Abusing Drugs: From Social

to
Professional Rostrum
Highlights…… !

 Drugs and drug abuse

 Stages of drug abuse
 Addiction, Reasons, Symptoms
 Drug Classifications (Legal, Chemical)
 Types of drug abuse:
Societal , Professional
 Societal drug abuse and Impact
 Professional drug abuse: Doping
 Analysis (Collection and Identification)
 Real time case studies
 What are drugs ?
 Therapeutic molecule: A chemical which is given to people to treat or
prevent illness or disease

 Drugs of abuse... ?
 A drug that is taken for non-medicinal reasons
• usually for mind-altering effects
• pleasure activities
• recreation

leads to
Addiction Dependence
Examples: Cocaine, Heroin, codeine, morphine and so on

https://en.wikipedia.org/wiki/Drug
  Stages of drugs abuse

EXPERIMENTATION

REGULAR USE

RISKY USE/ABUSE

ULTIMATE
ADDICTION
and
DEPENDENCY
https://en.wikipedia.org/wiki/Drug
 What is addiction ?
 A disease that affects a person's brain and behavior
 leads to an inability to control the use of a drug
 existence of both psychological dependence and physical dependence

EMOTIONAL
TRIGGER

GUILT CRAVING

Addiction cycle

USING RITUAL

https://www.mayoclinic.org/
https://slideplayer.com/slide/12529102/
 Chronic
 Often brain relapsing
disease
Similar to other chronic,
relapsing diseases, such as
diabetes, asthma or heart
causes

Compulsive drug diseases, drug addiction can

seeking and use be managed successfully.

Treatment should be
reinstated, adjusted or
alternated to help the
individual regain control and
recover.

https://www.financialexpress.com/lifestyle/science/brain-molecule-that-may-drive-cocaine-addiction/344
 Addiction Scenario

100
67%

26%

10 5.5%

1.5%

1
Child Teen Young Adult Adult

<12 12-17 18-25 >25

www.nida.nih.gov, www.drugabuse.gov
 Probable reasons of Drug Addiction
• Genetics
• Exposure from peers
• Availability
• Use by parents
• Poor family environment
• Psychological problems
• Depression
• Job stress
• Unemployment
• Poverty
• Social and family stress

https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
https://greatoaksrecovery.com/factors-that-contribute-to-drug-addiction/
http://therapyoncall.org/what-is-drug-addiction/
 This happens to your brain when you take drugs
FRONTAL LOBE PARIETAL LOBE
• Paralysis • Inability to focus visual attention
• Inability to focus in a task • Problems with reading
• Persistence of single thought • Difficulty drawing objects
• Inability to express language • Lack of awareness of body parts
• Loss of flexibility of thinking • Inability to distinguish body parts
• Changes in social and
emotional behavior OCCIPITAL LOBE
• Defects in vision
• Difficulty in identifying
colors
• Hallucinations
TEMPORAL LOBE • Word blindness
• Inability to recognize
faces
• Loss of memory CEREBELLUM
• Visual and hearing • Tremors
problems • Slurred speech
• Increased • Inability to coordinate
aggressive behavior • Inability to walk
• Inability to take rapid action

https://phoenixhouse.com/about/about-addiction https://slideplayer.com/slide/4489201/
 Why can’t addicts quit ?

Non- addicted brain Addicted brain

Control
Control

Drive NO Drugs
Saliency Drive GO for Drugs
Saliency

Memory Memory

www.nida.nih.gov www.drugabuse.gov
 Symptoms of drug addiction
 Hiding substance use
 Lying about substances used or the amount of the drug used
 Violent or erratic behavior
 Extreme mood changes
 Complaints of physical illness
 Continued use of drugs despite negative consequences
 Inability to maintain employment or function well at work
 Rationalizing drug use despite consequences
 Inability to remain clean and sober for any length of time
 Disrupted sleeping and eating patterns

https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
  Legal Classification of Drugs
I II
High potential for abuse, that High potential for abuse, have
have no currently accepted currently accepted medical use
medical use in treatment in the in treatment in the United States
United States, and that there is a or currently accepted medical use
lack of accepted safety for use of with severe restrictions, and that
the drug under medical the abuse of may lead to severe
supervision e.g. cannabis, SCHEDULE psychological or physical
ecstasy, GHB, heroin, LSD, dependence e.g. amphetamine,
mescaline, and methaqualone cocaine, fentanyl, hydromorpho-
ne, oxycodone, and hydrocodone.

III
V
Potential for abuse less than
Low potential for abuse relative
the drugs or other substances IV to the drugs or other
in schedules I and II, have a
Low potential for abuse rel- substances in schedule IV, have
currently accepted medical use
ative to the drugs or other a currently accepted medical use
in treatment in the United States,
substances in schedule III, in treatment in the United States,
and that the abuse of may lead to
have a currently accepted and that the abuse of may lead to
moderate or low physical
medical use in treatment in the limited physical dependence or
dependence or high psychological
United States e.g. psychological dependence relative
dependence e.g. anabolic ster-
benzodiazepines, modafinil, and to the drugs or other substances in
oids, buprenorphine and ketamine
tramadol schedule IV e.g. diphenoxylate
  Chemical classification of drugs

Depressants
barbiturates, benzodiazepines

Hallucinogens Stimulants
magic mushrooms, LSD cocaine, amphetamine,

Opioids Inhalants
heroin, codeine, paint, glue, paint thinners
.

Cannabis New psychoactive

THC substances (NPS)
ketamine, piperazine
Depressants
 Suppress or slow the activity of the brain and nerve
 Directly acts upon the CNS
 Barbiturates , benzodiazepines , alcohol etc.

Stimulants
 Accelerate the activity of the central nervous system
 Make you feel energetic, focused, alert, edgy, angry.
 Cocaine, crack cocaine, amphetamine, and methamphetamine

Opioids
 Act through the opioid receptors
 Aommonly prescribed medicines used to treat pain and cough
 Make you feel energetic, focused, alert, edgy, angry.
 Heroin, codeine, morphine, fentanyl, hydrocodone, oxycodone

https://luxury.rehabs.com/drug-abuse/classifications/
Inhalants
 Consumed through inhalation
 Cross through the lungs into the bloodstream
 paint, glue, paint thinners, gasoline, marker or pen ink

New psychoactive substances (NPS)

 Drugs designed to evade the existing drug laws.
 Drugs such as synthetic cannabinoids, synthetic cathinone, ketamine, piperazine and
some plant-based drugs such as khat and kratom are examples of NPS

Hallucinogens
 Act on the central nervous system to alter your perception of reality, time, and space
 Cause you to hear or see things that don’t exist or imagine situations that aren’t real
 Psilocybin (found in magic mushrooms), lysergic acid diethylamide LSD

https://luxury.rehabs.com/drug-abuse/classifications/
 Types of Drug Abuse

Societal Professional
(Individual, Family, (Doping)
Society)

https://slideplayer.com/slide/4489201/
 Societal Drug Abuse and Impact
Effects of Drug Abuse on Individual
 Physical effects :
 Organ damage
 Hormone imbalance
 Cancer (caused by nicotine or steroids)
 Prenatal and fertility issues
 Gastrointestinal disease
 HIV/AIDS

 Neurological and emotional effects :

 Depression
 Anxiety
 Memory loss
 Aggression
 Mood swings
 Paranoia

https://www.serenityatsummit.com/resources/consequences-of-addiction/
Effects of Drug Abuse on Family

 Intense feeling of humiliation and guilt

 Loss of spirit of togetherness and unity
 Occurrence of domestic violence
 Money loss
 Family isolation

Ultimate output =0
Effects of Drug Abuse on Society
 Lost productivity at work
 Increased crime rates
 Loss of economy
 Suicides, murders
 Decreased birth rates

https://www.serenityatsummit.com/resources/consequences-of-addiction/
 Legal consequences of addiction

 Large fines
 Extensive jail sentences
 Arrest records that make it difficult to find a job
 Driver’s license suspension and transportation difficulty
 Restrictions on living in certain communities

https://www.serenityatsummit.com/resources/consequences-of-addiction/
 Professional Drug Abuse

“DOPING”
 Defined as use by competing athlete of any foreign substance to
the body or any physiological substance taken in an abnormal
quantity or taken by abnormal route of entry into the body with the
sole purpose of increasing his/her performance in an artificial and
unfair manner

 Originated from ‘DOP’ referred to an alcoholic drink used in South

Africa
 Ancient athletes used alcoholic drinks to enhance their
performance

https://www.slideshare.net/RajeshKamtane/drugs-of-abuse-in-sports
 Why sports person take drugs ?

Purposefully Prescription

Self- administration

Coach advise, Doctors,

physiological reasons psychological reasons

https://www.slideshare.net/ParasuramanParasuraman/4-drug-abuse-among-athletes
 In 1999, an internationally independent organization, the World Anti-
Doping Authority (WADA), was established

 It works to coordinate the fight against doping in sport internationally

 Today, there are as many different Performance Enhancing Drugs (PEDs)

as there are sports, and it’s a big and difficult job trying to keep track of
them all

https://www.science.org.au/curious/people-medicine/drugs-sport
Types of performance enhancing drugs

 Stimulants
 Anabolic Steroids
 Human Growth Hormons
 Blood Doping Agents
- Erythropoietin (EPO)
- Synthetic oxygen carriers
- Blood transfusions
 Beta Blockers
1. Stimulants
 Directly affect the central nervous system
 Speed up parts of the brain and body
 Increase the heart rate, blood pressure, metabolism
 Used by athletes to reduce tiredness and fatigue, and to
increase alertness, competitiveness and aggressiveness.

Amphetamines, Cocaine, Ecstasy and Methylphenidate (Ritalin)

2. Anabolic steroids
 Drugs derived from testosterone which is partially responsible
for the developmental changes that occur during puberty and
adolescence and is also involved in controlling the build-up and
breakdown of the main biochemical components of all tissues,
including muscle

Stanozolol, nandrolone, boldenone, trenbolone, androstenedione,

tetrahydrogestrinone (referred to as THG)

https://www.science.org.au/curious/people-medicine/drugs-sport
3. Human growth hormone
 Naturally-occurring hormone promotes physical development
 HGH increases the number of red blood cells, boosts heart function
 Other effects attributed to HGH include increase in muscle mass and strength as
well as tissue-repairing (recovery).

4. Blood doping
 Using various methods and substances to increase the red blood cell mass
 Higher levels of red blood cells in the blood result in more oxygen being
transported to the muscles
 Result in increased stamina and performance.
 There are three main types of blood doping:
(i) Erythropoietin (EPO)
(ii) Synthetic oxygen carriers
(iii) Blood transfusions

https://www.science.org.au/curious/people-medicine/drugs-sport
(i) Erythropoietin (EPO)

 EPO hormon stimulates the production of red blood cells in bone marrow
 Regulate the concentration of red blood cells and hemoglobin in the blood
 Useful for athletes, since red blood cells shuttle oxygen to the cells, including muscle
cells, enabling them to operate more effectively

(ii) Synthetic oxygen carriers (SOC)

 Purified proteins or chemicals that have that ability to carry oxygen
 SOCs were developed for use in crisis situations where blood transfusions are not
possible or blood products are not available
Two of the most common types include haemoglobin based oxygen carriers (HBOCs) and perfluorocarbons (PFCs)

(iii) Blood transfusions

 Blood transfusion is an effective and relatively simple method of allowing athletes to
boost the number of red blood cells in their blood, improving their aerobic capacity and
endurance.
 Athletes who choose to use this method generally begin undergoing blood withdrawals
several weeks before a competition
https://www.science.org.au/curious/people-medicine/drugs-sport
4. Beta Blockers
 Beta Blockers work to block the effects of adrenaline
 They work to slow the heart rate, thereby reducing blood pressure, anxiety and
muscle tremors, and improving the ability to focus
 This makes them particularly useful to athletes performing in sports that require a
steady hand such as shooting, archery, darts, snooker, even golf

Propranolol, Metoprolol, Atenolol, Bisoprolol, Esmolol

Some known cases….!
 Case Study - I

Hans-Gunnar
 First athlete to be disqualified from the Olympics for
doping.

 Won a bronze medal but was disqualified when a post-

event drug test showed him positive for cocaine and
beer in his system

https://www.slideshare.net/catherinelambert/ped-35574517
 Case Study -II

Ben Johnson
 He was tested positive for stanozol
 Stripped of his gold medal as well
as all his World Championship title

https://www.slideshare.net/catherinelambert/ped-35574517
https://www.google.com/search?q=ben+johnson+sports&rlz=1C1CHBF_enIN832IN832&source=lnms&tbm=isch&sa=X&ved=0ahU
KEwiQ2u_5ps_gAhVGOSsKHdboBs4Q_AUIDigB&biw=1366&bih=618
 Case Study-III

Armstrong
 Used performance enhancing drugs,
testerone
 Punishedment for using PED was to lose
all medals he had ever won.

https://www.slideshare.net/catherinelambert/ped-35574517
https://www.google.com/search?q=lance+armstrong+doping&rlz=1C1CHBF_enIN832IN832&source=lnms&tbm=isch&sa=X&ved=0ahUKEwi8yo3nqM_gAh
VokuAKHTFmAaEQ_AUIDygC&biw=1366&bih=618#imgrc=92zbF4Oh9vxYJM:
 Case Study-IV

Nathan Braggaley
 Australian sprint canoer & surfski champion,
3 times World Champion in the K-1 500m
events and won 2 Olympic Silver medals.
 In 2005, was tested positive for banned
steroids, stanozol and methandienone
and hence banned for 15 months by
Australian Canoeing.

Chapter 5 – Sports Medicine for Sports Trainer Manual Sports medicine Australia
https://www.google.com/search?q=Nathan+Baggaley&rlz=1C1CHBF_enIN832IN832&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjc4JaBpNHgAhULvo8KHdQxD88Q_AUIDygC&biw=1366&bi
h=667#imgrc=4BCBhXst3yDEmM:
How, forensically, the drug related cases are solved ?
 Types of samples

• Hair

• Blood

• Urine

• Nails

https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcS1xwupauGRUSN_2a-Dtmm9rcJhoJRMzQy_X1xa2IyvebC0fuYp
 Drug Identification

• Selection of an Analytical Scheme

• Factors include amount of substance to be analyzed, time available, and

disposition of the analyzed material

Screening test Confirmatory test

 Drug Identification

Screening test Confirmatory test

• Visual examination
• Color test

Chromatographic examination Spectroscopy

• TLC (Thin layer chromatography) • UV-VIS
• HPTLC ( High performance Thin layer chromatography) • FT-IR
• HPLC ( High performance liquid chromatography)
• GC (Gas chromatograph)
• NMR
• MS
• Raman
Extraction Protocols …… !
 Hair Sample

Assignment of investigation
Information about case story and purpose of investigation
Choice of appropriate analysis technique

Sampling & storage

Segmentation

Decontamination by washing

Cutting/grinding
 Extraction/digestion of hair matrix

Clean-up of hair matrix Pre-test immunoassay

Qualitative and quantitative analysis by GC-MS, LC-MS

RESULTS

https://www.google.com/search?q=forensic+analysis+of+hair+for+drugs&rlz=1C1CHBF_enIN832IN832&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjRg
YPM39PgAhXJMI8KHagtCf4Q_AUIDygC&biw=1338&bih=658#imgrc=C2VYfWKyioe6LM:
 Urine Sample

https://www.google.com/search?q=urine+drug+analysis&rlz=1C1CHBF_enIN832IN832&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiS78zddPgAhVcknAKHX5qDKcQ_AUIDigB&biw=1366&bih=6
18#imgrc=W60OWNU3NAW1xM:
 Blood Sample

sample Decontamination by removal of proteins

Extraction of acidic, basic, neutral drugs by varying pH,

buffer via standard extraction protocols

results Chromatographic/Spectroscopic analysis

 Nail Sample

Decontamination by Homogenization by
Nail sample
washing cutting / grinding

Drugs can be identified in nail clippings two weeks to four

weeks following ingestion.
Extraction / digestion of matrix
A 3 mm specimen of fingernail represents up to eight
months of collective history of drug exposure.

Qualitative and quantitative analysis by GC-MS/LC-MS Clean-up of matrix

https://www.researchgate.net/figure/Pre-analytical-and-analytical-steps-of-nail-analysis_fig1_269420398