SUBSTANE OF ABUSE414 PHG

DR. PERWEZ ALAM

• Identify pharmacological actions of halucinogens.

• Differentiate between different halucinogens according to their signs of abuse.

• Plan treatment regimen for different hallucinogen’s addiction.

• Hallucinogens are a group of drugs that work on the brain to affect the senses and cause ‘hallucinations’.

• Seeing, hearing, smelling, tasting or touching things that do not exist.

• Psychedelics: substances that alter perception and consciousness.

•Psychotomimetic: substances that mimic psychosis.

• Psychotogenic: substances that produce psychosis.

• Some hallucinogens occur naturally.

• Others are synthesized in laboratories from chemical

substances (‘LSD’).

• Some drugs, such as cannabis and ecstasy can cause

hallucinogen-like effects when used in high doses or in

certain ways.

• Using hallucinogens is often called ‘tripping’.

• The main effects of hallucinogens are changes in

the way you perceive things with your senses.

• They can include strange sensations such as

floating or your body becoming part of another

object.

Main effects of hallucinogens

• Some users can experience many general senses

of fear, unrelieved terror, they are going insane or

will never return to reality.

• Users may exhibit actions suggesting harm to

themselves or others. This harm could take the

form of suicidal ideation.

Main effects of hallucinogens

• For centuries, hallucinogens have been used in many different cultures for a wide variety of reasons.

• Often they have been used in religious rituals or spiritual pursuits, to produce mystical "visions" or simply to induce detachment from reality.

• In more recent years, hallucinogenic (eg. LSD) and dissociative drugs (eg. PCP) have been used for more social or recreational purposes "just for fun."

• People also use hallucinogens to deal with stress, or to try to achieve what they believe is an enlightened state of mind.

• 1) Serotonin-like (serotonergic)» LSD» Psilocybin» DMT» Bufotenine

• 2) Psychedelic anesthetics– PCP (Phencyclidine)– Ketamine (Ketalar)

• 3) Anticholinergic– Scopolamine– Hyoscine– Hyoscyamine– Atropine

• 4) Catecholamine-like (methylated amphetamines)• Mescaline • Myristin • Elemicin

• Act as agonist of Serotonin Receptors.• Examples:• LSD• Psilocybin• DMT• Bufotenine

Serotonin

• LSD (‘acid, ‘trips’) is the most often used form of hallucinogen.

• In its pure form, LSD is a white, odorless powder.

• Synthesized from lysergic acid, which is found in ergot alkaloids of the rye fungus growing on various grains.

• Produced in labs specifically for illegal drug market.

• No current medical use.

• The pure form is very strong.

• It comes in liquid form, tablets, capsules or squares

of gelatin or blotting paper or postage stamp-sized

papers impregnated with varying doses of LSD (50

to 300 mg or more).

• Effects are felt within an hour, and last 2 to 12 hours.

• Perception intensifies, colors appear brighter, objects more sharply defined or distorted.

• Dilation of pupils, dizziness, dreamy detached feelings.

• Possible changes in the perception of time and distance.

• Thinking and concentration are difficult and short-term memory is impaired.

• Extreme mood swings, including joy, inspiration, depression, anxiety, terror, aggression can occur.

• At high doses causes nausea, tremors, & confusion.

• After taking the acid, I imagined that we had

driven head-on into an eighteen-wheeler and

were killed. I could hear the screeching metal,

then a dark and evil quiet. I was terrified at this

point, I actually thought we were dead....For a

year I wouldn’t go into any cemetery because I

was terrified I would find my own grave.” —Jenny

•Street Names: mushrooms, magic mushrooms, shrooms, Musk, Silly Putty, Simple Simon.

• Psilocybin (O-phosphoryl-4-hydroxy-N,N-dimethyltryptamine or 4-PO-DMT)

4-HO-DMT

How it is Consumed?•Eaten – While the mushrooms are usually

dried prior to sale and/or consumption, they can be eaten raw or cooked like regular mushrooms.

•Drank – Heated with water to make a tea or a soup.

•Smoked – The mushroom is ground into a fine powder and often smoked on top of marijuana.

• Its presence is widespread throughout the plant

kingdom.

•Short-acting serotonin agonist (30 min)

•Snorted or smoked

•Can’t be taken orally.

Bufotenine

It is an alkaloid found in the skin of some species of toads; in mushrooms, higher plants, and mammals.It is also known by the chemical names 5-hydroxy-N,N-dimethyltryptamine (5-HO-DMT).

•PCP (Phencyclidine) (dissociative drug)

•Ketamine(Ketalar)

•Glutamate-like hallucinogens (like PCP and

ketamine) were originally put to use as anesthetics.

•Since they render glutamate, an amino acid used

for learning, unable to function normally, they can

cause blackouts and memory loss.

Glutamate-like hallucinogens

• Street Names: Angel Dust, Black Dust,

Blue Madman, Busy Bee, Crazy Coke.

• Developed as intravenous anesthetic.

• Use was discontinued due to delirium and mania

experienced after coming off drug (effects lasted up to

18hours).

• Administered orally, smoked, snorted, or injected.

• Withdrawal symptoms sometimes occur.

• Street Names: Cat Valium, Jet, Kit Kat, Special K, Vitamin K• Developed to replace PCP as anesthetic.• Injected, snorted, orally ingested.• Odorless, tasteless so often used as date rape drug

• Structurally similar to Acetylcholine and act by blocking muscarinic acetylcholine receptors (mAChRs) so Acetylcholine cannot attach.

• Impairs learning and memory as result• Found in Belladonna, Nightshade, Jimsonweed

and Mandrake plants.

Effects: • Dry mouth, decreased sweating, dry skin, increased

body temperature, blurred vision, increased heart rate, dilated pupils, drowsiness, decreased attention.

• @ High Doses = Hallucinations, paralysis of

respiratory system, coma, and death.

• Examples:

• Scopolamine

• Hyoscine

• Hyoscyamine

• Atropine.

•Also called Phenethylamine Psychedelics

•Structurally similar to catecholamines

(Norepinephrine & Dopamine) and

Amphetamines.

EXAMPLES:

a. Mescaline

Norepinephrine Dopamine

Mescaline

• Mescaline is a hallucinogenic alkaloid

• Found in Peyote or "Mescal buttons"

• Consists of the dried tops of the cactus

Lophophora Williamsii, (Fam.

Cactaceae).

• The plant has been associated with

Indian ceremonies for many years.

• It disturbs normal mental function and

causes concomitant hallucinations and

euphoria.–Chewed raw or cooked and eaten –Pure powder form

b. Myristicin and Elemicin

Source: From Nutmeg and mace.

Structurally similar to mescaline

Onset of effects, within 2-5 hours and last up to

24-72 hours

5-15 g à confusion, euphoria, hallucinations,

nausea and vomiting, tremors elemicin

Myristicin

tiny bit of crunched up leaves soaked in extract

Salvinorin A

• Many other Salvia spp. may also contain

psychoactive diterpenes. “Salvinorin A”

• Related to Sage plants/Mint family

• Mexican origin

• First reported in 1962 but popularity increased via

Internet.

• Salvinorin A acts as opioid receptor agonist.

• The plant leaf is chewed, smoked or taken as

tincture.

• Produce brief effect.

• The most common after effect include improved

mood, sensation of insight and calmness.

• Low toxicity and low addictive potential

• Depends on:• how much you take• your height and weight• your general health• your mood• your past experience with hallucinogens

• Depends on:• whether you use hallucinogens on their own or

with other drugs• whether you use alone or with others, at home• or at a party, etc.• The effects of hallucinogens are not easy to

predict.• The effects are different for different people and at

different times

• Medical treatment consists of

Supportive therapy and minimization of external

stimuli.

In some cases, sedation is used when necessary to

control self-destructive behavior, or when

hyperthermia occurs.

• Medical treatment consists of

Diazepam is the most frequently used sedative for

such treatment, but other benzodiazepines such as

lorazepam are also effective.

• In severe cases, antipsychotics such as haloperidol

can reduce or stop hallucinations.

• Spontaneous recurrence of trip after period of normalcy

• Can occur after long periods of abstinence• More common after multiple high dose use• Prolonged afterimages for days and weeks after• Flashbacks can be brought on by using other drugs,

stress, tiredness or exercise• Usually last for a minute or two• Can be brought on by other drugs or setting • Most commonly reported in low light situations• Not intrinsically dangerous and usually go away

• DOM (dimethoxymethylamphetamine)• MDA (Methylenedioxyamphetamine)• TMA (trimethoxyamphetamine) DMA (dimethoxymethylamphetamine)• MDE (methylenedioxyethylamphetamine)• MDMA (methylenedioymethamphetamine)• PMA (paramethoxyamphetamine)