Narcotics drugs of abuse Introduction Drugs are so

Narcotics & drugs of abuse

Introduction Drugs are so commonly used and abused in modern societies that virtually everyone has some familiarity with the concept of drug addiction and abuse. drugs that affect behavior are particularly likely to be taken in excess when the behavioral effects are considered pleasurable

Drugs of abuse Is simply excessive use of a drug or use of a drug for purposes for which it was not medically intended.

Drug Categories for Substances of Abuse • • Narcotics Depressants Stimulants Hallucinogen Cannabis Alcohol Steroids

Narcotics Drugs used medicinally to relieve pain High potential for abuse Cause relaxation with an immediate "rush" Initial unpleasant effects - restlessness, nausea • Types: Opium, Morphine, Codiene, Heroin, Hydromorphone, Meperidine, Methadone.

Depressants Drugs used medicinally to relieve anxiety, irritability, tension High potential for abuse, development of tolerance Produce state of intoxication similar to that of alcohol Combined with alcohol, increase effects, multiply risks • Types: Barbiturates, Methaqualone, Tranquilizers, Chloral hydrate, Glutethimide.

Stimulants Drugs used to increase alertness, relieve fatigue, feel stronger and more decisive; used for euphoric effects or to counteract the "down" felling of tranquilizers or alcohol. • Types: Cocaine, Amphetamines, Methamphetamine, Phenmetrazine, Methylphenidate, Other stimulants, Ice.

Hallucinogens Drugs that produce behavioral changes that are often multiple and dramatic No known medical use, but some block sensation to pain and use may result in self-inflicted injuries "Designer Drugs", made to imitate certain illegal drugs, are often many times stronger than drugs they imitate • Types: PCP (angel dust, loveboat), LSD (acid, green/red dragon), mescaline, peyote, psilocybin, designer drugs (ecstasy-PCE).

Cannabis Hemp plant from which marijuana and hashish are produced; Hashish consists of resinous secretions of the cannabis plant; Marijuana is a tobacco-like substance. • Types: marijuana, tetrahydrocannabinol, hashish, hashish oil.

Alcohol Liquid distilled product of fermented fruits, grains and vegetables Used as solvent, antiseptic and sedative Moderate potential for abuse. • Types: ethyl alcohol, ethanol.

Steroids Synthetic compounds available legally and illegally Drugs that are closely related to the male sex hormone, testosterone Moderate potential for abuse, particularly among young males. • Types: dianabol, nandrolone.

Narcotics • The term "narcotic, " derived from the Greek word for stupor, originally referred to a variety of substances that dulled the senses and relieved pain. term originally applied to all compounds that produce insensibility to external stimuli through depression of the central nervous system, but now applied primarily to the drugs known as opiates— compounds extracted from the opium poppy and their chemical derivatives. Also classed as narcotics are the opioids, chemical compounds that are wholly synthesized, but which resemble the opiates in their actions.

• Narcotics have a high potential for abuse. As abused drugs they are sniffed, smoked, or selfadministered by the more direct routes of subcutaneous (“skin-popping”) and intravenous (“mainlining”) injection. Drug effects depend heavily on the dose, route of administration, and previous exposure to the drug. Aside from their medical use, narcotics produce a general sense of well-being by reducing tension, anxiety, and aggression. These effects are helpful in a therapeutic setting but con tribute to their abuse

Does using opiates cause dependence or addiction? • Yes. Dependence is likely, whether using large amounts frequently or occasionally over a long period of time. When a person becomes dependent, finding and using the drug often becomes the main focus in life. As more and more of the drug are used over time, larger amounts are needed to get the same effects. This is called tolerance. Withdrawal signs usually begin shortly before the user’s body expects its next dose of narcotics.

Types of narcotics • Naturally occurring narcotics: -Heroin -Codeine -Morphine -Opium • Synthetic narcotics/opiates: -Neperidine (Demerol) -Percodan -Darvon -lomotil

Street Names: • Morphine: Morpho, Unkie, M, Miss Emma, Hocus, dreamer. • Codeine: Schoolboy • Heroine: Snow, Stuff, Harry, H, White Horse, Hard Stuff, White Stuff, Joy Powder, Scag, Junk, brown sugar. • Meperidine: Doctors • Methadone: Dollies, Methadose, frizzies. • Cocaine: coke, crank, crack, snow, zip.

Opium, narcotic drug produced from the drying resin of unripe capsules of the opium poppy, Papaver somniferum. Today opium is sold on the street as a powder or dark brown solid and is smoked, eaten, or injected.

Papaver somniferum

Heroin, Of all illegal drugs, is responsible for the greatest number of deaths. In its pure form, heroin is white and has a bitter taste. Most street preparations of heroin are diluted or “cut, ” with other substances. Illegal (street) heroin comes in different forms, ranging in color from white to dark brown.

Heroin is usually “mainlined, ” but it can be inhaled or smoked. Heroin may cause physical and psychological problems such as nausea, panic, insomnia, and tolerance. Its addictive properties create a need for repeated use of the drug (craving) and painful physical withdrawal symptoms.

heroin

• Codeine is mostly produced from morphine. Used for relief of moderate pain, codeine may be in the form of tablets or can be combined with other products, such as aspirin or acetaminaphin (Tylenol 3 ). Liquid codeine preparations are used for the relief of coughs. Codeine is also manufactured to a lesser extent in an injectable form for the relief of pain. It is by far the most widely used naturally occurring narcotic in medical treatment. Codein tablet

Morphine the principal product of opium is one of the most effective drugs known for the relief of pain. Morphine is the active ingredient in most narcotics, marketed in the form of white crystals, hypodermic tablets, and injectable preparations. It is used legally primarily in hospitals. Morphine is odorless, tastes bitter, and darkens with age. It may be administered subcutaneously, intramuscularly, or intravenously. Tolerance and dependence develop rapidly. Only a small part of the morphine obtained from opium is used medically. Most is converted to codeine.

• Percodan is similar to codeine but is usually mainlined. Percodan is much more potent and has a higher dependence potential than codeine. • Dilaudid, a shorter acting and more sedative drug than morphine, is usually 2 – 8 times the potency. Dilaudid is usually marketed in tablet and injectable form and is generally obtained through theft and false prescriptions

Cocaine, alkaloid obtained from leaves of the coca plant and used medically as a local anesthetic. It is also widely abused as a drug. Cocaine is classified as a narcotic for legal purposes by the United States government. It causes strong psychological dependence. .

Coca plant

Crack cocaine

The plant Cannabis sativa is the source of both marijuana and hashish. Both drugs are usually smoked. Their effects are similar: a state of relaxation, accelerated heart rate, perceived slowing of time, and a sense of heightened hearing, taste, touch, and smell. These effects can differ, however, depending on the amount of drug consumed and the circumstances under which it is taken.

Marijuana and hashish do not produce psychological dependence except when taken in large daily doses. The drugs can be dangerous, however, especially when smoked before driving.

Cannabis sativa

Marijuana cigarette marijuana pipe

Drug dependance Drug Dependence, psychological and sometimes physical state characterized by a compulsion to use a drug to experience psychological or physical effects. Drug dependence takes several forms: • Tolerance, a form of physical dependence, occurs when the body becomes accustomed to a drug and requires ever-increasing amounts of it to achieve the same pharmacological effects. • Habituation, a form of psychological dependence, is characterized by the continued desire for a drug, even after physical dependence is gone. • Addiction is a severe craving for the substance and interferes with a person’s ability to function normally. It may also involve physical dependence.

The intensity and character of the physical symptoms experienced during withdrawal are directly related to the particular drug of abuse, the total daily dose, the interval between doses, the duration of use, and the health and personality of the user.

Symptoms: • • • Abscesses at injection sites Drowsiness, slowed pulse Constricted pupils respiratory depression Nausea, vomiting and Constipation Needle marks on extremities Euphoria, lethargy and Lack of motivation Flushing of skin on face, chest and neck Except in cases of acute intoxication, there is no loss of motor coordination or slurred speech as occurs with many depressants.

Overdose Symptoms: • • • Shallow breathing Slowed pulse, clammy skin Pulmonary edema Respiratory arrest, coma Convulsions, possible death

Withdrawal Symptoms: The withdrawal symptoms associated with heroin/morphine addiction are usually experienced shortly before the time of the next scheduled dose. • • • Runny nose, teary eyes and Excessive yawning Restlessness, irritability, nausea and loss of appetite Diarrhea, tremors and Goose bumps Chills, shakes, flushing and excessive sweating Muscle jerks, cramps, Nodding and sleep Severe depression and vomiting are common. The heart rate and blood pressure are elevated. And drug craving appear. At any point during this process, a suitable narcotic can be administered that will dramatically reverse the withdrawal symptoms. Without intervention, the syndrome will run its course, and most of the overt physical symptoms will disappear within 7 to 10 days.

When an opiate-dependent person stops • taking the drug, withdrawal usually begins within 4 -6 hours after the last dose. the intesity of withdrawal symptoms depend on amount of the drug taken, how often and for how long. These symptoms for most opiates are stronger approximately 24 -72 hours after they begin and subside with 7 -10 days. sometimes symptoms such as sleeplessness and drug craving can last for months.

Treatment of opiate addiction The basic appeoaches to drug abuse treatment are: • Detoxification. supervised withdrawal from drug dependence, either with or without medication, in a hospital or as an putpatient. • Drug-free program, which emphasize various forms of counseling as the main treatment. • Methadone maintenance, which provides methadone, (a substitute for heroin) to an opiate-dependent person in a daily basis to help them lead productive lives while still in treatment.

Social issues In a 1999 household survey by the Substance Abuse and Mental Health Services Administration an estimated 14. 8 million people in the United States classified themselves as current illicit drug users. Among youths aged 12 to 17, close to 8 percent of respondents were regular users of marijuana. The percentage of youths in the same age range who used cocaine at least once a month was 49. 8 percent. The survey also reported an estimated 1. 6 million U. S. residents used prescription drugs for nonmedical purposes in 1998. The state with the highest rates of dependence on illicit drugs was Alaska with 2. 8 percent of its 12 and older population dependent on illicit drugs and 7. 3 percent dependent on illicit drugs or alcohol.

International control of drugs The purpose of the conventions is to provide Governments with the necessary tools to address drug production, trafficking and abuse problems individually and collectively. Each of the major conventions relating to drug control now has over 140 signatories.

There are three major international drug control treaties currently in force: • 1961. The Single Convention on Narcotic Drugs • 1971. The Convention on Psychotropic Substances • 1988. The UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances • These three United Nations conventions embody the efforts of the international community to cooperate in the field of drug abuse control. They also contain the principal objective of all previous international conventions in this field, namely to restrict the use of drugs to purely medical and scientific purposes. The UN drug control conventions do not recognize a distinction between licit and illicit drugs and describe only the use as licit or illicit.

The provisions of these conventions, upon its coming into force, shall, as between parties hereto, terminate and replace the provisions of the following treaties: • International Opium Convention, signed at The Hague on 23 January 1912; • Agreement concerning the Manufacture of, Internal Trade in and Use of Prepared Opium, signed at Geneva on 11 February 1925; • International Opium Convention, signed at Geneva on 19 February 1925; • Convention for Limiting the Manufacture and Regulating the Distribution of Narcotic Drugs, signed at Geneva on 13 July 1931;

• Agreement for the Control of Opium Smoking in the Far East, signed at Bangkok on 27 November 1931; • Protocol signed at Lake Success on 11 December 1946, amending the Agreements, Conventions and Protocols on Narcotic Drugs concluded at The Hague on 23 January 1912, at Geneva on 11 February 1925 and 19 Febryary 1925 and 13 July 1931, at Bangkok on 27 November 1931 and at Geneva on 26 June 1936, except as it affects the last -named convention; • The Conventions and Agreements referred to in the last paragraphs as amended by the Protocol of 1946;

• Protocol for Limiting and Regulating the Cultivation of Poppy Plant, the Production of, International Wholesale Trade in, and Use of Opium, signed at New York on 23 June 1953, should that Protocol have come into force. • Protocol signed at Paris on 19 November 1948 Bringing under Intentional Control Drugs outside the Scope of the Convention of 13 July 1931 for Limiting the Manufacture and Regulation the Distribution of Narcotic Drugs, as Amended by the Protocol signed at Lake Success on 11 December 1946;

The objectives of these conventions are: • To gather all the existing multilateral treaties. • To create a single unified body, which is the INCB (International Narcotics Control Board). • To limit the production of Narcotic plants.

Single Convention on Narcotic Drugs, 1961 The adoption of this Convention is regarded as a milestone in the history of international drug control. The Single Convention codified all existing multilateral treaties on drug control and extended the existing control systems to include the cultivation of plants that were grown as the raw material of narcotic drugs. The principal objectives of the Convention are to limit the possession, use, trade in, distribution, import, export, manufacture and production of drugs exclusively to medical and scientific purposes and to address drug trafficking through international cooperation to deter and discourage drug traffickers. The Convention also established the International Narcotics Control Board, merging the Permanent Central Board and the Drug Supervisory Board.

Yellow list • This document contains the current list of narcotic drugs under international control and additional • information to assist governments in filling in the International Narcotics Control Board questionnaires related • to narcotic drugs, namely, form A, form B and form C. It is divided into four parts:

• Part 1 gives a list of narcotic drugs under international control; it is subdivided into three sections: the first section listing those drugs included in Schedule I of the 1961 Convention and/or Group I of the 1931 Convention, the second section listing those drugs in Schedule II of the 1961 Convention and/or Group II of the 1931 Convention and the third section listing those drugs in Schedule IV of the 1961 Convention and/or Group II of the 1931 Convention. The names and descriptions used are those given in the 1961 Convention or in the official notifications of the Secretary-General of the United Nations. International non-proprietary names recommended by the World Health Organization are printed in bold type; in many cases the chemical formula is given to facilitate identification.

• Part 2 lists the preparations of narcotic drugs exempted from some provisions and included in Schedule III of the 1961 Convention. • Part 3 is a list in alphabetical order of the names given to the narcotic drugs other than the names listed in Part 1, and other designations (mainly trade names) of preparations containing narcotic drugs.

• Part 4 contains tables showing the pure anhydrous drug content of esters, ethers and salts of narcotic drugs listed in the Schedules as well as the equivalents, in terms of the pure anhydrous drug, of certain extracts and tinctures.

Convention on Psychotropic Substances 1971 This Convention establishes an international control system for psychotropic substances. It responded to the diversification and expansion of the spectrum of drugs of abuse and introduced controls over a number of synthetic drugs according to their abuse potential on the one hand their therapeutic value on the other.

Green list The Green List is divided into four parts: • Part one. Substances in Schedules I-IV of the Convention on Psychotropic Substances of 1971; • Part two. Names, synonyms and trade names of psychotropic substances, their salts and preparations containing psychotropic substances under international control; • Part three. Pure drug content of bases and salts of psychotropic substances under international control; • Part four. Prohibition of and restrictions on export and import pursuant to article 13 of the Convention on Psychotropic Substances of 1971.

United Nations Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988 This Convention provides comprehensive measures against drug trafficking, including provisions against money laundering (practice of engaging in financial transactions in order to conceal the identity, source and/or destination of money and is a main operation of underground economy) and the diversion of precursor chemicals. It provides for international cooperation through, for example, extradition of drug traffickers, controlled deliveries and transfer of proceedings.

Red list The list is comparable to the lists of narcotic drugs and psychotropic substances under international control, and the alphabetical listings of other names and trade names of narcotic drugs and psychotropic substances, which are published by the Board as the "Yellow List" and the "Green List", respectively.

• Part One gives a list of those substances scheduled in Tables I and II of the 1988 Convention. The list is divided into two sections, the first listing those substances included in Table I, and the second listing those substances in Table II. English, French and Spanish names as used in the respective versions of the Tables of the 1988 Convention are given, as well as Harmonized System (HS) codes and Chemical Abstracts Service (CAS) registry numbers, to facilitate rapid identification of all scheduled substances. The full Chemical Abstracts Index name of each substance is given also for reference purposes.

• Part Two lists in alphabetical order the chemical names, synonyms and trade names, etc. , of the substances included in Part One. Although not explicitly stated in the 1988 Convention, it is understood that the name of each of those substances, as given in the Tables of the Convention, covers also all isomeric forms of the substance. Consequently, it should be noted that where a specific isomer is listed in Part Two, for example l-ephedrine as a synonym for ephedrine, this should not be understood to mean that only the l-form of ephedrine is controlled.

• Part Three provides a table of conversion factors needed to convert quantities of scheduled substances in their salt form into quantities of pure anhydrous base. • Part Four lists those Governments that have requested pre-export notifications pursuant to article 12, paragraph 10 (a), of the 1988 Convention.

presented by: • Nahid Osman • Nuha Bashir • Shaimaa Jabir • • • Marwa Nasr Alhadi Afraa Altayyib Dania Abdalla Magboola Mohammed Nusayba Sa’eed Under the supervision of: Dr. Ahmad El-jamal

Thanks