Controlled Substance Identification Notes

Course Overview

  • TPO: Identify prescription narcotics, illicit street drugs, common terms, nomenclature, prices, weights, and safe handling procedures.

  • EPO #1: Identify the DEA Drug Schedule and the five classes of commonly abused drugs

  • EPO #2: Gain insights into the patterns of drug abuse and the impact of these substances on society, including psychological and physical effects.

EPO #1: DEA Drug Schedules

Overview of the Controlled Substances Act (CSA)

  • Total Schedules: 5 (I to V) with each schedule categorizing substances based on their potential for abuse, medical application, and safety considerations.

  • Basis for Scheduling:

    • Medical use: Determines if a substance has accepted medical applications in treatment.

    • Potential for abuse: An assessment of how easily users can develop dependency on the drug.

    • Safety and dependence liability: Evaluates the risk of addiction and other adverse health effects associated with the substance.

Schedule I

  • Characteristics:

    • Substances under this category have no accepted medical use in the U.S., making them strictly controlled by law.

    • They exhibit a high potential for abuse and addiction, with a complete lack of accepted safety for use even under medical supervision.

    • Examples: Heroin, Lysergic acid diethylamide (LSD), and 3,4-methylenedioxymethamphetamine (MDMA).

Schedule II

  • Characteristics:

    • Substances that are deemed appropriate for medical use but come with severe restrictions.

    • They carry a high potential for abuse that could lead to severe psychological or physical dependence, requiring strict oversight and prescription regulations.

    • Examples: Morphine, Oxycodone, and Fentanyl, all of which are heavily regulated in terms of prescription and dispensing.

Schedule III to V

  • Schedule III: Moderate potential for abuse; accepted medical use, with prescriptions being less strictly monitored compared to Schedule I and II.

  • Schedule IV: Low potential for abuse relative to Schedule III, still accepted for medical use; typically, prescribed medications for anxiety and sleep disorders fall into this category.

  • Schedule V: Contains substances with the lowest potential for abuse and recognized medical use, often available without a prescription in some states.

5 Classes of Drugs Regulated by Controlled Substance Act (CSA)

Narcotics (Analgesics)

  • Definition: Substances which relieve pain through their action on the central nervous system (CNS); include opium and its derivatives.

  • Common Examples:

    • Morphine: A potent pain reliever widely used in clinical settings, particularly for severe pain.

    • Oxycodone: Often prescribed for moderate to severe pain but has a high potential for abuse, leading to addiction.

    • Fentanyl: A synthetic opioid that is significantly stronger than morphine, posing a high risk of overdose.

Stimulants

  • Definition: Drugs that heighten alertness, attention, and energy by increasing the levels of neurotransmitters in the brain.

  • Common Examples:

    • Amphetamines: Used in the treatment of ADHD and narcolepsy; popular among substance abusers for their energizing effects.

    • Cocaine: A powerful stimulant that can lead to intense euphoria and is highly addictive.

    • Among most potent agents of reward and reinforcement that underlie problem of dependence

Depressants

  • Definition: Substances that reduce CNS activity; often used to treat anxiety and sleep disorders.

  • Common Examples:

    • Alcohol: The most widely abused depressant, which can lead to physical dependence and withdrawal symptoms.

    • Barbiturates: Used for anxiety and sleep disorders, they carry a significant risk of overdose when misused. Less than 10% of all depressant prescriptions

  • Risks: Tolerance builds rapidly, contributing to dependence and increasing danger of overdose.

  • Cannabis: Usually smoked, effects felt within minutes, peak 10-30 minutes, linger 2-3 hrs

    • low doses induce a sense well being and dreamy state of relaxation

    • Stronger doses intesify reaction

Hallucinogens

  • Definition: Substances that significantly alter an individual's perception, thought processes, and feelings.

  • Common Examples:

    • LSD: Known for its psychological effects, including altered sensory perceptions and a distorted sense of time.

    • Psilocybin: Found in certain mushrooms, known for inducing profound changes in consciousness.

Inhalants

  • Definition: Substances that are inhaled to produce psychoactive effects, commonly associated with a quick high.

  • Common Forms: Adhesives, aerosol sprays, cleaning fluids, and paint, often accessible and inexpensive, making them popular among younger users.

  • Risks: Can lead to sudden death from heart failure or asphyxiation upon inhalation.

Anabolic Steroids

  • Definition: Synthetic derivatives of testosterone designed to enhance muscle growth and physical strength.

  • commonly used: testosterone, nandrolone, methenolone, stanozolol, and methandrostenolone

  • Risks: Abuse can lead to severe health issues, including cardiovascular diseases, liver damage, and hormonal imbalances within both male and female users.

EPO #2: Commonly Abused Prescription Medications

Identification and Imprint

  • Imprint requirement by the FDA: Critical safety measure to differentiate medications by size, shape, and color, thereby reducing medication errors and protecting public health.

Examples of Abused Medications

  1. Fentanyl (Schedule II) - Used medically for severe pain; available in various forms including capsules, patches, and injectable forms.

    • Price: Approx. $25 per dose, significantly higher on the black market due to its potency and effects.

  2. Morphine

  3. Methadone

  4. Oxycodone

  5. Hydrocodone (Schedule II) - Commonly prescribed for pain relief, frequently combined with acetaminophen.

    • Price: $10 to $20 per pill, often diverted for illicit use.

  6. Xanax (Schedule IV) - Prescribed for anxiety disorders and panic attacks; presents high risk for dependence if misused.

    • Price: $5 to $10 per pill on the street, widely abused for its relaxing effects.

EPO #3: Illicit Controlled Substances

Common Examples and Street Names

  • Cocaine (Schedule II) - Has stimulant properties and can be used recreationally, leading to addiction.

    • Street Names: Blow, Crack, where Crack refers to a smokable form of cocaine.

    • Price: Approx. $40 per gram, with prices varying regionally.

  • Methamphetamine (Schedule II) - A potent and addictive stimulant that affects the central nervous system, often synthesized in illegal labs.

    • Street Names: Meth, Ice, highlighting the drug's crystallized form.

    • Forms: powder, pills, glass, ble-white shards

    • Price: $40-$60 per gram, subject to fluctuations in availability.

  • MDMA (Schedule I) - Known for its euphoric and empathogenic effects, generally used recreationally.

    • Street Names: Ecstasy, Molly, which typically refer to different formulations of the drug.

    • Price: $10-$20 per pill, popular at parties and raves.

  • Heroin (Schedule I) - opioid drug made from morphine

    • Street Names: Brown Sugar, Smack, China White, White Horse

    • Price: $2200 an ounce

  • PCP (Phencyclidine)(Schedule I,II) - Dissociative drug developed as an intravenous anesthetic

    • Street Names: Angel Dust, Love Boat, Peace PIll

    • Price: $20 an ounce

  • LSD (lysergic acid diethylamide) (Schedule I) - from Lysergic Acid found in ergot, a fungus that grows on rye and other grains

    • Street Names: Acid

    • Price:$10 a hit

  • LSD (lysergic acid diethylamide) (Schedule I) - from Lysergic Acid found in ergot, a fungus that grows on rye and other grains

    • Street Names: Acid

    • Price:$10 a hit

  • Marijuana (Schedule I) - Hemp plant, cannabis sativa

    • Street Names: Weed

    • Price:$250-300 an ounce

  • Synthetic Cannabinoids

  • Synthetic Cathinones(Bath Salts)

  • N-dimethyltrypptamine (DMT)

EPO #4: Safety precautions and handling procedures

Personal Protective Equipment (PPE)

  • Essential to use nitrile gloves when handling any suspected controlled substances to minimize exposure and contamination risks.

Key Actions in Case of Exposure

  1. Recognize Symptoms: Identifying signs of opioid intoxication, which include drowsiness, slowed breathing, cold and clammy skin, and pinpoint pupils.

  2. Call for Help: Critical to get emergency medical assistance when someone is suspected of overdosing on any controlled substance.

  3. Administer Naloxone: An opioid antagonist that can temporarily reverse an overdose; however, medical attention must still be sought immediately.

Guidelines for Law Enforcement

  • Caution Advised: Officers are advised against conducting presumptive field tests for suspected controlled substances; these tests can produce false positives.

  • Sample Submission: Directly submit any suspected drugs to a forensic lab for comprehensive analysis, especially when dealing with potential fentanyl exposure.

CoL’s

  • Under federal law, how many schedules are in the Controlled Substance

    Act?

    5

  • What does the Food and Drug Administration (FDA) encourage drug

    manufacturers to have on most over-the-counter and prescription drugs

    to help easily identify them?

    Imprint

  • What is the common name for a dissociative drug developed as an

    intravenous anesthetic that has been discontinued due to serious

    adverse effects?

    PCP

  • What medication can temporarily reverse the side effects of an

    overdose, if it is administered right away?

    Naloxone (Narcan)