Common drugs of abuse
LSD (lysergic acid diethylamide) is one of the major drugs making up the hallucinogen class. LSD was discovered in 1938 and is one of the most potent mood-changing chemicals. It is manufactured from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains.
LSD, commonly referred to as acid, is sold on the street in tablets, capsules, and, occasionally, liquid form. It is odourless, colourless, and has a slightly bitter taste and is usually taken by mouth. Often LSD is added to absorbent paper, such as blotter paper, and divided into small decorated squares, with each square representing one dose.
The US Drug Enforcement Administration reports that the strength of LSD samples obtained currently from illicit sources ranges from 20 to 80 micrograms of LSD per dose. This is considerably less than the levels reported during the 1960s and early 1970s, when the dosage ranged from 100 to 200 micrograms, or higher, per unit.
The effects of LSD are unpredictable. They depend on the amount taken; the user's personality, mood, and expectations; and the surroundings in which the drug is used.
Usually, the user feels the first effects of the drug 30 to 90 minutes after taking it. The physical effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth, and tremors.
Sensations and feelings change much more dramatically than the physical signs. The user may feel several different emotions at once or swing rapidly from one emotion to another. If taken in a large enough dose, the drug produces delusions and visual hallucinations. The user's sense of time and self changes. Sensations may seem to cross over, giving the user the feeling of hearing colours and seeing sounds. These changes can be frightening and can cause panic.
Users refer to their experience with LSD as a trip and to acute adverse reactions as a bad trip. These experiences are long - typically they begin to clear after about 12 hours. Some LSD users experience severe, terrifying thoughts and feelings, fear of losing control, fear of insanity and death, and despair while using LSD.
Some fatal accidents have occurred during states of LSD intoxication. Many LSD users experience flashbacks, recurrence of certain aspects of a person's experience, without the user having taken the drug again. A flashback occurs suddenly, often without warning, and may occur within a few days or more than a year after LSD use. Flashbacks usually occur in people who use hallucinogens chronically or have an underlying personality problem; however, otherwise healthy people who use LSD occasionally may also have flashbacks. Bad trips and flashbacks are only part of the risks of LSD use.
LSD users may manifest relatively long-lasting psychoses, such as schizophrenia or severe depression. It is difficult to determine the extent and mechanism of the LSD involvement in these illnesses.
Most users of LSD voluntarily decrease or stop its use over time. LSD is not considered an addictive drug since it does not produce compulsive drug-seeking behaviour as do cocaine, amphetamine, heroin, alcohol, and nicotine. However, like many of the addictive drugs, LSD produces tolerance, so some users who take the drug repeatedly must take progressively higher doses to achieve the state of intoxication that they had previously achieved. This is an extremely dangerous practice, given the unpredictability of the drug.
The drinkable form of alcohol is ethanol, or ethyl alcohol. It is a powerful, addictive, central nervous system depressant produced by the action of yeast cells on carbohydrates in fruits and grains.
A liquid that is taken orally, alcohol is often consumed in copious quantities. Surveys of adolescent and young adult drinkers indicate that they are particularly likely to drink heavily with the intention of getting drunk - often every time they drink.
There are three basic types of alcoholic drinks:
- Beer is made from fermented grains and has an alcohol content of three to six percent.
- Wine is made from fermented fruits and has an alcohol content of 11 to 14 percent. Some wine drinks, such as wine coolers, have fruit juice and sugar added, lowering alcohol content to between four and seven percent. Fortified wines, such as port, have alcohol added, bringing alcohol content to between 18 and 20 percent.
- Spirits are made by distilling a fermented product to yield a drink that usually contains 40 to 50 percent alcohol. The alcohol content in a spirit is sometimes indicated by degrees of proof.
A 12-ounce glass of beer, a 5-ounce glass of wine, and a 1.5-ounce shot of a spirit all contain the same amount of alcohol and, therefore, have an equal effect on the drinker. All three forms of alcohol have the same potential for intoxication and addiction. (Quoted from the American Council for Education)
When a person consumes alcohol, the drug acts on nerve cells deep in the brain. Alcohol initially serves as a stimulant, and then induces feelings of relaxation and reduced anxiety.
Consumption of two or three drinks in an hour can impair judgment, lower inhibitions, and induce mild euphoria. Five drinks consumed in two hours may raise the blood alcohol level to 0.10 percent, high enough to be considered legally intoxicated in every state.
Once a drinker stops drinking, his or her blood alcohol level decreases by about 0.01 percent per hour.
Signs and symptoms of alcohol use and intoxication:
- Smell of alcohol on breath
- Loss of physical coordination
- Inappropriate or violent behaviour
- Loss of balance
- Unsteady gait
- Slurred and/or incoherent speech
- Loss of consciousness
- Slowed thinking
- Impaired short-term memory
Signs and symptoms of alcohol withdrawal, experienced by alcoholics and problem drinkers:
- Anxiety and panic attacks
- Paranoia and delusions
- Hallucinations (usually visual)
- Nausea and vomiting
- Increased body temperature
- Elevated blood pressure and heart rate
In addition to risk of injury or death as a result of accident or violence, alcohol abuse poses a broad range of physiological and psychological dangers.
Neurological dangers include impaired vision and impaired motor coordination, memory defects, hallucinations, blackouts, and seizures. Long-term consumption can result in permanent damage to the brain.
Cardiological problems include elevated blood pressure and heart rate, risk of stroke and heart failure.
Respiratory dangers include respiratory depression and failure, pneumonia, tuberculosis, and lung abscesses. Additionally, alcohol abuse increases the risk of mouth and throat cancer.
Liver disease caused by chronic alcohol abuse, including alcoholic fatty liver, hepatitis, and cirrhosis, kills 25,000 Americans each year.
Other physiological dangers include damage to the gastrointestinal system (including duodenal ulcers, reflux, and diarrhoea), the pancreas, and the kidneys. In addition, alcohol consumption may cause malnutrition, disrupt the absorption of nutrients in food, and suppress the immune system, thus increasing the potential for illness.
Psychological angers include impaired judgment and verbal ability, apathy, introversion, antisocial behaviour, inability to concentrate, and deterioration of relationships with family, friends, and co-workers. (Quoted from the American Council for Education).
- Club drugs
MDMA (Ecstasy), Rohypnol, GHB, and Ketamine are among the drugs used by teens and young adults who are part of a nightclub, bar, rave, or trance scene.
Current science is showing change to critical parts of the brain from use of these drugs. Also, in high doses most of these drugs can cause a sharp increase in body temperature (malignant hyperthermia) leading to muscle breakdown and kidney and cardiovascular system failure.
GHB, Rohypnol, and ketamine are predominantly central nervous system depressants. Because they are often colourless, tasteless, and odourless, they can be added to beverages and ingested unknowingly.
These drugs emerged a few years ago as date rape drugs. Because of concern about their abuse, US Congress passed the Drug-Induced Rape Prevention and Punishment Act in October 1996. This legislation increased Federal penalties for use of any controlled substance to aid in sexual assault.
Since about 1990, GHB (gamma hydroxybutyrate) has been abused in the U.S. for euphoric, sedative, and anabolic (body building) effects. It is a central nervous system depressant that was widely available over-the-counter in health food stores during the 1980s and until 1992.
GHB was purchased largely by body builders to aid fat reduction and muscle building. Street names include Liquid Ecstasy, Soap, Easy Lay, and Georgia Home Boy.
Coma and seizures can occur following abuse of GHB and, when combined with methamphetamine, there appears to be an increased risk of seizure. Combining use with other drugs such as alcohol can result in nausea and difficulty breathing. GHB may also produce withdrawal effects, including insomnia, anxiety, tremors, and sweating.
GHB and two of its precursors, gamma butyrolactone (GBL) and 1,4 butanediol (BD) have been involved in poisonings, overdoses, date rapes, and deaths.
These products, obtainable over the internet and sometimes still sold in health food stores, are also available at some gyms, raves, nightclubs, gay male parties, college campuses, and the street. They are commonly mixed with alcohol (which may cause unconsciousness), have a short duration of action, and are not easily detectable on routine hospital toxicology screens. 
Rohypnol, a trade name for flunitrazepam, has been of particular concern for the last few years because of its abuse in date rape. It belongs to a class of drugs knows as benzodiazepines.
When mixed with alcohol, Rohypnol can incapacitate victims and prevent them from resisting sexual assault. It can produce "anterograde amnesia," which means individuals may not remember events they experienced while under the effects of the drugs. Also, Rohypnol may be lethal when mixed with alcohol and/or other depressants.
Ketamine is an anaesthetic that has been approved for both human and animal use in medical settings since 1970; about 90 percent of the ketamine legally sold is intended for veterinary use. It can be injected or snorted. Ketamine is also known as Special K or vitamin K.
Certain doses of ketamine can cause dream-like states and hallucinations, and it has become common in club and rave scenes and has been used as a date rape drug.
At high doses, ketamine can cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.
Cocaine is a powerfully addictive drug of abuse. Once having tried cocaine, an individual cannot predict or control the extent to which he or she will continue to use the drug.
The major routes of administration of cocaine are sniffing or snorting, injecting, and smoking (including free-base and crack cocaine).
There is great risk whether cocaine is ingested by inhalation (snorting), injection, or smoking. It appears that compulsive cocaine use may develop even more rapidly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and brings an intense and immediate high. The injecting drug user is at risk for transmitting or acquiring HIV infection/AIDS if needles or other injection equipment are shared.
Crack is the street name given to cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Rather than requiring the more volatile method of processing cocaine using ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water and heated to remove the hydrochloride, thus producing a form of cocaine that can be smoked. The term crack refers to the crackling sound heard when the mixture is smoked (heated), presumably from the sodium bicarbonate.
Cocaine is a strong central nervous system stimulant that interferes with the re-absorption process of dopamine, a chemical messenger associated with pleasure and movement. Dopamine is released as part of the brain's reward system and is involved in the high that characterizes cocaine consumption.
Physical effects of cocaine use include constricted peripheral blood vessels, dilated pupils, and increased temperature, heart rate, and blood pressure. The duration of cocaine's immediate euphoric effects, which include hyper-stimulation, reduced fatigue, and mental clarity, depends on the route of administration. The faster the absorption, the more intense the high.
On the other hand, the faster the absorption, the shorter the duration of action. The high from snorting may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes. Increased use can reduce the period of stimulation.
Some users of cocaine report feelings of restlessness, irritability, and anxiety. An appreciable tolerance to the high may be developed, and many addicts report that they seek but fail to achieve as much pleasure as they did from their first exposure. Scientific evidence suggests that the powerful neuropsychological reinforcing property of cocaine is responsible for an individual's continued use, despite harmful physical and social consequences.
In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. However, there is no way to determine who is prone to sudden death.
High doses of cocaine and/or prolonged use can trigger paranoia. Smoking crack cocaine can produce a particularly aggressive paranoid behaviour in users.
When addicted individuals stop using cocaine, they often become depressed. This also may lead to further cocaine use to alleviate depression. Prolonged cocaine snorting can result in ulceration of the mucous membrane of the nose and can damage the nasal septum enough to cause it to collapse. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.
Added Danger: Coca Ethylene
When people mix cocaine and alcohol consumption, they are compounding the danger each drug poses and unknowingly forming a complex chemical experiment within their bodies.
NIDA-funded researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, coca ethylene that intensifies cocaine's euphoric effects, while possibly increasing the risk of sudden death.
Heroin is a highly addictive drug, and its use is a serious problem in America. Recent studies suggest a shift from injecting heroin to snorting or smoking because of increased purity and the misconception that these forms of use will not lead to addiction.
Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the Asian poppy plant. Heroin usually appears as a white or brown powder. Street names for heroin include smack, H, skag, and junk. Other names may refer to types of heroin produced in a specific geographical area, such as Mexican black tar.
Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and infectious diseases, including HIV/AIDS and hepatitis.
The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours. After an injection of heroin, the user reports feeling a surge of euphoria (rush) accompanied by a warm flushing of the skin, a dry mouth, and heavy extremities. Following this initial euphoria, the user goes on the nod, an alternately wakeful and drowsy state. Mental functioning becomes clouded due to the depression of the central nervous system.
Long-term effects of heroin appear after repeated use for some period of time. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, cellulitis, and liver disease. Pulmonary complications, including various types of pneumonia, may result from the poor health condition of the abuser, as well as from heroin's depressing effects on respiration.
In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs.
Tolerance, Addiction, and Withdrawal
With regular heroin use, tolerance develops. This means the abuser must use more heroin to achieve the same intensity or effect. As higher doses are used over time, physical dependence and addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped.
Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhoea and vomiting, cold flashes with goose bumps (cold turkey), kicking movements (kicking the habit), and other symptoms.
Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin withdrawal is considered much less dangerous than alcohol or barbiturate withdrawal.
Inhalants are breathable chemical vapours that produce psychoactive (mind-altering) effects. Many do not think of inhalable substances as drugs because most of them were never meant to be used in that way.
Young people are likely to abuse inhalants, in part because inhalants are readily available and inexpensive. Inhalants fall into the following categories:
- Industrial or household solvents or solvent-containing products, including paint thinners or solvents, degreasers (dry-cleaning fluids), gasoline, and glues
- Art or office supply solvents, including correction fluids, felt-tip-marker fluid, and electronic contact cleaners
- Gases used in household or commercial products, including butane lighters and propane tanks, whipping cream aerosols or dispensers (whippets), and refrigerant gases
- Household aerosol propellants and as associated solvents in items such as spray paints, hair or deodorant sprays, and fabric protector sprays
- Medical anaesthetic gases, such as ether, chloroform, halothane, and nitrous oxide (laughing gas)
- Aliphatic nitrites, including cyclohexyl nitrite, which is available to the general public; amyl nitrite, which is available only by prescription; and butyl nitrite, which is now an illegal substance.
Although different in makeup, nearly all abused inhalants produce effects similar to anaesthetics, which act to slow down the body's functions. When inhaled via the nose or mouth into the lungs in sufficient concentrations, inhalants can cause intoxicating effects. Intoxication can last only a few minutes or several hours if inhalants are taken repeatedly.
Initially, users may feel slightly stimulated; with successive inhalations, they may feel less inhibited and less in control; finally, a user can lose consciousness.
Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death. This is especially common from the abuse of fluorocarbons and butane-type gases. High concentrations of inhalants also cause death from suffocation by displacing oxygen in the lungs and then in the central nervous system so that breathing ceases.
Serious but potentially reversible effects include:
- Liver and kidney damage - toluene- containing substances and chlorinated hydrocarbons (correction fluids, dry- cleaning fluids)
- Blood oxygen depletion - organic nitrites (poppers, bold, and rush) and methylene chloride (varnish removers, paint thinners).
Death from inhalants usually is caused by a very high concentration of fumes. Deliberately inhaling from an attached paper or plastic bag or in a closed area greatly increases the chances of suffocation. Even when using aerosols or volatile products for their legitimate purposes (i.e., painting, cleaning), it is wise to do so in a well-ventilated room or outdoors.
- Laughing gas
Laughing gas is a colourless, odourless, slightly sweet tasting gas that is usually kept in gas bottles of various sizes. Laughing gas is a solvent and the active agent in it is dinitrogen monoxide (N2O), another name for laughing gas is Nitrous Oxide.
Laughing gas is available several forms, one being the medical form which is produced to be used as an anaesthetic and is therefore subject to pharmaceuticals law. A second, less pure form of laughing gas is for commercial use and is commonly used to tune engines. This less pure form may often contain other chemicals or gases such as methyl nitrate which can lead to oxygen deficiency in the human body. Laughing gas can also be purchased in cartridges that can be used to make whipped cream.
For recreational use, laughing gas is normally inhaled from a balloon which has been filled from a canister. Once inhaled the effects of the drug are felt within five to ten seconds and, depending how much has been inhaled, can last for anywhere between thirty seconds and four minutes. Ten to fifteen minutes after inhalation the high subsides, around an hour later laughing gas will have been completely eliminated from the body, long term effects remain.
Short-term side effects
The main risks of inhaling laughing gas are caused by the lack of oxygen being inhaled at the same time. This can lead to asphyxiation or loss of consciousness and subsequent brain and organ damage as a result of oxygen deficiency. Other associated side effects are exhaustion, dizziness and headaches and numbness and twitching of limbs.
Long-term side effects
When used regularly in medium to high doses, laughing gas can lead to nerve damage as it reduces the effectiveness of Vitamin B12 which normally helps protect the nerves. This damage may lead to motor disorders which cause tingling and numbness in the limbs. The use of laughing gas can cause long term damage to the brain cells if oxygen deficiency occurs too often while using it.
- Magic mushrooms
Psilocybin mushrooms, more commonly known as magic mushrooms, are a group mushrooms that grow in the wild which have similar effects to LSD when consumed. Psilocybin is the psychoactive chemical in the mushrooms. There are many types of psilocybin mushrooms, psilocybe semilanceata being the one most often consumed for recreational drug use. There are other species of mushrooms, not containing psilocybin but still containing psychoactive substances, which are often called magic mushrooms. The most frequently quoted of these is amanita muscaria which is highly poisonous and potentially deadly. Appearance-wise, psilocybin mushrooms look similar to normal mushrooms, and amanita muscaria mushrooms are spotted red and white.
Magic mushrooms are normally consumed orally (ie. eaten) either raw or dried out. Raw magic mushrooms are about 90% water. Amanita muscaria is not often eaten raw as the user can experience severe nausea. Magic mushrooms may also be cooked or combined in food dishes though heating generally breaks down the psychoactive substance. 1 to 5 grams are normally consumed.
The effects of taking magic mushrooms are similar to that of taking LSD, but the trip will normally be shorter and milder. It takes 30 minutes to two hours to be noticeable. A taker might feel euphoric, confident, excited or relaxed. One may feel more emotionally sensitive, creative or enlightened. Magic mushrooms are hallucinogens, as such hallucinations can occur, especially with larger doses. Colours, sounds and objects can be distorted and senses might be confused, such as thinking you can see sounds. One?s senses can also be slowed down and the experience can feel like dreaming. Whilst not being addictive, one becomes tolerant of magic mushrooms quickly, requiring a greater dose to achieve the same high.
With magic mushroom use, one can never be sure of what they are taking. There are hundreds of different types, some of which are highly poisonous and can cause serious illness and can be potentially fatal. The strength depends on the freshness, season and origin of the mushrooms so the amount of psychoactive chemical entering the body is difficult to predict.
Magic mushrooms can make you feel nauseated, tired and disorientated. One can also have ?bad trip? which is a frightening experience during which the user will experience severe anxiety or paranoia. There?s no way to tell if a particular use of magic mushrooms will be a bad or good trip and there?s no way of going back other than waiting for the effects to wear off. As a hallucinogen, you?re not always aware and in complete control of what you do, which could cause you to do or get involved in dangerous situations.
Also, any mental health problems, such as depression, anxiety or paranoia, can be complicated by magic mushroom use and can result in long term mental health problems.
Marijuana is a green or grey mixture of dried, shredded flowers and leaves of the hemp plant Cannabis sativa. There are over 200 slang terms for marijuana including pot, herb, weed, boom, Mary Jane, gangster and chronic.
It is usually smoked as a cigarette (called a joint or a nail) or in a pipe or bong. In recent years, marijuana has appeared in blunts, which are cigars that have been emptied of tobacco and refilled with marijuana, often in combination with another drug, such as crack. Some users also mix marijuana into foods or use it to brew tea.
The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol). In 1988, it was discovered that the membranes of certain nerve cells contain protein receptors that bind THC. Once securely in place, THC kicks off a series of cellular reactions that ultimately lead to the high that users experience when they smoke marijuana.
The short term effects of marijuana use include problems with:
- memory and learning
- distorted perception
- difficulty in thinking and problem-solving
- loss of coordination
- increased heart rate
- panic attacks
Scientists have found that whether an individual has positive or negative sensations after smoking marijuana can be influenced by heredity. A recent study demonstrated that identical male twins were more likely than non-identical male twins to report similar responses to marijuana use, indicating a genetic basis for their sensations. Identical twins share all of their genes, and fraternal twins share about half.
Environmental factors such as the availability of marijuana, expectations about how the drug would affect them, the influence of friends and social contacts, and other factors that differentiate identical twins' experiences also were found to have an important effect; however, it also was discovered that the twins' shared or family environment before age 18 had no detectable influence on their response to marijuana.
Health Hazards - Effects of Marijuana on the Brain
Researchers have found that THC changes the way in which sensory information gets into and is processed by the hippocampus. The hippocampus is a component of the brain's limbic system that is crucial for learning, memory, and the integration of sensory experiences with emotions and motivations. Investigations have shown that neurons in the information processing system of the hippocampus and the activity of the nerve fibres in this region are suppressed by THC. In addition, researchers have discovered that learned behaviours, which depend on the hippocampus, also deteriorate via this mechanism.
Recent research findings also indicate that long-term use of marijuana produces changes in the brain similar to those seen after long-term use of other major drugs of abuse.
Effects on the Lungs
Someone who smokes marijuana regularly may have many of the same respiratory problems as tobacco smokers. These individuals may have daily cough and phlegm, symptoms of chronic bronchitis, and more frequent chest colds. Continuing to smoke marijuana can lead to abnormal functioning of lung tissue injured or destroyed by marijuana smoke.
Regardless of the THC content, the amount of tar inhaled by marijuana smokers and the level of carbon monoxide absorbed are three to five times greater than among tobacco smokers. This may be due to the marijuana users' inhaling more deeply and holding the smoke in the lungs and because marijuana smoke is unfiltered.
Effects on Heart Rate and Blood Pressure
Recent findings indicate that smoking marijuana while shooting up cocaine has the potential to cause severe increases in heart rate and blood pressure. In one study, experienced marijuana and cocaine users were given marijuana alone, cocaine alone, and then a combination of both. Each drug alone produced cardiovascular effects; when they were combined, the effects were greater and lasted longer. The heart rate of the subjects in the study increased 29 beats per minute with marijuana alone and 32 beats per minute with cocaine alone. When the drugs were given together, the heart rate increased by 49 beats per minute, and the increased rate persisted for a longer time.
The drugs were given with the subjects sitting quietly. In normal circumstances, an individual may smoke marijuana and inject cocaine and then do something physically stressful that may significantly increase the risk of overloading the cardiovascular system.
Effects of Heavy Marijuana Use on Learning and Social Behaviour
A study of college students has shown that critical skills related to attention, memory, and learning are impaired among people who use marijuana heavily, even after discontinuing its use for at least 24 hours. Researchers compared 65 heavy users, who had smoked marijuana a median of 29 of the past 30 days, and 64 light users, who had smoked a median of 1 of the past 30 days. After a closely monitored 19- to 24-hour period of abstinence from marijuana and other illicit drugs and alcohol, the undergraduates were given several standard tests measuring aspects of attention, memory, and learning.
Compared to the light users, heavy marijuana users made more errors and had more difficulty sustaining attention, shifting attention to meet the demands of changes in the environment, and in registering, processing, and using information. These findings suggest that the greater impairment among heavy users is likely due to an alteration of brain activity produced by marijuana.
Longitudinal research on marijuana use among young people below college age indicates those who used marijuana have lower achievement than the non-users, more acceptance of deviant behaviour, more delinquent behaviour and aggression, greater rebelliousness, poorer relationships with parents, and more associations with delinquent and drug-using friends.
Research also shows more anger and more regressive behaviour (thumb sucking, temper tantrums) in toddlers whose parents use marijuana than among the toddlers of non-using parents.
Effects on Pregnancy
Any drug of abuse can affect a mother's health during pregnancy, making it a time when expectant mothers should take special care of themselves. Drugs of abuse may interfere with proper nutrition and rest, which can affect good functioning of the immune system.
Some studies have found that babies born to mothers who used marijuana during pregnancy were smaller than those born to mothers who did not use the drug. In general, smaller babies are more likely to develop health problems.
A nursing mother who uses marijuana passes some of the THC to the baby in her breast milk. Research indicates that the use of marijuana by a mother during the first month of breast-feeding can impair the infant's motor development (control of muscle movement).
A drug is addicting if it causes compulsive, often uncontrollable drug craving, seeking, and use, even in the face of negative health and social consequences. Marijuana meets this criterion. More than 120,000 people enter treatment per year for their primary marijuana addiction. In addition, animal studies suggest marijuana causes physical dependence, and some people report withdrawal symptoms.
MDMA is a synthetic, psychoactive drug with both stimulant (amphetamine-like) and hallucinogenic (LSD-like) properties. Street names for MDMA include Ecstasy, Adam, XTC, hug, beans, and love drug.
Its chemical structure is similar to methamphetamine, methylenedioxyamphetamine (MDA), and mescaline - other synthetic drugs known to cause brain damage.
MDMA also is neurotoxic. In addition, in high doses it can cause a sharp increase in body temperature (malignant hyperthermia) leading to muscle breakdown and kidney and cardiovascular system failure.
Brain imaging research in humans indicates that MDMA causes injury to the brain, affecting neurons that use the chemical serotonin to communicate with other neurons. The serotonin system plays a direct role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain.
Many of the risks users face with MDMA use are similar to those found with the use of cocaine and amphetamines:
- Psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia - during and sometimes weeks after taking MDMA.
- Physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating.
- Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
Also, there is evidence that people who develop a rash that looks like acne after using MDMA may be risking severe side effects, including liver damage, if they continue to use the drug.
Research links MDMA use to long-term damage to those parts of the brain critical to thought and memory. One study, in primates, showed that exposure to MDMA for 4 days caused brain damage that was evident 6 to 7 years later.
MDA, the parent drug of MDMA, is an amphetamine-like drug that has also been abused and is similar in chemical structure to MDMA. Research shows that MDA also destroys serotonin-producing neurons in the brain.
MDMA also is related in its structure and effects to methamphetamine, which has been shown to cause degeneration of neurons containing the neurotransmitter dopamine. Damage to these neurons is the underlying cause of the motor disturbances seen in Parkinson's disease. Symptoms of this disease begin with lack of coordination and tremors and can eventually result in a form of paralysis.
Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater.
Both drugs have some medical uses, primarily in the treatment of obesity, but their therapeutic use is limited. Methamphetamine is made in illegal laboratories and has a high potential for abuse and dependence.
Street methamphetamine is referred to by many names, such as speed, meth, and chalk. Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as ice, crystal, and glass.
Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. It also appears to have a neurotoxic effect, damaging brain cells that contain dopamine and serotonin, another neurotransmitter. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson's disease, a severe movement disorder.
Methamphetamine is taken orally or intranasally (snorting the powder), by intravenous injection, and by smoking. Immediately after smoking or intravenous injection, the methamphetamine user experiences an intense sensation, called a rush or flash, that lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria - a high, but not a rush. Users may become addicted quickly, and use it with increasing frequency and in increasing doses.
Animal research going back more than 20 years shows that high doses of methamphetamine damage neuron cell-endings. Dopamine and serotonin-containing neurons do not die after methamphetamine use, but their nerve endings (terminals) are cut back and re-growth appears to be limited.
The central nervous system (CNS) actions that result from taking even small amounts of methamphetamine include increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, and euphoria. Other CNS effects include irritability, insomnia, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness. Hyperthermia and convulsions can result in death.
Methamphetamine causes increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes. Other effects of methamphetamine include respiratory problems, irregular heartbeat, and extreme anorexia. Its use can result in cardiovascular collapse and death.
Nicotine is one of the most heavily used addictive drugs in the United States. Cigarette smoking has been the most popular method of taking nicotine since the beginning of the 20th century.
In 1989, the U.S. Surgeon General issued a report that concluded that cigarettes and other forms of tobacco, such as cigars, pipe tobacco, and chewing tobacco, are addictive and that nicotine is the drug in tobacco that causes addiction. In addition, the report determined that smoking was a major cause of stroke and the third leading cause of death in the United States.
Nicotine is highly addictive. It is both a stimulant and a sedative to the central nervous system. The ingestion of nicotine results in an almost immediate kick because it causes a discharge of epinephrine from the adrenal cortex. This stimulates the central nervous system, and other endocrine glands, which causes a sudden release of glucose. Stimulation is then followed by depression and fatigue, leading the abuser to seek more nicotine. Nicotine is absorbed readily from tobacco smoke in the lungs, and it does not matter whether the tobacco smoke is from cigarettes, cigars, or pipes.
Nicotine also is absorbed readily when tobacco is chewed. With regular use of tobacco, levels of nicotine accumulate in the body during the day and persist overnight. Thus, daily smokers or chewers are exposed to the effects of nicotine for 24 hours each day. Nicotine taken in by cigarette or cigar smoking takes only seconds to reach the brain but has a direct effect on the body for up to 30 minutes.
Research has shown that stress and anxiety affect nicotine tolerance and dependence. The stress hormone corticosterone reduces the effects of nicotine; therefore, more nicotine must be consumed to achieve the same effect. This increases tolerance to nicotine and leads to increased dependence. Studies in animals have also shown that stress can directly cause relapse to nicotine self-administration after a period of abstinence.
Addiction to nicotine results in withdrawal symptoms when a person tries to stop smoking. For example, a study found that when chronic smokers were deprived of cigarettes for 24 hours, they had increased anger, hostility, and aggression, and loss of social cooperation. Persons suffering from withdrawal also take longer to regain emotional equilibrium following stress. During periods of abstinence and/or craving, smokers have shown impairment across a wide range of psychomotor and cognitive functions, such as language comprehension.
Adolescent smokeless tobacco users are more likely than nonusers to become cigarette smokers. Behavioural research is beginning to explain how social influences, such as observing adults or other peers smoking, affect whether adolescents begin to smoke cigarettes. Research has shown that teens are generally resistant to many kinds of anti-smoking messages.
In addition to nicotine, cigarette smoke is primarily composed of a dozen gases (mainly carbon monoxide) and tar. The tar in a cigarette, which varies from about 15 mg for a regular cigarette to 7 mg in a low-tar cigarette, exposes the user to a high expectancy rate of lung cancer, emphysema, and bronchial disorders. The carbon monoxide in the smoke increases the chance of cardiovascular diseases. The Environmental Protection Agency has concluded that second hand smoke causes lung cancer in adults and greatly increases the risk of respiratory illnesses in children and sudden infant death.
- Prescription Medications
Over $78 billion in prescription and over-the-counter (OTC) drugs are produced each year in the United States alone. Although most people use these medications properly, a significant number do not. They might take them without a doctor's prescription, use more than prescribed, or take them for reasons other than those that the drugs were prescribed for.
In 1998, the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Household Survey on Drug Abuse showed that over 20 million people over the age of 12 reported having used one or more psychotherapeutic drugs (stimulants, sedatives, tranquilizers, and analgesics available through prescription) for non-medical purposes at some time in their lives. Stimulants, analgesics, and tranquilizers were the most widely used drugs of abuse that fit this category.
Psychotherapeutic drugs are abused because they directly affect the brain and central nervous system (CNS), producing desired effects. 
What Are Some Of The Most Common Medications?
Amphetamines and caffeine
These are stimulants used primarily to delay the onset of mental and physical fatigue. Students studying long hours for exams, athletes who feel the drugs will improve their performance, and workers who want to stay awake on the job often use stimulants. These drug compounds are often found in diet pills which, if misused, can lead to anorexia nervosa. Anorexia nervosa is a pathological loss of appetite thought to be psychological in origin that is manifested in extreme dieting and excessive thinness. Caffeine is also found in many beverages, pain medications, and allergy and cold remedies.
Unusually high doses, or excessive use of stimulants over long periods of time can lead to anxiety, hallucinations, severe depression, or physical and psychological dependence. From a strong stimulant such as cocaine to nicotine in cigarettes and caffeine in coffee and cola drinks, stimulants are an intimate part of our lives.
Some of the most widely used analgesics, available in both prescription and over-the-counter forms, include:
- Aspirin - The most common analgesic used today to treat fever, arthritis and pain; possible side effects can include nausea, heartburn or development of bleeding ulcers. Aspirin prevents stomach upset. Reye's syndrome may develop if aspirin is given to children with the flu or chicken pox. This disease is characterized by vomiting, swelling of the brain and liver, difficulty with mental functioning, and can often lead to death. People with liver damage should also avoid using aspirin.
- Aceteminophen (Tylenol) - is used to treat aches, pains and fevers and is generally free from side effects. Large doses or overuse of this drug may cause rashes, fevers or changes in blood composition. People with kidney or liver problems should consult a doctor before using acetaminophen.
- Ibuprofen (Motrin, Advil, Nuprin) - is used to relieve pain associated with arthritis, menstrual cramping and discomfort, fever, and muscle strains. Possible side effects might include upset stomach, dizziness, drowsiness, headache, or ringing in the ears. Overuse of this drug may lead to confusion, tingling in hands and feet, and vomiting.
These are prescription medications used to treat depression, a disease affecting over 15 million Americans. Some of the original drugs of this group were Nardil, Tofranil and Elavil. Although not technically an antidepressant, lithium, which used to treat manic depression, is often in this group. The side effects of prolonged and excessive use of these drugs are excessive urination or thirst, diarrhoea, vomiting, drowsiness, dizziness or muscle weakness. Some newer antidepressants that show great promise in treating this disease are Wellbutrin, Prozac and Zoloft. The incidence of side effects with these seem to be less than with the previously used medications.
Sedative-Hypnotics and Tranquilizers
Benzodiazepines are the most widely prescribed tranquilizers and sleep-inducing medications. Drugs used to treat anxiety and tension are Valium, Xanax, Ativan, and Tranxene. Drugs used for sleeping are Dalamine, Restotril and Halcion. Possible side effects include drowsiness, poor coordination or light-headedness. Overuse of these drugs can lead to respiratory difficulties, sleeplessness, coma and even death.
They are less commonly prescribed medications used to treat anxiety and insomnia. Some examples are Seconal, Phenopbarbital and Nembutal. If improperly used, these drugs can cause an individual to feel depressed or experience respiratory difficulties.
Cough and Cold Preparations
Colds are caused by viruses and typically last 7 to 10 days. Most cold preparations are designed to treat specific cold symptoms and provide temporary relief from discomfort. Most widely used cold remedies include the following:
- Antihistamines and Decongestants - These medications are typically used to relieve the itchy, watery eyes and reduce congestion due to allergies, colds and flu. They can cause drowsiness or excitability.
- Antitussives and Expectorants - Antitussives are cough suppressants used to treat painful, persistent coughs. Expectorants are used to help clear mucous from the respiratory system. Both medications may contain alcohol and some may contain narcotics, such as codeine, to relieve pain and induce sleep. Some may be addictive. Young people may abuse these medications for the effects derived from alcohol use, as the alcohol content in some OTC preparations may be as high as 40 percent.
They are among the most widely misused and abused over the counter medications. Use of laxatives should be restricted to short term-use for constipation, since chronic use leads to dependency.
Misuse of prescription and OTC drugs can often lead to psychological and physical dependence. People use increased amounts of drugs to ensure a sense of well-being while treating unrelated illnesses or health problems, or for non-medical purposes.
Many medications contain alcohol and narcotics such as codeine, which can be addictive and life-threatening. Use of alcohol, a depressant, with some prescription and over-the-counter drugs may inhibit or increase the drug's effectiveness and cause a loss of coordination. Combining OTC drugs with some prescription drugs can cause the similar effects, or even more harmful types of reactions.
 Quoted from The National Clearinghouse for Alcohol and Drug Information.
For more information about drugs or prescription medications contact:
The National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
Anabolic-androgenic steroids are man-made substances related to male sex hormones. Anabolic refers to muscle-building, and androgenic refers to increased masculine characteristics. Steroids refers to the class of drugs.
These drugs are available legally only by prescription, to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence. They are also used to treat body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass. Abuse of anabolic steroids, however, can lead to serious health problems, some irreversible.
Today, athletes and others abuse anabolic steroids to enhance performance and also to improve physical appearance. Anabolic steroids are taken orally or injected, typically in cycles of weeks or months (referred to as cycling), rather than continuously. Cycling involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. In addition, users often combine several different types of steroids to maximize their effectiveness while minimizing negative effects (referred to as stacking).
The major side effects from abusing anabolic steroids can include liver tumours and cancer, jaundice (yellowish pigmentation of skin, tissues, and body fluids), fluid retention, high blood pressure, increases in LDL (bad cholesterol), and decreases in HDL (good cholesterol). Other side effects include kidney tumours, severe acne, and trembling.
In addition, there are some gender-specific side effects:
- For men: shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, and an increased risk of prostate cancer.
- For women: growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
- For adolescents: growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.
In addition, people who inject anabolic steroids run the added risk of contracting or transmitting HIV/AIDS or hepatitis, which causes serious damage to the liver.
Scientific research also shows that aggression and other psychiatric side effects may result from abuse of anabolic steroids. Many users report feeling good about themselves while on anabolic steroids, but researchers report that extreme mood swings also can occur, including manic-like symptoms leading to violence.
Depression often is seen when the drugs are stopped and may contribute to dependence on anabolic steroids. Researchers report also that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility. 
Research also indicates that some users might turn to other drugs to alleviate some of the negative effects of anabolic steroids. For example, a study of 227 men admitted in 1999 to a private US treatment centre for dependence on heroin or other opioids found that 9.3 percent had abused anabolic steroids before trying any other illicit drug. Of these 9.3 percent, 86 percent first used opioids to counteract insomnia and irritability resulting from the anabolic steroids. 
 The DAWN Report (2000), The Substance Abuse and Mental Health Services Administration (SAMHSA), USA.
The report is available online at www.samhsa.gov or by calling 1-800-729-6686.
 The information in this fact sheet is taken primarily from the June 2000 Highlights and Executive Summary, Epidemiologic Trends in Drug Abuse, a summary of the proceedings of the June 2000 meeting of NIDA's Community Epidemiology Work Group (CEWG).
CEWG is a NIDA-sponsored network of researchers from 21 major U.S. metropolitan areas and selected foreign countries who meet semi-annually to discuss the current epidemiology of drug abuse.