Uppers
and
Mental Health Disorders
“What goes up. . .
. . . must
. . . come
. . . down.”
Cocaine

“Coke, C, Cane”


(powdered) “Blow, snow, flake, nose candy,
toot”
(crack cocaine) “Crack, rock, base”

Cocaine is derived from the densely-leafed
coca plant native to South America.

Cocaine is the world's most powerful
naturally occurring stimulant.
Cocaine is considered the second-most addictive
substance of common use – can anyone guess what
the #1 most highly addictive substance is?
How is Cocaine used?

Coca and its derivatives
are most commonly used
as follows:

Cocaine hydrochloride, or
cocaine powder, a white
crystalline powder with a
bitter, numbing taste is
sniffed, or diluted and
then injected.
How is Cocaine used?

Freebase or crack cocaine is made by
cooking cocaine hydrochloride with
ammonia or baking soda.



Freebase was originally produced in an
explosive, multi-step process.
Crack is safer to produce - no explosions.
Crack and freebase are smoked from
pipes; burnt on a piece of tin foil; or mixed
with tobacco or marijuana in a smokeable
joint.
Does anyone remember the incident that Richard
Pryor had with exploding freebase?
What’s the pay-off?

“Cocaine provides a
stimulating, alert, and
sexually arousing high:”

Increased talkativeness
and sociability

Extreme mental alertness

Feelings of euphoria
What’s the cost of using Cocaine?

Nervousness and jumpiness,
insomnia

Anxiety, irritability, paranoia

Diminished decision-making
ability

Tremors and dizziness

Muscle twitches and spasms

Loss of self-control, violent
behavior
Long-term costs of Cocaine use

Irritability and mood
disturbances;

Auditory hallucinations
(imaginary sounds that seem
real);

Formication (The sensation
that insects are crawling
under the skin);

Often immediate addiction;
Dual Disorder concerns . . .



Co-occurring thought
disorders
Co-occurring mood
disorders
Co-occurring
personality disorders
Amphetamine /
Methamphetamine

“Meth, crystal meth, speed, ice, crank, glass”

Amphetamine / Methamphetamine are powerful,
tremendously addictive, psychomotor stimulants.

Methamphetamine is a white, odorless, bittertasting crystalline powder that easily dissolves in
water or alcohol. Another common form of the drug
is called crystal meth, or "ice," because it comes in
large chunky crystals that look like ice chunks or
rock candy.
How is Methamphetamine used?

The powder form
of the drug may be
snorted,
swallowed, or
diluted and
injected.

The "crystal" form
of the drug is
smoked in a glass
pipe like crack
cocaine.
What’s the pay-off?

Immediately after smoking, snorting, or
injecting methamphetamine, the user
experiences an intense "rush" of
excitement and pleasure, lasting between
15 and 30 minutes.

Methamphetamine gives users dramatic
bursts of energy, talkativeness, and
excitement. On meth, users don’t feel
the need for sleep or food, and they
can keep going and going for hours.
What’s the cost?

The other effects of
methamphetamine
tend to last from 6 to
12 hours. During these
hours, the user
generally feels
nervous and agitated.
What’s the cost?

Under the influence of
meth, users feel "wired"
and edgy. They are often
unpredictable, acting
friendly and sociable, and
then suddenly lashing out
in suspicion and violence.
Many users compulsively
repeat meaningless tasks
for hours or pick at
imaginary bugs on their
skin until it bleeds.
Longer-term costs of Meth use

As the high wears off,
the user enters a
stage called
"tweaking." Tweakers
experience
delusions,
compulsive
behavior, paranoia,
and a tendency to
violence.
Longer-term costs of Meth use

Many users try to
avoid the "crash" at
the end of a meth high
by continuing to use
the drug until they run
out of money or
collapse. A binge and
crash cycle like this
is called a "run."
Dual Disorder concerns . . .



Co-occurring thought
disorders
Co-occurring mood
disorders
Co-occurring
personality disorders
What about Caffeine?

Vivarin, No-Doz, coffee,
tea, soft drinks

Caffeine intoxication and
withdrawal are recognized
as diagnosable conditions in the DSM-IV

Individuals with co-occurring mental/emotional health
disorders may need to be careful about their use of
caffeine . . .
Caffeine Intoxication –
Five or more of the following:
Restlessness
 Nervousness
 Excitement
 Insomnia
 Flushed face
 Diuresis
 Gastrointestinal
disturbance

Muscle twitching
 Rambling flow of
thought and
speech
 Tachycardia /
cardiac arrhythmia
 Periods of
inexhaustibility
 Psychomotor
agitation

Caffeine Withdrawal –
Five or more of the following:
 Prolonged
daily caffeine use is
abruptly stopped or reduced,
with the following symptoms:




Headache
Marked fatigue / drowsiness
Marked anxiety or depression
Nausea or vomiting
Dual Disorder concerns . . .



Co-occurring thought
disorders
Co-occurring mood
disorders
Co-occurring
personality disorders