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HEROIN Is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown powder or as a black sticky substance, known as “black tar heroin.” Poppy plants have been grown as far back as 3400 B.C., but it was only in the 19th century that use became widespread across the world at large. Heroin, originally created in 1874 by a chemist named C.R. Alder Wright, was formed by creating a concentrated form of morphine, a drug already in use as a painkiller. Even though heroin was addictive, it was originally marketed as a non-addictive substitute for morphine, as well as a cough suppressant used on children. This continued until it was found that, after heroin enters the body, it is actually converted back into morphine. Heroin enters the brain, where it is converted to morphine and binds to receptors known as opioid receptors. These receptors are located in many areas of the brain (and in the body), especially those involved in the perception of pain and in reward. Opioid receptors are also located in the brain stem—important for automatic processes critical for life, such as breathing (respiration), blood pressure, and arousal. Heroin overdoses frequently involve a suppression of respiration. After an intravenous injection of heroin, users report feeling a surge of euphoria (“rush”) accompanied by dry mouth, a warm flushing of the skin, heaviness of the extremities, and clouded mental functioning. Following this initial euphoria, the user goes “on the nod,” an alternately wakeful and drowsy state. Users who do not inject the drug may not experience the initial rush, but other effects are the same. With regular heroin use, tolerance develops, in which the user’s physiological (and psychological) response to the drug decreases, and more heroin is needed to achieve the same intensity of effect. COCAINE Cocaine is a powerfully addictive stimulant drug. The powdered hydrochloride salt form of cocaine can be snorted or dissolved in water and then injected. Crack is the street name given to the form of cocaine that has been processed to make a rock crystal, which, when heated, produces vapors that are smoked. The term “crack” refers to the crackling sound produced by the rock as it is heated. derived from the leaves of the coca plant, it is a crystalline tropane alkaloid, and its name is derived from “coca” and the alkaloid suffix “-ine”- forming the name of one of the most recognized drug names today: Cocaine. This drug is both a stimulant and suppressant, together creating a euphoric sensation of happiness and energy. There are also unfortunately negative side effects to the use of this drug, effects which in some cases require hospitalization or drug treatment for cocaine addiction. The original use of the coca plant as a nutritional, medicinal, and spiritual source is not to be confused with today’s abuse of cocaine in injecting, snorting and smoking of the isolated alkaloid. Today’s abuse of cocaine will often lead to addiction which in many cases requires the involvement of a cocaine rehab treatment center. Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical (or neurotransmitter) associated with pleasure and movement, in the brain’s reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of the neurotransmitter to build up, amplifying the message to and response of the receiving neuron, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine’s euphoric effects. With repeated use, cocaine can cause long-term changes in the brain’s reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their

first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects. STREET METHADONE Street methadone is methadone sold or given to someone it was not prescribed for. Methadone is a powerful medication that is part of a group of drugs called opioids. Codeine, morphine, Percocet, OxyContin and heroin are all opioids. Methadone is prescribed by a doctor to treat people who have been addicted to opioids. When taken as prescribed, methadone is safe. It does not get a person high, but it does stop opioid withdrawal for a full day. A person who does not have to worry about withdrawal can find time to do things like go to school or work. When methadone is sold or given to someone it is not prescribed for, it is very dangerous. Methadone (also known as Symoron, Dolophine, Amidone, Methadose, Physeptone, Heptadon, Phy and many other names) It was developed in Germany in 1937. Although chemically unlike morphine or heroin, methadone acts on the same opioid receptors as these drugs, and thus has many of the same effects. Methadone is also used in managing severe chronic pain, owing to its long duration of action, extremely powerful effects, and very low cost. Methadone was introduced into the United States in 1947 by Eli Lilly and Company. The effects of methadone last longer than those of morphine-based drugs. Methadone’s effects can last up to 24 hours, thereby permitting administration only once a day in heroin detoxification and maintenance programs. Deaths occur more frequently at the beginning of treatment in methadone programs; they are usually a cause of excessive doses (i.e. erroneously estimated tolerance) and they are affected by concomitant diseases (hepatitis, pneumonia). Methadone generally entails the entire spectrum of opioid side effects, including the development of tolerance and physical and psychological dependence. Respiratory depressions are dangerous. The released histamines can cause hypotension or bronchospasms. Other symptoms are: constipation, nausea or vomiting, sedation, vertigo, edema. ALCOHOL Alcohol is a beverage composed of ethanol and other components such as grain, sugar and starches which is produced through fermentation. Alcohol is affects the central nervous system because it alters the way the brain functions.

There is a saying about alcohol consumption: "everything in moderation." Drinking affects every organ in your body. Once consumed, alcohol enters the bloodstream and begins to affect functions in the body. Alcohol has many long-term and even debilitating effects on the brain. Heavy drinking has been linked to symptoms from minor "slips" of memory to significant paralysis. It also has a negative impact on brain function after the alcohol has worn off. Research shows the damaging effects of alcohol on the brain is most significant in the frontal lobe, which provides us with the ability for complex thought. Alcohol decreases the effects of your nerve cells firing and lessens the effects your neurotransmitters have on carrying information through your brain. Your level of mental sharpness decreases, along with coordination and alertness. Alcohol can affect memory, mood and impulse control. KETAMINE Ketamine hydrochloride ("Special K" or "K") was originally created for use as a human anaesthetic, and is still used as a general anaesthetic for children, persons of poor health, and in veterinary medicine.Ketamine belongs to a class of drugs called "dissociative anaesthetics," which separate perception from sensation. Other drugs in this category include PCP, DXM and nitrous oxide (laughing gas).Ketamine usually comes as a liquid

in small pharmaceutical bottles, and is most often cooked into a white powder for snorting.
Ketamine, developed in 1962, was initially promoted as a fast acting general anesthetic.A few years later, in 1970, the federal government approved ketamine for human use, and as a result it soon became popular as a battlefield anesthetic. The first evidence of illicit abuse of the drug was on the West Coast.Later, during the late 1970s and early 1980s abuse began to increase across the country, especially among certain sub-cultures (e.g., mind explorers and New Age spiritualists).Around the same time, new forms of the drug were being introduced into the illegal drug markets including capsules, powder, crystals, tablets, and solutions, in addition to other injectable forms.Starting in the mid-1980s another increase in the social-recreational use of ketamine was beginning to be linked to various dance cultures, initially as an adulterant - an added ingredient that can alter the effects of the drug - of MDMA (ecstasy). In fact there are reports that party/club goers in the United Kingdom first used ketamine when they ingested a pill they thought to be ecstasy. Today, there are still valid medicinal uses of ketamine for anesthetic reasons, though use is uncommon and tightly restricted. Illicit use today is also of great concern to many. Despite difficulty in determining its prevalence, use is higher today than it was when first introduced. Consequently, and perhaps in response to increases in recreational use, the federal government classified ketamine as a Schedule III controlled substance in August 1999, creating more stringent controls of the drug. The effects of ketamine are considered dose dependent. That is, lower doses of the drug produce varying results when compared to higher doses. A dose of 1.0 to 2.0 mg per kilogram of body weight produces an intense experience lasting about one hour. The effects include a sense of floating and dissociation, stimulation, and hallucinations. Larger doses of ketamine may produce what users refer to as a “K-hole.” A K-hole is generally reached when the user is on the brink of being fully sedated and is likened to an out-of-body or near-death experience. High doses of ketamine may result in severe respiratory depression, muscle twitches, dizziness, slurred speech, nausea, and vomiting.One of the most dangerous effects of ketamine is the helpless and/or confused state the user may be put into after use of the drug. This causes the user to have difficulty with balance, combined with numbness, muscle weakness, and impaired vision. The combined effects can leave the user vulnerable to particular forms of crime,especially "date rape".

BENZODIAZEPINE A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963. Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA), which results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant and amnesic action.These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures. Benzodiazepines are categorized as either short-, intermediateor long-acting. Short- and intermediate-acting benzodiazepines are preferred for the treatment of insomnia; longer-acting benzodiazepines are recommended for the treatment of anxiety. In general, benzodiazepines are safe and effective in the short term, although cognitive impairments and paradoxical effects such as aggression or behavioral disinhibition occasionally occur.Long-term use is controversial due to concerns about adverse psychological and physical effects, increased questioning of effectiveness and because benzodiazepines are prone to cause tolerance, physical dependence, and, upon cessation of use after long term use, a withdrawal syndrome.Due to adverse effects associated with the long-term use of benzodiazepines, withdrawal from benzodiazepines, in general, leads to improved physical and mental health. The elderly are at an increased risk of suffering from both short- and long-term adverse effects.

There is controversy concerning the safety of benzodiazepines in pregnancy. While they are not major teratogens, uncertainty remains as to whether they cause cleft palate in a small number of babies and whether neurobehavioral effects occur as a result of prenatal exposure; they are known to cause withdrawal symptoms in the newborn. Benzodiazepines can be taken in overdoses and can cause dangerous deep unconsciousness. However, they are much less toxic than their predecessors, the barbiturates, and death rarely results when a benzodiazepine is the only drug taken. When combined with other central nervous system depressants such as alcohol and opiates, the potential for toxicity increases.Benzodiazepines are commonly misused and taken in combination with other drugs of abuse. AMPHETHAMINE Amphetamine is a psychostimulant drug of the phenethylamine class that produces increased wakefulness and focus in association with decreased fatigue and appetite. The drug is also used recreationally and as a performance enhancer. Recreational users of amphetamine have coined numerous street names for amphetamine, such as "speed". Physical effects of amphetamine can include severe addiction, hyperactivity, dilated pupils, vasoconstriction, blood shot eyes, flushing, restlessness, dry mouth, bruxism, headache, tachycardia, bradycardia, tachypnea, hypertension, hypotension, fever, diaphoresis, diarrhea, constipation, blurred vision, aphasia, dizziness, twitching, insomnia, numbness, palpitations, arrhythmias, tremors, dry and/or itchy skin, acne, pallor, convulsions, and with chronic and/or high doses, seizure, stroke, coma, heart attack and death can occur. Psychological effects can include euphoria, anxiety, increased libido, alertness, concentration, energy, self-esteem, selfconfidence, sociability, irritability, aggression, psychosomatic disorders, psychomotor agitation, grandiosity, repetitive and obsessive behaviors, paranoia, and with chronic and/or high doses, amphetamine psychosis can occur. BUPRENORPHINE Buprenorphine is a semi-synthetic opioid that is used to treat opioid addiction in higher dosages (>2 mg), to control moderate acute pain in non-opioid-tolerant individuals in lower dosages (~200 µg), and to control moderate chronic pain in dosages ranging from 20– 70 µg/hour. It is available in a variety of formulations: Subutex, Suboxone (typically used for opioid addiction), Temgesic, Buprenex (solutions for injection often used for acute pain in primary-care settings), Norspan and Butrans (transdermal preparations used for chronic pain). Buprenorphine hydrochloride was first marketed in the 1980s by Reckitt & Colman (now Reckitt Benckiser) as an analgesic, generally available as Temgesic 0.2 mg sublingual tablets, and as Buprenex in a 0.3 mg/ml injectable formulation. In October 2002, the Food and Drug Administration (FDA) of the United States also approved Suboxone and Subutex, buprenorphine's high-dose sublingual tablet preparations indicated for detoxification and longterm replacement therapy in opioid dependency, and the drug is now used predominantly for this purpose. In the European Union, Suboxone and Subutex, buprenorphine's high-dose sublingual tablet preparations, were approved for opioid addiction treatment in September 2006. In the Netherlands, Buprenorphine is a List II drug of the Opium Law, though special rules and guidelines apply to its prescription and dispensation. In the USA, it has been a Schedule III drug under the United Nations' Convention on Psychotropic Substances since it was rescheduled from Schedule V just before FDA approval of Suboxone and Subutex. In recent years, buprenorphine has been introduced in most European countries as a transdermal formulation for the treatment of chronic pain.

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