A GUIDE TO SUBSTANCE MISUSE
For Medical Professionals
Health Service Executive South
A Guide To Substance Misuse
For Medical Professionals
(Edition 1.2)
Compiled by: Sinead O’Mahony Carey
'UXJ(GXFDWLRQ2IÀFHU
Substance Misuse Service
11-12 Peter St., Clonmel. (052) 77900
Graphic Design: Leo McCormack
Contents
Introduction...................................................................................................................................................................................... 03
Section One - Drug Category
1.
Hallucinogens ...........................................................................................................................................................................5
t"NBOJUB.VTDBSJB'MZ"HBSJD
.....................................................................................................................................7
t$BOOBCJT ..............................................................................................................................................................................8
t,FUBNJOF .......................................................................................................................................................................... 10
t-4% ..................................................................................................................................................................................... 12
t1TJMPDZCFTFNJMBODFBUB-JCFSUZDBQ
..................................................................................................................... 13
0QJBUFT ..................................................................................................................................................................................... 14
t)FSPJO ................................................................................................................................................................................ 16
t.FUIBEPOF ...................................................................................................................................................................... 17
4UJNVMBOUT ............................................................................................................................................................................... 18
t(FOFSBM*OGPSNBUJPOPO4UJNVMBOUT ........................................................................................................................ 18
t"NQIFUBNJOF4VMQIBUF ............................................................................................................................................. 22
t$PDBJOF ............................................................................................................................................................................. 25
t$SBDL$PDBJOF ................................................................................................................................................................. 26
t%FYFESJOF......................................................................................................................................................................... 27
t,IBU$BUIB&EVMJT
........................................................................................................................................................ 28
t.FUIZMBNQIFUBNJOF$SZTUBM.FUI
...................................................................................................................... 29
t.FUIZMBNQIFUBNJOF.FUIFESJOF
....................................................................................................................... 31
t&DTUBTZ ............................................................................................................................................................................... 32
7PMBUJMF4VCTUBODFT .............................................................................................................................................................. 35
t"EIFTJWFTBOE(MVFT .................................................................................................................................................... 36
t"FSPTPMT ............................................................................................................................................................................ 37
t$MFBOJOH"HFOUT ............................................................................................................................................................ 38
t1FUSPMMJHIUFSGVFMBOEPUIFSQSPEVDUT .................................................................................................................. 39
t1PQQFST ............................................................................................................................................................................. 40
t4VEEFO4OJó
OH%FBUI4ZOESPNF44%4
............................................................................................................ 42
.JTDFMMBOFPVT4VCTUBODFT ................................................................................................................................................ 43
t"OBCPMJD4UFSPJET .......................................................................................................................................................... 43
t#;1 ..................................................................................................................................................................................... 44
t()# .................................................................................................................................................................................... 45
t,SBUPN............................................................................................................................................................................... 46
t0WFSUIFDPVOUFSNFEJDBUJPOT ................................................................................................................................. 47
t4BMMZ% ................................................................................................................................................................................ 48
t.JTDFMMBOFPVT .................................................................................................................................................................. 49
#BSCJUVSBUFT ............................................................................................................................................................................ 50
#FO[JPEJB[FQJOF ................................................................................................................................................................... 52
%FQSFTTBOUT ............................................................................................................................................................................ 54
t"MDPIPM .............................................................................................................................................................................. 54
Section Two - Recognising Drug Use
1IZTJDBM4JHOT......................................................................................................................................................................... 58
#FIBWJPVSBM4JHOT ................................................................................................................................................................. 58
1PTTJCMFTJHOTPGBMDPIPMBOEESVHNJTVTFJOUIFXPSLQMBDF ............................................................................... 58
3FDPHOJTJOH%SVH6TF ........................................................................................................................................................ 59
3JTLGBDUPSBOBMZTJT ............................................................................................................................................................... 59
)PXMPOHEPESVHTTUBZJOZPVSTZTUFN .................................................................................................................... 59
Section Three - Facts about drugs
%FöOJUJPOPGBESVH ............................................................................................................................................................. 62
8IBUBSFESVHT .................................................................................................................................................................... 62
-FHBM%SVH6TF ...................................................................................................................................................................... 62
4PIPXEJEESVHTCFDPNFTUSFFUESVHT ..................................................................................................................... 62
)PXMPOHIBWFESVHTCFFOBSPVOE ............................................................................................................................. 63
8IZEPQFPQMFUBLFESVHT .............................................................................................................................................. 63
4PXIBUTUIFQSPCMFN ..................................................................................................................................................... 64
5IF&QJEFNJPMPHJDBM5SJBOHMF........................................................................................................................................... 64
4UBHFTPG%SVH6TF .............................................................................................................................................................. 65
'BDUPST"TTPDJBUFEXJUIJMMJDJUESVHVTF ........................................................................................................................ 66
3FBTPOTGPSJMMJDJUESVHVTF ................................................................................................................................................ 67
$PSSFMBUFTPGESVHVTF ........................................................................................................................................................ 69
.JTVTFPG%SVHT1TZDIPTPDJBMFOWJSPONFOUBMJOøVFODFT .................................................................................. 70
)PXJTTPDJBMBOEDPNNVOJUZIBSNEFUFSNJOFE ................................................................................................... 71
Section Four - Drug Dangers
1.
Injection ................................................................................................................................................................................... 73
0WFSEPJOH*U ........................................................................................................................................................................... 73
%PVCMJOH6Q........................................................................................................................................................................... 73
*OEJWJEVBM%JòFSFODFT ......................................................................................................................................................... 74
"EVMUFSBUJPOBOE.JTUBLFO*EFOUJUZ .............................................................................................................................. 74
1SFHOBODZ ............................................................................................................................................................................... 74
5IFXBZESVHTBSFUBLFO.................................................................................................................................................... 74
%FQFOEFODF........................................................................................................................................................................... 75
%FUPYJöDBUJPO ........................................................................................................................................................................ 75
%SVH&òFDUT ............................................................................................................................................................................ 76
Section Five - Drugs and the Law
1.
Introduction ........................................................................................................................................................................... 78
,FZ4UBUVUFTBOEUIFJSQSPWJTJPOT ................................................................................................................................... 78
Section Six - The Jargon
3.
5IF+BSHPO .............................................................................................................................................................................. 86
"EEJDUJPO4FSWJDFT.BOBHFST(SPVQ............................................................................................................................. 94
Notes ......................................................................................................................................................................................... 96
Introduction
%VSJOHEJTDVTTJPOTCFUXFFO)4&4PVUIBOE(FOFSBM1SBDUJUJPOFSTIJHIMJHIUFEUIFOFFE
GPSJODSFBTFEJOGPSNBUJPOBOEBXBSFOFTTBSPVOEUIFVTFPGJMMJDJUESVHT5IJTJTTVFXBTCSPVHIUUPUIF
BUUFOUJPOPGUIF)4&4PVUI3FHJPOBM5SBJOJOHBOE"DDSFEJUBUJPO$PNNJUUFFBOEJO0DUPCFSUIFZ
SFDPNNFOEFEUIBUBQPTUFSBSPVOEUIFVTFPGDPDBJOFTIPVMECFEFTJHOFEBOEEJTTFNJOBUFEUPBMMUIF
(FOFSBM1SBDUJUJPOFSTJOUIF4PVUI&BTUFSO)FBMUI4FSWJDF&YFDVUJWF
5IFBWBJMBCJMJUZPGUIJTQPTUFSBOEUIFDPOUJOVJOHEJBMPHVFXJUINFEJDBMQSBDUJUJPOFST
IJHIMJHIUFEUIFOFFEGPSBQSBDUJDBMBOEFBTZUPSFBEHVJEFGPSUIFCSPBESBOHFPGJTTVFTBSPVOE
TVCTUBODFBCVTFBOEESVHSFMBUFEJTTVFT5IJTJOUVSOMFEUPUIFDPODFQUPGEFTJHOJOHB.FEJDBM
1SBDUJUJPOFST.BOVBMPO4VCTUBODF.JTVTFBOE%SVH3FMBUFE*TTVFT
5IFNBOVBMPGXIJDIUIJTJTUIFöSTUFEJUJPOJTJOUFOEFEGPSBMM(FOFSBM1SBDUJUJPOFSTBOENFEJDBM
QSPGFTTJPOBMTJOUIF4PVUIFSO)FBMUI4FSWJDF&YFDVUJWFSFHJPO5IFNBOVBMTUBSHFUJTUPIJHIMJHIUJTTVFT
SFMBUJOHUPBMDPIPMBOEESVHSFMBUFEDPODFSOTJOBOFBTJMZBDDFTTJCMFRVJDLSFGFSFODFNBOOFS
5IJTNBOVBMXBTEFTJHOFEJOTVDIBXBZBTUPJODMVEFOFXJOGPSNBUJPOBTJUDPNFTUPIBOEBOE
4VCTUBODF.JTVTF6OJUTJO)4&4PVUIXJMMGFFEJOOFXJOGPSNBUJPOPOBOBOOVBMCBTJTJOPSEFSUPVQEBUF
UIFQBDL5IJTXJMMFOTVSFUIBUUIF.BOVBMXJMMSFNBJOSFMFWBOUBOEVQUPEBUF
5IF%SVH&EVDBUJPO0óDFSJO4PVUI5JQQFSBSZMFEPOUIFEFTJHOPGUIFUFNQMBUFPGUIJT
NBOVBMBOEUIF%SVH&EVDBUJPO0óDFSTJOUIF4PVUI&BTUXFSFDPOTVMUFEBOEJOWPMWFEJOUIFQSPDFTT
UISPVHIPVU5IJTJOGPSNBUJPOJTUBLFOBOESFGFSFODFEGSPNBOVNCFSPGEJòFSFOUTPVSDFTBOEPVSUIBOLT
HPUPBMMXIPHBWFJOQVUBOEIFMQFEXJUIUIJTQVCMJDBUJPO
.BOVBM"JN
5IJTNBOVBMXBTEFTJHOFEJOPSEFSUPGBDJMJUBUFEFUBJMFEJOGPSNBUJPOPO4VCTUBODF.JTVTFJOUIF
4PVUIFSO3FHJPO
5IF0CKFDUJWFPGUIJTNBOVBMJT
t 5PQSPWJEFBOFBTZBDDFTTRVJDLSFGFSFODF
t 4VCTUBODF.JTVTFSFMBUFENBOVBMGPSBMM.FEJDBM1SBDUJUJPOFSTJOUIF4PVUIFSO)FBMUI4FSWJDF3FHJPO
t 5PJODMVEFSFMFWBOUVQUPEBUFESVHTGBDUTBOEJOGPSNBUJPO
t 5PQSPWJEFB%JSFDUPSZPG4FSWJDFTUPBMMSFMFWBOUTFSWJDFT
t 5PQSPWJEFB.BQQJOHPG4FSWJDFTSFMFWBOUGPSBMM.FEJDBM1SBDUJUJPOFST
t 5PQSPWJEFBOBQQSPQSJBUFSFGFSSBMTZTUFNGPSQPUFOUJBMDMJFOUTBDSPTTUIF4PVUIFSOSFHJPO
t 5PDSFBUFBTZTUFNUIBUDBOCFBEEFEUPPWFSUIFGPMMPXJOHZFBSTBTJOGPSNBUJPOBSPVOEESVHTDIBOHFT
8FXPVMEMJLFUPUIBOLBOEBDLOPXMFEHFUIPTFXIPSFWJFXFEUIJTNBOVBMBUEJòFSFOUTUBHFTPGJUT
JODFQUJPO5IFZJODMVEF
%S%FT$PSSJHBO5SJOJUZ$PMMFHF
.S#BSSZ0#SJFO/%4
4PVUI&BTU5SBJOJOH"DDSFEJUBUJPO(SPVQ
.T$FDJMZ3PBDIF1IBSNBDJTU
%S.BSUJO3PVTF8FTUFSO3PBE.FEJDBM$FOUSF$MPONFM
)4&4PMJDJUPS
)FBMUI1SPNPUJPO/*
8FXPVMEBMTPMJLFUPHJWFBTQFDJBMUIBOLTUP&EEJF.BUUIFXTGPSIJTLJOETQPOTPSTIJQPGUIJTQSPKFDU
Tony Barden - Regional Drug Coordinator HSE South
A Guide To Substance Misuse For Medical Professionals
Drug Category
Section One
Drug Category
‡
‡
‡
‡
‡
‡
‡
‡
+DOOXFLQRJHQV
2SLDWHV
6WLPXODQWV
9RODWLOH6XEVWDQFHV
0LVFHOODQHRXV6XEVWDQFHV
%DUELWXUDWHV
%HQ]RGLD]HSLQHV
'HSUHVVDQWV
4
Drug Category
Section 1
Hallucinogens
(FOFSBMJOGPSNBUJPOPO)BMMVDJOPHFOT
5IJTTFDUJPOJODMVEFTJOGPSNBUJPOPO-4%BOEPUIFS
TZOUIFUJDIBMMVDJOPHFOTIBMMVDJOPHFOJDNVTISPPNT
BOEDBOOBCJT5IFIBMMVDJOPHFOJDBNQIFUBNJOFTBSF
JODMVEFEVOEFSTUJNVMBOUTBMUIPVHIUIFZIBWFCPUI
IBMMVDJOPHFOJDBOETUJNVMBOUQSPQFSUJFT
Cannabis joints (rolled) and Cannabis pipe
Drugs include:
DRUG NAME
STREET NAME
Amanita muscaria (Fly agaric)
Magic mushrooms, M&Ms
Cannabis
Pot, dope, blow, skunk
Lysergic acid diethylamide
LSD, Acid
Ketamine
Special K
Phencyclidine
PCP, Angel dust
Psilocybe semilanceata
Liberty cap, Magic mushrooms
A Guide To Substance Misuse For Medical Professionals
Drug Category
Hallucinogens
4USFFU6TF
$BOOBCJTJTUIFNPTUXJEFMZVTFEJMMJDJUESVH*UTVTFUFOETUPCFSFDSFBUJPOBMJOOBUVSF4JNJMBSMZ
UIFVTFPG-4%BOENBHJDNVTISPPNTJTOPSNBMMZBTTPDJBUFEXJUISFDSFBUJPOBMVTF-JCFSUZ$BQ
HSPXTJOUIFBVUVNOUIFSFGPSFJUTVTFUFOETUPCFTFBTPOBMBMUIPVHIUIFESJFEGVOHVTDBOCF
stored.
%SVH&òFDU
)FJHIUFOFEBQQSFDJBUJPOPGTFOTPSZFYQFSJFODFTQFSDFQUVBMEJTUPSUJPOTGFFMJOHTPG
EJTBTTPDJBUJPOBOEFMFWBUJPOPGNPPE
%FQFOEFODZ
.JOJNBMSJTLPGQIZTJDBMEFQFOEFODF"MMDBSSZSJTLPGQTZDIPMPHJDBMEFQFOEFODZ
-POHUFSN6TF
"QBSUGSPNUIPTFMJOLFEUPTNPLJOHDBOOBCJT
UIFSFBSFOPLOPXOQIZTJDBMEBOHFSTBUUSJCVUFE
UPMPOHUFSNVTF"EWFSTFQTZDIPMPHJDBMSFBDUJPOTBSFQPTTJCMFXJUI-4%1$1BOEMJCFSUZDBQ*O
TPNFDBTFTUIFZDBOCFTFWFSFBOEMPOHMBTUJOH.VTISPPNQPJTPOJOHJTBMTPQPTTJCMF
0WFSEPTF3JTL
0WFSEPTFSJTLJTTNBMM)PXFWFSXJUILFUBNJOFJOIBMBUJPOPGWPNJUNBZCFBSJTLXIFOEPTFT
TVó
DJFOUUPJOEVDFBOBFTUIFTJBBSFUBLFO
&DQQDELV6DWLYD+HUEDOIRUPRI&DQQDELV
/6'LVRIWHQDGGHGWRDEVRUEHQWSDSHUVXFKDV
EORWWHUSDSHUDQGGLYLGHGLQWRVPDOOGHFRUDWHG
VTXDUHVZLWKHDFKVTXDUHUHSUHVHQWLQJRQHGRVH
6
Section 1
Drug Category
Hallucinogens
Amanita Muscaria (Fly agaric)
4USFFU/BNF
.BHJDNVTISPPNT
%SVH&òFDU
Hallucinogen
%FTDSJQUJPO
"SFENVTISPPNBCPVUDNIJHIXJUIXIJUF
TQPUT5IFQTZDIPBDUJWFESVHTBSFNVTDBSJOFBUSPQJOF
BOECVGPUFOJOF
.FUIPEPG6TF
6TVBMMZDPPLFEBOEFBUFOPSCPJMFEJOXBUFSUPNBLFBiUFBw.VTISPPNTDBOBMTPCFESJFEGPS
storage.
%FQFOEFODZ
No
8JUIESBXBM
&òFDUTXIJDIJODMVEFTXFBUJOHOBVTFBSFEVDFEIFBSUSBUFBOEIBMMVDJOBUJPOTCFHJOXJUIJO
NJOVUFTBOEVTVBMMZMBTUCFUXFFOGPVSBOEFJHIUIPVST"HHSFTTJWFNPPEDIBOHFTIBWF
BMTPCFFOSFQPSUFE
-POHUFSN6TF
-JUUMFJTLOPXOBCPVUUIFMPOHUFSNVTFPGøZBHBSJD
0WFSEPTF3JTL
'MZBHBSJDNVTISPPNTBSFWFSZUPYJD)FBSUGBJMVSFJTUIFNPTUDPNNPODBVTFPGEFBUI
7
A Guide To Substance Misuse For Medical Professionals
Drug Category
Hallucinogens
Cannabis (Tetra-hydrocannabinol)
4USFFU/BNF
#MPXESBXQPUEPQFHSBTTCMBDLIBTI
%SVH&òFDU
/BUVSBMMZPDDVSSJOHIBMMVDJOPHFOGSPNUIFQMBOU
DBOOBCJTTBUJWB
4USFFU'PSN
$BOOBCJTSFTJOIBTIJTINPTUDPNNPOMZVTFE
GPSNJTTNBMMCMPDLTMVNQTPGCSPXOSFTJOPVTNBUFSJBM.BSJKVBOBIFSCBMDBOOBCJTQSFQBSBUJPO
SFTFNCMFTESJFEHSBTTPSMFBWFT$BOOBCJTPJMTUSPOHFTUQSFQBSBUJPOCSPXOUPCMBDLDPMPVSFE
UIJDLPJM
.FUIPEPG6TF
4NPLFEFBUFO
%FQFOEFODZ
:FTQSPCBCMZQTZDIPMPHJDBM
8JUIESBXBM
*GTNPLFEFòFDUTMBTUGPSVQUPUISFFIPVST*GFBUFOUIFESVHJTBCTPSCFENPSFTMPXMZBOE
FòFDUTNBZMBTUGPSIPVST/PQIZTJDBMXJUIESBXBMTZNQUPNTSFQPSUFECVUIFBWZVTFSTNBZ
FYQFSJFODFSFTUMFTTOFTTBOEEFQSFTTJPO
-POHUFSN6TF
3FTQJSBUPSZQSPCMFNTBTTPDJBUFEXJUITNPLJOH1TZDIPMPHJDBMEJTUVSCBODFXJUIIFBWZVTFSBSF
0WFSEPTF3JTL
7FSZVOMJLFMZBMUIPVHIWPNJUJOHJTDPNNPOXIFOUBLFOGPSUIFöSTUUJNF
8
Cannabis (Tetra-hydrocannabinol)
$BOOBCJTDBOIBWFUIFFòFDUPGBEFQSFTTBOUPSNJMEIBMMVDJOPHFOEFQFOEJOHPOUIFBNPVOU
UBLFOBOETJUVBUJPOBMGBDUPST
$BOOBCJTTIPSUUFSNFòFDUT
5IFJNNFEJBUFFòFDUTPGMPXEPTFTNBZJODMVEF
t UFOEFODZUPMBVHIFBTJMZ
t CFDPNJOHUBMLBUJWF
t -PTTPGDPODFOUSBUJPO
t *NQBJSFECBMBODF
t 4MPXFSSFøFYFT
t *ODSFBTFEBQQFUJUF
t *ODSFBTFEIFBSUSBUF
t 'FFMJOHPGXFMMCFJOH
t -PTTPGJOIJCJUJPOT
t NPSFSFMBYFECFIBWJPVSSFEEFOJOHPGFZFTESZNPVUIIVOHFS
*GUIFESVHJTTNPLFEJUQSPEVDFTBEJTUJODUJWFTXFFUTNFMM
)JHIFSEPTFT
t $POGVTJPOBOEBOYJFUZ
t 3FTUMFTTOFTT
t %FUBDINFOUGSPNSFBMJUZ
t )BMMVDJOBUJPOT
t 1BSBOPJB
t 1BOJDBUUBDLT
$BOOBCJTDBOBMTPBòFDU
t 4IPSUUFSNNFNPSZ
t -PHJDBMUIJOLJOH
t .PUPSTLJMMTNPWFNFOUTLJMMT
t "CJMJUZUPQFSGPSNDPNQMFYUBTLT
5IFTFTZNQUPNTVTVBMMZEJTBQQFBSXIFOUIFFòFDUTPGDBOOBCJTXFBSPò
9
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Hallucinogens
Ketamine
4USFFU/BNF
,TQFDJBM,
%SVH&òFDU
"OBOBFTUIFUJDXJUIBOBMHFTJDQBJOLJMMJOH
BOE
IBMMVDJOPHFOJDQSPQFSUJFT
#SBOE/BNF
,FUBMBS1BSLF%BWJT
4USFFU'PSN
$MFBSMJRVJE8IJUFQPXEFS
Ketamine in 10 mL Vial Bottle
5IFSBQFVUJD6TF
6TFEBTBOBOBFTUIFUJDNPTUDPNNPOMZJOFNFSHFODZTVSHFSZ
.FUIPEPGVTF
#ZNPVUITOJó
OHTNPLJOHPSCZJOKFDUJPO
%FQFOEFODZ
:FTQTZDIPMPHJDBM
8JUIESBXBM
,FUBNJOFUBLFTCFUXFFOTFDPOETBOENJOVUFTUPUBLFFòFDUEFQFOEJOHPOIPXJUJT
BENJOJTUFSFE%SVHFòFDUTXIJDIJODMVEFBDPDBJOFMJLFiSVTIwMPTTPGNVTDVMBSDPPSEJOBUJPO
BOE-4%MJLFIBMMVDJOBUJPOTMBTUCFUXFFOPOFUPUISFFIPVSTCVUGPSDPOTJEFSBCMZTIPSUFS
QFSJPETBNPOHIFBWZVTFST5IFSFBSFOPQIZTJDBMXJUIESBXBMTZNQUPNTCVUIFBWZVTFSTSFQPSU
BTUSPOHQTZDIPMPHJDBMEFQFOEFODF
-POHUFSN6TF
*OGPSNBUJPOPOUIFMPOHUFSNVTFPGLFUBNJOFJTMJNJUFE-4%MJLFiøBTICBDLTwIBWFCFFO
SFQPSUFEUPHFUIFSXJUIMPTTPGBQQFUJUFBOEXFJHIUMPTT5IFSFNBZBMTPCFBQPUFOUJBMGPSUIF
EFWFMPQNFOUPGQTZDIJBUSJDQSPCMFNTGPMMPXJOHIFBWZVTF
0WFSEPTF3JTL
'FXEFBUITIBWFCFFOSFQPSUFE)PXFWFSBTXJUIBOZBOBFTUIFUJDJOIBMBUJPOPGWPNJUBGUFS
FBUJOH
JTBTFSJPVTSJTLJGEPTFTTVó
DJFOUUPJOEVDFBOBFTUIFTJBBSFUBLFO
10
What is ketamine?
,FUBNJOFJTBiEJTTPDJBUJWFBOBFTUIFUJDwXIJDINFBOTJUEFUBDIFTUIFNJOEGSPNUIFCPEZ*UT
VTFEBTB)PSTF5SBORVJMMJ[FSBOEJTSFMBUFEUPUIFWFUFSJOBSZBOBFTUIFUJD1$1BMTPLOPXOBT
angel dust.
5IF,FUBNJOF&òFDU
5IFSFTBOJOJUJBMSVTITJNJMBSUPUIFDPDBJOFSVTIUIBUNBZIBQQFOXJUIJOTFDPOETJGUIFESVH
JTJOKFDUFEPSNJOVUFTJGTXBMMPXFE5IFOJUTSBQJEMZEPXOIJMMGPSBCPVUUIFOFYUUISFF
IPVST5IFCPEZJTOVNCBOEQBSBMZTFE5IFSFNBZCFTJDLOFTTBOEWPNJUJOH$PPSEJOBUJPO
HPFTBOEUIFTJNQMFTUUBTLTBSFJNQPTTJCMF5IFSFTGFFMJOHPGCFJOHXFJHIUMFTTBOEPGCFJOH
TFQBSBUFEGSPNUIFCPEZ5FSSJGZJOHIBMMVDJOBUJPOTDBOPDDVSMJNCTGFFMBTUIPVHIUIFZSF
HSPXJOHBOETISJOLJOHUIFSFTUVOOFMWJTJPOBOEGBDFTMPPLHSPTTMZEJTUPSUFE5IFIBMMVDJOBUJPOT
TFFNBTJGUIFZMMOFWFSTUPQBOEUIFSFTBGFFMJOHPGCFJOHDMPTFUPEFBUI
t,FUBNJOFJTOPUBEBODFESVHBOEUBLJOHJUJOBDMVCJTBCBEJEFB
t5IFOPJTZEJTPSJFOUBUJOHFOWJSPONFOUXJMMXPSTFOUIFCBEFòFDUTPGLFUBNJOF
t*UTIPVMEOFWFSCFUBLFOPOUIFTQVSPGUIFNPNFOU
t,FUBNJOFTIPVMEOPUCFNJYFEXJUIBOZPUIFSESVHT
t,FUBNJOFBOETQFFELFUBNJOFBOEBDJEBOELFUBNJOFBOEBMDPIPMBSFBMMSFDJQFTGPSEJTBTUFS
,FUBNJOFBOE&DTUBTZ
#FBXBSF,FUBNJOFJTPOFPGUIFESVHTNPTUPGUFOiDVUwXJUI.%."JOFDTUBTZQJMMT1FPQMF
TPNFUJNFTTBZUIFZWFIBEBiTNBDLZw&NFBOJOHJUNBEFUIFNGFFMTFEBUFEJOTUFBEPG
FVQIPSJDBOEFOFSHFUJD8PSTFTUJMMLFUBNJOFQJMMTBSFTPNFUJNFTTPMEBTFDTUBTZTPCFDBSFGVM
,FUBNJOFIBTBOZUIJOHCVUUIFFòFDUPGUIF&BOEDBOCFUFSSJGZJOHGPSTPNFPOFXIPJTOU
QSFQBSFEGPSJU
A brief history of Ketamine
Ketamine was first synthesized in 1962 by Calvin Stevens at Parke Davis Labs while
searching for PCP anaesthetic replacements. He named it “CI581”. In 1965 Ketamine
was discovered to be a useful anaesthetic and was first used recreationally by Edward
Domino who coined the term “dissociative anaesthetic”.
Ketamine was used for anaesthesia because it suppresses breathing much less than
most other available anaesthetics, but in the 1970’s patients began to report unwanted
visions while under its influence. In 1978, John Lilly published his book “The Scientist”
and Ketamine popularity grew through the 1980’s until in 1995 the DEA in the United
States added Ketamine to its “emerging drugs list”.
In 1998 & 1999, Ketamine was lumped by media and legislators with GHB as a ‘date rape
drug’ and a ‘club drug’ and was emergency scheduled by the DEA on August 12, 1999.
11
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Hallucinogens
LSD (Lysergic Acid Diethylamide)
4USFFU/BNF
"DJEBDJEUBCTUSJQTUSBEFOBNFTFH4USBXCFSSJFT
%SVH&òFDU
Hallucinogen
4USFFUGPSN
$POTJEFSBCMFMPDBMWBSJBUJPOQBQFSTRVBSFTNJDSPEPUT
UBCMFUT
.FUIPEPG6TF
#ZNPVUI
Sample of LSD printed onto Blotting Paper
%FQFOEFODZ
/PFWJEFODFPGQIZTJDBMEFQFOEFODZ
8JUIESBXBM
5SJQTCFHJOVQUPPOFIPVSBGUFSEPTFBOEMBTUGPSUXPUPIPVSTEFQFOEJOHPOTUSFOHUI
5PMFSBODFEFWFMPQTRVJDLMZBGUFSEBZTTPUIBUGVSUIFSEPTFTBSFJOFòFDUJWF/PQIZTJDBM
QTZDIPMPHJDBMXJUIESBXBMTZNQUPNTSFQPSUFE
-POHUFSN6TF
'MBTICBDLTSFFYQFSJFODJOHQSFWJPVTUSJQ
DPNNPO5FNQPSBSZQTZDIPMPHJDBMEJTUVSCBODFXJUI
IFBWZVTF
0WFSEPTFSJTL
0OMZPOFSFDPSEFEPWFSEPTFEFBUIXPSMEXJEFBMUIPVHI
TVJDJEFTBOEBDDJEFOUBMEFBUITBMTPSFQPSUFE
&òFDUTDBOWBSZEFQFOEJOHPOUIFOBUVSFPGUIFFYQFSJFODF5IFZJODMVEF
tSFMBYFECFIBWJPVSBHJUBUFECFIBWJPVS
tEJMBUJPOPGQVQJMTVODPPSEJOBUFENPWFNFOUT
12
Hallucinogens
Psilocybe semilanceata (Liberty cap)
4USFFU/BNF
.BHJDNVTISPPNTNVTIJFT
%SVH&òFDU
)BMMVDJOPHFO5IFNVTISPPNFòFDUJTEFTDSJCFE
BTBAUSJQBOENBZMBTUVQUPIPVST*UDBOCFB
QPXFSGVMFYQFSJFODFXIJDINBZQSPEVDFBEJTUPSUJPO
PGOPSNBMQFSDFQUJPOTJNJMBSUPBO-4%FòFDU
%FTDSJQUJPO
-JHIUCSPXONVTISPPNBCPVUDNIJHIDPOUBJOJOH
QTJMPDZCJO
.FUIPEPG6TF
6TVBMMZDPPLFEBOEFBUFOPSCPJMFEJOXBUFSUPNBLFBiUFBw.VTISPPNTDBOBMTPCFESJFEGPSTUPSBHF
%FQFOEFODZ
No
8JUIESBXBM
&òFDUTXIJDIJODMVEFFVQIPSJBBOEIBMMVDJOBUJPOTCFHJOXJUIJONJOVUFTBOEVTVBMMZMBTU
CFUXFFOGPVSBOEFJHIUIPVST4MFFQPGUFOGPMMPXTVTF/PXJUIESBXBMTZNQUPNTIBWFCFFOOPUFE
-POHUFSN6TF
1TJMPDZCJODBODBVTFJNQBJSFEDPHOJUJWFGVODUJPOJOHBOEQPPSQFSGPSNBODFPOBUUFOUJPOUFTUT
)PXFWFSOPBEWFSTFMPOHUFSNFòFDUTIBWFCFFOSFQPSUFE
0WFSEPTF3JTL
-JCFSUZDBQTBSFOPUWFSZUPYJDBOETPUIFPWFSEPTFSJTLJTMPX"NPVOUTPGNVTISPPNTVTFEWBSZ
GSPNPOFPSUXPNVTISPPNTUPPSNPSF)PXFWFSUIFSFJTBSJTLPGNJTUBLJOHMZUBLJOHBNPSF
QPJTPOPVTNVTISPPNPSGVOHVT
13
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Opiates
(FOFSBMJOGPSNBUJPOPO0QJBUFT
0QJBUFTDBOCFEJWJEFEJOUPUXPHSPVQTUIFOBUVSBMMZPDDVSSJOHPQJBUFTMJLFIFSPJOBOE
NPSQIJOFXIJDIBSFEFSJWFEGSPNUIFPQJVNQPQQZBOEUIFTZOUIFUJDPQJBUFTMJLFNFUIBEPOF
BOEEJQJQBOPOF
Drugs include:
DRUG NAME
BRAND/COMMON
NAME
STREET NAME
THERAPEUTIC DOSE
RANGE
Codeine
Actifed, Phensedyl,
Codeine, Linctus
Codis
Buprenorphine
Temgesic
Tems
0.6-1.6mg
Dextropropoxyphene
Distalgesic
Co-proximol
Dextromoramide
Palfium
Palf, peach
5-10mg
Diamorphine
Heroin
Smack, H
Dihydrocodeine
DF118
DFs, diffs
120-180mg
Dipipanone
Diconal
Dikies
30mg
Methadone
Physeptone
Meth, phy
15-40mg
Morphine
MST Continus,
Kaolin and
Morphine
Cyclimorph
Opium
Gees Linctus
Nubain
Nalbuphine
hydrochloride
1 ml vial
14
Opiates
4USFFU6TF
0QJBUFTDBOCFTNPLFETOJòFEJOIBMFEPSJOKFDUFE
EFQFOEJOHPOUIFESVHBOEQSFQBSBUJPO
%SVH&òFDU
0QJBUFTBSFVTFEGPSUIFJSBOBMHFTJDQBJOLJMMJOH
QSPQFSUJFT5IFZBMTPSFEVDFCSFBUIJOHSBUFIFBSUSBUF
IVOHFSBOEBOYJFUZ5IFTFFòFDUTDPNCJOFEXJUI
BOJODSFBTFJOCMPPEøPXUPUIFTLJOHJWFTUIFXBSN
DPOUFOUFEBOETPNFUJNFTFVQIPSJDGFFMJOHUIBUJTPGUFO
SFQPSUFE'JSTUUJNFVTFSTNBZWPNJUCVUUIJTTUPQTXJUI
SFQFBUFEVTF"UMPXEPTFTPQJBUFTEPOPUJOUFSGFSFXJUI
QIZTJDBMDPPSEJOBUJPOPSNFOUBMBMFSUOFTT"GUFSIJHIEPTFT
PQJBUFTQSPEVDFBTUVQPSHBVDIJOH
%FQFOEFODF
5PMFSBODFUPPQJBUFTEFWFMPQTWFSZRVJDLMZBOEBGUFSBGFXXFFLTPGSFHVMBSVTFEPTFTNVTUCFJODSFBTFE
UPQSPEVDFUIFTBNFFòFDU%FQFOEFODFUBLFTMPOHFSUPEFWFMPQCVUBGUFSUBLJOHPQJBUFTSFHVMBSMZGPS
TPNFNPOUITUIFSFBSFQIZTJDBMXJUIESBXBMTZNQUPNT5IFTQFFEXJUIXIJDIEFQFOEFODFEFWFMPQT
BOEUIFTFWFSJUZPGXJUIESBXBMTZNQUPNTFYQFSJFODFEEFQFOETVQPOUIFRVBOUJUZBOEUZQFPGESVH
UBLFOUIFNFUIPEPGBENJOJTUSBUJPOBOEUPTPNFFYUFOUUIFFYQFDUBUJPOTPGUIFVTFS8JUIESBXBM
VTVBMMZCFHJOTFJHIUUPIPVSTBGUFSUIFMBTUEPTFPGESVHQFBLTBGUFSUISFFUPöWFEBZTBOEUIFOGBEFT
BGUFSöWFUPEBZT8JUIESBXBMGSPNPQJBUFTDBOCFVOQMFBTBOUBOEVODPNGPSUBCMF4ZNQUPNTBSF
TJNJMBSUPBCBECPVUPGøVBOEJODMVEFTXFBUJOHTUPNBDIDSBNQTNVTDVMBSQBJOSVOOJOHOPTFBOE
EJBSSIPFB.PTUTZNQUPNTGBEFGBJSMZRVJDLMZCVUTMFFQMFTTOFTTBOEGFFMJOHTPGXFBLOFTTNBZDPOUJOVF
GPSTPNFNPOUIT
-POHUFSN6TF
5IFQIZTJDBMFòFDUTPGMPOHUFSNPQJBUFVTFBSFOPUPGUFOTFSJPVTJOUIFNTFMWFT$PNNPOTJEFFòFDUT
JODMVEFDPOTUJQBUJPOJSSFHVMBSQFSJPETNFOTUSVBMDZDMF
BOEXFJHIUMPTT)PXFWFSUIFVTFPGVOTUFSJMF
FRVJQNFOUBOEUIFJOKFDUJOHPGBEVMUFSBUFEIFSPJODSVTIFEUBCMFUTPSUIFDPOUFOUTPGDBQTVMFTDBOMFBE
UPNPSFTFSJPVTQSPCMFNTJODMVEJOHBCTDFTTFTWFJODPMMBQTFMPTTPGMJNCTIFQBUJUJT#BOE$BOE)*7
JOGFDUJPO
0WFSEPTF3JTL
%FBUITGSPNPQJBUFPWFSEPTFTBSFSFMBUJWFMZSBSFBMUIPVHIUIFJOUSBWFOPVTVTFPG%JDPOBMJTQBSUJDVMBSMZ
EBOHFSPVT5IFSJTLJODSFBTFTBGUFSBQFSJPEPGBCTUJOFODFPSXIFOPQJBUFTBSFNJYFEXJUIPUIFSESVHT
TVDIBTDPDBJOFCBSCJUVSBUFTPSBMDPIPM
3JTLTJO1SFHOBODZ
.BOZXPNFOEPOPUIBWFQFSJPETNFOTUSVBMDZDMF
XIFOUIFZBSFVTJOHPQJBUFTSFHVMBSMZCVUBTTPPO
BTUIFZDVUEPXOPSTUPQUIFJSQFSJPETSFUVSO.BOZGFNBMFESVHVTFSTCFDPNFQSFHOBOUBUUIJTUJNF
5IFSFJTOPFWJEFODFUIBUPQJBUFTDBVTFCJSUIEFGFDUTBMUIPVHIUIFZNBZQPTTJCMZJODSFBTFUIFSJTLPG
NJTDBSSJBHFBOETUJMMCJSUIT)PXFWFSPQJBUFVTFTIPVMEOPUCFTUPQQFETVEEFOMZCFDBVTFUIJTBMTP
JODSFBTFTUIFSJTLPGNJTDBSSJBHFPSQSFNBUVSFMBCPVS(SBEVBMXJUIESBXBMPWFSXFFLTNBZCFBEWJTFE
#BCJFTCPSOUPNPUIFSTXIPDPOUJOVFUPVTFUISPVHIPVUUIFQSFHOBODZTIPXXJUIESBXBMTZNQUPNT
XJUIJOUISFFEBZTPGCJSUIQPTTJCMZMPOHFSJGUIFNPUIFSIBTCFFOVTJOHNFUIBEPOF
4ZNQUPNTJODMVEF
FYDFTTJWFSFTUMFTTOFTTTISJMMDSZJOHTMFFQMFTTOFTTDPOTUBOUTVDLJOHEJBSSIPFBZBXOJOHBOETOFF[JOH*O
TFWFSFDBTFTCBCJFTNBZTVòFSDPOWVMTJPOTXIJDIDBOCFGBUBM
15
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Opiates - Heroin
)FSPJOBDUTBTBEFQSFTTBOU
4IPSU5FSN&òFDU
tTMPXJOHEPXOPGCSFBUIJOHBOEIFBSUSBUF
tTVQQSFTTJPOPGDPVHISFøFY
tJODSFBTFJOTJ[FPGDFSUBJOCMPPEWFTTFMT
tJUDIZTLJOSVOOZOPTF
tMPXFSJOHPGCPEZUFNQFSBUVSF
tTXFBUJOH
t0OFUPUXPNJOVUFiSVTIw
t8BSNøVTIJOHPGUIFTLJO
t%SZNPVUI
t)FBWZGFFMJOHJOBSNTBOEMFHT
t/BVTFB7PNJUJOH
t4FWFSFJUDIJOH
t%SPXTJOFTTBOEDPOGVTJPOGPSVQUPTJYIPVST
t4MPXFEIFBSUSBUFTMPXFECSFBUIJOHSBUF
)FSPJOTNBOZQIZTJDBMEBOHFSTJODMVEF
t1BJOGVM8JUIESBXBMUIBU.BJOUBJOT"EEJDUJPO
t3FTUMFTTOFTT
t.VTDMFBOECPOFQBJO
t.VTDMFTQBTNT
t*OTPNOJB
t%JBSSIFBBOEWPNJUJOH
t$IJMMTBOEHPPTFCVNQT
t*OUFOTFBOYJFUZ
Heroin powder
$BSEJPWBTDVMBS%BNBHF
t&OEPDBSEJUJT)FBSUJOGFDUJPO
t4DBSSFEBOEPSDPMMBQTFEWFJOT
t#MPPEWFTTFMTDMPHHFECZGPSFJHOQBSUJDMFTDBVTJOH
DFMMEFBUI
*OGFDUJPOTBOE7JSVTFT
t#PJMTBOEBCTDFTTFT
t4PGUUJTTVFJOGFDUJPOT
t)*7"*%4
t)FQBUJUJT#BOE$
t4ZTUFNJDJOGFDUJPOTCBDUFSFNJBPSTFQTJT
0UIFS0SHBO%BNBHFBOE%JTFBTF
t-JWFSEJTFBTF
t,JEOFZEJTFBTF
t"SUISJUJT
Heroin powder (Asian)
%BOHFS%VSJOH1SFHOBODZ
t.JTDBSSJBHFQSFNBUVSFEFMJWFSZPSTUJMMCJSUIPGQSFHOBODJFT
t"EEJDUFEOFXCPSOTHSFBUFSSJTLPG4VEEFO*OGBOU%FBUI4ZOESPNFiDPUEFBUIw
16
Section 1
Opiates - Methadone
4USFFU/BNF
.FUIQIZ
#SBOEOBNF
1JOBEPOF%5'BOE1IZTFQUPOF$BMNJD
%SVHFòFDU
1BJOLJMMFSBOEEFQSFTTBOUiEPXOFSw
%FTDSJQUJPO
8IJUFTDPSFEUBCMFUNBSLFE8FMDPNFNH
NMBNQPVMFTNHNM
.JYUVSFNHNM
-JODUVT
5IFSBQFVUJDVTF
4FWFSFQBJOBOEPQJBUFEFQFOEFODF
.FUIPEPGVTF
#ZNPVUIPSJOKFDUJOHDSVTIFEUBCMFUTMJODUVTPSBNQPVMF
%FQFOEFODZ
Yes
8JUIESBXBM
5IFFòFDUTPGNFUIBEPOFMBTUVQUPIPVSTXIJDIJTMPOHFSUIBOIFSPJO8JUIESBXBMTZNQUPNTBSF
TMPXFSUPEFWFMPQCVUMBTUMPOHFS'MVMJLFTZNQUPNTBQQFBSVQUPUXPEBZTBGUFSMBTUEPTFQFBLBGUFS
öWFUPTJYEBZTBOEGBEFBGUFSEBZT4MFFQMFTTOFTTNBZMBTUGPSMPOHFS*UIBTCFFOTVHHFTUFEUIBU
XJUIESBXBMJTNPSFEJóDVMUUIBOGSPNIFSPJO
-POHUFSNVTF
$POTUJQBUJPOCSFBUIJOHEJóDVMUJFTJSSFHVMBSQFSJPETNFOTUSVBMDZDMF
*GJOKFDUFE
tJOGFDUJPOSJTLBOEDJSDVMBUPSZQSPCMFNT
%FQSFTTFTFòFDUTPGPUIFSPQJBUFT.
0WFSEPTFSJTL
%FBUITGSPNUIFVTFPGNFUIBEPOFBMPOFBSFSFMBUJWFMZJOGSFRVFOU)PXFWFSUIFPWFSEPTFSJTLJODSFBTFT
BGUFSBQFSJPEPGBCTUJOFODFPSJGNFUIBEPOFJTNJYFEXJUIPUIFSESVHTTVDIBTCFO[PEJB[JQJOFTPSBMDPIPM
17
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
General information on Stimulants
5IFNPTUDPNNPOMZVTFETUJNVMBOUTBSFBNQIFUBNJOFTBOEDPDBJOF$PDBJOFJTEFSJWFE
GSPNUIFMFBGPGUIFDPDBQMBOU&SZUISPYZMVN$PDB
BOEBNQIFUBNJOFTBSFNBOVGBDUVSFE
CPUIMFHBMMZBOEJMMFHBMMZ.PTUSFDFOUMZUIFSFDSFBUJPOBMVTFPG&DTUBTZIBTCFDPNFDPNNPO
QBSUJDVMBSMZBNPOHZPVOHQFPQMFXIPGPMMPXUIFDMVCTDFOF
Drugs include:
DRUG NAME
STREET NAME
Amphetamine sulphate
Speed
Cocaine hydrochloride
Cocaine
Catha edulis-khat
Khat
Dexamphetamine sulphate
Dexedrine
Methlamphetamine
Methamphetamine/crystal meth/meth/
ice
Methylenedioxymethamphetamine
Ecstasy
18
Ecstasy Tablets
Stimulants (continued)
4USFFU6TF
4UJNVMBOUTDBOCFTXBMMPXFETOJòFEPSJOKFDUFE
"NQIFUBNJOFTVMQIBUFDBOBMTPCFTNPLFEBOE
DPDBJOFGSFFCBTFIFBUFEBOEJOIBMFE&DTUBTZJT
VTVBMMZUBLFOCZNPVUI
%SVH&òFDU
4UJNVMBOUTJODSFBTFDFSFCSBMBDUJWJUZDBVTJOH
FYDJUFNFOUBOEFVQIPSJB5IFZBMTPEJMBUFUIF
QVQJMTPGUIFFZFJODSFBTFIFBSUSBUFBOECMPPE
QSFTTVSFDBVTFTMFFQMFTTOFTTBOEBOPSFYJBMPTTPG
BQQFUJUF
$PDBJOFJTBQPXFSGVMMPDBMBOBFTUIFUJD
CVUBNQIFUBNJOFTBSFOPU-PXUPNPEFSBUFEPTFT
PGTUJNVMBOUTEPOPUEJTSVQUUIJOLJOHCVUVTFSTNBZFYQFSJFODFNPPETXJOHT)JHIEPTFTPO
UIFPUIFSIBOEDBODBVTFUIPVHIUEJTPSEFSBOEBESVHJOEVDFEQTZDIPTJTSFTFNCMJOHQBSBOPJE
TDIJ[PQISFOJBJTOPUVODPNNPO5IFJSVTFNBZBMTPDBVTFIBMMVDJOBUJPOTBOEQBSBOPJEUIJOLJOH
%FQFOEFODF
5PMFSBODFEFWFMPQTRVJDLMZXJUIBNQIFUBNJOFTQSPWPLJOHNBTTJWFJODSFBTFTJOEPTFT
5PMFSBODFUPDPDBJOFUFOETUPCFNVDIMFTTNBSLFEBMUIPVHIUPMFSBODFUPUIFFVQIPSJDFòFDUT
PGiGSFFCBTFwIBTCFFOOPUFEDBVTJOHJODSFBTJOHGSFRVFODZPGVTF%FQFOEFODFPOTUJNVMBOUTJT
TBJEUPCFNPSFQTZDIPMPHJDBMUIBOQIZTJDBMBMUIPVHISFDFOUFWJEFODFTVHHFTUTQPTTJCMFMPOH
UFSNDIBOHFTUPUIFOFSWPVTTZTUFN8JUIESBXBMJTDIBSBDUFSJTFECZIVOHFSGBUJHVFQFSJPET
PGöUGVMTMFFQJODSFBTFJOESFBNJOHBOEEFQSFTTJPO*OTPNFJOEJWJEVBMTEFQSFTTJPODBOCF
QSPMPOHFEBOETFWFSF
-POHUFSN6TF
1SPMPOHFEVTFPGTUJNVMBOUTDBOMFBEUPXFJHIUMPTTJOTPNOJBFYIBVTUJPOBOENFOUBMDPOGVTJPO
TFWFSFEFQSFTTJPOBOEESVHJOEVDFEQTZDIPTJTVTVBMMZSFTPMWFEBGUFSESVHUBLJOHJTTUPQQFE
0WFSEPTF3JTL
%FBUIGSPNESVHPWFSEPTFTJTNPSFDPNNPOXJUIDPDBJOFUIBOXJUIBNQIFUBNJOFTBOEPGUFO
SFTVMUTGSPNSFTQJSBUPSZGBJMVSF*OEJWJEVBMTXJUIIJHICMPPEQSFTTVSFPSBIFBSUDPOEJUJPOBSFBU
SJTLXIFOVTJOHTUJNVMBOUTCFDBVTFFYUSBTUSFTTJTQMBDFEPOUIFDBSEJPWBTDVMBSTZTUFN
3JTLTJO1SFHOBODZ
4UJNVMBOUTDBODBVTFDPOHFOJUBMBCOPSNBMJUJFTNJTDBSSJBHFQSFNBUVSFMBCPVSBOETNBMMFS
UIBOBWFSBHFCBCJFT%SVHVTFTIPVMECFTUPQQFEJNNFEJBUFMZXJUIPVUBOZESVHTVCTUJUVUJPO
CFDBVTFPGSJTLUPUIFCBCZ#BCJFTCPSOUPNPUIFSTXIPDPOUJOVFUPUBLFTUJNVMBOUTEVSJOH
QSFHOBODZTIPXBXJUIESBXBMTZOESPNF8JUIESBXBMBNPOHOFXCPSOCBCJFTJTDIBSBDUFSJTFE
CZTISJMMDSZJOHJSSJUBCJMJUZBOESFQFBUFETOFF[JOH
19
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants (continued)
Stimulant drugs
(amphetamines, butyl nitrite, cocaine)
5IFTF%SVHTDBODBVTF
tJODSFBTFEQVMTFSBUF
tJODSFBTFECMPPEQSFTTVSF
tBHJUBUJPO
tMBDLPGDPIFSFOUTQFFDIPSUBMLBUJWFOFTT
tEJMBUFEQVQJMT
tMPTTPGBQQFUJUF
tEBNBHFUPOBTBMQBTTBHFTUFOEFODZUPTOJò tJODSFBTFEUFOEFODZUPHPUPUIFUPJMFU
tNPVUIVMDFSTGBUJHVFBGUFSVTF
Dexredine Capsules
4IPSU5FSN&òFDUTPG$PDBJOF6TF
t5BMLBUJWFOFTTBOETPDJBCJMJUZ
t&YUSFNFNFOUBMBMFSUOFTT
t/FSWPVTOFTTBOEKVNQJOFTT
t"OYJFUZFTQFDJBMMZBCPVUCFJOHDBVHIUVTJOH
t*SSJUBCJMJUZ
t1BSBOPJB
t%JNJOJTIFEEFDJTJPONBLJOHBCJMJUZ
t*OTPNOJB
t5SFNPSTBOEEJ[[JOFTT
t.VTDMFUXJUDIFTBOETQBTNT
t-PTUTFMGDPOUSPM
t7JPMFOUCFIBWJPVS
t%SZNPVUI
t$POTUSJDUFECMPPEWFTTFMT
t%JMBUFEQVQJMT
t%FDSFBTFEBQQFUJUF
t"CEPNJOBMQBJOBOEOBVTFB
t#MVSSFEWJTJPO
t'FWFS
t*ODSFBTFEIFBSUSBUFBOECMPPEQSFTTVSF
t*NQPUFODFDPNCJOFEXJUIFYDFTTJWFJOUFSFTUJOTFY
Butyl Nitrite (Poppers)
Cocaine Powder
-POH5FSN&òFDUTPG$PDBJOF6TF
5IFSFJTOPTBGFXBZUPVTFDPDBJOF5IFIFBMUISJTLTCFDPNFNVDIXPSTFXIFODPNCJOFEXJUI
BMDPIPMPSPUIFSESVHT"MDPIPMBOEDPDBJOFDPNCJOFEQSPEVDFDPDBFUIZMFOFXIJDIJOUFOTJöFT
DPDBJOFTFòFDUTBOENBZJODSFBTFUIFSJTLPGTVEEFOEFBUI$PDBJOFTNBOZEBOHFSTJODMVEF
20
Section 1
Drug Category
/FVSPMPHJDBM&òFDUT
t)FBEBDIFT
t$POWVMTJPOT
t4FJ[VSFT
t$PNB
)FBSU%JTFBTF
t"MUFSFEIFBSUSIZUIN
t$IFTUQBJO
t7FSZIJHIPSWFSZMPXCMPPEQSFTTVSF
t)FBSUBUUBDL
t&OEPDBSEJUJT)FBSUJOGFDUJPO
t4USPLF
t4VEEFOEFBUI
-VOH%BNBHFBOE%JTFBTF
t%Jó
DVMUZCSFBUIJOH
t$ISPOJDCSPODIJUJT
t3VQUVSFEMVOHTUSVDUVSFT
t$PMMBQTFEMVOH
t3FTQJSBUPSZGBJMVSF
1TZDIPMPHJDBM%BNBHF
t*SSJUBCJMJUZBOENPPEEJTUVSCBODFT
t"VEJUPSZIBMMVDJOBUJPOTJNBHJOBSZTPVOETUIBUTFFNSFBM
t'PSNJDBUJPO5IFTFOTBUJPOUIBUJOTFDUTBSFDSBXMJOHVOEFSUIFTLJO
3FQSPEVDUJWF4ZTUFN%BNBHF
t4FYVBMEZTGVODUJPOJOCPUINBMFTBOEGFNBMFT
t.FOTUSVBMDZDMFEJTUVSCBODFT
t*OGFSUJMJUZJOCPUINBMFTBOEGFNBMFT
%BOHFS%VSJOH1SFHOBODZ
t.JTDBSSJBHFQSFNBUVSFEFMJWFSZPSTUJMMCJSUIPGQSFHOBODJFT
t"EEJDUFEOFXCPSOT
t-PXCJSUIXFJHIUTNBMMFSIFBETJ[FBOETIPSUFSMFOHUIJOOFXCPSOT
t%FGPSNJUJFTJOOFXCPSOTPGBEEJDUFENPUIFSTPSBEEJDUFEGBUIFST
0UIFS%BNBHF
t#VSOTJONPVUIBOEPOIBOETGSPNTNPLJOH
ti5SBDLTwQVODUVSFNBSLTPOBSNTPSXIFSFWFSJOKFDUJPOTBSFNBEF
t*OGFDUJPOTBOETPSFTBTTPDJBUFEXJUIJOKFDUJPOUSBDLT
t*ODPOUJOFODFJOBCJMJUZUPDPOUSPMVSJOBUJPOBOEPSCPXFMNPWFNFOUT
t"MMFSHJDSFBDUJPOTUPDPDBJOFPSUIFBEEJUJWFTJOTUSFFUESVHT
t#SBJOJOGFDUJPOTCPUICBDUFSJBMBOEGVOHBMTPNFUJNFTMFBEJOHUPBCTDFTTFT
t8FJHIUMPTTBOENBMOPVSJTINFOUEVFUPEFDSFBTFEBQQFUJUFGPSGPPE
t(BOHSFOFSPU
PGCPXFMTBOEPUIFSCPEZQBSUTGSPNMBDLPGCMPPEøPX
t.PSFSJTLUBLJOHCFIBWJPVSJODMVEJOHVOTBGFTFY
t*ODSFBTFESJTLPG)*7"*%4BOEIFQBUJUJTFJUIFSGSPNVOTBGFTFYPSVTJOHJOGFDUFEOFFEMFT
21
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Amphetamine Sulphate
4USFFU/BNF
4VMQIBUFTVMQIXIJ[[TQFFECJMMZ
%SVH&òFDU
4USPOHTUJNVMBOUiVQQFSw
4USFFUGPSN
8IJUFZFMMPXDSZTUBMMJOFQPXEFSVTVBMMZTPMEJO
iXSBQTw
.FUIPEPG6TF
&BUFOTOJòFEPSJOKFDUFE
$PSKHWDPLQH6XOSKDWH:UDSV
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFUPBNQIFUBNJOFTVMQIBUFEFWFMPQTSBQJEMZBOEVTFSTDBOJODSFBTFEPTFVQUP
GPME&òFDUTPGBNQIFUBNJOFTVMQIBUFMBTUGPSUISFFUPGPVSIPVST8JUIESBXBMGSPNUIJTESVH
JTEJWJEFEJOUPUXPQIBTFT5IFJNNFEJBUFiDSBTIwPSSFCPVOEMBTUTUXPUPUISFFXFFLTBOEJT
DIBSBDUFSJTFECZIVOHFSFYUSFNFGBUJHVFBOEMPOHQFSJPETPGEJTUVSCFETMFFQ*OUIFTFDPOE
QIBTFIFBWZVTFSTCFDPNFJSSJUBCMFBOEEFQSFTTFETPNFUJNFTTFWFSFMZ
5IFTFDPOEQIBTF
DBOMBTUXFFLTBOETPNFUJNFTNPOUIT
-POHUFSN6TF
&YDFTTJWFSFTUMFTTOFTTBOEJOTPNOJBXFJHIUMPTTBNQIFUBNJOFQTZDIPTJTIBMMVDJOBUJPOTBOE
QBSBOPJEUIJOLJOH
*GJOKFDUFEJOGFDUJPOSJTLDJSDVMBUPSZQSPCMFNT
0WFSEPTFSJTL
%FBUIGSPNPWFSEPTFJTQPTTJCMFXJUIMBSHFEPTFTCVUSBSF0WFSEPTFSJTLJODSFBTFTJG
BNQIFUBNJOFJTNJYFEXJUIESVHTTVDIBTIFSPJOPSEFQSFTTBOUTMJLFCBSCJUVSBUFTPSBMDPIPM
$PSKHWDPLQH6XOSKDWH3RZGHU
22
Amphetamines
"NQIFUBNJOFTBSFOJDLOBNFEiTQFFEwPSiVQQFSTwCFDBVTFPGUIFCVSTUPGFOFSHZUIFZQSPWJEF
"CVTFSTEPOPUGFFMUIFOFFEUPTMFFQPSFBUXIFOUIFZBSFVTJOH4PNFVTFSTBMTPFYQFSJFODF
FVQIPSJBBTFOTFPGXFMMCFJOHBOETFMGDPOöEFODF6TFSTBSFVTVBMMZUBMLBUJWFBOENBZCF
BHHSFTTJWFBOEQBSBOPJEFWFOBUBOFBSMZTUBHFPGVTF5IFEFTJSBCMFFòFDUTPGBNQIFUBNJOFT
BSFOPUXJUIPVUBQSJDF6TFSTTIPSUMZCVJMEUPMFSBODFBOEEFQFOEFODFoBEEJDUJPO4PPOUIFZ
OFFEBNQIFUBNJOFTUPHFUUISPVHIBOPSEJOBSZEBZ*OUIFNFBOUJNFUIFESVHTEPTFSJPVT
QTZDIPMPHJDBMBOEQIZTJDBMEBNBHF
4IPSUUFSN&òFDUT
"NQIFUBNJOFTDBOCFFYUSFNFMZEBOHFSPVTPSGBUBMGSPNUIFöSTUVTF6TFSTNBZEJFGSPNCVSTU
CMPPEWFTTFMTJOUIFCSBJOIFBSUGBJMVSFPSTVQFSFMFWBUFECPEZUFNQFSBUVSF
$PNNPOTIPSUUFSNFòFDUTJODMVEF
t%SZNPVUIBOEPS)FBEBDIF
t%JMBUFEQVQJMT
t*OTPNOJB
t%SZJUDIZTLJO
t"DOFTPSFT
t%J[[JOFTTBOECMVSSZWJTJPO
t-PTTPGDPPSEJOBUJPO
t6ODPOUSPMMBCMFNPWFNFOUTUXJUDIJOHKFSLJOHUSFNPSTFUD
t'FWFSøVTIJOHBOETXFBUJOH
t%JBSSIPFBPSDPOTUJQBUJPO
t/VNCOFTT
t*NQBJSFETQFFDI
t*ODSFBTFEIFBSUSBUF
t3BQJECSFBUIJOHSBUF
0WFSEPTF
"NQIFUBNJOFPWFSEPTFJTGBJSMZDPNNPOXIJDIJTQSPCBCMZEVFUPBCVTFSTFWFSJODSFBTJOH
OFFEGPSNPSFBOENPSFPGUIFESVHUPMFSBODF
"CVTFSTUSZUPPWFSDPNFUIFJSUPMFSBODFCZ
FTDBMBUJOHUIFJSVTFUIFZPWFSEPJUBOEUIFZPWFSEPTF"NQIFUBNJOFPWFSEPTFJTPGUFOGBUBM
4ZNQUPNTJODMVEF
t$IJMMTGFWFSBOETXFBUJOH
t.VTDMFTQBTNTJODMVEJOHTFWFSFMZFYBHHFSBUFEBSDIJOHPGUIFCBDL
t$POWVMTJPOT
t-BDLPGVSJOFPVUQVU
t%Jó
DVMUZCSFBUIJOH
t%JMBUFEQVQJMTBOECMVSSFEWJTJPO
t#MVFMJQTBOEöOHFSOBJMT
t/BVTFBBOEPSWPNJUJOH
t&MFWBUFECMPPEQSFTTVSFGPMMPXFECZBESBNBUJDESPQJOCMPPEQSFTTVSF
t*SSFHVMBSIFBSUCFBU
t$IFTUQBJO
t/FSWPVTOFTTJSSJUBCJMJUZ
t3FTUMFTTOFTTBOEPS"HHSFTTJWFCFIBWJPVS
t$PNB
23
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Amphetamines (continued)
-POHUFSN&òFDUT
"NQIFUBNJOFTDBVTFBXJEFWBSJFUZPGQPUFOUJBMMZGBUBMEBNBHFUPVTFSTNFOUBMBOEQIZTJDBM
IFBMUI0OFPGUIFNPTUUSPVCMJOHFòFDUTPGBNQIFUBNJOFBCVTFJTUIFBEEJDUJPOJUTFMGXIJDI
DBOCFMJGFBMUFSJOH8JUIESBXBMDBVTFTQBJOGVMTJEFFòFDUTBTXFMM
"EEJDUJPO
t"NQIFUBNJOFQTZDIPTJTTFFCFMPX
t$SBWJOH
t5PMFSBODFEFQFOEFODF
8JUIESBXBM
t$SBWJOH
t&YIBVTUJPO
t%FQSFTTJPO
t.FOUBMDPOGVTJPO
t3FTUMFTTOFTTBOEJOTPNOJB
t%FFQBOEEJTUVSCFETMFFQMBTUJOHVQUPIPVST
t&YUSFNFIVOHFS
t1TZDIPTJT
t*OUFOTFBOYJFUZ
0UIFSTFSJPVTMPOHUFSNEBNBHFDBVTFECZBNQIFUBNJOFBCVTFJODMVEFT
t(BTUSPJOUFTUJOBMOVUSJUJPOBMEBNBHF
t.BMOVUSJUJPO
t6MDFST
t6OXBOUFEXFJHIUMPTT
t)FBSUEJTFBTFSBQJEIFBSUSBUFEBOHFSPVTMZIJHICMPPEQSFTTVSF
t$BSEJPNZPQBUIZFOMBSHFEBOEPSXFBLFOFEIFBSU
IFBSUBUUBDL
t/FVSPMPHJDBMEBNBHFQFSNBOFOUCSBJOEBNBHFEJTUVSCFEUIPVHIUQSPDFTTFTTQFFDI
EJó
DVMUJFTDPOGVTJPONFNPSZMPTT
t1TZDIPMPHJDBMEBNBHFIBMMVDJOBUJPOTEFFQEFQSFTTJPOIZQPDIPOESJBUIFGBMTFCFMJFG
UIBUPOFJTQIZTJDBMMZJMM
EFMVTJPOTPGQPXFSPSGBNFBOUJTPDJBMCFIBWJPVSTUFSFPUZQJD
CFIBWJPVSTPEESFQFUJUJWFNPWFNFOUTPSIBCJUT
t1TZDIPTJTQBSBOPJBCJ[BSSFBOEWJPMFOUCFIBWJPVS
t%BOHFSUPOFXCPSOTPGXPNFOXIPVTFEVSJOHQSFHOBODZBEEJDUJPOBOEXJUIESBXBM
DBSEJBDEFGFDUTDMFGUQBMBUFPUIFSQIZTJDBMBCOPSNBMJUJFT
t%FWFMPQNFOUBMEFMBZTOFVSPMPHJDBMEBNBHFOPUEFUFDUBCMFBUCJSUI
t0UIFSEBNBHFMJWFSEBNBHFJNQPUFODF
Amphetamine Tablets
24
Section 1
Drug Category
Stimulants
Cocaine hydrochloride
(cocaine/cocaine freebase)
4USFFU/BNF
$PLFTOPXDSBDLGSFFCBTFSPDL
%SVH&òFDU
4USPOHTUJNVMBOUiVQQFSw
MPDBMBOBFTUIFUJD
%FTDSJQUJPO
$PDBJOFXIJUFQPXEFS
$PDBJOFGSFFCBTFTNBMMXIJUFDIJQT
3RZGHUHG&RFDLQHLQSODVWLFZUDS
5IFSBQFVUJDVTF
"TMPDBMBOBFTUIFUJDGPSFZFTFBSTBOEOPTFSBSFMZVTFE
.FUIPEPGVTF
$PDBJOFIZESPDIMPSJEFTOJòFEJOKFDUFESVCCFEPONVDVPTNFNCSBOFFBUFOBOFDEPUBM
FWJEFODFPGDPDBJOFCFJOHQMBDFEVOEFSFZFMJETBOEBENJOJTUFSFEUISPVHIBOBMQBTTBHF
$PDBJOFGSFFCBTFIFBUFEBOEJOIBMFE
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
&òFDUTPGDPDBJOFMBTUGPSUPNJOVUFT&òFDUTPGGSFFCBTFDSBDLMBTUGPSPOMZöWFUPUFO
NJOVUFT/PQIZTJDBMXJUIESBXBMTZNQUPNTCVUBGUFSUIFiIJHIwVTFSTFYQFSJFODFBiDSBTIwPS
SFCPVOEEZTQIPSJBXIFOUIFZGFFMFYUSFNFMZUJSFEBOEEFQSFTTFE
-POHUFSNVTF
&YDFTTJWFSFTUMFTTOFTTBOEJOTPNOJBXFJHIUMPTTJODSFBTFJOCMPPEQSFTTVSFQBSBOPJE
QTZDIPTJT*GTOJòFEEBNBHFUPOBTBMNFNCSBOFEBNBHFUPTFQUVNCFUXFFOOPTUSJMT
*GJOKFDUFEDJSDVMBUPSZQSPCMFNTBOEPSJOGFDUJPOSJTL
*GJOIBMFESFTQJSBUPSZQSPCMFNTBOEMVOHEBNBHF
0WFSEPTFSJTL
)JHIEPTFTDBOSFTVMUJOBOJODSFBTFJOCPEZUFNQFSBUVSFFYUSFNFBHJUBUJPODPOWVMTJPOTBOE
SFTQJSBUPSZBSSFTU0WFSEPTFSJTLJODSFBTFTJGDPDBJOFJTNJYFEXJUIPUIFSESVHTTVDIBTIFSPJO
PSEFQSFTTBOUTMJLFCBSCJUVSBUFTBOEBMDPIPM
3FDFOUBOFDEPUBMJOGPSNBUJPOTVHHFTUTUIBUATZOUIFUJDIPNFNBEFDPDBJOFJTCFJOHDJSDVMBUFE
/BTBMBQQBSBUVTTVDIBTSPMMFEVQCBOLOPUFTBOETUSBXTDBOTQSFBEWJSBMJOGFDUJPOTFH
)FQBUJUJT
25
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Crack Cocaine
8IBUEPFTJUMPPLMJLF )PXJTDSBDLBCVTFE
$SBDLUZQJDBMMZJTBWBJMBCMFBTSPDLT$SBDLSPDLTBSF
XIJUFPSPòXIJUF
BOEWBSZJOTJ[FBOETIBQF$SBDL
JTOFBSMZBMXBZTTNPLFE4NPLJOHDSBDLDPDBJOF
EFMJWFSTMBSHFRVBOUJUJFTPGUIFESVHUPUIFMVOHT
QSPEVDJOHBOJNNFEJBUFBOEJOUFOTFFVQIPSJD
FòFDU
8IBUJTDSBDLDPDBJOF )PXJTJUQSPEVDFE
$SBDLDPDBJOFJTBIJHIMZBEEJDUJWFBOEQPXFSGVM
TUJNVMBOUUIBUJTEFSJWFEGSPNQPXEFSFEDPDBJOFVTJOHBTJNQMFDPOWFSTJPOQSPDFTT$SBDL
FNFSHFEBTBESVHPGBCVTFJOUIFNJET*UJTBCVTFECFDBVTFJUQSPEVDFTBOJNNFEJBUF
IJHIBOECFDBVTFJUJTFBTZBOEJOFYQFOTJWFUPQSPEVDF‰SFOEFSJOHJUSFBEJMZBWBJMBCMFBOE
BòPSEBCMF$SBDLJTQSPEVDFECZEJTTPMWJOHQPXEFSFEDPDBJOFJOBNJYUVSFPGXBUFSBOE
BNNPOJBPSTPEJVNCJDBSCPOBUFCBLJOHTPEB
5IFNJYUVSFJTCPJMFEVOUJMBTPMJETVCTUBODF
GPSNT5IFTPMJEJTSFNPWFEGSPNUIFMJRVJEESJFEBOEUIFOCSPLFOJOUPUIFDIVOLTSPDLT
UIBU
BSFTPMEBTDSBDLDPDBJOF
8IBUBSFUIFSJTLT
$PDBJOFJOBOZGPSNJTBQPXFSGVMQTZDIPMPHJDBMMZBEEJDUJWFESVHBOEBEEJDUJPOTFFNTUP
EFWFMPQNPSFRVJDLMZXIFOUIFESVHJTTNPLFE‰BTDSBDLJT‰UIBOTOPSUFE‰BTQPXEFSFE
DPDBJOFUZQJDBMMZJT*OBEEJUJPOUPUIFVTVBMSJTLTBTTPDJBUFEXJUIDPDBJOFVTFDPOTUSJDUFECMPPE
WFTTFMTJODSFBTFEUFNQFSBUVSFIFBSUSBUFBOECMPPEQSFTTVSFBOESJTLPGDBSEJBDBSSFTUBOE
TFJ[VSF
DSBDLVTFSTNBZFYQFSJFODFBDVUFSFTQJSBUPSZQSPCMFNTJODMVEJOHDPVHIJOHTIPSUOFTT
PGCSFBUIBOEMVOHUSBVNBBOECMFFEJOH$SBDLDPDBJOFTNPLJOHBMTPDBODBVTFBHHSFTTJWF
BOEQBSBOPJECFIBWJPVS
&UDFN&RFDLQH
6WUHHWGRVHRI&UDFN&RFDLQH
26
Stimulants
Dexamphetamine sulphate (Dexedrine)
4USFFUOBNF
%FYJFT
#SBOEOBNF
%FYFESJOF&WBOT
%SVHFòFDU
4USPOHTUJNVMBOUiVQQFSw
%FTDSJQUJPO
8IJUFTDPSFEUBCMFUNH
NBSLFE%#
5IFSBQFVUJDVTF
/BSDPMFQTZVODPOUSPMMFETMFFQJOH
BOEIZQFSBDUJWJUZJODIJMESFO
.FUIPEPGVTF
#ZNPVUIPSJOKFDUFE
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFUP%FYFESJOFEFWFMPQTSBQJEMZBOEVTFSTDBOVTFVQUPUJNFTUIFUIFSBQFVUJDEPTF
&òFDUTMBTUGPSUISFFUPGPVSIPVST8JUIESBXBMJTEJWJEFEJOUPUXPQIBTFT5IFJNNFEJBUFiDSBTIw
PSSFCPVOEMBTUTGPSUXPUPUISFFXFFLTBOEJTDIBSBDUFSJTFECZIVOHFSFYUSFNFGBUJHVFBOE
MPOHQFSJPETPGöUGVMTMFFQ*OUIFTFDPOEQIBTFIFBWZVTFSTCFDPNFJSSJUBCMFBOEEFQSFTTFE
TPNFUJNFTTFWFSFMZ
5IFTFDPOEQIBTFDBOMBTUXFFLTBOETPNFUJNFTNPOUIT
-POHUFSNVTF
&YDFTTJWFSFTUMFTTOFTTBOEJOTPNOJBXFJHIUMPTTQTZDIPTJTIBMMVDJOBUJPOTBOEQBSBOPJE
UIJOLJOH
*GJOKFDUFE
tDJSDVMBUPSZQSPCMFNT
tJOGFDUJPOSJTL
0WFSEPTFSJTL
%FBUIGSPNPWFSEPTFJTQPTTJCMFXJUIMBSHFEPTFTCVUSBSF0WFSEPTFSJTLJODSFBTFTJG%FYFESJOF
JTNJYFEXJUIPUIFSEFQSFTTBOUESVHTTVDIBTPQJBUFTCBSCJUVSBUFTPSBMDPIPM
27
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Catha edulis-khat
(contains cathinone and cathine)
4USFFUOBNF
,IBUDIBURBURVBBELB
%SVHFòFDU
,IBUJTBNJMETUJNVMBOU6TFSTPGUFOSFQPSUBDBMNJOH
FòFDU
%FTDSJQUJPO
(SFFOMFBGZQMBOUDVMUJWBUFEUISPVHIPVU"GSJDB
.KDWOHDYHV'ULHG
5IFSBQFVUJDVTF
,IBUJTVTFETPDJBMMZJONBOZ"GSJDBODPVOUSJFTJONVDIUIFTBNFXBZBTDPòFFJTVTFEJO8FTUFSO
culture.
.FUIPEPGVTF
$IFXJOHMFBWFTPSESJOLJOHJOGVTJPOPGMFBWFTMJLFUFB
6TFIBTCFFOMJOLFEJO4DPUMBOEUPUIF
EBODFSBWFTDFOF
%FQFOEFODZ
5IFSFJTOPSFDPSEPGEFQFOEFODZUIPVHIJUXPVMECFSFBTPOBCMFUPFYQFDUTJNJMBSQTZDIPMPHJDBM
EFQFOEFODZFYIJCJUFECZPUIFSTUJNVMBOUVTFST
8JUIESBXBM
5IFSFJTOPSFDPSEFEXJUIESBXBMTZOESPNF*UXPVMECFSFBTPOBCMFUPFYQFDUMJTUMFTTOFTTBOE
UJSFEOFTTFYQFSJFODFECZPUIFSTUJNVMBOUVTFST
-POHUFSNVTF
,IBUJTOPSNBMMZDIFXFEBOEUIJTDBODBVTFNFEJDBMQSPCMFNTBTTPDJBUFEXJUIUIFPSBMDBWJUZ
BOEEJHFTUJWFUSBDUMFBEJOHUPJOøBNNBUJPOBOETFDPOEBSZJOGFDUJPOT5IFSFJTFWJEFODFUIBU
FYDFTTJWFLIBUVTFDBODBVTFQTZDIPMPHJDBMQSPCMFNTTVDIBTEFQSFTTJPOBOEBOYJFUZMFBEJOHUP
ESVHJOEVDFEQTZDIPTJT5IFSFIBWFCFFOTPNFSFQPSUTPGQPJTPOJOHTPGLIBUDIFXFSTBTBSFTVMU
PGUIFJOBQQSPQSJBUFVTFPGGFSUJMJTFSTVTFEJOGBSNJOH5IFSFJTBMTPTPNFFWJEFODFPGJODSFBTFE
SJTLPGPSBMDBODFS
0WFSEPTFSJTL
5IFSFJTOPLOPXOSFDPSEPGLIBUSFTVMUJOHJOPWFSEPTFBMUIPVHIJUXPVMECFMJLFMZUPBDUXJUI
PUIFSTUJNVMBOUTDBVTJOHQBMQJUBUJPOTBOEBHJUBUJPO
28
Drug Category
Section 1
Stimulants
Crystal Methamphetamine
.FUIBNQIFUBNJOFXBTöSTUTZOUIFTJ[FEJO
CVUXFOUVOOPUJDFEVOUJMJUCFDBNFUIFBMUFSOBUJWF
UPFQIFESJOFBESVHDPNNPOMZVTFEUPUSFBU
BTUINB.FEJDBMMZQSPEVDFEBNQIFUBNJOFT
JODMVEJOHNFUIBNQIFUBNJOF
XFSFVTFEJO+BQBO
#SJUBJO(FSNBOZBOEUIF64EVSJOHUIF4FDPOE
8PSME8BSUPFOBCMFTPMEJFSTUPTUBZBXBLFBMFSUBOE
DPNQVMTJWFMZGPDVTTFE.FUIBNQIFUBNJOFVTFBOE
JUTTQSFBEJTPGDPODFSOJOTFWFSBMDPVOUSJFTQBSUJDVMBSMZJO
4PVUI&BTU"TJB5IBJMBOEBOE+BQBO
UIF64""VTUSBMJBBOEUIF
$[FDI3FQVCMJD*UJTSFMBUJWFMZVODPNNPOJO*SFMBOEQSFTFOUMZBMUIPVHI
UIFESVHTXJEFTQSFBEVTFBCSPBEBOEJUTBQQFBSBODFPOUIFEBODFTDFOFIBWFMFEUPGFBST
PGJUCFDPNJOHNPSFQPQVMBS5IFESVHJTSFMBUJWFMZDIFBQBOEFBTZUPNBOVGBDUVSFBMUIPVHI
NFUIPETNBZJOWPMWFJOøBNNBCMFDIFNJDBMTBOEUIFSFMFBTFPGUPYJDGVNFT5IFDIFNJDBMT
OFFEFEUPNBOVGBDUVSFUIFESVHFHFQIFESJOFSFEQIPTQIPSPVTBOEJPEJOF
BSFSFBEJMZ
BWBJMBCMF
4USFFUOBNF
5IFESVHJTBMTPLOPXOCZUIFTUSFFUOBNFTPGADSZTUBMNFUIADSBOLAUJOBPSAJDF*UTFVQIPSJD
FòFDUTBSFTJNJMBSUPCVUNPSFJOUFOTFBOEMPOHFSMBTUJOHUIBOUIPTFPGDPDBJOF
%SVHFòFDU
.FUIBNQIFUBNJOFJTBDFOUSBMOFSWPVTTZTUFNTUJNVMBOUXJUIBIJHIQPUFOUJBMGPSNJTVTFBOE
EFQFOEFODF"TZOUIFUJDESVHJUJTDMPTFMZSFMBUFEDIFNJDBMMZUPBNQIFUBNJOFATQFFE
CVU
QSPEVDFTHSFBUFSFòFDUTPOUIFDFOUSBMOFSWPVTTZTUFN5IFESVHBMUFSTNPPEJOEJòFSFOUXBZT
EFQFOEJOHPOIPXJUJTUBLFO*NNFEJBUFMZBGUFSTNPLJOHPSJOKFDUJOHUIFVTFSFYQFSJFODFTBO
JOUFOTFSVTITJNJMBSUPUIBUQSPEVDFECZDSBDLDPDBJOFCVUMPOHFSMBTUJOH&WFOTNBMMBNPVOUT
PGNFUIBNQIFUBNJOFDBOQSPEVDFFVQIPSJBBSPVTBMXBLFGVMOFTTJODSFBTFEQIZTJDBMBDUJWJUZ
EFDSFBTFEBQQFUJUFBOEJODSFBTFESFTQJSBUJPO$PNNPOTJEFFòFDUTJODMVEFOBVTFBQBOJD
BUUBDLTDPNQVMTJWFSFQFUJUJWFCFIBWJPVSBOEKBXDMFODIJOH
%FTDSJQUJPO
.FUIBNQIFUBNJOFUBLFTUIFGPSNPGBXIJUFPEPVSMFTTBOECJUUFSUBTUJOHDSZTUBMMJOFQPXEFS
SFBEJMZTPMVCMFJOXBUFSPSBMDPIPMBOEDBOBMTPCFQSPEVDFEJOUBCMFUPSQPXEFSGPSN*UDBOCF
TNPLFEJOKFDUFETOPSUFEPSDPOTVNFEPSBMMZ
%FQFOEFODZ
3FHVMBSVTFPGNFUIBNQIFUBNJOFDBOMFBEUPEFQFOEFODZXJUIJODSFBTFEUPMFSBODFUPUIF
FòFDUTPGUIFESVHBOEQIZTJDBMBOEQTZDIPMPHJDBMXJUIESBXBMTZNQUPNT
29
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Crystal Methamphetamine(continued)
8JUIESBXBM
8JUIESBXBMTZNQUPNTDBOJODMVEFEFQSFTTJPOBOYJFUZBOEDSBWJOHGPSUIFESVH4PNFTUVEJFT
IBWFMJOLFESFEVDFENPUPSTLJMMTXJUINFUIBNQIFUBNJOFVTFXIJDINBZCFJOEJDBUJWFPGB
QSFEJTQPTJUJPOUPXBSET1BSLJOTPOTEJTFBTFGPSVTFSTPGUIFESVH
-POHUFSNVTF
&òFDUTDBOMBTUCFUXFFOBOEIPVSTEFQFOEJOHPOUIFSPVUFPGBENJOJTUSBUJPOXIJDI
FRVBUFTUPCFUXFFOGPVSBOEUXFMWFUJNFTUIFEVSBUJPOPGDPDBJOFTFòFDUT*UDBODBVTF
QTZDIJBUSJDQSPCMFNTXJUITZNQUPNTSFTFNCMJOHUIPTFBTTPDJBUFEXJUIQBSBOPJETDIJ[PQISFOJB
TVDIBTQBSBOPJBBOEIBMMVDJOBUJPOT.FUIBNQIFUBNJOFJOEVDFEQTZDIPTJTDBOSFTVMUJO
IPNJDJEBMPSTVJDJEBMUIPVHIUT*UJTBMTPBTTPDJBUFEXJUIWJPMFOUBOEBHHSFTTJWFCFIBWJPVSBOE
XJUIBDRVJTJUJWFDSJNF
%SVHVTFSTXIPJOKFDUUIFESVHBSFBUSJTLPGJOGFDUJPOGSPN)*7IFQBUJUJT$BOEIFQBUJUJT#JGUIFZ
TIBSFOFFEMFTBOEPUIFSJOKFDUJOHQBSBQIFSOBMJB*ODSFBTFETFYVBMBSPVTBMBOEMPTTPGJOIJCJUJPO
JODSFBTFUIFMJLFMJIPPEPGVOTBGFTFYVBMQSBDUJDFT)FBWZBOESFHVMBSVTFSTPGUIFESVHNBZTVòFS
UPPUIMPTTBOEEFDBZBDPOEJUJPOLOPXOBTANFUINPVUI
30
Section 1
Drug Category
Stimulants
Methylamphetamine (methedrine)
%SVHFòFDU
)BTBWFSZTUSPOHBOEMPOHMJWFETUJNVMBOUFòFDU
%FTDSJQUJPO
8IJUFZFMMPXQJOLDSZTUBMMJOFQPXEFSDMFBSMJRVJE
BNQPVMFTNFUI
4NBMMXIJUJTIDIJQTJDF
.PTU
NFUIZMBNQIFUBNJOFJTJMMJDJUMZNBOVGBDUVSFEBOEBT
TVDIJTPGRVFTUJPOBCMFRVBMJUZ
5IFSBQFVUJDVTF
.FUIFESJOFJTOPMPOHFSBWBJMBCMFPOQSFTDSJQUJPO
0HWKSRZGHU
.FUIPEPGVTF
4NPLFEPSJOKFDUFE
%FQFOEFODZ
:FTUIPVHINBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFUPNFUIZMBNQIFUBNJOFEFWFMPQTRVJDLMZ5IFFòFDUTMBTUGSPNUISFFUPGPVSIPVST
-JLFBNQIFUBNJOFTVMQIBUFXJUIESBXBMJTJOUXPQIBTFT'JSTUMZUIFiDSBTIwPSiDPNFEPXOw
XIJDIQSPEVDFTUJSFEOFTTBOEEFQSFTTJPO*OUIFTFDPOEQIBTFVTFSTDBOCFDPNFJSSJUBCMFBOE
TFWFSFMZEFQSFTTFE5IJTXJMMMBTUGPSUISFFUPGPVSXFFLTBOEJOTPNFDBTFTDBOMBTUGPSNPOUIT
-POHUFSNVTF
1SPMPOHFEVTFPGNFUIZMBNQIFUBNJOFDBOMFBEUPTFWFSFXFJHIUMPTTJOTPNOJBFYIBVTUJPO
QBSBOPJEQTZDIPTJTUIJTJTHFOFSBMMZESVHJOEVDFEBOEBTTVDIXJMMCFSFTPMWFEXJUIJOBGFX
XFFLTBGUFSESVHUBLJOHIBTTUPQQFE
BOETFWFSFEFQSFTTJPO4NPLJOHiJDFwPWFSMPOHQFSJPET
DBVTFTTFWFSFQTZDIPUJDFQJTPEFTXJUICPUIWJTVBMBOEBVEJUPSZIBMMVDJOBUJPOTQSFTFOUJOHOPU
VOMJLFTDIJ[PQISFOJB
0WFSEPTF3JTL
0WFSEPTFJTOPUTPDPNNPOXJUINFUIZMBNQIFUBNJOFCVUXIFOJUEPFTPDDVSJUDBOSFTVMUJO
IFBSUBOEPSSFTQJSBUPSZGBJMVSF6TFSTXIPFYIJCJUBQSFEJTQPTJUJPOGPSBIFBSUDPOEJUJPOBSFBU
SJTLEVFUPFYDFTTTUSFTTQMBDFEPOUIFDBSEJPWBTDVMBSTZTUFN
¶0HWK0RXWK·DFRPPRQVLGHHIIHFW
0HWKSLSH
31
0HWKXVH
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Methylenedioxymethamphetamine
(MDMA)(Ecstasy)
%SVHFòFDU
)BTBWFSZTUSPOHBOEMPOHMJWFETUJNVMBOUFòFDU
4USFFUOBNF
&DTUBTZ&&DDZBEBN95$%FOOJTUIF.FOBDF
4PNFUJNFTLOPXOCZiCSBOEOBNFTwTVDIBTiEPWFTw
iTQFDLMFEEPWFTwiOFXZPSLFSTwPSiNFSDFEFTwUIPVHI
UIFTFOBNFTGSFRVFOUMZDIBOHFBTUIFMPHPTDIBOHF
%SVHFòFDU
4UJNVMBOUXJUINJMEQTZDIFEFMJDFòFDU1PTTJCMFIBMMVDJOPHFOJDFòFDUQBSUJDVMBSMZJOIJHIEPTFT
%FTDSJQUJPO
0òXIJUFPSPDDBTJPOBMMZDPMPVSFEUBCMFUT
$MFBSPSDPMPVSFEDBQTVMFT
8IJUFQPXEFSSBSF
.FUIPEPGVTF
1BSUJDVMBSMZBTTPDJBUFEXJUIUIFEBODFNVTJDTDFOF6TVBMMZUBLFOCZNPVUI
%FQFOEFODZ
1TZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFUP&DTUBTZEFWFMPQTXJUIUJNFCVUOPUBTSBQJEMZBTDPDBJOFPSBNQIFUBNJOF%SVH
FòFDUTCFHJOXJUIJONJOVUFTBGUFSVTF5IFSFJTOPFWJEFODFPGQIZTJDBMXJUIESBXBM
BMUIPVHIBGUFSFòFDUTPGUIFESVHDBOJODMVEFGBUJHVFEFQSFTTJPOBOEBOYJFUZi'MBTICBDLTw
GPMMPXJOHSFQFBUFEVTFPWFSTFWFSBMEBZTIBWFCFFOSFQPSUFE
-POHUFSNVTF
&DTUBTZVTFDBOCFBTTPDJBUFEXJUIBOYJFUZQBOJDBUUBDLTBOEJOTPNOJBFTQFDJBMMZJODBTFTPG
MPOHUFSNVTFPSVTFPGMBSHFEPTFT*ODSFBTFETVTDFQUJCJMJUZUPNJOPSJOGFDUJPOTTVDIBTDPMET
øVBOETPSFUISPBUTIBTBMTPCFFOSFQPSUFE4PNFGFNBMFVTFSTIBWFSFQPSUFEBOJODSFBTFJO
HFOJUPVSJOBSZJOGFDUJPOT1SFFYJTUJOHDPOEJUJPOTTVDIBTIJHICMPPEQSFTTVSFHMBVDPNBBOE
FQJMFQTZDBOCFFYBDFSCBUFE*OBEEJUJPOUIFSFJTTPNFFWJEFODFUPTVHHFTUUIBU&DTUBTZNBZ
IBWFUIFQPUFOUJBMUPDBVTFCSBJOEBNBHFBTTPDJBUFEXJUINPPEEJTPSEFST&DTUBTZJODSFBTFT
CPEZUFNQFSBUVSFBOEIBTBEFIZESBUJOHFòFDU6TFSTTIPVMEUBLFDBSFUPSFQMFOJTIMPTUCPEZ
øVJETBOEUBLFSFHVMBSCSFBLTGSPNQIZTJDBMFYFSUJPOUPIFMQBWPJEEFIZESBUJPOBOEPWFSIFBUJOH
*OBDVUFDBTFTPG&DTUBTZSFMBUFEPWFSIFBUJOHBOEEFIZESBUJPOUIFCPEZUFNQFSBUVSFSFHVMBUJPO
TZTUFNDBOCFJNQBJSFEPSCSFBLEPXOBMUPHFUIFS
32
0WFSEPTFSJTL
0WFSEPTFSJTLTUJMMOFFETUPCFQSPQFSMZBTTFTTFE)PXFWFSUIFSFIBWFCFFOBOVNCFSPG
EFBUITJOUIF6,MJOLFEUPUIFVTFPG&DTUBTZ.PTUPGUIFTFBSFUIPVHIUUPIBWFCFFOBTTPDJBUFE
XJUIBSBSFCVUGBUBMESVHSFBDUJPOXIJDIDBODBVTFCMPPEDMPUTUPEFWFMPQJOUIFMVOHT
'VSUIFSNPSFIFBUTUSPLFPSEFIZESBUJPOBSFBMTPUIPVHIUUPCFQPTTJCMFDPOUSJCVUJOHGBDUPST
5IFSFJTBMTPFWJEFODFUIBU&DTUBTZDBOEBNBHFUIFMJWFS5IFSJTLPGPWFSEPTFGSPN.%"BDMPTF
SFMBUJWFPG.%."XIJDIJTTUSPOHFSBOEPGUFOTPMEBT&DTUBTZ
JTTJHOJöDBOUMZHSFBUFS"EPTFPG
NHPG.%"IBTQSPWFEGBUBMJOUFTUT4VDIBEPTFJTUIFFRVJWBMFOUPGTUSFFUUBCMFUT
4PNFEFBUITBTTPDJBUFEXJUIUIFUBLJOHPG&DTUBTZIBWFCFFOBUUSJCVUFEUPEJMVUJPOBM
IZQPOBUSFNJB5IBUJTQFPQMFIBWFESVOLUPPNVDIXBUFSJOBUUFNQUJOHUPDPVOUFSBDUUIF
EFIZESBUJOHFòFDUPGUIFESVH0OFFòFDUPG.%."JTUPDBVTFUIFSFMFBTFPGBIPSNPOFDBMMFE
BOUJEJVSFUJDIPSNPOF"%)
XIJDIQSFWFOUTUIFQSPEVDUJPOPGEJMVUFVSJOF&YDFTTJWFESJOLJOH
JOUVSODBVTFTøVJECVJMEVQJOTJEFUIFCPEZDFMMTQBSUJDVMBSMZJOUIFCSBJOXIJDITPBLTVQUIF
øVJEBOEJTFWFOUVBMMZiDSVTIFEwBTJUTXFMMTBHBJOTUUIFJOTJEFPGUIFTLVMM"MMJUTGVODUJPOTBSF
JSSFQBSBCMZEBNBHFEXIJDIMFBETUPEFBUI
A selection of Ecstasy tablets depicting popular cultural images.
Various ecstasy tablets
33
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Stimulants
Methylenedioxymethamphetamine
(MDMA)(Ecstasy)
&DTUBTZJTTPNFUJNFTSFGFSSFEUPBTBIBMMVDJOPHFOJD
TUJNVMBOU*UTFòFDUTXJMMUIFSFGPSFJODMVEFUIPTFMJTUFE
GPSTUJNVMBOUT
*OBEEJUJPOJUDBODBVTF
t JODSFBTFEUFNQFSBUVSF
t QPTTJCMZFYDFTTJWFTXFBUJOH
t WFSZESZNPVUIBOEUISPBU
t IBMMVDJOBUJPOTBOEIFJHIUFOFEQFSDFQUJPOTXIJDI
NBZNBLFVTFSTNPSFUBDUJMFPSESFBNZ
t KFSLZVODPPSEJOBUFENPWFNFOUT
t SFQFUJUJWFNPWFNFOUTNBOZVTFSTXBOUUPEBODF
t DMFODIFEKBXTHSJOEJOHUFFUI
t VODPOUSPMMFEKBXNPWFNFOUTDBVTFECZNVTDMFTQBTNT
t PDDBTJPOBMOBVTFBXIFOöSTUVTFE
t GBUJHVFBGUFSVTFQPTTJCMZBDDPNQBOJFECZTPNFBOYJFUZEFQSFTTJPOBOENVTDMFQBJO
t XFJHIUMPTT
&DTUBTZFòFDUT
0OFQBSUJDVMBSFòFDUPG&DTUBTZJTPWFSIFBUJOHFTQFDJBMMZBGUFSDPOTUBOUEBODJOHJOBDMVCXJUI
BIPUBUNPTQIFSF*OUIFTFDJSDVNTUBODFTJUJTWFSZJNQPSUBOUUIBUUIFQFSTPOXIPIBTUBLFO
&DTUBTZDPPMTEPXOBOESFIZESBUFTRVJDLMZ
t (JWFUIFNXBUFSUPESJOLCVUOPUUPPNVDIPSUPPRVJDLMZUBLFUIFNUPBDPPMQMBDF
t MPPTFOUIFJSDMPUIJOHBOEBQQMZDPPMEBNQDMPUITPSUPXFMTUPUIFCBDLPGUIFJSOFDL
t *GUIFZTUPQTXFBUJOHBOEPSDPMMBQTFQIPOFGPSBOBNCVMBODFJNNFEJBUFMZ
t 1VUUIFNJOUIFSFDPWFSZQPTJUJPOBOELFFQUSZJOHUPDPPMUIFNEPXO
t *GUIFZTUPQCSFBUIJOHCFHJONPVUIUPNPVUISFTVTDJUBUJPOBOEUFMMUIFBNCVMBODFDSFX FYBDUMZXIBUIBTIBQQFOFEBOEXIBUUIFQFSTPOIBTUBLFO
t *GUIFQFSTPOIBTUBLFOBIBMMVDJOPHFOTVDIBT-4%NBHJDNVTISPPNTPSDBOOBCJTJO
DPNCJOBUJPOXJUI&DTUBTZUIFZNBZCFDPNFWFSZBOYJPVTEJTUSFTTFEBOEGFBSGVM5IFZNBZ
BDUJOBOVOVTVBMXBZ
t *UJTWFSZJNQPSUBOUUPSFBTTVSFUIFQFSTPOUFMMUIFNUIBUZPVXJMMMPPLBGUFSUIFNUIBUUIFZ
BSFJOOPEBOHFSUIBUJUJTUIFFòFDUTPGUIFESVHBOEUIBUUIFFòFDUTXJMMTPPOXFBSPò
t :PVNBZXBOUUPUBLFUIFNUPBRVJFUQMBDFLFFQPUIFSQFPQMFBXBZBOEDPOUJOVF
UPSFBTTVSFUIFN+VTUTUBZXJUIUIFNBOEUBMLDBMNMZUPUIFN5IJTNBZUBLFBMPOHUJNF EFQFOEJOHPOUIFBNPVOUUBLFO
t *GUIFZTIPXOPTJHOTPGCFDPNJOHDBMNFSPSUIFZCFDPNFIZTUFSJDBMUBLFUIFNUPIPTQJUBM
FYQMBJODBMNMZUPUIFQFSTPOXIBUJTIBQQFOJOHUIJTXJMMIFMQEFDSFBTFBOZGFFMJOHTPG QBOJD
34
Volatile Substances
"SBOHFPGWPMBUJMFTVCTUBODFTBSFBWBJMBCMFEJSFDUMZPWFS
UIFDPVOUFS5IPTFNPTUDPNNPOMZVTFEGBMMJOUPGPVS
DBUFHPSJFT
"EIFTJWFTBOE(MVFT
"FSPTPMT
$MFBOJOHBOEEFHSFBTJOHBHFOUT
1FUSPMMJHIUFSGVFMBOEPUIFSQSPEVDUT
1PQQFST
4USFFUVTF
7BQPVSTGSPNWPMBUJMFTVCTUBODFTBSFVTVBMMZJOIBMFE
EJSFDUMZGSPNUIFJSDPOUBJOFSTPSGSPNQPMZUIFOFCBHT
%SVHFòFDU
7BQPVSTGSPNWPMBUJMFTVCTUBODFTQBTTSBQJEMZGSPN
UIFMVOHTUPUIFCSBJODBVTJOHEFQSFTTJPOPGUIFDFOUSBMOFSWPVTTZTUFN&òFDUTTJNJMBSUP
BDVUFBMDPIPMJDJOUPYJDBUJPOPDDVSXJUIJOUXPUPUISFFNJOVUFT'FFMJOHTPGFVQIPSJBBSFWFSZ
DPNNPOBOETPNFVTFSTSFQPSUIBMMVDJOBUJPOT*GJOIBMBUJPOTOJó
OH
DPOUJOVFTUIFSFJTGVSUIFS
EFQSFTTJPOPGUIFDFOUSBMOFSWPVTTZTUFNXIJDIMFBETUPMPTTPGBXBSFOFTTKVEHFNFOUBOE
NVTDVMBSDPPSEJOBUJPOBOEFWFOUVBMDPNB5IFJOUPYJDBUJOHFòFDUTMBTUGPSNJOVUFTBGUFS
TOJó
OHDFBTFT4OJòFSTPGUFOSFQPSUBNJMEiIBOHPWFSwGPSVQUPBEBZBGUFSVTF
%FQFOEFODZ
5PMFSBODFEFWFMPQTTPUIBUPWFSUJNFHSFBUFSBOEHSFBUFSRVBOUJUJFTPGWPMBUJMFTVCTUBODFBSF
SFRVJSFEUPQSPEVDFUIFTBNFFòFDU
8JUIESBXBM
0DDBTJPOBMNJMEQIZTJDBMXJUIESBXBMTZNQUPNTTVDIBTIFBEBDIFTIBWFCFFOOPUFE)PXFWFS
QTZDIPMPHJDBMSBUIFSUIBOQIZTJDBMEFQFOEFODFJTNPSFDPNNPO
-POHUFSNVTF
'PMMPXJOHSFHVMBSVTFPGWPMBUJMFTVCTUBODFTiTOJòFSTSBTIwNFNPSZJNQBJSNFOUBOEMPTTPG
DPODFOUSBUJPOIBWFCFFOSFQPSUFE8JUIDISPOJDVTFMPTTPGNVTDVMBSDPPSEJOBUJPOTMVSSJOH
PGTQFFDIBOEWJTJPOJNQBJSNFOUBSFDPNNPO)PXFWFSUIFTFFòFDUTBSFVTVBMMZSFWFSTJCMFJG
TOJó
OHTUPQT-POHUFSNIFBWZVTFZFBSTPSNPSF
NBZMFBEUPQFSNBOFOUCSBJOEBNBHF"
TNBMMOVNCFSPGDBTFTJOWPMWJOHQFSNBOFOUMJWFSBOELJEOFZEBNBHFIBWFBMTPCFFOSFQPSUFE
0WFSEPTFSJTL
&WFSZZFBSUIFSFBSFPWFSEFBUITJOUIF6,MJOLFEUPTOJó
OH%FBUITJO/PSUIFSO*SFMBOE
BSFGBSMFTTGSFRVFOUCVUEPPDDVS0WFSIBMGBSFMJOLFEEJSFDUMZUPUIFUPYJDFòFDUTPGTVCTUBODFT
JOIBMFE5IFSFNBJOEFSBSFDBVTFECZBDPNCJOBUJPOPGBDDJEFOUTJOIBMBUJPOPGWPNJUBOE
TVòPDBUJPODBVTFECZBQMBTUJDCBHPWFSUIFIFBE
3JTLTJOQSFHOBODZ
7PMBUJMFTVCTUBODFTQBTTUIFQMBDFOUBMCBSSJFSCVUUIFSFJTMJUUMFJOGPSNBUJPOBCPVUUIFJSFòFDUT
POUIFGPFUVT
35
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Volatile Substances
Adhesives and Glues
1SPEVDUT
$POUBDUBEIFTJWFTHMVFTQMBTUJDDFNFOUSVCCFS
TPMVUJPOBEIFTJWFT
4VCTUBODFT
5PMVFOF/IFYBOF9ZMFOFBOE5SJDIMPSPFUIZMFOF
%SVHFòFDU
%FQSFTTBOU
.FUIPEPGVTF
6TVBMMZJOIBMFEGSPNQPMZUIFOFCBH
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFEFWFMPQTXJUIJOUISFFNPOUITPGSFHVMBSTOJó
OHTFTTJPOT0DDBTJPOBMNJOPSQIZTJDBM
XJUIESBXBMTZNQUPNTJODMVEFIFBEBDIFT
-POHUFSNVTF
$ISPOJDVTFSTNBZIBWFiTOJòFSTSBTIwVTVBMMZBSPVOENPVUIBOEOPTF
BOETIPXJNQBJSFE
QFSGPSNBODFPONFNPSZJOUFMMJHFODFBOEDPODFOUSBUJPOUFTUT*ONPTUDBTFTGVODUJPOTSFUVSO
UPOPSNBMPODFTPMWFOUVTFDFBTFT5PMVFOFIBTCFFOJNQMJDBUFEJOSFWFSTJCMFJNQBJSNFOUPGUIF
DFOUSBMOFSWPVTTZTUFNBOEWJTVBMQSPCMFNT)PXFWFSJOBTNBMMOVNCFSPGDBTFTMPTTPGCSBJO
UJTTVFIBTBMTPCFFOSFQPSUFE
/IFYBOFIBTCFFOMJOLFEUPWJTVBMQSPCMFNTBOEMJNCEZTGVODUJPOXIJMFUSJDIMPSPFUIZMFOFIBT
CFFOBTTPDJBUFEXJUIBTNBMMOVNCFSPGDBTFTPGMJWFSLJEOFZEBNBHF
36
Drug Category
Section 1
Volatile Substances
Aerosols
1SPEVDUT
1FSGVNFTQSBZTEFPEPSBOUTQBJOUTQSBZTøZTQSBZT
QBJOSFMJFWJOHTQSBZTBJSGSFTIFOFST
4VCTUBODFT
1SPQBOF#VUBOF$IMPSJOBUFEøVPSPDBSCPOT
%SVHFòFDU
%FQSFTTBOU
.FUIPEPGVTF
7PMBUJMFTVCTUBODFTBSFJOIBMFEEJSFDUMZGSPNDBOJTUFSTPSTQSBZFEJOUPBQMBTUJDCBHBOEUIFO
JOIBMFE
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFEFWFMPQTXJUISFQFBUFEVTF0DDBTJPOBMQIZTJDBMXJUIESBXBMIBTCFFOOPUFE
-POHUFSNVTF
"FSPTPMQSPQFMMBOUTQBSUJDVMBSMZCVUBOFBSFUIPVHIUUPTFOTJUJTFUIFIFBSUUPFYDJUFNFOUPS
FYFSUJPO5IJTDBODBVTFDBSEJBDGBJMVSFJGUIFVTFSFYFSUTIJNIFSTFMGEVSJOHPSJNNFEJBUFMZBGUFS
use.
0WFSEPTFSJTL
$PPMJOHFòFDUTPGBFSPTPMTQSBZTPOUIFMBSZOYCBDLPGUISPBU
NBZNBLFJUTXFMMBOEDBODBVTF
EFBUICZTVòPDBUJPO"TOPUFECVUBOFIBTBMTPCFFOMJOLFEUPTVEEFOEFBUIDBVTFECZIFBSU
GBJMVSF'PSUIJTSFBTPOJUJTBEWJTFEUIBUTOJòFSTBSFOFWFSTUBSUMFEPSDIBTFEJGUIFZBSFEJTDPWFSFE
TOJó
OH
([DPSOHRI
1LWURXV2[LGH
KDUGZDUHNLW
DYDLODEOHLQWKH
8QLWHG6WDWHV
37
A Guide To Substance Misuse For Medical Professionals
Drug Category
Volatile Substances
Cleaning and de-greasing agents
1SPEVDUT
*OEVTUSJBMBOEEPNFTUJDESZDMFBOFSTEFHSFBTJOH
BHFOUTUZQFXSJUFSDPSSFDUPSøVJEBOEUIJOOFSTOBJM
WBSOJTISFNPWFS
4VCTUBODFT
USJDIMPSPFUIBOF5FUSBDIMPSPFUIBOF
5FUSBDIMPSPFUIZMFOF.FUIZMFOFDIMPSJEF$BSCPO
UFUSBDIMPSJEF"DFUPOF
%SVHFòFDU
%FQSFTTBOU
.FUIPEPGVTF
*OIBMFEEJSFDUMZGSPNDPOUBJOFSPSBCTPSCFOUNBUFSJBMTPBLFEJOBHFOU
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFEFWFMPQTXJUISFQFBUFEVTF0DDBTJPOBMQIZTJDBMXJUIESBXBMIBTCFFOOPUFE
-POHUFSNVTF
4JNJMBSUPMPOHUFSNVTFPGBEIFTJWFT5SJDIMPSPUFUSBDIMPSPFUIBOFBOEUFUSBDIMPSPFUIZMFOFIBWF
BMTPCFFOJNQMJDBUFEJOBGFXDBTFTPGMJWFSLJEOFZEBNBHF$BSCPODIMPSJEFJTIJHIMZUPYJDBOE
DBVTFTMJWFSBOECSBJOEBNBHF
0WFSEPTFSJTL
5IJTHSPVQPGTPMWFOUTQBSUJDVMBSMZUIPTFDPOUBJOJOHUSJDIMPSPFUIBOF
JTBTTPDJBUFEXJUI
BCPVUBUIJSEPGTPMWFOUSFMBUFEEFBUIT
38
Volatile Substances
Petrol, lighter fuel and other products
1SPEVDUT
(BTMJHIUFSGVFMTQFUSPMöSFFYUJOHVJTIFST
4VCTUBODFT
(BTMJHIUFSGVFM#VUBOF1FUSPM#FO[FOF5FUSBFUIZMMFBE
'JSFFYUJOHVJTIFST#SPNPEJDIMPSPøVPSPNFUIBOF
%SVHFòFDU
%FQSFTTBOU
.FUIPEPGVTF
6TVBMMZJOIBMFEEJSFDUMZGSPNDBOJTUFS
%FQFOEFODZ
:FTNBJOMZQTZDIPMPHJDBM
8JUIESBXBM
5PMFSBODFEFWFMPQTXJUISFQFBUFEVTF0DDBTJPOBMQIZTJDBMXJUIESBXBMIBTCFFOOPUFE
-POHUFSNVTF
4JNJMBSUPUIFMPOHUFSNVTFPGBEIFTJWFT4OJó
OHQFUSPMIBTCFFOMJOLFEUPQFSNBOFOUCSBJO
EBNBHF)PXFWFSJUJTVODMFBSXIFUIFSUIJTJTEVFUPUIFIZESPDBSCPOTPSUIFUFUSBFUIZMMFBE
BEEFEUPMFBEFEQFUSPM#FO[FOFJTIJHIMZUPYJDBOEIBTCFFOTIPXOUPDBVTFCPOFNBSSPX
EFQSFTTJPO
0WFSEPTFSJTL
5IFJOIBMBUJPOPGHBTGVFMTNBJOMZCVUBOF
IBTCFFOMJOLFEUPBCPVUPGEFBUIT)PXFWFS
TJODFJUTVTFJTMFTTDPNNPOUIBOUIFJOIBMBUJPOPGTPMWFOUTGSPNBEIFTJWFTJUBQQFBSTUPCF
TJHOJöDBOUMZNPSFEBOHFSPVT5IFQSFTTVSJTFEHBTJOCPUIHBTMJHIUFSGVFMTBOEöSFFYUJOHVJTIFST
NBLFTUIFJOIBMBUJPOPGUIFTFQSPEVDUTFYUSFNFMZEBOHFSPVTBTXJUIUIFJOIBMBUJPOPGBFSPTPMT
UIFSFJTBTJHOJöDBOUSJTLPGTVòPDBUJPODBVTFECZTXFMMJOHPGUIFMBSZOYCBDLPGUIFUISPBU
#VUBOFJTBMTPUIPVHIUUPTFOTJUJTFUIFIFBSUUPFYFSUJPOXIJDIDBOMFBEUPIFBSUGBJMVSF
39
Drug Category
Section 1
A Guide To Substance Misuse For Medical Professionals
Drug Category
Volatile Substances
Poppers
1SPEVDUT
"MLZMOJUSJUFTBSFSFMBUFEUPOJUSPVTPYJEFMBVHIJOH
HBT
BOEBSFDMFBSZFMMPXWPMBUJMFMJRVJET5IFZBSF
BWBJMBCMFGPSTBMFBUTPNFSFUBJMPVUMFUTBOECZNBJM
PSEFS%SVHTJODMVEFBNZMOJUSJUFSVTIPSQPQQFST
BOECVUZMOJUSJUFQPQQFST
%SVHFòFDU
"MLZMOJUSJUFTBSFWBTPEJMBUPST5IFZDBVTFEJMBUJPO
PGUIFCMPPEWFTTFMTMFBEJOHUPUIFIFBSU5IJTJT
BDDPNQBOJFECZBESPQJOCMPPEQSFTTVSFBOEBO
JODSFBTFJOIFBSUSBUF6TFSTSFQPSUBiSVTIwBOE
FYQFSJFODFFVQIPSJBBOEEJ[[JOFTT5IFFòFDUTGPMMPXJOHJOIBMBUJPOBSFWJSUVBMMZJOTUBOUBOFPVT
BOEMBTUGSPNUXPUPöWFNJOVUFT"MLZMOJUSJUFTBMTPJODSFBTFTFYVBMBSPVTBMBOEDBVTFUIFSFDUBM
TQIJODUFSUPSFMBYFBTJOHBOBMJOUFSDPVSTF
.FUIPEPGVTF
"MLZMOJUSJUFTBSFVTFENBJOMZCZNFNCFSTPGUIFNBMFHBZDPNNVOJUZXIPJOIBMFWPMBUJMFGVNFT
UPFOIBODFTFYVBMBSPVTBMBOEQFSGPSNBODF)PXFWFSSFDSFBUJPOBMBOEFYQFSJNFOUBMVTFIBT
BMTPCFFOSFQPSUFEBNPOHPUIFSHSPVQTPGZPVOHQFPQMF
%FQFOEFODZ
5PMFSBODFEFWFMPQTXJUIJOUXPUPUISFFXFFLTJGVTFEPOBEBJMZCBTJT)PXFWFSUIJTJTMPTU
GPMMPXJOHBGFXEBZTPGBCTUJOFODF5IFSFIBWFCFFOOPSFQPSUTPGXJUIESBXBMTZNQUPNTFJUIFS
QIZTJDBMPSQTZDIPMPHJDBM)FODFEFQFOEFODZEPFTOPUBQQFBSUPCFBQSPCMFN
-POHUFSNVTF
"MLZMOJUSJUFTBSFFYDSFUFESBQJEMZGSPNUIFCPEZBOEUIFSFEPOPUBQQFBSUPCFBOZTFSJPVT
DPOTFRVFODFTPGMPOHUFSNVTFBNPOHIFBMUIZBEVMUT)PXFWFSQFPQMFXJUIBIJTUPSZPGIFBSU
QSPCMFNTBOEHMBVDPNBNBZCFBUSJTLCFDBVTFPGUIFJODSFBTFETUSBJOPOUIFDBSEJPWBTDVMBS
TZTUFN
0WFSEPTFSJTL
&YDFTTJWFVTFDBOMFBEUPMBDLPGPYZHFOJOUIFCMPPE6TFSTCFDPNFDZBOPTFEXIJDIHJWFT
UIFJSTLJOBOEMJQTBCMVFDPMPVS5IJTJTVTVBMMZBDDPNQBOJFECZTFWFSFWPNJUJOHBOEDBOMFBE
UPDMJOJDBMTIPDLBOEMPTTPGDPOTDJPVTOFTT%FBUITIBWFPDDVSSFEXIFOOJUSJUFTIBWFCFFO
TXBMMPXFE
40
Section 1
Drug Category
Volatile Substances
General Information on Solvent Misuse
4PMWFOUTJODMVEFHMVFTCVUBOFHBTSFöMMTBFSPTPMTUZQFXSJUJOHDPSSFDUJOHøVJETBOEUIJOOFST
4JHOTPGTPMWFOUNJTVTFJODMVEF
t VTVBMTJHOTPGJOUPYJDBUJPO
t QPTTJCMFPEPVSPODMPUIFTBOECSFBUI
t JGVTJOHHMVFSFEOFTTBSPVOENPVUIBOEOPTF
t BDPVHI
t QPTTJCMFTUBJOTPODMPUIJOHEFQFOEJOHPOUZQFPGTPMWFOUVTFE
t QFSTJTUFOUDPVHIJOHXJUIBSVOOZOPTFBOEFZFT
4IPSUUFSNFòFDUTPG*OIBMBOUT
t 4OJó
OHPSIVó
OHJOIBMBOUTDBOLJMMPOUIFWFSZöSTUVTFPSBOZVTF*OIBMBOUTDBVTFNBTTJWF
IFBMUIEBNBHFJOCPUIUIFTIPSUBOEMPOHUFSN
The physical damage includes:
Short Term Effects
Long Term Effects
-PTTPG4FOTBUJPO
$PNQVMTJWF6TF
%SPXTJOFTTMBDLPGFOFSHZ
8JUIESBXBM
3JTLUBLJOHCFIBWJPVS
%JTPSJFOUBUJPO
-JHIUIFBEFEOFTT
8FJHIUMPTT
"HJUBUJPO
*SSFHVMBSPSSBQJEIFBSUCFBU
)PTUJMJUZ
*SSJUBCJMJUZBOEPSEFQSFTTJPO
-BDLPGDPODFSOBCPVUMJGFBSPVOEUIFN
*NQBJSFEUIJOLJOHBCJMJUZ
1PPSKVEHFNFOU
%FNFOUJBMPTFDPOUBDUXJUISFBMJUZ
*OBCJMJUZUPGVODUJPOJOUIFJSFOWJSPONFOU
-PTFTFOTFPGUPVDI
4MVSSFE4QFFDI
%FBGOFTTBOEPSCMJOEOFTT
1PPSSFøFYFT
3FQSPEVDUJWFDPNQMJDBUJPOT
.VTDMFXFBLOFTT
#POFNBSSPXJOKVSZ
1PPSDPPSEJOBUJPO
-VOHIFBSUMJWFSPSLJEOFZEBNBHF
$POGVTJPOBOEEFMJSJVN
%BNBHFUPOFSWFDFMMT
/BVTFBBOEWPNJUJOH
#SBJOTISJOLBHF
6ODPOTDJPVTOFTTBOEPSTVEEFOEFBUI
1PTTJCMFEFBUI
41
A Guide To Substance Misuse For Medical Professionals
Drug Category
Volatile Substances
Sudden Sniffing Death Syndrome
4VEEFO4OJó
OH%FBUI4ZOESPNF44%4
JTUIFNPTUDPNNPOLJMMFSPGJOIBMBOUBCVTFST"WJDUJN
NBZCFUSZJOHJOIBMBOUTGPSUIFöSTUUJNFPSNBZIBWFUSJFEUIFNBOZOVNCFSPGUJNFTJOUIF
QBTU44%4PDDVSTXIFOBOBCVTFSJTTVSQSJTFEPSTUBSUMFEXIJMFTOJó
OHPSIVó
OH
0GUFOUIJTPDDVSTXIFOBQBSFOUPSPUIFSBVUIPSJUZöHVSFöOETUIFQFSTPOJOIBMJOH"O
FTQFDJBMMZFYDJUJOHPSGSJHIUFOJOHIBMMVDJOBUJPODPVMEBMTPUSJHHFS44%48IFOUIFBCVTFSJT
TVSQSJTFEPSTUBSUMFEIFIBTBTVEEFOTVSHFPGUIFIPSNPOFFQJOFQISJOF&QJOFQISJOFJTBMTP
DBMMFEBESFOBMJOF&QJOFQISJOFBJETJOSFHVMBUJOHUIFGVODUJPOTPGUIFCPEZUIBUBSFCFZPOE
BQFSTPOTDPOTDJPVTDPOUSPMMJLFIFBSUSBUF8IFOBQFSTPOJTIJHIMZTUJNVMBUFECZGFBSPS
DIBMMFOHFGPSFYBNQMF
FYUSBBNPVOUTPGFQJOFQISJOFBSFSFMFBTFEJOUPUIFCMPPETUSFBNUP
QSFQBSFUIFCPEZGPSFOFSHFUJDBDUJPO&QJOFQISJOFJODSFBTFTCMPPEQSFTTVSFIFBSUSBUFBOE
DBSEJBDPVUQVU5IFQSFTFODFPGUIFDIFNJDBMJOIBMBOUTJOUIFCPEZNBLFTUIFIFBSUNVTDMF
NPSFTFOTJUJWFUPFQJOFQISJOF8IFOUIFTVSHFPGFQJOFQISJOFSFBDIFTUIFIFBSUUIFIFBSU
TVòFSTBOBSSIZUINJBJSSFHVMBSIFBSUCFBU
5IJTNBTTJWFBSSIZUINJBLJMMTUIFVTFSJOTFDPOET
$FOUSBM/FSWPVT4ZTUFN%BNBHF
.BOZPGUIFDIFNJDBMTGPVOEJODPNNPOMZBCVTFEJOIBMBOUTDBVTFTFWFSFBOEQFSNBOFOU
CSBJOBOEOFSWFDFMMEBNBHF#SBJOTDBOTPGJOIBMBOUBCVTFSTTIPXESBNBUJDTISJOLBHFJOUIF
PWFSBMMTJ[FPGUIFCSBJO"CVTFSTBMTPMPTFiXIJUFNBUUFSwJOUIFCSBJOXIJDIJTSFTQPOTJCMFGPS
DPOEVDUJOHOFSWFJNQVMTFTUISPVHIPVUUIFCPEZ5IFXIJUFNBUUFSJTEFTUSPZFECFDBVTFFBDI
DFMMJTFODBTFEJONZFMJOBMJQJEPSGBUBOENBOZDPNNPOMZVTFEJOIBMBOUTBSFMJQJETPMWFOUT
UIBUJTUIFJSQVSQPTFJTUPCSFBLEPXOMJQJET
$ISPOJDJOIBMBOUBCVTFSTTVòFSNBTTJWFDFOUSBMOFSWPVTTZTUFNEBNBHFXIJDISFTVMUTJO
EFNFOUJBMPTUDPOUBDUXJUISFBMJUZ
BOEMPTTPGDFSFCFMMVNGVODUJPO5IFDFSFCFMMVNJTUIF
QPSUJPOPGUIFCSBJOUIBUDPPSEJOBUFTNPWFNFOUTPGUIFWPMVOUBSZNVTDMFT"CVTFSTMPTFUIF
BCJMJUZUPUIJOLSFBTPOMFBSOBOESFNFNCFS5IFJSXBZPGXBMLJOHCFDPNFTBCOPSNBMBOEUIFZ
lose coordination.
7KHEUDLQVFDQIURPDQRQDEXVHU
7KHEUDLQVFDQIURPDQLQKDODQWDEXVHU
42
Miscellaneous Substances
Anabolic steroids
(e.g. Durabolin, Stanozolol, Dianabol)
4USFFUOBNF
*SPO#SFX
%SVHFòFDU
6TFSTUBLFUIFESVHBTBOBJEUPNVTDMFEFWFMPQNFOU
UIPVHIUIFSFJTBTUSPOHDIBODFUIBUVTFSTXJMM
CFDPNFNPSFBHHSFTTJWF
.FUIPEPGVTF
5BCMFUTJOKFDUJPOTDBQTVMFT
%FQFOEFODZ
1TZDIPMPHJDBMEFQFOEFODFJTDPNNPO
5IFSBQFVUJDVTF
$BOCFVTFEJOUIFUSFBUNFOUPGBOBFNJBUISPNCPTJTBOEPGUFOVTFEUPCVJMENVTDMFGPSQBUJFOUT
XIPBSFMPOHUFSNCFESJEEFO
8JUIESBXBM
4PNFTUFSPJEVTFSTIBWFSFQPSUFEMFUIBSHZBOEEFQSFTTJPOPOTUPQQJOHVTF
-POHUFSNVTF
*UJTEJó
DVMUUPPòFSDPODMVTJWFFWJEFODFSFHBSEJOHUIFFòFDUTPGMPOHUFSNTUFSPJEVTFBTNPTU
VTFSTBSFUBLJOHNVMUJQMFDPNCJOBUJPOTBOEBUEPTFTUIBUBSFXFMMBCPWFUIFSFDPNNFOEFE
MFWFM5IFSFJTTPNFDMFBSFWJEFODFUIBUQFSTJTUFOUBOEIFBWZVTFNBZDBVTFJOGFSUJMJUZPSMBDL
PGTFYESJWFJONFO$POWFSTFMZTPNFNFONBZCFDPNFTFYVBMMZWJPMFOU8PNFONBZEFWFMPQ
NBTDVMJOFTJEFFòFDUTTVDIBTBEFFQFSWPJDFBOETNBMMFSCSFBTUT
0WFSEPTFSJTL
$BODBVTFIJHICMPPEQSFTTVSF*OFYUSFNFDBTFTUIFZDBODBVTFMJWFSEBNBHFBOEUIFSFJTTPNF
FWJEFODFPGMJWFSDBODFS
43
Drug Category
Section 1