DRUGS CLASSIFICATION BY L.J. Amphetamine Amphetamine is a synthetic stimulant also known as speed, base and whiz. It is usually found as a white, grey, yellowish or pinky powder. It has a varied effect, from feelings of wakefulness, alertness and increased physical or mental activity through to restlessness, anxiety and irritability. Excessive use, particularly intravenously, can bring on a psychotic condition, similar to paranoid schizophrenia. Tolerance can develop and although it is chiefly emotional, there is an abstinence syndrome, suggesting a mild physical dependency. Amphetamines are absorbed easily and have a half-life of 12 hours. Metabolism includes deamination and hydroxylation. Clearance is pH dependent with 20-30% typically excreted in the urine, although this can be up to 80% in acidic urine. Regular use leads to weight loss and constipation, with heavy long-term use reducing resistance to disease. Barbiturates Barbiturates are a synthetic sedative that slow down the central nervous system and used to be regularly prescribed for anxiety, depression and insomnia. The effects from barbiturates have a varied duration and are classified as ultra short, intermediate or acting. Strong emotional, physical dependence and tolerance to barbiturates occurs. Since the 1960 s they have been increasingly replaced by benzodiazepines, which may also be addictive but are less likely to cause death from overdose. If abused the signs of intoxication include confusion, unsteadiness, difficulty in speaking, hostility and suicidal tendencies. Barbiturate metabolism is chiefly hepatic. Metabolites and parent barbiturates are eliminated in urine, with excretion being maximal in alkali urine. Benzodiazepines Benzodiazepines are the most commonly used sedative and are available as prescription drugs. They include diazepam, temazepam and oxazepam. They depress the central nervous system, have a wide range of sedative, anxiolytic and anticonvulsant effects and are highly addictive. Benzodiazepines tend to lose their sedative effect with long-term use, which may lead the user to increase the dose progressively. On stopping the drug, a long-term user may develop withdrawal symptoms that include anxiety, panic attacks, insomnia, nausea and loss of appetite. Benzodiazepines may also increase the effects of alcohol. Oxazepam is a common metabolite of a number of benzodiazepines including diazepam and chlordiazepoxide. Buprenorphine An opioid mixed agonist antagonist used both as a potent analgesic and in the treatment of opiate abuse. Buprenorphine is sold under the Subutex (R), Buprenex (R) and Temgesic (R) product names. Buprenorphine is up to 40 times more potent than morphine. For pain relief it is administered as an injection or sublingually, using doses between 0.2 and 0.6 mg. Subutex (R), used in the treatment of opiate abuse, is given sublingually, in higher doses, between 0.4 and 8 mg. Buprenorphine is extensively metabolised to nor-buprenorphine, buprenorphine glucorinide and nor-buprenorphine glucorinide. Cannabis Cannabis is usually smoked, often with tobacco. It can be in the form of a resin, dried and chopped leaves or less commonly oil. The most pharmacologically active compound in cannabis is 9-tetrahydrocannabinol (9-THC). The effects of the drug are varied and include euphoria and laughter with sensations becoming more vivid. The vivid sensations may give rise to imagery and hallucinations. As the dose increases, persistent ideas can verge on paranoia. THC and other cannabinoids are metabolised in the liver to produce many different metabolic compounds. Cannabinoids and their metabolites are extremely fat soluble. Cocaine Cocaine is most commonly found as a white crystalline powder, usually snorted, occasionally made into a solution and injected. Crack, the smokable form of cocaine is found as small lumps or rocks. Both are strong, short acting stimulants that produce effects of euphoria and excitement. The physical effects include an increase in heart rate and blood pressure, dilation of the pupils and sweating. Larger doses can cause agitation, paranoia and hallucinations. Very high doses may lead to convulsions and death due to heart failure. The snorting of cocaine can lead to mucosal constriction and eventually necrosis and perforation of the nasal septum. Cocaine is rapidly distributed and metabolised to benzoylecgonine. Cotinine Cozart provides a range of kits to detect the presence of Cotinine (the primary metabolite of Nicotine) in serum, plasma, urine and oral fluid. The tests accurately differentiate between smokers and non-smokers and are widely used by the insurance industry and in clinical research. The non-isotopic test is straightforward to use and provides rapid results within about an hour. The microplate system offers great flexibility, it can be used in a fully automated, high throughput system or it can accommodate low sample volumes with manual or semi-automated equipment. Flunitrazepam Flunitrazepam is a benzodiazepine, branded under the product name Rohypnol (R). It is prescribed as a hypnotic, used to help with insomnia. Flunitrazepam has a prolonged action and may give rise to residual effects the next day, with repeated doses tending to be cumulative. Routine use is undesirable as tolerance to the effects will build up over 3 14 days of continuous use and the user can become dependant. Long-term use will cause a withdrawal effect when the user stops taking the drug. Fluoxetine Fluoxetine, also known as Prozac (R), is commonly prescribed for the treatment of depression or obsessive compulsive disorders and is administered in a pill form. It is thought that these conditions are caused by an imbalance of chemicals within the central nervous system and Fluoxetine is believed to inhibit the release, effects and re-uptake of seratonin, one of these chemicals. Fluoxetine can cause insomnia, headaches and nausea but is not considered to be a drug of dependence and there have been no recorded overdoses associated with the drug by itself. However, taken with other antidepressants, it can lead to very high blood pressure, vomiting and shock. LSD LSD (lysergic acid diethylamide) is a very potent hallucinogenic drug most commonly found as a liquid, either on its own or absorbed onto paper sheets. The effect or trip can last up to 20 hours and the state, which it produces, can vary. The intensity and involvement of the hallucinations can range from feelings of euphoria to terror. Methadone Methadone is an opiate agonist and can be used as a substitute for opioids, preventing the onset of withdrawal symptoms. Its analgesic properties are similar to those of morphine but accumulation of the drug can produce a sedative effect. Methamphetamine A synthetic stimulant with mild hallucinogenic effects, related to amphetamine and MDMA (ecstasy), usually found in tablet form and taken orally. It causes feelings of euphoria in the user and an increase in their respiration. In low doses it produces mental relaxation, tense muscles, increased sensitivity to stimuli and sometimes hallucinations. Higher doses have amphetamine-like effects, sometimes producing severe or fatal reactions, even after a single dose. Morphine Morphine, like other opiates is a sedative that suppresses the central nervous system. The assay identifies morphine but has a negligible cross reactivity to codeine and morphine-3-glucuronide. Opiates Opiates are analgesics that depress the central nervous system, causing analgesia, euphoria and narcosis. They include drugs like heroin, morphine and codeine and are either derived from the opium poppy (opiates) or are synthetic compounds (opioids) with similar actions. The drug is injected, snorted or taken orally. Tolerance will occur with frequent use and they all have the potential for the user to become dependent. Strong opiates will produce feelings of well being and contentment. Breathing and the heart rate are slowed and the cough reflex is inhibited. With higher doses there is an increased drowsiness, sometimes leading to coma and possibly death from respiratory depression. After several weeks of regular use, a sudden cessation of use will produce withdrawal symptoms. PCP PCP is an anaesthetic that has hallucinogenic effects. It is regarded as a very powerful drug that can have disturbing actions. It comes in a liquid, crystal, pill or powder form, can be smoked, snorted, swallowed or injected and is easily absorbed. PCP abuse is associated with intoxication and euphoria. In high doses it mimics schizophrenia and delusions.