Substance abuse (patient information)
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Synonyms and Keywords: Drug abuse; Illicit drug abuse; Narcotic abuse; Hallucinogen abuse

# Overview
Drug abuse is the use of illegal drugs, or the misuse of prescription or over-the-counter drugs for at least a year with negative consequences.

# Marijuana
- Marijuana is also called "grass," "pot," "reefer," "joint," "hashish," "cannabis," "weed," and "Mary Jane."
- About 2 in 5 Americans have used marijuana at least once in their life.
- Marijuana comes from a plant called hemp (cannabis sativa). The main, active ingredient in marijuana is THC (short for delta-9-tetrahydrocannabinol). This and other ingredients, called cannabinoids, are found in the leaves and flowering parts of the marijuana plant. Hashish is a substance taken from the tops of female marijuana plants. It contains the highest amount of THC.
- How fast you feel the effects of marijuna depend on how you use it:
- If you breathe in marijuana smoke (such as from a joint or pipe), you may feel the effects within seconds to several minutes.
- If you eat foods containing the drug (such as "hash brownies,") you may feel the effects with 30 -60 minutes.
- Marijuana acts on your central nervous system.
- Low-to-moderate amounts of the drug may cause:
- Increased appetite ("the munchies")
- Feeling of joy (euphoria)
- Relaxed feeling
- Increased sensations of sight, hearing, and taste
- Other effects can include:
- Feelings of panic, or rarely severe paranoia
- Decreased ability to perform tasks that require a lot of coordination (such as driving a car)
- Decreased interest in completing tasks
- Delirium or seeing or hearing things that aren't there (hallucinations)
- Bloodshot eyes
- Changes in body image
- Increased heart rate and blood pressure
- Infections such as sinusitis, bronchitis, and asthma in heavy users
- Irritation of the airways causing narrowing or spasms
- Possibly weakening of the immune system
- Sore throat
- Trouble concentrating and paying attention, which can interfere with learning
- Trouble telling oneself from others
- Violence (may be related to marijuana that is laced with a drug called PCP)
- Regular users may have withdrawal effects when they stop marijuana use. These may include:
- Agitation
- Anxiety
- Insomnia
- Irritability
- Medical Marijuana:
- The medical use of marijuana is controversial, yet it's active ingredient (THC) is legal for medical purposes in at least 16 states. (Whole marijuana is illegal, even for medical use.)
- THC has been approved by the U.S. Food and Drug Administration (FDA) for the following medical purposes:
- Relieving chronic pain and spasticity
- Stimulating appetite in patients with AIDS or who have undergone chemotherapy
- Treating glaucoma
- Treating nausea caused by chemotherapy in cancer patients

# Phencyclidine (PCP, angel dust)
- PCP is an illegal drug that comes as a white powder, which can be dissolved in alcohol or water. PCP may be smoked, shot into a vein, or taken by mouth.
- How quickly it affects you depends on how you take it:
- Shooting up: If given through a vein, PCP's effects start within 2-5 minutes.
- Smoked: The effects begin within 2 - 5 minutes, peaking at 15 - 30 minutes.
- Taken by mouth: In pill form, or mixed with food or drinks, PCP's effects usually start within 30 minutes. The effects tend to peak in about 2 - 5 hours.
- Different doses of PCP will cause different effects:
- Lower doses of PCP: typically produce feelings of joy (euphoria) and less inhibition, similar to being drunk.
- Higher doses: cause numbness throughout the body, and perception changes that may lead to extreme anxiety and violence.
- Large doses: may produce paranoia, "hearing voices" (auditory hallucinations), and psychosis similar to schizophrenia.
- Massive doses: usually from taking the drug by mouth, may cause acute kidney failure, heart arrhythmias, muscle rigidity, seizures, and even death.
- Because of the pain-killing (analgesic) properties of PCP, users who get seriously injured may not feel any pain.

# Lysergic acid diethylamide (LSD)
- LSD (lysergic acid diethylamide) is a very strong hallucinogen. Only tiny amounts are needed to cause effects, such as hallucinations.
- Other commonly abused hallucinogens include:
- Psilocybin (mushrooms, "shrooms")
- Peyote (a cactus plant containing the active ingredient mescaline)
- LSD use may cause:
- Anxiety
- Blurred vision
- Dilated pupils
- Seeing things that aren't there (hallucinations)
- Paranoid delusions
- Tremors
- Hallucinogens can lead to extreme anxiety and lack of reality, called "bad trips". These experiences can come back as a flashback, even without using the drug again. Such experiences typically occur during times of increased stress, and tend to occur less often and intensely after stopping the drugs.

# Cocaine
- The abuse of cocaine increased dramatically in the late 1980s and early 1990s, but is now on the decline.
- Other names to describe different forms of cocaine include "crack," "coke," "snow," and "speedball."
- Cocaine may be taken in different ways:
- Snorting: Inhaling it through the nose
- Shooting up: Dissolving it in water and injected it into a vein
- Speedball: Mixed with heroin and shot into a vein
- Smoked: Cocaine may be changed into a smokeable form known as freebase or crack
- Smoking cocaine produces a nearly instant and intense sense of joy (euphoria), which is attractive to abusers.
- Other effects include:
- Feelings of increased confidence and energy
- Less inhibition
- Local numbness
- Powerful stimulation of the central nervous system
- Regular users of cocaine may need larger amounts of the drug to feel these effects. Regular users of cocaine may have:
- Loss of interest in school, work, family, and friends
- Memory loss
- Mood swings
- Sleep problems
- Social withdrawal
- Heavy use may cause paranoia, which can lead to violence.

# Amphetamines
- Amphetamines are stimulants.
- Other names used to desrribe amphetamines or methamphetamines include "crystal," "go," "crank," and "cross-tops."
- Amphetamines are very addictive. Prescription amphetamines are considered controlled substances. Over-the-counter (OTC) amphetamine look-alike drugs are often abused. These drugs typically contain caffeine and other stimulants, and are sold as appetite suppressants or stay-awake/stay-alert aids.
- Signs and symptoms of stimulant use:
- Dilated pupils
- Exaggerated feeling of well-being (euphoria)
- Fast heart rate
- Restlessness and hyperactivity
- Skin flushing
- Sleep disturbances
- Tremors
- Weight loss

# Inhalants
- Inhalant use became popular with young teens in the 1960s with "glue sniffing." Since then, a greater variety of inhalants have become popular.
- Inhalant use typically involves younger teens or school-age children.
- Commonly abused inhalants include:
- Aerosols for deodorants or hair sprays
- Cleaning fluids
- Gasoline
- Liquid typewriter correction fluid
- Model glue
- Spray paints
- Negative effects of inhalant abuse include:
- Brain damage
- Convulsions
- Liver or kidney damage
- Nerve damage (peripheral neuropathy)
- Sudden death

# Opiates, Opioids and Narcotics
- Opiates come from opium poppies.
- These drugs include morphine and codeine. Opioids are artificial substances that have the same effect as morphine or codeine. The term "narcotic" refers to either type of drug.
- Narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes, feelings of euphoria.
- These drugs include:
- Codeine
- Heroin
- Hydromorphone (Dilaudid)
- Methadone
- Meperidine (Demerol)
- Opium
- Oxycodone (Percocet or Oxycontin)
- Signs and symptoms of narcotic use:
- Coma, respiratory depression leading to coma, and death in high doses
- Needle marks on the skin (tracks) if drug use is by injection
- Rapid heart rate
- Relaxed or euphoric state
- Scars from skin abscesses if drug use is by injection
- Small pinpoint pupils
- Because heroin is commonly injected into a vein (used intravenously), there are health concerns about sharing contaminated needles among IV drug users.
- Complications of sharing contaminated needles include hepatitis, HIV infection, and AIDS.

# Central nervous system depressants
- These substances produce a sedative and anxiety-reducing effect, which can lead to dependence.
- These types of drugs include:
- Alcohol
- Barbiturates (amobarbital, pentobarbital, secobarbital), also called "yellow jackets"
- Benzodiazepines (Valium, Ativan, Xanax)
- Chloral hydrate
- Paraldehyde
- Signs and symptoms of alcohol or other depressant use:
- Decreased attention span
- Impaired judgment
- Lack of coordination
- Slurred speech

# Other drugs
- Ketamine: a substance related to PCP, commonly called "Special K"
- Ecstasy or MDMA (3,4-methylenedioxy-methamphetamine)
- GHB and Rohypnol, also called "date rape," "acquaintance rape," or "drug-assisted assault" drugs

# When to seek urgent medical care?
- If you are concerned about the possibility of getting addicted to any prescribed medications
- If you are concerned about possible drug abuse by yourself or a family member
- If you are interested in getting more information on drug abuse
- If you are seeking treatment of drug abuse for yourself or a family member

# Where to find medical care for Substance abuse?
Directions to Hospitals Treating Substance abuse

# Support groups
- There are a number of different support groups available to help those with drug abuse.
- Alcoholism support group:
- ALCOHOLICS ANONYMOUS (AA)
- AL-ANON
- Alateen
- SMART recovery; LifeRing recovery and SOS; Women for Sobriety; Moderation Management
- National Institute on Alcohol Abuse and Alcoholism
- Substance Abuse and Mental Health Services Administration
- Chemical dependence support group:
- International Association for Pain and Chemical Dependency
- Narcotics Anonymous
- National Institute on Drug Abuse

# Source