Drug Information for common drugs of abuse
- Methamphetamine and Amphetamine: Methamphetamine and amphetamine belong to a group of structurally related drugs called sympathomimetic amines (SMAs) that are central nervous system stimulants. Amphetamine was first introduced in 1930 and has been legally prescribed to treat nasal congestion, narcolepsy, obesity and depression. Methamphetamine metabolizes to amphetamine and both are eliminated in the urine.
- Cocaine: Cocaine is a naturally occurring anesthetic with vaso-constrictive properties and is a potent central nervous system stimulant. As a local anesthetic, cocaine is used in 1-4% solutions for eye procedures and 10-20% solutions for nose and throat procedures. It is self-administered as a drug of abuse in doses of 10-200 mg. Cocaine is still used as a local anesthetic. Medicinal cocaine use is rarely found outside hospital settings because of the high potential for abuse, the difficulty maintaining the license to store cocaine and the availability of suitable substitutes,. Cocaine is not contained in any prescription medications from a pharmacy or in any over-the-counter medications. As late as 1986 an herbal tea sold under the name of “Health Inca Tea” contained enough cocaine to cause positive urine test results. The DEA continues to seize herbal teas containing cocaine
- Synthetic Stimulant Substances (“Bath Salts”): This group consists of several different “designer” drugs, however, they are frequently referred to collectively because they are often indiscriminately prepared together within one dose and because of their similar affects on the body. Designer drugs are so named because they were developed to subvert law enforcement and drug testing agencies and so are advertised as “legal” highs. This group of drugs was designed to produce similar effects as amphetamines, ecstasy and cocaine. They are characterized as central nervous system (CNS) stimulants and dopamine reuptake inhibitors, therefore considered stimulant drugs with psychedelic psychoactive properties. The most common synthetics are Cathinone, Methcathinone, Mephedrone and MDPV. Cathinone is extracted from the shrub plant Catha edulis (khat) and is chemically similar to ephedrine and the amphetamines. Methacathinone originally prescribed in the Soviet Union in the 1930s as an anti depressant and diet drug, is a recreational drug considered addictive in nature and is similar to Cathinone. Methcathinone is created by “bathtub” chemists by oxidizing the common drug ephedirene an easily obtainable legal stimulant. Mephedrone belongs to this same group of synthetic Cathinone derivatives. It was first synthesized in 1929 but was rediscovered in 2003 and is reportedly manufactured in China. MDPV (methylenedioxypyrovalerone) started appearing around 2004 as a “research chemical,” with reportedly four times the potency of Ritalin. It has been popularized as a club drug, often used in combination with alcohol, GHB, cannabis and other abused drugs. Most recently it has been established as the primary ingredient of “bath salts,” such as Ivory Wave, and is associated with extreme side effects of psychological disturbances causing the user to mutilate themselves and others while submerged in paranoid hallucinations. There are currently no known prescribed uses for the synthetic stimulants.
- Nicotine / Cotinine: Nicotine is a drug to which virtually every member of a tobacco using society is exposed. Although cotinine (the metabolite of nicotine) is often detected in the urine of nonsmokers, the level of urinary cotinine can still be used to differentiate smokers from nonsmokers who are exposed to second-hand tobacco smoke.
- Spice/K2: Spice/K2 is a synthetic cannabinoid (marijuana) functionally similar to 9-tetrahydrocannabinol (THC), the principle active component of cannabis. Synthetic cannabinoids were initally designed over the last 40 years as therapeutic agents, often for the treatment of pain. They compete for the same recepter agonists as THC, CB1 and CB2. These synthetics, however, have a much higher and complete binding affinity than THC, reportedly allowing similar, yet far more intense affects over its THC counterpart (3-700 times more powerful). There are currently no known prescribed uses for the synthetic cannabinoids. The DEA has recently declared specific elements of Spice/K2 as a controlled substance.
- LSD: Lysergic acid diethylamide (LSD) is an indole derivative that was first synthesized in 1938, and is considered the most potent hallucinogen known to man. It is manufactured from lysergic acid, which can be found in a fungus grown on rye and grain. There is no current prescribed use for this drug.
- Peyote: Mescaline (Peyote) is a hallucinogenic alkaloid first isolated in 1896 from the peyote cactus of northern Mexico. It is related to the more potent synthetic amphetamine derivatives. Peyote has been used for thousands of years by natives of northern Mexico and the southwestern United States in traditional religious rituals. There are no prescribed uses for this drug, however is still authorized in limited use by certain religious groups.
- PCP: Phencyclidine (PCP) is a popular drug of abuse as well as a legitimate veterinary tranquilizer. It is structurally related to Ketamine and was first developed for possible human use as an intravenous anesthetic agent in World War II. Its side effects and long half life make it unsuitable for human medical applications.
- Mushrooms: Psilocybin (Mushrooms) is a phosphate derivative of N,N-dimethyltryptamine that naturally occurs at concentrations of 0.1-1.5% in about a dozen species of the Psilocybegenus of mushrooms as well as in some species of the Panelous and Concybegenera. Psilocybin is considered non-addictive and rarely abused. There are currently no legally-prescribed uses for this drug.
- Barbiturates: Barbiturates are a group of drugs that act as central nervous system depressants. Opiates, benzodiazepines and alcohol are also CNS depressants, and like their use, the effect seems to the user as an overall sense of calm. Barbiturates were introduced in 1903, dominating the sedative-hypnotic market for the first half of the 20th century. Unfortunately, because barbiturates have a relatively low therapeutic -to-toxic index and substantial potential for abuse they quickly became a major health problem. Barbiturates are commonly abused for their sedative properties and widespread availability. The introduction of Benzodiazepines in the 1960s quickly supplanted the barbiturates due to their higher safety index and slightly lower abuse potential. Barbiturates have a high potential for lethal overdose.
DEPRESSANTS / SEDATIVES / HYPNOTICS
- Benzodiazepines: Benzodiazepines are a large group of drugs that act as central nervous system depressants. Opiates and alcohol are also CNS depressants, and like their use, provides the user with an overall calming effect . The marketing of Benzodiazepines began in the 1960’s, designed for the treatment of seizures, insomnia, anxiety disorders, acute alcoholism withdrawal, convulsions and as muscle relaxants. Benzodiazepines are commonly abused for their sedative properties and widespread availability. In fact, it has been predicted 1 in 5 current controlled substance prescriptions in the United States is a Benzodiazepine.
- GHB: Gamma -Hydroxybutyrate (GHB) is a low potency central-nervous-system depressant that has been popularized as a date-rape drug and a recreational intoxicant. It was first introduced in 1960 as an anesthetic. It had been marketed at gymnasiums and health food stores as an alternative to steroids for weight control. 1,4 butanediol (BDL) and gamma-butyrolactone (GBL) are efficiently converted in the body to GHB and therefore give the same effect as GHB. Only GHB is eliminated in the urine. In April 2000, GHB was placed on the Schedule 1 list of federally controlled substances but BDL and GBL remain legal in most parts of the country.
- EtG: Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) are direct ethanol metabolites produced by a minor pathway of the liver. EtG and EtS are considered highly sensitive, water soluble, non-volatile metabolites that can be detected at quantifiable levels in hair, urine, saliva, plasma and body tissues up to 80 hours after use whereas parent alcohol testing is limited to 8-12 hours for detection of consumption. The primary mode of metabolism of ethanol is through the alcohol dehydrogenase pathway (ADH). The microsomal ethanol oxidizing system (MEOS), however, has become very important to the forensic and clinical communities for producing metabolites that can be tested for an extended period of time over their parent compound. This enzymatic process is a minor pathway that is specifically selective to ethanol and not to any other common alcohols such as methanol and isopropyl alcohol (common household rubbing alcohol). If EtG and EtS (or only EtS), are present in the urine it is from the direct exposure to or ingestion of ethanol, or alcoholic beverages.
- Opium: Opium contains morphine and codeine in a ratio of about 10 to 1. The semi-synthetic opiates derived from opium include (among others): Hydrocodone, Hydromorphone, Oxycodone and Heroin. Opiates are characterized by their analgesic properties, their similar chemical structure, and the tendency for users to form a physical dependency and develop tolerance with extended use.
NARCOTICS/ ANALGESICS / OPIOIDS
- Codeine and Morphine: Codeine is a commonly prescribed analgesic taken orally, frequently in combination with acetaminophen, aspirin or other prescription drugs. Codeine is converted in the body to morphine and both are excreted in the urine. Morphine is used primarily in hospital settings as a powerful short term pain reliever. Heroin is an illicit drug no longer used therapeutically in the U.S.
- Heroin: Heroin is rapidly converted in the body to 6-acetylmorphine (6-AM) and then to Morphine. Since 6-AM is unique to heroin metabolism, its presence is evidence of heroin use, however, the absence of 6-AM in a specimen does not necessarily exclude the use of heroin.
- Oxycodone: Oxycodone, like other opiates is characterized by its analgesic properties, and the tendency for users to form a physical dependency and develop tolerance with extended use. It is a commonly prescribed analgesic taken orally, frequently in combination with acetaminophen or aspirin. OxyContin, the time-release form of oxycodone, is supplied in 80 mg doses and is often called “hillbilly heroin”. When the pills are crushed, the contents can be snorted or dissolved in water and injected. Its use as a “Club Drug” is reported as on the increase.
- Meperidine: Meperidine is a synthetic narcotic analgesic introduced in 1931, originally created to control muscle spasms. It has one-eighth the potency of Morphine and a shorter duration of action. The current intended use is the management of moderate-to-severe pain and as an adjunct to anesthesia and preoperative sedation.
- Methadone: Methadone was first synthesized as a morphine substitute in Germany during World War II, and was made clinically available in the United States in 1947. Methadone is equally as potent as Morphine as an analgesic, however, unlike Morphine, produces a marked sedative effect with repeat administration, due to a slow and steady buildup within the body. This is an important aspect when prescribing dosages for the treatment of opioid addiction as the individual dose will vary with each patient depending on their dependence level. Its intended uses are the management of moderate-to-severe pain and detoxification and maintenance treatment of opioid addiction.