involve the use of heated volatile substances and consequently, virtually eliminates the dangers of explosion and fire encountered in the conventional freebasing. After conversion, the product is sold in ready-to-smoke powder which can be sprinkled on cigarettes. The name "crack" may have developed because this form of drug resembles crackled paint chips or because it makes a crackling noise when smoked. Crack often is distributed in a "rock" form allowing the user to smoke the cocaine in a traditional glass pipe.
- #46 The effects of cocaine occur within the first few minutes, peak in 15-20 minutes and disappear in about 1- hours. The immediate effects are what make cocaine so addicting. The user is willing to endure the lows in order to experience the highs. The half-life of cocaine in plasma is about 50 minutes, but inhalant (crack) users typically desire more cocaine after 10 to 30 minutes. Intranasal and intravenous use also results in a high of shorter duration than would be predicted by plasma cocaine levels, suggesting that a declining plasma concentration is associated with termination of the high and resumption of cocaine seeking. The major route for cocaine metabolism involves hydrolysis of each of its two ester groups resulting in loss of pharmacological activity. Benzoylecgonine results from the loss of the methyl group and this represents the major urinary metabolite. Standard tests to detect cocaine use target this metabolite which can be found in the urine for two to five days after a binge. Heavy users have been found to have positive urines for up to 10 days and thus the urine test is only a marker of use, but not necessarily recent use.
- #47 Cocaine has been reported to produce a prolonged and intense orgasm if taken prior to intercourse. Thus its use is associated with sexual activity, often compulsive and promiscuous. However, long term cocaine use may result in reduced sexual drive and complaints of sexual problems are common among cocaine users presenting for treatment
- #50 Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures. Pulmonary complications of cocaine toxicity include pulmonary edema, pulmonary hemorrhages, pulmonary barotrauma, foreign body granulomas, cocaine related pulmonary infection, obliterative bronchiolitis, asthma, and persistent gas-exchange abnormalities 'Sterile infections' can only occur after cocaine injections. These are infections which are not caused by bacteria but by dying dermis (true skin). A patient developed fever, bronchoconstriction, hypoxaemia, pulmonary infiltrates, and serum and bronchoalveolar lavage fluid eosinophilia on two occasions after inhaling crack cocaine. Transbronchial biopsy specimens showed normal lung parenchyma but a dense eosinophilic infiltrate within the bronchial wall. Both episodes resolved promptly after treatment with corticosteroids. Eosinophilic lung disease may be a steroid responsive complication of crack cocaine abuse.
- #52 Cocaine and heroin taken together is referred to as "speed ball." It is thought that the two drugs enhance one another's effects. Heroin may also temper some of the unpleasant after effects of cocaine use. Stedman's medical dictionary describes overdose symptoms as: "Strange indescribable feelings with giddiness, yawning, staggering or falling on attempting to walk; dryness of mouth and throat, sense as of suffocation, swallowing difficult, voice husky; face at first pale later suffused with a scarlatiniform rash which extends to the body; pupils widely dilated; pulse, at first bounding and rapid, later becomes irregular and faint".
- #53 Since cocaine withdrawal is generally mild, treatment of withdrawal symptoms is generally not required. The major problem in treatment is not stopping cocaine, but rather it is helping the patient to resist the urge to re-start compulsive cocaine use. There is evidence that rehabilitation programs involving individual and group psychotherapy based on the principles of Alcoholics Anonymous and behavioral treatments based on reinforcing cocaine free urine tests can result in significant improvement in the majority of cocaine users. Nevertheless, there is great interest in finding a medication that can aid in the rehabilitation of cocaine addicts.
- #55 Research began by the CIA in the 50’s, by the 60’s the CIA realized that an adversary intelligence service could employ LSD "to produce anxiety or terror in medically unsophisticated subjects unable to distinguish drug-induced psychosis from actual insanity". The only way to be sure that an operative would not freak out under such circumstances would be to give him a taste of LSD (a mind control vaccine?) before he was sent on a sensitive overseas mission. Such a person would know that the effects of the drug were transitory and would therefore be in a better position to handle the experience. CIA documents actually refer to agents who were familiar with LSD as "enlightened operatives". Included in this group are LSD and hallucinogens derived from plants such as mescaline from peyote cactus, psylocybin from mushrooms, dimethyltryptamine (DMT) from seeds and myristicin from nutmeg. LSD is similar to compounds found in ergot, a fungus that grows on rye. Albert Hofmann, a scientist for Sandoz Pharmaceutical Laboratories in Basel, Switzerland found LSD while working on a series of ergot compounds. Lysergic acid was similar in structure to a compound called nikethamide, a stimulant. Hofmann was attempting to create a similar chemical that might be used for medicinal purposes. Some of the compound he had created was on his hands when he ate a sandwich. The resulting effects led to further experimentation. See page 341 in the text. LSD has been used experimentally in treatment of alcoholism, autism, paranoia, schizophrenia and various other mental illnesses with no particular success. Therapeutic use has been limited by the legal aspects and by difficulty in finding the pure substance. Impurities in LSD cause adverse reactions. The use of LSD declined after the 1960s and began to increase in the 1990s. Peer pressure and approval plus lack of understanding of potential problems resulting in use have led to increased use. Several students have suggested that the individuals imprisoned for production of LSD are being released and are making it again resulting in increased use. LSD is synthesized in laboratories, but the process is not simple. Producing it takes approximately a week. An illegal operation in San Francisco is the primary source of LSD. The amount of LSD needed to produce the desired effect is extremely small. Therefore a very small amount can satisfy the demand and can be easily hidden. In its purified form, LSD is colorless, odorless and tasteless making detection difficult. Due to the small amount needed to produce a reaction, it is sold in microdots (tablets approximately one tenth the size of aspirin), in liquid or in the form of "panes" (absorbent paper impregnated with LSD). One gram of LSD can provide 10,000 individual doses and is valued on the street at $50,000.00. The typical dose in the 1990s is 20 to 30 micrograms compared with a typical dose of 150 to 300 micrograms in the 1960s. Severe side effects with current use are fairly rare. A lethal dose is estimated to be five milligrams per kilogram of body weight (approximately half the pound weight). When taken into the body, LSD readily crosses all body tissues. It readily passes the BBB and the placenta. The brain receives approximately 1% of the total dose. In the brain, LSD concentrates in the hypothalamus, the limbic system and the auditory and visual reflex areas. Electrodes placed in the limbic system indicate and "electrical storm" or a massive increase in neural activity that might correlate with the overwhelming flood of sensations and the phenomenon of synesthesia. LSD also activates the sympathetic nervous system shortly after ingestion. Body temperature, heart rate and blood pressure rise. Sweating occurs along with increased salivation and nausea. Half of the LSD is cleared from the body within three hours and more than 90% is excreted in 24 hours. Tolerance develops rapidly and lasts longer than tolerance to other substances. Repeated doses lead to tolerance that might relate to the inability of the neurons to be altered to any greater extent. There are no withdrawal symptoms for LSD and addiction is thought to be psychological rather than physiological. Tolerance wears off in a matter of days after use is discontinued. The stages of the LSD experience have been described as Heightened, exaggerated senses Altered sense of time Perception of objects, colors, sounds altered Loss of control Flashbacks Self reflection User becomes aware of thoughts and feelings long hidden, forgotten or repressed Loss of identity and sense of cosmic merging Skin ceases to be a boundary between self and others Behavioral Effects include feelings of Being more creative – creative projects done while under the influence of LSD do not support this belief. being more insightful – new insights are short-lived, behavior does not change and answers achieved while under the influence are not "earth-shattering" Psychotic adverse reaction or "freakout" – this experience is referred to as a bad trip. Persons using LSD in an unfavorable setting or who have mental problems prior to use are most likely to have this experience. Flashback is now referred to as Post Hallucinogenic Perceptual Disorder (PHPD). Flashbacks might take the form of reoccurrence of body sensations, a distressing thought or emotion or altered visual perceptions. The most disturbing aspect of PHPD is that it comes on unexpectedly. The individual feels out of control and is concerned about safety of self or others. Treatment consist of reassurance that the condition will go away. Most such experiences occur within weeks or months of using LSD. Occasionally there is a report of five years after using a hallucinogen. LSD "freakout" is an intense, nighmarish experience with loss of emotional control. The individual susceptible to suggestions might have a syndrome resulting in being easily controlled, experience of paranoid delusions, hallucinations, panic attacks, psychosis and catatonic seizures. In rare instances some of these reactions are prolonged, lasting days. Varying degrees of tension, anxiety, fear, depression and despair might also occur, but are not as intense as the "freakout". These symptoms are more likely to occur when taken in unfavorable setting, a person having psychological problems or a strong need to be in conscious control. Genetic damage and birth defects are not proven. Individuals who use hallucinogens are likely to also use other substances that might cause birth defects or problems with the pregnancy. Adulterants in the LSD might also cause problems in pregnancy. In the 1950s, the U. S. government and military experimented with LSD and gave it to humans without consent. Participants were coerced into taking the drug or not told that it was being given. The legal consequences of the LSD studies are ongoing. Large cash settlements have been awarded to families surviving persons who committed suicide as a result of taking LSD.
- #59 Drug Slang Terms (NB: many of these refer to the carrier, ie, "Blotter" or "Sugar Cubes". Often the local names will refer to patterns printed on the blotter, eg, "Blue unicorn".): Acid, 'Cid, Sid, Bart Simpsons, Barrels, Tabs, Blotter, Heavenly blue, "L", Liquid, Liquid A, Lucy in the sky with diamonds, Microdots, Mind detergent, Orange cubes, Orange micro, Owsley, Hits, Paper acid, Sacrament, Sandoz, Sugar, Sugar lumps, Sunshine, Tabs, Ticket, Twenty-five, Wedding bells, Windowpane, etc.
- #60 In spite of the impressive degree of prior problems noted in many of these patients, there are occasional reports of severe and prolonged reactions occuring in basically well adjusted individuals. In the same vein, there are many instance of faily poorly adapted individuals who suffer _no_ ill effects from repeated psychedelic drug use. In fact, it has been hypothesized that some schizophrenics do not suffer adverse reactions because of their familiarity with such acute altered states. Another possibility is that there individuals may be "protected" by possible "down- regulation" of the receptors for LSD, bu the (over-)production of some endogenous compound. _Individual_ prediction of adverse reactions, therefore, is quite difficult... Hensala et al. compared LSD-using and non-LSD-using psychiatric inpatients. They found that this group of patients was generally of a younger age and contained more characteristically disordered individuals than the non- LSD-using group. Patients with specific diagnoses with or without LSD histories were not compared. Based on their observations, they concluded that LSD was basically just another drug of abuse in a population of frequently hospitalized individuals in the San Francisco area, and that it was unlikely that psychedelic use could be deemed etiological in the development of their psychiatric disorders
- #61 The effect sets in after 30 to 90 minutes and gen- erally lasts 5 to 12 hours. However, intermittent distur- bances of affect may occasionally persist for several days. 1973: "Of 189 samples of LSD quantitatively analyzed, the average dose was 67.25ug LSD. Useful dose is 50-200 mcg, with “Transcending doses as high as 500 mcg
- #62 LSD acts to preferentially inhibit serotonergic cell firing and seems to spare postsynaptic serotnergic receptors. This preference is shared by other simillar hallucinogens but in a limited fashion. Nonhallucinogenic analogs of LSD show no preference. These results suggest that there are two different steric conformation of serotonergic receptors, one of which has higher affinity for LSD than the other. In general, 5-ht is an inhibitory transmitter; thus, when its activity is decreased, the next neuron in the chain is freed from inhibition and becomes more active. blocks re-uptake of 5-HT similarly to SSRI (serotonin specific reuptake inhibiting) anti-depressants such as fluoxetine (Prozac), sertraline, and paroxetine. Agonist (stimulation rather than blocking) properties at the 5-HT2 receptor have been found to fairly universally be associated with "classical" psychedelic drugs such as LSD, psilocybin and mescaline.
- #63 Since serotnergic systems appear to be intimately involved int eh control of sensation, sleep, attention, and mood, it may be possible to explain the actions of LSD and other hallucinogens by their disinhibition of these critical systems. There is also evidence for interaction with dopaminergic systems. These include an oxytocic action and constriction of the blood vessels of isolated vascular beds. In intact animals LSD causes a fall in blood pressure, but its adrenergic blocking potency is low. LSD causes mydriasis in man and other species. It also causes hyperglycaemia and mydriasis, has a hyperthermic action and causes piloerection. These effects are sympathetic in nature and are abolished by ganglion blocking or adrenergic blocking agents. Parasympathetic effects include salivation, lachyrmation, vomiting, hypotension, and brachycardia. Low doses stimulate respiration but larger doses depress it. (NB: mydriasis = pupillary dilation) The "speedy" quality of unadulterated LSD is due to the pharmacological actions of LSD itself, and not necessarily due to decomposition or impurities. LSD typically causes early adrenergic effects such as sweating, nervousness, jaw grinding and insomnia which are easily confused with the side effects of amphetamine. Actually, I think the fact that PharmChem analyzed something on the order of 2,000 LSD samples between 1972 and 1979 and never found one with strychnine in it would be better. I'm going over all their data with a toothpick and I'll get back to you on exactly what I find. It looks like the percent of LSD with strychnine in it is, however, at least under .05%. More a little later. The reported LD50 values for LSD are 46, 16.5, 0.3 mg/kg I.V. for mice, rats, and rabbits, respectively. Again, it's hard to accurately translate these numbers to oral values. Note that an average human dose is 0.001 mg/kg, ie, 1 microgram/kg, ie, 1 part per billion by weight.
- #64 Insomnia occurs frequently after the trip. A mild, over-the-counter sleeping aid can help, and these antihistamines do not produce adverse interactions. Also, some people like to consume a small amount of alcoholic beverage to "smooth the jitteries". The usual precautions about sleeping aids if alcohol has been consumed apply of course.
- #67 ADDICTION POTENTIAL: Zero physical addiction potential. Not something that makes you want to do it again immediately. Essentially zero psychological addiction potential. Rarely people use it to escape in a negative way or as part of "polydrug abuse" behavior or pattern of behavior. Usually in this case other drugs are causing more harm, and the fundamental problem is a personal difficulty; the escapism/distraction is a symptom. The mental effects of Delysid can be rapidly reversed by the i.m. administration of 50 mg. chlorpromazine. Literature available on request. SANDOZ LTD., BASLE, SWITZERLAND 9792*-Z1540 e.-sp./d.-fr. Printed in Switzerland. ..... ~From: An Introduction to Pharmacology 3rd edition, JJ Lewis, 1964 (p 385) Peripheral Actions