4343 exam 2: substance use disorders (drugs and routes)

Benzodiazepines and barbiturates [verify, not in slides]

• Sedatives acting on GABA • Used for anxiety and insomnia • Withdrawal can cause seizures • Dangerous with alcohol

Opioids [verify, not in slides]

• Heroin, morphine, painkillers • Act on endorphin (opioid) receptors • Euphoria, pain relief, drowsiness • Overdose slows breathing

Opioid withdrawal [verify, not in slides]

• Flu-like symptoms • Aches, nausea, sweating • Strong cravings

Methadone maintenance

• Safe, legal, medically supervised substitute for heroin • Drug maintenance therapy

Stimulants: general effects

• Activate the central nervous system • Energy, happiness, power • Less need for sleep • Diminished appetite

Stimulants include

• Caffeine • Nicotine • Amphetamines • Cocaine

Caffeine intoxication

• Restlessness, nervousness, insomnia • Rapid heart rate • Shaking or twitching

Caffeine withdrawal

• Fatigue • Headaches • Irritability

Nicotine [verify, not in slides]

• Acts on acetylcholine and releases dopamine • Withdrawal: irritability, craving, trouble concentrating

Amphetamines

• Some prescribed • Methamphetamine: low cost, rapid acting • Tolerance and dependence develop fast • Release dopamine and norepinephrine, block reuptake

Cocaine

• From coca plant • Instant rush and euphoria • Highly addictive • Blocks dopamine reuptake

Cocaine/amphetamine psychosis

• Cocaine/amphetamine-induced psychosis can occur

Cocaine and amphetamine intoxication

• Behavior changes, rapid heartbeat • Pupil dilation • Blood pressure changes • Sweating or chills, nausea • Weight loss, agitation • Chest pain, confusion, seizures, coma

Cocaine and amphetamine withdrawal

• Dysphoric mood • Fatigue • Vivid unpleasant dreams • Insomnia or hypersomnia • Increased appetite • Psychomotor agitation or retardation

Cannabis: source and potency

• From hemp plant • Marijuana and hashish • THC is the main potent chemical

Cannabis: effects

• Mixed: depressant and hallucinogenic • Increases risk of psychotic disorder

Cannabis intoxication

• Impaired coordination • Euphoria, anxiety • Sensation of slowed time • Red eyes, dry mouth • Rapid heartbeat

Cannabis withdrawal

• Irritability, anger • Nervousness • Trouble sleeping • Restlessness • Depressed mood • Sweating, shaking, stomach aches, fever, chills

Hallucinogens [verify, not in slides]

• LSD, psilocybin • Distort perception, cause hallucinations • Act on serotonin • Bad trips, flashbacks

Inhalants [verify, not in slides]

• Glue, paint thinner, household chemicals • Quick high • Brain and organ damage • Can be fatal

Route: inhaling

• 7 seconds to the brain (fastest)

Route: injection

• IV: 20 seconds • Intramuscular: 4 minutes

Route: snorting

• 4 minutes to the brain

Route: oral ingestion

• 30 minutes to the brain (slowest)