Drugs Across the Spectrum Raymond Goldberg Chapter 11 Stimulants

1. Albia Dugger • Miami Dade College
Chapter 11
Stimulants

2. Types of Stimulants
• Stimulants modify a person’s activity level, mood, and central
nervous system
• Some stimulants, such as cocaine and methamphetamines,
are illegal
• Others, such as amphetamines, require a prescription
• Legal stimulants such as caffeine and nicotine are among the
most widely used drugs in the world

3. Cocaine
• Cocaine comes from the leaves of the coca plant,
Erythroxylon coca
• Natives of the Andes Mountains chew coca leaves to relieve
fatigue, for spiritual reasons, or to enhance well-being
• Colombia is the largest producer of cocaine

4. Sources of Cocaine
• Bolivia and Peru
account for a small
percentage of
cocaine production

5. Properties of Cocaine
• Cocaine is an odorless, crystalline, white powder that
produces intense euphoria, alertness, and energy
• Cocaine may be used in a Brompton’s cocktail, which is
used to manage cancer pain
• Cocaine is used in surgical procedures on the facial area

6. Mode of Intake
• Injected cocaine reaches the brain the fastest, and euphoria
is rapid and intense
• Snorted cocaine is absorbed into the bloodstream through
the nasal mucous membranes
• Crack cocaine is made by heating cocaine after mixing it with
baking soda and water
• Freebase cocaine is separated from its hydrochloride salt by
heating, using a volatile chemical such as ether

7. Crack Cocaine

8. Cocaine Paraphernalia

9. Forms of Cocaine

10. Historical Use of Cocaine
• Cocaine was isolated from coca leaves by the German
scientist Niemann around 1859
• Freud recommended cocaine to alleviate opiate addiction,
depression, and fatigue
• Cocaine was originally included in Coca-Cola
• The Harrison Narcotic Act of 1914 designated cocaine as a
narcotic

11. Early Products Containing Cocaine

12. Current Use of Cocaine
• Cocaine use increased again in the 1970s, accompanied by
an increase in cocaine-related deaths
• In the 1980s celebrity users made cocaine glamorous
• In 2010, an estimated 1.5 million Americans aged 12 and
older were cocaine users

13. 2010 Drug Use

14. Crack
• Crack is usually smoked, but it can also be injected
• Because it comes in small units, the cost is low
• The euphoria is brief (about 10 to 20 minutes), and the desire
to repeat usage is high
• Crack use is a problem among impoverished, inner-city
adolescents

15. Crack
• Many addicts exchange
sex for crack
• Rates of AIDS are high

16. Crack Law
• In 1984, laws mandated harsher penalties for individuals
arrested for crack cocaine than for powder cocaine
• In 2010, the United States Sentencing Commission reversed
that law
• The law was viewed as racially discriminating – 85% of
offenders are African American, only 5% are White

17. Crack Arrests

18. Cocaine and the Media
• Drugs and musicians:
• Jazz musicians commonly used cocaine during the 1930s
and 1940s
• Starting in the 1960s, references to drugs in music were
conspicuous
• In the early 1990s, rap musicians promoted cocaine use
• The media offer a paradoxical view of cocaine – the drug is
connected with high status, yet the messages often carry a
negative connotation

19. Physical Effects of Cocaine
• Elevated blood pressure
• Excessive perspiration
• Nausea, vomiting,
abdominal pain
• Headache
• Tightened muscles
• Slower digestion
• Anorexia
• Nutritional deficiencies
• Rapid pulse
• Faster breathing rate
• Increased body temp
• Urge to urinate,
defecate, belch
• Inflammation of trachea
and bronchi
• Hoarseness or laryngitis
• Wheezing and coughing
• Coughing up pus,
mucus, blood
• Seizures
• Hallucinations

20. Physical Effects of Cocaine
• Physical effects of cocaine depend on how the drug enters
the body
• The speedball, an injected mixture of cocaine and heroin,
carries a higher risk of dependency and overdose
• Smoked cocaine can affect the heart to the point of
congestive heart failure and death
• Injected cocaine has been linked to inflammation of the heart
lining and liver

21. Psychological Effects of Cocaine
• Talkativeness
• Mood swings
• Hallucinations
• Repetitive behaviors
• Extreme depression
• Neglect of personal
hygiene
• Rage and violent
behavior
• Delusions
• Distorted perceptions
• Depersonalization
• Suicidal ideation
• Paranoia

22. Rates of Emergency Room Visits

23. Cocaine Dependence
• Cocaine users build up tolerance to the drug, but not to the
health risks
• Withdrawal symptoms include depression, lack of energy,
poor appetite, restlessness, and agitation
• Scientists are working on a vaccine for preventing addiction to
cocaine and other drugs

24. Three phases following abstinence
• Intense craving, agitation, anorexia, and deep depression –
the desire for cocaine may increase
• Withdrawal, during which the person is incapable of feeling
normal pleasure, but depression moderates and sleeping
becomes easier
• Extinction, during which improvement is considerable, but
periods of depression and craving can occur

25. Drugs to treat cocaine withdrawal
• The African hallucinogen ibogaine is a controversial drug
given to cocaine addicts
• Propranolol eases withdrawal symptoms, making it easier for
cocaine addicts to remain in treatment
• Disulfiram, a drug used to treat alcoholism, has also shown
potential as a treatment for cocaine addicts
• Typically cocaine addicts are given antidepressants to lessen
withdrawal symptoms

26. Death from Cocaine
• Cocaine can cause irregular heartbeat (cardiac arrhythmias),
high blood pressure, chest pains and heart attacks
• Coronary artery disease leading to death is relatively common
in cocaine users
• Some fatalities result from uncontrolled seizures, strokes, or
paralysis of breathing muscles
• People who inject cocaine are in danger of contracting HIV
and other potentially fatal infections

27. Cocaine and Pregnancy
• 1 out of every 25 women use an illegal drug while pregnant
• Cocaine constricts blood vessels and reduces blood flow and
oxygen to the fetus
• Cocaine can cause detachment of the placenta, as well as
premature labor
• Cocaine may reduce immunity in the fetus, increasing the risk
of HIV infection

28. Cocaine and Pregnancy
• Prenatal exposure to cocaine delays growth and language
development
• Some babies have neurological problems, perhaps caused by
strokes before birth
• Babies have higher rates of congenital heart defects, lower
birth weights, seizures, and are at risk for sudden infant death
• Babies tend to be born with smaller heads, and are more
prone to urinary tract problems

29. Amphetamines
• Amphetamines were developed as inhalers to treat asthma,
sold under the name Benzedrine
• Amphetamines were used for treating depression, for
increasing work capacity, and for treating narcolepsy
• It then was used to suppress appetite and ward off fatigue
• In the late 1930s, it was given to hyperactive children

30. Common Amphetamines

31. Pharmacology of Amphetamines
• Amphetamines can be administered by ingestion, injection,
snorting, or inhalation
• Tolerance develops quickly – many users increase the
dosage or go on binges to maintain their high
• Amphetamines are sympathomimetic drugs – their effects are
similar to those in people who are emotionally aroused
• Their chemical structure is similar to that of the
neurotransmitters norepinephrine and dopamine

32. Pharmacology of Amphetamines
• The half-life is 10 to 12 hours, and they are not totally
eliminated from the body for about two days
• Amphetamines are removed from the body in two ways:
1. They are excreted through urine after being transformed
by liver enzymes
2. They are deactivated and removed by adding molecules
to the amphetamine compound

33. Pharmacology of Amphetamines
• Psychological effects include paranoia, violence,
restlessness, agitation, hallucinations, confusion, and anxiety
• Physical effects are tremors, tinnitus (ringing in ears), dry
mouth, excessive perspiration, increased blood pressure,
poor coordination, and convulsions
• Amphetamines are especially harmful to the cardiovascular
system and can cause cardiac arrest

34. The Amphetamine Trade
• In the 1940s, Japan and Sweden had severe problems with
amphetamine abuse
• In the 1930s, people in the US could legally obtain
amphetamines
• In 1970, they represented about 8% of prescriptions

35. Consequences of Amphetamine Use
• Most people who are dependent on amphetamines
experience withdrawal, continue using them despite
problems, cannot stop, develop tolerance, and give up other
activities to use amphetamines
• Stimulants can improve mental and physical performance for
simple tasks – but not for tasks requiring complex thinking,
such as problem-solving and decision-making

36. Consequences of Amphetamine Use
• High doses negatively affect judgment and decision-making
skills, and can cause severe behavioral problems
• Gross motor skills improve; fine motor skills are impaired
• Amphetamine psychosis – marked by paranoia,
aggressiveness, fearfulness, disordered thinking, mania, and
hallucinations – is a significant problem related to chronic use

37. Methamphetamines
• Methamphetamines (speed) are more potent forms of
amphetamine
• “Speed freaks” go on binges, shooting up every few hours
over a five- or six-day period before crashing
• Many users take methamphetamines in conjunction with other
drugs such as cocaine and marijuana

38. Nicknames for Methamphetamines
• Speed
• Ice
• Crystal
• Meth
• Chicken powder
• Go-fast
• Glass
• Crank
• Christy
• Crystal-meth
• Chalk
• Peanut butter-crank
• Shabu-shabu
• Zip

39. Methamphetamine Laboratories
• In the US, methamphetamines have become the number-one
drug problem in rural areas
• Types of harm associated with meth labs:
• Physical injury from explosions, fires, chemical burns, and
toxic fumes
• Environmental hazards
• Child endangerment

40. Methamphetamine’s Effects
• Slurred speech
• Loss of appetite
• Excitement
• Increased blood
pressure and heart rate
• Irregular heartbeat
• Pounding heart
• Severe chest pain
• Hot flashes
• Excessive perspiration
• Anxiety
• Tremors
• Confusion
• Insomnia
• Convulsions
• Memory loss
• Violent behavior
• Elevated body temp
• Paranoia
• Auditory hallucinations
• Death

41. Methamphetamine “Ice”

42. Ritalin and Adderall
• Ritalin (methylphenidate) and Adderall are the most
prescribed drugs for ADHD
• Ritalin and other stimulants enhance the functioning of the
reticular activating system, which helps children focus
attention and filter out extraneous stimuli
• Side effects include insomnia, weight loss, headaches,
irritability, nausea, and dizziness

43. Caffeine
• Caffeine is the world’s most frequently consumed stimulant
• Tea contains caffeine and theophylline, a stimulant from the
same chemical family as caffeine
• Products containing caffeine include gum, mints, beer, candy,
sunflower seeds, many prescription medicines, and chocolate
• Another stimulant in chocolate, theobromine, is related
chemically to caffeine but is less powerful

44. High-Energy Caffeinated Beverages
• The FDA does not regulate caffeine in food and drinks –
however, it suggests that a safe level is 72 mg per 12 ounces
• Many beverages such as Red Bull, Monster, and Rock Star
exceed that level
• To counter the sedating effects of alcohol, some individuals
alternate with these high-energy drinks when drinking alcohol

45. Caffeine Content

46. Pharmacology of Caffeine
• Caffeine acts as an antagonist to receptors for the inhibitory
neurotransmitter adenosine
• Peak effects occur 30 to 45 minutes after consumption
• Caffeine use by well-conditioned athletes has been found to
improve endurance on a short-term basis
• Extreme caffeine intake has been linked to a low blood sugar
condition called hypoglycemia

47. Properties and Risks of Caffeine
• Caffeine is a xanthine – stimulants that improve work
capacity, alertness, motor performance, and curb fatigue
• Caffeine may delay the progression of Alzheimer’s disease;
help asthmatics breathe easier; and may reduce risk of type 2
diabetes in younger and middle-aged women
• Caffeine taken on an empty stomach releases stomach acids
and digestive enzymes, causing an upset stomach

48. Properties and Risks of Caffeine
• Side effects include nervousness, anxiety, insomnia,
heartburn, and symptoms of premenstrual syndrome
• Caffeine has been implicated in cardiovascular conditions
from heart disease to hypertension
• Caffeine might contribute to breast lumps, breast tenderness,
and cysts
• Caffeinated coffee decreases the likelihood of certain cancers

49. Effects of Caffeine
• At moderate levels, caffeine increases blood pressure, body
temperature, blood sugar levels, metabolism, urination, and
hand tremors, and decreases appetite and coordination
• In large amounts, it causes nausea, diarrhea, shaking,
headache, and nervousness
• At worst, caffeine can cause convulsions, respiratory failure,
and, if one drinks 70 to 100 cups of coffee, death

50. Effects of Caffeine
• Caffeine users need the drug to achieve alertness and to
eliminate withdrawal symptoms
• Withdrawal symptoms appear in people who consume 2½
cups of coffee or more daily
• Withdrawal symptoms include headache, depression,
lethargy, lower energy level, drowsiness, and irritability

51. Decaffeinated Coffee
• Caffeine is displaced from the coffee bean using a hot water
solution – then is taken out of the water an organic solvent
• The original solvent, trichloroethylene, is potentially
carcinogenic – it was replaced by methylene chloride, which
also might contribute to cancer
• Decaffeinated coffee still has some caffeine: 5 mg to 32 mg
per 10 to 12 ounces (compared to 100mg)

52. Caffeinism
• Excessive caffeine consumption resulting in caffeine
dependency is called caffeinism
• More than one-half of moderate coffee drinkers who stop
drinking it experience moderate to severe headaches
• Caffeinism is marked by irritability, depression, insomnia,
headaches and morning lethargy
• About one-fourth of users experience withdrawal symptoms
when they discontinue drinking caffeine