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Substance Use Disorder, Intentional Self-Harm, Gun Violence, and HIV/AIDS
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
SUD first begins by experimentation with substances, which leads to stimulation of the dopamine reward pathway of the brain. Depending on the form of the substance, a stimulant or a depressant, certain physiological effects are experienced by users, with some causing feelings of euphoria through reward circuit activation (e.g. cocaine, methamphetamine, and heroin). Addiction is subsequently marked by symptoms of craving, followed by increased physiologic tolerance for the substance. Tolerance is demonstrated by the need for increased amounts to achieve the desired effect, and markedly diminished effects with continued use of the same amount of the substance. Attempts to reduce, or eliminate use of the substance, are met with withdrawal symptoms, which is indicative of dependence.
Hallucinogens and Phencyclidine
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
With hallucinogens the onset of action begins within 15 min after oral ingestion on an empty stomach and peaks after 45 to 60 min with the oral route. Other forms of ingestion peak more rapidly. The person has manifestations that are somatic, perceptual, and affective. Often euphoria is present, but interrupted with bursts of anxiety and lability of mood. Perceptual errors (illusions) are common, and there is almost always a deranged interpretation of sensory input analogous to the sensory-deprivation syndrome. Hallucinations occur in only a minority of uses, and these usually appear with higher doses. In nearly all users there are alterations in mood, distortion of time, and altered shapes and colors. This is not frightening and is usually depersonalized. An observer will witness rapid change in moods, hostility of expression, incoordination and ataxia, and may witness agitation, nystagmus, and inability to reach the person through ordinary conversation.
Deception and the Systemic Problem of Substance Abuse
Published in Harold V. Hall, Joseph G. Poirier, Detecting Malingering and Deception, 2020
Harold V. Hall, Joseph G. Poirier
Natural opioid derivatives are obtained from the opium poppy. The native range of opium poppy is the Eastern Mediterranean, but it is grown and cultivated worldwide in botanically inviting temperate climates. Naturally occurring alkaloids from the opium poppy are used in raw form or are extracted to produce synthetic opioids. Heroin is one alkaloid form of opioid. Heroin is highly addictive because of its intense psychogenic properties of inducing euphoria. Heroin is a controlled substance; it is illegal in most developed countries, and it is a prime, potent substance of addiction. Illegal heroin eventually becomes street available and prolifically so. Presently, Mexico is a major source of illicit heroin making its way into the United States (see www.dea.gov/sites/default/files/docs/DIR-040-17_2017-NDTA.pdf).
Fentanyl use disorder characterized by unprescribed use of transdermal patches: a case report
Published in Journal of Addictive Diseases, 2022
Cavid Guliyev, Zehra Olcay Tuna, Kültegin Ögel
Fentanyl is a pure mu receptor agonist that crosses the blood–brain barrier rapidly. Its analgesic effect is 75–100 times higher than that of morphine.1 The routes of administration for prescribed use include oral, intravenous, epidural, transdermal, intranasal, and transmucosal routes. Transdermal fentanyl patch (TFP) has been widely used as an effective analgesic since 1990.2 TFP has several clinical advantages, such as long-acting analgesic effect and low incidence of undesirable side effects compared to morphine. Owing to such features, the use of TFP has been accepted as a noninvasive method for pain relief.3 Because of its low molecular weight and lipophilic properties, fentanyl is easily absorbed through skin.4 TFPs are available in doses of 25, 50, 75, and 100 mcg/hour. The effect of fentanyl lasts for up to 72 hours when used as transdermal patches.2 Compared to other forms, TFPs have a reduced possibility of misuse due to the fact that TFPs release the drug in a sustained and long-acting manner with a stable serum concentration.5 In addition, it is accepted that the risk of developing tolerance and use disorder is minimal because it rarely causes euphoria.6
Prescription and over-the-counter drug misuse among female students at a Saudi university
Published in Journal of Substance Use, 2021
Rufaidah Dabbagh, Munirah Aldofyan, Wejdan Alzaid, Aseel Alsulimani, Sarah Alshamrani, Samar Alqahtani, Alanoud Abuhaimed
Prescription and OTC drugs with addictive potential come in different types. The commonly misused OTC drugs with addictive potential include decongestants (such as pseudoephedrine and chlorpheniramine), cough suppressants (such as dextromethorphan), OTC sedatives (such as diphenhydramine) and antiemetics (such as dimenhydrinate) (Conca & Worthen, 2012; Lessenger & Feinberg, 2008; Shi & Bayard, 2011). Although these drugs are considered safe within the required dosage for reasons indicated, they have been used in larger dosage to experience euphoria, secondary to the psychoactive effects of some of these drugs (Lessenger & Feinberg, 2008). For example, dextromethorphan, the active substance in cough syrups, is popularly used among adolescents to enter a hallucinogenic, dissociative state described as a “dream-like experience” (Conca & Worthen, 2012; Stanciu et al., 2016).
Cocaine induced heart failure: report and literature review
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Sherif Elkattawy, Ramez Alyacoub, Abraham Al-Nassarei, Islam Younes, Sarah Ayad, Mirette Habib
Cocaine is a highly addictive stimulant that alters human behavior through the limbic system’s activity, a structure in the brain involved in motivation, emotion, learning, and memory. The nucleus accumbens (NA) is a specific area within the limbic system that receives connections through dopaminergic neurons. When stimulated, the accumulation of dopamine at the NA causes euphoria, conditioning the brain to establish a reward pathway in association with a stimulant. Cocaine inhibits dopamine transport protein (DAT) embedded within presynaptic neurons of the NA, forming a reward pathway; thus, explaining the drug’s highly addictive nature and potential for abuse [1, 5]. Although the overall incidence of recreational cocaine use has been declining over the years within the United States, the global prevalence of cocaine is still approximately 0.4%. Many studies have provided significant evidence explaining the relationship between cocaine use and the onset of cocaine-induced morbidity (including cardiovascular, neurovascular, psychiatric, and infectious illnesses) and mortality over time.[2,3,4,6,7]