1. The Major (vs. minor) Stimulants Cocaine and Amphetamine
SPECIFIC DRUGS
The Major (vs. minor) Stimulants
Cocaine and Amphetamine

2. Major Stimulants - Cocaine
* What is coke and where does it come from?
coca leaf / coca bush
Incas and Spanish
Freud
American history (VIP usage)

3. Major Stimulants - Cocaine
street cocaine: coca paste and hydrochloric acid =
type of salt--powder sniffed or snorted
more addictive uses:
can inject it if mix with water--IV quicker
smoking: freebase - powder and ether
crack - dissolve cocaine salt in baking soda solution, boil off water, left with rock
Cocaine - ETOH combo (coca-ethylene) - may alter metabolics of cocaine, which may be more cardiotoxic via increased half-life of cocaine

4. Major Stimulants - Cocaine
Prevalence
Cocaine (Crack) Cocaine (Crack)
Past month .8% (.2) .6% (.1)
Past year 1.7% (.4) 1.8% (.3)
Lifetime 10.6% (2.0) 14.7% (3.6)
cheapness of crack--national crisis
shift of users from college educated to high school dropouts
smoking cocaine becoming more popular, especially among young users

5. U.S. Banned Ephedra in 2004
used primarily for weight loss and body building in the U.S.
linked to 155 deaths and dozens of heart attacks and strokes.
Derived from a plant (powdered and then put in pills)
Contains ephedrine & pseudoephedrine

6. ephedra ban, cont…
side effects can be life threatening even for a healthy individual (constricts blood vessels, raises blood pressure).
FDA was aware of a problem for 8 years, however the high profile death of Baltimore Orioles pitcher, Steve Bechler stimulated concern from the FDA as well as many others.
1st government ban on a dietary supplement

7. Major Stimulants Neurotransmitters and behavioral pharmacology
Effects of the Major Stimulants
Desired effects
Negative effects
Overdose
Withdrawal SXs

8. Major Stimulants Medical Effects Fetal Exposure during Pregnancy
Other Co-morbid Diagnoses
Factors in Initiation of use leading to
dependence

9. Major Stimulants - Speed
Amphetamines
ephedrine, principal chemical in these drugs, has been known for thousands of years; used as Chinese medicinal herb
ephedrine first isolated in late 1800's, and synthesized in 1920s when it was named “amphetamine”
first medically used in 1920's for treating obesity, narcolepsy, colds, and much later ADHD
used to enhance performance, decrease fatigue – sport & military applications

10. Methamphetamine (speed, crystal, crank, ice)

11. How is it made ? Anhydrous nitrate Ephedrine Red Phosphorous Lithium
Antifreeze
Lantern fuel

12. Abscesses caused by “cranking” (injecting Meth intravenously)

13. Meth needle marks

14. Stages of use
Rush ( 20 – 40 minutes)
Binge High ( 3 days )
Crash

15. Short term effects anxiousness and nervousness incessant talking
extreme moodiness and irritability
purposeless, repetitious behavior, such as picking at skin or pulling out hair
sleep disturbances
false sense of confidence and power; aggressive or violent behavior

16. Dilated pupil - stimulant intoxication

17. Dental problems caused by Meth