FSCI 371 Understanding Substance Use and Treatment

Prescription Drugs

• Opioids are often prescribed to treat pain.
• CNS depressants are used to treat sleep and anxiety disorders.
• Stimulants are prescribed to treat ADHD, obesity, and narcolepsy.

Nonmedical Use

• In 2020, nonmedical use of prescription drugs was reported by 6.2 million people.
• Nonmedical use of prescription drugs is second only to marijuana use.
• Pain relievers account for the largest portion of nonmedical prescription drug use.
• 6,210,000 people used prescription durgs.
• 4,377,000 people use pain relievers.
• 1,804,000 people use tranquilizers.
• 1,218,000 people use stimulants.
• 436,000 people use sedatives.

Teens and Drugs

• More than 60% of teens said drugs were used, sold, or kept at their school.
• Half of 7th graders have been pressured to take drugs.
• Half of 12th graders will have given in to drug pressure.
• Every day, 2500 kids age 12 to 17 try a painkiller or muscle relaxer for the first time.
• Teens abuse prescription drugs more than any illicit street drug.
• A drug can be easily overdosed when crushed or snorted.
• A drug becomes increasingly more dangerous when mixed with drugs or alcohol.
• Exchanging prescription medication at "pharming parties" is dangerous.

Ritalin

• Methylphenidate is a mild stimulant to the central nervous system (brain and nerves).
• Methylphenidate is used to treat ADD, ADHD, and narcolepsy.

Inhalants

• Young people are likely to abuse inhalants because they are availablereadily inexpensive.
• Sniffing correction fluid can stop your heart.
• Breathable chemicals in inhalants produce mind-altering effects.
• There are three types of inhalants: solvents, gases, and nitrites.
• Street names for inhalants include poppers, snappers, and ozone.
• Inhalants are ingested into the body by breathing in the product's vapors.
• Several methods of inhalation can be used by abusers including: using a bag, rag, or pressurized containers.
• Solvents include industrial/household solvents like paint thinners, degreasers, gasoline, and glues.
• Solvents include office supplies like correction fluids, felt-tip-marker fluid, and electronic contact cleaners.

Gases Used Include:

• Gases used include household or commercial products like butane lighters, propane tanks, and whipping cream aerosols.
• Gases also include household aerosol propellants found in spray paints, hair and deodorant sprays, and fabric protector sprays.
• Medical anesthetic gases like ether, chloroform, halothane, and nitrous oxide (laughing gas) are also used.

Inhalant Use Statistics (2020)

• 8th Graders: 17.9% have ever used, 9.4% used in the past year, and 4.5% used in the past month.
• 10-12th Graders: 16.6% have ever used, 7.3% used in the past year, and 2.6% used in the past month.
• 8th Graders: 14.2% have ever used, 5.9% used in the past year, and 2.2% used in the past month.

Marijuana

• Marijuana is formed from the dried leaves and flowering tops of the Indian hemp plant Cannabis sativa.
• The first direct reference to a cannabis product as a psychoactive agent dates from 2737 BC.
• The reference dates came from the writings of the Chinese emperor Shen Nung.
• Cannabis use spread from China to India and then to North Africa.
• Cannabis reached Europe at least as early as A.D. 500.
• Cannabis usage was focused on its powers as a medication for rheumatism, gout, malaria, and forgetfulness.
• Cannabis was clearly used recreationally in India.
• Muslims also used cannabis recreationally as alcohol consumption was banned by the Koran.
• Spanish brought marijuana to America in 1545 in New World.
• In 1611, the English introduced marijuana in Jamestown where it became a major commercial crop alongside tobacco.
• Hemp was grown as a source of fiber.
• By 1890, hemp had been replaced by cotton as a major cash crop in southern states.
• Marijuana began popularity in the 1920s during prohibition.
• Marijuana was restricted to jazz musicians and people in show business.
• "Reefer songs" became the rage of the jazz world.
• Marijuana clubs, called tea pads, sprang up in every major city.
• Marijuana was listed in the United States Pharmacopoeia from 1850 until 1942.
• Marijuana was prescribed for conditions like labor pains, nausea, and rheumatism.
• The Controlled Substances Act of 1970 classified marijuana.
• Marijuana was classified along with heroin and LSD as a Schedule I drug.
• Most marijuana came from Mexico, but in 1975 the Mexican government started using paraquat.
• Colombia then became the main supplier.
• The marijuana plant has both male and female forms.
• The sticky flowers of the female plant are the most potent.
• The flowering tops of the Cannabis plant secrete a sticky resin that contains the active ingredient of marijuana.
• The ingredient is known as delta-9-tetrahydrocannabinol (THC).
• THC connects to specific sites called cannabinoid receptors on nerve cells.
• Many cannabinoid receptors are found in brain areas that influence pleasure, memory, thought, concentration, sensory perception, and coordinated movement.
• The two phases of marijuana intoxication are initial stimulation and sedation.
• Initial stimulation includes giddiness and euphoria.
• Sedation includes pleasant tranquility .
• Teens use marijuana because of Peer pressure, family influence, listening musical references, as well as their belife of escaping form problems.
• Over 900 Marijuana fields were found in Delaware last year.
• Marijuana smoke contains 50 to 70 percent more carcinogenic hydrocarbons than tobacco smoke.
• Cancer from tar in 5 cigarettes is the same as 5 Joints per week.
• 5 joints per week has the same cancer risk as a pack per day.
• Marijuana users typically inhale more deeply and hold their breath longer than tobacco smokers.
• Deeper inhalation increases the lungs' exposure to carcinogenic smoke.
• A smoked 20 MGS dose will increase heart by 20-50 beats per minute.
• Marijuana and cocaine doubles increase in heart rate.
• Use of Marijuana should be controlled because they are associated with: treat chronic pain, help with muscle spasms, may improve lung capacity, and may be of use to treat a varity of ailments.

Marijuana (Medical Uses)

• Best supported medical use is treatment for chronic pain.
• It can also help with muscle spasms.
• It may also decrease anxiety in low doses.
• Research shows that Chemicals found in marijuana may stop the spread of certain cancers
• It doesn't seem to harm lung capacity, and may even improve it.
• It may be of some use in treating glaucoma, or it may be possible to derive a drug from marijuana for this use.
• IT it also being tested for Dravet or other seizure disorders, THC may slow the progression of Alzheimer's disease and other ailments.

Hashish

• It was the Muslims who introduced hashish.
• The popularity of hashish spread quickly throughout 12th century Persia (Iran) and North Africa.
• Hashish is comprised of only the resin from the cannabis plant.
• Hash oil is a sticky black liquid that is a resin from the cannabis plant.
• Current samples of hash oil are a viscous liquid, ranging from amber to dark brown in color.
• The average average THC content of hash oil is about 15 percent
• A drop or two of hash oil on a cigarette equals a single "joint" of marijuana in terms of psychoactive effect.
• Advantages of THC oil: no hot, harsh smoke, no tar, very little smell, no carcinogens, 5x as much THC.

Testing

• False positives for marijuana can arise due to ibuprofen, naproxen, riboflavin, kidney infections, and liver disease.
• Marijuana use can be detected in urine 48-72 hours after use.
• Habitual marijuana use can be detected for 12 weeks.

THC Levels

• THC average percentage in seized samples 1985-2007
• 1985: 3.48%
• 2007: 9.64%
• Selected modern mean THC levels in strains:
  • Kosher Kush: 21.5%
  • Ghost Train Haze: 20.8%
  • Bruce Banner: 23.4%
  • Ghost OG: 23.7%
  • The White: 24.3%
  • Death Star: 21.6%
  • Chemdawg: 23.0%
  • White fire OG: 23.2%

Cocaine History

• Coca chewing was practiced throughout South America as far back as 3000 B.C.
• Coca was believed to be a gift from God.
• Cocaine metabolite benzoylecognine can be trapped in hair.
• 8 Chilean mummies with dates ranging from 2,000 BC to 1,500 AD were tested for benzoylecognine and it was found in their har.
• Cocaine is derived from the coca plant in the high mountain ranges of South America.
• The stimulating effects of the drug increase breathing.
• Increased breathing increases oxygen intake.
• Records show back 5000 to to Peru & Bolivia
• Inca's chewed coca leave which had 2$ of cocaine.
• Late 1850s, the active ingredient of coca plant was extracted by Alfred Nieman
• Conquistadors found it so nutritious that the Indians labored whole days with coca.
• 1505, accounts of coca use made their way back to Europe.
• Early 1500s, Incan Coca plantations were taken over by holders of Spanish land grants.
• Spanish tax laws were revised to allow land owners to make their tax payments in coca leaves.
• 1539, The Bishop of Cuzco then tithes coca, taking 1/10 of the value of crops in taxes.
• When the coca leaf is soaked and mashed, the extract coca paste is 60-80% pure.
• 1855, Cocaine was extracted from Coca leaves.
• 1862, Merck produces 1/4 pound of cocaine.
• 1884 Sigmund Freud publishes On Coca- recommends use of cocaine for morphine addiction.
• Sigmund Freud advocated for cocaine use.
• Sherlock Holmes felt Cocaine was transcendentally stimulating and clarifying to the mind.
• By the 1880s in the United States, it was Freely prescribed by physicians.
• Cocaine was presribed for maladies and treatments.
• In the 1870s Parke-Davis manufactures a fluid extract of coca.
• The company Advertised it to insensitize patients to PAIN.
• From the 1850's to the early 1900's, cocaine and opium laced elixirs, tonics and wines were broadly used .
• Users were of all social classes.
• Famous users were Sarah Bernhardt, Queen Victoria of England, Thomas Edison and Pope Leo the II.
• 1886 John Pemberton included cocaine as the main ingredient in his new soft drink now known as Coca Cola.
• Cocaine's euphoric and energizing effects launched Coke into its place as the most popular soft drink in history.
• Until 1903 a typical serving contained 60MG of cocaine.
• Coca-Cola (Coke) had cocaine in it, in varying amounts, from 1886 – 1929.
• At the time cocaine was legal and treated as a medicine.

Cocaine effects

• Cocaine as a substance, in its legal itierations (1800s early 1900s) had positive effects, most notably it would be prescribed to treat Alchohol addiction, due to cocaine enabling pain resistence and providing euphoria
• From 1900 – 1929 opinion turned against cocaine.
• Coke continued to use trace amounts of cocaine and "spent” coca leaves to maintain its flavor and trademark.
• Today Coca-Cola uses caffeine rather than cocaine.
• Cocaine blocks pain sensation, stimulates the central nervous system, and produces a sudden increase in heart rate, temperature, and blood pressure.
• Cocaine blocks the synaptic reabsorption of certain neurotransmitters (in particular dopamine).

Cocaine Hydrochloride

• Cocaine Hydrochloride is ~ 30% pure, Gram-sized packs is diluted with mannitol, sucrose, lactose etc.
• Snorted 30-60 x 2 mm lines = average 25 mg dose.
• 50-100mgs necessary for snorting and with these the High lasts 15-30 minutes.
• The Short-term effects include Increased energy, Decreased appetite, and Mental alertness.
• Other shot term increase include Increased heart rate, Increased blood pressure and Constricted blood vessels.
• Facilitated by the large surface area of the lungs' air sacs, cigarette and drug use, when using a combination administeration with other drugs increases.
• Inhalation of other drags is absorbed almost immediatelyinto the bloodstream
• Facilitated inhalation taking approximately taking 19 seconds to reach the brain.
• Available studies indicates that 30 to 60 percent of theavailable dose is absorbed which happens due to incomplete inhalation of the cocaine and other drug mixture, and with the improper heating temperature adjustments

Cocaine - FreeBase

• 1976. First developed freebase cocaine (probably in California).
• This mixture would soon be popularized bydealers and glamorized by Hollywoodmedia.
• Is cocaine without its water-soluble component or "base."
• It is prepared by dissolving cocainehydrochloride with a strong alkali.
• Its main benefits were drawing out the "pure" cocaine from manyof the impurities.
• Cocaine hydrochloride is very stable andbinds closely to the ink in in paper hence the substance can be found on most Americans currency (paper).
• Crack is actually a less pure sort of free- base cocaine.
• Base-cocaine vaporizes at a low temperature so it can be easily inhaled using a heated pipe.
• This type of base-cocaine makes acracking sound when heated.
• Crack is usually made by mixing:two parts of cocaine hydrochloridewith one part baking sodain about 20 ml of water.
• The solution is then heated gently until white precipitates form.
• Heating is halted when precipitation stops
• The precipitate is filtered and retained.
• The precipitate may then be washed

Effects

• Crack use, during pregnancy increased.
• Increased blood vessel constriction causes the placenta to tear away from the uterus which induces premature delivery
• The use can create Low blood return and less oxygen to fetus and fetal brain.
• Infants exposed have a increased rate of SIDS

Detection

• SUBSTANCE =Cocaine Benzoylecgonine
• DETECTION PERIOD in Urinein trace amountsup to 5 days
• DETECTION PERIODin UrineChronic Use up to 3 week