Abuse and Misuse of Hallucinogens PDF

Abuse and Misuse of Hallucinogens, Marijuana, Inhalants, and Prescription Drugs IMPH-495 Click to edit Master subtitle style Dr Christos Petrou Content: The abuse and misuse of psychoactive subst...

Abuse and Misuse of Hallucinogens, Marijuana, Inhalants, and Prescription Drugs IMPH-495 Click to edit Master subtitle style Dr Christos Petrou Content: The abuse and misuse of psychoactive substances have risen significantly over recent decades. These trends lead to severe health, social, and economic challenges worldwide. This presentation explores the complexities of hallucinogens, marijuana, inhalants, and prescription drugs. Categories of Psychoactive Drugs Hallucinogens, Marijuana, Inhalants, Prescription Drugs Effects on CNS: Alter perceptions, impact mood and behavior Dependency Potential: Varies by drug type Hallucinogens: Psychedelic experiences, sensory alterations Marijuana: Relaxation, altered sense of time Inhalants: Quick highs, severe risk factors Prescription Drugs: Medical use leading to potential misuse Synthetic Drugs: Laboratory-created, often unpredictable Chemical Properties Hallucinogens: Psychoactive compounds affecting serotonin pathways Marijuana: Cannabinoids, primarily THC and CBD Inhalants: Volatile chemicals, rapid bloodstream entry Prescription Drugs: Diverse pharmacological profiles Synthetic Drugs: Lab-created psychoactive properties Impact on Brain: Alters perception, mood, cognition Toxicity Levels: Variable, dependent on substance and dosage Metabolism: How substances are processed and cleared Influences on Effects: Environmental and genetic factors Overview of Categories of substances: Hallucinogens, Marijuana, Inhalants, Prescription Drugs. Psychoactive Each category has unique chemical properties and societal impacts. These substances alter perceptions, cognitive functions, and can lead to Substances severe addiction and long-term health consequences. Understanding Psychoactive Substances Education: Key to prevention and awareness Policy Development: Informed decisions for legislation Public Health Strategies: Better planning and resources Support Systems: Strengthen networks for recovery Personal Impact: Larger societal role Scientific Research: Informative on drug effects and therapies Therapeutic Uses: E.g., psilocybin for depression research Cultural Understanding: Historical and societal perceptions Ancient Use of Psychedelics Prehistoric Times: Archaeological evidence suggests ancient societies Aztec Culture: The Aztecs used South America: Indigenous cultures used psychedelics for religious and psilocybin mushrooms, known as used ayahuasca, a brew containing healing purposes. Rock art in the Teonanácatl, in religious ceremonies DMT, for spiritual and healing Sahara dating back to 7000 BC to communicate with their gods. rituals. depicts mushrooms with psychedelic properties.  Historical Context Ancient Use: 20th Century: Modern Era: Societal Shift: Key Psychedelics in Rise of Renewed From Questions: recreational interest in therapeutic to How history spiritual use, legal therapeutic recreational informs practices restrictions use caution current use Cannabis: Key Mescaline: Cultural Research Visual: Integration: Milestones: Timeline of role in early Ritualistic use Influence on Discoveries civilizations by indigenous significant art, music, like LSD by (China, India) cultures and media Hofmann developments  Ancient Use of Psychedelics Cultural Archaeological Purpose: Modern Connection Dual Uses: Resurgence: Artifacts: Evidence: with deities, Medicinal and Influence on Depictions in Sahara rock spiritual religious contemporary art and art, 7000 BC healing practices literature Aztec South Ancient Texts: Geographic Ceremonies: America: References in Spread: Use of Ayahuasca in historical Transcultural psilocybin cultural rites documents use mushrooms  The Lost Psychedelic Cult of Ancient Greece https://classicalwisdom.com/uncategorized/the-lost-psychedelic-cult-of-ancient-greece/?utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz-- HGSE7PgtrJwTxkalO5d7e-w7WpCsSh5h6OmMbEjAupajLzYx64iAIvp_kWHB55aJHdcma Modern Discovery and Research of Psychedelics Albert Hofmann: In 1938, Swiss scientist Albert Hofmann first synthesized LSD (lysergic acid diethylamide). He discovered its psychoactive properties in 1943. 1950s-1960s: This period saw a peak in psychedelic research. LSD and other psychedelics were studied for their potential to treat mental health conditions like alcoholism and depression. Therapeutic Applications: Exploration in psychiatry Cultural Impact: Psychedelic movement of the 60s Research Halt: 1970s legal restrictions (Schedule I) Current Studies: Psilocybin for depression, MDMA for PTSD Regulatory Bodies: Changing perspectives on use Clinical Trials: New methodologies and findings Limitations: Current legal and ethical considerations https://www.bbc.com/travel/article/20200713-basel-the- birthplace-of-hallucinogenic-science History of Cannabis (Ancient to Modern) Origin: Central Asia, spread to China and India Early Uses: Medical, spiritual, textile (fiber use) Ancient Texts: Records in Chinese pharmacopeia Spread: Move to Middle East, Africa, Europe 19th Century: Western medical use and decline 20th Century Regulation: 1937 Marijuana Tax Act in the US Modern Era: Shift towards legalization Medical Uses: Growing acceptance for conditions like chronic pain Industrial Applications: Hemp in manufacturing Spread and Regulation of Cannabis Middle East and Africa: Cannabis spread to the Middle East and Africa through trade and migration. It was used for medicinal and recreational purposes. Europe: Cannabis was introduced to Europe by the Scythians and later by the Greeks and Romans. It was used for its fibers and medicinal properties. Americas: Cannabis was brought to the Americas by European colonists. It was grown for hemp fiber and later used recreationally. Spread and Regulation of Cannabis Middle East/Africa: Europe: 1937 Tax Act: US Americas: Brought Historical medicinal Introduction by criminalization, by colonists, hemp and recreational Scythians, Greek, impact on public cultivation uses Roman adoption policy Controlled Decriminalization Cultural Shifts: Current Debates: Substances Act Trends: Medical Changing Medical 1970: Schedule I and recreational in perceptions among legalization and classification 21st century public policy reform Economic Impact: New markets and industries History of Mescaline Indigenous Use: Peyote in North America, San Pedro in South America Spanish Conquest: Early European encounters and attempts to suppress Cultural Persistence: Continued indigenous rituals 19th Century Discoveries: Medical journaling, commercial interest 20th-century Synthesis: Ernst Späth's contributions Psychiatric Research: Mescaline studies in mental health Cultural Impact: Influences in literature and films (e.g., Huxley's work) Traditional Practices: Legal status in Native American Church Therapeutic Research: Renewed interest in psychedelic therapy Countries of Origin and Spread Cannabis: Roots in Mescaline: Found in Spread through Trade: Psychedelics: Origins African Traditions: Central Asia; Americas; ritualistic Historical exchanges in Central/South Lesser-known but spreading to multiple use by indigenous influencing America and Europe significant uses continents peoples distribution 20th-century Traditional vs. Modern Cultural Integration: Regional Trends: Globalization: Impact Use: Differences in Varied uses in Current patterns in on spread and application and different societies use and regulation accessibility perspective Historical Influences on Art and Culture Psychedelic Art: 1960s visual art and music influence Key Artists: Peter Max, Alex Grey, effects of LSD on creativity Psychedelic Rock: Bands like The Beatles, Pink Floyd Literary Works: Influence on authors (e.g., Huxley's "The Doors of Perception") Cinematic Impact: Films exploring psychedelic themes Tie-dye Fashion: Cultural iconography of a generation Spiritual Exploration: Artistic interpretations of consciousness Modern Revivals: Influence on contemporary artists and musicians Historical Art: Evidence of ancient psychedelic influences Modern Resurgence in Research Current Clinical Trials: Psilocybin and MDMA therapeutic potential Published Studies: Major depressive disorder treatment with psilocybin Regulatory Shifts: FDA guidance for psychedelic trials Potential Markets: Growth in therapeutic applications Ethical Considerations: Safe use and consent in therapy Brain Connectivity: Effects of psychedelics on neurological structures Longevity of Effects: Examining therapeutic durability Case Study Evidence: Documented treatment successes Future Prospects: Areas for expanded research currently unexplored Drugs Overview and Analysis Street Names Hallucinogens Overview Hallucinogens are substances that alter perception, thoughts, and feelings. Examples include: LSD (Lysergic Acid Diethylamide) Psilocybin (Magic Mushrooms) Mescaline (Peyote) Salvia Divinorum Ecstasy/MDMA – noted for its dual hallucinogenic and stimulant properties. Ketamine – a dissociative hallucinogen, commonly used in anesthesia. Marijuana and Concentrates Cannabis Plant: Forms include flowers, oil, wax THC: Main psychoactive compound, determines potency CBD: Non-psychoactive, potential health benefits Methods of Use: Smoking, vaping, edibles, tinctures Health Effects: Euphoria, relaxation vs. anxiety, paranoia Concentrates: Hash oil, dabs with higher THC levels Medical Use: Pain relief, anti-inflammatory properties Legalization Trends: Variation globally and domestically Cultural Acceptance: Increasing integration in daily life, debate continues Inhalants Overview Common Products: Paint thinners, glue, aerosols Methods of Abuse: Sniffing, huffing, direct inhalation Short-term Effects: Dizziness, hallucinations, euphoria Health Risks: Damage to brain and organs, sudden sniffing death Demographics: Predominantly younger users Legal Status: Not controlled, but misuse causes legal issues Educational Programs: Focus on prevention for youth Long-term Consequences: Irreversible neurological and physical damage Warning Signs: Behavioral changes, chemical smells, residue presence Prescription Drugs Overview Opioids, stimulants, sedatives, steroids Phenylcyclidine Opioids: Morphine, oxycodone, high addiction risk Stimulants: Adderall, Ritalin, used for ADHD Sedatives: Benzodiazepines, often prescribed for anxiety or insomnia Anabolic Steroids: Used for muscle growth, athletic performance  Phencyclidine (PCP) Phencyclidine (PCP), commonly known as "angel dust," is a dissociative anesthetic that was originally developed in the 1950s for medical use. It is a drug that can alter perceptions of reality, mood, and sensory experiences. Historical Context: Medical Development: PCP was initially synthesized in 1926 and studied as an anesthetic in the 1950s. It was used in surgical procedures for its analgesic properties but was discontinued due to adverse effects. Shift to Recreational Use: By the 1970s, PCP emerged as a popular recreational drug, leading to widespread misuse and a reputation for unpredictable effects. Recreational Use of PCP: PCP is used recreationally in various forms, which can influence the intensity and nature of its effects. Here’s how PCP is commonly consumed for recreational purposes: Phenylcyclidine Effects of Recreational Use Dissociative Experiences: Feelings of detachment from reality and one’s body, often referred to as a "dissociative" effect. Hallucinations: Induction of vivid visual and auditory hallucinations, altering perceptions of time and space. Euphoria and Stimulation: Users may experience heightened mood and increased sensory perception. Altered Judgment: Impaired decision-making leading to risky behaviors. Risks Associated with Recreational Use Psychological Effects: High doses can lead to severe agitation, paranoia, hallucinations, and psychotic episodes. Physical Risks: Can cause elevated heart rate, increased blood pressure, and potential respiratory issues. Addiction Potential: While not physically addictive, PCP can lead to psychological dependence, with users developing a tolerance and craving for the drug. Synthetic drugs K2/Spice: Synthetic cannabinoids, mimic THC effects Designer Drugs: Constantly evolving to avoid legal restrictions Manufacturing: Often produced in unregulated labs Market: Sold as "herbal incense" or "bath salts" Abuse Potential: Severe, unpredictable psychoactive reactions Health Risks: Psychosis, cardiovascular disturbances, potential for fatal outcomes Legal Challenges: Regulatory bodies struggling to keep up Public Health Risk: Emergence of new substances, quick adaptation Increasing reports of legal and health incidents K2/Spice: Synthetic cannabinoids Synthetic cannabinoids, commonly known by names such as K2 and Spice, are a class of designer drugs created to mimic the effects of THC, the main psychoactive component of marijuana. These substances are part of a broader category of synthetic drugs designed to replicate the effects of naturally occurring drugs. Early 2000s: Synthetic cannabinoids were first developed by scientists researching cannabinoids for potential medical applications1. However, these compounds were soon repurposed for recreational use. 2008: The first significant reports of synthetic cannabinoids in the United States emerged when U.S. Customs and Border Protection seized a shipment of “Spice” in Dayton, Ohio2. Composition and Production: Synthetic cannabinoids are not derived from the cannabis plant. Instead, they are chemical compounds created in laboratories. These substances are often sprayed onto plant material to create products that can be smoked, similar to marijuana. Manufacturing: The majority of synthetic cannabinoids are produced in Asia, often without stringent manufacturing requirements or quality control standards3. These bulk products are then smuggled into various countries, including the United States, typically as misbranded imports. Formulation: The synthetic compounds are usually found in bulk powder form. They are dissolved in solvents like acetone before being applied to dry plant material to create “herbal incense” products3. These products are often marketed as “not for human consumption” to evade legal restrictions. https://www.euda.europa.eu/topics/pods/synthetic-cannabinoids_en K2 Market and Distribution Synthetic cannabinoids are sold under various brand names, including K2, Spice, Blaze, RedX Dawn, and many others. They are marketed as legal alternatives to marijuana and are often sold in convenience stores, head shops, gas stations, and online Street Names: Some common street names for synthetic cannabinoids include Spice, K2, Blaze, RedX Dawn, Paradise, Demon, Black Magic, Spike, Mr. Nice Guy, Ninja, Zohai, Dream, Genie, Sence, Smoke, Skunk, Serenity, Yucatan, Fire, and Crazy Clown Packaging: These products are typically packaged without information regarding their health and safety risks. They are labeled as “herbal incense” or “potpourri” to avoid legal scrutiny Impact and Effects Societal Impact of Psychoactives Public Health: Overdose crises, hospital admissions Economic Burden: Healthcare costs, productivity loss Crime Rates: Low-level drug offenses to major trafficking charges Family Dynamics: Strain, disruption, support challenges Youth Risk: Vulnerabilities at different developmental stages Policy Implications: Informed legislation for harm reduction Community Programs: Education and intervention initiatives Media Influence: Representation and public perception Global Trends: Differences in regional use and issues Short-term vs. Long-term Effects Short-term: Immediate impact, generally acute Hallucinogens: Intense sensory experiences, but rapid conclusion Marijuana: Quick relaxation, cognitive clarity affected Inhalants: Short-lived euphoria, quick addiction potential Prescription Drugs: Varied responses, risk of acute overdose Long-term: Consequences manifesting over prolonged usage Hallucinogens: Potential for lasting perceptual disorders Prescription Drugs: Risk of chronic health conditions, dependency Importance of Monitoring: Health evaluation and intervention Long-term Health Impacts (Mental and Physical) Hallucinogens: Persistent perceptual changes, potential cognitive decline Marijuana: Possible increase in psychosis risks, chronic bronchitis Inhalants: Severe permanent neurological damage, organ failure Prescription Drugs: Hormonal disruptions, cardiovascular issues Synthetic Drugs: Long-lasting psychological disorders Mortality Risk: Overdose potential across categories Quality of Life: Diminished by prolonged substance use Functional Impairment: Social, occupational, and personal lives affected Societal Burden: Support needed for affected individuals  Short-term vs. Long-term Effects Drug Category Short-term Effects Long-term Effects Hallucinogens Altered perceptions, hallucinations, euphoria Anxiety, depression, HPPD, cognitive impairment Marijuana Euphoria, relaxation, altered perception Respiratory issues, memory loss, risk of psychosis Inhalants Euphoria, dizziness, slurred speech Cognitive deficits, organ damage, respiratory failure Prescription Drugs - Opioids Pain relief, euphoria Respiratory issues, dependency, overdose risk Prescription Drugs - Stimulants Increased alertness, energy Anxiety, cardiovascular problems, psychosis Prescription Drugs - Sedatives Relaxation, drowsiness Cognitive impairment, dependency, emotional blunting Anabolic Steroids Enhanced strength, aggression Hormonal imbalance, cardiovascular disease, liver damage Effects  LSD: Visual distortions, emotional swings, dilated pupils Psilocybin: Euphoria, altered thinking, nausea Mescaline: Vivid imagery, muscle relaxation Salvia: Delusional thoughts, detachment from reality Hallucinogens MDMA: Enhanced mood, empathy, potential overheating Effects Ketamine: Dissociation, hallucinations, reduced physical response Impact Duration: Typically 6 to 12 hours depending on substance Risk of HPPD: Long-lasting perception disorder Safety Concern: Unpredictable reaction severity Visual: Image representing hallucination effects Marijuana Effects THC Influence: Psychoactive effect causing "high" Short-term: Euphoria, paranoia, motor skill disturbance Physical Effects: Increased appetite, dry mouth Cognitive Impact: Impairment in memory, learning Long-term Risks: Respiratory issues, cognitive decline Dependency Potential: Increased with concentrated forms Impact on Adolescents: Potential developmental harm Psychological Effects: Anxiety, altered reality perception Cultural Usage: Varied acceptance and application Visual: Chart comparing THC vs. CBD effects Inhalants Effects Immediate Euphoria: Rapid but short-lived high Physical Impact: Dizziness, disorientation, nausea Long-term Damage: Brain and organ harm, nerve damage Neurotoxicity: Destruction of brain cells Sudden Sniffing Death: Heart failure instance by single use Demographic Risk: Predominantly young users Signs of Use: Chemical odors, stains, social withdrawal Education Emphasis: Early intervention to prevent use Legal Consequences: Restricted sales to minors  Opioids: Pain relief vs. addiction, respiratory depression Stimulants: Increased focus, energy, potential paranoia Sedatives: Relaxation, dependency, withdrawal risk Prescription Steroids: Muscle growth vs. hormonal imbalance, aggression Drugs Health Risks: Overdose and dependency Effects Withdrawal Symptoms: Severe for opioids and benzodiazepines Abuse Indicators: Unused prescriptions sold or shared Social Consequences: Strain on relationships and responsibilities Treatment Necessity: Medical intervention often required Synthetic Drugs Effects K2/Spice: Paranoia, hallucinations, rapid heart rate Composition: Unregulated production, variable potency Short-term Impact: Intense, unpredictable euphoric effects Physical Harm: Cardiovascular and respiratory issues Long-term Risks: Mental disorders, cognitive impairment Legal Challenge: Difficulty keeping legislation current Market Expansion: Unauthorized distribution channels Public Health Strain: Increasing ER visits and treatment costs Abuse Patterns: Often appeal to youth as legal alternatives Signs and symptoms of addiction for each substance What are the signs and symptoms of addiction for each substance? Hallucinogens (e.g., LSD, MDMA): Signs: Increased tolerance to the drug, frequent use despite negative consequences, and neglecting responsibilities. Symptoms: Visual or auditory hallucinations, changes in mood or perception, and experiencing flashbacks long after use. Marijuana: Signs: Increased use over time, continued use despite health issues, and withdrawal from social or recreational activities. Symptoms: Cravings, irritability, sleep disturbances, and appetite changes when not using. Inhalants Signs: Signs of substance in home or personal items (e.g., spray cans, glue), unusual behavior, and neglecting hygiene. Symptoms: Dizziness, confusion, and persistent nosebleeds. Anabolic Steroids: Signs: Changes in mood (increased aggression or irritability), physical changes (acne, hair loss), and legal issues due to possession. Symptoms: Dependency on the substance for mood enhancement, withdrawal symptoms when not using (e.g., depression, fatigue).  Withdrawal Symptoms by Substance Substance Common Physical Symptoms Common Psychological Symptoms Hallucinogens Headaches, fatigue Anxiety, flashbacks, HPPD Marijuana Headaches, sweating Irritability, insomnia Inhalants Muscle cramps, chills, seizures Mood swings, cravings Opioids Nausea, vomiting, respiratory issues Anxiety, cravings Stimulants Fatigue, sleep disturbances Depression, irritability Sedatives Tremors, seizures Panic, psychosis Steroids Fatigue, muscle weakness Depression, mood swings Treatment Options Overview Detoxification: Initial step for severe dependency Behavioral Therapies: CBT, motivational interviewing, effective interventions Medication-Assisted Treatment (MAT): Helpful in opioid recovery Support Groups: Community integration through NA, SMART Recovery Holistic Approaches: Complementary aids like yoga, art therapy Co-occurring Treatment: Address addiction alongside mental health conditions Relapse Prevention Plans: Addressing triggers, support structures vital Family Involvement: Enhances treatment success Importance of Personalized Plans: Tailored to individual's needs Drug-specific Treatments Hallucinogens: No specific withdrawal treatments, focus on therapy Marijuana: CBT and Motivational Enhancement Therapy (MET) Inhalants: Residential treatment programs for severe cases Opioid Treatment: Methadone, Buprenorphine, Naltrexone Stimulants & Sedatives: Gradual tapering and therapy Anabolic Steroids: Hormonal treatment for physiological effects Synthetic Drugs: Managed care and therapy critical Emphasis on Monitoring: Ensuring medical assistance throughout Treatment Variability: Modes and effectiveness vary by drug Behavioral Therapies Cognitive Behavioral Therapy (CBT): Addressing thought patterns Motivational Interviewing: Increasing willingness to change Contingency Management: Rewards for maintaining sobriety Group Therapy: Peer interaction, shared experience Family Therapy: Systemic approach involving relatives Dialectical Behavior Therapy (DBT): Emotional regulation focus Coping Skills: Building resilience against cravings and stress Personalized Coaching: Therapy individualized to patient's needs Role of a Therapist: Guide through emotional and behavioral recovery  Methadone: Long-acting opioid agonist, reduces cravings Buprenorphine: Partial agonist safe for detox maintenance Medication- Naltrexone: Antagonist, reduces euphoric effects Assisted Benzodiazepines: Used temporarily in certain detox protocols Treatment Antidepressants: Support mental health during withdrawal Opioid Use Disorder: Reduced relapse, improved retention (MAT) Legislation: Increasing acceptance in medical protocols Integrated Plan: Combining drugs with counseling for best results Risk Reduction: Improved safety and effectiveness  Varied Globally: Laws impacting usage, health outcomes Hallucinogens: Mostly illegal, some therapeutic trials Marijuana: Legalization shifts with ongoing debate Legal Status Prescription Drugs: Regulated distribution, high misuse potential and Synthetic Drugs: Challenge to classify, constant adaptation Regulations Factors Influencing Laws: Cultural, economic, public health Consequences of Legal Differences: Enforcement consistency Evolving Policies: Reflecting shifts in public opinion and science Impact on Crime Rates: Illegal possession, trafficking penalties Hallucinogens Legal Status Schedule I Drugs: High abuse potential, no accepted medical use (LSD, MDMA) Limited Studies: Exceptions for controlled research International Frameworks: UN conventions, national laws Societal Debates: Balancing research with misuse determent Therapeutic Developments: Clinical studies approved narrowly Historical Perspective: Impact of 1960-70s legislation Alternative Access: "Smart shops" in some jurisdictions Regulatory Exceptions: Specific indigenous use allowances Penalties: Fines to imprisonment for trafficking and possession  Status Overview: United States: From total Canada: Fully Federal vs. state legalization to strict legalized, regulated level discrepancies Marijuana prohibition Legal Status Europe: Mixed South America: Asia: approaches across Uruguay, pioneer of Around the nations, tolerance recreational Predominantly strict enforcement World policies legalization Africa: Varying Social Implications: Market Impact: levels of Opinions Economic acceptance and influencing policy implications of control shifts legalization  Prescription Drugs: Controlled distribution frameworks Prescription Opioids Regulation: Responses to overdose crises Stimulants and Sedatives: Monitored, regulated prescribing Drugs and Anabolic Steroids: Severe penalties for non-prescriptive distribution Anabolic Doctors' Responsibilities: Risk management in prescriptions Steroids Legislation Changes: Evolving as per addictive potential recognition Regulation Illicit Trade: Effect on availability and regulation enforcement Research and Safety: Ongoing trials and risk evaluations Strengthening Laws: Promoting safe, responsible medical usages  Education and Community Skills Training: Awareness: Avoidance Engagement: Developing coping and Effective through informed knowledge Establishing supportive environments decision-making abilities Prevention Youth Programs: Accessibility to Policy and Legislation: Strategies Tailored interventions for vulnerable populations Resources: Ensuring availability of healthcare Reflective of protective and enabling frameworks Summary Media Role: Impactful, Monitoring and Cross-Sector accurate Evaluation: Impact Cooperation: Involving representation of measurement all stakeholders substance use importance  DEPRESSANTS ABUSE AND MISUSE IMPH-495 Dr Christos Petrou Click to edit Master subtitle style A Comprehensive Analysis of Stimulant Drugs, Their Uses, and Effects Overview of Depressants CNS Depressants: Substances that reduce brain activity, producing calming effects Therapeutic Uses: Used to manage anxiety, insomnia, seizures (e.g., benzodiazepines, barbiturates) Recreational Uses: Often abused for their relaxing and euphoric effects (e.g., alcohol, opioids) Risks: Addiction, overdose, death when misused Deaths from depressants According to the World Health Organization (WHO), an estimated 500,000 deaths per year are attributable to drug use, with opioids accounting for the majority of these fatalities. In the U.S., over 80,000 overdose deaths in 2021 were attributed to opioid use, marking a record high for the country. Public Health Crisis Rising rates of misuse: Depressants, especially opioids, are increasingly abused worldwide The Opioid Epidemic: A critical driver of overdose deaths, particularly in North America Addiction cycle: Tolerance builds, leading to increased doses and dependency Impact on society: Strain on healthcare, law enforcement, and families Categories and Types of Depressants Category Examples Primary Use Risks Opioids Heroin, Fentanyl, Pain relief High risk of Oxycodone addiction and overdose Benzodiazepines Xanax, Valium, Anxiety and Addiction, Klonopin insomnia dangerous treatment withdrawal symptoms Barbiturates Phenobarbital, Sedation and High overdose Secobarbital seizure control potential Alcohol Beer, Wine, Recreational and Addiction, liver Spirits social use damage Other Ketamine, GHB Dissociation, Cognitive Depressants recreational use impairment, bladder damage Types of Depressants Opioids: Pain relievers, but highly addictive (e.g., heroin, fentanyl, oxycodone) Benzodiazepines: Prescribed for anxiety and insomnia (e.g., Xanax, Valium) Barbiturates: Used for sedation and seizure control Alcohol: Legal but widely abused substance Impact of Misuse Addiction: Physical and psychological dependency Overdose deaths: Rising globally, especially due to fentanyl Mental health effects: Anxiety, depression, and cognitive decline Economic burden: High healthcare costs, lost productivity Opioids Examples: Heroin, fentanyl, oxycodone Mechanism: Bind to opioid receptors in the brain to reduce pain Therapeutic Use: Prescribed for pain relief Risks: High addiction potential, overdose risk Benzodiazepines Common examples: Xanax, Valium, Klonopin Medical use: Anxiety relief, panic disorder treatment Addiction potential: Rapid tolerance build-up, dependency Withdrawal risks: Seizures, hallucinations Barbiturates Medical use: Sedation, seizure control, anesthesia Overdose risk: Narrow therapeutic index Decline in use: Largely replaced by benzodiazepines Examples: Phenobarbital, Secobarbital Alcohol as a Depressant Widely consumed legal depressant Short-term effects: Impairs motor skills, judgment Long-term health risks: Liver damage, heart disease Fetal Alcohol Syndrome: Impact on babies during pregnancy Other Depressants Ketamine: Used as an anesthetic, abused for hallucinogenic effects GHB: Party drug with sedative effects Dangers: Cognitive impairment, 'ketamine bladder' Street Names: Special K, Liquid Ecstasy Short-term Effects of Depressants Euphoria and relaxation: Temporary relief from stress, anxiety Impaired coordination: Risk of accidents, injuries Drowsiness, confusion: Impacts decision-making Respiratory depression: Can lead to coma or death Long-term Effects of Depressants Tolerance: Higher doses needed for the same effect Physical dependence: Withdrawal symptoms upon reduction Cognitive decline: Memory, learning, and decision-making affected Organ damage: Alcohol leads to liver damage; opioids affect respiration Mental Health Impacts Depression, anxiety: Worsened with long-term depressant use Self-medication: Users often use drugs to manage mental health issues Cognitive impairment: Long-term misuse damages brain function Cycle of addiction: Mental health and addiction feed into each other Social Consequences Relationship breakdown: Addiction strains personal relationships Job loss: Difficulty maintaining employment due to absenteeism Financial instability: Cost of drugs and inability to work Social isolation: Withdrawn from friends, family, exacerbating the issue Physical Health Consequences Accident risks: Increased due to impaired motor skills Respiratory depression: Fatal if mixed with alcohol Organ damage: Liver (alcohol), kidneys (opioids), brain (benzodiazepines) Overdose risks: Especially high when mixing multiple depressants Heroin Global production: Illegal opioid: Afghanistan, Derived from Mexico are key morphine producers Effects: Euphoria Risks: High followed by deep overdose relaxation, slowed potential, respiration especially when mixed with fentanyl  Heroin Synthesized from morphine. It is one of the most dangerous and addictive drugs in the world, known for its rapid onset of euphoria and high overdose potential. Street Names: H, Smack, Brown Sugar. Production: Afghanistan remains the largest producer of heroin, followed by Mexico. Heroin is often trafficked across borders by criminal organizations, with the U.S. being a major consumer market. Effects: Heroin produces an intense euphoria, followed by a deep sense of relaxation. However, it also slows heart rate and respiration, leading to a high risk of fatal overdose. Global Heroin Trade According to the United Nations World Drug Report, heroin production in Afghanistan has reached record levels in recent years, supplying up to 90% of the world's heroin Global Heroin Supply Historically, most of the world's illicit opium for heroin has been grown in the Golden Triangle of Southeast Asia. However, over the last decade, opium production in the Golden Triangle has declined while cultivation and production rates in Southwest Asia have increased considerably. In 2010, Afghanistan, as the world's largest opium supplier, accounted for nearly 80 percent of the world's opium, according to UN estimates. During the 1990's, Latin America evolved as the primary supplier of heroin to the United States, with Mexican heroin most prevalent west of the Mississippi and Colombian heroin most prevalent east of it. https://obamawhitehouse.archives.gov/ondcp /global-heroin-market Fentanyl Synthetic opioid: 50-100 times stronger than morphine Medical use: Severe pain management Illicit use: Major cause of opioid overdose deaths Overdose risk: Tiny amounts can be lethal Fentanyl Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. While it is used medically for pain management, it has become a leading cause of overdose deaths due to its potency and frequent presence in the illicit drug market. Street Names: China White, Jackpot. Role in the Opioid Epidemic: Fentanyl is responsible for a significant proportion of opioid overdose deaths in North America. It is often mixed with heroin or pressed into counterfeit pills, leading to accidental overdoses. Effects: Fentanyl can cause rapid sedation and respiratory failure, leading to death within minutes if not treated with naloxone, an opioid antagonist. Oxycodone Prescription painkiller: Used for moderate to severe pain Role in the opioid crisis: Overprescribed, leading to addiction Transition to illicit use: Many users switch to heroin or fentanyl Risks: Addiction and overdose, especially when mixed with alcohol Street Names: Oxy, Percs, Hillbilly Heroin. Effects: Euphoria, relaxation, and pain relief, but with a high risk of addiction and overdose. Dangers: When prescriptions run out, many users turn to illicit opioids like heroin or fentanyl, increasing the risk of overdose. Comparing Overdose Risks Fentanyl: Lethal dose is less than 2 mg Heroin: Often mixed with fentanyl, increasing risk Oxycodone: Moderate overdose risk, but can escalate with misuse Polydrug use: Combining opioids increases risk significantly Kratom What is Kratom? Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia, particularly found in countries like Thailand, Malaysia, and Indonesia Traditionally used for its stimulant and sedative effects. Current Use Gained popularity in the U.S. as an herbal remedy for pain and opioid withdrawal. Potential for abuse and significant health risks.  Street Names Kratom is known by several street names, including: Biak Mitragynine Ketum Kakuam Ithang Thom https://www.euda.europa.eu/publications/drug- profiles/kratom_en Effects of Kratom The effects of kratom vary based on the dosage. At lower doses, kratom acts as a stimulant, increasing energy, alertness, and sociability. Users often compare its stimulant effect to that of coffee, as both contain alkaloids that act on similar receptors. At higher doses, kratom has sedative and opioid-like effects, which can lead to drowsiness, relaxation, and euphoria. This dual nature of kratom makes it appealing for both recreational and self- medicating purposes. Kratom Withdrawal Kratom withdrawal can produce symptoms similar to those of opioid withdrawal, though typically less severe. Common symptoms include: Muscle aches Irritability Anxiety Insomnia Runny nose Nausea These symptoms can vary in intensity depending on the duration and quantity of kratom use. Users who attempt to quit kratom abruptly after prolonged use may find it challenging without medical support.  Use Traditionally, the fresh or dried leaves of kratom are chewed or brewed into tea. When making tea, lemon juice is often added to facilitate the extraction of plant alkaloids; before drinking, sugar or honey may be added to mask the bitter taste of the brew. The dried leaves are occasionally smoked. To experience vigour and euphoria, traditional ‘kratom eaters’ chew one to three fresh leaves at a time. The veins are usually removed from the leaves before eating and sometimes salt is added ‘to prevent constipation’. Only the masticated material is swallowed. Consumption is followed by drinking warm water or coffee, tea or palm sugar syrup. Regular and addicted users chew 3 to 10 times a day. When kratom is not available, the leaves of Mitragyna javanica (other name Mitragyna parvifolia) are used as substitute. In southern Thailand, in recent years homemade ice-cold cocktails, called ‘4x100’, have become popular for their alleged alcohol-mimicking effect among young Muslim people. The cocktails are made from kratom leaves, a caffeine- containing soft drink, and codeine- or diphenhydramine-containing cough syrup as the three basic ingredients to which ice cubes, an anxiolytic, an antidepressant or an analgesic drug is added. Kratom effects Stimulant vs. Sedative Effects Low Doses: Acts as a stimulant, increasing energy, alertness, and sociability.High Doses: Acts as a sedative, leading to drowsiness, relaxation, and euphoria. Dual Nature Appeals to both recreational users and individuals self- medicating for pain or anxiety. Mitragyna speciosa Neither Mitragyna speciosa nor mitragynine or other alkaloids from the plant are listed in any of the Schedules of the United Nations Drug Conventions. Mitragyna speciosa and/or mitragynine and/or 7-hydroxymitragynine have been reported to be controlled in at least 12 EMCDDA countries. Denmark, Estonia, France, Italy, Latvia, Lithuania, Poland, Portugal, Romania, Finland, Sweden, Turkey. Six Asian and four African Mitragyna species are known to be used in traditional medicine but the stimulant/sedative- narcotic/psychoactive effects are characteristic only for Mitragyna speciosa. In South East Asia, kratom is used as an antidiarrheal, a cough suppressant, an antidiabetic, an intestinal deworming agent and wound poultice as well as to wean addicts off heroin. Benzodiazepines Common examples: Xanax, Valium, Klonopin Medical use: Anxiety relief, panic disorder treatment Addiction potential: Rapid tolerance build-up, dependency Withdrawal risks: Seizures, hallucinations Barbiturates Barbiturates were once the primary treatment for anxiety, insomnia, and seizures but are now rarely prescribed due to their high overdose potential. However, they are still misused in certain populations. Street Names: Barbs, Downers. Effects: Sedation, relaxation, impaired motor function. Dangers: Barbiturates have a narrow therapeutic index, meaning even a slight increase in dose can cause overdose. Medical use: Sedation, seizure control, anesthesia Overdose risk: Narrow therapeutic index Decline in use: Largely replaced by benzodiazepines Examples: Phenobarbital, Secobarbital Benzodiazepines Benzodiazepines remain widely prescribed for anxiety and insomnia but are highly addictive and often misused. Street Names: Xannies, Benzos. Effects: Relaxation, sedation, and anxiety relief, but with the risk of dangerous withdrawal symptoms when used long-term. The Dangers of Combining Benzodiazepines with Opioids The combination of benzodiazepines with opioids significantly increases the risk of fatal overdose. This is because both drug classes depress the central nervous system, leading to slowed breathing, heart rate, and potentially death. Other Depressants Ketamine: Used as an anesthetic, abused for hallucinogenic effects GHB: Party drug with sedative effects Dangers: Cognitive impairment, 'ketamine bladder' Street Names: Special K, Liquid Ecstasy Ketamine Ketamine is a dissociative anesthetic that has some hallucinogenic effects. Ketamine distorts the perception of sight and sound and makes the user feel disconnected and not in control. It is referred to as a “dissociative anesthetic hallucinogen” because it makes patients feel detached from their pain and environment. Ketamine can induce a state of sedation (feeling calm and relaxed), immobility, relief from pain, and amnesia (no memory of events while under the influence of the drug) and is abused for the dissociative sensations and hallucinogenic effects. Ketamine has also been used to facilitate sexual assault. Street Names: Cat Tranquilizer, Cat Valium, Jet K, Kit Kat, Purple, Special K, Special La Coke , Super Acid, Super K, Vitamin K Medical Use: Used as an anesthetic and, more recently, in low doses for treating depression. Effects: Hallucinations, dissociation, and sedation. Long-term misuse leads to cognitive impairment and bladder damage (known as "ketamine bladder"). GHB WHAT IS GHB Gamma-Hydroxybutyric acid (GHB) is another name for the generic drug sodium oxybate. Xyrem® (which is sodium oxybate) is the trade name of the Food and Drug Administration (FDA)-approved prescription medication. Xyrem® is approved as a treatment to improve daytime sleepiness and muscle weakness with narcolepsy (a disorder marked by sudden, unexplained, spontaneous fatigue, napping, or falling asleep throughout the day). Analogues that are often substituted for GHB include GBL (gamma butyrolactone) and 1,4 BD (also called just “BD”), which is 1,4-butanediol. WHAT IS GHB Common street names include: Easy Lay, G, Georgia Home Boy, GHB, Goop, Grievous Bodily Harm, Liquid Ecstasy, Liquid X, and Scoop GHB and its analogues are misused for their euphoric and calming effects and because some people believe they build muscles and cause weight loss. GHB overdose can cause coma and death. Treatment Options Medication-Assisted Treatment: Methadone, buprenorphine for opioids Naloxone: Emergency treatment for opioid overdose Therapy: CBT and support groups help manage addiction Tapering: Necessary for benzodiazepine withdrawal Withdrawal Symptoms of Opioids Early symptoms: Muscle aches, anxiety, sweating Later symptoms: Nausea, vomiting, diarrhea, cravings Severe withdrawal: More intense with fentanyl Street Names: 'Kicking' (slang for heroin withdrawal symptoms) Withdrawal Symptoms Drug Withdrawal Symptoms Heroin Muscle pain, insomnia, nausea, vomiting, diarrhea, cold sweats, cravings. Fentanyl Severe anxiety, muscle spasms, nausea, vomiting, cravings. Oxycodone Flu-like symptoms, nausea, vomiting, insomnia, anxiety. Benzodiazepines Seizures, panic attacks, hallucinations, confusion, insomnia. Barbiturates Seizures, agitation, hallucinations, delirium, death in severe cases. Alcohol Delirium tremens (shaking, confusion, hallucinations), seizures. Benzodiazepine Withdrawal Potentially life-threatening: Seizures, severe panic attacks Gradual tapering: Recommended to avoid dangerous symptoms Street Names: 'Benzo shakes' (slang for benzodiazepine withdrawal) Risks: Long-term withdrawal effects lasting weeks or months Alcohol Withdrawal Delirium tremens (DTs): Life-threatening with shaking, confusion Seizure risk: High risk of fatality without medical supervision Street Names: 'Shakes' (slang for alcohol withdrawal symptoms) Timeline: Symptoms onset 6 to 48 hours after last drink The Risk of Overdose Polydrug use: Combining depressants magnifies overdose risk Fentanyl contamination: Common cause of accidental overdose Street Names: 'Speedballing' (mixing heroin with cocaine) Combining opioids and alcohol: Frequently leads to respiratory failure Medication-Assisted Treatment (MAT) Methadone and buprenorphine: Reduce opioid cravings and withdrawal Long-term support: Helps manage addiction over time Street Names: 'Liquid handcuffs' (methadone maintenance treatment) Chart: MAT effectiveness in opioid addiction recovery Naloxone: Opioid Overdose Reversal Life-saving intervention: Street Names: Blocks opioid 'Narcan' (common receptors to brand for reverse overdose naloxone) Available as nasal Immediate effect: spray or injection Must be administered quickly for best results Detoxification for Alcohol and Benzodiazepines Medical detox: Safe detox: Always Tapering: Gradual Essential to Street Names: conducted in dose reduction for prevent delirium 'Dry out' (detox medical settings benzodiazepines tremens for from alcohol) to manage severe alcohol symptoms Cognitive Behavioral Therapy (CBT) in Addiction Recovery Addresses underlying issues: Anxiety, depression, trauma Teaches coping skills: Manage stress without substances Relapse prevention: Identifies triggers and replaces negative thought patterns Combines with MAT: For opioid and benzodiazepine addictions Support Groups and Recovery Networks Narcotics Anonymous (NA): Peer support for addiction recovery Alcoholics Anonymous (AA): 12-step recovery program for alcohol dependence Importance of peer support: Accountability and shared experiences Building sober communities: Involvement in social groups and sober events Relapse Triggers and Strategies for Prevention Environmental triggers: People, places associated with substance use Emotional triggers: Stress, anxiety, depression Behavioral strategies: Developing new coping mechanisms and healthy routines Social support: Building a sober network to avoid relapse Global Perspectives on Addiction Treatment Portugal's decriminalization: Focuses on treatment rather than punishment Switzerland's harm reduction: Safe injection sites to prevent overdose Canada: Naloxone access and harm reduction strategies Lessons learned: How different countries tackle addiction Economic and Social Impact of the Opioid Crisis Financial cost: Over $1 trillion spent on healthcare, lost productivity Impact on families: Children placed in foster care due to parental addiction Community disruption: Drug-related crimes and homelessness Government response: Lawsuits, prevention programs, treatment funding Future of Drug Policy and Harm Reduction Harm reduction strategies: Safe injection sites, needle exchanges Decriminalization discussions: Reducing the criminal penalties for drug use Increasing access to treatment: Expansion of MAT and naloxone availability Lessons from successful programs: What’s working and how to scale it The Opioid Epidemic and Purdue Pharma History of the Epidemic In the late 1990s, Purdue Pharma released OxyContin, a long- acting form of oxycodone, and marketed it aggressively to physicians, claiming that it had a low risk of addiction. Purdue’s marketing campaign, coupled with the increased emphasis on pain management in the medical community, led to a dramatic increase in opioid prescriptions. By the early 2000s, it became clear that many patients were becoming addicted to opioids. However, by that time, millions of prescriptions had already been written, and the damage had been done. As prescriptions became harder to obtain, many individuals turned to street drugs like heroin and, eventually, fentanyl. Consequences of the Opioid Epidemic According to the Centers for Disease Control and Prevention (CDC), nearly 500,000 people died from opioid overdoses between 1999 and 2019. The opioid epidemic has had devastating consequences on families, communities, and public health systems. The economic costs of the opioid epidemic are staggering, with estimates suggesting that it has cost the U.S. economy over $1 trillion in healthcare costs, lost productivity, and law enforcement expenses. Conclusion: Addressing the Crisis Public health approach: Coordinated efforts from healthcare, law enforcement, and community Early intervention: Education and awareness to prevent addiction Comprehensive treatment: Combining MAT, therapy, and peer support Hope for the future: Reducing stigma and increasing access to care Illegal Production and Trade of Depressants Heroin Heroin is produced primarily in Afghanistan, which supplies more than 90% of the world's heroin. The drug is smuggled into consumer markets by organized crime groups, including Mexican cartels, which control much of the heroin trade into the United States. Fentanyl Fentanyl is primarily manufactured in clandestine labs in China and Mexico. The drug is often mixed with heroin or pressed into counterfeit pills, making it difficult for users to know the true potency of the drugs they are taking. In 2020, the DEA reported a significant increase in fentanyl seizures at the U.S.- Mexico border, as cartels began trafficking larger quantities of the drug to meet growing demand in the U.S. Benzodiazepines Illicit benzodiazepines are often produced in illegal labs, particularly in Eastern Europe and Asia. These counterfeit pills are frequently mixed with fentanyl or other dangerous substances, increasing the risk of overdose.  STIMULANTS ABUSE AND MISUSE IMPH-495 Dr Christos Petrou Click to edit Master subtitle style A Comprehensive Analysis of Stimulant Drugs, Their Uses, and Effects Μαθησιακά αποτελεσματα Κατανοήστε τις φυσιολογικές και ψυχολογικές επιδράσεις διαφόρων διεγερτικών Μάθετε μεθόδους λήψης και αναγνωρίστε τα πρότυπα κακής χρήσης Αναγνωρίστε τα συμπτώματα στέρησης και την πιθανότητα εξάρτησης Συζητήσετε τις μεθόδους διακοπής/απεξάρτησης  Types of Stimulant Drugs Drug Common Names Forms Methods of Use Cocaine Blow, Coke Powder, Crack Snorted, Injected, Smoked Methamphetamine Meth, Crystal Crystal, Powder Smoked, Snorted, Injected Nicotine Tobacco Cigarettes, E-cigarettes Smoked, Vaped Caffeine Coffee, Tea Liquid, Pills Ingested  Street Names Stimulant Street Names Blow, Coke, Snow, Flake, White, Toot, Crack (for Cocaine the smokable form) Meth, Crystal, Ice, Crank, Speed, Chalk, Tweak, Methamphetamine Glass, Batu, Shards No specific street names (common beverages: Caffeine Coffee, Tea, Energy Drinks) Khat Abyssinian Tea, African Salad, Catha, Chat, Kat, Oat Ecstasy (MDMA) E, X, XTC, Molly, Adam, Beans, Disco Biscuits Speed, Uppers, Pep Pills, Adderall (for prescription Amphetamines forms), Bennies, Black Beauties Synthetic Cathinones Bath Salts, Plant Food, Flakka, Cloud Nine, Scarface  Effects of Stimulants Drug Short-term Effects Long-term Effects Cocaine Euphoria, Alertness Heart issues, Nasal damage Methamphetamine Increased energy Severe dental problems, Skin sores Nicotine Increased alertness Cancer, Heart disease Caffeine Increased alertness Insomnia, Anxiety Cocaine Cocaine History and Origin of Cocaine: Derived from the coca plant (Erythroxylon coca), native to South America. Traditionally used by indigenous people for stamina and as a medicine. Cocaine was isolated in the 19th century and became popular in medicine. Its use has since shifted to recreational misuse and addiction. Chemical Structures: Cocaine (active compound) - Ecgonine (primary metabolite) - Similar molecules: Procaine, Lidocaine (synthetic analogs used as anesthetics) - Other metabolites: Benzoylecgonine, Methylecgonine Cocaine: Effects and Risks Short-term effects: Intense euphoria, increased energy, heightened alertness. Long-term effects: Heart disease, respiratory problems, paranoia, hallucinations, weight loss. Withdrawal: Depression, fatigue, increased appetite, irritability, sleep disturbances. Health risks: Heart attack, stroke, severe nasal damage from snorting. Cocaine: Forms and Methods of Use Forms of Cocaine: Powdered Cocaine (Cocaine Hydrochloride) Crack Cocaine (Cocaine Base) Methods of Use: Snorting Smoking Injection Medical Uses of Cocaine Cocaine is occasionally used for its anesthetic properties, especially in ENT surgeries due to its vasoconstrictive abilities. However, its medical use is highly limited because of its high potential for abuse. Physiological and Neurological Effects Short-term effects: Euphoria Increased heart rate Vasoconstriction Neurological Impact: Increases dopamine by blocking reuptake. Cocaine Misuse and Addiction Patterns of Misuse: Binge use - Speedballing Addiction Potential: Rapid tolerance Psychological dependence Cocaine Withdrawal Symptoms Cocaine: Long-term Health Risks Cardiovascular damage, including heart attack, stroke, and high blood pressure. Nasal damage from snorting, including perforated septum. Permanent brain damage, leading to cognitive impairment and mood disorders. Increased risk of respiratory failure, especially with crack cocaine. Cocaine: Addiction and Withdrawal Cocaine is highly addictive due to the intense but short-lived high. Withdrawal symptoms include depression, fatigue, irritability, and intense cravings. Users often experience 'crashes' that lead to further drug-seeking behavior. Health Risks and Dangers Cardiovascular Risks: Heart attack Stroke Arrhythmias Respiratory and Nasal Damage: Erosion of nasal cavity Respiratory issues Cocaine and the 'Fight-or-Flight' Response Mechanism: Cocaine stimulates the sympathetic nervous system, triggering the 'fight-or- flight' response. Effects: Heightened alertness Increased anxiety Physical stress response Social and Behavioral Effects Behavioral Effects: - Increased risk-taking - Social inhibition reduction Sexual Effects: - Enhanced desire - Impaired performance Cocaine addiction Cocaine addiction leads to serious physical, psychological, and social consequences. It affects the brain's reward system, driving compulsive drug- seeking behavior and making it difficult to stop without professional help. Long-term use can lead to permanent damage to the heart, brain, and other vital organs. Additionally, the mental health impacts, including paranoia, depression, and anxiety, can persist long after cocaine use has stopped, making recovery challenging but crucial for long-term health and well-being. Key Facts About Alcohol and Cocaine Co-abuse Prevalence: Co-abuse of alcohol and cocaine is common, leading to compounded health risks. Shared Neural Mechanisms: - Both substances affect the same neural pathways, creating reinforcing effects and greater neuroadaptation. Neuroadaptations from Chronic Use Chronic use of cocaine leads to neuroadaptations, particularly in the glutamate system. Impact on Glutamate: - Changes in glutamate homeostasis contribute to dependence. Potential for Treatment: - Research focuses on targeting glutamate transporters for treating dependence. Challenges in Treating Co-dependence Treating co-dependence of alcohol and cocaine requires addressing the unique interactions between the two substances. Different treatment approaches are needed to tackle the complexity of co- abuse. Cocaine Addiction Treatment Behavioral Therapy (CBT and Contingency Management): CBT helps manage cravings and prevent relapse. Contingency management provides rewards for staying clean. Motivational Interviewing (MI): Focuses on building motivation to stop using cocaine. 12-step Programs: Support groups like Cocaine Anonymous (CA) offer a structured, community-based support system. Medications (in research): Studies are looking into medications like Disulfiram (used for alcohol dependence) and Topiramate. Inpatient and Outpatient Rehabilitation: Structured programs that offer detox, counseling, and therapy. Medications (In Research) Disulfiram: Currently used to treat alcoholism, it has shown promise in some studies for reducing cocaine use. Topiramate: An anticonvulsant drug being studied for its potential to reduce cocaine cravings. Modafinil: A medication used to treat narcolepsy, which is being researched for its effects on reducing cocaine use. Baclofen: A muscle relaxant that has shown potential in decreasing cocaine cravings in some studies. Slang Terms for Cocaine and Related Use Cocaine Slang Terms: - Blow, Coke, Snow, Flake, Soda, Cot Crack Cocaine Slang Terms: - Crack, Rock Usage and Combination Slang: - Speedballing, Binge Cultural and Regional Variations: Slang terms vary widely by region and culture. Reasons for Abuse and Misuse Reasons for Cocaine Abuse and Misuse: - Desire for euphoria and enhanced mood - Increased alertness and energy - Peer pressure and social factors - Escapism from stress, anxiety, or depression - Curiosity and experimentation - Influence of media and glamorization of drug use Summary Points Key Takeaways: - Cocaine is a potent stimulant with significant implications for health and behavior. Complexity of Co-abuse: - Understanding the neural mechanisms is crucial for developing effective treatments. Call to Action: - Emphasize the importance of education and awareness in preventing misuse and treating addiction. Conclusion Cocaine is a potent stimulant with significant risks to both physical and mental health. Continued education and awareness are essential in combating its misuse and promoting safe practices. Amphetamines Amphetamine: What is it? Amphetamine is a central nervous system stimulant that is used to treat ADHD, narcolepsy, and obesity. It has a high potential for abuse and is commonly used illicitly. Amphetamines were first synthesized in 1887 in Germany and were initially used medically in the 1930s to treat nasal congestion and ADHD. Amphetamine: Street Names Speed, Uppers, Bennies, Black Beauties, Eye- openers, Wake-ups. Amphetamine: Appearance and How it’s Abused Amphetamine is commonly available in pill It can be snorted, or capsule form but can swallowed, or injected. also be crushed, dissolved in water, and injected. Amphetamine: Effects on the Mind Increased alertness, euphoria, excitement, enhanced cognitive performance, reduced fatigue. Amphetamine: Effects on the Body Increased heart rate, blood pressure, decreased appetite, insomnia, weight loss. Amphetamine: Overdose Effects Paranoia, psychosis, heart attack, stroke, seizures, hyperthermia. Amphetamine: Similar Drugs Methamphetamine Cocaine. Amphetamine: Legal Status Amphetamine is a Schedule II drug in the U.S., meaning it has a high potential for abuse but is available by prescription for specific conditions. Methamphetamine: What is it? Methamphetamine is a potent and addictive stimulant that affects the central nervous system, closely related to amphetamine but with stronger effects. First synthesized in Japan in 1893, methamphetamine has been used as a decongestant, weight-loss aid, and to increase alertness. Methamphetamine: Street Names Crystal, Meth, Crank, Ice, Tina, Glass, Shards. Methamphetamine: Appearance and How it’s Abused Methamphetamine comes in powder, pill, and crystal form. It can be swallowed, snorted, injected, or smoked. Methamphetamine: Effects on the Mind Increased energy, euphoria, enhanced alertness, hallucinations, paranoia, violent behavior. Methamphetamine: Effects on the Body Increased heart rate, hyperthermia, weight loss, skin sores, severe dental problems ('meth mouth'). Methamphetamine’s effects include increased metabolism, heightened alertness, and a sense of euphoria, which can explain its popularity, especially among certain communities such as long-haul truck drivers and in sexual contexts. However, methamphetamine use can lead to dangerous side effects, including paranoia, hallucinations, aggressive behavior, and heart failure. Tolerance develops quickly, requiring users to take higher doses to achieve the same effects. Withdrawal from methamphetamine can result in severe depression, fatigue, and violent behavior. Heavy users may suffer from a drug-induced psychosis that mimics schizophrenia. Methamphetamine: Short-term Effects Intense euphoria, heightened energy, increased alertness. Increased heart rate, rapid breathing, and elevated blood pressure. Aggressive behavior, paranoia, and anxiety during intoxication. Can lead to risky behaviors, such as unsafe sexual practices and violent outbursts. Methamphetamine: Long-term Health Risks Cognitive impairment, including memory loss and difficulty concentrating. 'Meth mouth' – severe dental problems caused by dry mouth and teeth grinding. Permanent brain damage, leading to emotional instability and psychosis. Increased risk of heart attack, stroke, and respiratory issues. Methamphetamine: Addiction and Withdrawal Highly addictive due to intense euphoria and rapid tolerance development. Withdrawal symptoms include severe fatigue, depression, anxiety, and intense cravings. Psychosis, hallucinations, and violent behavior can occur during withdrawal. Methamphetamine: Addiction and Withdrawal Methamphetamine also carries high risks for those engaged in hypersexual behaviors, particularly in the context of unprotected sex, which increases the transmission of sexually transmitted infections such as HIV/AIDS. Booty-bumping (rectal administration) is a method of methamphetamine use particularly popular in the gay community. Methamphetamine: Overdose Effects Heart failure, stroke, seizures, hyperthermia, kidney failure. "Meth Mouth": Severe dental problems, including tooth decay and gum disease, are commonly associated with meth use. Meth reduces saliva, leading to dry mouth, and users often grind their teeth. Premature Aging: Accelerated Aging: Meth users often appear much older than their actual age due to the damage it causes to the body and skin, as well as the malnutrition and poor hygiene associated with chronic use. Methamphetamine: Similar Drugs Amphetamine, Cocaine. Khat Khat: What is it? Khat is a stimulant drug derived from the leaves of the Catha edulis shrub. It is commonly chewed for its stimulating effects. Khat: Origins Khat is a flowering evergreen shrub native to the Horn of Africa and the Arabian Peninsula, particularly in countries like Ethiopia, Yemen, Somalia, and Kenya. It has been consumed for centuries for its mild stimulant effects, especially during social gatherings. The main active ingredients in khat are cathinone and cathine, both of which produce effects similar to amphetamines, though much milder. The use of khat is deeply ingrained in cultural and social practices in these regions, where it is commonly chewed in a communal setting, much like coffee is consumed in other parts of the world. The effects are mild euphoria, increased sociability, and heightened alertness. Khat: Street Names Abyssinian African Catha Tea Salad Chat Kat Khat: Appearance and How it’s Abused Khat is typically chewed, and the leaves are kept in the cheek to release the active chemicals. It can also be brewed as tea or smoked. Active Ingredients and Effects Cathinone: The primary stimulant in fresh khat leaves. Produces effects similar to amphetamine, such as increased energy, alertness, and mild euphoria. Breaks down quickly into cathine, a less potent stimulant. Cathine: Found in dried khat leaves. Less potent than cathinone, but still provides mild stimulating effects. Effects of Khat Use Short-Term Effects: Increased alertness and energy. Euphoria and increased sociability. Suppressed appetite. Increased heart rate and blood pressure. Long-Term Effects: Oral health problems, including tooth decay and gum disease. Gastrointestinal issues. Sleep disturbances and insomnia. Anxiety, irritability, and depression in chronic users. Increased risk of cardiovascular issues like high blood pressure and heart disease. Khat Effects on the Mind: Khat induces euphoria, increased sociability, and mild hallucinations. Chronic use can lead to paranoia, depression, and violent behavior. Effects on the Body: Increased heart rate, high blood pressure, brown staining of teeth, and gastrointestinal problems. Overdose Effects: Toxicity symptoms include delusions, difficulty breathing, heart complications, and liver damage. Khat: Similar Drugs Amphetamine, Methamphetamine. Trade and impact The global illegal trade of khat has grown in response to its prohibition in Western countries. Smuggling networks operate to transport fresh khat leaves to markets where demand exists, primarily within immigrant communities from East Africa and the Arabian Peninsula, who maintain traditional uses of the plant. Smugglers often use couriers, hidden compartments in vehicles, and air freight to transport the plant before it loses its potency. Supply and Demand: Countries like Kenya, Ethiopia, and Yemen are primary producers of khat, with large swathes of farmland dedicated to cultivating the shrub. In Kenya, khat is known as "miraa," and it is a significant source of income for farmers. The demand for khat remains high in countries where it is legal, and there is also demand in regions where it is banned, particularly among immigrant populations from khat-growing regions. Transportation: Smugglers must ensure that the khat leaves are kept fresh, as the psychoactive component, cathinone, degrades quickly after harvesting. It is often transported via air freight, with smugglers using secretive methods to move khat quickly from East Africa to Europe or North America. Courier networks often use vehicles with hidden compartments to bypass customs checks. Legal Consequences: In countries where khat is banned, individuals caught possessing or trafficking khat face severe legal penalties, including imprisonment and large fines. There have been numerous high-profile khat trafficking busts, particularly in the UK and US, where law enforcement agencies target smuggling rings. Economic Impact: The cultivation of khat is a major economic driver in some East African countries. In Kenya, for example, it is a vital cash crop for many farmers in areas like Meru. However, it has sparked debates about the negative impacts of its cultivation, particularly concerning water usage and the replacement of food crops with khat farming. Khat's illegality in key markets such as Europe has created a black market that sustains organized crime. Impact The long-term use of khat has been associated with several health risks, including: Addiction and Dependence: While khat is not as addictive as substances like cocaine or methamphetamine, long-term use can lead to psychological dependence. Users often chew khat for several hours a day, leading to social and economic consequences. Mental Health Issues: Chronic use can lead to mental health problems such as anxiety, irritability, and depression. Heavy users may experience manic episodes, paranoia, and psychosis. Oral and Dental Issues: Chewing khat leaves can cause serious dental issues, including tooth decay, gum disease, and the staining of teeth. Socioeconomic Impact: In some regions, heavy khat use has been associated with reduced productivity, family breakdown, and financial difficulties due to the amount of time and money spent on khat consumption. Bath salts Local Admissions (EU) Synthetic Cathinones: What is it? Bath Salts (Synthetic Cathinones) Overview Bath salts are a group of synthetic stimulants that are chemically similar to cathinone, a substance found in the khat plant. These synthetic drugs are part of a broader class of substances known as designer drugs, created to mimic the effects of other stimulants, such as methamphetamine or MDMA (ecstasy). Despite their name, they have no connection to actual bathing products; the term "bath salts" was adopted as a misleading marketing tactic to avoid legal restrictions. Bath salts are commonly sold as a white or brown crystalline powder and are often labeled "not for human consumption." They are marketed under various names, including "plant food," "research chemicals," or even "cleaners." The substances are typically sold online or in head shops and gas stations, packaged in small, colorful packets. Synthetic Cathinones: Origins Synthetic cathinones appeared in the recreational drug market in the mid- 2000s, often sold as 'bath salts' or 'plant food'. Synthetic Cathinones The active ingredients in bath salts are synthetic cathinones, a class of drugs that includes substances such as: Methylenedioxypyrovalerone (MDPV) Mephedrone Methylone Alpha-PVP (Flakka) These chemicals are potent central nervous system stimulants that mimic the effects of more commonly known drugs, such as amphetamines, cocaine, and MDMA Synthetic Cathinones: Street Names Bath Salts Plant Food Flakka Cloud Nine. Synthetic Cathinones: Appearance and How it’s Abused Bath salts are typically ingested through the following routes: Snorted: The powder form of bath salts is often snorted through the nose, producing rapid effects. Ingested: Some users mix the powder with liquid and ingest it, although this method takes longer for the effects to be felt. Injected: In some cases, bath salts are dissolved in water and injected, which increases the intensity of the effects and the associated health risks. Smoked: Occasionally, bath salts are smoked, although this is less common. Synthetic Cathinones: Effects on the Mind Short-Term Effects The effects of bath salts are highly unpredictable, depending on the specific chemical used, the dose, and the user's individual response. Some of the common short-term effects include: Euphoria: Users report intense feelings of pleasure, heightened energy, and increased alertness. Increased Sociability: Bath salts can lead to heightened social interaction, similar to the effects of MDMA. Sexual Arousal: Some users report increased sexual arousal, which can lead to risky sexual behaviors. Agitation and Aggression: One of the most dangerous short-term effects is extreme agitation, which can escalate into aggression, violence, or self-harm. Synthetic Cathinones: Effects on the Body The unpredictable nature of bath salts is what makes them particularly dangerous. Many users experience severe side effects, even after taking relatively small doses. These side effects include: Paranoia: Users may become extremely paranoid, often believing they are being watched or pursued. Hallucinations: Bath salts can cause vivid and frightening hallucinations, leading to dangerous or erratic behavior. Panic Attacks: The intense stimulation of the nervous system can cause extreme panic, anxiety, and fear. Increased Heart Rate and Blood Pressure: Users often experience a rapid heart rate, elevated blood pressure, and even chest pain, which increases the risk of heart attack or stroke. Hyperthermia: One of the most dangerous effects is a severe increase in body temperature, which can lead to organ failure or death. Muscle Breakdown: Rhabdomyolysis, the breakdown of muscle tissue, is another severe side effect that can cause kidney failure. Effects Addiction and Dependence: Users of bath salts can quickly develop a tolerance to the drug, leading to frequent and higher doses. Long-term users often develop a dependence, experiencing cravings and withdrawal symptoms when not using the drug. Memory Loss: Chronic use of bath salts can impair cognitive function, particularly memory and decision-making abilities. Psychosis: Many users experience prolonged psychosis, characterized by paranoia, hallucinations, and erratic behavior. This can persist long after the drug has left the system. Aggressive and Violent Behavior: Long-term users may develop increasingly violent tendencies, often attacking others or engaging in self-harm. Cardiovascular Problems: Prolonged use can lead to chronic high blood pressure, heart damage, and an increased risk of heart attack or stroke. Kidney and Liver Damage: The toxic nature of bath salts can cause damage to the kidneys and liver, especially in users who frequently inject or ingest the substance. Synthetic Cathinones: Overdose Effects Overdose can lead to heart attack, stroke, severe dehydration, kidney failure, and death. Synthetic Cathinones: Similar Drugs Amphetamines, Methamphetamine. Caffeine Caffeine: What is it? Caffeine is a stimulant found in coffee, tea, cola, chocolate, and various over- the-counter medications. It is the most widely consumed psychoactive drug. Caffeine: Effects and Risks Found in coffee, tea, energy drinks, and chocolate. Short-term effects: Increased alertness, decreased fatigue, jitteriness. Long-term risks: Anxiety, insomnia, heart problems, digestive issues. Withdrawal symptoms: Headaches, fatigue, irritability, nausea. Overdose: Rapid heart rate, high blood pressure, seizures, and in rare cases, death. Caffeine Effects on the Mind: Increased alertness, decreased fatigue, improved focus, but can cause anxiety and insomnia in high doses. Effects on the Body: Increased heart rate, increased urination, jitteriness, gastrointestinal discomfort. Overdose: In high doses, caffeine can cause restlessness, rapid heartbeat, muscle tremors, and, in extreme cases, death. SSRIs SSRIs: What is it? Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of antidepressants used to treat major depressive disorders and anxiety. SSRIs help alleviate depression, anxiety, and mood disorders by increasing serotonin levels in the brain. SSRIs can cause nausea, dizziness, dry mouth, sexual dysfunction, and weight changes. SSRIs: Overdose Effects While SSRI overdose is rare, it can cause serotonin syndrome, leading to confusion, rapid heart rate, and high blood pressure. SSRIs: Uses and Risks Selective Serotonin Reuptake Inhibitors (SSRIs) used as antidepressants. Commonly prescribed for depression and anxiety disorders. Long-term use: Can lead to emotional numbness, sexual dysfunction, weight gain. Withdrawal: Anxiety, dizziness, flu-like symptoms, 'brain zaps'. Not typically abused, but some misuse due to withdrawal avoidance. Nicotine Nicotine: Nicotine is a naturally occurring stimulant found in tobacco plants. It is one of the most commonly abused stimulants, primarily through smoking cigarettes, cigars, and using smokeless tobacco products. Nicotine acts on the central nervous system by stimulating the release of dopamine, leading to feelings of pleasure and relaxation. However, nicotine is highly addictive, and its use is associated with numerous health risks, including cardiovascular disease, respiratory issues, and cancer. Nicotine Health risks, including: Cardiovascular Disease: Nicotine increases heart rate and blood pressure, leading to long-term damage to the heart and an increased risk of heart attacks and strokes. Respiratory Issues: Smoking tobacco products can lead to respiratory problems, including chronic obstructive pulmonary disease (COPD) and lung cancer. Cancer: Nicotine use is linked to various types of cancer, including lung, throat, and mouth cancer. Addiction and Dependence: Nicotine use leads to physical and psychological dependence, characterized by intense cravings and withdrawal symptoms. Nicotine therapies Nicotine Replacement Therapies (NRTs): NRTs, such as patches, gums, and lozenges, provide controlled doses of nicotine to help manage withdrawal symptoms. Bupropion (Zyban/Wellbutrin): Bupropion is a prescription medication that reduces cravings and withdrawal symptoms by acting on the brain's reward pathways. Varenicline (Chantix): Varenicline blocks nicotine receptors in the brain, reducing both cravings and the pleasurable effects of nicotine. Behavioral Therapy: Counseling and support programs play an essential role in smoking cessation by addressing the psychological aspects of nicotine addiction. Energy Drinks Energy Drinks They are often consumed by individuals seeking a quick pick-me-up, particularly during periods of intense physical activity, studying, or work. However, the high caffeine and stimulant content in energy drinks, combined with aggressive marketing, has raised concerns about their impact on health, especially when abused or misused. Composition of Energy Drinks Energy drinks typically contain a combination of ingredients designed to boost energy and mental focus. The primary active components are: Caffeine: The most common stimulant in energy drinks, caffeine levels can range from 50 to over 300 mg per serving, with some drinks containing even higher amounts. Caffeine stimulates the central nervous system, improving alertness, reducing fatigue, and enhancing physical endurance. However, excessive caffeine consumption can lead to side effects like jitters, anxiety, increased heart rate, and insomnia. Sugar: Most energy drinks contain high levels of sugar, which provides a rapid source of energy. However, excessive sugar intake is linked to various health problems, including weight gain, insulin resistance, and metabolic disorders. Taurine: An amino acid that supports neurological development and regulates water and mineral balance in the blood. Taurine is believed to improve physical performance, but its long-term effects, especially in combination with caffeine, are not well understood. B-Vitamins: Energy drinks often contain high doses of B vitamins, such as B12, B6, niacin, and riboflavin. These vitamins are essential for converting food into energy, but excessive intake can lead to side effects like skin flushing and gastrointestinal issues. Herbal Extracts (e.g., Ginseng, Guarana): These ingredients are believed to enhance cognitive performance and energy levels, although their efficacy in energy drinks is not well- supported by scientific evidence. Guarana, in particular, is a source of additional caffeine, increasing the stimulant content. Other Additives: Some energy drinks may include other substances such as L-carnitine (involved in fat metabolism) or glucuronolactone (a substance thought to reduce fatigue). Use and Role of Energy Drinks Energy drinks are predominantly consumed for: Increased Alertness: Caffeine and other stimulants in energy drinks improve mental alertness, making them popular among students, athletes, and workers who require extended focus. Physical Endurance: Many athletes and fitness enthusiasts use energy drinks to enhance physical performance during workouts or competitions. Social and Recreational Purposes: Energy drinks are often consumed in social settings, sometimes combined with alcohol to prolong energy levels during parties or events. Stress Management and Study Aid: Students frequently use energy drinks to stay awake and maintain concentration during late-night study sessions or exams. Short-term Effects Increased Energy and Alertness: Energy drinks can temporarily increase energy levels, mental alertness, and concentration, making them useful for short bursts of physical or mental activity. Elevated Heart Rate and Blood Pressure: The caffeine content in energy drinks stimulates the cardiovascular system, increasing heart rate and blood pressure. This can be problematic for individuals with underlying heart conditions or those prone to anxiety. Improved Physical Performance: Some studies suggest that energy drinks can enhance endurance and physical performance, particularly in aerobic exercises. However, this benefit is generally outweighed by potential risks, especially if consumed excessively. Long-term Effects Caffeine Dependence: Regular consumption of energy drinks can lead to caffeine dependence, resulting in withdrawal symptoms like headaches, irritability, fatigue, and depressed mood when caffeine intake is reduced. Obesity and Metabolic Issues: Many energy drinks contain high amounts of sugar, contributing to excessive calorie intake, which can lead to weight gain, insulin resistance, and increased risk of type 2 diabetes. Cardiovascular Risks: Chronic use of energy drinks, particularly those high in caffeine, has been associated with cardiovascular issues such as hypertension, heart palpitations, and, in extreme cases, heart arrhythmias or cardiac arrest. Mental Health Issues: Excessive consumption of energy drinks has been linked to anxiety, agitation, and sleep disturbances. It can also exacerbate mental health disorders, including depression and panic attacks. Treatment Options for Stimulant Addiction Behavioral Therapy: Cognitive Behavioral Therapy (CBT), Contingency Management. Support Groups: Narcotics Anonymous (NA), Cocaine Anonymous (CA). Medications: Trials for meth addiction include Bupropion. Inpatient/Outpatient Rehabilitation: Structured recovery programs with therapy and counseling. Counseling and Mental Health Support: Treating co-occurring mental health disorders. Treatment Options for Cocaine Addiction Behavioral Therapies: CBT, Contingency Management, Motivational Interviewing. Support Groups: Cocaine Anonymous (CA), Narcotics Anonymous (NA), Group Therapy. Medications (in research): Disulfiram, Topiramate, Modafinil, Baclofen. Inpatient Rehabilitation: Detox, Residential Treatment, long-term care in structured settings. Outpatient Rehabilitation: Intensive Outpatient Programs (IOP), Standard Outpatient Programs. Dual Diagnosis Treatment: Treating co-occurring mental health conditions (depression, anxiety, PTSD). Exercise and Nutrition Therapy: Physical activity and proper nutrition to support recovery. Relapse Prevention: Coping strategies, ongoing counseling, and support. Family Therapy: Improving communication and relationships, involving family support. Phased Recovery Programs: Gradual progression towards recovery with increasing responsibility. Medications under research: Disulfiram, Topiramate, Modafinil Methamphetamine Addiction Treatment Options Behavioral therapies: CBT, Contingency Management, Matrix Model. Inpatient rehabilitation: Detox, structured therapy, counseling. Outpatient rehabilitation: Intensive Outpatient Programs (IOP). Overview: Treatment Options for Stimulant Addiction Behavioral therapies: CBT, Motivational Interviewing, Contingency Management. Medications: No FDA-approved medication for meth or cocaine addiction (research ongoing). Support Groups: CA, NA, 12-step programs, Group Therapy. Inpatient and Outpatient Rehabilitation: Detox, structured therapy, and counseling. Common Triggers for Relapse Stress and Anxiety: High-stress situations often trigger relapse. Social Circles: Being around people who use drugs increases temptation. Emotional Distress: Sadness, loneliness, or anger can drive relapse. Environmental Cues: Places or objects associated with drug use can trigger cravings. Overconfidence in Recovery: Some believe they can handle 'just one more time'. Cocaine Relapse Triggers Cocaine: High-Stress Situations: Stressful life events or overwhelming responsibilities can trigger a desire for the drug's stimulating effects. Social Circles and Parties: Being around individuals who use cocaine or attending parties where it's used. Emotional Distress: Feelings of sadness, anger, loneliness, or frustration can push individuals toward relapse. Triggers in the Environment: Places where cocaine was used in the past or seeing paraphernalia. Overconfidence in Recovery: Some people may feel they have fully recovered and can use cocaine "just once" without falling back into addiction. Relapse Prevention Strategies Develop coping mechanisms for stress and triggers. Build a strong support network through family, friends, and support groups. Continue therapy and counseling to address ongoing challenges. Stay active and engaged in healthy, fulfilling activities. Consumption Trends Over Time Withdrawal Symptoms Comparison Treatment Options Comparison Common Relapse Triggers Meth vs. Cocaine Effects Comparison Caffeine vs. Meth vs. Cocaine Effects Legal Consequences of Stimulants Consumption Trends Over Time Methamphetamine vs Cocaine Effects Comparison Caffeine vs Methamphetamine vs Cocaine Effects Case Study 1: Methamphetamine Addiction John, a 32-year-old male, began using methamphetamine in his early 20s to cope with stress. Over time, he developed a serious addiction, leading to job loss and social isolation. Symptoms included severe weight loss, paranoia, and 'meth mouth' (extensive dental decay). He entered an inpatient rehab program and underwent Cognitive Behavioral Therapy (CBT). After 12 months of treatment and support from Narcotics Anonymous, John has been drug-free for two years. Case Study 2: Cocaine Addiction Sarah, a 28-year-old woman, began using cocaine recreationally at parties, but quickly became dependent. She developed severe mood swings, anxiety, and had a series of panic attacks related to cocaine use. After experiencing a heart attack from a cocaine overdose, Sarah sought help. She completed a 90-day inpatient program and continues therapy through Cocaine Anonymous. Sarah has been clean for 18 months and is focusing on rebuilding her career and relationships. Case Study 3: Caffeine Addiction David, a 40-year-old office worker, developed a dependency on caffeine, consuming up to 10 cups of coffee daily. He experienced chronic insomnia, anxiety, and frequent headaches when he reduced his intake. He decided to quit caffeine after being diagnosed with high blood pressure. Through gradual reduction, hydration, and support from a therapist, David successfully reduced his caffeine intake. He now limits himself to one cup per day and has significantly improved his sleep and mental health. Case Study 4: Dual Diagnosis (Methamphetamine and Depression) Anna, a 35-year-old woman, was diagnosed with both methamphetamine addiction and severe depression. Meth use intensified her depressive episodes and led to self-isolation and suicidal ideation. She entered a dual diagnosis treatment program, receiving therapy for both addiction and depression. Through a combination of CBT and antidepressant medication, Anna has remained sober for over a year. She continues to attend outpatient therapy and participate in Narcotics Anonymous meetings. Case Study 5: Khat Addiction and Legal Consequences Ahmed, a 45-year-old man from East Africa, was a habitual khat chewer for over 10 years. He experienced paranoia, weight loss, and oral health issues, but continued due to social acceptance. After moving to the U.S., where khat is illegal, he faced legal consequences and was arrested for possession. Ahmed entered a court-mandated rehab program, receiving counseling and support to quit khat. He has been sober for 8 months and is working to restore his legal status and health. Κατάχρηση Φαρμάκων και Εξάρτηση IMPH-495 L2 Substance Use Disorders Click to edit Master subtitle style Δρ Χρίστος