Meth cathinones inhalants

Methamphetamines and Inhalants

Methamphetamine Overview

• Potency: Structurally similar to amphetamine but more potent.

• History: Synthesized from ephedrine in 1893; widely used in WWII for military endurance.

• Current Trends: Increase in home labs has led to a rapid upswing in use; many labs discovered due to solvent explosions.

  • Approx. 15% of meth labs are found in rental properties, motel rooms, or stolen cars.

• Statistics: In Indiana, the number of discovered meth labs rose from 6 in 1995 to ~1,250 in 2003. Major syndicates produce ~80% of U.S. meth, while 20% comes from small labs.

Methamphetamine Pharmacokinetics

• Metabolism: Primarily metabolized in the liver; chief metabolite is amphetamine which is also active.

• Plasma Concentration: Peak levels occur at 3-6 hours after oral intake, half-life is ~12 hours.

• Methods of Use:

  • IV/Smoked: Produces initial rush followed by euphoria.

  • Snorting: Slower onset with no rush.

• Properties: Highly lipophilic leading to severe issues with impurities.

Dopamine Cycle

• Dopamine Synthesis: Synthesized from DOPA, transported by vesicular transporter VMAT2.

• Transporters:

  • DAT (Dopamine Transporter): Clears dopamine from synapse; blockage increases synaptic dopamine.

  • MAO (Monoamine Oxidase): Metabolizes stray neurotransmitters; its inhibition increases neurotransmitter availability.

Amphetamines

• Mechanisms of Action: Amphetamines reverse transporters rather than blocking them which leads to neurotransmitter release directly into the synaptic cleft.

• Effects: Increase in dopamine, norepinephrine, and serotonin levels.

• MAO Inhibition: Further enhances available dopamine for vesicles.

Effects of Methamphetamine

• Positive Effects:

  • Sense of well-being via dopamine pathways.

  • Increased alertness and excitement due to stimulation of noradrenergic system.

  • Decreased appetite; historically prescribed as a weight-loss drug (Obetrol).

• Health Risks:

  • Serious cardiovascular issues: hypertension, tachycardia, stroke.

  • Meth-mouth: reduced saliva leads to oral pathogens and tooth loss.

  • Cerebral inflammation due to prolonged usage.

MDMA (Ecstasy)

Overview

• Development: Developed by Merck in 1914; rise in ER visits from 250 in 1994 to 2,850 in 1999.

• Consumption: Usually taken orally; lasting effects 6-8 hours with only 63% of tablets containing detectable MDMA.

• Classification: Schedule II drug with stimulant and hallucinogenic properties.

Effects of MDMA

• Mechanism: Increases serotonin release and inhibits reuptake of catecholamines.

• Positive Effects:

  • Elevated mood, energy, extroversion, self-confidence.

• Adverse Effects:

  • Bruxism, hypertension, tachycardia, sweating.

MDMA Hyperthermic Syndrome

• Associated with 'rave' parties; symptoms of dehydration, high ambient temps, increased activity, leading to serious health risks such as rhabdomyolysis and acute renal failure.

• Possible liver damage, heart arrhythmia, and dose-related serotonergic axon destruction.

Cathinones and Bath Salts

Overview of Cathinones

• Khat: Derived from Catha edulis and used in Horn of Africa and Yemen.

• Designer Drugs: New generation of powerful drugs with easy synthesis; examples include mephedrone and methylone.

Bath Salts Specifics

• Composition: Can contain various compounds; known for powerful dopamine effects causing release and elevated levels.

• Market: Marketed as 'bath salts' and often labeled 'not for human consumption'.

• Legal Status: Notable legal challenges have arisen; substances are now illegal in many states.

• Addictive Potential: Users report symptoms including hallucinations, paranoia, panic attacks.

Inhalants Overview

Common Inhalants

• Defined as volatile liquids or gases inhaled for recreational use (huffing).

• Household Products: Includes adhesives, paint thinners, gasoline, aerosol sprays, and gases like nitrous oxide.

Epidemiology

• In a 2002 survey, 22.8 million Americans reported using inhalants; they are particularly abused by adolescents due to low cost and ease of access.

• Acute Effects: Similar to alcohol intoxication; can lead to respiratory depression and cognitive impairments with frequent use; potential for overdose.

• Health Risks: Includes damage to vital organs, brain degeneration, and fetal solvent syndrome from maternal use.

Behavioral Effects

• Usage Patterns: High-frequency users report negative effects leading to tolerance and withdrawal symptoms, while low-frequency users tend to experience euphoric effects.

• Treatment: No specific programs exist; general treatment may include therapy approaches similar to those for other substance abuse disorders.

Summary of Key Concepts

• Methamphetamine: Powerful stimulants with a high potential for addiction and numerous health risks.

• MDMA: A drug with both stimulant and hallucinogenic properties, used recreationally but carries risks of severe side effects.

• Cathinones: Newer class of drugs related to traditional use of khat, exhibiting strong stimulant effects with potential for addiction.

• Inhalants: Widely abused but often overlooked; health effects and risks associated with inhalants can be severe and result in serious health complications.