Central Nervous System Stimulants Living & Dying Harder & Faster in

Central Nervous System Stimulants Living & Dying Harder & Faster in the Night of the Living Dead

CNS Stimulants Sub-Categories of CNS Stimulants Synthetics - pharmaceuticals - illicit mfg Organics - cocaine

Pharmaceutical Stimulants Medical Uses 1. control of narcolepsy 2. control of hyperactivity in children 3. prevention of fatigue 4. treatment of mild depression 5. control of appetite

Pharmaceutical Stimulants Medical Uses 6. prevention and treatment of surgical shock 7. treatment of Parkinson's disease 8. blood pressure maintenance during surgery 9. enhance the action of certain analgesic drugs 10. antagonize the effects of certain depressant drugs

Pharmaceutical Stimulants Common Examples Methamphetamine (Desoxyn, Biphetamine) – weight control Ritalin (methylphenidate) – ADD Preludin (phenmetrazine) – weight control Cylert (pemoline) – ADD

Pharmaceutical Stimulants Common Antagonist Examples Eskatrol – stimulant & depressant combo Dexamyl – stimulant & depressant combo

Illicitly Manufactured Stimulants Amphetamine Sulfate Methamphetamine (speed, crank) P2P Methods (DL Meth) Ephedrine Methods (D Meth)

Methamphetamine Ephedrine Methods Crystal Meth – Ephedrine – Red Phosphorus – Hydriotic Acid Ice

Methamphetamine Clan Lab Safety Considerations Do NOT – turn anything on or off – transport chemicals – handle contaminated items

Methamphetamine Clan Lab Safety Considerations DO – – – – call a supervisor call narcs fire dept. standing by, if needed call Haz Mat team

Methamphetamine Powder – tan, brown, white, pink, ?

Methamphetamine Rock – tan, brown, white, pink, ?

Methamphetamine Rock – tan, brown, white, pink, ?

Methamphetamine Rock – tan, brown, white, pink, ?

Methamphetamine Methods of Ingestion Inhaled Injected

Methamphetamine Methods of Ingestion Smoked Oral

Methamphetamine Liquid – light amber, dark amber, black

Methamphetamine Crystal Meth Ice

Organic Stimulants Caffeine Nicotine Adrenaline Cocaine

Cocaine Coca leaf Mountains of Bolivia, Peru, Colombia Chewing, Medical Use, Illicit Use semi-lengthy mfg process

Forms of Illicit Cocaine 1) Cocaine HCL (powder form)

Forms of Illicit Cocaine 1) Cocaine HCL (powder form)

Forms of Illicit Cocaine 1) Cocaine HCL (powder form)

Forms of Illicit Cocaine 1) Cocaine HCL (powder form)

Forms of Illicit Cocaine 1) Cocaine HCL (snorted, injected)

Forms of Illicit Cocaine 2) Base Cocaine – Free Base – Rock – Crack

Forms of Illicit Cocaine 2) Base Cocaine – Free Base – Rock – Crack

Forms of Illicit Cocaine 2) Base Cocaine (smoked)

CNS Stimulants Possession for Sale – quantity what does a user normally possess/use? – paraphernalia scales cut . . packaging pays & owes .

CNS Stimulants Signs & Symptoms - aggressive - euphoria - inattention - sweating - paranoia meth sores

CNS Stimulants Signs & Symptoms Dopamine & Norepinephrine - restlessness - anxiety - hyperactive - bruxism - irritable - tremors - misperceive time & distance

CNS Stimulants Signs & Symptoms - Cortisone immune system, healing, stress - Histamines itching, allergy-like symptoms

CNS Stimulants Signs & Symptoms white tongue if stimulant smoked

CNS Stimulants Evidence of Smoking Cocaine burnt/blistered thumb/fingers, lips

CNS Stimulants Evidence of Smoking Cocaine blackened gums

CNS Stimulants Signs & Symptoms (High Dose or Low Tolerance) hallucinations extreme paranoia coma convulsions violence death

CNS Stimulants Binging meth psychosis cocaine psychosis Chemically induced 5150’s! ! BEWARE !

CNS Stimulants Addiction Chemical Tolerance Overdose Dependency

Onset of the Effects of Cocaine (in seconds) 30 25 20 Minimum Maximum 15 10 5 0 Injected Inhaled Smoked Oral

Duration of the Effects of Cocaine (in minutes) 120 100 80 Minimum Maximum 60 40 20 0 Injected Inhaled Smoked Oral

Cocaine Toxicology Blood – metabolite: 3-5 hours Urine – metabolite: 36-48 hours

Onset of the Effects of Meth (in seconds) 30 25 20 Minimum Maximum 15 10 5 0 Injected Inhaled Smoked Oral

Duration of the Effects of Methamphetamine (in HOURS) Oral Smoked Inhaled Minimum Maximum Injected 40 35 30 25 20 15 10 5 0

Methamphetamine Toxicology Blood – while they are under the influence Urine – 36-48 hours

CNS Stimulants Difference between Cocaine Methamphetamine - anesthetic - not an anesthetic - short duration - longer duration - users convert - users try to mfg.

CNS Stimulant Evaluation 1) Preliminary Observations - Medical Questions - General Observations: hyper, sweaty, dilated pupils, paranoia, 2) Eye Exams VGN:No LOC: No HGN: No

CNS Stimulant Evaluation 3) Pulse UP! 4) Divided Attention Tests Romberg: Heel to Toe: One Leg Stand: Finger to Nose: Fast Fast/Impaired Fast/Impaired Fast/Impaired

CNS Stimulant Evaluation 5) Pupil Examination Room Light: Dilated (Mydriasis) Near Total Darkness: Dilated Indirect Light: Dilated Direct Light: Slow Reaction - Hippus: No - Rebound: Cocaine

CNS Stimulant Evaluation 6) Methods of Ingestion Nasal Cavity: possible debris Oral Cavity: possible debris Injection Sites: possibly present Burnt fingers: Cocaine Burnt lips/tongue: Cocaine