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Some Common Drugs of Abuse (click on the name for more info) (Opiates) Heroin / Oxycodone / Oxycontin / Percocet / Vicodin Amphetamines / Methamphetamines / Ecstasy / Crystal Meth / Ice Marijuana(for a printable version click here)Profile Marijuana, the most commonly used illicit drug in the United States, is taken from the leaves and flowering tops of the Cannabis sativa plant. It also comes in a more concentrated, resinous form, called hashish, and as a sticky black liquid called hash oil. The name “hemp” usually refers to low-THC varieties of cannabis that are grown for industrial uses (i.e., rope, clothing). According to the 2000 National Household Survey on Drug Abuse, an estimated 34% of Americans over the age of 12 have used marijuana in their lifetime.1 The average potency of the drug has increased substantially in the last twenty years, although it can vary significantly, depending on the type of plant and its origin. The main psychoactive chemical in the plant is THC (delta-9-tetrahydrocannabinol), although marijuana contains some 400 other chemicals as well. History2 Marijuana first became popular in the United States with Mexican immigrants in the 1920’s and was quickly adopted by those in the jazz community. Later, the Great Depression of the 1930’s led to a growing hostility toward the increase in marijuana use that was linked to immigration. The Marihuana Tax Act of 1937 placed control of the Cannabis plant into the hands of the federal government, which released highly exaggerated portrayals of marijuana’s effects (i.e., “Reefer Madness”) and made the drug illegal. These stories, paired with the ban on private use, kept marijuana use fairly uncommon until the 1960’s. After the “hippie” counterculture rediscovered marijuana in the 1960’s, demand for, and use of, the substance grew until about 1978, when the favorable attitude toward the substance reached a peak. Since then, public attitudes have varied greatly from complete intolerance to ideas of legalization. In 1970, marijuana was listed as a Schedule I drug where it still remains today; however, the medical use of marijuana has been a hot topic for the last decade, along with the advent of synthetic forms of THC (i.e., Marinol). Methods of Use Various methods of smoking marijuana include rolling it into “joints” (marijuana cigarettes) or “blunts” (marijuana rolled into the leaf wrap of a hollowed-out cigar). Smoking through a pipe or bowl, through a waterpipe (or “bong”), or a vaporizer are also common methods. While marijuana is most often smoked, it can also be ingested. The drug can be ingested alone or cooked into food, most notoriously in “hash brownies.” In addition, it can be used to brew tea or “bhang,” a highly potent beverage originating from India.3 The effects of smoking are typically felt within a few minutes and can peak in 10 to 30 minutes. Short-term effects from smoking generally wear off within 2 to 3 hours. And when eaten, the effects do not appear for 30 to 60 minutes, but can last up to 6 hours.4 It is important to note, however, that the effects of the drug can be very different than expected if the marijuana has been laced with other drugs. Laced Marijuana One of the dangers of smoking marijuana is the possibility that it has been laced with another, more dangerous substance such as cocaine, crack, PCP, or even embalming fluid. Dealers have been known to sell joints, blunts, or cigarettes dipped in embalming fluid and laced with PCP. Though reports of laced marijuana are infrequent, and most lacing of marijuana is done at user-level, it is important to remember that with unregulated drugs such as marijuana, the user has no way of knowing what other types of substances have been added. When individual users lace marijuana, they may sprinkle powdered cocaine or crack into a joint or blunt, combining the stimulant effects of cocaine with the depressant and hallucinogenic effects of cannabis. This can be very dangerous, especially for a person with no tolerance for cocaine. Users have also been known to snowcap bowlfuls of marijuana with powdered opium or heroin, in addition to cocaine and crack. Again, combining other drugs with marijuana can be extremely dangerous. Smoking a joint that has been dipped in embalming fluid or formaldehyde has effects similar to those of a joint laced with PCP - a drug that causes hallucinations, euphoria, and often times, panic or rage. Having a negative reaction is even more likely if the user is expecting only the normal marijuana high. In addition to these psychological dangers, marijuana that has been laced is also extremely unhealthy. Formaldehyde is a known carcinogen linked to nasal and lung cancer, with possible links to brain cancer and leukemia, and should not be smoked or ingested in any way.
Physical Effects When a person smokes or ingests marijuana, THC and other chemicals enter the user’s body. The chemicals make their way through the bloodstream to the brain, where THC and the neurotransmitter anandamide bonds to cannabinoid receptors. High concentrations of these receptors exist in those parts of the brain associated with short-term memory and reasoning, coordination, and unconscious muscle movements.5 These findings may explain the loss of short-term memory and coordination associated with heavy marijuana use. Marijuana also causes the user’s heart rate to increase, the mouth to become dry (commonly referred to as “cotton-mouth”), blood vessels in the eyes to expand (producing bloodshot eyes), and can also cause the “munchies” – the increase in appetite that many users experience. Long-term marijuana use produces changes in the brain similar to those seen after long-term use of other drugs, and can cause behaviors such as uncontrollable drug craving, delinquent behavior, and aggression. Regular marijuana smokers also face some of the same problems as cigarette addicts, including daily cough and phlegm, symptoms of chronic bronchitis, and frequent chest colds. Because marijuana is usually smoked without a filter, the amount of carbon monoxide and tar inhaled by marijuana smokers is three to five times greater than that inhaled by tobacco smokers.
Psychological Effects Many users describe two phases of the marijuana high: initial stimulation (giddiness and euphoria), followed by sedation and a pleasant tranquility. Users also report altered perceptions of distance and time along with a heightened sensitivity to sights and sounds. Effects can vary from person to person and can differ with each use. While some users may experience lowered inhibitions, drowsiness, and contentment, others may feel great anxiety and paranoia. And depending upon the user and setting, the effects and categorization of marijuana can vary from a stimulant to a depressant to a hallucinogen. Any of these effects can begin within a few minutes after inhaling, and can last 2 to 3 hours after initial intoxication.
Is Marijuana Addictive? The debate between marijuana and addiction has been growing steadily over the last decade. Many users may not display any signs of addiction or withdrawal, yet the number of users seeking treatment has been growing steadily over the years.6 Overall, it is difficult to say whether or not the drug is physically addictive, but it is known that marijuana use can lead to psychological addiction and social dependence.7
Is Marijuana a “Gateway Drug?” There has been a great deal of debate concerning the dangers of marijuana use. While its effects may be seen as benign when compared to other drugs, many believe that marijuana can often be the starting point for a person’s experimentations with drugs. A recent study in New Zealand found that 99% of other illicit drug users had previously used marijuana.8 However, a majority of marijuana users studied (63%) did not progress to the use of other illicit drugs. There is still no conclusive evidence that marijuana is, in fact, a gateway drug, though it is clear that most illicit drug users have experimented with marijuana at some point in time. Although marijuana may not necessarily be a “gateway drug” for all users, its use constitutes engagement in risky behavior and may set a pattern for future behavior.
Short-Term Effects A person who is high on marijuana might display some of these symptoms and signs of abuse:9
Long-Term Effects Long-term marijuana abuse has several negative impacts on the user, including:10
Cannabis Indica Originally cultivated in the United States, Cannabis indica, or “ganja,” is taken from the tops of the female plant, and smoked as a form of marijuana. Indica plants are short, dense plants with broader, darker green leaves than that of the Cannabis Sativa plant. It is commonly referred to as “skunk” (for the pungent odor it produces while growing), Northern Lights, Early Girl, and many other names. Many users substitute this drug for ecstasy or LSD, or use it in combination with these drugs. Frequently, the drug is mixed with tobacco and smoked. Cannabis indica and Cannabis sativa produce two greatly different effects. Cannabis sativa produces a “high” effect, while indica produces a more relaxed, “stoned” effect. Indica contains a higher amount of THC, causing the psychological effects to be heightened. Labeled a Class C drug, it has been approved by the FDA for the use of treating nausea in cancer patients, stimulating appetite in AIDS patients, and for the treatment of glaucoma.
Paraphernalia There are many different methods through which users smoke. Marijuana that has been rolled into cigarette paper is referred to as a “joint,” and can be rolled by hand or by a rolling machine. A “blunt” simply refers to a common cigar that is split open, emptied of tobacco, and refilled and rolled with marijuana. This term comes from Phillies Blunts, but other, similar types of cigars are also commonly used, including White Owls, El-Productos, Backwoods, Garcia-Vegas, and Dutchmasters. Users also commonly smoke marijuana through hand-pipes made of glass or wood, and through waterpipes (bongs) made of glass or plastic. Water pipes allow the smoke to be filtered and cooled prior to inhalation, providing the user with larger, cleaner hits. Also, vaporizers supply another way of smoking marijuana, in which the drug is heated enough to vaporize the plant and release the THC, without the user having to inhale large amounts of smoke.
Terminology
Slang Terms for Marijuana Laced with Other Drugs
Potency-Related Terms
Use and Users
_______________________________________________________ 1 ONDCP Marijuana Fact Sheet. Retrieved October 25, 2006, from http://www.whitehousedrugpolicy.gov/drugfact/marijuana/index.html. 2 David F. Musto. (July 1991). “Opium, Cocaine and Marijuana in American History.” Scientific American. 3 HowStuffWorks. How Marijuana Works. Retrieved October 25, 2006, from http://www.howstuffworks.com/marijuana.htm. 4 InTheKnowZone. Marijuana. Retrieved October 25, 2006, from http://www.intheknowzone.com/marijuana/index.htm. 5 NIDA. Marijuana Facts for Teens. Retrieved October 25, 2006, from http://www.drugabuse.gov/MarijBroch/Marijteenstxt.html. 6 Lynn Zimmer and John P. Morgan. (1997). Marijuana Myths, Marijuana Facts. New York: The Lindesmith Center. 7 Narconon. Marijuana Information. Retrieved October 25, 2006, from http://www.marijuanaaddiction.info/marijuana-information.htm. 8 David M. Fergusson and L. John Horwood. (2000). “Does Cannabis Use Encourage Other Forms of Illicit Drug Use?” Addiction 95: 505-520. 9 NIDA. Marijuana: Facts for Teens. Retrieved October 25, 2006, from http://www.drugabuse.gov/MarijBroch/teenpg9-10.html#Tell. 10 American Council for Drug Education. Basic facts about Drugs: Marijuana. Retrieved October 25, 2006, from http://www.acde.org/youth/Research.htm. *Information regarding Marijuana supplied by the Center for Substance Abuse Research, University of Maryland
Cocaine(for a printable version click here) (Powder)Profile Cocaine is a highly addictive drug of abuse. It is categorized as a stimulant, and is currently a Schedule II substance. Stimulants heighten the body’s activity, including increases in energy, alertness, heart rate, and blood pressure. The form of cocaine that is commonly used is a white powder obtained from the leaves of the Erythroxylon Coca plant. History Humans have known about the stimulant effects of the Coca plant since ancient South American cultures chewed the leaves in everyday activities and religious rituals. Cocaine first appeared in American society in the 1880’s as a surgical anesthetic, and soon became a common household drug, as well as an ingredient in Coca-Cola and in several types of wines1. Snorting cocaine was slowly becoming popular in the early 1900’s until the drug was banned in 1914 as a result of the Harrison Act. Abuse began rising again in the 1960’s, causing Congress to classify it as a Schedule II drug in 1970.2 Later, in the mid-1980’s, crack cocaine, which is derived from powder cocaine, became an enormously popular drug of abuse. Today, synthetic forms of cocaine such as Novocain are still used as local anesthetics for surgical purposes; however, medical use has become more sporadic with the introduction of safer and more improved pharmaceuticals.3 Illicit, recreational use of cocaine remains popular today.
Methods of Use The most common method of using powder cocaine is snorting – sniffing the powder into the nasal passages. It can also be injected intravenously, ingested orally, or even rubbed on the user’s gums. Powdered cocaine can also be smoked, as users occasionally sprinkle it on cigarettes or ‘joints’. The drug can also be smoked as crack cocaine or ‘freebase’ after the powder has been processed into a rock form. Because smoking a substance allows it to reach the brain more quickly than other methods, smoking crack or freebase creates an intense and immediate high (in about 10 to 15 seconds), making the drug even more addictive.4
Cocaine’s Effects on the Brain Cocaine is a strong central nervous stimulant that interferes with and causes excess amounts of dopamine in the brain. Dopamine, a neurotransmitter related to pleasure and movement, is primarily associated with the brain’s reward system. Cocaine is especially addictive because it alters the brain’s sense of reward and punishment. A buildup of dopamine causes constant stimulation of the brain’s sense of reward until the effects of the drug wear off. This explains why users may experience feelings of euphoria while under the influence of cocaine and why they may crave the drug after the effects have worn off.5
Short-Term Effects The immediate, intense cocaine high lasts about 15 to 30 minutes when snorting while effects from smoking last approximately 5 to 10 minutes; residual effects can continue for 1 to 2 hours, however. These effects include:6
Increased possibility of risky behaviors that can lead to sexually transmitted illnesses or transmission of HIV or Hepatitis through shared needles
Long-Term Effects Prolonged cocaine abuse can cause a number of other problems including:7 • Headaches • Convulsions and seizures • Heart disease and heart attack • Stroke • Lung damage and disease (respiratory failure and difficulty breathing) • Damage to the nasal septum (when snorting) • Irritability and mood disturbances • Auditory and tactile hallucinations (“coke bugs”) • Sexual dysfunction in both males and females • Reproductive damage and infertility • Sudden death – even one use can cause overdose or death
Addiction and Withdrawal Cocaine is a highly addictive substance, and users can quickly develop a tolerance to the drug, needing more of the substance to achieve the desired effects. Also, when use of the drug is stopped, withdrawal symptoms occur. These symptoms will be more severe the more heavily someone has been using cocaine. Users may continue using cocaine simply to relieve these effects of withdrawal. Symptoms can include depression, irritability, extreme fatigue, anxiety, and an intense craving for the drug.
Terminology Slang Terms for Powder Cocaine:
Common Quantity-Related Terms:
Use and Users:
Effects of Powder Cocaine Use
_____________________________________________- 1 In The Know Zone. History of Cocaine and Crack Use. Retrieved October 27, 2006, from http://www.intheknowzone.com/cocaine/history.htm. 2 ONDCP Cocaine Page. Retrieved October 27, 2006, from http://www.whitehousedrugpolicy.gov/drugfact/cocaine/index.html. 3 DEA Cocaine Brief. Retrieved October 27, 2006, from http://www.dea.gov/concern/cocaine.html. 4 NIDA Cocaine InfoFacts. http://www.nida.nih.gov/Infofacts/cocaine.html. 5 NIDA Research Report Series: Cocaine Abuse and Addiction. Retrieved October 27, 2006, from http://www.drugabuse.gov/PDF/RRCocain.pdf. 6 In The Know Zone. Short-Term Effects of Cocaine Use. Retrieved October 27, 2006, from http://www.intheknowzone.com/cocaine/sterm.htm. 7 In The Know Zone. Long-Term Effects of Cocaine Use. Retrieved October 27, 2006, from http://www.intheknowzone.com/cocaine/lterm.htm
*Information regarding Cocaine (Powder) supplied by the Center for Substance Abuse Research, University of Maryland
Crack Cocaine(for a printable version click here)Profile “Crack” is the name given to cocaine that has been processed with baking soda or ammonia, and transformed into a more potent, smokable, “rock” form. The name refers to the crackling sound heard when the rock is heated and smoked. Cocaine is a stimulant that has been abused for ages; however, crack cocaine is the most potent form in which the drug has ever appeared. There is great risk when using any form of cocaine, but crack cocaine is the riskiest form of the substance. Smoking a substance allows it to reach the brain more quickly than other routes of administration, and compulsive cocaine use will develop even more rapidly if the substance is smoked rather than snorted. Smoking crack cocaine brings an intense and immediate but very short-lived high that lasts about fifteen minutes.1 A person can become addicted after his or her first time trying crack cocaine.
History Crack cocaine was first developed during the cocaine boom of the 1970’s, and its use became enormously popular in the mid-1980s, particularly in urban areas.2 Today it remains a very problematic and popular drug, as it is inexpensive to produce, and is much cheaper to purchase than powder cocaine.
Methods of Use Crack cocaine, once processed from cocaine powder, appears as a yellowish-white rock. It is cut or broken into smaller rocks weighing a few tenths of a gram. Crack cocaine is generally smoked through a glass handpipe or waterpipe. Also, there have been reports of the drug being injected intravenously or even snorted, but these methods are less common. In many areas of the country, users report combining crack cocaine with heroin, marijuana, and other types of drugs in order to create different, more intense effects.3
Crack Cocaine’s Effects on the Brain Crack cocaine is a strong central nervous stimulant that interferes with, and causes excess amounts of, dopamine in the brain. A neurotransmitter associated with pleasure and movement, dopamine is the neurotransmitter released as part of the brain’s reward system. As a result, the psychological effects can be extremely reinforcing; after having tried crack cocaine, the user will rapidly develop an intense craving for the drug since the chemistry of the brain’s reward system has been altered.
Short-Term Effects The high from crack cocaine begins almost immediately after the vapors are inhaled and lasts about 5 to 15 minutes. After the initial ‘rush’ subsides, the user experiences an intense desire for more of the drug – this is how users can become addicted after just their first hit. Other short-term effects include:4
• Increased blood pressure and heart rate • Constricted peripheral blood vessels • Increased rate of breathing • Dilated pupils • Hyper-stimulation • Intense euphoria • Decreased appetite • Anxiety and paranoia • Aggressive, paranoid behavior • Depression • Intense drug craving • Sudden death – even one use can cause overdose or death It is important to note that with any drug, effects may vary greatly due to the uncertainty of the drug’s content.
Long-Term Effects Prolonged crack cocaine abuse causes a number of problems, including:5 • Severe depression • Irritability and mood disturbances • Aggressive, paranoid behavior • Delirium or psychosis • Tolerance and addiction, even after just one use • Auditory and tactile hallucinations • Heart attack and heart disease • Stroke • Respiratory failure • Brain seizures • Sexual dysfunction (for both men and women) • Reproductive damage and infertility (for both men and women) • Increased frequency of risky behavior • Death
Addiction and Withdrawal Cocaine is a highly addictive substance, and crack cocaine is substantially more addicting, as the drug is far more potent and is smoked.6 Users quickly develop a tolerance to crack cocaine, needing more of the substance to achieve the desired effects. Because the high from crack cocaine is so short-lived, users commonly smoke it repeatedly in order to sustain the high. This can lead to an even faster onset of addiction. Also, because crack cocaine works on the brain’s system of reward and punishment, withdrawal symptoms occur when the drug’s effects wear off. These symptoms can include depression, irritability, extreme fatigue, anxiety, an intense craving for the drug, and sometimes even psychosis. Users will often keep using crack cocaine simply to avoid the negative effects of withdrawal.
Terminology Slang Terms for Crack Cocaine:
Use and Users:
Effects of Crack Cocaine Use:
____________________________________________________________ 1 NIDA Cocaine and Crack InfoFacts. Retrieved October 27, 2006, from http://www.nida.nih.gov/Infofacts/cocaine.html. 2 ONDCP Crack Overview. Retrieved October 27, 2006, from http://www.whitehousedrugpolicy.gov/drugfact/crack/index.html. 3 ONDCP Crack Overview. 4 In The Know Zone. Short-Term Effects of Cocaine Use. Retrieved October 27, 2006, from http://www.intheknowzone.com/cocaine/sterm.htm. 5 In The Know Zone. Long-Term Effects of Cocaine Use. Retrieved October 27, 2006, from http://www.intheknowzone.com/cocaine/sterm.htm. 6 NIDA Crack and Cocaine InfoFacts
*Information regarding Cocaine (Crack) supplied by the Center for Substance Abuse Research, University of Maryland
Opiates(for a printable version of this click here) HeroinProfile Heroin (diacetylmorphine) is a highly addictive Schedule I drug, and a heavily abused and extremely potent opiate. It is processed from morphine, a naturally-occurring substance extracted from the opium poppy - Papaver somniferum - a plant indigenous to the Middle East and Southeast Asia. Pure heroin, which is a bitter-tasting white powder, is rarely sold on the streets.1 Most that is sold is a powder varying in color from white to dark brown. The differences in color are due to impurities in the manufacturing process and/or the presence of other drugs or additives such as powdered milk or quinine.2 Another form of heroin known as “black tar” is available mostly in the western and southwestern United States. This form is primarily made in Mexico using crude processing methods.3 Currently, it has become an issue because it is cheaper than conventional heroin, but is extremely potent and addictive.
History The opium poppy has had a long history. Our earliest knowledge of its cultivation dates back to the ancient Mesopotamian and Sumerian cultures, who passed it on to the Assyrians, Babylonians, and Egyptians. The Greeks introduced opium to Persia and India, where it was grown in mass quantities. In the eighteenth century, the British began exporting it to China, where they traded it for tea. Opium abuse reached epic proportions in China, where millions of people became addicted in the 1800’s. When the Chinese government tried to ban all opium imports in 1839, The First Opium War began, ending in the British taking Hong Kong. The Second Opium War of 1856 made opium imports into China legal again, still against the wishes of the Chinese government. Heroin was synthesized from morphine in 1874 by the pharmaceutical company Bayer and was touted as a safer, non-addictive form of morphine.4 It became a widely used drug in cough medicines and a variety of other ailments. By the beginning of the twentieth century, heroin was understood to be highly addictive and in 1914 was banned as part of the Harrison Narcotics Act.5
Methods of Use Heroin is most often injected intravenously for a quick and potent high, but there is a rising segment of users who sniff, snort, and smoke heroin to avoid the dangers of sharing needles.6 There are also reports of users sniffing liquefied heroin using a nasal spray bottle, a practice known as “shabanging.”7 Users have also been known to combine heroin and cocaine, snorting alternate lines or “crisscrossing,” or injecting the two drugs simultaneously, called “speedballing.”8 A common misconception is the idea that snorting or smoking heroin is not as addictive as injecting heroin. The truth is, however, that heroin is a highly addictive drug regardless of the route of administration.
Heroin’s Effects on the Brain Heroin, like all opiates, works as a central nervous system depressant. In fact, the human brain contains numerous opiate receptors, as morphine is a naturally occurring chemical. Heroin and morphine are both chemically similar to endorphins, the body’s natural painkillers, as they all bind to those opiate receptors related to pain, movement and emotion.
Short-Term Effects The short-term effects of heroin abuse appear soon after a single dose and last for a few hours. Intravenous injection provides the greatest intensity and most rapid onset of effects, as users can feel peak effects after 7 to 8 seconds.9 Intramuscular injection produces the euphoric high within 5 to 8 minutes, and when the drug is sniffed or smoked, effects are felt within 10 to 15 minutes. After taking heroin, the user reports feeling a surge of euphoria (or a “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” for several hours – a period of alternating between a wakeful and drowsy state. Mental functioning becomes clouded due to the depression of the central nervous system. Also, breathing may become slowed to the point of respiratory failure.10 Other short-term effects can include dry mouth, nausea, vomiting, and severe itching.
Long-Term Effects After repeated use of heroin, more long-term effects may begin to appear. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses (pus-filled infections), liver disease, and lung-related complications such as pneumonia. In addition to the effects of the drug itself, some heroin may contain additives that do not easily dilute in the bloodstream, resulting in clogging of the blood vessels in the lungs, liver, kidneys, or brain. Overdose, severe addiction, and/or death may also occur following initial use. In addition to the dangers of the drug itself, users who inject heroin also put themselves at risk for contracting HIV, Hepatitis B and C, and other blood-borne pathogens. This type of risk is the cause for controversial “needle-exchange programs” that have been established in areas of highest heroin use. Yet another threat for heroin users is that they cannot know the real strength of the drug or its true contents, putting them at an increased risk for overdose or even death.
Addiction and Withdrawal One of the most significant effects of heroin use is addiction. Also, with regular use, a tolerance develops, where more and more heroin is needed to achieve the same effect. The average heroin addict can spend up to $200 per day to maintain his or her addiction.11 As higher doses are taken over time physical dependence and addiction will develop. Within a few hours after the last administration of heroin, withdrawal may occur, producing intensely negative effects such as drug craving, restlessness, muscle and bone pain, and vomiting. Methadone and Buprenorphine, both semi-synthetic narcotic opiates, were developed as a way to minimize the drug’s severe withdrawal symptoms. In the worst cases, this withdrawal can even cause death. Many users continue abusing the drug even after they no longer experience the euphoric effects, simply to provide relief from the painful, flu-like withdrawal symptoms. In heavy users, major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week.12
Overdose Overdosing is a very real danger for heroin users. It is far more common than one might expect; a 2001 study in Australia concluded that 54% of regular injecting drug users reported experiencing at least one non-fatal overdose in their lifetime.13 Signs of an overdose can include one or more of the following: extremely slow and shallow breathing, convulsions, pinpoint pupils, confusion, and possibly coma or death. 14 Someone who is overdosing should be taken to the hospital immediately.
Paraphernalia Those who inject heroin use a set of paraphernalia that includes hypodermic needles, small cotton balls used to strain the drug, spoons or bottle caps for “cooking” (liquefying) the heroin, and a “tie-off” that the user wraps around his or her arm to make his or her veins protrude. Paraphernalia for sniffing or smoking heroin can include razor blades, straws, rolled dollar bills, and pipes. Also, balloons are used as a method of transporting and/or trafficking the drug.
Terminology General:
Other Slang:
__________________________________________________ 1 InTheKnowZone: Heroin. Retrieved October 20, 2006, from http://www.intheknowzone.com/heroin/index.htm. 2 ONDCP Drug Facts: Heroin. Retrieved October 20, 2006, from http://www.whitehousedrugpolicy.gov/drugfact/heroin/index.html. 3 ONDCP Drug Facts: Heroin. 4 ONDCP Drug Facts: Heroin. 5 ONCDP Drug Facts: Heroin. 6 ONDCP Drug Facts: Heroin. 7 Texas Commission on Alcohol and Drug Abuse. (1997). A Dictionary of Slang Drug Terms, Trade Names, and Pharmacological Effects and Uses. Retrieved October 20, 2006, from http://www.tcada.state.tx.us/research/slang/terms.pdf. 8 BBC News. (2006, September 13). “The Nightmare of ‘Speedballing’.” Retrieved October 20, 2006, from http://news.bbc.co.uk/1/hi/uk/5341642.stm. 9 ONDCP Drug Facts: Heroin. 10 NIDA InfoFacts: Heroin. Retrieved October 20, 2006, from http://www.nida.nih.gov/Infofacts/heroin.html. 11 InTheKnowZone: Heroin. 12 NIDA InfoFacts: Heroin. 13 Paul Dietze et al. (2001). “The Context, Management and Prevention of Heroin Overdose in Victoria, Australia: The Promise of a Diverse Approach.” Addiction Research and Theory 9:437-458. 14 InTheKnowZone: Heroin.
*Information regarding Crack Cocaine supplied by the Center for Substance Abuse Research, University of Maryland
Methadone (for a printable version of this click here)Profile Methadone is a synthetic, narcotic analgesic (pain reliever). Often used by and associated with the treatment of heroin addicts, it is also used for other medical purposes, such as pain relief. The drug shares many of the same effects and characteristics of morphine and acts in similar ways to it and other narcotic medications. However, with methadone the gradual and mild onset of action prevents the user from getting high and experiencing euphoric effects.1 Doses used in heroin treatment vary based on a person’s body weight and opiate tolerance; but proper dosage is measured and determined by a patient’s decline in opiate cravings. Despite its use in the treatment community, there are addicts who use methadone as their primary drug of choice. Supplies of the drug for these users are illegal and are diverted from legitimate methadone programs by enrolled methadone patients.2 In 2000, there were an estimated 1,200 treatment facilities in the U.S. dispensing methadone.3 The drug is currently a Schedule II and is available in oral solutions, tablets, and injectable forms.4 Although there is no one manufacturer responsible for producing methadone, the active ingredient is always the same: methadone hydrochloride.5 Still, methadone is frequently encountered on the illicit market and has been associated with a growing number of overdose deaths.6 History The chemical structure of methadone was first produced in the 1930’s as a team of German scientists was searching for a pain-killing drug (analgesic) that would not be as addictive as morphine. In 1937, two scientists (Max Bockmühl and Gustav Ehrhart) uncovered a synthetic substance that they called Hoechst 10820 or polamidon. Years later during World War II another team of German scientists expanded on earlier research and began synthesizing the substance as a result of short supplies of morphine and other analgesics.7 By the end of the war, the United States had obtained the rights to the drug from war requisitions and later coined the name methadone.8 In 1947, methadone was introduced into the United States to be used as a pain reliever for a variety of conditions, but eventually uncovered its usefulness in treating narcotic addictions.9 Until the 1960’s, little scientific advancement was made with regard to methadone. But with a resurgence of heroin addiction, researchers began to search for a substance that could reduce or eliminate drug craving and withdrawal signs and symptoms.10 The idea behind this research was that methadone could be used to manage or maintain heroin addiction. In 1964, the effectiveness and usefulness of using methadone maintenance (i.e., using it as a substitute narcotic to prevent withdrawal) was realized. In the spring of 1971, methadone treatment for opiate dependence began to expand. That year the Federal Government developed regulations governing the use of methadone in the treatment of heroin addiction; final regulations were published in December 1972. Little advancement was made until 2001 when regulations over methadone were modified to allow physicians and other health care professionals to provide methadone more effectively and consistently.11
Methods of Use Methadone is dispensed primarily in oral forms, including tablets, powder, and liquid for the treatment of narcotics addiction. Single doses, which should not exceed 80 – 100 milligrams daily, can last anywhere from 24 to 36 hours depending on user characteristics (e.g., age, weight, level of addiction, and tolerance); the long-acting nature of the drug is a distinct advantage since it requires less frequent administration, limiting potential harmful effects.12 Tablet forms of the drug, sometimes called diskettes, contain approximately 40 milligrams of methadone and are often dissolved in water and ingested orally. There is also a white crystalline powder form available that is dissolved in water and swallowed. Finally, liquid is sometimes used in treatment clinics; with this method dosages of methadone can be tightly controlled and adjusted to as small as one milligram, this allows patients to receive just the right amount of methadone needed to curb their withdrawal symptoms.13 Illicit methadone is sometimes administered through injection (injection is not a valid route of administration in treatment) directly into the bloodstream. This form subjects users to increased risks of a variety of diseases, including HIV/AIDS. Physical Effects Though methadone is primarily used for treating narcotics addiction, users can still experience negative physical effects. Careful monitoring and a close relationship between a doctor and the patient are essential to its proper use.14 Reinforcing effects of methadone are limited, as the drug is designed to block the pleasurable effects of opiates, but only when administered in the correct dosage(s). Some of the physical and side effects of methadone are: Short-term:
Long-term:
Effects on Women:
Methadone Maintenance First appearing in Canada, methadone maintenance programs in the U.S. are often thought about as one of the most common and effective means for treating heroin addiction15; in the late 1970’s they gained considerable acceptance and already had more than 75,000 participants.16 The term “maintenance” is used in describing these programs because the goal is to “maintain” a narcotics abuser for the purpose of helping him or her avoid the negative and sometimes severe withdrawal symptoms.17 This type of treatment views addiction as a disease rather than a psychological disorder or character flaw.18 A number of studies have looked at the effectiveness of methadone programs, and a majority of them have found that methadone can reduce narcotics related deaths, heroin users’ involvement in crime, the spread of AIDS, and also help users gain control of their lives.19 Addiction, Tolerance, Withdrawal, and Dependence Although methadone is intended to prevent narcotics addiction and dependence along with associated withdrawal symptoms, there is still the possibility of becoming addicted. In fact methadone is an extremely physically addictive drug; however addiction is less likely when under the supervision of a doctor.20 Tolerance to methadone can also occur with frequent administration, though studies have shown that a user’s tolerance may not increase if prescribed correctly.21 Withdrawal symptoms occurring from the use of methadone are not as common as they are with heroin; therefore it is possible to maintain an addict on methadone without certain harsh side effects.22 Psychological and physical dependence can develop with the use of methadone.23 For instance, use of the drug continues a user’s opioid dependency, but frees them from uncontrolled, compulsive, and disruptive behavior associated with heroin addiction.24 Alternatives to Methadone Aside from methadone, there are currently at least two alternative options for the treatment of opioid dependence: Buprenorphine and LAAM. But it is still important to remember that outside of a doctor’s care these drugs can be equally as addictive as methadone, resulting in dependence, tolerance, and withdrawal. Buprernorphine Buprenorphine is a potent (30-50 times greater than morphine) semi-synthetic narcotic substance that has recently been approved (after 12 years of extensive research) to help treat heroin and opioid dependency.25 First developed in the late 1970’s, Buprenorphine is currently available in the United States as an injectable Schedule V narcotic analgesic (Buprenex®) for human and veterinary use26 (tablet forms are also available). Unlike the other treatment drugs, Buprenorphine produces far less respiratory depression and is thought to be safer in the event of an overdose. In addition, it does not produce significant levels of physical dependence or discomforting withdrawal symptoms; so discontinued use is easier than methadone. LAAM In 1994 the FDA approved L-alpha-acetyl-methadol (LAAM) as a Schedule II drug for use in treatment of addiction.27 LAAM may be used instead of methadone because it has longer lasting effects, and instead of daily visits to treatment, addicts may only need to take the drug three times a week.28 Considered safe and effective, this drug is available primarily in oral forms such as pills and tablets. Like methadone, LAAM does not produce euphoric effects; however, because most patients are not familiar with LAAM, they may be initially more anxious and need more counseling and support when receiving the medication than they would with methadone.29 In addition to anxiety, users are subjected to a number of side effects such as: abnormal liver functioning, rashes, nausea, and increased blood pressure.30 Terminology Slang Terms for Methadone Dollies, Dolls, Mud, Phyamps, Red Rock, Tootsie Roll, Amidone, Fizzies, Balloons, Breaze, Burdock, Buzz Bomb, Cartridges, Jungle Juice, Junk Paraphernalia Cracker – device used for opening methadone cartridges _______________________________________ 1 Kuhn, C. Swartzwelder, S. and Wilson, W. (1998). Buzzed; The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. W.W. Norton and Company: New York, NY. 2 Inciardi, J.A. and McElrath, K. (1995). The American Drug Scene: An Anthology. Roxbury Publishing Company: Los Angeles, California. 3 Drug and Alcohol Services Administration (DASIS). (2002, December 6). Facilities Providing Methadone/LAAM Treatment to Clients with Opiate Addiction. Retrieved October 25, 2006, from http://www.oas.samhsa.gov/2k2/methadoneTX/methadoneTX.htm. 4 Drug Enforcement Administration. Methadone. Retrieved October 25, 2006, from http://www.dea.gov/concern/methadone.html. 5 The Lindesmith Center-Drug Policy Foundation. (2000). About Methadone. The Lindesmith Center-Drug Policy Foundation: New York. 6 Drug Enforcement Administration. Methadone. 7 Inciardi, J.A. and McElrath, K. (1995). 8 The National Alliance of Methadone Advocates. (2002). “Basic Pharmacology of Methadone: How Methadone Works, Part 2.” Retrieve October 25, 2006, from http://www.methadone.org/downloads/namadocuments/es05basic_pharmacology2.pdf. 9 Inciardi, J.A. and McElrath, K. (1995). 10 Kreek. M.J. and Vocci, F.J. (2002). “History and Current Status of Opioid Maintenance Treatments: Blending Conference Session.” Journal of Substance Abuse Treatment 23: 93-105. 11 Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA News. Volume IX, No. 2 Spring 2001. U.S. Department of Health and Human Services: Washington, D.C. 12 Lyman, M.D. and Potter, G.W. (1998). Drugs in Society: Causes, Concepts and Control. Anderson Publishing: Cincinnati, OH.
*Information regarding Methadone supplied by the Center for Substance Abuse Research, University of Maryland Oxycodone (OxyContin) (for a printable version of this click here)Profile Oxycodone is a semi-synthetic opiate manufactured by modifying the chemical thebaine, an organic chemical found in opium.1 It is the active ingredient in a number of commonly prescribed pain relief medications such as Percocet, Percodan, and Tylox. Each of these contains oxycodone in small doses combined with other active ingredients like aspirin.2 OxyContin, another prescription form of oxycodone, is available in doses ranging in strength from 10mg to 80mg tablets. Intended use of OxyContin is for long-term relief (up to 12 hours) of moderate to severe pain associated with conditions such as cancer and arthritis.3 A unique property of OxyContin is that the tablets are time released; that is, the effects of the drug and its analgesic properties take effect over a set period of time rather than all at once. It is similar to codeine and methadone in its analgesic (pain-killing) properties4. Currently, oxycodone products, and all of the medications containing it, are Schedule II controlled substances. OxyContin, which may be the most recognized form of oxycodone, is a drug with a high abuse potential, and in the past few years it has been linked to a number of overdose deaths.5 As of November 1, 2001, medical examiner offices in 31 states reported 1,096 overdose deaths involving oxycodone; 117 of these deaths were related to OxyContin.6 The use of OxyContin and oxycodone products also continues to increase, and though nobody knows exactly how many people are abusing them, a research study in 2000 found that more than 8% of teenagers reported having abused pain relievers at least once in their lifetime.7 Use is not limited to adolescents and teenagers; every age group has been affected by illicit use of oxycodone and its perceived safety. Sometimes seen as a "white collar" addiction, oxycodone abuse has increased among all ethnic and economic backgrounds.8 OxyContin can be rather expensive. A 40mg tablet (prescribed from a doctor) costs approximately $4, but the street value (the cost when illegally obtaining the drug) can range in price from $25 to $40.9 History The potential dangers of oxycodone can be traced as far back as the 1960’s when the United Nations Office on Drugs and Crime classified it as a dangerous drug as part of The Dangerous Drugs (Amendment) Ordinance, 1960.10 Abuse in the United States has been a continuing problem since the early 1960’s, prompting the United States Government to classify it as a Schedule II drug. Until 1995, when the Food and Drug Administration approved OxyContin, there was little concern over the abuse of oxycodone producers. However, in 1996 when the manufacturer of OxyContin began to market and distribute the drug, concerns and reports of illicit use and abuse began to increase.11 At first, drug abuse treatment centers, law enforcement personnel, and pharmacists in Maine, Virginia, West Virginia, Ohio, Kentucky, and Maryland reported increases in the abuse of OxyContin. Now, abuse of the drug has expanded throughout the United States.12
Methods of Use Oxycodone products can be administered intramuscularly (injection directly into the muscle), intravenously (injection into the blood stream), subcutaneously (injection under the skin), rectally, and/or orally through pills and tablets.13 OxyContin, taken orally (in tablet form), can remain effective for up to 12 hours, making it the longest acting oxycodone product available. While legal doses vary by patient, a typical dose prescribed by a physician ranges from two to four tablets daily. Currently there are four dosages available - 10, 20, 40, and 80mg tablets. The 160mg tablet (available in 2000) was suspended in May 2001 due to its severe abuse potential.14 Those who abuse the drug generally do so in three different ways: crushing the pill into a fine powder and snorting it; chewing it; or crushing and dissolving the tablets in water and injecting the solution. Many of these methods are primarily used with OxyContin in order to defeat the time-release mechanism of the drug, causing the active ingredient to take effect almost immediately after ingestion. When using OxyContin this way, the risk of an overdose increases dramatically since the drug is not intended to be used in this manner. Some users also mix the drug with alcohol to achieve an even greater high15, even though it can be a fatal combination. Pharmacology The chemical structure of oxycodone is similar to another pain reliever - codeine - and is almost as potent as morphine in its ability to produce opiate-like effects.16 Oxycodone works by binding to the pain receptors in the brain so that the sensation of pain is reduced.17 In other words, it attempts to change pain messages being sent to the brain so the user will be relieved of moderate to severe or chronic pain linked to such conditions as cancer and arthritis. Illicit users ingest the drug for a number of reasons. Some use it to control withdrawal symptoms of heroin or morphine18, while others use and/or abuse the drug only in an attempt to achieve a euphoric high. Effects When using oxycodone products, including OxyContin, under the care of a physician, most users will experience mild side effects. Like many other narcotic medications, oxycodone can impair certain daily activities, such as driving and other mental and physical abilities. These side effects are usually mild, but there are more serious complications and negative effects from using products containing oxycodone, particularly when abused.
Side effects of Oxycodone products include:
Addiction and Withdrawal Since oxycodone products should only be used based on a doctor’s prescription, signs of addiction can be monitored and controlled more effectively than if the user is not under a physician’s care. When used illicitly, the chances of becoming addicted to it increase exponentially. Oxycodone, for example, has many similarities to other drugs of abuse including alcohol, heroin, and marijuana, in that they elevate levels of dopamine, the neurotransmitter linked with pleasure experiences. As a result, prolonged use and abuse of oxycodone medications eventually change the brain in such a way that a user cannot quit on his or her own, a typical sign of addiction.19 The likelihood of experiencing withdrawal symptoms when using prescription opioids (e.g., oxycodone) is extremely high, especially when the user stops suddenly. Withdrawal symptoms may be severe and can include anxiety, nausea, insomnia, muscle pain, fevers, and other flu like symptoms. Street Terms Slang Terms for Percodan and Percocet:
Slang Terms for OxyContin:
OxyContin Use:
________________________________________________ 1 Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA). (2001). OxyContin Situation Report, 2001. 2 Drug Enforcement Administration. March 2002. Drug Intelligence Brief: OxyContin. Retrieved October 27, 2006, from http://www.avitarinc.com/pdf/Drug-Intelligence-Brief-Oxycotine-Facts.pdf. 3 Drug Enforcement Administration. March 2002. 4 Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA). (2001). 5 Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA). (2001).
*Information regarding Ocycodone supplied by the Center for Substance Abuse Research, University of Maryland
Amphetamines(for a printable version of this click here) Profile
Amphetamines are a group of synthetic psychoactive drugs
called central nervous system (CNS) stimulants.1
The collective group of amphetamines includes amphetamine, dextroamphetamine,
and methamphetamine.2
Amphetamine is made up of two distinct compounds: pure dextroamphetamine and
pure levoamphetamine. Since dextroamphetamine is more potent than
levoamphetamine, pure dextroamphetamine is also more potent than the amphetamine
mixture.3
Medications containing amphetamines are prescribed for narcolepsy, obesity, and
attention deficit/hyperactivity disorder.4
Prescription names for these medications include Adderall©, Dexedrine©,
DextroStat©, and Desoxyn©.5
The basic molecule of amphetamine can be modified to emphasize specific
actions—such as appetite suppressant, CNS stimulant, and cardiovascular
actions—for certain medications, including diethylproprion, fenfluramine,
methylphenidate (commonly known as the prescription drugs Ritalin© or
Concerta©), and phenmetrazine.6
Both methylphenidate and amphetamine have been in Schedule II of the Controlled
Substances Act since 1971.7
In medical use, there is controversy about whether the benefits of amphetamines
prescribed for ADHD and weight loss outweigh the drug's harmful side effects.
There is agreement, however, that prescription amphetamines are successful in
treating narcolepsy.8
"Look-alike" drugs, which imitate the effects of amphetamines and contain
substances legally available over-the-counter, including caffeine, ephedrine,
and phenylpropanolamine, are sold on the street as "speed" and "uppers." History When amphetamine was first synthesized in 1887, by the German chemist L. Edeleano, the stimulant effects were not noticed. In the early 1930s, when amphetamine's CNS stimulant properties and use as a respiratory stimulant were discovered it was marketed as an inhaler for nasal congestion (Benzedrine©). At this time, medical professionals recommended amphetamine as a cure for a range of ailments—alcohol hangover, narcolepsy, depression, weight reduction, hyperactivity in children, and vomiting associated with pregnancy. The use of amphetamines grew rapidly because it was inexpensive, readily available, had long lasting effects, and because professionals purported that amphetamine did not pose an addiction risk.10 Oral and intravenous preparations of amphetamine derivatives, including methamphetamine, were developed and became available for therapeutic purposes. During World War II, the military in the United States, Great Britain, Germany, and Japan used amphetamines to increase alertness and endurance and to improve mood.11 Abuse began rising during the 1960s and 1970s with the discovery that the intravenous injection of amphetamines (particularly methamphetamine) produced enhanced euphoric effects with a more rapid onset than oral administration. Although structurally similar to amphetamine, methamphetamine has more pronounced effects on the CNS.12 Between 1986 and 1989, law enforcement and treatment admission professionals in Hawaii reported that abuse of a concentrated form of methamphetamine (known as "ice," "glass," and "crystal") was increasing.13 Methods of Use Amphetamine and methamphetamine pills can be ingested orally, crushed and snorted, dissolved in water and injected, or smoked (inhalation of the vaporized drug). "Glass" and "ice" (pure methamphetamine, which look like clear crystalline rock) is most often smoked (vaporized and inhaled) in a glass pipe, allowing for quick absorption into the bloodstream without the risks of injecting the drug. "Crystal" the powder form of methamphetamines, is consumed orally, injected, or inhaled.14 Amphetamine's Effects on the Brain When amphetamines are used, the neurotransmitters dopamine and norepinephrine are released from nerve endings in the brain and their reuptake is inhibited. This a buildup of these neurotransmitters at synapses in the brain. When nerve cells in the brain and spinal cord are activated by amphetamine, the mental focus, the ability to stay awake, and the ability to concentrate is improved, which is helpful for those with hyperactivity disorders or narcolepsy. Although the physiological experience of using amphetamines and cocaine is almost identical, the effects of amphetamines can last several hours whereas the effects of cocaine generally last less than one hour.15 When mixed with alcohol or other drugs, the effects of prescription amphetamines are enhanced.16 The onset of effects from injecting methamphetamines occurs immediately. When this drug is snorted, effects occur within 3 to 5 minutes; when ingested orally, effects occur within 15 to 20 minutes.17
Short-Term Effects
Long-Term Effects
Potential for Abuse The National Drug Intelligence Center reports that between two and four million children have been diagnosed with attention deficit/hyperactivity disorder and as a result been legally prescribed amphetamine, which can improve symptoms when used properly.34 When prescription amphetamines are taken orally and in low doses, drug abuse and addiction is not a serious risk. However, drug addiction becomes a risk when prescription amphetamines are consumed at doses higher than those prescribed for medical treatment.35 Abuse of amphetamines, which can lead to tolerance and physical and psychological dependence, is characterized by consuming increasingly higher dosages, and by the "binge and crash" cycle, when users attempt to maintain their high by overindulging on these drugs.36 When binge episodes end, the abuser "crashes" and is left with severe depression, anxiety, extreme fatigue, and a craving for more drugs.37 The chronic abuse of amphetamine and methamphetamine is characterized by violent and erratic behavior, as well as a psychosis similar to schizophrenia, that can involve paranoia, picking at the skin, and auditory/visual hallucinations. All forms of methamphetamine are highly addictive and toxic.38 Terminology Street amphetamine:
Street dextroamphetamine:
Street methamphetamine:
Concentrated methamphetamine hydrochloride:
Combinations:
Use and users:
__________________________________________________ 1 MEDLINEplus. (2004, November 8). Amphetamines (Systemic). Retrieved October 13, 2006, from http://medlineplus.nlm.nih.gov/medlineplus/druginfo/uspdi/202031.html. 2 Drug Enforcement Administration: Methamphetamine. Retrieved October 13, 2006, from http://www.dea.gov/concern/meth_factsheet.html. 3 Brands, B., Sproule, B., and Marshman, J. (Eds.). (1998). Drugs & Drug Abuse (3rd ed.). Addiction Research Foundation. 4 National Drug Intelligence Center. (2002, August). Prescription Drug Abuse and Youth. In Information Brief Retrieved October 13, 2006, from http://www.usdoj.gov/ndic/pubs1/1765/index.htm; MEDLINEplus; Carson-DeWitt, R. (Ed.). (2001). Encyclopedia of Drugs, Alcohol & Addictive Behavior (2nd ed., Vol. 1 (A-D)). Durham, NC: Macmillan. 5 MEDLINEplus, (2004). 6 Carson-DeWitt, R. (2001). 7 DEA Congressional Testimony, by Terrance Woodworth (2000, May 10). Retrieved October 13, 2006, from http://www.dea.gov/pubs/cngrtest/ct051600.htm. 8 Carson-DeWitt, R. (2001). 9 Indiana Prevention Resource Center. Stimulants. Retrieved October 13, 2006, from http://www.drugs.indiana.edu/resources/druginfo/drugs/stimulants.html; Brands, B., (1998). 10 Carson-DeWitt, R. (Ed.). (2001); Brands, B., (1998). 11 Carson-DeWitt, R. (Ed.). (2001). 12 National Institute on Drug Abuse. (2002, January). Methamphetamine Abuse and Addiction. Retrieved October 13, 2006, from http://www.nida.nih.gov/ResearchReports/methamph/methamph.html. 13 Carson-DeWitt, R. (Ed.). (2001); Brands, B., (1998); Goldstein, A. (2001). Addiction: from biology to drug policy (2nd ed.). New York: NY: Oxford University Press. 14 Brands, B., (1998); National Drug Intelligence Center; DEA Congressional Testimony, by Terrance Woodworth; Carson-DeWitt, R. (Ed.). (2001); Indiana Prevention Resource Center; Goldstein, A. (2001). In The Know Zone: Amphetamines 15 Brands, B., (1998). Drug Enforcement Administration. Stimulants. Retrieved October 13, 2006, from http://www.dea.gov/pubs/abuse/5-stim.htm. 16 DEA Diversion Control Program. (2001, June). Stimulant Abuse By School Age Children: A Guide for School Officials Retrieved October 13, 2006, from http://www.deadiversion.usdoj.gov/pubs/brochures/stimulant/stimulant_abuse.htm; Brands, B., (1998). 17 National Institute on Drug Abuse, (2002). 18 National Drug Intelligence Center, (2002); Brands, B., (1998). 19 National Drug Intelligence Center, (2002). 20 Carson-DeWitt, R. (Ed.). (2001). 21 Indiana Prevention Resource Center. 22 Brands, B., (1998). 23 Goldstein, A. (2001). 24 Carson-DeWitt, R. (Ed.). (2001). 25 MEDLINEplus, (2004). 26 Carson-DeWitt, R. (Ed.). (2001). 27 Indiana Prevention Resource Center. 28 National Drug Intelligence Center (2002). 29 DEA Diversion Control Program, (2001). 30 National Institute on Drug Abuse, (2002). 31 DEA Congressional Testimony, by Terrance Woodworth; Carson-DeWitt, R. (Ed.). (2001); Brands, B., (1998); Goldstein, A. (2001). 32 Goldstein, A. (2001). 33 Indiana Prevention Resource Center; Brands, B., (1998). 34 Carson-DeWitt, R. (Ed.). (2001); Goldstein, A. (2001). 35 NIDA Info Facts. (2005, May). Methamphetamine. Retrieved October 13, 2006, from http://www.nida.nih.gov/Infofax/methamphetamine.html. 36 Brands, B., (1998); Carson-DeWitt, R., M.D., (2001). 37 Carson-DeWitt, R. (Ed.). (2001). 38 Brands, B., (1998); DEA:
*Information regarding Amphetamines supplied by the Center for Substance Abuse Research, University of Maryland
Methamphetamine(for printable version of this click here) PROFILE Methamphetamine is a highly addictive and very potent central nervous stimulant, also known as “meth,” “crystal meth,” “ice,” and “glass.”1 A Schedule II drug, methamphetamine is an extremely powerful amphetamine. The effects are long-lasting and users have been known to stay awake for days during binges. Methamphetamine abuse and production is concentrated in the Western, Southwestern, and Midwestern United States.2 Additionally, the growth of independent U.S.-based laboratories has dramatically increased in the Pacific Northwest, Midwest, and some portions of the Southeast. Production and availability is also beginning to spread to the Northeast. Due to increased restrictions on cold preparations and pharmaceuticals containing methamphetamine, as well as restrictions on the importation of bulk pseudoephedrine from Canada, the number of domestic methamphetamine superlabs has greatly decreased in the past few years. To offset that decline, the expansion of Mexican-based trafficking groups has increased their control of illegal laboratories and superlabs.3 HISTORY Methamphetamine was derived from amphetamine in Japan in 1919. Both of these chemicals were originally used in nasal decongestants and in bronchial inhalers. Methamphetamine has also been used in the treatment of obesity. 4 It first was brought to the United States in the 1930’s, but use of the drug surged in the 1950’s and 1960’s when users began injecting more frequently.5 The drug was outlawed as a part of the U.S. Drug Abuse and Regulation Control Act of 1970. Production and trafficking soared again in the 1990’s in relation to organized crime in the Southwestern United States and Mexico.6 METHOD OF USE Methamphetamine can be taken orally, by intravenous injection, by smoking, or by snorting. The drug appears in powder (“crystal”) form, which can be processed into a rock (“ice”) or liquid form for the purpose of injection. After taking the drug, users experience a short but intense rush that lasts 5 to 30 minutes, depending on the route of administration. Afterwards, the stimulant’sother effects, including increased activity, decreased appetite, and a sense of well-being, can last 6 to 12 hours. Some users will continue taking doses of methamphetamine occasionally to sustain the high and to avoid the severe withdrawal symptoms.7 METHAMPHETAMINE’S EFFECTS ON THE BRAIN Methamphetamine stimulates the release of excess dopamine, which plays an important role in the regulation of pleasure.8 The release of dopamine and serotonin produce the intense rush that users feel. Even after the initial rush subsides, the brain remains in an alert state and keeps the user’s body on edge. After the effects have worn off, the brain is depleted of its dopamine, and depression is a common result. Methamphetamine is easily addictive because the highs are so intense and the lows are so severe. In addition, regular users build up a tolerance to the drug’s effects, needing more of the drug to feel the original effect. Furthermore, methamphetamine can be extremely addictive. Methamphetamine appears to have neurotoxic (brain-damaging) effects, destroying brain cells that contain dopamine and serotonin.9 Over time, abuse appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson’s disease.10 Methamphetamine also stimulates locomotor activity (i.e., reflexes, basic physical movements) and produces “stereotypic behaviors”—random, repetitive, compulsive movements and actions such as twitching or picking at the skin—as a side effect.11 METHAMPHETAMINE’S EFFECTS ON THE USER In addition to being physically addictive, methamphetamine can also be very psychologically addictive as well. Under the influence of methamphetamine, users experience bursts of energy, talkativeness, and excitement. Users are able to go for hours or even days without sleep or food.12 High doses or chronic use have been associated with increased nervousness, irritability, paranoia, and occasionally violent behavior, while withdrawal from high doses generally leads to severe depression. Chronic abuse produces a psychosis similar to schizophrenia and is characterized by paranoia, picking at the skin, self-absorption, auditory and visual hallucinations, and sometimes episodes of violence.13 Tweaking The most dangerous stage of methamphetamine abuse occurs when an abuser has not slept in 3-15 days and is irritable and paranoid. This behavior is referred to as “tweaking,” and the user is known as the “tweaker.” The tweaker craves more methamphetamine, but it is difficult to achieve the original high, causing frustration and unstable behavior in the user. Because of the tweaker’s unpredictability, there have been reports that they can react violently, which can lead to involvement in domestic disputes, spur-of-the-moment crimes, or motor vehicle accidents. A tweaker can appear normal – eyes clear, speech concise, and movements brisk; however, a closer look will reveal that the person's eyes are moving ten times faster than normal, the voice has a slight quiver, and movements are quick and jerky. These physical signs are more difficult to identify if the tweaker has been using a depressant such as alcohol; however, if the tweaker has been using a depressant, his or her negative feelings—including paranoia and frustration – can increase substantially. A person should use extreme caution when dealing with an individual on methamphetamine.14
Short-Term Effects15
Long-Term Effects16 These negative effects can occur during or after methamphetamine intoxication:
SIGNS OF ABUSE There are several indicators that can help identify a person who has been abusing methamphetamine. Chronic use can cause violent behavior, anxiety, confusion, insomnia, auditory hallucinations, mood disturbances, delusions, and paranoia.17 Chronic methamphetamine users also often display poor hygiene, a pale, unhealthy complexion, and sores on their bodies due to formication—the sensation of bugs creeping on the skin.18 If this type of behavior is not typical for that person, he or she may have a drug problem.
TERMINOLOGY19 Slang Terms for Methamphetamine:
Slang Terms for Smokable Methamphetamine:
___________________________________________________________________ 1 NIDA Methamphetamine Infofax. http://www.drugabuse.gov/Infofax/methamphetamine.html. October 6, 2006. 2 DEA Methamphetamine Page. http://www.dea.gov/concern/meth_factsheet.html. October 6, 2006. 3 ONDCP Methamphetamine Page. http://www.whitehousedrugpolicy.gov/drugfact/methamphetamine/index.html. October 6, 2006 4 Methamphetamine Addiction Page. http://www.methamphetamineaddiction.com/methamphetamine_hist.html. October 6, 2006. 5 ACDE Methamphetamine Facts. http://www.acde.org/common/meth.htm. October 6, 2006. 6 ACDE Methamphetamine Facts. October 9, 2006. 7 NIDA Research Report. http://www.drugabuse.gov/ResearchReports/methamph/methamph.html. October 9, 2006. 8 NIDA Research Report. 9 NIDA Methamphetamine Infofax. 10 NIDA Methamphetamine Infofax. 11 NIDA Methamphetamine Infofax. 12 ACDE Methamphetamine Facts. 13 ACDE Methamphetamine Facts. 14 Stop Drugs Methamphetamine Page. http://www.stopdrugs.org/tweaking.html. October 9, 2006 15 NIDA Research Report. 16 NIDA Research Report. 17 DEA Methamphetamine Page 18 NIDA Research Report. 19 ONDCP Methamphetamine Street Terms. http://www.whitehousedrugpolicy.gov/streetterms/ByType.asp?intTypeID=14. October 9, 2006.
*Information regarding Methamphetamines supplied by the Center for Substance Abuse Research, University of Maryland
Ecstasy(for a printable version of this click here) Profile MDMA (3,4-Methylenedioxymethamphetamine) is the chemical found in the synthetic "club drug" ecstasy, a drug with stimulant and hallucinogenic effects. It is currently a Schedule I drug. History In 1912, a German pharmaceutical company first synthesized MDMA in an attempt to create an appetite suppressant. In the late 1970's, it was rediscovered by a small group of U.S. therapists hoping to utilize it in psychotherapy and marriage counseling. MDMA became illegal in 1988 and was categorized as a Schedule I drug. Recreational, illicit use of the drug started becoming popular in the United States in the late 1980's and early 1990's.1 Ecstasy soon became popular at 'raves' - large dance parties with throbbing electronic music and pulsating lights. Currently, however, raves are not the only setting where ecstasy is used; abuse at house parties, college dorms, and various other places has become more widespread. Methods of Use Ecstasy is most often available in tablet form and is usually ingested orally, although some users have reported taking it anally (known as "plugging" or "shafting"). Users have also been known to "parachute" the tablet, by placing the pill in a napkin, crushing it, and then swallowing the piece of napkin in an attempt to speed up the drug's onset. MDMA is also available in powder form, often contained in geltabs, and is sometimes snorted and occasionally smoked, but rarely injected. Purity Today, a high percentage of pills contain other drugs; some pills marketed as ecstasy may not even contain any MDMA. These adulterants can include other club drugs such as MDA, PMA, Ketamine, PCP, and DXM, while some pills are cut with ephedrine, pseudoephedrine, and even caffeine and over-the-counter medications. It is believed that the contents of a pill can be identified based on its logo or color (e.g.- red pills are believed to contain mescaline, brown pills assumed to contain heroin, etc.), but a pill's color and logo say nothing about its ingredients, as pill manufacturers often add food coloring to dye the tablets.2 MDMA'S Effects on the Brain MDMA affects levels of serotonin, a neurotransmitter in the brain that is related to mood (and pleasure), sleep, and heart rate. When ingested in the body, MDMA causes the brain to flood itself with serotonin, causing the body to have heightened sensitivity and the individual to be intensely emotional and empathetic. However, when the effects of ecstasy wear off, the brain is depleted of much of its supply of serotonin. Because of this substantial loss, depression is a common after-effect of MDMA use. MDMA has also been shown to damage some critical thought and memory functions of the brain, along with contributing to the degeneration of serotonin-producing neurons and dopamine transmitters. This damage may be long-term.3
MDMA'S Effects on the User About 20 to 40 minutes after taking a tablet, the user experiences small rushes of exhilaration, often accompanied by nausea. Sixty to 90 minutes after taking the drug, the user feels the peak effects. Users may continue to experience effects for up to 6 hours, and can feel "cracked-out" (drained, burned-out) for up to 2 days later, due to the heavy loss of serotonin and the great strain that the drug causes on the user's body.4 Short-Term Effects Short-term effects of ecstasy use can include:
Long-Term Effects Long-term effects of ecstasy use can include:
Ecstasy-related deaths have been reported, usually as a result of heatstroke from dancing in hot clubs for long hours without replenishing lost body fluids.6 Dehydration and heat exhaustion are the two biggest dangers when under the influence of MDMA. It is important to note that there are many other side effects that can occur from other unknown drugs/substances that could be in the ecstasy tablet. These can include addiction, overdose, and death. MDMA and Sex Many users will abuse ecstasy simply for the 'body high' - the senses of feeling and touch that become intensely pleasurable. This physical sensitivity, paired with the feelings of self-acceptance and empathy for others, can often lead to an increased sex drive and feelings of intimacy. This is why some people consider ecstasy to be an aphrodisiac, or even one of the date-rape drugs. Nevertheless, while MDMA may enhance sexual desire, it also impairs sexual performance. Males may be unable to achieve erection under the peak effects of ecstasy, while both sexes have great difficulty in achieving orgasm. In addition, due to the effects of dehydration and heat exhaustion, both sexes can encounter a lack of lubrication - the number one cause of condom breakage. And because ecstasy lowers inhibitions and can heighten arousal, it can easily lead to risky behavior in which the user would not generally participate.
Sextasy Throughout the country, and Maryland, there have been reports of a new combination of drugs that has been hitting the streets and club scenes. Ecstasy (a drug with stimulant and hallucinogenic effects) and Viagra (a prescription drug for erectile dysfunction) are being used as one, a combination known as "sextasy" or "trail mix7." Together they produce a synergistic effect where the effects of the two drugs are greater then the effect of each drug individually.8 Ecstasy, which research has shown to negatively effect serotonin levels in the brain, has been found to increase the senses of feeling and touch. This physical sensitivity can often lead to an increased sex drive and feelings of intimacy. However, ecstasy can also impair sexual performance, making it more difficult for males to achieve an erection.9 Viagra on the other hand relaxes muscles within the penis allowing for increased blood flow necessary to achieve and maintain an erection.10 By combining the two drugs users are attempting to defeat the impotence side effect of ecstasy in order to increase sexual performance and functioning. And although having sex may not be the intention in combining Viagra with ecstasy, sex often occurs in these instances leaving both partners open to increased risks of sexually transmitted diseases.11 But regardless, even without the involvement of sex, the mixture of these two drugs can produce severe side effects. One of the most well-known and frequent is known as "priapism," a condition in which an erection can last for four hours, which can lead to permanent damage.12 The most current research involving these two drugs took place in San Francisco where researches found that about 43% of gay men surveyed were using ecstasy in combination with Viagra.13 Paraphernalia Users can often be seen with water and pacifiers - items used to counteract side effects of MDMA such as dry-mouth, dehydration, and jaw or teeth-clenching. Lollipops and chewing gum may also be used for the same reasons. Dancers at raves often use glowsticks and small handheld lights used to enhance the visual effects of ecstasy, although glowsticks are also a common feature of this style of dancing. Other paraphernalia includes Vick's Vapo-Rub®, Vick's Inhaler®, other menthol products, and nearly anything else that can be used to stimulate the senses. Users can often be seen hugging or massaging one another, as physical sensitivity is extremely heightened. Terminology Slang Terms for Ecstasy:
Slang Terms Related to Dosage or Effects:
Common "Brand Names" of Ecstasy Pills:
Use & Users:
_________________________________________________________ 1 NIDA Research Report Series. MDMA (Ecstasy) Abuse – A Brief History of MDMA. Retrieved October 18, 2006, from http://www.drugabuse.gov/ResearchReports/MDMA/MDMA2.html#history; NIDA Notes. Facts About MDMA (Ecstasy). Retrieved October 18, 2006, from http://www.nida.nih.gov/NIDA_Notes/NNVol14N4/tearoff.html. 2 Julie Holland. Ecstasy: The Complete Guide. A comprehensive look at the risks and benefits of MDMA. 2001. 3 NIDA. (2004, June). InfoFacts: MDMA (Ecstasy). Retrieved October 18, 2006, from http://www.drugabuse.gov/Infofacts/ecstasy.html. 4 NIDA Notes. Facts About MDMA (Ecstasy). 5 NIDA. InfoFacts: MDMA (Ecstasy). 6 American Council for Drug Education. Basic Facts About Drugs: Ecstasy. Retrieved October 18, 2006, from http://www.acde.org/common/ecstasy.htm. 7 DEA. (2006, August). MDMA (Ecstasy). Retrieved October 18, 2006, from http://www.dea.gov/concern/mdma.html; NIDA Notes. Facts About MDMA (Ecstasy). 8 WebMD. “New Drug Phenom: Ecstasy + Viagra = 'Trail Mix'.” Retrieved October 18, 2006, from http://my.webmd.com/content/article/1728.84361. 9 Baltimore Sun. “Mixed Drugs Spur Renewed Warnings.” 10 Centers for Disease Control and Prevention. (2001, August 24). “A Deadly Mix – Viagra and ‘Club Drug’ Use Found Prevalent.” Retrieved October 18, 2006, from http://www.thebody.com/cdc/news_updates_archive/aug24_01/viagra.html. 11 WebMD. “Sildenafil – Oral.” Retrieved October 18, 2006, from http://www.webmd.com/drugs/mono-297-SILDENAFIL+-+ORAL.aspx?drugid=7417&drugname=Viagra. 12 National Review of Medicine. (2004, April 30). “The Agony and the Sextasy.” Retrieved October 18, 2006, from http://www.nationalreviewofmedicine.com/issue/2004_04_30/men03_09.html. 13 Centers for Disease Control and Prevention. “A Deadly Mix – Viagra and ‘Club Drugs’ Use Found Prevalent.” 14 Centers for Disease Control and Prevention. (2002, July 11). “San Francisco: Increased Risk of HIV and Sexually Transmitted Disease Transmission Among Gay or Bisexual Men Who Use Viagra.” Retrieved October 18, 2006, from http://www.thebody.com/cdc/news_updates_archive/july11_02/viagra.html.
*Information regarding Ecstasy supplied by the Center for Substance Abuse Research, University of Maryland
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