Drug Abuse - Stimulant drugs
The legitimate use of stimulant drugs and their great capacity for abuse stem from the same property: their ability to speed up the processes of the central nervous system. Physicians may prescribe amphetamines primarily to curb the appetites of patients who are dieting or to counteract mild depression. More rarely, they use stimulant drugs to treat narcolepsy , a disease in which the patient is subject to irresistible bouts of sleep, and to counteract the drowsiness caused by sedatives. Amphetamines and an amphetamine-like drug (Ritalin) may be used to treat some hyperactive children who are extremely excitable and easily distracted. For reasons that are imperfectly understood, the drug calms these children instead of stimulating them.
The major forms of the amphetamines are: amphetamine (Benzedrine), the more powerful dextroamphetamine (Dexedrine), and methamphetamine (Methedrine, Desoxyn). The street name for these drugs is “speed.”
The consumption of amphetamines is reportedly far greater than the prescription books indicate. Some 10 billion tablets are produced in the United States annually, enough for 50 doses for every man, woman, and child. Of this amount, probably half is diverted into illicit channels. Underground laboratories manufacture even more.
Abusers of amphetamines include students cramming for exams, housewives trying to get through the day without collapsing from exhaustion, and the businessman who has tossed and turned all night in a strange hotel bedroom and needs to be alert for a conference the next morning.
Used judiciously, amphetamines can improve performance, both mental and physical, over moderate periods of time. In effect, they delay the deterioration in performance that fatigue normally produces. Required to carry out routine duties under difficult circumstances and for extended periods, some astronauts have used amphetamines under long-range medical supervision.
Amphetamines give some persons feelings of self-confidence, well-being, alertness, and an increased ability to concentrate and perform. Others may experience an increase in tension ranging from the uncomfortable to an agonizing pitch of anxiety. High doses may produce dry mouth, sweating, palpitations, and raised blood pressure. Because amphetamines only defer the effects of fatigue, the letdown can be dangerous, especially for such users as longdistance truck drivers. In addition, the feelings of self-confidence about improved performance may be highly deceptive. Some college students who have crammed for exams while on speed have turned in blank examination books, or written a whole essay on one dense line.
Amphetamine abusers quickly develop a tolerance to the drug. They may have continually to increase dosages, and may undergo different kinds of drug experiences. Psychological dependence can build rapidly.
Several drugs that are chemically unrelated to the amphetamines produce very similar effects on the body. They are, also, equally amenable to abuse. Among them are methylphenidate (Ritalin) and phenmetrazine (Preludin). The latter has been commonly used as a diet pill.
Ranked as powerful stimulants to the central nervous system, cocaine and its derivatives have become the trendy drugs of the late 20th century. An alkaloid found in the leaves of the coca bush, Erythroxylon coca , cocaine in its crystalline form is a white powder that looks like moth flakes. Cocaine can be sniffed, smoked, or taken intravenously. Abusers of cocaine may or may not develop a tolerance for the drug. But some evidence indicates that the same dose repeated frequently will not produce similar effects over a period of time.
Very little street-purchased cocaine is pure. Usually, the drug is mixed, or cut, with other drugs or with substances that resemble it, such as talcum powder or sugar.
Physical dependence on cocaine is rare. Psychological dependence is much more common. When physical dependence occurs, the withdrawal symptoms may include hunger, irritability, extreme fatigue, depression, and restless sleep. With psychological dependence, abusers come to need the feeling of euphoria induced by cocaine. When a dose wears off, the abuser may go into a period of deep depression.
The use of cocaine as a legal anesthetic need not lead to addiction.lt has been used particularly in surgical operations on the mouth, eyes, and throat because it can constrict blood vessels and because it is rapidly absorbed by the mucous membranes.
Cocaine's effects as a stimulant last only a short time. Generally, the effects depend on the size of the dose. A small dose may produce sensations of euphoria and illusions of increased strength and sensory awareness. A large dose may magnify these effects. The abuser may engage in irrational behavior, and may experience such physical side effects as sweating, dilation of the pupils, and rapid heartbeat.
In extreme cases abusers may have hallucinations and feelings of paranoia and depression. They may imagine that insects are crawling over their skins (formication) and may have chest pains. Injections by needle may produce skin abscesses. Both heavy and light users may develop runny noses, eczema around the nostrils, and deterioration of the nasal cartilage. The latter occurs because cocaine is usually “snorted” into the nostrils through a straw or a roll of paper, or from a spoon.
Death results, occasionally, from overdoses of cocaine, with respiratory arrest as a prime cause. The abuser may also have high fever, heart rhythm disturbances, or convulsions.
By a simple process dealers in cocaine can convert cocaine in white powder form, cocaine hydrochloride, into cocaine alkaloid, called freebase . The process involves mixing powdered cocaine with baking soda and water to form a paste. Once the concoction hardens, it looks like lumpy, off-white granulated sugar. Unlike powdered cocaine, the drug in this form, called crack or rock , can be smoked, eliminating the need for needles.
However made, crack is a purified cocaine base that is usually smoked in a special pipe with wire screens, or sprinkled on a tobacco or marijuana cigarette. The drug produces a high that may start in eight seconds and last two minutes. By contrast, snorted cocaine takes effect after about five minutes.
Crack produces a very intense euphoria along with other physical symptoms. Because the drug in this form is far more potent than powdered cocaine, the heartbeat speeds up and the abuser's blood pressure may rise. Heart-lung problems may follow, and seizures can occur. Death may ensue. Because of the variations in the strength and purity of crack, and because of the variability of a body's response, death can occur on the first use or the thousandth. Abuse of crack may lead to physical addiction in weeks, with the victim needing continually larger doses to achieve a high.