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Subject FORENSIC SCIENCE

Paper No and Title PAPER: 9, Drugs of Abuse

Module No and Title MODULE: M3, Terminology of drug abuse

Module Tag FSC_P9_M3

TABLE OF CONTENTS

1. Learning Outcomes
2. Common Terms of Drug Abuse
2.1 Drug Abuse
2.2 Addiction
2.3 Designer Drugs
2.4 Dissociatives
2.5 Psychoactive Drugs
2.6 Stimulants
2.7 Hallucinogens
2.8 Depressants
2.9 Physical Dependence
2.10 Poly-drug Abuse
2.11 Tolerance
2.12 Tranquilizers
2.13 Withdrawal

3. Summary

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1. Learning Outcomes

After studying this module, you shall be able to know

· About meaning of various terms that are commonly used in context of drug abuse

2. Common terms of Drug Abuse

2.1 Drug Abuse

Drug is a patterned usage of a substance in which the user or abuser ingest the substance
in quantity or with means neither authorized nor directed by health care specialist is
known as Drug Abuse or Substance Abuse. It is impossible to know the definite cause of
substance abuse because there is not just one direct cause. However, substance abuse and
addiction is known to run parallel to each other or can be said run in families. A theory
states that there is a genetic disposition which predisposes certain individuals towards
substance abuse. Another theory suggests that substance abuse is cultivated from the
surroundings i.e. it is an acquired behviour. Substance abuse starts with a bad habit but
when addiction expands it manifests as a chronic devitalizing disease.

The drugs like alcohol, amphetamines, barbiturates, benzodiazepines, cocaine and

opioids are associated with the term Drug Abuse. Using and abusing such drugs leads to
criminal penalty adding to physical, social and psychological harm. Many cases are there
where criminal or antisocial behavior are seen when the person is under the dominance of
a drug. Even personality changes in individuals may occur as well for long time.

Drug abuse affects the central nervous system, which is abbreviated as CNS. It produces
mood fluctuation, transforms the levels of consciousness or opinions and senses. Most of
the drugs also have an affect on the systems other than the central nervous system.

Associated Risks

Drug abuse leads to health problems, social-life problems, road accidents, injuries,
violence, deaths, homicides and suicides, physical dependency or psychosomatic
addiction.

Drug abuse, involving alcohol and prescribed drugs, can lead to medical condition, which
corresponds to mental illness. This symptomatology can happen both in the intoxicated
state and also during the withdrawal state.

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2.2 Addiction

The term addiction in context of drugs; is the driving need to use drugs in order to
operate normally. When these substances are unattainable, the user experience
withdrawal. According to the (DSM-IV) i.e. Diagnostic and Statistical Manual of Mental
Disorders, they have not used the word addiction at all. Instead of, it uses the word
substance dependence for describing such a condition.

With the help of physiological dependence, the indication of withdrawal, or without the
help physiological dependence, substance dependence can be identified

Addictive Potential

From person to person and from substance to substance, the addictive potential of a drug
varies. Dosage, frequency, pharma-co-kinetics of a specific substance, the route and
mode of administration, and time are the critical factors for growing a drug addiction.

An article was published in “The Lancet” that analyzed the harm and dependence of 20
drugs, using a scale, which has a range from 0 to 3 in the category of physical addiction,
psychological addiction, and pleasure to make a mean score for addiction. The results are
as follows:

Drug Mean Pleasure Psychological dependence Physical dependence

Heroin 3.00 3.0 3.0 3.0
Cocaine 2.39 3.0 2.8 1.3
Tobacco 2.21 2.3 2.6 1.8

Barbiturates 2.01 2.0 2.2 1.8

Alcohol 1.93 2.3 1.9 1.6
Benzodiazepines 1.83 1.7 2.1 1.8
Amphetamine 1.67 2.0 1.9 1.1
Cannabis 1.51 10.9 1.7 0.8

2.3 Designer Drugs

A designer drug usually is a structural or functional equivalent of controlled substances

that has been developed to imitate the pharmacological effects of the original drug and at
the same time, being avoided and classified as illegal. European Union has designated
this type of drugs as New Psychoactive Substances (NPS) as well as analogs of
performance-boosting drugs such as designer steroids.

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Academic and industrial researchers has originally synthesized some of the Designer
drugs in an effort to design more effective derivatives with least side effects but later can
be abused for illicit use.

In some situations, designer drugs have analogous consequences to other known potent
drugs, but there chemical structures are completely dissimilar. Even though designer
drugs is a very broad term, even then it is applicable to almost every synthetic drug and
often mentioned as synthetic recreational drugs.

2.4 Dissociatives

Dissociatives are a kind of hallucinogens, which affects the perceptions of vision, sound
and produce a feeling of disengagement from the outer world and self. They lowers and
block signals to the responsive mind from other parts of the brain. In spite the fact that
many types of drugs are competent of producing such effects, like hallucinogens
dissociatives are exclusive in that way as they do so in such a way that they produces
hallucinogenic effects, which includes sensory destitution, disconnection, hallucinations,
and a dream-like behviour. Some dissociatives which are non-discriminating in action
may be capable of provoking a feeling of well-being. Moreover, many other dissociatives
have common depressant effects and produces calmness, respiratory distress, analgesia,
anesthesia in combination with cognitive and memory deterioration and amnesia.

2.5 Psychoactive Drugs

A psychoactive drug, psycho-pharmaceutical or psychotropic drug is a chemical
substance that acts principally upon the central nervous system where it
affects brain function, resulting in modification
in perception, mood, consciousness, cognition and behavior. These substances may be
used recreationally, to purposefully change one's consciousness, or for ritual, spiritual or
shamanic purposes. e.g., like anesthetics, analgesics or for the treatment of psychiatric
disorders, these types of psychoactive drugs also have therapeutic activity.
Psychoactive drugs bring about marked changes in alertness and mood swings that the
user find himself pleasant (e.g. euphoria) or advantageous (e.g. increased state of mind)
and are thus, reinforcing. Despite health risks and neglecting consequences, many
psychoactive substances are misused/ abused, that is, used excessively, with continuous
use of some substances, psychological and physical dependence ("addiction") may
develop.
Worldwide many governments posed restrictions on drug production and sales in an
attempt to decrease drug abuse, due to misuse and physical dependency on drugs.

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Classification
Human beings use psychoactive substances for varied reasons. Some of the available
substances have controlled or illegal uses while others may have shamanic purposes, and
still others are used medicinally. Social sleep aids and social drinking are some of the
common examples. World’s largest consumption of psychoactive substance is caffeine,
but unlike other drugs, it is unregulated and legal in nearly all jurisdictions.
According to pharmacological effects in the body, psychoactive drugs are divided into
different categories.
Generally used psychoactive drugs are:-
Narcotics, stimulants, Hallucinogens and Depressants

2.6 Stimulants

Stimulants are a kind of psychoactive drugs that induces transitory advancement in

mental or physical functions or both. Stimulants are often referred to as "uppers" as they
lead to a characteristic “up” feeling. This category consists of substances that wakes one
up, stimulate the mind, and even cause a feeling of well-being, but does not affects
understanding. These drugs are also referred in the terminology of “speed”.
Examples: Amphetamines, methamphetamines, caffeine, nicotine, cocaine, etc.

Amphetamine or its derivative methamphetamine may be injected direct into the blood
stream through intravenous injection. The desire for a more intense experience is the
chief motive behind this route of administration. First sensation of “flash” or “rush”
initiates, followed by high feeling of pleasure, euphoria that produces hyperactivity, with
a sensation of clarity of vision as well as hallucinations. After the effect wears off, the
individual passes through a period of exhaustion and may sleep continuously for one to
two days.

Another type of amphetamine is methamphetamine called “speed” because of its rapid

stimulation of central nervous system.

Cocaine is also a powerful stimulant that produces similar effects as that of

amphetamines- namely, increased alertness, accompanied by suppression of hunger and
fatigue. It is commonly sniffed and is taken into the body by the mucous membrane of
the nose.

One other form of cocaine, which is quite popular, is “crack”. It is manufactured by

heating the mixture of cocaine, baking soda and water. It is also snorted and produces
similar effects like cocaine.

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2.7 Hallucinogens

Hallucinogens, includes psychedelics, dissociatives and deliriants.

This classification comprises all those substances that produces well-defined alterations
in normal thought processes, perceptions and mood. There are a number of substances
with varying chemical compositions that have hallucinogenic properties.

Examples: LSD (lysergic acid diethylamide), PCP (phencyclidine), DMT

(dimethyltryptamine), mescaline, psilocybin, etc.

LSD is synthesized from lysergic acid, a substance derived from ergot, which is a type of
fungus that attacks certain type of grains. This is a very potent drug, only 25 micrograms
is sufficient to start vivid visual hallucinations that may last for about 12 hours. This drug
creates noticeable changes in mood, leading to laughing and crying at the slightest
provocation. Feeling of anxiety and tension always accompanied LSD use.

On the other hand, PCP is synthesized by quite a simple chemical process, thus is much
more easily available. It is frequently mixed with other drugs like LSD or amphetamine,
and is generally available as a powder (“Angel Dust”), capsules or tablets, or as a liquid.
The drug is smoked, ingested or sniffed.

Criteria of Hallucinogens

L. E. Hollister's yardstick for distinguishing a drug as hallucinogenic as follows

· Dominating changes in thought process, understanding, and mood swings

· Minimum intellectual or memory deterioration
· Unconsciousness , narcosis or enormous stimulation should not be an integral
effect
· Minimum side effects on autonomic nervous system, and
· Addictive craving should be absent

2.8 Depressants

A depressant is a kind of drug or endogenous compound that diminishes

neurotransmission levels i.e. it decreases or reduces awareness or stimulation, in different
parts of the brain. Depressants are sometimes pointed as "downers" as they lower the
level of awaking when taken.

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Depressants are extensively used worldwide as prescribed medicines and as illicit

substances. When these drugs are taken, effects often include pain relief, calmness and
memory impairment, as well as in some cases a feeling of wellbeing, disengagement,
muscles loosen up, lowered B.P or heart rate, respiratory distress, and anti-convulsant
effects, and at high dosage total anesthesia or even death.

Symptoms

Depressants are taken medicinally to diminish the following symptoms:

· Insomnia
· Seizures
· Anxiety and Tension

Anxiety and Tension can be further divided into four categories:-

v Generalized anxiety
v Obsessive anxiety
v Social anxiety
v Panic attacks

· Muscle spasm, and

· Depression

Combinations

It is very dangerous to combine the different depressants because the central nervous
system's depressive characteristics tend to increase exponentially rather than linearly.
This characteristic feature makes the depressants a frequent choice for purposeful
overdoses in the cases of suicide. In many cases, along with the usual dosage of heroin, if
the usage of alcohol or benzodiapines is done, then it is usually the reason of overdose
deaths in opiate addicts.

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2.9 Physical Dependence

Physical dependence represents a state that is resulting from chronic usage of a drug and
has produced tolerance, where unfavorable physical withdrawal symptoms results from
abruptly discontinuation or dosage reduction. The therapeutic usage of certain medicines
like benzodiazepines, antidepressants etc. as well as the misuse and abuse of recreational
drugs like alcohol, opioids, and benzodiazepines develops a physical dependence.

Reaction from withdrawal varies according to the dosage and potency, the kind of drug
used, time span of use, the age of the user, the beginning of first use and depends from
individual to individual. Acute withdrawal symptoms lasts for days, weeks or even
months.

Symptoms

Physical dependence manifests itself in the presence of both physical and psychological
symptoms, which are caused by physiological changes in the CNS and the brain due to
chronic exposure to a substance. The withdrawal from drugs or decreasing the dosage
develops increased in heart rate and blood pressure, sweating and shaking. More severe
withdrawal symptoms include disorientation, seizures, visual hallucinations and Sedative
hypnotic

The commonly available substances that can be fatal in withdrawal are alcohol,
benzodiazepines and barbiturates because of their severity to induce convulsions. Swift
withdrawal from drugs like opioids can cause an exceptional physiologically and
psychologically painful withdrawal but this condition is rarely fatal.

2.10 Poly-drug Abuse

Poly-drug abuse means combining and using two or more psychoactive drugs to achieve
a distinct effect. It has been seen in many cases one particular drug is used as a base or
primary drug, with additional secondary drugs to satisfy for the side effects of the
primary drug that makes the experience more pleasurable with drug synergy effects, or
additive for primary drug when outcome is low.

Associated Risks

Consumption of Poly-drug abuse generally has more risks and harm as compared to the
abuse of a single drug, due to drug synergism. The increasing potential of one drug on
another every now and then is considerable and here the medicines and illicit drugs like
antidepressants, alcohol and nicotine – have to be acknowledge in combination with the
controlled psychoactive substances. The level of risk depends on the potency of both
substances.

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Like alcohol and cocaine increases cardiovascular

toxicity. Likewise when alcohol or depressants taken with
opioids, it leads to an increased risk of overdose. Benzodiazepines are prominent for
causing death when it is mixed with other CNS depressants such as alcohol and
barbiturates.

2.11 Tolerance

Drug tolerance or Physiological tolerance is the diminition of effectiveness of a drug due

to continuous and prolonged usage of that drug or a similar drug (Cross-tolerance). In this
case, one’s reaction to a specific drug and potency of the drug is gradually reduced,
demanding an upsurge in strength to obtain the desired result. Physiological tolerance
also occurs when an individual builds up a resistance to the effects of a substance after
repeated exposure.

The salient features of drug tolerance are, that it is reversible; the degree depends on the
discrete drug, potency and frequency of use, differential development occurs for diverse
effects of the same drug.

2.12 Tranquilizers

A tranquilizer is a kind of drug that brings tranquility in an individual. These drugs

produce a general tranquility without the deterioration of high- thinking efficiency or the
inducement of a sleep. For reducing or compressing of anxiety and tension Tranquilizers
like reserpine and chlorpromazine are useful for mental patients. Tranquility is a feeling
of calmness and tension-free.

2.13 Withdrawal

Withdrawal from drugs accompanies a numeral symptoms that happens when one
abruptly discontinue or decreases the consumption of medicines and recreational drugs.

These symptoms are experienced only when one first develops a physical or mental
dependency. This takes place after sustained usage of any substance (drug).

Signs and Symptoms to body response from the absence of drug dependency varies from
slight uneasiness to irritation. Even once the withdrawal signs have subsided, or even
after a long period of temperance, a recovering addict can be triggered to re-live his/her
withdrawal symptoms through the exposure to a spark. A spark is a hint that retells the
recovering addiction of the drug.

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The route of entry of drug into the body also plays a part
in determining the extremity of withdrawal symptoms.

Uneasiness, sweating, nausea, and diarrhea are some of the withdrawal indications of
opiate abuse. Abuse of Alcohol comprises of withdrawal symptoms like irritability,
fatigue, tremble, sweating and vomiting, similarly Nicotine abuse has the Withdrawal
signs like irritability, fatigue, insomnia, headache, and difficulty in concentrating.

3. Summary

· Drug is a patterned usage of a substance in which the user or abuser ingest the
substance in quantity or with means neither authorized nor directed by health care
specialist is known as Drug Abuse or Substance Abuse
· The term addiction in context of drugs; is a compulsive need to use drugs in order
to function normally
· A designer drug is a structural or functional analog of controlled substances that
has been designed to imitate the pharmacological effects of the original drug and
at the same time, being avoided and classified as illegal and detection in standard
drug tests.
· Dissociatives are a kind of hallucinogens which affects the perceptions of vision,
sound and produce a feeling of disengagement from the outer world and self.
· A psychoactive drug, psycho-pharmaceutical or psychotropic drug is a chemical
substance that acts principally upon the central nervous system where it
affects brain function, resulting in modification
in perception, mood, consciousness, cognition and behaviour.
· Stimulants are a kind of psychoactive drugs that induces transitory advancement
in mental or physical functions or both. Due to their rendering a characteristic
"up" feeling, stimulants are often referred to as "uppers".
· Hallucinogens are a kind of psychoactive drugs which includes psychedelics,
dissociatives and deliriants.
· A depressant is a kind of drug or endogenous compound that diminishes
neurotransmission levels i.e. it decreases or reduces awareness or stimulation, in
different parts of the brain.
· Physical dependence represents a state that is resulting from chronic usage of a
drug and has produced tolerance, where unfavourable physical withdrawal
symptoms results from abruptly discontinuation or dosage reduction.
· Poly-drug abuse means combining and using two or more psychoactive drugs to
achieve a distinct effect.

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· Drug tolerance or Physiological tolerance is the

diminition of effectiveness of a drug due to continuous and prolonged usage of
that drug or a similar drug (Cross-tolerance).
· A tranquilizer is a kind of drug that induces tranquillity in an individual. These
drugs produces a general tranquillity without the deterioration of high- thinking
efficiency or the inducement of a sleep.
· Withdrawal from drugs accompanies a number of symptoms that happens when
one abruptly discontinue or decreases the consumption of medicines and
recreational drugs.

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