Cocaine and other UPPERS

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Cocaine and other UPPERS

• PPR 130

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Why do People Use?

• Main reason physical or mental uplift
• Other reasons include
• Reduction of fatigue
• Prevention of sleep
• Elevation of mood

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Chemical Uppers

• CNS stimulants
• Focus on behavioral stimulants
• Increase mental and physical activity
• Elevate mood in healthy individuals

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Most Powerful

• These drugs are the most powerful and most often
  used and abused.
• Cocaine
• Amphetamines
• Caffeine
• Pleasurable effects compel users to repeat use.

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Common Effects

• Release natural stimulants (neurotransmitter
  substances)
• Norepinephrine
• Dopamine
• Serotonin
• Cocaine, amphetamines, caffeine, and certain
  anti-anxiety depressants resemble norepinephrine.

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Common Effects cont.

• Low dose behavioral arousal with
• Increased alertness
• Surge of energy
• Shifting of blood flow fro skin to internal
  organs to muscles
• Increase in levels of oxygen and blood sugar
• Represent an exaggerated mobilization of the
  fight or flight response.

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Common Effects cont.

• Over-stimulation causes
• Irritability
• Restlessness
• Insomnia
• At excessive high doses can cause body systems to
  shut down, physical collapse, and mental
  depression

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The Power

• Psychological reliance is common
• Allows users to feel stronger, more decisive, and
  self-possessed
• Euphoria
• Decreased perception of fatigue
• Decreased need for sleep
• Decreased appetite
• Increase the desire for sexual behavior

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Patterns of Use

• eye openers used recreationally to increase
  alertness.
• Most common patterns of use include
• Oral administration (pill form of amphetamine)
• Inhalation (snorting cocaine)
• Intravenous (meth or cocaine), later development
• Often used with other depressant drugs

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Patterns of Use

• Large doses induce negative effects as well as
  desired effects. These negative effects include
• Dizziness
• Tremors
• Confusion
• Headaches
• Flushing/sweating
• Nausea
• Chest pain
• Racing heart

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Patterns of Use

• flash or rush reaction- after injection this
  is the term used to define the short, intense,
  generalized sensation similar to a splash of cold
  water.
• Users may display aggressive and hostile
  behavior.
• speeding up and slowing down

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Drug Dependence

• Tolerance develops fast with intravenous
  injection.
• High dosage feelings of paranoia and compulsive
  activities (e.g. teeth grinding).
• Toxic syndrometremors, panic, perspiration,
  abdominal cramps.
• No medical intervention high fever, convulsions,
  blood-vessel collapse and possible death.

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Drug Dependence

• Speed runs or binges- several days of
  continuous use of uppers. (e.g. amphetamines or
  cocaine).
• This helps to continue the high and avoid
  withdrawal symptoms.
• Crashing- a mental low or period of depression
  after use has seized.

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Drug Dependence

• After crash user experiences
• Sleep for long periods of time
• Huge appetite
• Lethargic for several days to several weeks
• Continued depression
• Panic reactions
• Irritability
• Assaultive and suicidal behavior

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Drug Dependence

• CNS stimulants physical dependence and
  psychological dependence.
• Not all users become addicted.
• Tolerance and withdrawal reactions do occur with
  use.
• Physical withdrawal is more severe in heroin and
  alcohol dependency.

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Cocaine

• Cocaine- extracted from the coca plant and most
  powerful CNS stimulant of natural origin.
• Legally classified as a narcotic but has the drug
  action of a stimulant.
• One of the most effective euphoriants.
• Medical uses limited to local anesthetic and
  former pain reliever.

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Cocaine

• Slang words
• Coke
• C
• Snow
• Blow
• Toot
• Leaf
• Flake
• Freeze
• White girl

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Cocaine

• Historical and legal aspects
• First use South American Indians
• Use was associated with political authority and
  social status
• Popular drinks contained cocaine (e.g.
  Coca-Cola).
• Therapeutic agent in non-prescribed drugs in late
  1800s
• Harrison Narcotics Act of 1914 ended use in meds.

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Cocaine

• History continued
• Reemergence of cocaine as recreational drug in
  the mid-1960s
• Present epidemic of abuse related to perception
  of cocaine as the caviar of drugs
• Original perception as safe and non-addictive and
  now declining use in America due to health risks.
• 1.5 million users today compared to 5.7 million
  in 1985

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Cocaine Usage

• Oral use- chewing leaves (Peru) less problems
• Snorting or sniffing (some can avoid tolerance)
  cocaine hydrochloride
• Absorption of drug through mucous membranes of
  the gums, tongue, etc.
• Absorption through genitalia, thought to increase
  orgasm.
• Intravenous injection- alone or in combination
  with another euphoriant. Different type of high
  rush that last ten minutes.

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Cocaine Usage

• Freebasing- (1970s) do it yourself process of
  converting the powder to a smokable base
  substance. Smoked in a water pipe or sprinkled
  on marijuana or cigarette. Effect intense
  euphoria and immediate response.
• Crack smoking- (1985) conversion from powder to
  hard shavings by using ammonia or baking soda and
  water. A cracking sound occurs when smoked and
  requires elaborate paraphernalia. Most addictive
  with short high.

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Cocaine Usage

• First dose of freebase or crack can kill and
  creates
• Uncontrolled body seizures
• Paralysis of breathing muscles
• Irregular heartbeat
• Possible heart attack
• Rapid elevation of blood pressure leading to
  stroke

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Effects of Cocaine

• Dependent upon
• Dose
• Drug purity
• Users mind-set
• Psychosocial setting
• Route of administration

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Effects of Cocaine

• Initial euphoria
• Increased self-confidence
• Increased heart rate
• Blood pressure
• Reduction of fatigue
• Enhanced mental alertness

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Effects of Cocaine

• Regular use
• Feelings of restlessness, irritability, anxiety,
  sleeplessness, mood swings
• Occasional light use
• Pleasurable psychological effects
• Occasional depression and irritability

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Effects of Cocaine

• Prolonged freebasing and crack-smoking
• Lung damage
• Prolonged snorting
• Dry out mucous membrane linings of the nose
• Ulcer-like sores
• Erode the cartilage separating the nostrils

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Effects of Cocaine

• Cocaine exposed babies display
• Hyperactivity
• Tension
• Muscle stiffness
• Poor reflexes
• Delayed motor

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Continued Cocaine Use

• May result in various adverse conditions
• Malnutrition
• Weight loss
• Sexual problems
• Mental confusion
• Anxiety
• Cocaine psychosis (paranoia) and formication
  (bugs)
• Kindling effect- the increased sensitivity of the
  brain to cocaines effects, low doses may cause
  seizures

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Use with Depressants

• Cocaine with depressant drugs are common, reduce
  respiratory activity.
• Cocaine and heroin speedball
• Softens crash and reduces stimulants effects.
• Speedballing increases risk of drug dependency,
  toxic overdoses, and financial disaster.

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Amphetamines

• Powerful CNS stimulants with cocaine-like effects
• Synthetic substances that produce alertness for
  hours
• Amphetamine can be applied to
• Amphetamine or levoamphetamine
• Dextroamphetamine
• Methamphetamine (meth or speed)
• Dextromethamphetarnine (ice)

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Effects of Amphetamines

• Include
• Production of wakefulness
• Alertness
• Mood elevation
• Self-confidence
• Reduced feelings of fatigue
• Depressed appetite
• Euphoria
• Increased motor and speech activity

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Effects of Amphetamines

• Prolonged use or large doses may result in
• Rapid tolerance after repeated oral and injected
  doses
• Psychological dependence
• Withdrawal symptoms of severe mental depression,
  fatigue, and hunger
• Stimulant-induced toxic psychosis

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Amphetamine Dependence

• Similar to cocaine dependence (psychological and
  physical dependence)
• Taking large amounts addiction/dependence
• Tolerance develops after repeated
• Oral
• Smoked
• Injected doses
• Increase dosage to receive desired effects

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History and Legal Aspects

• First synthesized in Germany in 1887.
• 1927- found ability to stimulate the CNS,
  alleviate fatigue, and relieve congested nasal
  passages.
• 1935- used in narcolepsy treatment.
• 1937- found to have a paradoxical calming effect
  on children with hyperkinetic disorders (extreme
  activity and impulsivity)

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History and Legal Aspects

• During WWII- soldiers used amphetamines to combat
  fatigue and prolong endurance.
• 1950s and 1960s- prescribed widely for the
  control of depression and dieting. Treatment of
  epilepsy, asthma, sedative overdose, and nausea
  during pregnancy.

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History and Legal Aspects

• 1970- Controlled Substances Act placed
  amphetamines under Schedule II, which restricted
  manufacture and distribution.
• 1988- ice surfaced in Hawaii (smokable meth
  with lasting effects and negative consequences).
• Today- illicit amphetamine use is popular.
  Fastest growing drug threat in America.

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Amphetamines

• Crystal- is a type of meth that is injected.
  This is the most powerful form of speed and
  produces intense physical and psychic
  exhilaration.
• Crank- is a type of meth that comes in a pill
  form. Can refer to pharmaceutical amphetamines
  and various bootleg amphetamines.

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Medical Uses

• Used to curb appetite and control obesity,
  referred to anorectics or pep-pills.
• Attention deficit-hyperactivity disorders in
  children.
• 1960s- extreme caution used to prescribe
  anorectics and a decrease in legitimate
  production. High addiction risk and may
  contribute to paranoid delusions.
• Today, amphetamine congeners or surrogates are
  alternative drugs for weight loss.

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Caffeine

• Contained in various beverages and candies as
  well as various medications.
• The most widely used social drug in the world.
• A bitter tasting, odorless compound.
• A natural constituent of various plants that are
  the sources of coffee, tea, kola nut extracts,
  cocoa, and chocolate.

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Effects of Caffeine

• Effects typically include
• Immediate increase in body temperature
• Increase in blood pressure
• Increase in body chemistry
• Induces clearer thought
• Less drowsiness
• Shortened reaction time
• Improved intellectual effort
• Increased motor activity, respiratory rate, and
  excitability.

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Effects of Caffeine

• Effects in the cardiovascular system
• Increases the rate and force of the heartss
  contraction
• General vasodilation of systemic blood vessels
  which increase blood flow.
• Causes relief from hypertensive and migraine
  headaches.
• Speeds up the production of urine, increases the
  capacity for muscular work.

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Caffeinism

• Desired effects often derived from coffee, tea,
  or soda.
• Different forms different effects
• Effects vary from person to person
• caffeine intoxication stimulated condition or
  poisoning also known as caffeinism mood changes,
  anxiety, disruption of sleep, possible
  manifestation of other medical and psychological
  problems.

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Caffeinism

• Toxic condition includes symptoms of
• Restlessness
• Nervousness
• Excitement
• Insomnia
• Flushed face
• Diuresis (increase urine production)
• Gastrointestinal disturbance
• Rambling low of thought and speech
• Rapid heart beat

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Caffeine Dependence and Tolerance

• morning lift encourage continued use
• Activates brains pleasure centers difficulty
  in kicking habit
• Psychological dependence
• Pharmacological tolerance disputed
• Withdrawal symptoms are mild and tolerable

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Caffeine Dependence and Tolerance

• Withdrawal symptoms include
• Headache
• Irritability
• Lethargy
• Apathy
• Difficulty in concentration
• Decreased work efficiency
• Nervousness
• Restlessness
• Mild nausea

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Caffeine, Pregnancy, and Birth Defects

• Extreme consumption inhibits conception
• Nursing mothers who drink high amounts of
  caffeine report babies whom are sleepless and
  irritable.
• Research proven capable of chromosomal
  abnormalities (plant and animals).
• Consumption before and during pregnancy
  increased risk of fetal loss.

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Caffeine and Diseases

• Caffeine related to
• Cancer
• Heart Disease
• Irregularities in heartbeat

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Methcathinone

• Gaining popularity in Midwest and Northwest.
• Homemade drug, cat.
• Destructive side effects such as addictiveness,
  paranoia, intense anxiety.
• Similar to cathinone.
• Typically snorted, can also be smoked, injected,
  or consumed orally in beverage.

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Methcathinone

• Desired effects include
• Burst of energy
• Extreme well-being or euphoria
• Overuse of drug effects include
• Paranoia
• Excruciating nervousness
• Hallucinations
• Decrease in appetite/weight loss
• Dehydration
• Headaches
• stomach

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Ephedrine

• Natural extract of Ephedra sinica
• Close relative of the amphetamines
• Used to treat asthma/decongestant
• Ephedrine caffeine weight loss
• thermogenic aid boosts metabolism
• Unsupervised use linked to
• Fatal strokes and heart attacks

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Ephedrine

• Other negative consequences
• Restlessness
• Insomnia
• Nerve damage
• Rapid and irregular heartbeats
• Psychotic episodes
• Loss of memory
• Liver failure
• Elevated blood pressure

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Other Plant Stimulants

• Betel nuts- placed in the cheek or under the
  tongue and sucked for two or more hours (pleasure
  feeling reduction of fatigue).
• Yohimbe- used to brew a mildly stimulating tea
  (aphrodisiac effect).