>> Hello. Welcome.
I am -- okay, you can see my screen.
I always got to get things
set up here of course.
So, today we're talking about stimulants.
Sorry, one more thing here.
Okay. Thanks for being patient
unless you're not being patient
which I don't know because I can't see you.
Anyway, focusing.
Stimulants today.
We're talking general stimulants so not just
one specific thing but stimulants in general.
This is the last chapter that
will be on your first exams.
So, the first exam is going to be chapters
one through six, so this is the last one.
Make sure you're studying.
Let's get started here.
There we go.
So, stimulants is a lot of different things.
These are substances that keep
a person going both mentally,
as well as physically going, going, going.
Restricted stimulants, these are things
like our cocaine and our amphetamines.
Readily available stimulants or
things like caffeine, nicotine,
although we will talk more later about nicotine
and how it has multiple effects,
but that's another day.
So, let's talk about cocaine.
We're going to learn about
history of all the different drugs.
We're going to learn about how they interact
with the body for each drug and we're going
to talk about a lot of different things.
So, we start with coca.
This is just simply a bush.
It grows in the Andes and it produces cocaine.
It's been harvested for thousands of years.
Actively cultivated for over 800 years.
The coca leaf was a really
important part of the Inca culture.
It was used as a currency.
It was used in religious
ceremonies, so a lot of that culture.
A lot of natives of the Andes
still chew coca leaves.
It helps them reduce fatigue
and increases productivity.
They chew coca leaves in the same way that
people hear drink coffee or drink caffeine,
and chewing coca leaves is a more mild
stimulant than using the pure cocaine.
Cocaine was used in Europe by the 19th century.
For a while we had this thing called coca wine.
Coca wine used the coca leaf
extract and a bunch of other stuff.
They also used this for -- they made coca tea
and lozenges with cocaine; lots of these things.
But coca wine was very popular among cyclists.
It was popular among lots of
different kinds of people.
It wasn't seen as a problem because people
didn't talk about its addictive parts.
Now we've talked about this before, and
that is that cocaine was used in the US
in many versions of things
like patent medicines.
This is, again, that example
of those cocaine tooth drops.
Patent medicines that said "Hey, cocaine
makes you feel a little bit better,"
and they were right.
Again, you kind of need to tell people about
side effects, and they weren't doing that.
Cocaine was also used in the early
versions of Coca-Cola hence cocaine.
They have taken the cocaine out.
It doesn't mean Coca-Cola is good for
you now, but it doesn't contain cocaine.
So, in 1860, cocaine was
isolated from the plant.
Well, actually they think it was done
before then, but around that time.
So, if you process about 500
kilograms of coca leaves,
you're going to end up with
one kilogram of cocaine.
So, you can see, sort of, the differences there.
Medical use.
Cocaine is still used for
certain medical reasons.
Originally, we had this Dr. W. S. Halsted.
He experimented with cocaine as
a local anesthetic which is huge,
and then he also delivered things via
this newly developed hypodermic syringe.
The hypodermic syringe changed
the medicine completely.
So W. S. Halsted is known, sort of,
as the father of modern surgery.
So, cocaine played a huge part here.
When they could have a local
anesthetic, that's a game changer.
You no longer have your bite your bullet as
your main method of getting through surgery.
[ Clicking noise ]
And then we have Freud.
Do know this.
Sigmund Freud studied the use of cocaine
as a treatment for depression as well
as a treatment for morphine dependence.
Now, of course, that's interesting to use it
as a treatment for dependence of another drug
because this is a drug that is highly
addictive if people become dependent on it.
But people including Freud didn't really know.
What they did see is, "Wow.
The people who are using
cocaine, they're really happy."
They are no longer thinking that
they just want to die and feel sad.
So, it seemed fantastic.
Freud was really about it.
Freud recommended it to people.
Freud just thought cocaine was the best.
I always like to mention that because
it's good to keep that in mind
when you do learn a lot of things about Freud.
When you think about some of his
theories if you've taken simply Psych 1
or one before you know about
Freud and some of his theories.
Do remember that Freud used
a good number of drugs.
However, he went from really
liking cocaine and recommending it
to pretty much everybody to
then saying absolutely not.
So, he opposed the drug after he had
to deal with a friend who was going
through cocaine psychosis and
that was really upsetting for him,
and he's done a lot of writing about that also.
And then after that, he changed
his tune, was very anti-cocaine.
Like I said, do know that for your exam.
When we talk about early
legal controls, the press,
politicians made this wildly
unsubstantiated claims
about cocaine use among southern
black individuals.
I mentioned this in a previous lecture, and
your book really talks about it specifically.
I highly recommend that you open your book and
you look at the pictures that were published.
Pictures, drawings, whatever,
that were published
and the articles that were published about this.
They talked about widespread use.
They talked about it being associated
with increased violent crime,
but specifically "southern blacks."
That they were going out on these violent
rampages and raping and flipping cars
over and just this ridiculous stuff.
Completely unsubstantiated, but
because it was said by the press
and politicians, people started to get scared.
People started to freak out about it.
And then, 46 states passed laws to
regulate cocaine between 1887 and 1914.
It's really this negative racially
charged publicity about cocaine
that really shaped American drug policy.
For good or bad, cocaine was one of the
big things that started changing things
about American drug policy from that
laissez faire attitude to regulations.
So, this is a picture of cocaine hydrochloride.
This is often what people think
about when they think about cocaine.
This powder form.
Let's go back here.
Coca paste, so coca paste is this crude extract.
It's created during the manufacturing
of cocaine.
In places like South America, coca
paste is often mixed with tobacco.
It's often smoked.
We see it a lot less often here.
I mean, really, you could find any drug
here, but this is not a popular thing.
Cocaine hydrochloride, this
is our most common form
of pure cocaine, and that's
what this picture is.
It's stable.
It's water soluble salt basically,
and it's typically snorted.
It goes in through the mucous
membranes so it is absorbed quickly.
People notice that high very quickly,
and it also doesn't last that long.
So, we've talked before, but things that
are more addictive are things that are taken
in quickly, that hit you quickly, and that
are out of your system somewhat quickly.
The faster this happens, the more likely it is
to be physically and psychologically addictive
because you know if you're feeling down and
you use it, it's going to work right away.
So snorting helps that process.
Freebasing.
So freebasing is the extraction of
the cocaine base with a solvent.
Typically, something like ether.
It could be heated.
The vapors are inhaled.
So that's when people say
somebody is freebasing.
That's what they're doing.
Now, typically when people talk about cocaine,
they talk either about the
powder versus the crack cocaine.
So, crack cocaine is actually like little rocks.
Like lumps of cocaine based.
It's prepared by mixing cocaine
with water and baking soda.
Now then these little rocks can be
heated, and the vapors are inhaled.
So, inhaling it, it's getting that to us again
very quickly and it's going away very quickly.
So, it's a little bit more short-lived.
It's inexpensive, and this is where
we start to see the difference
between who uses powder cocaine
and who uses crack cocaine.
The powder cocaine hydrochloride is much
more expensive than crack rock cocaine.
There have been celebrities who have
made comments about this, and also,
then we see people who are less educated that
have less income end up using crack cocaine.
But just to be clear, they're the same drug.
Powder and crack cocaine are the same drug.
Cocaine base is the active
ingredient in all forms of cocaine.
So, some people that use powder
cocaine think that they are better
than people that use crack cocaine.
You're using the same drug.
Now, cocaine use increased in the late 1960s.
Prior to 1985, the major form of the drug was
that cocaine hydrochloride and it was snorted.
Typically sold in both amounts,
pretty expensive.
It was associated with status, wealth, fame.
Celebrities pretty much any movie that you see
where people have money whether they are
regular movie stars, porn stars, businessmen,
anything like that, you're going
to see people using cocaine.
So, it is.
It has been in the past and
it somewhat still now,
is seen and used by upper class,
typically white individuals.
Now, by the mid-1980s, crack became available.
Pretty inexpensive.
Like five to ten dollars a hit.
So you know you'd get your
check, you go buy crack.
Smoked cocaine was associated
with poor black Americans.
A completely different view of who
is using these different things,
and because people had this
different view of, "Oh, well,
these wealthy famous people
are using this particular drug
but these poor African-Americans are using
this other drug, so therefore the conclusion is
that powder cocaine is fine, and
crack cocaine is horrible and very bad
and those people should go to jail."
The logic is bad here; however,
that's what happens.
Media and politicians started to focus
on crack cocaine use specifically
among urban black Americans.
They really felt like it was
associated with violence and dependency.
I'm not saying it wasn't associated
with those things; however,
this really started to target
poor black Americans.
The Anti-Drug Abuse Act in
1986, penalties for sale
of crack cocaine were significantly
more severe compared to powder cocaine.
There were also tougher penalties
for first time users of crack.
Now, I want to believe that
people had good intentions,
that people didn't really understand it.
People really felt like they were going to save
people from a drug that was very addictive;
however, the US Sentencing Commission really
started to show concerns about this policy.
The penalties and severity of penalties were
disproportionately impacting black Americans,
and there was this exaggerated relative
harmfulness of crack versus powder cocaine.
So fair; no.
However, people still have this feeling
that crack is significantly worse
for you than powder cocaine.
It may be somewhat worst.
It may be more addictive but people have
an exaggerated idea of the difference.
Feel free to spend as much time
looking at this chart as you want.
It gives you a lot of information.
This is federal cocaine offenders [inaudible].
Big differences here.
Again, pause this.
Look at it.
Move on when you're ready.
Now let's talk about cocaine's
mechanism of action.
So, it's complex actually.
So, it's going to block the reuptake of
dopamine, serotonin, and norepinephrine.
Now if that reuptake is confusing
to you please go back to some
of our other lectures or go back to your book.
This should make sense based
on previous lectures.
And, you only need to know it
for this class on a mild level.
GABA and glutamate have also been implicated.
So really, we're talking about a
lot of different neurotransmitters.
That it is affecting reuptake or
transmission or a lot of things going on.
Now, absorption and onset.
Of course, we're going to have differences
based on how the drug is getting into the body.
So, if somebody is chewing
on or sucking coca leaves,
the slow absorption and onset [inaudible].
If somebody is snorting,
this is again, like I said,
absorbed through the nasal mucous membranes,
the absorption is going to be rapid.
The onset of effects are
going to be pretty quick.
Now, some people inject cocaine.
Some people shoot up cocaine.
The effects are going to be very rapid and
briefer, which again makes it more likely
that someone will become addicted to it.
And then, of course, there's smoking.
And again, this is rapid and briefer.
So again, yes.
Probably more likely to become addicted to
this method of getting cocaine into your body.
How does it get out?
It's metabolized by enzymes in the
blood as well as enzymes in the liver.
The half-life of cocaine is about an hour.
Of course, this changes based on how you
got it into your body, but metabolizing it
and getting it out is generally about half-life
of about one hour, which, of course, means,
in one hour, about half of
it is out of your system.
And in the next hour, about half
of that is out of your system.
And in the next hour, about half
of that is out of your system.
The major metabolites have
a high-life of eight hours.
So this is how we say one can be detected
on drug screens which is different
than the half-life that you notice.
So it takes about three days for the metabolites
to be completely eliminated after moderate use.
So, beneficial uses.
Cocaine is not all bad.
We've started off by saying cocaine was
used and helped a lot of things originally.
It's just the addictive piece and some
other things that are not as good.
So, it can be used as a local anesthesia.
Used medically since 1884, early applications
were for eye surgery and dentistry.
Synthesized drugs with few central nervous
system effects have really replaced cocaine;
however, in medical practices now legally,
cocaine still remains in use for surgery
for things like nasal surgeries,
surgeries on the larynx, and the esophagus.
They just find that this is what works best.
Now, acute toxicity.
To give you a heads up, when you're studying
for your exam, do you know the differences
between acute toxicity and chronic
toxicity and know the differences
between behavioral with that
physiological effects.
Just the general ideas there.
So acute toxicity.
There's really no evidence that an occasional
use of small amounts is detrimental to health.
I want to be clear.
I am not advocating for cocaine use;
however, when people use it occasionally
in small amounts, it doesn't seem to
affect the person in any negative way.
Potential toxicity though does
increase with larger doses.
It has a serious central nervous system affect.
It stimulates that central nervous system, and
it increases your heart rate and increases all
of those central nervous system things.
Now, with those larger doses, this can
lead to respiratory or cardiac arrest.
That means you stop breathing
when your heart stops working,
and it can be faster than you think.
There have been many celebrities
that have died of cocaine overdose.
Another issue is that cocaine is
illegal and therefore some people
who sell cocaine are bad people or just
people that are trying to make money
and don't really care if you're
getting what you're wanting.
So often cocaine is adulterated which
means other stuff is in your cocaine
that you are then snorting,
smoking, or shooting into your veins.
The adulterants may be more toxic than the
drug but you don't know, and you won't know.
You will just trust, and you will use,
and you have no friggin clue what's
actually going into your body.
That should make people nervous;
however, it's not going to stop people
from using the drug forever or anything.
So there's that.
So, larger doses, dangerous.
Very small doses don't seem to
make a difference, and, of course,
there's just other junk that ends up in there.
Chronic toxicity.
So, longer term toxicity.
Binge use.
Binge use is this drug -- any drug, the drug is
taken repeatedly and in increasingly high doses.
The risks of binge use are
increasing irritability,
restlessness, paranoia, paranoid psychosis.
A lot of those things are miserable.
People do seem to recover once the drug leaves
the system, so it's not something that is going
to destroy you for life unless it kills you.
But unless it kills you, it's
not going to destroy you for life
like alcohol will kill your
brain and then you can't fix it.
You're just -- that's the way it is.
So, paranoid psychosis would not
be a good time, but it doesn't mean
that you're going to be psychotic forever.
Dependence potential.
So, cocaine addiction occurs in some users.
Animal and human studies have shown that
cocaine is a powerful reinforcing drug.
So the way that they test this, of course, is
they put animal models -- we say animal models.
That means an animal is being
used to model human behavior.
So, if we put the animal in a cage
and give them a lever and say,
"You're allowed to give yourself
cocaine if you feel like it,"
animals will readily self-administer the drug.
So animals will continue
to give themselves cocaine.
They want cocaine, cocaine,
cocaine, cocaine, cocaine, cocaine.
Sometimes they're given a
choice between food or cocaine.
They pick cocaine.
So that's how we see in an animal
model that this drug is addictive.
After binge use, some people
experience withdrawal symptoms.
Withdrawal symptoms are going to
be like just crazy in cocaine.
Again, of course, because you know if
you use it, you're going to feel better.
Irritability, anxiety, depressed mood, increased
appetite, fatigue, and often these things are
because -- I mean, if you're using
cocaine, you're really not hungry.
You're really not sleeping.
You feel pretty freaking good, and all of that.
I don't know if you've ever been around somebody
that's using cocaine, but they love everybody.
It's kind of nice because they'll come up
and be like, "I'm so happy to see you,"
and "We're so excited you're here,"
and you're like, "That's great.
What's wrong with you?"
It's typically easy to notice.
So, these would be our withdrawal symptoms.
Now, going back to media issues.
The media really overreported, overstated this.
There was this big thing about
this crack baby phenomenon.
The media reported these expected long-term
effects of cocaine exposure; however,
recent studies indicate no
consistent association
between cocaine exposure
and developmental problems.
So they actually do not -- these "crack babies"
later in life we actually don't see differences
in hyperactivity or developmental
delays or behavioral problems,
abilities to read, write, and do math.
We don't really see problems with that;
however, the baby is born addicted to cocaine,
and therefore, does sometimes
have to go through withdrawal.
A brand new baby going through
withdrawals is pretty sad.
However, that child, if then raised in a healthy
environment shouldn't show these developmental
problems, shouldn't show problems based
on that being born addicted to cocaine.
Now, if that child remains in the
home or the home remains a problem,
then you're going to have issues
due to that but not due to the fact
that the child was born addicted to cocaine.
Now cocaine use during pregnancy
is not a good idea.
There is increased risk of
miscarriage and an increased risk
of [inaudible] placenta due to cocaine use.
So often, births don't happen.
So there's that.
Now, cocaine was readily available in
all major US cities and small towns also.
The pricing [inaudible] really remained
pretty stable for the past decade.
Most illegal cocaine in the US
comes from Peru, Bolivia, Columbia.
Now, these surveys that we talked
about before, they indicate that less
than 1% of adults currently use cocaine.
That's from the 2012 data,
which is down from a peak of 12.
Twelve percent in the 1980s.
So, if you have parents or know people that
were young adults in the 1980s and they ever say
that things are terrible now, you just let
them know that things were actually terrible
when they were in their teens and 20s.
Down from a peak of 12%.
So only about 1% now.
In general, usage rates of cocaine and
amphetamine tend to go in opposition.
So that is when cocaine is
trendy, amphetamine use is down.
When amphetamine use is trendy, cocaine use goes
down, then it kind of goes back and forth there.
So, let's talk about amphetamines.
I have strong feelings about some of this stuff.
So, the Chinese used a medicinal tea
made from Ma Huang, and that's ephedra.
You may recognize that word.
We will talk about ephedra again, or ephedrine.
That has been in certain
energy drinks in the past.
It's a stimulant, and the active
ingredient in Ma Huang is that ephedrine.
It stimulates the sympathetic branch
of the autonomic nervous system.
It's what we call a sympathomimetic drug.
Sympathomimetic meaning it mimics
the sympathetic nervous system.
Interestingly, it was also used
to treat asthma, so there's a pro.
Some people use this for asthma treatment.
What in the world?
No, no. Sorry.
Resume slide show, yes.
Let's see.
Let's go back here.
I'm not exactly sure what happened.
So, amphetamine is a synthesized
chemical similar to ephedrine.
It's patented in 1932.
Early medical uses were things like asthma,
narcolepsy, hyperactivity in children,
appetite suppressants, and
just generally as a stimulant.
People were given amphetamines like, "Oh, you
just had a baby, and you gained all this weight,
so we're going to just give you an amphetamine
or we're just going to give you cocaine,
and you can take it home, and that'll help."
I mean, amphetamines are still used
for ADHD, still used for narcolepsy.
It's still used for asthma.
The appetite suppressant, yes, technically
it will work while you're using it
but it's not a fantastic weight loss metric.
In war times, people used it to have increased
efficiency and also to reduce fatigue.
In the 1960s, there was something
called the "speed scene."
So this is when a lot of ivy drug users used
amphetamine; that is, they shot up amphetamines,
and they did that either just
the amphetamine or in combination
with heroin, and that's what a speed ball is.
If you've ever heard people use that term, a
speed ball is amphetamines combined with heroin.
Oh, my gosh.
That's a horrible idea, right?
However, some people love it.
So most street amphetamine came
from prescriptions at the time.
So it was a bit safer than it is now.
Now, amphetamines have become
a lot more tightly controlled,
and of course, that leads to more cocaine use.
It also leads to people illegally
manufacturing methamphetamine.
Now methamphetamine, that's a whole mess.
Let's talk.
Illegal manufacturing of
methamphetamine is dangerous.
It's associated with toxic fumes.
It's associated with toxic residues.
Sometimes homes of people
who are making it blow up.
It is unacceptable to have children
in places where this is being made.
That is child abuse.
You will have your children taken away besides
the fact that you are doing something illegal,
you are also doing something
very dangerous to children.
I mean, answer yourself.
But the drug contains impurities
that may be toxic.
Now, this is not a real thing, but I always
think about if you walked around your house
and you picked up a bunch of things that said,
"Don't ingest this," or "This is poison,"
on the bottle, and then you made soup out of
it, that would basically be methamphetamine.
And no, like I said, that's not real.
That's not really how you make it.
I just like to think of it that way.
Methamphetamine abuse rose in the western
and mid-western US through the 1990s.
The increase in the eastern
US cities were kind of modest.
People really liked their cocaine up there,
but in the other parts of the country,
methamphetamine became more popular.
Before we go on, I want to
go to -- here, let's see.
Let's see if we can still see my screen here.
I'm going to go to faces of meth.
So if you can't see my screen,
I am going to facesofmeth.us.
[Inaudible].
I missed an H. So, it's www.facesofmeth.us.
Now I'm going to scroll to
the bottom of this page.
I've been to this page many times, and
I'm going to click on the yellow part.
It does give you a warning.
It can be kind of not great.
So, here's the thing about meth.
It messes you up quickly, and it messes up
the way you look which is really interesting.
So the thing you can do with these
pictures is you can scroll over there
and it shows you what they looked
like and what they looked like later.
So here's our first guy, and here
is, it says three months later.
This lovely woman, two and a half years later.
And do you see that the facial
structures change?
I always find that very interesting.
Two and a half years later,
and a year and a half later.
Meth is a hell of a drug and you're
welcome to look at these things.
Show your friends if they are having any
thoughts of maybe I'd like to use meth.
If you look at the red dots on people, I've
seen clients in my office who are using meth.
Not my current office.
In the past in other states, people that are
using meth and they have these red welts all
over them, and that's because people start
to feel like things are crawly on them
or feel itchy or feel crawly is the right
word, and they start to pick and they pick
and they pick and they pick at that spot,
and they pick and they pick and they pick
and they pick until they have an open
wound and are bleeding, and then they move
on to the next spot and they do it
again and again and again to the point
where they just have these
open wounds on their bodies,
and it doesn't stop them from using meth.
That's how intensely addictive
methamphetamine is.
Now, let's move on.
So, amphetamine pharmacology.
Now we're going back to just
amphetamines in general.
The chemical structure of amphetamine is
similar to catecholamine neurotransmitters.
Causes increased activity of
the monoamine transmitters.
It stimulates their release.
So, things like dopamine,
norepinephrine, serotonin.
The structure of methamphetamine allows it
to easily cross that blood brain barrier.
Ephedrine is less able to cross the
barrier so therefore produces more
of the peripheral effects and fewer
of the central nervous system affects.
Methamphetamine is going to be much more
of those central nervous system effects.
Peak effects.
About an hour and half if
you're ingesting it orally.
About five to 20 minutes if you are snorting it.
In about five to ten minutes, if
you are injecting it or smoking it,
the half-life is going to
vary here from about five
to 12 hours completely eliminated
in a couple of days.
Rapid tolerance can occur after high
doses, and that is if you take it
and almost immediately your tolerant to
it, so you want to get that same effect
because you feel like crap because you're
coming down from it, you have to up your dose
and up your dose and up your dose.
So, you're upping your dose very rapidly
which you can imagine is extremely
dangerous, but that's what happens.
Now, beneficial uses, right?
Depression.
It was the treatment choice, not meth,
just amphetamines in general was the
treatment choice during the 1950s and 60s.
Sometimes it's now used as
an adjunctive therapy.
That means an in addition to therapy.
So that is maybe somebody takes a different
antidepressant and they're in therapy
like psychological talking therapy and
then they use some sort of amphetamine.
Now, people are not typically
going to use this all the time.
The advantage would be that the
antidepressant takes two weeks to start working,
and an amphetamine is going to work right now.
So it may be, if somebody is in such a
horrible place, that they can take this.
Having said that, there are a lot of other
drugs that are being studied currently
that we will talk about; ketamine for
example, that also have rapid effects
and are not addictive like an
amphetamine is going to be.
Weight control in the 1960s, it was
widely used to reduce food intake
and body weight for short periods of time.
There is a methamphetamine that is
currently FDA approved for this.
It's really specific, and it's only used in very
specific situations and only by some doctors.
Long-term effects on obesity though are unclear,
so we don't really see this type of a medication
or drug is going to work long-term because once
you stop using it, it's not helping anymore.
That's why learning behavioral
techniques for weight control seem
to be the best way to go for long term.
Narcolepsy.
Narcolepsy is when people just fall
asleep all of a sudden during the day.
It's uncontrolled daytime episodes of
muscular weakness and falling asleep.
So stimulants are used to keep
people awake during the day,
to keep them functioning, to
keep them able to do things.
People with narcolepsy typically can't drive
anyway or that is they're not allowed to,
but it may help you make sure that you can stay
awake while cooking or stay awake while working.
This quote smart pills here.
This is our ADHD medication
that they're talking about.
Low levels of arousal, it improves performance.
With people that are at high levels of
arousal, it may decrease performance.
It actually, now that I see what they've
written under here, it's interesting.
With people that don't have ADHD if they take
these pills, if they're sort of going slowly,
it may improve performance, but
if they're already overly anxious,
taking a pill like this is
going to decrease performance.
And the reason I say this
interesting is that people with ADHD,
it appears that their brains
work a little different,
and it appears that their brains
are actually going, going,
and going and these amphetamines actually
help them to focus, as to where somebody
without ADHD taking the same
dose may do something different.
There's more information about that in
your book if you want to look at it.
So, athletics.
Under some circumstances, it may
produce a slight improvement.
A slight improvement in academic performance.
Now when you're competing at a
hugely high level where one second
or half of a second makes a difference, then
you're going to want to use something like this.
But if you're just talking about
general athletics, the improvements are
so slight you probably wouldn't notice them.
So here's a difference between a
simple task and a complex task.
And that is, so methamphetamines here a
reaction time for a simple task, it may help
but for a complex task, you actually see people
do more poorly when using the methamphetamine
because it just gets too confusing
and they jump to a conclusion
when that's not the one that it actually is.
So simple tasks.
You know, performance is a little bit
better; however, a complex task not as good.
Here's our ADHD.
So treatment of ADHD is characterized
by problems
with inattention, hyperactivity, impulsivity.
Some people have just inattention.
Some people have just hyperactivity
and impulsivity,
and some people have a combination of both.
So stimulant medications can interestingly
reverse that catecholamine associated deficits
that we believe to underlie what's causing ADHD.
It seems to work.
There are a lot of other non-stimulant
medications now that are used;
however, the stimulant medications work.
The reason that people go to non-stimulant
medications is because they are worried
about people selling them, they are worried
about people being addicted to them.
In younger children if children take them
continuously, you see some stunted growth
which is why they recommend what
they call low-drug holidays,
which in this case means not taking it.
That means that on the weekends
don't take the medication.
Over the summer, don't take the medication,
which is really difficult for parents sometimes
with children with severe
ADHD, and in those cases,
these other non-stimulant
medications are fantastic.
So there's that.
There are concerns about abuse and
side effects which, like I said,
lead to other treatment options; however, this
is really interesting, but the data suggests
that stimulants is actually protective
against other substance abuse.
So, when people are taking these things, they're
actually less likely to abuse other drugs.
So, take from that what you will.
Amphetamines, acute toxicity.
Acute behavioral toxicity would be increased
feelings of power, suspicion, paranoia.
In animals, very high doses destroy
catecholamine neurotransmitters; however,
let me say this, and this
goes with all animal studies.
In all animal studies, the dosing regiments
that they use don't mimic those used by humans.
So, for example, when they give animals
doses of sugar substitutes and then say
that this sugar substitute will cause cancer,
they give them so much that I had a teacher once
that said, you would drown before drinking
that much diet soda, which is, I don't know.
I find that entertaining.
They give them so much so the high
doses that they give these animals,
they end up destroying the
catecholamine neurotransmitters that may
or may not demonstrate that that's actually
something that would happen in humans
because the doses are really,
really high that they give them.
Now we have chronic long-term toxicity.
Current psychosis following binge use.
Now, it could be due to different things.
It's possible that people who
already have schizoid personalities
or psychotic features are more likely to
use methamphetamine and therefore it looks
like methamphetamine is causing it but maybe
it's something that's already kind of there
and then methamphetamine triggers it
or makes it worst or it just happens
to be those people who are using it.
But it may not be.
It may be that the methamphetamine
is causing it.
We don't know it.
That's not something that
will be easily studied,
or it can be primarily due to sleep deprivation.
So that is just simply you've been up for way
too long because you're using the amphetamines
and you haven't slept and you're psychotic.
There's no evidence for permanent behavioral or
personality disruption for some of these things.
Even methamphetamine as far as
behavioral or personality disruption.
With methamphetamines, like I said, we
do often see changes in facial structure,
but people can recover from this
behaviorally, personality wise.
Going back though, I've done a lot of
evaluations for people applying for disability,
and I've definitely seen a few people that have
come in, and the reason they can't get a job is
because they look like someone who uses meth.
Even if it's been 10 years since they've
used methamphetamines, they look that way.
Maybe their teeth are gone or look bad or their
facial structure has changed in ways that they,
like I said, looks like someone who
uses meth and people won't hire them,
so they're applying for disability.
So, again, things to think about.
Concerns for dependence potential.
It can produce psychological dependence in
the individuals defined by that DSM criteria.
It's a potent reinforcer
in animals and in humans.
Abuse is really quite likely
to be dose dependent.
So that is low to moderate doses for
medical use; rarely lead to dependence.
Higher recreational use doses
are likely to lead to dependence.
Occasional use, probably not dependence.
That binge use, regular use does lead to
dependence, and now we've gotten to our end.
Okay. So, that's generally the
information you need on stimulants.
For your exam, when you are studying,
the majority of the information
that I ask questions on is in the lectures.
Remember, there are only 50
questions, and they're multiple choice.
And I only say 50 questions because this is
six chapters, so it's really difficult for me
to only pick less than 10 questions from each
chapter, and that means that you're going
to study a lot of things, and I want
you to, and I want you to know a lot
of things, and I want you to learn a lot.
And then you're going to get to the test, and
I'm only going to ask you questions about some
of those things that you studied.
But you study all of it because you don't
know which things I'm going to ask about.
Some people say do I give a study guide?
The PowerPoints are generally the study guide.
But again, I just want to warn you, if you
take the test and you feel disappointed
because there's lot of things that you
knew that I didn't ask about, I'm sorry.
But there will hopefully be a lot of
things that I do ask about that you do know
about because you prepared so
well on all of the information.
I hope everybody does great.
I do recommend that you study.
You do need to study.
I don't want to say this
test is easy and don't study.
It's not. However, I do hope that the
questions that I picked are absolutely things
that I've covered and there
shouldn't be surprises.
As long as you've studied,
there shouldn't be surprises.
We'll put it that way.
Okay. Good luck, and I will
be grading your assignments,
and I will be back for chapter seven.
