Psychoactive Drugs Classification and History CAS 712R definitions 2 What is a Psychoactive Drug? Definitions Any substance that directly alters the normal functioning of the central nervous system. Any substance that when entering the body can change either the structure or function of the organism. Each culture, each generation, each profession, and each user has a definition of what constitutes a psychoactive drug. 3 Psychoactive Drugs Uppers Stimulants Downers CNS depressants. All-Arounders Psychedelics, hallucinogens, marijuana. Other drugs. Inhalants Steroids and other sports drugs Psychiatric medications 4 Process / behavioral addictions Compulsive gambling Compulsive shopping Hoarding Eating disorders Sexual addiction Internet / electronic addictions 5 Drug Scheduling Developed in 1970 to classify and regulate controlled substances. V VI III II I Most Dangerous Least Dangerous 6 Then and Now Historical Perspective Alter their state of consciousness Reduction of pain Forget harsh surroundings / discomfort Alter mood Medicate a mental illness Enhances senses Current Perspective To feel good …looking for pleasure To feel better …looking for relief To do better …looking for improvement Curiosity and “because others are doing it” 7 Current Societal Concerns What is getting our attention currently? Continued debate of legalization of marijuana Development of SYNTHETIC THC and methamphetamine-like drugs Development of more “designer” drugs Impact of increased prescription drug abuse 8 Costs of addiction – work productivity, medical costs, impact on family members, legal action, financial issues, etc. Connection between drug use and crime Increase in electronic based addictions Continued legalization and expansion of all forms of gambling 9 Societal Focuses, Continued Steroids and performance enhancing drugs Limitations on where people can smoke cigarettes and efforts by tobacco companies to find new methods of delivery Understanding, recognizing and treating cooccurring disorders in persons with addictions and mental illness Historical Themes for Drug Use 1. Coping with the environment and enhancing existence. Ingesting certain plants could ease fear and anxiety, reduce pain, treat some illnesses, give pleasure, and let them talk to their gods. 1 Historical Themes 2. Human brain chemistry can be affected by psychoactive drugs, behavioral addictions and mental illness to induce an altered state of consciousness. If psychoactive drugs and behavioral addiction did not work, we wouldn’t do it. 1 Historical Themes 3. The ruling classes, governments, and businesses as well as criminal organizations have been involved in growing, manufacturing, distributing, taxing, and prohibiting drugs. Demand for Substances Control of Supplies / Distribution 1 Historical Themes 4. Technological advances in refining, synthesizing, and manufacturing drugs has increased the potency of these substances. Distilling, refining and synthesizing substances has increased the potency. Marijuana in 2007 has up to 14x as much THC as the average street marijuana in the 1970’s. Coca leaves contain only 0.5% to 2.0% cocaine, whereas street cocaine is often 60% to 70% pure. 1 Historical Themes 5. The development of faster and more efficient methods of putting drugs into the body has intensified their effects. Mixing drugs together for a greater impact. Inhaling, snorting, smoking and injecting all increase the speed with which drugs impact the brain. 1 Hiking through history 16 So How Far Back Does It Go? About 4000 plants yield psychoactive substances . . . only about 60 of these plants have been in continuous use somewhere in the world throughout history. Evidence shows that 50,000 years ago Neanderthals in Europe and Asia used medicinal and psychedelic plants in shamanistic religions. 17 Ancient Civilizations (4000 B.C. to A.D. 400) Alcohol was the most popular substance. The earliest crops were wheat and barley, used to make bread . . . and beer. First written references to alcohol are on Sumerian clay tablets from 4000 B.C. 18 Ancient Civilizations (4000 B.C. to A.D. 400) In many ancient cultures, alcohol was considered a gift from the gods . . BUT . . it caused both the desired effect and side effects capable of creating social and health problems. Most civilizations throughout history have placed religious, social, and legal CONTROLS on the use of alcohol and other drugs. 19 Ancient Civilizations (4000 B.C. to A.D. 400) And then there is the opium poppy. 5,000 years ago, Egyptians used opium for soothing crying babies, treating mental illness, soothing female hysteria and for pain control. In A.D. 312 in Rome, an excise tax was placed on stores selling opium which generated 15% of the city’s revenue. 20 Ancient Civilizations (4000 B.C. to A.D. 400) Marijuana Historically, cannabis has been prized as a source of oil and fiber, for its edible seeds, as a medicine, and as a psychedelic. Peyote and psychedelic mushrooms. Sacramental use of these plants can be traced back approximately 7000 years. 21 Ancient Civilizations (4000 B.C. to A.D. 400) Finally there is tobacco and the coca leaf. Plants containing stimulant alkaloids occurred 65 to 250 million years ago – the bitter alkaloids were the plants’ way of repelling dinosaurs, herbivores and insects. Discoveries in the Andes show the use of coca leaves for spiritual and medical practices going back to 3000 B.C. 22 Middle Ages (A.D. 400 to 1400) Psychedelic herbs and molds. Psychoactive plants from the nightshade family were used in religious, magical and social ceremonies. Low Dose Medicine Moderate Dose Psychoactive Drug High Dose Deadly poison Datura, henbane, belladonna and mandrake 23 Middle Ages (A.D. 400 to 1400) ERGOT, a fungus which grows on infected rye and wheat plants, contains the natural active ingredient LSD, the precursor to the modern hallucinogen. Middle Ages (A.D. 400 to 1400) Distillation of alcohol. Knowledge / techniques became widespread. Evaporation process now raised the alcohol content from 14% to 40%. Religious ceremonies began using less and less alcohol until it was only used symbolically. It was thought that the excessive use of alcohol led users away from God. Controlling drinking becomes a MORAL ISSUE. 25 Middle Ages (A.D. 400 to 1400) And they found caffeine. First coffee was consumed by chewing the beans or by infusing in water. Then people learned how to roast and grind the beans. It was not until 1820 that the active ingredient, caffeine was identified. Approximately 60 plants contain caffeine. Chocolate has been traced back to 1500 B.C. 26 Renaissance (AD 1400 to 1700) Trade routes put drugs and drug-using customs in the hands of the rest of the world and so drugs spread. Laws were developed Limiting the use of alcohol Produced hefty tax revenue 27 Age of Enlightenment (1700 – 1900) Seeing more substance users, more mental and physical problems, more ties to financial arena. London Gin Epidemic from 1710 to 1750 when the English Parliament ENCOURAGED the production and consumption of gin. 1751 prohibition laws were put in place to control consumption. 28 Age of Enlightenment (1700 – 1900) Rum was the chief “coin” of exchange in the slave trade. Whiskey and tobacco were mainstays of the economy of colonial America. The federal government enacted a tax on liquor to help pay off federal debt – led to the Whiskey Rebellion. Age of Enlightenment (1700 – 1900) Opium was refined to create morphine and then to heroin. Opium Morphine Heroin Morphine was about 10x more powerful than opium. Heroin was about 2x – 5x stronger than morphine. 30 Age of Enlightenment (1700 – 1900) The alkaloid cocaine was isolated from the coca leaf. Users went from experiencing only a mild stimulatory sensation to an intense rush followed by ecstatic feelings. Age of Enlightenment (1700 – 1900) Invention of hypodermic needles led to new methods of drug delivery. Meant drugs could be put directly into the bloodstream creating a more intense effect. 20th Century Government and business exploit psychoactive substances Government starts regulating psychoactive substances 33 Addiction as a moral issue Regulation activities varied from trying to control the supply to providing treatment. Eliminated over-the-counter tonics – opiates and cocaine. Alcoholics Anonymous, a spiritual program that teaches twelve steps to recovery was founded by Bill Wilson and Dr. Bob Smith in 1934. Marijuana cultivation and use banned in 1937. 34 Early 20th Century Alcohol prohibition . . . and treatment. Alcohol consumption is illustrated in the fact that between 1870 and 1915, between 1/2 and 2/3 of the U.S. budget came from the liquor tax. In 1920 the 18th Amendment prohibited the manufacture and sale of any beverage with an alcohol content of greater than 0.5%. 35 Experimentation, Changing Values, and Governmental Response In 1963 the first legislation was created to treat addiction (under the guise of mental illness). In 1965 Drug Abuse Control Amendment prohibited the illicit manufacture of stimulants and depressants. In 1970 laws expanded the 1965 legislation and developed “schedules” to rate drugs. President Nixon declared the “War on Drugs” Culture of the “60s” Counter-culture Quick-Fix generation Attitudes about Addiction Counter-Culture: 1956-1974 Negative attitudes about the Cold War and Vietnam precipitated the birth of the Hippie Counter Culture Drug revolution with increases in drug experimentation and popularity (Zinberg, 1984) Timothy Leary: LSD Sexual mores: Woodstock Civil Rights & Race Change in beliefs about individual rights 2. Quick-Fix Generation Microwave meals Weight loss in a flash Got a headache? Credit Cards…. Quick Fix A medication to fix anything that ails you Increased use of prescriptions and OTC medication Increased chance of adverse interactions with alcohol and other substances An Era of Ambivalence Drinking age raised to 21 in 1984. In 1986 the Anti-Drug Abuse Act strengthened federal efforts to encourage foreign cooperation in eradicating drug crops. 1990 Crime Control Act allowed for the seizure of drug traffickers’ assets, and controlled drug paraphernalia and money laundering. Treatment option for first-time nonviolent drug offenders developed in 2000. Since 1996, 36 states have passed laws legalizing medical use of marijuana. In 2000 legislation in California required a treatment option for first-time nonviolent drug offenders. 41 20th Century: Office on National Drug Control Policy Formal efforts to address problems of abuse, addiction and crime brought on by misuse of drugs. Demand reduction – prevention plus treatment. Harm reduction – reduce the physical and social damage cause by abuse and dependence. Supply reduction – stricter laws concern use and “war on drugs.” Treatment of addiction became a medical as well as social science. 42 20th Century: Changing Use Amphetamines – First synthesized in 1887 and methamphetamines created in 1919. Used to fight fatigue, heighten endurance, etc. for soldiers. Over past few years there has been intense focus on amphetamine-type stimulants (ATSs). Restricted sale of OTC cold medications containing drugs used in the manufacture of methamphetamines. 43 20th Century Steroids and performance enhancing drug usage prompts Olympic Committee to institute drug testing. Synthesizing medications rather than relying on extracts from natural products. Recognition of brain chemical imbalances as the cause of almost all mental illnesses spurred the development of psychiatric medications. Methadone used as a legal substitute for heroin. 44 20th Century Development of new ways of preparing and using cocaine led to the crack epidemic and then to smokable methamphetamine. Prescription drug abuse/dependence. HIV, AIDS and Hepatitis C. “Raves” and “club drugs.” Behavioral addictions explode Now and Future Worldwide figures – 2.0 billion people drink alcohol with at least 76 million having an alcohol use disorder, and 2.5 million die from it every year. 155 million to 250 million people use illicit substances. 1 billion use tobacco. 129 million to 190 million smoke marijuana. 2011 Global Commission on Drug Policy declared, “The global war on drugs has failed, with devastating consequences for individuals and societies around the world” 46 2012 Americans voted to legalize marijuana in Washington and Colorado… What is next?