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The 2014 Region 4 Prevention Resource Center's Regional Needs Assessment has been completed, and the PRC team is eager to disseminate the report, gather feedback, and find new sources for data collection as we discuss it with the community. For data...read more

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CDC Recruiting for Next “Tips from a Former Smoker” Campaign

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  CDC’s 2016 Tips Campaign Recruitment Dear Colleagues,   We are beginning our ad participant recruitment efforts for the 2016 Tips From Former Smokers (Tips) campaign and would greatly appreciate your help to broadly share this information. Similar to previous ...read more

Town Hall Meetings Update from SAMHSA

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Town Hall Chat   Preventing Underage Drinking During the Holidays Please share this e-alert with others to encourage them to add underage drinking prevention to their holiday activities.  Also, join Frances M. Harding, Director of the Substance Abuse and...read more

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Marijuanna/Hashish

Common Names: weed, pot, grass, bud, joints, bong hits, Mary Jane

Methods of Use: smoked or ingested

Psychological/Physical Effects: poor concentration, short-term memory loss, anxiety, increased appetite Long Term Effects: psychological addiction, impaired memory, low motivation, lung and oral cancer

The main active chemical in marijuana is delta-9tetrahydrocannabinol, or THC. It also contains more than 400 other chemicals. Many individuals believe marijuana is a harmless recreational drug, but in reality it is dangerous and psychologically addictive. THC affects the hippocampus of the brain, the area of the brain that controls learning and memory and is tied to the senses, emotions and motivation. This means the pot user has a major break between his/her senses and what is reality because the THC alters the hippocampus’ ability to properly process sensory information. This obviously impairs judgment, which could easily endanger the user or those with whom they come into contact. For example, in one study 33 percent of arrested reckless drivers tested positive for marijuana.

Many believe that marijuana simply causes one to relax, relieve stress, have a good time, but marijuana’s effects can be unpredictable. Users can become dizzy, have difficulty walking and have red, bloodshot eyes. Terrible thirst – “cotton mouth” – and hunger – “the munchies” – are common experiences. Some people fall asleep when they use pot, but others experience anxiety or paranoia every time they use the drug. Another misconception is that smoking marijuana is safer than smoking cigarettes, but in truth its takes four cigarettes to equal just one marijuana joint in terms of carcinogens or cancer causing agents, so the health risks are greater.

There are both short and long-term effects of using marijuana. After only a few uses, marijuana can create problems with memory, learning, and problem solving, which often results in poor grades. Coordination is damaged and senses are distorted often contributing to weaker performances in sports and other activities. On the long-term marijuana use can lead to amotivational syndrome – a loss of interest in the future or things the pot smoker use to care about or find important. It can take up to two years off pot to gain a normal motivational level. The long-term health consequences associated with marijuana include: permanent damage to thinking and reasoning ability; chronic bronchitis, frequent chest colds, and pneumonia; increased risk of lung or oral cancer; weakened immune system; damage to the reproductive system and infertility in both sexes; miscarriage or brain damage to fetuses.

Alcohol

Common Names: beer, wine, distilled spirits

Methods of Use: ingested

Psychological/Physical Effects: disorientation, poor coordination, slurred speech, loss of inhibitions, headache, nausea, vomiting, diarrhea, unconsciousness

Long Term Effects: addiction, sleep disturbances, brain damage, heart disease, liver disease, cancers, death

Alcohol is the most commonly used drug in our society today and is responsible for thousands of deaths each year. The term alcohol refers to ethyl or grain alcohol, which is the active ingredient found in all alcoholic beverages. A standard drink is 12 grams of pure ethanol, which equals: 12 ounces of beer or wine cooler; 8 ounces of malt liquor; 5 ounces of wine; 1 ½ ounces of 80-proof distilled spirits (whiskey, etc.) None of these drinks is safer than the other because alcohol is alcohol, and over time the effect is still the same.

Alcohol is a depressant, not a stimulant and its effect on the central nervous system is similar to that of other depressants. It slows the reflexes and impairs coordination. As the brain slows, dopamine is released and the level of opioid peptides increase, (opioid peptides are naturally occurring chemicals in the body, and when mixed with alcohol, mimic opium and sedate the senses) the drinker becomes numb to pain and grows sleepy. As a person continues to drink the central nervous system slows down, sometimes to dangerous levels. Over time, alcohol causes neuroadaptation – permanent changes in the brain. Alcohol has almost no vitamins, minerals, protein, or fat – just large amounts of carbohydrates. The body’s cells cannot use alcohol, and only an enzyme from the liver can metabolize alcohol from the body, which is why liver damage is so common among alcoholics. More than two million Americans suffer from liver disease caused by alcohol.

Alcohol is also addictive, and the addiction is both mental and physical. One in seven drinkers becomes dependent on alcohol, and the disease of alcoholism worsens over time causing multiple personal problems for the user, including troubled relationships and economic loss, not to mention the devastating health effects. On average the life expectancy of an alcoholic is 10 to 12 years less than that of the general population.

Abuse of alcohol through binge drinking also creates serious risks. Binge drinking is defined as five standard drinks in a row for men and four for women. For example, three drinks in one hour for a 170 pound person could easily put that drinker over the legal limit. In most states the legal limit is .10 percent, but in the state of Texas .08 percent is the legal limit, so what does that mean? In the state of Texas it means that when a person’s Blood Alcohol Concentration (BAC) reaches .08 percent, that person is considered legally drunk and in no way should engage in activities, such as driving, that put himself/herself at risk or anyone else. It also means that individual could be charged with Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) if stopped by law enforcement. If that person happened to be a minor then additional penalties could apply.

Heavy, fast drinking is also a terribly risky thing to do. Besides the normal effects of a hangover, which brings headache, nausea, vomiting, shakiness, etc., there is also a risk of alcohol poisoning and respiratory arrest, and they can lead to coma or death. BAC levels of .40 percent or higher could produce such a result. Accidents also occur more frequently during episodes of binge drinking as well as the likelihood of having unsafe sex. Even though binge drinking is not considered alcoholism, binge drinkers are more likely to develop the disease than the average population and binge drinkers are putting their health at great risk.

The short-term effects of drinking include: slower reactions and poor coordination; heavy sweating; blurry or double vision; nausea and vomiting; lowered reasoning ability; doing or saying things you otherwise would not; lower heart rate; slowed breathing; anxiety and restlessness; mental confusion; memory loss; coma; death from respiratory arrest.

Long-term effects of drinking include: liver disease; heart disease and stroke; brain cell death; cancer of the mouth, pharynx, esophagus, breast, pancreas, liver, colon, and rectum; decreased bone density; damage to eyes and skin; malnutrition and gastric illnesses; sexual dysfunction in men and women.

Every effect of alcohol is more damaging in teenagers than it is in adults because the adolescent body is still developing, and alcohol can impede that development, especially the brain and bones. Women are also at greater risk because most alcohol-related diseases progress more rapidly in women than in men.

Rohypnol

Common Names: roofies, forget-me-pill, date-rape drug

Methods of Use: ingested or snorted

Psychological/Physical Effects: disorientation, poor coordination, slurred speech, headache, nausea, vomiting and diarrhea, unconsciousness

Long Term Effects: addiction, sleep disturbances, brain damage, heart disease, liver disease, cancers and death

Rohypnol, a trade name for the drug flunitrazepam, is a central nervous system depressant. The drug is legally manufactured and available outside the United States but is neither manufactured nor approved for sale within the United States. Since the 1990s individuals in the United States have used Rohypnol illegally, often as a means of mitigating the depression that results from using stimulants such as cocaine and methamphetamine. Rohypnol also has been used in the commission of sexual assaults.

Rohypnol is manufactured as a caplet. In 1997 the manufacturer responded to concerns about the drug's role in sexual assaults by reformulating the white, 2-milligram tablets. (The original tablets dissolved clear in liquid, making it nearly impossible for a victim to detect their presence in a beverage.) The new smaller dosage (0.5 mg and 1.0 mg) caplets are dull green with a blue core that, when dissolved in light-colored drinks, will dye the liquid blue. However, the dye may be disguised in blue or dark-colored liquids, and generic versions of the drug may not contain the blue dye.

Individuals who abuse Rohypnol may swallow the caplets whole, crush and then snort the powdered caplets, or dissolve the caplets in liquid and then inject the solution. Sexual predators who administer Rohypnol to their victims typically slip the drug into a drink, often at a bar or party. The blue color that results from mixing Rohypnol with a beverage often is masked by serving blue tropical drinks or by serving the drink in dark or opaque containers.

The effects of the drug typically are felt within 15 to 20 minutes of administration and may persist for more than 12 hours. Individuals who abuse Rohypnol often experience drowsiness, headaches, memory impairment, dizziness, nightmares, confusion, and tremors. Although the drug is classified as a depressant, Rohypnol can induce aggression or excitability.

In addition to the risks associated with the drug itself, individuals who use Rohypnol may put themselves at risk of sexual assault. While many sexual predators lace unsuspecting victims' drinks with the drug, others offer Rohypnol to victims who consume the drug without understanding the effects it will produce. Rohypnol users who inject the drug expose themselves to additional risks, including contracting HIV (human immunodeficiency virus), hepatitis B and C, and other blood-borne viruses.

GHB (Gamma Hydroxybutyrate) and its analogs

Common Names: grievous bodily harm, G liquid x

Methods of Use: Ingested

Psychological/Physical Effects: disorientation, poor coordination, slurred speech, headache, nausea, vomiting, and diarrhea, unconsciousness

Long Term Effects: addiction, sleep disturbances, brain damage, heart disease, liver disease, cancers, death

GHB (gamma-hydroxybutyrate) is a powerful central nervous system depressant that the human body produces in small amounts. A synthetic (man-made) version of GHB was developed in the 1920s as an anesthetic. Individuals abuse synthetic GHB because of its euphoric and sedative effects. Because of its anesthetic properties, GHB also has been used by sexual predators to incapacitate their victims. GHB analogs, which include GBL, BD, GHV, and GVL, are drugs that possess chemical structures that closely resemble GHB. These analogs produce effects similar to those associated with GHB and are often used in its place.

GHB and its analogs typically are sold either as a white powder or as a clear liquid. The drugs often have a salty taste.

GHB and its analogs usually are taken orally. Because of the drugs' salty taste, they often are mixed with a flavored beverage. Sexual predators who administer GHB or an analog to their victims typically slip the drug into a drink, often at a bar or party. Use of GHB and its analogs can cause nausea, vomiting, delusions, depression, dizziness, hallucinations, seizures, respiratory distress, loss of consciousness, slowed heart rate, lowered blood pressure, amnesia, coma, and death. Mixing GHB or its analogs with alcohol is particularly dangerous because alcohol enhances the drug's depressant effects.

Sustained use of GHB or its analogs can lead to addiction, and chronic users experience withdrawal symptoms when they stop using the drugs. These symptoms include anxiety, insomnia, tremors, tachycardia (abnormally fast heart rate), delirium, and agitation. Users may experience these symptoms within 1 to 6 hours of their last dose, and the symptoms may persist for months.

In addition to the risks associated with the drugs themselves, individuals who use GHB or its analogs may put themselves at risk of sexual assault. While many sexual predators lace unsuspecting victims' drinks with the drugs, others offer GHB or an analog to victims who consume the drug without understanding the effects it will produce.

Prescription Pain Relievers

Common Names: benzodiazepines, barbiturates, Xanax, Valium, benzos

Methods of Use: ingested

Psychological/Physical Effects: disorientation, poor coordination, slurred speech, headache, nausea, vomiting, and diarrhea, unconsciousness

Long Term Effects: addiction, sleep disturbances, brain damage, heart disease, liver disease, cancers, death

Cocaine/Crack

Common Names: coke, blow, crack, rock

Methods of Use: snorted, smoked, or injected

Psychological/Physical Effects: increased alertness, false sense or power, hallucinations, itchy skin, compulsive tooth grinding, nausea, insomnia

Long Term Effects: addictions, nasal damage, tooth decay, liver and kidney damage, brain damage and heart failure

Powdered cocaine (cocaine hydrochloride) is a stimulant that is extracted from the leaves of the coca plant, which is native to South America. In the late 19th century cocaine was used as an anesthetic, but the availability of safer drugs rendered many of its medical applications obsolete. Today powdered cocaine is abused for the intense euphoric effects it produces. Cocaine typically is sold to users as a fine, white, crystalline powder.

Powdered cocaine typically is snorted (inhaled through the nose), although it may be dissolved in water and injected. When snorted, the drug is absorbed into the bloodstream through the nasal membranes. The drug reaches the brain--and produces its euphoric effect--within 3 to 5 minutes. When injected, the drug is released directly into the bloodstream and reaches the brain within 15 to 30 seconds. Powdered cocaine is a powerful central nervous system stimulant. Individuals who use the drug may become restless, irritable, and anxious. Use of powdered cocaine also can result in constricted blood vessels and increased temperature, heart rate, and blood pressure. Heart attack, respiratory failure, stroke, and seizure also may result from cocaine use. Using cocaine at the same time as alcohol is consumed is particularly dangerous because it heightens the cocaine's euphoric effect and potentially increases the risk of sudden death.

Cocaine is a very addictive drug. Chronic users risk developing tolerance to cocaine's effects. Many addicts report that as tolerance develops they fail to achieve the positive effects they experienced when they first began using the drug; thus, they begin to use cocaine with greater frequency and in larger doses.

Cocaine users who inject the drug expose themselves to additional risks, including contracting human immunodeficiency virus (HIV), hepatitis B and C, and other blood-borne viruses.

Crack cocaine is a highly addictive and powerful stimulant that is derived from powdered cocaine using a simple conversion process. Crack emerged as a drug of abuse in the mid-1980s. It is abused because it produces an immediate high and because it is easy and inexpensive to produce--rendering it readily available and affordable. Although, many crack cocaine users are now using crystal meth because the high is very similar, and the effects are much longer.

Crack is produced by dissolving powdered cocaine in a mixture of water and ammonia or sodium bicarbonate (baking soda). The mixture is boiled until a solid substance forms. The solid is removed from the liquid, dried, and then broken into the chunks (rocks) that are sold as crack cocaine. Crack typically is available as rocks. Crack rocks are white (or off-white) and vary in size and shape. Crack is nearly always smoked. Smoking crack cocaine delivers large quantities of the drug to the lungs, producing an immediate and intense euphoric effect.

Cocaine, in any form, is a powerfully addictive drug, and addiction seems to develop more quickly when the drug is smoked--as crack is--than snorted--as powdered cocaine typically is.

In addition to the usual risks associated with cocaine use (constricted blood vessels; increased temperature, heart rate, and blood pressure; and risk of cardiac arrest and seizure), crack users may experience acute respiratory problems, including coughing, shortness of breath, and lung trauma and bleeding. Crack cocaine smoking also can cause aggressive and paranoid behavior.

Methamphetamine

Common Names: meth, crystal, speed, crank, ice, glass, tweak

Methods of Use: smoked, snorted, or injected

Psychological/Physical Effects: increased alertness, false sense of power, hallucinations itchy skins, compulsive tooth grinding, nausea, insomnia

Long Term Effects: addiction, nasal damage, tooth decay, heat stroke, liver and kidney damage, brain damage, heart failure

Methamphetamine is one of the most dangerous drugs in our society today, and its use is on the rise. The most popular form of the drug is known as crystal methamphetamine and is most comparable to crack cocaine, but the high is of a much longer duration. So what exactly is methamphetamine and how does it work? Methamphetamine is a stimulant that acts on the nervous system, which controls the heart and lungs, digestion, sweating, etc. In the brain it imitates a specific neurotransmitter, which basically acts as a messenger chemical to the brain. It increases the release and blocks the uptake of dopamine, which creates the feelings of pleasure that meth users experience. The pleasurable effects fade quickly, but the user will maintain others effects of the high for hours. For example, meth users can stay “wired” for up to 12 hours. When the high ends the user usually experiences extreme depression, so he/she will immediately take the drug again. The creates a “binge and crash” cycle that can lasts for days. At the end of the run a user usually collapses. Needless to say, a meth user can have little productivity during or after a binge cycle.

Methamphetamine is highly addictive and fairly easy to get. Unfortunately it is being manufactured in illegal laboratories across the nation, including rural areas. Most of the products used to manufacture the drug can be purchased over the counter. However, they are still extremely dangerous and toxic, so meth labs themselves pose a danger because they can easily explode or ignite if chemicals are mixed or stored improperly. Exposure to the fumes can cause serious illnesses and reactions such as dizziness, nausea, pulmonary edema, respiratory problems, chemical burns and damage to internal organs. Unfortunately, children are sometimes exposed and become innocent victims of a parent’s or guardian’s drug habit.

Methamphetamine is very hard on a user’s body and mind, and it often creates unpredictable behavior. Users can expect to have short-term health consequences very early in their use. When a user first begins meth his/her physical activity level greatly increases, and the desire to eat and sleep are gone. Paranoia sets in early and this often leads to aggressive behavior or violence in many users. Other common side effects include nausea, vomiting, diarrhea, muscle twitches, and uncontrolled movements. Users often experience headaches due to compulsive jaw clenching. Methamphetamine commonly causes acne, and body sores are typical as well because the user can’t control obsessive scratching. Meth is a stimulant so the breath and heart rate are elevated, and the body temperature rises, so convulsions can also occur.

Methamphetamine is a very dangerous drug, and over time damage will occur. Heavy or long- term users can expect: tooth decay; anxiety, paranoia, and insomnia; psychotic behavior and violence; auditory hallucinations and delusions; homicidal or suicidal thoughts; elevated blood pressure; stroke; heart infections; kidney and liver damage; lead poisoning; brain damage similar to Alzheimer’s disease; premature delivery and/or birth defects; increased risk of HIV/AIDS and hepatitis B and C if injecting; and finally death.

MDMA (methylene dixoy methamphetamine) or Ecstasy

Common Names: X, XTC, the club drug, the love drug, rolls, Adam, the hug drug, lovers’ speed

Methods of Use: ingested

Psychological/Physical Effects: increased alertness, false sense of power, hallucinations, itchy skin, compulsive tooth grinding, nausea, insomnia

Long Term Effects: addiction, toothy decay, heat stroke, liver and kidney damage, brain damage, heart failure MDMA (3,4-methylenedioxymethamphetamine, also known as ecstasy) is a synthetic (man-made) drug that causes both hallucinogenic and stimulant effects. The drug was developed in Germany in the early twentieth century as an appetite suppressant, but today's users consume the drug for its hallucinogenic effects, which they claim heighten their senses and make them feel less inhibited. Users also consume MDMA for its stimulant properties, which enable them to dance for hours at all-night parties and nightclubs.

MDMA generally is sold as a tablet, which is taken orally. MDMA tablets are available in various colors and shapes and generally are imprinted with a logo. Popular logos include smiley faces, clover leaves, cartoon characters, and symbols associated with commercial brands such as Mitsubishi, Nike, and Mercedes.

MDMA is called a club drug because it often is used at all-night dance parties (called raves) or at techno parties and nightclubs. In addition, MDMA increasingly is being used in private homes and on high school and college campuses. The average retail price of an MDMA tablet is between $20 and $30 making it attractive and accessible to younger users.

The effects produced by consuming MDMA can last for 4 to 6 hours, depending upon the potency of the tablet. Using the drug can cause confusion, depression, anxiety, sleeplessness, craving for the drug, and paranoia. Use of the drug also may result in muscle tension, involuntary teeth clenching, nausea, blurred vision, tremors, rapid eye movement, sweating, or chills. People who have circulatory problems or heart disease face particular risks because MDMA can increase heart rate and blood pressure.

MDMA abusers also risk dehydration, hyperthermia (exceptionally high fever), and heart or kidney failure if they use the drug while physically exerting themselves or in hot environments. (These factors pose particular risks to individuals who use MDMA at raves or techno parties, where they may be dancing among crowds of people.)

Users also are at risk of consuming other drugs that may be sold to them as MDMA. In some instances, the synthetic drug PMA (paramethoxyamphetamine) has been sold as MDMA. Because PMA's hallucinogenic effects take longer to appear, users may consume too much of the drug, which can result in overdose death.

An additional risk results when other substances are added to MDMA tablets without the user's knowledge. Drugs such as heroin and methamphetamine reportedly have been added to MDMA tablets in some parts of the United States.

Prescription Pain Relievers

Common Names: amphetamines, Ritalin

Methods of Use: ingested

Psychological/Physical Effects: increased alertness, false sense of power, itchy skin, compulsive tooth grinding, nausea, insomnia

Long Term Effects: addiction, tooth decay, liver and kidney damage, brain damage, heart failure

The prescription drugs that are commonly abused in the United States fall into several broad categories: opioids/narcotics/pain relievers, depressants, and stimulants. Individuals abuse these drugs because they are an easily accessible and inexpensive means of altering a user's mental and physical state; the effects vary depending upon the drugs they abuse.

Prescription drugs are abused in a variety of ways. Many of the prescription drugs that are commonly abused are available as tablets. Typically abusers either consume the tablets orally or crush them into a powder, which they then snort. In some instances, abusers dissolve crushed tablets in water and then inject the solution.

The risks associated with prescription drug abuse vary depending upon the drugs that are abused. Abuse of opioids/narcotics/pain relievers can result in life-threatening respiratory depression (reduced breathing). Individuals who abuse depressants, including benzodiazepines, tranquilizers, barbiturates, and sedatives, place themselves at risk of seizures, respiratory depression, and decreased heart rate. Stimulant abuse can cause high body temperature, irregular heart rate, cardiovascular system failure, and fatal seizures. It can also result in hostility or feelings of paranoia. Individuals who abuse prescription drugs by injecting them expose themselves to additional risks, including contracting HIV (human immunodeficiency virus), hepatitis B and C, and other blood-borne viruses.

Prescription drugs are obtained in various ways. In some cases, unscrupulous pharmacists or other medical professionals either steal the drugs or sell fraudulent prescriptions. In a process known as doctor shopping, abusers visit several doctors to obtain multiple prescriptions. Individuals also call pharmacies with fraudulent prescription refills, or they alter prescriptions. Prescription drugs occasionally are stolen from pharmacies.

Young people typically obtain prescription drugs from peers, friends, or family members. Some individuals who have legitimate prescriptions sell or give away their drugs. Young people also acquire prescription drugs by stealing them from relatives and other individuals with legitimate prescriptions or from school medicine dispensaries.

Heroin

Common Names: dope, smack, stuff, horse, junk

Methods of Use: injected, snorted, or smoked

Psychological/Physical Effects: confusion, drowsiness, blocked pain messages, slowed breathing and heart rates, nausea and vomiting, itching and constipation

Long Term Effects: addiction, insomnia, arthritis, increased risk of HIV/AIDS and hepatitis, possible death

Heroin is a highly addictive and rapidly acting opiate (a drug that is derived from opium). Specifically, heroin is produced from morphine, which is a principal component of opium. Opium is a naturally occurring substance that is extracted from the seedpod of the opium poppy. The appearance of heroin can vary dramatically. In the eastern United States, heroin generally is sold as a powder that is white (or off-white) in color. (Generally, the purer the heroin the whiter the color, because variations in color result from the presence of impurities.) In the western United States, most of the heroin available is a solid substance that is black in color. This type of heroin, known as black tar, may be sticky (like tar) or hard to the touch. Powdered heroin that is a dirty brown color also is sold in the western United States. Heroin is injected, snorted, or smoked. Many new, younger users begin by snorting or smoking heroin because they wish to avoid the social stigma attached to injection drug use. These users often mistakenly believe that snorting or smoking heroin will not lead to addiction. Users who snort or smoke heroin at times graduate to injection because as their bodies become conditioned to the drug, the effects it produces are less intense. They then turn to injection--a more efficient means of administering the drug--to try to attain the more intense effects they experienced when they began using the drug.

Both new and experienced users risk overdosing on heroin because it is impossible for them to know the purity of the heroin they are using. (Heroin sold on the street often is mixed with other substances such as sugar, starch, or quinine. An added risk results when heroin is mixed with poisons such as strychnine.) Heroin overdoses--which can result whether the drug is snorted, smoked, or injected--can cause slow and shallow breathing, convulsions, coma, and even death.

All heroin users--not just those who inject the drug--risk becoming addicted. Individuals who abuse heroin over time develop a tolerance for the drug, meaning that they must use increasingly larger doses to achieve the same intensity or effect they experienced when they first began using the drug. Heroin ceases to produce feelings of pleasure in users who develop tolerance; instead, these users must continue taking the drug simply to feel normal. Addicted individuals who stop using the drug may experience withdrawal symptoms, which include heroin craving, restlessness, muscle and bone pain, and vomiting.

Trying to break a heroin addiction is very difficult because heroin withdrawal is the worst there is. Severe psychological symptoms begin to occur six to eight hours after the last dosage. The addict first experiences intense cravings for the drug, and as time passes withdrawal symptoms increase, and they include: runny nose; heavy feeling in legs; horrible muscle and bone pain; emotional distress and restlessness; abdominal cramps; diarrhea and vomiting; hot flashes with heavy sweating; cold flashes with goose bumps; insomnia; racing thoughts and anxiety; full body shakes; jerking leg movements; and an overwhelming need for more heroin.

Heroin users who inject the drug expose themselves to additional risks, including contracting human immunodeficiency virus (HIV), hepatitis B and C, and other blood-borne viruses. Chronic users who inject heroin also risk scarred or collapsed veins, infection of the heart lining and valves, abscesses, pneumonia, tuberculosis, and liver and kidney disease.

Prescription Pain Relievers

Common Names: Vicodin, codeine, Percodan, Demerol, OxyContin, oxy, oxycotton, percs, hillbilly heroin

Methods of Use: injected, ingested, or snorted

Psychological/Physical Effects: confusion, drowsiness, blocked pain messages, slowed breathing and heart rates, nausea and vomiting, itching and constipation

Long Term Effects: addiction, insomnia, arthritis, increased risk of HIV/AIDS and hepatitis, possible death

LSD (lysergic acid diethylamide)

Common Names: Acid, microdot, blotter, tabs, Mickey Mouse

Methods of Use: ingested

Psychological/Physical Effects: sensing imaginary things, anxiety, nausea, sense of indestructibility, chills and sweating, trembling and elevated body temperature

Long Term Effects: depression, flashbacks, violence, psychosis, amnesia

LSD (lysergic acid diethylamide) is a synthetic (man-made) drug that has been abused for its hallucinogenic properties since the 1960s. If consumed in a sufficiently large dose, LSD produces delusions and visual hallucinations that distort the user's sense of time and identity. LSD typically is sold as a liquid (often packaged in small bottles designed to hold breath freshening drops) or applied to blotter paper, sugar cubes, gelatin squares, and tablets. LSD generally is taken by mouth. The drug is colorless and odorless but has a slightly bitter taste. The effects associated with LSD use are unpredictable and depend upon the amount taken, the surroundings in which the drug is used, and the user's personality, mood, and expectations. Some LSD users experience a feeling of despair, while others report terrifying fears--of losing control, going insane, or dying. Some users have suffered fatal accidents while under the influence of LSD.

LSD users often have flashbacks, during which certain aspects of their LSD experience recur even though they have stopped taking the drug. In addition, LSD users may develop long-lasting psychoses, such as schizophrenia or severe depression.

LSD is not considered an addictive drug--that is, it does not produce compulsive drug-seeking behavior as cocaine, heroin, and methamphetamine do. However, LSD users may develop tolerance to the drug, meaning that they must consume progressively larger doses of the drug in order to continue to experience the hallucinogenic effects that they seek.

Ketamine

Common Names: special K, vitamin K, cat tranquilizers

Methods of Use: ingested, snorted, or injected

Psychological/Physical Effects: sensing imaginary things, anxiety, nausea, chills and sweating, trembling and elevated body temperature Long Term Effects: depression, flashbacks, violence, psychosis, amnesia

Ketamine is an anesthetic that is abused for its hallucinogenic properties. Its predominant legitimate use is as a veterinary anesthetic; however, it has been approved for use with both animals and humans. Abuse of the drug gained popularity when users discovered that it produced effects similar to those associated with PCP. Because of its anesthetic properties, ketamine also reportedly has been used by sexual predators to incapacitate their intended victims.

Ketamine generally is sold as either a colorless, odorless liquid or as a white or off-white powder.

In either its powder or liquid forms, ketamine is mixed with beverages or added to smokable materials such as marijuana or tobacco. As a powder the drug is snorted or pressed into tablets--often in combination with other drugs such as 3,4-methylenedioxymethamphetamine (MDMA, also known as ecstasy). As a liquid, ketamine is injected; it often is injected intramuscularly.

Ketamine causes users to have distorted perceptions of sight and sound and to feel disconnected and out of control. Use of the drug can impair an individual's senses, judgment, and coordination for up to 24 hours after the drug is taken even though the drug's hallucinogenic effects usually last for only 45 to 90 minutes.

Use of ketamine has been associated with serious problems--both mental and physical. Ketamine can cause depression, delirium, amnesia, impaired motor function, high blood pressure, and potentially fatal respiratory problems.

In addition to the risks associated with ketamine itself, individuals who use the drug may put themselves at risk of sexual assault. Sexual predators reportedly have used ketamine to incapacitate their intended victims--either by lacing unsuspecting victims' drinks with the drug or by offering ketamine to victims who consume the drug without understanding the effects it will produce.

PCP (phencyclidine)

Common Names: PCP, angel dust, super weed, killer weed

Methods of Use: ingested, smoked or injected

Psychological/Physical Effects: sensing imaginary things, anxiety, nausea, sense of indestructibility, chills and sweating, trembling and elevated body temperature, sense of indestructibility

Long Term Effects: depression, flashbacks, violence, psychosis, amnesia, memory loss and speech difficulties

PCP (phencyclidine) was developed in the 1950s as an intravenous anesthetic, but its use for humans was discontinued because it caused patients to become agitated, delusional, and irrational. Today individuals abuse PCP because of the mind-altering, hallucinogenic effects it produces. PCP is a bitter-tasting, white crystalline powder that is easy to dissolve in water or alcohol. PCP may be dyed various colors and often is sold as a tablet, capsule, liquid, or powder.

Users snort PCP powder, swallow tablets and capsules, or smoke the drug by applying it (in powder form) to a leafy substance such as marijuana, mint, parsley, or oregano. In addition, users increasingly are dipping marijuana or tobacco cigarettes in liquid PCP and smoking them. PCP is an addictive drug; its use often results in psychological dependence, craving, and compulsive behavior. PCP produces unpleasant psychological effects, and users often become violent or suicidal.

PCP poses particular risks for young people. Even moderate use of the drug can negatively affect the hormones associated with normal growth and development. PCP use also can impede the learning process in teenagers.

High doses of PCP can cause seizures, coma, and even death (often as a consequence of accidental injury or suicide while under the drug's effects). At high doses, PCP's effects may resemble the symptoms associated with schizophrenia, including delusions and paranoia.

Long-term use of PCP can lead to memory loss, difficulty with speech or thought, depression, and weight loss. These problems can persist for up to a year after an individual has stopped using PCP.

Psilocybin/Psilocyn Mushrooms

Common Names: mushrooms, shrooms

Methods of Use: ingested

Psychological/Physical Effects: sensing imaginary things, anxiety, nausea, chills and sweating, trembling and elevated body temperature Long Term Effects: depression, flashbacks, violence, psychosis, amnesia

Psilocybin is a hallucinogenic substance obtained from certain types of mushrooms that are indigenous to tropical and subtropical regions of South America, Mexico, and the United States. These mushrooms typically contain 0. 2 to 0.4 percent psilocybin and a trace amount of psilocyn, another hallucinogenic substance. Both psilocybin and psilocyn can be produced synthetically, but law enforcement reporting currently does not indicate that this is occurring.

Mushrooms containing psilocybin are available fresh or dried and have long, slender stems topped by caps with dark gills on the underside. Fresh mushrooms have white or whitish- gray stems; the caps are dark brown around the edges and light brown or white in the center. Dried mushrooms are generally rusty brown with isolated areas of off-white.

Psilocybin mushrooms are ingested orally. They may be brewed as a tea or added to other foods to mask their bitter flavor. Some users coat the mushrooms with chocolate--this both masks the flavor and disguises the mushrooms as candy. Once the mushrooms are ingested, the body breaks down the psilocybin to produce psilocyn.

Use of psilocybin is associated with negative physical and psychological consequences. The physical effects, which appear within 20 minutes of ingestion and last approximately 6 hours, include nausea, vomiting, muscle weakness, drowsiness, and lack of coordination. While there is no evidence that users may become physically dependent on psilocybin, tolerance for the drug does develop when it is ingested continuously over a short period of time.

The psychological consequences of psilocybin use include hallucinations and an inability to discern fantasy from reality. Panic reactions and psychosis also may occur, particularly if a user ingests a large dose.

In addition to the risks associated with ingestion of psilocybin, individuals who seek to abuse psilocybin mushrooms also risk poisoning if one of the many varieties of poisonous mushrooms is incorrectly identified as a psilocybin mushroom.

Inhalants: adhesives, solvents, aerosol sprays, medical gases

Common Names: poppers, snappers, huffing, glue, laughing gas, rush

Methods of Use: sniffing or inhaling

Psychological/Physical Effects: headaches, nausea and vomiting, red or blistered nose and mouth, limb spasms, lost control of bladder and bowels

Long Term Effects: damaged senses, muscle weakness, nerve damage, blood disease, damage to brain, liver and kidneys

The name inhalants covers a group of more than 2,000 common household products. They include paint thinners, gasoline, cleaners or strippers, glues, markers, paints, aerosol sprays, medical gases, and other specialized chemicals. Many of these chemical are flammable or explosive, and all are harmful or deadly if used in the wrong ways.

When a chemical is inhaled, it is quickly soaked up in the linings of the mouth, nose, throat, and lungs and passed to the blood. The toxins quickly race to the brain and start affecting behavior and sensations. The toxins continue to circulate throughout the body, causing permanent damage everywhere they go.

Inhalants are actually classified as depressants because they first slow down the brain and then the entire body. If someone inhales too much at once or for too long, unconsciousness and even death can result. Deaths are referred to as “Sudden Sniffing Death,” and it can happen the very first time.

The short-term effects of inhalants include: headaches; dizziness; dilated pupils; runny and red nose; nosebleeds; lost sense of smell; blisters or rash around the nose or mouth; chronic coughing; lost control of bowels and bladder; lost muscle coordination; slurred speech; confusion and forgetfulness; sudden mood swings; a “don’t care” feeling and attitude; stomachache or vomiting; tingling in the hands and feet; seizures and blackouts.

Over the long-term inhalant use destroys the outer lining of brain cells, and those cells lose the ability to communicate. Memory, intelligence, problem-solving abilities, and the senses of taste, smell, hearing and sight are all damaged. Permanent damage can occur to the heart, lungs, liver, kidneys, and bones. In addition, severe muscle weakness can result and dramatic changes to a person’s appearance. Some inhalant users even develop blood diseases and digestive problems. Besides “Sudden Sniffing Death,” kids have died from heart attacks.

Anabolic Steroids: Anadrol, Depo-Testosterone, Equipoise, Multiple Others

Common Names: roids, juice, sauce, slop, gym, candy, stacking Methods of Use: injected, ingested or applied to skin

Psychological/Physical Effects: poor concentration, aggression, acne and rashes, headaches, nausea, vomiting, and diarrhea, bone pain and muscle cramps

Long Term Effects: aggression, poor blood clotting, heart attacks, liver and kidney cancer, stunted growth, deformed genitals

Steroids, the popular name for synthetic (man-made) substances related to the male sex hormones, promote muscle growth and the development of male sexual characteristics. Steroids are legally available only with a prescription. They are prescribed to treat conditions such as delayed puberty, some types of impotence, and body-wasting in patients suffering from AIDS (acquired immunodeficiency syndrome). Steroids are abused, often by athletes, to enhance athletic performance and to improve physical appearance.

Steroids are available in tablet, liquid, gel, and cream form. The appearance of these products varies depending upon the type and the manufacturer.

Users typically ingest steroids orally, inject them intramuscularly, or rub them on their skin. Individuals who abuse steroids may take doses that are 10 to 100 times higher than those used for medical conditions.

Steroid abusers often take two or more different forms of the drug and mix oral steroids with injectable steroids, a process known as stacking. Abusers also frequently administer their doses in cycles of 6 to 12 weeks, a process called pyramiding. Steroid abusers believe that stacking and pyramiding enhance the benefits of the drug while lessening the toll that drug use takes on their bodies; however, there is no scientific evidence to support these theories.

Steroid abuse is associated with a range of physical and emotional problems. Physical consequences include liver tumors and cancer, jaundice, high blood pressure and increases in cholesterol levels, kidney tumors, fluid retention, and severe acne. Men may experience shrinking of the testicles, reduced sperm count, infertility, baldness, breast development, and increased risk of prostate cancer. Women may experience growth of facial hair, male-pattern baldness, changes or cessation in menstrual cycle, and deepening of the voice. Individuals who are still growing (adolescents) risk prematurely halting their growth because of early skeletal maturation and acceleration of puberty.

Emotional problems associated with steroid use include dramatic mood swings (including manic symptoms that can lead to violence called roid rage), depression, paranoid jealousy, extreme irritability, delusions, and impaired judgment.

In addition to the risks directly associated with steroid abuse, individuals who inject the drugs expose themselves to the risk of needle-borne diseases, including HIV (human immunodeficiency virus), hepatitis B and C, and other blood-borne viruses.