Drugs of abuse

This chapter provides an overview of drugs of abuse—amphetamines, cannabinoids, opioid analgesics, and cocaine. An uncommon presentation of amphetamine-related acute myocardial infarction due to coronary artery spasm has been observed. The toxic effects of methamphetamine on brain neurotransmitters were investigated. The effects of in utero exposure to methamphetamine on fetal growth and withdrawal symptoms were also investigated. The combination of syndrome of inappropriate antidiuretic hormone secretion (SIADH) and excessive fluid intake after the use of ecstasy played a significant role in causing water intoxication, which was worsened by isotonic saline in the early stages of treatment. Coronary no-flow and ventricular tachycardia after habitual marijuana use has been observed in several cases. Cocaine use may account for up to 25% of acute myocardial infarctions among patients aged 18–45 years. The safety of a 12-hour observation period in a chest pain unit followed by discharge in individuals with cocaine-associated chest discomfort who are at low risk of cardiovascular events has been evaluated in some patients aged 18 years or older who developed chest pain within 1 week of cocaine use or who tested positive for cocaine.