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Signs of Drug Use
Personality
Physical Appearance
Social activity/school performance
According to the latest estimates available, in 2004, 19.1 million Americans, or 7.9 percent of the population aged 12 or older, were current illicit drug users, current use meaning use of an illicit drug during the month prior to the survey interview. 1 22.5 million Americans aged 12 or older in 2004 were classified with past year substance dependence or abuse (9.4 percent of the population), about the same number as in 2002 and 2003. Of these, 3.4 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol, and 15.2 million were dependent on or abused alcohol but not illicit drugs.2 References: The use and abuse of prescription medication non-medically is an issue equally as serious as the use of illegal drugs. These are drugs, regardless of whether they are prescribed or diverted, there is potential for abuse. Some medications have properties related to other drugs that are legal and some have chemical structures related to those of illegal drugs. The addictive potential for some of these drugs is the same as that for heroin or methamphetamine, but, because they are prescribed by doctors, they are perceived as safe. A new trend among young people is called Pharming Parties where they get together at a party and exchange prescription medications and get high on either one or multiple types of medications. Medications that appear at these types of parties are of various types of stimulants, narcotics, and depressants. Prescription narcotics, also known as narcotic analgesics or opioids, are among the most widely used and abused medicines today. When used as directed, prescription narcotics can alleviate varying degrees of pain. Morphine is typically used before or after surgery to alleviate severe pain. Oxycodone and hydrocodone are used to alleviate moderate to severe pain. Codeine is prescribed to treat mild pain and is also prescribed to alleviate coughing. According to NIDA, opioids (prescription narcotics) act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach to certain opioid receptors, they can effectively change the way a person experiences pain. In addition, opioid medications can affect regions of the brain that mediate what we perceive as pleasure, resulting in the initial euphoria that many opioids produce. They can also produce drowsiness, cause constipation, and, depending upon the amount taken, depress breathing. Taking a large single dose could cause severe respiratory depression or death. Opioids may interact with other medications and are only safe to use with other medications under a physician’s supervision. Typically, they should not be used with substances such as alcohol, antihistamines, barbiturates, or benzodiazepines. 2 References: Long-term use can lead to physical dependence – the body adapts to the presence of the substance and withdrawal symptoms occur if use is reduced abruptly. This can also include tolerance, which means that higher doses of a medication must be taken to obtain the same initial effects. Note that physical dependence is not the same as addiction – physical dependence can occur even with appropriate long-term use of opioid and other medications. Addiction, is defined as compulsive, often uncontrollable drug use in spite of negative consequences. 5 Those taking narcotics should be supervised when stopping use in order to reduce or avoid withdrawal symptoms. Withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements. 1 References: Oxycodone (OxyContin®) Oxycodone is a narcotic prescribed to relieve pain and is twice as potent as morphine. There are many variations of enzoylec products on the market but of those, OxyContin, Percocet, and Percodan are used and abused most frequently. OxyContin® ( enzoylec hydrochloride ER) is a timed-release version of enzoylec and, until recently, was the only extended release version of enzoylec. In March 2004, a generic version became available by prescription. The generic version quickly became available on the illegal drug market and may pose a significant threat because it is only available in 80 mg. doses, whereas OxyContin® is available in 10, 20, 40 and 80 mg. doses. Oxycodone HCI ER (the generic version) comes in small oval, light green tablets. One side of the tablet is labeled “93”, the other side is labeled “33”. 1 Used as a substitute for heroin, abusers use the drug to relieve pain, alleviate withdrawal symptoms, and gain euphoric effects typically associated with use of the drug. Signs of enzoylec use include nausea, drowsiness, impaired coordination, weakness, confusion, small pupils, and clammy skin. Other general effects include muscle relaxation, lowered blood pressure, lowered heart rate, and lowered respiratory rate. Possible negative effects include an allergic reaction, difficulty breathing, swelling of the face, hives, seizures, loss of consciousness, and coma. Effects of long term use include constipation, respiratory depression, physical tolerance and psychological and physical dependence. Withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and involuntary leg movements. References: Hydrocodone Signs of hydrocodone use include nausea, drowsiness, impaired coordination, weakness, confusion, and small pupils. Other general effects include muscle relaxation, lowered blood pressure, lowered heart rate, and lowered respiratory rate. An allergic reaction, difficulty breathing, closing of the throat, facial swelling, hives, seizures, loss of consciousness, and coma are also possible consequences of hydrocodone use. Long term effects include constipation, dryness of the mouth, respiratory depression, physical tolerance, and psychological and physical dependence. Brand names for hydrocodone products include Anexsia®, Hycodan®, Hycomine®, Lorcet®, Lortab®, Tussionex®, Tylox®, Vicodin®, and Vicoprofen®. Hydromorphone Morphine Morphine is marketed under generic and brand name products including MS-Contin®, Oramorph SR®, MSIR®, Roxanol®, Kadian®, and RMS®. Morphine is used parenterally (by injection) for preoperative sedation, as a supplement to anesthesia, and for analgesia. It is the drug of choice for relieving pain of myocardial infarction and for its cardiovascular effects in the treatment of acute pulmonary edema. Traditionally, morphine was almost exclusively used by injection. Today, morphine is marketed in a variety of forms, including oral solutions, immediate and sustained-release tablets and capsules, suppositories, and injectable preparations. In addition, the availability of high-concentration morphine preparations (i.e., 20-mg/ml oral solutions, 25-mg/ml injectable solutions, and 200-mg sustained-release tablets) partially reflects the use of this substance for chronic pain management in opiate-tolerant patients. Fentanyl Stimulants are drugs that increase alertness and energy. Stimulants are typically prescribed for attention-deficit hyperactivity disorder, however, are also prescribed for narcolepsy and some forms of depression. Two of the most common prescribed stimulants are Ritalin® (methylphenidate) and Adderall® (dextroamphetamine). These two products are also the most commonly abused stimulants. Stimulants, such as dextroamphetamine (Adderall®, Dexedrine®) and methylphenidate (Ritalin®, Methylin®, Concerta®) have chemical structures that are similar to a family of key brain neurotransmitters called monoamines, which include norepinephrine and dopamine. Stimulants increase the amount of these chemicals in the brain. This, in turn, increases blood pressure and heart rate, constricts blood vessels, increases blood glucose, and opens up the pathways of the respiratory system. In addition, the increase in dopamine is associated with a sense of euphoria that can accompany the use of these drugs. 1References: Ritalin® AND Adderall® References: Prescription depressants have effects that are similar to the effects of alcohol, but can have more or less potent effects dependent on the dose and type of drug taken. Depressants are typically used to treat anxiety disorders and short-term sleep disorders. CNS depressants can be divided into two groups, based on their chemistry and pharmacology:
Prescription depressants can be addictive, especially if misused, and withdrawal is a common ramification with those who abuse the drugs. Discontinuing prolonged use of high doses of CNS depressants can lead to withdrawal. Because they work by slowing the brain’s activity, a potential consequence of abuse is that when one stops taking a CNS depressant, the brain’s activity can rebound to the point that seizures can occur. Someone thinking about ending their use of a CNS depressant, or who has stopped and is suffering withdrawal, should speak with a physician and seek medical treatment. A large percentage of people entering treatment for narcotic or cocaine addiction also report abusing benzodiazepines. Alprazolam® and Diazepam® are the two most frequently encountered benzodiazepines on the illicit market CNS depressants should be used with other medications only under a physician’s supervision. Typically, they should not be combined with any other medication or substance that causes CNS depression, including prescription pain medicines, some over-the-counter cold and allergy medications, or alcohol. Using CNS depressants with these other substances – particularly alcohol – can slow breathing, or slow both the heart and respiration, and possibly lead to death. 2 References: Royhypnol® Signs of use include poor coordination, sedation, fatigue, confusion, and dizziness. Other general effects of use include decreased heart rate and blood pressure, muscle relaxation, memory impairment, amnesia, nightmares, and tremors. Long term effects include physical and psychological dependence. Signs of overdose include loss of muscle control, loss of consciousness, and anterograde amnesia. References: DXM There are more than 120 different products on the market that contain DXM. At the doses recommended for treating coughs (1/6 to 1/3 ounce of medication, containing 15 mg to 30 mg dextromethorphan), the drug is safe and effective. At much higher doses (4 or more ounces), dextromethorphan produces dissociative effects similar to those of PCP and Ketamine. The effects of excessive DXM use can last for up to 6 hours and include loss of muscle control, slurred speech, diarrhea, rash, abdominal pain, fever and sweating, nausea and vomiting, high blood pressure, headache, numbness of fingers and toes, loss of consciousness, mania, brain damage, coma, cerebral hemorrhages, seizures, stroke and death. Over-the-counter products that contain DXM often contain other ingredients such as acetaminophen, chlorpheniramine, and guaifensin. Large dosages of acetaminophen can cause liver damage; large dosages of chlorpheniramine can cause increased heart rate, lack of coordination, seizures, and coma; and large dosages of guaifenesin can cause vomiting. Some first-time users may not abuse DXM repeatedly if they experience negative side effects – such as vomiting – commonly associated with the other ingredients contained in over-the-counter DXM medications. Nonetheless, some DXM abusers “robo shake”, a practice whereby they drink a large amount of couch syrup containing DXM and then force themselves to vomit so as to absorb enough DXM through the stomach lining to achieve the desired effect while expelling the other ingredients. Some more experienced abusers use a chemical procedure to extract the DXM from the other ingredients contained in cough syrup to avoid such side effects. (This procedure cannot be used on DXM products sol in non-liquid form.) 1 References: Ecstasy (MDMA) MDMS (3,4-methylenedioxymethamphetamine) is a synthetic drug with both stimulant and hallucinogenic qualities. MDMA (ecstasy) is sometimes referred to as a “designer drug”. A designer drug is one that is either a copycat of another drug (a variation of it) or a synthetic compound of two or more drugs. MDMA is the latter – its chemical structure is similar to methamphetamine, methylenedioxyamphetamine (MDA), and mescaline MDMA is typically distributed in urban areas, beach resorts, at or near college universities, raves, dance clubs, and bars. Most MDMA distribution occurs in urban and suburban areas; however, much of the increased distribution is occurring in midsize cities with large college populations. Because of MDMA’s popularity not only is production increasing around the world but tablets and capsules being sold as “Ecstasy” are increasingly not pure MDMA. The growing number of pills and capsules being marketed as MDMA but containing drugs like methamphetamine, PCP, amphetamine, enzoyle, and PMA – with or without MDMA – has increased the dangers associated with MDMA use. References: Ocotea Cymbarum References: General effects of MDMA use include increased heart rate and blood pressure, increased body temperature, possible hyperthermia, jaw and teeth clenching, muscle tension, hypertension, dehydration, chills and or sweating, nausea, blurred vision, faintness, dizziness, confusion, insomnia, and paranoia. Long term effects of MDMA use include rash, depression, sleep disorders, drug craving, persistent elevation of anxiety, paranoia, aggressive and impulsive behavior An ecstasy overdose is characterized by a rapid heart beat or high blood pressure, faintness, muscle cramping, panic attacks, and in more severe cases, loss of consciousness or seizures. Other adverse effects include nausea, hallucinations, chills, sweating, tremors, hyperthermia, tachycardia, breakdown of skeletal muscle with kidney failure, and blurred vision. Ecstasy users also report after-effects of anxiety, paranoia, and depression. Death has resulted from kidney or cardiovascular failure induced by hyperthermia and dehydration. 1 MDMA abuse may permanently inhibit the user’s ability to produce serotonin – a neurotransmitter that regulates mood, sleep, pain, emotion, and appetite – resulting in chronic depression and anxiety. 2 Because MDMA is a relatively new drug, pending advancement in research may discover other long term effects of MDMA use Controlled studies in humans have shown that MDMA has potent effects on the cardiovascular system and on the body’s ability to regulate its internal temperature. Of great concern is MDMA’s adverse effect on the pumping efficiency of the heart – in the presence of MDMA, increased physical activity increases heart rate significantly, but the heart does not respond in its normal manner, which is to increase the efficiency with which it pumps blood. Since MDMA use is often associated with sustained, strenuous activity, such as dancing, MDMA’s effects on the heart could increase the risk of heart damage or other cardiovascular complications in susceptible individuals. 1 MDMA in its true form works in the brain by increasing the activity levels of at least three neurotransmitters (the chemical messengers of brain cells): serotonin, dopamine, and norepinephrine. Like amphetamines, MDMA causes these neurotransmitters to be released from their storage sites in neurons resulting in increased brain activity. Compared to the very potent stimulant, methamphetamine, MDMA causes greater serotonin release and somewhat lesser dopamine release. Serotonin is a neurotransmitter that plays an important role in regulation of mood, sleep, pain, emotion, appetite, and other behaviors. By releasing large amounts of serotonin and also interfering with its synthesis, MDMA causes the brain to become significantly depleted of this important neurotransmitter. As a result, it takes the human brain time to rebuild its serotonin levels. For people who take MDMA at moderate to high does, depletion of serotonin may be long-term. These persistent deficits in serotonin are likely responsible for many of the persistent behavioral effects that the user experiences. There is a growing body of evidence that associates this serotonin loss in heavy MDMA users to confusion, depression, sleep problems, persistent elevation of anxiety, aggressive and impulsive behavior and selective impairment of some working memory and attention processes. 2 References: STIMULANTS References: Methamphetamine Methamphetamine can cause a variety of cardiovascular problems. These include rapid heart rate, irregular heartbeat, increased blood pressure, and irreversible, stroke-producing damage to small blood vessels in the brain. Hyperthermia (elevated body temperature) and convulsions can occur with a methamphetamine overdose, and if not treated immediately, can result in death. Chronic methamphetamine abuse can result in inflammation of the heart lining, and among users who inject the drug, damaged blood vessels and skin abscesses. Heavy users also exhibit progressive social and occupational deterioration. Psychotic symptoms (paranoia, delusions, mood disturbances) can sometimes persist for months or years after use has ceased. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson’s disease, a severe movement disorder. Acute lead poisoning is another potential risk for methamphetamine abusers. A common method of illegal methamphetamine production uses lead acetate as a reagent. Production errors therefore may result in methamphetamine contaminated with lead. There have been documented cases of acute lead poisoning in intravenous methamphetamine abusers.2 References: Meth Mouth Signs of methamphetamine use include dilated pupils, sweating and flushed skin, dry mouth, tremors, increased energy or hyperactivity, and clouded mental functioning. Other general effects include elevated heart rate, blood pressure, and respiratory rate; decreased appetite, alertness, aggression, paranoia, depression, and irritability. At high doses, hallucination and delusions have been reported. Long-term effects include strong psychological dependence and varying degrees of physical tolerance; malnutrition, skin abscesses, mood disturbances and psychosis; kidney and other tissue damage; cardiac and neurological damage including irregular heartbeat, increased blood pressure, inflammation of the heart lining and stroke-producing damage to small blood vessels in the brain. Methamphetamine has many faces. Because of the various production methods, varying degrees of skill of the clandestine lab operator, and different chemicals used to manufacture methamphetamine, the finished product varies in color and texture. Pure methamphetamine is most commonly a shade of tan or white. References: Crystal Meth The effects of crystal meth are similar to those of powdered methamphetamine. Typically, crystal meth has a high level of purity and the effects can last 12 or more hours. Cocaine Signs of cocaine use include blurred vision, dilated pupils, tremors and twitching, chest pain or pressure, and fever. In general, cocaine use causes an elevated heart rate, elevated blood pressure, elevated respiratory rate, decreased appetite, aggression, paranoia, depression, and irritability. At high doses, cocaine may produce hallucinations or delusions. Long term effects of use include a strong psychological dependence and varying degrees of physical tolerance. Eating disorders, malnutrition, impotence, seizures, strokes, severe withdrawal symptoms, and permanent damage to the nasal passage are also consequences of cocaine use. Cocaine-related deaths are often attributed to cardiac arrest or seizures followed by respiratory arrest. There are two forms of cocaine: powdered cocaine and crack. The powdered, hydrochloride salt is the form of cocaine. Crack is cocaine that has not been neutralized by an acid to make the hydrochloride salt, and comes in a rock crystal form. Wholesale cocaine is wrapped in plastic and taped for protection while in transit to the United States. Lab operators place markings on the “kilo bricks” or wrappings, identifying the lab operator or designating who the recipient should be. Some producers have used bar coding. Wholesale distributors typically purchase cocaine in kilogram or multi-kilogram allotments. Colombian traffickers continue to dominate the movement of coca from the jungles of Bolivia and Peru to the large cocaine HCL conversion laboratories in southern Colombia. Much of the processing activities take place in the southern rain forests and eastern lowlands of Colombia. Also, cultivation occurs in areas of high insurgency that are effectively beyond the control of the Colombian government. Cocaine is generally sold on the street as a fine, white, crystalline powder. Street dealers may dilute pure cocaine with inert substances such as lactose, inositol, mannitol cornstarch, and/or sugar, or with active drugs such as procaine or lidocaine (a chemically-related local anesthetic) or with other stimulants such as amphetamines. References: Crack Smoking crack delivers large quantities of the drug to the lungs, producing effects comparable to intravenous injection. These effects are felt almost immediately after smoking and are very intense, but do not last long. References: Khat Fresh khat leaves contain cathinone – a Schedule 1 drug under the Controlled Substances Act; however, the leaves typically begin to deteriorate after 36 hours, causing the chemical composition of the plant to break down. Once this occurs, the leaves contain cathine, a Schedule IV drug. Fresh khat leaves are glossy and crimson-brown in color, resembling withered basil. Deteriorating khat leaves are leathery and turn yellow-green in color. Street terms for khat include Kat, Qat, Chat, Gat, Tohai, Tschat, Mirraa, African Salad, Bushman’s Tea, Catha, Abyssinian Tea, and Mairungi. Khat is often wrapped in banana leaves to preserve freshness. Recently, khat seizures have involved freeze-dried khat. Common side effects include tachycardia, hypertension, insomnia, and gastric disorders. Chronic use can result in physical exhaustion, anorexia, violence, suicidal depression and khat can also induce manic behavior, hyperactivity and hallucinations. Methcathinone Signs of use include dilated pupils, elevated body temperature, insomnia, tremors/muscle twitching, and headaches. Other general effects include increased heart rate, convulsions, restlessness, euphoric feelings, increased alertness, and hallucinations. Long term effects of use include delusions, paranoia, anxiety, depression, malnutrition, weight loss, dehydration, electrolyte imbalance, stomach pains, nausea, nose bleeds, destruction of nasal tissue, body aches, permanent brain damage, and death. Amphetamine Street terms for amphetamine include P, Phet, Billy, Whizz, Sulph, and Base. Amphetamine is often taken with other drugs, in particular, MDMA (ecstasy). Amphetamine is used medically as an aid in treating narcolepsy, some forms of depression, and Attention Deficit Hyperactivity Disorder (ADHD). However, due to the potential for abuse and addiction, other treatment methods are used more frequently. Brand name amphetamines include Adderall®, Desoxyn®, Dexedrine®, and DestroStat®. In the United States, amphetamine or dextroamphetamine abuse is not common. However, in Europe , amphetamine abuse is widespread. Historically in Europe, amphetamine has been the drug most commonly used after cannabis. However, recent survey evidence suggests that the use of MDMA (ecstasy) now equals, or even exceeds, amphetamine use in some parts of Europe.1 Worldwide amphetamine production appears to be concentrated in Europe with 82% of the total amphetamine seized worldwide in 2003 coming from western Europe, in particular the Netherlands, followed by Poland and Belgium. 2. Signs of amphetamine use include sweating, tremors, and dry mouth. In general, abusers of amphetamines may show signs of rapid and/or irregular heart rate, rapid breathing, high blood pressure, feelings of exhilaration, high energy, increased mental alertness, reduced appetite, and possible hallucinations. Long term effects include weight loss, loss of coordination, irritability, anxiousness, restlessness, delirium, panic, paranoia, impulsive behavior, aggressiveness, tolerance, addiction, brain damage, and heart failure. Signs of amphetamine overdose include restlessness, tremors, rapid breathing, confusion, vomiting, diarrhea, irregular heartbeat, and seizures. Withdrawal symptoms include depression, anxiety, stomach cramps, nausea, tremors (“the shakes”), and intense cravings. References: NARCOTICS Although some narcotics are synthetic, even the synthetic drugs are made to replicate the makeup of ingredients extracted from the opium poppy. Opium consists of morphine, codeine, thebaine and other substances. Opium (specifically its derivative, morphine) is used to make heroin, the most abused of the narcotics. Signs of opium use include constricted pupils, droopy eyelids, watery eyes, clammy or itchy skin, loss of appetite, sniffles, cough, nausea, lethargy, drowsiness, and nodding. Other general effects include lowered heart rate, blood pressure, and respiratory rate; nausea, drowsiness, poor concentration, lowered body temperature, decreased appetite, decreased sexual drive, and intense (but short) euphoria. Effects of long-term use include physical and psychological dependence, addiction and physical tolerance; mood swings, severe constipation, menstrual irregularities, lung damage, skin infections, seizures, unconsciousness, and coma. References: Heroin References: Black tar heroin The color and consistency of black tar heroin results from the crude processing methods used to illicitly manufacture the substance. Black tar heroin may be sticky, like roofing tar or hard like coal, and its color may vary from dark brown to black. It is often sold on the street in its tar-like state at purities ranging from twenty to eighty percent. References: The effects of heroin use References: HALLUCINOGENS & DISSOCIATIVE DRUGS LSD, (lysergic acid diethylamide), is the most potent and highly studied hallucinogen known to man. Originally synthesized in 1938 at Basle, Switzerland by Dr. Albert Hoffman, its hallucinogenic effects were unknown until 1943 when Hoffman accidentally consumed some of the LSD Hallucinogenic drugs have played a role in human life for thousands of years. Cultures from the tropics to the arctic have used plants to induce states of detachment from reality and to precipitate “visions” thought to provide mystical insight. These plants contain chemical compounds, such as mescaline, psilocybin, and ibogaine, that are structurally similar to serotonin, and they produce their effects by disrupting normal functioning of the serotonin system LSD is usually produced from lysergic acid, which is made from ergotamine tartrate, a substance derived from an ergot fungus on rye, or from lysergic acid amide, a chemical found in morning glory seeds. Although theoretically possible, the manufacture of LSD from morning glory seeds is not economically feasible and these seeds never have been found to be a successful starting material for LSD production. Ergotamine tartrate used in clandestine LSD laboratories is believed to be acquired from sources in Europe, Mexico, Costa Rica, and Africa The effects of LSD are unpredictable. The effects depend on the amount taken, the user’s personality, mood, and expectations and the surroundings in which the drug is used. The average effective oral dose is from 20 to 80 micrograms with the effects lasting two to three hours. With a larger dose, the effects can last ten to twelve hours. Typically, the user feels the first effects of the drug 30 to 90 minutes after taking it. Most users of LSD voluntarily decrease or stop its use over time LSD is not considered an addictive drug since it does not produce compulsive drug-seeking behavior as do cocaine, amphetamine, heroin, alcohol, and nicotine. However, like many of the addictive drugs, LSD produces tolerance, so some users who take the drug repeatedly must take progressively higher doses to achieve the state of intoxication that they had previously achieved. This is an extremely dangerous practice, given the unpredictability of LSD. Signs of LSD use include dilated pupils, sweating, dry mouth, abnormal laughter, distracted persona, and rapid reflexes. Other general effects include varying degrees of illusions, hallucinations, synesthesia, disorientation, impaired coordination, higher body temperature, loss of appetite, sleeplessness, tremors, delusions and confusion. LSD can cause elevated heart rate, blood pressure, extreme mood swings and impaired short-term memory. The user’s sense of time and self changes and sensations may seem to “cross over”, giving the user the feeling of hearing colors and seeing sounds. These changes can be frightening and can cause panic. Possible long-term effects include physical tolerance and psychological dependence (and possible psychosis), prolonged depression, anxiety, and flashbacks. DOI PCP In its original state, PCP is a white crystalline powder. Dipping a cigarette or marijuana joint (or other leafy material such as parsley, mint, and oregano) into liquid PCP is its most common use. PCP is also manufactured into capsules or tablets. It’s most common form, a liquid, looks like apple juice. When something is dipped in PCP, it is difficult to see it: the best way to tell if something has been dipped in PCP is to smell it. PCP has a distinct chemical smell. Signs of PCP use include eye fluttering, sweating, flushed skin, drooling, numbness, blurred vision, and garbled speech. Other general effects include varying degrees of illusions, hallucinations, synesthesia, disorientation, impaired coordination, confusion, agitation, coma, altered state of consciousness, stupor, convulsions, and unresponsiveness. PCP decreases heart rate, blood pressure, and body temperature. PCP is also widely known for causing violent experiences (“bad trips”). Long-term effects include physical tolerance and psychological dependence (and possible psychosis). Prolonged depression, anxiety, and flashbacks are also attributed to PCP use. PCP can cause effects that mimic the full range of symptoms of schizophrenia, such as delusions, paranoia, disordered thinking, a sensation of distance from one’s environment, and catatonia. Speech is often sparse and garbled. People who use PCP for long periods report memory loss, difficulties with speech and thinking, depression, and weight loss. These symptoms can persist up to a year after cessation of PCP use. Mood disorders also have been reported. PCP has sedative effects, and interactions with other central nervous system depressants, such as alcohol and benzodiazepines, can lead to coma or accidental overdose. 1 References: KETAMINE Signs of enzoyle use include dilated pupils, sweating, slurred speech, and disorientation. Other general effects include a depressed respiratory rate, nausea, loss of coordination, temporary amnesia, hallucinations, paranoia, coma, and death. Long term effects of use include flashbacks, physical tolerance, physical and/or psychological dependence. Signs of an enzoyle overdose include vomiting and convulsions. HALLUCINOGENIC MUSHROOMS There are more then 2500 mushroom varieties grown in the world today. Of these, several species have hallucinogenic properties. They are often referred to as “magic mushrooms.” Some hallucinogenic mushrooms are domestically gown indoors or harvested in the wild. Others are smuggled from Mexico and Central America. Hallucinogenic mushrooms contain two psychoactive ingredients: psilocybin and psilocin. Psilocybin is the main psychoactive ingredient and psilocin is found in smaller amounts, yet is more potent. When hallucinogenic mushrooms are ingested, the psilocybin is metabolized into psilocin. Like peyote, mushrooms have been used in native rites for centuries. Dried mushrooms contain about 0.2 to 0.4 percent psilocybin and only trace amounts of psilocin. The hallucinogenic dose of both substances is about 4 to 8 milligrams or about 2 grams of mushrooms. Effects last for six to eight hours. Both psilocybin and psilocin can be produced synthetically. Mushrooms are eaten, brewed in tea, dried and put in capsule form, or dried and laced with cigarettes or marijuana joints for their hallucinogenic effects. The effects produced by consuming preparations of dried or brewed mushrooms are far less predictable (than LSD) and largely depend on the particular mushrooms used and the age and preservation of the extract. There are many species of “magic” mushrooms that contain varying amounts of tryptamines, as well as uncertain amounts of other chemicals. As a consequence, the hallucinogenic activity, as well as the extent of toxicity produced by various plant samples, is often unknown. 1 Signs of mushroom use include dilated pupils, aggressive behavior, and confusion. Other general effects include varying degrees of illusions, hallucinations, synesthesia, disorientation, impaired coordination, and confusion. Psilocybin use causes elevated heart rate, blood pressure, and body temperature. A mushroom experience is similar to a mild LSD experience, but less acute hallucinations and high durations are attributed to psilocybin. Possible long-term effects of use include physical tolerance and psychological dependence (and possible psychosis). Psilocybin is cultivated in indoor and outdoor grow sites in most regions of the country, particularly in the Pacific region. Local independent indoor cultivation appears to be increasing, likely aided by an increase in the availability of mail order cultivation kits and indoor cultivation information available via the internet. 2 References: MESCALINE Street terms for mescaline include buttons, cactus, nubs, tops, seni, britton, half moon and hikori. Signs of mescaline use include dilated pupils, sweating, garbled speech, and disorientation. Other general effects include varying degrees of illusions, hallucinations, synesthesia, disorientation, impaired coordination, and confusion. Like LSD, mushrooms, and ecstasy, mescaline causes elevated heart rate, blood pressure, and body temperature. Less acute hallucinations and high durations of effects are attributed to mescaline. Possible long-term effects of use include physical tolerance and psychological dependence (and possible psychosis),. PEYOTE CACTUS SAN PEDRO CACTUS DEPRESSANTS GHB analogs (GBL and BD) are solvents that have chemical structures that closely resemble that of GHB. These analogs metabolize into GHB upon ingestion, and thus produce the same effects of GHB. GHB analogs have been appearing in the illegal drug market as GHB substitutes. GHB analogs are available legally as industrial solvents used to produce polyurethane, pesticides, elastic fibers, pharmaceuticals, coatings on metal or plastic, and other products. They also are sold illicitly as supplements for bodybuilding, fat loss, reversal of baldness, improved eyesight, and to combat aging, depression, drug addiction, and insomnia. GHB product names include Longevity, Revivarant, G.H. Revitalizer, Gamma G, Blue Nitro, Insom-X, Remforce, Firewater and Invigorate. Products that contain BD include Revitalize Plus, Serenity, Enliven, GHRE, SomatoPro, NRG3, Thunder Nectar and Weight Belt Cleaner.1 GHB is considered a date rape drug because it is virtually undetectable (although it has a salty taste) when mixed with liquids and a victim may not be able to detect it. GHB and its analogs are also cleared from the body relatively quickly, so it is sometimes difficult to detect them in emergency rooms and other treatment facilities. GHB and its analogs are also not detectable in routine blood and urine screens – a GHB screen needs to be requested in possible rape situations. Detectable levels of GHB remain in the urine for 8-12 hours, and 4-8 hours in the blood (after ingestion). In 2002, law enforcement agencies in every region of the United States reported that GHB appeared to have surpassed Rohypnol® as the most common substance in drug-facilitated sexual assault. References: GHB is often taken after a night of partying to come down off a high. The drugs often have a salty taste. Because of the salty taste, they are often mixed in a flavored beverage. They are often used in combination with alcohol, making them even more dangerous. GHB and its analogs act quickly in the body. When taken in overdose unconsciousness can occur after 15 minutes, and coma within 30 to 40 minutes. Overdose frequently requires emergency room care, including intensive care for respiratory depression and coma. Most individuals regain consciousness within two to four hours. General effects of GHB intoxication include a drunken-like state exhibiting nausea, drowsiness, dizziness, confusion, muscle relaxation, impaired coordination, lowered blood pressure, lowered heart rate, and lowered respiratory rate. High doses of GHB produce memory loss, sedation, seizures, coma, and death. Long term effects include physical tolerance as well as psychological and physical dependence. Withdrawal symptoms include insomnia, tremors, tachycardia (abnormally fast heart rate), delirium, and agitation. STEROIDS Anabolic steroids are any drug or hormonal substance chemically and pharmacologically related to testosterone (other than estrogens, progestins, and corticosteroids), that promotes muscle growth. Most illicit steroids are sold at gyms, competitions and through mail order operations. For the most part, these substances are smuggled into the United States. The major side effects from abusing anabolic steroids can include liver tumors and cancer, jaundice (yellowish pigmentation of skin, tissues, and body fluids), and decreases in HDL (good cholesterol). Other side effects include kidney tumors, severe acne, and trembling. In addition, there are some gender-specific side effects:
Anabolic steroids were developed in the late 1930s primarily to treat hypogonadism, a condition in which the testes do not produce sufficient testosterone for normal growth, development and sexual functioning. 2 References: INHALANTS But inhalant abuse is deadly serious and one of the most dangerous of “experimental behaviors”. Sniffing volatile solvents, which includes most inhalants, can cause severe damage to the brain and nervous system. By starving the body of oxygen or forcing the heart to beat more rapidly and erratically, inhalants can kill sniffers, most of whom are adolescents. Inhalant abuse came to public attention in the 1950s when the news media reported that young people who were seeking a cheap “high” were sniffing glue. The term “glue sniffing” is still widely used, often to include inhalation of a broad range of common products besides glue. Although different in makeup, nearly all abused inhalants produce effects similar to anesthetics, which act to slow down the body’s functions. When inhaled via the nose or mouth in sufficient concentrations, inhalants can cause intoxicating effects that can last a few minutes or several hours if taken repeatedly. Initially, users may feel slightly stimulated; with successive inhalations they may feel less inhibited and less in control; finally, a user can lose consciousness. Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death. This is especially common from the abuse of fluorocarbon and butane-type gases. High concentrations of inhalants also cause death from suffocating by displacing oxygen in the lungs and then in the central nervous system causing breathing to cease. Typical inhalants include airplane glue, rubber, cements, nail polish remover, spray paint, whip cream cans, correction fluid, gasoline, nitrous oxide, paint thinner, air freshener, butane fuels, wax removers, hair spray, analgesic sprays, deodorants, air freshener, lighter fuels, PVC cement, cleaning fluid, spot remover and degreaser. EFFECTS OF INHALANT ABUSE Chemical Specific Drug Reactions: 3
Benzene (found in gasoline)
Butane, propane (lighter fluid, hair and paint sprays)
Freon (refrigerant and aerosol propellant)
Methylene chloride (pain thinners and removers, degreasers)
Nitrous oxide (laughing gas), hexane
Toluene (gasoline, paint thinners and removers, correction fluid)
Trichlorethylene (spot removers, degreasers)
Slang terms;2 References: OTHER DRUGS Poppers are small bottles filled with liquid alkyl nitraies (amyl nitrite, butyl nitrite, isobutyl nitrite). Once used to ease chest pain (angina) alkyl nitrates are now used recreationally as an inhalant. Alkyl nitrites are usually inhaled from a bottle or through a cloth and produce a short but powerful high which lasts from 2-5 minutes. Poppers have a sweet smell when first opened, but after time the smell turns sour. If swallowed, alkyl nitrites can be poisonous. The most common side effect of using alkyl nitrites is a powerful headache but others include rashes around the nose and mouth and a flushed face. Risks of use include loss of consciousness and heart attack. People with glaucoma, anemia, heart problems or high blood pressure should not take alkyl nitrites. When in contact with skin, liquid nitrites can burn. Nitrites often are considered a special class of inhalants. Unlike most other inhalants, which act directly on the central nervous system (CNS), nitrites act primarily to dilate blood vessels and relax the muscles. And while other inhalants are used to alter mood, nitrites are used primarily as sexual enhancers. VIAGRA® SALVIA DIVINORUM At the is time there is no accepted medical use for Salvia Divinorum, however, Mazatec Indians in Mexico use the plant in traditional healing ceremonies and to induce visions. The manner in which Salvia Divinorum interacts with the brain to produce its hallucinogenic effect remains unclear. The hallucinogenic effects generally last 1 hour or less unlike other hallucinogens like LSD and PCP. High doses of the drug can cause unconsciousness and short-term memory loss. The long-term effects of Salvia Divinorum abuse are unknown, as medical studies undertaken to examine the drug’s physiological effects have focused only on short-term effects. However, information provided by users indicates that the negative long-term effects of Salvia Divinorum may be similar to those produced by other hallucinogens such as LSD including depression and schizophrenia. Some users also indicate that long-term abuse can cause hallucinogen persisting perception disorder, or “flash backs”. A NOTE ABOUT “LEGAL HIGHS” References: MARIJUANA The plant, cannabis sativa, contains chemicals called “enzoylecgon.” THC (delta-9-tetrhydrocannabinol) is the enzoylecgo believed to be responsible for the psychoactive effects of cannabis. THC can be found in all parts of the cannabis plant, including hemp. This is why hemp is regulated carefully – some hemp products such as clothing, rope, yarn, lotion and soap are legal products because they do not cause THC to enter the human body. Marijuana varies significantly in its potency, depending on the source and selection of plant materials. The form of marijuana known as sinsemilla (Spanish, sin semilla: without seed), derived from the unpollinated female cannabis plant, is preferred for its high THC content. Marijuana advancements in plant selection and cultivation have resulted in highly potent domestic varieties. In 1974, the average THC content of illicit marijuana was less than one percent. In 2002, the average THC level was more than 6 percent. Sinsemilla potency increased in the past two decades from 6 percent to more than 13 percent, with some samples containing THC levels of up to 33 percent. References: THE EFFECTS Note: Need a disclaimer e.g. information is not all inclusive should not be used a substitute for professional medical advice. Also, all registered Trademarks should be listed and the Trademark ownership acknowledged, may also wish to include a disclaimer acknowledging that these drugs are legal prescription drugs used outside of the context of their intended use and the manufacturers instructions for use
Oral fluid collection: The neglected variable in oral fluid testing Abstract Several factors should be considered if a commercial OF collection device is used. In vitro collection experiments demonstrated that the mean collection volume varied between devices from 0.82 to 1.86 mL. The percentage of the collected volume that could be recovered from the device varied from 18% to 83%. In vitro experiments demonstrated considerable variation in the recovery of amphetamines (16–59%), opiates (33–50%), cocaine and enzoylecgonine (61–97%), carboxy-THC (0–53%) and PCP (9–56%). Less variation in collection volume, volume recovered and drug recovery was observed intra-device. The THC stability was evaluated in a common commercial collection protocol. Samples in the collection buffer were relatively stable for 6 weeks when stored frozen. However, stability was marginal under refrigerated conditions and poor at room temperature. Very little has been published on the efficacy of using IgG concentration, or any other endogenous marker, as a measure of OF specimen validity. Preliminary rinsing experiments with moderate (50mL and 2 _ 50mL) volumes of water did not reduce the OF IgG concentration below proposed specimen validity criteria. In summary, obvious and more subtle variables in the OF collection may have pronounced effects on OF–drug concentrations. This has rarely been acknowledged in the literature, but should to be considered in OF drug testing, interpretation of OF–drug results and future research studies. 2005 Elsevier Ireland Ltd. All rights reserved. www.elsevier.com Cognition and motor control as a function of _9-THC concentration in serum and oral fluid: Limits of impairment Abstract © 2006 Elsevier Ireland Ltd. All rights reserved. www.elsevier.com Oral fluid testing for cannabis: On-site OraLine1
IV s.a.t. device versus GC/MS Abstract © 2006 Elsevier Ireland Ltd. All rights reserved. www.elsevier.com Note: Obtain written confirmation from Elsevier Press that the company may list these abstracts on their website with links back to Elsevier Press for persons wishing to purchase the full published paper. These abstracts are in the public domain hence Elsevier Press do not have any basis to prevent the posting of the abstract however better to take the precaution rather than getting pinged for copywrite infringement. |
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