Drugs of abuse

Tetrahydrocannabinol -THC- ( Cannabis )

The main psychoactive alkaloid contained in marijuana
N.B. Hashish , Marijuana & bhang obtained from cannabis plant
- THC can produce : - Adverse effects :

- euphoria, followed by drowsiness and relaxation. - increased heart rate,

- affecting short-term memory and mental activity. - decreased blood pressure,
- decreasing muscle strength - Red eye
- impairs highly skilled motor activity, such as that required to drive a car.
- At high doses, a toxic psychosis develops.
• Its wide range of effects include:
- appetite stimulation,
- Tolerance and mild physical dependence occur with
- xerostomia,
continued, frequent use of the drug.
- visual hallucinations,
- delusions,
- enhancement of sensory activity.

Appearance: Dried plant material, in different shades of

……………………green and brown
Delivery: Commonly smoked, occasionally ingested

Lysergic acid diethylamide -LSD- ( Hallucinogens )

Actions Treatment
The drug shows serotonin (5-HT) agonist activity at : - Haloperidol
and other neuroleptics can block the hallucinatory action of LSD
- presynaptic 5-HT1 receptors in the midbrain,
and quickly abort the syndrome.
- also 5-HT2 receptors.
- BZDz.
- Acute effects (with low doses)of LSD induce : - Antipsychotic.
1- hallucinations – delusions – illusions
2- brilliant colors.
3- Ephoria & sensory changes.

Nicotine ( CNS stimulants )

- Adverse effects
Nicotine is a selective agonist of the nicotinic acetylcholine
receptor (nAChR) that is normally activated by acetylcholine, - intestinal cramps,
nAChRs are expressed on dopamine neurons. - diarrhea,
- increased heart rate and blood pressure.
- cigarette smoking increases the rate of metabolism for a
Acute effects : number of drugs.
some degree of euphoria and arousal as well as relaxation.It - Treatment
improves attention, learning, problem solving, and reaction time.
- Psychotherapy
- nicotine replacement by : - nicotine gum
Risk of chronic abuse :
- transdermal nicotine patch
- cancer - lung diseases - ischemic heart diseases.
- Bupropion :
Withdrawal syndrome : • is an atypical antidepressant and smoking cessation aid
Insomnia – anxiety – increase appetite – decrease concentration – • Bupropion reduces the severity of nicotine cravings and
headache – aggressiveness withdrawal symptoms.

Barbiturates & Benzodiazepines ( CNS depressant )

Acute effects : - Treatment
Euphoria – relieve anxiety - insomnia
Risk of chronic abuse : Replace the short acting agent by a longer acting one (less sever
Anterograde – retrograde memory loss withdrawal :

Withdrawal syndrome : - Phenobarbital for pentobarbital

Insomnia – anxiety – tremor – delirium – hallucinations – - Diazepam for alprazopam triazolam
convulsions
Opioids ( CNS depressant )
- Treatment
Acute effects :
1- Methadone : (longer-acting, less withdrawal symptoms)
Euphoria – Drowsiness & hyperactivity Replacement of heroin or morphine by methadone followed by its
Risk of chronic abuse : gradual withdrawal
Fatal overdose – homicide – suicide – increase risk of infection 2- Clonidine:
Withdrawal syndrome : To inhibit sympathetic discharge
Insomnia – anxiety – tremor – SPATHATIC OVER ACTIVITY. 3- treatment of the sympathetic withdrawal symptoms e.g. anxiolytics
, antiemetics , anti-spasmodics.
 1- Oxycodone (opioids)
Dr.Ahmados
- It is a semisynthetic derivative of morphine.
• Appearance: Pills
• Delivery: oral ingestion
• Effects: relaxed, calm, lower rate of respiration

- Abuse of the sustained-release preparation (ingestion of crushed tablets) has been implicated in many deaths.

2- Heroin (opioids)
• Heroin is converted to morphine in the body
• Appearance: Powder, or black tar-like substance, colors can range from white to brown to black
• Delivery: injected or smoked
• Effect: sleepiness, slow resiration, loss of appetite or other desires, constipation, loss of memory

Cocaine ( CNS stimulants )

• Appearance: powder or in solid pieces
• Delivery: injected, intranasal or smoked
• Effects:
Cocaine is highly addictive drug due to it's short duration of action (1,5 h), so need to get the drug each 15 min. to get the euphoria and avoid the
physical withdrawal symptoms.
- Risks during acute administration:
1- euphoria I.V : intense & risk of infection,, Intranasal: less euphoria & nasal septal perforation ,, Smoking: intense euphoria
2- increases mental awareness
3- and produces a feeling of well-being Withdrawal symptoms :
Fatigue – sleep – depression – overeating
- Overdose toxicity (due to potentate the actions of catecholamines) :
1- tremors and convulsions,
Treatment
2- Arrythmia – increase BP – myocardial infarction – cerebral aciddents
Treated by : Anti-depressants – antipsycotics
- Risk with chronic use: produce hallucinations and delusions

Amphetamine & Methamphetamine ( CNS stimulants )

• Appearance: Pill
• Delivery: oral ingestion
• Effect:
Amphetamine Similar to the Cocaine but: longer acting – less addictive with more psychosis.
Methamphetamine is a CNS stimulants as amphetamine with hallucinogenic properties.
The effects of amphetamine on the CNS and peripheral nervous system are indirect; depending on an elevation of the level of catecholamine
neurotransmitters in synaptic spaces. by releasing intracellular stores of catecholamines.
Ecstasy
• Known as: MDMA, the love or hug drug
• Appearance: Almost always a pill or capsule
• Delivery: Oral ingestion, snorting
• Effect: Euphoria, alert, affectionate, increases metabolism, enhances emotions and perception, Hyperthermia, sweating, dehydration, jaw
clenching, depression, short-term memory loss.

MDMA causes 5-HT release into the synaptic cleft, inhibits its synthesis, and blocks its reuptake resulting in increase 5-HT concentration in the
synaptic cleft and a depletion of intracellular 5-HT stores.

Gamma-hydroxybutyric acid (GHB)

• Appearance: liquid, clear, odorless, nearly tastless
• Delivery: Oral ingestion, or mixed with other beverage
Notes: Commonly used as a date rape drug, is used in sexual assaults.
• Effect: sleepy, calm, mildly euphoric effects can last up to 4 hours and can result in unconsciousness, ………….Hallucinations, bradycardia,
hypotension

Low doses of the drug stimulate dopamine synthesis but inhibit its release, causing dopamine to concentrate in the nerve terminal

• Treatment :
- Bradycardia unresponsive to stimulation should be treated with atropine.
- Pentobarbital has been used successfully in the treatment of severe GHB withdrawal.
Ketamine
• Appearance: liquid, powder, pill or capsule
• Delivery: injection, snorted, oral ingestion
• Effect: Can cause hallucinations in large doses, duration of effect can last up to 2 hours
It also stimulates the central sympathetic outflow, resulting in increased blood pressure and cardiac output.

It is a short-acting, nonbarbiturate anesthetic,

Sudafed
• Alias: pseudoehedrine
• Appearance: pills
• Delivery: Oral ingestion
• Effects: effects the central nervous system, similar to but less intense than amphetamines

Often abused in its original form, but also used for the manufacture of methamphetamine