CHAPTER 1 History and Classification

Themes of Drug UseBasic Need to CopeBrain Chemistry can be affected by

substancesGovernment

Cultivating/manufacturingDistributionTaxationProhibition/enforcement

Themes of Drug UseTechnology

DistillationRefiningSynthesis of new drugsExtractionModification

Themes of Drug UseMethods of Administration

Mixing substancesMore efficient absorptionInhalation of volatilesInjectionSnorting – insufflationSmokingCrush and inject

HistoryNeolithic

Shamanism/religious useAlcoholMushroomsOpiumMarijuanaCocoaCocaTea/coffeeKhatTobacco

HistoryAncient

Development of agriculture Grain for bread and beer/wine Fruit for wine Opium Cannabis

HistoryAlcohol – Drink vs. Drunk

Alcohol available, but laws on usePenalties for drunkenness sometimes severeDionysus vs. Bacchus

HistoryOpium

WidespreadMedical and euphoric use

CannabisMost common in the EastMedical and ‘Recreational’ use

HistoryMescaline

North/South AmericaMostly ceremonial

HistoryMushrooms

India, East and Americas

HistoryCoca/Tobacco

Central/South America/North AmericaAlkaloids to discourage herbivores, etc.Used medicinally and recreationally

HistoryMiddle Ages

All of the aboveAdditions

Nightshade family Ergot Distillation Medical uses - purification/concentration Coffee/Tea – roasting, cuktivation

History‘Renaissance/Age of Discovery

Distilled Alcohol Problems Taxation

Substances from the New World Coca Tobacco Coffee/Tea – use increases Opium – rediscovered Greek/Moorish writing

HistoryAge of Enlightenment/Industrial Revolution

Improvements in production/AdministrationTaxation/RevenueEncouragement/DiscouragementInhalentsOpium to Heroin

Morphine – pure form, overdose Heroin Opium Wars

CocaineTemperance/Prohibition

HistoryPatent Medicines

Heroin, Cocaine Elixers Pain Killers Coca Cola

History20th Century

Tobacco – rise of cigarettesLegislation

Pure Food and Drug Act 1906 Accurate Labelling

Opium Exclusion Act 1909 Reduction of use worldwide

Harrison Narcotic Act 1914 Controlled/taxed opium, cocaine Illicit drug trade

HistoryAlcohol Prohibition 1920

Did improve Public HealthCaused dramatic increase in organized crime

HistoryMarijuana

Increased use due in part to Popular musician/artist use

Marijuana Tax Act – 1937 Banned Cannabis Sativa

Cultivation improved Greatly increased use in 50s to present

HistoryAmphetamines

Synthesized 1887/1919StimulantDecongestantAppetite SuppressantMilitary UseGreat increase in use 50s-60sControlled Substance Act 1970

HistorySports

Anabolic Steroids – OlympicsIOC – banned performance enhancers 1968NCAA – 1984NFL, MLB, NBA

HistorySedatives/Hypnotics

Barbiturates (1st non-alcohol related sedatives)Benzodiazepines (less toxic)

Psychiatric DrugsAntipsychoticsLithiumAntianxietyAntidepressants

HistoryPsychedelics

LSDMushroomsSynthetics

MDMA MDA STP DMT Etc.

HistoryResponse to growing misuse/abuse

Supply reduction – interdictionDemand reduction – educationHarm reduction – methadone, needle exchange

HistoryMethadone/Heroin

Substitute on substance for anotherRisk/benefitExpectations

HistoryCocaine/Crack

Cocaine HCl Snorted or injected

Crack – cocaine free base Smoked (volatilized) powerful and fast effect Expensive

MethamphetamineSimilar salt vs. free baseLonger half life than cocaineCheaper

Current EventsOver all drug abuse has declined since 1980Age of first use has also gone downSeverity of abuse problems increased

Political issuesPublic Health issues

Current EventsHeroin use increasing

Geographical differences – portsMexican/South American sourcesPolitical hotspots

Afghanistan Myanmar (Burma) Thailand

Current EventsCocaine

South AmericaTraffickers control/influence governmentsMexican border30 tons/month from just one source

Current EventsPublic Health

HIV AIDSHepC

Current EventsMeth

Geographic differences Nationwide – large scale Mexican labs NW – small labs in rural settings

Restrictions on precursors Ephedrine pseudoephedrine

Current EventsClub Drugs

MDAMDMAKetamineRohypnolGHB

Current EventsMarijuana

Stronger than everMedical marijuana

No way to legally obtain Federal law still considers illegal Canada has new medical law

Legalization – support increasing but still low

Current EventsTobacco

Use decreased after mid-60sIncreased in 90s

Women Young people

Slight decrease in 2000sLegal issues

Companies knewWhere are they selling now??

Current EventsOxycontin/Other Opiates

Time-release oxycodoneMS-continHydrocodone (Vicodin)Chronic Pain clinics

Current EventsAlcohol

Still the most widely abused drugKills more than 10 times as many people as all

other drugs combinedSingle biggest Public Health and Law

Enforcement problem of all drugs

Current EventsNewly identified addictions

EatingGamblingInternetShoppingSex

Current EventsDrug Court

Specific to drug-only crime1st time offendersTreatment vs. jailAccountability‘Coerced treatment’

Classification of DrugsPsychoactive Drug

Alters the function of the CNSChanges or substitutes for the action of CNS

neurotransmitters

ClassificationUppers

Stimulants Cocaine Amphetamines Amphetamine congeners (relatives) Modafinil Khat, betel, ephedra Caffeine nicotine

ClassificationDowners

Depressants Opiates

Opium Codiene Morphine

Opioids Hydrocodone Hydromorphone Oxycodone Oxymorphone

Opiate like Meperidine Propoxyphene

ClassificationDowners (cont.)

Sedative/Hypnotics Barbiturates

Phenobarbital Butalbital

Benzodiazepines Diazepam – Valium Chlordiazepoxide – Librium Alprazolam - Xanax

Alcohol Misc.

Antihistamines Muscle relaxants

ClassificationAll Arounders

Psychedelics – Hallucinogens LSD Phenylalkylamines (mescaline, MDMA, etc.) Psilocybin Anticholinergics Marijuana Ketamine Phencylidine (PCP)

ClassificationOther

Inhalants – usually depressantsSteroidsPsychiatric medsCompulsive behaviors

ClassificationControlled Substance Act 1970

Schedule I – High abuse potential, no medical use

Schedule II – High abuse potentialScheduleIII – Lesser abuse potentialSchedule IV – Even less abuse potentialSchedule V – Minimal abuse potential