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 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 N IDA, 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.
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Narcotics
The narcotic analgesics act primarily on the CNS. The perception of
and emotional response to pain is modified when the narcotic analgesics bind
with stereospecific receptors in the CNS. Five major groups of opioid receptors
are known: mu, kappa, sigma, delta and epsilon. Narcotic analgesic activity
occurs at the mu, kappa and sigma receptors. Opioid agonists such as morphine
and others exert their activity mainly at the mu receptor. Mixed
agonist-antagonists such as butorphanol, nalbuphine and pentazocine act
primarily at the kappa receptors (thought to mediate analgesic effects) and
sigma receptors (may produce subjective and psychotomimetic effects).
As well as analgesia, opioid agonist activity in the CNS causes
suppression of the cough reflex, change in mood such as euphoria or dysphoria,
mental clouding and EEG changes. Nausea and vomiting, probably caused by
stimulation of the chemoreceptor trigger zone, can also occur. Peripheral
vasodilation, reduced peripheral resistance and the inhibition of baroreceptors
can result in orthostatic hypotension and fainting. The inhibition of
peristalsis can lead to constipation while increased bladder sphincter tone may
cause urinary retention.
Large doses may elicit excitation or seizures. Morphine and its
congeners cause miosis. In therapeutic doses they increase accommodation and
sensitivity to light reflex and decrease intraocular pressure in both normal
patients and those with glaucoma.
Depressants
In medicine, a drug or other agent that slows the activity of vital
organs of the body. Depressants acting on the central nervous system include
general anesthetics, opiates, alcohol, and hypnotics. Tranquilizing drugs
(ataractics) act primarily on the lower levels of the brain, relieving tension
without reducing mental sharpness.
Chloral Hydrate
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Noctec; Somnos; Felsules
|
|
Medical Uses
|
Hypnotic
|
|
Physical Dependence
|
Moderate
|
|
Tolerance
|
Yes
|
|
Duration
|
5-8(hours)
|
|
Usual Method
|
Oral
|
|
Possible Effects
|
Slurred speech; Disorientation; Drunken behavior without odor of alcohol
|
|
Overdose
|
Shallow respiration; Clammy skin; Dilated pupils; Weak and rapid pulse;
Coma; Possible death
|
|
Withdrawal
|
Anxiety; Insomnia; Tremors; Delirium; Convulsions; Possible death
|
Barbiturates
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Amytal; Florinal; Nembutal; Seconal; Tuinal; Phenobarbital;
Pentobarbital
|
|
Medical Uses
|
Anesthetic; Anti-convulsant; Sedative; Hypnotic; Veterinary euthanasia
agent
|
|
Physical Dependence
|
Moderate
|
|
Tolerance
|
Yes
|
|
Duration
|
5-8(hours)
|
|
Usual Method
|
Oral; Injected
|
|
Possible Effects
|
Slurred speech; Disorientation; Drunken behavior without odor of alcohol
|
|
Overdose
|
Shallow respiration; Clammy skin; Dilated pupils; Weak and rapid pulse;
Coma; Possible death
|
|
Withdrawal
|
Anxiety; Insomnia; Tremors; Delirium; Convulsions; Possible death
|
Benzodiazepines
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Ativan; Dalmane; Diazepam; Librium; Xanax; Serax; Valium; Tranxene;
Verstran; Versed; Halcion; Paxpam; Restoril
|
|
Medical Uses
|
Anti-anxiety; Sedative; Anti-convulsant; Hypnotic
Physical Dependence Low
|
|
Physical Dependence
|
Low
|
|
Tolerance
|
Yes
|
|
Duration
|
4-8(hours)
|
|
Usual Method
|
Oral; Injected
|
|
Possible Effects
|
Slurred speech; Disorientation; Drunken behavior without odor of alcohol
|
|
Overdose
|
Shallow respiration; Clammy skin; Dilated pupils; Weak and rapid pulse;
Coma; Possible death
|
|
Withdrawal
|
Anxiety; Insomnia; Tremors; Delirium; Convulsions; Possible death
|
Glutethimide
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Doriden
|
|
Medical Uses
|
Sedative; Hypnotic
|
|
Physical Dependence
|
High
|
|
Tolerance
|
Yes
|
|
Duration
|
4-8(hours)
|
|
Usual Method
|
Oral
|
|
Possible Effects
|
Slurred speech; Disorientation; Drunken behavior without odor of alcohol
|
|
Overdose
|
Shallow respiration; Clammy skin; Dilated pupils; Weak and rapid pulse;
Coma; Possible death
|
|
Withdrawal
|
Anxiety; Insomnia; Tremors; Delirium; Convulsions; Possible death
|
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Stimulants
Any drug that excites any bodily
function, but more specifically those that stimulate the brain and central
nervous system. Stimulants induce alertness, elevated mood, wakefulness,
increased speech and motor activity and decrease appetite. Their therapeutic use
is limited, but their mood-elevating effects make some of them potent drugs of
abuse.
The major stimulant drugs are amphetamines and related compounds,
methylxanthines (methylated purines), cocaine, and nicotine.
Amphetamines achieve their
effect by increasing the amount and activity of the neurotransmitter
norepinephrine (noradrenaline) within the brain. They facilitate the release of
norepinephrine by nerve cells and interfere with the cells' reuptake and
breakdown of the chemical, thereby increasing its availability within the brain.
The most commonly used amphetamines are methamphetamine (Methedrine),
amphetamine sulfate (Benzedrine), and dextroamphetamine sulfate (Dexedrine).
Amphetamines were first used in the 1930s to treat narcolepsy and subsequently
became prescribed for obesity and fatigue.
Their heavy or prolonged use
causes irritability, restlessness, hyperactivity, anxiety, excessive speech, and
rapid mood swings. Still higher doses or chronic use can cause agitation,
tremor, confusion, and, in the most serious cases, a state resembling paranoid
schizophrenia. Moreover, letdown effects of deep depression and physical
exhaustion may occur after only a single dose of moderate strength wears off.
With repeated use, tolerance develops, so that a user needs to take larger
doses, but the accompanying dependence is not strong enough to be termed a
physical addiction. Amphetamines are widely abused, in some cases by workers or
students seeking enhanced physical energy and mental acuity to fulfill demanding
tasks.
Certain drugs related to the amphetamines have the same mode of
action but are somewhat milder stimulants. Among them are phenmetrazine
(Preludin) and methylphenidate (Ritalin). The latter drug is widely used to
“slow down” hyperactive children and improve their ability to concentrate.
The methylxanthines are even milder stimulants. Unlike the
amphetamines and methylphenidate, which are synthetically manufactured, these
compounds occur naturally in various plants and have been used by humans for
many centuries. The most important of them are caffeine, theophylline, and
theobromine. The strongest is caffeine, which is the active ingredient of
coffee, tea, cola beverages, and maté. Theobromine is the active ingredient in
cocoa. Caffeine constricts blood vessels of the brain; for this reason it is
often a component of headache remedies. Theophylline is used in the treatment of
severe asthma because of its capacity for relaxing the bronchioles in the lungs.
Cocaine is one of the strongest and shortest-acting stimulants
and has a high potential for abuse owing to its euphoric and habit-forming
effects. Nicotine, the active ingredient in cigarettes and other tobacco
products, may also be regarded as a stimulant.
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Hallucinogens
Hallucinogenic drugs are substances that distort
the perception of objective reality. The most well-known hallucinogens include
phencyclidine, otherwise known as PCP, angel dust, or loveboat; lysergic acid
diethylamide, commonly known as LSD or acid; mescaline and peyote; and
psilocybin, or "magic" mushrooms. Under the influence of hallucinogens, the
senses of direction, distance, and time become disoriented.
These drugs can produce unpredictable, erratic, and
violent behavior in users that sometimes leads to serious injuries and death.
The effect of hallucinogens can last for 12 hours.
LSD produces tolerance, so that users who
take the drug repeatedly must take higher and higher doses in order to achieve
the same state of intoxication. This is extremely dangerous, given the
unpredictability of the drug, and can result in increased risk of convulsions,
coma, heart and lung failure, and even death.
LSD
| Mescaline & Peyote
| Amphetamine Variants | Phencyclidine & Analogs
LSD
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Acid; Microdot
|
|
Medical Uses
|
None
|
|
Physical Dependence
|
None
|
|
Psychological Dependence
|
Moderate
|
|
Tolerance
|
Yes
|
|
Duration
|
8-12(hours)
|
|
Usual Method
|
Oral
|
|
Possible Effects
|
Illusions and hallucinations; Altered perception of time and distance
|
|
Overdose
|
Fatigue; Paranoia; Possible psychosis
|
|
Withdrawal
|
Longer; more intense "trip" episodes; Psychosis; Possible death
Withdrawal Unknown
|
Mescaline & Peyote
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
Mescal; Buttons; Cactus
|
|
Medical Uses
|
None
|
|
Physical Dependence
|
None
|
|
Psychological Dependence
|
Moderate
|
|
Tolerance
|
Yes
|
|
Duration
|
8-12(hours)
|
|
Usual Method
|
Oral
|
|
Possible Effects
|
Illusions and hallucinations; Altered perception of time and distance
|
|
Overdose
|
Fatigue; Paranoia; Possible psychosis
|
|
Withdrawal
|
Longer; more intense "trip" episodes; Psychosis; Possible death
Withdrawal Unknown
|
Amphetamine Variants
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
2,5-DMA; STP; MDA; MDMA; Ecstacy; DOM; DOB
|
|
Medical Uses
|
None
|
|
Physical Dependence
|
None
|
|
Psychological Dependence
|
Moderate
|
|
Tolerance
|
Yes
|
|
Duration
|
Variable(hours)
|
|
Usual Method
|
Oral; Injected
|
|
Possible Effects
|
Illusions and hallucinations; Altered perception of time and distance
|
|
Overdose
|
Fatigue; Paranoia; Possible psychosis
|
|
Withdrawal
|
Longer; more intense "trip" episodes; Psychosis; Possible death
Withdrawal Unknown
|
Phencyclidine & Analogs
|
Classification
|
|
CSA
|
Schedule IV
|
|
Trade or Other Names
|
PCE; PCPy; TCP; PCP; Hog; Loveboat;Angel Dust
|
|
Medical Uses
|
None
|
|
Physical Dependence
|
None
|
|
Psychological Dependence
|
High
|
|
Tolerance
|
Yes
|
|
Duration
|
Days(hours)
|
|
Usual Method
|
Oral; Smoked
|
|
Possible Effects
|
Illusions and hallucinations; Altered perception of time and distance
|
|
Overdose
|
Fatigue; Paranoia; Possible psychosis
|
|
Withdrawal
|
Longer; more intense "trip" episodes; Psychosis; Possible death
Withdrawal Unknown
|
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Anabolic Steriods
Anabolic Steroid abuse has become a national
concern. These drugs are used illicitly by weight lifters, body builders, long
distant runners, cyclists, and others who claim that the drugs give them a
competitive advantage and/or improve their physical appearance. Once viewed as a
problem associated only with professional athletes, recent reports estimate that
5 to 12 percent of male high school students and 1 percent of female students
have used anabolic steroids by the time they were seniors.
Concerns over a growing illicit market and
prevalence of abuse combined with the possibility of harmful long-term effects
of steroid use, led Congress to place anabolic steroids into Schedule III of the
Controlled Substance Act (CSA).
The CSA defines anabolic steroids as any drug or
hormonal substance chemically and pharmacologically related to testosterone
(other than estrogens, progestins, and corticosteroids), that promotes muscle
growth. Most illicit anabolic steroids are sold at gyms, competitions and
through mail order operations.
For the most part, these substances are smuggled
into the United States. Those commonly encountered on the illicit market
include: boldenone (Equipose), ethylestrenol (Maxibolin), fluoxymesterone
(Halotestin), methandriol, methandrostenolone (Dianabol), Depo-Testosterone
Android - 25 (mehyltestosterone), nandrolone (Durabolin, Deca-Durabolin),
oxandrolone (Anavar), oxymetholone (Anadrol), stanozolol (Winstrol),
testosterone and trenbolone (Finajet). In addition, a number of bogus or
counterfeit products are sold as anabolic steroids.
A limited number of anabolic steroids have been approved for
medical and veterinary use. The primary legitimate use of these drugs in humans
is for the replacement of inadequate levels of testosterone resulting from a
reduction or absence of functioning testes. In veterinary practice, anabolic
steroids are used to promote feed efficiency and to improve weight gain, vigor,
and hair coat. They are also used in veterinary practice to treat anemia and
counteract tissue breakdown during illness and trauma.
When used in combination with exercise training and high protein
diet, anabolic steroids can promote increased size and strength of muscles,
improve endurance and decrease recovery time between workouts. They are taken
orally or by intramuscular injection. Users concerned about drug tolerance often
take steroids on a schedule called a cycle. A cycle is a period of between six
and 14 weeks of steroid use followed by a period of abstinence or reduction in
use.
Additionally, users tend to "stack" the drugs, using multiple drugs
concurrently. Although the benefits of these practices are unsubstantiated, most
users feel that cycling and stacking enhance the efficiency of the drugs and
limit their side effects.
Another mode of steroid use is "pyramiding." Users slowly escalate
steroid use (increasing the number of drugs used at one time and/or the dose and
frequency of one or more steroids) reaching a peak amount at mid-cycle and
gradually tapering the dose toward the end of the cycle. The escalation of
steroid use can vary with different types of training. Body builders and weight
lifters tend to escalate their dose to a much higher level than do long distance
runners or swimmers.
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The Legal Issues
The
best way for passing saliva drug testing is
not to do drugs at all or at the very least lay off them for awhile.
There are many
legal ramifications one must consider and
any information provided here is not intended to interpret the law or give legal
advice, so please see an
attorney for legal services. We also must present you with our legal disclaimer which is
very important. We take this legality discussion very seriously, so
please read our disclaimer.
