Addiction ch 5

Crack discovered in 1984 was a

potent, smokable form of cocaine.

In 1986, Congress passed the Anti-Drug Abuse Act. The Act established mandatory minimum sentences for specific quantities of cocaine.

Distribution of just 5 grams of crack cocaine carried the same sentence (a minimum of five years in federal prison) as distribution of 500 grams of powder cocaine.

Although use has significantly declined since the 1980s, the United States remains one of the largest national cocaine markets in the world.

the average retail price per gram of cocaine has decreased by over 28 percent from $213 per gram to $153 per gram, and its average purity has increased by 39 percent, from 46 percent pure to 64 percent

African Americans are

significantly less likely than whites to use powder cocaine or methamphetamine, and are equally likely to use crack cocaine

Colombia leads the world in

cocaine production, producing up to three-fourths of the world’s annual yield

process of isolating the cocaine from the coca leaves:

the crude coca paste is extracted from the leaf, the coca paste is purified to a coke base, the coke base is converted into cocaine HCl.

Drug Enforcement Agency (DEA) reported that over 80 percent of cocaine shipments seized entering the United States were

cut with levamisole, a drug used to treat parasitic worm infections in humans and animals

Cocaine route fast to slow

Smoked, Injected, snorted and oral

Cocaine may be dissolved into solution or made into a paste for medical use as a local anesthetic for

effects occur within two to five minutes, and its effects last for up to an hour

Cocaine is not particularly well absorbed into the bloodstream when taken orally, because

it constricts the blood vessels of the mouth (vasoconstriction) and is broken down in the acidic stomach.

The reason injected cocaine takes longer to reach the brain is that it

travel in the bloodstream to the right side of the heart before being pumped to the lungs, sent to the left side of the heart, and then finally passed on to the brain and other organs of the body.

Cocaine increases dopamine levels in

basal ganglia, prefrontal cortex, ventral tegmental area (VTA), and nucleus accumbens

sympathomimetic

A substance whose actions mimic those of the sympathetic nervous system.

formication

The delusion that insects are crawling on or under one’s skin; usually associated with high doses of cocaine or amphetamines.

cocaethylene (CE)

cocaine and alcohol forms a new compound

cocaine withdrawal was associated with three distinct phases

crash, withdrawal, and extinction

Early uses of cocaine (prior to it being illegal) included treatment for

exhaustion.

allergies.

tuberculosis.

Which one of the statements below regarding forms of cocaine is true?

Drinks containing cocaine were once popular but drinking cocaine formulations is basically unheard of in modern times.

One of the major drawbacks of using cocaine in this form is that it is usually cut with another substance before being sold to consumers, and this additive may be more harmful than the drug.

Powder

Cocaine is a _______ drug because it is approved as a local anesthetic and is still used in _______ surgeries.

schedule 2; oral and eye

Serious adverse effects of cocaine use include

cardiac arrest.

formication.

pulmonary edema.

The combination of these two substances increases the risk of a user's death 18–25 times over that of cocaine alone, typically due to cardiovascular events, hepatoxicity, convulsion, or injury.

Cocaine and alcohol

Chronic users of cocaine may develop _______ to certain effects of the drug, including euphoria and some stimulant effects, more quickly than other less desirable effects.

tolerance

Compared to other common drugs of abuse, cocaine withdrawal is more dangerous than withdrawal from _______ , and less dangerous than withdrawal from _______ .

marijuana and nicotine; opioids and alcohol

All of the following pharmacological interventions may be helpful in treating cocaine addiction

Antabuse, which is used to treat cravings in alcohol addiction.

modafinil, which is used to treat narcolepsy.

propranolol, which is used to lower blood pressure.

amphetamines are more popular than cocaine worldwide because

effects are more potent and sustained, they can be administered by several routes, and they can be easily and inexpensively synthesized

United States consumes blank of the world’s medically prescribed amphetamines, with blank being prescribed to those under the age of 18

85% and 80%

About 2 million people each year report illicit methamphetamine mostly in

West Coast and in the Midwest, and Black people are least likely

The left-handed derivative (levo-amphetamine)

raises blood pressure, opens nasal passages, and causes headaches, but does not have significant mood-elevating effects

The right-handed isomer—dextro-amphetamine (Dexedrine)

has stronger effects in the brain, elevates mood, and enhances energy

ICE

A potent, smokable freebase form of methamphetamine.

Amphetamine and methamphetamine increase postsynaptic levels of dopamine, norepinephrine, and serotonin by

increasing release; blocking reuptake; and, at high concentrations, by inhibiting MAO

Amphetamine-related toxicity is usually due to

increased risk of cardiac arrest or cerebrovascular hemorrhage

This substance, historically used to treat breathing problems, has fewer psychostimulating effects compared to cocaine or amphetamine and was the impetus for creating synthesized amphetamine in the search for a more efficient treatment.

Ephedrine

For both cocaine and amphetamine, which of the following is in the correct order from fastest to slowest onset of action based on route of administration?

Smoking → injection → snorting → oral administration

Chronic users of methamphetamine often present with a distinctive look, resulting in their photos being used in anti-meth campaigns such as "Faces of Meth." All the following are chronic symptoms of amphetamine use that contribute to these facial changes

weight loss.

tooth deterioration.

sores that do not heal.

Mephedrone, methylone, and MDPV are all synthetic derivatives of _______ and therefore have psychoactive properties similar to _______.

cathinone; khat