Classic hallucinogens Common classic hallucinogens include: ● D-lysergic acid diethylamide ( LSD ) . LSD is one of the most potent mind-altering chemicals. A clear or white odorless substance is found in a fungus that grows on rye or grains (NIDA, 2020a). ● Psilocybin originates from mushrooms in tropical and subtropical regions of South America, Mexico, and the United States (NIDA, 2020a). ● Peyote (mescaline) is a small, spineless cactus with mescaline as its main ingredient (NIDA, 2020a). ● DMT (N, N-dimethyltryptamine) is a powerful chemical found in plants in the Amazon. Ayahuasca is a tea from these plants, called hoasca, aya , and yagé (NIDA, 2020a). ● 251-NBOMe is a synthetic hallucinogen similar to LSD and MDMA but much more potent. Classic hallucinogens temporarily disrupt communication through the brain and spinal cord (NIDA, 2020a). Additionally, ● PCP (phencyclidine) was developed as a general anesthesia but is no longer used because of severe side effects. Now it is found in a variety of forms. ● Ketamine is a dissociative anesthetic for animals and humans. Unfortunately, much of it is obtained illegally from veterinary offices. This is also a date rape drug (NIDA, 2020a). ● Dextromethorphan (DXM) is an over-the-counter cold and cough medicine. ● Salvia is a plant common in southern Mexico and Central and South America. This drug is ingested by chewing fresh leaves and drinking the extracted juice. Dissociative hallucinogens Common dissociative drugs include
some interfered with serotonin which regulates mood, sensory perception, sleep, hunger, body temperature, sexual behavior, and intestinal muscle control (NIDA, 2020a). These hallucinogens cause individuals to see images, hear sounds, and feel sensations that seem real, which generally begin within 20-90 minutes and can last from 15 minutes to 12 hours. These are commonly referred to as a trip by the individual. The short-term effects can range from tachycardia and nausea to seeing intense colors and changes in the sense of time (NIDA, 2020a). Other short-term effects of hallucinogens include increased blood pressure, tachypnea, hyperthermia, loss of appetite, dry mouth, spiritual experiences, relaxation, uncoordinated movements, excessive sweating, panic, paranoia and psychosis, and bizarre behaviors (NIDA, 2020a). Long-term effects include persistent psychosis and hallucinogen persistent perception disorder, which are evident in individuals with mental illness (NIDA, 2020a). Dissociative hallucinogens interfere with glutamate, which regulates pain perception, environmental response, emotion, learning, and memory (NIDA, 2020a). Dissociative drugs can cause numbness, disorientation and loss of coordination, hallucinations, and increased blood pressure, heart rate, and body temperature; long-term effects cause speech problems, memory loss, weight loss, anxiety, depression, or suicidal thoughts (NIDA, 2020a). PCP can be addictive. Individuals demonstrating a problematic pattern of substance use that leads to significant impairment as manifested by two or more criteria over 12 months meet the criteria for a hallucinogen use disorder (PCP)
INHALANT USE DISORDER
Inhalants produce chemical vapors that can be inhaled to induce psychoactive or mind-altering effects. The range of chemicals has various pharmacologic effects found in hundreds of products (NIDA, 2022). Categorizing these products is complex but generally identified in volatile solvents, aerosols, gases, and nitrates (NIDA, 2022). 1. Solvents include paint thinner, gasoline, lighter fluid, glue 2. Aerosols include spray paint, hair spray, vegetable oil sprays 3. Gases include propane tanks, whipped cream aerosols, butane lighters, and nitrous oxide 4. Nitrates include room odorizes, leather cleaner People who use inhalants will abuse any available substance. Inhalants are CNS depressants and influence gamma- aminobutyric acid (GABA). The physiologic effects of inhalant use include a variety of body functions. Most damage initially affects the brain, observed through tremors and uncontrolled shaking (Brannon, 2019). Headaches and seizures are common. Personality changes, memory loss, and decreased cognitive functioning may also develop. Inhalants can also cause lung damage with hypoxia, sinus discharge, coughing, and cyanosis. Hy inhalant use also makes arrhythmias, heart block, and heart
failure possible. Other medical effects of inhalant use include gastrointestinal, liver, and kidney failure, bone marrow damage, peripheral nervous system, and decreased damage (Brannon, 2019). Psychological effects of inhalant use include impaired judgment, hyperactivity, aggressive behavior, speech problems, and increased accidents, especially unplanned suicides in children who use inhalants (Brannon, 2019). Individuals demonstrating a problematic pattern of substance use that leads to significant impairment as manifested by two or more criteria over 12 months meet the criteria for a hydrocarbon- based disorder. The individual can overdose on inhalants when the ingested drug causes a toxic reaction, resulting in harmful symptoms or death (NIDA, 2020b). For example, the concentration of chemicals can cause cardiac arrest within minutes, which can occur in an otherwise healthy individual called sudden sniffing death . In addition, individuals who try to quit inhalants may experience withdrawal, including nausea, loss of appetite, diaphoresis, sleepiness, and mood changes.
TOBACCO USE DISORDERS/VAPING
Tobacco use is widespread in the United States, and its deleterious effects are well documented (NIDA, 2021; CDC, 2022a). Smoking cigarettes leads to disease and disability in almost every organ in the body (CDC, 2022a), including cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease. Additionally, there is an increased risk of tuberculosis and eye and immune diseases (CDC,2022a). Secondhand smoke also harms nonsmoking adults and children, including stroke, lung cancer, sudden infant death syndrome, middle ear disease, worsening asthma, acute respiratory infections, and slowed lung growth (CDC, 2022a). The strongest
predictors of nicotine addiction are the time to first cigarette and real cigarettes per day (Lande, 2018). Cigarettes are a highly efficient drug delivery system. On average, the individual takes 1-2 milligrams of nicotine per lit cigarette and takes 10 puffs over 5 minutes. This equates to 200 nicotine hits to the brain daily (CDC, 2022a). The adrenaline rush increases blood pressure, respiration, and heart rate while stimulating reward pathways in the brain. While nicotine is addictive, multiple dosing is needed to prevent withdrawal symptoms. Tobacco use disorders are documented in the DSM-5:
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