1. Drugs of abuse

2. Drugsof abuse
 def. drugs or chemicals which are taken
repeatedly in a pattern & amount that
interferes with one’s health or normal
function
 used for a variety of reasons; they have
multiple effects, usually producing a
feeling of well-being in the user
repeated use higher & higher dose
needed to replicate the feeling 
emotional dependence, & in some, true
physical dependence

3. Classification of dsoa
Opiates & Opioids: morphine, codeine,
heroin, meperidine (Demerol),
hydromorphone
Sympathomimetic stimulants: cocaine,
amphetamines, metamphetamines, MDMA
Depressants: barbiturates,
benzodiazepines, ethyl alcohol
Hallucinogens: LSD, mescaline, MDMA,
Others: PCP, marijuana, nicotine

4. Classification of drugsof abuse
CNS actions
Stimulants: amphetamine, caffeine, nicotine,
cocaine -
Depressants : barbiturates, benzodiazepines,
ETOH
Analgesics: narcotics (opiates & opioids)
Sedative–Hypnotics: relaxants, induce sleep:
alcohol; anti-anxiety agents-tranquilizers;
nonbarbiturates- Halcion, Quaalude; long-acting
barbiturates – Phenobarbital; short-acting
barbiturates - Seconal

5. Drugsof abuse

6. Legal classification
Schedule 1: high abuse, no recognized
medical use, lack of safety
Schedule 2: high abuse, medical utility,
high dependency risk
Schedule 3: lower abuse, medical utility,
moderate dependency risk
Schedule 4: limited abuse, high medical
utility, limited dependency risk
Schedule 5: minor problems

7. Drugsof abuse
Schedule 1:
 Heroin
 LSD
 MDMA
 Marijuana
 Methaqualone
Schedule 2:
 Opium
 Morphine
 Coca
 Cocaine
 Methadone
 Methampethamine
Schedule 3:
 Amphetamine
 Barbiturates
 Valium
 Xanax
 Anabolic steroids
 Codeine
Schedule 4:
 Chloral hydrate
 Meprobamate
 Paraldehyde
 phenobarbital
Schedule 5: limited amts

8. DEFINITIONS
Positive reinforcement: release of positive
reinforcement neurotransmitters e.g. dopamine,
endorphins
Tolerance: reduced effect with repeated use of
the drug  need for progressively higher doses
to produce the same effect; due to down-
regulation of receptors, changes in receptors,
exhaustion of neurotransmitters, increased
metabolic degradation, physiological adaptation
Cross-tolerance: for drugs of the same class

9. DEFINITIONS
Dependence- compulsion to take the drug
repeatedly
Psychological dependence – positive
reinforcement causes a compulsion to take the
drug
Physical dependence – negative reinforcement –
distress upon stopping the drug (withdrawal) is
the main reason for continuing to take it
Cross-dependence – different drugs within a
pharmacological class can generally maintain
physical dependence produced by another
member

10. DEFINITIONS
Sensitization – craving for the drug
Withdrawal – symptoms are opposite to
the acute effects of a drug
Detoxification – used to treat physical
dependence
 “cold turkey” – abrupt stoppage of the drug
 “warm turkey” – gradual reduction in drug dosage

11. Psychomotor stimulants
Drugs:
 Cocaine
 Amphetamine(s)
 Methylpenidate
 Ephedrine
 Cathinone
Effects
 Mood elevation
 Wakefulness; increased
alertness, restlessness
 Heightened energy
 Mild to moderate
anorexia
 Sleep disturbance

12. Psychomotor stimulants
 mechanism of action: indirect agonists –
increase synaptic activity of the monoamines
 withdrawal syndrome: lethargy. Depression,
hypersomnia, craving
Cocaine –
 available as leaves, paste, salt, smokeable base –
 can be chewed, inhaled, snorted, rubbed on mucosa (e.g. gums)
 metabolized in plasma, Liver
 “crack baby”

13. Amphetamines
 shabu (Metamphetamine) & ecstasy
(MethyleneDioxyMetAmphetamine)
metabolized by Liver or excreted unchanged
 effects:
 increased wakefulness,
 anorexia,
 Sympathomimetic: mydriasis, vasoconstriction, tachycardia,
hypertension, hyperthermia, hyperventilation,
 Vivid hallucinations & paranoid ideation
 Euphoria, sense of well-being, self-confidence

14. opiates
Opium – papaver (poppy plant)
Opiate alkaloids – morphine & Codeine
Semi-synthetic opioids – Heroin
(diacetylmorphine)
Synthetic opioids –
 phenylheptamines (Methadone),
 phenylpiperidines (Fentanyl, Meperidine),
 morphinans (Levorphanol),
 benzomorphans ( Pentazocine)

15. Opium creates a psychic screen between the mind
and the body of the smoker, so that pain becomes
an abstraction, without the sharpness of physical
sensation...The anesthesia produced by opium may
be described as a sort of cerebral intoxication, a
psychic fog between oneself and external reality
that diminishes the outer world. The smoker
forgets he has a body. His mind escapes the
prison of the flesh and the material world, and is
removed to the periphery of reality by the
centrifugal force of opium. He escapes not only
his own body, but also the physical world in which
his body exists. Opium plays a siren's tune on the
piano off his nerves, and as he listens, the smoker

16. opiates
 opioid receptors:
 mu,
 delta,
 kappa
Endogenous opioids:
 endorphins,
 enkephalins,
 dynorphins,
 endomorphins

17. opiates
Opioid antagonists:
 naloxone,
 naltrexone
 physiologic effects –
 analgesia,
 miosis,
 constipation,
 cough suppression

18. opiates
Chronic use:
 Tolerance
 Sensitizations
Physical dependence
Pharmacological Tx of Opioid abuse:
 Substitution: Methadone, Buprenorphine
 Opioid antagonist: Naltrexone

19. marijuana
delta-9-tetrahydrocannabinol (THC)
in the resin of Cannabis sativa
Cannabinoid receptors
Endogenous cannabinoids
Acute effects: euphoria & exhiliration;
relief of anxiety, disinhibition, time
distortion, hunger/thirst, bloodshot eyes,
attention & memory impairment, motor
impairment

20. marijuana
Therapeutic uses: Dronabinol (Marinol)
Antiemetic/antinausea – esp. in CA chemoTx
Appetite stimulant
Antispasmodic
Reduction of intraocular Pressure - in
Glaucoma
Analgesia – in tic doloreaux
Bronchodilation – in asthma
Neuroprotective – in seizures

21. Psychedelics/ hallucinogens
Serotonin-like: LSD
Catecholamine-like:
 Mescaline
 Methoxyamphetamines: MDMA
Anticholinergic
 Atropa belladona
 Datura stramonium
 Mandragora officinarum
 Scopolamine, Hyoscyamine, Atropine
Dissociatives
 Phencyclidine (PCP, angel dust)
 Ketamine

22. CAFFEINE & XANTHINES
Coffee : Coffea
arabica & C.
robusta
Tea: Camellia
(Thea) sinensis
Chocolate:
Theobroma cacao
Cola: Cola
acuminata
Effects:
 Bronchodilation
 Increased HR, BP
 Arousal
High dose:
caffeinism, panic
attacks; tremors

23. nicotine
Nicotiana tabacum (Tobacco)
Receptors: nicotonic ACh receptors
Effects
 Psycomotor activity
 Alertness attention
 Cognitive function
 Sensorimotor performance
 Fluid retention
 Tremors
 Increased respiration

24. nicotine
Withdrawal: craving, dysphoria, anxiety,
irritability, restlessness, impatience,
anger, increased appetite, insomnia
Toxicity: cigarette smoke
Cancer: mouth, throat, larynx, lungs,
bladder, pancreas, uterus,

25. Cnsdepressants& alcohol
Ethyl Alcohol: Acetaldehyde
 10 gm in 12 oz beer, 4 oz unfortified wine, or 1.5 oz 80-proof
liquor
 rapidly absorbed in the stomach & small intestines
 Metabolized by the liver at the rate of 10gm/hr
• Acute intoxication: mainly affects the CNS & Stomach
• 20-30mg/dL= powerful depressant effect on cortical inhibitory
centers= loss of inhibitions= “party” syndrome; Euphoria;
disordered cognitive & motor functions
• 100mg/dL= legal level of intoxication= Ataxia
• 200-250mg/dL= narcosis= drowsiness
• 300-400mg/dL= coma; profound anesthesia; death

26.  Chronic Alcoholism: induces injuries in all tissues
 Liver - most commonly & severely affected= fatty change, acute
hepatitis--- Cirrhosis
 CNS – Wernicke’s encephalopathy- ataxia, global confusion,
ophthalmoplegia, loss of neuropil & demyelination (vit B1 def) &
Korsakoff syndrome- profound memory deficit both recent &
remote; cerebellar degeneration; cerebral atrophy
 Fetal Alcohol Syndrome: microcephaly, cardiac defects, mental
deficiency, facial malformations
 Misc.: neuropathies; congestive cardiomyopathy; ↑frequency of
cancer in the larynx, oropharynx, esophagus, rectum, lung

28. Cnsdepressants
Drugs:
 Bromide, Chloral hydrate
 Barbiturates
 Methaqualone
 Benzodiazepines
 sedative effect
 toxicity: respiratory depression

30. Dangerousdrugsact
Republic Act 6425: DANGEROUS DRUGS
ACT OF 1972
RA 9165: an act instituting the
COMPREHENSIVE DANGEROUS DRUGS
ACT OF 2002, repealing RA 6425, as
amended, providing funds therefor, and
for other purposes

31. Declaration of policy
 It is the policy of the State to safeguard the integrity of
its territory and the well-being of its citizenry particularly
the youth, from the harmful effects of dangerous drugs
on their physical and mental well-being, and to defend the
same against acts or omissions detrimental to their
development and preservation. In view of the foregoing,
the State needs to enhance further the efficacy of the law
against dangerous drugs, it being one of today's more
serious social ills.
 Toward this end, the government shall pursue an intensive
and unrelenting campaign against the trafficking and use
of dangerous drugs and other similar substances through
an integrated system of planning, implementation and
enforcement of anti-drug abuse policies, programs, and
projects.

32. Declaration of policy
The government shall however aim to achieve a
balance in the national drug control program so
that people with legitimate medical needs are
not prevented from being treated with adequate
amounts of appropriate medications, which
include the use of dangerous drugs.
It is further declared the policy of the State to
provide effective mechanisms or measures to re-
integrate into society individuals who have
fallen victims to drug abuse or dangerous drug
dependence through sustainable programs of
treatment and rehabilitation.

33. Drug testing
 random urine sample
 other fluids: blood, sweat, saliva, milk;
other tissue: hair
 ‘screen’ : opiates, benzodiazepines,
barbiturates, cannabinoids,
amphetamines, cocaine, methadone,
buprenorphine


34. Length of timedrugsaredetected in
urine
Alcohol – up to 1 day
Amphetamines (incl. Ecstasy) – 1 to 3 days
Barbiturates – 1 to 3 days
Benzodiazepines – 1 to 3 days
Cannabis – up to 2 weeks
Cocaine – 1 to 3 days
Codeine; Dihydrocodeine – 1 to 2 days
Heroine, Morphine – up to 1 day
Methadone – 1 to 3 days

35. Thank
you !