DRUGS OF ABUSE o Tetrahydrocannabinol (THC) is the most potent

component or the psychoactive substance of

marijuana.
 Many of the abused drugs act directly on
o After a single use, THC-COOH can be detected in
dopaminergic neurotransmitter systems, urine for 3-5 days; up to 4 weeks for chronic
especially the limbic system (smell brain) users.
 Positive drug screening test cannot differentiate • THC a lipophilic substance, distributes in the
casual users from chronic or habitual user, adipose tissues; it easily enters the brain.
likewise detect the time frame from using the • Induces a sense of well-being and euphoria;
drug or the dose of the drug taken. it is a hallucinogen.
 Designer drugs are a modified forms of • THC is also associated with memory
established drugs of abuse. impairment and intellectual functions.
o Principal psychoactive agent Delta-9-
Amphetamine tetrahydrocannabinol
o Urinary metabolite 11-nor-
o Therapeutically used for treatment of
deltatetrahydrocannabinol (THCCOOH)
narcolepsy & attentional deficit.
o Physiologic effects Reddening of the
o Increase mental alertness and physical capacity,
conjunctiva and increase pulse rate
and has anorectic capacity.
o Toxic effects Paranoia, disorientation, altered
o Structurally related to dopamine &
physical senses & bronchopulmonary disorders
cathecolamines.
Cocaine
o Causes the release (together w/ cocaine) of
o Also known as “Crack”
dopamine from the brain leading to a pleasant
o It is an alkaloid salt (ecgonine) that can be taken
feeling (“high”) among users.
directly or by inhalation/snorting.
3,4-methylenedioxymethamphetamine
o Derived from coca plant (Erythroxylon) and
(MDMA or ECSTASY), a derivative of
used as additive to some foods.
methamphetamine is a popular o Used as local anesthetic for nasopharyngeal
recreational abused drugs and it has a surgery.
psychedelic effect. o It is a potent CNS stimulant that elicit a sense of
excitement and euphoria; increases physical
o Amphetamine-like compounds Ephedrine,
activity.
pseudoephedrine & phenylpropanolamine
o It is not considered as an addictive drug; it does
o Causes False (+) reaction Presence of anti- not reflect the true dependence commonly
histamine (diphenhydramine) seen in abusers of barbiturates and opiates.
o Sign of Acute intoxication Hyperpyrexia o It easily passes the placenta and mammary
o Acute psychotic syndromes Auditory and visual glands resulting to mental retardation, slow
hallucinations, suicidal tendency and paranoia mental development and drug dependence in
o Toxic effect Palpitation, hypertension, cardiac newborns.
arrhythmias, convulsions, psynctopenia, mental o It can cause malformations in the uterus,
impairment, and teeth grinding sudden death due to direct toxicity on
myocardium (cardiac toxicity).
Anabolic Steroids o It induces vasoconstriction, platelet aggregation
o Chemically associated to the male hormone and synthesis of plasminogen activator
testosterone (dihydrotestosterone & inhibitor.
testosterone). • Overdosage of this drug may result to
o Improves athletic performance by increasing violent behavior; high abuse potential.
muscle mass. • For single use, it can be detected in urine
o Toxic effects Chronic hepatitis, atherosclerosis, for up to 3 days; up to 20 days for chronic
abnormal platelet, aggregation and users.
cardiomegaly. o Inhibitor Prozac
Cannabinoids o Treatment for cocaine addiction Benzodiazepine
o Marijuana and hashish are the natural occurring o Toxic effects Hypertension, arrhythmias,
cannabinoids.
seizures, and myocardial infraction
 o Urine metabolite Benzoylecgonine (sensitive and o Activates charcoal: barbiturate chemo
specific indicator) adsorbent
o Toxic effects: Cheyne-Strokes respiration,
Opiates depression, cyanosis, areflexia, stupor, coma
o Capable of analgesia, sedation, and anesthesia.
o Derived chemically from opium poppy. Lysergic acid diethylamide (lsd, lysergide)
• Opium, morphine, and codeine are the o Semisynthetic indolalkylamine, a hallucinogen
naturally occurring opiates. o One of the most potent pharmacologic
• Heroin, hydromorphone, and oxycodone materials known
(percodar) are the chemically modifies o Produces effects at low doses (20 ug) through IV
opiates. or ingestion
o Most common adverse reaction: panic reaction
• Meperidine (demcrol), methadone
(bad trip)
(dolophine), propoxyphene (darvon),
o Toxic effects: blurred or “undulating vision” and
pentazocine (talwin), and fentanyl synesthesia
(sublimaze) are the common synthetic
opiates. Methaqualone (Quaalude)
o Methadone is a non-bicyclic drugs that binds o A 2,3-disubstituted quinazoline with anesthetic,
with morphine in the brain. antihistamine and antitussive properties
o Fentanyl “lollipops” or “patches” are more o Has sedative hypnotic properties, a
potent analgesic than morphine. hallucinogen
o Codeine is an antitussive drug. o Has similar symptoms of toxicity to
barbiturates, as well as pyramidal signs
Phencyclidine (Angel Dust or Angel Hair) (hypertonicity, hyperreflexia, myoclonus)
o A depressant, stimulant, and has hallucinogenic o Chemo adsorbent: activated charcoal
and anaesthetic properties Piperazines
o Can be ingested or inhaled by smoking o Produced the same “pleasant feeling” observed
o Acidification of urine helps in immediate in amphetamines
excretion o Major derivatives: N-benzylpiperazines (BZP or
o Physiologic effects: analgesia and anaesthesia A2) and phenylpiperazines
o Major metabolite: Phenycyclidine hydrochloride o Minor derivatives: 1-(3-4 methylene-
o Mode of Treatment: Isolation in a quiet and dark dioxybenzyl) piperazine (MDMP), 1-(3-
room triflourometylphenyl) piperazine (TFMPP or
o Toxic Effects: tachycardia, seizure, and coma Molly)
Sedative Hypnotics o Popular piperazine: BZP and TFMPP
o Have therapeutic roles and CNS depressants o Toxic effects: tachycardia, hypertension,
o Potentiate the effects of heroin hyperthermia, psychomotor agitation and sore
o Examples: Barbiturates and Benzodiazepines nasal and throat passages
– Barbiturates: condensation o No available screening or confirmatory test for
products of urea and malonic acid the identification of these drugs
Commonly abused barbiturates: Tryptamines
secobarbital, pentobarbital, o Derivatives of serotonin
phenobarbital and thiopental o Examples: N,N-dimethyltryptamine (DMT)
– Benzodiazepines: used for psilocin
treatment of cocaine addiction o DMT is a short term hallucinogen
Commonly used benzodiazepines: (“businessman’s lunch”), taken by smoking
diazepam (valium), chlordiazepoxide o Psilocyclin is a component of “magic
(Librium) and lorazepam(Ativan) mushroom” (psilocybe)
• Diazepam: clinical used for rapid o Ayahuasca is a tea which contain tryptamines
control of acute seizure activity, a minor o Monoamine oxidase inhibitor (Beta-carbolines)
tranquilizer enhances the hallucinogenic effect of
o Ethanol initiate the toxicity of this agent tryptamines
o Major metabolite: secobarbital (barbiturates) o Antagonist: benzodiazepines
 o Toxic effects: tachycardia, hypertension,
dystonia, seizures, rhabdomyolysis and paralysis

Specimen considerations
o Alcohol in blood samples may be analyzed even
after a moment of delay provided the samples
in tubes remain sealed.
o Urine temperature is a vital factor.
o Aspiration of gastric contents or vomitus may
reveal tablets or capsules

Sample requirements
o Urine
o Serum
o Hair
o Nails
o Whole blood or plasma
o Sweat
o Saliva
o Urine sample for toxicology assay has the
advantage.
o Once a urine specimen is collected, it is
subjected to concentration and extraction
procedures.
o Examination of the blood has the advantage of
identifying currently circulating drugs.
o -Advantage of knowing the complete composite
of drugs that have been ingested over a long
period that blood samples.
o -in extraction procedures, acidic drugs are
separated from the basic ones
- And this is to design treatment plans
and monitoring the success of
treatment
2 basic techniques
o Immunochemical
o Chromatography

References:
McPherson, R. A., & Pincus, M. R. (2017). Henrys clinical
diagnosis and management by laboratory methods.
Philadelphia, PA: Elsevier.

Bishop, M. L., Fody, E. P., & Schoeff, L. E. (2018). Clinical

chemistry: principles, techniques, and correlations.
Philadelphia: Wolters Kluwer.

PREPARED BY:
Ferrer, Ma. Riamyr T.
Reyes, Mary Grace C.
Reyes, Reyza Jane B.
Windesi, Susanthi I.L