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Flashcards in Drugs Deck (84)
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1
Q

What are developing countries especially bad for in relation to drugs?

A

Drug trafficking, people trafficking

2
Q

How many people use illicit drugs globally?

A

210 million people

3
Q

Almost how many people die from drugs?

A

200,000

4
Q

What are children who have drug user parents more likely to do?

A

Greater risk of drug use and other risky behaviours

5
Q

What do drugs generate?

A

Crime, street violence and other social problems that harm communities

6
Q

Other than crime what can illicit drug use contribute to?

A

Rapid spread of infectious diseases e.g. HIV and hepatitis.

7
Q

What is an expert witness?

A

Professional/ qualified in there fields

Expert witness- knows about the subject

8
Q

What is a professional witness?

A

Police officer who was there at the time

9
Q

What is an expert witness duty?

A

Duty to the court- explain the science
Summoned by the court to give evidence on relevant aspects of evidence.
Duty remains to the court alone.
Must direct answers to the decision maker.
Must be suitably qualified to the agreement of the decision maker.

10
Q

What are some examples of drugs of abuse?

A

Amphetamines, benzodiazepines, cannabis, ecstasy, cocaine, heroin, hallucinogenics (mushrooms, acid etc).

11
Q

What are some examples of prescription drugs?

A

Benzodiazepines and psychoactive drugs.

12
Q

How can you detect drugs?

A

Blood or urine sample (taken by Police Surgeon or Post Mortem Surgeon). Part of the sample removed is given to the subject (if living..). Drugs may re-distribute in death.
Analysed and interpreted by Forensic Scientist(s)

13
Q

What is an indicative test?

A

Presence of various classes of drugs – usually by immunochemistry

14
Q

What is an evidential test?

A

Actual concentration of specific drugs – usually by Gas Chromatography/Mass Spectrometry or Liquid Chromatography/Mass Spectrometry
- highly sensitive and selective
Cannabis, ecstasy, heroine, hallucinogens
Usually given something- blood/semen

15
Q

Why may drugs redistribute in death?

A

Tramadol- blood taken from myocardium, some drugs may stay in certain areas and not be so prominent in others

16
Q

In what is cannabis most commonly used?

A

Used in religious sex

17
Q

Is cannabis allowed for non-medicinal uses in the UK?

A

No

18
Q

How long do cannabis effects usually last?

A

2 hours

19
Q

What is the active ingredient in cannabis?

A

THC (Tetrahydrocannabinol)

20
Q

What is half life?

A

Time it takes for half of everything in the system to be removed

21
Q

What is the half life of cannabis?

A

Up to 30 days to be removed- lipid soluble, sequester into fat

22
Q

How many compounds are in cannabis?

A

Contains > 400 compounds, > 60 cannabinoids.

23
Q

How long does smoked cannabis elicit effects?

A

Approximately 2 hours

24
Q

What is the peak plasma concentration of THC?

A

~ 10 mins after smoking, ~4-6 hours following oral dosing. The half-life of THC is ~ 7 days. Up to 30 days for a single dose to be eliminated.

25
Q

Is there a correlation between cannabis and driving abilities?

A

No clear correlation between blood levels and psychomotor skills/driving performance.

26
Q

What are the acute effects of cannabis?

A

Feelings of euphoria and relaxation.

27
Q

What are the unwanted effects of cannabis?

A

Depersonalisation, paranoia, panic, fear and feelings of loss of control.

28
Q

What mental illnesses are linked with cannabis?

A

Cannabis use has been linked to the exacerbation of existing mental illness and the development of psychotic-like symptoms which may persist years after periods of heavy cannabis use, even when patients abstain from cannabis use. This syndrome is similar to schizophrenia, and chronic organic brain syndrome seen after chronic alcohol misuse

29
Q

What is one of the most commonly used drugs in Glasgow?

A

Heroin

30
Q

What is heroin?

A

Narcotic

31
Q

How can you take heroin?

A

Can be injected, snorted or smoked

32
Q

What happens when you take heroin?

A

Rapidly metabolised
Lying for several hours, no muscle contraction can cause hypothermia
Directly into circulatory system
Binds to opiod receptors

33
Q

What is heroin dervied from?

A

Opiate derived analgesic and narcotic

34
Q

What are some of the reported effects of heroin?

A

Pleasurable rushing sensations.
Flushing of the skin, dry mouth, feelings of ‘heavy limbs’, nausea, vomiting,
severe itching, bradycardia, depressed respiration, impaired cognition

35
Q

What can chronic use of heroin lead to?

A

Constipation, tooth decay, menstrual irregularity, impotence, anorexia, addiction.
Lowered body temperature by affecting the hypothalamic heat regulation mechanism, cutaneous vasodilation, and decreased muscle activity

36
Q

How long does it take heroin to cross the blood brain barrier?

A

20 seconds

37
Q

How much heroin reaches the brain?

A

About 70%

38
Q

What is morphine hydrolysed into?

A

6-acetyl morphine,

(6-MAM) and morphine and agonises the ĸ, µ, δ opioid receptors

39
Q

How long do the effects of heroin last?

A

“Rushing” occurs within seconds, and lasts for 1-2 minutes. “High”
may last 4-6 hours and produces ‘warm’ and pleasant sensations and
indifference to internal and external stimuli.

40
Q

What is the estimated lethal dose of heroin?

A

~200 mg

41
Q

How may addicts tolerate doses?

A

In the order of 2 grams per day

42
Q

What may happen because of heroin use?

A

Rhabdomyolysis- breakdown of muscle from not moving for hours, broken down by kidney, kidney then fails

43
Q

What are the effects of cocaine?

A

Similar to alcohol

Inability to feel pleasure- take more to feel happy

44
Q

What are the most sudden death cases caused by in cocaine incidents?

A

Heart attack or stroke

45
Q

What is the half life of cocaine?

A

1 hour- BE half life 6 hours, no cocaine present look for BE look for in death
BE- Benzoylcognine

46
Q

What are the physiological manifestations of cocaine?

A

Physiological Manifestations of Cocaine:
Severe vasoconstriction, hypertension, cardiac arrhythmias, stroke,
convulsions.

47
Q

What are the causes of sudden death in cocaine related incidents?

A

Related cases are largely
cardiovascular; cerebrovascular, excited delirium, and respiratory. Violence,
traffic, accidental.

48
Q

How are blood levels at post mortem of cocaine?

A

Blood cocaine levels are often very low at post-mortem (range 0.01–3 mg/L,
median 0.1 mg/L in a study of 49 (Pilgrim et al)). Benzoylcognine may be
higher.

49
Q

What are the peak plasma levels of cocaine following muscosal membrane absorption?

A

60 minutes

50
Q

How long do intravenous and inhalation effects take to kick in?

A

5-10 mins

51
Q

How does cocaine cause hypothermia?

A

Cocaine raises body temperature by limiting the amount of blood flow to the
skin, making it difficult to sweat, and reducing the perception of excessive heat, so the body doesn’t register sweating.

52
Q

What is LSD?

A

A hallucinogenic

53
Q

What does LSD facilitate?

A

Free release of serotonin receptors and blocks the re uptake

54
Q

How can you take LSD?

A

Snorted, smoked, injested and injected

55
Q

What are the effects of LSD?

A

Euphoria, ‘rushing’, loss of control. Anxiety, paranoia, dysphoria,
anhedonia, restlessness, insomnia, loss of libido
hypnagogic experiences and dreams, and changes to time perception (including speeding and slowing). Sweating, agitation, insomnia, tachycardia and piloerection. Changes in body image and egotism also often occur

56
Q

What is LSD derived from?

A

Ergot (Claviceps purpurea)

57
Q

What actions are LSD?

A

Both agonistic and
antagonistic and the mechanism by which LSD elicits its effects are not fully
understood.

58
Q

How long does LSD effects last?

A

Around 30 minutes post ingestion and they may last for more than 12 hou

59
Q

What is the half life of LSD?

A

LSD has a plasma half-life of 2.5-4 hours. Metabolites of LSD include N-desmethyl-LSD, hydroxy-LSD, 2-oxo-LSD, and 2-oxo-3-hydroxy-LSD. These metabolites are all inactive.

60
Q

What is psilocybin commonly known as?

A

Magic Mushrooms

61
Q

How are magic mushrooms obtained?

A

Generally eaten, cooked or brewed in tea. Rarely smoked.

62
Q

What are the effects of magic mushrooms?

A

Tingling, euphoria, lightness, laughter, vibrant colours, music perceptions, shimmers and glitter trails, profound details, time distortion, merging objects, intensity, audio and visual hallucinations, mystical experiences.
Nausea, cramping, vomiting, diarrhoea, anxiety, fear, paranoia, confusion, pupil dilation, distorted vision, frightening hallucinations, loss of muscle control, mood swings, toxic feeling, hyper-awareness of breathing/body, mild/mod tachycardia, increased respiration. Body temperature remains normal.

63
Q

What happens if you take incorrect mushrooms?

A

May result in fatal poisoning

64
Q

When is the peak hallocinogenic effect of mushrooms?

A

70-90 mins, while the psilocybin plasma peak is reached after 105 min with a half-life of 163 min
5-Ht receptor agonist

65
Q

What have high doses of psilocybin found to produce?

A

Transient increase in BP, not considered to be dangerous in healthy individuals. Minor increases in TSH, prolactin, cortisol, adrenocorticotropic hormone. Returned to normal after 300 mins.

66
Q

What is ecstasy?

A
Ecstasy’ is an illegal, class A stimulant drug containing the active ingredient 
3,4-methylenedioxymethamphetamine (MDMA)
67
Q

What form is ecstasy usually in?

A

Tablet forms that are white, off-white, pink or blue in colour.
Tablets are usually taken orally or crushed into powder and snorted,
injected or smoked. Tablets usually carry an identifying symbol
(often copies of major international brands such as ‘Mitsubishi’ or ‘Rolex’)

68
Q

What feelings are caused by ecstasy?

A

Feelings of intense wellbeing and happiness, extrovert behaviour, moderate derealisation and perceptual changes. It is often referred to as the “love-drug”, with many users reporting intense feelings of love towards others who may be strangers.

69
Q

What is the physiological response to MDMA?

A

Elevated heart rate and blood pressure, slight increase in psychomotor drive, muscle spasms, hyperthermia, jaw clenching, loss of appetite and impaired concentration (Liechti et al., 2000). In cases of toxicity, patients may present with hypertension, faintness, syncope, panic attacks, loss of consciousness, severe hyperthermia (38.5’C to 43 ‘C), which can result in rhabdomyolysis, renal failure, seizures, disseminated intravascular coagulopathy, cerebrovascular events, cardiac arrhythmias and death (Rieder, 2002).

70
Q

What is methamphetamine?

A

CNS stimulant

Highly addictive psychoactive stimulant.

71
Q

How addictive is meth?

A

One of the most addictive substances

Considered one of the most addictive substances on the street. 92% of 1st time users will re-use,

72
Q

How is meth taken?

A

Normally smoked

(lightbulbs, pipes etc). Injecting, snorting, ingesting.

73
Q

What are the effects of meth?

A

Appetite suppression, increased energy and libido, euphoria,
tachycardia, hyperthermia, insomnia, excitation, aggression,
anxiety, depression, fatigue, diminished coping abilities,
unprovoked violence

74
Q

What are the effects of meth on chronic users?

A

May develop psychosis.

75
Q

What is meths excitatory duration?

A

3 or more hrs and it is metabolised to amphetamine, (active metabolite).

76
Q

What are the symptoms when meth is metabolised?

A

These symptoms are normally associated with methamphetamine levels in blood of 0.15 to 0.5 mg/L

77
Q

What are the symptoms of toxicity meth?

A

Toxicity includes confusion, restlessness, anxiety, hallucinations, cardiac arrhythmia, hypertension, circulatory collapse, convulsions and coma. 1.4- 13 mg/L (ingestion).

78
Q

When are the peak plasma levels of meth reached?

A

~ mins after smoking.

79
Q

What is the mean half life for smoked meth?

A

11.1 hrs

80
Q

What is the mean half life of intravenous meth?

A

12.2 hrs

81
Q

How can you distinguish therapeutic use of meth and abuse use of meth?

A

Blood concentrations

82
Q

What are the concentrations of therapeutic meth use?

A

0.02-0.05 mg/L
Highest 0.2 mg/L
Concentrations greater than this represent abuse

83
Q

What does meth stimulate?

A

Norepinephrine release from sympathetic nerve terminals, which then enhances thermogenesis in skeletal muscle under the permissive action of glucocorticoids.

84
Q

After death where is meth redistributed?

A

Into central blood and the myocardium.