FORENSIC CHEMISTRY & TOXICOLOGY

DANGEROUS DRUGS
DEFINITION OF TERMS
Drugs – natural or synthetic substance that is used to produce physiological or psychological effects
in humans or other higher order animals within a short period of time after ingestion of a specified
dose.

Dangerous Drugs – has a low therapeutic margin of safety (e.g. the amount of medication to help
and the dose that causes death is not large) typically have more serious side effects and greater
risks.

Prohibited Drugs – are not to be sold or used by anybody without special permission; also called
illegal or illicit drugs

Regulated Drug – one of the many types of medication that is used to treat or cure a disease or illness
that is regulated by and has met the standards set by the Food and Drug Administration (FDA).

Drug Dependence (WHO) – a cluster of physiological, behavioral and cognitive phenomena of

variable intensity, in which the use of psychoactive drug takes on a high priority thereby involving,
among others, a strong desire or a sense of compulsion to take the substance and the difficulties in
controlling substance-taking behavior in terms of its onset, termination, or levels of use.

Drug Abuse – the use of illegal drugs, or the misuse of prescription or over-the-counter drugs for at
least a year with negative consequences.

Drug Syndicate – any organized group of two or more persons forming or joining together with the
intention of committing any offense.

Illegal Trafficking – illegal cultivation, culture, delivery, administration, dispensation, manufacture,

sale, trading, transportation, distribution, importation, exportation and possession of any dangerous
drug and/or controlled precursor and essential chemical.

Instrument – anything that is used in or intended to be used in any manner in the commission of illegal
drug trafficking or related offenses.

Laboratory Equipment – the paraphernalia, apparatus, materials or appliances when used, intended
for use or designed for use in the manufacture of any dangerous drug and/or controlled precursor
and essential chemical.

Pharmacology – the branch of medicine concerned with the uses, effects, and modes of action of
drugs.

Screening Test – a rapid test performed to establish potential/presumptive positive result.

Trading – transactions involving the illegal trafficking of dangerous drugs and/or controlled precursors
and essential chemicals using electronic devices such as, but not limited to, text messages, email,
mobile or landlines, two-way radios, internet, instant messengers and chat rooms or acting as a
broker in any of such transactions whether for money or any other consideration.
PDEA Philippine Drug Enforcement Agency
 (Filipino: Kawanihan ng Pilipinas Laban sa Droga) is the lead anti-drugs law enforcement
agency, responsible for preventing, investigating and combating any dangerous drugs,
controlled precursors and essential chemicals within the Philippines.
 The implementing arm of the Dangerous Drugs Board (DDB), is the policy-making and strategy-
formulating body in the planning and formulation of policies and programs on drug prevention
and control.
 PDEA and DDB are both under the supervision of the Office of the President.

FACTORS AFFECTING THE EFFECTS OF DRUGS

1. Dosage – prescribed administration of a specific amount, number, and frequency of doses
over a specific period of time.
*Dose – refers to a specified amount of medication taken at one time.
2. Purity/Potency – the concentration or dose of a drug required to produce 50% of that drug’s
maximal effect.
3. Drug Mixing (Multiplier effect) –
4. Method of Administration

FACTORS CONSIDERED IN RANKING THE HARMFULNESS OF EACH DRUG

1. Physical harm to the user
2. Addictive potential of the drug
3. The drug’s overall impact on society

DRUG DYNAMICS
 Drug works because they physically resemble the chemicals naturally produced with in the
body
 Drugs affect our physical functions by mimicking these natural chemicals in our body. (e.g.
painkillers resemble endorphins)

RECEPTOR SITE THEORY

 Drugs bind to specific receptor sites in the body
 These sites are specialized cells (because of their size, shape, electrical charge and chemical
properties), drugs can attach themselves.
 Most drugs attach themselves to multiple receptors (e.g. Heart & Circulatory System, liver,
lungs, kidneys, brain, and gonads (testicles/ovaries)

SIX TYPES OF DRUGS

1. Prescription Drugs – those that can only be obtained through a written prescription
2. Over-the-Counter Drugs – can be purchased without a prescription
3. Recreational Drugs – drugs used to help a person relax or socialize (e.g. alcohol, tea, coffee,
tobacco, chocolate)
4. Herbal Preparations – approximately 750 substances are herbal teas and other products of
botanical (plant) origin that are believed to have medicinal purposes
5. Illicit Drugs – these are the most notorious type of drugs generally, recognized as harmful, all
are psychoactive (have the potential to alter mood or behavior)
6. Commercial Drugs – most commonly recognized drugs; are more than 1,000 (e.g. perfumes,
cosmetics, household cleaners, paints, glues, inks, dyes, gardening chemicals, pesticides, and
industrial by-products)
ROUTES OF ADMINISTRATION / WAYS TO ADMINISTER DRUGS
1. Oral Ingestion – through the mouth
2. Inhalation – through the mouth or nose (sniffing, snorting or smoking)
3. Injection – introduction via hypodermic needle
4. Intravenous Injection – introduction directly to the vein
5. Inunction – introduction through the skin
6. Suppositories – mixture of drugs and wax made to melt at body temperature and are inserted
into the anus or vagina
*Others
 Intramuscular – muscles
 Intrathecally – space around the spinal cord
 Subcutaneously – beneath the skin
 Sublingually – under the tongue
 Buccally – between gums and cheek
 Rectally – inserted in the rectum
 Vaginally – inserted in the vagina
 Ocular route – eyes
 Otic route – ears
 Nasally – nose
 Cutaneously – to the skin
 Transdermally – skin patch

NATURE OF DRUG DEPENDENCE

 When an individual becomes strongly attached to a drug
 Dependency is subdivided into two categories:
Physiological – continually feels sick if drug is discontinued
Psychological – desperate need to continue using; uncontrollable craving (mental or
emotional need)
DRUG OF ABUSE – any substance that, because of some desirable effect, is used for some purposes
other than that intended.

DRUG ADDICTION – Continued use of drugs despite knowledge of the harm that it causes yourself
and others (deterioration in work performance, relationships, and social interaction)

SIGNS OF ADDICTION
Four Common Symptoms:
1. Compulsion – excessive need to perform the behavior of obsession
2. Loss of Control – the inability to predict reliability whether any isolated occurrence of
the behavior will be healthy or damaging
3. Negative Consequence – physical damage, legal trouble, financial problems,
academic failure, or family dissolution
4. Denial – the inability to perceive that the behavior is self-destructive

How to Detect Signs and Symptoms

- Bluish coloration of the skin - Convulsions
- Fever - Low Body Temperature
- Muscle Spasm/Twitching - Slurred speech
- Staggering/Trembling
MAJOR CLASSES OF ABUSED DRUGS
Six Basic Categories
1. Narcotic Drugs- taken as painkillers (analgesic)
2. Stimulants – taken to increase mental and physical energy
3. Hallucinogens – taken to change one’s mental state
4. Depressants, Hypnotics & Tranquilizers – taken to dull one’s senses
–to reduce anxiety or induce sleep
5. Club Drugs – taken to enhance one’s enjoyment or other social activities
6. Performance Enhancing Drugs – taken to build muscles, endurance or enhance athletic
performance

1. OPIATES or NARCOTIC DRUGS

- Derived from opium poppy (Papaver somniferum L)
- All natural and drug compounds derived from opium are known as opiates.

Opium – narcotic drug produced from the drying resin of unripe capsules of the opium poppy.
The green seed heads are cut to release milky latex which contains morphine. This
latex dries on the seed head to form a gum, which is then collected and bulked as raw opium.

Form/Use:
- Granulated
- Powdered
- Tincture (solution)
- Used for GIT pain and diarrhea for infants
Method of Intake: Oral or Smoking
Effects:
General:
Pale/Emaciated appearance Euphoria
Drowsiness Secretiveness
Loss of Appetite Neglect of sex life
Lack of Sleep Possession of Paraphernalia
Neglect of Personal Hygiene

Withdrawal:
Anxiety Running nose Excessive yawning
Depression Nausea Convulsion
Tremors Insomnia Loss of Appetite
Cramps Vomiting Waves of gooseflesh
Watery eyes Diarrhea

a. Morphine
 “Morpheus” – Greek word
 The primary active drug in opium. It comes in white crystalline powder, light porous cubes
of small white tablets.
 Major sedative and pain relieving drug found in opium, being approximately 10% of the
crude opium exudates.
 A bitter alkaloid, the soluble salts of which are used in medicine as analgesic, a light
anesthetic or a sedative.

Street Names: M, Dreamer, Emma, Emsel, Pulbos

Method of Intake: Any route, but mostly Intravenous Injection
 Effects:
General: Initial reaction is unpleasant to most peoples, but calming supersedes and
depending on dose, may progress to coma and death from respiratory failure.

Dangers: Sensitivity to respiratory depressant effects until tolerance develops;

psychological and physical dependence develop readily.

b. Codeine
 Second most abundant component of opium, used as a strong painkiller and cough
suppressant (antitussive)

Street Names: Schoolboy

Method of Intake: Usually orally (tablet form for pain or liquid preparation for cough)
Effects:
General: Analgesic and cough suppressant with very little sedation or euphoric action.
Dependence can be produced or partially supported, but large doses are required.

c. Heroin
 Sometimes known as “Chinese Heroin”
 White powder (from South East Asia) that consists of diamorphine hydrochloride and minor
amounts of other opium alkaloids.
 Heroin from South West Asia is much cruder product (brown powder) that contains
diamorphine base, variable amounts of other opium-derived alkaloids as well as
adulterants.
 Heroin is a highly addictive drug. Prolonged use also gives rise to drug tolerance, resulting
in higher levels of drug intake required to gain the same pleasurable effects.

Method of Intake: Ideally suited to injection

*Clues for identifying Heroin users: Needle tracks (Hypodermic needle marks) and
sclerosing of veins
Vein Sites:
- Inside of arm (beginners: middle biceps to middle forearm)
- Arm toward the back of the hand
- Feet, Legs, Thighs and Groin
- Veins of the Neck
- Under the tongue
- Breast (for females)
- Dorsal veins of the penis (for males)

Half-life (IV): 3 minutes

Effects:
Analgesia Constipation
Euphoria Respiratory depression
Reduction in Anxiety Pinpoint pupils (lasts for approximately 3 hours)

SYNTHETIC OPIATES – have similar physiological effects as analgesics or opium narcotics

a. Methadone
 Pharmacologically related to heroin with minimal side effects.
 Used for treatment of heroin addiction.
 b. Propoxyphene (Darvon)
 Used for relief of moderate pain but an increase of its abuse and overdose was
recorded.
 Similar pharmacologic properties to opiates and morphine
 Oral form
 Toxicity: Respiratory depression, Cardiac arrhythmias, Seizures, Pulmonary edema,
Coma

2. STIMULANTS
- Are taken to make one feel more energetic, strong or awake (referred as uppers; reverse
the effects of fatigue from both mental and physical tasks)
- When used in moderation, these substances tend to relieve malaise and increase alertness
- Abuse stimulants: Amphetamine, Methamphetamine, and Cocaine

a. Amphetamine/Methamphetamine (Met HCL)

 Closely resemble epinephrine and norepinephrine: exert sympathomimetic effects
 Cause euphoria and increased mental alertness
 Increased heart rate, increased blood pressure, palpitations, bronchodilation, anxiety,
pallor and tremulousness
 Medically used to treat obesity due to its ability to inhibit mobility of digestive tract
 Produced in clandestine laboratories
 Preparation: Leuckart Reaction
 Common Adulterants for Amphetamine
- Caffeine (increase stimulant effect or mask low levels)
- Sugars (e.g. lactose, milk sugar, disaccharide) used as diluent

*Amphetamine vs. Methamphetamine

Amphetamine Methamphetamine
- Normally produced as - Produced as methamphetamine
amphetamine sulfate, hydrochloride hydrochloride
or phosphate - More popular in North America and
- Commonly abused in Europe Japan

Clinical Symptoms
- CNS and respiratory stimulation and parasympathetic activity.
- Pyschic stimulation and excitability: temporary increase in mental and physical
activity and nervousness

Acute Toxicity
- Cardiovascular: flushing or pallor, tachypnea, palpitation, tremor, cardiac
arrhythmias
- Mental disturbances: delirium, confusion, delusions and hallucinations
- Acute psychotic syndromes: vivid auditory and visual hallucinations, paranoid
ideation
- Frequent and potential sign: hyperpyrexia
 Chronic Usage
- Emotional lability, somnolence, loss of appetite, occupational deterioration, mental
impairment and social withdrawal
- Trauma and ulcer of the tongue and lip
- Paranoid schizophrenia

Detection and Treatment

- Toxi-lab EMIT
 False Positive: antihistamines: diphenhydramine
- No specific antidote
- Symptomatic treatment:
 General physiologic supportive measures
 Cardiovascular symptoms: propranolol

b. Cocaine
 A naturally occurring alkaloid found in certain varieties of plants of the genus
Erythroxylum (coca leaves)
 A local anesthetic, vasoconstrictor and powerful psychostimulant
“Crack Cocaine” – base form of cocaine; more prevalent in the recent years
- Prepared from cocaine hydrochloride using baking soda and water
- More granular texture than the salt form, often occurring as “rocks” with slightly
waxy appearance.

Street Names: Coke, crack, gold dust, heaven’s dust, stardust, white girl,
speedballs (when mixed with heroin)
Method of Intake:
- Orally by mixing cocaine with liquid or semi-liquid, then placed in a capsule
- Directly applied to the gums, underneath the tongue or side of the eyelid
- To prevent premature climax, some males apply it directly to the penis & the
females under the vagina
- Injection
- Sniffing/Snorting
Effects:
General: Sensation of mental and physical stimulation, Euphoria, Self-satisfaction & comfort
of the mind and body, Forgetfulness, Desire for sexual activities, Feeling of rejection,
Extreme depression (suicidal tendencies), Psychological dependence
Physical: Sense of smell intensifies, Loss of perception as to time and distance, Constipation,
Dryness of mouth, Insomnia
Immediate: Dilated pupils, Hypertension, Increased heart rate & body temperature,
Heightened sense of awareness, Feeling of being energetic & alert, Loss of appetite,
Slurred speech
*effects are seen within a few minutes, peak in 15-20 minutes and disappear
within an hour
Dangers: Low dose may create psychological problems; overdose may cause delirium,
convulsions, respiratory failure and eventually death. Regular intake of high doses may
cause paranoia or may lead to “cocaine psychosis” (hallucinations); may expose the
user to death from fire or explosion that can occur from preparation of free base.
3. HALLUCINOGENS
- Cause significantly altered mental state, often including hallucinations
- Marijuana is one of the oldest

a. Phencylidine (PCP)
 Synthesized in the early 1900s and tested during the World War I as a surgical anesthetic
 Discontinued for human use due to the side-effects: Delirium, Paranoia, Hallucinations
and Euphoria

Street Names: Angel Dust, Angel Hair, Crystal, Keeler Weed

Physiologic Effects: Analgesic, Anesthetic, Stimulatory
Acute Toxicity: Depression to Euphoria, Violence auditory and Visual hallucinations

b. Lysergicacid Diethylamide (LSD) / Lysergide

 Semisynthetic indoalkylamine; its properties were first discovered in the 1930s and its
popularity as a drug of abuse was very high during the 1960s and 1970s when it was
associated with the “hippy” movement.
 Lysergic acid – starting material which can be obtained from the rye fungus or using
ergometrine or ergotamine tartrate
 Preparations: Powder in gelatin capsules, gelatin squares, sugar cubes and microdots
*Nowadays LSD is encountered mostly in paper-dose form

Method of Intake: Oral and IV

Effects:
Hyperarousal of the CNS;
Intense visual hallucinations, wide range of behavior and mood, trance-like state, dilated
pupils, elevated temperature, tremors, hypertension and increased heart rate,
sweating, chills, distortion of perception of space and time
Acute panic reactions

c. Marijuana (Cannabis)
 Oldest and most widely used mind-altering drug
 Cut, dried and ground hemp plant: Cannabis sativa (rich in cannabinoids, a
psychoactive)
 Major psychoactive agent: Delta-9-tetrahydrocannabinol

Method of Intake: Inhaled or ingested

*Once absorbed, it’s readily stored in body fat
Half-life: 1 week

Hashish – cannabis resin made from the flowering tops of the plant
Hash oil: extract of cannabis resin and contains up to 60% of cannabinoids
*Hash oil can be mixed with tobacco or other vegetable material

Metabolites of Marijuana:
 Delta 9 Carboxy-tetrahydrocannabinol
 III-hydroxy-delta-9-THC
*Detectable in urine from 1-4 weeks after last injection

Major Physiologic Effects:

- Reddening of the conjunctivae
 - Increased pulse rate
- Muscle weakness, deterioration in muscle coordination
- Perceptual and psychic changes (distortion of time, sound and color)
- Mild euphoria, enhancement or alteration of physical senses
- Heightened sensory awareness, feeling of relaxation

d. Dimethyltryptamine (DMT)
 A naturally occurring psychedelic compound
 When ingested, it produces “trips” or hallucinations
 Unique for producing remarkably consistent hallucinations. People who take DMT as a
psychedelic drug consistently report clear, detailed visions of encounters with strange
beings in another dimension. Depending on the person’s worldview, the beings are
identified as either aliens or angels/demons. Visions like these also occur with other
psychedelic drugs, but with nowhere near the consistency of DMT.

e. Mescaline
 Obtained from the bud the of small, spineless cactus Peyote (Lophophora williamsi)
 Also found in certain members of the Fabaceae (bean family)
 The top of the cactus above ground, also referred to as the crown, consists of disc-
shaped buttons that are cut from the root and dried. The buttons are generally chewed
or soaked in water to produce an intoxicating liquid
 Main active ingredient: Mescaline

f. Magic Mushrooms
 Genus Psilocybe, Pscilocybe mexicana mushroom
 Other Names: Psychedelic mushrooms, Shrooms
 Active components: Psilocin and Psilocybin
 Found in dried or fresh mushrooms or as a powder in capsules
 Usually taken orally or sometimes brewed into a tea

4. DEPRESSANTS, HYPNOTICS & TRANQUILIZERS

- Therapeutic in nature/Prescribed
- Slow down the activity of the CNS which reduces a person’s alertness, and also slows down
the functions such as breathing and heart rate

a. Barbiturates
 Physiologically active depressants, resulting in a physical and mental state similar to
alcohol-induced intoxication
 Anti-seizure and anti-convulsion
 Causes drowsiness, sleepiness
 Condensation product of urea and malonic acid
 Fat soluble – easily crosses the Blood-brain Barrier

Effects:
Low Doses: Sedation, Drowsiness and Sleep
Higher Doses: Anesthesia
Very High Doses: Stupor, Coma and Death
Toxicity: Depression, Cyanosis, Hypothermia, Hypotension

1) Barbituric Acid
2) Phenobarbital – long-acting; anticonvulsant
3) Amobarbital – intermediate-acting
 4) Pentobarbital – short-acting
5) Thiopental – ultra-short-acting; sedative-hypnotic

b. Benzodiazepines
 Tranquilizers
 Pharmaceutical preparations that contain diazepam, flunitrazepam, nitrazepam,
flurazepam and temazepam
 Mediates the effect of gamma-aminobutyric acid (GABA)
 Most are rarely prescribed; illicit synthesis is rare
 Commonly abused in conjunction with other drugs, particularly opiates or with alcohol
 Gained notoriety for its association with “date rape” or drug facilitated sexual assault
 Cause hypnotic, anticonvulsant, muscle relaxant and amnesia effects
 Uses: Treatment of anxiety, insomnia, agitation, seizures, and muscle spasms

*In the US, Lorazepam and Alprazolam are typically abused

*Flunitrazepam is banned; can cause anterograde amnesia

Valium – tranquilizer drug designed to relieve anxiety

Rohypnol or Roofies (Flunitrazepam) – a major drug of abuse at raves and in clubs

c. Alcohol
 Most abused depressant in the world
 Standard drink: any drink containing 10g of alcohol
one standard drink always contains the same amount of alcohol
regardless of container size or alcohol type (i.e. beer, wine or spirits)
*One drink is:
- 12 ounces of regular beer
- 8-9 ounces of malt liquor, which has more alcohol than beer
- 5 ounces of wine
- 1 1/2 ounces of distilled spirits like vodka and whiskey

Common Methods of Alcohol Abuse

 Binge Drinking and Heavy Drinking
- Binge drinking is excessive drinking that is defined as 5 or more drinks in 2
hours for a man and 4 or more drinks for a woman.
- Binge drinking can lead to numerous health problems, including alcohol
poisoning, car accidents, violence, sexually transmitted diseases, cancer
(including breast, mouth, liver, and colon), and memory and learning
problems.
 Pregnant Women and Alcohol
- Alcohol can present various dangers during pregnancy, and there is no
known level of use that is considered safe.
- Drinking while pregnant is dangerous because the alcohol is passed on to the
baby and can cause miscarriage; stillbirth; and numerous physical,
behavioral, and intellectual development issues, including low body weight,
poor coordination, hyperactive behavior, poor memory, learning disabilities,
poor judgment skills, visions or hearing problems.
 Teen Alcohol Use
- Many teenagers misuse alcohol due to the accessibility of the substance and
peer pressure.
- Teenagers who misuse alcohol may exhibit signs including low energy, having
alcohol paraphernalia, concentration problems, problems with coordination,
 mood swings, changing social circles, declining academic performance,
behavioral issues/rebelling, smelling of alcohol.
- Studies show that brain development continues past the teenage years.
Alcohol abuse during the brain's formative years can negatively impact how
the brain develops and can also lead to learning problems and increase the
risk of developing an alcohol use disorder in the future.

Effects:
Short-term: Nausea, Vomiting, Headaches, Slurred speech, Impaired judgment, Anxiety,
Insomnia, Trouble concentrating, Memory loss, Problems breathing

Long-term/Chronic Alcohol Consumption: Mouth, esophageal, throat, liver, and breast

cancer, Raised risk of heart problems, such as cardiomyopathy, Brain damage,
Weakened immune system, Liver disease, Pancreatitis, Ulcers, Violence or self-harm,
Accidents, such as vehicle collisions

Intoxication – a limitation of the body’s physical and mental status, ranging from feeling
energized to being unconscious.

Blood Alcohol Content (BAC)

- Scientific method for determining when a person is drunk
- The percentage of alcohol in the blood (or proportion of alcohol to blood in the
body) as someone drinks
- Amount of alcohol present in a 100mL of volume of blood
- The BAC is related to the user’s body weight, metabolism, and drinking speed

BAC Levels and Effects

BAC Level Generalized Dose Specific Effects
No loss of coordination, slight euphoria, and loss of shyness.
0.020-0.039%
Relaxation, but depressant effects are not apparent.
Feeling of well-being, relaxation, lower inhibitions, and sensation of
0.040-0.059% warmth. Euphoria. Some minor impairment of judgment and memory,
lowering of caution.
Slight impairment of balance, speech, vision, reaction time, and
0.06-0.099% hearing. Euphoria. Reduced judgment and self-control. Impaired
reasoning and memory.
Significant impairment of motor coordination and loss of good
0.100-0.129% judgment. Speech may be slurred; balance, peripheral vision,
reaction time, and hearing will be impaired.
Gross motor impairment and lack of physical control. Blurred vision
0.130-0.159% and major loss of balance. Euphoria is reducing and beginning
dysphoria (a state of feeling unwell)
Dysphoria predominates, nausea may appear. The drinker has the
0.160-0.199%
appearance of a sloppy drunk.
Needs assistance in walking; total mental confusion. Dysphoria with
0.200-0.249%
nausea and vomiting; possible blackout.
0.250-0.399% Alcohol poisoning. Loss of consciousness.
0.40% + Onset of coma, possible death due to respiratory arrest.
5. CLUB DRUGS
a. Methylenedioxymethamphetamine (MDMA)
 “Love Drug”
 Most common drug encountered in “ecstasy” tablets (30-100 mg per tablet)
 Prepared by clandestine labs or obtained legally from other countries
 Derivative of methamphetamine
 Increases the secretion and inhibition of reuptake of serotonin, dopamine, and
norepinephrine in the brain
 Recreational drug of abuse

Effects:
Causes euphoria, a feeling of empathy, increased energy and tactile sensation
Short-term health risks: Hypertension, Hyperthermia and Dehydration
Long-term: Severe depression due to permanent disruption of serotonin production in the
CNS
b. Gamma-hydroxybutyric Acid and Analogues
 A substance endogenously present in the brain
 Originally developed as an anesthetic drug and is still used for that purpose in some
countries
 Manufactured easily by adding aqueous sodium hydroxide to gamma-butyrolactone
(GBL)
 Acts as CNS depressant and hypnotic; chemically related to GABA
 Synonyms: Sodium oxybate (Xyrem), Gamma-OH, Somotomax, “GHB” and “Liquid
ecstasy”
 Gained notoriety for its use in drug facilitated sexual assault

c. Ketamine
 Anesthetic and animal tranquilizer
 Causes anterograde amnesia
 Used in powdered or liquid form as an anesthetic, usually on animals

Methods of Intake:
- Injected
- Consumed in drinks
- Snorted
- Added to joints or cigarettes

Effects:
Short-term and Long-term: Increased heart rate and blood pressure, Nausea, Vomiting,
Numbness, Depression, Amnesia, Hallucinations and Potentially fatal respiratory
problems.
* Ketamine users can also develop cravings for the drug.
High Doses: Users experience an effect referred to as “K-Hole,” an “out of body” or “near-
death” experience

***Rohypnol, GHB, and Ketamine have implicated in cases of Drug Facilitated Sexual
Assaults (Date-rape Drugs)
6. ATHLETIC PERFORMANCE ENHANCERS
 Athletes trying to gain competitive edge may abuse stimulants and painkillers
 The first drug controlled because of their abuse by athletes were Anabolic Steroids

a. Anabolic Steroids
 Promote cell growth resulting in growth of the muscle tissue and sometimes bone size
and strength
 Synthetic, or human-made, variations of the male sex hormone testosterone. The proper
term for these compounds is anabolic-androgenic steroids.
- Androstenedione – marketed as to body builders in dietary supplements and
claimed to have an anabolic effect

Street Names: Gear, Juice, Roids, and Stackers

Effects:
Physiological: Increase in protein synthesis, muscle mass, strength, appetite and bone growth
Side-effects: Elevated cholesterol levels, acne, high blood pressure, liver damage and
damage to the left ventricle of the heart

OTHER COMMONLY ABUSED DRUGS

a. Nicotine
 Cigarettes, Tobacco
 A nitrogen-containing chemical which is made by several types of plants, including the
tobacco plant
 Also used as an insecticide

Effects:
Pharmacological: Increased heart rates, heart muscle oxygen consumption rate and heart
stroke volume
Psychodynamic: Raised alertness, Euphoria, Sensation of relaxation
Addictive Properties: Highly addictive, Sudden stop of taking nicotine can cause
withdrawal symptoms which includes cravings, a sense of emptiness, anxiety, depression,
moodiness, irritability, and inattentiveness.

*The American Heart Association says that nicotine (from smoking tobacco) is one of the
hardest substances to quit – at least as hard as heroin.
*Vapes do not actually help in cigarette addiction
*Second hand smokers have 14% chance to suffer lung cancer

b. Dextromethorphan (DXM)
 Cough and cold medications
 E.g. Robitussin

Method of Intake: Swallowed, Snorted, Injected

Street Names: CCC, DXM, Poor Man’s PCP, Robo, Tussin, Skittles, Triple C
Effects:
Short-term: Can range from mild stimulation to alcohol- or marijuana-like intoxication
At High Doses: Hallucinations or feelings of physical distortion, Extreme panic, Paranoia,
Anxiety, and Aggression
Other Effects: Hyperexcitability, Poor motor control, Lack of energy, Stomach pain, Vision
changes, Slurred speech, Increased blood pressure, Sweating
 c. Inhalants
 Contain dangerous substances that have psychoactive (mind-altering) properties when
inhaled
 When these substances are used for getting high, they are called inhalants.
 Solvents (e.g. Paint thinners, Gasoline, Glues, Rugby)
 Gases (e.g. Butane, Propane, Ether, Chloroform, Nitrous oxide)
 Nitrites (prescription medicines for chest pain, leather cleaner, room odorizer)

Method of Intake: People who use inhalants breathe in the fumes through their nose or
mouth, usually by “sniffing,” “snorting,” “bagging,” or “huffing”
Effects:
Short-term: Slurred or distorted speech, Lack of coordination (control of body movement),
Euphoria (feeling "high"), Dizziness, sometimes Hallucinations
Long-term: Liver and kidney damage, Hearing loss, Bone marrow damage, Loss of
coordination and limb spasms (from nerve damage), Delayed behavioral development
(from brain problems), Brain damage (from cut-off oxygen flow to the brain)

SCHEDULE OF DRUGS

Includes drugs with no proven or acceptable medical use and a high abuse
potential - authorized research only.
Schedule 1
(Heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-
methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote)
Includes narcotic drugs with a high potential for abuse but with currently
accepted medical use in treatment.
Schedule 2
(Opiates, cocaine, methadone, meperidine, oxycodone, morphine,
hydrocodone, fentanyl)
Includes non-narcotic drugs with a high potential for abuse, such as
Schedule 2N amphetamines, phenmetrazine, pentobarbital, methylphenidate, and short-
acting barbiturates.
Includes narcotics in combination with other non-narcotic drugs, such as
Schedule 3
codeine combined with acetaminophen or aspirin, and buprenorphine.
Includes ketamine, anabolic steroids, and central nervous system depressants,
Schedule 3N such as glutethimide, methyprylon, and barbiturates not listed in other
schedules. Also includes anorectant agents not included in other schedules.
Includes narcotics in combination with other non-narcotic drugs,
antidiarrheals, mild CNS depressants, mild CNS stimulants, and tranquilizers.
Schedule 4 Drugs such as chloral hydrate, meprobamate, phenobarbital, diphenoxylate
with atropine sulfate, chlordiazepoxide, diazepam, carisoprodol, midazolam,
alprazolam, and phentermine are in this group.
Includes narcotic cough syrups and ephedrine, pseudoephedrine, and
Schedule 5
phenylpropanolamine products.
REPUBLIC ACT NO. 9165 COMPREHENSIVE DANGEROUS DRUGS ACT OF 2002
 June 7, 2002
 Repealed RA 6425, otherwise known as the Dangerous Drug Act of 1972

Drug Testing
- Increasing applicability in:
o Government agencies
o Industrial agencies
o Sports agencies

Forensic Drug Testing

- The application of drug testing to the question of law

General Information
Urine Specimen – the usual sample used to test a number of drugs of abuse
 Requires the highest standard of analytical methodology, specimen security and
documentation
 Certification of the laboratory is required
 Important to guard against specimen exchange or adulteration
 Urine is collected in a tamper proof specimen cup often proportioned into separate
specimens
 Positive specimens are to be stored frozen for a minimum of 1 year
Disadvantages of Urine Specimen:
 Detects only fairly recent drug use
 Will not differentiate casual use from chronic drug abuse
 Does not determine degree of impairment to tissues
 Does not determine dose of drug taken
 Will not state exact time of use
 Detection limited to a few days after drug use
Three Ways of Tampering Urine for Drug Testing
 Dilution
 Adulteration – substances are added to urine that will interfere with drug testing
 Substitution – checking the clothing of the client if there are extra vials
*Checking the temperature of the urine sample; fresh urine is warm (32.5°C to 37.7°C)

Random Testing – an unscheduled, unannounced urine drug testing of randomly selected

individuals; ensures non-discriminatory manner of selection

Screening Test – initial test: to screen urine specimens, to eliminate “negative ones” from
further consideration and identify the presumptively positive specimens that of the initial test to
ensure reliability and accuracy.

Alternative Specimens
 Meconium
- First stools of the newborn
- Begins to form during second trimester and continues to accumulate until birth
- Provides evidence of maternal drug use anytime during the last two trimesters

 Hair
- Obtained easily
- Not altered or manipulated easily to prevent drug detection
- Prior drug abuse may be detected for several months
 - Mechanism of Drug Deposition in Hair:
 Transfer from blood to growing hair shaft
 Transfer from sweat
 Environmental contamination
- Tested through radioimmunoassay

 Sweat
- Sweat-patch collection devices, worn for several days to several weeks during
which the drug, if present, accumulates in the absorbent pad in the patch, while
water vapor escapes through the semipermeable covering
- Advantage: monitoring of drug use in correctional institutions or in drug rehab
programs

 Saliva
- Easy to obtain, less invasion of privacy and ease of adulteration
- Ultrafiltrate of plasma
- Detection of drug level is shorter compared to urine
- Recent drug use
- Correlates with degree of impairment
- Sweat production: 1.5L/day in average

Laboratory Considerations
1. Specimen Collection
 Urine: Sample of choice; represents the net load of the drug over a long period
Guard against exchange, adulteration or tampering
Urine pH is 6.0 in average; Specific gravity = 1.002 – 1.030
Presence of creatinine
 Blood: Represents transient passage of the drug thru the circulation
Only a quick picture of the drug level at a specific time
2. Processing and Handling
 Confidentiality and Chain of Custody
3. Analytical Methods
 Screening Assay – good sensitivity with marginal specificity
 Confirmatory Assay – high sensitivity and specificity
– qualitative and quantitative information
– different from screening procedure
Levels of Drug Testing
1. Emergency Room Testing
- Rapid, stat, screening methods
- EMIT, FPIA and TLC
2. Forensic Testing
- Confirmatory testing
- HPLC and GC-MS

Lower Limits of Detection (Sensitivity)

Method Approximate LL of Detection (mg/dL)
1. TLC 0.2 – 5
2. EIA 0.025 – 5
3. HPLC 0.02 – 5
4. GC 0.02 – 10
0.01 – 10
5. GC-MS
0.001 – 5
TECHNIQUES OF DRUG ANALYSIS
A. IMMUNOLOGIC
i. Enzyme Multiplied Immunoassay Technique (EMIT)
- Drug to be measured: hapten part of the antigen
- Serum + antibody mixture + enzyme labeled drug + substrate
- Measure enzyme activity: drug concentration
- More rapid than RIA
ii. Enzyme-Linked Immunoabsorbent Assay (ELISA)
- Drug to be measured is the hapten/antigen
- Specific antibodies bound to a solid state carrier
- Separation of the bound drug from the unbound
iii. Fluoroscence Immunoassay
- Drug bound to an enzyme substrate
- Fluorogenic reagent + antibody + beta-galactoside  incubated with serum
sample
- Drug and FDR compete for binding to the antibody
- Amount of unbound FDR varies directly with serum drug concentration
- Absence of fluorescence = Absence of drug
iv. Radioimmunoassay
- Drug (hapten) + protein + antibody
- Incubation of serum + antibody + radio labeled drug (competition for
antibody binding sites)
- Separation of free from antibody bound drug

B. CHROMATOGRAPHIC METHODS
i. Thin Layer Chromatography
- Use of solid phase support medium and liquid mobile phase separation
system
- Drugs are separated on the basis of their ability to dissolve in the solvent
system and its strength of interaction with the support phase
- Color reactions are then used to locate and identify the specific substance
- Urine sample adjusted to pH 8.5
- Screening for drug identification
ii. High Performance Liquid Chromatography
- Able to separate a variety of different materials fairly rapidly
- Not very specific
iii. Gas Chromatography/Mass Spectrometry
- Most specified and sensitive: Gold Standard
- Parent drug and metabolites may be detected
- Sample is placed in a solvent to extract the substance
- Extract is concentrated and injected into a gas chromatograph
- Fractionation pattern is determined
- Mass Spectrometry: determine molecular weight and structural
characteristics to identify the drug
**HPLC and GC-MS are the confirmatory methods for drug identification

C. SPECTROPHOTOMETRIC
- Based on the absorption of the amount of light by a solution that contains analyte
- Spectral Scan: tentative identification for drugs
- Protein precipitation or extraction
- Quantitative analysis
- E.g. Salicylate: 340-700 nm, Barbiturates: <340 nm (UV), Quinidine: Fluorescent