SUBSTÂNCIAS DE ABUSO II

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SUBSTÂNCIAS DE ABUSO II
Semana 8
Psilocibina,
Solventes, Cetamina
Hallucinogens are a general group of pharmacological agents that can be divided into three broad categories: psychedelics,
dissociatives, and deliriants. These classes of psychoactive drugs have in common that they can cause subjective changes in
perception, thought, emotion and consciousness. Unlike other psychoactive drugs, such as stimulants and opioids, these drugs do
not merely amplify familiar states of mind, but rather induce experiences that are qualitatively different from those of ordinary
consciousness. These experiences are often compared to non-ordinary forms of consciousness such as trance, meditation,
dreams, or insanity.
L. E. Hollister's criteria for establishing that a drug is hallucinogenic is:
• in proportion to other effects, changes in thought, perception, and mood should predominate;
• intellectual or memory impairment should be minimal;
• stupor, narcosis, or excessive stimulation should not be an integral effect;
• autonomic nervous system side effects should be minimal; and
• addictive craving should be absent.
Not all drugs produce the same effect and even the same drug can produce different effects in the same individual on different
occasions
Dissociatives are a class of hallucinogen, which distort perceptions of sight and sound and produce feelings of detachment dissociation - from the environment and self. This is done through reducing or blocking signals to the conscious mind from other
parts of the brain. Although many kinds of drugs are capable of such action, dissociatives are unique in that they do so in such a way
that they produce hallucinogenic effects, which may include sensory deprivation, dissociation, hallucinations, and dream-like states or
trances.[2] Some, which are nonselective in action and affect the dopamine [3] and/or opioid[4] systems, may be capable of inducing
euphoria. Many dissociatives have general depressant effects and can produce sedation, respiratory depression[citation needed], analgesia,
anesthesia, and ataxia, as well as cognitive and memory impairment and amnesia
The term illusion refers to a specific form of sensory distortion. Unlike a hallucination, which is a
distortion in the absence of a stimulus, an illusion describes a misinterpretation of a true sensation. For
example, hearing voices regardless of the environment would be a hallucination, whereas hearing voices
in the sound of running water (or other auditory source) would be an illusion
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entheogen ("the god within”)
Psylocibe cubensis
Source, European Monitoring Center for Drugs and Drug Addiction, 2012
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Hallucinogenic mushrooms
Hallucinogenic mushrooms’ is the name commonly given to
psychoactive fungi, containing hallucinogenic compounds, most
commonly psilocybin and psilocin. At low doses, hallucinogenic drugs
have as their primary effects perceptual distortions and alterations of
thought, or mood, with the presence of lucid awareness and minimal
effects on memory and orientation. Despite their name, the use of
hallucinogenic drugs rarely results in true hallucinations. The
hallucinogens are a chemically diverse class.
Grouping the hallucinogens based on their chemical structure
includes, but is not limited to, three major classes: indolealkylamines
or tryptamines (e.g. LSD, psilocybine and psilocin), phenethylamines,
including mescaline and methylenedioxymethamphetamine (MDMA);
and cannabinoids
Hallucinogenic mushrooms
Chemistry
Psilocybin (PY, 4-phosphoryloxy-N,N-dimethyltryptamine) is the main psychoactive
principle of hallucinogenic mushrooms. After ingestion, psilocybin is converted into
the pharmacologically active form psilocin. Psilocin itself is also present in the
mushroom, but in smaller amounts. Psilocybin and psilocin are both
indolealkylamines and structurally similar to the neurotransmitter serotonin (5hydroxytryptamine or 5-HT). Besides psilocybin and psilocin, two further
tryptamines — baeocystin and norbaeocystin — could also be present but are
thought to be less active than the former two.
Psilocybin (psilocybine, psilocibina, psilocybinum, psylosybiini) (CAS-number: 52052-5) is 4-phosphoryloxy-NN-dimethyltryptamine. According to IUPAC, the fully
systematic chemical name is [3-(2-dimethylaminoethyl)-1H-indol-4-yl] dihydrogen
phosphate. Psilocybin is the dihydrogen phospate of psilocin. Psilocybin is soluble
in water, moderately soluble in methanol and ethanol, and insoluble in most
organic solvents. Psilocybin is a prodrug of psilocin, in vivo the molecule is
metabolised into psilocin by dephosphorylation (see next slide)
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Hallucinogenic mushrooms
Psilocybin is rapidly dephosphorylated in the
body to psilocin, which is a partial agonist for
several serotonergic receptors
The toxicity of psilocybin is low. In rats, the
median lethal dose (LD50) when administered
orally is 280 milligrams
Hallucinogenic mushrooms
The neurotransmitter serotonin is structurally
similar to psilocybin
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Hallucinogenic mushrooms
Hallucinogenic mushrooms
Physical form
Hallucinogenic mushrooms are available in fresh form, treated/preserved (e.g. deliberately
dried, cooked, frozen) or even as dry powders or capsules.
The fungi containing psilocybin and psilocin mainly belong to the genuses Psilocybe,
Panaeolus and Copelandia and their number exceeds 50 species. Most of the mushrooms
containing psilocybin are small brown or tan mushrooms. In the wild, these mushrooms are
easily mistaken for any number of non-psychoactive, inedible, or poisonous mushrooms.
This makes them difficult, and potentially hazardous, to identify.
Panaeolus cinctulus
Copelandia cyanescens
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Hallucinogenic mushrooms
Hallucinogenic mushrooms
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Hallucinogenic mushrooms
Because it is difficult to distinguish
non-psilocybin species from the
hallucinogenic ones by
morphological observation in the
wild, psilocybin-containing
mushrooms may also be easily
ingested unintentionally.
Hallucinogenic mushrooms
resemble the common store
mushroom Agaricus bisporus,
although the flesh of Psilocybe
mushrooms characteristically turns
blue or green when bruised or cut.
An identification method based on a
genetic approach has been
developed.
Hallucinogenic mushrooms
A different species of mushroom, Amanita muscaria (fly agaric), produces a state of
delirium that also includes hallucinations, but its primary active agents are muscimol
and ibotenic acid (and traces of muscarine)
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Hallucinogenic mushrooms
A possible biosynthetic route to psilocybin. Although the order of the first (decarboxylation) and last
(phosphorylation) steps are known with some certainty, the sequence of the two intermediate steps is
speculative
Psilocybin (O-phosphoryl-4-hydroxy-N,N-dimethyltryptamine or
4-PO-DMT) is a prodrug that is converted into the
pharmacologically active compound psilocin in the body by a
dephosphorylation reaction
Hallucinogenic mushrooms
Pharmacology
Psilocin mainly interacts with 5-HT1A, 5-HT2A and 5-HT2C receptor subtypes: it is a
mixed receptor agonist. In contrast to LSD, psilocin does not have an effect on the
dopamine receptor. Tryptamines and phenethylamine hallucinogens both have a
relatively high affinity for serotonin 5-HT2 receptors, but they differ in their affinity
for other subtypes of serotonin receptors. The correlation between the relative
affinity of hallucinogens for 5-HT2-receptors and their potency as hallucinogens in
human beings suggest that an important component of the mechanism of action of
these substances is through stimulation of brain 5-HT2-receptors.
A primary role for the 5-HT2-receptor in the mechanism of hallucinations is further
suggested by the observation that antagonists of the 5-HT2-receptor are effective in
blocking the behavioural and electrophysiological effects of hallucinogenic drugs in
animals and in man. Although 5HT2-receptors are certainly involved, at present, it is
not possible to attribute the psychedelic effects to any single 5-HT receptor subtype
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Hallucinogenic mushrooms
Hallucinogenic mushrooms
Behavioural effects are dependent on dose and the individual reaction and sensitivity
to psilocybin, previous experiences and the setting. The major effects are related to the
central nervous system, but there are also some sympathomimetic effects. The
subjective effects, however, may vary greatly between individuals and from one episode
of use to the next within the same person. The effects range from mild feelings of
relaxation, giddiness, euphoria, visual enhancement (seeing colours brighter), visual
disturbances (moving surfaces, waves), to delusions, altered perception of real events,
images and faces, or real hallucinations. The sensory distortions may be coupled with
restlessness, incoordination, feelings of anxiety, impaired judgement of time or
distance, sense of unreality or even depersonalisation.
These effects may be termed 'bad trips' by users and can also involve panic reactions
and psychosis-like states.
In general, the physiological effects are not significant, but may include dizziness,
nausea, weakness, muscle aching, shivering, abdominal pain, dilation of pupils
(mydriasis), mild-to-moderate increase in heart rate (tachycardia) and breathing
(tachypnea) and elevation of blood pressure. Generally, body temperature remains
normal. However, pronounced physical symptoms such as severe stomach pain,
persistent vomiting, diarrhoea etc. have been recorded
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Hallucinogenic mushrooms
Set and setting describes the context for psychoactive and
particularly psychedelic drug experiences:
one's mindset and the setting in which the user has the experience.
This is especially relevant for psychedelic or hallucinogenic
experiences
'Set' is the mental state a person brings to the experience, like thoughts, mood
and expectations. 'Setting' is the physical and social environment. Social
support networks have shown to be particularly important in the outcome of
the psychedelic experience. They are able to control or guide the course of the
experience, both consciously and subconsciously. Stress, fear, or a disagreeable
environment, may result in an unpleasant experience (bad trip). Conversely, a
relaxed, curious person in a warm, comfortable and safe place is more likely to
have a pleasant experience.
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Hallucinogenic mushrooms
Perceptual distortions
Psilocybin is known to strongly
influence the subjective experience
of the passage of time. Users often
feel as if time is slowed down,
resulting in the perception that
"minutes appear to be hours"
The ability of psilocybin to cause perceptual
distortions is linked to its influence on the
activity of the prefrontal cortex
Hallucinogenic mushrooms
Origin
Both psilocybin and psilocin can be produced synthetically, but this form
of the drug is not often found. Users purchase hallucinogenic mushrooms
and by-products from smartshops and on the Internet, or pick them wild.
The cubensis varieties are cultivated specifically (mostly in the
Netherlands). The types of magic mushrooms most commonly sold by
smartshops in the Netherlands are the Psilocybe cubensis varieties,
notably the Psilocybe mexicana.
Online shops sell a variety of hallucinogenic mushroom products ranging
from fresh mushrooms to spore prints, spawnbags and growkits. The
majority of online shops offer international shipping, although most sites
do not ship to countries where sales are prohibited.
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Hallucinogenic mushrooms
Mode of use
Recreational doses range from 1–5 grams of dry mushrooms depending
on the species and individual strength of the specimens.
Dosages for fresh mushrooms will be approximately 10 times higher
(10–50 grams).
The material may be eaten raw, boiled in water to make tea, or cooked
with other foods to cover its bitter flavour. After ingestion, the
psilocybin is enzymatically converted to psilocin. Absorbed from the
gastro-intestinal tract, hallucinogenic effects usually occur within 30
minutes of ingestion with a duration of effect of 4–6 hours.
Hallucinogenic mushrooms
Other names
Common names in the English language are: shrooms; magic mushrooms; sacred
mushrooms; teonanácatl. Various terms have also been used by users for various forms of
psilocybin and psilocin or mushrooms containing these hallucinogens: blue caps; boomers;
booms; buttons; caps; champ; fungus; funguys; God's flesh; hombrecitos; las mujercitas;
little smoke; Mexican mushroom; mushies; mushroom soup; mushroom tea; mushrooms;
musk; pizza toppings; rooms; silly putty; simple Simun; zoomers (Martindale, 2007).
Translations of ‘hallucinogenic mushrooms’ in European languages include:
Bulgarian — ‘магически гъби'; Czech — 'magické houby'; Danish — 'psilocybinsvampe',
'magiske svampe'; Estonian — 'hallutsinogeense toimega seened'; Greek — 'μαγικά
μανιτάρια'; French — 'champignons hallucinogènes' or 'champis'; German — 'Psychoaktive
Pilze' or 'Zauberpilze'; Hungarian — 'varázsgombák', 'hallucinogén gombák',
'pszilocibingombák'; Italian — 'funghi magici'; Latvian — ‘Halucinogēnās (maģiskās) sēnes';
Lithuanian — 'haliucinogeniniai grybai', 'magiškieji grybai'; Norwegian — 'fleinsopp'; Polish
— 'magiczne grzybki', 'grzyby halucynogenne'; Portuguese — 'cogumelos mágicos',
'cogumelos psicadélicos'; Slovakian — 'magické huby'; Slovenian — 'čudeţne gobe';
Spanish — 'hongos alucinógenos', 'hongos lisérgicos', 'honguitos'; Romanian — 'ciuperci
halucinogene'; Swedish — 'magiska svampar', 'psykedeliska svampar'
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Hallucinogenic mushrooms
Control status
Psilocin and psilocybin are controlled substances under Schedule I of the United
Nations 1971 Convention on Psychotropic Substances. However, the control of the
mushrooms that contain these substances is interpreted in many different ways
across Europe. Probably this reflects the extent to which they grow freely in certain
conditions, and the fact that they appear to be a somewhat regional phenomenon.
For example, in some European countries, the law specifically lists hallucinogenic
mushrooms themselves as a controlled substance and forbids their sale or
possession. Other countries simply treat the mushrooms as being the controlled
substances of psilocin or psilocybin in compound form. Some look at the intent of the
act; they ban cultivation, possession or sale only when for the purposes of abuse.
Their condition is also considered — fresh mushrooms might not be considered
illegal, but prepared or treated mushrooms are illegal — again perhaps reflecting the
intent Interpretation of the term ‘prepared’ or ‘treated’ is a complex matter for the
courts. Other countries use a catch-all phrase in the law (‘cultivation of any plant for
the purposes of making a psychoactive substance’). Finally, a number of countries
remain with unclear legislation, simply as there have been so few cases that have
come to court.
Hallucinogenic mushrooms
Prevalence
Prevalence estimates for lifetime use of hallucinogenic mushrooms among young
adults (15–34 years) range between 0.3 % and 14.1 % and last year prevalence
estimates between 0.2 % and 5.9 %. Among 15–16 year old school students, most
countries report lifetime prevalence estimates between 1 % and 4 %, with Slovakia
(5 %) and the Czech Republic (7 %) reporting higher levels (Annual Report 2010, p.
55).
Price
Supplies needed for mushroom cultivation can be purchased over the Internet. The
prices of the kits vary between EUR 23–140, depending on the type of
hallucinogenic mushroom species for which spores are available. Psilocybe
Mexicana, also known as ‘Philosopher’s stones' or truffles, cost between 10 and
17.5 EUR per 10 grams online in 2011 (unpublished results).
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Hallucinogenic mushrooms
Medical use
In the 1960s, pure synthetic psilocybin (Indocybin®) was marketed by Sandoz for
experimental and psychotherapeutic purposes. At present, there are no medical
indications for psilocin or psilocybin. Recent research with psilocybin has been
reported on the treatment of compulsive disorders in humans.
In the past few years, a growing number of studies using human volunteers have
begun to explore the possible therapeutic benefits of drugs such as psilocybin, LSD,
DMT, MDMA, ibogaine and ketamine. These studies are looking at psilocybin and
other hallucinogens to treat a number of otherwise intractable psychiatric disorders,
including chronic depression, post-traumatic stress disorder, and drug or alcohol
dependency.
Hallucinogenic mushrooms
M.D.Cole, “Analysis of Controlled Substances”
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Hallucinogenic mushrooms
Hallucinogenic mushrooms
The drug reacts in the Marquis test to produce a yellow color,
and a green color in the Mandelin test.[
Neither of these tests, however, is specific for
psilocybin; for example, the Marquis test will
react with many classes of controlled drugs,
such as those containing primary amino groups
and unsubstituted benzene rings, including
amphetamine and methamphetamine
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Hallucinogenic mushrooms
MSTFA
BSTFA
Derivatization is a technique used in
chemistry which transforms a chemical
compound into a product (the reaction's
derivate) of similar chemical structure,
called a derivative.
Generally, a specific functional group of
the compound participates in the
derivatization reaction and transforms
the educt to a derivate of deviating
reactivity, solubility, boiling point,
melting point, aggregate state, or
chemical composition. Resulting new
chemical properties can be used for
quantification or separation of the educt
Hallucinogenic mushrooms
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Hallucinogenic mushrooms
Decreto-Lei n.º 15/93, de 22 de Janeiro
TABELA II-A
2C-I (2,5-dimetoxi-4-iodofenetilamina).7
2C-T-2 (2,5-dimetoxi-4-etiltiofenetilamina).8
2C-T-7 (2,5-dimetoxi-4-propiltiofenetilamina).9
Bufotenina - 5-hidroxi-N-N-dimetiltripptamina.
Catinona - (-)-α-aminopropiofenona.
DET - N-N-dietiltriptamina.
DMA - (±)-2,5-dimetoxi-α-metilfeniletilamina.
DMHP - 3-(1,2-dimetil-heptil)-1-hiroxi-7,8,9,10-tetraidro-6,6,9-trimetil-6H-dibenzo-( b,d) pirano.
DMT - N-N-dimetiltriptamina.
DOB - 2,5 dimetoxi-4-bromoanfetamina.
DOET - (±)-2,5-dimetoxi-4α-etil-metilfeniletilamina.
DOM, STP - 2-amino-1-(2,5-dimetoxi-4-metil)fenil propano.
DPT - dipropiltriptamina.
Eticiclidina, PCE - N-etil-1-fenilciclo-hexilamina.
Etriptamina – 3-(2-aminobutil)indol.10
Fenciclidina, PCP - 1-(1-fenilciclo-hexi) piperidina.
Lisergida, LSD, LSD-25-(±)-N-N-dietilisergamida; dietilamida do ácido dextro-lisérgico.
MDMA - 3,4-metilenadioxianfetamina.
Mescalina - 3,4,5-trimetoxifenetilamina.
Metcatinona – 2-(metilamino)-1-fenilpropan-1-ona.11
4-metilaminorex - (±)-cis-2-amino-4-metil-5-fenil-2-oxazolina.
MMDA - (±)-5-metoxi-3,4-metilenodioxi-α metilfeniletilamina.
4-MTA (p-metiltioanfetamina ou 4-metiltioanfetamina).12
Para-hexilo - 3-hexilo-1-hidroxi-7,8,9,10-tetraidro-6,6,9-trimetil-6H-dibenzo (b,d) pirano.
PMA - 4 α-metoxi-metilfeniletilamina.
Psilocibina - fosfatodiidrogenado de 3-(2-dimetilaminoetil)-4-indolilo.
Psilocina - 3-(-2-dimetilaminoetil)-4-(hidroxi-indol).
Roliciclidina, PHP, PCPY - 1-(1-fenilciclohexil) pirrolidina.
Tenanfetamina-MDA - (±)-3,4 N-metilenodioxi, α-dimetilfeniletilamina.
Tenociclidina, TCP - 1-[1-(2-tienil) ciclo-hexil] piperidina.
TMA - (±)-3,4,5-trimetoxi-a-metilfeniletilamina.
TMA-2 (2,4,5-trimetoxianfetamina).13
PMMA - [parametoximetilanfetamina ou N-metil-1-(4-metixifenil)-2-aminopropano]14
2C-B (4-bromo-2,5-dimetoxifenetilamina).15
GHB ((gama)-ácido hidroxibutírico).16
1-benzilpiperazina (1-benzil-1,4-diazacilohexano, N-benzilpiperazina ou, de forma menos precisa, benzilpiperazina ou BZP)17
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source, European Monitoring Center for Drugs and Drug Addiction, 2012
Volatile Substances
Volatile substance use may be defined as the
deliberate inhalation of volatile compounds to
produce psychoactive effects.
These compounds have few characteristics in common,
other than their intoxication effects and the behavioural
effects they produce. Such volatile substances are often
referred to as inhalants, a term which encompasses a
diverse group of psychoactive chemicals that are defined
by the route of administration, rather than their
mechanism of action on the central nervous system or
psychoactive effects.
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Volatile Substances
The use of volatile substances is unlike most other forms of drug use in
that it involves various compounds contained in readily accessible
domestic or commercial products. These compounds, that are safe
when used for their intended purposes, may cause intoxication and in
some cases death when their vapours are deliberately concentrated
and inhaled.
A specific subgroup of volatile substances — alkyl nitrites — are used
on the dance club scene because they cause relaxation of vascular
smooth muscle (anal sphincter) and produce a ‘rush’, or to enhance a
sexual experience. They are generally known as ‘poppers’ and can be
found on the ‘street’ market in bars and clubs. In some countries, they
are available in sex shops and ‘head’ shops
Volatile Substances
Physical form
The compounds used are volatile liquids or gases
contained in domestic, industrial or medicinal
products often freely available to the public in a range
of shops, from the workplace or laboratories.
The nitrite-containing products (‘poppers’) usually
contain butyl or isobutyl nitrite and are often impure.
The products have suggestive names and are typically
packaged in small glass bottles. The smell is
distinctive, sweet and sickly — sometimes described
as similar to the smell of ‘old socks’
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Tipos de voláteis:
Volatile Substances
Pharmacology
The mode of action of these compounds is not well understood as is also
the case for the volatile anaesthetics legitimately used in medical practice. It
is the physical properties, such as volatility and fat solubility, of the
compounds that determine their ability to be used as drugs.
The chemical properties and consequently the degree to which they are
metabolised may however be important in terms of morbidity because the
metabolites may be toxic and cause lasting organ damage.
The intoxication induced by inhalation of volatile substances produces some
behavioural effects similar to those due to alcohol. Minutes after inhalation,
dizziness, disorientation and a short period of excitation with euphoria are
observed, followed by a feeling of light-headedness and a longer period of
depression of consciousness
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Volatile Substances
Pharmacology (cont.)
Marked changes in mental state are induced in people who misuse
toluene and other solvents. Most users report elevation of mood
and hallucinations. Potentially dangerous delusions can occur,
thoughts are likely to be slowed, time appears to pass more quickly,
and tactile hallucinations are common. These behavioural effects
are accompanied by visual disturbances, nystagmus, incoordination
and unsteady gait, slurred speech, abdominal pain and flushing of
the skin.
The duration of action varies greatly, depending largely on the
volatility of the compound. The effects of butane last only a few
minutes — requiring frequent repeated doses —whereas toluene is
much longer acting (more like alcohol) requiring less frequent
doses. There are indications that toluene activates the brain’s
dopamine system that plays a role in the rewarding effects of many
psychoactive drugs
Volatile Substances
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Volatile Substances
Toxicology
Most deaths are believed to occur from ‘sudden sniffing death
syndrome’ (SSDS) an irregular and rapid heart rhythm brought on by
the use of volatile substances and anoxia or hypercapnia and a
sudden stimulus that produces an epinephrine (adrenaline) release.
Unless a defibrillator is available, death can result within minutes
from a single session in an otherwise healthy young person. Deaths
also may result from asphyxiation, particularly if a plastic bag is used
to inhale the compound (e.g. when inhaling glue). Deaths from
trauma may occur, particularly with the longer acting compounds,
e.g. toluene.
The chronic exposure to solvents such as toluene damages the
protective sheath around certain nerve fibres in the brain and
peripheral nervous system. This extensive destruction of nerve fibres
may be similar to that seen with neurological diseases such as
multiple sclerosis. Trichloroethylene may cause cirrhosis of the liver,
reproductive complications, hearing and vision damage.
Volatile Substances
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Volatile Substances
Indivíduo normal
Utilizador de Tolueno
45
Volatile Substances
A18
46
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Volatile Substances
Synthesis and precursors
The compounds are commercially available so there is no need for them to be
synthesised covertly.
Mode of use
The mode of use depends upon the volatile compound and also the nature of
the product that contains it. Gases may be inhaled directly from containers,
such as cigarette lighter refills. Aerosols may be discharged when inverted, to
enrich the outflow of propellant (usually butane) which may then be sprayed
through fabric (e.g. a towel or socks) to further remove the non-volatile
components of the product. Solvents, such as toluene, may be poured onto a
handkerchief or into a bag and the vapour inhaled. Glue is usually poured into a
plastic bag which is palpated as the vapour is inhaled. Helium, often from
disposable cylinders purchased from shops selling party balloons can also be fed
into a plastic bag covering the head.
Other names
Names related to the phenomenon: huffing, inhalant abuse, (glue) sniffing,
dusting, chroming.
Alkyl nitrites are most commonly known as ‘poppers’, but other names include:
locker room, bolt, hardware, room odouriser
Volatile Substances
Analysis
Analysis of biological specimens (blood, tissue) is most
commonly performed using headspace gas chromatography
coupled with mass spectrometry (GC-MS) or with flame
ionisation (GC-FID) or electron capture (GC-ECD) detection.
Precautions need to be taken to prevent the loss of the analyte
during sample collection and analysis, particularly for the
gaseous compounds, e.g. butane. The blood sample may need
to be collected directly into the headspace vial used for the
analysis if meaningful quantitative data are to be obtained.
Urine analysis is generally of little value except for the less
volatile and more extensively metabolised compounds, such as
toluene.
The volatile components of products may be analysed by vapour
phase infra-red spectrophotometry (VP-IR) or gas
chromatography (GC).
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Volatile Substances
Typical purities
The products that contain the volatile compounds may also contain other
components. For example, aerosols, where the propellant ‘butane’ (a blend
of butane, iso-butane and propane) is used, may contain active ingredients
such as aluminum hydroxychloride in the case of antiperspirants or they
may be essentially ‘pure’ e.g. cigarette lighter refills. The aerosols that are
used are those that contain a high proportion of propellant
(deodorants/antiperspirants, hair spray, air freshener or paint).
The purity of the volatile compound itself may also vary depending on its
intended legitimate use, for example, butane used as a propellant in
aerosols is likely to be deodorised (low in sulphur compounds) whereas
butane used as a fuel may not be deodorised and may have odorants
(sulphur compounds) added. Limits (<0.1 %) are imposed on the
carcinogen 1,3-butadiene in butane used in aerosols, but may not be when
used for fuel
Volatile Substances
Control status
In Sweden, as of 1 June 1997, ‘poppers’ became
regulated through being listed as a legal equivalent to
prescription medicines, but this law makes it illegal to
import, sell or give them away without a license.
In Romania, amyl-nitrite is controlled by
Governmental decision which entered into force on
15 February 2010
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Volatile Substances
DL 15/93 de 22 de Janeiro
Volatile Substances
Prevalence
Use of volatile substances is thought to be usually confined to short periods during early
adolescence and may be superseded by use of other psychoactive substances (such as alcohol
and cannabis) as age and disposable income increase access to alternatives. Long term or
intensive use of volatile substances is generally confined to socially marginalised individuals or
groups, often under-represented in general population household surveys and school surveys.
In some EU countries, estimates of persons ever having used volatile substances are higher
among 15- to 16-year-old school students than estimates for cannabis use. The highest lifetime
prevalence rates in the EU are reported in Cyprus, Malta and Slovenia (16 %), Ireland (15 %),
Austria (14 %), Slovakia (13 %) and Latvia (13 %). The lowest lifetime prevalence rates are found
in Bulgaria and Lithuania (3 %), as well as Portugal and Romania (4 %) (ESPAD 2007). A 2009
survey of smoking, drinking and drug use in England of 11- to 15-year-old school pupils found
that the highest lifetime prevalence for any drug was for volatile substances at 12.7 %.
Routine monitoring of mortality and morbidity data associated with volatile substances is
extremely limited in the European Union. The United Kingdom and Spain are the only Member
States to report that they monitor deaths associated with volatile substances. The United
Kingdom produces an annual report about 'Trends in death associated with the abuse of volatile
substances', which is published in June each year. According to this report, in 2005 butane from
all sources accounted for 36 of the 45 deaths and of these butane cigarette lighter refills formed
the largest group. There were three times more deaths in males than females. The peak age of
death from volatile substance use in the United Kingdom is between the ages of 15 and 16.
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Volatile Substances
Price at consumer level
Commercial products and aerosols cost only a
few euros.
Medical use
Some volatile substances are used in human and
veterinary medicine as anaesthetics (see
Chemistry and typical use table). Amyl nitrite is
used as a first aid treatment for cyanide
poisoning, whereas the other compounds have
no medical uses.
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Volatile Substances
National Institute on Drugs Abuse, USA
55
Volatile Substances
56
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KETAMINE
Ketamine
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Ketamine
Chemical description
The chemical name of ketamine is 2-(2-chlorophenyl)-2-(methylamino)cyclohexanone, an arylcycloalkylamine. It is structurally related to phencyclidine
(PCP: ‘angel dust’) and cyclohexamine. It occurs in racemic form and
also as the S-enantiomer.
Registered names (for human use) are: Ketalar, Ketamine Panpharma, Ketolar,
Ketanest-S.
Registered names (for veterinary use) are: Ketalar, Ketaminol Vet., Clorketam,
Imalgene, Anesketin, Ketamine Ceva, Vetalar Vet., Narketan, Ketaset.
Ketamine is known in Member States by the street names: K, special K,
kit kat, tac et tic, cat valium, vitamin K, ket, super K and others
Ketamine
Pharmaceutical description
Ketamine was first synthesised in 1962 and patented in Belgium in 1963.
As an anaesthetic and analgesic, ketamine has a recognised unique
therapeutic value in veterinary practice and, to a lesser extent, in
human medicine.
For therapeutic purposes, ketamine usually is administered intravenously
or intramuscularly.
In recreational use, typical doses are: 75–125 mg intramuscularly or
subcutaneously; 60–250 mg intranasally; 50–100 mg intravenously; and
200–300 mg orally.
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Ketamine
Due to the complicated multi-step synthesis, and
the difficulty of purchasing the necessary precursors
and numerous solvents and reagents, ketamine sold
illicitly for recreational use appears to be mostly
obtained by diversion of legitimate supplies of either
the bulk drug or of pharmaceutical preparations
containing it
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Ketamine
Health risks
Individual health risks
Acute effects: Ketamine is a dissociative anaesthetic. The term
‘dissociative’ has two meanings. Firstly, it refers to an effect on the
brain, inducing a lack of responsive awareness, not only to pain but
also to the general environment.
Secondly, it refers to a feeling of dissociation of the mind from the
body (‘out-of-body experience’). Ketamine would be expected to block
or interfere with sensory input to centres of the central nervous system
(CNS); in a way, the drug selectively interrupts association pathways of
the brain before producing somaesthetic (sensation of having a body)
sensory blockade
Ketamine differs from most anaesthetic agents in that it appears to stimulate the
cardiovascular system, producing changes in heart rate, cardiac output and blood
pressure. In recreational ketamine users presenting themselves to an emergency
department, tachycardia was the most common finding
Ketamine
Clinical effects: Ketamine is considered to be an
anaesthetic with a good safety profile, based on
extensive clinical experience. The major drawback,
which limits clinical use, is the occurrence of emergence
reactions in patients awakening from ketamine
anaesthesia.
These reactions include hallucinations, vivid dreams,
floating sensations and delirium
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Ketamine
Dependence: Tolerance, dependence and withdrawal signs have been
observed in a number of animal studies
Psychological effects: The recreational user of ketamine may
experience an altered, ‘psychedelic’ state of mind (‘the K-hole’) that
allows the user to travel beyond the boundaries of ordinary existence
Ketamine
The acute psychological effects of ketamine may lead to loss of self
control and subsequently increase the risk of self-injury and accidents
Substances that result in pharmacological interactions with ketamine and
therefore increase the risks associated with the use of ketamine are:
— CNS and respiratory depressants; notably, ethanol, opioids, barbiturates
and benzodiazepines (flunitrazepam);
— sympathomimetic agents; notably, cocaine, amphetamine and its
congeners, and other substances causing inhibition of central catecholamine
re-uptake or increasing levels of circulating catecholamines.
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Ketamine
Ketamine
ANALYTICAL
Clarke's Analysis of Drugs and Poisons
Edited by Anthony C Moffat, M David Osselton, Brian Widdop and Jo Watts
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Ketamine
ANALYTICAL
Ketamine
ANALYTICAL
35