SOCIAL OR STREET DRUGS AND THEIR EFFECTS

 

Marijuana:

 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

Methamphetamine (meth):

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

Stages:

  • 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.

Heroin:

 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.