Illicit Use of Prescription Drugs in College Students and Designer Drugs - PowerPoint PPT Presentation

1 / 23
About This Presentation
Title:

Illicit Use of Prescription Drugs in College Students and Designer Drugs

Description:

Illicit Use of Prescription Drugs in College Students. and. Designer Drugs. Josh Spencer ... With increased prescription rates of adderall and ritalin abuse ... – PowerPoint PPT presentation

Number of Views:560
Avg rating:3.0/5.0
Slides: 24
Provided by: joshsp3
Category:

less

Transcript and Presenter's Notes

Title: Illicit Use of Prescription Drugs in College Students and Designer Drugs


1
Illicit Use of Prescription Drugs in College
StudentsandDesigner Drugs
  • Josh Spencer
  • AM Report
  • 8-21-2007

2
ADHD
  • Rise in prescribing psychoactive meds for ADHD
  • Use of prescription stimulants and diagnosis of
    ADHD higher in US than any other nation
  • We consume majority of worlds ritalin
  • Increased awareness of ADHD
  • Increased treatment duration meaning more people
    bringing to college

3
ADHD
  • First line therapy stimulants
  • Methylphenidate
  • ritalin
  • Amphetamine-dextroamphetamine
  • Adderall

4
Abuse of Adderall and Ritalin
  • With increased prescription rates of adderall and
    ritalin abuse also rising
  • Non-medical use of prescription subtances in
    college second only to MJ in illicit use
  • EtOH abuse staying steady

5
Prevalance of Abuse Study 1
  • Survey of over 10,000 college students randomly
    selected
  • Lifetime prevalence of 6.9
  • Past year prevalence 4.1
  • Past month prevalence 2.1
  • Use highest in white male members of fraternities
    with lower GPAs
  • Highest use in north eastern colleges and
    colleges with high academic requirements
  • More likely to abuse other drugs--Binge drinking,
    MJ, ecstasy, cocaine

6
Pevalence of Abuse Study 2
  • Self-administered web based survey of randomly
    selected college students N4580
  • Lifetime-8.3
  • Past year-5.9
  • 3/4 of the past year use with adderall
  • 1/4 of past year with ritalin
  • Caucasians and Hispanics 3X more likely to use
    than African-Americans and 2X more likely than
    Asians

7
Motives
  • Better grades

8
Motives
  • Increase concentration
  • Help Study
  • Increase alertness
  • Get high
  • Experimentation
  • Lose weight (women)

9
Routes of Administration
  • Oral use 95
  • 38 snorting
  • 5 smoke
  • Very few inject

10
Clinical Manifestations of Amphetamine overdose
  • Increase peripheral and central catecholamine
    concentrations
  • Tachycardia, HTN, AMI, seizures, intracranial
    bleeds, CVA
  • Hyperthermia, rhabdo
  • Mydriasis
  • Agitation
  • Acute psychosis
  • Death

11
Amphetamine OverdoseTreatment
  • ABCs
  • Monitor and treat arrhythmias
  • Gastric lavage if oral ingestion and recent use
    (approximately 1 hour)
  • IV drips for vasodilatation-nifedipine,
    nitroprusside alpha blockade-phentolamine
    alpha-beta antagonists-labetalol)
  • Hold BB
  • IV fluids if signs of rhabdo
  • Cool down patient (more on this later)
  • Counseling

12
Designer Drugs
  • Synthetic derivatives of controlled substances
    made by altering molecular structure
  • Mid 80s legislation made illegal to due this
  • Some of most popular amphetamine derivatives

13
Amphetamine Analogs
  • Made by attaching different substituent groups to
    different positions on the phenyl ring of
    amphetamine or methamphetamine
  • Substituents-methoxy, methyl, halogen, sulfur

14
MethylenedioxymethamphetamineMDMA
  • Ecstasy, E, X-TC, Adam, Clarity, Stacy, Lovers
    Speed, Essence
  • First made in 1914 for appetite suppressant,
    later use in 1970s by psychotherapists and now a
    schedule I drug
  • Most made in Europe and smuggled to US
  • Stimulant and psychedlic effects
  • Effects by serotonin and small degree Dopamine

15
Forms of MDMA
  • Capsule or tablet
  • Powder snorted or smoked
  • One tablet-10-30 or more
  • Can find descriptions of synthesis in scientific
    journals and internet but still hard to make
  • Improper synthesis responsible of the many
    impurities found in MDMA

16
Mechanism of Action
  • On neurons that make and release serotonin
  • MDMA-causes release of serotonin into synaptic
    cleft, inhibits its breakdown, and does not allow
    reuptake
  • Therefore increased concentration in cleft and
    intracellular depletion of serotonin
  • Effects begin 1 hour after ingestion and last 3-6
    hours
  • Chronic use-paranoid psychosis similar to
    schizophrenia and can go away after prolonged
    drug free state
  • Chronic use-can lead to cognitive decline

17
Other Amphetamine Analogs
  • Methamphetamine
  • Speed, crank, meth, crystal meth
  • Schedule II drug
  • Contaminants-lead (acute lead poisoning)
  • Methylenedioxyamphetamine
  • Methylenedioxyethamphetamine
  • Paramethoxyamphetamine

18
Clinical Manifestations
  • Increased energy and ability to concentrate,
    euphoria, relaxation, empathy, paranoia
  • Impulsive with increased risk taking
  • Suppress thirst and hunger-dehydration and heat
    exhaustion
  • Tachycardia, HTN, hyperthermia, tremors,
    pupillary dilation
  • MDMA-raised HR 28BPM, DBP 7mmHg, cardiac output
    by 2L/Min

19
Treatment
  • As amphetamine overdose

20
Treatment-Drug Induced Hyperthermia
  • Life threatening and similar to heat stroke
  • Discussion with toxicologist recommended
  • Active cooling measures--iced IVF, cool water
    bladder washes, cooling blanket
  • Hypotension-IVF and pressors
  • Dantrolene has been used but no controlled trials
  • Intubation and paralyzation to decrease muscle
    contractions and rigidity
  • Careful with succinylcholine as can cause
    malignant hyperthermia making problem worse
  • Normalize intracranial pressures
  • DIC
  • Metabolic acidosis and hypocalcemia

21
(No Transcript)
22
(No Transcript)
23
References
  • http//www.mdconsult.com.libproxy.lib.unc.edu/das/
    article/body/76596072-2/jorgjournalsourcesp14
    206749sid0/N/393096/1.html
  • Hoecker, Cynthia C. Designer Drugs in Adults.
    UpToDate. 2007.
  • Teter, Christian, et al. Illicit Use of Specific
    Prescription Stimulants Among College Students
    Prevalence, Motives, and Routes of
    Administration. Pharmacotherapy. October 2006.
    1501-1510.
  • UpToDate. Drug information on Dextroamphetamine
    and amphetamine. 2007
  • McCabe, Sean et al. Non-Medical Use of
    Prescription Stimulants Among US College
    Students Prevalence and Correlates From National
    Survey. Addiction. 2005. 96-106.
Write a Comment
User Comments (0)
About PowerShow.com