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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5536_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •EDITORIAL BOARD
- •TABLE OF CONTENTS
- •Glossary of Selected Terms
- •Preface
- •Introduction
- •Basic concept of Drug Related Health Issues
- •Definitions of Drug and Alcohol Problems
- •Overview of Alcohol
- •References
- •Introduction
- •Alcohol Intoxication
- •References
- •Introduction
- •Basic Concept of Tobacco
- •Pharmacology
- •Chronic System Toxicity
- •Smoking Cessation Strategies
- •References
- •Introduction
- •Overview on Cannabis
- •Pharmacology
- •Amphetamines
- •References
- •Introduction
- •History of Drug Addiction and Drug Abuse
- •What is Drug Abuse and Addiction?
- •What does a Drug and Alcohol Abuse Counselor do?
- •Alcohol Abuse Careers
- •Drug and Alcohol Worker
- •References
- •Index

Overview of Drugs
■ anxiety
■ insomnia
■ panic
■ hallucinations
■ depersonalisation
■ heightened sensory awareness
■ depression
■ a risk of seizures with abrupt withdrawal
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Cannabis (marijuana, grass, dope, pot, puff, weed)
Cannabis is usually smoked with tobacco. It is available in the form of resin, dried
and chopped leaves and - less commonly - oil. The main active compound in
cannabis is THC.
The effects of the drug are varied and include:
■ euphoria
■ laughter
■ vivid sensations
■ imagery and hallucinations
■ persistent ideas
■ paranoia
These effects will vary depending on the person, the environment and the potency
and amount of the drug used.
Cocaine (Charlie, coke, snow)
Cocaine is most commonly found as a white crystalline powder, and is usually
snorted but is occasionally made into a solution and injected.
The effects of cocaine are similar to amphetamines and crack in that they create
physical and mental arousal. When cocaine is snorted the effect is almost immediate
and then peaks and fades within 15 - 30 minutes. This often results in users repeating
their use almost every 20 minutes or so in order to maintain the desired effect.

10
Citation: https://i.ytimg.com/vi/iunRzPP7NVw/maxresdefault.jpg
The snorting of cocaine can lead to mucosal constriction and eventually perforation
of the nasal septum.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Crack (base, rocks, crystal)
Crack is similar to cocaine although the effects are even more extreme. They take
effect immediately and last for about 10 minutes.
Crack is usually smoked and this can produce particularly aggressive and paranoid
behaviours. Crack is highly addictive, although reports that crack is instantly
addictive are false.
People experience feelings of:
■ wellbeing
■ exhilaration
■ increased confidence
■ loss of appetite
■ indifference to pain and fatigue
■ hallucinations
■ paranoia
In rare cases users have died from overdose. Heavy and regular use can cause
feelings of nausea, restlessness, insomnia, over-excitability and weight loss.

Overview of Drugs
11
Ecstasy (xtc, Adam & Eve, doves, pills)
Ecstasy mainly comes in tablet form but can come in capsules or powder. The
tablets can come in a number of different colours and often display a logo. It is
usually swallowed but is sometimes snorted; its effects are experienced after 20 - 60
minutes and can last for 3 - 6 hours. The chemical name for pure ecstasy is MDMA.
Ecstasy acts on the central nervous system and increases brain activity. The pupils
become dilated, the jaw tightens and there is often brief nausea, sweating, dry mouth
and throat. The blood pressure and heart rate increases and sweating is common.
Users report a mild euphoric and hallucinogenic effect, loss of anger, empathy with
other people and an enhanced sense of communication.
Ecstasy affects the body’s temperature regulation, with excessive dancing this can
lead to overheating and dehydration - and in some cases death. It is recommended
that users take small, regular sips of water but no more than a pint of water an
hour as deaths have also been related to users taking in too much water, which is
very dangerous to the body.
Heroin (scag, smack, gear)
Heroin is one of a group of drugs called opiates that are derived from the opium
poppy. It usually comes as an off white or brown powder. A number of synthetic
opiates are also manufactured for medical use and are open to abuse due to their
similar effects to heroin, these include:
■ dihydrocodeine (Df118)
■ codeine
■ tramadol
■ pethedine
■ diconal
Methadone and Subutex are prescribed as substitute drugs in the treatment of
heroin addiction.
Heroin is usually smoked (‘chasing the dragon’), snorted or prepared for injection.
Heroin is a powerful pain killer and has euphoric qualities. The combined effects
make heroin a very effective escapist drug.
Effects include:
■ sense of wellbeing
■ feeling warm and content
■ drowsy and untroubled
■ sense of calm
■ feeling of pleasure

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■ absence of worry, anxiety or pain
At higher doses, the user may become heavily sedated, be sleepy, unable to talk, and
appear to fall asleep for a few minutes at a time. This is referred to as ‘gauching’
or ‘nodding.’
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://www.zerohedge.com/sites/default/files/images/user230519/imageroot/Heroin.
jpg
There is an unpleasant period of withdrawal (often called “cold turkey”). These
symptoms may begin within 6 to 24 hours of discontinuation and last for weeks,
or even months after.
Symptoms include:
■ sweating
■ malaise
■ anxiety
■ depression
■ general feeling of heaviness
■ excessive yawning or sneezing
■ insomnia
■ cold sweats
■ chills
■ severe muscle and bone aches
■ nausea and vomiting

Overview of Drugs
■ diarrhoea
■ cramps
■ fever
Heroin remains one of the most problematic illicit substances in the UK.
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Solvents
Solvents are rapidly absorbed through the lungs into the bloodstream and quickly
distributed to the brain and other organs. Within minutes users experience intoxication,
with symptoms similar to those produced by drinking alcohol. Intoxication lasts only
a few minutes, so some users prolong the “high” by continuing to inhale repeatedly.
The users initially feel slightly stimulated and after successive inhalations feel less
inhibited and less in control. Hallucinations may occur and loss of consciousness.
Sudden death syndrome is a risk, although rare it more commonly occurs amongst
young people when using air conditioning coolants, butane, propane and some
aerosols. These cause the heart to beat rapidly and erratically resulting in cardiac
arrest.
Long term users can suffer from:
■ weight loss
■ muscle weakness
■ disorientation
■ in-attentiveness
■ lack of coordination
■ irritability
■ depression
Regular abuse of them can result in serious harm to vital organs. Serious, but
potentially reversible effects include liver and kidney damage. Harmful irreversible
effects include: hearing loss, limb spasms, bone marrow and central nervous system
(including brain) damage.
Mephedrone (meow, M-CAT, magic, plant food)
Mephedrone is a stimulant drug similar to ecstasy or speed. It comes in capsules,
tablets or more commonly in powder form. The capsules or tablets are swallowed
whilst the powder is usually snorted.
Users report a feeling of ‘coming up’ or of rushes as the drug takes effect. The
main effects include:
■ feeling alert
■ a sense of calm wellbeing

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■ excitement
■ stimulation
■ elevated mood
■ chattiness
■ dry mouth
■ loss of appetite
■ poor concentration
■ increased heart rate
■ raised body temperature
■ racing heart
■ panic
■ sweating
■ distinct fishy smell coming from sweat
The effects occurs within 10 to 20 minutes and on average last for 40 to 60 minutes.
According to users there is a highly addictive quality to the substance.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://www.profoundservices.com/uploads/protection/hot_topics/x1-hot-topic-
image.jpg.pagespeed.ic.ZzghRft8nl.jpg
NRG-1
Naphyrone (NRG-1; Energy1) is a stimulant drug that is closely related to mephedrone
with similar effects to amphetamines, cocaine and ecstasy. It is considered 5-10
times more potent than mephedrone or ecstasy.

Overview of Drugs
Naphyrone usually comes in the form of a white crystalline powder and is normally
snorted or swallowed in wraps of paper. It is sold on the internet as plant food or
pond cleaner for £12 - £15 per gram.
Users report feelings of euphoria, empathy, talkativeness and alertness.
As with other stimulant drugs, harmful effects include:
■ adverse effects on the heart and blood vessels
■ hyperthermia (overheating of body temperature)
■ increased body temperature
■ likelihood to become dependent
■ psychiatric effects including psychosis and anxiety
In extreme cases, amphetamine-like drugs like NRG1 can cause death due to
cardiovascular collapse or heart shock.
15
Top Ten Drugs and their Effects
Drug abuse is a very common problem in most countries so it seemed like a good
topic for a list. This is a list of ten of the most abused drugs and the effects they
have on people.
Citation: https://i.ytimg.com/vi/2l80zoVSKEU/maxresdefault.jpg
Heroin
Heroin is an opiate processed directly from the extracts of the opium poppy. It was
originally created to help cure people of addiction to morphine. Upon crossing
the blood-brain barrier, which occurs soon after introduction of the drug into

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the bloodstream, heroin is converted into morphine, which mimics the action of
endorphins, creating a sense of well-being; the characteristic euphoria has been
described as an “orgasm” centered in the gut. One of the most common methods
of heroin use is via intravenous injection.
For the last 4 months, my partner and I have been recreationally using heroin. H
became our weekend ritual. Lighting candles, playing music, brie and wine and
grapes, reading tarot and finally fucking… for hours on end, the most intense
beautiful technicolor sex. Each time we did it we got closer to each other. And
each time we did it, we wanted to do it again, and again. We tried saying we’d
only do it once every two weeks, but that lasted 6 days. We have rules about how
much we do in one night, how late we stay up and so on. So far the rules have
kept us safe from addiction. Unless you consider the nagging i-don’t-wanna-go-aweekend-or-have-sex-without-it feelings.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the
coca plant. It is both a stimulant of the central nervous system and an appetite
suppressant, giving rise to what has been described as a euphoric sense of happiness
and increased energy. It is most often used recreationally for this effect. Cocaine is
a potent central nervous system stimulant. Its effects can last from 20 minutes to
several hours, depending upon the dosage of cocaine taken, purity, and method of
administration. The initial signs of stimulation are hyperactivity, restlessness, increased
blood pressure, increased heart rate and euphoria. The euphoria is sometimes
followed by feelings of discomfort and depression and a craving to experience the
drug again. Sexual interest and pleasure can be amplified. Side effects can include
twitching, paranoia, and impotence, which usually increases with frequent usage.
Methamphetamine
Methamphetamime, popularly shortened to meth or ice, is a psychostimulant
and sympathomimetic drug. Methamphetamine enters the brain and triggers a
cascading release of norepinephrine, dopamine and serotonin. Since it stimulates
the mesolimbic reward pathway, causing euphoria and excitement, it is prone to
abuse and addiction. Users may become obsessed or perform repetitive tasks such
as cleaning, hand-washing, or assembling and disassembling objects. Withdrawal
is characterized by excessive sleeping, eating and depression-like symptoms, often
accompanied by anxiety and drug-craving.

Overview of Drugs
Citation: http://fordetox.com/images/articles/methamphetamine-addiction-detox.jpg
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Crack Cocaine
Crack cocaine, often nicknamed “crack”, is believed to have been created and
made popular during the early 1980s . Because of the dangers for manufacturers
of using ether to produce pure freebase cocaine, producers began to omit the step
of removing the freebase precipitate from the ammonia mixture. Typically, filtration
processes are also omitted. Baking soda is now most often used as a base rather
than ammonia for reasons of lowered odor and toxicity; however, any weak base
can be used to make crack cocaine. When commonly “cooked” the ratio is 1:1 to
2:3 parts cocaine/bicarbonate
LSD
Lysergic acid diethylamide, LSD, LSD-25, or acid, is a semisynthetic psychedelic
drug of the tryptamine family. Arguably the most regarded of all psychedelics, it
is considered mainly as a recreational drug, an entheogen, and a tool in use to
supplement various types of exercises for transcendence including in meditation,
psychonautics, and illegal psychedelic psychotherapy whether self administered
or not. LSD’s psychological effects (colloquially called a “trip”) vary greatly from
person to person, depending on factors such as previous experiences, state of mind
and environment, as well as dose strength. They also vary from one trip to another,
and even as time passes during a single trip. An LSD trip can have long term
psychoemotional effects; some users cite the LSD experience as causing significant
changes in their personality and life perspective. Widely different effects emerge
based on what Leary called set and setting; the “set” being the general mindset of
the user, and the “setting” being the physical and social environment in which the
drug’s effects are experienced.

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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: http://abuse-drug.com/wp-content/uploads/2016/02/lsd-4.jpg
About ten years ago you bought my third trip from a guy in my home town Norwich
(UK) It was a ‘Strawberry’ and you was told it had been double dipped. The guy
had a reputation for selling good acid so you happily gave him my cash. You took
the single LSD tab in the late morning in a positive state of mind with no worries
or anxieties. You began to come up on the acid towards the lunch time. It was to
be the first and last time you did ever trip alone. Outside it was a glorious sunny
day but I was happy enough in my temporary sanctuary to even think about going
outside. The LSD rush started blazing up my spine and racing through my guts, you
felt a little uneasy with it but had enough mind to allow myself to just go with
it and wait until the rush plateaued. You was having a wonderful time, watching
floral Escher type patterns breathing over my skin. You vaguely recall deciding to go
downstairs again for some reason then the next thing you recall was awakening on
the floor of the dining room alone. The first thing you noticed was that there were
blowflies buzzing around a bowl of catfood on the kitchen floor. you remember
feeling perplexed as to why both flies had two bright neon after images in red and
blue. Somehow you navigated myself through Norwich during the busy lunchtime
shoppers and begun to head in the direction of the city’s central park ‘Chapelfield
gardens’. If you could imagine for a moment being surrounded by people in a
busy place where their heads had been removed and replaced by Squids and
Octopus you might begin to accurately picture the scene confronting me in the
park. Everyone had tentacles smothering their faces and dangling down their necks
like fleshy snake beards, even the women and children were not exempt from this
disfiguration. In retrospect, it was the worst day of my entire life, It was the closest
you can imagine to having full blown psychosis.
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