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Developed to treat acute pain, diarrhea, coughs, & other illnesses ... Hydrocodine- Vicodin. One of the most widely abused prescription drug ... – PowerPoint PPT presentation

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Title: Downers

  • Opiates/Opioids
  • Sedative-Hypnotics

General Classification
  • Downers Slow down activity in the Center Nervous
  • Sedation, muscle relaxation, drowsiness
  • Extreme cases coma by depressing the Central
    Nervous System
  • Downers work on many more receptor
  • sites than in the body than uppers.

Major Depressants
  • Opiates/Opioids
  • Developed to treat acute pain, diarrhea, coughs,
    other illnesses
  • Abused for euphoric effects, pain relief,
    suppression of withdrawal symptoms

Major Depressants
  • Sedative- reduce anxiety
  • Hypnotics- induce sleep
  • Synthesized drugs, devised to treat nervousness
  • All have toxic side effects, can cause dependence

Sedative-Hypnotics Benzodiazepines Xanax ?,
Valium ?, Halcion ?, Librium ?, Rohypnol ?,
Klonopin ?, Restoril ?, Ativan ? Barbiturates Sec
onal ?, Nembutal ?, Amytal ?, phenobarbital Other
s Chloral hydrate, GHB, GBL, Placidyl ?, etc.
Minor Depressants
  • Skeletal Muscle Relaxants
  • Synthetically developed to depress areas
  • of the brain responsible for muscle coordination
  • Prescribed for muscle tension pain
  • Antihistamines
  • Synthetic drugs used to treat allergies, ulcers,
    shock, rashes, motion sickness, produce
    drowsiness, block the release of histamine, can
    induce depression/drowsiness

Minor Depressants
  • Over-The-Counter Downers
  • Nytol Sominex, Calm,
  • Many new products on the market
  • Promoted as sleep aids sedatives

  • Classification
  • Some of the most widely used drugs
  • Have been the source of worldwide problems,
    political, economic, health
  • History of Use
  • Opium was used by the ancient Sumerians,
    Egyptians, Chinese
  • Used as medicine, pleasure inducing substance,

Legal Changes
  • 20th Century
  • 1914 Harrison Narcotic Act passed
  • Non-medical use of opiates cocaine made illegal
    in US
  • Required all distributors to pay a tax on the
    drugs used for medical purposes
  • Legal prescriptions diverted to illegal markets

Methods of Ingestion
  • Oral
  • Opium was originally chewed, eaten, or drunk
  • Used in medications from Middle Ages to present
  • 30-20 minutes to reach brain
  • Smoking
  • Non-medical use increased the intensity
  • multiplied abuse potential
  • 710 seconds to reach brain

Opium Changes
  • Refinement of Opium
  • Morphine made from opium, increased the
    strength 10X
  • Heroin refined from morphine, made it even
  • Codeine 1/5 the strength of morphine

Methods of Ingestion
  • IV Use
  • 1858 The invention of hypodermic needles
  • Morphine/Heroin began to be injected
  • Increased intensity/addictive potential
    (especially with heroin
  • 15-30 seconds to reach brain
  • Snorting
  • Popular methods of taking heroin
  • Requires more drug to produce highs
  • 5-8 minutes to reach brain

Effects of Opioids
  • Pain
  • Prevent transmission of neurotransmitters that
    transmit pain
  • Painkilling effects lowered anxiety, serenity,
    drowsiness, deadening of unwanted emotions
  • Pleasure
  • Artificially activate reward/pleasure center
  • Pain relief euphoria main reasons for addiction

Natural Pain Suppression
Artificial Pain Suppression
Effects of Opioids
  • Satiation
  • Disrupts the pleasure-regulating control in the
    brain, causes craving of pleasurable effects
  • Receptor Sites
  • Opioids slot into the receptors causing more
    intense reactions than normal
  • Cough Suppression Diarrhea Control
  • Opioids suppress coughs by controlling the cough
    center in the brain stem
  • Inhibit gastric secretions depress intestinal

Effects Opiates/Opioids Pain suppression Pinpoint
pupils Lowered heart rate, blood pressure,
respiration Constipation Cough suppression Lax
muscle tone Dryness of mouth Euphoria
Side Effects of Heroin Opioids
  • Physical Effects
  • Felt in almost every part of the body
  • Includes Drooping eyelids, nodding,
    slowed/slurred speech, slowed muscle reactions
  • More severe in digestive/hormonal systems
  • Tolerance
  • Tolerance Body builds up a resistance to the
    drug requires user to increase usage to
    maintain usual effects. Occurs rapidly with

Side Effects of Heroin Opioids
  • Tissue Dependence
  • Tissue Dependence Adaptation to effects of a
    drug alters brain chemistry. Body begins to
    rely on drug to feel normal. Intensifying the
    desire to use the drug again
  • Withdrawal occurs after 2-3 weeks of continuous
    use followed by abstinence
  • Heroin/morphine cause severe physical withdrawal
    peak at 48 hours lasts 5-7 days
  • Methadone milder, but longer lasting up to 14 days

Additional Problems
  • Neonatal Effects crosses the placental barrier
    giving large doses to unborn fetus
  • Overdose occurs when so much of the drug enters
    the brain the nervous system shuts down. Blood
    pressure drops, heart becomes to weak to pump
    blood, lungs labor fill with fluid
  • Dirty Shared Needles Hepatitis B C, HIV,
    flesh eating bacteria, gangrene, endocarditic,
    malaria, syphilis

Polydrug Use
  • Mixing Opioid users often mix cocaine or
  • amphetamine, speedball. Combine heroin
  • marijuana to give it more kick.
  • Alcohol benzodiazepines create synergistic
    effects increase potential for overdose,
    respiratory depression death
  • Cycling Addicts go on off their drug of choice
  • Lowers tolerance tissue dependence so
    the body can attempt to return to normal. Switch
    to alcohol, marijuana,
  • barbiturates, benzodiazepines

Other Opioids
  • Codeine
  • Used for relief of moderate pain control cough
  • Hydrocodine- Vicodin
  • One of the most widely abused prescription drug
  • Methodone- longer acting synthetic opioid
  • Reduces drug craving blocks withdrawal symptoms
  • Oxycodone Percodan, Oxycontin
  • Both extremely addictive

  • Sedative hypnotic over 2,500 different types of
    the drug
  • Many medical uses Phenobarbital, seizures
  • Seconal, Nembutal induce sleep
  • Pentothal used in anesthesia
  • Temporary stimulation then sedation
  • Immediate Unconsciousness

Tolerance Tissue Dependence
  • Develop very quickly with sedative-hypnotics
  • Liver becomes very efficient in processing
  • Age dependences occurs
  • Tissue Dependence occurs when 8-10 times
  • the normal dosage is taken for 30 days
  • Withdrawal can be severe, seizures,
    convulsions, death
  • Must have professional intervention for
    successful withdrawal

  • Widely prescribed legal sedatives
  • Zanax,Valuim, Ativan
  • Medical Uses
  • Anxiety, panic disorders
  • Calm down before surgical procedures
  • Sleep problems
  • Muscular spasms
  • Help with acute alcohol withdrawal

Benzodiazepines Very Long Acting Short
Acting Halazepam (Paxipam?) Alprazolam (Xanax
?) Prazepam (Centrax ?) Temazepam (Restoril ?)
Flurazepam (Dalmane ?) Oxazepam (Serax
?) Lorazepam (Ativan ?) Intermediate
Acting Very Short Acting Clonazepam (Klonipin ?)
Triazolam (Halcion ?) Chlordiazepoxide (Librium
?) Diazepam (Valium ?)
Effects of Benzodiazepines Anxiety control (e.g.,
panic attack) Relaxation Drowsiness
sleep Control seizures Reduced muscular
coordination Dulled physical sensations Tolerance
to effects develops
Other Sedative-Hypnotics
  • GHB (gammahydroxybutyrate)
  • Odorless, tasteless, colorless powder
  • Popular among bodybuilders
  • Has an effect similar to alcohol intoxication
  • Also popular in rave clubs
  • Two CSU, Chico student deaths due to
  • GHB Alcohol
  • Female Butte College student Spring 2002

Drug Interactions
  • Synergism
  • Combined effects of drugs are greater than the
    individual effects
  • Results in 4,000 deaths 50,000 ER visits/year
  • Cross-Tolerance Cross Dependence
  • Development of tolerance to other drugs because
    of exposure to a drug
  • Addiction to one drug increases liability to
    addiction to other drugs in the same family

  • 2002 Americans spent 91 billion on prescription
  • Three times the amount 10 years ago
  • 15 billion on over- the- counter drugs
  • 50-60 billion on illegal drugs
  • 75 billion on tobacco
  • 140 billion on alcohol WOW!!

United States 33
Australia 1
Africa 1
Japan 18
Europe 29
Middle East 2
Latin America 7
Canada 1
Southeast Asia China 8
World Prescription Drug Market