SOCIAL OR STREET DRUGS AND THEIR EFFECTS
Active substance: d-9-tetrahydrocannabinol (THC), found in resin of the Cannabis sativa plant
With smoking, about 50% is absorbed through the lungs; when ingested, only 10% is absorbed; with heavy use the following adverse effects have been reported: alterations of sensory perceptions, cognitive and psychomotor impairment (e.g., inability to judge time, speed, distance); smoking 3 or 4/day is similar to smoking 20 cigarettes/day in regard to frequency of chronic bronchitis and may contribute to lung cancer; data, from animal studies only, indicate reproductive changes including reduced fertility, decreased sperm motility, and decreased circulatory testosterone level; fetal abnormalities including low birth weight and increased frequency of childhood leukemia; increased frequency of infectious illness is thought to be the result of depressed cell-mediated and humoral immunity
Amine derivation of amphetamine (C10H15N) used as crystalline hydrochloride
CNS stimulant; in large doses causes irritability, aggressive (violent) behavior, anxiety, excitement, auditory hallucinations, and paranoia (delusions and psychosis); mood changes are common and the abuser can swiftly change from friendly to hostile; paranoiac swings can result in suspiciousness, hyperactive behavior, and dramatic mood swings. Appeals to abusers because body’s metabolism is increased and produces euphoria, alertness, and perception of increased energy
- Low intensity: user is not psychologically addicted and uses methamphetamine by swallowing or snorting
- Binge and high intensity: user has psychologic addiction and smokes or injects to achieve a faster, stronger high
- Tweaking: most dangerous stage; user is continually under the influence, not sleeping for 3 to 15 days, extremely irritated, and paranoid
Cocaine and crack:
Extracted from the leaves of the coca plant and sold as a water-soluble powder (cocaine hydrochloride) liberally diluted with talcum powder or other white powders; extraction of pure alkaloid from cocaine hydrochloride is “free-base” called crack because it “cracks” when heated.
Crack is more potent than cocaine; cocaine is widely used as an anesthetic, usually in procedures involving the oral cavity; it is a potent CNS stimulant, blocking reuptake of the neurotransmitters norepinephrine, dopamine, and serotonin; also increases synthesis of norepinephrine and dopamine; dopamine induces a sense of euphoria, and norepinephrine causes adrenergic potentiation, including hypertension, tachycardia, and vasoconstriction; cocaine can therefore cause severe coronary artery narrowing and ischemia; not clear why cocaine increases thrombus formation; other cardiovascular effects include arrhythmias, sudden death, dilated cardiomyopathy, rupture of descending aorta (i.e., secondary to hypertension); effects on the fetus include premature labor, retarded fetal development, stillbirth, hyperirritability.
Opiate closely related to morphine, methadone, and codeine
Highly addictive, and withdrawal causes intense fear (“I’ll die without it”); sold “cut” with similar-looking white powder; dissolved in water, it is often highly contaminated; feeling of tranquility and sedation lasts only a few hours and thus encourages repeated intravenous or subcutaneous injections; acts on the receptors enkephalins, endorphins, and dynorphins, which are widely distributed throughout the body with high affinity for the CNS; effects can include infectious complications, especially Staphylococcus aureus, granulomas of the lung, septic embolism, and pulmonary edema—in addition, viral infections from casual exchange of needles and HIV; sudden death is related to over dosage secondary to respiratory depression, decreased cardiac output, and severe pulmonary edema.