Psych - Drugs Of Abuse Other Than Alcohol

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Notes for this lecture

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are good, read them

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Sedatives - drug classes included

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Benzos (includes Rohypnol), barbs, chloral hydrate

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Sedatives - effects

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Similar to EtOH

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Sedatives - mech of action

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Potentiate GABA response

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Sedatives - Problems

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Tolerance, physical dependence, respiratory (esp. when combined with alcohol) and cardiac depression.

Cardiac less likely with benzos alone.

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Cocaine mechanism of action

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In addition to other stimulants mech of action...

Enhance DA transmission in mesolimbic and mesocortical areas of brain. Also depletes presynaptic dopamine with prolonged use.

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Stimulants - Mech of action

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Release of DA and NE and blockade of catecholamine reuptake.

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Stimulants - drug classes included

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Cocaine (crack included here), amphetamines

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Stimulants - Problems

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Enxiety, confusion, cardiac/CNS/respiratory failure.

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Stimulants - withdrawal sx

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Depression/suicide, need for sleep, increased appetite fatigue, anhedonia, cravings.

These are usually not life threatening.

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Opioids - Which drugs included?

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Morphine, heroin, codeine, oxycodone (Percocet), meperidine (demerol), MS Contin, Oxycontin

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Opioids - Effects

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Intense pleasure that feels orgasmic, decreased mental/physical awareness and of decreased physical/emotional pain

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Opioids - Problems

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Rapid tolerance, physical dependence, resp depression, cellulitis, sepsis, endocarditis, HIV/hepatitis from sharing of needles.

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Opioids - Withdrawal sx

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Drug craving, dysphoria (unpleasant mood), yawning, piloerection (gooseflesh), bone pain

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Opioids - Withdrawal tx

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Methadone or non-opiates using clonidine and symptomatic meds.

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Cannabis (marijauna and THC) - action

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Absorbed through lungs and binds endogenous THC receptor sites in the brain.

Interacts with mesolimbic dopamine pathway.

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Cannabis (marijauna and THC) - desired effects

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Relaxation, euphoria, altered perceptions, altered time sense, sexual arousal

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Cannabis (marijauna and THC) - problems

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Panic, dizziness, motor impairment, resp problems, immune problems, reproductive problems (children with low birth-weight)

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Cannabis (marijauna and THC) - withdrawal

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Craving and other things.

Not usually treated.

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Can second-hand cannabis give positive urine?

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No

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LSD - Hallucinogen - action

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Acts like serotonin on 5HT2 receptors.

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LSD - Hallucinogen - drugs in this class

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LSD, mescaline, psilocybin, DMA, DOT, DMT

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LSD and MDMA - Hallucinogen - Effects

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Increased awareness of sensory input, hallucinations, claims of special insight, increased epathy.

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LSD - Hallucinogen - Problems

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Flashbacks long after-leading to depression and panic attacks. Psychotic disorders as well.

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LSD and MDMA - Hallucinogen - withdrawal sx

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None

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Medical indications for LSD or MDMA

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None

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MDMA - Hallucinogen - actions

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Effects are serotonergic binding sites as well as alpha-2 adrenergic sites and M1 muscarinic cholinergic and H-1 histaminergic sites.

Effects are a combo of LSD-like hallucinations and amphetamine-like arousal.

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MDMA - Hallucinogen - Drugs in this class

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MDMA (ecstasy), MDA

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MDMA - Hallucinogen - Problems

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Nausea, jaw/teeth clenching, muscle tension, depression, anxiety, hyperthermia, cardiac arrest, coagulopathy, possible degeneration of serotonergic nerve terminals.

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Phencyclidine (PCP) - Action

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Through NMDA receptor-channel complex in brain.

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Phencyclidine (PCP) - Effects

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visual illusions, hallucinations, feelings of strength.

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Phencyclidine (PCP) - Problems

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Nystagmus, hypersalivation, vomiting, fever, psychosis, bizarre behavior, hostility, severe anxiety/doom.

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Phencyclidine (PCP) - withdrawal sx

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none in humans. some in primates.

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Phencyclidine (PCP) - medical uses

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possible use in prevention of neurological damage due to ischemia.

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Inhalants - drugs included

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Glue, paint, nitrous oxide, nitrites

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Inhalants - Action

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Absorbed by alveolar capp bed and disrupt neural function. Intox similar to CNS depressants.

Nitrites - act by vasodilatation

NO - unclear

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Inhalants - effects

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Hydrocarbons - Rush euphoria, sensation of floating.

Nitrites - Postpone/enhance orgasm - especially in gay males.
NO - euphoria, altered perceptions.

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Inhalants - problems

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Hydrocarbons - sudden sniffing death due to cardiac arrythmias, aspiration or resp depression, atrophy of brain, renal complications.

Nitrites - Panic rxns, nausea, dizziness, hypotension.

NO - paranoid psychosis with confusion.

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Inhalants - withdrawal

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only psychological sx documented

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Hydrocarbons - who uses them the most?

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Males of low SES

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Anabolic androgenic steroids - action

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Bind to receptors in every organ. Also have direct effect on neuronal cell membranes.

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Anabolic androgenic steroids - effects

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enhancement of appearance or athletic performance with self-confidence as well.

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Anabolic androgenic steroids - problems

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more facial hair, deepening of voice, baldness, acne, reduction of HDL, liver failure, hypomania, mania, depression, panic, aggressiveness

Women - Clitoral enlargement,menstrual irreg

Men - man boobs (gynecomastia)

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Anabolic androgenic steroids - withdrawal sx

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Depression, fatigue, decreased libido, muscle pain, HA.

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Anabolic androgenic steroids - Classicly addictive?

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no

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Nicotine - action

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Agonist at nicotinic receptors centrally and peripherally. Modulated inhib and excit elements and can act as opiates and sedative hypnotics.

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Nicotine - Desired effects

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Relaxation, stimulation, social acceptance, image.

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Nicotine - problems

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cough, bronchitis, resp infections, copd, lung/oral CA, low birth weight babies.

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Nicotine - withdrawal sx

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craving, irratibility, anxiety, possible depression.

cessation often results in weight gain.

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Number one preventable cause of morbidity and mortality in US

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Nicotine addiction

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Cross tolerance

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Concept that taking a substance from one class will relieve sx of withdrawal of a drug from another class.

The basis of tx for alcohol and sedative-hypnotic withdrawal.