SUBSTÂNCIAS DE ABUSO II - vivaciencia.planetaclix.ptvivaciencia.planetaclix.pt/SA2-8.pdf · 3 Hallucinogenic mushrooms ’ is the name commonly given to psychoactive fungi, containing

1

SUBSTÂNCIAS DE ABUSO II

Aula 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. Some, which are nonselective in action and affect the dopamine and/or opioid 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

2

Source, European Monitoring Center for Drugs and Drug Addiction, 2017

Psylocibe cubensis

entheogen ("the god within”)

3

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: indolealkylaminesor 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 (5-

hydroxytryptamine 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: 520-

52-5) 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)


4

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


The neurotransmitter serotonin is structurally

similar to psilocybin


5


Physical formHallucinogenic 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


6



7

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.


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.


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)


8

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


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


9


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


10

A toxidrome (a portmanteau of toxic and syndrome) is a

syndrome caused by a dangerous level of toxins in the body.

The term was coined in 1970 by Mofenson and Greensher. It

is often the consequence of a drug overdose. Common

symptoms include dizziness, disorientation, nausea,

vomiting, and oscillopsia. A toxidrome may indicate a

medical emergency requiring treatment at a poison control

center

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.


11

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"

Perceptual distortions

The ability of psilocybin to cause perceptual distortions is linked to its influence on the

activity of the prefrontal cortex


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.


12

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.


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'


13

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.


PrevalencePrevalence 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).

PriceSupplies 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).


14

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.


M.D.Cole, “Analysis of Controlled Substances”


15


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


16

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


17

TABELA II-A2C-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

Decreto-Lei n.º 15/93, de 22 de Janeiro


18

source, European Monitoring Center for Drugs and Drug Addiction, 2017

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.

Volatile substance use may be defined as the deliberate inhalation of volatile compounds to produce psychoactive effects.

Volatile Substances

19

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’

Volatile Substances

20

Tipos de voláteis:

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

Volatile Substances

21

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

Volatile Substances

22

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

Volatile Substances

23

Utilizador de ToluenoIndivíduo normal

45

Volatile Substances

46A18

Volatile Substances

24

Synthesis and precursorsThe compounds are commercially available so there is no need for them to be

synthesised covertly.

Mode of useThe 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 namesNames 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).

Volatile Substances

25

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

Volatile Substances

26

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.

Volatile Substances

27

Price at consumer levelCommercial products and aerosols cost only a

few euros.

Medical useSome 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.

Volatile Substances

28

55

National Institute on Drugs Abuse, USA

Volatile Substances

56

Volatile Substances

29

KETAMINE

Ketamine

30

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.

Ketamine

31

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

Ketamine

32

Health risksIndividual 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

Ketamine

33

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 selfcontrol 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.

Ketamine

34

Ketamine

Ketamine

ANALYTICAL

Clarke's Analysis of Drugs and PoisonsEdited by Anthony C Moffat, M David Osselton, Brian Widdop and Jo Watts

35

Ketamine

ANALYTICAL

Ketamine

ANALYTICAL

Documents

SUBSTÂNCIAS DE ABUSO II - vivaciencia.planetaclix.ptvivaciencia.planetaclix.pt/SA2-8.pdf · 3 Hallucinogenic mushrooms ’ is the name commonly given to psychoactive fungi, containing