IDA BAGUS PUTU ALIT

DEFINITIONS

WHO definitions
A drug is any substance other than
those required for the maintenance of
normal health, that when taken into
living organism may modify one or more
of its functions

SUBSTANCES MISUSE

ADICTION:
PHYSICAL , PSYCHOLOGICAL, LIFE STYLE

DRUG MISUSE (Royal College of

Psychiatrists)
Harm and threatens physical and mental or

social well-being

DEPENDENCE
Psychic and physical sate, behavioural

compulsion to take on continous basis in order

psychic effects and disconfort of it absence

TOLERANCES
FORENSIK FK UNUD

SUBSTANCES MISUSE

Experimental use
Social use
Situational use
Abuse
Pathologic
Social and occupational impairment

Dependence
Tolerance
Withdrawal

SUBSTANCE INDUCED ORGANIC

DISORDER -1
(FAULK)
1.

INTOXICATION

2.

IDIOSYNCRATIC INTOXICATION

3.

EXCESSIVE
ALTERED PSYCHOLOGICAL
FUNCTIONING
MANIA A POITU
DELIRIUM
AUTONOMIC CHANGES

WTHDRAWAL EFFECT

STOPPING THE SUBSTANCE

SUBSTANCE INDUCED
ORGANIC DISORDER -2
4. MENTAL ILNESS
(FAULK)

Direct (Amphetamine, Cocaine, LSD)

b) An effect of sudden withdrawal
a)

c)

Chronic effects of drugs

d)

Paranoid psychosis
Alcoholic dementia

Precipitating relaps in patient with

Schizophrenia

canabis

YURIDICAL ASPECTS

REGULATION :

NARCOTICS :
1.
2.
3.

UU PSIKOTROPIKA (UU No.5 TH 1997)

UU NARKOTIKA ( UU No. 22 TH 1997)
OPIAT
CANNABIS
COCAINE

ADDITIVE SUBSTANCES :
1.
2.
3.
4.
5.
6.
7.
8.

ALCOHOL
AMPHETAMINE
HALUSINOGEN
SEDATIVE-HIPNOTIC
SOLVEN
PCP
NICOTINE
CAFEINE

FORENSIK FK UNUD

NARCOTICS
CNS DEPRESSANT
OPIATE

CNS STIMULANT
COCAINE

MIND EXPANDING PSYCHODELICT

CANNABIS, MARIHUANA

FORENSIK FK UNUD

PSYCHOGENIC OF DEPENDENCE-1
LONG AND
CONTINUOS
STIMULATION

ABSENT

PROTRACTED WITHDRAWAL
SYNDROMES

Craving
Exitation
Pain
Piloerection
Disforia
Insomnia
Anxieta
etc

PSYCHOGENIC OF
DEPENDENCE-2

OPIAT
SENSATION

LC
(LOCUS
SERELEUS)
NAC
(NUCLEUS
ACUMBENS)
NECLEUS
CAUDATUS
PUTAMEN
AMIGDALA

MEDICO LEGAL ASPECT

CRIME WITHOUT VICTIM

VICTIMLESS CRIME
ORGANIZED- CRIME
impunity

PARTICIPATED-VICTIM CRIME
CRIMINALS CONTRIBUTION
HOT SHOT
SWALLOWER
BODY PACKER SYNDROME
MULLES

MORFINE AND HEROINE

Heroine 6 Mono Acetyl Morfine (MAM)

Exitation phase euphoria
Narcose phase :
Somnolens
Coma
Pin head size

Mechanism of death

Direct mechanism
Depression of respiration center
Swelling of the lungs (Narcotics Lung)
Anaphylactic Shock (COLLOIDOCLASTIC

CRISIS)

Indirect mechanism of death

Unsteril

FORENSIK FK UNUD

Forensic medicine
examination

Needle Mark
Intravenous Mainline Tracks
Granuloma, Abses (Skin-Popper)
Nasal Perforation
Enlargement of lymph node
Skin Blister
Achute pulmonal oedema

FORENSIK FK UNUD

Cannabis (marihuana)

Psychosa marihuana
Instability of emosion
Delusion
Panic
Anorexia
Weakness
Loss of libido

Precipitate mental disorder

COCCAINE-1

The most potent of the CNS stimulants

Potent addictive compound
Increasing of Catecholamine
Stimulate the release of NE
Blocking reuptake of NE

Mechanism of death
1)Cardiac arrhytmia
-

Direct action on myocardium

2)Cardiopulmonary arrest
-

Central action on CNS

COCCAINE-2
A CHEMICAL PARANOID PSYCHOSIS
EXTREMELY VIOLENT AND ASSAULTIVE
AGGRESIVE
PARANOID

The three curse of mankind :

Alcohol
Morphine
coccaine

METHAMPHETAMINE AND
AMPHETAMINE-1

EFFECT :
Increasing release of DOPAMINE and

blocking reuptake of DOPAMINE

hyperstimulation of receptor neurons

Increasing release of NE and blocking

reuptake of NE

THE EUPHORIC EFFECTS TEN TIME

THAN OF COCCAINE
ENTACTOGENIC EFFECTS

METHAMPHETAMINE AND
AMPHETAMINE-2

Over dosis :
Restlessness
Confulsion
Hallucination
Coma, convulsion
Cardiac arrhytmia

Chronics use
a chemical paranoid psychoses

Death generally not dose related

ALCOHOL (ETHYLALCOHOL)

The most misuse

Related to accident, homicide, suicide
and assault (physical or sexual)
Burning, drowning
Both as victim or perpetrator

Banay reaserch at Sing Sing jail

HOW MANY ALCOHOLICS ARE
CRIMINALS AND HOW MANY
CRIMINALS ARE ALCOHOLICS

Absorbtion-MethabolismExretion

Absorpsi :
Oral absorpsi at gut (small gut 80%)

blood CNS depression

Methabolism :
Hepar (enz ADH & NAD) acetaldehyda

(enz ALDH) acetic acid CO2 & H20

Exretion:
Urine(90%), expiration, sweat, saliva

FORENSIK FK UNUD

Metabolisme

FORENSIK FK UNUD

Gejala-Gejala

Kadar dalam darah :

< 30 mg/100cc: mudah terangsang / tulisan
30 50 mg: kontrol diri, kecepatan reaksi,penglihatan
60 80 mg: penglihatan 3 dimensi,pendengaran,kons
80 100 mg: keracunan pusat vital
300 mg: fase narkose delirium halusinasi
400 mg: depresi SSP, kelumpuhan kardiorespirasi
Dosis toksis kebiasaan minum alc, sensitivitas

individual(ALDH 1), sinergisme dengan obat2an lain,

penyakit

FORENSIK FK UNUD

DELIRIUMTREMENS ( VIOLENT
INSANITY)

Narcoses phase : over than 300 mg

Delirium
Halusinasi
Neuro-muscular control disturbance
hypothermia

Deformity on chronic
alcoholism

Encefalitishemoragic superior (Wernicke)

Necroses of hypothalamus, corpus mammilaria,

cortex athrophy

Marchiava Bignami Syndrome

Thinning of corpus callosum anterior

Korsakoffs syndrome
Accumulation of lipochrome at cortex, neuroglia

and microglia
ALCOHOLIC DEMENTIA

CONCLUSION

Substances induce psychoorganic by

intoxication, idiosyncratic, withdrawal
and mental ilness
Three curse of mankind : alcohol,
morphine and coccaine
Substances of misuse give contribution
in criminals

THANKS YOU
Taceant colloquia Effugiat risus. Hic Locus
est ubi mors gaudet succurrere vitae

28