“The Faces of Substance Abuse in America”It’s Ugly and Getting Uglier

by

Paul L. Doering, M.S.

Distinguished Service Professor, Emeritus

College of Pharmacy

University of Florida

The Two Faces of Drug Abuse

• Faces of those who use and abuse.http://www.facesofmeth.us/main.htm

• Faces of the drugs being used.– News Flash: Quaalude is “out”– Breaking News: “Bath Salts” are “in” out

HEALTH PROFESSIONALS KNOW A LOT ABOUT DRUGS, BUT………...

• Many curricula do not contain coursework in substance abuse

• Thus, they are not schooled in this “other” use of pharmaceutical products

• Most have limited personal experience with recreational drugs (thankfully)

• But, these persons are often sought out by parents, family members, etc. for help

The Faces of Three Drug Experts From the 1960s

Janis Lyn Joplin Born- 1/19/43Died- 10/4/70

James Marshall HendrixBorn- 11/27/42Died- 9/18/70

Paul Louis DoeringBorn- 2/25/49Not Dead Yet

Makin’ the “Big Time”

Florida IS the Face of Drug Abuse in Our Country

http://abcnews.go.com/WNT/video/florida-drug-bust-targets-doctors-presibtion-illegal-painkillers-pill-mill-dea-12985087

And It’s a Local Problem too….

But it is a knotty problem…..

Marijuana: The flowering top of the pistillate plant (or female) of the genus and species, Cannabis Sativa, Family Moraceae.Lecture by Prof. Carl Johnson in Weeds and Seeds course, circa 1969

“Square Grouper” that used to fall into Biscayne Bay in Miami

Lot’s of Pot!

The New Face of Marijuana (aka Spice or K2)

“Synthetic Marijuana”

Cannabicyclohexanol

JWH-018

HU-210JWH-073

Tetrahydrocannabinol

For More Information:http://info.publicintelligence.net/spicealert.pdf

DEA Re-Scheduling

On November 24, 2010, the DEA notified the public through the Federal Register of their intent to temporarily control five

synthetic cannabinoid chemicals found in so-called “fake pot”

products such as K2 and Spice.

The Face of Real Bath Salts

•magnesium sulfate (Epsom salts)

•sodium chloride (table salt)

•sodium bicarbonate (baking soda)

•sodium hexametaphosphate (Calgon, amorphous/glassy sodium metaphosphate)

•sodium sesquicarbonate

•borax

The Face of “Not Real” Bath Salts

Methylenedioxypyrovalerone (MDPV)

Some Brand Names:

Cloud 9, Ivory Wave, Ocean, Charge Plus, White Lightning, Scarface, Hurricane Charlie, Red Dove and White Dove.

Emergency Re-Scheduling in Florida

Digital Drugs

Digital Drugs

Example of a Digital Drug

In Your Face: Nitrous Oxide

• Synonyms:– nitrous, laughing gas, whippets, “Blue Nun”

• Mental effects:– giddiness, silly laughter, buzzing or ringing in ears

• Duration of effect is only 2-3 minutes• Danger:

– hypoxia, possible nerve damage with prolonged use

Whip-Its

Individual Cylinders of N20

Whipped Cream Dispenser

                                                                                             

The Many Recognizable Faces of Ecstasy

The Fashionable Face of Ecstasy

The Kinda Weird Faces of People Rolling

The Three Faces of Coke

An Impromptu Drug Delivery Device

This is called a “stem” on the street

From The Face of a Meth User

Meth Bugs

The Face of a Burn Victim from Meth lab- 19 yo

Oxycontin Express

http://www.huffingtonpost.com/currenttvs-vanguard/vanguard-season-premiere_b_320867.html

Pharmaceutical Drugs are “In”

• Obtained from legal prescriptions

• Given or sold among friends

• Stolen from medicine cabinets

• Stolen from pharmacies

The Ugly Face of Prescription Drug Abuse In America

http://www.cdc.gov/nchs/data/hus/hus10_InBrief.pdf

The Figures Fit the Face

• >27,000 deaths from Rx drug Ods in 2007– five-fold increase since 1990

• declining mortality rates for all other conditions– including heart disease and cancer

• OD deaths from Rx opioids are exceeding deaths from heroin and cocaine overdoses combined.

The Figures Fit the Face (cont’d)

• Drug-induced deaths (which includes all drugs) is approaching the number of deaths from motor vehicle crashes.

• Drug abuse deaths have also surpassed deaths from suicide, homicide, and fire arms.

Pharmaceutical vs Street Drugs

• Safer– identity– purity– less HIV / hepatitis risk

• Safer because "it's just a prescription drug"• Low or no acquisition cost

– Medicaid, Workers’ Comp, private insurance, VA, Indian Health Service

Ritalin LA 20 mg Ritalin LA 30 mg Ritalin LA 40 mg

Ritalin 10 mg Ritalin 5 mg

Concerta ER 18 mg

Ritalin SR 20 mg

Concerta ER 54 mgConcerta ER 36 mg

The Different Faces of “Ritalin”

Stimulant

Identification

OxyContin (oxycodone HCl)

The Face of Grandaddy Morphine

The Face of Codeine (aka methoxymorphine

The Face of Hydrocodone

The All-Too Familiar Face of Oxycodone

The Face of Methadone

The Face of Meperidine

Comparing the Faces

MorphineCodeine Hydrocodone

OxycodoneMethadoneMeperidine

Rohypnol is now wearing a mask to hide his sneaky face

Xanax- A Household Word

Depressants: Benzodiazepines and non-benzodiazepines

Valium 2 mg Valium 5 mg Valium 10 mg

Xanax 0.5 mg

Xanax 1 mg Xanax 2 mg

Depressants Identification

Depressants Identification

Restoril 30 mg

Just Your Typical FDA Certified Manufacturing Laboratory

                      

Turning this……………….into this.

'Skittling' New Drug Of Choice For Some Teens: Product Sold On Store Shelves

October 22, 2003

Ingredients:

Dextromethorphan

Chlorpheniramine Maleate

Other Products Containing Dextromethorphan

                                          

Buying Dextromethorphan in Bulk