Hey!, Wanna See Some Sin?

"Cry aloud, spare not, lift up your voice like a trumpet and show my people their transgressions and . . . their sins." Isa. 58:1

3. The Chemical Sins: Substance Abuse

3b.1 Drugs:

Page 1

Definitions
How many people are doing drugs?
Drugs and their effects

Page 2

Details and Sources:
The risks of drug abuse
Teenagers and drugs
Driving under the influence of drugs
Drug deaths
Drug manufacturing
Why do people abuse drugs?
The cost of drug abuse
Is it sin?
Where to get help
For more information

Definitions:

What is a drug?

"Scientists define a drug as any substance, other than food, which is taken to change the way the body or the mind functions.

Drugs may or may not come from doctors or drug stores. They may or may not have medicinal properties or purposes. Drugs can come from plants growing wild in fields, or they can be manufactured in labs. They can be legal or illegal. They can be helpful or harmful.

By this definition penicillin is a drug and heroin is a drug. Even toothpastes that contain fluoride and deodorants that contain antiperspirants are drugs. So long as a substance changes the way the body or the mind functions in some way, then it is a drug.

Mood Drugs

Mood-altering drugs - also called psychoactive drugs - are drugs that can change or affect the way a person thinks, feels, or acts. These drugs usually have physical effects as well, but the thing that sets them apart from other drugs is that they work on the mind and the senses. The word "psychoactive" literally means working (active) on the mind or behaviour (psycho).

A large number of the drugs prescribed each year . . . are psychoactive. Some of these mood-altering drugs can be used to relieve pain, to calm nervousness, or to aid sleep. But not all psychoactive drugs are prescription drugs. Some, like nicotine and alcohol, can be purchased and used by almost anyone. Others, like cannabis and cocaine, are illegal street-drugs.

Because of their mood-altering properties, psychoactive drugs are the most abused of all drugs.

Invisible Psychoactive Drugs

Since we know that drugs are substances that affect the way the body works, and that psychoactive drugs are substances that specifically affect the senses and the mind, we can begin to see that some commonly used substances are actually psychoactive drugs - such as alcohol (a sedative), coffee (which contains caffeine, a stimulant), and tobacco (which contains nicotine, also a stimulant). These substances are so common, so taken for granted, that we often don't think of them as drugs at all. But they are. In fact, these `invisible' psychoactive drugs are among those which are most abused."
http://www.hc-sc.gc.ca/hppb/alcohol-otherdrugs/pube/straight/content.htm#Drug%20Abuse


What is "substance abuse"?

"substance abuse:1) excessive use of a drug (as alcohol, narcotics, or cocaine);
2) use of a drug without medical justification"
http://www.m-w.com/cgi-bin/dictionary

"Drug abuse is any use of a drug that causes a problem (apart from some undesirable but unavoidable side effects of certain medically used drugs).

Drug abuse can result in health problems like increased illness and physical damage to the body.
Drug abuse can result in personal problems such as loss of motivation, or addiction.
Drug abuse can result in group problems like strained and unhappy family relationships.
Drug abuse can result in social problems like increased crime, as well as economic problems and traffic accidents.

Sometimes even the use of a drug as prescribed by a medical practitioner can cause problems and lead to abuse.

Different Types of Drug Abuse

Drug abuse is not limited to the illicit drugs like heroin, cannabis, or cocaine. Any drug can be abused, intentionally or unintentionally.

Too Much: A drug can be abused if too much is taken. Some medicinal drugs can have a beneficial effect if taken in small doses. Other drugs, like alcohol, may not be harmful if taken in moderation. But taking too much of any drug at one time, or taking small doses too frequently, can cause problems. These can range from harmful or fatal overdoses to addiction.

Too Long: A drug can be abused if it's taken regularly for a long period of time. Some medicinal drugs, like pain killers, can cause serious problems if they are taken after they are no longer needed.

Wrong Use: A drug can be unintentionally abused if it's taken for the wrong reason or taken without following instructions. A drug prescribed to help one person get to sleep may be overly strong for someone else. Taking drugs without following warnings can also lead to serious problems, especially with drugs that can impair driving performance and drugs that shouldn't be mixed with alcohol.

Wrong Combination: A drug can be abused if it's taken in combination - knowingly or unknowingly - with certain other drugs. Some combinations can produce unwanted and unexpected effects. Other combinations, like barbiturates with alcohol, can cause death.

Wrong Drug: With a few drugs, like PCP (Angel Dust), the potential dangers are extremely high and there are no legitimate human uses. These drugs can cause serious problems no matter how or when they are taken. With such drugs there is no difference between use and abuse. To use them is to abuse them.

The drugs that are most often abused are psychoactive drugs. Aside from caffeine, the psychoactive drug most widely used and abused by both young people and adults is alcohol. Alcohol abuse is by far the most widespread form of drug abuse in our society, and the most costly and damaging. Excluding prescription drugs, nicotine is the second most often used psychoactive drug, followed by cannabis."
http://www.hc-sc.gc.ca/hppb/alcohol-otherdrugs/pube/straight/content.htm#Drug%20Abuse

Is "substance abuse" a sin?

drunkenness: 3178, Gk. methe - an intoxicant, i.e. (by impl.) intoxication: drunkenness.
Dict. - intoxicated; having one's mental and physical faculties impaired by excessive drinking.
Heb. 7302, raveh, sated with drink; drunkenness (Deu. 29:19-20).

Gal 5:21 Envyings, murders, drunkenness, revellings, and such like: of the which I tell you before, as I have also told you in time past, that they which do such things shall not inherit the kingdom of God.

Scripture condemns drunkenness as sin (Gal. 5:21; Rom. 13:11-14; Lk. 21:33-36; 1 Cor. 5:11-13).
-- Drunkenness is the impairment of one's mental and physical faculties. It is substance abuse.
-- The condemnation of drunkenness (and other sins) includes the phrase "and such like" (Gal. 5:21).
-- The use of illicit drugs or the abuse of any drug impairs one's mental and physical faculties.

Number of Americans Involved:

Americans, age 12 and over, who have ever used illicit drugs        86,900,000
(38.9% of total population)

Americans, 12 and over, who used illicit drugs in the year 2000     24,500,000    

Americans who used illicit drugs in previous year ('99-'00):
(http://www.drugwarfacts.org/druguse.htm)
                                                                    Marijuana            18,600,000
                                                                    Cocaine                 3,300,000
                                                                    Crack                       721,000
                                                                    Heroin                      308,000  
                  

Americans who are "current users" of illicit drugs:
(http://www.samhsa.gov/oas/NHSDA/2kNHSDA/chapter2.htm)
(http://www.usdoj.gov/dea/concern/marijuana.html)
(as of 2000) 
                                                                    Hallucinogens         1,000,000

                                                                    Marijuana             11,500,000

People who used marijuana on 100 or more days in 2000:              6,454,200
People who used marijuana on 300 or more days in 2000:              2,176,200
                                                                    

Americans using cocaine (at least once per month):                        1,700,000
http://www.drugwarfacts.org/cocaine.htm   (1998)

Americans who have used the drug "ecstasy" at least once in their lifetime:
                                                                                                 6,400,000

Americans who first used ecstasy during the past year:                   1,300,000

Americans ages 12 to 17 who have used inhalants:                         2,100,000

Eighth and tenth grade students using anabolic steroids:                     500,000 +
(1999)

People who drove while under the influence of an illicit drug in 2000:
                                                                                                 7,000,000

Americans, age 12 and over who abused prescription drugs:            9,000,000
(1999)

 

Drugs of abuse, and their effects:

Alcohol

"Alcohol is the most widely used and abused drug in the United States. Alcoholism is one of the most preventable illnesses. Alcohol is a central nervous system depressant that slows down body functions such as heart rate and respiration. Small quantities of alcohol may induce feelings of well-being and relaxation; but in larger amounts, alcohol can cause intoxication, sedation, unconsciousness, and even death. When consumed, alcohol goes to the stomach and passes through to the small intestine, where it is absorbed into the bloodstream. When the blood alcohol content (BAC) reaches .10, the legal limit in most states, the average drinker will experience blurred vision, slurred speech, poor muscle coordination, and a lack of rational judgment. A BAC of .40 to .50 will induce coma. Breathing is likely to stop with a BAC of .60. Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with the drug, use of the drug despite adverse consequences, and distortions in thinking, most notably denial. A drinker is physically dependent if withdrawal symptoms are experienced when alcohol use is discontinued abruptly. Symptoms vary but include delirium tremors ("DTs"), cramps, vomiting, elevated blood pressure, sweating, dilated pupils, sleep problems, irritability, and convulsions. Most of these symptoms will subside in two or three days, though irritability and insomnia may last two to three weeks. Psychological dependence occurs when the drinker becomes so preoccupied with alcohol that it is difficult to do without it. Short-term memory loss and blackouts are common among heavy drinkers. A blackout, which is an amnesia-like period often confused with passing out or losing consciousness, results when the drinker appears normal and may function normally; however, the person has no memory of what has taken place. Alcohol acts as an irritant of the gastrointestinal system and increases the hydrochloric acid production in the lining of the stomach. Alcohol also causes numerous liver disorders including fatty liver, alcoholic hepatitis, and cirrhosis of the liver. Alcohol is also associated with heart disease and reproduction and pregnancy problems."

http://www.cornerdrugstore.org/CommonDrugsPage.htm

See also: "3a. Drunkenness:"

"Alcohol abuse is a pattern of problem drinking that results in health consequences, social, problems, or both. However, alcohol dependence, or alcoholism, refers to a disease that is characterized by abnormal alcohol-seeking behavior that leads to impaired control over drinking.

Short-term effects of alcohol use include:
- distorted vision, hearing, and coordination
- altered perceptions and emotions
- impaired judgment
- bad breath; hangovers

Long-term effects of heavy alcohol use include:
- loss of appetite
- vitamin deficiencies
- stomach ailments
- skin problems
- sexual impotence
- liver damage
- heart and central nervous system damage
- memory loss"
http://www.health.org/govpubs/rpo884/


Amphetamines (see Stimulants)

"Amphetamines are drugs which speed up the way your body works. They make your heart work faster and they pump adrenaline into the system. Initially synthesized between the two world wars, they were used as a military drug to give soldiers more energy and increased alertness.

Medical use of amphetamines was common in the 50s and 60s when they were widely used to combat depression and cause weight loss. However, due to the side effects they fell out of favour and the majority of brands were removed from the market.

The most common type of Amphetamine on the street is a white powder called Amphetamine Sulphate. This is an illegally manufactured powder of varying strength, usually of between 6% and 10% purity . . . another form of speed known as 'base' is far stronger and is between 25% and 35% pure . . ."

" . . . in the U.S., methamphetamine is most commonly referred to as 'crank', 'meth', 'sh-t' (as in, Do you have any sh-t ?) or 'crystal'. It is smoked, sniffed ('snorted'), eaten, mixed into a liquid such as coffee and drank, or injected ('banged', 'shot', 'whapped'). The latter method is extremely addictive. Smoking it increases tolerance and addiction quicker, too. This method causes a 'rush' that results in people quickly increasing the amount and frequency needed to obtain the feeling."

"People have been known to cut product with poisonous substances, such as boric acid. The consequences of this type of cut should be obvious. Crank is often cut with cocaine, heroine, or crushed codeine tablets (referred to as 'speed balls'). This is done to increase the rush or 'buzz' of an inferior product, or done by the user himself. California crank, and sometimes other crank, directly from the manufacturer should be cut with some innocuous material, since it is concentrated enough to kill with as little as 1/4 gram or less, depending of course on the batch and individual user tolerance."
"The reason I am including all this info is because I feel that if someone is going to use crank, they should know what they are using. It has caused stroke, heart attack, suicide, murder, imprisonment, insanity,and death to a lot of people I care about, not to mention what it does to the people around them. I know that most junkies don't care what they are doing as long as they 'get off', others can't get a grip on their habit, many have mental and emotional problems that they can't deal with and thus use, some have tried to get clean and failed. I understand this all too well. I fight my addiction every day. I know a lot of people and I don't know anyone who isn't affected by addiction."
http://area51.upsu.plym.ac.uk/~harl/amphets.html

Analgesics (painkillers)

"Analgesics are medicines that help to control pain and reduce fever. Examples of analgesics that are available over the counter are: aspirin, acetaminophen, ibuprofen, ketoprofen and naproxen sodium. Some analgesics contain a combination of ingredients in one pill, such as aspirin, acetaminophen and caffeine.

These medicines are generally safe when taken as directed. However, their heavy or long-term use may harm the kidneys. Up to an estimated eight to ten percent of the new cases of chronic kidney failure each year may be caused by chronic overuse of these medicines. It is important to realize that, while helpful, these medicines are not completely without risk, and they should be used carefully. Kidney disease related to analgesics is preventable."
http://www.kidney.org/general/atoz/content/analgesics.html

Barbiturates

"A barbiturate is any depressant drug derived from barbituric acid. In low doses, barbiturates have a tranquilizing effect. Increased doses are hypnotic or sleep-inducing, and still larger doses act as anticonvulsants and anesthetics. Barbiturates were widely used as sleeping pills; such use may lead to psychological dependency, physiological tolerance, and even death by overdose. Barbiturates do not relieve pain."
http://www.addictions.org/drugad.htm

Some barbiturates are Amytal, Nembutal, Seconal, and Phenobarbital.

Caffeine

"Caffeine is an odorless, slightly bitter alkaloid found in coffee, tea, cola nuts, mate', and cocoa. In moderation, caffeine is a mild stimulant that increases urination and the heart rate and rhythm. Excessive intake can cause restlessness, insomnia, heart irregularities, and delirium."
http://www.addictions.org/drugad.htm


Club Drugs

"The term "club drugs" is a general term used for certain illicit substances, primarily synthetic, that are usually found at nightclubs, bars, and raves (all night dance parties). Substances that are often used as club drugs include, but are not limited to, MDMA (Ecstasy), GHB (gamma hydroxybutyrate), Rohypnol, Ketamine, and methamphetamine [Meth].

To some, club drugs seem harmless. In reality these substances can cause serious physical and psychological problems—even death. Often, the raves where these drugs are used are promoted as alcohol-free events, which gives parents a false sense of security that their children will be safe attending such parties. These parents are not aware that raves may actually be havens for the illicit sale and abuse of club drugs (Information Bulletin: Raves, 2001).
Because club drugs are illegal and are often produced in unsanitary laboratories, it is impossible for the user to know exactly what he or she is taking. The quality and potency of these substances can vary significantly from batch to batch.

Additionally, substitute drugs are sometimes sold in place of club drugs without the user’s knowledge. For example, PMA (paramethoxyamphetamine) has been used as a substitute for MDMA. When users take PMA thinking they are really ingesting MDMA, they often think they have taken weak ecstasy because PMA’s effects take longer to appear. They then ingest more of the substance to attain a better high, which can result in overdose death (The Hallucinogen PMA: Dancing with Death, 2000)."
http://www.ncjrs.org/club_drugs/club_drugs.html


Cocaine

"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 neuropsychologic 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."

Source: National Institute on Drug Abuse, Infofax: Cocaine No. 13546 (Rockville, MD: US Department of Health and Human Services), from the web at http://www.nida.nih.gov/Infofax/cocaine.html

"Because cocaine is very short acting, heavy users may inject it IV or smoke it in 10 to 15 min. This repetition produces toxic effects, such as tachycardia, hypertension, mydriasis, muscle twitching, sleeplessness, and extreme nervousness. If hallucinations, paranoid delusions, and aggressive behavior develop, the person may be dangerous. Pupils are maximally dilated, and the drug's sympathomimetic effect increases heart and respiration rates and BP."
"An overdose of cocaine may produce tremors, convulsions, and delirium. Death may occur due to arrhythmias and cardiovascular failure."

Source: "Cocaine Dependence", The Merck Manual of Diagnosis and Therapy, Section 15.Psychiatric Disorders, Chapter 195.Drug Use and Dependence, Merck & Co. Inc., from the web at http://www.merck.com/pubs/mmanual/section15/chapter195/195f.htm

"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, cocaethylene, that intensifies cocaine's euphoric effects, while possibly increasing the risk of sudden death."

Source: National Institute on Drug Abuse, Infofax: Cocaine No. 13546 (Rockville, MD: US Department of Health and Human Services), from the web at http://www.nida.nih.gov/Infofax/cocaine.html
http://www.drugwarfacts.org/cocaine.htm


Crack Cocaine

"Cocaine is a white powder that comes from the leaves of the South American coca plant. Cocaine is either "snorted" through the nasal passages or injected intravenously. Cocaine belongs to a class of drugs known as stimulants, which tend to give a temporary illusion of limitless power and energy that leave the user feeling depressed, edgy, and craving more. Crack is a smokable form of cocaine that has been chemically altered. Cocaine and crack are highly addictive. This addiction can erode physical and mental health and can become so strong that these drugs dominate all aspects of an addict's life.

Physical risks associated with using any amount of cocaine and crack:
- increases in blood pressure, heart rate, breathing rate, and body temperature
- heart attacks, strokes, and respiratory failure
- hepatitis or AIDS through shared needles
- brain seizures
- reduction of the body's ability to resist and combat infection

Psychological risks:
- violent, erratic, or paranoid behavior
- hallucinations and "coke bugs"--a sensation of imaginary insects crawling over the skin
- confusion, anxiety and depression, loss of interest in food or sex
- "cocaine psychosis"--losing touch with reality, loss of interest in friends, family, sports, hobbies, and other activities

Some users spend hundred or thousands of dollars on cocaine and crack each week and will do anything to support their habit. Many turn to drug selling, prostitution, or other crimes.

Cocaine and crack use has been a contributing factor in a number of drownings, car crashes, falls, burns, and suicides.

Cocaine and crack addicts often become unable to function sexually.

Even first time users may experience seizures or heart attacks, which can be fatal.
http://www.health.org/govpubs/rpo884/


Depressants

Depressants are drugs used medicinally to relieve anxiety, irritability and tension.
They have a high potential for abuse and development of tolerance.
They produce a state of intoxication similar to that of alcohol.
Combined with alcohol, they increase the effects and multiply the risks.

Amobarbital
Benzodiazepine
Chloral Hydrate
Chlordiazepoxide
Diazepam
Glutethimide
Meprobamate
Methaqualone
Nitrous Oxide
Pentobarbital
Secobarbital
Valium
Xanax

Possible Effects:
- Sensory alteration, anxiety reduction, intoxication.
- Small amounts cause calmness, relaxed muscles.
- Larger amounts cause slurred speech, impaired judgment, loss of motor coordination.
- Very large doses may cause respiratory depression, coma, death.
- Newborn babies of abusers may show dependence, withdrawal symptoms, behavioral problems, birth defects.

Symptoms of Overdose:
- Shallow respiration, clammy skin, dilated pupils.
- Weak and rapid pulse, coma, death.

Withdrawal Syndrome:
- Anxiety, insomnia, muscle tremors, loss of appetite.
- Abrupt cessation or reduced high dose may cause convulsions, delirium, death.

Indications of Possible Misuse:
- Behavior similar to alcohol intoxication (without odor of alcohol on breath).
- Staggering, stumbling, lack of coordination, slurred speech.
- Falling asleep while at work, difficulty concentrating.
- Dilated pupils.
http://www.health.org/govpubs/rpo926/#Hall

Designer Drugs (see Club Drugs)

"Designer Drugs", made to imitate certain illegal drugs, are often many times stronger than drugs they imitate.

Ecstasy, MDMA (a hallucinogen) (see Club Drugs)

"MDMA produces both amphetamine-like stimulation and mild mescaline-like hallucinations. It is touted as a "feel good" drug with an undeserved reputation of safety. MDMA produces euphoria, increased energy, increased sensual arousal, and enhanced tactile sensations. However, it also produces nerve cell damage that can result in psychiatric disturbances and long-term cognitive impairments. The user will often experience increased muscle tension, tremors, blurred vision, and hyperthermia. The increased body temperature can result in organ failure and death."
http://www.usdoj.gov/dea/concern/mdma/mdma.html


"MDMA can cause a user’s blood pressure and heart rate to increase to dangerous levels, and can lead to heart or kidney failure. It can cause severe hyperthermia from the combination of the drug’s stimulant effect with the often hot, crowded atmosphere of a rave.
MDMA users may also suffer from long-term brain injury. Research has shown that MDMA can cause damage to the parts of the brain that are critical to thought and memory (MDMA Fact Sheet, 2002)."
http://www.ncjrs.org/club_drugs/club_drugs.html

"Although ecstasy, or the more scientific term, methylenedioxymethamphetamine (MDMA), is only now just beginning to rear its ugly head in the popular media, it is not a new drug. In fact, its origin dates back to the early 1900s when MDMA was synthesized, developed and patented in Germany by the pharmaceutical company Merck. It does not appear that MDMA was developed with any specific purpose in mind, but came about as a by-product in the more routine drug development process. The drug remained somewhat dormant until the 1970s when it began being used by some psychotherapists who claimed that it enhanced communication in patient sessions. In the mid 1980s, MDMA emerged as a so-called "party" or "club" drug at raves or all night dance parties by some young adult populations."

". . . last week (June 13-16, 2000) researchers and public health officials from the 20 major U.S. metropolitan areas and the state of Texas that comprise the CEWG, reported that the use of MDMA is spreading beyond the more traditional rave setting. It is being used increasingly in both urban and suburban populations and is reportedly being combined with other drugs, such as LSD where it has been termed "rolling and trolling." Some cities, such as Boston, Minneapolis, St. Louis, Miami and Detroit, are reporting sharp increases in MDMA use among adolescents and young adults."
"Past year use of MDMA increased from 3.3 percent in 1998 to 4.4 percent in 1999 among tenth graders. Twelfth graders increased in all three categories [lifetime, past year and past month use]. Lifetime use increased from 5.8 percent in 1998 to 8.0 percent in 1999. Past year use rose from 3.6 percent in 1998 to 5.6 percent in 1999. There also appears to be an increase in the number of twelfth graders who are reporting that ecstasy is "fairly easy" or even "very easy" to get."

"What is most disturbing about these trends is the fact that MDMA is not a benign drug. In fact, all of the studies conducted to date in both animals and more recently in humans, confirm that club drugs, particularly MDMA, are not harmless "fun party drugs." While users of club drugs may think they're taking them simply for energy to keep on dancing or partying, research shows these drugs can have long-lasting negative effects on the brain that can alter memory function and motor skills.

Animal research has confirmed that MDMA shares the properties of both the hallucinogenic (LSD-like) and stimulant (amphetamine-like) drugs. Structurally, MDMA is similar to the stimulant methamphetamine and the hallucinogen mescaline. MDMA is typically taken orally, usually in capsule or tablet form, and its effects last three to six hours depending on the dosage, although confusion, depression, sleep problems, anxiety and paranoia have been reported to occur even weeks after the drug is taken. MDMA is also available in a powder and is sometimes snorted and occasionally smoked, but rarely injected.

MDMA can produce increases in heart rate, blood pressure and body temperature. And because its stimulant properties enable users to dance for extended periods, it can also lead to dehydration, hypertension, and heart or kidney failure. MDMA use can lead to long-lasting damage to serotonin-containing brain cells. In fact, through the use of modern imaging techniques, we now have direct evidence in humans to support the voluminous animal literature showing a decrease in a structural component of serotonergic or brain 5-HT neurons in human MDMA users."
"Serotonin is critical to normal experiences of mood, emotion, pain, and a wide variety of other behaviors."

". . . MDMA has the ability to impair one's cognitive abilities as well. . . . MDMA users who also occasionally used marijuana . . . were tested for attention, memory and learning, frontal lobe function and general intelligence. In general, MDMA users, had poorer performance results in three general intelligence tests, they also required more repetitions to learn a word than both the marijuana and the non-drug users, and when compared to the non-drug users had poorer short-term memory performance. The researchers concluded that MDMA use over a period of months or a few years may cause long-term impairment of cognitive performance even when MDMA is taken in relatively small doses."
http://www.drugabuse.gov/Testimony/7-25-00Testimony.html

In short, a little ecstasy destroys your brain and makes you dumber for a long time and maybe forever.

In 2000, it was estimated that two million tablets were smuggled into the United States every week.
http://www.usdoj.gov/dea/concern/mdma/mdma.html


Gamma Hydroxy Butyrate (GHB) (see Club Drugs)

"GHB and Rohypnol are central nervous system depressants that are often connected with drug-facilitated sexual assault, rape, and robbery. These drugs cause muscle relaxation, loss of consciousness, and an inability to remember what happened during the hours after ingesting the drug (Fact Sheet: Rohypnol, 1998)."
http://www.ncjrs.org/club_drugs/club_drugs.html

"Gamma hydroxybutyric acid (GHB) produces a wide range of central nervous system effects, including dose-dependent drowsiness, dizziness, nausea, amnesia, visual hallucinations, hypotension, brady-cardia, severe respiratory depression, and coma. The use of alcohol in combination with GHB greatly enhances its depressant effects. Overdose frequently requires emergency room care and many GHB-related fatalities have been reported.

GHB generates feelings of euphoria and intoxication. It is often combined in a carbonated, alcohol, or health food drink, and is reportedly popular among adolescents and young adults attending raves and nightclubs. At lower doses, GHB causes drowsiness, nausea, and visual disturbances. At higher dosages, unconsciousness, seizures, severe respiratory depression, and coma can occur.

GHB has been used in the commission of sexual assaults because it renders the victim incapable of resisting, and may cause memory problems that could complicate case prosecution. GHB recipes are accessible over the Internet; the drug is simple to manufacture, and can be made in a bathtub or even a Pyrex baking dish."
http://www.usdoj.gov/dea/concern/ghb.html


Hallucinogens

"Hallucinogenic drugs are substances that distort the perception of objective reality. The most well-known hallucinogens include phencyclidine, otherwise known as PCP, angel dust, or loveboat; lysergic acid diethylamide, commonly known as LSD or acid; mescaline and peyote; and psilocybin, or "magic" mushrooms. Under the influence of hallucinogens, the senses of direction, distance, and time become disoriented. These drugs can produce unpredictable, erratic, and violent behavior in users that sometimes leads to serious injuries and death. The effect of hallucinogens can last for 12 hours.

LSD produces tolerance, so that users who take the drug repeatedly must take higher and higher doses in order to achieve the same state of intoxication. This is extremely dangerous, given the unpredictability of the drug, and can result in increased risk of convulsions, coma, heart and lung failure, and even death.

Physical risks associated with using hallucinogens:
- increased heart rate and blood pressure
- sleeplessness and tremors
- lack of muscular coordination
- sparse, mangled, and incoherent speech
- decreased awareness of touch and pain that can result in self-inflicted injuries
- convulsions
- coma; heart and lung failure

Psychological risks associated with using hallucinogens:
- a sense of distance and estrangement
- depression, anxiety, and paranoia
- violent behavior
- confusion, suspicion, and loss of control
- flashbacks
- behavior similar to schizophrenic psychosis
- catatonic syndrome whereby the user becomes mute, lethargic, disoriented, and makes meaningless repetitive movements
Everyone reacts differently to hallucinogens--there's no way to predict if you can avoid a "bad trip.""
http://www.health.org/govpubs/rpo884/

Other hallucinogens include Ecstasy-PCE, Bufotenine, MDA, MDEA and MMDA.

Hallucinogenic drugs are an "alkaloid substance that alters consciousness; also called psychotomimetic, or, popularly, psychedelic or mind-expanding drug. Hallucinogens include mescaline, or peyote; psilocin and psilocybin, from the mushrooms Psilocybe mexicana and Stropharia cubensis; LSD (lysergic acid diethylamide); belladonna; and mandrake. Marijuana has hallucinogenic properties but is pharmacologically distinct. Hallucinogens have been used by primitive societies in both the Old and New Worlds to facilitate meditation, cure illness, placate evil spirits, and enhance mystical and magical powers. They produce a wide range of effects, from pleasant to very disturbing, depending on dosage, potency, and the personality and environment of the drug taker. Effects include altered perception of time and space and of the color, detail, and size of objects; also the experience of imaginary conversations, music, odors, tastes, and other sensations. Hallucinogens are not physically habit-forming, but tolerance, i.e., the need to take increased quantities to induce the original effect, may develop."
http://www.addictions.org/drugad.htm


Heroin/Morphine (see opiates/narcotics)

"Acute intoxication (overdose) with opioids is characterized by euphoria, flushing, itching of the skin (particularly with morphine), miosis, drowsiness, decreased respiratory rate and depth, hypotension, bradycardia, and decreased body temperature."

"Many complications of heroin addiction are related to the unsanitary administration of the drug. Others are due to the inherent properties of the drug, overdose, or intoxicated behavior accompanying drug use. Common complications include pulmonary disorders, hepatitis, arthritic disorders, immunologic changes, and neurologic disorders."

Source: "Opioid Dependence", The Merck Manual of Diagnosis and Therapy, Section 15.Psychiatric Disorders, Chapter 195.Drug Use and Dependence, Merck & Co. Inc., from the web at http://www.merck.com/pubs/mmanual/section15/chapter195/195c.htm last accessed December 5, 2000.

"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."

Source: National Institute on Drug Abuse, Infofax on Heroin No. 13548 (Rockville, MD: US Department of Health and Human Services), from the web at http://www.nida.nih.gov/Infofax/heroin.html last accessed November 16, 2000.

"A striking finding from the toxicological data was the relatively small number of subjects in whom morphine only was detected. Most died with more drugs than heroin alone 'on board', with alcohol detected in 45% of subjects and benzodiazepines in just over a quarter. Both of these drugs act as central nervous system depressants and can enhance and prolong the depressant effects of heroin."

Source: Zador, Deborah, Sunjic, Sandra, and Darke, Shane, "Heroin-related deaths in New South Wales, 1992: toxicological findings and circumstances," The Medical Journal of Australia, published on the web at http://www.mja.com.au/public/issues/feb19/zador/zador.html last accessed on November 17, 2000.

http://www.drugwarfacts.org/heroin.htm


Inhalants

"Inhalants refer to substances that are sniffed or huffed to give the user an immediate head rush or high. They include a diverse group of chemicals that are found in consumer products such as aerosols and cleaning solvents. Inhalant use can cause a number of physical and emotional problems, and even one-time use can result in death.

Using inhalants even one time can put you at risk for:
- sudden death
- suffocation
- visual hallucinations and severe mood swings
- numbness and tingling of the hands and feet

Prolonged use can result in:
- headache, muscle weakness, abdominal pain
- decrease or loss of sense of smell
- nausea and nosebleeds
- hepatitis
- violent behaviors
- irregular heartbeat
- liver, lung, and kidney impairment
- irreversible brain damage
- nervous system damage
- dangerous chemical imbalances in the body
- involuntary passing of urine and feces

Short-term effects of inhalants include:
- heart palpitations
- breathing difficulty
- dizziness
- headaches

Remember, using inhalants, even one time, can kill you. According to medical experts, death can occur in at least five ways:
- asphyxia--solvent gases can significantly limit available oxygen in the air, causing breathing to stop;
- suffocation--typically seen with inhalant users who use bags;
- choking on vomit;
- careless behaviors in potentially dangerous settings; and
- sudden sniffing death syndrome, presumably from cardiac arrest.'
http://www.health.org/govpubs/rpo884/

Substances used for "sniffing" include butyl nitrite, amyl nitrite (the gas in aerosol cans),
gasoline and toluene vapors (correction fluid, glue, marking pens), solvents (paint thinners, glues), gases (butane, propane, aerosol propellants, nitrous oxide), nitrites (isoamyl, isobutyl, cyclohexyl); and laughing gas.

"Inhalants are a diverse group of substances that include volatile solvents, gases, and nitrites that are sniffed, snorted, huffed, or bagged to produce intoxicating effects similar to alcohol. These substances are found in common household products like glues, lighter fluid, cleaning fluids, and paint products. Inhalant abuse is the deliberate inhaling or sniffing of these substances to get high, and it is estimated that about 1,000 substances are misused in this manner. The easy accessibility, low cost, legal status, and ease of transport and concealment make inhalants one of the first substances abused by children. Survey data indicates that about 15 to 20 percent of junior and senior high school students have tried inhalants with about 2 to 6 percent reporting current use. The highest incidence of use is among 10 to 12 year old children with rates of use declining with age. Parents worry about alcohol, tobacco, and drug use but may be unaware of the hazards associated with products found throughout their homes. Knowing what these products are, how they might be harmful, and recognizing the signs and symptoms of their use as inhalants, can help a parent prevent inhalant abuse.

Volatile solvents are found in a number of everyday products. Some of these products include nail polish remover, lighter fluid, gasoline, paint and paint thinner, rubber glue, waxes, and varnishes. Chemicals found in these products include toluene, benzene, methanol, methylene chloride, acetone, methyl ethyl ketone, methyl butyl ketone, trichhloroethylene, and trichlorethane. The gas used as a propellant in canned whipped cream and in small lavender metallic containers called "whippets" (used to make whipped cream) is nitrous oxide or "laughing gas"--the same gas used by dentists for anesthesia. Tiny cloth-covered ampules called poppers or snappers by abusers contain amyl nitrite, a medication used to dilate blood vessels. Butyl nitrite, sold as tape head cleaner and referred to as "rush," "locker room," or "climax," is often sniffed or huffed to get high.

Inhalants may be sniffed directly from an open container or huffed from a rag soaked in the substance and held to the face. Alternatively, the open container or soaked rag can be placed in a bag where the vapors can concentrate before being inhaled. Some chemicals are painted on the hands or fingernails or placed on shirt sleeves or wrist bands to enable an abuser to continually inhale the fumes without being detected by a teacher or other adult. Although inhalant abusers may prefer one particular substance because of taste or odor, a variety of substances may be used because of similar effects, availability, and cost. Once inhaled, the extensive capillary surface of the lungs allows rapid absorption of the substance and blood levels peak rapidly. Entry into the brain is fast and the intoxicating effects are intense but short lived.

Inhalants depress the central nervous system, producing decreased respiration and blood pressure. Users report distortion in perceptions of time and space. Many users experience headaches, nausea, slurred speech, and loss of motor coordination. Mental effects may include fear, anxiety, or depression. A rash around the nose and mouth may be seen, and the abuser may start wheezing. An odor of paint or organic solvents on clothes, skin, and breath is sometimes a sign of inhalant abuse. Other indicators of inhalant abuse include slurred speech or staggering gait, red, glassy, watery eyes, and excitability or unpredictable behavior.

The chronic use of inhalants has been associated with a number of serious health problems. Glue and paint thinner sniffing produce kidney abnormalities while the solvents toluene and trichloroethylene cause liver damage. Memory impairment, attention deficits, and diminished non-verbal intelligence have been related to the abuse of inhalants. Deaths resulting from heart failure, asphyxiation, or aspiration have occurred."
http://www.usdoj.gov/dea/concern/inhalants.html

Inhalants also refers to illicit drugs which are taken by inhalation such as Opium, Heroin, Dilaudid, Methadone.


Ketamine (see Club Drugs)

"Ketamine is an animal anesthetic that, when used by humans, can cause impaired motor function, high blood pressure, amnesia, seizures, and respiratory depression (An Overview of Club Drugs, 2000)."
http://www.ncjrs.org/club_drugs/club_drugs.html

"Ketamine is a rapidly acting general anesthetic. Its pharmacological profile is essentially the same as phencyclidine. Like PCP, ketamine is referred to as a dissociative anesthetic because patients feel detached or disconnected from their pain and environment when anesthetized with this drug. Unlike most anesthetics, ketamine produces only mild respiratory depression and appears to stimulate, not depress, the cardiovascular system. In addition, ketamine has both analgesic and amnesic properties and is associated with less confusion, irrationality, and violent behavior than PCP. Use of ketamine as a general anesthetic for humans has been limited due to adverse effects including delirium and hallucinations. Today, it is primarily used in veterinary medicine, but has some utility for emergency surgery in humans.

Although ketamine has been marketed in the United States for many years, it was only recently associated with significant diversion and abuse and placed in Schedule III of the CSA in 1999. Known in the drug culture as "Special K" or "Super K," ketamine has become a staple at dance parties or "raves." Ketamine is supplied to the illicit market by the diversion of legitimate pharmaceuticals (Ketaset®, Ketalar®). It is usually distributed as a powder obtained by removing the liquid from the pharmaceutical products. As a drug of abuse, ketamine can be administered orally, snorted, or injected. It is also sprinkled on marijuana or tobacco and smoked. After oral or intranasal administration, effects are evident in about 10 to 15 minutes and are over in about an hour.

After intravenous use, effects begin almost immediately and reach peak effects within minutes. Ketamine can act as a depressant or a psychedelic. Low doses produce vertigo, ataxia, slurred speech, slow reaction time, and euphoria. Intermediate doses produce disorganized thinking, altered body image, and a feeling of unreality with vivid visual hallucinations. High doses produce analgesia, amnesia, and coma."
http://www.usdoj.gov/dea/concern/ketamine.html


Lysergic Acid Diethylamide (LSD) (See Hallucinogens)

"Lysergic acid diethylamide (LSD) is the most potent hallucinogen known to science, as well as the most highly studied. LSD was originally synthesized in 1938 by Dr. Albert Hoffman. However, its hallucinogenic effects were unknown until 1943 when Hoffman accidentally consumed some LSD. It was later found that an oral dose of as little as 0.000025 grams (or 25 micrograms, equal in weight to a few grains of salt) is capable of producing rich and vivid hallucinations. LSD was popularized in the 1960s by individuals like Timothy Leary who encouraged American students to "turn on, tune in, and drop out." LSD use has varied over the years but it still remains a significant drug of abuse. In 1999, over 12 percent of high school seniors and college students reported that they had used LSD at least once in their lifetime.

Because of its structural similarity to a chemical present in the brain and its similarity in effects to certain aspects of psychosis, LSD was used as a research tool to study mental illness. The average effective oral dose is from 20 to 80 micrograms with the effects of higher doses lasting for 10 to 12 hours. LSD is usually sold in the form of impregnated paper (blotter acid), typically imprinted with colorful graphic designs. It has also been encountered in tablets (microdots), thin squares of gelatin (window panes), in sugar cubes and, rarely, in liquid form.

Physical reactions may include dilated pupils, lowered body temperature, nausea, "goose bumps," profuse perspiration, increased blood sugar, and rapid heart rate. During the first hour after ingestion, the user may experience visual changes with extreme changes in mood. In the hallucinatory state, the user may suffer impaired depth and time perception, accompanied by distorted perception of the size and shape of objects, movements, color; sound, touch, and the users own body image. During this period, the users' ability to perceive objects through the senses is distorted: they may describe "hearing colors" and "seeing sounds." The ability to make sensible judgments and see common dangers is impaired, making the user susceptible to personal injury. After an LSD "trip," the user may suffer acute anxiety or depression for a variable period of time. Flashbacks have been reported days or even months after taking the last dose."
http://www.usdoj.gov/dea/concern/lsd.html


Marijuana

Cannabis (marijuana), Tetrahydrocannabinol, hashish and hashish oil are produced from the hemp plant.

"Euphoria followed by relaxation; loss of appetite; impaired memory, concentration, knowledge retention; loss of coordination; more vivid sense of taste, sight, smell, hearing; stronger doses cause fluctuating emotions, fragmentary thoughts, disoriented behavior, psychosis; may cause irritation to lungs, respiratory system; may cause cancer"

"Symptoms of Overdose: Fatigue, lack of coordination, paranoia, psychosis.

Withdrawal Syndrome: Insomnia, hyperactivity, sometimes decreased appetite.

Indications of Possible Misuse:
- Animated behavior, loud talking, followed by sleepiness
- Dilated pupils, bloodshot eyes
- Distortions in perception; hallucinations
- Distortions in depth and time perception; loss of coordination"
http://www.health.org/govpubs/rpo926/#Hall

"Although marijuana grown in the United States was once considered inferior because of a low concentration of THC, advancements in plant selection and cultivation have resulted in highly potent domestic marijuana. In 1974, the average THC content of illicit marijuana was less than one percent; in 1999, potency averaged 7.03 percent. The THC of today's sinsemilla averages 13.65 and ranges as high as 30 percent."

"The form of marijuana known as sinsemilla (Spanish, sin semilla: without seed), derived from the unpollinated female cannabis plant, is preferred for its high THC content."

"Marijuana is usually smoked in the form of loosely rolled cigarettes called joints, or hollowed out commercial cigars called blunts. Joints and blunts may be laced with a number of adulterants including phencyclidine (PCP), substantially altering the effects and toxicity of these products."

["Manufacturers of small cigars called "blunts" also wink at the practice of users removing part of the tobacco from their products and filling the cigars with marijuana, even to the extent of making [drug culture] clothing and paraphernalia with the brand names of the cigars." http://www.drugs.indiana.edu/publications/iprc/factline/cigar.html]

Marijuana contains known toxins and cancer-causing chemicals. Marijuana users experience the same health problems as tobacco smokers, such as bronchitis, emphysema, and bronchial asthma. Some of the effects of marijuana use also include increased heart rate, dryness of the mouth, reddening of the eyes, impaired motor skills and concentration, and frequently hunger and an increased desire for sweets. Extended use increases risk to the lungs and reproductive system, as well as suppression of the immune system. Occasionally, hallucinations, fantasies, and paranoia are reported. Long-term chronic marijuana use is associated with an Amotivational Syndrome characterized by apathy; impairment of judgment memory and concentration; and loss of interest in personal appearance and the pursuit of conventional goals."
http://www.usdoj.gov/dea/concern/marijuana.html


Methadone

"A synthetic narcotic, similar in effect to morphine, used primarily in the treatment of narcotic drug addiction. Given to addicts, it blocks the euphoric action of heroin without itself causing euphoria and causes less severe and hazardous withdrawal symptoms than other narcotic drugs (although critics of methadone therapy point out that methadone patients are still addicts). Methadone is also used as an analgesic, especially in patients who are terminally ill."
http://www.addictions.org/drugad.htm


Methamphetamines (Meth, Crystal, Ice, Crank, Speed, Glass) (see Club Drugs, Stimulants)

"Methamphetamine: A potent high that kills your brain cells....

To understand how methamphetamine works on the brain is to understand a cruel joke.

At low doses the drug can block hunger, focus attention, steady the heart and boost endurance. That's why virtually every major military power this century has tried giving methamphetamine or amphetamines to its soldiers in battle. But try to tell a battle-weary soldier not to take too much of a good thing. They ended up with troops confused, making bad decisions and going psychotic.

Every day there are desperate people making the same mistake: smoking, snorting and injecting high doses of a drug that briefly makes the body feel good, but kills the the brain along the way. Users of the drug can become walking zombies. They often have paranoid fantasies that are fueled by days without sleep and/or food, only craving for more of the drug.

Methamphetamine works like this: it sends a message to brain cells to fire more dopamine, a feel-good chemical that is also critical to normal brain functioning. Hours after it's ingested, cell receptors begin to turn off to slow the flow of dopamine, and here's where methamphetamine differs from other stimulants, such as cocaine. While other stimulants allow brain cells to capture and repackage the dopamine, methamphetamine doesn't. The brain cells respond by releasing an enzyme to knock out the extra dopamine. With repeated use, those enzymes eventually kill the dopamine cell, and that leads to a chemical change in the way your brain works.

Ever heard of Parkinson's Disease? That's what you look like.You lose things like motivation, you become apathetic. You eventually lose interest in pleasurable things ... If you liked to go fishing, well, fishing just doesn't excite you anymore."

This methampetamine-induced brain damage has been proven in animals, but no humans have ever been tested because it would require dissection of the brain. As the drug's doing its damage, the brain begins to crave more as it becomes better at shutting off its effects. It's kind of like listening to loud music. After a while, it doesn't seem so loud. You need a lot more of the drug to maintain the high.

Abusers follow a classic pattern of consuming more and more of the drug before something happens like a car accident, arrest or family fight that scares them into quitting, but it doesn't last. Most addicts don't constantly use. It's not the fact that you can't quit. It's the fact that you can't stay quit ... You get back into it and it's off to the races.

Doctors aren't sure why, but one-third of heavy users will develop bizarre, paranoid behavior and suffer hallucinations and voices in the mind that are as real as real gets.

Individuals who seek treatment have a rough time kicking the drug, and can still suffer from psychosis for up to a half-year. Cravings, irritability, nightmares and depression are also common for months after someone goes cold turkey. The cravings eventually wane but sometimes the damage is irreparable but won't show for years."
http://geocities.datacellar.net/beyondbadge/drugs/Mlabs.htm


"Methamphetamine is a stimulant drug chemically related to amphetamine but with stronger effects on the central nervous system.

Methamphetamine is used in pill form, or in powdered form by snorting or injecting. Crystallized methamphetamine known as "ice," "crystal," or "glass," is a smokable and more powerful form of the drug.

The effects of methamphetamine use include:
- increased heart rate and blood pressure
- increased wakefulness; insomnia
- increased physical activity
- decreased appetite
- respiratory problems
- extreme anorexia
- hypothermia, convulsions, and cardiovascular problems, which can lead to death
- euphoria
- irritability, confusion, tremors
- anxiety, paranoia, or violent behavior
- can cause irreversible damage to blood vessels in the brain, producing strokes

Methamphetamine users who inject the drug and share needles are at risk for acquiring HIV/AIDS.

Methamphetamine is an increasingly popular drug at raves (all night dancing parties), and as part of a number of drugs used by college-aged students. Marijuana and alcohol are commonly listed as additional drugs of abuse among methamphetamine treatment admissions. Most of the methamphetamine-related deaths (92%) reported in 1994 involved methamphetamine in combination with at least one other drug, most often alcohol (30%), heroin (23%), or cocaine (21%). Researchers continue to study the long-term effects of methamphetamine use."
http://www.health.org/govpubs/rpo884/


Nitrous Oxide (see Depressants)

Laughing gas (see Inhalants)

Mushrooms and Toads (Psilocybin & Psilocyn and other Tryptamines))

"A number of Schedule I hallucinogenic substances are classified chemically as tryptamines. Most of these are found in nature but many, if not all, can be produced synthetically. Psilocybin (O-phosphoryl-4-hydroxy-N, N-ethyltryptamine) and psilocyn (4-hydroxy-N, N-dimethyltryptamine) are obtained from certain mushrooms indigenous to tropical and subtropical regions of South America, Mexico, and the United States. As pure chemicals at doses of 10 to 20 mg, these hallucinogens produce muscle relaxation, dilation of pupils, vivid visual and auditory distortions, and emotional disturbances. However, the effects produced by consuming preparations of dried or brewed mushrooms are far less predictable and largely depend on the particular mushrooms used and the age and preservation of the extract. There are many species of "magic" mushrooms that contain varying amounts of these tryptamines, as well as uncertain amounts of other chemicals. As a consequence, the hallucinogenic activity, as well as the extent of toxicity produced by various plant samples, are often unknown.

Dimethyltryptamin (DMT) has a long history of use and is found in a variety of plants and seeds. It can also be produced synthetically. It is ineffective when taken orally, unless combined with another drug that inhibits its metabolism. Generally it is sniffed, smoked, or injected. The effective hallucinogenic dose in humans is about 50 to 100 mg and lasts for about 45 to 60 minutes. Because the effects last only about an hour; the experience has been referred to as a "businessmans trip."

A number of other hallucinogens have very similar structures and properties to those of DMT. Diethyltryptamine (DET), for example, is an analogue of DMT and produces the same pharmacological effects but is somewhat less potent than DMT. Alpha-ethyltryptamine (AET) is another tryptamine hallucinogen added to the list of Schedule I hallucinogens in 1994. Bufotenine (5-hydroxy-N-N-dimethyltryptamine) is a Schedule I substance found in certain mushrooms, seeds, and skin glands of Bufo toads. In general, most bufotenine preparations from natural sources are extremely toxic. N,N-Diisopropyl-5-methoxytryptamine (referred to as Foxy-Methoxy) is an orally active tryptamine recently encountered in the United States."
http://www.usdoj.gov/dea/concern/psilocybin.html


Opiates/Narcotics

Drugs used medicinally to relieve pain
High potential for abuse
Cause relaxation with an immediate "rush"
Initial unpleasant effects - restlessness, nausea

Alfentanil
Cocaine
Codeine
Dilaudid
Fentanyl
Heroin
Hydromorphone
Meperidine
Methadone
Morphine
Nalorphine
Opium
Oxycodone
Propoxyphene

Possible Effects:
- Euphoria
- Drowsiness, respiratory depression
- Constricted (pin-point) pupils

Symptoms of Overdose:
- Slow, shallow breathing, clammy skin
- Convulsions, coma, possible death

Withdrawal Syndrome:
- Watery eyes, runny nose, yawning, cramps
- Loss of appetite, irritability, nausea
- Tremors, panic, chills, sweating

Indications of Possible Misuse:
- Scars (tracks) caused by injections
- Constricted (pin-point) pupils
- Loss of appetite
- Sniffles, watery eyes, cough, nausea
- Lethargy, drowsiness, nodding
- Syringes, bent spoons, needles, etc.
http://www.health.org/govpubs/rpo926/#Hall

Opium

"There were no legal restrictions on the importation or use of opium until the early 1900s. In the United States, the unrestricted availability of opium, the influx of opium-smoking immigrants from East Asia, and the invention of the hypodermic needle contributed to the more severe variety of compulsive drug abuse seen at the turn of the 20th century. In those days, medicines often contained opium without any warning label. Today, there are state, federal, and international laws governing the production and distribution of narcotic substances.

Although opium is used in the form of paragoric to treat diarrhea, most opium imported into the United States is broken down into its alkaloid constituents. These alkaloids are divided into two distinct chemical classes, phenanthrenes and isoquinolines. The principal phenanthrenes are morphine, codeine, and thebaine, while the isoquinolines have no significant central nervous system effects and are not regulated under the CSA."
http://www.usdoj.gov/dea/concern/opium.html

Peyote & Mescaline

"Peyote is a small, spineless cactus, Lophophora williamsii, whose principal active ingredient is the hallucinogen mescaline (3, 4, 5-trimethoxyphenethylamine). From earliest recorded time, peyote has been used by natives in northern Mexico and the southwestern United States as a part of their religious rites.

The top of the cactus above ground--also referred to as the crown--consists of disc-shaped buttons that are cut from the roots and dried. These buttons are generally chewed or soaked in water to produce an intoxicating liquid. The hallucinogenic dose of mescaline is about 0.3 to 0.5 grams and lasts about 12 hours. While peyote produced rich visual hallucinations that were important to the native peyote cults, the full spectrum of effects served as a chemically induced model of mental illness. Mescaline can be extracted from peyote or produced synthetically. Both peyote and mescaline are listed in the CSA as Schedule I hallucinogens."
http://www.usdoj.gov/dea/concern/peyote.html


Phencyclidine (PCP) (see hallucinogens)

"In the 1950s, phencyclidine was investigated as an anesthetic but, due to the side effects of confusion and delirium, its development for human use was discontinued. It became commercially available for use as a veterinary anesthetic in the 1960s under the trade name of Sernylan® and was placed in Schedule III of the CSA. In 1978, due to considerable abuse, phencyclidine was transferred to Schedule II of the CSA and manufacturing of Sernylan® was discontinued. Today, virtually all of the phencyclidine encountered on the illicit market in the United States is produced in clandestine laboratories.

Phencyclidine, more commonly known as PCP, is illicitly marketed under a number of other names, including Angel Dust, Supergrass, Killer Weed, Embalming Fluid, and Rocket Fuel, reflecting the range of its bizarre and volatile effects. In its pure form, it is a white crystalline powder that readily dissolves in water. However, most PCP on the illicit market contains a number of contaminants as a result of makeshift manufacturing, causing the color to range from tan to brown, and the consistency from powder to a gummy mass. Although sold in tablets and capsules as well as in powder and liquid form, it is commonly applied to a leafy material, such as parsley, mint, oregano, or marijuana, and smoked.

The drug's effects are as varied as its appearance. A moderate amount of PCP often causes the user to feel detached, distant, and estranged from his surroundings. Numbness, slurred speech, and loss of coordination may be accompanied by a sense of strength and invulnerability. A blank stare, rapid and involuntary eye movements, and an exaggerated gait are among the more observable effects. Auditory hallucinations, image distortion, severe mood disorders, and amnesia may also occur. In some users, PCP may cause acute anxiety and a feeling of impending doom; in others, paranoia and violent hostility; and in some, it may produce a psychosis indistinguishable from schizophrenia. PCP use is associated with a number of risks, and many believe it to be one of the most dangerous drugs of abuse."
http://www.usdoj.gov/dea/concern/pcp.html


Prescription Drugs

" . . . the nonmedical use or abuse of prescription drugs remains a serious public health concern. Certain prescription drugs - opioids, central nervous system (CNS) depressants, and stimulants - when abused, can alter the brain's activity and lead to dependence and possibly addiction."

"Chronic use of opioids can result in tolerance for the drugs, which means that users must take higher doses to achieve the same initial effects. Long-term use also can lead to physical dependence and addiction - the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements. Finally, taking a large single dose of an opioid could cause severe respiratory depression that can lead to death. Many studies have shown, however, that properly managed medical use of opioid analgesic drugs is safe and rarely causes clinical addiction, defined as compulsive, often uncontrollable use of drugs. Taken exactly as prescribed, opioids can be used to manage pain effectively."

"Despite their many beneficial effects, barbiturates and benzodiazepines have the potential for abuse and should be used only as prescribed. During the first few days of taking a prescribed CNS depressant, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug, these feelings begin to disappear. If one uses these drugs long term, the body will develop tolerance for the drugs, and larger doses will be needed to achieve the same initial effects. In addition, continued use can lead to physical dependence and - when use is reduced or stopped - withdrawal. Because all CNS depressants work by slowing the brain's activity, when an individual stops taking them, the brain's activity can rebound and race out of control, possibly leading to seizures and other harmful consequences. Although withdrawal from benzodiazepines can be problematic, it is rarely life threatening, whereas withdrawal from prolonged use of other CNS depressants can have life-threatening complications. Therefore, someone who is thinking about discontinuing CNS depressant therapy or who is suffering withdrawal from a CNS depressant should speak with a physician or seek medical treatment."

"The consequences of stimulant abuse can be dangerous. Although their use may not lead to physical dependence and risk of withdrawal, stimulants can be addictive in that individuals begin to use them compulsively. Taking high doses of some stimulants repeatedly over a short time can lead to feelings of hostility or paranoia. Additionally, taking high doses of a stimulant may result in dangerously high body temperatures and an irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures."

"Older adults

The misuse of prescription drugs may be the most common form of drug abuse among the elderly. Elderly persons use prescription medications approximately three times as frequently as the general population and have been found to have the poorest rates of compliance with directions for taking a medication. In addition, data from the Veterans Affairs Hospital System suggest that elderly patients may be prescribed inappropriately high doses of medications such as benzodiazepines and may be prescribed these medications for longer periods than are younger adults. In general, older people should be prescribed lower doses of medications, because the body's ability to metabolize many medications decreases with age.

An association between age-related morbidity and abuse of prescription medications likely exists. For example, elderly persons who take benzodiazepines are at increased risk for falls that cause hip and thigh fractures, as well as for vehicle accidents. Cognitive impairment also is associated with benzodiazepine use, although memory impairment may be reversible when the drug is discontinued. Finally, use of benzodiazepines for longer than 4 months is not recommended for elderly patients because of the possibility of physical dependence.

Source: Office of Applied Studies, Substance Abuse and Mental Health Services Administration.
National Household Survey on Drug Abuse, 1999.

Adolescents and young adults

Data from the National Household Survey on Drug Abuse indicate that the most dramatic increase in new users of prescription drugs for nonmedical purposes occurs in 12- to 17-year-olds and 18- to 25-year-olds. In addition, 12- to 14-year-olds reported psychotherapeutics (for example, painkillers or stimulants) as one of two primary drugs used. The 1999 Monitoring the Future survey showed that for barbiturates, tranquilizers, and narcotics other than heroin, the general, long-term declines in use among young adults in the 1980s leveled off in the early 1990s, with modest increases again in the mid- to late 1990s. For example, the use of methylphenidate (Ritalin) among high school seniors increased from an annual prevalence (use of the drug within the preceding year) of 0.1 percent in 1992 to an annual prevalence of 2.8 percent in 1997 before reaching a plateau.

It also appears that college students' nonmedical use of pain relievers such as oxycodone with aspirin (Percodan) and hydrocodone (Vicodin) is on the rise. The 1999 Drug Abuse Warning Network, which collects data on drug-related episodes in hospital emergency departments, reported that mentions of hydrocodone as a cause for visiting an emergency room increased by 37 percent among all age groups from 1997 to 1999. Mentions of the benzodiazepine clonazepam (Klonopin) increased by 102 percent since 1992.

Gender differences

Studies suggest that women are more likely than men to be prescribed an abusable prescription drug, particularly narcotics and anti-anxiety drugs - in some cases 48 percent more likely.

Overall, men and women have roughly similar rates of nonmedical use of prescription drugs. An exception is found among 12- to 17-year-olds: In this age group, young women are more likely than young men to use psychotherapeutic drugs nonmedically.

In addition, research has shown that women and men who use prescription opioids are equally likely to become addicted. However, among women and men who use either a sedative, anti-anxiety drug, or hypnotic, women are almost two times more likely to become addicted."
http://www.nida.nih.gov/ResearchReports/Prescription/prescription5.html#Older


Psychedelics (see Hallucinogens)

Ritalin®, Methylphenidate

"Methylphenidate, a Schedule II substance, has a high potential for abuse and produces many of the same effects as cocaine or the amphetamines. The abuse of this substance has been documented among narcotic addicts who dissolve the tablets in water and inject the mixture. Complications arising from this practice are common due to the insoluble fillers used in the tablets. When injected, these materials block small blood vessels, causing serious damage to the lungs and retina of the eye. Binge use, psychotic episodes, cardiovascular complications, and severe psychological addiction have all been associated with methylphenidate abuse.

Methylphenidate is used legitimately in the treatment of excessive daytime sleepiness associated with narcolepsy, as is the newly marketed Schedule IV stimulant, modafinil (Provigil®). However; the primary legitimate medical use of methylphenidate (Ritalin®, Methylin®, Concerta®) is to treat attention deficit hyperactivity disorder (ADHD) in children. The increased use of this substance for the treatment of ADHD has paralleled an increase in its abuse among adolescents and young adults who crush these tablets and snort the powder to get high. Youngsters have little difficulty obtaining methylphenidate from classmates or friends who have been prescribed it. Greater efforts to safeguard this medication at home and school are needed."
http://www.usdoj.gov/dea/concern/methylphenidate.html


Rohypnol (see Club Drugs)

"GHB and Rohypnol are central nervous system depressants that are often connected with drug-facilitated sexual assault, rape, and robbery. These drugs cause muscle relaxation, loss of consciousness, and an inability to remember what happened during the hours after ingesting the drug (Fact Sheet: Rohypnol, 1998)."
http://www.ncjrs.org/club_drugs/club_drugs.html

"Flunitrazepam (Rohypnol®) is a benzodiazepine that is not manufactured or legally marketed in the United States, but is smuggled in by traffickers. In the mid-1990s, flunitrazepam was extensively trafficked in Florida and Texas. Known as "rophies," "roofies," and "roach," flunitrazepam gained popularity among younger individuals as a "party" drug. It has also been utilized as a "date rape" drug. In this context, flunitrazepam is placed in the alcoholic drink of an unsuspecting victim to incapacitate them and prevent resistance from sexual assault. The victim is frequently unaware of what has happened to them and often does not report the incident to authorities. A number of actions by the manufacturer of this drug and by government agencies have resulted in reducing the availability and abuse of flunitrazepam in the United States."
http://www.usdoj.gov/dea/concern/benzodiazepines.html

Steroids

Anabolic steroids and human growth hormone are often abused by athletes and bodybuilders seeking to increase muscle mass.

"Anabolic steroid or androgenic steroid -- any of a group of synthetic derivatives of testosterone that promote muscle and bone growth. Used therapeutically to treat chronic debilitating diseases, anabolic steroids have also been used by bodybuilders and athletes seeking increased muscle mass and enhanced strength and stamina. Such use is banned by the International Olympic Committee and other governing bodies in sports, and in 1988 a federal law made it illegal to distribute anabolic steroids for nontherapeutic uses. Abuse of anabolic steroids may lead to increased aggressiveness, irritability, and other disruptive behavioral effects, including symptoms characteristic of drug addiction; long term effects are not known."
http://www.addictions.org/drugad.htm

"The long-term adverse health effects of anabolic steroid use are not definitely known. There is, however, increasing concern of possible serious health problems associated with the abuse of these agents, including cardiovascular damage, cerebrovascular toxicity, and liver damage.

Physical side effects include elevated blood pressure and cholesterol levels, severe acne, premature balding, reduced sexual function, and testicular atrophy. In males, abnormal breast development (gynecomastia) can occur. In females, anabolic steroids have a masculinizing effect, resulting in more body hair, a deeper voice, smaller breasts, and fewer menstrual cycles. Several of these effects are irreversible. In adolescents, abuse of these agents may prematurely stop the lengthening of bones, resulting in stunted growth.

With some individuals the use of anabolic steroids may be associated with psychotic reactions, manic episodes, feelings of anger or hostility, aggression, and violent behavior."
http://www.usdoj.gov/dea/concern/steroids.html


"Anabolic (male hormone)- steroids most frequently abused
Cortical
Estrogenic (female hormone)

Synthetic compounds available legally and illegally.
Drugs that are closely related to the male sex hormone, testosterone.
Moderate potential for abuse, particularly among young males.

Any use of steroids can cause:
- Severe acne, rashes, stunted growth
- Sexual function problems
- Women to take on masculine traits, develop hairiness
- Behavioral changes, aggressiveness ("roid rages")
- Long-term effects, such as cholesterol increases, heart disease, liver tumors, cancer, cataracts and death

Steroids are popular because of the following possible effects:
- Increase in body weight
- Increase in muscle strength
- Enhance athletic performance
- Increase physical endurance

Symptoms of Overdose:
- Quick weight and muscle gains
- Extremely aggressive behavior or "Roid rage"
- Severe skin rashes
- Impotence, withered testicles
- In females, development of irreversible masculine traits

Withdrawal Syndrome:
- Significant weight loss
- Depression
- Behavioral changes
- Trembling

Indications of Possible Misuse:
- Increased combativeness and aggressiveness
- Jaundice
- Purple or red spots on body; unexplained darkness of skin
- Persistent unpleasant breath odor
- Swelling of feet or lower legs
http://www.health.org/govpubs/rpo926/#Hall

"Anabolic steroids cause no intoxication effects. They do produce hypertension, blood clotting and cholesterol changes, liver cysts and cancer, kidney cancer, hostility and aggression and acne.
In adolescents they cause premature stoppage of growth. In males they cause prostate cancer, reduced sperm production, shrunken testicles and breast enlargement.
In females they cause menstrual irregularities, development of beard and other masculine characteristics."
http://www.drugabuse.gov/DrugsofAbuse.html

"Human growth hormone (HGH) or somatotropin, glycoprotein hormone released by the anterior pituitary gland that is necessary for normal skeletal growth in humans."
"Pituitary dwarfism can be treated by injections of synthetic growth hormone produced by genetic engineering in bacteria. HGH is also used illegally by bodybuilders and athletes to increase muscle mass."
http://www.addictions.org/drugad.htm


Stimulants

Includes Cocaine, Amphetamines, Methamphetamine, Phenmetrazine, Methylphenidate and others.

Drugs used to increase alertness, relieve fatigue, feel stronger and more decisive; used for euphoric effects or to counteract the "down" felling of tranquilizers or alcohol.

Possible Effects:
- Increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite; high doses may cause rapid or irregular heartbeat, loss of coordination, collapse; may cause perspiration, blurred vision, dizziness, a feeling of restlessness, anxiety, delusions.

Symptoms of Overdose:
- Agitation, increase in body temperature, hallucinations, convulsions, possible death.

Withdrawal Syndrome:
- Apathy, long periods of sleep, irritability, depression, disorientation.

Indications of Possible Misuse:
- Excessive activity, talkativeness, irritability, argumentativeness or nervousness
- Increased blood pressure or pulse rate, dilated pupils
- Long periods without sleeping or eating
- Euphoria
http://www.health.org/govpubs/rpo926/#Hall

"Stimulants are sometimes referred to as uppers and reverse the effects of fatigue on both mental and physical tasks. Two commonly used stimulants are nicotine, found in tobacco products, and caffeine, an active ingredient in coffee, tea, some soft drinks, and many non-prescription medicines. Used in moderation, these substances tend to relieve malaise and increase alertness. Although the use of these products has been an accepted part of U.S. culture, the recognition of their adverse effects has resulted in a proliferation of caffeine-free products and efforts to discourage cigarette smoking.

A number of stimulants, however, are under the regulatory control of the CSA. Some of these controlled substances are available by prescription for legitimate medical use in the treatment of obesity, narcolepsy, and attention deficit disorders. As drugs of abuse, stimulants are frequently taken to produce a sense of exhilaration, enhance self esteem, improve mental and physical performance, increase activity, reduce appetite, produce prolonged wakefulness, and to "get high." They are recognized as among the most potent agents of reward and reinforcement that underlie the problem of dependence.

Stimulants are diverted from legitimate channels and clandestinely manufactured exclusively for the illicit market. They are taken orally; sniffed, smoked, and injected. Smoking, snorting, or injecting stimulants produces a sudden sensation known as a "rush" or a "flash." Abuse is often associated with a pattern of binge use-sporadically consuming large doses of stimulants over a short period of time. Heavy users may inject themselves every few hours, continuing until they have depleted their drug supply or reached a point of delirium, psychosis, and physical exhaustion. During this period of heavy use, all other interests become secondary to recreating the initial euphoric rush. Tolerance can develop rapidly; and both physical and psychological dependence occur. Abrupt cessation, even after a brief two or three-day binge, is commonly followed by depression, anxiety, drug craving, and extreme fatigue known as a "crash."

Therapeutic levels of stimulants can produce exhilaration, extended wakefulness, and loss of appetite. These effects are greatly intensified when large doses of stimulants are taken. Physical side effects, including dizziness, tremor; headache, flushed skin, chest pain with palpitations, excessive sweating, vomiting, and abdominal cramps, may occur as a result of taking too large a dose at one time or taking large doses over an extended period of time. Psychological effects include agitation, hostility, panic, aggression, and suicidal or homicidal tendencies. Paranoia, sometimes accompanied by both auditory and visual hallucinations, may also occur. In overdose, unless there is medical intervention, high fever, convulsions, and cardiovascular collapse may precede death. Because accidental death is partially due to the effects of stimulants on the body's cardiovascular and temperature-regulating systems, physical exertion increases the hazards of stimulant use."
http://www.usdoj.gov/dea/concern/stimulants.html


Tobacco and Nicotine

See "3c. Smoking and Tobacco Products"

Other drugs:

This is by no means a complete list of abused drugs.

For information on other drugs including:
Anorectic Drugs
Benzodiazepines
Buprenorphine
Butorphanol
Chloral Hydrate
Codeine
Depressants
Dextroproxyphene
Fentanyl
Glutethimide & Methaqualone ("Quaalude")
Hydrocodone
Hydromorphone
Khat
LAAM
Meperidine
Meprobamate
Methadone
Methcathinone
Morphine
Oxycodone
Pentazocine
Paraldehyde
Steroids
Thebaine

See "Drug Descriptions" at http://www.usdoj.gov/dea/concern/concern.htm

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