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INTRODUCTION

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Some of the more frequently abused drugs are listed here. Agents such as cocaine and the psychedelics are illicit drugs with no major pharmacotherapeutic value. Other drugs such as barbiturates, benzodiazepines, and opioids are used routinely for therapeutic reasons but have a strong potential for abuse when taken indiscriminately. Finally, drugs such as alcohol, caffeine, and nicotine are readily available in various commercial products but may also be considered drugs of abuse when consumed in large quantities for prolonged periods.

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Drug(s) Classification/Action Route/Method of Administration Effect Desired by User Principal Adverse Effects Additional Information

Alcohol

Sedative-hypnotic

Oral, from various beverages (wine, beer, other alcoholic drinks)

Euphoria; relaxed inhibitions; decreased anxiety; sense of escape

Physical dependence; impaired motor skills; chronic degenerative changes in the brain, liver, and other organs

See Chapter 6

Barbiturates

  • Nembutal

  • Seconal

  • Others

Sedative-hypnotic

Oral or injected (IM, IV)

Relaxation and a sense of calmness; drowsiness

Physical dependence; possible death from overdose; behavior changes (irritability, psychosis) following prolonged use

See Chapter 6

Benzodiazepines

  • Valium

  • Librium

  • Others

Similar to barbiturates

Similar to barbiturates

Similar to barbiturates

Similar to barbiturates

Similar to barbiturates

Caffeine

CNS stimulant

Oral; from coffee, tea, other beverages

Increased alertness; decreased fatigue; improved work capacity

Sleep disturbances; irritability; nervousness; cardiac arrhythmias

See Chapter 26

Cannabinoids

  • Hashish

  • Marijuana

Psychoactive drugs with mixed (stimulant and depressant) activity

Smoked; possible oral ingestion

Initial response: euphoria, excitement, increased perception; later response: relaxation, stupor, dreamlike state

Endocrine changes (decreased testosterone in males) and changes in respiratory function similar to chronic cigarette smoking are associated with heavy use

Cocaine

CNS stimulant (when taken systemically)

"Snorted" (absorbed via nasal mucosa); smoked (in crystalline form)

Euphoria; excitement; feelings of intense pleasure and well-being

Physical dependence; acute CNS and cardiac toxicity; profound mood swings

See Chapter 12

Narcotics

  • Demerol

  • Morphine

  • Heroin

  • Others

Natural and synthetic opioids; analgesics

Oral or injected (IM, IV)

Relaxation; euphoria; feelings of tranquility; prevent onset of opiate withdrawal

Physical dependence; respiratory depression; high potential for death due to overdose

See Chapter 14

Nicotine

CNS toxin; produces variable effects via somatic and autonomic nervous system interaction

Smoked or absorbed from tobacco products (cigarettes, cigars, chewing tobacco)

Relaxation; calming effect; decreased irritability

Physical dependence; possible carcinogen; associated with pathological changes in respiratory function during long-term tobacco use

Psychedelics

  • LSD

  • Mescaline

  • Phencyclidine

(PCP)

  • Psilocybin

Hallucinogens

Oral; may also be smoked or inhaled

Altered perception and insight; distorted senses; disinhibition

Severe hallucinations; panic reaction; acute psychotic reactions

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