Presentation on theme: "MIND ALTERING… SYNTHETIC (DESIGNER) AND NATURALLY OCCURING…DRUGS"— Presentation transcript:
1MIND ALTERING… SYNTHETIC (DESIGNER) AND NATURALLY OCCURING…DRUGS Cardwell C. Nuckols, PhD(407)
2FDA CLASSIFICATION Schedule I Controlled Substances Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.Some examples of substances listed in Schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4-methylenedioxymethamphetamine ("Ecstasy").
3FDA CLASSIFICATION Schedule II Controlled Substances Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.Examples of Schedule II narcotics include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®). Other Schedule II narcotics include: morphine, opium, and codeine.Examples of Schedule II stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®).
4FDA CLASSIFICATION Schedule III Controlled Substances Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.Examples of Schedule III narcotics include: combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®), products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine®), and buprenorphine (Suboxone®).Examples of Schedule III non-narcotics include: benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as Depo®-Testosterone.
5FDA CLASSIFICATION Schedule IV Controlled Substances Substances in this schedule have a low potential for abuse relative to substances in Schedule III.Examples of Schedule IV substances include: alprazolam (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®).
6FDA CLASSIFICATION Schedule V Controlled Substances Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.Examples of Schedule V substances include: cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC®, Phenergan with Codeine®), ezogabine (Potiga, seizures) and pregabalin (Lyrica) .
7PHARMACOLOGICAL CATEGORIES STIMULANT DRUGS“BATH SALTS”KHAT (CATHINONE)CANNABINOIDS“SPICE” AND A WIDE VARIETY OF CANNABINOID RECEPTOR AGONISTSDEPRESSANTSGHB
8PHARMACOLOGICAL CATEGORIES HALLUCINOGENS2C-E AND RELATED SYNTHETIC PSYCHEDELIC PHENETHYLAMINESTHE NEUROSOUP GUIDE (http://www.neurosoup.com/neurosoup_trip_guide.htm )MDMA3,4-methylenedioxymethamphetamineSALVIA DIVINORUM
10STIMULANT DRUGS IN GENERAL MethamphetamineCocaineNicotineCaffeineRoutes of AdministrationOralIVPulmonary
11STIMULANT TOXICITY Increased levels of Norepinephrine and Dopamine Hyper-arousalPleasureParanoiaIncreased levels of SerotoninReduced hungerDifficulty sleeping
12STIMULANT CRASH Reduced levels of Norepinephrine and Dopamine DysphoriaDepressionAnhedoniaReduced levels of SerotoninMood swingsSleep disturbances
13ACUTE ABSTINENCE SYNDROME Reduced Noradrenergic activity1 to 4 daysLow stimulant cravingHigh carbohydrate craving4 to 10 daysFree floating anxietyEuphoric dreamsDrug cravings
14“BATH SALTS” AND RELATED STIMULANTS In the 1970s, a medicinal chemist named Richard A. Glennon was studying what it would take to convert a stimulant drug to a hallucinogen and vice versa in order to determine how these substances work in the brain. He knew that small modifications to a drug's molecular structure could result in major changes in its effects. By introducing an oxygen atom to the side chain of amphetamine, he created something called a beta-keto amphetamine. Beta-keto amphetamine was what we now call cathinone.
21“BATH SALTS” AND RELATED STIMULANTS INGREDIENTS3,4-METHYENEDIOXYPYROVALERONE (MDPV)MPPPMDPPP4-METHYLMETHCATHINONE (MEPHEDRONE OR 4-MMC)PHARMACOLOGYMDPV IS A POWERFUL STIMULANT THAT FUNCTIONS AS DOPAMINE-NOREPINEPHRINE REUPTAKE INHIBITORS (NDRI)
22“BATH SALTS” AND RELATED STIMULANTS Taking bath salts, it seemed, was similar to taking amphetamine and cocaine at the same time. Except for one thing: MDPV is as much as 10 times stronger than cocaine.
23“BATH SALTS” AND RELATED STIMULANTS PHARMACOLOGY (CONTINUED)4-MMC IS CHEMICALLY SIMILAR TO AMPHETAMINE AND KHAT, MANUFACTURED IN CHINA AND COMES IN TABLETS OR POWDER THAT CAN BE SWALLOWED, SNORTED OR INJECTEDTHEY HAVE STIMULATORY EFFECTS ON THE CENTRAL NERVOUS SYSTEM (CNS) AND CARDIOVASCULAR SYSTEMMDPV AND 4-MMC PHYSICAL SYMPTOMS INCLUDE RAPID HEART RATE, INCREASED BLOOD PRESSURE, VASOCONSTRICTION AND SWEATING
24“BATH SALTS” AND RELATED STIMULANTS PHARMACOLOGY (CONTINUED)MDPV AND 4-MMC MENTAL SYMPTOMS INCLUDE EUPHORIA, INCREASED ALERTNESS, INCREASED WAKEFULNESS, ANXIETY, AGITATION, AND REDUCED DESIRE FOR FOOD AND SLEEPMDPV IS REPORTEDLY FOUR TIMES AS STRONG A STIMULANT AS RITALIN AND IS SOMETIMES LABELED AS LEGAL COCAINE OR LEGAL AMPHETAMINE
25“BATH SALTS” AND RELATED STIMULANTS TRADE NAMES-SOLD AS PLANT FOOD AN DFOR AROMATHERAPY ALSOMDPV“RED DOVE”, “BLUE SILK”, “CLOUD NINE”, “ZOOM”, “BLOOM”, “VANILLA SKY”, “SCARFACE”, AND “STAR DUST”ALSO SOLD AS INSECT REPELLANT AND PLANT FOOD WITH NAMES LIKE “BONSAI GROW”4-MMC“MEPH”, “DRONE”, “MCAT” AND “MEOW, MEOW”DURATION OF EFFECTSMDPV IS ROUGHLY 3-4 HOURS WITH AFTER EFFECTS LASTING 6-8 HOURS
26KHAT NATIVE TO TROPICAL EAST AFRICA AND ARABIAN PENINSULA PART OF SOCIAL CULTURE IN SOME AREASFRESH LEAVES/TOPS CHEWED OR CONSUMED AS TEASTIMULANT AND EUPHORIANTCATHINONE (SCHEDULE 1)STRUCTURALLY SIMILAR TO AMPHETAMINE
34“SPICE” AND OTHER SYNTHETIC CANNABINOIDS INGREDIENTSA DIVERSE GROUP OF CANNABINOID RECEPTOR AGONISTS FALLING INTO SEVEN MAJOR STRUCTURAL GROUPSNAPHTOYLINDOLESNAPTHYLMETHYLINDOLESNAPTHOYLPYRROLESNAPTHYLMETHYLINDENESPHENYLACETYLINDOLESCYCLOHEXYLPHENOLSCLASSICAL CANNABINOIDS (DIBENZOPYRAN)
38CANNABINOID MODULATORS Work on CB-1 and CB-2 receptor sitesRimonabant (Acomplia)Blocks CB-1 receptorsSuppresses appetiteFavorable changes in blood fats, cholesterol and glucose toleranceHigh drop out rate
39RIMONABANT Clinical Trials BRAINWORK (May-June 2006) Test subjects No psychiatric historyNo family historyHigh Drop-out ratePsychiatric Side-EffectsAnxietyDepressionBRAINWORK (May-June 2006)
40CANNABINOID MODULATORS Anxiety and depression involve the endocannabinoid systemRimonabant blocks receptorsMay see increase in psychiatric symptomsIf boost endocannabinoid system get antianxiety and antidepressant effects
41SYNTHETIC CANNABINOIDS-COMMERCIAL Rimonabant (also known as SR141716; trade names Acomplia, Bethin, Monaslim, Remonabent, Riobant, Slimona, Rimoslim, Zimulti, and Riomont) is an anorectic antiobesity drug. It is an inverse agonist for the cannabinoid receptor CB1. Its main effect is reduction in appetite. Rimonabant blocks the psychoactive and some of the cardiovascular effects of Δ9-tetrahydrocannabinol (THC) in humans without affecting the pharmacokinetics.
42SYNTHETIC CANNABINOIDS-COMMERCIAL Dronabinol (Marinol, Delta-9-tetrahydrocannabinol, delta-9-THC) is synthetic THC. It is used to treat nausea and vomiting caused by chemotherapy in people who have already taken other medications to treat this type of nausea and vomiting without good results. Dronabinol is also used to treat loss of appetite and weight loss in people who have acquired immunodeficiency syndrome (AIDS). Dronabinol is in a class of medications called cannabinoids. It works by affecting the area of the brain that controls nausea, vomiting, and appetite.
43SYNTHETIC CANNABINOIDS-COMMERCIAL Nabilone is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. It is a synthetic cannabinoid, which mimics the main ingredient of cannabis (THC). Chemically, nabilone is similar to the active ingredient found in naturally occurring Cannabis sativa L.In Canada, the United States, the United Kingdom and Mexico, nabilone is marketed as Cesamet. It was approved in 1985 by the U.S. Food and Drug Administration (FDA) for treatment of chemotherapy-induced nausea and vomiting that has not responded to conventional antiemetics. Though it was approved by the FDA in 1985, the drug only began marketing in the United States in It is also approved for use in treatment of anorexia and weight loss in patients with AIDS.Although it doesn't have the official indication (except in Mexico), nabilone is widely used as an adjunct therapy for chronic pain management. Numerous trials and case studies have demonstrated various benefits for condition such as fibromyalgia and multiple sclerosis.
44SYNTHETIC CANNABINOIDS-COMMERCIAL Sativex is an oromucosal (mouth) spray developed by the UK company GW Pharmaceuticals for multiple sclerosis patients, who can use it to alleviate neuropathic pain, spasticity, overactive bladder, and other symptoms. Sativex is also being prescribed to alleviate pain due to cancer and has been researched in various models of peripheral and central neuropathic pain.Sativex is distinct from all other pharmaceutically produced cannabinoids currently available because it is derived from botanical material, rather than a solely synthetic process. Sativex is a pharmaceutical product standardized in composition, formulation, and dose. Its principal active cannabinoid components are the cannabinoids: tetrahydrocannabinol (THC) and cannabidiol (CBD). The product is formulated as an oromucosal spray which is administered by spraying into the mouth. Each spray of Sativex delivers a fixed dose of 2.7mg THC and 2.5mg CBD.
49“SPICE” AND OTHER SYNTHETIC CANNABINOIDS PHARMACOLOGYCANNABINOID RECEPTOR AGONISTS MIMIC THE EFFECTS OF THC AND ANADAMIDE BY INTERACTING WITH THE CB1 RECEPTOR IN THE BRAINSOME OF THESE SYNTHETICS HAVE A HIGHER AFFINITY FOR THE RECEPTOR THAN CANNABIS THC AND MAY BE PARTICULARLY LONG ACTINGOFTEN LARGE AMOUNTS OF TOCOPHEROL (VITAMIN E) ADDED TO MASK ANALYSIS
50“SPICE” AND OTHER SYNTHETIC CANNABINOIDS PHARMACOLOGY (CONTINUED)SMOKING MIXTURES ARE USUALLY SOLD IN METAL-FOIL SACHETS TYPICALLY CONTAINING THREE GRAMS OF DRIED VEGETABLE MATTER TO WHICH ONE OR MORE OF THE CANNABINOIDS HAVE BEEN ADDEDTRADE NAMES“SPICE GOLD”, “SPICE SILVER”, “YUCATAN FIRE”, “CHILL X”, “SENSE” AND MANY OTHERS
51GHB (CNS DEPRESSANT)γ-Hydroxybutyric acid (GHB), also known as 4-hydroxybutanoic acidNaturally occurring substance found in the human Central nervous System (CNS)General anesthetic, to treat conditions such as insomnia, clinical depression, narcolepsy, and alcoholism, and to improve athletic performance (elevates Human Growth Hormone). It is also used as an intoxicant or as a “date rape drug”. Has a salty taste like baking soda
52GHBGeorgia Home Boy", "Juice", “Grievous Bodily Harm”, "Liquid Ecstasy", "Mils", "G", "Liquid X", and "Liquid G", as well as "Fantasy"Its effects have been described anecdotally as comparable with alcohol and ecstasy use, such as euphoria, disinhibition, enhanced sensuality and empathogenic states
57GHB TOXICITY LOW DOSE (.5-1.5 GRAMS) EQUAL TO 1-3 ALCOHOLIC DRINKS) Reduces anxietyActs as a depressantSlurred speechEnergeticPlayfulReduction in motor skillsMild dizziness
58GHB TOXICITY MEDIUM DOSE (1-2.5 GRAMS) Affectionate and sensual responseIncreased erectile capacityHeightened orgasmTactile sensitivityNausea and grogginessIncreased appreciation for music, dancing and/or talking
59GHB TOXICITY High dose (2.5 grams +) Overdose (greater than 2 grams) EuphoriaIncreased grogginess and nausea/vomitingOverdose (greater than 2 grams)Nausea and vomitingLike other CNS depressant drugs( alcohol, heroin)Seizure activityComaNOTE: Dose is hard to titrate so might quickly move from medium to overdose
60GHB ACUTE ABSTINENCE SYNDROME Initially feel drowsy, groggy and sleepy as the “morning after” effectsThe AAS includes…InsomniaAnxiety and tremorResolved in 3-12 daysProlonged and difficult
61HALLUCINOGENS 2C-E NICKNAMED “EUROPA” SYNTHESIZED IN 1970’S-1980’SPSYCHEDELIC PHENETHYLAMINE4-ETHYL-2,5 DIMETHOXYPHENETHYLAMINETAKEN ORALLYPOWERFUL HALLUCINOGENIC EFFECTSHIGH LASTS 4-9 HOURSSOLD THROUGH EUROPEAN SOURCES
622C-E NICKNAMED “EUROPA” SYNTHESIZED BY ALEXANDER SHULGINPOPULARIZED MDMA (ECSTASY)PIHKAL BOOK (1991)PHENETHYLAMINES I HAVE KNOW AND LOVED2C-I ANOTHER PHENETHYLAMINE IS AVAILABLE2C-E IS SCHEDULE I
682C-E PHARMACOLOGY TOTAL DURATION 4-9 HOURS ONSET 20-90 MINUTES PLATEAU HOURSCOMING DOWN HOURSAFTER EFFECTS HOURSHANGOVER HOURS
692C-E PHARMACOLOGY: SUBJECTIVE EXPERIENCE POSITIVESENSE OF WELL-BEINGMENTAL AND PHYSICAL STIMULATIONINCRESED AWARENESS OF SENSESVISUAL EFFECTSSPIRITUAL EXPERIENCESINCREASE IN CREATIVE THINKING
702C-E PHARMACOLOGY: SUBJECTIVE EXPERIENCE NEUTRALPUPIL DILATIONCONFUSIONDIFFICULTY CONCENTRATINGCHANGE IN TIME PERCEPTIONINCREASE IN BODY TEMPERATURESLIGHT INCREASE IN HEART RATE
712C-E PHARMACOLOGY: SUBJECTIVE EXPERIENCE NEGATIVEMUSCLE TENSION AND ACHINGJAW TENSIONINCREASED PERSPIRATIONNAUSEA AND VOMITINGDIZZINESS AND CONFUSIIONPARANOIADIFFICULTY INTEGRATING EXPERIENCE
72MDMA 3,4 methylenedioxy-methamphetamine Ecstasy, XTC Synthetic psychoactive drug similar to both the stimulant drug methamphetamine and the hallucinogen mescalineIntroduced in the 1970’s as an aid in psychotherapyInitially popular with the adolescent and young adult population but now has a broad audience“Raves”
73MDMA-SUBJECTIVE EXPERIENCE Increased energyEuphoriaEmotional warmthEmpathy towards othersDistortions in sensory and time perceptionUsually taken orally as a tablet or capsuleSome gay and bisexual men use MDMA mixed with cocaine, GHB, methamphetamine, ketamine and sildenafil (Viagra)
74MDMA PHARMACOLOGY Methamphetamine breakdown product Sympathetic Nervous System (Sympathomimetic)Increased heart rateIncreased blood pressureDilated pupilsPerspirationReduced hunger and thirstHallucinogenicSensory hallucinations
75MDMA PHARMACOLOGY Increases the activity of… SerotoninNorepinephrineDopamineSerotonin triggers the release of oxytocin and vasopressinLoveTrustSexual arousal
76There are at least two sides to the neurotransmitter story Functional domains of Serotonin and Norepinephrine1-4Serotonin (5-HT)Norepinephrine (NE)Depressed MoodAnxietyIrritabilityThought processSexAppetiteAggressionConcentrationInterestMotivationVague Aches and painSome symptoms (e.g. appetite, attention) seem to be mediated more by one neurotransmitter than the other. Some other symptoms (e.g. anxiety) seem to be mediated by either. There are other symptoms (e.g. aches and pain) that seem to be mediated more consistently by a combination of both the neurotransmitters.Both serotonin and norepinephrine mediate a broad spectrum of depressive symptoms
83MDMA TOXICITY Dehydration Hyperthermia Increased ANS functioning SeizuresHeart and kidney failure“Stacking and combining”Serotonin damage
84MDMA WITHDRAWAL Acute Abstinence Syndrome Pale Dysphoric Depressed Confusion and anxietySomnolentParanoia(can last for weeks)
85MDMA MEDICAL MANAGEMENT Benzodiazepines(Ativan)Sedation, muscle relaxation and seizure managementBenzodiazepines(Valium)Depresses the CNSAnticonvulsants(Dilantin)Barbiturates(Phenobarbital)Anticonvulsant when Benzo and Dilantin fail
86MDMA MEDICAL MANAGEMENT Antihypertensives (Regitine)Lower blood pressureGI DecontaminateActivated charcoalAbsorbs MDMA and limits absorption
87SALVIA DIVINORUM DIVINER’S SAGE INDUCES DISSOCIATIVE STATES AND PRODUCER OF “VISIONS” AND OTHER HALLUCINATORY EXPERIENCESSIERRA MAZATECA OF OAXACA, MEXICOUSED BY MAZATEC SHAMANS FOR RELIGIOUS AND SPIRITUAL HEALING SESSIONS
92SALVIA DIVINORUM PHARAMCOLOGY ACTIVE INGREDIENT SALVINORUM A IS A POTENT K-OPIOID AND D2 RECEPTOR AGONISTUSUALLY SMOKED OFTEN WITH WATER PIPEPOTENT NATURALLY OCCURRING HALLUCINOGEN ALTHOUGHT DOES NOT SEEM TO WORK THROUGH THE SEROTONIN SYSTEM
93SALVIA DIVINORUM-SUBJECTIVE POSITIVESHORT DURATION ESPECIALLY WHEN SMOKEDRADICAL PERSPECTIVE SHIFTINGINCREASE IN SENSUAL APPRECIATIONDREAMLIKE EXPERIENCESINSIGHT INTO SELFNEUTRALCHANGE IN BODY TEMPERATURE, FLUSHINGSENSATION OF ENTERING OR PERCEIVING OTHER DIMENSIONS
94SALVIA DIVINORUM-SUBJECTIVE NEUTRAL (CONTINUED)FEELING OF PRESENCE OR ENTITY CONTACTDISSOCIATION AT HIGHER DOSESNEGATIVEOVERLY-INTENSE EXPERIENCESFEAR, TERROR AN DPANICMILD TO MODERATE HEADACHECOORDINATION PROBLEMS
95KRATOM (OPIOIDS) LEAF FROM LARGE TREES NATIVE TO SOUTHEAST ASIA MITRAGYNA SPECIOSAFOUND INMALAYSIATHAILANDINDONESIAITHANG, BIAK BIAK, KETUM, KAKUAM, THOM
101Journal of Psychoactive Drugs Vol. 20 (No 4) 1988 ...leaves of Mitragyna speciosa, tree of Malaysia and Thailand, used as opium substitute, methods included tea, smoking and chewing. Found to suppress opiate withdrawal syndrome. Chronic users said to have darkened skin. Said to have both stimulating and depressant qualities as if chewing coca leaves and smoking opium simultaneously. Large doses lead to stupor. Withdrawal said to be considerably milder than that with the opiates. Mitragynine is thus a drug with a highly unusual but never the less well-documented history of being described as both a stimulant and depressant while at the same time possessing the chemical structure one might expect of a psychedelic. The Thai narcotic book described Kratom as weaker than morphine and less harmful than cocaine.
102KRATOM PHARMACOLOGY MITRAGYNINE 7-HYDROXYMITRAGYNINE (MAIN ACTIVE INGREDIENT)SIMILAR IN STRUCTURE TO PSYHEDELICS BUT HAS NO REAL PSYCHEDELIC EFFECTSINTERACTS WITH OPIOID RECEPTORSLOW DOSE-ATTACHES TO DELTA OPIOID RECEPTORHIGHER DOSES-ATTACHES TO MU OPIOID RECEPTOR
103KRATOM PHARMACOLOGY 7-HYDROXYMITRAGYNINE POTENT OPIATE AGONIST NATURAL CEILING EFFECTLIMITS EUPHORIALIMITS RESPIRATORY DEPRESSIONLIMITS OD POTENTIALNO KNOWN FATAL OD
104KRATOM PHARMACOLOGY USED IN TREATMENT OF OPIATE DEPENDENCE 1897, EUROPEANS BELIEVE LEAVES OF THE PLAN TO BE A CURE FOR OPIATE DEPENDENCECURRENTLY, USED FOR METHADONE DETOXIFICATION IN SOME COUNTRIES (EX. NEW ZEALAND) AND IN THAILAND TO DETOX AND MANAGE HEROIN ACUTE ABSTINENCE SYNDROME (AAS)TO PREVENT ONSET OF AAS SYMPTOMS
105KRATOM PHARMACOLOGY SEEMS TO BE… ONSET OF ACTION: 5-10 MINUTES A STIMULANT AT LOWER DOSES (MITRAGYNINE)A SEDATIVE AT HIGHER DOSES (7-HYDROXYMITRAGYNINE)ONSET OF ACTION: 5-10 MINUTESDURATION OF ACTION: SEVERAL HOURS
106KRATOM PHARMACOLOGY SHORT TERM EFFECTS: INTERMEDIATE EFFECTS DRY MOUTH INCREASED OR REDUCED URINATIONLOSS OF APPETITENAUSEA/ VOMITINGINTERMEDIATE EFFECTSANOREXIA WITH WEIGHT LOSSINSOMNIADEPENDENCE
107KRATOM PHARMACOLOGY LONG TERM HIGH DOSE EFFECTS NERVOUSNESS SLEEPLESSNESSLOSS OF LIBIDOCONSTIPATIONDARKENING OF SKIN
109KRATOM PHARMACOLOGY ACUTE ABSTINENCE SYNDROME SIMILAR TO OPIOIDS AROUSED SYMPATHETIC NERVOUS SYSTEMINCREASED HEART RATEINCREASED BLOOD PRESSUREDILATED PUPILSTREMORSCASE OF BODY FLUMUSCLE ACHESNAUSEA/VOMITING
110KROKODIL RAMPANT ABUSE IN RUSSIA MIXTURE OF CODEINE AND GASOLINE, PAINT THINNER, IODINE, HYDROCHLORIC ACID AND RED PHOSPHOROUSDESOMORPHINE-SYNTHESIZED IN US IN 1932HEROIN-LIKE EFFECTS (8-10 stronger than morphine)MUCH CHEAPER TO OBTAIN-CODEINE SOLD OTC IN RUSSIA
111KROKODIL PHARMACOLOGY Half-life short so have to inject every minutesShort half-life means Acute Abstinence Syndrome comes on very quicklyPharmacology similar to other opioids with typical subjective effects and acute abstinence syndrome
117KROKODILName comes from the appearance of the skin of chronic users and the derivative of codeine (chlorocodide) used in productionSevere tissue damage, phlebitis and gangreneThe amount of tissue damage is so severe the life expectancy of a chronic addict is only 3-4 years
118“JENKEM” (INHALANT) FERMENTATION OF HUMAN WASTE FECES AND URINE STORED IN TIGHT CONTAINER FOR SEVERAL DAYSREACTION PRODUCES METHANE GAS“HUFFED” BY USERS TO CREATE ANOXIA