Types of Drugs

Heroin / Opioid / Brown Sugar

• The term opium derives from the Greek word for ‘juice’ and refers to juice from the poppy plant Papaver somniferum.
• Heroin, a highly addictive drug.
• 2 to 3 times more potent than morphine.
• It is usually injected, smoked or snorted (sniffed) up the nose.
• Common street names of Brown Sugar

Opioid Classification

1. A) Narcotic agonist :

Natural opium alkaloids (e.g.. Morphine, Codeine),

Semi-synthetic and synthetic compounds (e.g.. Meperidine, levorphanol, Methadone, Sulfentanil, alfentanil, fentanyl, remifentanil, and levomethadyl.)

1. B) Mixed agonist : antagonist drugs

(e.g.. Nalbuphine, Pentazocine, butorphanol buprenorphine).

1. C) Narcotic antagonists : Narcotic antagonists (e.g.. Naloxone)

• After an injection, the user reports feeling a surge of euphoria (the “rush”) accompanied by a warm flushing of the skin, a dry mouth, heavy extremities ,alternately wakeful and drowsy state.

• Mental functioning becomes clouded due to the depression of the central nervous system.

Clinical effects :

Euphoria , analgesia , respiratory depression , constipation , reduced appetite , low libido .

Tolerance develops rapidly and diminishes rapidly . ”

Associated with criminal activities and prostitution .

90 % of people with opioid dependence have comorbid psychiatric disorder , MDD ADS ASPD , Anxiety .

Any three of the following signs must be present :

Withdrawal usually starts 6 hrs after the last dose

• Craving for an opioid drug
• Rhinorrhoea or sneezing/Lacrimation/ Diarrhoea
• Muscle aches or cramps
• Abdominal cramps
• Nausea or vomiting
• Pupillary dilatation
• Piloerection or recurrent chills
• Tachycardia or hypertension
• Yawning
• Fever ,Restless sleep

Cocaine – Drug

• Cocaine is a tropane alkaloid and stimulant drug obtained primarily from the leaves of two coca species, Erythroxylum coca and Erythroxylum novogranatense.
• It is most commonly used as a recreational drug and euphoriant.
• Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits.

Stimulants Cocaine

• Street Names: Coke , Powder , Snow , Crack , Stone, Rock
• Can be snorted , smoked or injected ( Speedballing “)
• Causes excitement , increased energy , euphoria , grandiose thinking , impaired judgment sexual disinhibition
• Higher doses cause visual and auditory hallucinations . Paranoid ideation may lead to aggression .
• Causes paranoid psychosis

Cocaine Bugs / Formication

• These are a from of tactile hallucinations experienced by some cocaine users. They feel as  bugs or worms are crawling on or under the skin.
• Coke bug hallucinations cause people to dig, Scratch, itch, pick and even cut their skin in an attempt to get rid of bugs
• Causes increased BP , pulse , dilated pupils
• Severe adverse effects can lead to cardiac arrhythmias , myocardial infarction , myocarditis and cardiomyopathy , also CVAs , Seizures and respiratory arrest can also occur .
• Following Intoxication – ‘ Crash ‘ , consisting of dysphoria , anhedonia , anxiety , irritability , fatigue , hypersomnolence . Relatively mild but can be severe leading to suicidal ideation .
• Treatment is sedation with benzodiazepines and supportive like Psychotherapy

Amphetamine Drug

• Amphetamine is a central nervous system stimulant that is used in the treatment of attention deficit hyperactivity disorder, narcolepsy, and obesity.
• Amphetamines are used for recreational purposes. They are addictive.

Stimulants – Amphetamines Also

• Also known as ‘ Speed ‘ or ‘ Whizz, Up, Uppers, Loyee, Goey, M rack
• Can be taken orally . Intravenously or snorted .
• Causes over talkativeness over – activity , insomnia , dryness of mouth anorexia increased pulse and BP
• Higher doses cause cardiac arrhythmia severe hypertension cerebrovascular accident, Seizures and coma
• May cause paranoid psychosis – drug induced psychosis .
• Treatment is sedation and supportive.

Ice – Crystal Methamphetamine

• What is ice?
• Crystal methamphetamine (‘ice’, ice drug) is a stimulant drug, It’s stronger, more addictive than the powder form of methamphetamine known as speed.
• Other names
• Crystal meth, Shabu, Crystal, Glass
• It can be Smoked  /Injected    /  Swallowed    /  Snorted

Hallucinogens – LSD

• LSD (lysergic acid diethylamide), first synthesized in 1938, is an extremely potent hallucinogen.
• It is synthetically made from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains.
• It is so potent its doses tend to be in the microgram (mcg) range.
• It’s effects, often called a “trip”, can be stimulating, pleasurable, and mind-altering or it can lead to an unpleasant, sometimes terrifying experience called a “bad trip.“
• Flashback’s can occur
• Effects typically include altered thoughts, feelings, and awareness of one’s surroundings.
• Many users have visual or auditory hallucinations. Dilated pupils, increased blood pressure, and increased body temperature are typical.
• Street Names Acid, Blotter, acid, Doses, Dots, Trips, Mellow Yellow, Window Pane, as well as names that reflect the designs on sheets of blotter paper (for example, “purple dragon”).

LSD is usually found on the streets in various forms, for example: –

• Blotter paper (LSD soaked onto sheets of absorbent paper with colorful designs; cut into small, individual dosage units) – the most common form
• Thin squares of gelatin (commonly referred to as window panes)
• Tablet form (usually small tablets known as Microdots) or capsules
• Liquid on sugar cubes

Other hallucinogens include:

• Psilocybin (Magic Mushrooms, Shrooms)
• Mescaline (Peyote, Buttons, Cactus)
• Phencyclidine (PCP, Angel Dust)
• Ayahuasca (DMT)
• Salvia divinorum (salvia)

Mephedrone

• Mephedrone is classed among New Psychoactive Substances (NPS), It was originally marketed online as a plant fertilizer or ‘research chemical’.

Other names – Meph, meow, meow-meow, mm-cat, plant food, drone bubbles, kitty cat.

• Mephedrone comes in different forms, including:

white powder with a yellowish tinge

crystals

capsules

pills 2

• How is mephedrone used? Mephedrone powder is usually sniffed/snorted or swallowed or rarely injected
• Swallowing is the most common way of taking the drug.
• It is usually mixed with liquid to drink or wrapped in a cigarette paper (known as ‘bombing’).

Stimulants – MDMA

Methylenedioxymethamphetamine ( MDMA ) is Synthetic Psychoactive drug / stimulation

• Ecstasy
• XTC
• Moly
• it s powder from is known as mandy or
• MD
• Superman Drug (as Drug pill has Superman logo)

Produces positive mood state , with euphoria sociability , Intimacy , heightened perceptions loss of appetite tachycardia , bruxism , and sweating

Tolerance develops quickly with crash

Severe adverse effects cause hyperthermia and death . Cardiac arrhythmia and vertebral hemorrhage can occur

can cause acute and chronic paronold psychosis Flashbacks

Solvent abuse / ‘ Glue sniffing (Whitener / Oil Paint Sniffing)

• Solvents are Volatile hydrocarbons .
• Euphoria and excitement appear within 5 minutes, can last up to 30 minutes to several hours –
• Intoxication causes euphoria , blurring of vision . slurring of speech , apathy diminished social occupational functioning ,impaired judgment , Impulsive or aggressive behaviour ,nausea , anorexia nystagmus reduced reflexes diplopia , High doses can lead to stupor and unconsciousness .
• can lead to delirium dementia psychotic disorder

WHAT IS SPEEDBALLING?

• SPEEDBALL DEFINED
• Typically a “Speedball” involves a combination of an opioid (a depressant) and a stimulant (e.g., cocaine, methamphetamine).
• SPEEDBALL DEFINED –
• In a speedball, the cocaine (or other stimulant) may be:
• Injected in a mixture with heroin
• “Piggy-backed’: injected immediately before or after the heroin (sometimes without removal of the syringe),2 the drug being ‘back-loaded’ directly in the same syringe.3

What is Khat?

• Khat is a stimulant drug Chewing khat is part of some social traditions in some parts
• The buds and leaves of the khat plant (Catha edulis) are chewed for stimulant and euphoric effects, and traditionally have been used for medicinal purposes as well as recreationally.’ Khat contains cathinone and cathine, which
• Other names –  Qat kat, chat, qaad

Caffeine

• What is caffeine?
• Caffeine is a stimulant drug
• It’s found in the seeds, nuts and leaves of a number of different plants, including:
• Coffea Arabica (used for coffee)
• Thea sinensis (used for tea)
• Cola acuminata (used as a nut, tea or in soft drinks)
• Theobroma cacao (used in cocoa and chocolate)
• Paullinia cupana (used as guarana in snack bars and energy drinks).

Betel nut

• What is betel nut?
• Betel nut is the seed of the fruit of the areca palm. It is also known as areca nut.  Betel nut is a stimulant drug, which means it speeds up the messages travelling between the brain and the body.
• How is it used?
• The seed is separated from the outer layer of the fruit and may be used fresh, dried, boiled, baked, roasted.

Commonly Abused Substances

Designated classes of pharmacological agents (i.e. Substance)

1. Alcohol
2. Nicotine
3. Cannabis
4. Opioids – heroine / brown Sugar / morphine
5. Cocaine
6. Amphetamines / Methamphetamines(Ice) / Methylene dioxy methamphetamine MDMA
7. Hallucinogens – LSD, Phencyclidine /  Inhalants / Solvents
8. Drugs – Sedatives, Hypnotics and anxiolytics
9. Legal highs – e.g. Mephedrone
10. Caffeine
11. Betel nut
12. Khat
13. Anabolic steroids & nitrous oxide

BEFORE STARTING TREATMENT YOU SHOULD LOOK FOR

1) Details of substance use – onset, duration, average daily consumption, presence of withdrawal symptoms  overintoxication with alcohol

2) Reasons for initiation and continued drinking.

3) Behavioral problems associated with alcohol use depression, memory problems, suspiciousness, interpersonal problems.

4) Familial, social and legal consequences of alcohol use.

5) Financial and occupational consequences include current financial status and current occupational status.

6) Previous treatment attempts – reasons for seeking help this time, motivation for getting changed.

Information About Treatment of Drugs Please Click on this Link

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