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Hallucinogens

Hallucinogens

• Hallucinogens aresubstances that altersensory processing in thebrain, causing perceptualdisturbances, changes inthought processing, anddepersonalization

Hallucinogens

Organic and synthetic agents that inducevisual, auditory, and tactile hallucinations.

Disrupt cognition and perception. Use has decreased with the onset of the

cocaine/crack epidemic. Taken orally, in the form of pills, tablets,

capsules, or blotter papers. The intoxication is a typical example of an

acute psychotic state.

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LSD class drugs

LSD, mescaline, Psilocybin, DMT, bufotenine Primarily act on Serotonin receptors Frontal cortex and limbic system Also act on raphe nucleus which

functions to filter incoming sensory stimuli Disrupts the sorting process Flood of sensations and perceptions

LSD Physical Effects

Physiological effects:– Massive increase in neural

activity in some brainregions

– Activates sympatheticnervous system (rise inbody temperature, heartrate, and blood pressure)

– Parasympathetic nervoussystem (increase insalivation and nausea)

Psilocybin Psilocybin—its principal source is the Psilocybe

mexicana mushroom. It is not very common on the street. Hallucinogenic effects produced are quite similar

to LSD. Cross-tolerance among psilocybin, LSD,

mescaline. Stimulates the autonomic nervous system, dilates

the pupils, increases the body temperature

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Psilocybin Mushrooms Small brown mushrooms that

stain blue to the touch Illicit cultivation but also searched

from countries with temperateclimates

Continues use in religious rituals

Amphetamine Hallucinogens

Drugs are chemically related to amphetamines. They have varying degrees of hallucinogenic

and CNS stimulant effects. Released serotonin explains their hallucinogenic

action Released dopamine explains their stimulant

effects

Amphetamine ClassHallucinogenes

Mescaline Synthetic amphetamine derivatives

(DOM, MDA, MDMA) Act on dopamine and serotonin

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Amphetamine Hallucinogens

Mescaline “Designer” amphetamines 3,4 Methylenedioxyamphetamine (MDA) Methylenedioxymethamphetamine (MDMA,

Ecstasy)

Mescaline Mescaline is the most active drug in

peyote cactus; it induces intensifiedperception of colors and euphoria

Effects include dilation of the pupils,increase in body temperature,anxiety, visual hallucinations, andalteration of body image, vomiting,muscular relaxation.

Very high doses may cause death. Street samples are rarely authentic.

Peyote

Lophophoria williamsii contains1.5% mescaline (b-3,4,5-trimethoxyphenethylamine)

3mg/kg potent intoxication Up to 8 to 10 hour duration Continued religious use in

North America Other cacti used in South

America

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The Peyote Ceremony

Stewart OC. Peyote Religion. Norman, OK: Universityof Oklahoma Press, 1987.

Aberle DF. The Peyote Religion Among the Navaho.Chicago, IL: Aldine Publishing Co., 1966.

• PCP (phencyclidine)• Ketamine• Dextromethorphan

Dissociative Drugs

Phencyclidine (PCP) It was developed as an intravenous anesthetic,

but found to have serious adverse side effects. It differs from the other traditional hallucinogens. It is a general anesthetic in high doses. It causes incredible strength and extreme violent

behavior. Fat solvable, can store in organs for a long time Management of the severe psychological

reactions requires drug therapy.

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PCP physiological effects

Hallucinogenic effects, stimulation,depression, anesthesia, analgesia

Large doses can cause coma, convulsions,and death.

PCP psychological effects:– Feelings of strength, power, invulnerability;– perceptual distortions, paranoia, violence,– Potential for psychotic break.

Ketamine (“Special K”)• Anesthetic developed to replace PCP,

manufactured by Pfizer

• Used in human and veterinary medicine

• Injected or dried and snorted

• Feelings of floating, or sometimes terrifying “badtrip” called “K hole”

• “Vitamin K”

• “K”

• “Bump”

DXM (dextromethorphan)• Cough suppressant• Also used to boost effects of analgesics

for severe pain)• Typical dose 15-30 mg. for cough• 4 or more ounces may cause distorted visual

perceptions, similar effects to PCP and Ketamine• Internet groups to discuss “Robo-ing”

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Inhalants

Inhalant use refers to the intentional breathing of gas orvapors with the purpose of reaching a high.

Inhalants are legal, everyday products which have auseful purpose, but can be misused - paint, glue andothers.

There are more than 1,000 products that are verydangerous when inhaled (typewriter correction fluid, air-conditioning refrigerant, felt tip markers, spray paint, airfreshener, butane and even cooking spray).

What is inhalant use?

Categories of Inhalants Volatile solvents – Include items such as nail polish

remover, lighter fluids, paint thinner, cleaningproducts, correction fluid, felt-tip markers andgasoline.

Aerosols –hair spray, spray paint, computer dusterand anything that comes from an aerosol can.

Gases – Include helium, nitrous oxide (laughing gas),freon, ether, butane and chloroform.

Nitrites –The nitrites are sealed in capsules and are"popped" to release the vapors and are referred to as"poppers" in street lingo.

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Signs include the following:

paint or stains on body or clothing spots or sores around the mouth red or runny eyes or nose chemical breath odor drunk, dazed or dizzy appearance nausea, loss of appetite anxiety, excitability, irritability

Nearly all used products produce effects similar toanesthetics, which slow down the body's function.

The user can experience slight stimulation, feelingof less inhibition or loss of consciousness.

The user can also suffer from Sudden SniffingDeath Syndrome. The user can die the 1st, 10th or100th time he or she uses an inhalant.

Sudden Sniffing Death Syndrome

BRAIN: Many inhalants dissolve the protectivemyelin sheath that surrounds neurons - brain cells- resulting in cell death.

CEREBRAL CORTEX: Cellular death causespermanent personality changes, memoryimpairment, hallucinations and learning disabilities.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

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CEREBELLUM: This is the center that controlsbalance and coordination. Inhalant-related damageresults in loss of coordination and slurred speech.Chronic abusers experience tremors anduncontrollable shaking.

OPHTHALMIC NERVE: Toluene may affect thisnerve causing sight disorders.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

BLOOD: Some substances like paint thinnerchemically block the oxygen carrying capacity ofthe blood.

LUNGS: Repeated use of spray paint as aninhalant can cause lung damage.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

HEART: "sudden sniffing death syndrome“ - asudden disturbance of the heart's rhythm. Allinhalants can produce sudden sniffing deathsyndrome.

LIVER: a component of aerosol paints andcorrection fluid have been linked to damage ofthis organ.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

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KIDNEY: Toluene impair the kidney's ability to controlthe amount of acid in the blood. This is reversiblewhen toluene leaves the body but, in the long-term,kidney stones may develop

MUSCLE: Muscle wasting, reduced muscle tone andstrength.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

PERIPHERAL NERVOUS SYSTEM: Inhalation ofnitrous oxide (whipped cream propellant) andhexane (glues and camp stove fuels) results indamage to the peripheral nerves. Symptoms caninclude numbness, a tingling sensation or totalparalysis.

ACOUSTIC NERVE AND MUSCLE: Tolueneinhalation destroys cells that relay sound to thebrain. Chronic users can become deaf.

DAMAGE INHALANTS CANDO TO THE BODY & BRAIN

Can inhalant use be treated?

Treatment facilities for inhalant users arerare and difficult to find. Users suffer a highrate of relapse, and require thirty to fortydays or more of detoxification.

Users suffer withdrawal symptoms whichcan include hallucinations, nausea,excessive sweating, hand tremors, musclecramps, headaches, chills and deliriumtremens.

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Steroids

Chemicals that are similar to the male sexhormone testosterone

Used by an increasing number of youngpeople to enhance their muscle size

Trigger dependence in users, particularlywhen taken in the large doses that havebeen known to be used by manybodybuilders and athletes

What are Steroids?

Androgenic Anabolic Steroids Synthetically produced testosterone

The Major Issues

Steroids have adverse side effects Steroids have severe health risks Steroid use by elite athletes influences the

children who look up to them as hero’s.

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Why do people abusesteroids?

To improve physicalperformance

To gain a competitiveedge

To become stronger To improve self-esteem To lose weight, burn fat

and increase muscle

Dangers of Steroid UseDangers for Men:

Even though anabolic steroids are derived from amale sex hormone, men who take them may actuallyexperience a "feminization" effect along with adecrease in normal male sexual function. Somepossible effects include:

Reduced sperm count Impotence Development of breasts Shrinking of the testicles Difficulty or pain while urinating Erectile dysfunction

Steroid Use

High correlation with aggressivebehavior and violence

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New Synthetic Drugs

“Designer” Psychoactive Substances

SOURCE: http://www.drugs-forum.com, updated 2013.

“Designer” Psychoactive SubstancesTwo classes:

Stimulants: mephedrone, MPDV, piperazines,“bath salts”

Psychedelics: 2C-B, mescaline, DMT, etc. Differences in users:

Stimulant users similar to other ecstasy users;(shifting to mephedrone and MPDV due toshortage of Ecstasy?)

Psychedelic users started ecstasy use earlier;were more frequent users; used multiplesubstances; had more legal, mental health,and social problems.

SOURCE: Bruno et al. (2012). Drug and Alcohol Dependence, 124(1-2), 19-25.

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Examples of Major Synthetic PsychedelicsDRUG NAME DESCRIPTION

2C-I Phenethylamine, via PiHKAL; stimulant andhallucinogenSlow onset (1 hr); long duration of action (8-10 hr.)

2C-B Phenethylamine, via PiHKAL; visualsFaster onset; shorter duration than 2C-I

5-MeO-DMT Tryptamine; naturally occurring (toad,shamantic brews)Smoked: almost immediate, very intense,short effect (<30 min)

DMT Tryptamine; naturally occurringSmoked: almost immediate, very intense,short effect (<20 min)

SOURCE: Slide courtesy of R. Bruno et al., 2011, with revisions by James Hall, 2012. 40

Examples of Major Synthetic Stimulants

DRUG NAME DESCRIPTIONMephedrone 4-methyl-methcathinone; “Miaow”

Similar to cocaine and MDMA (ecstasy)Methylone β-MDMA: 3,4-methylenedioxy-

methcathinone; “Explosion”Similar to cocaine and MDMA (ecstasy)

MDPV 3,4-methylenedioxyprovalerone; MDPV;“NRG-1” (Brandt, 2010); “Ivory Wave”Stimulant with rapid onset; 2-4 hour durationof action

BZP 1-benzyl-piperazoneSimilar to amphetamine1/10 potency of d-methamphetamine

SOURCE: Slide courtesy of R. Bruno et al., 2011, with revisions by James Hall, 2012.

From the term “Bath Salts” to…

SyntheticCathinones

Mephedrone,methylone, 4-MEC

Stimulants relatedtomethcathinone,MDMA,amphetamines

2C-Phenethylamines

Psychedelicsrelated tomescaline

Some werecreated in thepast to imitateMDMA

Tryptamines

5-MeO-DMT & 4-AcO-DMT

Psychedelicsrelated to psilocin& bufotenin

Piperazines

BZP & TFMPP

Stimulants

And Dissociatives related to ketamine and PCP and Opioidsrelated to morphine, fentanyl, and heroin.

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SyntheticDrugs

Not really “Spice,” “Bath Salts,”“Incense,” or “Plant Food”

Chemically-based; not plant derived Complex chemistry Constantly changing to “stay legal” Need to prove “intended to use” to

convict in some areas

Synthetic CannabinoidsSpice vs. “Spice”

Synthetic CathinonesBath Salts vs. “Bath Salts”

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Synthetic Cannabinoids Wide variety of herbal mixtures Marketed as “safe” alternatives to marijuana Brand names include: “Spice,” “K2,” fake weed,

“Yucatan Fire,” “Skunk,” “Moon Rocks,” herbalincense, “Crazy Clown,” “Herbal Madness”

Labeled “not for human consumption” Contain dried, shredded plant material

(inert) and chemical additivesthat are responsible for their psychoactiveeffects.

SOURCE: NIDA. (2012). NIDA DrugFacts: Spice (Synthetic Marijuana).

Synthetic Cannabinoids• Mainly abused by smoking (alone or with

marijuana); may also be prepared as anherbal infusion for drinking.

• Many of the active chemicals most frequentlyfound in synthetic cannabis products havebeen classified as Schedule Icontrolled substances,making them illegal to buy,sell, or possess.

• Multiple “generations” of drugs.

SOURCE: NIDA. (2012). NIDA DrugFacts: Spice (Synthetic Marijuana).

• JWH-018/073 arrived early and have come and gone.• JWH-250 arrived a little later and has also cycled out.• JWH-081 was part of a second wave that has already completed its

cycle.• JWH-122 was part of the same wave but has persisted in popularity

and is part of the current scene.• AM-2201 was part of the same second wave and has gained in

popularity, probably currently the most prevalent.• JWH-022 and JWH-210 are showing signs of increasing popularity.• Recent emergent drugs are the adamantoyl (AM-1248) and

tetramethylcyclopropyl (XLR-11 and UR-144) indoles which areahead of the latest attempts to schedule these drug classes.

SOURCE: Logan, B.K. (2012). Testing Strategies to Monitor Novel/Emerging/Designer Drug Use in At-Risk Populations,Presented at 74th Annual CPDD.

The Emergence ofSynthetic Cannabinoids

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Timeline of SyntheticCannabinoid Products

SOURCE: Fattore & Fratta. (2011). Frontiers in Behavioral Neuroscience, 5(60), 1-12.

Factors Associated withSynthetic Cannabinoid Popularity

• They induce psychoactive effects• They are readily available in retail

stores and online• The packaging is highly attractive• They are perceived as safe drugs• They are not easily detectable in urine

and blood samples

SOURCE: Fattore & Fratta. (2011). Frontiers in Behavioral Neuroscience, 5(60), 1-12. 50

Synthetic Cannabinoid Use Leads toDangerous Symptoms in Pregnant Women

Leads to symptoms similar to thosecaused by dangerous conditions known aspreeclampsia and eclampsia– Preeclampsia is marked by high blood

pressure and a high level of protein in theurine

– Preeclampsia can lead to eclampsia, whichcan cause a pregnant woman to developseizures or coma, and in rare cases is fatal

SOURCE: Join Together Online, May 8, 2013. 51

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Synthetic Cathinones

• Could be MDPV, 4-MMC,mephedrone, or methylone

• Sold on-line with little info oningredients, dosage, etc.

• Advertised as legal highs, legal meth, cocaine, or ecstasy• Taken orally or by inhaling• Serious side effects include tachycardia, hypertension,

confusion or psychosis, nausea, convulsions• Labeled “not for human consumption” to get around

laws prohibiting sales or possession

SOURCE: Wood & Dargan. (2012). Therapeutic Drug Monitoring, 34, 363-367.

Sources and Continuing Availability A number of synthetic marijuana and bath salt

products appear to originate in multiplecountries and are manufactured in the absenceof quality controls and devoid of governmentalregulatory oversight.

The large profits from sales, plus the fact thatthese chemicals can be easily synthesized tostay one step ahead of control, indicate there isno incentive to discontinue retail distributionof synthetic cannabinoid products under thecurrent statutory and regulatory scheme.

“New Zealand’s Designer DrugLaw Draws Global Interest”

The law, enacted in July 2013, representsa U-turn from the traditional approach ofretroactively banning synthetic drugs

New Zealand will attempt to regulatedesigner drugs, allowing their sale if theygo through rigorous safety testing similarto that for pharmaceuticals

54SOURCE: Maxwell, J.C. (In Press). Drug and Alcohol Dependence.