Medical Toxicology of Drug Abuse

Dr. Donald G. Barceloux is presently a Staff Physician in the Department of Emergency Medicine at Pomona Valley Community Hospital. He is also a teacher at UCLA, an active consultant on medical toxicology, and a fellow at the American Academy of Clinical Toxicology, American College of Medical Toxicology, and the American College of Emergency Medicine. In addition, he has written an array of papers and co-authored a medical toxicology reference book.

Foreword xi

Preface xiii

Contributors xv

Review Panel xvii

Acknowledgments xix

Part 1 Synthetic and Semisynthetic Chemicals 1

I Amphetamines and Phenethylamine Derivatives 3

1 Amphetamine and Methamphetamine 3

2 Methylphenidate 57

3 Prolintane 69

4 Propylhexedrine 72

II Club Drugs 77

5 Flunitrazepam 77

6 Gamma Hydroxybutyrate and Related Drugs 89

7 Ketamine 110

8 Methcathinone, Mephedrone, and Methylone 120

9 Methylenedioxymethamphetamine (Ecstasy, MDMA) 126
Nicholas A. Buckley, MD

10 Psychoactive Phenethylamine, Piperazine, and Pyrrolidinophenone Derivatives 156
Brandon Wills, DO, MS, Timothy Erickson, MD

11 Tryptamine Designer Drugs 193

III Eating Disorders and Appetite Suppressants 200

12 Diuretics, Ipecac, and Laxatives 200
Cyrus Rangan, MD

13 Noradrenergic Agents 233
Cyrus Rangan, MD

14 Serotoninergic and Mixed Agents 255

IV Ergogenic Agents and Supplements 275

15 Anabolic-Androgenic Steroids 275

16 Clenbuterol and Salbutamol (Albuterol) 295
James Rhee, MD, Timothy Erickson, MD

17 Erythropoietin Stimulation and Other Blood Doping Methods 306
James Rhee, MD, Timothy Erickson, MD

18 Human Chorionic Gonadotropin 326

19 Human Growth Hormone and Insulin-Like Growth Factor 334

20 Nutritional Supplements 351

V Ethanol 365

21 Ethanol 365

VI Lysergic Acid Diethylamide 452

22 Lysergic Acid Diethylamide (LSD) 452

VII Older Sedative Hypnotic Drugs 467

23 Barbiturates (Amobarbital, Butalbital, Pentobarbital, Secobarbital) 467

24 Ethchlorvynol 486

25 Glutethimide 491

26 Meprobamate 497

27 Methaqualone and Related Compounds 504

VIII Opioids 514

28 Buprenorphine 514

29 Dextromethorphan 527

30 Fentanyl Analogues 539

31 Heroin and the Opium Poppy Plant (Papaver somniferum L.) 546

32 Methadone 579

33 1-Methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) 603

IX Phencyclidine 608

34 Phencyclidine and Phencyclidine Analogues 608

X Volatile Substances of Abuse 633

35 Volatile Substance Abuse 633

A Anesthetics 642

36 Chloroform 642

37 Ethers 647

38 Halogenated Ethers (Enflurane, Isoflurane, Methoxyflurane, Sevoflurane) 653

39 Halothane 664

40 Nitrous Oxide 670

B Fluorinated Alkanes 676

41 Fluorinated Alkanes 676

C Industrial Hydrocarbons 684

42 Butane, Isobutane, and Propane 684

43 Ethyl Chloride 691

44 Gasoline 695

45 n-Hexane 702

46 Methanol 709

47 Naphthalene and para-Dichlorobenzene (Mothballs) 716

48 Toluene 725

49 Trichloroethane 737

50 Trichloroethylene 743

D Nitrogen Compounds 751

51 Amyl and Butyl Nitrites 751

Part 2 Psychoactive Plants 759

52 Absinthe 761

53 Ayahuasca, Harmala Alkaloids, and Dimethyltryptamines 768

54 Betel Quid and Areca Nut 781

55 Caffeine 788

56 Cocaine 805

57 Ibogaine (Tabernanthe iboga Baill.) 867

58 Khat (Catha edulis (Vahl) Forsskal ex Endl.) and Cathinone 873

59 Kratom [Mitragyna speciosa (Korth.) Havil.] 880

60 Marijuana (Cannabis sativa L.) and Synthetic Cannabinoids 886

61 Mate Tea (Ilex paraguariensis A. St. Hil.) 932

62 Morning Glory Family (Convolvulaceae) 938

63 Peyote [Lophophora williamsii (Lem. Ex Salm-Dyck) Coult.] and Mescaline 944

64 Psilocybin and Hallucinogenic Mushrooms 950

65 Salvia divinorum Epling & Jativa and Salvinorin A 961

66 Tobacco, Nicotine, and Pituri 968

Index 993