“The Faces of Substance
Abuse in America”
It’s Ugly and Getting Uglier
by
Paul L. Doering, M.S.
Distinguished Service Professor, Emeritus
College of Pharmacy
University of Florida
The Two Faces of Drug Abuse
• Faces of those who use and abuse.
http://www.facesofmeth.us/main.htm
• Faces of the drugs being used.
– News Flash: Quaalude is “out”
– Breaking News: “Bath Salts” are “in” out
HEALTH PROFESSIONALS KNOW A
LOT ABOUT DRUGS, BUT………...
• Many curricula do not contain coursework
in substance abuse
• Thus, they are not schooled in this “other”
use of pharmaceutical products
• Most have limited personal experience with
recreational drugs (thankfully)
• But, these persons are often sought out by
parents, family members, etc. for help
The Faces of Three Drug Experts
From the 1960s
James Marshall Hendrix
Born- 11/27/42
Died- 9/18/70
Paul Louis Doering
Born- 2/25/49
Not Dead Yet
Janis Lyn Joplin
Born- 1/19/43
Died- 10/4/70
Makin’ the “Big Time”
Florida IS the Face of Drug Abuse in
Our Country
http://abcnews.go.com/WNT/video/florida-drug-bust-targets-doctors-presibtion-illegalpainkillers-pill-mill-dea-12985087
And It’s a Local Problem too….
But it is a knotty problem…..
Marijuana: The flowering top of the pistillate plant
(or female) of the genus and species, Cannabis
Sativa, Family Moraceae.
Lecture by Prof. Carl Johnson in Weeds and Seeds course,
circa 1969
“Square Grouper” that used to fall into Biscayne Bay in Miami
Lot’s of Pot!
The New Face of Marijuana
(aka Spice or K2)
“Synthetic Marijuana”
Cannabicyclohexanol
JWH-018
Tetrahydrocannabinol
JWH-073
HU-210
For More Information:
http://info.publicintelligence.net/spicealert.pdf
DEA Re-Scheduling
On November 24, 2010, the DEA notified the public through
the Federal Register of their intent to temporarily control five
synthetic cannabinoid chemicals found in so-called “fake pot”
products such as K2 and Spice.
The Face of Real Bath Salts
•magnesium sulfate (Epsom salts)
•sodium chloride (table salt)
•sodium bicarbonate (baking soda)
•sodium hexametaphosphate (Calgon,
amorphous/glassy sodium metaphosphate)
•sodium sesquicarbonate
•borax
The Face of “Not Real” Bath Salts
Methylenedioxypyrovalerone (MDPV)
Some Brand Names:
Cloud 9, Ivory Wave, Ocean, Charge Plus, White Lightning, Scarface,
Hurricane Charlie, Red Dove and White Dove.
Emergency Re-Scheduling in
Florida
Digital Drugs
Digital Drugs
Example of a Digital Drug
In Your Face: Nitrous Oxide
• Synonyms:
– nitrous, laughing gas, whippets, “Blue Nun”
• Mental effects:
– giddiness, silly laughter, buzzing or ringing in ears
• Duration of effect is only 2-3 minutes
• Danger:
– hypoxia, possible nerve damage with prolonged use
Whip-Its
Individual Cylinders of N20
Whipped Cream Dispenser
The Many Recognizable Faces of Ecstasy
The Fashionable Face of Ecstasy
The Kinda Weird Faces of People Rolling
The Three Faces of Coke
An Impromptu Drug Delivery Device
This is called a “stem” on the street
From The Face of a Meth User
Meth Bugs
The Face of a Burn Victim from Meth lab- 19 yo
Oxycontin Express
http://www.huffingtonpost.com/currenttvs-vanguard/vanguard-season-premiere_b_320867.html
Pharmaceutical Drugs are “In”
•
•
•
•
Obtained from legal prescriptions
Given or sold among friends
Stolen from medicine cabinets
Stolen from pharmacies
The Ugly Face of Prescription
Drug Abuse In America
http://www.cdc.gov/nchs/data/hus/hus10_InBrief.pdf
The Figures Fit the Face
• >27,000 deaths from Rx drug Ods in 2007
– five-fold increase since 1990
• declining mortality rates for all other conditions
– including heart disease and cancer
• OD deaths from Rx opioids are exceeding
deaths from heroin and cocaine overdoses
combined.
The Figures Fit the Face (cont’d)
• Drug-induced deaths (which includes all drugs)
is approaching the number of deaths from motor
vehicle crashes.
• Drug abuse deaths have also surpassed deaths
from suicide, homicide, and fire arms.
Pharmaceutical vs Street Drugs
• Safer
– identity
– purity
– less HIV / hepatitis risk
• Safer because "it's just a prescription drug"
• Low or no acquisition cost
– Medicaid, Workers’ Comp, private insurance,
VA, Indian Health Service
The Different Faces of “Ritalin”
Concerta ER 18 mg
Ritalin 10 mg
Ritalin LA 20 mg
Concerta ER 36 mg
Ritalin 5 mg
Ritalin LA 30 mg
Concerta ER 54 mg
Ritalin SR 20 mg
Ritalin LA 40 mg
Stimulant
Identification
OxyContin (oxycodone HCl)
The Face of Grandaddy Morphine
The Face of Codeine
(aka methoxymorphine
The Face of Hydrocodone
The All-Too Familiar Face of
Oxycodone
The Face of Methadone
The Face of Meperidine
Comparing the Faces
Codeine
Morphine
Meperidine
Methadone
Hydrocodone
Oxycodone
Rohypnol is now wearing a mask to hide his sneaky face
Xanax- A Household Word
Depressants: Benzodiazepines and
non-benzodiazepines
Valium 2 mg
Xanax 0.5 mg
Valium 5 mg
Valium 10 mg
Xanax 1 mg
Xanax 2 mg
Depressants Identification
Depressants Identification
Restoril 30 mg
Just Your Typical FDA Certified Manufacturing Laboratory
Turning this……………….into this.
'Skittling' New Drug Of Choice For Some Teens:
Product Sold On Store Shelves
October 22, 2003
Ingredients:
Dextromethorphan
Chlorpheniramine
Maleate
Other Products Containing
Dextromethorphan
Buying Dextromethorphan in Bulk