All Arounders
Introduction
While uppers generally stimulate the CNS and downers depress the CNS, all
arounders may produce either of these effects. The common effect
of any drug classified as an all arounder is an ability to distort or alter
perception of the user. These agents are the true "mind altering"
drugs and their use often results in hallucinations or the sense of a "world
separate from reality". This class of drugs are also referred to
as the psychedelics. Psychedelic drugs may be roughly classified
as belonging to one of five groups of drugs: One group includes drugs like
LSD and psilocybin, the second mescaline and the amphetamine-like drugs
such as "ecstasy", the anti-cholinergics such as belladonna, marijuana
and similar cannabinoids, and the fifth miscellaneous group including drugs
such as PCP.
The exact effects that are produced have been poorly researched, due
to the limitations of research tools. Use of human subjects is often
ethically improper. Given the hallucinogenic effects, which comprise
a major reason for their use, animal models are difficult to assess.
Therefore, while many of the pharmacologic effects of psychedelics are
known, the pharmacodynamic response (what the person experiences) is less
well investigated. This lack of knowledge is also due, at least in
part, to the variety of experiences that individuals may report.
In this respect, the psychedelics share a common effect with the depressants,
that the mood of the user at the time of dosing may determine the specific
effect produced (i.e. a patient that is angry may become more violent or
angrier -- it also appears that persons with diagnosed mental disease such
as schizophrenia will become more schizophrenic when using a psychedelic
-- an exception to this general rule is with first time users who may experience
effects from nausea and vomiting with no mind alteration to an almost child-like
state of naivete). It is known that psychedelics influence
many neurotransmitter systems, including dopamine, acetylcholine, noradrenaline,
and serotonin. It is most likely the effects on the serotonin system
that result in altered states of perception.
General Physical Effects of Psychedelics
Most of these agents stimulate the sympathetic nervous system.
They may result in fast heart and breathing rates, increased blood pressure,
arrhythmias, sweating, and nausea. They also stimulate sensory nerves
so that the user is much more sensitive to sensory stimulation (sounds
are louder, colours brighter, touch more sensitive, et c.) even
to the point that sensory pathways become mingled so that sounds are seen
(as colours), colours are smelled, et c. This crossover of
sensory pathways is called SYNÆSTHESIA.
General Emotional Effects of Psychedelics
The ability of these agents to alter the limbic (emotional) centre
of the brain contributes to the altered perceptions of the users.
These may present as one of three different types.
Illusions -- mistaken perceptions of real stimuli, for example a rope
is perceived as a snake.
Delusions -- mistaken ideas that do not respond to reason, for example
to person can fly
Hallucinations -- the perception does not relate to reality at all,
for example the pink dragon eating a popsicle while sitting in the recliner,
when the recliner is actually empty.
LSD and Similar Drugs
LSD (lysergic acid diethylamide)
LSD is one of the active components of the ergot fungus (Claviceps
purpurea). Street names include "acid" and "blotter". Extremely
popular in the 1960s, LSD use declined during the 70s and 80s. However,
its use is again on the rise by young people. Reasons for the use
include the typical reasons for initial use (experimentation, peer pressure)
and the popularity of "rave" clubs where the supply is high (easy to get).
Drug screens rarely test for LSD and the relatively low dose (approximate
1/20 to 1/10 the dose used in the 1960s) make it a relatively "safe" drug
to use (additionally, the effects are not a noticeable as ethanol).
LSD is typically dissolve in alcohol and dropped onto blotter paper
or sugar cubes and ingested or placed on small cubes of gelatin and placed
in the eye for absorption. In low doses (25 mcg), LSD mainly causes
stimulation with mild psychedelic effects ("spaciness", altered perception
of time, mild euphoria). Higher doses (up to 300 mcg) are required
for full psychedelic effects. Tolerance develops rapidly to the psychedelic
effect which may demonstrate a cross tolerance to the effects of psilocybin
or mescaline. A more potent form of LSD (LSD-49, "illusion") preferentially
provides the user with visual hallucinations, relative to older forms of
LSD (LSD-25).
LSD can cause the typical types of stimulatory effects discussed above.
Individuals may also experience light-trails (after-images) in response
to the drug. In addition to the altered states of perception, LSD
will effect the portion of the brain that controls word processing and
speech formulation so that the user cannot express himself. Responses
are often inappropriate and may appear unrelated to the question or statement
that elicited the response. It also impairs judgement and reasoning
and slows reaction time which, coupled with the hallucinogenic effect,
make operating cars or machinery hazardous.
As stated previously, the state of the person at time of use may often
influence the effect of the drug. Some "trips" (as the rush or high of
psychedelics are called) may be "bad". That is, the user may experience
euphoria or hallucinations, but these may be coupled with fear, paranoia,
and acute and severe anxiety all of which contribute to a feeling of panic
in the user. This type of experience is often viewed as "bad" and
likely results from the effects of the drug on numerous neurotransmitter
systems simultaneously. Additionally, some users may experience "flashbacks",
situations that were present at the time of use of the drug are present
and act as a stimulus, reminding the brain of the "trip" that was taken
last time those stimuli were present. The person may then experience
or remember the trip, even though no drug has been taken. These stimuli
are often visual, auditory, olfactory, or tactile in origin.
Psilocybin & Psilocin
These agents are the active constituents of the hallucinogenic mushrooms,
which are comprised of three species, Psilocybe, Panaeolus, and
Conocybe. The actions of these agents are similar in mechanism
and effect to LSD. Differences include a higher incidence of nausea
with oral dosing and less panic during the "trip" than LSD. The length
of the trip is usually shorter and psychotic reactions are not as severe
as those seen with LSD. In addition to traditional sources of abused
substances, the mushrooms are available through underground mail-order
companies for personal mushroom gardens. However, their only legal
use is in the ceremonial rites of certain aboriginal tribes.
Other LSD-Like Psychedelics
Ibogaine -- derived from Tabernanthe iboga, use of this substance
is predominantly limited to Africa. At low doses it is a CNS stimulant
and higher doses produce psychedelic effects. It can also produce
a catatonic-like state that can be controlled by the user (he may emerge
from the catatonia when he chooses). It is also been suggested as
a treatment of heroin and cocaine addiction, by its ability to prevent
the increase in dopamine (thereby preventing the pleasure/reward centre
activation) that is seen with those drugs.
Morning Glory Seeds (ololiuqui) -- these seed possess very mild psychedelic
effects and the amount that have to be ingested to produce the desirable
effect also produces nausea, limiting their use.
DMT (Dimethyltryptamine) -- this substance is found in numerous plant
stuffs. It has a long history of use in South American cultures.
The plants are typically dried and a snuff made, which is blown into the
noses of the users (it is destroyed by stomach acids, so that it is ineffective
taken orally). Effects include intense visual hallucinations and
altered state perceptions. A related compound, 5-methoxy-DMT, is
milked from the Sonoran desert toad onto cigarettes, dried and smoked.
Tryptamine and its derivatives are the components that are supposedly present
in banana peels, which accounts for the urban myth of smoking them for
their psychedelic effects. The relatively short duration of action
makes DMT popular among young professionals. For this reason, it
is often referred to as the "businessman's special".
Yage -- this psychedelic of the Amazon basin produces severe stomach
upset (vomiting, diarrhœa) which is followed by an intense dreamlike state,
lasting as long as 10 hr. The active ingredient is probably the alkaloid
harmaline. It is often combined with DMT to enhance the hallucinogenic
effects of both drugs.
Amphetamine-Like Psychedelics
These agents are chemically similar to the stimulant amphetamines, but
produce psychedelic effects. They also take much longer to achieve
peak effects (up to several hours after administration).
Peyote (Mescaline)
The source of mescaline is the peyote and San Pedro cacti. It
is harvested from the tops of the cacti as "buttons" and may be eaten fresh
or dried (6 to 10 buttons are usually required for the full effect, although
less may be used). It is a relatively long-acting psychedelic (up
to 12 hours) with a higher incidence of often colourful hallucinations.
There is a high incidence of nausea and vomiting, however tolerance may
develop to the side effects as well as to the psychedelic effects.
Peyote is also used in Native American religious ceremonies.
Designer Psychedelics -- MDA (methylenedioxyamphetamine), MDMA (methylenedioxymethamphetamine),
DOM (dimethoxymethylamphetamine), numerous others. These agents are
derivatives of the stimulant amphetamine that have a much greater effect
on serotonin receptors, giving them psychedelic properties. MDA was
the first of these designer drugs and was widely used. It has been
supplanted by MDMA in popularity.
MDMA ("ecstasy", "rave", "X")
MDMA is intermediate acting (4-6 hours) and produces effects similar
to the amphetamines. It may cause altered perception to stimuli (20
min-1 hr after administration) but rarely causes illusions or hallucinations
more commonly associated with the psychedelics. However, high doses
have been reported to cause "bad trips" and flashbacks. Adverse effects
are also similar to the amphetamines. Death has occurred due to hyperthermia
(increased body temperature) and dehydration. There have also been
reports of major depression and suicidal tendencies following use of MDMA.
"Rave" Clubs -- The use of psychedelics and other drugs of abuse is
popular at these parties. Common drugs that may be encountered at
such gatherings include MDMA, LSD, amphetamines, marijuana, volatile nitrates
and nitrites (discussed later), and alcohol. Polydrug abuse is common
and some of the more popular combinations include MDMA and LSD ("X's and
L's") and speed balls of heroin and MDMA. The high level of exertion
(dancing, et c.) at these parties often contributes to the hyperthermia
and dehydration that may be potentially lethal with MDMA.
DOM ("STP", "serenity")
DOM is relatively long acting (12 hours) that produces a high degree
of stimulation and mild psychedelic effect.
Belladonna and Related Drugs
These agents are derived from many plant sources, with the classic being
Belladonna atropos. The active ingredient is atropine or similar
alkaloids. The drug produces drowsiness, dry mouth, constipation.
It also speeds up the heart and may cause arrhythmias and may increase
body temperature and make the person thirsty. Very high doses are
usually required to alter perception and while hallucinations may occur,
they are relatively rare, compared with other psychedelics. The drugs
most commonly abused are prescription products that have been illegally
diverted for use. Belladonna cigarettes are also available.
An historic popular use of anticholinergics as an abused substance was
the smoking of "rabbit" tobacco, which was one of a number of un-related
plants, some of which contained atropine or atropine-like substances.
NOTE that these drugs produce their primary effects by altering the effects
of the neurotransmitter acetylcholine.
Miscellaneous Psychedelics
PCP ("angel dust"), Ketamine
Phencyclidine or PCP belongs to a class of drugs called dissociative
anæsthetics. Its use was limited to veterinary medicine (giving
it another of its street names, "horse"), however even that product has
been pulled from the market. A similar drug (ketamine, street name
"special K", "super K") is used in human and veterinary medicine.
PCP may be smoked, snorted, swallowed, or injected. It distorts the
sensory system and also produces disinhibition, analgesia, and produces
an effect users describe as an "out of body" experience (hence the term
dissociative anæsthetic). PCP is relatively dangerous in that
the dose that produces the desirable effect and the dose that causes coma
or convulsions are relatively close. In addition to altered perceptions
of reality, these agents may produce a dream-like state with illusions/hallucinations.
Amanita Mushrooms
Most of the species of amanita are poisonous. Two (A. muscaria
and A. pantherina) may be abused. The active constituents
are ibotenic acid and muscimole. They also produce a dreamlike state
accompanied by hallucinations and delirium. These are most often
ingested. They are also used on a limited basis by some Indian tribes.
Nutmeg, Mace
These spices, if taken in sufficient quantities, may produce a mild
state of dissociation and delirium. However, the dose required also
produces a severe hangover and stomach irritation. The active ingredients
are similar to MDA.
Marijuana and the Cannabinoids
The hemp plant has a long history of use and abuse throughout human history.
It has been used as a source of rope, fibre, and paper, as well as for
a medicinal agent and substance of recreational abuse.
History of Abuse
The use of marijuana (street names include "grass", "weed", "pot")
became relatively popular during the 1920s and 30s. It use declined
greatly following legislation banning its use. During the 1960s,
the illegal use of marijuana began to rise at an accelerated rate, peaking
in 1979. Use then began to decline, but is currently on the rise
again.
Botany
The primary source of marijuana is Cannabis sativa and Cannabis
indica, which is grown worldwide. The plants may grow as high
as 20 feet (although 12 feet is a more common limit) and have a characteristic
stem composed of five thin, serrated leaves.
Sinsemilla -- this growing technique increases the concentration of
the active component of the plant, which is delta-9 tetrahydrocannabinol
(delta-9 THC, or THC). These are produced by female plants that have
not been pollinated. This technique has increased the THC content
from 1-3% to up to 14% in the plant.
Depending upon the part of the plant used, varying strengths of marijuana
may be processed. The weakest (Bhang) is made from stem and leaves,
Ganja is made from leaves and flowering tops of plants. The strongest
form is concentrated from the resin of the plant and is referred to as
hash or hashish. Any of these forms may be smoked or ingested (often
added to food -- the "hash" brownie).
The only legal garden for marijuana growth (for research purposes) in
the U.S.A. is at the University of Mississippi and is operated by the School
of Pharmacy Research Institute of Pharmaceutical Sciences/National Centre
of the Development of Natural Products.
Pharmacology
Marijuana is probably acting through a receptor that has recently been
discovered in the brain. The receptor is for the neurotransmitter
anandamide and is closely associated with the reward/pleasure centre of
the limbic system and the area of the brain that integrates sensory input.
THC acts as an agonist at this receptor and these actions account for its
addictability (through the pleasure/reward effects) and the psychedelic
effects (through the sensory integration effects).
Physical Effects
Marijuana initially causes relaxation/sedation, bloodshot eyes, coughing,
increased appetite, and a drop in blood pressure with a reflex increase
in heart rate. It will also cause pressure within the eye to decrease
and decreases nausea. These account for the medical uses of marijuana,
but there are other drugs that are much more effective in each of these
effects that do not produce the psychedelic or addictive actions of marijuana.
Marijuana also causes a decrease in testosterone secretion in males, which
may reduce their fertility and with chronic use cause feminisation.
Other effects include slowed reaction time, inability to track moving
objects, trailing (afterimages), and reduced hand to eye coordination.
These effects increase the danger of driving or operating machinery under
the influence of marijuana.
Mental Effects
Marijuana is similar to other drugs of the class in that the specific
effect may vary with individual persons and settings and often depends
upon the mental state of the user. Some users report a stimulatory
effect, while more report a depressant effect. In general, marijuana
will produce a feeling of detachment (dissociation), drowsiness, and a
decreased ability to concentrate. Some stronger varieties and higher
doses may produce giddiness, silliness, stimulation, and altered perceptions
of time, colour, sounds, illusions, and hallucinations. It may also
produce a state of paranoia. Short term memory is also frequently
affected (decreased).
Long-Term Effects
Respiration -- use of marijuana irritates the bronchial passages, causing
bronchitis. Chronic use also decreases the cilia of the lung (not
as radically as tobacco) and increases mucous secretion into the pulmonary
passages, contributing to the cough and bronchitis. There is also
an increased risk of cancer with marijuana smoking, as with nicotine cigarettes.
Immune System -- marijuana depresses the immune system, increasing the
risk of infections. This obviates its use medically in AIDS patients.
Reproductive System -- as stated previously, marijuana will decrease
testosterone secretion in males, leading to potential infertility.
Learning and Emotional Maturation
As stated previously, marijuana decreases short term memory and is
therefore detrimental in persons who "cram" or memorise for tests.
It appears that there are no effects on long-term memory. It has
also been associated with an amotivational syndrome, removing a person's
desire or motivation to learn, work, or perform some other task.
This may be in part due to the use of the drug when bored. The reward
the drug offers in place of the work or learning provides the basis for
future use when faced with working again.
Acute Mental Effects
As stated previously, paranoia may occur with marijuana use.
Other effects include an exaggeration or exacerbation of existing mental
disease, as with other drugs of the class.
Tolerance, Addiction, and Withdrawal
Tolerance -- develops rapidly to the psychic effects of marijuana.
Additionally, the drug persists in the body for long periods of time (which
may contribute to the tolerant effects). This persistence may result
in detection by urine tests. Occasional use may result in detection
as late as 5-7 days after the drug was taken. Daily use may permit
detection for as long as 10-15 days after the last dose, while heavy, chronic
use may persist in the body for up to 1 year after quitting the drug.
Withdrawal -- Because marijuana does stay in the body for a long period
of time, withdrawal is delayed and may not cause immediate responses as
with other drugs (refer to the discussion of acute vs. long withdrawal
in the sedative hypnotic section). Symptoms of marijuana withdrawal
may include anger or irritability, aches, pains, chills, depression, tremors,
insomnia and other sleep changes, decreased appetite, sweating, and craving.
Addiction -- The activity of the marijuana on the reward/pleasure centre
account for its ability to cause addiction and compulsive use, by mechanisms
and effects previously discussed. Additionally and also as previously
stated, those persons with addictive personalities are more likely to abuse
marijuana and other drugs. This increases their likelihood of polydrug
abuse. Moreover, by associating with dealers and other users, the
probability of introduction to other drugs of abuse is increased.
In this respect, marijuana acts as a "gateway" drug that may introduce/permit
the abuse of other substances with subsequent addiction.
END MATERIAL FOR EXAM TWO.