Psychoactive Drugs and Depressants

• Psychoactive drugs are substances, natural or synthetic, that alter the central nervous system, affecting thoughts, emotions, and behaviors.
• Psychoactive drugs impact the central nervous system (CNS), influencing thoughts, emotions, and behaviors, and the autonomic nervous system (ANS), balancing or disrupting core biological functions.
• Examples of psychoactive drugs include depressants, opioids, psychotherapeutic drugs, stimulants, and hallucinogens.

Depressants

• Depressants slow down both the central and peripheral nervous systems, decreasing heart rate, the respiratory system, thought processes, and reaction time, potentially inducing euphoria, relaxation, and pain dulling.
• Alcohol, barbiturates, and benzodiazepines, are culturally acceptable and medically useful depressants.
• Barbiturates are sedatives that relieve anxiety and produce calm, and hypnotics that induce sleep, but disrupt dreams, working on the GABA neurotransmitter.
• Examples of barbiturates: pentobarbital, withdrawal can be very severe, carrying a risk of fatality, and dependence may develop in 2-4 weeks.
• Non-barbiturate sedative-hypnotics were considered safe and non-addictive, but can cause physical dependence, rapid tolerance development, and REM sleep disruption.
• Benzodiazepines are used to reduce anxiety, but can cause physical or psychological dependence within 4 weeks.
• Rohypnol (flunitrazepam), Xanax, and Valium are examples of benzodiazepines; mixing with alcohol is particularly dangerous.
• Short-term effects of benzodiazepines include muscle relaxation, anxiety relief, dizziness, and combating withdrawal from other drugs, mediated by the GABA neurotransmitter.
• Z-drugs, a type of benzodiazepine, treat insomnia with less severe withdrawal and dependency risks, e.g., Ambien.
• Inhalants and solvents are depressants with minor hallucinogenic effects, leading to mood enhancement, exhilaration, and feelings of invincibility.
• Organic inhalants are legally available substances not intended for human consumption, such as gasoline, paint, and cleaning products, disproportionately popular among young individuals.
• Anesthetic inhalants are approved for medical use, but are also used recreationally to produce euphoria, examples include chloroform and nitrous oxide, and can cause permanent brain damage.
• Gamma hydroxybutyrate (GHB) and gamma butyrolactone (GBL) are inhalants, which, when combined with alcohol, can cause memory loss and unconsciousness, used in sexual assaults.
• Long-term effects of inhalant and solvent abuse include physical and psychological dependence, nerve, liver, and kidney damage, neurological damage, tolerance, and withdrawal.
• Antihistamines are used to combat allergic reactions (Sinutab), nausea (Gravel), serve as sleep aids (Benadryl), muscle spasm relief (Valdrene), and stomach acid reduction (Tagamet).
• Short-term effects of alcohol include relaxation, impaired coordination, slowed reflexes and mental processes, altered attitude, and increased risk-taking behavior.

Opioids

• Derived from the opium poppy, opioids depress the CNS depressant, slow the GI tract, and relieve pain, making them medically valuable.
• Opioids are distinguished from other substances by their analgesic effect and potential for intense euphoria.
• Natural opioids, derived directly from the poppy plant, include opium, morphine, and codeine.
• Opium is usually smoked, a raw, milky substance is extracted from unripe poppy seeds.
• Morphine is the primary active ingredient in opium, and approximately 10x stronger.
• Codeine, used for analgesic effects, cough suppression, and as an anti-diarrheal agent, is the most used medically.
• Semi-synthetic opioids combine natural opioids with other chemicals, buprenorphine, heroin, and oxycodone are examples.
• Buprenorphine is used in the treatment of opioid dependence, can also prevent withdrawals.
• Hydromorphone, stronger than morphine, is employed for pain management when other treatments are unsuccessful.
• Heroin is created by adding two additional chemicals to morphine, making it more potent.
• Effects of heroin include feelings of warmth, an orgasmic-like high, and detachment from life.
• Oxycodone is similar to codeine but more potent, used medically for moderate to severe pain management, carries a potential for dependency.
• OxyContin is 16x more potent than Percocet, was once advertised as non-addictive for pain treatment.
• Percocet contains oxycodone and acetaminophen, while Percodan contains oxycodone and aspirin.
• Synthetic opioids, examples include fentanyl and methadone, have no origin in poppy plants, but have similar effects to other opioids.
• Fentanyl is 100x stronger than morphine.
• Methadone does not produce euphoric effects, lasts for 24 hours, is used for maintenance or substitution therapy.
• Carfentanil is 10x more potent than fentanyl, used as a veterinary drug for large animals.
• Naloxone (Narcan) provides no pain relief, but reverses opioid-induced respiratory depression.

Psychotherapeutic Drugs

• Psychotherapeutic drugs alter thought processes, mood, and emotional reactions to the environment, used to diagnose and treat mental health conditions, including antipsychotics, mood stabilizers, and antidepressants.
• Psychosis involves delusions, hallucinations, apathy, anxiety, restlessness, and depression, seen in conditions like schizophrenia.
• Antipsychotics reduce behavioral and physiological responses to stimuli, induce drowsiness, and diminish delusions, but do not cause dependencies.
• Bipolar disorder is characterized by manic depression and mood fluctuations.
• Mood stabilizers includes lithium, carbamazepine, and valproate, which are used to treat mania.
• Lithium reduces the risk of suicide, but can easily accumulate, causing intoxication.
• Valproate is effective for rapid cycling, has unpleasant and dangerous side effects.
• Carbamazepine increases the risk of suicide.
• Depression is a chronic, recurring, and debilitating mental illness.
• Antidepressants elevate mood, lessening feelings of guilt and helplessness.
• Three categories of antidepressants: first-generation typical, second-generation typical, and atypical.
• First-generation typical antidepressants, such as tricyclics, increase the concentration of neurotransmitters.
• Second-generation typical antidepressants block reuptake, leading to prolonged exposure to neurotransmitters.
• Selective serotonin reuptake inhibitors (SSRIs) include Zoloft and Prozac.
• Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) include Effexor and Cymbalta.
• Norepinephrine-dopamine reuptake inhibitors (NDRIs) include Wellbutrin and Zyban.
• Atypical antidepressants change neurotransmitter levels through processes other than blocking reuptake.

Stimulants

• Stimulants increase activity in the central and autonomic nervous systems, inducing euphoria, excitement, and agitation, while enhancing concentration and reducing fatigue.
• Cocaine originates from coca plants, it was used as a stimulant for heavy labor and by indigenous people as an anesthetic.
• Cocaine functions as a dopamine reuptake inhibitor, increasing dopamine in synapses, also acts as a local anesthetic and stimulant.
• Infrequent cocaine use leads to elevated mood, self-confidence, and self-esteem, but frequent use can result in bizarre, erratic behavior, and seizures.
• Amphetamines act similarly to adrenaline, causing raised energy levels, reduced appetite, and feelings of clear-headedness.
• Methamphetamine helps users stay awake and causes a powerful rush and euphoria.
• Crystal meth, a synthesized form of meth that is smoked, releases significant amounts of dopamine, with effects lasting 6-12 hours.
• Methylphenidate, like Ritalin, Concerta, and Adderall, treats ADHD in children and adults by preventing dopamine reuptake.
• Side effects of methylphenidate include delayed physical growth, increased suicidal ideation, and cardiovascular health risks.
• Anorexiants, for weight reduction and clinical obesity, include Tenuate, Ponderal, and Lonamin.
• Decongestants, low dependency amphetamines, constrict blood vessels, relieving congestion.
• Khat leaves contain substances chemically similar to amphetamine, reducing fatigue and hunger, and enhancing concentration.
• Bath salts are a synthetic version of khat, similar to ecstasy, can be injected.
• Betel is a mild stimulant placed between the gum and cheek to increase work capacity, alertness, and suppress hunger.
• Nicotine, found in tobacco, stimulates then reduces brain and nervous system activity.
• Effects of nicotine include reduced muscle tone, loss of appetite, depressed spinal reflexes, and increased blood pressure.
• Caffeine is the most widely consumed psychoactive drug, with 80% of people consuming it regularly.

Hallucinogens

• Hallucinogens create a disconnect between the physical world and individual perception, with no physical dependency or withdrawal symptoms, non-addictive, except for cannabis.
• Psychoactive effects of hallucinogens include separation from self and reality, altered perception of body image, and changes in the perception of colors, distances, and shapes.
• Physical effects of hallucinogens are similar to amphetamine, also including nausea and vomiting.
• Hallucinogens are being studied as potential treatments for anxiety, depression, PTSD, and addiction.
• LSD-like hallucinogens is a semi-synthetic drug derived from fungus on rye and other grains, it is the most powerful hallucinogen.
• Psilocybin (shrooms) is less potent than LSD, with no physical dependence, and used to treat anxiety, depression, and terminal cancer diagnosis
• Dimethyltryptamine (DMT) is similar to psilocybin, it is often brewed into tea.
• Morning glory seeds contain an active ingredient chemically related to LSD.
• Phenylethylamines, such as mescaline-like hallucinogens, are weaker than LSD and act on norepinephrine.
• Mescaline is a natural substance that can also be synthesized, more powerful than cannabis but less than LSD, with no withdrawal symptoms.
• MDA induces a sense of peacefulness and emotional closeness to others, may cause decreased serotonin.
• MDMA (Molly, Ecstasy) is a semi-synthetic drug derived from oil of nutmeg, decreases amygdala activity (fear), treats PTSD, creates feelings of warmth.
• Dissociative anesthetics possess depressant properties and hallucinatory effects, experiences are difficult to predict, can cause reduced sensitivity to pain and memory loss during use.
• Phencyclidine (PCP, angel dust) developed as an anesthetic, high doses can induce acute toxic psychosis.
• Ketamine is used as a surgical anesthetic in low-income countries, recreationally for euphoria and mild dissociation, it has also been used to spike drinks, but also treats depression, pain disorders, and anxiety.
• Novel psychoactive substances are synthetic substances created to cause psychoactive effects similar to illegal drugs, most mimic stimulants or opioids.
• Cannabis alters perception at low doses and produces hallucinogenic effects at high doses.
• Cannabinoids' psychoactive effects come from THC, while CBD has therapeutic effects.
• Low doses of cannabis creates relaxation, euphoria, talkativeness and laughing, heightened appetite, and impaired logical thinking, large doses similar to LSD, anxiety, confusion, psychosis.
• Long-term effect of cannabis include impaired motor coordination, emotional flatness, decreased fertility, and impaired ability to control emotions.
• Therapeutic uses of cannabis include treatment of acute anxiety, depression, and diabetes.

Psychoactive drugs alter the central nervous system, affecting thoughts, emotions, and behaviors. Depressants slow down the nervous system, decreasing heart rate and reaction time. Common examples include alcohol, barbiturates and benzodiazepines.