Hello everyone and welcome back. In our last section we talked about alcohol and how it worked and some of the things it did on the body. In this section we begin with a new classification of drugs and these are what we call the stimulants.

As we can see in slide two, stimulants are substances that increase neuronal and behavioral activity when you give them. Consequently, they have lots of different effects. You increase your motor and mood activity. You increase your alertness. In contrast, you will decrease your appetite. You will also decrease your need to sleep and of course when you take too many of them or too strong a dosage you can cause seizures and hallucinations. Another aspect of stimulants is that they often cause some types of paranoia. This paranoia can mimic the paranoia you often see in other paranoid disorders from the mental health side.

Lots of different substances contain stimulants and some of these are shown in slide three. The classic examples are some of the analgesics such as aspirin, etc. There are a wide variety of stay alert compounds that you usually get over-the-counter. No-doZ is a classic example. Some decongestants have some stimulant activity. And finally there are all sorts of herbal substances out there that claim to stimulate your metabolism or whatever it may be.

So how do you get stimulants into the system? As we can see in slide four, you can take them orally, you can inhale them or smoke them, and you can also inject them. Regardless of the method used to get the stuff into the system the material usually goes and is distributed through the bloodstream. One of the major differences between stimulants and other drugs such as alcohol is that stimulants primarily target neurons and that is what gives them their effect. They also can influence other structures such as cardiac tissue, etc. This is commonly what happens with cocaine and what happened with {??Could not understand what was said??}. Stimulants can also damage and destroy other types of structures such as your septum which is in your nose, the little solid part between your nose. It can also cause teeth problems and a wide variety of other things.

Generally, once stimulants are in the system they basically cause neurotransmitter release at the synapse site. Many also will block the reuptake of the neurotransmitter consequently it stays in the synaptic cleft for a longer period of time. Some stimulants also shutdown inhibitory neurons and consequently that will cause the increased stimulation across the system. However we are not going to go into the process of that for this class.

So what are some stimulants? As we can see in slide six there is a wide variety. The ones you commonly hear about are the Amphetamines and its friend Methamphetamine. There are other types of stimulants as well. These include substances such as cocaine, nicotine, and ephedrine. We also have one major group of stimulants called the Xanthenes. These include coffee, tea, and chocolate which we will talk about. Finally, there are other types of stimulants that are out there that are given for specific kinds of disorders. The classic one of these is Ritalin and this is commonly used by now by a wide variety of people for abuse as well.

So let's talk about some of these drugs in particular. The first of these are Amphetamines which we start seeing in slides seven and eight. Amphetamines are used for lots and lots of different types of disorders. They are primarily used to reduce fatigue and enhance performance. They have commonly been used by soldiers for many, many years. Widespread abuse of these drugs has been around for a long time. Often times they have been used by students to help them get through exams and by truck drivers to help them stay alert while driving for long periods of time. In more recent times these drugs have been used as appetite suppressants. The problem is that these drugs develop a rapid tolerance, that is, you need more, and more of the drug to get the same effect. They also cause strong physical and psychological dependence as well. Primarily this occurs through both classical conditioning and negative reinforcement.

The pharmacokinetics of Amphetamines is basically very simple. You can take them through oral or injection routes, and that is the primary way they are used, that material then travels through the bloodstream, goes to the target organ wherever it may be. It is then metabolized by the Liver to other substances and the byproducts are excreted through the urine. Urine tests for these substances are good for about forty-eight to seventy-two hours; however, hair samples can detect these substances for a long period of time until your hair is cut.

Once the drug is in the system it has a wide variety of effects which are shown on slide ten. It will impact your nervous system; it also impacts cardiac tissue, and other types of structures. The specific thing that it does is the release of norepinephrine and dopamine from presynaptic elements. It also blocks the reabsorption of these neurotransmitters. Consequently the neurotransmitters stay on the binding sites a lot longer and you get more action potential and more stimulation.

The results of all these drugs and as we see in slide eleven, is that you get lots and lots of stimulation. You move faster, you talk faster, and you do a lot of things much quicker. However, if you do too much of these drugs you can not perform as well. You can also get increased blood pressure, alertness, and concentration, and you even get some memory increases. Consequently all these things are good for studying. You may also get an arousal in mood and all sorts of other things like that. There is often times a feeling of power that becomes associated when one is taking the drug. Ultimately these result through classical conditioning and even operant conditioning.

In high doses as we see in slide twelve, you can get repetitive acts. That is, things go on over and over again. You often develop extreme amounts of paranoia, and paranoia is important when you are trying to work with a client in some kind of counseling situation. Too much of the drug can also cause aggression and violence. Often when you take too much of it you can get delusions, hallucinations, and a wide variety of other psychotic behavior. It is often times very difficult to determine the difference between amphetamine psychotic behavior and true psychotic behavior. And, of course you have a wide variety of physical problems that can occur as well.

Now in addition to these major problems there are also other problems that can occur and some of these are shown in slide thirteen. Often times individuals will neglect their health and as a consequence they can get all kinds of infections, etc. Persons on amphetamines also have deterioration in social life and in other life aspects as well. Often times, if one takes them for too long a period you can actually develop cognitive problems. Initially it might have worked well for enhancing your academic performance but over time your academic performance deteriorates and so does your mental functioning. So, take them off the drugs and what happens? You get lethargy, depression, and a feeling of being down and you can't get yourself going, etc. So consequently you need to take the drug again to feel more normal.

Now, a related friend to the general group of amphetamine is methamphetamine and as we can see in slide fifteen it is a very, very powerful substance. It is also highly addictive and it has a lot of different names. The major difference between methamphetamine and other types of amphetamines is that methamphetamine is synthetic but the results are almost identical. You get the same kinds of behaviors, etc. The key is that it is very, very powerful and it makes you feel very good. I have thrown a few slang terms in here for people who are using methamphetamine. On slide sixteen you can get a feeling for what those are.

The past, as you can see in slide seventeen, most of the people who took methamphetamine were white males, blue collar workers who lived in urban areas. Today however, it is everywhere. It is in rural communities, it is in urban communities, etc. Four point seven million Americans have tried methamphetamine, relatively low percentage but still a lot of people since we have about two hundred eighty million people in the United States. A more alarming variable is that four point eight percent of high school seniors have tried methamphetamine and one point nine percent within the last year. That is a lot of students and causes lots of problems.

Basically, you get methamphetamine into the system, as we see in slide eighteen, via orally, injection or through inhalation of some sort. Consequently it takes different amounts of time to get into the system and have some kind of effect.

The effects of methamphetamine are shown in slide nineteen and as you can see there is a wide variety of effects that occur here.

One of the big problems with methamphetamine, as we can see in slide twenty, is that it damages the post synaptic elements of dopamine neurons. It will also kill other brain cells. As a consequence it will case problems with memory and assorted other things.

In general, as one continues to use methamphetamine, as we can see in slide twenty-one, it begins to change your impression of what normal is. So what I would like you to do right now is sit back and close your eyes and feel what it is like to be normal right now. Now that you have done that for a few seconds you have a feeling for what normal is. For a person who is a meth addict this would feel weird. When you are on the meth is when you feel normal. When you are off the meth you feel different, you feel weird. In addition to that, methamphetamine can increase your risk for blood borne pathogens especially HIV, AIDS, Hepatitis, and other things. A person who is high on meth really does not care what is going on with them; they really do not care what is happening with them. They are really not thinking about what is going on. A new combination is occurring with all of this is the use of Viagra with Methamphetamine. So now you do not care about what happens and now you have sexual activity going on all the time. So what happens when you stop using methamphetamine? When you do stop using it you get major depression, fatigue, and intense cravings. Consequently it is very hard to kick.

A substance that is related to methamphetamine but more in the way that it is taken in is what we call "Ice". Ice is a freebase form of methamphetamine and it is very potent. Smoking allows you to get it into your system extremely fast. Once you get it in there the high is extremely intense and lasts for a long time. Of course, chronic use is going to create all kinds of problems including psychiatric problems, cardiovascular problems such as getting an immediate system arousal, endocrine changes and of course neuromuscular changes as well, as one continues to use the drug.

Now another type of stimulant that we often see and hear about out there is cocaine. Cocaine as we see in slides twenty-three and twenty-four basically comes from the coca plant. It has been used in South America for religious, social, euphoriant, and medicinal purposes for many, many years. The alkaloid was purified from the leaves in 1860 and was one of the first local anesthetics ever used in surgery and is still used today in a variety of ear, nose and throat procedures.

Cocaine as seen in slide twenty-five, has been used in many substances for a long time. It was incorporate into a wide variety of medicines and beverages in the 1800's such as Coca-Cola. However, the Harrison Narcotic Act banned its use in 1914. Since then its use has been relatively limited to certain subpopulations such as the "Jet setters". In the 1960's cocaine experienced a major comeback; again it was primarily in the Jet setters who could afford it. However, in the 1980's a new type of substance became available, and this was Crack cocaine. These were smaller amounts of cocaine and what was basically done was put into smaller and smaller particles which could then be smoked.

Slide twenty-six and twenty-seven is primarily put in here to demonstrate the differences in the types of cocaine. You have cocaine hydrochloride which is sort of a paste and is ultimately the powder that is used. Then we have crack on slide twenty-seven which is similar to coca paste which is ultimately put into a pipe and smoked. It is much cheaper and gives you a very good high.

Cocaine can enter the system in a wide variety of ways, through oral route, the lungs or through the stomach. The half-life is about thirty to forty minutes depending upon the person’s genetics. It is metabolized by the liver and then the byproducts are excreted in the urine. However, it is slowly removed from the brain; it takes quite a while to get out of there. A person can easily test positive for cocaine through urine tests for twelve hours. However, depending on the type of test that is done, a long time can occur between ingestion and detection. For example, hair samples can contain elements of cocaine for long periods of time after use.

There is a variety of ways individuals can put cocaine into the system. The fastest is through injection and through smoking which is shown in slide twenty-nine. With injection you get a rapid surge of cocaine into the system consequently it gives you a very intense high then it kind of backs off a little bit.
Crack does a very similar type of thing. You get an intense rush but it is a little faster than injection, the onset peaks in about five minutes and lasts for about thirty minutes total. Then you have to have another bowl to make that feeling come back. That is what makes it very addictive. You have that rapid rise and a very rapid drop off and you want that same feeling again.

Generally when you look at cocaine, as you can see in slide thirty, once you get it into the system it is distributed into the circulatory system very quickly. It penetrates the brain very rapidly as well especially when you smoke it. The primary site of action is on the Dopamine neurons. What it specifically does is block the reabsorption of dopamine back in the presynaptic elements. Consequently, dopamine stays in the synapse longer and you get more action potentials. Ultimately you get a very intense feeling of euphoria and it feels good.

There is also a wide variety of effects from cocaine and these are shown on slide thirty-one. You get an initial euphoria and increased motor activity, etc. You also get a rapid flow of motor activity and mental activity as well. Cocaine will also depress your appetite and you usually have a depressive state that follows as the drug is removed from your system.

There is also a wide variety of effects from cocaine and some of these are shown in slide thirty-two. The classic one and the one you commonly hear about are cardiovascular effects. That is, you develop heart attack or what more commonly occurs is you develop an irregular rhythm within the heart and that causes the blood to not go to your brain and you die. You can also get respiratory failure and if you take too much of the drug you can commonly get seizures as well.

The next major category is the Xanthenes and as we can see in slide thirty-four there is a wide variety of types. There is Theophylline which is primarily found in tea. There is Theobromine which is commonly found in chocolate. And then there s caffeine which is commonly found in coffee and in colas.

Let's look at Theophylline first. As we can see in slide thirty-five it is primarily found in tea however there are very minimal amounts here so it does not have much of an effect. Theophylline is also used medically for breathing problems with asthmatics. What it does is help to relax and open the bronchial tubes.

Theobromine is another type of Xanthene. It is primarily found in chocolate and has far less potency than caffeine that is out there.

The third Xanthene that I would like to discuss and shown in slide thirty-seven is caffeine. Caffeine is the most commonly consumed psychoactive substance used in the world. The average intake per person per day is about eighty to four hundred milligrams. Of course it is not considered drug abuse and there is no regulation on the sale or use.

Caffeine is found in a wide variety of products and I have listed some of these and the amounts of caffeine that is found in each of them on slide thirty-eight. As you can see, it is everywhere.

What are some of the effects of caffeine? As we can see in slide thirty-nine, it will enhance your mental alertness and that is good for sustained intellectual efforts such as studying. It is also good for increased energy and well-being, it will reduce fatigue and will decrease sleep onset. This is the classic drug people drink when they try to stay awake.

Chronic use, as we see in slide forty, causes habituation and tolerance, that is, you need to have more and more of the drug to get the same effect. There is a guy I know in Boise that wakes up in the morning, he goes to his local expresso store, and has a quadruple shot, that's four shots. Goes to about ten o'clock, goes back and gets another four. And that lasts him until about two in the afternoon so he has developed major, major amounts of tolerance. When he does not use this substance he often experiences withdrawal which includes headaches, drowsiness, fatigue and even depression.

Now, as we see in slide forty-one, once caffeine enters the system it goes throughout the system and blood levels are reached in about thirty to forty-five minutes with peak levels being about two hours. It also has about a three and one half to five hour half life and basically it is distributed through the body water. Once it gets into the system and is going around as we see in slide forty-two, it is broken down into a wide variety of metabolites. Ultimately these are then removed from the kidneys.

The major site of action as we see in slide forty-three for caffeine is on the adenosine receptors and I am not worrying about what the adenosine receptor is for this class. Basically, when you block this receptor you get more firing in other neurons. This ultimately causes the stimulation effects one may encounter.

Another major stimulant and shown in slide forty-four is nicotine.

Nicotine as we see in slide forty-five is the primary active ingredient in tobacco. It is one of the three most widely used psychoactive drugs out there besides caffeine and alcohol. Nicotine has few if any therapeutic applications. It is important for us due to its widespread use and toxicity. Tobacco, if you did not know is great plant herbicide and is a great plant insecticide, it kills bugs.

A little background on nicotine and what its effects are primarily through the use of cigarettes. It is responsible as we see in slide forty-six for the deaths of about eleven hundred Americans each day. Each day six thousand American teenagers try their first cigarette and of those, three thousand will become regular cigarette smokers and of those, one thousand will die of a smoking related disease. Nine out of every ten smokers become addicted before age twenty-one and girls become addicted faster than boys. They also have a harder time quitting as well primarily due to the weight gain that occurs after they quit using it.

As we see in slide forty-seven, smoking causes a wide variety of diseases. Four thousand Americans die each year from lung cancer caused by second-hand smoke. Thirty-seven thousand individuals will die each year from heart disease caused by second-hand smoke.

Nicotine as we see in slide forty-eight, exerts a very powerful effect on a variety of systems and these are listed here for you.

It will also stimulate your vomit center, as we see in slide forty-nine and will basically cause nausea in the early stages of smoking. However, tolerance develops very rapidly and that then goes away. Nicotine will also suppress your appetite consequently helps you reduce your weight.

Essentially in the central nervous system, as we see in slide fifty, nicotine increases psychomotor activity, it helps to stimulate cognitive functioning, stimulate attention and focus to detail, and it helps to work with memory.

Now, there is a wide variety of problems that occur as with nicotine withdrawal and some of these are listed on slide fifty-one. You get intense craving, irritability, anger, etc, weight gain and insomnia.

So how do you get the stuff into your system? Nicotine is easily absorbed by a wide variety of mechanisms. It is absorbed through the lungs, through breathing it in through the mucosal membrane, it is absorbed through the skin, and it is even absorbed through the gastrointestinal tract. Once you get it into the system it is easily distributed throughout the body. There are no barriers to nicotine distribution. You get rapid brain penetration. It easily crosses the placental barrier and will ultimately appear in all of your bodily fluids. Nicotine is ultimately removed by the liver and the metabolites of those substances are then removed by the kidney.

The last major stimulant I want to discuss in this section is Methylphenidate and this is shown in slide fifty-three. Methylphenidate is basically a non-amphetamine stimulant. It has a half life of about two to four hours and has a release half life of three to eight hours. While methylphenidate works well for ADD it does not work well for ADHD. It is basically erratically absorbed and the blood levels are actually unpredictable.

Primarily it is used, as we see in slide fifty-four, for ADD and Narcolepsy.

The effects of methylphenidate and shown in slide fifty-five, include excitation, increased heart rate and basically increased alertness which is the most important reason it is given. The person taking it also experiences loss of appetite, etc.

As we see in slide fifty-six, there are a couple of ways methylphenidate is taken into the system. Orally, which is primarily used with children and adults. You do not get very much euphoria and basically you get the long effects. When injected, however, you get rapid euphoria and you get a major surge of dopamine. Consequently, this causes a high potential for abuse and is often used within youth groups.

Once you get the drugs into the system and as we can see in slide fifty-seven it is distributed to the brain and all other structures via the bloodstream. And ultimately it is metabolized by the liver.

When it gets to the brain, as shown in slide fifty-eight, it generally shuts down some parts of the frontal lobe. This gives you greater focus and why it is given to young children. It also stimulates a wide variety of other areas of the brain including the LC and the NA.

The side effects however include apathy, depression when you stop using it, irritability, and even disorientation.

Neuronal effects as seen in slide sixty includes things such as blocking the reuptake of dopamine like the other amphetamines do and is very similar to cocaine. It will also slightly increase the release of dopamine like the other amphetamines.

However, if you take it in larger dosages as we see in slide sixty-one this is when you get the rush. Low doses, on the other hand, give you minimal euphoric effects.

In conclusion we have lots and lots of stimulants out there that impact a wide variety of social areas and now they are causing lots, and lots of problems. Basically, when a person uses these substances they believe they are doing great. That is, until they develop tolerance to the drug and then this causes you to have all kinds of major problems.

Well, that concludes that section. In the next section we are going to talk about its opposite, the depressants. So until then we hope you have yourself a good day and we look forward to talking with you soon.

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