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Zyprexa

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:16:14 GMT

Zyprexa (Olanzapine) is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder.

More information/images in the Prescription Drug Brochure.

When you receive Zyprexa extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive Zyprexa extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility.

A program has been set up to help people receive Zyprexa extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program.

For people being treated with olanzapine extended-release injection or Zyprexa injection:

Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment.

Olanzapine injection and olanzapine extended-release injection are not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is being treated with olanzapine injection or olanzapine extended-release injection. For more information visit the FDA website: http://www.fda.gov/Drugs

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with olanzapine extended-release injection and each time you receive an injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.

extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive olanzapine extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility.

A program has been set up to help people receive olanzapine extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program.

For people being treated with olanzapine extended-release injection or olanzapine injection:

Zoloft

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:14:18 GMT

Zoloft (Sertraline) is included in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs is used to treat depression, anxiety, and other mood disorders.

Zanaflex

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:13:18 GMT

Zanaflex (Tizanidine) is a short-acting muscle relaxer.

Tizanidine is used to relieve the spasms and increased muscle tone caused by multiple sclerosis (MS, a disease in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscle coordination and problems with vision, speech, and bladder control), stroke, or brain or spinal injury. Tizanidine is in a class of medications called skeletal muscle relaxants. It works by slowing action in the brain and nervous system to allow the muscles to relax.

Tizanidine comes as a tablet and a capsule to take by mouth. It is usually taken consistently either always with or always without food two or three times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tizanidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Tizanidine capsules may be opened and sprinkled on soft foods such as applesauce. Talk to your doctor before opening the capsules because the effects of the medication, when used in this manner, may be different than when swallowing the capsule whole.

The medication in the capsule is absorbed differently by the body than the medication in the tablet, so one product cannot be substituted for the other. Each time you have your prescription filled, look at the tablets or capsules in the bottle and make sure that you have received the right product. If you think you received the wrong medication, talk to your doctor or pharmacist right away.

Your doctor will probably start you on a low dose of tizanidine and gradually increase your dose, depending on your response to this medication.

Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will probably decrease your dose gradually.

Xenical

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:11:41 GMT

Xenical (orlistat 120mg) was approved as a prescription product by FDA in 1999 for obesity management in conjunction with a reduced calorie diet, and to reduce the risk of regaining weight after prior weight loss.

Orlistat (prescription and nonprescription) is used with an individualized low-calorie, low-fat diet and exercise program to help people lose weight. Prescription orlistat is used in overweight people who may also have high blood pressure, diabetes, high cholesterol, or heart disease. Orlistat is also used after weight-loss to help people keep from gaining back that weight. Orlistat is in a class of medications called lipase inhibitors. It works by preventing some of the fat in foods eaten from being absorbed in the intestines. This unabsorbed fat is then removed from the body in the stool.

Orlistat may cause side effects. The most common side effect of orlistat is changed in bowel movement (BM) habits. This generally occurs during the first weeks of treatment; however, it may continue throughout your use of orlistat. Tell your doctor if any of these symptoms are severe or do not go away:

-oily spotting on underwear or on clothing
-gas with oily spotting
-urgent need to have a bowel movement
-loose stools
-oily or fatty stools
-increased number of bowel movements
-difficulty controlling bowel movements
-pain or discomfort in the rectum (bottom)
-stomach pain
-irregular menstrual periods
-headache
-anxiety

Xanax

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:10:01 GMT

Xanax (Alprazolam) is commonly used and FDA approved panic disorder and anxiety disorders.

Alprazolam, Xanax is used to treat anxiety disorders and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Alprazolam is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain.

Alprazolam, Xanax comes as a tablet, an extended-release tablet, an orally disintegrating tablet (tablet that dissolves quickly in the mouth), and a concentrated solution (liquid) to take by mouth. The tablet, orally disintegrating tablet and concentrated solution usually are taken two to four times a day. The extended-release tablet is taken once daily, usually in the morning. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take alprazolam exactly as directed.

To take the concentrated liquid, follow your doctor’s directions. Draw into the dropper the amount prescribed for one dose. Squeeze the dropper contents into a liquid or semi-solid food such as water, juice, soda, applesauce, or pudding. Stir the liquid or food gently for a few seconds. The concentrated liquid will blend completely with the food. Drink or eat the entire mixture immediately. Do not store for future use.

Remove the orally disintegrating tablet from the bottle just before it is time for your dose. With dry hands, open the bottle, remove the tablet, and immediately place it on your tongue. The tablet will dissolve and can be swallowed with saliva. The orally disintegrating tablet can be taken with or without water.

Swallow the extended-release tablets whole; do not chew, crush, or break them.

Your doctor will probably start you on a low dose of alprazolam and gradually increase your dose, not more than once every 3 or 4 days.

Alprazolam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Do not stop taking alprazolam or decrease your dose without talking to your doctor. If you suddenly stop taking alprazolam you may experience withdrawal symptoms such as seizures; shaking of a part of your body that you cannot control; headache; blurred vision; increased sensitivity to noise or light; change in sense of smell; sweating; difficulty falling asleep or staying asleep; difficulty concentrating; nervousness; depression; irritability; aggressive behavior; muscle twitching or cramps; diarrhea; vomiting; pain, burning, numbness, or tingling in the hands or feet; a decrease in appetite; or weight loss. Your doctor will probably decrease your dose gradually.

Wellbutrin

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:08:47 GMT

Bupropion is an antidepressant medication used to treat depression.

Some people have reported symptoms such as changes in behavior, hostility, agitation, depressed mood, and suicidal thoughts (thinking about harming or killing oneself or planning or trying to do so) while taking bupropion to stop smoking. The role of Wellbutrin in causing these mood changes is unclear since people who quit smoking with or without medication may experience changes in their mental health due to nicotine withdrawal. However, some of these symptoms occurred in people who were taking bupropion and continued to smoke. Some people had these symptoms when they began taking Wellbutrin, and others developed them after several weeks of treatment or after stopping bupropion. These symptoms have occurred in people without a history of mental illness and have worsened in people who already had a mental illness. Tell your doctor if you have or have ever had depression, bipolar disorder (mood that changes from depressed to abnormally excited), schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), or other mental illnesses.

If you experience any of the following symptoms, stop taking bupropion (Zyban) and call your doctor immediately: suicidal thoughts or actions; new or worsening depression, anxiety, or panic attacks; agitation; restlessness; angry or violent behavior; acting dangerously; mania (frenzied, abnormally excited or irritated mood); abnormal thoughts or sensations; hallucinations (seeing things or hearing voices that do not exist); feeling that people are against you; feeling confused; or any other sudden or unusual changes in behavior. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own. Your doctor will monitor you closely until your symptoms get better.

For people taking bupropion (Wellbutrin) for depression:

A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as bupropion during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. This risk should be considered and compared with the potential benefit in the treatment of depression, in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take bupropion, but in some cases, a doctor may decide that bupropion is the best medication to treat a child’s condition.

No matter what your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal, especially at the beginning of your treatment or any time that your dose is increased or decreased. This risk is higher if you or anyone in your family has or has ever had bipolar disorder or mania or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.

You should know that your mental health may change in unexpected ways when you take bupropion or other antidepressants even if you are an adult over age 24 or if you do not have a mental illness and you are taking bupropion to treat a different type of condition. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

Wax

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:07:23 GMT

Cannabinoids, to include THC, are extracted from marijuana plant material in a variety of ways. The majority of the cannabinoids are found in the oily resin on the outside of the cannabis plant. One of the most common and most dangerous methods of extraction involves the use of butane, a solvent that dissolves the cannabinoids, allowing them to separate from the other plant material. Other solvents, like Freon, hexane, isopropyl alcohol, and ethanol, are also used. Carbon dioxide extraction, also known as supercritical fluid extraction, uses high pressure to separate the cannabinoids from the plant material. The ice-water filtration method uses ice or dry-ice for this separation: the cold temperatures make the resin brittle enough to break away from the plant material. The “rosin technique” extracts cannabinoids using heated pressure, often from a flat-iron, heated spoon, or a commercial heat-press made for producing marijuana concentrates.

W-18

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:06:09 GMT

Health Canada has identified through scientific analysis that some pills being sold in Calgary as fentanyl—the typically blue-green, round fake OxyContin pills—actually contained a drug 100 times more potent than fentanyl, W-18. This synthetic is 1-(4-Nitrophenylethyl)piperidylidene-2-(4-chlorophenyl)sulfonamide a highly potent opioid agonist with a distinctive chemical structure which is not closely related to older established families of opioid drugs. It was invented by Canadian chemists Edward Knaus, Brent Warran and Theodore Ondrus in 1981.

Authorities in British Colombia are already preparing when a new drug referred to as W-18 becomes available on the streets. It is reported to be more than 100 times more potent than fentanyl and fentanyl is reported to be 100 times more potent than morphine. This new synthetic opioid has been discovered in Canada, but it has just started. A South Florida synthetic drug expert reports that W-18 has found its way to Florida.

In preparation for its arrival, officials in Canada are trying to educate opiate users by reminding them not to use these drugs alone, to test their drugs in small doses and be aware of this new synthetic which should be arriving soon. Furthermore, it has not been proven that NARCAN (naloxone) can reverse opioid depression caused by W-18 as it does with heroin.

Tryptamine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:04:28 GMT

Tryptamine is a number of Schedules I hallucinogenic substances are classified chemically as tryptamines. Most of these are found in nature but many, if not all, can be produced synthetically. Psilocybin (O-phosphoryl-4-hydroxy-N, N-methyltryptamine) and psilocybin (4-hydroxy-N, N-dimethyltryptamine) are obtained from certain mushrooms indigenous to tropical and subtropical regions of South America, Mexico, and the United States. As pure chemicals at doses of 10 to 20 mg, these hallucinogens produce muscle relaxation, dilation of pupils, vivid visual and auditory distortions, and emotional disturbances. However, the effects produced by consuming preparations of dried or brewed mushrooms are far less predictable and largely depend on the particular mushrooms used and the age and preservation of the extract. There are many species of “magic” mushrooms that contain varying amounts of these tryptamines, as well as uncertain amounts of other chemicals. As a consequence, the hallucinogenic activity, as well as the extent of toxicity produced by various plant samples, are often unknown.

DIMETHYLTRYPTAMINE (DMT) has a long history of use and is found in a variety of plants and seeds. It can also be produced synthetically. It is ineffective when taken orally unless combined with another drug that inhibits its metabolism. Generally, it is sniffed, smoked, or injected. The effective hallucinogenic dose in humans is about 50 to 100 mg and lasts for about 45 to 60 minutes. Because the effects last only about an hour; the experience has been referred to as a “businessman’s trip.”

A number of other hallucinogens have very similar structures and properties to those of DMT. Diethyltryptamine (DET), for example, is an analog of DMT and produces the same pharmacological effects but is somewhat less potent than DMT.

Alpha-methyltryptamine (AET) is another tryptamine hallucinogen added to the list of Schedule I hallucinogens in 1994. Bufotenine (5-hydroxy-N-N-dimethyltryptamine) is a Schedule I substance found in certain mushrooms, seeds, and skin glands of Bufo toads. In general, most bufotenine preparations from natural sources are extremely toxic. N,N-Diisopropyl-5-methoxytryptamine (referred to as Foxy-Methoxy) is an orally active tryptamine recently encountered in the United States.

Source: DEA

Alpha-methyltryptamine (AMT), known as “spirals,” was designated a Schedule I drug by the DEA in April of 2003. 5-methoxy-alpha-methyltryptamine (5-MeO-AMT) is also a tryptamine. Other common names for 5-MeO-AMT are “alpha-O”, “alpha” and “O-DMS.”

EFFECTS:

Users of tryptamines typically experience a multitude of effects. These effects include hallucinations, euphoria, dilated pupils, empathy, visual and auditory disturbances/distortions, “feelings of love,” and emotional distress. Some users may experience nausea, vomiting, and diarrhea. Tryptamines, like Foxy and AMT, are very dose-dependent, which means that the doubling of a moderate dose could result in effects similar to LSD. The duration of effects from 20 mg of AMT usually lasts between 12 and 24 hours, while the effects from 6 to 10 mg of Foxy reportedly last from 3 to 6 hours.

Source: DEA

Bufotenin (5-HO-DMT, N, N-dimethylserotonin), is a tryptamine related to the neurotransmitter serotonin. It is found in the skin of some species of toads, in mushrooms, higher plants, and mammals.

Other Source:

CEWG June 2014, Patterns and Trends of Drug Abuse in …
https://www.drugabuse.gov/sites/default/files/chicago2014.pdf

Patterns and Trends of Drug Abuse in Chicago: 2013 … Tryptamine reports declined steeply from 403 in 2011, to 307 in 2012, and to 168 in 2013. PCP …

HALLUCINOGENS AND DISSOCIATIVE DRUGS
https://www.drugabuse.gov/sites/default/files/hallucinogensrrs4.pdf

Hallucinogens and dissociative drugs … tryptamine)—also known as magic mushrooms, shrooms, boomers, or little smoke—is extracted

www.drugabuse.gov
https://www.drugabuse.gov/sites/default/files/ndspcatalog23rdedition.pdf

Tramadol

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 23:02:20 GMT

Tramadol, brand names; Ultram®, Ultram ER®, Conzip®, Rybix® ODT, Ryzolt®, is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time. This drug is associated with the serious risks of potent narcotics, some of which are potentially fatal. It is contraindicated in patients who have previously demonstrated hypersensitivity to the drug or any other components, or other opioids.

This pain reliever is also contraindicated in any situation where other opioids are contraindicated, including acute with alcohol, hypnotics, narcotics, centrally acting analgesics, opioids or psychotropic drugs, due to the risk of worsening central nervous system (CNS) and respiratory depression.

Source: FDA

In the body, tramadol is converted in the liver to the active form of the opioid, called O-desmethyltramadol. Some people have genetic variations that cause tramadol to be converted to the active form of the opioid faster and more completely than usual. These people, called ultra-rapid metabolizers, are more likely to have higher-than-normal amounts of the active form of the opioid in their blood after taking this drug, which can result in breathing difficulty that may lead to death. Recently, a 5-year-old child in France experienced severely slowed and difficult breathing requiring emergency intervention and hospitalization after taking a single prescribed dose of tramadol oral solution for pain relief following surgery to remove his tonsils and adenoids. The child was later found to be an ultra-rapid metabolizer and had high levels of O-desmethyltramadol in his body.

Tobacco

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:57:57 GMT

Tobacco use is the leading preventable cause of disease, disability, and death in the United States. According to the Centers for Disease Control and Prevention (CDC), cigarette smoking results in more than 480,000 premature deaths in the United States each year—about 1 in every 5 U.S. deaths—and an additional 16 million people suffer from a serious illness caused by smoking. In fact, for every one person who dies from smoking, about 30 more suffer from at least one serious tobacco-related illness.

The harmful effects of smoking extend far beyond the smoker. Exposure to secondhand smoke can cause serious diseases and death. Each year, an estimated 88 million nonsmoking Americans are regularly exposed to secondhand smoke and almost 41,000 nonsmokers die from diseases caused by secondhand smoke exposure.

How Does Tobacco Affect the Brain?

Cigarettes and other forms of tobacco—including cigars, pipe tobacco, snuff, and chewing tobacco—contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked. A typical smoker will take 10 puffs on a cigarette over the period of about 5 minutes that the cigarette is lit. Thus, a person who smokes about 1 pack (25 cigarettes) daily gets 250 “hits” of nicotine each day.

Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate.

Similar to other addictive drugs like cocaine and heroin, nicotine increases levels of the neurotransmitter dopamine, which affects the brain pathways that control reward and pleasure. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction—a condition of compulsive drug seeking and use, even in the face of negative consequences. Studies suggest that additional compounds in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain.

When an addicted user tries to quit, he or she experiences withdrawal symptoms including irritability, attention difficulties, sleep disturbances, increased appetite, and powerful cravings for tobacco. Treatments can help smokers manage these symptoms and improve the likelihood of successfully quitting.

What Other Adverse Effects Does Tobacco Have on Health?

Cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. Smokeless tobacco (such as chewing tobacco and snuff) also increases the risk of cancer, especially oral cancers. In addition to cancer, smoking causes lung diseases such as chronic bronchitis and emphysema and increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm. Smoking has also been linked to leukemia, cataracts, and pneumonia. On average, adults who smoke die 10 years earlier than nonsmokers.

Although nicotine is addictive and can be toxic if ingested in high doses, it does not cause cancer—other chemicals are responsible for most of the severe health consequences of tobacco use. Tobacco smoke is a complex mixture of chemicals such as carbon monoxide, tar, formaldehyde, cyanide, and ammonia—many of which are known carcinogens. Carbon monoxide increases the chance of cardiovascular diseases. Tar exposes the user to an increased risk of lung cancer, emphysema, and bronchial disorders.

Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birthweight. Maternal smoking may also be associated with learning and behavioral problems in children. Smoking more than one pack of cigarettes per day during pregnancy nearly doubles the risk that the affected child will become addicted to tobacco if that child starts smoking.

While we often think of medical consequences that result from direct use of tobacco products, passive or secondary smoke also increases the risk for many diseases. Secondhand smoke, also known as environmental tobacco smoke, consists of exhaled smoke and smoke given off by the burning end of tobacco products.

Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25–30 percent and lung cancer by 20–30 percent. In addition; secondhand smoke causes health problems in both adults and children, such as coughing, overproduction of phlegm, reduced lung function and respiratory infections, including pneumonia and bronchitis. Each year about 150,000 – 300,000 children younger than 18 months old experience respiratory tract infections caused by secondhand smoke. Children exposed to secondhand smoke are at an increased risk of ear infections, severe asthma, respiratory infections, and death. In fact, more than 100,000 babies have died in the past 50 years from sudden infant death syndrome (SIDS), and other health complications as a result of parental smoking. Children who grow up with parents who smoke are more likely to become smokers, thus placing themselves (and their future families) at risk for the same health problems as their parents when they become adults.

Although quitting can be difficult, the health benefits of smoking cessation are immediate and substantial—including reduced risk for cancers, heart disease, and stroke. A 35-year-old man who quits smoking will, on average, increase his life expectancy by 5 years.

Are There Effective Treatments for Tobacco Addiction?

Tobacco addiction is a chronic disease that often requires multiple attempts to quit. Although some smokers are able to quit without help, many others need assistance. Both behavioral interventions (counseling) and medication can help smokers quit, but the combination of medication with counseling is more effective than either alone.

The U.S. Department of Health and Human Services’ (HHS) has established a national toll-free quitline, 800-QUIT-NOW, to serve as an access point for any smoker seeking information and assistance in quitting. NIDA’s scientists are looking at ways to make smoking cessation easier by developing tools to make behavioral support available over the internet or through text-based messaging. In addition, NIDA is developing strategies designed to help vulnerable or hard-to-reach populations quit smoking.

Behavioral Treatments

Behavioral treatments employ a variety of methods to help smokers quit, ranging from self-help materials to counseling. These interventions teach people to recognize high-risk situations and develop coping strategies to deal with them.

Nicotine Replacement Treatments

Nicotine replacement therapies (NRTs) were the first pharmacological treatments approved by the Food and Drug Administration (FDA) for use in smoking cessation therapy. Current FDA-approved NRT products include nicotine chewing gum, the nicotine transdermal patch, nasal sprays, inhalers, and lozenges. NRTs deliver a controlled dose of nicotine to a smoker in order to relieve withdrawal symptoms during the smoking cessation process. They are most successful when used in combination with behavioral treatments.

Other Medications

Bupropion and varenicline are two FDA-approved non-nicotine medications that have helped people quit smoking. Bupropion, a medication that goes by the trade name Zyban, was approved by the FDA in 1997, and Varenicline tartrate (trade name: Chantix) was approved in 2006. It targets nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people resume smoking.

Current Treatment Research

Scientists are currently developing new smoking cessation therapies. For example, they are working on a nicotine vaccine, which would block nicotine’s reinforcing effects by causing the immune system to bind to nicotine in the bloodstream preventing it from reaching the brain. In addition, some medications already in use might work better if they are used together. Scientists are looking for ways to target several relapse symptoms at the same time—like withdrawal, craving, and depression.

How Widespread Is Tobacco Use?

Current smoking rates among 8th-, 10th-, and 12th-grade students reached an all-time low in 2014. According to the Monitoring the Future survey, 4.0 percent of 8th-graders, 7.2 percent of 10th graders, and 13.6 percent of 12th-graders reported they had used cigarettes in the past month. Although unacceptably high numbers of youth continue to smoke, these numbers represent a significant decrease from peak smoking rates (21 percent in 8th-graders, 30 percent in 10th-graders, and 37 percent in 12th-graders) that were reached in the late 1990s.

The use of hookahs has also remained steady at high levels since its inclusion in the survey in 2010–past year use was reported by 22.9 percent of high school seniors. Meanwhile, past year use of small cigars has declined since 2010 yet remains high with 18.9 percent of 12th graders reporting past year use. Past-month use of smokeless tobacco in 2014 was reported by 3.0 percent of 8th graders, 5.3 percent of 10th graders, and 8.4 percent of 12th graders.

Source: NIDA

Thebaine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:54:53 GMT

Thebaine, a minor content of opium, is controlled in Schedule II of the Controlled Substance Act as well as under international law. Although chemically similar to both morphine and codeine, this drug produces stimulant rather than depressant effects. This drug is not used therapeutically but is converted into a variety of substances including oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, and buprenorphine. The United States ranks first in the world in utilization.

Tenuate

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:54:02 GMT

Tenuate (diethylpropion) is a stimulant similar to an amphetamine. Diethylpropion is an appetite suppressant that affects the central nervous system. Tenuate and a number of drugs have been developed and marketed to replace amphetamines as appetite suppressants. These anorectic drugs include benzphetamine (Didrex®), diethylpropion, Tepanil®), mazindol (Sanorex®, Mazanor®), phendimetrazine (Bontril®, Prelu-27®), and phentermine (ionamin®, Fastin®, Adipex®).

These substances are in Schedule III or IV tenuate-2 of the CSA and produce some amphetamine-like effects. Of these diet pills, phentermine is the most widely prescribed and most frequently encountered on the illicit market. Two Schedule IV anorectics often used in combination with phentermine (phen-fen combo), fenfluramine and dexfenfluramine, were removed from the U.S. market due to heart valve problems.

Soma

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:52:41 GMT

oma, like Equanil and Miltown is a muscle relaxer. One of its metabolites, meprobamate (a controlled substance), may cause dependence.

Source: FDA

Meprobamate was introduced as an anti-anxiety agent in 1955 and is prescribed primarily to treat anxiety, tension, and associated muscle spasms. More than 50 tons are distributed annually in the United States under its generic name and brand names such as Miltown® and Equanil®. Its onset and duration of action are similar to the intermediate-acting barbiturates; however, therapeutic doses of meprobamate produce less sedation and toxicity than barbiturates. Excessive use can result in psychological and physical dependence. Carisoprodol (Soma®), a skeletal muscle relaxant, is metabolized to meprobamate. This conversion may account for some of the properties associated with carisoprodol and likely contributes to its abuse.

Source: DEA

Skelaxin

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:51:19 GMT

Skelaxin (Metaxalone) is a muscle relaxant.

San Pedro Cactus

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:50:16 GMT

The San Pedro Cactus, principle active ingredient is mescaline which can only be used legally by some native American tribes which have a history of using the plant.

The San Pedro cactus is very easy to grow in most areas. Because it grows naturally in the Andes Mountains at high altitude and with high rainfall, it can withstand temperatures far below that of many other cacti. It requires fertile, free-draining soil. They average half a meter per year of new growth. They are susceptible to fungal diseases if over-watered, but are not nearly as sensitive as many other cacti, especially in warm weather. They can be sunburned and display a yellowing chlorotic reaction to overexposure to sunlight.

In winter, plants will etiolate, or become thin, due to lower levels of light. This may be problematic if the etiolated zone is not sufficiently strong to support future growth as the cactus may break in strong winds.

Salvia

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:48:57 GMT

Salvia, traditionally, S. divinorum has been ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves of S. divinorum can also be smoked in rolled cigarettes or pipes or vaporized and inhaled.

Although information about S. divinorum is limited, its use may be driven in part by drug-related videos and information on Internet sites. Because of the nature of the drug’s effects—brief hallucinogenic experiences that mimic psychosis—it is more likely to be used in individual experimentation than as a social or party drug.

The main active ingredient in salvia, salvinorin A, is a potent activator of nerve cell targets called kappa opioid receptors. (These receptors differ from the receptors activated by commonly known opioid drugs such as heroin and morphine.) Although salvia is generally considered a hallucinogen, it does not act at serotonin receptors that are activated by other hallucinogens like LSD or psilocybin, and its effects are reported by experienced users to be different from those drugs.

Subjective effects of S. divinorum use have been described as intense but short-lived, appearing in less than 1 minute and lasting less than 30 minutes. They include psychedelic-like changes in visual perception, mood and body sensations, emotional swings, feelings of detachment, and a highly modified perception of external reality and the self, leading to a decreased ability to interact with one’s surroundings. This last effect has prompted concern about the dangers of driving under the influence of salvinorin.

What Are the Other Health Effects of Salvia?

The psychological or physical health effects of S. divinorum use have not been investigated systematically, and consequences of long-term use are not known. Experiments in rodents demonstrated deleterious effects of salvinorin A on learning and memory, but there is little evidence of salvia causing dependence or long-term psychiatric problems in humans.

Other Sources:

National Institute on Drug Abuse
https://www.drugabuse.gov/sites/default/files/drugfacts_salvia.pdf

Recreational use and legal status in …
https://www.drugabuse.gov/international/abstracts/salvia-divinorum-recreational-use-legal-status-in-france

S. Djezzar1, L. de Haro2, M.A. Courné3, R. Garnier1,4, The Addictovigilance and Toxicovigilance Networks1. 1Centre of Evaluation, Information on …

Rohypnol

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:47:19 GMT

Rohypnol remains readily available, mainly through pharmaceutical operators located in Mexico, especially Tijuana. Rohypnol is marketed by Hoffman-La Roche Inc. and is legally sold in Latin America and Europe as a short-term treatment for insomnia, and as a preanesthetic medication. One of the significant effects of the drug is anterograde amnesia, a factor that strongly contributed to its inclusion in the Drug-Induced Rape Prevention and Punishment Act of 1996. Anterograde amnesia is a condition in which events that occurred while under the influence of the drug are forgotten.

Rohypnol is available as a .5-milligram and 1-milligram oblong tablet, as well as a 1-milligram per milliliter injectable solution. Hoffman-La Roche phased out the 2-milligram dose tablet from 1996 to 1997 and is currently phasing out the round, white 1-milligram tablet. The licit market for the drug is currently supplied with a 1-milligram dose in an olive green, oblong tablet, imprinted with the number 542. The new tablet includes a dye that, according to Hoffman-La Roche, will be visible if it is slipped into a drink. Reports indicate that Rohypnol is often sold for between $2 and $5 per dosage unit, although it may sell for from $10 to $30 per dosage unit.

In addition to the chemically induced amnesia, Rohypnol often causes decreased blood pressure, drowsiness, visual disturbances, dizziness, confusion, gastrointestinal disturbances, and urinary retention. Users of the drug report effects similar to intoxication, yet claim that they wake up the next morning without a hangover. Adding to the popularity of the drug is the perception that the drug cannot be detected in a urinalysis. While the drug can be detected (2-milligram doses can be detected within 72 hours of ingestion), it does break down very quickly, and many commercial toxicological screens do not detect flunitrazepam. In sexual assault cases, forensic laboratories need to screen for the flunitrazepam metabolite, 7-aminoflunitrazepam, using gas chromatography and/or mass spectrometry.

Source: DEA Drug Intelligence Brief, “Club Drugs: An Update

STREET NAMES: Roofies, Rophies, Roche, Forget-me Pill, Circles, Mexican Valium, Rib, Roach-2, Roopies, Rope, Ropies, Ruffies, and Roaches.

Other Sources;

Club Drugs | National Institute on Drug Abuse (NIDA)
https://www.drugabuse.gov/drugs-abuse/club-drugs

Brief Description Club drugs tend to be used by teenagers and young adults at bars, nightclubs, concerts, and parties. Club drugs include GHB, Rohypnol …

DrugFacts: Lessons from Prevention Research | National …
https://www.drugabuse.gov/publications/drugfacts/lessons-prevention-research

DrugFacts: Lessons from Prevention Research. Revised March 2014. The principles listed below are the result of long-term research studies on the …

Ritalin (Methylphenidate)

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:45:37 GMT

Methylphenidate is the drug used to help ADHD patients. ADHD is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development.

This pattern of behavior usually becomes evident in the preschool or early elementary years, and the median age of onset of ADHD symptoms is 7 years. For many individuals, ADHD symptoms improve during adolescence or as age increases, but the disorder can persist into adulthood. In the United States, ADHD is diagnosed in an estimated 8 percent of children ages 4–17 and in 2.9–4.4 percent of adults.

By far the most controversial, and at the same time, most important public health concern in ADHD is the treatment of the disorder, especially among our nation’s youth. The most common treatment is the psychopharmacological agent, methylphenidate.

Methylphenidate is a schedule II narcotic which is regulated by the DEA as a controlled substance. It is a psychotropic drug with chemical properties, placing it in the amphetamine family of stimulants. Due to the lack of research of the long-term efficacy (greater than 24 months and in preschool populations) and safety of such treatment at the population level, a public health perspective should be applied to the treatment of ADHD. The lack of such research, coupled with an increase in the length of treatment during the formative growth years; a decrease in the age of initiation into treatment; and the growing prevalence estimates are cause for concern. As treatment options are considered, it is apparent that more reliance is placed on pharmaceutical remedies than on psychological interventions such as behavior modification, although the latter has been shown to have beneficial effects. Apparent emphasis on pharmacological intervention as first-line treatment exists in common practice despite a lack of adequate evidence of long-term academic and functional improvements using this intervention.

In an effort to delineate the issues in the treatment of ADHD individuals as well as gaps in treatment research, the Division of Birth Defects, Child Development, and Disability and Health (proposed)/NCEH hosted a one-day meeting with two researchers experienced in the study of ADHD treatments and the NCEH ADHD work group which is comprised of DDB staff. Prior to the meeting Division of Birth Defects, Child Development, and Disability and Health (proposed) had identified and provided to all participants an outline of the specific issues and questions related to the pharmacological and psychological treatment of ADHD. The questions and discussion that ensued resulted in the following points during this one-day meeting:

Please note that all answers are the summarized sentiments of the participants invited to this meeting and not those of the CDC. Statements herein are not, in any way, to be interpreted as promissory for inclusion in any ADHD research agenda setting nor are they ADHD policy statements by the Centers for Disease Control and Prevention, National Center for Environmental Health. This meeting was exploratory in nature and the results are provided here in an attempt to share the most information with the public.

Other Sources:

Pubertal delay in male nonhuman primates (Macaca mulatta …
www.cdc.gov/niosh/nioshtic-2/20039783.html

Juvenile male rhesus monkeys treated with methylphenidate hydrochloride (MPH) to evaluate genetic and behavioral toxicity were observed after 14 mo of …

[PDF] State Profile: ADHD Treatment in Washington – cdc.gov
www.cdc.gov/ncbddd/adhd/stateprofiles-behavioral/stateprofile-behavioral-washington.pdf
State Profile: ADHD Treatment in Washington www.cdc.gov/adhd … •Methylphenidate if behavior therapy is insufficient Elementary school …

Psilocybin

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:43:54 GMT

Prozac (Fluoxetine) is an antidepressant approved for the treatment of major depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder.

Other Sources:

A Double-Blind Trial of Naltrexone and Fluoxetine for …
https://www.drugabuse.gov/international/abstracts/double-blind-trial-naltrexone-fluoxetine-heroin-addiction

A Double-Blind Trial of Naltrexone and Fluoxetine for Heroin Addiction. E. Krupitsky. E. Krupitsky, E. Zvartau, D. Masalov, M. Tsoi, V. Egorova, A …

Fentanyl | National Institute on Drug Abuse (NIDA)
https://www.drugabuse.gov/drugs-abuse/fentanyl

Brief Description Fentanyl is a powerful synthetic opiate analgesic similar to but more potent than morphine. It is typically used to treat patients …

DISCA-Supported Research Supports Fluoxetine as …
https://www.drugabuse.gov/international/disca-supported-research-supports-fluoxetine-pharmacotherapy-methamphetamine-disca-team-awarded

DISCA-Supported Research Supports Fluoxetine as Pharmacotherapy for Methamphetamine; DISCA Team Awarded Additional Binational Funding

Prozac

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:42:37 GMT

Other Sources:

A Double-Blind Trial of Naltrexone and Fluoxetine for …
https://www.drugabuse.gov/international/abstracts/double-blind-trial-naltrexone-fluoxetine-heroin-addiction

A Double-Blind Trial of Naltrexone and Fluoxetine for Heroin Addiction. E. Krupitsky. E. Krupitsky, E. Zvartau, D. Masalov, M. Tsoi, V. Egorova, A …

Fentanyl | National Institute on Drug Abuse (NIDA)
https://www.drugabuse.gov/drugs-abuse/fentanyl

Brief Description Fentanyl is a powerful synthetic opiate analgesic similar to but more potent than morphine. It is typically used to treat patients …

DISCA-Supported Research Supports Fluoxetine as …
https://www.drugabuse.gov/international/disca-supported-research-supports-fluoxetine-pharmacotherapy-methamphetamine-disca-team-awarded

DISCA-Supported Research Supports Fluoxetine as Pharmacotherapy for Methamphetamine; DISCA Team Awarded Additional Binational Funding

Prescription Drugs

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:41:08 GMT

Some Prescription Drugs are the most commonly abused substances are taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed. In fact, prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.

The classes of prescription drugs most commonly abused are: opioid pain relievers, such as Vicodin® or Oxycontin®; stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall®, Concerta®, or Ritalin®; and central nervous system (CNS) depressants for relieving anxiety, such as Valium® or Xanax®.1 The most commonly abused OTC drugs are cough and cold remedies containing dextromethorphan.

People often think that prescription and OTC drugs are safer than illicit drugs. But they can be as addictive and dangerous and put users at risk for other adverse health effects, including overdose—especially when taken along with other drugs or alcohol. Before prescribing drugs, a health care provider considers a patient’s health conditions, current and prior drug use, and other medicines to assess the risks and benefits for a patient.

How Are Prescription Drugs Abused?

Prescription and OTC drugs may be abused in one or more of the following ways:

Taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing their unused pain relievers with their family members.

Most teenagers who abuse prescription drugs are given them for free by a friend or relative.

Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects.

Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects in sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.

ADHD drugs like Adderall® are also often abused by students seeking to improve their academic performance. However, although they may boost alertness, there is little evidence they improve cognitive functioning for those without a medical condition.

How Do Prescription and OTC Drugs Affect the Brain?

Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs.

For example, stimulants such as Ritalin® achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin® attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and Rohypnol®. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences.

When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.

What Are the Other Health Effects of Prescription and OTC Drugs?

Opioids can produce drowsiness, cause constipation, and—depending on the amount taken—depress breathing. The latter effect makes opioids particularly dangerous, especially when they are snorted or injected or combined with other drugs or alcohol.

Opioids and Brain Damage

While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.

Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

More people die from overdoses of prescription opioids than from all other drugs combined, including heroin and cocaine.

Stimulants can have strong effects on the cardiovascular system. Taking high doses of a stimulant can dangerously raise body temperature and cause irregular heartbeat or even heart failure or seizures. Also, taking some stimulants in high doses or repeatedly can lead to hostility or feelings of paranoia.

CNS depressants slow down brain activity and can cause sleepiness and loss of coordination. Continued use can lead to physical dependence and withdrawal symptoms if discontinuing use.

Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.

All of these drugs have the potential for addiction, and this risk is amplified when they are abused. Also, as with other drugs, abuse of prescription and OTC drugs can alter a person’s judgment and decision making, leading to dangerous behaviors such as unsafe sex and drugged driving.

Prescription Opioid Abuse: A First Step to Heroin Use?

Prescription opioid pain medications such as Oxycontin® and Vicodin® can have effects similar to heroin when taken in doses or in ways other than prescribed, and research now suggests that abuse of these drugs may actually open the door to heroin abuse.

Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.

Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.

Poppy

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:38:52 GMT

Foreign sources of opium Poppy are responsible for the entire supply of heroin consumed in the U.S. Efforts to reduce domestic heroin availability face significant problems. Unlike cocaine, which is concentrated in South America, opium production occurs in three source regions—Southeast Asia, Southwest Asia, and Latin America- creating a worldwide problem. While an undetermined amount of the opium is consumed in the producing regions, a significant amount of the drug is converted to heroin and sent to Europe and North America.

Historically, most of the world’s illicit opium for heroin has been grown in the Golden Triangle of Southeast Asia. However, Latin America has emerged, in recent years, as the primary supplier of heroin to the United States. Colombian and Mexican heroin comprises 60 and 24 percent respectively of the heroin seized today in the United States. Low-level opium-poppy cultivation in Venezuela and even more limited growing in Peru currently produce only marginal amounts of heroin but could become the foundation for an expanding opium and heroin industry beyond Colombia. Opium-poppy cultivation in Venezuela is limited to the mountains opposite Colombia’s growing area and appears to be a spillover from cultivation on the Colombian side of the border. Reports indicate that opium poppy cultivation in Peru over the last several years is nearly negligible.

With long-established trafficking and distribution networks and exclusive markets for black tar and brown powder heroin, Mexico’s hold on the U.S. heroin market in the West seems secure. Mexico grows only about two percent of the world’s illicit opium, but virtually the entire crop is converted into heroin for the U.S. market. Opium cultivation and production in Mexico have been relatively stable through most of the 1990s.

Source: ONDCP Fact Sheet: “Breaking Heroin Sources of Supply.”

The U.S. State Department annually estimates yields of opium poppy and other narcotic crops around the world. This is a difficult task because poppy is grown illegally under a variety of conditions and in many locations. To understand how opium poppy growth, development, and gum yield can be affected by weather variables such as temperature, plants were grown in controlled environments at temperatures ranging from nighttime lows of 7 degrees C to daytime highs of 28 degrees C. The optimum temperature for growth was between 16 and 20 degrees C.

Plants in optimum temperatures had more leaf area per unit of leaf tissue. These plants captured more light and grew faster than plants under the influence of higher or lower temperatures.

Development rate (time to flower) was practically the same for plants grown in temperatures of 17.5 degrees C or above, but time to flower was increased by 10% if plants were grown in 13.5 degrees C and by 50% if they were grown in an average temperature of 9.5 degrees C. The yield of gum, which is collected from the capsule, was positively correlated with capsule dry weight and capsule volume. Conditions that favored growth also favored yield. By understanding these responses to temperature, we can better predict the effect of weather conditions on flowering times, growth, and yield of opium poppy around the world. Improved models of poppy growth will improve the U.S. State Department yield estimates and give Congress better information for directing the War on Drugs.

Technical Abstract: The U.S. State Department annually estimates yields of opium poppy (Papaver somniferum L.) and other narcotic crops around the world. Field sampling is preferred. However, field sampling is expensive and can be dangerous, so other techniques are being sought. One method is to simulate crop performance using a computer model. To develop such a model, crop response to soil conditions, weather, and management practices must be understood. The first step in this process is to examine crop growth in controlled environments, keeping all environmental factors except one at optimum levels, and varying the one factor over a wide range. To study the effects of temperature on opium poppy, young seedlings were grown in controlled environment chambers in a 12 h photoperiod at a light intensity of 1000 micromol with day/night temperatures of 12/7 degrees C, 16/11 degrees C, 20/15 degrees C, 24/19 degrees C and 28/23 degrees C. Dry weights of plant parts and specific leaf area (SLA) were measured at various stages during plant development. The optimum mean temperature for poppy growth was between 16 and 20 degrees C. Development rate was reduced at lower temperatures but remained relatively constant over the 20/15, 24/19, and 28/23 degrees C treatments. SLA was sensitive to temperature, maximizing at 19.5 degrees C. Variation in SLA could explain some differences in relative growth rate and growth rate associated with temperature. Gum yield could be estimated from capsule dry weight or capsule volume using a linear regression model (r2 =0.71 and 0.75 respectively). Analyses of these data represent a first step in quantifying the effects of temperature on poppy growth, development, and gum yield.

Other Sources:

Heroin | National Institute on Drug Abuse (NIDA)
https://www.drugabuse.gov/drugs-abuse/heroin

Brief Description Heroin is an opioid drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian …

Urine Drug Testing for Chronic Pain Management
www.drugabuse.gov/sites/default/files/files/UrineDrugTesting.pdf

Urine Drug Testing for Chronic Pain Management. Introduction. … Opiates Morphine 300-2,000 Poppy seeds Rifampin Chlorpromazine Dextromethorphan 2-4 …

Drug-FreeFederal Register Codification

Phentermine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:35:27 GMT

Ionamin and Ionamin contain 15 mg and 30 mg respectively of phentermine as the cationic exchange resin complex. Phentermine is α, α-dimethyl phenethylamine (phenyl-tertiary-butylamine). Ionamin is a sympathomimetic amine with pharmacologic activity similar to the prototype drug of this class used in obesity, amphetamine (d- and dl-amphetamine). Actions include central nervous system stimulation and elevation of blood pressure.

Phenaphen

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:34:16 GMT

Codeine is in a group of drugs called narcotic pain relievers. Acetaminophen is a less potent pain reliever that increases the effects of codeine. The combination of acetaminophen and codeine is used to relieve moderate to severe pain.

Addiction to painkillers is well known. Acetaminophen (APAP), combined with opiate drugs, may lead to liver toxicity in cases in which high doses of APAP are used, especially in acute intoxication. During chronic abuse, liver disorders also may be expected.

Other Sources:

[PDF] Drugs Most Frequently Used in Office Practice National …
www.cdc.gov/nchs/data/ad/ad089acc.pdf
Tylenol with codeine (acetaminophen, codeine). . . . . . . . . . . . . . . . . . . . . ., ., ., . Actifed …

[PDF] Highlights of Drug Utilization in Office Practice National …
www.cdc.gov/nchs/data/ad/ad134acc.pdf
Tylenol No.3(acetaminophen, codeine) … Highlights of Drug Utilization in Office Practice: National Ambulatory Medical Care Survey, 1985 Created …

NHANES National Youth Fitness Survey – Centers for Disease …
www.cdc.gov/nchs/nnyfs/Y_RXQ_RX.htm
NHANES National Youth Fitness Survey NNYFS 2012 Data … For multi-ingredient products, the ingredients are listed in alphabetical order (i.e., …

Peyote

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:32:54 GMT

From the earliest recorded time, peyote has been used by natives in northern Mexico and the southwestern United States as a part of their religious rites.

The top of the cactus above ground–also referred to as the crown–consists of disc-shaped buttons that are cut from the roots and dried. These buttons are generally chewed or soaked in water to produce an intoxicating liquid. The hallucinogenic dose of mescaline is about 0.3 to 0.5 grams and lasts about 12 hours.

While this cactus produced rich visual hallucinations that were important to the native peyote cults, the full spectrum of effects served as a chemically induced model of mental illness.

Mescaline can be extracted from this cactus or produced synthetically. Both this cactus and

mescaline are listed in the CSA as Schedule I hallucinogens.

Source: DEA

PCP

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:31:25 GMT

Hallucinogens are a class of drugs that cause hallucinations—profound distortions in a person’s perceptions of reality. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be man-made, and they are commonly divided into two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). When under the influence of either type of drug, people often report rapid, intense emotional swings and seeing images, hearing sounds, and feeling sensations that seem real but are not.While the exact mechanisms by which hallucinogens and dissociative drugs cause their effects are not yet clearly understood, research suggests that they work at least partially by temporarily disrupting communication between neurotransmitter systems throughout the brain and spinal cord that regulate mood, sensory perception, sleep, hunger, body temperature, sexual behavior, and muscle control.

PCP (Phencyclidine)—also known as ozone, rocket fuel, love boat, hog, embalming fluid, or superweed—was originally developed in the 1950s as a general anesthetic for surgery. While it can be found in a variety of forms, including tablets or capsules, it is usually sold as a liquid or powder. PCP can be snorted, smoked, injected, or swallowed. It is sometimes smoked after being sprinkled on marijuana, tobacco, or parsley.

PCP is a white crystalline powder that is readily soluble in water or alcohol. It has a distinctive bitter chemical taste. PCP can be mixed easily with dyes and is often sold on the illicit drug market in a variety of tablet, capsule, and colored powder forms that are normally snorted, smoked, or orally ingested. For smoking, PCP is often applied to a leafy material such as mint, parsley, oregano, or marijuana. Depending upon how much and by what route PCP is taken, its effects can last approximately 4–6 hours.

At low-to-moderate doses, physiological effects of PCP include a slight increase in breathing rate and a pronounced rise in blood pressure and pulse rate. Breathing becomes shallow; flushing and profuse sweating, generalized numbness of the extremities, and loss of muscular coordination may occur.

At high doses, blood pressure, pulse rate, and respiration drop. This may be accompanied by nausea, vomiting, blurred vision, flicking up and down of the eyes, drooling, loss of balance, and dizziness. PCP abusers are often brought to emergency rooms because of overdose or because of the drug’s severe untoward psychological effects. While intoxicated, PCP abusers may become violent or suicidal and are therefore dangerous to themselves and others. High doses of PCP can also cause seizures, coma, and death (though death more often results from accidental injury or suicide during PCP intoxication). Because PCP can also have sedative effects, interactions with other central nervous system depressants, such as alcohol and benzodiazepines, can also lead to coma.

The use of PCP as an approved anesthetic in humans was discontinued in 1965 because patients often became agitated, delusional, and irrational while recovering from its anesthetic effects. PCP is a “dissociative drug,” meaning that it distorts perceptions of sight and sound and produces feelings of detachment (dissociation) from the environment and self. First introduced as a street drug in the 1960s, PCP quickly gained a reputation as a drug that could cause bad reactions and was not worth the risk. However, some abusers continue to use PCP due to the feelings of strength, power, and invulnerability as well as a numbing effect on the mind that PCP can induce. Among the adverse psychological effects reported are—

Symptoms that mimic schizophrenia, such as delusions, hallucinations, paranoia, disordered thinking, and a sensation of distance from one’s environment.

Mood disturbances: Approximately 50 percent of individuals brought to emergency rooms because of PCP-induced problems—related to use within the past 48 hours—report significant elevations in anxiety symptoms.

People who have abused PCP for long periods of time have reported memory loss, difficulties with speech and thinking, depression, and weight loss. These symptoms can persist up to one year after stopping PCP abuse.

Addiction: PCP is addictive—its repeated abuse can lead to craving and compulsive PCP-seeking behavior, despite severe adverse consequences.

Paxil

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:29:49 GMT

axil (Paroxetine) is included in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs is used to treat depression, anxiety, and other mood disorders.

Source: FDA

Use of certain antidepressants, selective serotonin-reuptake inhibitors most commonly known as SSRIs, during pregnancy does not significantly increase the risk for most birth defects, according to a new Centers for Disease Control and Prevention (CDC) study, released today in the New England Journal of Medicine NEJM).

The study, “Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects,” found no significant increase in the risks for the majority of birth defects assessed when all SSRIs were studied together. This finding includes the risk for congenital heart defects, which were associated with SSRI use in previous studies. Researchers, did, however, find associations between SSRI use and three specific birth defects: a defect of the brain, one type of abnormal skull development and a gastrointestinal abnormality. CDC plans to continue to study the association to clarify whether a true risk exists.

“Overall, our results are generally reassuring with respect to the use of antidepressants during pregnancy,” said Jennita Reefhuis, a CDC epidemiologist and one of the authors of the study. “We know that both the mother and baby benefit when a pregnant woman with a serious depressive illness is able to stay on some sort of treatment. The risks may vary for different SSRIs and groups of women. It’s important that women talk with their doctor about the risks and benefits of taking SSRIs during pregnancy.”

Reefhuis noted that while the study found an association between SSRI use and increased risk for three specific birth defects, the increases in risk were minimal and have not been found before. Further, the second study on SSRI and birth defects, also published in the June 28 issue of NEJM, did not find such an association with birth defects overall but did find significant associations between specific SSRIs and several birth defects.

According to Reefhuis, every pregnancy has a 3 percent risk of a major birth defect, regardless of exposures. A woman’s lifetime risk for major depression is 10 percent to 25 percent, with the highest prevalence in childbearing years (18-44 years).

The study examined four SSRIs used to treat such depression—fluoxetine, sertraline, paroxetine, and citalopram—and 18 birth defect categories, including defects of the brain, spine, heart, and mouth. The women in the study took these SSRIs the month before they became pregnant or in the first three months of pregnancy. SSRIs are the most frequently used class of antidepressant medications in general and during pregnancy in the United States, but available data on the safety of SSRI medications in pregnancy has been limited.

The study examined data from 9,622 infants with major birth defects and 4,092 infants without major birth defects, all born during 1997–2002. The data were obtained from the CDC–funded National Birth Defects Prevention Study (NBDPS). The NBDPS is an ongoing study that collects information from the states of Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas and Utah on the pregnancies of mothers of children with and without birth defects. It is one of the largest epidemiological efforts ever undertaken in the United States to identify causes of birth defects.

Reefhuis noted that as with all medications, CDC’s overall recommendation is that women carefully review the potential benefits and risks of SSRI treatment with their doctor so they can make informed decisions about therapies.

Genomics|Genetic Testing|EGAPP Recommendations|CYP450 …
www.cdc.gov/genomics/gtesting/EGAPP/recommend/CYP450.htm
CYP450 Genotyping to Predict Response to SSRIs Used to Treat Non-psychotic Depression in Adults: EGAPP™ Recommendation

Meningitis | About Bacterial Meningitis Infection | CDC
www.cdc.gov/meningitis/bacterial.html
Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing …

General Public: CYP450 Genotyping and Use of SSRI Drugs …

Opium

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:28:14 GMT

Global use of deadly opioid drugs has risen significantly, a new United Nations report reported on June 26, 2019, amid a growing synthetic drug crisis in the United States.

According to the latest World Drug Report, up to 53 million people are estimated to have used opioids globally in 2017, an increase of 56% year-on-year. Opioids include both heroin and legal pain relievers. The United Nations estimates up to 585,000 people died as a result of drug use in 2017, with the use of highly-addictive substances continuing to grow around the world. The report highlights an “ongoing crisis” in the United States and Canada around the use of synthetic opioid drugs, which led to more than 51,000 overdoses in 2017 alone.

There were no legal restrictions on the importation or use of Opioids until the early 1900s. In the United States, the unrestricted availability of narcotic, the influx of Opioid-smoking immigrants from East Asia, and the invention of the hypodermic needle contributed to the more severe variety of compulsive drug abuse seen at the turn of the 20th century. In those days, medicines often contained Opioids without any warning label. Today, there are state, federal, and international laws governing the production and distribution of narcotic substances.

Although Opioids is used in the form of paregoric to treat diarrhea, most opium imported into the United States is broken down into its alkaloid constituents.

These alkaloids are divided into two distinct chemical classes, phenanthrenes and isoquinolines. The principal phenanthrenes are morphine, codeine, and thebaine, while the isoquinolines have no significant central nervous system effects and are not regulated under the CSA.

Source: DEA

Guidelines have concluded that the risk of opioids is likely greater than their benefits when used for most non-cancer chronic conditions including headaches, back pain, and fibromyalgia. Thus they should be used cautiously in chronic non-cancer pain. In treating chronic pain, opioids are an option to be tried after other less risky pain relievers have been considered, including paracetamol/acetaminophen.

Some types of chronic pain, including the pain caused by fibromyalgia or a migraine, are preferentially treated with drugs other than opioids. The efficacy of using opioids to lessen chronic neuropathic pain is uncertain.

Opioids are contraindicated as a first-line treatment for a headache because they impair alertness, bring the risk of dependence, and increase the risk that episodic headaches will become chronic. Opioids can also cause heightened sensitivity to headache pain. When other treatments fail or are unavailable, opioids may be appropriate for treating headache if the patient can be monitored to prevent the development of a chronic headache.

Opioids are being used more frequently in the management of non-malignant chronic pain. This practice has now led to a new and growing problem with addiction and misuse of opioids. Because of various negative effects, the use of opioids for long-term management of chronic pain is not indicated unless other less risky pain relievers have been found ineffective. Chronic pain which occurs only periodically, such as that from nerve pain, migraines, and fibromyalgia, frequently is better treated with drugs other than opioids. Paracetamol and non-steroidal anti-inflammatory drugs including ibuprofen and naproxen are considered safer alternatives. They are frequently used combined with opioids, such as paracetamol combined with oxycodone (Percocet) and ibuprofen combined with hydrocodone (Vicoprofen), which boosts the pain relief but is also intended to deter recreational use.

Other Sources:

CDC Releases Guideline for Prescribing Opioids for Chronic …

www.cdc.gov/media/releases/2016/p0315-prescribing-opioids-guidelines.html
CDC Releases Guideline for Prescribing Opioids for Chronic Pain. Recommendations to improve patient care, safety, and help prevent opioid misuse and …

Overdose Prevention | Drug Overdose | CDC Injury Center

www.cdc.gov/drugoverdose/opioids/odprevention.html
The best way to prevent opioid overdose deaths is to improve opioid prescribing to reduce exposure to opioids, prevent abuse, and stop the addiction.

CDC – Prescription Opioid Abuse – CDC’s Primary Care and …

www.cdc.gov/primarycare/materials/opoidabuse/index.html
Balancing Pain Management and Prescription Opioid Abuse. Recommend on Facebook Tweet Share Compartir. Educational Module (Released October 24, 2012)

Nicotine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:23:43 GMT

Nicotine is a potent alkaloid found in several flowering plants and is a stimulant drug. This drug is addictive. In lesser doses (an average cigarette yields about 2 mg of absorbed drug), the substance acts as a stimulant in mammals, while high amounts (50–100 mg) can be harmful. This stimulant effect is a contributing factor to the addictive properties of tobacco smoking. Nicotine’s addictive nature includes psychoactive effects, drug-reinforced behavior, compulsive use, relapse after abstinence, physical dependence and tolerance.

When a cigarette is smoked, nicotine-rich blood passes from the lungs to the brain within seven seconds and immediately stimulates nicotinic acetylcholine receptors; this indirectly promotes the release of many chemical messengers such as acetylcholine, norepinephrine, epinephrine, arginine vasopressin, serotonin, dopamine, and beta-endorphin in parts of the brain.

Methcathinone

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:22:10 GMT

Methcathinone, known on the streets as “Cat,” is a structural analog of methamphetamine and cathinone. Clandestinely manufactured, “Cat” is almost exclusively sold in the stable and highly water-soluble hydrochloride salt form. It is most commonly snorted, although it can be taken orally by mixing it with a beverage or diluted in water and injected intravenously. “Cat” has an abuse potential equivalent to methamphetamine and produces amphetamine-like activity. It was placed in Schedule I of the CSA in 1993.

Methamphetamine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:20:45 GMT

Methamphetamine (also called meth, crystal, chalk, and ice, among other terms) is an extremely addictive stimulant drug that is chemically similar to amphetamine. It takes the form of a white, odorless, bitter-tasting crystalline powder.

Methamphetamine is taken orally, smoked, snorted, or dissolved in water or alcohol and injected. Smoking or injecting the drug delivers it very quickly to the brain, where it produces an immediate, intense euphoria. Because the pleasure also fades quickly, users often take repeated doses, in a “binge and crash” pattern.

Methamphetamine increases the amount of the neurotransmitter dopamine, leading to high levels of that chemical in the brain. Dopamine is involved in reward, motivation, the experience of pleasure, and motor function. Methamphetamine’s ability to release dopamine rapidly in reward regions of the brain produces the euphoric “rush” or “flash” that many users experience. Repeated methamphetamine use can easily lead to addiction—a chronic, relapsing disease characterized by compulsive drug seeking and use.

Methamphetamine can be prescribed by a doctor to treat attention deficit hyperactivity disorder and other conditions, although it is rarely used medically, and only at doses much lower than those typically abused. It is classified as a Schedule II drug, meaning it has a high potential for abuse and is available only through a prescription that cannot be refilled.

People who use methamphetamine long-term may experience anxiety, confusion, insomnia, and mood disturbances and display violent behavior. They may also show symptoms of psychosis, such as paranoia, visual and auditory hallucinations, and delusions (for example, the sensation of insects crawling under the skin).

Chronic methamphetamine use is accompanied by chemical and molecular changes in the brain. Imaging studies have shown changes in the activity of the dopamine system that are associated with reduced motor skills and impaired verbal learning. In studies of chronic methamphetamine users, severe structural and functional changes have been found in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in these individuals.

Some of these brain changes persist long after methamphetamine use is stopped, although some may reverse after being off the drug for a sustained period (e.g., more than 1 year).

Most of the methamphetamine abused in the United States is manufactured in “superlabs” here or, more often, in Mexico. But the drug is also easily made in small clandestine laboratories, with relatively inexpensive over-the-counter ingredients such as pseudoephedrine, a common ingredient in cold medicines. To curb production of methamphetamine, pharmacies and other retail stores are required by law to keep logs of purchases of products containing pseudoephedrine; individuals may only purchase a limited amount of those products on a single day.

Methamphetamine production also involves a number of other, very hazardous chemicals. Toxicity from these chemicals can remain in the environment around a methamphetamine production lab long after the lab has been shut down, causing a wide range of health problems for people living in the area. (See the Methamphetamine Labs link).

What Are the Other Health Effects of Methamphetamine?

Taking even small amounts of methamphetamine can result in many of the same physical effects as those of other stimulants, such as cocaine or amphetamines. These include increased wakefulness, increased physical activity, decreased appetite, increased respiration, rapid heart rate, irregular heartbeat, increased blood pressure, and increased body temperature.

Long-term methamphetamine use has many negative consequences for physical health, including extreme weight loss, severe dental problems (“meth mouth”), and skin sores caused by scratching.

Methamphetamine use also raises the risk of contracting infectious diseases like HIV and hepatitis B and C. These can be contracted both by sharing contaminated drug injection equipment and through unsafe sex. Regardless of how it is taken, methamphetamine alters judgment and inhibition and can lead people to engage in these and other types of risky behavior.

Methamphetamine use may also worsen the progression of HIV/AIDS and its consequences. Studies indicate that HIV causes more injury to neurons and greater cognitive impairment in individuals who are HIV-positive and use methamphetamine than it does in HIV-positive people who do not use the drug.

Meth Labs

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:18:00 GMT

October 2019
The asylum seekers interviewed at the bridge, requested anonymity, but otherwise spoke freely about current conditions in their home town. A small group from Ciudad Hidalgo, Michoacan explained that meth labs have popped up back home, drug abuse has skyrocketed and gangsters extort residents for payments of up to $2,000. Residents are fearful their children will be forced into the ranks of the drug gangs.

Meth Labs On The Increase Again

Instances of meth labs and methamphetamine trafficking and abuse in the United States are on the increase and it appears that opioid deaths are the trigger. As a result, this drug is having a devastating impact again on communities across the nation.

Clandestine production, Meth Labs, accounts for nearly all of the methamphetamine trafficked and abused in the United States. Domestic methamphetamine production, trafficking, and abuse are concentrated in the western, southwestern, and Midwestern United States. Methamphetamine is also increasingly available in portions of the South and the eastern United States, especially Georgia and Florida. Clandestine laboratories in California and Mexico are the primary sources of supply for methamphetamine available in the United States.

Meth Lab Injuries

Injuries and deaths due to accidents or explosions in illegal methamphetamine labs are on the rise in the United States, a new study shows. Many of the injured were law enforcement and other First Responders, as well as children who lived in the home.

Meth labs are being discovered in remote areas of some of our national forests. These labs are an environmental hazard, the byproducts of meth labs contaminate the ground, lakes, and streams with harmful and highly explosive chemical compounds. Abandoned meth labs are basically time bombs, waiting for the single spark that can ignite the contents of the lab or a tourist visiting the park.

One-Pot Meth Labs

Meth labs of the past (referred to as garage labs) required hundreds or thousands of cold tablets, a large quantity of fuel, other household chemicals, glassware and other products and a room large enough to set up the lab. Making meth using the “one pot” method, is accomplished by pouring all the ingredients into a plastic soda bottle, or other container. The ingredients are then mixed by shaking (shake and bake) the container and regulating the pressure created by the chemical reaction of the cold tablets and household chemicals. The quantity of meth is small, usually enough for one or two doses, with quality varying.

Mexican Meth Labs

Mexican drug trafficking organizations have become the primary manufacturers and distributors of methamphetamine to cities throughout the United States, including in Hawaii. Domestic clandestine laboratory operators also produce and distribute meth but usually on a smaller scale. The methods used depend on the availability of precursor chemicals.

Currently, this domestic clandestinely produced meth is mainly made with diverted products that contain pseudoephedrine. Mexican methamphetamine is made with different precursor chemicals.

Source: DEA

Methamphetamine is clandestinely manufactured in Meth Labs using the ephedrine or pseudoephedrine reduction method. In this process, over-the-counter cold and allergy tablets containing ephedrine or pseudoephedrine are placed in a solution of water, alcohol, or another solvent for several hours until the ephedrine or pseudoephedrine separates from the tablet. Then, using common household products and equipment listed on the following page and a recipe learned from friends or taken off the Internet, the ephedrine or pseudoephedrine is converted into high-quality Methamphetamine in makeshift, illegal labs by untrained individuals.

The state of Oregon requires a prescription to purchase certain over-the-counter medications that can be used to make methamphetamine. Other states are considering similar laws.

Household products contain most of the necessary chemicals to complete the manufacturing process. Certain brands of drain cleaner, for instance, have a high concentration of sulfuric acid. When mixed with table or rock salt, hydrogen chloride gas is produced for use in the final stage of methamphetamine production.

The hydrogen chloride gas procedure as well as other procedures are extremely dangerous and can cause death or serious injury not only to the individuals making the methamphetamine but to others who may be living in an adjoining house or apartment.

The chemicals used to make meth are toxic, and the lab operators routinely dump waste into streams, rivers, fields, and sewage systems. The chemical vapors produced during cooking permeate the walls and carpets of houses and buildings, making them uninhabitable. Cleaning up these sites requires specialized training and costs an average of $2,000-$4,000 per site in funds that come out of the already-strained budgets of state and local police.

Common Chemicals Used to Make Methamphetamine:

Alcohol (Isopropyl or rubbing alcohol)
Toluene (brake cleaner)
Ether (engine starter)
Sulfuric Acid (drain cleaner)
Red Phosphorus (matches/road flares)
Salt (table/rock)
Iodine (teat dip or flakes/crystal)
Lithium (batteries)
Trichloroethane (gun scrubber)
MSM (cutting agent)
Sodium Metal
Methanol/Alcohol (gasoline additives)
Muriatic Acid
Anhydrous Ammonia (farm fertilizer)
Sodium Hydroxide (lye)
Pseudoephedrine (cold tablets)
Ephedrine (cold tablets)
Acetone, Cat Litter

Typical Equipment Used to Make Methamphetamine:

Pyrex or Corning dishes (glass)
Jugs/bottles
Paper towels
Coffee filters
Thermometer
Cheesecloth
Funnels
Blenders
Rubber tubing/gloves
Pails/buckets
Gas Cans
Tape/clamps
Internet documents/notes
“How to Make Methamphetamine” books
Aluminum foil
Propane cylinders (20-lb)
Hotplates
Plastic storage containers/ice chests
Measuring cups
Towels/bed sheets
Laboratory beakers/glassware

Mescaline

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:09:48 GMT

Peyote is a small, spineless cactus, Lophophora williamsii, whose principal active ingredient is the hallucinogen mescaline (3, 4, 5-trimethoxyphenethylamine). From the earliest recorded time, peyote has been used by natives in northern Mexico and the southwestern United States as a part of their religious rites.

The hallucinogenic dose of 3, 4, 5-trimethoxyphenethylamine is about 0.3 to 0.5 grams and lasts about 12 hours. While peyote produced rich visual hallucinations that were important to the native peyote cults, the full spectrum of effects served as a chemically induced model of mental illness. Mescaline can be extracted from peyote or produced synthetically. Both peyote and 3, 4, 5-trimethoxyphenethylamine are listed in the CSA as Schedule I hallucinogens.

Other Sources:

San Pedro
Other mescaline-containing cacti such as the San Pedro have a long history of use in South America, from Peru to Ecuador. In traditional peyote preparations 34 KB (3,169 words) – 15:09, 27 March 2016

Psychedelic drug (category Articles needing additional references from January 2012) mushrooms” or “shrooms”), mescaline (the active constituent of peyote), and DMT (the active constituent of ayahuasca and an endogenous compound produced in the
19 KB (2,223 words) – 19:25, 19 February 2016

Cactus (category Articles containing potentially dated statements from February 2012)
Americas: peyote, Lophophora williamsii, in North America, and the San Pedro cactus, Echinopsis pachanoi, in South America. Both contain mescaline. L. williamsii 95 KB (11,577 words) – 01:21, 15 March 2016

Meridia

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:08:21 GMT

On October 8, 2010, the U.S. Food and Drug Administration (FDA) asked Abbott Laboratories to voluntarily withdraw Meridia from the U.S. market, its weight loss drug Meridia (sibutramine) because of clinical trial data indicating an increased risk of cardiovascular adverse events, including heart attack and stroke, in the studied population. Abbott has agreed to voluntarily stop the marketing of Meridia in the United States.

Source: FDA

Marijuana

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 22:07:00 GMT

March 20, 2020

the Drug Enforcement Administration and the Department of Justice announced action to further expand opportunities for scientific and medical research on marijuana in the United States.

The Notice of Proposed Rulemaking provides details on the proposed process and was filed for public inspection today, March 20. The proposed rule will be published in the Federal Register on Monday, March 23. The new approach will expand opportunities for marijuana growers who seek to grow marijuana for research purposes and outline the agency’s proposed process for administering the new program, consistent with applicable law.

“The Drug Enforcement Administration continues to support additional research into marijuana and its components, and we believe registering more growers will advance the scientific and medical research already being conducted,” said DEA Acting Administrator Dhillon. “DEA is making progress to register additional marijuana growers for federally authorized research, and will continue to work with other relevant federal agencies to expedite the necessary next steps.”

This proposed rule will result in additional registered growers and a larger, more diverse variety of marijuana available for research. The new regulations will enable DEA to evaluate each of the 37 pending applications to grow marijuana for research under the applicable legal standard and conform the overall program to relevant laws.

The release of this Notice of Proposed Rulemaking is the latest and most significant action taken to expand the number of registered marijuana growers in the United States and underscores the federal government’s support for scientific and medical research with marijuana and its chemical constituents.

Since the beginning of this Administration, there has been a 58 percent increase in the number of active researchers registered with DEA to conduct research with marijuana, marijuana extracts, and marijuana derivatives – from 377 in January 2017 to 595 in March 2020. At present, more researchers are registered to conduct research on marijuana, marijuana extracts, and marijuana derivatives than on any other schedule I substance in the United States. More than 70 percent of DEA’s total schedule I research registrant population is registered to conduct research on these substances. To accommodate this growth in research, DEA has increased the annual production quota for marijuana by 575 percent – from 472 kilograms in 2017 to 3,200 kilograms in 2020.

To ensure transparency and public participation, this process will provide applicants and the general public with an opportunity to comment on the regulations that will govern the program of growing marijuana for research.

______________________________________________________

Changes in marijuana policies across states legalizing marijuana for medical and/or recreational use suggest that marijuana is gaining greater acceptance in our society. Thus, it is particularly important for people to understand what is known about both the adverse health effects and the potential therapeutic benefits linked to marijuana.

Because marijuana impairs short-term memory and judgment and distorts perception, it can impair performance in school or at work and make it dangerous to drive. It also affects brain systems that are still maturing through young adulthood, so regular use by teens may have negative and long-lasting effects on their cognitive development, putting them at a competitive disadvantage and possibly interfering with their well-being in other ways. Also, contrary to popular belief, marijuana can be addictive, and its use during adolescence may make other forms of problem use or addiction more likely.

Whether smoking or otherwise consuming marijuana has therapeutic benefits that outweigh its health risks is still an open question that science has not resolved. Although many states now permit dispensing marijuana for medicinal purposes and there is mounting anecdotal evidence for the efficacy of marijuana-derived compounds, the U.S. Food and Drug Administration has not approved “medical marijuana.” However, safe medicines based on cannabinoid chemicals derived from the marijuana plant have been available for decades and more are being developed.

Marijuana—also called weed, herb, pot, grass, bud, ganja, Mary Jane, and a vast number of other slang terms—is a greenish-gray mixture of the dried flowers of Cannabis sativa. Some people smoke marijuana in hand-rolled cigarettes called joints; in pipes, water pipes (sometimes called bongs), or in blunts (marijuana rolled in cigar wraps).1 Marijuana can also be used to brew tea and, particularly when it is sold or consumed for medicinal purposes, is frequently mixed into foods (edibles) such as brownies, cookies, or candies. Vaporizers are also increasingly used to consume marijuana. Stronger forms of marijuana include sinsemilla (from specially tended female plants) and concentrated resins containing high doses of marijuana’s active ingredients, including honey like hash oil, waxy budder, and hard amberlike shatter. These resins are increasingly popular among those who use them both recreationally and medically.

The main psychoactive (mind-altering) chemical in marijuana, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol (THC). The chemical is found in resin produced by the leaves and buds primarily of the female cannabis plant. The plant also contains more than 500 other chemicals, including more than 100 compounds that are chemically related to THC, called cannabinoids. Higher THC levels may mean a greater risk for addiction if users are regularly exposing themselves to high doses.

Marijuana is the most commonly used illicit drug (22.2 million people have used it in the past month) according to the 2015 National Survey on Drug Use and Health.3 Its use is more prevalent among men than women—a gender gap that widened in the years 2007 to 2014.

Marijuana use is widespread among adolescents and young adults. According to the Monitoring the Future survey—an annual survey of drug use and attitudes among the Nation’s middle and high school students—most measures of marijuana use by 8th, 10th, and 12th graders peaked in the mid-to-late 1990s and then began a period of gradual decline through the mid-2000s before levelling off. Most measures showed some decline again in the past 5 years. Teens’ perceptions of the risks of marijuana use have steadily declined over the past decade, possibly related to increasing public debate about legalizing or loosening restrictions on marijuana for medicinal and recreational use. In 2016, 9.4 percent of 8th graders reported marijuana use in the past year and 5.4 percent in the past month (current use). Among 10th graders, 23.9 percent had used marijuana in the past year and 14.0 percent in the past month. Rates of use among 12th graders were higher still: 35.6 percent had used marijuana during the year prior to the survey and 22.5 percent used in the past month; 6.0 percent said they used marijuana daily or near-daily.

Medical emergencies possibly related to marijuana use have also increased. The Drug Abuse Warning Network (DAWN), a system for monitoring the health impact of drugs, estimated that in 2011, there were nearly 456,000 drug-related emergency department visits in the United States in which marijuana use was mentioned in the medical record (a 21 percent increase over 2009). About two-thirds of patients were male and 13 percent were between the ages of 12 and 17.6 It is unknown whether this increase is due to increased use, increased potency of marijuana (amount of THC it contains), or other factors. It should be noted, however, that mentions of marijuana in medical records do not necessarily indicate that these emergencies were directly related to marijuana intoxication.

When marijuana is smoked, THC and other chemicals in the plant pass from the lungs into the bloodstream, which rapidly carries them throughout the body to the brain. The person begins to experience effects almost immediately (see “How does marijuana produce its effects?”). Many people experience a pleasant euphoria and sense of relaxation. Other common effects, which may vary dramatically among different people, include heightened sensory perception (e.g., brighter colors), laughter, altered perception of time, and increased appetite.

If marijuana is consumed in foods or beverages, these effects are somewhat delayed—usually appearing after 30 minutes to 1 hour—because the drug must first pass through the digestive system. Eating or drinking marijuana delivers significantly less THC into the bloodstream than smoking an equivalent amount of the plant. Because of the delayed effects, people may inadvertently consume more THC than they intend to.

Pleasant experiences with marijuana are by no means universal. Instead of relaxation and euphoria, some people experience anxiety, fear, distrust, or panic. These effects are more common when a person takes too much, the marijuana has an unexpectedly high potency, or the person is inexperienced. People who have taken large doses of marijuana may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity. These unpleasant but temporary reactions are distinct from longer-lasting psychotic disorders, such as schizophrenia, that may be associated with the use of marijuana in vulnerable individuals. (See “Is there a link between marijuana use and psychiatric disorders?”)

Although detectable amounts of THC may remain in the body for days or even weeks after use, the noticeable effects of smoked marijuana generally last from 1 to 3 hours, and those of marijuana consumed in food or drink may last for many hours.

Endogenous cannabinoids such as anandamide (see figure) function as neurotransmitters because they send chemical messages between nerve cells (neurons) throughout the nervous system. They affect brain areas that influence pleasure, memory, thinking, concentration, movement, coordination, and sensory and time perception. Because of this similarity, THC is able to attach to molecules called cannabinoid receptors on neurons in these brain areas and activate them, disrupting various mental and physical functions and causing the effects described earlier. The neural communication network that uses these cannabinoid neurotransmitters, known as the endocannabinoid system, plays a critical role in the nervous system’s normal functioning, so interfering with it can have profound effects.

For example, THC is able to alter the functioning of the hippocampus (see “Marijuana, Memory, and the Hippocampus”) and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely (see “Does marijuana use affect driving?”) and may have problems playing sports or engaging in other physical activities.

People who have taken large doses of the drug may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity. THC, acting through cannabinoid receptors, also activates the brain’s reward system, which includes regions that govern the response to healthy pleasurable behaviors such as sex and eating. Like most other drugs that people misuse, THC stimulates neurons in the reward system to release the signaling chemical dopamine at levels higher than typically observed in response to natural stimuli. This flood of dopamine contributes to the pleasurable “high” that those use who recreational marijuana seek.

Marijuana significantly impairs judgment, motor coordination, and reaction time, and studies have found a direct relationship between blood THC concentration and impaired driving ability.

Marijuana is the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes, including fatal ones. Two large European studies found that drivers with THC in their blood were roughly twice as likely to be culpable for a fatal crash than drivers who had not used drugs or alcohol. However, the role played by marijuana in crashes is often unclear because it can be detected in body fluids for days or even weeks after intoxication and because people frequently combine it with alcohol. Those involved in vehicle crashes with THC in their blood, particularly higher levels, are three to seven times more likely to be responsible for the incident than drivers who had not used drugs or alcohol. The risk associated with marijuana in combination with alcohol appears to be greater than that for either drug by itself.

Several meta-analyses of multiple studies found that the risk of being involved in a crash significantly increased after marijuana use in a few cases, the risk doubled or more than doubled. However, a large case-control study conducted by the National Highway Traffic Safety Administration found no significant increased crash risk attributable to cannabis after controlling for drivers’ age, gender, race, and presence of alcohol.

Marijuana use can lead to the development of problem use, known as a marijuana use disorder, which takes the form of addiction in severe cases. Recent data suggest that 30 percent of those who use marijuana may have some degree of marijuana use disorder.18 People who begin using marijuana before the age of 18 are four to seven times more likely to develop a marijuana use disorder than adults.

Marijuana use disorders are often associated with dependence—in which a person feels withdrawal symptoms when not taking the drug. People who use marijuana frequently often report irritability, mood and sleep difficulties, decreased appetite, cravings, restlessness, and/or various forms of physical discomfort that peak within the first week after quitting and last up to 2 weeks. Marijuana dependence occurs when the brain adapts to large amounts of the drug by reducing production of and sensitivity to its own endocannabinoid neurotransmitters.

Marijuana use disorder becomes addiction when the person cannot stop using the drug even though it interferes with many aspects of his or her life. Estimates of the number of people addicted to marijuana are controversial, in part because epidemiological studies of substance use often use dependence as a proxy for addiction even though it is possible to be dependent without being addicted. Those studies suggest that 9 percent of people who use marijuana will become dependent on it, rising to about 17 percent in those who start using in their teens.

In 2015, about 4.0 million people in the United States met the diagnostic criteria for a marijuana use disorder;3 138,000 voluntarily sought treatment for their marijuana use.

Rising Potency

Marijuana potency, as detected in confiscated samples, has steadily increased over the past few decades.2 In the early 1990s, the average THC content in confiscated marijuana samples was roughly 3.8 percent. In 2014, it was 12.2 percent. The average marijuana extract contains more than 50 percent THC, with some samples exceeding 80 percent. These trends raise concerns that the consequences of marijuana use could be worse than in the past, particularly among those who are new to marijuana use or in young people, whose brains are still developing (see “What are marijuana’s long-term effects on the brain?”).

Researchers do not yet know the full extent of the consequences when the body and brain (especially the developing brain) are exposed to high concentrations of THC or whether the recent increases in emergency department visits by people testing positive for marijuana are related to rising potency. The extent to which people adjust for increased potency by using less or by smoking it differently is also unknown. Recent studies suggest that experienced people may adjust the amount they smoke and how much they inhale based on the believed strength of the marijuana they are using, but they are not able to fully compensate for variations in potency.

Substantial evidence from animal research and a growing number of studies in humans indicate that marijuana exposure during development can cause long-term or possibly permanent adverse changes in the brain. Rats exposed to THC before birth, soon after birth, or during adolescence show notable problems with specific learning and memory tasks later in life.32–34 Cognitive impairments in adult rats exposed to THC during adolescence are associated with structural and functional changes in the hippocampus.35–37 Studies in rats also show that adolescent exposure to THC is associated with an altered reward system, increasing the likelihood that an animal will self-administer other drugs (e.g., heroin) when given an opportunity (see “Is marijuana a gateway drug?”).

Imaging studies of marijuana’s impact on brain structure in humans have shown conflicting results. Some studies suggest regular marijuana use in adolescence is associated with altered connectivity and reduced volume of specific brain regions involved in a broad range of executive functions such as memory, learning, and impulse control compared to people who do not use.38,39 Other studies have not found significant structural differences between the brains of people who do and do not use the drug.

Several studies, including two large longitudinal studies, suggest that marijuana use can cause functional impairment in cognitive abilities but that the degree and/or duration of the impairment depends on the age when a person began using and how much and how long he or she used.

Among nearly 4,000 young adults in the Coronary Artery Risk Development in Young Adults study tracked over a 25-year period until mid-adulthood, cumulative lifetime exposure to marijuana was associated with lower scores on a test of verbal memory but did not affect other cognitive abilities such as processing speed or executive function. The effect was sizeable and significant even after eliminating those involved with current use and after adjusting for confounding factors such as demographic factors, other drug and alcohol use, and other psychiatric conditions such as depression.

A large longitudinal study in New Zealand found that persistent marijuana use disorder with frequent use starting in adolescence was associated with a loss of an average of 6 or up to 8 IQ points measured in mid-adulthood.43 Significantly, in that study, those who used marijuana heavily as teenagers and quit using as adults did not recover the lost IQ points. People who only began using marijuana heavily in adulthood did not lose IQ points. These results suggest that marijuana has its strongest long-term impact on young people whose brains are still busy building new connections and maturing in other ways. The endocannabinoid system is known to play an important role in the proper formation of synapses (the connections between neurons) during early brain development, and a similar role has been proposed for the refinement of neural connections during adolescence. If the long-term effects of marijuana use on cognitive functioning or IQ are upheld by future research, this may be one avenue by which marijuana use during adolescence produces its long-term effects.

However, recent results from two prospective longitudinal twin studies did not support a causal relationship between marijuana use and IQ loss. Those who used marijuana did show a significant decline in verbal ability (equivalent to 4 IQ points) and in general knowledge between the preteen years (ages 9 to 12, before use) and late adolescence/early adulthood (ages 17 to 20). However, at the start of the study, those who would use in the future already had lower scores on these measures than those who would not use in the future, and no predictable difference was found between twins when one used marijuana and one did not. This suggests that observed IQ declines, at least across adolescence, may be caused by shared familial factors (e.g., genetics, family environment), not by marijuana use itself.45 It should be noted, though, that these studies were shorter in duration than the New Zealand study and did not explore the impact of the dose of marijuana (i.e., heavy use) or the development of a cannabis use disorder; this may have masked a dose- or diagnosis-dependent effect.

The ability to draw definitive conclusions about marijuana’s long-term impact on the human brain from past studies is often limited by the fact that study participants use multiple substances, and there is often limited data about the participants’ health or mental functioning prior to the study. Over the next decade, the National Institutes of Health is funding the Adolescent Brain Cognitive Development (ABCD) study—a major longitudinal study that will track a large sample of young Americans from late childhood (before first use of drugs) to early adulthood. The study will use neuroimaging and other advanced tools to clarify precisely how and to what extent marijuana and other substances, alone and in combination, affect adolescent brain development.

Memory impairment from marijuana use occurs because THC alters how the hippocampus, a brain area responsible for memory formation, processes information. Most of the evidence supporting this assertion comes from animal studies. For example, rats exposed to THC in utero, soon after birth, or during adolescence, show notable problems with specific learning/memory tasks later in life. Moreover, cognitive impairment in adult rats is associated with structural and functional changes in the hippocampus from THC exposure during adolescence.

As people age, they lose neurons in the hippocampus, which decreases their ability to learn new information. Chronic THC exposure may hasten age-related loss of hippocampal neurons. In one study, rats exposed to THC every day for 8 months (approximately 30 percent of their lifespan) showed a level of nerve cell loss at 11 to 12 months of age that equaled that of unexposed animals twice their age.

Some research suggests that marijuana use is likely to precede use of other licit and illicit substances and the development of addiction to other substances. For instance, a study using longitudinal data from the National Epidemiological Study of Alcohol Use and Related Disorders found that adults who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an alcohol use disorder within 3 years; people who used marijuana and already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening. Marijuana use is also linked to other substance use disorders including nicotine addiction.

Early exposure to cannabinoids in adolescent rodents decreases the reactivity of brain dopamine reward centers later in adulthood. To the extent that these findings generalize to humans, this could help explain the increased vulnerability for addiction to other substances of misuse later in life that most epidemiological studies have reported for people who begin marijuana use early in life.It is also consistent with animal experiments showing THC’s ability to “prime” the brain for enhanced responses to other drugs. For example, rats previously administered THC show heightened behavioral response not only when further exposed to THC but also when exposed to other drugs such as morphine—a phenomenon called cross-sensitization.

These findings are consistent with the idea of marijuana as a “gateway drug.” However, the majority of people who use marijuana do not go on to use other, “harder” substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs and are, like marijuana, also typically used before a person progresses to other, more harmful substances.

It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.

Research has shown that marijuana’s negative effects on attention, memory, and learning can last for days or weeks after the acute effects of the drug wear off, depending on the person’s history with the drug. Consequently, someone who smokes marijuana daily may be functioning at a reduced intellectual level most or all of the time. Considerable evidence suggests that students who smoke marijuana have poorer educational outcomes than their nonsmoking peers. For example, a review of 48 relevant studies found marijuana use to be associated with reduced educational attainment (i.e., reduced chances of graduating). A recent analysis using data from three large studies in Australia and New Zealand found that adolescents who used marijuana regularly were significantly less likely than their non-using peers to finish high school or obtain a degree. They also had a much higher chance of developing dependence, using other drugs, and attempting suicide. Several studies have also linked heavy marijuana use to lower income, greater welfare dependence, unemployment, criminal behavior, and lower life satisfaction.

To what degree marijuana use is directly causal in these associations remains an open question requiring further research. It is possible that other factors independently predispose people to both marijuana use and various negative life outcomes such as school dropout.58 That said, people report a perceived influence of their marijuana use on poor outcomes on a variety of life satisfaction and achievement measures. One study, for example, compared people involved with current and former long-term, heavy use of marijuana with a control group who reported smoking marijuana at least once in their lives but not more than 50 times. All participants had similar education and income backgrounds, but significant differences were found in their educational attainment: Fewer of those who engaged in heavy cannabis use completed college, and more had yearly household incomes of less than $30,000. When asked how marijuana affected their cognitive abilities, career achievements, social lives, and physical and mental health, the majority of those who used heavily reported that marijuana had negative effects in all these areas of their lives.

Studies have also suggested specific links between marijuana use and adverse consequences in the workplace, such as increased risk for injury or accidents. One study among postal workers found that employees who tested positive for marijuana on a pre-employment urine drug test had 55 percent more industrial accidents, 85 percent more injuries, and 75 percent greater absenteeism compared with those who tested negative for marijuana use.

Several studies have linked marijuana use to increased risk for psychiatric disorders, including psychosis (schizophrenia), depression, anxiety, and substance use disorders, but whether and to what extent it actually causes these conditions is not always easy to determine. The amount of drug used, the age at first use, and genetic vulnerability have all been shown to influence this relationship. The strongest evidence to date concerns links between marijuana use and substance use disorders and between marijuana use and psychiatric disorders in those with a preexisting genetic or other vulnerability.

Research using longitudinal data from the National Epidemiological Survey on Alcohol and Related Conditions examined associations between marijuana use, mood and anxiety disorders, and substance use disorders. After adjusting for various confounding factors, no association between marijuana use and mood and anxiety disorders was found. The only significant associations were increased risk of alcohol use disorders, nicotine dependence, marijuana use disorder, and other drug use disorders.

Recent research (see “AKT1 Gene Variations and Psychosis”) has found that people who use marijuana and carry a specific variant of the AKT1 gene, which codes for an enzyme that affects dopamine signaling in the striatum, are at increased risk of developing psychosis. The striatum is an area of the brain that becomes activated and flooded with dopamine when certain stimuli are present. One study found that the risk of psychosis among those with this variant was seven times higher for those who used marijuana daily compared with those who used it infrequently or used none at all.

Bar graph comparing AKT1 gene variants and their carriers’ risk for psychosis. Whether adolescent marijuana use can contribute to developing psychosis later in adulthood appears to depend on whether a person already has a genetically based vulnerability to the disorder. The AKT1 gene governs an enzyme that affects brain signaling involving the neurotransmitter dopamine. Altered dopamine signaling is known to be involved in schizophrenia. AKT1 can take one of three forms in a specific region of the gene implicated in susceptibility to schizophrenia: T/T, C/T, and C/C. Those who use marijuana daily (green bars) with the C/C variant have a seven times higher risk of developing psychosis than those who use it infrequently or use none at all. The risk for psychosis among those with the T/T variant was unaffected by whether they used marijuana.

Source: Di Forti et al. Biol Psychiatry. 2012.

Another study found an increased risk of psychosis among adults who had used marijuana in adolescence and also carried a specific variant of the gene for catechol-O-methyltransferase (COMT), an enzyme that degrades neurotransmitters such as dopamine and norepinephrine (see “Genetic Variations in COMT Influences the Harmful Effects of Abused Drugs”). Marijuana use has also been shown to worsen the course of illness in patients who already have schizophrenia. As mentioned previously, marijuana can produce an acute psychotic reaction in non-schizophrenic people who use marijuana, especially at high doses, although this fades as the drug wears off.

Bar graph showing how the influence of adolescent marijuana use on adult psychosis is affected by COMT genetic variation. The influence of adolescent marijuana use on adult psychosis is affected by genetic variables. This figure shows that variations in a gene can affect the likelihood of developing psychosis in adulthood following exposure to cannabis in adolescence. The COMT gene governs an enzyme that breaks down dopamine, a brain chemical involved in schizophrenia. It comes in two forms: “Met” and “Val.” Individuals with one or two copies of the Val variant have a higher risk of developing schizophrenic-type disorders if they used cannabis during adolescence (dark bars). Those with only the Met variant were unaffected by cannabis use.

Source: Caspi et al. Biol Psychiatry. 2005.

Inconsistent and modest associations have been reported between marijuana use and suicidal thoughts and attempted suicide among teens. Marijuana has also been associated with an amotivational syndrome, defined as a diminished or absent drive to engage in typically rewarding activities. Because of the role of the endocannabinoid system in regulating mood and reward, it has been hypothesized that brain changes resulting from early use of marijuana may underlie these associations, but more research is needed to verify that such links exist and better understand them.

Adverse Consequences of Marijuana Use
Acute (present during intoxication)
Impaired short-term memory
Impaired attention, judgment, and other cognitive functions
Impaired coordination and balance
Increased heart rate
Anxiety, paranoia
Psychosis (uncommon)
Persistent (lasting longer than intoxication, but may not be permanent)
Impaired learning and coordination
Sleep problems
Long-term (cumulative effects of repeated use)
Potential for marijuana addiction
Impairments in learning and memory with potential loss of IQ*
Increased risk of chronic cough, bronchitis
Increased risk of other drug and alcohol use disorders
Increased risk of schizophrenia in people with genetic vulnerability**

*Loss of IQ among individuals with persistent marijuana use disorder who began using heavily during adolescence

**These are often reported co-occurring symptoms/disorders with chronic marijuana use. However, research has not yet determined whether marijuana is causal or just associated with these mental problems.
Like tobacco smoke, marijuana smoke is an irritant to the throat and lungs and can cause a heavy cough during use. It also contains levels of volatile chemicals and tar that are similar to tobacco smoke, raising concerns about risk for cancer and lung disease.
Marijuana smoking is associated with large airway inflammation, increased airway resistance, and lung hyperinflation, and those who smoke marijuana regularly report more symptoms of chronic bronchitis than those who do not smoke. One study found that people who frequently smoke marijuana had more outpatient medical visits for respiratory problems than those who do not smoke. Some case studies have suggested that, because of THC’s immune-suppressing effects, smoking marijuana might increase susceptibility to lung infections, such as pneumonia, in people with immune deficiencies; however, a large AIDS cohort study did not confirm such an association.68 Smoking marijuana may also reduce the respiratory system’s immune response, increasing the likelihood of the person acquiring respiratory infections, including pneumonia. Animal and human studies have not found that marijuana increases risk for emphysema.
Whether smoking marijuana causes lung cancer, as cigarette smoking does, remains an open question. Marijuana smoke contains carcinogenic combustion products, including about 50 percent more benzoprene and 75 percent more benzanthracene (and more phenols, vinyl chlorides, nitrosamines, reactive oxygen species) than cigarette smoke. Because of how it is typically smoked (deeper inhale, held for longer), marijuana smoking leads to four times the deposition of tar compared to cigarette smoking. However, while a few small, uncontrolled studies have suggested that heavy, regular marijuana smoking could increase risk for respiratory cancers, well-designed population studies have failed to find an increased risk of lung cancer associated with marijuana use.
One complexity in comparing the lung-health risks of marijuana and tobacco concerns the very different ways the two substances are used. While people who smoke marijuana often inhale more deeply and hold the smoke in their lungs for a longer duration than is typical with cigarettes, marijuana’s effects last longer, so people who use marijuana may smoke less frequently than those who smoke cigarettes.
Additionally, the fact that many people use both marijuana and tobacco makes determining marijuana’s precise contribution to lung cancer risk, if any, difficult to establish. Cell culture and animal studies have also suggested THC and CBD may have antitumor effects, and this has been proposed as one reason why stronger expected associations are not seen between marijuana use and lung cancer, but more research is needed on this question.
Within a few minutes after inhaling marijuana smoke, a person’s heart rate speeds up, the breathing passages relax and become enlarged, and blood vessels in the eyes expand, making the eyes look bloodshot. The heart rate—normally 70 to 80 beats per minute—may increase by 20 to 50 beats per minute or may even double in some cases. Taking other drugs with marijuana can amplify this effect.
Limited evidence suggests that a person’s risk of heart attack during the first hour after smoking marijuana is nearly five times his or her usual risk. This observation could be partly explained by marijuana raising blood pressure (in some cases) and heart rate and reducing the blood’s capacity to carry oxygen. Marijuana may also cause orthostatic hypotension (head rush or dizziness on standing up), possibly raising danger from fainting and falls. Tolerance to some cardiovascular effects often develops with repeated exposure.75 These health effects need to be examined more closely, particularly given the increasing use of “medical marijuana” by people with health issues and older adults who may have increased baseline vulnerability due to age-related cardiovascular risk factors (see “Is marijuana safe and effective as medicine?”).
A few studies have shown a clear link between marijuana use in adolescence and increased risk for an aggressive form of testicular cancer (nonseminomatous testicular germ cell tumor) that predominantly strikes young adult males. The early onset of testicular cancers compared to lung and most other cancers indicates that, whatever the nature of marijuana’s contribution, it may accumulate over just a few years of use.
Studies have shown that in rare cases, chronic use of marijuana can lead to Cannabinoid Hyperemesis Syndrome—a condition marked by recurrent bouts of severe nausea, vomiting, and dehydration. This syndrome has been found to occur in persons under 50 years of age and with a long history of marijuana use. Cannabinoid Hyperemesis Syndrome can lead sufferers to make frequent trips to the emergency room, but may be resolved when a person stops using marijuana.
The potential medicinal properties of marijuana and its components have been the subject of research and heated debate for decades. THC itself has proven medical benefits in particular formulations. The U.S. Food and Drug Administration (FDA) has approved THC-based medications, dronabinol (Marinol®) and nabilone (Cesamet®), prescribed in pill form for the treatment of nausea in patients undergoing cancer chemotherapy and to stimulate appetite in patients with wasting syndrome due to AIDS. The FDA also approved a CBD-based liquid medication called Epidiolex® for the treatment of two forms of severe childhood epilepsy, Dravet syndrome and Lennox-Gastaut syndrome. It’s being delivered to patients in a reliable dosage form and through a reproducible route of delivery to ensure that patients derive the anticipated benefits. CBD does not have the rewarding properties of THC.
In addition, several other marijuana-based medications have been approved or are undergoing clinical trials. Nabiximols (Sativex®), a mouth spray that is currently available in the United Kingdom, Canada, and several European countries for treating the spasticity and neuropathic pain that may accompany multiple sclerosis, combines THC with another chemical found in marijuana called cannabidiol (CBD).
Researchers generally consider medications like these, which use purified chemicals derived from or based on those in the marijuana plant, to be more promising therapeutically than use of the whole marijuana plant or its crude extracts. Development of drugs from botanicals such as the marijuana plant poses numerous challenges. Botanicals may contain hundreds of unknown, active chemicals, and it can be difficult to develop a product with accurate and consistent doses of these chemicals. Use of marijuana as medicine also poses other problems such as the adverse health effects of smoking and THC-induced cognitive impairment. Nevertheless, a growing number of states have legalized dispensing of marijuana or its extracts to people with a range of medical conditions.
An additional concern with “medical marijuana” is that little is known about the long-term impact of its use by people with health- and/or age-related vulnerabilities—such as older adults or people with cancer, AIDS, cardiovascular disease, multiple sclerosis, or other neurodegenerative diseases. Further research will be needed to determine whether people whose health has been compromised by disease or its treatment (e.g., chemotherapy) are at greater risk for adverse health outcomes from marijuana use.
Medical Marijuana Legalization and Prescription Opioid Use Outcomes
Two recent studies in JAMA Internal Medicine report an association between not only medical marijuana laws (MML) but also protected access to dispensaries and their association with opioid prescription patterns based on Medicaid or Medicare Part D prescription data. The first study found that Medicare Part D prescriptions filled for all opioids decreased in states with MML by 2 million daily doses per year per state. In states with medical cannabis dispensaries, prescriptions decreased by 3.742 million daily doses per year per state.79 Similarly, the second study examined Medicaid prescription data and found that MMLs and adult-use marijuana laws were associated with lower opioid prescribing rates (5.88% and 6.38% lower, respectively).
Additionally, NIDA funded two studies that explored the relationship between marijuana legalization and adverse outcomes associated with prescription opioids. The first study found an association between medical marijuana legalization and a reduction in overdose deaths from opioid pain relievers; an effect that strengthened in each year following the implementation of legislation. The second NIDA-funded study was a more detailed analysis by the RAND Corporation that showed legally protected access to medical marijuana dispensaries is associated with lower levels of opioid prescribing, lower self-report of nonmedical prescription opioid use, lower treatment admissions for prescription opioid use disorders, and reduction in prescription opioid overdose deaths. Notably, the reduction in deaths was present only in states with dispensaries (not just medical marijuana laws) and was greater in states with active dispensaries. It should be noted that the population-based nature of these studies, and the two above, do not establish a causal relationship or give evidence for changes in individual pain patient behavior and caution should be used when interpreting their results.
To date, research into the effects of cannabis on opioid use in pain patients is mixed. Some data suggest that medical cannabis treatment may reduce the dose of opioids required for pain relief, while another NIH-funded study found that cannabis use appears to increase the risk of developing nonmedical prescription opioid use and opioid use disorder. Though no single study is definitive, they cumulatively suggest that medical marijuana products may play a role in reducing the use of opioids needed to control pain but that these products don’t come without risk. More research is needed to investigate the potential therapeutic role of marijuana including its role as a treatment option for opioid use disorder and its ability to reduce specific types of pain.
People often ask about the possible psychoactive effect of exposure to secondhand marijuana smoke and whether a person who has inhaled secondhand marijuana smoke could fail a drug test. Researchers measured the amount of THC in the blood of people who do not smoke marijuana and had spent 3 hours in a well-ventilated space with people casually smoking marijuana; THC was present in the blood of the nonsmoking participants, but the amount was well below the level needed to fail a drug test. Another study that varied the levels of ventilation and the potency of the marijuana found that some nonsmoking participants exposed for an hour to high-THC marijuana (11.3 percent THC concentration) in an unventilated room showed positive urine assays in the hours directly following exposure; a follow-up study showed that nonsmoking people in a confined space with people smoking high-THC marijuana reported mild subjective effects of the drug—a “contact high”—and displayed mild impairments on performance in motor tasks.
The known health risks of secondhand exposure to cigarette smoke—to the heart or lungs, for instance—raise questions about whether secondhand exposure to marijuana smoke poses similar health risks. At this point, very little research on this question has been conducted. A 2016 study in rats found that secondhand exposure to marijuana smoke affected a measure of blood vessel function as much as secondhand tobacco smoke, and the effects lasted longer. One minute of exposure to secondhand marijuana smoke impaired flow-mediated dilation (the extent to which arteries enlarge in response to increased blood flow) of the femoral artery that lasted for at least 90 minutes; impairment from 1 minute of secondhand tobacco exposure was recovered within 30 minutes. The effects of marijuana smoke were independent of THC concentration; i.e., when THC was removed, the impairment was still present. This research has not yet been conducted with human subjects, but the toxins and tar levels known to be present in marijuana smoke (see “What are marijuana’s effects on lung health?”) raise concerns about exposure among vulnerable populations, such as children and people with asthma.
More research is needed on how marijuana use during pregnancy could impact the health and development of infants, given changing policies about access to marijuana, as well as significant increases over the last decade in the number of pregnant women seeking substance use disorder treatment for marijuana use.89 One study found that about 20% of pregnant women 24-years-old and younger screened positive for marijuana. However, this study also found that women were about twice as likely to screen positive for marijuana use via a drug test than they state in self-reported measures. This suggests that self-reported rates of marijuana use in pregnant females may not be an accurate measure of marijuana use.90 Additionally, in one study of dispensaries, nonmedical personnel at marijuana dispensaries were recommending marijuana to pregnant women for nausea, but medical experts warn against it.
There is no human research connecting marijuana use to the chance of miscarriage, although animal studies indicate that the risk for miscarriage increases if marijuana is used early in pregnancy. Some associations have been found between marijuana use during pregnancy and future developmental and hyperactivity disorders in children. Evidence is mixed as to whether marijuana use by pregnant women is associated with low birth weight or premature birth, although long-term use may elevate these risks. Research has shown that pregnant women who use marijuana have a 2.3 times greater risk of stillbirth. Given the potential of marijuana to negatively impact the developing brain, the American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists counsel women against using marijuana while trying to get pregnant, during pregnancy, and while they are breastfeeding.
Some women report using marijuana to treat severe nausea associated with their pregnancy; however, there is no research confirming that this is a safe practice, and it is generally not recommended. Women considering using medical marijuana while pregnant should not do so without checking with their health care providers. Animal studies have shown that moderate concentrations of THC, when administered to mothers while pregnant or nursing, could have long-lasting effects on the child, including increasing stress responsivity and abnormal patterns of social interactions. Animal studies also show learning deficits in prenatally exposed individuals.
Human research has shown that some babies born to women who used marijuana during their pregnancies display altered responses to visual stimuli, increased trembling, and a high-pitched cry, which could indicate problems with neurological development. In school, marijuana-exposed children are more likely to show gaps in problem-solving skills, memory, and the ability to remain attentive. More research is needed, however, to disentangle marijuana-specific effects from those of other environmental factors that could be associated with a mother’s marijuana use, such as an impoverished home environment or the mother’s use of other drugs. Prenatal marijuana exposure is also associated with an increased likelihood of a person using marijuana as a young adult, even when other factors that influence drug use are considered. More information on marijuana use during pregnancy can be found in the NIDA’s Substance Use in Women Research Report.
Very little is known about marijuana use and breastfeeding. One study suggests that moderate amounts of THC find their way into breast milk when a nursing mother uses marijuana. Some evidence shows that exposure to THC through breast milk in the first month of life could result in decreased motor development at 1 year of age. There have been no studies to determine if exposure to THC during nursing is linked to effects later in the child’s life. With regular use, THC can accumulate in human breast milk to high concentrations.98 Because a baby’s brain is still forming, THC consumed in breast milk could affect brain development. Given all these uncertainties, nursing mothers are discouraged from using marijuana. New mothers using medical marijuana should be vigilant about coordinating care between the doctor recommending their marijuana use and the pediatrician caring for their baby.
Marijuana use disorders appear to be very similar to other substance use disorders, although the long-term clinical outcomes may be less severe. On average, adults seeking treatment for marijuana use disorders have used marijuana nearly every day for more than 10 years and have attempted to quit more than six times. People with marijuana use disorders, especially adolescents, often also suffer from other psychiatric disorders (comorbidity). They may also use or be addicted to other substances, such as cocaine or alcohol. Available studies indicate that effectively treating the mental health disorder with standard treatments involving medications and behavioral therapies may help reduce marijuana use, particularly among those involved with heavy use and those with more chronic mental disorders. The following behavioral treatments have shown promise:
Cognitive-behavioral therapy: A form of psychotherapy that teaches people strategies to identify and correct problematic behaviors in order to enhance self-control, stop drug use, and address a range of other problems that often co-occur with them. Contingency management: A therapeutic management approach based on frequent monitoring of the target behavior and the provision (or removal) of tangible, positive rewards when the target behavior occurs (or does not).
Motivational enhancement therapy: A systematic form of intervention designed to produce rapid, internally motivated change; the therapy does not attempt to treat the person, but rather mobilize his or her own internal resources for change and engagement in treatment. Currently, the FDA has not approved any medications for the treatment of marijuana use disorder, but research is active in this area. Because sleep problems feature prominently in marijuana withdrawal, some studies are examining the effectiveness of medications that aid in sleep. Medications that have shown promise in early studies or small clinical trials include the sleep aid zolpidem (Ambien®), an anti-anxiety/anti-stress medication called buspirone (BuSpar®), and an anti-epileptic drug called gabapentin (Horizant®, Neurontin®) that may improve sleep and, possibly, executive function. Other agents being studied include the nutritional supplement N-acetylcysteine and chemicals called FAAH inhibitors, which may reduce withdrawal by inhibiting the breakdown of the body’s own cannabinoids. Future directions include the study of substances called allosteric modulators that interact with cannabinoid receptors to inhibit THC’s rewarding effects.

Source: NIDA; NIH; U.S. Department HHS

Luvox

Courtney@simple.biz (Courtney Andresen) — Sat, 29 Jan 2022 22:00:39 GMT

Luvox is a selective serotonin reuptake inhibitor (SSRI) antidepressant. This medicine affects chemicals in the brain that may be unbalanced in people with obsessive-compulsive symptoms. Luvox is used to treat social anxiety disorder (social phobia), or obsessive-compulsive disorders involving recurring thoughts or actions.

Khat

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:23:49 GMT

Khat (pronounced COT) is known by over 40 different street names including, kat, qat, chat, gat, graba, tohai, tschat, and mirraa. Khat is a stimulant derived from Catha Edulis, a 6-12-foot flowering evergreen shrub. The fresh young leaves of the shrub have been consumed where the plant is cultivated, primarily in East Africa and the Arabian peninsula.

There, chewing “graba” predates the use of coffee and is used in a similar social context. It is estimated that over 10 million people use and abuse “graba” today, primarily in the Middle East. Khat is used for its stimulant effects. The effects are similar to but less intense than those of methamphetamine or cocaine.

Fresh leaves are chewed and dried leaves are smoked, made into a paste and chewed, or brewed in tea. Used moderately, “Graba alleviates fatigue and reduces appetite. Long-term use or abuse can cause insomnia, anorexia, gastric disorders, depression, liver damage and cardiac complications.

Manic behavior, delusional behavior, violence, suicidal depression, hallucinations, paranoia and khat-induced psychosis have also been reported. “Graba” contains a number of chemicals among which are two controlled substances, cathinone (Schedule I) and cathine (Schedule IV).

As the leaves mature or dry, cathinone is converted to cathine which significantly reduces its stimulatory properties. Cathinone is approximately 10 more times more potent than cathine and is only present in fresh leaves. Cathine, the secondary active ingredient in “graba”, does not lose much of its potency with age as with cathinone. Leaves less than 48 hours old are preferred to ensure a maximum potency of cathinone. However, Khat can be preserved by freezing, the same way that vegetables and meats are kept fresh in the United States.

Ketmamine

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:22:00 GMT

Marketed as a dissociative general anesthetic for human and veterinary use, the only known source of ketamine is via diversion of pharmaceutical products. Recent press reports indicate that a significant number of veterinary clinics are being robbed specifically for their supplies.

DEA reporting indicates that a major source of ketamine in the United States is product diverted from pharmacies in Mexico. Ketamine liquid can be injected, applied to a smokable material, or consumed in drinks. The powdered form is made by allowing the solvent to evaporate, leaving a white or slightly off-white powder that, once pulverized, looks similar to cocaine. The powder can be put into drinks, smoked, or dissolved and then injected. Prices average $20 to $25 per dosage unit.

Ketamine produces physical effects similar to PCP, with the visual effects of LSD. Users report that it is better than PCP or LSD because the trip lasts an hour or less. Low doses of the drug produce an experience called “K-Land,” a mellow, colorful “wonder world.” Higher doses produce an effect referred to as “K-Hole,” an “out of body,” or “near-death” experience. Due to its dissociative effect, it is reportedly used as a date-rape drug.

Ketamine is similar molecularly to phencyclidine (PCP) and thus creates similar effects including numbness, loss of coordination, sense of invulnerability, muscle rigidity, aggressive/violent behavior, slurred or blocked speech, exaggerated sense of strength, and a blank stare.

Since the drug is an anesthetic, it stops the user from feeling pain, which could lead the user to inadvertently cause injury to himself/herself. Ketamine may relieve tension and anxiety, is purported to be a sexual stimulant, and intensifies colors and sounds.

The effects of a ‘high’ usually last an hour but they can last for 4-6 hours, and 24-48 hours are generally required before the user will feel completely “normal” again. Effects of the chronic use of this drug may take from several months to two years to wear off completely. Low doses (25-100mg) produce psychedelic effects quickly. Large doses can produce vomiting and convulsions and may lead to oxygen starvation to the brain and muscles; one gram can cause death. Flashbacks may even occur one year after use. Long-term effects include tolerance and possible physical and/or psychological dependence.

Source: NCADI (National Clearinghouse for Alcohol and Drug Information), “Ketamine: A Fact Sheet.”

Kava

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:19:54 GMT

Kava is consumed in various ways throughout the Pacific Ocean cultures of Polynesia, Vanuatu, Melanesia and some parts of Micronesia and Australia. Traditionally, it is prepared by either chewing, grinding or pounding the roots of the plant.

The several cultivars of kava vary in concentrations of primary and secondary psychoactive alkaloids. The largest number are grown in the Republic of Vanuatu, and so it is recognized as the “home” of the plant. This plant was historically grown only in the Pacific islands of Hawaii, Federated States of Micronesia, Vanuatu, Fiji, the Samoas, and Tonga. Some are grown in the Solomon Islands since World War II, but most are imported. Kava is a cash crop in Vanuatu and Fiji.

The plant cannot reproduce sexually. Female flowers are especially rare and do not produce fruit even when hand-pollinated. Its cultivation is entirely by propagation from stem cuttings.

Traditionally, plants are harvested around four years of age, as older plants have higher concentrations of kavalactones. After reaching about 2 m height, plants grow a wider stalk and additional stalks, but not much taller. The roots can reach a depth of 60 cm.

In Vanuatu, exportation of kava is strictly regulated. Only strains they deem as “noble” varieties that are not too weak or too potent are allowed to be exported. Only the most desirable strains for everyday drinking are selected to be noble varieties to maintain quality control. In addition, their laws mandate that exported kava must be at least five years old and farmed organically. Their most popular noble strains are “Boroguu” or “Boronggoru” from Pentecost Island, “Melomelo” from Aoba Island (called sese in north Pentecost Island), and “Palarasul” kava from Espiritu Santo. In Vanuatu, Tudei (“two days”) kava is reserved for special ceremonial occasions and exporting it is not allowed. “Palisi” is a popular Tudei variety.

In Hawaii, there are many other strains of kava (Hawaiian: ʻawa). Some of the most popular strains are the Mahakea, Moʻi, Hiwa and Nene varieties. The Aliʻi (kings) of precolonial Hawaii covered the Moʻi variety, which had a strong cerebral effect due to a predominant amount of the kavalactone kavain. This sacred variety was so important to them that no one but royalty could ever experience it, “lest they suffer an untimely death”. The reverence for Hiwa in old Hawaiʻi is evident in this portion of a chant recorded by Nathaniel Bright Emerson and quoted by E. S. Craighill and Elizabeth Green Handy. “This refers to the cup of sacramental ʻawa brewed from the strong, black ʻawa root (ʻawa hiwa) which was drunk sacramentally by the kudu hula.”

Inhalants

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:18:22 GMT

How Are Inhalants Abused?

Inhalants are products readily found in the home or workplace—such as spray paints, markers, glues, and cleaning fluids—contain volatile substances that have psychoactive (mind-altering) properties when inhaled. People do not typically think of these products as drugs because they were never intended for that purpose. However, these products are sometimes abused in that way. They are especially (but not exclusively) abused by young children and adolescents, and are the only class of substance abused more by younger than by older teens.

How Do Inhalants Affect the Brain?

Abusers of inhalants breathe them in through the nose or mouth in a variety of ways (known as “huffing”). They may sniff or snort fumes from a container or dispenser (such as a glue bottle or a marking pen), spray aerosols (such as computer cleaning dusters) directly into their nose or mouth, or place a chemical-soaked rag in their mouth. Abusers may also inhale fumes from a balloon or a plastic or paper bag. Although the high produced by inhalants usually lasts just a few minutes, abusers often try to prolong it by continuing to inhale repeatedly over several hours.

People tend to abuse different inhalant products at different ages. New users ages 12–15 most commonly abuse glue, shoe polish, spray paints, gasoline, and lighter fluid. New users ages 16–17 most commonly abuse nitrous oxide or “whippets.” Adults most commonly abuse a class of inhalants known as nitrites (such as amyl nitrites or “poppers”).

What Are the Other Health Effects of Inhalants?

Most abused inhalants other than nitrites depress the central nervous system in a manner, not unlike alcohol. The effects are similar—including slurred speech, lack of coordination, euphoria, and dizziness. Inhalant abusers may also experience light-headedness, hallucinations, and delusions. With repeated inhalations, many users feel less inhibited and less in control. Some may feel drowsy for several hours and experience a lingering headache.

Unlike other types of inhalants, nitrites enhance sexual pleasure by dilating and relaxing blood vessels.

Although it is not very common, addiction to inhalants can occur with repeated abuse.

Chemicals found in different types of inhaled products may produce a variety of other short-term effects, such as nausea or vomiting, as well as more serious long-term consequences. These may include liver and kidney damage, hearing loss, or bone marrow damage. Effects may also include loss of coordination and limb spasms due to damage to myelin—a protective sheathing around nerve fibers that helps nerves transmit messages in the brain and peripheral nervous system. Inhalants can also cause brain damage by cutting off oxygen flow to the brain.

Inhalants can even be lethal. Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly cause heart failure within minutes. This syndrome, known as “sudden sniffing death,” can result from a single session of inhalant use by an otherwise healthy young person. High concentrations of inhalants may also cause death from suffocation, especially when inhaled from a paper or plastic bag or in a closed area. Even when using aerosols or volatile products for their legitimate purposes like painting or cleaning, it is wise to do so in a well-ventilated room or outdoors.

Nitrites are a special class of inhalants that are abused to enhance sexual pleasure and performance. They can be associated with unsafe sexual practices that increase the risk of contracting and spreading infectious diseases like HIV/AIDS and hepatitis.

Volatile solvents—liquids that vaporize at room temperature

Industrial or household products, including paint thinners or removers, degreasers, dry-cleaning fluids, gasoline, and lighter fluid

Art or office supply solvents, including correction fluids, felt-tip marker fluid, electronic contact cleaners, and glue

Aerosols—sprays that contain propellants and solvents

Household aerosol propellants in items such as spray paints, hair or deodorant sprays, fabric protector sprays, aerosol computer cleaning products, and vegetable oil sprays
Gases—found in household or commercial products and used as medical anesthetics

Household or commercial products, including butane lighters and propane tanks, whipped cream aerosols or dispensers (whippets), and refrigerant gases.

Medical anesthetics, such as ether, chloroform, halothane, and nitrous oxide (“laughing gas”)

Nitrites—used primarily as sexual enhancersInhalants

Organic nitrites are volatiles that includes cyclohexyl, butyl, and amyl nitrites, commonly known as “poppers.” Amyl nitrite is still used in certain diagnostic medical procedures. When marketed for illicit use, organic nitrites are often sold in small brown bottles labeled as “video head cleaner,” “room odorizer,” “leather cleaner,” or “liquid aroma.”
Source: NIDA

A gas used as a propellant in whipped cream aerosol containers, nitrous oxide, is used as a recreational drug. A whipped cream charger (also called whippits, whippets nossies, nangs, or chargers) is a steel cylinder or cartridge filled with nitrous oxide (N2O) that is used as a whipping agent in a whipped cream dispenser. The narrow end of a charger has a foil covering which is broken to release the gas.

Imitrex

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:13:51 GMT

Imitrex (Sumatriptan) is a synthetic drug belonging to the class, used for the treatment of migraine headaches. Sumatriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Other Sources:

CDC – Single-dose/Single-use Vials – Safe Practices for …
www.cdc.gov/injectionsafety/providers/provider_faqs_singlevials.html
Single-dose/Single-use vials; Multi-dose vials; References; What is a single-dose or single-use vial? A single-dose or single-use vial is a vial of …

[TXT] Keywords:
stacks.cdc.gov/view/cdc/24197/cdc_24197_DS2.txt
… ≈2 weeks before hospitalization and included a severe generalized headache initially thought to be a migraine, but sumatriptan resulted in no …

[PDF] West Nile Virus Aseptic Meningitis and Stuttering in Woman
stacks.cdc.gov/view/cdc/24197/cdc_24197_DS1.pdf
sumatriptan. Her symptoms started ≈2 weeks before hospitalization and included a severe generalized headache initially thought to be a migraine, but s …

West Nile Virus Aseptic Meningitis and Stuttering in Woman …
wwwnc.cdc.gov/eid/article/17/8/10-1691_article.htm
… ≈2 weeks before hospitalization and included a severe generalized headache initially thought to be a migraine, but sumatriptan resulted in no …

[PDF] SIPC Injection Safety Checklist
www.cdc.gov/injectionsafety/PDF/SIPC_Checklist.pdf
INJECTION SAFETY CHECKLIST The following Injection Safety checklist items are a subset of items that can be found in the CDC Infection Prevention …

Imipramine Hydrochloride

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:12:32 GMT

Imipramine is used in the treatment of depression, such as depression associated with agitation or anxiety. Imipramine tablets and capsules are also used to prevent bedwetting in children. Imipramine is in a class of medications called tricyclic antidepressants. Tofranil (Imipramine) is a tricyclic antidepressant used to treat symptoms of depression.

Other Sources:

[PDF] Methadone for Pain Management: The Clinician’s Role in …
emergency.cdc.gov/coca/ppt/2012/08_01_12_Methadone_FIN.pdf
Methadone for Pain Management: The Clinician’s Role in Reducing the Risk of Overdose.

[PDF] Uti~zation of Psychotropic Drugs in Office-Based …
www.cdc.gov/nchs/data/ad/ad090acc.pdf
National Ambulatory Medical Care Survey findings resulted in an estimated 1,160,921,856 visits made to oi%ce … Amoxapine

The enzymatic removal of a surfactant coating from quartz …
www.cdc.gov/niosh/nioshtic-2/00232504.html
The enzymatic removal of a surfactant coating from quartz and kaolin by P388D1 vells. Authors. Hill-CA; … chloroquine, …

Complications of Diabetes Mellitus – CDC WONDER
wonder.cdc.gov/wonder/prevguid/p0000063/p0000063.asp
The Prevention and Treatment of Complications of Diabetes Mellitus A Guide for Primary Care Practitioners. … nortriptyline plus …

Hydrocodone

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:11:12 GMT

Hydrocodone is an effective antitussive (anti-cough) agent, and as an opiate it is also an effective analgesic for mild to moderate pain control. Five mg of this drug is equivalent to 30 mg of codeine when administered orally. Early comparisons concluded that hydrocodone and morphine were equipotent for pain control in humans. However, it is now considered that a dose of 15 mg (1/4 gr) is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is considered to be morphine-like in all respects.

There are over 200 products containing opioid in the U.S. In its most usual product forms this opioid is combined with acetaminophen (Vicodin, Lortab), but it is also combined with aspirin (Lortab ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine). Both tablet and liquid forms of this opioid are available (e.g., Tussionex)

Hydrocodone is in Schedule II of the Controlled Substances Act. Preparations containing hydrocodone in combination with other non-narcotic medicinal ingredients are in Schedule III. Vicodin, hydrocodone in combination with acetaminophen, is a commonly abused version of hydrocodone.

Hydrocodone is the most frequently prescribed opioid in the United States and is associated with more drug abuse and diversion than any other licit or illicit opioid.

Vicodin, as with all narcotic analgesics, can be habit forming—causing dependence, tolerance, and withdrawal symptoms if not used as it is prescribed. Even when used as prescribed, the following effects are possible:

COMMON SIDE EFFECTS MAY INCLUDE:

Dizziness, lightheadedness, nausea, sedation, vomiting, and constipation.Hydrocodone

LESS COMMON SIDE EFFECTS:

Allergic reactions, blood disorders, mood changes, mental cloudiness, anxiety, lethargy, urine retention, ureteral spasm, irregular breathing, respiratory depression, and skin rash.

SYMPTOMS OF OVERDOSE:

Bluish tinge to skin, cold and clammy skin, extreme sleepiness progressing to a possible state of unresponsiveness or coma, heart problems, heavy perspiration, kidney problems, limp muscles, liver failure, low blood pressure, nausea, slow heartbeat, troubled or slowed breathing, and vomiting.

Heroin

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:08:52 GMT

Heroin is an opioid drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown powder or as a black sticky substance, known as “black tar heroin.”

Prescription Opioid Abuse: A First Step to Heroin Use?

Prescription opioid pain medications such as Oxycontin and Vicodin can have effects similar to heroin when taken in doses or in ways other than prescribed, and they are currently among the most commonly abused drugs in the United States. Research now suggests that abuse of these drugs may open the door to heroin abuse.

Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.

How Is Heroin Used?

Heroin can be injected, inhaled by snorting or sniffing, or smoked. All three routes of administration deliver the drug to the brain very rapidly, which contributes to its health risks and to its high risk for addiction, which is a chronic relapsing disease caused by changes in the brain and characterized by uncontrollable drug-seeking no matter the consequences.

How Does Heroin Affect the Brain?

When it enters the brain, heroin is converted back into morphine, which binds to molecules on cells known as opioid receptors. These receptors are located in many areas of the brain (and in the body), especially those involved in the perception of pain and in reward. Opioid receptors are also located in the brain stem, which controls automatic processes critical for life, such as blood pressure, arousal, and respiration.

Heroin overdoses frequently involve a suppression of breathing. This can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.

After an intravenous injection of heroin, users report feeling a surge of euphoria (“rush”) accompanied by dry mouth, a warm flushing of the skin, heaviness of the extremities, and clouded mental functioning. Following this initial euphoria, the user goes “on the nod,” an alternately wakeful and drowsy state. Users who do not inject the drug may not experience the initial rush, but other effects are the same.

Researchers are also investigating the long-term effects of opioid addiction on the brain. One result is tolerance, in which more of the drug is needed to achieve the same intensity of the effect. Another result is dependence, characterized by the need to continue use of the drug to avoid withdrawal symptoms. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

Injection Drug Use and HIV and HCV Infection

People who inject drugs are at high risk of contracting HIV and hepatitis C (HCV). This is because these diseases are transmitted through contact with blood or other bodily fluids, which can occur when sharing needles or other injection drug use equipment. (HCV is the most common blood-borne infection in the United States.) HIV (and less often HCV) can also be contracted during unprotected sex, which drug use makes more likely.

Because of the strong link between drug abuse and the spread of infectious disease, drug abuse treatment can be an effective way to prevent the latter. People in drug abuse treatment, which often includes risk reduction counseling, stop or reduce their drug use and related risk behaviors, including risky injection practices and unsafe sex.

How is heroin harmful?

-Heroin is an illegal, highly addictive opioid drug.
-A heroin overdose can cause slow and shallow breathing, coma, and death.
-People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.
-Heroin is typically injected but is also smoked or snorted. When people inject heroin, they are at risk of serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.

Who is most at risk of heroin addiction?

-People who are addicted to prescription opioid painkillers
-People who are addicted to cocaine
-People without insurance or enrolled in Medicaid
-Non-Hispanic Whites
-Males
-People who are addicted to marijuana and alcohol
-People living in a large metropolitan area
-18 to 25-year-olds

Source: CDC

What Are the Other Health Effects of Heroin?

Opioid abuse is associated with a number of serious health conditions, including fatal overdose, spontaneous abortion, and infectious diseases like hepatitis and HIV (see box, “Injection Drug Use and HIV and HCV Infection”). Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease. Pulmonary complications, including various types of pneumonia, may result from the poor health of the user as well as from heroin’s effects on breathing.

In addition to the effects of the drug itself, street heroin often contains toxic contaminants or additives that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs.

Chronic use of heroin leads to physical dependence, a state in which the body has adapted to the presence of the drug. If a dependent user reduces or stops the use of the drug abruptly, he or she may experience severe symptoms of withdrawal. These symptoms—which can begin as early as a few hours after the last drug administration—can include restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (“cold turkey”), and kicking movements (“kicking the habit”). Users also experience a severe craving for the drug during withdrawal, which can precipitate continued abuse and/or relapse.

Besides the risk of spontaneous abortion, heroin abuse during pregnancy (together with related factors like poor nutrition and inadequate prenatal care) is also associated with low birth weight, an important risk factor for later delays in development. Additionally, if the mother is regularly abusing the drug, the infant may be born physically dependent on heroin and could suffer from neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants that requires hospitalization. According to a recent study, treating opioid-addicted pregnant mothers with buprenorphine (a medication for opioid dependence) can reduce NAS symptoms in babies and shorten their hospital stays.

Source: NIDA

Hemp

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:05:02 GMT

Hemp, The Drug Enforcement Administration (DEA) announced rules to clarify the legal status of Hemp products. Hemp is part of the cannabis plant, which is also known as marijuana. The rules published in the Federal Register explain the circumstances under which “hemp” products are subject to control under federal law.

“Hemp” and marijuana are actually separate parts of the species of plant known as cannabis. Under federal law, Congress defined marijuana to focus on those parts of the cannabis plant that are the source of tetrahydrocannabinol (THC). THC is the hallucinogenic substance in marijuana that causes the psychoactive effect or “high.” The marijuana portions of the cannabis plant include the flowering tops (buds), the leaves, and the resin of the cannabis plant. The remainder of the plant — stalks and sterilized seeds — are what some people refer to as “hemp.” However, “hemp” is not a term that is found in federal law.

Many Americans do not know that hemp and marijuana are both parts of the same plant and that hemp cannot be produced without producing marijuana.”

While most of the THC in cannabis plants is concentrated in the marijuana, all parts of the plant, including hemp, have been found to contain THC. The existence of THC in hemp is significant because THC, like marijuana, is a schedule controlled substance. Federal law prohibits human consumption and possession of schedule I controlled substances. In addition, they are not approved by the Food and Drug Administration for medical use.

The rules that DEA has published explain which hemp products are legal and which are not. This will depend on whether the product causes THC to enter the human body. If the product does cause THC to enter the human body, it is an illegal substance that may not be manufactured, sold, or consumed in the United States. Such products include “hemp” foods and beverages that contain THC.

If, however, the product does not cause THC to enter the human body, it is a non-controlled substance that may lawfully be sold in the United States. Included in the category of lawful hemp products are textiles, such as clothing made using fiber produced from cannabis plant stalks. Also in the lawful category are personal care products that contain oil from sterilized cannabis seeds, such as soaps, lotions, and shampoos.

Hashish

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:03:35 GMT

Hashish or hash consists of the THC-rich resinous material of the cannabis plant, which is collected, dried, and then compressed into a variety of forms, such as balls, cakes, or cookie-like sheets.

Pieces are then broken off, placed in pipes, and smoked. The Middle East, North Africa, Pakistan, and Afghanistan are the main sources of hash.

The THC content of hash that reached the United States, where demand is limited, averaged about 5 percent in the 1990s.

To make hash, workers rub cannabis blossoms with their hands to get the resin to stick to their hands, and then the resin is collected. Another way to make hash is to sift the ground-up, dried leaves through a screen and compress the powder resin to make a “brick”.

A more modern method of producing hash is through alcohol extraction. In this method, cannabis plants are ground up and covered with isopropyl alcohol or butane and left to sit. The resulting mixture is then evaporated off the alcohol leaving the active terpenoid and terpene compounds which can be used immediately or cooked into bricks.

When a person wants to use hashish, they usually smoke it by putting a small piece of hash in a joint with tobacco or marijuana. Then the person lights the paper roll with a flame and inhales the smoke that comes out, exhaling 1-3 seconds after holding in the smoke.

Another way that people use hash is by putting a small piece of hashish in a pipe or bong (water pipe) then lighting it with a flame, inhaling the smoke. Some people also eat hashish, usually by mixing it into food or baked goods.

Other Sources:

NHANES 2009 – 2010: Drug Use (Ages 18+) Data Documentation …
www.cdc.gov/nchs/nhanes/nhanes2009-2010/DUQ_F.htm

Subject: The drug use questions (DUQ) focused on lifetime and current use of marijuana or hashish, cocaine, heroin, and methamphetamine, as well as …

[PDF] Driving Under the Influence of Alcohol, Marijuana, and …
www.cdc.gov/mmwr/pdf/wk/mm6448.pdf
hashish (“hash”) within the past 12 months. Driving under the influence of alcohol alone was defined as an affirmative response to the question, …

[PDF] Drug Use Questionnaire
www.cdc.gov/nchs/data/nhanes/nhanes_11_12/duq_acasi.pdf
DUQ.219 During the time that you smoked marijuana or hashish, how many joints or pipes would you smoke usually in a day?

NHANES National Youth Fitness Survey
www.cdc.gov/nchs/nnyfs/limited_access/Y_DUQ.htm
Component Description. The drug use questionnaire (variable name prefix DUQ) focused on lifetime and current (past 30 days) use of marijuana or hashish …

[PDF] DRUG USE – DUQ Target Group: SPs 12-69 (Audio-CASI)
www.cdc.gov/nchs/data/nhanes/nhanes_09_10/ai_duq_f.pdf
DUQ.200 The first questions are about marijuana and hashish. Marijuana is also called pot or grass. Marijuana is usually smoked, either in cigarettes, …

National Health and Nutrition Examination Survey
www.cdc.gov/nchs/nhanes/nhanes2003-2004/DUQ_C.htm
National Health and Nutrition Examination Survey 2003 – 2004 Data Documentation, Codebook, and Frequencies Drug Use (DUQ_C)

NHANES 2007 – 2008: Drug Use (Ages 20+) Data Documentation …
www.cdc.gov/nchs/nhanes/nhanes2007-2008/DUQ_E.htm
Subject: The drug use questions (DUQ) focused on lifetime and current use of marijuana or hashish, cocaine, heroin, and methamphetamine, as well as …

Hash Oil

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 18:01:44 GMT

Hash oil (“dabs”), is gaining popularity

The term hash oil is used by illicit drug users and dealers but is a misnomer in suggesting any resemblance to hashish.

Hash oil is produced by extracting the cannabinoids from plant material with a solvent. The color and odor of the resulting extract will vary, depending on the type of solvent used. Current samples of the oil, a viscous liquid ranging from amber to dark brown in color, average about 15 percent THC although it is frequently as high as 50.9% according to the DEA.

The tetrahydrocannabinol (THC) content of the oil varies tremendously since the manufacturers use a random assortment of marijuana plants and preparation techniques. Dealers sometimes cut their oils with other oils.

In terms of its psychoactive effect, a drop or two of this liquid on a cigarette is equal to a single “joint” of marijuana.

Hash, or marijuana oil, can also be known as hashish oil, butane/butane hash/honey oil (BHO), cannabis oil, liquid cannabis, hemp bud oleoresin, wax, or simply a dab is an oleoresin obtained by extraction of marijuana and/or hashish. In an industry that is not carefully monitored or have strict standards changes happen quickly.

Source: DEA

SECOND POINT FOR USERS

A new method for administering cannabinoids, called butane hash oil (“dabs”), is gaining popularity among marijuana users. Despite press reports that suggest that “dabbing” is riskier than smoking flower cannabis, no data address whether dabs users experience more problems from use than those who prefer flower cannabis.

OBJECTIVE:
The present study aimed to gather preliminary information on dabs users and test whether dabs use is associated with more problems than using flower cannabis.

METHOD:
Participants (n=357) reported on their history of cannabis use, their experience with hash oil and the process of “dabbing,” reasons for choosing “dabs” over other methods, and any problems related to both flower cannabis and butane hash oil.

RESULTS:
Analyses revealed that using “dabs” created no more problems or accidents than using flower cannabis. Participants did report that “dabs” led to higher tolerance and withdrawal (as defined by the participants), suggesting that the practice might be more likely to lead to symptoms of addiction or dependence.

CONCLUSIONS:
The use of butane hash oil has spread outside of the medical marijuana community, and users view it as significantly more dangerous than other forms of cannabis use.

Source: National Institute of Health

Hallucinogens

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:59:28 GMT

Hallucinogens and dissociative drugs are both categories of drugs that alter a persons’ state of mind and mood. Hallucinogens can cause a person to hallucinate–that is to see, hear, or feel things that aren’t actually real. Hallucinogens include LSD, Mescaline (Peyote), Psilocybin, and Psilocyn.

Dissociative drugs, such as Ketamine or PCP, alter a persons state of mind and mood but do not cause a person to hallucinate. Dissociative drugs cause a person to detach, or dissociate, from his or her surroundings.

D-lysergic acid diethylamide (LSD) is the most potent hallucinogenic substance known to man. Dosages of LSD are measured in micrograms or millionths of a gram. By comparison, dosages of cocaine and heroin are measured in milligrams or thousandths of a gram. Compared to other hallucinogenic substances, LSD is 100 times more potent than psilocybin and psilocin and 4,000 times more potent than mescaline.

The dosage level that will produce a hallucinogenic effect in humans generally is considered to be 25 micrograms. Over the past several years, the potency of LSD obtained during drug law enforcement operations has ranged between 20 and 80 micrograms per dosage unit. The Drug Enforcement Administration (DEA) recognizes 50 micrograms as the standard dosage unit equivalency.

LSD is classified as a Schedule I drug in the Controlled Substances Act of 1970. As a Schedule I drug, LSD meets the following three criteria: it is deemed to have a high potential for abuse; it has no legitimate medical use in treatment; and, there is a lack of accepted safety for its use under medical supervision.

LSD was synthesized in 1938 by a chemist working for Sandoz Laboratories in Switzerland. It was developed initially as a circulatory and respiratory stimulant. However, no extraordinary benefits of the compound were identified and its study was discontinued. In the 1940’s, interest in the drug was revived when it was thought to be a possible treatment for schizophrenia. Because of LSD’s structural relationship to a chemical that is present in the brain and its similarity in effect to certain aspects of psychosis, LSD was used as a research tool in studies of mental illness.

The effects of LSD are unpredictable. They depend on the amount taken, the user’s personality, mood and expectations, and the surroundings in which the drug is used. Usually, the user feels the first effects of the drug 30-90 minutes after taking it. These effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth, and tremors. Sensations and feelings change much more dramatically than the physical signs. The user may feel several different emotions at once or swing rapidly from one emotion to another. Depending on the dose, the drug can produce delusions and visual hallucinations, which can be frightening and cause panic. Users refer to their experience with these acute adverse reactions as a “bad trip,” and the effects typically last for about twelve hours. Terrifying thoughts and feelings, fear of insanity and death, injuries, and fatal accidents have occurred during states of LSD intoxication. Anyone can experience a bad trip and there is no way to predict what your own experience will be.

LSD is being concealed in candy Sweet Tarts by simply placing a clear drop of the drug in the tart. Tarts may or may not have a slight discoloration such as on the pink tart above. Tarts are becoming more popular as a method of concealment. Tarts are used in this instance, however, many other candy products can be used as well.

GHB

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:56:08 GMT

GHB (Gama Hydroxybutyric Acid) is a synthetic depressant produced in clandestine labs. While available as a prescription for sleep disorders in some other countries Gama Hydroxybutyric Acid) was banned (in the U.S.) by the FDA in 1990 because of the dangers associated with its use. However, on July 17th, 2002, Gama Hydroxybutyric Acid) was approved for treatment of a rare form of narcolepsy. Most of the GHB used in the U.S. is illegally manufactured within its borders. Like Rohypnol, GHB and its analogs are considered “date rape” drugs because they can be mixed with liquids (even water) and a victim wouldn’t notice by smelling or looking at it. Gama Hydroxybutyric Acid), by itself, has a soapy or salty taste–but when mixed in a drink it may be difficult to detect.

Other products such as GBL and 1,4 butanediol (BD) are appearing in the illegal market as GHB substitutes. These analogs are just as dangerous and have similar effects on the body.

Gama Hydroxybutyric Acid) can be made from ingredients such as GBL (gamma-butyrolactone), a solvent commonly used as a paint stripper, or butanediol (1,4-butanediol), a chemical used in the production of plastics and adhesives. Both GBL and butanediol are metabolized into GHB in the body. GHB, GBL, and butanediol (BD) are difficult to trace because they quickly leave the body and may be difficult to detect in emergency rooms and other treatment facilities. The FDA has issued warnings for both GBL and 1,4-butanediol, stating that the drugs have a potential for abuse and are a public health danger.

GHB and it’s analogs are known as “G,” “liquid x”,”caps,” “scoop,” “goop,” “Georgia home boy,” and “grievous bodily harm.”

Gama Hydroxybutyric Acid) is a clear odorless liquid (usually mixed with alcohol) or a white powder (usually made into tablets or capsules.) GHB is snorted, smoked, or mixed into drinks. The most commonly abused form is the liquid.

On the street, it is usually sold as a liquid by the dose (a capful from a bottle or drops). In some cities, GHB is put into water guns, and users buy it by the squirt. In other instances, candy, such as a lollipop, is dipped in GHB and sold.

Source: SAMHSA/CSAT, “GHB: A Club Drug to Watch.”

Substance Abuse Treatment Advisory

EFFECTS OF USE:

The effects of Gama Hydroxybutyric Acid) vary each time a person uses it and it affects each person differently. Initial effects include euphoria and relaxation. Within 15 minutes nausea, dizziness, drowsiness, visual disturbances, respiratory distress, amnesia, seizures, and coma are possible. It is difficult to predict a person’s reaction to GHB– because GHB is produced in clandestine labs, the purity and strength of doses vary. Coma, poisoning, and death resulting from ingestion of Gama Hydroxybutyric Acid) have been well documented. As of November 2000, DEA documented 71 Gama Hydroxybutyric Acid)-related deaths.

Coma and seizures can occur following abuse of Gama Hydroxybutyric Acid) and, when combined with methamphetamine, there appears to be an increased risk of seizure. Combining use with other drugs such as alcohol can result in nausea and difficulty breathing. Gama Hydroxybutyric Acid) may also produce withdrawal effects, including insomnia, anxiety, tremors, and sweating. Because of concern about Rohypnol, Gama Hydroxybutyric Acid), and other similarly abused sedative-hypnotics, Congress passed the “Drug-Induced Rape Prevention and Punishment Act of 1996” in October 1996. This legislation increased Federal penalties for use of any controlled substance to aid in sexual assault.

Source: “Rohypnol and GHB,” NIDA InfoFacts, #13556

Flexeril

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:52:22 GMT

Flexeril, (cyclobenzaprine) is a muscle relaxant. Cyclobenzaprine, a muscle relaxant, is used with rest, physical therapy, and other measures to relax muscles and relieve pain and discomfort caused by strains, sprains, and other muscle injuries.

Cyclobenzaprine comes as a tablet and an extended-release capsule to take by mouth. The tablet is usually taken two to four times a day. The extended-release capsule is usually taken one or two times a day. Do not take this drug for more than 3 weeks without talking to your doctor. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cyclobenzaprine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Cyclobenzaprine may cause side effects.

Tell your doctor if any of these symptoms are severe or do not go away:

-drowsiness
-dry mouth
-dizziness
-upset stomach
-severe skin rash
-swelling of the face or tongue
-difficulty breathing or swallowing
-irregular heart rate
-chest pain
-fever
-seizures

Other Sources:

Cyclobenzaprine

Flexeril® … Cyclobenzaprine, a muscle relaxant, is used with rest, physical therapy, and other measures to relax muscles and … Cyclobenzaprine comes as a tablet and an extended-release capsule to take by mouth. The tablet is …
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682514.html – Drugs and Supplements

Best Medications to Treat Fibromyalgia (Consumers Union of U.S.)
… in the studies of fibromyalgia. Tricyclic medications: amitriptyline, cyclobenzaprine, and nortriptyline In general, people with fibromyalgia who … MJ, Reynolds WJ, et al. Comparison of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia. A …
www.consumerreports.org/…/index.htm – External Health Links

Drugs that may cause impotence

… Other medicines: Aminocaproic acid (Amicar) Atropine Clofibrate (Atromid-S) Cyclobenzaprine (Flexeril) Cyproterone Digoxin (Lanoxin) Disopyramide (Norpace) Estrogen Finasteride ( …
https://www.nlm.nih.gov/medlineplus/ency/article/004024.htm – Medical Encyclopedia

Flakka

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:50:39 GMT

A dangerous synthetic cathinone, Flakka, alpha-pyrrolidinopentiophenone (alpha-PVP), is becoming popular in the Southeast part of the U.S.

ALPHA-PYRROLIDINOPENTIOPHENONE (ALPHA-PVP)

Alpha-PVP is chemically similar to other synthetic cathinone (Brochure) drugs popularly called “bath salts,” and takes the form of a white or pink, foul-smelling crystal that can be eaten, snorted, injected, or vaporized in an e-cigarette or similar device. Vaporizing, which sends the drug very quickly into the bloodstream, may make it particularly easy to overdose. Like other drugs of this type, alpha-PVP can cause a condition called “excited delirium” that involves hyperstimulation, paranoia, and hallucinations (Brochure) that can lead to violent aggression and self-injury. The drug has been linked to deaths by suicide as well as heart attack. It can also dangerously raise body temperature and lead to kidney damage or kidney failure.

Fioricet

Courtney@simple.biz (Courtney Andresen) — Sat, 29 Jan 2022 17:49:14 GMT

Fioricet and Esgic are brand names of a combination of butalbital (a barbiturate), acetaminophen and caffeine which is indicated for the treatment of tension headaches, muscle contraction headaches and post-dural puncture headaches. Although not indicated, they are commonly used to treat migraines and other pain related ailments.

More information in the Prescription Drug Booklet

Other Sources:

List of Confused Drug Names (Institute for Safe Medication Practices) – PDF

… Fastin (dietary supplement) Femara Femhrt fenta NYL Fetzima Fioricet Fiorinal flavox ATE Flonase Floranex Florastor Florinef Florinef … Fastin ( phentermine) Femhrt Femara SUF entanil Farxiga Fiorinal fluvoxa MINE Flovent Florinef Florinef Floranex Florastor Flonase …
www.ismp.org/Tools/confuseddrugnames.pdf – External Health Links

Headache Causes and Diagnosis in Adults (Beyond the Basics)(UpToDate)
… the following: ● If possible, avoid butalbital combinations (Fiorinal®, Esgic®) and narcotics completely. ● Do not use triptans ( …
www.uptodate.com/…s-in-adults-beyond-the-basics?view=print – External Health Links

State Estimates of Nonmedical Use of Prescription Pain Relievers(Substance Abuse and Mental Health Services Administration) – PDF
… were (4) codeine; (5) Demerol®; (6) Dilaudid®; (7) Fioricet®; (8) Fiorinal®; (9) hydrocodone; (10) methadone; (11) morphine; ( …

Fentanyl

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:47:27 GMT

Fentanyl was first synthesized in Belgium in the late 1950s, with an analgesic potency of about 80 to 100 times that of morphine, and introduced into medical practice in the 1960s as an intravenous anesthetic under the trade name of Sublimaze®. Thereafter; two other analogs were introduced; alfentanil (Alfenta®), an ultra-short (5-10 minutes) acting analgesic, and sufentanil (Sufenta®), an exceptionally potent analgesic (5 to 10 times more potent ) for use in heart surgery.

Today, fentanyl are extensively used for anesthesia and analgesia. Duragesic®, for example, is a transdermal patch used in chronic pain management, and Actiq® is a solid formulation of citrate on a stick that dissolves slowly in the mouth for transmucosal absorption. Actiq® is intended for opiate-tolerant individuals and is effective in treating breakthrough pain in cancer patients. Carfentanil (Wildnil®) is an analog of fentanyl with an analgesic potency 10,000 times that of morphine and is used in veterinary practice to immobilize certain large animals.

Illicit use of pharmaceutical fentanyl first appeared in the mid-1970s in the medical community and continues to be a problem in the United States. To date, over 12 different analogs of fentanyl have been produced clandestinely and identified in the U.S. drug traffic.

The biological effects of the fentanyl are indistinguishable from those of heroin , with the exception that the fentanyl may be hundreds of times more potent. Fentanyl is most commonly used by the intravenous administration, but like heroin, they may also be smoked or snorted.

Source: DEA

This narcotic drug has been diverted by pharmacy theft, fraudulent prescriptions, and illicit distribution by patients, physicians, and pharmacists. Theft has also been identified at nursing homes and other long-term care facilities. Oral transmucosal lozenges (Actiq®) are typically sold at $20-25 per unit or $450 per carton (contains 24 units) while transdermal patches (Duragesic®) are sold at prices ranging from $10 to $100 per patch depending upon the dose of the unit and geographical area. There is evidence of large illegal distribution rings selling fentanyl products along with other opioid pharmaceuticals.

Source: DEA Diversion Control Program Drop dead and suicide packets are street terms for fentanyl products.

The drug naloxone can reverse a fentanyl overdose when applied in time. However, because fentanyl is 50 times more potent than heroin, it may require several doses of naloxone to bring someone out of a fatal fentanyl overdose. Unfortunately, the person applying the naloxone will probably not know if fentanyl was present or how much fentanyl was consumed, and will probably not know that it is necessary to administer more naloxone to save the addicts life.

More info in the Prescription Drug Brochure

Other Sources:

Transdermal Patch
Fentanyl patches are used to relieve severe pain in people who are expected to need pain medication … and who cannot be treated with other medications.
As a Narcotic
This narcotic is used to treat breakthrough pain (sudden episodes of pain that occur despite round the clock … effects of the medication) to narcotic pain medications.
Nasal Spray
A nasal spray is used to treat breakthrough pain (sudden episodes of pain that occur despite round … effects of the medication) to narcotic pain medications.
https://www.nlm.nih.gov/medlin
Other Sources Drug Identification Guide CDC Facts CDC Addiction Info CDC Overdose Stats CDC Substance Treatment Whitehouse Drug Free Communities Samhsa Workplace Programs Drug Free Federal Register Codification

Ephedra

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:44:39 GMT

Dietary supplements are marketed as “performance enhancers,” “energy boosters,” “fat burners,” “street drug alternatives,” or “legal highs” on the internet, television, and in nutrition stores. With the increased attention to Ephedra, which was recently banned by the FDA, other products are quickly gaining attention. These new products, promoted as safe, ephedra-free supplements, are considered to be just as risky as Ephedra-based supplements.

EPHEDRINEIN

There are two reasons they are dangerous: 1) the supplements contain high levels of stimulants often in combination with caffeine 2) the makers of the supplements are not required to list the quantity or amount of the stimulants that are in their products.

WHAT IS A DIETARY SUPPLEMENT?

Congress defined the term “dietary supplement” in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product taken by mouth that contains a “dietary ingredient” intended to supplement the diet. The “dietary ingredients” in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates and may be found in many forms such as tablets, capsules, soft gels, gel caps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of “foods,” not drugs, and requires that every supplement be labeled a dietary supplement.

EPHEDRA (aka epitonin, ma huang, Sida Cordifolia, Sinica) is a herbal stimulant and the main ingredient in energy-enhancing and weight loss products. Several organizations, including the American Medical Association and Health Canada, have recommended banning the sale of ephedra and many other organizations, including the National Collegiate Athletics Association, the International Olympic Committee, and the National Football League, prohibit the use of products containing ephedra.

China is a major manufacturer of ephedrine and pseudoephedrine and is one of the world’s primary exporters of both chemicals. China owns and operates ephedra farms, where ephedra grass (Ephedra Sinica) is cultivated under strict government control.

The active alkaloids, pseudoephedrine, and ephedrine are chemically extracted from the plant material and processed for pharmaceutical purposes. These chemicals are then sold domestically and internationally.

China and India are the major producers of these chemicals when extracted from the ephedra plant. In low doses, ephedrine and pseudoephedrine act as nasal decongestants. Ephedrine and pseudoephedrine are ingredients in many over-the-counter asthma medications and are also key components in illegal methamphetamine manufacturing. In high doses, the stimulant effects of these drugs can raise blood pressure and many studies have linked ephedra use to heart attacks, strokes, seizures, psychosis, insomnia, and heatstroke. Those people suffering from kidney disease, liver disease, diabetes, glaucoma, heart disease or high blood pressure, thyroid disease, emphysema or chronic bronchitis, have an enlarged prostate, are pregnant or nursing, or are taking an MAOI are advised NOT to take products containing ephedrine and pseudoephedrine.

A recent study, published in the Annals of Internal Medicine and based on information collected by the American Association of Poison Control Centers concluded: * Products containing ephedra accounted for 64% of all adverse reactions to herbs in the United States, yet these products represented only 0.82% of herbal product sales. The relative risks for an adverse reaction in persons using ephedra compared with other herbs were extremely high. Even with an extremely high estimate for ephedra’s share of the total herbal market (13.5%), the relative risks for adverse reactions among ephedra users were still 10- to 40-fold greater than the risk among users of other herbal products.

OTHER SUPPLEMENTS:

Bitter Orange: (Citrus Aurantium, aka green orange, neroli oil) contains a stimulant, synephrine that is similar to Ephedra. Given its similarities, experts believe Bitter Orange may have the same adverse effects as Ephedra. Guarana: contains 2-3 times more caffeine than coffee, other caffeine-containing supplements include kola and mate.

Green Tea Extract: Contains less caffeine than coffee, contains antioxidants, is often combined with other caffeine-based supplements.

Usnic acid: Touted as a weight loss aid, FDA issued warning about this product and possible liver damage associated with use.

Source: “The Relative Safety of Ephedra Compared with Other Herbal Products,” Stephen Bent, MD; Thomas N. Tiedt, Ph.D.; Michelle C. Odden, BS; and Michael G. Shlipak, MD, MPH; Annals of Internal Medicine, FDA, and DEA.

Other Sources:

Dietary supplement From the National Institutes of Health (National Center for Complementary and Integrative Health)
… R S T U V W X Y Z Share: On This Page Introduction What the Science …
https://nccih.nih.gov/health/ – Drugs and Supplements

Weight Loss and Complementary Health Practices: What the Science Says From the National Institutes of Health (National Center for Complementary and Integrative Health)
… risk of sunburn, particularly in light-skinned people.
https://nccih.nih.gov/health/providers/digest/weightloss-science – External Health Links

Guarana
… evidence that a specific combination product containing guarana, ephedra, and 17 other vitamins, minerals, and supplements (Metabolife- … excretion. CreatineThere is some concern that combining caffeine, ephedra, and creatine might increase the risk of serious …
https://www.nlm.nih.gov/medlineplus/druginfo/natural/935.html – Drugs and Supplements

Dietary Supplements for Weight Loss From the National Institutes of Health (National Institutes of Health, Office of Dietary Supplements) – PDF
… weight loss dietary supplements that used to contain ephedra, another stimulant- containing herb that was banned from … U.S. market in 2004. Does it work? Bitter orange might slightly increase …
https://ods.od.nih.gov/pdf/factsheets/WeightLoss-Consumer.pdf – External Health Links

Effexor

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:41:44 GMT

Effexor (Venlafaxine) is used to treat depression. It may improve your mood and energy level, and may help restore your interest in daily living. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

Ecstasy

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:40:53 GMT

MDMA, ecstasy, stimulates the release of serotonin. Prozac and other prescription drugs also stimulate the release of serotonin the difference being that the release is controlled by the strength of the Prozac.

Ecstasy abuse and the trafficking of Ecstasy is on the rise, posing serious social concerns. Once confined to major metropolitan areas, Ecstasy trafficking has now expanded to smaller communities. Teenagers and young adults continue to be the primary targets of sophisticated crime syndicates who are supplying distribution groups with ever-increasing amounts of Ecstasy tablets. As the trend to consume Ecstasy in tandem with alcohol and other drugs continues, the harmful effects of the drug will increase exponentially.

“The body normally releases serotonin a little at a time, but Ecstasy dumps it all.”

(3,4-methylenedioxy-N-methylamphetamine), also referred to as Ecstasy, XTC, Adam, and Essence, is an illegally manufactured variation of mescaline and amphetamine. It is considered a designer drug—a substance on the drug market that is a chemical analog or variation of another psychoactive drug.

MDMA is marketed as a feel-good drug. Devotees say it produces profoundly positive feelings, empathy for others, elimination of anxiety, and extreme relaxation–hence the nickname “hug drug,” or “love drug.” MDMA is also said to suppress the need to eat, drink, or sleep, enabling club scene users to endure all-night and sometimes two, or three-day parties.

MDMA is taken orally, usually in tablet or capsule form. MDMA tablets are often “stamped” with icons or logos intended to appeal to a young audience. Its effects last approximately four to six hours.

Tablets sold as Ecstasy are not always pure MDMA. As demand for Ecstasy has increased, so has the appearance of Ecstasy “fakes” often containing other substances such as amphetamine, caffeine, codeine, DXM, ephedra/ephedrine, ketamine, MDA, methamphetamine, and PCP. When used alone, MDMA is dangerous. It is even more dangerous when used in combination with other substances, as the physical and psychological effects are difficult to determine or predict.

SHORT TERM EFFECTS:

Increased heart rate, blood pressure, and body temperature; jaw and teeth clenching/muscle tension, hypertension, dehydration, chills and/or sweating, nausea, blurred vision, faintness, dizziness, confusion, insomnia, and paranoia.

MEDICAL COMPLICATIONS:

LARGE DOSE:

Muscle breakdown, hyperthermia, kidney failure and cardiovascular system failure.

LONG TERM USE:

Depression, sleep disorders, paranoia, drug craving, persistent elevation of anxiety, liver damage, brain damage, paralysis, and possible others pending research.

Ecstasy can cause body temperature can soar up to 108 degrees.

For more information, get the Club Drug Booklet or the Drug ID Desk Reference which has hundreds of images of Ecstasy tablets as well as the Ecstasy Poster.

DXM

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:38:04 GMT

Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms including pain, coughs and colds, diarrhea, constipation, acne, and others. Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages.

Dextromethorphan (DXM) is a cough suppressant found in many OTC cold medicines. The most common sources of abused DXM are “extra-strength” cough syrup, tablets and gel capsules. OTC medications that contain DXM often also contain antihistamines and decongestants. DXM may be swallowed in its original form or may be mixed with soda for flavor, called “robo-tripping” or “skittling.” Users sometimes inject it. These medicines are often misused in combination with other drugs, such as alcohol and marijuana.

DOB

bob@simplesitecompany.com (Bob Hansen) — Sat, 29 Jan 2022 17:36:13 GMT

DOM, DOB, STP, 2C-B, 2C-E, 2C-1

DOM, DOB, STP, 2C-b, 2C-e, 2C-i, MDA Many chemical variations of mescaline and amphetamine (Dom-Dob-STP-2c-b-mda) have been synthesized for their “feel good” effects. MDMA (Ecstasy) is the most popular and widely abused variation used today. DOM, DOB, STP, 2C-b, 2C-e, 2C-i, MDA DOM (4-Methyl-2,5-dimethoxyamphetamine) was introduced to the San Francisco drug scene in the late 1960’s…

Hallucinogens, DOM, DOB, STP, 2C-b, 2C-e, 2C-i, MDA, are found in plants and fungi or are synthetically Hallucinogens and are among the oldest known group of drugs used produced and are among the oldest known group of drugs used for their ability to alter human perception and mood.

Throughout the drug discovery process, pharmaceutical companies, academic institutions, research institutions, and other organizations publish their studies in scientific journals, books, and patents. This information exchange, which is essential to the legitimate scientific enterprise, can be, and is, used by clandestine chemists who duplicate the technical sophistication used by the research community to manufacture and market a seemingly endless variety of analogs of so-called designer drugs.

The term “designer drug” is a colloquial term that references substances with properties and effects similar to those of stimulant, depressant, hallucinogenic or narcotic drugs but that are chemically modified to evade control as an illicit drug. Although news reports tend to portray the appearance of these substances as a new trend, designer drugs have been in the illicit marketplace for decades. The distinction of today’s designer drugs is the substantial volume and endless variety of designer drugs easily available to the public and the organized, extensive distribution networks utilized by designer drug traffickers.

Since the 1970s, domestic clandestine chemists have attempted to manipulate the molecular structures of controlled substances to create synthetic drugs that would have the same pharmacologic properties of a controlled drug, but not expose the chemist or distributor to criminal violations under the Federal Controlled Substances Act (CSA) or similar state statutes. Since these drugs are created in a clandestine laboratory, no manufacturing standards or safety and efficacy studies, such as those required by the Food and Drug Administration (FDA) with respect to pharmaceutical drugs, ensure the safety of the products ingested. Designer drugs were distinguished from traditional illicit drugs of abuse due to the lack of history and appreciation for the short and long-term health effects of use. Historically, the introduction of “designer drugs,” Dom-Dob-STP-2c-b-mda, into the marketplace was generally similar to that of illicit controlled substances: covert meetings and sales on street corners, back alleys, and in dark clubs. During this time period, the infusion of these drugs into the illicit marketplace wreaked havoc in certain areas of the country.

In the 1970s and 1980s, clandestine chemists introduced synthetic alternatives to the Schedule II drug fentanyl into the illicit marketplace. These drugs were distributed to heroin abusers who were unaware that the drug they were purchasing was 100 to 500 times more potent than morphine. Drug abusers were the unknowing test subjects used to determine the viability of the substances as a replacement for controlled narcotics. This uncontrolled experimentation resulted in overdose deaths in concentrated areas of the country with law enforcement authorities scrambling to identify the drug and locate the clandestine laboratories and chemists that produced the substances. In some instances, it wasn’t the strength of the drug, but its toxic contaminants that ultimately harmed the users. For example, a domestic chemist was attempting to manufacture MPPP, a synthetic alternative to the Schedule II drug meperidine (Demerol®). During the manufacturing process, the chemist manufactured MPPP that was contaminated with MPTP, a neurotoxin that caused end-stage Parkinson’s symptoms (involuntary motor movement) in the user. Again, the clandestine chemist was using illicit drug users as subjects for his own personal laboratory experiment, with tragic results. At the time, these synthesized drugs were not controlled substances under the CSA and therefore there was little, if any, criminal exposure and little incentive to stop manufacturing and producing the drugs. The possibility of synthesizing a non-controlled substance that could produce millions of dollars in income was too enticing to stop experimenting on a readily-available number of test subjects.

SOURCE: DEA

Didrix

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:48:24 GMT

Didrex (Benzphetamine hydrochloride) is a sympathomimetic amine with pharmacologic activity similar to the prototype drugs of this used in obesity, the amphetamines. Actions include central nervous system stimulation and elevation of blood pressure. “

Stimulants speed up the body’s systems. This class of drugs includes prescription drugs such as amphetamines (Adderall® and Dexedrine®), methylphenidate (Concerta® and Ritalin®), diet aids (such as Didrex®, Bontril®, Preludin®, Fastin®, Adipex P®, Ionomin®, and Meridia®) and illicitly produced drugs such as methamphetamine, cocaine, and methcathinone.

Street names

Bennies, Black Beauties, Cat, Coke, Crank, Crystal, Flake, Ice, Pellets, R-Ball, Skippy, Snow, Speed, Uppers, Vitamin R

Stimulants or diet aids like Didrex can be pills or capsules that are swallowed. Smoking, snorting, or injecting stimulants produces a sudden sensation known as a “rush” or a “flash.” Abuse is often associated with a pattern of binge use —sporadically consuming large doses of stimulants over a short period of time. Heavy users may inject themselves every few hours, continuing until they have depleted their drug supply or reached a point of delirium, psychosis, and physical exhaustion. During heavy use, all other interests become secondary to recreating the initial euphoric rush.

When used as drugs of abuse and not under a doctor’s supervision, stimulants are frequently taken to produce a sense of exhilaration, enhance self-esteem, improve mental and physical performance, increase activity, reduce appetite, extend wakefulness for a prolonged period, and “get high.” Chronic, high-dose use is frequently associated with agitation, hostility, panic, aggression, and suicidal or homicidal tendencies. Paranoia, sometimes accompanied by both auditory and visual hallucinations, may also occur. Tolerance, in which more and more drug is needed to produce the usual effects, can develop rapidly, and psychological dependence occurs. In fact, the strongest psychological dependence observed occurs with the more potent stimulants, such as amphetamine, methylphenidate, methamphetamine, cocaine, and methcathinone. Abrupt cessation is commonly followed by depression, anxiety, drug craving, and extreme fatigue, known as a “crash.”

Stimulants are sometimes referred to as uppers and reverse the effects of fatigue on both mental and physical tasks. Therapeutic levels of stimulants can produce exhilaration, extended wakefulness, and loss of appetite. These effects are greatly intensified when large doses of stimulants are taken. Taking too large a dose at one time or taking large doses over an extended period of time may cause such physical side effects as dizziness, tremors, headache, flushed skin, chest pain with palpitations, excessive sweating, vomiting, and abdominal cramps.

Some hallucinogenic substances, such as Ecstasy, have a stimulant component to their activity.

In overdose, unless there is medical intervention, high fever, convulsions, and cardiovascular collapse may precede death. Because accidental death is partially due to the effects of stimulants on the body’s cardiovascular and temperature-regulating systems, physical exertion increases the hazards of stimulant use.

Diazepam

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:23:50 GMT

Diazepam, first marketed as Valium, is a medication of the benzodiazepine family that typically produces a calming effect. It is commonly used to treat a range of conditions including anxiety, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, seizures, trouble sleeping, and restless legs syndrome. Common side effects include sleepiness and trouble with coordination.

This drug is mainly used to treat anxiety, insomnia, panic attacks and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis, or amnesia before certain medical procedures.

SIDE EFFECTS FROM DIAZEPAM ARE COMMON AND INCLUDE THE FOLLOWING:

-drowsiness
-dizziness
-tiredness
-weakness
-dry mouth
-diarrhea
-nausea
-changes in appetite

Other Sources

Drug Identification Guide

CDC Facts

CDC Addiction Info

CDC Substance Treatment

Samhsa Workplace Programs

Drug-Free

Federal Register Codification

Detropropoxyphene

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:22:33 GMT

Dextropropoxyphene is associated with a number of toxic side effects and is among the top 10 drugs reported by medical examiners in drug abuse deaths.

DEXTROPROPOXYPHENE

A close relative of methadone, dextropropoxyphene was first marketed in 1957 under the trade name of Darvon®. Oral analgesic potency is one-half to one-third that of codeine, with 65 mg approximately equivalent to about 600 mg of aspirin. Dextropropoxyphene is prescribed for relief of mild to moderate pain. Bulk dextropropoxyphene is in Schedule II, while preparations containing it are in Schedule IV. More than 100 tons of dextropropoxyphene are produced in the United States annually, and more than 30 million prescriptions are written for the products. This narcotic is associated with a number of toxic side effects and is among the top 10 drugs reported by medical examiners in drug abuse deaths.

The Controlled Substances Act (CSA) regulates five classes of drugs: narcotics, depressants, stimulants, hallucinogens, and anabolic steroids. Each class has distinguishing properties, and drugs within each class often produce similar effects. However, all controlled substances, regardless of class, share a number of common features. It is the purpose of this introduction to familiarize the reader with some of these shared features and to give definition to terms (printed in bold) frequently associated with these drugs.

With the exception of anabolic steroids, drugs in the other classes are utilized to alter mood, thought, and feeling through their actions on the central nervous system (brain and spinal cord). For example, some of these drugs alleviate pain, anxiety, or depression. Some induce sleep and others energize. Though therapeutically useful, the “feel good” effects of these drugs contribute to their abuse. The extent to which a substance is reliably capable of producing intensely pleasurable feelings (euphoria) increases the likelihood of that substance being abused.

When drugs are used in a manner or amount inconsistent with the medical or social patterns of a culture, it is called drug abuse. In legal terms, the non-sanctioned use of substances controlled in Schedules I through V of the CSA is considered drug abuse. While legal pharmaceuticals placed under control in the CSA are prescribed and used by patients for medical treatment, the use of these same pharmaceuticals outside the scope of Sound medical practice is drug abuse.

In addition to having abuse potential, most controlled substances are capable of producing dependence, either physical or psychological. Physical dependence refers to the changes that have occurred in the body after repeated use of a drug that necessitates the continued administration of the drug to prevent a withdrawal syndrome. This withdrawal syndrome can range from mildly unpleasant to life-threatening and is dependent on a number of factors. The type of withdrawal experienced is related to the drug being used; the dose and route of administration; concurrent use of other drugs; frequency and duration of drug use; and the age, sex, health, and genetic makeup of the user. Psychological dependence refers to the perceived “need” or “craving” for a drug. Individuals who are psychologically dependent on a particular substance often feel that they cannot function without the continued use of that substance. While physical dependence disappears within days or weeks after drug use stops, psychological dependence can last much longer and is one of the primary reasons for relapse/initiation of drug use after a period of abstinence).

Contrary to common belief, physical dependence is not addiction. While addicts are usually physically dependent on the drug they are abusing, physical dependence can exist without addiction. For example, patients who take narcotics for chronic pain management or benzodiazepines to treat anxiety as compulsive drug-seeking behavior where acquiring and using a drug becomes the most important activity in the user’s life. This definition implies a loss of control regarding drug use, and the addict will continue to use a drug despite serious medical and/or social consequences. The National Institute on Drug Abuse (NIDA) estimates that about five million Americans suffer from drug addiction.

Individuals that abuse drugs often have a preferred drug that they use, but may substitute other drugs that produce similar effects (often found in the same drug class) when they have difficulty obtaining their drug of choice. Drugs within a class are often compared with each other with terms like potency and efficacy. Potency refers to the amount of a drug that must be taken to produce a certain effect, while efficacy refers to whether or not a drug is capable of producing a given effect regardless of dose. Both the strength and the ability of a substance to produce certain effects play a role in whether that drug is selected by the drug abuser.

It is important to keep in mind that the effects produced by any drug can vary significantly and is largely dependent on the dose and route of administration. Concurrent use of other drugs can enhance or block an effect and substance abusers often take more than one drug to boost the desired effects or counter unwanted side effects. This means that the risks associated with drug abuse cannot be accurately predicted because each user has his/her own unique sensitivity to a drug. There are a number of theories that attempt to explain these differences, and it is clear that a genetic component may predispose an individual to certain toxicities or even addictive behavior.

Youths are especially vulnerable to drug abuse. According to NIDA, young Americans engaged in extraordinary levels of illicit drug use in the last third of the twentieth century. Today, the majority of young people (about 55 percent) have used an illicit drug by the time they leave high school and about 25 percent of all seniors are current (within the past month) users. The behaviors associated with teen and preteen drug use often result in tragic consequences with untold harm to others, themselves, and their families. For example, an analysis of data from the National Household Survey on Drug Abuse indicates that youngsters between the ages of 12 and 17 who have smoked marijuana within the past year are more than twice as likely to cut class, steal, attack people, and destroy property than are those who did not smoke marijuana. The more frequently a youth smokes marijuana, the more likely he or she is to engage in these antisocial behaviors.

In the sections that follow, each of the five classes of drugs is reviewed and various drugs within each class are profiled. Although marijuana is classified in the CSA as a hallucinogen, a separate section is dedicated to that topic. There are also a number of substances that are abused but not regulated under the CSA. Alcohol and tobacco, for example, are specifically exempt from control by the CSA. In addition, a whole group of substances called inhalants are commonly available and widely abused by children. Control of these substances under the CSA would not only impede legitimate commerce but would likely have little effect on the abuse of these substances by youngsters. An energetic campaign aimed at educating both adults and youth about inhalants is more likely to prevent their abuse. To that end, a section is dedicated to providing information on inhalants. The last section in this publication is entitled U.S. Chemical Control. In recent years, a significant effort has been initiated by the United States to reduce the availability of clandestinely produced drugs by limiting the availability of chemicals and equipment needed to produce them. This section provides information on chemical control and specifically lists those chemicals that are currently regulated under the CSA.

Source: DEA

Other Sources

Drug Identification Guide

CDC Facts

CDC Addiction Info

CDC Overdose Stats

CDC Substance Treatment

Whitehouse Drug-Free Communities

Samhsa Workplace Programs

Drug-Free

Federal Register Codification

Depressants

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:20:05 GMT

Depressants are substances that depress the activity of the central nervous system. They are often referred to as “downers” because of their sedative, hypnotic and tranquilizing effects. There are both legal and illegal depressants. Alcohol is the most common legal depressant. Others that are legal such as Methaqualone, Chloral Hydrate, and Glutethimide are often prescribed medications used to induce sleep, relieve stress, and subdue anxiety.

Another view is: A depressant, is a drug that lowers neurotransmission levels, which is to depress or reduce arousal or stimulation, in various areas of the brain. Depressants are also occasionally referred to as “downers” as they lower the level of arousal when taken. Stimulants or “uppers” increase mental and/or physical function, hence the opposite drug class of depressants is stimulants, not antidepressants. When these drugs are used, effects often include ataxia, anxiolysis, pain relief, sedation or somnolence, and cognitive/memory impairment, as well as in some instances euphoria, dissociation, muscle relaxation, lowered blood pressure or heart rate, respiratory depression, and anticonvulsant effects, and even complete anesthesia or death at high doses.

XANAX

How can I help? (Nemours Foundation)

… How Can I Help a Friend Who Cuts? KidsHealth > For Teens > Print A A A … How Can Someone Quit?
Fact Sheet (Drug Enforcement Administration) – PDF

Drug Fact Sheet Overview Includes barbiturates (barbs), benzodiazepines (benzos) and sedative-hypnotics.
Commonly Abused Drugs Charts From the National Institutes of Health (National Institute on Drug Abuse)
… in treating prescription opioid addiction. Prescription Sedatives (Tranquilizers,) Medications that slow brain activity, which makes them … shared needles. In Combination with Alcohol Masks the depressant action of alcohol, increasing the risk of alcohol overdose; …
https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts – External Health Links
Improper Use of Medications NIHSeniorHealth (National Institute on Drug Abuse)
… improper use of prescription and illicit drugs. Painkillers, Stimulants. The types of prescription medications most … any age are painkillers (such as Vicodin, OxyContin), Xanax, Valium, and stimulants (such as …

Sodium Oxybate

The way that sodium oxybate works to treat …
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a605032.html – Drugs and Supplements
Prescription Drugs From the National Institutes of Health (National Institute on Drug Abuse)

… Marijuana MDMA (Ecstasy or Molly) Methamphetamine (Meth) Prescription Medications Prescription Drugs Prescription Pain Medications (Opioids) Prescription …

https://teens.drugabuse.gov/drug-facts/prescription-drugs – External Health Links

Other Sources

Drug Identification Guide

CDC Facts

CDC Addiction Info

CDC Overdose Stats

CDC Substance Treatment

Whitehouse Drug-Free Communities

Samhsa Workplace Programs

Drug-Free

Federal Register Codification

Crack Cocaine

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:18:03 GMT

Another popular method is to smoke cocaine that has been processed to make a rock crystal (also called “freebase cocaine”). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack, which refers to the crackling sound of the rock as it’s heated.

Crack Cocaine is the freebase form of cocaine that can be smoked.

A coca farmer in Colombia S.A. receives about 5 cents for every gram of cocaine he produces which sells for approximately $100.00 in the U.S.

Codeine

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:16:15 GMT

Codeine is an opioid pain reliever used to treat mild to moderately severe pain. It is also used, usually in combination with other medications, to reduce coughing. Codeine is available as a single-ingredient product, or in combination with acetaminophen or aspirin, and in some cough and cold medications.

Cocaine

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:14:18 GMT

Cocaine Hydrochloride is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. It produces short-term euphoria, energy, and talkativeness in addition to potentially dangerous physical effects like raising heart rate and blood pressure.

How Is Cocaine Used?

The powdered form of Cocaine Hydrochloride is either inhaled through the nose (snorted), where it is absorbed through the nasal tissue or dissolved in water and injected into the bloodstream.

Crack is a form of this drug that has been processed to make a rock crystal (also called “freebase”) that can be smoked. The crystal is heated to produce vapors that are absorbed into the blood-stream through the lungs. (The term “crack” refers to the crackling sound produced by the rock as it is heated.)

The intensity and duration of cocaine’s pleasurable effects depend on the way it is administered. Injecting or smoking cocaine delivers the drug rapidly into the bloodstream and brain, producing a quicker and stronger but shorter-lasting high than snorting. The high from snorting coke may last 15 to 30 minutes; the high from smoking may last 5 to 10 minutes.

In order to sustain their high, people who use cocaine often use the drug in a binge pattern—taking the drug repeatedly within a relatively short period of time, at increasingly higher doses. This practice can easily lead to addiction, a chronic relapsing disease caused by changes in the brain and characterized by uncontrollable drug-seeking no matter the consequences.

Where does cocaine come from?

Cocaine is smuggled to the US mainland by many routes and by many drug smuggling organizations. One such organization starts the progress in Peru, South America where a kilo of pure cocaine can be purchased for around $1000. The cocaine is smuggled from the west coast of Peru to the north coast of Venezuela by Peruvian traffickers where it is further transferred to the Dominican Republic, approximately 500 miles distant on small fishing boats. The value of the one kilo of cocaine on the north coast of Venezuela is now $10,000. Fishing boats move the cocaine to the Dominican Republic and from there across the northwest coast of the Dominican Republic and across the Mona Passage to Puerto Rico approximately 90 miles distant and the gateway to the US mainland. The value of one kg of cocaine is now approximately $20,000. Using multiple methods, air, land, and Sea, the cocaine is transferred to the Miami region where the value of the one kilo of Cocaine is now approximately $40,000.

Because of the cocaine trafficking thru Puerto Rico, homicide rates are up six times that of the United States. About 30 percent of the cocaine that reaches Puerto Rico is trafficked in Puerto Rico mostly because traffickers are paid in cocaine rather than currency by their bosses.

Speedball” = mix of cocaine and heroin.

“Bulked” cocaine is cut or diluted cocaine.

“Solid” cocaine if pure cocaine

For more information and photographs of coke and crack cocaine, get the crack brochure or the Drug Identification Guide.

Other Sources:

Stimulant (National Library of Medicine)

Coke is a white powder. It can be snorted up the nose or mixed with water and injected with a needle. Coke can also be made into small white rocks, … Crack is smoked in a small glass pipe. Cocaine speeds up your whole body. You may feel …

Stimulant intoxication
Intoxication may be caused by taking too much cocaine or too concentrated a form of coke Using cocaine when the weather is hot, which …
https://www.nlm.nih.gov/medlineplus/ency/article/000946.htm – Medical Encyclopedia

Stimulant From the National Institutes of Health (National Institute on Drug Abuse)
… to-Read Web site Citation Site Map Print Street names: Blow, Coke, Crack Home / Drug Facts / What Is Cocaine? Also known as: “coke,” “Coca,” “C,” “snow,” “flake,” “ …
https://teens.drugabuse.gov/drug-facts/stimulants – External Health Links

Stimulant From the National Institutes of Health (National Institute on Drug Abuse)
… Search Share Print Home » Publications » DrugFacts »

Other Sources:

Drug Identification Guide

CDC Facts

CDC Addiction Info

CDC Substance Treatment

Samhsa Workplace Programs

Drug-Free

Federal Register

Coca Leaf

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:11:05 GMT

Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. It produces short-term euphoria, energy, and talkativeness in addition to potentially dangerous physical effects like raising heart rate and blood pressure.

The coca leaves are ground up in a outdoor laboratory and saturated with a chemical liquid, usually gasoline, that removes the Cocaine alkaloid crystals from the leaf. This produces a damp mud-like paste. The liquid mix if filtered and dried allowing the the cocaine crystals to appear as a paste.

Although there are 200 varieties of this plant, only two of them contain enough cocaine for refining. These two types are found in the mountains of South and Central America. This alkaloid is a very powerful stimulant and people used it for centuries before it became a popular high-end drug.

Clonazepam

Courtney@simple.biz (Courtney Andresen) — Fri, 28 Jan 2022 21:09:39 GMT

Clonazepam is used alone or in combination with other medications to control certain types of seizures. It is also used to relieve panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). This drug is in a class of medications called benzodiazepines. It works by decreasing abnormal electrical activity in the brain.

Clonazepam comes as a tablet and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. It usually is taken one to three times a day with or without food. Take this drug at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Do not try to push the orally disintegrating tablet through the foil. Instead, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it in your mouth. The tablet will quickly dissolve and can be swallowed with or without liquid.

Your doctor will probably start you on a low dose of clonazepam and gradually increase your dose, not more often than once every 3 days.

Clonazepam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time or in a different way than prescribed by your doctor. Take clonazepam exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Clonazepam may help control your condition, but will not cure it. It may take a few weeks or longer before you feel the full benefit of this drug. Continue to take the drug even if you feel well. Do not stop taking clonazepam without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood, If you suddenly stop taking the drug, you may experience withdrawal symptoms such as new or worsening seizures, hallucinating (seeing things or hearing voices that do not exist), changes in behavior, sweating, uncontrollable shaking of a part of your body, stomach or muscle cramps, anxiety, or difficulty falling asleep or staying asleep. Your doctor will probably decrease your dose gradually.

Clonazepam is also used to treat symptoms of akathisia (restlessness and a need for constant movement) that may occur as a side effect of treatment with antipsychotic medications (medications for mental illness) and to treat acute catatonic reactions (state in which a person does not move or speak at all or moves or speaks abnormally). Talk to your doctor about the possible risks of using this medication for your condition.

Other Sources:

More is used alone or in combination with other medications to control certain types of seizures. It … of extreme fear and worry about these attacks).
Myoclonus From the National Institutes of Health (National Institute of Neurological Disorders and Stroke)

… myoclonus, especially certain types of action myoclonus, a type of tranquilizer. Dosages of the drug usually are increased gradually until the individual improves …
10 “Poison Pills” for Pets (American Veterinary Medical Association)

… become very agitated and develop elevated heart rates. Clonazepam (Klonopin®) is used as an anticonvulsant and anti- … prescribed as a sleep-aid.
Myoclonus From the National Institutes of Health (National Institute of Neurological Disorders and Stroke) – Short Summary
… reduce symptoms. The drug of choice is clonazepam, a type of tranquilizer. Many of the drugs … be used either alone or in combination with clonazepam.

Myoclonus may require the use of multiple drugs …
Medications for Ataxia Symptoms (National Ataxia Foundation)

… depression Dizziness/Vertigo : Acetazolamide (Diamox), 4-aminopyridine, Baclofen, Clonazepam, Flunarizine, Gabapentin (Neurontin), Meclizine, Memantine, Ondansetron (Zofran), Scopolamine ( …

Pregnancy and Childbirth with Neuromuscular Disease (Muscular Dystrophy Association) – PDF
… been performed. azathioprine (Azasan, Imuran) baclofen (Kemstro, Lioresal) clonazepam (Klonopin) dermatomyositis inclusion-body myositis polymyositis myasthenia gravis •

Chloral Hydrate

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:07:09 GMT

The oldest of the hypnotic (sleep inducing} depressants, chloral hydrate was first synthesized in 1832. Marketed as syrups or soft gelatin capsules, chloral hydrate takes effect in a relatively short time (30 minutes) and will induce sleep in about an hour. A solution of chloral hydrate and alcohol constituted the infamous “knockout drops” or “Mickey Finn.” Chloral Hydrate has a very limited use today.

At therapeutic doses, chloral hydrate has little effect on respiration and blood pressure; however; a toxic dose produces severe respiratory depression and very low blood pressure. Chronic use is associated with liver damage and a severe withdrawal syndrome. Although some physicians consider chloral hydrate to be the drug of choice for sedation of children before diagnostic, dental, or medical procedures, its general use as a hypnotic has declined. Chloral hydrate (Noctec® and other) and compounds, preparations, or mixtures containing chloral hydrate are in Schedule IV of the CSA. SIGNS OF OVERDOSE: Confusion (continuing); convulsions (seizures); difficulty in swallowing; drowsiness (severe); low body temperature; nausea, vomiting, or stomach pain (severe); shortness of breath or troubled breathing; slow or irregular heartbeat; slurred speech; staggering; weakness (severe).

Chloral hydrate is illegal without a prescription and is a schedule IV controlled substance in the United States. Its properties have sometimes led to its use as a date rape drug.[21][unreliable source?] This drug is still available in the United States, albeit it is relatively uncommon and not often kept in the inventory of major pharmacies. It has largely been abandoned for the treatment of insomnia in favor of newer drugs such as the Z-drugs family, which includes zolpidem, zaleplon, zopiclone, and eszopiclone. A small number of medical practitioners continue to prescribe it to treat insomnia when all other more modern medications have failed. In the United States, it is commonly supplied in syrup form in a 500 mg/5mL concentration. It is also supplied in suppository form, through use of this method of administration is extremely rare.

It is not controlled in Canada except that a prescription is required to purchase the pharmaceutical forms. Possession without a prescription is not illegal and industrial trade is not regulated.

The United Kingdom does not consider chloral hydrate to be a controlled substance.

Chloral hydrate is a prescription-only medicine (POM) in the Netherlands, but possession without a valid prescription will result only in a seizure of the drug, not prosecution. Production, sale, and distribution are however punishable by law. It is not listed under the Dutch Opium Law, but when the intent is human consumption, it is covered by the Geneesmiddelenwet (Medicine Act).

Other Sources:

Chloral Hydrate

a sedative is used in the short-term treatment of insomnia (to help you fall asleep … Chloral hydrate comes as a capsule and liquid to take by mouth and as a suppository to insert …
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682201.html – Drugs and Supplements

Substance use disorder
… They include alcohol, barbiturates, benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. Using these substances can lead to …
https://www.nlm.nih.gov/medlineplus/ency/article/001522.htm – Medical Encyclopedia

Treatments for Sleep Changes (Alzheimer’s Association)
… temazepam “Sleeping pills” such as zolpidem, zaleplon, and chloral hydrate “Atypical” antipsychotics such as risperidone, olanzapine, and quetiapine …
www.alz.org/alzheimers_disease_10429.asp – External Health Links

Drug abuse
… yellow jackets” Benzodiazepines (e.g. Valium, Ativan, Xanax) Chloral hydrateParaldehyde Signs and symptoms of excessive alcohol or …
https://www.nlm.nih.gov/medlineplus/ency/article/001945.htm – Medical Encyclopedia

Known and Probable Human Carcinogens (American Cancer Society)
Chloramphenicol alpha-Chlorinated toluenes (benzal chloride, benzotrichloride, benzyl …

Celexa

Courtney@simple.biz (Courtney Andresen) — Fri, 28 Jan 2022 21:04:57 GMT

Celexa (Citalopram) is included in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs is used to treat depression, anxiety, and other mood disorders.

The U.S. Food and Drug Administration (FDA) is clarifying dosing and warning recommendations for the antidepressant Celexa (citalopram hydrobromide; also available in generic form). In August 2011, FDA issued a Drug Safety Communication (DSC) stating that citalopram should no longer be used at doses greater than 40 mg per day because it could cause potentially dangerous abnormalities in the electrical activity of the heart.

Citalopram use at any dose is discouraged in patients with certain conditions because of the risk of QT prolongation, but because it may be important for some of those patients to use citalopram, the drug label has been changed to describe the particular caution that needs to be taken when citalopram is used in such patients. The revised drug label also describes lower doses that should be used in patients over 60 years of age.

Changes in the electrical activity of the heart (specifically, prolongation of the QT interval of the electrocardiogram [ECG]) can lead to a risk of an abnormal heart rhythm called Torsade de Pointes, which can be fatal. Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to having low levels of potassium and magnesium in the blood.

The citalopram drug label was revised on August 12, 2011, and again on March 27, 2012, to include new warnings about the potential for QT interval prolongation and Torsade de Pointes, as well as new drug dosage and usage recommendations. (See Additional Information for Healthcare Professionals).

Source: FDA

Other Sources;

Citalopram

Citalopram is used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It is thought to work by increasing the amount of …

https://www.nlm.nih.gov/medlineplus/druginfo – Drugs and Supplements

Citalopram/Escitalopram (Lexapro) and Pregnancy(Organization of Teratology Information Specialists) – PDF
Citalopram/Escitalopram (Celexa®/Lexapro®) and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having a … risk. This sheet talks about whether exposure to citalopram/escitalopram may increase the risk of birth defects …
mothertobaby.org/…/pdf – External Health Links

Best Medications to Treat Fibromyalgia (Consumers Union of U.S.)
… stopped taking the drug due to side effects. Citalopram, fluoxetine, paroxetine These medications are not well studied … draw conclusions about the effectiveness of fluoxetine and citalopram for treating fibromyalgia symptoms due to the small …
www.consumerreports.org – External Health Links

NIH-Supported Clinical Trial Finds Antidepressant Reduces Alzheimer’s Agitation From the National Institutes of Health (National Institute on Aging)
… Medical Association reported results from the NIH-supported Citalopram for Agitation in Alzheimer’s Disease Study (CitAD) clinical trial of the antidepressant citalopram (Celexa, Cipramil) as a possible treatment for Alzheimer’s …

Butorphanol

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:02:45 GMT

While butorphanol can be made from thebaine, it is usually manufactured synthetically. It was initially available in injectable formulations for human (Stadol®) and veterinary (Torbugesic® and Torbutrol®) use. Butorphanol is a morphinan-type synthetic opioid analgesic developed by Bristol-Myers.

This nasal spray is used to relieve moderate to severe pain. Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way the body senses pain.

This nasal spray comes as a solution (liquid) to spray in the nose. It is usually used as needed for pain, but not more often than once every 3 to 4 hours. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

This nasal spray should relieve your pain soon after you use it. If you are using a low starting dose of butorphanol nasal spray, your doctor may tell you that you may use a second dose if you still have pain 60 to 90 minutes after your first dose. Do not use this second dose unless your doctor tells you that you may. Call your doctor if you still have pain after using the nasal spray as prescribed. Also, call your doctor if you have used the nasal spray for some time and find that it no longer works as well as it did at the beginning of your treatment.

Butorphanol nasal spray may be habit-forming. Use the nasal spray exactly as directed. Do not use a larger dose or use it more often or for a longer time than prescribed by your doctor. Call your doctor if you develop a strong desire to use more medication than prescribed.

Do not stop using butorphanol nasal spray without talking to your doctor. If you suddenly stop using butorphanol nasal spray, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, sweats, difficulty falling asleep or staying asleep, loss of coordination, confusion, or hallucinations (seeing things or hearing voices that do not exist).Your doctor will probably decrease your dose gradually.

Before you use butorphanol nasal spray for the first time, read the written directions provided by the manufacturer. Ask your doctor or pharmacist if you have any questions about how to use this nasal spray.

This brand is no longer on the market. Generic alternatives may be available.

Other Sources:

Butorphanol Injection

The injection is used to relieve moderate to severe pain. Butorphanol injection is also used to relieve pain during … pain and decrease awareness before or during surgery. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682667.html – Drugs and Supplements

Nasal Spray

The nasal spray is used to relieve moderate to severe pain.
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601204.html – Drugs and Supplements

Your Pet’s Medications (American Veterinary Medical Association)

… be potent pain relievers. Examples include oxycodone, hydromorphone, butorphanol, meperidine, and fentanyl. Most of these drugs are …
https://www.avma.org/public/PetCare/Pages/YourPetsMedications.aspx – External Health Links

Opioid Use and Neural Tube Defects (Centers for Disease Control and Prevention)
… oxycodone, hydrocodone, morphine, propoxyphene, meperidine, methadone, tramadol, hydromorphone, butorphanol, heroin, fentanyl, buprenorphine, nalbuphine, and diphenoxylate. Making Treatment …

Buprenorphine

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 21:00:46 GMT

Buprenorphine is a semi-synthetic narcotic derived from thebaine and is currently being investigated for the treatment of narcotic addiction.

Like methadone and LAAM, buprenorphine is potent (30 to 50 times the analgesic potency of morphine), has a long duration of action, and does not need to be injected. The products under development are sublingual tablets. Unlike the other treatment drugs, this drug produces far less respiratory depression and is thought to be safer in overdose. The drug is currently available in the United States as an injectable Schedule V narcotic analgesic (Buprenex®) for human and veterinary use.

Source: DEA – Schedule III narcotic medications Suboxone® tablets (buprenorphine hydrochloride and naloxone hydrochloride) received FDA approval for the treatment of opioid addiction.

Both buprenorphine and methadone are medications used for detoxification, short- and long-term opioid replacement therapy. Buprenorphine has the advantage of being only a partial agonist; hence negating the potential for life-threatening respiratory depression in cases of abuse.[4] Studies show the effectiveness of this drug and methadone are almost identical, and largely share adverse-effect profiles apart from more sedation among methadone users. At low doses from 2 to 6 mg, however, the drug has a lower retention rate than low doses of 40 mg or less of methadone.

Other Sources:

Sublingual and Buccal
Buprenorphine and the combination of buprenorphine and naloxone are used to treat opioid dependence (addiction to opioid drugs, including heroin and narcotic painkillers). Buprenorphine is in a …

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a605002.html – Drugs and Supplements

Pregnancy Reduces Neonate Distress From the National Institutes of Health(National Institute on Drug Abuse)

… Notes » Treatment » Buprenorphine During Pregnancy Reduces Neonate Distress Buprenorphine During Pregnancy Reduces Neonate Distress Email Facebook Twitter …

https://www.drugabuse.gov/…ring-pregnancy-reduces-neonate-distress – External Health Links

3. Transdermal Patch
Buprenorphine patches are used to relieve severe pain in people who are expected to need pain medication … Transdermal buprenorphine comes as a patch to apply to the skin. The patch is usually applied to the skin …

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a613042.html – Drugs and Supplements

Facts about Treatment of Opioid Addiction (Substance Abuse and Mental Health Services Administration) –

PDF the facts about BUPRENORPHINE for Treatment of Opioid Addiction U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration …

Bontril

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:58:40 GMT

Bontril (phendimetrazine) is a sympathomimetic amine, which is similar to an amphetamine.

Phendimetrazine (Bontril, Adipost, Anorex-SR, Appecon, Melfiat, Obezine, Phendiet, Plegine, Prelu-2, Statobex) is a stimulant drug of the morpholine chemical class used as an appetite suppressant.

Phendimetrazine is similar to an amphetamine. It is also known as an “anorectic” drug as it stimulates the central nervous system, which increases your heart rate and blood pressure and decreases your appetite.

Phendimetrazine is used as a short-term supplement to diet and exercise in the treatment of obesity.

Bontril may cause blurred vision or impair your thinking or reactions. Driving could be hazardous to the driver or pedestrians. Those who take this drug should not do work that requires you to be alert and able to see clearly. Phendimetrazine could be habit-forming and should be used only by the person for who it was prescribed and dosing instruction should be followed. Control should be kept in a secure place where children and others cannot get at it.

More information in the Prescription Drug Booklet

References:

Landau D, Jackson J, Gonzalez G (2008).

“A case of demand ischemia from phendimetrazine”.

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“Therapeutic potential of monoamine transporter substrates” .

Current Topics in Medicinal Chemistry 6 (17): 1845–59. doi:10.2174/156802606778249766. PMID 17017961.

Black Tar Heroin

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:56:55 GMT

“Black tar” a relatively crude and unrefined form of heroin is sticky like roofing tar or hard like coal and is predominantly produced in Mexico and sold in U.S. areas west of the Mississippi River. The production of this crude heroin does not require complex lab equipment, high-purity acetylating chemicals or lengthy reflux steps necessary to produce pure heroin, making tar heroin attractive to clandestine drug producers. The dark color associated with black tar heroin results from crude processing methods that leave behind impurities. Impure heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.

Source: NIDA

Betel Nut

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:55:28 GMT

Betel Nut is used by almost a tenth of the world’s population, mostly in Asia. It is a stimulant equivalent to the nicotine in cigarettes or several cups of coffee and is reported to be used variously as a symbol of love, marriage and a cure for indigestion and impotence.

The nut comes from the areca tree which is described as a feathery tropical palm tree that produces the nut all year. The chewing of betel nut dates to antiquity.

Betel Nuts are found across Asia where they are harvested from the Areca palm and are chewed for their stimulating properties. Used by women and children, the nuts are especially popular among working-age men, who chew to stay awake through long hours of work. Betel Nuts have a downside. They can cause oral cancer.

An international working group of scientific experts convened by the Monographs Program of the International Agency for Research on Cancer (IARC), part of the World Health Organization, has reviewed the published studies related to cancer and chewing betel quid and areca nut. A previous evaluation in 1985 had found that chewing betel quid with tobacco is carcinogenic to humans. The new evaluation goes further to conclude that chewing betel quid without tobacco is also carcinogenic to humans. The working group also concluded that the areca nut, a common component of many different chewing habits, is carcinogenic to humans.

Betel Nut – ARECA NUTS WRAPPED IN BETEL LEAVES

Oral cancers are more common in parts of the world where betel quid is chewed. Of the 390,000 oral and oropharyngeal cancers estimated to occur annually in the world, 228,000 (58%) occur in South and South-East Asia. In some parts of India, oral cancer is the most common cancer. Striking evidence has emerged from Taiwan, China, where the incidence of oral cancer in men has tripled since the early 1980s, coinciding with a steep rise since the early 1970s and predominantly among men, in the practice of chewing betel quid. Tobacco generally is not added to the betel quid in that region.

Source: World Health Organization

Benzodiazepines

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:53:15 GMT

More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. Benzodiazepines (sometimes called “benzos”) work to calm or sedate a person, by raising the level of the inhibitory neurotransmitter GABA in the brain. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), among others.

Every day, more than 115 Americans die after overdosing on opioids. However, between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67%, from 8.1 million to 13.5 million. The quantity obtained also increased from 1.1 kg to 3.6 kg lorazepam-equivalents per 100,000 adults. Combining opioids and benzodiazepines can be unsafe because both types of drug sedate users and suppress breathing—the cause of overdose fatality—in addition to impairing cognitive functions. In 2015, 23 percent of people who died of an opioid overdose also tested positive for benzodiazepines. Unfortunately, many people are prescribed both drugs simultaneously. In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2001. The study showed that people concurrently using both drugs are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency.

Previous studies have also highlighted the dangers of co-prescribing opioids and benzodiazepines. A cohort study in North Carolina found that the overdose death rate among patients receiving both types of medications was 10 times higher than among those only receiving opioids. In a study of overdose deaths in people prescribed opioids for noncancer pain in Canada, 60 percent also tested positive for benzodiazepines. A study among U.S. veterans with an opioid prescription found that receiving a benzodiazepine prescription was associated with increased risk of drug overdose death in a dose-response fashion.

In 2016, the Centers for Disease Control and Prevention (CDC) issued new guidelines for the prescribing of opioids. They recommend that clinicians avoid prescribing benzodiazepines concurrently with opioids whenever possible. Both prescription opioids and benzodiazepines now carry FDA “black box” warnings on the label highlighting the dangers of using these drugs together. People being prescribed any medications should inform their doctors about all of the other drugs and medications they use, and patients should consult with their doctors about the potential dangers of using various medications and substances together, including the use of alcohol.

Source: NIDA

Bath Salts

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:51:10 GMT

Synthetic cathinones, more commonly known as “bath salts,” are human-made stimulants chemically related to cathinone, a substance found in the khat plant. Khat is a shrub grown in East Africa and southern Arabia, where some people chew its leaves for their mild stimulant effects. Human-made versions of cathinone can be much stronger than the natural product and, in some cases, very dangerous.

Synthetic cathinones usually take the form of a white or brown crystal-like powder and are sold in small plastic or foil packages labeled “not for human consumption.” They can be labeled as “bath salts,” “plant food,” “jewelry cleaner,” or “phone screen cleaner.”

Synthetic cathinones are part of a group of drugs that concern public health officials called “new psychoactive substances” (NPS). NPS are unregulated psychoactive mind-altering substances with no legitimate medical use and are made to copy the effects of controlled substances. They are introduced and reintroduced into the market in quick succession to dodge or hinder law enforcement efforts to address their manufacture and sale.

Synthetic cathinones are marketed as cheap substitutes for other stimulants such as methamphetamine and cocaine, and products sold as Molly (MDMA) often contain synthetic cathinones instead.

People can buy synthetic cathinones online and in drug paraphernalia stores under a variety of brand names, which include:

Bliss
Cloud Nine
Lunar Wave
Vanilla Sky
White Lightning

How do people use synthetic cathinones?
People typically swallow, snort, smoke, or inject synthetic cathinones.

How do synthetic cathinones affect the brain?

Much is still unknown about how synthetic cathinones affect the human brain. Researchers do know that synthetic cathinones are chemically similar to drugs like amphetamines, cocaine, and MDMA.

A study found that 3,4-methylenedioxypyrovalerone (MDPV), a common synthetic cathinone, affects the brain in a manner similar to cocaine, but is at least 10 times more powerful. MDPV is the most common synthetic cathinone found in the blood and urine of patients admitted to emergency departments after taking “bath salts.”

Synthetic cathinones can produce effects that include:

paranoia—extreme and unreasonable distrust of others
hallucinations—experiencing sensations and images that seem real but are not
increased friendliness
increased sex drive
panic attacks
excited delirium—extreme agitation and violent behavior

What are other health effects of synthetic cathinones?

Raised heart rate, blood pressure, and chest pain are some other health effects of synthetic cathinones. People who experience delirium often suffer from dehydration, breakdown of skeletal muscle tissue, and kidney failure.

The worst outcomes are associated with snorting or needle injection. Intoxication from synthetic cathinones has resulted in death.

Are synthetic cathinones addictive?

Yes, synthetic cathinones can be addictive. Animal studies show that rats will compulsively self-administer synthetic cathinones. Human users have reported that the drugs trigger intense, uncontrollable urges to use the drug again.

Taking synthetic cathinones can cause strong withdrawal symptoms that include:

depression
anxiety
tremors
problems sleeping
paranoia

How can people get treatment for addiction to synthetic cathinones?
Behavioral therapy can be used to treat addiction to synthetic cathinones. Examples include:

cognitive-behavioral therapy
contingency management, or motivational incentives—providing rewards to patients who remain substance free
motivational enhancement therapy
behavioral treatments geared to teens

As with all addictions, health care providers should screen for co-occurring mental health conditions. While there are no FDA-approved medicines for synthetic cathinone addiction, there are medicines available for common co-occurring conditions.

Source: NIDA, NIH, U.S. Department of Health and Human Services.

Barbiturates

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:46:05 GMT

Barbiturates were first introduced for medical use in the early 1900s. More than 2,500 barbiturates have been synthesized, and at the height of their popularity, about 50 were marketed for human use. Today, about a dozen are in medical use. Barbiturates produce a wide spectrum of central nervous system depression, from mild sedation to coma, and have been used as sedatives, hypnotics, anesthetics, and anticonvulsants. The primary differences among many of these products are how fast they produce an effect and how long those effects last. Barbiturates are classified as ultrashort, short, intermediate, and long-acting.

The ultrashort-acting barbiturates produce anesthesia within about one minute after intravenous administration. Those in current medical use are the Schedule IV drug methohexital (Brevital®), and the Schedule III drugs thiamyl (Surital®) and thiopental (Pentothal®). Barbiturate abusers prefer the Schedule II short-acting and intermediate-acting barbiturates that include amobarbital (Amyta®), pentobarbital (Nembutal®), secobarbital (Seconal®), and Tuinal (an amobarbital/secobarbital combination product). Other short and intermediate-acting barbiturates are in Schedule III and include butalbital (Fiorina®), butabarbital (Butisol®), talbutal (Lotusate®), and aprobarbital (Alurate®). After oral administration, the onset of action is from 15 to 40 minutes, and the effects last up to six hours. These drugs are primarily used for insomnia and preoperative sedation. Veterinarians use pentobarbital for anesthesia and euthanasia.

Long-acting barbiturates include phenobarbital (Luminal®) and mephobarbital (Mebaral®), both of which are in Schedule IV. Effects of these drugs are realized in about one hour and last for about 12 hours and are used primarily for daytime sedation and the treatment of seizure disorders.

Get the Prescription Drug Booklet for more information.

Other Sources:
Barbiturate intoxication and overdose
Intoxication – barbiturates … Barbiturate abuse is a major addiction problem for many people. Most people who take these medications for …
https://www.nlm.nih.gov/medlineplus/ency/article/000951.htm – Medical Encyclopedia
Toxicology screen
Barbiturates – screen; Benzodiazepines – screen; Amphetamines – screen; Analgesics – screen; Antidepressants – screen; Narcotics – screen; Phenothiazines – screen; Drug abuse screen; …
https://www.nlm.nih.gov/medlineplus/ency/article/003578.htm – Medical Encyclopedia
Phenobarbital
… need to continue taking the medication) on another barbiturate medication and are going to stop taking the … Phenobarbital is in a class of medications called barbiturates. It works by slowing activity in the brain.
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682007.html – Drugs and Supplements
Secobarbital
… Secobarbital is in a class of medications called barbiturates. It works by slowing activity in the brain. … pharmacist if you are allergic to secobarbital; other barbiturates such as amobarbital (Amytal, in Tuinal), butabarbital (Butisol), …
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682386.html – Drugs and Supplements
Butabarbital
… Butabarbital is in a class of medications called barbiturates. It works by slowing activity in the brain. … pharmacist if you are allergic to butabarbital; other barbiturates such as amobarbital (Amytal, in Tuinal), pentobarbital, phenobarbital, …
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682417.html – Drugs and Supplements
Depressants (Drug Enforcement Administration) – PDF
Drug Fact Sheet Depressants Overview Includes barbiturates (barbs), benzodiazepines (benzos) and sedative-hypnotics. Depressants will put you to sleep, relieve anxiety and muscle spasms, and prevent seizures.

Anabolic Steroids

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 20:42:42 GMT

Anabolic steroids are synthetic, or human-made, variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.

Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders misuse these drugs in an attempt to boost performance or improve their physical appearance.

The majority of people who misuse steroids are male weightlifters in their 20s or 30s. Anabolic steroid misuse is much less common in women. It is difficult to measure steroid misuse in the United States because many national surveys do not measure it. However, use among teens is generally minimal. The 2016 NIDA-funded Monitoring the Future study has shown that past-year misuse of steroids has declined among 8th and 10th graders in recent years, while holding steady for 12th graders.

People who misuse anabolic steroids usually take them orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions.

Commons patterns for misusing steroids include :

cycling—taking multiple doses for a period of time, stopping for a time, and then restarting
stacking—combining two or more different steroids and mixing oral and/or injectable types
pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero
plateauing—alternating, overlapping, or substituting with another steroid to avoid developing a tolerance

There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.

Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a “high”; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior.

Misuse of anabolic steroids might lead to negative mental effects, such as :

paranoid (extreme, unreasonable) jealousy
extreme irritability and aggression (“roid rage”)
delusions—false beliefs or ideas
impaired judgment
mania

Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.

Long-Term Effects
Anabolic steroid misuse might lead to serious, even permanent, health problems such as:

kidney problems or failure
liver damage and tumors
enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people
increased risk of blood clots

Several other effects are gender- and age-specific:

In men :
shrinking testicles
decreased sperm count
baldness
development of breasts
increased risk for prostate cancer

In women :

growth of facial hair or excess body hair
decreased breast size
male-pattern baldness
changes in or stop in the menstrual cycle
enlarged clitoris
deepened voice

In teens :

stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
stunted height (if teens use steroids before their growth spurt)
Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.

Are anabolic steroids addictive?

Even though anabolic steroids do not cause the same high as other drugs, they can lead to a substance use disorder. A substance use disorder occurs when a person continues to misuse steroids, even though there are serious consequences for doing so. The most severe form of a substance use disorder is addiction. People might continue to misuse steroids despite physical problems, high costs to buy the drugs, and negative effects on their relationships. These behaviors reflect steroids’ addictive potential. Research has further found that some steroid users turn to other drugs, such as opioids, to reduce sleep problems and irritability caused by steroids.

People who misuse steroids might experience withdrawal symptoms when they stop use, including:

fatigue
restlessness
loss of appetite
sleep problems
decreased sex drive
steroid cravings
One of the more serious withdrawal symptoms is depression, which can sometimes lead to suicide attempts.

How can people get treatment for anabolic steroid addiction?
Some people seeking treatment for anabolic steroid addiction have found a combination of behavioral therapy and medications to be helpful.

In certain cases of addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient’s hormonal system.

SOURCE: NIDA, NIH, U.S. Department of Health and Human Services.

Amphetamines

bob@simplesitecompany.com (Bob Hansen) — Fri, 28 Jan 2022 19:46:25 GMT

Amphetamine, dextroamphetamine and methamphetamine, are collectively referred to as amphetamines. Their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken.

Amphetamine was first marketed in the 1930s as Benzedrine in an over-the-counter inhaler to treat nasal congestion. By 1937 amphetamine was available by prescription in tablet form and was used in the treatment of the sleeping disorder narcolepsy and the behavioral syndrome called minimal brain dysfunction (MBD), which today is called Attention Deficit Hyperactivity Disorder (ADHD).

During World War II, amphetamine was widely used to keep the fighting men going; both dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) became readily available.

As use of amphetamines spread, so did their abuse. Amphetamines became a cure-all for helping truckers to complete their long routes without falling asleep, for weight control, for helping athletes to perform better and train longer, and for treating mild depression. Intravenous amphetamine abuse spread among a subculture known as “speed freaks.” With experience, it became evident that the dangers of abuse of these drugs outweighed most of their therapeutic uses. Today, amphetamine is used as an aid in treating narcolepsy, some forms of depression, and Attention Deficit Hyperactivity Disorder (ADHD). Yet, due to its potential for abuse or addiction, other treatment methods are used more frequently.

BRAND NAME AMPHETAMINES: Adderall, Desoxyn, Desoxyn Gradumet, Dexedrine, Dexedrine Spansule and DestroStat.

SIGNS OF AMPHETAMINE OVERDOSE: Symptoms include restlessness, tremors, rapid breathing, confusion, hallucinations, panic, aggressiveness, nausea, vomiting, diarrhea, an irregular heartbeat, and seizures.

WITHDRAWAL EFFECTS: depression, stomach cramps, nausea or vomiting, “the shakes,” tiredness. Amphetamine, dextroamphetamine and methamphetamine, are collectively referred to as amphetamines. Their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken.

Today, amphetamine is used as an aid in treating narcolepsy, some forms of depression, and Attention Deficit Hyperactivity Disorder (ADHD). Yet, due to its potential for abuse or addiction, other treatment methods are used more frequently.

More information in the Prescription Drug Booklet.

Other Sources:

Club Drugs (National Library of Medicine)
Club drugs are group of psychoactive drugs. They act on the central nervous system and can cause changes in mood, awareness, and how you act. These drugs …

https://www.nlm.nih.gov/medlineplus/clubdrugs.html – Health Topics
Methamphetamine (National Library of Medicine)
Methamphetamine – meth for short – is a very addictive stimulant drug. It is a powder that can be made into a pill or a shiny rock (called a crystal). The powder can be eaten …

https://www.nlm.nih.gov/medlineplus/methamphetamine.html – Health Topics

Dextroamphetamine and Amphetamine
The combination of dextroamphetamine and amphetamine is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; …

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601234.html – Drugs and Supplements

Stimulants

Amphetamine (Dyanavel XR, Evekeo) is used as part of a treatment program to control symptoms of attention … are the same age) in adults and children. Amphetamine (Evekeo) is used to treat narcolepsy (a sleep …

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a616004.html – Drugs and Supplements

Stimulants (Nemours Foundation) …

How Can I Help a Friend Who Cuts? Amphetamines Kids Health > For Teens > Amphetamines Print A A A … How Can Someone Quit? Avoiding Amphetamines What Are Amphetamines? Amphetamines are stimulants. They speed up functions in …

kidshealth.org/en/teens/amphetamines.html – External Health Links

Dextroamphetamine

Dextroamphetamine is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder ( … are the same age) in adults and children. Dextroamphetamine is also used to treat narcolepsy (a sleep …

https://www.nlm.nih.gov/medlineplus/druginfo/meds/a605027.html – Drugs and Supplements

Methamphetamine overdose:

Intoxication – amphetamines; Intoxication – uppers; Amphetamine intoxication; Uppers overdose; Overdose – methamphetamine; Crank overdose; Meth overdose; Crystal meth overdose; Speed overdose; …

https://www.nlm.nih.gov/medlineplus/ency/article/007480.htm – Medical Encyclopedia

Stimulant ADHD Medications — Methylphenidate and -Amphetamines (National Institute on Drug Abuse) and Amphetamines

DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetamines Email Facebook Twitter Revised January 2014 Stimulant medications …

https://www.drugabuse.gov/…edications-methylphenidate-amphetamines – External Health Links

Substance use – stimulants

Amphetamines are drugs. They can be legal or illegal. They are legal when they are prescribed by … obesity , narcolepsy , or attention deficit hyperactivity disorder (ADHD). Amphetamines are illegal when they are used without a …

https://www.nlm.nih.gov/…/ency/patientinstructions/000792.htm – Medical Encyclopedia

ADIPEX

bob@simplesitecompany.com (Bob Hansen) — Mon, 22 Apr 2019 07:19:32 GMT

Phentermine is similar to an amphetamine. It stimulates the central nervous system (nerves and brain), which increases your heart rate and blood pressure and decreases your appetite.

Adipex, (phentermine) is a stimulant that is similar to amphetamine. Phentermine, Adipex, is used for a limited period of time to speed weight loss in overweight people who are exercising and eating a low-calorie diet. Phentermine is in a class of medications called anorectics. It works by decreasing appetite. Phentermine comes as tablets and extended-release capsules. It usually is taken as a single daily dose in the morning or three times a day 30 minutes before meals. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take phentermine exactly as directed. Most people take phentermine for 3 to 6 weeks; the length of treatment depends on how you respond to the medication. Phentermine can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period than your doctor tells you to. If you are taking the extended-release (long-acting) tablets, do not split, chew, or crush the tablet. There are some tablets that can be crushed and mixed with food.

Before taking phentermine tell your doctor and pharmacist if you are allergic to phentermine, any other medications, or any of the ingredients in phentermine tablets. Ask your pharmacist for a list of the ingredients. Tell your doctor and pharmacist what prescription and nonprescription medications, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: fluoxetine (Prozac), fluvoxamine (Luvox), guanethidine, insulin medications for weight loss and depression, paroxetine (Paxil), and sertraline (Zoloft). Also tell your doctor if you are taking monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) and tranylcypromine (Parnate), or if you have stopped taking one of these medications in the past 2 weeks. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you have or have ever had heart disease, high blood pressure, arteriosclerosis (narrowing of the arteries), hyperthyroidism (overactive thyroid gland), diabetes, glaucoma, or a history of drug abuse.

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking phentermine, call your doctor. Talk to your doctor about the risks and benefits of taking phentermine if you are 65 years of age or older. Older adults should not usually take phentermine because it is not as safe as other medications that can be used to treat the same condition. You should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. Ask your doctor about the safe use of alcohol while you are taking phentermine. Alcohol can make the side effects of phentermine worse.If you have diabetes, you may need to decrease your dose of insulin while taking phentermine. Call your doctor if you have questions or problems.

Phentermine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

-dry mouth
-unpleasant taste
-diarrhea
-constipation
-vomiting

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

-increased blood pressure
-heart palpitations
-restlessness
-dizziness
-tremor
-insomnia
-shortness of breath
-chest pain
-swelling of the legs and ankles
-difficulty doing exercise that you have been able to do

See the Prescription Drug Booklet Source: FDA Other Sources Drug Identification Guide CDC Facts CDC Addiction InfoCDC Substance Treatment Samhsa Workplace Programs Drug-Free Federal Register Codification

Alcohol

bob@simplesitecompany.com (Bob Hansen) — Mon, 22 Apr 2019 07:15:11 GMT

People drink to socialize, celebrate, and relax. Alcohol often has a strong effect on people – and throughout history, we’ve struggled to understand and manage alcohol’s power. Why does alcohol cause us to act and feel differently? How much is too much? Why do some people become addicted while others do not?

Here at NIAAA, we are constantly researching the answers to these and many other questions about alcohol. Here’s what we know:

Alcohol’s effects vary from person to person, depending on a variety of factors, including:

How much you drink
How often you drink
Your age
Your health status
Your family history

While drinking alcohol is itself not necessarily a problem – drinking too much can cause a range of consequences, and increase your risk for a variety of problems.

Consequences of drinking too much Alcohol enters your bloodstream as soon as you take your first sip. Alcohol’s immediate effects can appear within about 10 minutes. As you drink, you increase your blood alcohol concentration (BAC) level, which is the amount of alcohol present in your bloodstream. The higher your BAC, the more impaired you become by alcohol’s effects. These effects can include:

Reduced inhibitions
Slurred speech
Motor impairment
Confusion
Memory problems
Concentration problems
Coma
Breathing problems
Death
Other risks of drinking can include:

Car crashes and other accidents
Risky behavior
Violent behavior
Suicide and homicide
People who drink too much over a long period of time may experience alcohol’s longer-term effects, which can include:

Alcohol use disorder
Health problems
Increased risk for certain cancers

Alcohol’s Effects on the Body
Drinking too much – on a single occasion or over time – can take a serious toll on your health. Here’s how alcohol can affect your body:

Brain:Heart:

Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:

Cardiomyopathy – Stretching and drooping of heart muscle
Arrhythmias – Irregular heart beat
Stroke
High blood pressure
Research also shows that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease.

Liver:
Heavy drinking takes a toll on the liver and can lead to a variety of problems and liver inflammations including:

Steatosis, or fatty liver
Alcoholic hepatitis
Fibrosis
Cirrhosis

Pancreas:
Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.

Cancer:
Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the:

Mouth
Esophagus
Throat
Liver
Breast

Immune System:
Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.

Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. Approximately 7.2 percent or 17 million adults in the United States ages 18 and older had an AUD in 2012. This includes 11.2 million men and 5.7 million women. Adolescents can be diagnosed with an AUD as well, and in 2012, an estimated 855,000 adolescents ages 12–17 had an AUD.

To be diagnosed with an AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of an AUD—mild, moderate, or severe—is based on the number of criteria met.

To assess whether you or loved one may have an AUD, here are some questions to ask. In the past year, have you:

Had times when you ended up drinking more, or longer than you intended?

More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

Spent a lot of time drinking? Or being sick or getting over the aftereffects?

Experienced craving — a strong need, or urge, to drink?

Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

Continued to drink even though it was causing trouble with your family or friends?

Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present.

WINE

However severe the problem may seem, most people with an alcohol use disorder can benefit from treatment. Unfortunately, only of a fraction of people who could benefit from treatment receive help. In 2012, for example, 1.4 million adults received treatment for an AUD at a specialized facility (8.4 percent of adults in need). This included 416,000 women (7.3 percent of women in need) and 1.0 million men (8.9 percent of men in need).

Ultimately, receiving treatment can improve an individual’s chances of success in overcoming an AUD.

FETAL ALCOHOL EXPOSURE

Fetal alcohol exposure occurs when a woman drinks while pregnant. No amount of alcohol is safe for pregnant women to drink. Nevertheless, data from prenatal clinics and postnatal studies suggest that 20 to 30 percent of women do drink at some time during pregnancy.

Alcohol can disrupt fetal development at any stage during a pregnancy – including at the earliest stages and before a woman knows she is pregnant. Research shows that binge drinking, which means consuming four or more drinks per occasion, and regular heavy drinking put a fetus at the greatest risk for severe problems.2

Fetal Alcohol Spectrum Disorders (FASD)
Drinking during pregnancy can cause brain damage, leading to a range of developmental, cognitive, and behavioral problems, which can appear at any time during childhood. Fetal Alcohol Spectrum Disorders (FASD) is the umbrella term for the different diagnoses, which include Fetal Alcohol Syndrome, partial Fetal Alcohol Syndrome, Alcohol-related neurodevelopmental disorder, and Alcohol-related birth defects.

People with FASD often have difficulty in the following areas:

Coordination
Emotional control
School work
Socialization
Holding a job

In addition, they often make bad decisions, repeat the same mistakes, trust the wrong people, and do not understand the consequences of their actions.

Risk Factors3
In addition to how much, how often, and in what stage of pregnancy a woman drinks, other factors can also play a role in how fetal alcohol exposure affects children. These factors include:

Poor health and inadequate nutrition
Living in a culture where binge or heavier drinking is common and accepted
Little awareness of FASD
Not receiving adequate prenatal care
Social isolation
Exposure to higher levels of stress
Interventions

Researchers and clinicians have developed some effective learning and behavioral interventions to help people living with FASD. They are also investigating new behavioral interventions, as well as dietary supplementation and physical therapy.

Support & Treatment
Treatment for alcohol use disorders (AUDs), once essentially limited to the mutual support group Alcoholics Anonymous founded in 1935, has seen many significant advances. In addition to mutual support groups, AUDs can be treated with medications and behavioral therapies, as well as combinations of treatments. Technology—such as email and the Internet—has opened new avenues for diagnosing and treating people with AUDs. And researchers continue to develop alternative treatment strategies that can offer help to everyone who wants to change their drinking habits.

For information on treatment and support in your area, please contact any of the following:
National Drug and Alcohol Treatment Referral Routing Service

The U.S. Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration’s (SAMHSA) toll-free telephone number for alcohol and drug information/treatment referral assistance.

Telephone: 1-800-662-HELP (4357)

When you call this toll-free number, a recorded message (English or Spanish language) gives you the following options:

1 – Speak to a representative concerning substance abuse treatment or to request printed material on alcohol or drugs.
2 – Local substance abuse treatment referral information in your state.

Get the Alcohol brochure.

Other sources:

National Institute on Alcohol Abuse

Alcohol Effects on Body

Alcohol Abuse Symptoms.

Amitriptyline

bob@simplesitecompany.com (Bob Hansen) — Mon, 22 Apr 2019 07:09:39 GMT

Amitriptyline is used to treat symptoms of depression.

A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as amitriptyline during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take amitriptyline, but in some cases, a doctor may decide that amitriptyline is the best medication to treat a child’s condition.

You should know that your mental health may change in unexpected ways when you take amitriptyline or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

Your healthcare provider will want to see you often while you are taking amitriptyline, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.

The doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with amitriptyline. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273.

No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.

More information in the Prescription Drug Booklet .

wholesaleproducts-tn

Zyprexa

Zoloft

Zanaflex

Xenical

Xanax

Wellbutrin

Wax

W-18

Tryptamine

Tramadol

Tobacco

Thebaine

Tenuate

Soma

Skelaxin

San Pedro Cactus

Salvia

Rohypnol

Ritalin (Methylphenidate)

Psilocybin

Prozac

Prescription Drugs

Poppy

Phentermine

Phenaphen

Peyote

PCP

Paxil

Opium

Nicotine

Methcathinone

Methamphetamine

Meth Labs

Mescaline

Meridia

Marijuana

Luvox

Khat

Ketmamine

Kava

Inhalants

Imitrex

Imipramine Hydrochloride

Hydrocodone

Heroin

Hemp

Hashish

Hash Oil

Hallucinogens

GHB

Flexeril

Flakka

Fioricet

Fentanyl

Source: DEA

Ephedra

Effexor

Ecstasy

DXM

DOB

DOM, DOB, STP, 2C-B, 2C-E, 2C-1

Didrix

Diazepam

Detropropoxyphene

Depressants

Crack Cocaine

Crack Cocaine is the freebase form of cocaine that can be smoked.

﻿

A coca farmer in Colombia S.A. receives about 5 cents for every gram of cocaine he produces which sells for approximately $100.00 in the U.S.

Codeine

Cocaine

Coca Leaf

Clonazepam

Chloral Hydrate

Celexa

Butorphanol

Buprenorphine

Bontril

Black Tar Heroin