misuse and abuse of CNS stimulants by zohra (pharma d student )

2. MISUSE & ABUSE OF CNS
STIMULANTS by zohra

3. • TOPIC NAME

4. What are drugs?
Drugs are substances that
• change a person's physical or mental state.
• The vast majority of drugs are used to treat
medical conditions, both physical and
mental.
• Some, however, are used outside the medical
setting for their effects on the mind.
• These are referred to as recreational drugs

5. WHY DO PEOPLE USE PSYCHOACTIVE DRUGS?
People use drugs for many reasons—
• for fun or excitement;
• to feel good, better or different
• to counteract negative feelings
• because they are bored or curious
• because their friends or family do it
• because they have a dependence on the drug.
• Often people who use drugs associate with other
people who use drugs. It is not always clear which
comes first— the friends or the drugs.

6. DRUGDEPENDENCE
• Drug dependence may occur when a person continues to use drugs— legal or
illegal—even though their drug use causes them significant problems. It is
regarded by many as a medical condition or a disorder not directly under the
control of the individual. The term 'addict', with its negative implications, is not
used any longer.
• In general, drug dependence may be diagnosed if a person:
• spends a significant amount of time obtaining the drug, using it, and/or
recovering from its effects
• develops a tolerance to the drug .
• continues using the drug even though they know it is causing them psychological
and/or physical harm
• wants to cut down or control their drug use (and perhaps makes repeated
unsuccessful attempts to do so)
• takes more of the substance, or uses it for longer, than they intend
• reduces, or gives up entirely, important social, recreational and/or work activities
because of their drug use
• suffers symptoms of withdrawal when they stop using the drug

7. withdrawal
•When a person who has been using a drug stops taking
it, or reduces the dose, they may experience a physical
and/or psychological reaction. This is called withdrawal.
Because the dependent person has become tolerant to
the drug's effects, they have been taking the drug just to
feel normal. When they stop taking the drug, they may
experience the opposite to the highs the drug originally
gave them.
•Withdrawal can be very unpleasant, producing
symptoms such as tremors, sweating and vomiting, as
well as extreme craving.

8. Stimulant drugs
• Drugs that are classed as stimulants include:
• Caffeine
• Nicotine
• Cocaine
• Amphetamines

9. What are stimulants?
• As the name suggests, stimulants increase
alertness, attention, and energy, as well as
elevate blood pressure, heart rate, and
respiration.
• Stimulants historically were used to treat
asthma and other respiratory problems,
obesity, neurological disorders, and a variety
of other ailments.

10. • SHORT-TERM EFFECTS
The short-term effects of stimulants include
exhaustion, apathy and depression—the “down”
that follows the “up.” It is this immediate and
lasting exhaustion that quickly leads the stimulant
user to want the drug again. Soon he is not trying
to get “high,” he is only trying to get “well”—to
feel any energy at all.
• LONG-TERM EFFECTS
Stimulants can be addictive. Repeated high doses
of some stimulants over a short period can lead to
feelings of hostility or paranoia. Such doses may
also result in dangerously high body temperatures
and an irregular heartbeat.

11. How do stimulants affect the brain and body?
• Stimulants act in the brain similarly to a family of key
brain neurotransmitters called monoamines, which
include norepinephrine and dopamine.
• Stimulants enhance the effects of these chemicals in
the brain.
• The associated increase in dopamine can induce a
feeling of euphoria when stimulants are taken
nonmedically.
• Stimulants also increase blood pressure and heart
rate, constrict blood vessels, increase blood glucose,
and open up breathing passages.

12. consequences of stimulant abuse
Physiological
 it is possible for individuals to become dependent upon or
addicted to stimulants. Withdrawal symptoms associated with
discontinuing stimulant use include
 fatigue,
 depression
 disturbance of sleep patterns.
 Repeated abuse of some stimulants (sometimes within a short
period) can lead to feelings of hostility or paranoia, even psychosis
 taking high doses of a stimulant may result in dangerously high
body temperature
 an irregular heartbeat.
 There is also the potential for cardiovascular failure or seizures.

13. Psychoactive
 that increase activity in the brain
 These drugs can temporarily elevate
alertness
 mood
 awareness
 can be addicting.

14.  Caffeine is the most commonly used mood-altering drug in the world.
 Caffeine is a stimulant that speeds up your central nervous system, and
is the world’s most popular drug.
• Caffeine occurs naturally
• in products such as coffee, tea, chocolate
• and cola soft drinks and is added to a
• variety of prescription and over-the-counter medications, including
cough, cold and pain remedies.

15. • Caffeine was first isolated from coffee in 1819. It is also
found in tea; in cacao pods, and hence in cocoa and
chocolate products; in kola nuts, used in the preparation
of cola drinks; in the ilex plant, from whose leaves the
popular South American beverage yerba mate is prepared;
and in guarana seeds, an ingredient in some soft drinks.
What does caffeine look like?
In its pure form, caffeine is a white, bitter-
tasting powder

16. Oral and Intravenous Routes of
Administration of Caffeine

17. Caffeine is a stimulant and can be
addictive

19.  In North America, more than 80 per cent of adults regularly consume
caffeine. Worldwide per-capita caffeine consumption (including that of
children) is estimated to be 70 mg per day, equivalent to approximately
one cup of coffee.
 In Canada, coffee consumption increased from 96 litres per person in
1990 to 101 litres per person in 2000.
 Consumption of tea has also increased, up from 42 litres per person in
1990 to 70 litres per person in 2000

20. IN PAKISTAN

22. Statistics:
Statistics 7.6 million (approximately 31%) of U.S.
teenagers say they drink energy drinks. In 2006, $2.3
billion was spent by teens and young adults on energy
drinks

23. • How long does the feeling last?
• When taken in beverage form, caffeine begins to take effect within five
minutes, and reaches its peak effect in about 30 minutes. It takes about
four hours for half of a given dose of caffeine to be metabolized by the
body.
• Normally, almost all ingested caffeine is metabolized,
• and there is no day-to-day accumulation of the drug in the body.

24. Structurally, caffeine closely resembles a molecule
that’s naturally present in our brain, called adenosine
(which is a byproduct of many cellular processes,
including cellular respiration)—so much so, in fact,
that caffeine can fit neatly into our brain cells’
receptors for adenosine, effectively blocking them off.
Normally, the adenosine produced over time locks
into these receptors and produces a feeling of
tiredness.
When caffeine molecules are blocking those receptors, they
prevent this from occurring, thereby generating a sense of
alertness and energy for a few hours. Additionally, some of
the brain’s own natural stimulants (such as dopamine) work
more effectively when the adenosine receptors are blocked,
and all the surplus adenosine floating around in the brain
cues the adrenal glands to secrete adrenaline, another
stimulant.
Mechanismof action

25. Absorbed in the stomach and the intestine Stimulates brain activity Physiologic effects:
Increase blood pressure Increase pulse Increase stomach acid production Fat stores break
down Fatty acids released into blood stream
Soon after you drink (or eat) something containing caffeine, it’s absorbed through the small
intestine and dissolved into the bloodstream. Because the chemical is both water- and fat-
soluble (meaning that it can dissolve in water-based solutions—think blood—as well as fat-
based substances, such as our cell membranes), it’s able to penetrate the blood-brain barrier
and enter the brain.
CAFFIENE TOLERANCE
In people who take advantage of this process on a daily basis (i.e. coffee/tea, soda or energy
drink addicts), the brain’s chemistry and physical characteristics actually change over time as
a result. The most notable change is that brain cells grow more adenosine receptors, which is
the brain’s attempt to maintain equilibrium in the face of a constant onslaught of caffeine, with
its adenosine receptors so regularly plugged (studies indicate that the brain also responds by
decreasing the number of receptors for norepinephrine, a stimulant). This explains why regular
coffee drinkers build up a tolerance over time—because you have more adenosine receptors, it
takes more caffeine to block a significant proportion of them and achieve the desired effect.

26. HEALTH EFFECTS OF CAFFIENE
 Too much caffeine can lead to
cardiovascular problems. When you
consume caffeine your blood pressure
and heart rate will rise. Additionally,
over time, an overuse of caffeine can
lead to heart disease.
 Caffeine can lead to the increased risk of
gastrointestinal problems such as ulcers.
•
 Since caffeine stimulates stress
hormones, this can lead to increased
anxiety, insomnia, and tension.

29. Suddenly giving up caffeine entirely can trigger a range of withdrawal effects. The
principle is that your brain is used to operating in one set of conditions (with an
artificially-inflated number of adenosine receptors, and a decreased number of
norepinephrine receptors) that depend upon regular ingestion of caffeine. Suddenly,
without the drug, the altered brain chemistry causes all sorts of problems, including
the dreaded caffeine withdrawal headache.
If you become addicted to caffeine, it will be
difficult to cut this out of your diet. When you
finally decide to do so, you may experience
symptoms associated with withdrawal. This
includes irritability, headaches, and more.
Withdrawal symptoms:
• Headache Tiredness
• Mood swings
• Jittery feeling
• Difficulty concentrating
WITHDRAWL EFFECTS

30. PREVENT WITHDRAWAL SYMPTOMS
 Taper your caffeine intake
 Eat small, frequent meals
 Exercise
 Get enough sleep
The Academy of Nutrition and Dietetics gives
these tips for cutting down on caffeine:
• Mix decaffeinated coffee in with regular
coffee
• Drink a latte with more low-fat milk than
coffee
• Brew tea for less time
• Pick soft drinks without caffeine

31. ANXIETY AND CAFFEINE
• Studies have shown that high dietary doses of
caffeine (200 mg or more) increase anxiety ratings
and induce panic attacks in the general population.
Individuals with panic and anxiety disorders are
especially sensitive to the effects of caffeine.
Although highly anxious individuals tend to be more
likely to limit their caffeine use, not all individuals
with anxiety problems naturally avoid caffeine, and
some may fail to recognize the role that caffeine is
playing in their anxiety symptoms.

32. SLEEP AND CAFFEINE
• Caffeine administered immediately prior to bedtime or
throughout the day has been shown to delay sleep onset, reduce
total sleep time, alter the normal stages of sleep, and decrease
the reported quality of sleep. There is some evidence to
• suggest that caffeine taken early in the day also negatively affects
nighttime sleep. Caffeine-induced sleep disturbance is greatest
among individuals who are not regular caffeine users. Although
there is evidence for some tolerance to the sleep disrupting
effects of caffeine, complete tolerance may not occur and thus
habitual caffeine consumers are still vulnerable to caffeine-
induced sleep problems.

33. CAFFEINE ADDICTION (i.e. CAFFEINE DEPENDENCE)
• Although caffeine does not produce with life-
threatening health risks commonly associated with
the use of classic drugs of addiction such as cocaine,
heroin and nicotine, some caffeine users report
becoming "addicted" to caffeine in the sense that
they report an inability to quit or to cut down their
caffeine use,
• they continue to use caffeine despite having medical
or psychological problems made worse by caffeine
and they continue to use caffeine to avoid
experiencing caffeine withdrawal symptoms.

34. DIAGNOSIS
• Caffeine dependence (ICD-10 diagnosis and DSM-IV criteria for substance
dependence applied to caffeine).
• Substance dependence is characterized by a cluster of cognitive, behavioral and
physiological symptoms indicating that the individual continues use of the
substance despite significant substancerelated problems (American Psychiatric
Association). The clinical diagnosis of substance dependence encompasses
several features which may or may not include physical dependence (i.e.,
withdrawal). The World Heath Organization (ICD-10) recognizes a diagnosis of
substance dependence due to caffeine.
• Despite the fact that DSM-IV uses very similar criteria for making a diagnosis of
substance dependence, caffeine dependence is not presently included in DSM-IV.
The rationale presented for excluding substance dependence on caffeine as a
DSM-IV diagnosis was that although it had been established that caffeine
produces physical dependence, there was insufficient information pertaining to
other features of dependence such as such as inability to stop use and use
despite harm.

35. A restrictive set of four of the seven DSM-IV criteria that seemed most
appropriate to problematic caffeine use were assessed ,
(1. continued use despite knowledge of a persistent or recurrent physical or
psychological problem that is likely to have been caused or exacerbated
by the substance;
2. persistent desire or unsuccessful efforts to cut down or control substance
use;
3. characteristic withdrawal syndrome or use of the substance to relieve or
avoid withdrawal symptoms;
4. tolerance as defined by a need for markedly increased amounts of the
substance to achieve desired effect, or markedly diminished effect with
continued use of same amount of substance).
Interestingly, among those who met criteria for caffeine dependence,
caffeine intake ranged from 129 mg to 2548 mg and the preferred
caffeine vehicle was equally divided between coffee and soft drinks.
Using the same four criteria, another study identified adolescents who
fulfilled diagnostic criteria for caffeine dependence. These studies, which
represent a series of case reports, demonstrate that a clinically
meaningful caffeine dependence syndrome does exist. The most
commonly reported symptom (56%) was persistent desire or
unsuccessful efforts to cut down or control caffeine use.

38. Nicotine is an alkaloid
present in Nicotiana
Tabacum, a member of
the Nightshade family
Nicotine is the addictive
substance in tobacco
smoke
It is CNS stimulant drug

39. EFFECTS ON BODY

41. Psychologically
• Nicotine, the primary alkaloid in tobacco products
binds stereo-selectively to nicotinic-cholinergic
receptors on autonomic ganglia, the adrenal
medulla, neuromuscular junctions and in the brain.
Nicotine exerts two effects, a stimulant effect exerted
at the locus ceruleus and a reward effect in the
limbic system. Itranvenous administration of
nicotine causes release of acetylcholine,
norepinephrine, dopamine, serotonine, vasopressin,
beta-endorphin and ACTH. Nicotine is a highly
addictive substance. Nicotine also induces
peripheral vasoconstriction, tachycardia and
elevated blood pressure

42. ADDICTIONOF NICOTINE

43.  Nicotine reaches the brain within 20 seconds and and creates a
dependency so that smokers become addicted
 People who smoke more than 20 cigarettes/day and have their first
cigarette within 30 minutes of waking
indicates high nicotine dependence
 Causes a release of adrenaline from the adrenal glands providing a
‘hit’ or ‘kick’ from each puff of a cigarette
 Dependence develops fairly rapidly
often within 60 days of regular use
 Withdrawal syndrome occurs when blood levels fall sharply
 Severity of dependence depends more on the difficulty the person has
in quitting smoking than on the amount and pattern of smoking
 Chronic disease  it can be progressive, relapsing and fatal

45. STEPS TO OVERCOME ADDICTION
Combination of counseling and
pharmacotherapy is more effective than
either option alone
The more intense the intervention, the
better the outcome of abstinence

46. Pharmacologic Options
Two categories of pharmaceutical options:
Nicotine replacement therapy (NRT)
Non-nicotine replacement therapy
Nicotine Replacement Therapy (NRT):
Nicotine Patch
Nicotine Lozenges
Nicotine Gum
Nicotine Inhalers

47. Non-nicotine Therapy
 Bupropion Hydrochloride (Zyban)
Also marketed as the anti-depressant medication
Wellbutrin
Presumed to alleviate cravings associated with nicotine
withdrawal affecting noradrenaline and dopamine
 Varenicline Tartrate (Champix)
Targets nicotinic acetylcholine receptors to decrease
cravings and withdrawal
 Clonidine & Nortriptyline
Second-line medications used in smoking cessation
All of these medications require a prescription
Non-
prescripti
on 
available
over-the-
counter

48. WITHDRAWL SYMPTOMS
 Irritability
 Anxiety
 Headache
 Restlessness
 Coughing
 Nausea
 Insomnia
 Dizziness
 Depression
 Difficulty concentrating
 Physical and psychological dependency

49. Interesting facts
 Alzheimer's Disease
The first neurons lost to Alzheimers are
cholinergic neurons
Patients showed increased capacity for learning
verbal material when exposed to nicotine
 Symptoms reduced in
ADHD
Tourette's Syndrome
Nicotine patches that slowly deliver nicotine
were used
 Glutamate
Increases learning and memory
Enhances connections between sets of neurons

50. Nicotine is also suspected as the reason for
the lower incidence of Parkinson's Disease
among smokers. And for those who have it,
nicotine appears to reduce the associated
symptoms
Evidence shows that around 50% of those
who start smoking in the adolescent years
continue to smoke for 15 to 20 years.

51. Research on nicotine
• Probably 2nd most commonly used drug
in US
• Cigarette smoking accounts for 90% of
lung cancer cases in the U.S., and about
38,000 deaths per year can be attributed
to secondhand smoke
• Most cigarettes in the U.S. market today
contain 10 milligrams (mg) or more of
nicotine

52. In 1989, the Surgeon General issued a report
that cigarettes and other forms of tobacco,
which contain nicotine (such as cigars, pipe
tobacco and chewing tobacco) are addictive.
The report also determined that smoking was a
major cause of stroke as well as the third
leading cause of death in the U.S
Approximately three quarters (74.1%) of
female university students in Egypt reported
preferring smoking tobacco via a water pipe to
smoking cigarettes because they believed it to
be less harmful

53. Drug abuses
• A maladapted pattern of use of a substance
• Excessive use from a harmful drug ( over use)
• Psychoactive drugs or performance
enhancing drugs for a non therapeutic or non
medical effect

54. Drug misuses
• A term used commonly for prescription
medications with clinical efficacy but abuse
potential & known adverse effects linked to
improper use such as psychiatric medications
with sedative, anxiolytic, analgesic or stimulant
properties
• Usage of drug to treat symptoms that it is either
not prescribed for or not effective against

55. Effect of nicotine in cigarette smoke

56. Misuses of nicotine
• Nicotine can be a stimulant or it can be a depressant
depending entirely upon the mood of the user. Normally
nicotine is absorbed by the lungs when cigarette or cigar
smoke is inhaled but it can also be absorbed through most
all of the membranes of the body.
• Then in 1964 the Surgeon General issued a report telling us
that cigarette smoking and (presumably) cigar smoking was
linked to lung cancer. That's when the anti-smoking
campaign began in earnest.

57. Abuses of nicotine
• Nicotine is rapidly absorbed in the
bloodstream
• It immediately stimulates the adrenal glands
to release the hormone epinephrine
(adrenaline). Epinephrine stimulates the
central nervous system and increases blood
pressure, respiration, and heart rate.

58. • For many tobacco users, long-term brain
changes induced by continued nicotine exposure
result in addiction—a condition of compulsive
drug seeking and use, even in the face of
negative consequences.
• When an addicted user tries to quit, he or she
experiences withdrawal symptoms including:
• Irritability
• Attention difficulties
• Sleep disturbances
• Increased appetite
• Powerful cravings for tobacco

59. Side effects due to misuse & abuse of nicotine

60. Other effects
• Increased risk of cancer
• Stroke
• Heart attack
• Chronic bronchitis and emphysema
• Vascular disease
• Leukemia
• Miscarriage ( in pregnancy)

62. • Hallucinogens are substances that alter
sensory processing in the brain,
causing perceptual disturbances,
changes in thought processing, and
depersonalization

63. • Hallucinogens are a type of drug that changes
a person’s perception of reality. Also known as
‘psychedelic drugs’, hallucinogens make a
person see, feel and hear things that aren’t
real, or distort their interpretation of what’s
going on around them. Some are quick acting,
others take longer to take effect. Being under
the influence of a hallucinogen is commonly
called ‘tripping’.

64. • Some hallucinogens are synthetically
manufactured, like LSD (lysergic acid
diethylamide), PCP (phencyclidine, or ‘angel
dust’) and ketamine. Others are naturally
occurring compounds found in particular
plants. For instance, the peyote cactus
produces the hallucinogen mescaline, while
psilocybin is found in certain mushrooms,
known as ‘magic mushrooms’.

65. It is also called as
• Psychedelics: substances that expand or heighten
perception and consciousness.
• Psychotomimetic:substances that mimic
psychosis.
• Psychotogenic: substances that produce
psychosis.

66. Hallucinogens come in a number of different forms. For example:
• LSD is a powerful drug – typically, small squares of blotting paper or gelatine are
soaked in LSD, which are then swallowed, although it may also come in tablets or
capsules.
• PCP usually comes in the form of pills, capsules or powders of various colours. It
is usually swallowed, sniffed or injected, but is sometimes smoked.
• Ketamine can be made into tablets or pills, or dissolved in liquid. It is usually
swallowed, snorted or injected.
• Magic mushrooms can be cooked, boiled into a drink or eaten raw.
• Mescaline can appear as a white powder while dried, ground peyote buttons are
usually found as capsules. It is usually swallowed, but can be chewed or smoked.
• Some depressant and stimulant drugs also have a hallucinogenic effect in high
doses, including cannabis and ecstasy. Since a person’s sense of distance, time
and objective reality are warped when under the influence of hallucinogens,
serious injury and accidental death are real risks.

67. • Synthetichallucinogens
In recent years, a wide range of synthetic products,
claiming to have similar effects to hallucinogens,
have also been available in Australia. The active
ingredient in these products can potentially be a
number of chemicals, such as 2C-B or NBOMe, but
it is difficult to know what exactly they contain, and
as a result, they can have more unpredictable
effects and are potentially more harmful than
hallucinogens.

68. Hallucinogens target specific centres of the
brain to alter the interpretations of sensory
input. For instance, a person might be looking
at a blank wall, but their hallucinating brain will
interpret the blank wall as moving and swirling,
or perhaps covered in insects.

69. The effects of hallucinogens depend on the type of drug, the strength of the
dose, the physiology of the person taking them and their state of mind.
Generally, some of the common effects of hallucinogens include:
• hallucinations of sight, sound, taste and touch
• a blurring of the senses, such as sounds being ‘felt’ or colours being
‘heard’
• feeling detached from the body
• distortions of time, direction and distance
• relaxation
• accelerated heart rate
• dilated pupils
• nausea and loss of appetite

70. • Short-Term Effects Hallucinogens affect all of senses, but in
particular vision and hearing. You may see and hear things
differently than they are (for example, colours may seem brighter
and richer, and sounds sharper), and you may even have visions of
things that aren’t there at all (hallucinations). You might experience
synesthesia, which means you believe you can “hear colours,” or
“see sounds.”
• These drugs also alter your sense of time and space.
• Hallucinogens may also give you a feeling of relaxed well-being,
happiness, love for those around you, and may make you feel as
though you have great insight into the world, your life, and yourself
• Some people experience the hallucination of spiders or insects
crawling all over their skin, and others have described their altered
perceptions as feeling they were “going crazy.”

71. • The effects of hallucinogens are very unpredictable, and can vary
each time you take a hallucinogen, so you never know what kind of
experience you’ll have.
• The effects depend on how much of a drug you take, your size and
weight, whether you’re mixing a hallucinogen with other drugs or
alcohol, as well as your state of mind and your expectations of the
experience.
• It’s also possible to experience a “bad trip,” in which the entire time
you’re high, you feel an intense sense of panic and fear. After a bad
trip, the anxiety and paranoia can stay with you for days, weeks,
and even months.
• Hallucinogens may also give you a loss of appetite, a loss of
coordination, paranoia, confusion, anxiety, chills, numbness, and
muscle weakness.

72. • FACT SHEET Hallucinogens 2006 2 2 Hallucinogens can also make you
feel like you’re observing yourself from a distance. This means that
when you take a hallucinogen, you’re less able to make conscious and
informed decisions about any risky activity, including sex. Because
LSD is illegally prepared in labs, it’s impossible to know what you’re
really taking, and how much. This makes your experience that much
harder to predict.
• Psilocybin also comes with risks—many mushrooms are poisonous,
and can be deadly. It’s illegal to possess or sell LSD or psilocybin in
Canada. Punishment can come in the form of a minimum $1000 fine,
and/or a prison sentence.

73. • Long-Term Effects Regular LSD use may give you flashbacks, which can cause
you problems years later.
• A flashback is when, days, weeks, or even years later, you re-experience the
effects of LSD, usually for one or two minutes. You may hallucinate again, or
may have your vision and thought processes temporarily altered.
• Flashbacks are often triggered by stress, fatigue, or other drug use. It is
believed that LSD can do long-term damage to your memory and ability to
concentrate. Addiction LSD and psilocybin are not physically addictive, and
come with no physical withdrawal symptoms. However, it is possible to
become psychologically dependent on either of these drugs—you may feel the
urge always use hallucinogens in certain situations, which may mean you
become compulsive and obsessed with taking the drug, placing it above other
things in your life that are important to you.

74. Technically, you don’t develop a tolerance to hallucinogens, meaning that you
would need to take more and more of the drug to continue feeling the effects.
Rather, if you take LSD or psilocybin a few days in a row, the drug stops having
any effect whatsoever. But when you stop using the drug for a week or so, your
resistance to the drug subsides, and you will feel the full effects of the drug the
next time you take it. Reducing the Risks
 If someone is experiencing a “bad trip,” don’t leave them alone. Make sure
they are safe and comfortable, and that they’re not able to hurt themselves.
 It is very dangerous to drive after taking a hallucinogen.
 Don’t inject LSD. Any needle use greatly increases the chance of acquiring
HIV or other diseases. Bet You Didn’t Know Over the last hundred years or
so, some psychologists and therapists have believed hallucinogens to be a
possible treatment for psychiatric disorders. However, no study has shown
that there is a medical use for these drugs. In fact, it’s quite the opposite:
regular use of LSD has been linked to chronic depression

75.  Psilocybin has been known to cause severe stomach pain, and
sometimes nausea and vomiting.
 In high doses, LSD can cause seizures.
 It’s very dangerous to take hallucinogens when taking other drugs,
including alcohol. Combining them with another drug makes it that
much harder to know what kind of physical and psychological
effects your body and mind will experience.
 There are no reported deaths from the direct effects of LSD or
psilocybin.
 However, the total lack of perception of the world around you can
lead to very risky behaviour.
 Many fatalities have been reported of people who were high on LSD
and had an accident. People who take LSD sometimes become
suicidal. Because your sense of sight and your perception are so
impaired, it’s very dangerous to drive after using a hallucinogen.

76. Signs of Hallucinogen Use, Addiction and
Dependence
• People intoxicated by hallucinogens show many different signs of
being high. When someone is under the influence of
hallucinogens, they are considered to be on a “trip” and have a
“psychedelic experience” such as seeing people as warped, feeling
disconnected or detached from their body, sights and sounds
being distorted, and moving shapes. This “trip” can be a bad or
good experience depending on various factors. Some of these
factors are:
• State of mind
• Previous experiences
• Anxiety
• Mood
• Physical environment
• Dose strength

77. • The user can display several of the following signs of a hallucinogenic
state:
• Dilated pupils
• Rapid eye movement
• Anxiety
• Increase or loss of appetite
• Feelings of being invulnerable
• Euphoria
• Increased heart rate
• Distorted perceptions
• Depression
• Weight loss
• Changes in personality
• Speech difficulty

78. • According to the Institute for Substance Abuse Treatment Evaluation,
hallucinogens work by stimulating neurotransmitter production in the
brain. Neurotransmitter chemicals, such as glutamate, serotonin,
norepinephrine and dopamine act as chemical messengers, enabling the
various regions of the brain to communicate with one another.
Neurotransmitter chemicals also regulate central nervous system
functions.
• With regular drug use, hallucinogen effects disrupt the brain’s natural
chemical balance, which in turn impairs its ability to regulate bodily
functions in a normal fashion. Once brain chemical imbalances reach a
certain point, physical hallucinogen withdrawal symptoms develop.
• In addition to triggering neurotransmitter secretions, hallucinogens also
cause damage to the brain cells that secrete these chemicals. This damage
weakens the cells’ ability to produce neurotransmitter supplies. When this
happens, a person has to keep taking larger doses of hallucinogens in
order to experience the desired drug effects.

79.  Physical hallucinogen withdrawal symptoms to watch
out for include –
 Stiff muscles
 Seizure episodes
 Extreme changes in body temperature
 Rapid heart rates
 Tremors
 Over time, the brain’s tolerance for hallucinogens
continues to increase. As tolerance levels rise,
physical withdrawal symptoms happen on a more
frequent basis and also increase in intensity

80. • Hallucinogen withdrawal symptoms not only affect the
body’s ability to function, but also the mind. Behavior-
based withdrawal symptoms develop once the drug’s
effects start to impair the brain’s cognitive and emotion-
based functions, according to .
• The hallucinations brought on by hallucinogens originate
from the cognitive and emotion-based regions of the
brain. The neurotransmitter chemical surges that bring on
these effects can leave behind some pretty distressing
aftereffects once a person stops using these drugs.

81.  Behavior-based withdrawal symptoms most often experienced include –
 Panic attacks
 Psychotic-like behavior displays
 Violent tendencies
 Extreme and frequent mood swings
 Speech difficulties
 During the withdrawal period, it’s difficult to function normally in everyday
life so be prepared to take time off from work until withdrawal runs its
course. In cases of chronic hallucinogen use, these symptoms can persist for
months and even years after stopping drug use, so it may be a good idea to
seek out professional treatment help rather than trying to go it alone.
 Ultimately, hallucinogen withdrawal symptoms worsen in severity the longer
a person has engaged in drug use. Frequency of use and dosage amounts
normally ingested also influence how intense your withdrawal period will be.

83. lsd
COMMON NAMES:
• Acid, Battery Acid, Pane, Brown Bombers,
Coffee, Crystal Tea, Dots, Golden Dragon,
Haze, Looney Toons, Microdot, Lucy, Paper
Acid, Pearly Gates, Pink Panther, Rainbow,
Superman, White Lightening, Window Glass,
Yin Yang, Zen, Yellow Sunshine, Sugar Cubes,
& others.

84. Derived from ergot alkaloids of the rye
fungus.
Colorless, odorless, bitter taste.
Most potent mood & perception altering
drug known to man. (can cause effects at 25
μg = in weight to a few grains of salt).
Can be synthesized in 1 week
Was used to treat alcoholism, paranoia,
schizophrenia, and autism.

85. pharmacokinetics
 Administered orally, smoked, snorted, or injected.
 Doses 25-300 μg. (lethal dose = 14,000 μg)
 Microdots: tablet form, Window panes: LSD in gelatin, Blotter
acid: liquid added to paper, Sugar cubes: LSD in sugar cubes.
 Absorbed within 1 hour.
 Effects last 6-12 hours.
 Diffuses across all barriers in body
 Metabolized in liver and excreted in urine
 No physical/physiological dependence
 Few if any withdrawal symptoms
 Tolerance and cross-tolerance to other hallucinogens does occur.
(is lost within days after cessation of use).

86. pharmacodynamic
Binds to 5-HT2 serotonin receptors
Effects due to disruption of raphe nuclei
(pons/medulla), which filters incoming
sensory stimuli, creating surge of sensory
information and overload of brain circuits.
Effects cerebral cortex (involved in mood,
cognition, and perception) & locus ceruleus
(receives sensory info)
LSD in high concentrations in iris of eye.

87. effects
Dilation of pupils, dizziness, dreamy detached
feelings, changes in time perception,
color/smells/sounds intensified, increase heart
rate & blood pressure, sweating, dry mouth,
hallucinations.
At High doses causes nausea, tremors, &
confusion.
Moods typically depends on mood prior to use,
causing those to become intensified.
However, moods can change quickly from
euphoria to terror and panic.

89. Long term effects
1. Psychosis = dramatic mood swings
2. HPPD (Hallucinogen Persisting Perception
Disorder) = also called Flashbacks. Former
users experience
spontaneous/repeated/continuous sensory
distortions (seeing false motions or trails,
etc.)

90. 2 Types of Emotional Responses to LSD:
 Ecstatic-Transcendental Reactions: users become
talkative, euphoric, ideas seem to have great
importance.
 Panic & Psychotic-like Reactions: users experience
intense anxiety & fear, lose control of thoughts &
emotions, become paniced.
Known as a Bad Trip
 Can result in accidents or accidental suicides due to
individual attempting to flee panic and terror they are
experiencing.

91. Lsd drug forms

93. DMT
• Short-acting serotonin agonist (30 min)
= Called “businessman’s lunch break drug”
• Produces LSD-like effects
• snorted or smoked
• Can’t be taken orally, because acid in stomach destroys drug
before absorption can occur.
• Metabolized by MAO (monoamine oxidase)
• Found in Leguminous trees & shrubs in West Indies
and South America
• Dose 60-150 mg

94. • Dimethyltryptamine (DMT)
• - A short-acting hallucinogen
• - It is inhaled and similar action as psilocybin.
• - High doses can be quite intoxicating.
• - Can also cause unpleasant reactions/.

95. legality
• it is illegal to have DMT or other plants that
contain DMT, such as the chacruna plant
• DMT has a high potential for abuse and there
is no medical use of DMT in treatments in the
U.S
• DMT lacks the accepted safety requirements
for use under medical supervision.

96. pharmacodynamics
• Anatomical:
• Resembles LSD, but mimics sympathetic reflex symptoms
like dilated pupils, heightened blood pressure, and
increased pulse rate are more common and more intense.
• Action in the brain:
• DMT much like LSD has it’s effect on the serotonergic
system. Binding the 5HT2a & 5HT2c receptor cites.
• Endogenous Neurochemical:
• DMT is one the only endogenous psychedelic known,
meaning is produced within the body. While it’s role in the
brain is unknown , it has been speculated that DMT is
released by the pineal gland.

97. Effects of dmt
* Intense visuals
* Altered concept of time
* Stomach discomfort
* Overwhelming fear
* Lung irritation
* Increased heart rate
* Increased body temperature

98. Dangers of DMT
Using DMT can be a serious health risk that
results in death. Users can go into a state of
unconsciousness or a drug induced coma.
Often, unconscious users will begin to vomit
resulting in choking and death.

102. PCP (Phencyclidine)
Common names:
Angel Dust, Peace Pill, Hog, Lovely, Wack,
Ozone, Dust, Embalming Fluid, Rocket Fuel;
Supergrass and Killer Joints are names that
refer to PCP combined with marijuana.

103. State:
PCP is a white crystalline powder that readily dissolves
in water or alcohol and has a distinctive bitter chemical
taste.
Available forms:
It is available in a variety of tablets, capsules, and
colored powders, which are either taken orally or by
insufflation ("snorted"). The liquid form of PCP is
actually PCP base dissolved most often in ether, a
highly flammable solvent. For smoking, PCP is typically
sprayed onto leafy material such as mint, parsley,
oregano, or marijuana. PCP may also be injected.

104.  A moderate amount of PCP often causes users to feel detached, distant, and
estranged from their surroundings. Numbness of the extremities, slurred speech,
and loss of coordination may be accompanied by a sense of strength and
invulnerability. A blank stare, rapid and involuntary eye movements, and an
exaggerated gait are among the more observable effects. Auditory hallucinations,
image distortion, severe mood disorders, and amnesia may also occur. In some
users, PCP may cause acute anxiety and a feeling of impending doom; in others,
paranoia and violent hostility, and in some, it may produce a psychoses
indistinguishable from schizophrenia. Many believe PCP to be one of the most
dangerous drugs of abuse.
 Physiological effects of PCP include a slight increase in breathing rate and a more
pronounced rise in blood pressure and pulse rate. Respiration becomes shallow,
and flushing and profuse sweating.
 At high doses of PCP, there is a drop in blood pressure, pulse rate, and respiration.
This may be accompanied by nausea, vomiting, blurred vision, flicking up and
down of the eyes, drooling, loss of balance, and dizziness. High doses of PCP can
also cause seizures, coma, and death (though death more often results from
accidental injury or suicide during PCP intoxication). Psychological effects at high
doses include illusions and hallucinations.
Effects of PCP Use:

105. Pharmacological effect:

106. Statistics and Trends

107. PCP Health Hazards:
PCP is addictive and its use often leads to psychological
dependence, craving, and compulsive PCP-seeking behavior.
Users of PCP report memory loss, difficulties with speech and
learning, depression, and weight loss. These symptoms can
persist up to a year after cessation of PCP use. PCP has
sedative effects, and interactions with other central nervous
system depressants, such as alcohol and benzodiazepines, can
lead to coma or accidental overdose. Use of PCP among
adolescents may interfere with hormones related to normal
growth and development. Many PCP users are brought to
emergency rooms because of PCP's unpleasant psychological
effects or because of overdoses. In a hospital or detention
setting, they often become violent or suicidal, and are very
dangerous to themselves and to others. They should be kept
in a calm setting and should not be left alone.

110. psilocybin
Psilocybin is the psychoactive component of
mushrooms
Classified in the tryptamine family because of
the indole ring
Other tryptamines; DMT, Melatonin,
Serotonin, tryptophan and LSD-25

111.  Psilocybin is converted to the psychoactive
metabolite Psilocin.
Psilocin is a partial agonist at the 5-HT2A
serotonin receptor in the brain
Psilocin is also an agonist 5-HT1A and 5-HT2C
receptors

112.  Duration (orally ingested)
Total duration: ~4-7hrs
Onset: 15-60min
Plateu: 2nd to 4th hours
 After effects:
Headache
In general, no physiological hangover/ day after effects

113. Sensory effects
• Visual Hallucinations (VUS subscale)
– Visionary restructuralization
• Illusions/ hallucinations
• synaesthetic phenomena
• Enhancement of percepts
– Contour distortion
– Increased sensitivity to light
– Closed eye visuals
• Auditory hallucinations
• Alterations in perception of time and space
• Sensation of buzzing in the peripheral limbs
• Recollective/ analytical stage
• Attribution of salience to random objects/ events

114. Psilocybin-induced psychosis provides
clues as to the physiological
mechanisms of Schizophrenia
• “Psilocybin induces schizophrenia-like psychosis in humans via
a serotonin-2 agonist action” Vollenweider et al. 1998
– Administered psilocybin to three groups who were pre-treated with
5-HT2 antagonist ketanserin, 5-HT/ D2 antagonist risperidone, or D2
antagonist haloperidol
Results:
– Pre-treatment with either ketanserin or risperidone dose-dependently blocked
psilocybin-induced psychosis on APZ-OAV scale
– Pre-treatment with haloperidol only reduced the effect of psilocybin on the
OSE subscale, no influence on psilocybin-induced visual hallucinations
• Haloperidol uniformly increased the AIA scores in all of the subjects treated with
psilocybin
– Also found that Psilocybin increased the RT on memory-guided delayed
response task during peak effects of drug (evidence of impairment of working
memory)

116. Effect on brain

117. Treatment of
hallocinogens

118. Hallucinogen Addiction Treatment
• Doctors usually base the diagnosis on
symptoms. Tests are not available to confirm the
use of many of these drugs.
• Most users do not seek treatment. A quiet, dark
room and calm, nonthreatening talk can help
users who are having a bad trip. They need
reassurance that the effects are caused by the
drug and will end. If anxiety is severe,
benzodiazepines (sedatives), such as lorazepam,
may help. People who experience a prolonged
psychosis may need mental health treatment.

119. overview