Cocaine and Incas

Drug use dates back to prehistoric times. The Incas, who lived on the territory of modern Peru and Bolivia, apparently adopted the custom of chewing coca leaves from Aymara Indians, who used coca from at least the 3rd century BC. Coca was the sacred drug of the Incas. “Mama Kok” was for them a godlike entity. One of the myths says that coca was a beautiful woman who was punished for adultery. From carrying the divine coca plant occurred, chewing its leaves could only know, and this was done in memory of a beautiful woman. Indeed, before the invasion of the Spaniards, the coca was consumed only by the highest strata of society. She was an important part of weddings, funerals, initiations, and other major rites. Spanish missionaries looked askance at Coke, because it seemed to them an idol, which prevented the conversion of the natives to the Christian faith. But coca played such an important role in Native American society that, over time, the Spaniards took its collection and distribution under their control, making the drug a means of controlling the indigenous population.
“Cocaine causes … excitement and prolonged euphoria”
Freud about cocaine.

Coca leaves

High in the Andes Mountains of Peru and Bolivia, a low shrub grows, which is called a tree or coca bush (Eryhoxylum coca). From the leaves of this plant is a potent stimulant – cocaine. The history of this drug is rooted in antiquity. Locals – the Incas and their historical successors – have been chewing coca leaves for centuries. It is not known exactly when cocaine use began. Archeology data allows us to give an approximate figure of several thousand years ago. Coca leaves played an important role in the religious rites of the Incas, and also used for medicinal purposes and just in the process. When the Spanish conquistadors encountered the Inca civilization in the 16th century, they initially fought against the use of coca for religious purposes, for this went against the Catholic faith. But having finished the conquest of the Inca Empire, the Spaniards allowed the use of coca and even encouraged it: because they saw that by chewing its leaves, the Indians could work better and longer. In the end, the Spaniards established control over the use of coca by starting to use its leaves as a means of payment: the Indians paid them some taxes. The Spaniards considered chewing coca a sin and therefore did not use it themselves and did not distribute it among other Europeans.

Thus, until the XIX century, Europe almost did not know about the existence of the coca tree. But when European naturalists reached Peru, they became acquainted with this plant, and soon strange and often contradictory stories spread about it. In some, like the German naturalist Edwin Poppig, coca leaves were called deadly: “Chewing coca has the most disastrous consequences, causing the same poisoning as opium. With each time, desire increases, and the strength to resist decreases, and so on, until death will save the unfortunate from suffering. ” Other authors, like the Italian biologist Mantegazza, who himself, while in Peru, chewed on a coca, treated this plant more positively: “I laughed at mere mortals doomed to live in this valley, while I was swept away on the wings of two leaves Coca and flew through 77.438 worlds, each of which was more delightful than the previous one. ”

Neither quotation is a sufficiently correct description of the effect of coca leaves on humans. Nevertheless, Mantegazza’s point of view was much more attractive: in almost all historical studies, the growth of scientific interest in coca is associated with this Italian. The result of scientific interest was the appearance of coca leaves in laboratories, and in the 50s of the XIX century, European chemists were able to isolate a potent substance called cocaine from the leaves. This opened up a new era in the history of stimulant drug use. The fact is that cocaine in its pure form is very effective, while the coca leaf itself contains a very small amount of this drug. In addition, it produces a different and stronger effect if administered intravenously or sniff, which is possible only if there is an extract. Obviously, intravenous injection of cocaine produces the most powerful effect, because a large amount of the substance reaches the brain very quickly.

The mechanism of action of opiates

One of the most outstanding achievements in neurology was the discovery in the 70s of the neural mechanism of action of opiates. Research on this topic led to the discovery of a class of chemicals secreted by the brain, called endorphins, which obviously function as neurotransmitters. According to modern concepts, the action of morphine, heroin and other opiates is caused by stimulation of the action of the endorphin system in the brain. After reviewing the events that led to these discoveries, you can see how they help to understand the actions of the opiates.

One of the first events was the discovery by chemists in the 60s. the fact that the slightest change in the morphine molecule causes the creation of a chemical that not only does not produce any of the typical effects of opiates (relief of pain, euphoria), but, on the contrary, blocks the action of morphine and other opiates. This substance is called naloxone (Narcane) and can be qualified as an opiate antagonist. When naloxone was given to a patient suffering from a heroin or morphine overdose, he completely reversed the effects of these drugs. If naloxone is given to a heroin recipient, then heroin will have no effect. Obviously, naloxone has practical application in the treatment of opiate overdose and also has theoretical value. Since the chemical structure of naloxone is similar to morphine, the researchers suggested that these two drugs may act on some common brain receptor, and the effect of morphine on this receptor is blocked by naloxone. In the early 70s. two researchers from Johns Hopkins University in Baltimore, Candace Perth and Solomon Snyder reported on the discovery of brain receptors that selectively respond to the effects of opiates and called them “opiate receptors.” The existence of such receptors has caused great interest. It may be reasonable to ask why there are neurons in the brain responsible for the effects of such drugs. Did nature itself push people to become addicted to heroin? The presentation of neurologists on this subject varied greatly. They believed that the presence of such receptors should mean that there are natural substances in the brain with a structure and properties resembling morphine. The scientific search began for “natural brain opiates” and in 1975 several such substances were discovered. Although several morphine-like substances were found in the brain (beta-endorphin, enkephalin, dinorphin – the most important among them), the whole complex of these peptides is collectively called endorphin (short name for endogenous morphine).

The scientific questions caused by the discovery of endorphins focused on why the brain is provided with its own morphine, what function they perform. Most researchers began with the premise that because opiates mimic the activity of endorphin by stimulating the opiate or endorphin receptors in the brain, endorphins should have many properties similar to opiates, such as the ability to relieve pain or pleasure. Perhaps the main function of endorphins is to serve as part of the natural pain relief system. According to modern concepts, certain types of pain or stress cause the release of endorphins, and an analgesic effect occurs. Such an approach may help explain why under certain circumstances, for example, on the battlefield or in a big sport, a person can withstand severe injuries without feeling pain for at least some time. Pain relief from acupuncture (through needle insertion) may also be caused by the release of endorphin, since the use of naloxone negates the anesthetic effect of acupuncture. Since the main action of naloxone is blocking endorphin receptors, the anesthesia, negated by naloxone, is strong evidence that acupuncture needles cause the release of endorphins and thereby reduce pain.

It seems that strength training causes the release of endorphins, and perhaps some of the positive effects of these exercises on your mood are also caused by the action of endorphins. Indeed, some researchers believe that “dependence” on exercise, which develops in some people, is due to the same mechanisms in the brain, due to which there is also a dependence on heroin! Does this mean that we will ever become addicted to the chemical substances of our own brain?

The use of opiates in medicine

Mainly in medicine, opiates are used because of their analgesic effect. As noted above, opiates have been used for this purpose for centuries, and to this day they remain the most powerful and selectively effective anesthetics known to medicine. Unlike anesthetic drugs such as depressants, analgesics-opiates anesthetize without impairment of consciousness. After taking a moderate dose of opiates, patients remain conscious and are still able to talk about pain, but no longer suffer from pain.

Another class of substances that has a similar analgesic effect are such common painkillers: aspirin, acetaminophen and ibuprofen. Table 9-1 shows the main opiates used as painkillers along with their effectiveness and duration of activity. As noted, the effectiveness of the drug is the dose required for the desired effect. In Table 9-1, the strength of a drug is expressed in terms of the amount of effective doses of morphine. For example, the effectiveness of heroin is indicated by the number 4. This means that if 8 mg of morphine is required for pain relief, then heroin will need only 2 mg. In other words, heroin is 4 times stronger than morphine. Morphine is a prototype of opiate analgesics and is used as a unit for measuring the effectiveness of other drugs. It is used mainly for very severe pain. Although heroin is much stronger than morphine, it is not used for medical purposes in the United States, because is included in the N1 Drug Group (see Appendix N1) Table 9-1 Characteristics of the main opiates Common name Trademark Effectiveness Duration (in hours) Morphine 1 4-5 Heroin 4 3-4 Hydromorphone Dilaudid 5 4-5 Codeine 0.1 4-6 Oxycodone Percodan 0-75 4-5 Methadone Dolophine 1 24-48 Mepredin Demerol 0-1 2-4 Propoxyphene Darvon 0-5 6 Fentanyl Sublimaze 80 1-3 Pentazocin Talwin 0-2 2-3

When the pain is not so strong, you can use drugs that are less effective than morphine. These are codeine, propoxifen (Darvon), oxycadone (Percodan) and pentazocine (Talwin), which are often prescribed for pain relief. In conclusion, we note that there are opiates that are more effective than heroin: for example, fentanyl, which is more effective than morphine 80 times. Fentanyl is mainly used for anesthesia. In general, opiates are the most powerful and effective pain medication known to medicine. Restrictions in their use as analgesics, occurs mainly due to their ability to induce tolerance and dependence. Tolerance and dependence are caused by the use of all these drugs, although it seems that some, for example, pentazocine (Talwin) cause these effects to a lesser extent. It is hoped that safer analgesics will be invented after endorphins have been better studied and their ability to cause natural pain relief.

Opioids are used in medicine and for other purposes. For example, opiates cause constipation, which can be a problem for drug addicts. Therefore, it is advisable to use them in the treatment of diarrhea. Opioids are still used to treat cough. Basically, dextromethorphan is used for this purpose, which is a synthetic opiate that does not have an analgesic effect and does not cause dependence, but is very effective in suppressing cough. The last medical use of opiates, such as methadone, is to use them to treat heroin addiction.

Psychological and physiological exacerbations

In addition to the analgesic effect of opiates, there are several other actions that they have on the body. The effects of opiates are euphoria, including drowsiness, warmth in the body, heaviness in the limbs. William Burroughs described these feelings in his autobiographical novel “The Addict”: “Morphine first hits the back of the legs, then the back of the neck, the rolling wave of relaxation separates the muscles from the bones so that it feels like you are spreading out, lying in warm saline water “. The pleasure of using opiates seems to harm the other interests of the addict. Burroughs describes it in this way: “A drug addict abruptly gives up sex. The path to non-sexual sociability begins at the same place where sex begins. When I get into the habit of thrashing with G (eeroin) or M (orfin), I become uncommunicative. If someone wants to talk Okay. But there’s no wish to meet someone. ” There is evidence that the use of opiates reduces sexuality, and men are often threatened with impotence. Laboratory studies also show that opiates are detrimental to human social relations.

In terms of physiological effects, opiates are somewhat similar to antidepressants, but there are a few differences. Like depressants, opiates cause breath-holding and lower body temperature, but the effects of opiates on the heart are more complex. Nausea and vomiting often follow immediately after taking antidepressants. Perhaps the most visible sign of opiate use is a narrowing of the pupil. This is such a typical symptom that it is used in the diagnosis of opiate poisoning. In case of death from overdose, respiratory failure is the immediate cause of death. However, the lethal dose of heroin is surprisingly large.

Most victims of overdose, as it turned out at the autopsy, injected the drug less than is necessary for death. Many of these cases included not just an excess of a dose of heroin, but a combination of its use with alcohol or depressants. Opioids and depressants reinforce each other’s actions. Most of the deadly “heroin” overdoses involve this kind of interaction, for example, this was the case with Janis Joplin’s death in 1970:A liter bottle of Southern Comfort whiskey, which she held over her head, was both a symbol of the severity of her life and a way of liberation. When she dried the bottle, she became happier and more radiant, more bizarre … Last week, on a day that seemed less lonely than everyone else, Janice Joplin died on the lowest and sadest note. Returning to her room at the Hollywood motel after working late in the recording studio, having a good drink with friends in a nearby bar, she filled a syringe with heroin and inserted a needle into her left hand. An injection killed her.

Consequences of chronic opiate use

Consequences of chronic opiate use

If opiates are consumed continuously, their effects are somewhat different. As noted, opiates cause tolerance, so if you do not increase the dose, their effect decreases, which often happens. Chart 9-1 data show examples of the effects of opiates on humans and monkeys in the laboratory with continued drug use. Both graphs show daily drug use during the course of the experiment. Data relating to people was obtained through an experiment in which volunteers with extensive experience using drugs were tested in the laboratory and could regulate their own doses. Note the increase in the dose of the drug chosen by the subject each time. In the first month, the subject did not need more than 500 mg per day. By the fourth month, he was taking more than 1000 mg per day. Also pay attention to the bottom of the chart, which demonstrates similar behavior in monkeys that could receive heroin intravenously by pressing a lever. It can be seen that heroin addiction is a universal phenomenon.

Opiate use patterns may change over time. While initially re-use is motivated by the desire to re-experience the pleasant sensations, “tightly seated” drug addicts argue that the drug does not even bring them much satisfaction as before. However, they continue to use the drug in order to avoid unpleasant withdrawal symptoms (“withdrawal”). Thus, heroin use is motivated first by positive and then negative reinforcement. Symptoms of heroin addiction make themselves felt after one to two weeks of using heroin, morphine or synthetic opioid. These symptoms become more severe with prolonged use of large doses. The first symptoms appear 8–12 hours after taking the last dose and include runny nose, tears, sweating, irritability and tremors. Over time, these symptoms become more severe, others appear – pupil dilation, anorexia, and tumors appear. These symptoms continue to intensify and peak between 48–72 hours. At this time, the heartbeat quickens and blood pressure rises, and severe symptoms appear: nausea, diarrhea, sneezing, excessive sweating and bone pain. In addition, the addict can begin spasmodic movements of the arms and legs. Other strange symptoms that are associated with the addict’s sexuality are involuntary erection and ejaculation in men and orgasm in women. The loss of fluid and the reluctance of the addict to eat can physically and emotionally drain the addict and are often fatal.

It is quite simple to rid the addict of withdrawal symptoms and regain his well-being with a suitable dose of any kind of opioid. Inpatient detoxification is the treatment of withdrawal syndromes with low doses of synthetic opiates, for example, methadone. The dose of methadone is sufficient to reduce the severity of withdrawal symptoms, but it is not capable of anything more. Gradually, within a few weeks, the methadone dose is reduced, until the addict is completely cured of his physiological dependence. If heroin continued to be taken solely to relieve withdrawal symptoms, detoxification would be sufficient for treatment. However, after detoxification procedures, the established rate of re-use of the drug is 90% within two years after discharge from the hospital. Most of these relapses occur within the first 6 months. Thus, if the addict returns to the environment where he or she became addicted, it is highly likely that a relapse will occur, despite the absence of physical withdrawal symptoms.

The fact that addiction to heroin (and other drugs) depends not only on physical abstinence is illustrated by a heroin epidemic that has been prevented. In the early 1970s, when the Vietnam War came to an end, the number of drug addicts among American soldiers exceeded 21%. These soldiers were required to undergo detoxification before returning to the United States, but since the relapse rate is 90%, it was expected that most of them would continue to use heroin on their return. Thus, in the USA they expected a surge of a heroin epidemic. However, subsequent studies have shown that very few relapses occurred (less than 15%). This clearly showed that addiction and psychosocial factors associated with Vietnam largely contributed to the development of addiction. Returning to the United States, veterans of the Vietnam War found that heroin became less available. This circumstance, as well as a change in lifestyle and social environment, eased the pressure that initially led them to addiction. However, radical changes in the environment (from Vietnam to the USA) cannot be repeated in the usual treatment. This is one of the reasons for the difficulty of treating heroin addiction, despite the presence of various treatments. Graphsto 9-1 Similar examples of the use of opiates by humans and monkeys in the conditions of constant availability of the drug. Both graphs show the amount of drugs taken for a specific time. Data concerning a person is obtained on the basis of an experiment in which a volunteer with drug use experience consumed them without restriction. Data relating to animals are taken from an experiment in which monkeys who wish to receive a dose of heroin pressed a lever to receive an intravenous injection of heroin.

Marijuana

Marijuana

Cannabis sativa (Cannabis sativa), better known as marijuana, is a cannabis plant growing almost all over the world. Cannabis plants are best known today as strong psychoactive substances, but for many years they have been harvested because of their fiber. Durable hemp fiber was used in the manufacture of ropes, clothing and ship gear. Also, for several centuries in many countries of the world, they were used for the purpose of misting the mind, while in the first third of our century in the United States they did not discover their psychoactive abilities. After that, the hemp plant began to collect more often due to its psychoactive effects.

The term “marijuana” comes from the Portuguese word mariguango, which translates as “intoxicating.” Both marijuana and hashish are derived from cannabis sativa. Marijuana is the upper part of the plant with leaves. Hashish is made from resin dust that is released by a hemp plant to protect it from the sun, heat, and to maintain fluid levels. Plants growing in warm climates emit more resin, which is a strong psychoactive agent.

This chapter begins with a historical overview of the origin and use of plants. It is followed by a section on the epidemiology of the use of marijuana. Then there is information about absorption, distribution, metabolism and excretion; mechanisms of action; tolerance and dependence. Next comes the consideration of the medical and therapeutic use of marijuana. The last section of the chapter is devoted to the psychological, physiological and social effects of marijuana.

Reports of marijuana commissions

Reports of marijuana commissions

The Laguardia Commission report was compiled by the New York Academy of Medicine at the request of the mayor of New York, Fiorelle Laguardia. This study, the second in the framework of the Commission on Indian Hemp Drugs only, was essentially an interdisciplinary study. It included the coordinated conclusions of doctors, physiologists, pharmacologists and sociologists. The main statement of the report was that the use of marijuana is not particularly dangerous for the user and for society as a whole. The report provided no evidence that aggression, violence, hostility had anything to do with marijuana smoking. It was not claimed, however, that marijuana does not cause any psychoactive effects. Certain changes in a person were noted, including in more powerful forms “slowing down of thought processes and admiration for delusional reality with periods of laughter and anxiety”.

The findings of this report coincided with the findings of previously published reports. Also, subsequent studies mirrored the main conclusions. These studies include the 1968 report of Baroness Bouton from Great Britain, the Intermediate Report of 1970 to the Delayan Canadian Government Commission and the First Report of the National Commission on Mental Health and Drug Abuse of 1972. Later reports, such as the US Congressional Marijuana and Health Report (1982) and the Study on Drug Abuse (1984, the first in a series of three-year Congress reports), were both presented by the National Institute on Drug Abuse, did not have controversial discoveries, however much more carefully described the negative effects of marijuana use.

Epidemiology Marijuana

Epidemiology Marijuana

Marijuana remains the most commonly used drug in the United States. The growth in the use of marijuana in the 1960s, 1970s was followed by a steady decline in the early 1990s. Nevertheless, there was a surge in the use of marijuana among high school students in 1993.

The data collected by the National Institute for the Study of Drug Abuse in 1991 show that almost 68 million Americans (33% of the population) have tried marijuana at least once in their lifetime. The percentage of those who have ever tried marijuana is as follows: 13% of adolescents (from 12 to 17 years old), 51% of young people (from 18 to 25 years old) and 33% of adults (from 26 years old and above).
These and other data are shown in chart 10-1. The most noticeable changes occur with adolescents. Between 1979 and 1991, the distribution of marijuana among adolescents dropped from 68% to 51%, the number of users once a year fell from 47% to 25% and constantly consuming (once a month) from 35% to 13%. The number of people who have ever used among adults has been steadily increasing, probably as a result of the growing up of people who used marijuana in the previous period.

Several findings from the studies of the 1990s are worth mentioning. First, men are more likely to use marijuana than women. The only exceptions were teenagers from 12 to 17 years old, where men and women use marijuana about equally. The second thing that matters is the frequency of use. The percentage of people using marijuana 100 times or more (among those who have used it at least once in their life) is: 14% for 12-17-year-olds, 21% for 18-25-year-olds, 27% for 26-34-year-olds and 20% for 34-year-olds and older. As a result, data comparing the percentage of regular smokers of marijuana and those who use drugs periodically, reflect the fact that non-regular smokers of marijuana use other drugs more often than regular ones. As an example: 28% of young marijuana smokers account for a certain number of people who use other drugs. In particular, 11% use cocaine.

Chart 10-2 shows that marijuana use in the United States increased significantly in 1993. For example, the number of older students who use marijuana every day increased from 1.9% to 2.4%. This shows that attitudes and stereotypes about drugs among older schoolchildren are “softened,” schoolchildren are no longer confident in the negative consequences of drug use and in their personal failures, which drug use entails.

Marijuana as a way to use other drugs

Marijuana as a way to use other drugs

The theory of the path or “walking stone” – the theory of drug use, based on the fact that the use of legal and illegal drugs leads to predictable consequences. This theory attracted particular attention in the 1960s, 1970s during the debate on the legalization of marijuana. Opponents of legalization, including the Federal Bureau of Drugs, argued that using marijuana is the first step towards addiction to heroin. However, studies have shown that the vast majority of smokers of marijuana do not become heroin users.

However, the use of one substance sometimes leads to the next. One of the first studies on this topic showed that alcohol use among high school students was a necessary transitional step between drug use and cannabis use. This study has been confirmed by others from the New York State Research Institute. They found that high school students usually use drugs in this order: alcohol, marijuana, and then “hard drugs” (such as cocaine, crack, other hallucinogens, and heroin). Recent studies have found that crackers almost always used marijuana before.

Two things to remember. The first, and perhaps most important, that not everyone who drinks alcohol will subsequently smoke marijuana, and whoever smokes marijuana will not necessarily use other drugs. Secondly, the one who starts smoking marijuana after drinking alcohol, usually does not stop drinking alcoholic beverages, and both substances can be included in his “repertoire”.

Ways to use

For psychoactive substances, marijuana and hashish are accepted in many ways. For example, they found out that several centuries ago these substances were taken in the form of liquids or in the form of food. In addition, the psychoactive effects of marijuana can be experienced by chewing on marijuana leaves. However, smoking remains the main mode of cannabis use, usually in the form of a cigarette or a joint. Inhalation of marijuana cigarette smoke is the most effective way to absorb marijuana.

Active ingredients

The first chemical analysis of cannabis was probably undertaken in 1821. Since then, it has been found that cannabis is a complex plant. It consists of more than 400 chemical elements. About 60 of them, called cannabinoids, are unique elements of cannabis. During ongoing research, new substances and compounds are likely to be found in cannabis.

Despite years of research, it was not until 1964 that the main psychoactive element of cannabis was isolated. This substance is called delta-9-tetraksidkannabinol, but most is known as D-9-THC or simply THC. The study found that TNScannabinoid explains the vast majority of known psychoactive effects of marijuana. THC is the main psychoactive element of cannabis, but other cannabinoids, such as cannabidiol and cannabinol, can be biologically active and can produce the effects of THC. Anyway, they are not psychoactive in themselves.