Drugs of Abuse

Assessment of drug abuse is of medical interest for many reasons:

1. In drug overdose, It is essential to identify the responsible agent to ensure appropriate

treatment.
2. In non-overdose situations, identification of drug abuse provides a rationale for treatment for
addiction.

For these reasons, drugs of abuse is commonly done.

Typically screening of single urine specimen for many substances by qualitative screening procedure.

However, this procedure only detects drugs of recent use, therefore abstinence for a short duration,
abusing patients. And also it does not differentiate single casual use and chronic abuse.

Drugs of Abuse:

a. Ampethamine and metampethamine

Function: used to treat narcolepsy and disorders that affect ability to focus; stimulants, provide
sense of mental and physical well being.
Metabolism: metabolized by the liver enzyme CYP2D6, so CYP2D6 inhibitors will prolong the
elimination half-life of methamphetamine. ... The pH of gastrointestinal content and urine
affects the absorption and excretion of methamphetamine.
Analysis: Immunoassays and gas or liquid Chromatography
People can take methamphetamine by:
 smoking
 swallowing (pill)
 snorting
 injecting the powder that has been dissolved in water/alcohol

Other common names for methamphetamine include blue, crystal, ice, meth, SHABU, and speed

b. 3,4-methylenedioxy-methamphetamine (MDMA)
Function: hallucinations, empathic and emotional response, euphoria, and increased visual and
tactile sensitivity.
Metabolism: Cytochrome P450 family enzymes play a central role in
the metabolismof MDMA,
Analysis: Routine drug screening by immunoassay, Gas chromatography–mass spectrometry

 People can take 3,4-methylenedioxy-methamphetamine (MDMA) by:

 Ecstasy is most often available in tablet form and is usually ingested orally.
although some users have reported taking it anally (known as "plugging" or "shafting").
  Users have also been known to "parachute" the tablet, by placing the pill in a napkin,
crushing it, and then swallowing the piece of napkin in an attempt to speed up the drug's
onset
 MDMA is also available in powder form, often contained in geltabs, and is sometimes
snorted and occasionally smoked, but rarely injected
c. Anabolic steroids:
Function: Used to increase muscle mass and athletic performance
Analysis: Gas or liquild chromatography
Metabolism: The general metabolism of AAS, which is separated into phase I and phase II
metabolism and includes a systematic discussion of metabolic changes in the steroid molecule
according to the regions (A-D rings), and the specific metabolism of AAS, which presents the
metabolism of 26 AAS in humans.

People can take anabolic steroids by:

 cycling—taking multiple doses for a period of time, stopping for a time, and then restarting
 stacking—combining two or more different steroids and mixing oral and/or injectable types
 pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak
amount, and then gradually tapering off to zero
 plateauing—alternating, overlapping, or substituting with another steroid to avoid
developing a tolerance
d. Cannabinoids:
Function: Hallucinogenic, provides a feeling of mental well- being and euphoria, impair mental
function and short-term memory
Marijuana: Tetrahydroocannabinol (THC) primary cannabinoid component: THC half-life in
blood is one day following single use and 3-5 days following chronic use
Metabolism: THC distributes distributes in lipophilic tissue such as the brain and adipose tissue.
Elimination is dependent on THC being metabolized by liver to 11-nor- Δ- tetrahydrocannabinol-
9-carboxylic acid (THC OOC) with this metabolic product filtered by the kidney.
Analysis: Immunoassay and gas chromatography/mass spectrometry

e. Cocaine:
Function: used as a local anaesthetic and at higher levels functions as a CNS stimulant.
Metabolism: Half life 0.5-1hour with elimination dependent on liver metabolism;
benzoyleegonine (half life 4-7 hours) primary metabolite and filtered by the kidney
Benzoyleegonine is detectable in urine for 3 days following single use and as long as 20 days
following chronic use
Analysis: immunoassays and gas chromatography/ mass spectrometry
f. Opiates
1. Types of Opiates:
a. Naturally occurring: Opium, morphine, codeine
b. Chemically modified: Heroine, dilaudid, oxycodone
c. Synthetic: Demerol, methadone, darvon, talwin, fentanyl
2. Function: Narcotics used for their analgesic, sedative, and anaesthetic properties
3. Metabolism: Respiratory center depressant cause respiratory acidosis
4. Analysis: Immunoassays and gas chromatography/ mass spectrometry
g. Phencyclidine (PCP)
Function: produces stimulant, depressant, anaesthetic, and hallucigonenic effects
Metabolism: Distribute in lipophilic tissue such as brain and adipose tissue; elimination
dependent on it being metabolized by the liver, with 10-15% of the parent compound filtered by
the kidney; detectable in urine for as long as 7-30 days following chronic use
Analysis: Immunoassays and gas chromatography/ mass spectrometry
h. Tranquilizers:
Types of tranquilizers
a. Barbiturates: Phenobarbital (long acting), amobarbital (intermediate acting), and
secobarbital and pentoarbitaa (short acting)
b. Benzodiazepines: Diazepam (valium), chroldiazepoxide (Librium), lorazepam (ativan)
Function: Sedative hypnosis that produce depression of the CNS
Metabolism: Respiratory center depressants causing respiratory acidosis
Analysis: Immunoassays and gas-liquild chromatography