Handicraft preparations of ephedrine

They are used, as a rule, intravenously or orally , less often by inhalation or intranasal.

A preparation obtained by treating ephedrine-containing drugs with potassium permanganate and acetic acid is known as ephedrone (methcathinone) ^{[Note 1]} ; by treating pseudoephedrine with red phosphorus and iodine , a solution of pervitin (methamphetamine) is obtained ^{[Note 2]} .

In the Russian Federation, there are restrictions on the distribution of precursors that can be used to prepare these drugs. Many of them are included in the “ List of narcotic drugs, psychotropic substances and their precursors to be controlled in the Russian Federation; List IV ": ephedrine , pseudoephedrine , norpsevdoephedrine , phenylpropanolamine (limited circulation, special control measures); potassium permanganate , hydrochloric acid , acetic acid in a concentration of 80% or more. Similar restrictions apply in Ukraine ^[1] .

Handicraft-made drug from a drug

The artificially prepared preparations of ephedrine, pseudoephedrine and preparations containing these substances have long been called the “ Soviet drug ” ^[2] , based on their popularity in the USSR. According to A. Danilin , they began to use them before the Great Patriotic War in the Soviet special services ^[3] . From them, information about artisanal methods for the manufacture of narcotic drugs moved to places of detention , from where, after the amnesty of 1953, this information was widely disseminated also at large. Already in the mid-1960s, the consequences of their use were encountered by Soviet psychiatrists-narcologists. In the 1970s, pervitin was used by many representatives of marginalized social groups in the USSR, but drugs produced at home were most popular in the late 1980s and early 1990s, when every third drug addict abused these drugs ^[4] . This was due to the fact that with a prescription in the pharmacy it was possible to purchase larger doses of ephedrine, and from it it was not difficult to make ephedron or pervitin . At the beginning of the XXI century, in the territory of the CIS, ephedron addiction ranks third in prevalence after the use of marijuana and opiates ^[4] . The growing popularity of ephedron is also noted in the work of the head of the sector of deviant behavior of the Institute of Sociology of the Russian Academy of Sciences M. E. Pozdnyakova ^[5] . In Moscow and the Moscow Region , according to the Ministry of Internal Affairs , in 2000 there were about 6-8 thousand Pervitin dens ^[3] . In recent years, despite the increasing popularity of cocaine and amphetamines , the level of use of artificially prepared drugs remains high ^[6] .

Fluid from yellowish, pink-red to brown, dark powder.

Ephedron and Pervitin are indirect monoamine agonists ^[7] . They cause the release of norepinephrine , serotonin and dopamine from the presynaptic endings and thus affect not only the central , but also the peripheral nervous system of a person. Although they block the reverse absorption of catecholamines , they can still be transported to the nerve ending. At the cellular level, they inhibit the accumulation of dopamine in the vesicles and its destruction by monoamine oxidase (MAO).

This leads to the accumulation of dopamine in the synapse and hyperactivation of postsynaptic receptors. Prolonged re-use of psychostimulants depletes the supply of catecholamines, so drug addicts experience irritable weakness during their physiological recovery (several days) ^[8] , similar to neurasthenia .

Pharmacokinetics Pharmacodynamics

When administered intravenously, the action begins within a few seconds ^[9] . The elimination half-life is 8–12 hours, the maximum action time is 10–24 hours, and the metabolite removal time from the body is 2-3 days ^[9] .

According to ICD 10 , mental and behavioral disorders caused by ephedron and pervitin are classified as F 15 ..

Acute drug intoxication

Narcotic intoxication caused by ephedron and pervitin is similar to the effect of other psychostimulant drugs. The duration of direct exposure to ephedron is 4-5 hours ^[10] . The duration of the consequences after taking the drug can reach from 5-6 hours to several days ^[11] . The effect of drug intoxication is quickly replaced by a bad mood, fatigue, apathy , and mental imbalance. The environment is alarming . Delusions of persecution are possible. Gait shaky, speech blurry.

Peripheral Effects

1. Cardiovascular system ^[8] :
   1. cardiopalmus;
   2. angina pectoris ;
   3. arrhythmia ( extrasystole );
2. Respiratory system - expansion of the bronchi ^[8] ;
3. Digestive system ^[8] :
   1. anorexia ;
   2. nausea and vomiting
   3. intestinal colic ;
   4. increased intestinal motility;
   5. diarrhea
   6. metallic taste in the mouth;
4. Urinary system - diuretic thiazide-like effect ^[8] ;
5. The endocrine system is a pathology of the mammary glands (especially in women with cystic-fibrotic diseases) ^[8] .

Atypical reactions with the use of ephedron and pervitin

These include the so-called Pervitin and Ephedron Paranoid Psychosis , first described in 1958 . PH Connell ^[12] under the name “amphetamine psychosis” and is currently classified as a type of stimulatory psychosis : the addict has anxiety, fear, suspicion, then hallucinations and paranoid ideas ( delusions of attitude , paralogic thinking), psychomotor agitation , symbolic thinking . Aggressive actions towards “pursuers” are possible. According to A. Danilin, in the absence of specialized medical care, a person can die after the 5th – 6th case of stimulative psychosis from cerebral edema ^[3] .

Among other atypical reactions with the use of ephedron and pervitin should be called twilight dizziness , impulsive stereotype , perseveration .

Chronic psychosis with ephedron and pervitin

When using Pervitinum, chronic Pervitinum psychosis can occur ^[13] , which manifests itself as persistent hallucinatory-paranoid symptoms . Against the background of dysphoria and fear, delusions of persecution, attitudes and influences develop, visual hallucinations arise. Kandinsky-Clerambo syndrome may occur. The duration of this condition varies from 2-3 weeks to many months. Chronic Pervitin psychosis in its symptoms is similar to schizophrenia ^[13] .

Overdose

With an overdose of ephedron and pervitin, depersonalization-derealization syndrome occurs, tactile, visual and auditory hallucinations , among vegetative disorders: dry mouth, pallor, arterial hypertension ^[14] , extrasystole.

Withdrawal Syndrome

First of all, “somatovegetative changes” are manifested ^[15] : headache , palpitations and angina pectoris, muscle pain, cramps of facial muscles and muscles of the tongue . The movements are atactic , their coordination is disturbed. Fever, hyperhidrosis , white dermographism , tactile hyperesthesia are observed. In the mental sphere, anxiety , suspicion and fear are observed. At the height of these phenomena, delirium can occur. With abstinence at the III stage of drug addiction, hypomania and paranoid syndrome are possible. The withdrawal syndrome lasts even with medical assistance for 2-3 days, after which an even longer (up to 1.5 months) post-withdrawal syndrome occurs: general weakness, adynamia, depressive syndrome , lability of emotions .

Pyrogenic reaction

Due to the fact that ephedron and pervitin are prepared and used under conditions far from sterile, toxemia often occurs against the background of their intake, which can lead to sepsis or septic or infectious toxic shock .

Mental and physical dependence are extremely pronounced ^[16] . Particularly quickly, dependence in the form of compulsive needs arises with the intravenous administration of pervitin. Physical dependence occurs after 2-3 weeks of regular oral administration or 3-5 injections, mental - much earlier.

Addiction develops in 3 stages. The first is mental addiction; the second - a significant increase in tolerance with the use of up to 0.8 g pervitin per day, while mental activity is replaced by physical activity, fading into the background; the third is the syndrome of the consequences of chronic anesthesia , which, in addition to general phenomena, is characterized by severe violation of the will , loss of moral and ethical standards. The roughest of them are apato-abulia , aggression , auto-aggression , sexual perversions ( pedophilia , gerontophilia ) ^[15] . Such drug addicts often commit crimes of violence against a person and on the basis of sex ^[5] . The physical condition of the body suffers. Also, drug use usually leads to problems with the law.

In case of simple drug intoxication, diazepam is administered with ephedron or pervitin and isotonic sodium chloride is introduced for the purpose of detoxification ^[17] . With extrasystole, Novocainamide is administered. Antipsychotics are administered with caution: haloperidol can cause severe akathisia , chlorpromazine and tizercin - orthostatic collapse . With severe paranoid syndrome, diazepam, chlorprotixen and tizercin are used.

Among the factors leading to the first use of artificially prepared psychostimulants, the main thing to consider is imitation ^[18] . Often a person, especially a mentally immature person, is affected by a group of people who have already taken drugs (group conformism ). As a rule, involvement takes place in a group where there is already an experienced addict, which is associated with a certain complexity of the technology for the preparation of narcotic drugs and the need to have at least primary skills.

• Montana Meth Project . Meth Project organization ( 2005 - 2016 ). - Project against methamphetamine (pervitin). Date of treatment January 20, 2016. Archived March 12, 2012.

Sources

1. Skripnikov A.M., Naprnko O.K. , Sonnik G.T. Narcology: educational-methodical manual = Narcology: primary methodical collection / Pid. ed. D.M.N. Professor Skripnіkova A. M. - Poltava , 2005 . - 427 p.
2. Kobzeva I.V. Controlled narcotic substances, the most common in Russia. - Mozhaysk , 2007 .
3. Savenko V. G., Sergeev A. N. , Poluektov S. S et al. Common narcotic substances. Tutorial. - 1992 .
4. Sorokin V.I. Narcotic drugs and psychotropic substances. Classification, brief description. - Moscow, 2002 .