Enno Freye

• Prof. Dr.
• Professor (Associate) at Heinrich Heine University Düsseldorf

The present study was undertaken to prove if the presently dominant quantitative “structure-activity relationship” theory of molecular signaling by means of chemical/physical binding, should rather be replaced by information processing using electromagnetic wave transmission. Rats after a steady-state isoflurane N2O/O2-anesthesia were exposed to el...

In order to replenish energy stores after exercise we developed a nutraceutical containing ingredients that precisely fuel the ATP generating mitochondria thus resulting in a faster recovery after workout. To test the working hypothesis 18 healthy female college soccer players (mean age 18) enrolled in a short but extreme workout on the treadmill f...

The concept of opioid-induced hyperalgesia has recently gained prominence as a contributing factor for long-term treatment failure. To evaluate possible differences of opioids used in anaesthesia, cumulative doses of sufentanil and remifentanil were compared with escalating doses of the oripavine derivative etorphine, in awake and trained canines....

Die endogenen Opioide haben aller Wahrscheinlichkeit nach eine entwicklungsgeschichtlich entscheidende Bedeutung beim Überlebenskampf erlangt. Denn bei den unter einer Belastungssituation ausgelösten Reaktionen des protektiven Systems sind endogene Opioide in der Lage, diese zu blockieren, wenn sie zum Überleben (Flucht oder Kampf) des Individuums...

Die Behandlungsziele bei einer Opiatabhängigkeit sind nach wie vor die Drogenfreiheit und eine bleibende Abstinenz. Für einen Entzug stehen dem Abhängigen unterschiedliche Verfahren zur Verfügung. Dies erscheint insofern von Bedeutung, als 30% aller Drogenkonsumenten sich in einer Ausstiegsphase befinden, 40% eine sog. Ambivalenzphase durchmachen,...

Arzneimittel werden durch enzymkatalysierte Abbaureaktionen in 2 Phasen metabolisiert. In der 1. Phase wird der Wirkstoff in ein reaktives Zwischenprodukt umgewandelt. In der 2. Phase werden die Stoffwechselprodukte der 1. Phase, wiederum enzymatisch, an körpereigene Substanzen gebunden und können renal oder biliär ausgeschieden werden. Sind diese...

Während die Zahl der Alkoholabhängigen in den alten und neuen Bundesländern auf etwa 5 Mio. der Gesamtbevölkerung geschätzt wird, beträgt die Zahl der Heroinabhängigen etwa 120.000. Wegen der Dunkelziffer kann die Zahl jedoch auch gut doppelt so hoch sein [1]. Letztlich muss mit einer Zunahme der von dieser Stoffklasse Abhängigen gerechnet werden....

Periphere Opioidrezeptoren sind in den verschiedenen Organen am Tier und am Menschen nachgewiesen worden, woraus ihre Bedeutung bei den unterschiedlichsten physiologischen und pathologischen Zuständen, insbesondere bei der Entwicklung chronischer Schmerzsyndrome, abgeleitet werden kann. In folgenden peripheren Geweben finden sich in unterschiedlich...

War die Ärztin und Reformerin Dr. Hope Bridges Adams Lehmann (1855–1916) aus München die erste Frau in Deutschland, die 1880 ein medizinisches Staatsexamen ablegte, so war sie auch die erste Frau, die in München und Bayern als Ärztin praktizierte und 1896 als erste Medizinerin einen vielfach aufgelegten Gesundheitsratgeber für Frauen schrieb. Weit...

Seit langem ist bekannt, dass Opioide durch Bindung an Opioidrezeptoren unterschiedliche immunologische Parameter und verschiedene Zelltypen des Immunsystems beeinflussen können. So reagieren z. B. die natürlichen Killerzellen (NK-Zellen) sehr empfindlich auf Morphin, indem die Aktivität der NK-Zellen in vivo bei der Ratte, der Maus, dem Affen und...

Bei Überschreitung einer gewissen Schmerzschwelle setzt der Organismus Endorphine (körpereigene, morphinähnliche Substanzen) frei, die überall dort entstehen, wo Schmerzmediatoren zur Übertragung der Schmerzimpulse beteiligt sind. Reicht nach Bindung an spezifische Rezeptoren die Hemmung der Impulsweiterleitung und Herabsetzung der Schmerzempfindun...

Während bei den verschiedenen Formen von Schmerzen erfolgreich die Opioide als wirkungsstarke Analgetika eingesetzt werden, gehen von ihnen jedoch auch Nebenwirkungen wie Atemdepression, Obstipation, Nausea und Abhängigkeits-entwicklung aus. Unsicherheit besteht bei Beantwortung der Fragestellung, ob und in welchem Ausmaß unter langfristiger Gabe s...

Weil Opioide ihre Wirkung über Rezeptoren vermitteln, sind spezifische Antagonisten auch in der Lage, diese Wirkungen kompetitiv, durch Verdrängung des Liganden vom Rezeptor wieder aufzuheben. Neben dem klassischen Opioidantagonisten Naloxon gibt es eine Reihe weiterer sog. reiner und gemischtwirkender Antagonisten, die klinisch und im Notfall eins...

Angesichts ungelöster Finanzprobleme der Gesetzlichen Krankenversicherung hat sich in der öffentlichen Meinung eine These mehr und mehr verfestigt: Die Ärzte würden den Kassen unnötige Milliardenkosten aufbürden, weil sie neuartige Arzneimittel verordneten, die zwar teuer seien, aber keinen medizinischen Zusatznutzen hätten. Wolle man Einsparungen...

Aufgrund des Anstiegs der durchschnittlichen Lebenserwartung in den westlichen Ländern rückt der ältere Patient immer mehr in den Mittelpunkt ärztlicher Handlungen. Denn es kann davon ausgegangen werden, dass mehr als die Hälfte der Bevölkerung mit über 65 Jahren mindestens einen operativen Eingriff über sich ergehen lassen muss. So nimmt auch das...

Die transdermale Opioidapplikation stellt eine innovative Form der Medikamentenapplikation dar. Dabei ist der Wirkstoff in einem Pflaster gebunden und wird über die Haut aufgenommen. Ziel der transdermalen Arzneimittelapplikation ist die Optimierung der therapeutischen Wirksamkeit und die Minimierung von Nebenwirkungen. So tragen neben der Verträgl...

Most medicines of the late nineteenth century with the exception of bottles with coca-extract products and/or opiates, were quite ineffective. So it’s no wonder that coca extract products were considered a boon to medicine; at least they worked (Fig. 14). It also has been reported that Queen Victoria and young house-guest Winston Churchill took coc...

All Datura plants contain tropane alkaloids such as scopolamine, hyoscyamine, and atropine, primarily in their seeds and flowers. Because of the presence of these substances, Datura has been used for centuries in some cultures as a poison and hallucinogen [132, 133]. There can easily be a 5:1 variation in toxins from plant to plant, and a given pla...

DMT, also known as N,N-dimethyltryptamine, is a naturally-occurring tryptamine and potent psychedelic drug, found not only in many plants, but also in trace amounts in the human body where its natural function is undetermined. Structurally, it is analogous to the neurotransmitter serotonin and other psychedelic tryptamines such as 5-MeO-DMT and 4-H...

Coca has been used for ages as a food substitute, a stimulant, a medicine, as an aphrodisiac, a means to stay warm, and as a measure of distance running. An important factor in the spread of coca-chewing among Indians was the need for a food substitute when the Incan agricultural economy broke down due to inter tribal wars. Nutritional analysis sho...

Coca contains at least 14 separate alkaloids. An alkaloid is a naturally occurring nitrogen-containing compound, which shows a basic, i.e. an alkaline reaction, resulting in water-soluble salts when added to an acid. It is assumed that alkaloids are produced by the plant as a type of defense against insects and herbivores. They are usually bitter t...

Although not fully understood as yet, a great deal of evidence suggests that the action of cocaine at central dopaminergic (and other adrenergic) neurons may provide the underlying cause of the craving for cocaine. The blocking of the re-uptake of dopamine and subsequent enhanced activity of this neurotransmitter at dopaminergic receptor sites loca...

During Early Use Magnification of pleasure, euphoria Alertness and in some cases hyperalertness Increased and/or a (grandiose) sense of well being Decreased anxiety Lower social inhibitions: more sociable and talkative Heightened energy, self-esteem, sexuality and emotions aroused by interpersonal experiences Appetite loss; weight loss With Compuls...

Methamphetamine increases dopamine levels in the central nervous system (CNS) by as much as 2,600%, primarily by stimulating presynaptic release of the neurotransmitter, rather than by re-uptake blockade [9, 11]. Such increase has the effect of stimulating regions of the brain linked with vigilance and the action of the heart [11]. For a short whil...

Ecstasy or MDMA in its pure form is a white crystalline powder. It is usually seen in capsule form, in pressed pills (Fig. 4), or as loose powder. Common routes of administration are swallowing or snorting, although it can be smoked or injected as well. MDMA in the US and Europe is on Schedule I of controlled substances, and it is illegal to manufa...

Factors that seem to contribute to the abuse potential of GHB include its intoxicating effects, its purported anabolic effects, its hypnotic effects, and its ability to incapacitate women for purposes of sexual assault [78, 79]. One of the main reasons GHB became a popular drug of abuse is its ability to produce a “high” [59, 80]. Those who take GH...

During the late 1960s, American cocaine smugglers travelling in South America noticed some of the local populace of Peru and Colombia smoking a substance identified to them as cocaine. When word of this reached the US, several users experimented with smoking cocaine hydrochloride sprinkled on cigarettes, and quickly discovered that street coke lite...

Chemically, cocaine is a [1R, 2R, 3S, 5S]-3-(benzoyloxy)-8-methyl-8-azabicyclo-­[3.2.1] octane-2-carboxylic acid methyl ester, or the methyl ester of benzoylecgonine. It appears as cocaine base (CAS-50-36-2) and the hydrochloride salt (CAS-53-21-4). There the three components of the molecule, the dotted lines around each component in the drawing ma...

Since the cause of an altered mental status in a person before having a lab test is never clear, initial treatment should comprise of the following 1. ABC’s (airway, breathing, cardiovascular support) 2. 100 ml 50% dextrose intravenously for reversal of a potential hypoglycemia 3. Thiamine 100 mg intramuscular for a potential alcoholic intoxication...

Once the patient survived the symptoms of an overdose, what can they look forward to next ? Cocaine, even for those who feel that they don’t use that much or that often, has some chronic effects that are not to be scoffed at. Paranoia is a consequence of alterations in dopamine activity, particularly in the limbic system. It is well known that othe...

The National Institutes of Health (NIH) suggests that gamma vinyl-GABA (GVG), a drug used to treat epilepsy, may prove to be an effective treatment for cocaine addiction. Researchers from New York University School of Medicine and Brookhaven National Laboratory in Upton, New York, reported in a small, preliminary clinical trial conducted in Mexico...

For decades, amphetamine stimulants have been used to ease hunger. Unfortunately, they are addictive and have adverse effects on blood pressure and heart health. Less addictive drugs related to amphetamines have not been proven to be very effective. Moreover, they produce serious side effects. Two of these, fenfluramine and phenteramine (called “fe...

Effects of MDMA usually begin 30–45 min after oral administration of a 75–150 mg dose with peak effects occurring 60–90 min after ingestion, which start to diminish after 2 h, however lasting up to 8 h (Table 3). The time to maximum concentration (Tmax) is 2 h after oral ingestion of MDMA 50, 75, or 125 mg. The half-life shows little variation afte...

There are three harvest times a year in March, June, October where 4 oz of leaves per bush can be obtained during the main harvest. It takes up to 2 days for two people to pick 12 kg and the grower (coquero) roughly makes $2.20/kg. Also, illicit growers may not get as good a yield from their plants due to their use of less potent species, and growi...

All of the illicit cocaine entering the US and Europe comes from South America where it is processed in makeshift jungle laboratories. These are located close to growing areas because the leaves are hard to transport far, owing to their weight (it takes 200–300 lb of leaves to make a kilo of cocaine) and the inability to conceal them easily. In con...

The vast majority of patients, who are alive when emergency personnel get to them, will survive cocaine poisoning. If someone is going to die, they will usually do so within 2–3 min of first experiencing symptoms of advanced CNS stimulation. Unless this occurs in the controlled medical environment of an emergency room (ER) or a fully equipped ambul...

Cocaine produces an array of neuropsychiatric states, and the violently agitated patient is perhaps the most dramatic ED presentation caused by this drug. This person typically arrives with a multitude of personnel who are attempting physical control. There is an appearance of incredible strength, but this may reflect an indifference to pain; the r...

Women addicted to cocaine often continue drug use through pregnancy, despite risks to the fetuses they are carrying. Primate studies have shown that intrauterine cocaine exposure (during a period corresponding to the second trimester in humans) results in a decrease in the number of neurons in the cerebral cortex and disorganization of the normal l...

When methamphetamine is first used, the effects, aside from a simple stimulant, include a sense of euphoria, openness, and intellectual expansion. There can be a mild psychedelic component as the new user feels they see the world a little differently. The sensation of “mind-expansion” and openness quickly fade after the first few uses and physical...

Crystal methamphetamine or “ice” typically resembles small fragments of glass or shiny blue-white “rocks” of various sizes (Fig. 13). Contrary to powdered methamphetamine (the other form of d-methamphetamine hydrochloride), which contains by-products from synthetic preparation, crystal methamphetamine has a higher purity level and produces longer-l...

Like mescaline, the primary psychoactive ingredient in peyote, MDMA belongs to a group of ring-substituted amphetamine congeners, commonly called “methoxylated amphetamines” (Fig. 6). The drug MDMA is a potent indirect monoaminergic agonist, which is thought to act by both increasing the release and inhibiting the reuptake of serotonin and, to a le...

Clandestine laboratories operating throughout Western Europe, primarily the Netherlands and Belgium, manufacture significant quantities of the drug in tablet, capsule, or powder form. Although the vast majority of ecstasy or 3,4-methylene-dioxymeth-amphetamine (MDMA) consumed domestically is produced in Europe, a limited number of MDMA labs operate...

There are several natural products such as extracts from plants, cacti, or mushrooms, which have no accepted medical use, however inherit an abuse potential Datura stramonium is a genus of nine species of vespertine flowering plants belonging to the family Solanaceae. Their exact natural distribution is uncertain, due to extensive cultivation and n...

Primarily, therapy for a “meth-addict” includes the importance of cutting ties with friends who engage in substance abuse. Not doing so will make it more difficult for the patient to live without the temptation. Abrupt interruption of chronic methamphetamine use results in the withdrawal syndrome in almost 90% of the cases. Withdrawal of methamphet...

Most of the therapeutic applications of GHB result from its sedative and hypnotic effects on the CNS. There are no currently accepted medical applications for GHB in the US, although it is being evaluated for the symptoms of narcolepsy. However, GHB has been extensively administered and studied for a variety of indications in other countries in Eur...

The exact mechanism of GHB action in the CNS has not been determined, but GHB is structurally related to GABA (Fig. 10), which is a precursor in GHB formation [33]. Much debate exists regarding whether GHB has neurotransmitter or neuromodulatory roles [34], because GHB has high-affinity brain receptors and undergoes synthesis, release, uptake, and...

This new agent became known as “Liquid Ecstasy, Liquid E, Liquid X, or Fantasy”. It is a central nervous system depressant, and has been used as an anxiolytic, anesthetic and sedative/hypnotic, inducing a sleep-like state in experimental animals in doses ranging from 0.1 to 1.5 g/kg [5]. GHB is also a putative neurotransmitter [6]. Treatment with G...

Lysergic acid diethylamide, LSD, LSD-25, or “acid”, is a semisynthetic psychedelic drug of the ergoline family. Its unusual psychological effects, which include visuals of colored patterns behind the eyes, a sense of time distorting, and crawling geometric patterns, has made it one of the most widely known psychedelic drugs. It has been used mainly...

Urine is currently the most widely used and validated specimen for drug testing [11, 33, 38]. Although other technologies for use in different biologic specimens are marketed for drug testing, there is a lack of information on their false-positive and false-negative results, interferences, and cross-reactivity. Therefore, most of these techniques m...

There are two types of test cards offered for UDT, both of which differ only in regard to how the specimen is being handled. In this test the user has to remove the cap from the test device and hold the absorbent tip into the urine for 10–15 s. There is no protective cap with every single test (Fig. 12). By using a pipette three drops of urine are...