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FACTS ABOUT ALCOHOL AND DRUGS

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SOME FACTS ABOUT ALCOHOL AND DRUGS Drugs Defined: Any substance, natural or synthetic, which has the capacity to alter the structure and/or function of the                                living organism.  Psycho-active drugs: Any drug having the capacity to alter the consciousness and/or behavior of the living organism. This                                     means the brain or central nervous system Drug Use: Taking drugs correctly, as prescribed. Neither more nor less, quiting when prescription expires. Drug Abuse:    Using prescription drugs incorrectly, more or less than instructed, shorter or longer than prescribed or changing                        Docs. Drug abuse does not necessarily mean constant (persistent) use of a drug. Using illegal drugs. Drug addiction:   Loss of control over when we will use or how much. Using for a reason not medical. Anabolic Steroids are abused but are not psychoactive. Drug related events that have had profound societal effects. (1) Vaccines pluses = reduced pain and death and misery.                   minuses = contribute to population explosion. (2) Psychoactive therapeutic drugs such as valium, prozac, clozapine. Pluses = let a lot of people out of insane asylums.                                                                                        Minuses = helped contribute to the overall addiction problem. (3) Birth control = The development of oral contraception.                Pluses = These have given women more sexual freedom.              Minuses= It could be argued that they contribute to promiscuity and a breakdown of family structure. (4) Antibiotics - Fewer people are dying of disease.                         They contribute to the population explosion. WHY DO PEOPLE ABUSE DRUGS ?         top (1)    Peer pressure - for peer approval & or acceptance. (2)    Escape - from guilt, anxiety, stress--to achieve relaxation. (3)    Elevated consciousness - experimenting with the unknown. (4)    Cultural - Their family may have been drug users. (5)    Influence of media (6)   Social interaction including sexual, conversation, dancing etc. (7)    Physical performance or appearance (usually sports & wt. loss. (8)    Chronic Pain- Cancer & arthritis. (9)    Prior addiction (10)  Slow suicide WHY DO PEOPLE CHOOSE A CERTAIN DRUG ?     top (1)   Availability (2)   Legality and illegality (3)   Brain neurotransmitter irregularities. Recent research suggest that certain people are predisposed by their brain chemistry to become dependant on a particular drug. Some narcotics addicts have less than a normal amount of brain opiates (endorphins). The endorphins and other brain opiates reduce pain, produce pleasure and help to mediate or control aggression and violent impulses. Some cocaine addicts have less than normal amounts of the neurotransmitters dopamine and norepinephrine (these are excitatory neurotransmitters). Alcoholism--- Some alcoholics are deficient in the inhibitory brain transmitter known as GABA. Having made these statements we should add that when discussing the neuron and the synaptic gap we speak of the "lock and key" principle. We should say here that--all things being equal-- it is amost positively the way the "key" fits in the "lock" that determines the drug of choice. PATTERNS OF DRUG ABUSE (not addictive) BEHAVIOR     top (1)   Experimental use (2)   Regular abuse (a) social, recreational (b) circumstantial (3)   Heavy use (compulsive) ROUTES OF ADMINISTRATION (1)   Oral--slow, inefficient, effect may vary, sometimes weak but you do not have to learn new skills - everyone swallows. (2)   Parenteral administration (a)   Intravenous injection - not convenient but efficient. (b)   Intramuscular - slightly less skill required, slower. (c)   Subcutaneous injection - still less skill, less effect (3)   Inhalation and absorption in lungs - quick-- if you smoke (4)   Absorption across mucous membrane (nose, vaginal, anus) (5)   Absorption through the skin. (6)   Nasal sprays have been used. Absorption-   The passage of drugs through the membrane of the blood vessel and into the blood stream. There is a fatty layer                        through which the drug must pass. In order to pass this lipid layer it must be lipid soluble. Distribution   The passage of drugs through the blood stream to the brain. Potency--      how high in concentration a drug just be in order for it to have an effect.                       Drugs that are high in potency are those that are effective in low concentration. Lipid Solubility is a major factor in determining a drugs potency. The higher the lipid solubility the greater the drug potency. DISTRIBUTION BARRIERS     top (1)   Protein molecules in blood. Drugs are attracted to these proteins and after binding it can never leave the blood. The        greater the attraction of the drugs to the protein molecules the less the effect of the drug since only unbound molecules can        leave the blood and effect the neurons of the brain. Alcohol is hardly attracted to these proteins at all. (2)   Organ barrier -- Kidneys and liver. (3)   Blood brain barrier-- the blood vessels here are thicker and different from other blood vessels and they reject, to some        degree, the drugs. These thick blood vessels in the blood brain barrier afford good protection against water soluble        molecules but not against lipid soluble molecules. ED = ====The effective dose of a given drug. ED99=== The size of the dose of a given drug necessary to produce an effect in 99% of the people. LD =====Lethal dose of a given drug. LD1 ====The size of the dosage for a given drug necessary to kill 1% of the population. SSM -=== Standard Safety Margin SSM ==== LD1 - ED99 / ED99 and * 100. The higher the SSM the safer the drug. Did You Know Sigmund Freud - The "father of psychology" didn't die of cancer but from an overdose of morphine? Freud did more that any other man to popularize the use of cocaine. He later regretted this. RECEPTOR BINDING     top Neurons in the brain have receptors that operate on a "lock and key" principle in which the drug is the key and the receptor is the lock. The drug "key" must fit into the receptor "lock", making the neuron shift slightly and fire an electrical charge down the axon to the axon terminals. This is an example of an excitory drug effect. Alternately the drug may "jam" the receptor "lock" and prevent the neuron from discharging an impulse. This is an example of an inhibitory drug effect. Psychoactive drugs may have excitory brain effects (cocaine, amphetamines), or inhibitory effects (alcohol, barbiturates). DOSE - RESPONSE RELATIONSHIP     top (1) Latency of onset - the time between dose and response. What determines the "latency of onset"?       1.     The speed of absorption into the blood.       2.     The speed of distribution.       3.     The speed of absorption from the blood to the neural tissue of the brain. (2)    The time to peak. (maximum effect). The amount of time it takes for the neurotransmitters to fill the receptors on the target                                                                 organ (the brain). (3)    The duration of action---The amount of time the drug stays in the neuron receptors. How long the drug stays in the                                            receptors depends on the strength of the bond between the drug and the receptor.                                           Many drugs have a much shorter duration of action than half life. INDIVIDUAL DIFFERENCES     top (1) AGE (a) The very young lack enzymes. (b) Old have less strength of heartbeat & circulation. (c) Lessened protein in the blood of the old. (d) Slow excretion in old. (e) Elderly tend to get smaller - less muscular. (f) Liver and kidney less effective in the old. (2) BODY WEIGHT - The concentration in total body mass is less for large people than for small people. (3) MUSCLE MASS - Most drugs absorb more readily into muscle tissue than into fatty tissue, therefore an individual with                                      more fatty tissue will retain more of the drug in the blood to go the brain. (4) GENDER - The typical woman is more sensitive to drugs than a typical man. The woman is smaller and pound for pound                           has more fat than a man. Men have one enzyme in the stomach that women do not have that starts the                           breakdown of the alcohol. This enzyme starts breaking alcohol down before it gets into the blood. FIVE TYPES OF TOLERANCE      top (1) PHYSIOLOGICAL TOLERANCE - In order to maintain the same initial effect the dose must be increased. There is an                                                                     increased stimulation at the threshold of the receptor site. This adaptive                                                                    mechanism of the body occurs at the receptor site level. (2) BEHAVIOR TOLERANCE - A set of adaptive behavioral skills employed by experienced drug users to appear not to                                                        be under the influence of drugs. (walking, talking, driving) (3) ACUTE TOLERANCE - The second dose or drink will not have as great an effect as the first. (4) CROSS TOLERANCE - The development of physiological tolerance for any one drug automatically results in tolerance                                                 for all drugs in that class. (example alcohol and seconal) (5) REVERSE TOLERANCE - The repeated frequent use of a given drug sometimes increases the sensitivity to the drug.                                                    When this happens it is likely to be due to some damage in the organ system responsible for                                                     metabolizing the drug. In drinking this is the very last stage. Psychological dependence: A craving for and a compulsive desire to keep taking a drug which often becomes more                                              compelling than other forms of motivation. Physical dependence: This is defined by a consistent set of physical symptoms (withdrawal) that accompany discontinued use                                      of the drug. ADDICTION - THREE KEY ELEMENTS     top 1.    profound psychological dependence. 2.    increased dosing because of physiological tolerance. 3.    physical dependence. AMPLIFIED EFFECTS     top This describes taking 2 drugs from the same class at the same time. They act multiplicatively (l+1=3, 1+1=5, 1+1=dead?). This is the number one cause of overdose. Also know as a multiplicitive effect. Taking drugs from different classes that have opposing forces may also be dangerous or deadly. Placebo - derived from the Latin meaning "I will please." Placebo effect - Psychoactive effect produced by an inactive or inert substance when the individual believes s/he has taken a                            psychoactive drug and is familiar with the psychological effects of that drug. Baseline fact:   Water injected instead of morphine gets a 60% effect. The Food and Drug Administration (FDA) requires that a new drug have more effect than a placebo in several double blind experiments before approving the drug. Double Blind - A research design employed in drug research which is used to control for the "placebo" effect and for certain other forms of experimental and subject ideas. Neither the subjects nor the person responsible for measuring the effects knows whether a given subject has received the drug or a placebo. It is believed that classical conditioning and cognitive expectations contribute to the placebo effect. Naloxone - A potent antagonist drug that neutralizes the effect of a narcotic given later. It also neutralizes the effects of a                     placebo. This is the most convincing evidence of placebo effect. THE TYPES OF DRUGS     top (1) Psycho-stimulants - Cocaine, amphetamines, methamphetamine, MDMA (ecstasy), xanthines (coffee, tea, cola's)                                        nicotine... (2) Depressants -         Alcohol, barbiturates, methaqualone (quaalude). (3) Anti-Depressants                     Monoamine oxidase (MAO),(-MAO=+DOPAMINE & NOREPINEPHRINE). MAO is an enzyme that                     breaks down norepinephrine & dopamine. MAO inhibitors lower MAO thus raising norepinephrine & dopamine                     & thus are anti-depressants. (parnate and nardil)                     Tricyclic Anti-depressants - These interfere with the re-uptake of the neurotransmitter norepinephrine & results                      in more available at the synapse. (elavil, riplin, doxatin, sinequan)                     Prozac - This appears to block synaptic uptake of serotonin exclusively. (4) Narcotics -Natural -       Opium, morphine, codeine, heroin.                      - Synthetic -    Demerol, percodan, dilaudid. (5) Hallucinogens -              LSD, mescaline, PCP, MDA. (6) Tetrahydrocannabinol - Just marijuana. (7) Anti-anxiety drugs -       Valium, librium. (8) Anti-psychotic -             thorazine, clozapine, lithium carbonate. THE LEVEL OF THE NEURON     top There are ~100 billion neurons in the brain. The dendrites receive information from other neurons and the soma transmits this information to the axon . The nerve impulse travels down the axon and reaches the terminal buttons of the axon terminals. THE STRUCTURE OF THE SYNAPSE     top The synapse is the physical space or gap between neurons. Events occur at the level of the synapse which permit a nerve impulse to pass from a transmitting (presynaptic) neuron to a receiving (post synaptic) neuron. There are many hundreds of dendrites, only one axon. Brain neurons do not contain myelin but this is found in the backbone neurons & throughout the rest of the body. Resting potential - This is when a neuron is charged positively on the outside relative to the inside. When a drug signal stimulates the neuron the charge is reversed and an electrical charge is sent down the axon to the axon terminal, or button. From here it is carried chemically across the synapse. Different receptors "recognize" different transmitters based on their molecular structure just as different locks recognize different keys. Some neurotransmitters are excitory (acetylcholine, dopamine) & wake a post synaptic neuron likely to fire a nerve impulse. Other neurotransmitters (GABA, serotonin) are inhibitory and make the post synaptic neuron less likely to fire. An excitatory causes more firing of neurons. A depressant causes less firing of neurons. The activity of neurotransmitters is terminated by: (1) Enzyme deactivation - some enzyme deactivates the neurotransmitter in the synapse. Cholinesterase - deactivates                                          acetylcholine. Monoamine oxidase (MAO) deactivates dopamine & norepinephrine. (2) Re-uptake -   Through a "pumping action" in the membrane of the presynaptic neuron the neurotransmitter is taken back                              up from the synapse to the presynaptic terminal button. NEURO CHEMICALS (1) neurotransmitters - Facilitates or inhibits the transmission of a drug impulse across the synapse. (2) neuro modulators - Are able to act at a distance. Their effect is not limited to the synapse. The best known are the                                       endorphins. (endorphins are also neurotransmitters) (3) Neurohormones -  Are able to act at a distance but also are essential in the regulation of growth and maturation, sexual                                      behavior, and aggressiveness. Dopamine is a neurotransmitter in certain parts of the brain and a                                      neurohormone in other parts of the brain. NEUROTRANSMITTERS SYSTEMS (1) Acetylcholine - and cholinergic systems The peripheral (not brain) neurons cause muscle contraction when they synapse with muscle tissue The African pygmies use "Curare". It is an anti-cholinergic which blocks the secretion of acetylcholine by the muscles. Since acetylcholine makes the muscles contract the lack of it results in "paralysis". The victim can't breath because the breathing muscles are paralyzed. Some drugs are potent cholinesterase inhibitors. "Cholinesterase" is an enzyme that metabolizes acetylcholine. There is a relationship between memory loss and loss of acetylcholine receptors in the brain, particularly the hippocampus. (alzheimers) THC blocks acetylcholine . (2) Serotonin and serotoninergic systems (an inhibitory neurotransmitter.) Acts on the brains reticular formation to inhibit those reticular neurons which normally keep the higher brain alert. Depressants (like alcohol & barbiturates) increase serotonin thus they have a tranquilizing effect on the Reticular Formation. The barbiturates, alcohol, and other CNS depressant drugs have a psychoactive effect on the brain partly because they cause neurons that synapse with the RT to secrete more Serotonin & also because they block the re-uptake of serotonin, thus increasing the supply available at the synapse. The RT constantly bombards the rest of the brain to keep the high brain alert. L-tryptophane (found in milk and other dairy products) the body converts it into a "natural" tranquilizer, serotonin. (3) Catecholamine - dopamine & norepinephrine-excitory. (a) Most psycho-stimulant drugs such as cocaine, amphetamine and caffeine, are known to cause an increase at the synaptic                            level. (b) Anti-depressants cause an increase at the synaptic level. (c) All drugs which have a depressant effect on the brain (alcohol, barbiturates) are known to deplete the amount of       catecholamine (dopamine & norepinephrine)at the synaptic level. (4) Endorphins - The endorphins, naturally occurring brain neurotransmitters, have the capacity to alleviate pain, produce "pleasure" and reduce the likelihood of aggression. Endorphins secretion is greatest in the brains hypothalamus amygdala & locus ceruleus. Our bodies have evolved their own natural narcotics - the endorphins. Prior to this the researchers had identified receptors for morphine. They reasoned that since our brains have evolved neuronal receptors that recognize opiate narcotics (e.g. morphine) this must be because the brain produces its own morphine like substance. Indeed as research has shown the molecular structure of endorphins and morphine are nearly identical. Endorphin facts: Research shows that subjects given an endorphin blocker (naloxone) report subjectively, greater pain. Drugs which block the endorphins also (a) decrease their enjoyment from music and art, and (b) reduce the euphoria accompanying strenuous exercise (c) reduce sexual arousal and orgasmic intensity. (5)   Gamma Aminobutyric Acid (GABA) - A major inhibitory neurotransmitter. Exerts its effects primarily in the cortical areas.                The pre-1970's view of addiction: (a)   Physical dependence as characterized by a definite, consistent, withdrawal syndrome was considered the most         important criteria for addiction. (b)   Physiological tolerance was second most important. (c)   Psychological dependence was least important. Cocaine was not addictive by this definition. What has happened to change our thinking? Cocaine. It is now thought that the most important criteria for addiction is psychological dependence. By this definition cocaine and other drugs are addictive whether demonstrable withdrawal symptoms are present or not. although they do not say so, this supports anf validates what we have said about alcoholism for years. That is, the highly unusual euphoria which ONLY the alcoholic feels, is evidence of the early stages of alcoholism, long before the alcoholic suffers any appreciable negative consequences. In the alcoholic this is evidence of a "chemical predisposition combined with a drink of alcohol. (ICSS) Intra-cranial self stimulation studies have shown that when an electrode was imbedded in a test animals brain and the animal had a way of firing the electrode, he would do this for pleasure, ignoring all other forms of pleasure including sex. We have pathways in our brain that reward us for what is necessary for our survival. In a sense our brains are "addicted" to life. We get "hooked" because the addictive drug resembles the natural drug our own body makes for our survival. All psychological things have a physiological component. People with low levels of MAO (monoamine oxidase) are excitement seekers. "Leader" monkeys have twice the serotonin level of followers. When a follower is given serotonin he becomes a leader. Women with pms have worse pms when the serotonin level is low. Bananas are a source of serotonin. Young male paraplegic - have lower levels of(monoamine oxidase) MAO. WHAT THE PSYCHO-STIMULANTS DO      top The primary effect of the stimulants is on the brains arousal system (reticular formation), but they also operate at all levels of the brain to increase alertness, decrease appetite, relieve fatigue and generally make the user "feel better". FREEBASE COCAINE Cocaine powder (cocaine hydrochloride) is mixed with ether (a solvent), and then heated. The residue contains a higher concentration of cocaine molecules. This residue can be smoked in a pipe to produce short acting but very intense experience. This procedure is called "freebasing" because it evolves separating the cocaine molecule (an alkaloid or base) from cocaine hydrochloride which is cocaine molecules combined with a salt. This was popular in the early 1980's. Freebasing was quickly replaced by crack cocaine because heating the ether for the freebasing was extremely dangerous. CRACK COCAINE Crack is similar to freebase cocaine in that it can be smoked. It differs from freebase in that cocaine hydrochloride (cocaine powder) can be mixed with common baking soda and heated to form a paste which hardens into a lump that can be smoked. Unlike freebase cocaine "crack" does not decompose. This means it can be made and stored for later use or sale. The psycho-stimulants are: (1) cocaine, (2) amphetamines, (3) xanthine (caffeine). The countries growing coca plants are: Peru, Ecuador, Colombia, Bolivia. The coca leaves decompose rapidly so they must be made into paste rather quickly. The leaves are treated to extract coca paste and then made into cocaine powder. The biggest manufacturer of cocaine powder is Colombia. In the late 1800's cocaine was used both as a topical anesthetic and to treat depression. From the 1960's cocaine became the drug of choice of the more elite because it was (1) expensive, (2) thought to be non-addictive, (3) produces a short but thrilling high. THE ADMINISTRATION OF COCAINE      top (1) snorting, (2) injection, (3) freebasing, (4) crack. Movie: When alcohol is added to the alcoholic it occupies the calcium channels so the brain makes more, then when the alcohol is discontinued the brain has more "channels" than normal so it race. The alcoholic brain is deficient in almost all areas of the brain but it is especially missing P-3. This P-3 is also absent in the sons of male alcoholics. DID YOU KNOW ? That cocaine users who mainline the cocaine are at far greater risk of contacting the HIV (aids) virus from contaminated needles than are mainliners of heroin? The reasons seem to be: (1)    The fact that cocaine "highs" are very brief and users are prone to "shoot up" again very quickly and thus inject more times          than do heroin mainliners. (2)    Unlike heroin cocaine is a stimulant and contributes more to reckless "party" or "shooting gallery" mode of use. INITIAL DOSE EFFECT (1) dilated pupils (2) increase in blood pressure (3) increase in heart rate (4) increase in breathing rate (5) increase in temperature (6) immediate alertness (7) a very powerful high or euphoria beginning just seconds after administration. The high begins to diminish after a few minutes. (8) the euphoria is followed by a dysphoria (post-coke blues) characterized by anxiety, depression weakness, fatigue and a      compulsion to use cocaine again. High-balls - are cocaine and heroin mixed. The cocaine is for the intense high, the heroin makes the high smooth and also levels out the "after-coke" blues. CHRONIC OR LONG TIME DOSING EFFECTS special hazards associated with chronic use of cocaine. (1) Increase risk of stroke and heart attack - especially for the person who suffers hypertension or who has some underlying cardiovascular blood problem. (e.g. arteriosclerosis, irregular heartbeat, value problem). Cocaine is a stimulant & like other stimulants causes the blood vessels to constrict making the heart work harder, and increases the risk of heart attack and stroke. (2) It is dangerous - even for people having no underlying pathology. Chronic use of cocaine is associated with lowering of the brains seizure threshold. Animal research supports this . So yesterdays safe dosage may be todays lethal dose. This type of reverse tolerance - is in the neural tissue of the brain which becomes more sensitive to the cocaine itself. (3) Cocaine psychosis - in some cases the individual may exhibit a "cocaine psychosis" or "toxic syndrome" characterized by: (a) paranoid suspiciousness (b) violent, erratic behavior (c) anxiety (d) delusion (e) hallucinations (f) careless, reckless, behavior (g) loss of appetite (h) grinding of teeth (i) a strong, reckless desire to get more cocaine. WHY COCAINE IS SO ADDICTING     top (1) very fast-acting - euphoria or high. (2) very powerful - euphoria or high. (3) very brief - euphoria followed by a dysphoria that makes the person so miserable they are very anxious to get high again. (4) dominates - it quickly comes to dominate a persons life. It becomes a more important (stronger) motivator than any other form of motivation. It often becomes stronger than the threat of death itself. THE PHARMACOLOGY AND PHYSIOLOGY OF COCAINE The psychoactive action mechanism of cocaine. (1) It prevents the re-uptake of dopamine & norepinephrine. (2) It tends to enhance the re-uptake of the inhibitory enzyme GABA. (3) It may? block the re-uptake of serotonin. (4) It also attaches to specific receptor sites on some neuron in these brain regions: (a) the media forebrain bundle (b) the locus ceruleus (c) the entire limbic system COCAINE AND PREGNANCY     top (1) Women who use crack in the first trimester run a significant risk of aborting. (2) Premature, underdeveloped brains, special and specific learning disabilities, generally nervous non-cuddling babies. The baby exposed to coke may have strokes prior to birth, underdeveloped or faulty sex organs, crib death or sleep apnea. Nursing mothers can continue to pass cocaine on to the child through the breast milk. COCAINE AND SEX At first cocaine enhance sex. It certainly relieves inhibitions about sex (or anything else) for a long time. Some users subjectively say that cocaine enhances the orgasm also. In addition to its extremely strong psychologically addictive properties it is now believed that high doses by chronic users causes tolerance and physical dependence. COCAINE WITHDRAWAL (1) anxiety, deep depression (2) irritability and sleep disorders (3) intense craving for more cocaine (4) high doses are associated with genuine physical dependence and an increased physiological tolerance. THE ECONOMICS OF COCAINE (1) There will be less and less demand in the future for unskilled workers. Users can hardly expect to become skilled at anything and stay skilled in their addiction. Young, uneducated people can make more peddling crack in a few hours than an adult can make legitimately in a week. The taxpayer starts to pay the bills of the pusher the very first time he is arrested. (2) Cocaine impacts on everyone economically because taxpayers have to pay for the hospitals, jails, rehabilitation centers etc. (3) Also users and pushers eventually wind up on the welfare rolls. (4) Cocaine pusher competition pushes the price down even as demand goes up. (5) Drug interception and law enforcement (jails). (6) Otherwise honest people are evolved in the drug trade. Such things as taking more money on rent for a crack house than normal rent would return. (7) Economic resentment by other countries and their citizens toward the U.S.. Our economy bids the coca paste up so that the local people cannot afford it. . THE AMPHETAMINES     top Amphetamines were first synthesized in 1887. (1)   Benzedrine inhalers were used. Also benzedrine was used by Doctors for narcolepsy and for allergies.        Soldiers brought back this addiction from the second world war, so use of amphetamines went up in the late 40's and 50's. (2)   We skipped two because it was so much like the others. (3)   Methadrine - first synthesized in 1930's. Large use started during the 40's and 50's. This was where the term "speed"         came from. The term "speed" was specific to methadrine at that time. Now "speed" refers to any amphetamine. (4)   Crystal Methamphetamine - (ice) - a smokable form is now available and is making a comeback among users. The fear is         that ice will take the place of crack cocaine because ice can also be smoked and the euphoria or high last much longer         than crack's. Crack Ice Origin ------------>Botanicalsynthetic legal status ------->very illegalIce is illegal but methamphetamine, which is used to make ice, can be obtained legally by                                    proscription as Niethedrine. Duration of effects->   short, intense high followed by a dysphoric, characterized by paranoid impulses and intense                                    craving.intense euphoria measured in hours with no sharp dysphoria. A sense of heightened sexuality                                    lasting up to one week. violent paranoid impulses and intense euphoria. Mixing the two together and smoking them gives us all the dangers and special hazards of each but additionally the user might suffer fatal lung and kidney disorders, long lasting psychological damage, may lead to permanent psychosis. MADA - (methylenedioxy methamphetamine) or ecstasy. It was intended to be a mild appetite suppressor. In addition to being a mild stimulant it is a very mild hallucinogen. The public discovered ecstasy after Life Magazine ran an article on it that left the impression that ecstasy was an aphrodisiac. In control studies this did not prove to be true. Placebo effect was identical to the effect of ecstasy. THE MECHANISM OF AMPHETAMINE ACTION     top (1)   All amphetamines stimulate the secretion of norepinephrine and dopamine, and block the re-uptake of these as well. (2)   Amphetamines also enhance the re-uptake of GABA and serotonin. (3)   The primary difference between cocaine and amphetamines is in the duration of action. (4)   Cocaine, which is usually 30% to 90% pure, is "cut" with others substances such as novocaine, procaine, and sometimes         sugar. XANTHINES    top (1) Caffeine - found in coffee, tea, cola's. (2) Theophylline - found in tea. (3) theobromine - found in chocolates. SOME CAFFEINE FACTS (1)   The per annum consumption is down from 20 lbs. per person in 1946 to 10 lbs. per person in 1990. The consumption of          cola's is up 300% so there has been no decrease in caffeine intake. (2)   5 or more cups of coffee and 7 or more cola's within an 8 hour period can produce caffeinism with insomnia, increase         heartbeat, diarrhoea, frequent urination, mood swings and even depression. (3)   It is difficult in controlled experiments to separate the other behavior from the caffeine effect that coffee drinkers have such        as heart problems, breast cancer, colon cancer. (4)   Some health hazards of caffeine (a)   even in low to moderate amounts upward heartbeat and blood pressure are observed and it may be harmful to people        who have these underlying pathologies. (b)   If you have a stomach ulcer it will act up with coffee. (c)   Children should avoid it. (d)   high doses should be avoided by everyone because it can cause caffeinism. ALCOHOL     top The first U.S. distillery was founded by a Baptist preacher named Elijah Craig in the mid 1700's. He found that if he let his corn liquor age in oak barrels it improved the taste. He called this bourbon after Bourbon County KY . BAL = Blood Alcohol Level. The BAL may range from 0% to 60%, at which time the brain medulla oblongata ceases to function and breathing stops. (dead) Drinkable alcohol (ethyl, ethanol) is the result of a process called fermentation. Fermentation is: sugar, yeast, and water exposed to high temperature. The yeast converts the sugar & water into ethanol and carbon dioxide. 14% is the highest level of alcohol content you can get with fermentation because at levels above 14% the yeast spores die. In order to get a higher concentration of alcohol you have to distill it. Alcohol is the number one abused substance in the U.S.. Types of alcoholic beverages. (1) Beer - made from cereal grains (corn, rice) & malt. Malt is sprouted Barley. The enzymes in the malt converts the grain to sugar, then yeast changes the sugar to alcohol. Hops (the blossoms of the hop plant) are added to the mixture for taste. In the U.S. the alcohol content of beer is limited by law to 5%. If the alcohol content is above 5% it cannot be called beer. Mostly this next level of alcohol content is malt liquor. (2) Malt liquor - has an alcohol content of 5% to 7%. (3) Wine - is made from fruit & has an alcohol content from 8% to 14%. (4) Fortified wine - is wine + brandy for more alcohol content. (5) Wine coolers - made for teenagers (this is white wine + soda pop), because the transition from sweet-tasting pop to sweet                                tasting wine is easy. LIQUORS (1) Vodka - as it is manufactured in the U.S. has no smell, no taste, and it is not aged. There is no difference in expensive                     vodka and cheap vodka. (2) Gin -       is vodka with Juniper berries added for taste. Both vodka and gin are pure alcohol with water added. (3) Rum -     comes from sugar cane. (4) Bourbon - made from corn alcohol aged in charred oak barrels. Jack Daniels is not a bourbon because it is "charcoal                       filtered". (5) Scotch - made from malt and other grains and aged in barrels which were previously used to age sherry. The malt has been                     dried over burning peat. (6) Brandy - distilled wine (7) liqueur - brandies with flavor added. About 20% alcohol, higher than wine but less than whiskey. ALCOHOL ABSORPTION Some alcohol is absorbed from the stomach but most is absorbed through the small intestine. FACTORS INFLUENCING THE ABSORPTION RATE OF ALCOHOL     top (1) The amount and kind - of food we eat. (2) The content of alcohol - being drunk. (3) Our mood - Fear and anger causes the stomach to dump its contents into the small intestine (including the alcohol), since                         most of the alcohol is absorbed in the small intestine we get drunk quicker. %BAL          The effect that alcohol has on humans. 40%==LD 50, 60%==LD 100 .05    Behavioral effects start, lower alertness, food feeling, release of inhibitions, impaired judgement, DASHING & DEBONAIR. .10    Slowed reaction time, impaired motor function, less caution, DANGEROUS & DEVILISH. .15    Large increases in reaction time .20    Decidedly intoxicated, marked reduction in sensory & motor functions. DIZZY & DISTURBING .25    Staggering, sensory perceptions greatly impaired, "smashed". .30    Conscious but stuporous, no comprehension of the world around them, delirious, disoriented. DECIDEDLY DRUNK .35     The equivalent of surgical anesthesia, about LD1     DEAD DRUNK .40     LD50 a fifty fifty chance you are dead. .60      LD100. all dead      DEFINITELY DEAD. ONCE ALCOHOL IS IN THE BLOOD IT IS DISTRIBUTED VERY QUICKLY (1)   Body weight - the larger person has more volume for distribution so increased body weight contributes to lower BAL. (2)   Muscle mass - alcohol absorbs more readily into muscle mass than into fatty tissue. Therefore the more muscular individual        will have a lower BAL than the individual with more fatty tissue. ALCOHOL METABOLISM (1) Alcohol dehydrogenase (an enzyme) & the liver are responsible for metabolism of most of the alcohol. (2) The primary by product is acetaldehyde. The amount of alcohol the liver can metabolize in an hour is .3 oz. of absolute alcohol (.6 of 100 proof) regardless of how much alcohol is in the body or the BAL. So when we drink more than .3 oz per hour our BAL goes up. ALCOHOL'S MECHANISM - THE PSYCHO-ACTIVE EFFECT (1) alcohol - makes neuronal receptors on the neuron dendrites more sensitive to the inhibitory neurotransmitter GABA. Drugs                    which block alcohol absolutely also block the psycho-active effect of alcohol. The experimental source is                    RO15-4513, by Eli Lilly. (2) alcohol - alters the neuronal membrane making it less permeable which makes it more difficult for the neuron to discharge a                     nerve impulse. Less firing means a more tranquilized effect. That unless one is alcohol dependent, pregnant, or suffers from liver, pancreas, or kidney disease, the health advantages of having one or two drinks a day may outweigh the disadvantages. Alcohol in this amount increases HDL ("good cholesterol") which is associated with lowered blood pressure and decreased risk of stroke and heart attach. *** HDL = high density cipoprotein. good cholesterol. *** *** LDL = low density cipoprotein bad cholesterol. *** Physicians routinely prescribe 1-2 ounces of alcohol for patients who are hypertensive, or who are recovering from heart attack or stroke. RELATIONSHIPS AMONG SEX, WEIGHT, ALCOHOL CONSUMPTION & BAL    top The standard drink will = ½ oz. pure alcohol. One hour after alcohol intake. Constant will be 100 proof or 50% alcohol. Empty stomach. ABSOLUTE ALCOHOL CONSUMEDTYPE OF BEVERAGE INTAKE FEMALES 150 lbs BALMALES 150 lbs BAL ½ oz.1 oz whiskey 1 can beer 1 glass wine .03.025 ½ oz.1 oz whiskey 1 can beer 1 glass wine100 lbs .045100 lbs .037 200 lbs .022 200 lbs .0191 oz. 2 oz whiskey 2 cans beer 2 glasses wine .09.75still 1 oz. 2 oz whiskey 2 cans beer 2 glass wine150 lb .06 150 lb .053 oz6 oz whiskey 6 beers 6 wines 200 lb .045200 lb .037 100 lb .27 100 lb .22 150 lb .18150 lb .15 200 lb .13 200 lb .10 DID YOU KNOW ? The alcohol content of distilled beverage is indicated by the term "proof". The percentage of alcohol is ½ the "proof". The term "proof" came from an old British Military custom. In order to insure that the alcoholic beverages that the military bought was high enough "proof" or "quality" they would pore the alcohol on some gunpowder and then strike a match to it. If it went "poof", the alcohol content was high enough to buy. Over the years "poof" became "proof". When corn is 51% to 79% of the grain in the mash it is called bourbon. From 79% upward it is "corn whiskey". THE ACUTE EFFECTS OF ALCOHOL   top 1.    A feeling of well being, social ease in the non-alcoholic. In the alcoholic it is a far greater sense of well being, often referred        to as being "ten feet tall and bullet proof." The alcoholic is unaware of any social goofs, sees himself as the strongest,       sexiest and brightest. What is even worse is that the alcoholic remembers the event the next morning through the same "rose        colored glasses" he saw it in the night before. This phenomena is called "euphoric recall." 2.   Non alcoholics sometimes feel slightly nauseous and out of control. The alcohol feels wonderful and completely in control. 3.    Drinkers are at more risk of freezing to death in cold weather because the blood vessels go closer to the skin and lose        more heat. At the same time the drinker thinks he is warmer and is fooled. Hypothermia means a lower body temperature. LIVER EFFECTS ALCOHOLIC FATTY LIVER IS ACUTE OR IMMEDIATE     top As a result of heavy drinking fatty acids accumulate in the liver and these are stored as droplets in the liver cells. These interfere with the liver functions up to the point where the liver cells actually die. The requirement for alcoholic fatty liver is 3 ounces of 100% alcohol or six drinks a day for 3 successive days. Alcoholic fatty liver is completely reversible by abstaining from alcohol. The requirement for reversing it is three days abstinence from alcohol. EFFECTS ON THE ENDOCRINE The adrenal gland The short term effects of alcohol is to reduce resistance to disease. Alcohol causes the adrenal cortex (the outer layer of the adrenal gland) to secret cortico steroids. Continued use of alcohol wears the adrenal cortex out. This makes the individual more subceptable to disease. Alcohol is not an aphrodisiac (physiologically alcohol does not increase sexual arousal or pleasure. Increasing the alcohol up to .06% causes a perceived arousal in both male and female. Any alcohol above .06% is actually a sexual depressant. HOWEVER, alcohol reduces inhibitions and nervousness which enhances the ability to tease and be romantic prior to intercourse. Many men report more control over ejaculation, thus enhancing the pleasure of their partner. Male increase in the amount of time to achieve an erection. decreased strength of erection. increased in the time needed to achieve orgasm. decrease in the intensity of organism. Females: increase in time needed for vaginal lubrication & blood congestion. increase in the amount of time to achieve an orgasm. Gender differences When males are "told" they are drinking alcohol they report a sexual arousal whether they are drinking alcohol or not. FETAL ALCOHOL SYNDROME drinking is dangerous for the pregnant woman. Symptoms: (1) bone abnormalities, (facial and cranial abnormalities) (2) small, light, body weight. HANGOVER SYMPTOM (1) headache, (2) upset stomach, (3) thirst, (4) weakness and fatigue, (5) anxiety, (6) depression (7) want to be alone. (1) Alcohol inhibits the anti-diuretic hormone which results in excessive urination and dehydration and upsets the bodies electrolyte balance. (2) Alcohol - dilates the blood vessels in the brain. (3) Alcohol - irritates the stomach lining and the rest of the gastrointestinal tract. (4) Congeners (similar plants) substances produced in the fermentation process. When congeners are metabolized they are much more toxic than acetaldehyde, which is the normal byproduct. The fewer the congeners the alcoholic drink contains, the less toxic the congener byproducts are. Thus a hangover from Vodka is less than one from scotch, bourbon, beer, or wine. HANG-OVER REMEDIES (1) Drink - liquids to restore the bodies liquids. (2) Drink coffee to reduce blood vessel size in the brain. (3) If you must take a pain killer, take an aspirin free one. (4) take an anti-acid. COGNITIVE DEFICITS CAUSED BY ALCOHOL      top (1) A BAL of .01% to .03% = no cognitive defect and some studies suggest it helps one think more clearly and exercise better                                                 judgement. (2) A BAL of .04% and up = alcohol interferes with ability to learn. (3) A BAL of .08% and up = produces some memory impairment for events that went on while one was drinking                                             (blackouts).9-pages CHRONIC EFFECTS OF ALCOHOLISM   top (alcohol is the number one drug of abuse) (1) LIVER (a) Alcoholic fatty liver - everyone who abuses alcohol has alcoholic fatty liver. It only requires 3 days drinking of 6 drinks                                           per day. It can be completely reversed by quitting drinking for 3 days. (b) Alcoholic hepatitis - is an inflammation of the liver. Not all abusers progress to hepatitis although it is not known why.                                         alcoholic hepatitis is characterized by vomiting and disorientation and can be fatal. Alcoholic                                          hepatitis can be reversed by quitting drinking for 3 days. (c) Cirrhosis - requires the intake of about a pint of liquor a day for 10 years. (debatable, also it is not guaranteed. some                        drink twice this amount for twice the time and do not suffer liver damage.) This is not reversible. This is a                        serious scarring of the liver and is almost always fatal. Cirrhosis has a positive correlation to a family history of                        cirrhosis. EFFECTS ON THE ESOPHAGUS (1) Bleeding esophagus - usually comes after drinking for many years and is found more often in those who drink straight.                                           95% fatal. EFFECTS ON THE PANCREAS     top (1) Chronic abuse - can inflame the pancreas (pancreatitis). This is fatal in 50% of the cases. CARDIOVASCULAR DEFECTS. (1) Moderate drinking - up to 2 drinks per day is good for raising HDL (good cholesterol). It also helps prevent heart attack                                     and stroke. (2) Three drinks a day can cause increased blood pressure, increase in LDL (bad cholesterol). (3) Heavy use (more than 2 drinks per day) has an adverse effect on the heart muscle. "cardiomyopathy" CHRONIC REPRODUCTIVE SYSTEM EFFECTS top MALE (1)   Atrophy of the testicles. (tends to be irreversible) (2)   Impotence - also tends to be irreversible (3)   Infertility (4)   Reduced production of testosterone - male sex hormone. (5)   Increased synthesis of estrogen (female sex hormone) causing decreased body hair, enlarged breast, increase in female        type fat. FEMALE (1) Painful menstrual period. More PMS. (2) Higher rate of gynecological surgery. (3) Problems with fertility. (4) Increased testosterone (male sex hormone) associated with decreased breast size, more body hair, more male fat patterns. ALCOHOL AND CANCER There is a positive link between alcohol and cancer of the (1) mouth (2) tongue (3) esophagus (4) stomach (5) pancreas (6) colon (7) rectum If smoking is combined with the drinking there is a amplified effect. ALCOHOL AND AIDS (1)    Alcohol decreases our immune system, especially the adrenal cortex so alcohol can contribute to aids. (2)    Aids patients who drink die much faster than non-drinkers do. CHRONIC BRAIN EFFECTS    top (1)   Wernicke-Korsakoff's Syndrome ---The associative area of the left cerebral cortex is used for memory. It cannot                  understand verbal language or produce verbal language. Long term abuse combined with B-2 (thiamine) deficit                  leads to a toxic brain syndrome with: (a)    Impairment of judgement associated (b)   Severe depression (c)    Degeneration of the brains cerebellum - enables us to coordinate our movements like walking, talking, touching our nose (d)    Degeneration of the brains corpus callosum which connects the two sides of the brain. This impairs the ability of the          cerebral hemispheres to communicate. (e)    Degeneration of the hippocampus - most of the brains memory is stored in the hippocampus. This causes anterograde         amnesia, a kind of amnesia where you cannot remember what has gone on since the onset of the disease. (f)     Degeneration of the neurons in the brains cerebrum. (most people will die of some related cause before this happens.) (g)     Severe memory loss of old information. (remembering that earlier we spoke of the loss of current information) The left brain is better at logical thinking. The right brain is better at spacial skills, illogical or intuitive thinking. Since not all alcohol abusers become physically dependent on alcohol should the term "alcoholism" be limited to physical dependence or do the psychosocial maladjustments associated with alcohol abuse also qualify as alcoholism? top The fallacy of the alcoholic personality Remember that there is no such thing as an "alcoholic personality" untill after it has been created by alcoholism. The following traits are a result of years of alcoholism and not a predictor of it. On reflection each of these can be seen to be related to a loss of control over drinking, then a gradual loss of control over how he reacted to situations because of the damage done by blackouts, repression, and euphoric recall. For further explanation of these three factors see "Alcoholism." (1) weak ego strength (2) low tolerance for frustration (3) poor impulse control (4) manipulative - hypochondriasis (5) lowered threshold for sensory stimulation (light, sound, pain) (6) severe depression (7) a "present" as opposed to a "future" orientation. (8) passive - dependent behavior or hostility - aggression. (9) extreme use of denial ALCOHOLICS ANONYMOUS No Official Position: Many members think: Alcoholism is a twofold disease combining an obsession of the mind and an allergy of the body. They say: If I can't predict when I will start drinking because of the obsession of the mind, and I can't predict when I will stop drinking because of the allergy of the body, then I am powerless over alcohol. The writers opinions on alcoholism as a disease can be read in my discussion of alcoholism. AMERICAN MEDICAL ASSOCIATION   Says it is a disease - a primary disease. AMA Definition - an illness characterized by preoccupation with alcohol, by loss of control over its consumption such as to usually lead to intoxication by progression and by a tendency to relapse. It is typically associated with physical disability impaired occupational and social maladjustments as a direct consequence of the continued use of alcohol. CRITICS OF THE DISEASE CONCEPT (1) Say alcoholics don't choose to have a disease. (implying that alcoholics choose to drink - and that drink is the disease (2) Say it can't be a disease unless we know its cause. (3) a disease either exist or it doesn't. ALCOHOL WITHDRAWAL SYNDROME   top Withdrawal from alcohol is more life threatening than withdrawal from narcotics. There are four stages of withdrawal. Treatment at any stage of withdrawal prevents the progression on to the next stage. Stage one starts just hours after the last drink. STAGE 1 (a) muscle tremors (b) rapid heartbeat (c) hypertension (d) heavy sweating (e) loss of appetite (f) insomnia STAGE II (1) (A) hallucinations - a false sensory experience (visual, auditory, tactile or olfactory). STAGE III (1) (a) disorientation and delirium. STAGE IV (1) (A) brain seizures (convulsions) Alcoholic withdrawal is treated with anti-anxiety drugs such as librium, or anti-seizure such as phenobarbital. CAUSE OF WITHDRAWAL The neurons have attempted to compensate for the depressant effects of the alcohol. When the alcohol is removed and the neurons are freed from the depressant effects of alcohol, their threshold of excitation is reduced and the brain becomes hyperactive. GENETIC FACTORS AND ALCOHOL DEPENDENCE    top TYPE ONE (1) Milieu-limited alcohol dependence. (a) The individual has at least one parent who was a problem drinker. (b) Has an environmental stimuli component.(something sets off the drinking). TYPE TWO (1) Male-limited is a father to son genetic condition. It is not dependent on an environmental condition to set of the drinking. (a) The individual had an alcoholic father. The predisposition to alcoholism is passed from father to son. Males born into families where the father is alcoholic are statistically more likely to become alcoholic than controls, even when adopted into "norman" families and independent of "environmental" factors. (b) Characterized by an early onset (teens) and often associated with criminal, antisocial behavior. ASIAN PEOPLE    top (1) Asian people are deficient in a chemical necessary to metabolize acetaldehyde. The liver enzyme alcohol dehydrogenase converts alcohol into acetaldehyde. Then a second enzyme (MEOS) converts acetaldehyde into acetic acid, carbon dioxide, and water which are eliminated through the lungs, urine, and kidneys. (microsomal ethanol oxidizing) systems or MEOS in asians is not as efficient as it is in other ethnic group. Acetaldehyde produces nausea, dizziness, skin flushing, and other unpleasant symptoms. NATIVE AMERICANS (INDIANS) MUCH TO BE ADDED HERE. 1.    Less than 10% of white Americans are predisposed to alcoholism but more than 80% of American Indians are        predisposed to alcoholism. 2.    American "clergymen" have an incidence of 40 times the rate than that of the Italian Mafia. So stress is not a        causitive factor. 3.    The American Indian predisposition to alcohol was dormant for hundreds of years untill the white man came        and the Indians began to consume alcohol. Voila, instant alcoholism. 4.    The French and Italians have the same cultural systems concerning drinking wine at meals from an early age        and drinking the same amount per capita, yet the French are many times more subceptable to alcoholism. 5.    When therapist ignorantly treat the patient for the third-order symptoms of guilt, shame, denial, defensiveness,        resentment and depression, created by the psychogenic paradigm in the first place, the therapist are not        healing but creating a new "disease" that fits their original idea that the disease is the cause of underlying        feelings. It's a self-validating practice. The patient now has an iatrogenic (therapist induced) disease. Thus the        Indian population is being treated for having dysfunctional feelings, when it is genetics that are causing the        problem. Some studies suggest that the Indian absorbs alcohol more rapidly and metabolizes it more slowly. HISPANICS (in the U.S.) SOCIO-CULTURAL FACTORS males females - have no higher percentage of alcoholism than whites and less than blacks. Hispanic males in their homeland have no high incidence of alcohol than white males in the U.S. (1) Hispanic males have a high rate of unemployment. (2) Machismo (macho), or loss of self esteem is high so they drink and abuse their wives to "be a man". (3) There is greater emphasis on the group rather than individual achievement. BLACKS (1) Blacks have a lower life expectancy than whites. (2) They also have a high rate of death due to homicide and disease. (3) Middle and upper class socioeconomic blacks drink less than middle socioeconomic whites. KENNETH CLARK - A BLACK PSYCHOLOGIST (1) Blacks have more economic frustration resulting from unemployment. (2) Peer pressure (3) Cultural pattern of heavy weekend binge drinking. (4) Prevalence of liquor stores in black neighborhoods is both (1) a symptom of a problem, and (2) a problem in itself. ARE ALCOHOLICS DIFFERENT?    top (1) Alcoholic men and their sons (not daughters) apparently process information differently than non-alcoholic men and their sons. When they are relaxed and not processing information the brain waves of alcoholic men and their sons show more "fast wave" activity than non-alcoholic men and their sons. Evidently the alcoholics are not as relaxed as the non-alcoholics. (All this is at an early age in childhood, and is not true later on in adult life. (2) Whenever a stimulus, either visual or auditory, is presented to the subject, the brain processes that bit of information and a characteristic change in brain wave activity occurs. This change is called an Event Related Potential or ERP, one component of which is the P-3 or P-300 (same thing) wave form which normally indicates greater electrical activity. (3) Compared to their controls alcoholic men and their sons are deficient in P-3 wave activity. When a stimulus is presented there is less differences between before and after stimulus. (1) The deficiency in P-3 brain wave ERP can be used as a genetic marker to predict the likelihood that the male child will have a drinking problem. (2) Alcoholics tend to have lower amounts of the enzyme known as monoamine oxidase or MAO. This enzyme terminates dopamine and norepinephrine (excitory neurotransmitters). THIQ or Tetrahydroisoquinoline is a substance found in the brains of many alcoholics but not found in the brains of non-alcoholics. This substance is similar to heroin. In a real alcoholic some of the acetaldehyde is not broken down but is transferred to the brain as THIQ. Rats were tested. They were offered their choice of water or alcohol. They never drank alcohol. The water was taken away, and the rats would starve to death instead of drinking alcohol. When some THIQ was taken from the brain of a dead alcoholic and transplanted into the brain of the rats, the rats drank the alcohol to the complete exclusion of the water. They actually drank themselves to death. VANITIES OF CANNABIS     top (1) Cannabis Sativa - grown worldwide (2) Cannabis India - grown in India, and now in U.S. (3) Cannabis Ruderalis - grown in Russia, Asia, Northern Europe. Marijuana - is the crushed leaves, seeds, or branches of the cannabis plant. Hashish - the concentrate of resins from the cannabis plant. Hash oil - the hashish is boiled in a solvent, either alcohol or ether, and the solvent is removed. Ganja - The resin from the flowering tops of female plants that has not yet pollinated. The male plants are removed from the field before the female plants become pollinated. Since no energy is wasted by the female plant in seed production the resin is more potent (higher in THC). In the U.S. this is known as sinsemille which is Spanish for "without seeds". Tetrahydrocannabinol - is THC The marijuana used in the U.S. varies from a low grade product of 1% THC to a very high grade sinsemille containing about 8% THC. The average is somewhere between 2% and 5%. ACUTE EFFECTS (1) Somatic - increased pulse rate, bloodshot eyes, dryness of the mouth, dizziness, hot or cold flashes, tingling sensations in the hands or feet, uncoordinated movement, drowsiness, craving for sweets, increased appetite. (2) Psycho-active - the first few times a person smokes pot he is likely to suffer more than feel good. The smoker has to learn to hold it in his lungs. No one has ever been known to overdose on THC. (a) Euphoria (b) the time sense is slowed (c) memory is poor (d) thinking is impaired (e) sometimes the details of objects are perceived more clearly and dramatically. (f) sometimes the vision is blurred CHRONIC EFFECTS (1) physiological tolerance - is produced. (2) physical dependence - is produced (but only in a minority). (3) withdrawal - characterized by: (a) nausea (b) loss of appetite (c) sleep disorder (insomnia) LONG TERM EFFECTS are ADVERSE and POTENTIALLY HAZARDOUS    top (1) Behaviorally dangerous - because of impaired motor skills. (2) THC reduces testosterone - levels and therefore the male sex drive. (3) Reduced sperm count - or lessened fertility in males. (4) possible permanent impairment - of memory due to the THC being an inhibitor of acetylcholine. (5) Lower weight babies - by mothers who smoke pot. (6) schizophrenia - ten times as likely to occur. (7) Emphysema & lung cancer - are at increased risk. MECHANISM OF THC    top (1) THC - reduces norepinephrine activity by helping its re-uptake and inhibits dopamine re-uptake. (2) THC - is anti-cholinergic, it reduces the amount of effective acetylcholine in the brains hippocampus. (3) THC - reduces Rapid Eye Movement. REM is a type of sleep. We are in this state of sleep about 20% of the time we sleep. REM is absolutely necessary to function normally. MEDICAL USES FOR THC (1) Treatment - of glaucoma. THC is the most effective treatment known. It reduces the pressure on the eye. (2) Anti-emetic - or anti-nausea in connection with chemotherapy in cancer patients. (3) Appetite stimulant - for treating anorexia. (4) MS or Multiple sclerosis - THC is sometimes used along with therapy demyelinating (breaking down) of the nervous system. OPIATE NARCOTICS - DERIVED FROM THE OPIUM POPPY PLANT. (a) Opium - A substance found in the ripe pod of the opium poppy plant. (b) Morphine - a substance which is extracted from opium. (c) Codeine - and alkaloid isolated from morphine. (d) Heroin - a semi-synthetic opiate, the results of a chemical action of the morphine molecule which involves the attachment of the two acetyl groups. Heroin was first marketed in 1898 by Bayer and was intended as a non-addictive substitute for codeine. So heroin is not a true synthetic or naturally occurring substance. It is semi-synthetic. (2) Synthetic narcotics (non-opiate) (a) demoral (b) percodan (c) dilaudid (a) Opium - A substance found in the ripe pod of the opium poppy plant. (b) Morphine - a substance which is extracted from opium. (c) Codeine - and alkaloid isolated from morphine. (d) Heroin - a semi-synthetic opiate, the results of a chemical action of the morphine molecule which involves the attachment of the two acetyl groups. Heroin was first marketed in 1898 by Bayer and was intended as a non-addictive substitute for codeine. So heroin is not a true synthetic or naturally occurring substance. It is semi-synthetic. (2) Synthetic narcotics (non-opiate) (a) demoral (b) percodan (c) dilaudid ACUTE EFFECTS    top (1) skin flush (2) thrilling rush (1 minute) (3) euphoria for hours                                                                Three things occur in the euphoria (1) nodding--intermittent dozing on and off (last for 3-4 hours) (2) driving (driving = hyper) talking emphatically, with force, walking with a stalk, or energy, becomes expansive, and knows the answers to all life's problems. (3) alternately nodding and driving. PHYSIOLOGICAL CHANGES     top A dry mouth, less appetite and sexual desire, pain goes away, blood pressure lowers, heart rate slows down, respiratory volume is reduced, need to urinate is reduced, pupils constrict, body temperature is reduced at first but increases above normal as the drug begins to wear off. NARCOTIC OVERDOSE (1) extreme pupil constriction (2) nausea & vomiting (3) depresses the brains vital reflex center (4) cold, clammy skin (5) loss of muscle tone (6) coma (7) death due to respiratory center CHRONIC OPIATE DOSING EFFECTS (1) weight loss (2) constipation (3) increased urination (4) reduced sexual arousal (5) menstrual difficulties in females (6) difficulty in ejaculation in males (7) elevated body temperature What is so striking about this set of symptoms is that they are no where near as devastating as withdrawal from alcohol. MECHANISM OF ACTION Morphine and heroin are structurally similar to the brains endorphins or opiod peptides, and bind to endorphin receptors through the brains endorphine pathway. WITHDRAWAL SYNDROME (1) nervousness and irritability (2) aches and pains in arms and legs. (3) stomach cramps and nausea (4) yawning (5) watering of the eyes (6) runny nose (7) constricted pupils (8) sweating (9) chills and shivering (goose flesh) (10) muscle tremor (11) increased blood pressure (12) increased heart rate (13) repeated vomiting (14) sleep difficulties BARBITURATES (depressants) phenobarbital, seconal    top Symptoms of using are about the same as alcohol, staggering, clumsy. The exception is that the eyeballs seem to move. (1) becomes sleepy (2) loses muscle tone (3) pupils widen or dilate (4) muscle twitches (5) skin - cold and clammy (6) skin looks bluish (7) coma occurs (8) death from respiratory failure, the medulla oblongata quits working. WITHDRAWAL SYMPTOMS begin after 24 hours. The first 5 days of withdrawal are the delirious stage. (1) fatigue (2) anxiety (3) shivering (4) goose flesh (5) muscle tremors (6) body temperature rises (7) sleep difficulties with scare dreams After the delirious first 5 days comes the sleep stage. This goes on for 3 to 5 days. Brains seizures are most likely on the second day. Hallucinations tend to be more tactile (skin sensory, snakes or bugs on me) than in alcohol withdrawal. HALLUCINOGENS Drugs that have the ability to produce marked distortions in perceptual experience. Except at very high doses these drugs do not produce true hallucinations or the seeing or hearing of things that are not there. Instead they distort the perception of real objects. SOME REPRESENTATIVE HALLUCINOGENS     top cysergic acid dimethyl - lsd-25 mescaline and peyote - phencyclidine - pcp, angel dust, DOA, HOG Albert Hoffman discovered ergot, a fungus that grows on rye in 1928. It is known as St. Anthony's Fire. Much of the behavior shown by the witches in the witch burnings was derived from molded rye. Hoffman succeeded in synthesizing lsd-25 in 1943. Gary Grant took lsd to aid in his therapy. What was wanted by therapist was a model psychosis so they could use it to study schizophrenia. It was used by our military in the 1940's - 1960's. Timothy Leary, a Harvard psychology professor turned from a long productive career and start advocating lsd to "turn on, tune in and drop out". He also helped Bill Wilson, cofounder of AA, take lsd in California when Bill was "searching for a cure" for alcoholism. MECHANISM OF LSD-25 It blocks the action of serotonin in various parts of the brain, particularity the visual cortex, (occipital lobe) and thr raphe nuclei located near the reticular formation. Serotonin inhibits the stimulation of the higher brain by the reticular formation which ordinarily bombards the higher brain for alertness. ACUTE EFFECTS OF LSD-25 is absorbed very quickly from the small intestine and is very fast action taken orally, so there is no need for shooting up. However response may vary. (1) synesticia - hearing colors and seeing sounds. (2) time distortion - (3) body image distortion - may feel like floating. (4) boundary - loss between self and the environment (depersonalization). (5) resurfacing of memories - seems to occur (6) mystical or religious experiences - a feeling of community with all the universe. Dr. Gibson says this seems to be more understanding than surrender. (7) fatigue and weakness - that may last two days. ADVERSE SHORT TERM EFFECTS If lsd is not taken in an environment that is conducive to support from others and a positive experience then a bad trip may occur. This seems to me to be the opposite of community and therefore like a panic attack, the complete loss of community, and a feeling of not being worth the attention of others. Dr. Gibson says (I disagree) that a real panic attack not induced by drugs does not respond that well to love and strokes. ADVERSE LONG TERM EFFECTS (1) can trigger a long term to permanent psychosis. (2) flashbacks are common in either stable or unstable people. There is some evidence that this may be by the same mechanism as pts. (3) people under the influence of pcp are very subject to suggestibility therefore reckless. (4) chromosome breakage (5) appears to be no definite link between birth defects and lsd use during pregnancy. Phencyclidine (PCP) HOG, DOA, ANGEL DUST   top it ceased being used as an anesthetic because of side effects. It was used in veterinary medicine, therefore named HOG ACUTE EFFECTS (1) depersonalization (2) distortion of body image (seem to be floating in the air) (3) loss of skin sensation (including pain, heat, cold, sharpness). Seem to be anesthetized or dead. MEDICAL - PHARMACOLOGICAL TREATMENT not requiring hospitalization (1) Drug maintenance therapies - methadone or dolophine hydrochloride is a synthetic narcotic, when taken orally is slow acting, is a mild analgesic and produces a very mild euphoria and no rush. It prevents opiate narcotic withdrawal symptoms and to some extend blocks the craving for opiate narcotics and blocks the pleasurable eff ects of the opiate narcotics. METHADONE MAINTENANCE   top Some clinics provide FDA (Federal Drug & Alcohol) supervised methadone programs where adult, certified narcotics can come once or twice a day and receive methadone orally under supervision of the staff. Therapy here consists of substituting a legally prescribed narcotic for an illegal one. It is merely a form of narcotic substitution. Methadone is addictive. ARGUMENTS FOR METHADONE MAINTENANCE (1) reduced illegal activities. The drug addict get free methadone so he doesn't have to resort to crime. (I have never heard this reported in 27 years in AA or by other AA old timers. They ALWAYS say they took the drugs and went and got more. (2) Methadone is taken orally so there is no risk of spreading aids. (3) This kind of program helps to reduce preoccupation because (1) the addict doesn't have to worry about how he will pay for his next fix, and (2) the positive reinforcement is less than heroin or morphine so it is less possessive of the mind. (Because the addict gets more elsewhere there is no evidence that he is less preoccupied. the weaker reinforcement just calls for more drugs. ARGUMENTS AGAINST METHADONE MAINTENANCE   top (1)   It is addictive and does not contribute to drug independence. (2)   It is often abused by narcotic addicts who take all the heroin they can afford and then come to the clinic for still more free        drugs. (3)  Methadone clinics are eyesores and a gathering place for addicts and pushers alike.