Understanding Drug Use, Effects, and History

Posted on Feb 19, 2025 in Medicine & Health

Understanding Drug Use

Drug use is the consumption of any drug to alter one’s state of mind, behavior, or feeling, often impacting daily activities.

Drugs can be administered through various routes, including:

  • Ingestion
  • Inhalation
  • Absorption
  • Smoking
  • Injection

What is a Drug?

A drug is any substance, other than food, that changes the way the body or mind functions. This includes:

  • Illicit drugs
  • Alcohol
  • Prescription medications
  • Over-the-counter drugs
  • Laxatives
  • Vitamins
  • Sleeping pills
  • Everyday beverages like colas, tea, and coffee

Drug Abuse

Drug abuse occurs when drug use leads to problems in one or more areas, such as:

  • School
  • Work
  • Family/friends
  • Drinking and driving
  • Health

Drugs in Early Times

The discovery of drugs was often accidental. Examples include:

  • Blue morning glories and brightly colored mushrooms, which produce hallucinogens similar to LSD.
  • Yellow-orange fruits on certain cacti, a source of the hallucinogenic drug peyote.
  • Poppy plants
  • Coca leaves
  • Cannabis plant

Individuals with knowledge of these plants gained power, leading to the beginning of shamanism.

A shaman acts as a healer through a combination of trances and plant-based medicines, usually within a local religious rite. Shamans still function today in remote areas of the world.

History of Drugs

Circa 1500 B.C.

  • Opium and castor oil are first documented as drugs.
  • The development of centralized religions in Egyptian and Babylonian societies led to the decline of shamanism.
  • Emphasis shifted to formal rituals and rules.
  • The Egyptian scroll Ebers Papyrus (dated approximately 1500 B.C.) contains over 800 prescriptions for various ailments and diseases.
  • More than a hundred preparations contained castor oil (a natural laxative); some contained “berry of the poppy” (opium).

Late 1800s

  • Drug use extended to all levels of Western society.
  • Significant strides in medicinal healing were made.
  • Morphine was identified as the active ingredient in opium and became the most reliable prescription to control pain.
  • The syringe was developed to deliver morphine directly into the bloodstream.
  • Cocaine, extracted from coca leaves, was used as a local anesthetic.
  • Vaccines were developed:
    • Edward Jenner (1796) developed the smallpox vaccine.
    • Louis Pasteur (1885) developed the rabies vaccine.
  • Opium was cheap, easily available, legal, and taken in liquid form.
  • Cocaine was in widespread use.
    • Coca-Cola was initially marketed as a remedy for chest colds.
    • In 1884, Sigmund Freud recommended cocaine as a treatment for morphine addiction.

Early to Mid-1900s

  • The social picture of drug-taking behavior became complicated.
  • Medical professionals and social reformers began to address societal problems from uncontrolled access to psychoactive drugs.
  • Remedies containing opium, alcohol, and cocaine were sold as answers to common complaints.
  • Amphetamines were used as decongestants, to treat depression, and by World War II soldiers to enhance alertness.
  • Widespread use of anti-schizophrenic drugs in mental hospitals began, revolutionizing psychiatric care.

Late 1960s to Early 1970s

  • Marijuana use symbolized a generation’s defiance of establishment values.
  • Experimentation with marijuana, LSD, stimulants, and depressants increased.
  • Heroin abuse increased.
  • Response: financing basic research related to the effects of drugs on the brain.
  • The 1970s focused on understanding the relationship between brain functioning and human behavior.

Early 1980s

  • Cocaine use peaked as a symbol of glamour and material success.

The Controlled Drugs and Substances Act

This comprehensive legislation in Canada includes several schedules that classify certain categories of drugs.

  • Schedule I includes the most dangerous drugs and narcotics, with the most serious penalties.
  • Schedule II lists cannabis and its derivatives.
  • Schedule III lists drugs such as LSD and psilocybin.
  • Schedule IV includes drugs such as tranquilizers, barbiturates, and anabolic steroids.

Substances in Schedule IV are not illegal to possess with a prescription. It is illegal to possess them without a prescription or to import, export, or traffic them.

There are lesser penalties for possession of small amounts of marijuana and lighter penalties for trafficking in small amounts.

Since drugs are listed by their chemical names, consulting a pharmacist or expert may be necessary to determine the schedule of a particular drug.

Classification of Drugs

Schedule I

Opium, codeine, morphine, PCP, heroin, cocaine, amphetamines (e.g., Benzedrine, Methedrine), MDA, MDMA, STP, angel dust, elephant, hog, H, horse, smack, junk, C, coke, snow, nose candy, crack, uppers, bennies, speed, meth.

Schedule II

Marijuana, hashish, hash oil, THC, pot, weed, grass, reefer, joint, honey oil.

Schedule III

LSD, psilocybin, acid, blotter, magic mushrooms.

Schedule IV

Tranquilizers (e.g., Valium, Librium), barbiturates, and anabolic steroids, downers, goofballs, reds, red birds, red devils, yellow jackets, blue heavens, Christmas trees, rainbows, ‘ludes.

Drug Cycle

After administration, a medication goes through several steps before excretion:

  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion

Absorption

Absorption is the process of the drug entering from the site of administration. The speed of absorption depends on the route of administration. Common routes include:

  • Oral (swallowing)
  • Intramuscular (injection into a muscle)
  • Subcutaneous (injection under the skin)
  • Intravenous (injection into a vein)
  • Transdermal (skin patch)

Drugs taken orally face significant obstacles. They are transported to the liver, where a large amount may be destroyed by metabolic enzymes (the “first-pass effect”). Other routes bypass the liver.

Medications injected into a muscle are usually absorbed more quickly than those given orally.

Distribution

Distribution is the movement of the drug throughout the body via the circulatory system. Side effects can occur when a drug affects an organ other than the target organ.

Many factors influence distribution, such as protein and fat molecules in the blood that can bind to drug molecules.

Blood-Brain Barrier

Drugs targeting the central nervous system (brain and spinal cord) face a barrier called the blood-brain barrier. This barrier protects the brain from dangerous substances.

General Properties of the BBB

  • Large molecules do not pass through easily.
  • Low lipid-soluble molecules do not penetrate the brain.
  • Highly lipid-soluble molecules, such as barbiturate drugs, cross rapidly.
  • Molecules with a high electrical charge are slowed.

Metabolism

Metabolism is the breakdown of the drug. The liver is the main organ of drug metabolism. Conditions affecting liver function, like hepatitis, affect drug metabolism.

The breakdown usually involves two steps, primarily in the liver.

Enzymes in the liver can:

  • Activate drugs
  • Deactivate drugs
  • Make drugs more effective (metabolite)
  • Increase or decrease drug toxicity
  • Convert drugs for easier excretion by the kidneys

Excretion

Excretion is the final stage, where the inactive drug exits via urine or feces. The kidneys are the main organs of drug excretion. Poor kidney function can prolong drug effects and lead to toxic buildup.

Caffeine

Caffeine stimulates the central nervous system. It occurs naturally in coffee, tea, chocolate, and cola soft drinks. It is also added to various medications and energy drinks. In its pure form, caffeine is a white, bitter-tasting powder.

Caffeine Content

  • Brewed coffee (1 cup): 135 mg
  • Instant coffee (1 cup): 76-106 mg
  • Decaffeinated coffee (1 cup): about 3 mg
  • Tea (1 cup): 43 mg
  • Regular cola (355 ml): 36-50 mg
  • Energy drink (250 ml): 80 mg
  • Dark chocolate (28 g): 19 mg
  • Milk chocolate (28 g): 7 mg
  • Hot chocolate mix (1 packet): 7 mg
  • Stay-awake pills: 100 mg

Health Canada recommends no more than 400 mg/day.

Caffeine is found in the leaves, seeds, or fruit of plants like coffee, tea, cocoa, kola, guarana, and yerba maté.

In Canada, manufacturers are not required to list naturally occurring caffeine on labels; only added caffeine must be listed. Some caffeine in energy drinks may come from plant ingredients, so it may not be listed.

Cocaine

Cocaine makes people feel energetic, talkative, alert, and euphoric. Senses seem heightened. Hunger and the need for sleep are reduced. Although a stimulant, some people find it calming. Others may feel nervous and agitated.

Long-Term Effects of High Doses

  • Panic attacks
  • Psychotic symptoms (paranoia, hallucinations, delusions)
  • Erratic, bizarre, and sometimes violent behavior
  • Tolerance to euphoric effects
  • Increased sensitivity to negative effects (anxiety, psychosis, seizures)
  • Increased heart rate, blood pressure, and body temperature

Methamphetamines

Methamphetamines are powerful stimulants that speed up the central nervous system. In the 1930s, methamphetamine was marketed as a nasal decongestant. Due to its high addictive potential, it is not legally available in Canada.

Effects of Methamphetamine

  • Alertness, energy, confidence, talkativeness
  • Reduced need for food or sleep
  • Unwanted effects: racing heart, chest pain, dry mouth, nausea, vomiting, diarrhea, physical tension
  • Anxiety, restlessness, irritability
  • Extreme effects: paranoid delusions, hallucinations, aggressive behavior, impulsive violence

Duration of Effects

  • Injected or taken orally: 6-8 hours
  • Smoked: 10-12 hours

After the effects wear off, users feel tired and depressed. Some use the drug continuously in a “binge and crash” pattern, leading to serious health risks and dependency.