【正文】 cohol or other depressants is even more likely to result in death. The effects last about four hours and can resolve quite suddenly. 64 GHB OVERDOSE The most distinctive and terrifying feature of GHB is its overdose time course. Within 15 minutes a person’ s state of mind bees altered and there is a high possibility of a loss of consciousness or an actual a. Breathing can slow to only four to six breathes per minute! Most people do ? sleep off? a GHB overdose。re taking a vitamin supplement or amino acid, even though GHB has been marketed as such. Just because trace, minute amounts of GHB are found in a human body doesn’ t make the labcreated form of it safe to consume! 72 GHB It has even been dubbed liquid ecstasy. Its highly concentrated street form is available as a liquid in small plastic bottles, about the size and shape of a hotel shampoo bottle. One dosage is usually a capful. There are approximately 9 hits per bottle, but this, too varies depending on the concentration of the mix. It39。ll know it39。 (六 )併發(fā)癥：感覺異常、運(yùn)動(dòng)障礙、聽力喪失、周邊神經(jīng)病變、心肌病變、肝腎傷害、缺氧、窒息、意外死亡。先有去抑制化現(xiàn)象 ,欣快感、飄浮感 ,繼而進(jìn)入幻旅 (trip),出現(xiàn)錯(cuò)覺、幻覺 ,然後進(jìn)入抑制期 ,略微嗜睡、口齒不清。s euphoric effects, while possibly increasing the risk of sudden death. 41 強(qiáng)力膠 (一 )歷史： 1960年代流行於美國(guó) ,1965年傳入日本 ,1972傳入臺(tái)灣 ,在青少年中流行起來。 33 Crack and Cocaine Cocaine is a powerfully addictive drug of abuse. Once having tried cocaine, an individual cannot predict or control the extent to which he or she will continue to use the drug. The major routes of administration of cocaine are sniffing or snorting, injecting, and smoking (including freebase and crack cocaine). Snorting is the process of inhaling cocaine powder through the nose where it is absorbed into the bloodstream through the nasal tissues. Injecting is the act of using a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection. 34 Crack Crack is the street name given to cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Rather than requiring the more volatile method of processing cocaine using ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water and heated to remove the hydrochloride, thus producing a form of cocaine that can be smoked. The term crack refers to the crackling sound heard when the mixture is smoked (heated), presumably from the sodium bicarbonate. 35 cocaine There is great risk whether cocaine is ingested by inhalation (snorting), injection, or smoking. It appears that pulsive cocaine use may develop even more rapidly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and brings an intense and immediate high. The injecting drug user is at risk for transmitting or acquiring HIV infection/AIDS if needles or other injection equipment are shared. 36 Health Hazards Cocaine is a strong central nervous system stimulant that interferes with the reabsorption process of dopamine, a chemical messenger associated with pleasure and movement. Dopamine is released as part of the brain39。在臺(tái)灣也有人引入國(guó)內(nèi)。十五世紀(jì)傳入歐洲 ,但未流行。 22 Methamphetamine Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater. Both drugs have some medical uses, primarily in the treatment of obesity, but their therapeutic use is limited. 23 Methamphetamine Methamphetamine is made in illegal laboratories and has a high potential for abuse and dependence. Street methamphetamine is referred to by many names, such as speed, meth, and chalk. Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as ice, crystal, and glass. 24 Health Hazards Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. It also appears to have a neurotoxic effect, damaging brain cells that contain dopamine and serotonin, another neurotransmitter. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson39。 (五 )中毒過量：多疑敏感、焦慮易怒、躁動(dòng)不安、妄想、幻覺、血壓上升、心跳加快、瞳孔放大、高燒、心律不整、出血性中風(fēng)、癲癇、心臟循環(huán)衰竭死亡。民國(guó) 78年日本嚴(yán)格取締後臺(tái)灣開始?xì)餅E，79年 10月列為麻醉藥品管制。 2436小時(shí)後 :加上腹瀉、脫水。 18 鴉片類藥物 (五 )戒斷癥狀： ? 愈短效的藥物 ,其戒斷癥狀及高峰期越快出現(xiàn)。 (三 )藥理作用：鴉片、嗎啡、海洛英或合成的類似作用於中樞神經(jīng)的鴉片受器的化合物通稱為鴉片劑 (Opiate)。嗎啡在臨床上具有鎮(zhèn)痛、止咳、止瀉及催眠作用。 that is, individuals may not remember events they experienced while under the effects of the drug. This may be why one of the street names for Rohypnol is the fetme pill and it has been reportedly used in sexual assaults. Other adverse effects associated with Rohypnol include decreased blood pressure, drowsiness, visual disturbances, dizziness, confusion, gastrointestinal disturbances, and urinary retention. 16 鴉片類藥物 (一 )歷史： ? 鴉片乃由罌粟植物未成熟之蒴果，以刀割痕取其流出之汁液而得，六千年前的蘇美人即記載罌粟為 ’快樂的植物 ’ 。, Halcion174。 ? 精神神經(jīng)科 :感覺、運(yùn)動(dòng)、認(rèn)知、情感、自我控制等方面的改變。具鎮(zhèn)靜、安眠、抗焦慮、肌肉放鬆、抗痙攣等效果。在臺(tái)灣 ,民國(guó) 68年之後 ,因速賜康被管制 ,此類藥物便逐漸流行氾濫。 ? 胃腸系統(tǒng) :胃炎、酒精性肝炎、脂肪肝、肝硬化、急慢性胰臟炎、膽結(jié)石。 ? 震顫性譫妄 (Delirium Tremens):通常在戒斷後 2472小時(shí)發(fā)生 ,表現(xiàn)為意識(shí)不清、波動(dòng)性變化、激躁不安、自主神經(jīng)系統(tǒng)過度亢奮、高燒、幻覺 (主要為視幻覺 )。 (二 )藥理作用 :中樞神經(jīng)抑制作用 ,及影響多種生理、代謝作用。 西元 800年 ,阿拉伯發(fā)明蒸餾製酒 ,’ alcohol’ 乃源自阿拉伯字 ? alkuhl? ,意為精髓 (essence)。 第二階段 :感受快感的盪漾 常用藥物 :加上大麻、大麻油 ,和安非他命、安眠藥之類。常見濫用藥物危害特性 及案例介紹 劉清輝醫(yī)師 高雄市立凱旋醫(yī)院 成癮防治科 1 成癮物質(zhì)的分類 鴉片類 (Opioids):海洛英 (Heroin)、速賜康(Pentazocine)、配西汀 (Demerol) 安非他命及其相關(guān)化合