Keeping Youth

DRUG FREE 

Keeping Youth

DRUG FREE 

U.S. Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Prevention
Acknowledgments 

This publication was prepared for the Substance 

Abuse and Mental Health Services Administration 

(SAMHSA) by the Center for Substance Abuse 

Prevention (CSAP) under contract number 

HHSS277201600001C, with SAMHSA, U.S. 

Department of Health and Human Services (HHS). 

David Lamont Wilson served as the Government 

Project Officer. 

Disclaimer 

The views, opinions, and content of this publication 

are those of the author and do not necessarily reflect 

the views, opinions, or policies of SAMHSA or HHS. 

SAMHSA complies with applicable Federal civil rights 

laws and does not discriminate on the basis of race, 

color, national origin, age, disability, or sex. SAMHSA 

cumple con las leyes federales de derechos civiles 

aplicables y no discrimina por motivos de raza, color, 

nacionalidad, edad, discapacidad o sexo. 

Public Domain Notice 

All material appearing in this report is in the public 

domain and may be reproduced or copied without 

permission from SAMHSA. Citation of the source 

is appreciated. However, this publication may not 

be reproduced or distributed for a fee without 

the specific, written authorization of the Office of 

Communications, SAMHSA, HHS. 

Electronic Access and Copies of Publication 

This publication may be downloaded or ordered at 

http://store.samhsa.gov. Or call SAMHSA’s Store 

at 1-877-SAMHSA-7 (1-877-726-4727) 

(English and Español). 

Recommended Citation 

Keeping Youth Drug Free. HHS Publication No. (SMA) 

17-3772. Rockville, MD: Center for Substance Abuse 

Prevention, Substance Abuse and Mental Health 

Services Administration, 2017. 

Originating Office 

Center for Substance Abuse Prevention, Substance 

Abuse and Mental Health Services Administration, 

5600 Fishers Lane, Rockville, MD 20857. 

HHS Publication No. (SMA) 17-3772. 

First printed 2002. Revised 2017. 
1

YOU HOLD THE KEY TO YOUR CHILD’S FUTURE.

Few things worry parents, grandparents, and other caregivers more than the prospect 

of children using alcohol, tobacco, and illicit drugs. They know youth under their charge 

spend many hours each day out of their sight and are subject to influences they can’t 

control. Youth may be encouraged by their peers to try marijuana, try inhalants, or misuse 

prescription drugs. Media often link alcohol use with fun and excitement and with being 

popular and sophisticated. Dangers seem to lurk everywhere. 
2

WHAT TO KNOW AND WHAT 

TO DO

Your 16-year-old may be taller than you 

and faster than you at certain tasks, but 

his brain will still be developing when 

he’s in his early twenties. From age 13 to 

25, the young brain is intensively shaped 

and reshaped based on its experiences. 

Connections within the brain that are used 

a lot become stronger while those that 

are not used much get weaker. That’s 

why it’s vital for youth to get involved in 

challenging intellectual, athletic, and social 

activities—it will do their brains good for 

the rest of their lives. 

The last region of the brain to develop 

is the pre-frontal cortex which governs 

judgment. Teens have a lot of energy and 

emotion, but without the ability to predict 

outcomes and plan accordingly, they can 

make choices such as using drugs and 

alcohol that will hurt them for life. 
3

In 2016, 1.9 million youth ages 12-17 

reported using illicit drugs and 2.3 million 

used alcohol in the past month, with more 

than half of those youth reporting binge 

drinking. Each day, about 3,300 youth 

try marijuana for the first time and about 

6,300 try alcohol for the first time.1

The long-term effects of early alcohol and 

illicit drug use are even more alarming. 

Multiple studies have found associations 

between early initiation of alcohol or illicit 

drug use (for example, in adolescence) 

and an increased likelihood of developing 

substance use disorders.

Recent years have brought heartening 

news with fewer youth using harmful 

substances. However, with many teens still 

using alcohol and illicit substances, our job 

in keeping youth alcohol-and drug-free, 

safe, and healthy is far from done. 

1U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics 

and Quality. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and 

Health. (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Retrieved from https://www.samhsa.gov/samhsa-data-outcomes-quality/major-datacollections/reports-detailed-tables-2016-NSDUH

2U.S. Department of Health and Human Services, Office of the Surgeon General. (2007). The Surgeon General’s call to action to prevent and reduce 

underage drinking. Retrieved from http://www.surgeongeneral.gov/library/calls/underage-drinking-educator-guide.pdf

The good news is that you can influence 

whether or not your child uses alcohol 

or drugs. Taking a clear stand against 

substance use by talking with children 

early is a good place to start. The majority 

of adolescents who start drinking do so 

when they are in the 7th or 8th grade 

and are about 13-14 years old.2 That’s 

why parents, caregivers, teachers, and 

others should start talking with children 

about alcohol use well before the teen 

years and should continue talking 

throughout adolescence. What’s more, 

the sooner you talk to your children about 

alcohol, the greater chance you have of 

influencing their decisions about drinking. 

Studies have shown that parents have a 

significant influence on young people’s 

decisions about alcohol, especially when 

parents create supportive and nurturing 

environments in which their children can 

make their own decisions.
4

Watching and supporting a youth’s 

emotional well-being is another important 

way for parents to reduce the odds of 

their child using harmful substances. 

Ties between substance use and mental 

health problems are strong. Youth who 

experience a major depressive episode 

are more likely to engage in illicit drug 

use and more likely to smoke cigarettes 

every day. They also are more likely 

to be dependent on or use illicit drugs 

or alcohol. 

Here are some steps you can take to 

help the child you love reject illicit drugs 

and alcohol. 

ESTABLISH AND MAINTAIN 

GOOD COMMUNICATION WITH 

YOUR CHILD.

Talk with your child every day—but most 

importantly, listen. We all need to be 

heard and understood. Listen especially 

for the feelings behind your child’s words. 

Is the child in your care frightened, lonely, 

depressed or hurt? 

Suppose your 13-year-old daughter 

says flatly, “Emily is having a party and 

Madison and Chloe are invited, but I’m 

not.” She doesn’t look sad, so you don’t 

think much of it and reply, “That’s good 

because we really need to get some 

errands done anyway.” 

What if your daughter was in fact very 

hurt about not being invited to the party? 

She may be more upset than she realizes. 

After a series of conversations like this 

with you, she may start to keep more 

things to herself and seem to have less 

to say. With less of a connection with 
you, she will need to seek gratification 

elsewhere and be more subject to peer 

pressures, as she searches for a place 

to belong and to have her emotional 

needs met.

What if you had instead responded 

with “Oh, honey, it must feel awful not 

to be invited when all your friends are 

going. I’m so sorry.” Your daughter may 

then open up and admit that she feels 

terrible and begin to cry. The tears will 

release her sadness, and she’ll walk 

away feeling better and glad that she 

talked to you. Your relationship will 

become stronger—and that strong 

relationship with you is her best 

protection against substance misuse.

If you are successful in opening 

lines of communication with your 

child about routine matters, she 

will be more likely to talk to you 

about serious issues.
6

GET INVOLVED IN YOUR 

CHILD’S LIFE.

Young people are much less likely to use 

drugs when they have caring adults in 

their lives and interesting activities to 

keep them busy, happy, and productive.

● Spend at least 15 minutes a day doing 

an age-appropriate activity that your 

child enjoys, such as reading a book, 

watching a TV program together, riding 

bikes, going to the library, or playing 

a game.

● Do something special together each 

week, such as going for a walk 

or searching on the Internet for 

information about a topic you both 

find interesting.

● Recognize good behavior consistently 

and immediately. Make the extra effort 

to catch your child being good.

● Use meal times as an opportunity to 

share news of the day or to discuss 

current affairs.

By being involved, you will notice when 

your child is under stress or needs 

extra attention.
7

MAKE CLEAR RULES AND 

ENFORCE THEM CONSISTENTLY.

If you let your child know that you don’t 

approve of him using alcohol, tobacco, or 

drugs, he is less likely to do it. You can:

● Discuss why tobacco, illicit drugs, and 

underage drinking are not acceptable.

● Make sure your child is clear about 

your rules.

● Lay out what the consequences will 

be if your rules are broken, and follow 

through if they are. 

● Acknowledge and praise your child when 

he obeys your rules.

Rules and consequences are 

important so your child knows 

exactly where you stand on the 

issue of substance misuse. Rules 

also provide structure that is 

needed for emotional well-being.

BE A POSITIVE ROLE MODEL.

Children learn by watching you. If you 

make yourself a drink to deal with 

disappointment or anger, they notice. If 

you tell your son not to smoke, but then 

ask him to get you an ashtray from the 

cupboard, he notices that, too. 

Children can understand that adults have 

privileges they don’t have, because adults 

assume responsibilities that children 

don’t. But if your kids see you misusing 

substances, you are setting an example 

that speaks much louder than words. “Do 

as I say, not as I do” has never been a 

very compelling argument. 

If you use illicit drugs or misuse 

prescription drugs, your children 

may conclude:

● The best way to cope with stress and 

worry is to use drugs.

● Happiness comes from being high on 

drugs, not from good relationships.

● It’s easier to take drugs to escape from 

your problems than to deal with them.
8

How to be a good role model to your child:

● Do not misuse alcohol or use tobacco or 

illicit drugs. Even young children imitate 

and are influenced by adult behaviors.

● If you can’t quit, then at least make 

sure you do not involve your child 

in your use of alcohol, tobacco, or 

illicit drugs. 

● When possible, point out examples 

of bad behavior and negative 

consequences as a result of 

substance misuse. 

The fact is, if you use alcohol, 

tobacco, or drugs, your children 

are more likely to use them too.

If you used illicit drugs in the past, this 

topic may make you uneasy. Should you 

tell your child that you used drugs? That 

depends on a variety of factors, such as 

your relationship and the child’s age and 

maturity. Some children may not want or 

need to know about it. Others may benefit 

from the lessons you learned.

Remember, your child needs your 

guidance. Don’t let your past drug use 

stop you from warning your child about 

the dangers of alcohol, tobacco, and 

illicit drugs. 

Some messages to share with your 

child are:

● Using drugs and alcohol won’t solve 

your problems. 

● Using drugs and alcohol won’t make 

you popular. 

● Drugs and alcohol won’t help you build 

a strong body or mind. In fact, they can 

harm your physical and mental growth 

and prevent you from participating in 

sports and other activities.

● I stopped doing drugs (or smoking 

cigarettes or drinking alcohol), and I’m 

much happier because of it. I find joy in 

life from my accomplishments, and from 

doing fun things with family and friends, 

not from getting stoned.
9

● I don’t want you to make the same 

mistakes I did.

● Your brain is still developing into your 

mid-twenties and doing drugs and 

alcohol may harm your brain in ways 

that can’t be corrected later. 

MONITOR YOUR CHILD’S 

ACTIVITIES.

Many young people say they started 

smoking marijuana or using drugs 

out of boredom. Children with lots of 

unsupervised time on their hands are at 

greater risk of substance misuse.

● Establish relationships with your 

child’s friends.

● Get to know other parents and reinforce 

each other’s efforts.

● Know where your child is going, with 

whom, and what the activity will be. 

● Ask for phone numbers and addresses 

of friends’ houses and other places your 

child goes, and let him know you might 

drop by. Start doing this when he is 

8 or 9, and it will seem normal when 

he is 14.

● Have your child check in at regular 

times. Many children have cell phones 

or can be taught to use a phone card. 

If your child’s cell phone has texting 

capability, use this feature to check in 

with them periodically. Make sure she 

has both your cell and work numbers so 

she can reach you.

● Set up a system (a “code” word or 

phrase) so your child can let you know 

if he needs to be picked up from a party 

or other social event where alcohol and 

drugs are being used. 
10

TEACH YOUR CHILD TO CHOOSE 

FRIENDS WISELY.

The power of peer pressure can be seen 

any time one person stands alone against 

a group, because we all want to fit in and 

belong. As an adult, you can probably 

remember times when everyone in a 

group seemed to be in agreement on a 

certain topic—except you. Was it hard to 

speak up, knowing you’d have the whole 

group against you? 

Maybe everyone wants to go to the 

all-you-can-eat buffet, but you know you 

will overeat if you do. You might feel torn 

between your desire to lose weight and 

your desire to be part of the group. 

Children have this same need to belong, 

but usually don’t have the strength to 

stand alone against the group. Therefore 

it’s important that your child not become 

part of a group that will collectively decide 

to use drugs, tobacco, or alcohol, for he 

will then be in the uncomfortable position 

of having to choose between his friends 

and his better instincts. 

Help your child make friends with kids 

who are involved in fun, healthy, 

wholesome activities, not kids with lots 

of time on their hands and no positive 

activities, hobbies or sports to focus 

on. The friendships formed in a swim 

team, newspaper club, theater group, 

choir, or pottery class are based on 

mutual aspirations and interests, and the 

children in those groups are usually too 

busy pursuing their goals to bother with 

substance use. 

Some specific action steps include:

● Encourage your child to get involved 

with groups doing the things that 

interest her. Whether it’s dog training, 

amateur astronomy, soccer, dance, 

yearbook, or music lessons, help your 

child pursue her interests with peers 

who are doing the same. 

● Help your child practice resisting peer 

pressure. Help her feel comfortable 

saying “No thanks” or even “Bye, 

I’m out of here.”
11

● Help your child feel comfortable in social 

situations by teaching her how to ask 

questions and be a good listener. Let her 

also know that it’s okay to feel awkward 

at times; we all do.

Loneliness, boredom and isolation 

are risk factors for mental and 

substance use disorders. Help 

your child develop healthy, 

wholesome relationships with other 

happy kids and you will make it 

less likely that she will turn to 

drugs or alcohol for comfort.
12

DRUG FACTS YOU NEED TO KNOW

Would you know what to say if your son asked you what roofies are? Or if your daughter 

told you that one of her friends has started smoking blunts? Here are some basics about 

commonly misused drugs, their symptoms, and their consequences. For the latest list of 

drug slang code words, visit https://ndews.umd.edu/sites/ndews.umd.edu/files/dea-drugslang-code-words-may2017.pdf. 

Alcohol

Products include Liquor, beer, and wine (bourbon, champagne, gin, tequila, vodka, 

whiskey, and wine coolers).

Street Names Booze, juice, sauce, brew.

Symptoms of use Slurred speech, confusion, impaired judgment and motor skills, 

drowsiness, nausea and vomiting, emotional volatility, loss of 

coordination, visual distortions, impaired memory, sexual dysfunction 

and depression.

Potential 

consequences

Impaired judgment can result in inappropriate sexual behavior, sexually 

transmitted diseases, injuries, and auto crashes. Habitual use can lead 

to an inability to control drinking, high tolerance level, blackouts and 

memory loss, interference with personal relationships, cirrhosis of the 

liver, vitamin deficiencies, damage to the heart and central nervous 

system, sexual impotence, and weight gain. Excessive consumption can 

result in death due to alcohol poisoning or asphyxiation. Overdoses can 

result in death.

How used Ingested by drinking.

Medical uses For appetite stimulation and mild sedation.

Legal status Illegal for purchase or use by those under 21.
13

Cannabinoids

Products include Marijuana, hashish, cannabis sativa, and 

delta-9-tetrahydrocannabinol (Sativex).

Street Names Marijuana: Weed, pot, grass, reefer, joint, ganga 

(pronounced GAHN-juh), herb, bud, Mary Jane, green, trees, smoke, 

sinsemilla, skunk, and blunt.

Hashish: Boom, gangster, hash, and hemp.

Symptoms of use Mood swings, relaxation, distorted sensory perception, euphoria, slow 

thinking and reflexes, dilated pupils, increased appetite, impaired 

balance and coordination, dry mouth, increased pulse rate, impaired 

learning, impaired attention and memory, sleepiness, anxiety, panic 

attacks, delusions, and hallucinations.

Potential 

consequences

Addiction; breathing problems, including inflammation of the airways 

and symptoms of chronic bronchitis, such as daily cough and phlegm; 

short-term declines in memory, attention, and learning; increased risk of 

poisoning among children; increased risk for low birth weight in babies 

when a mother uses during her pregnancy; increased risk for psychosis 

or schizophrenia.

How used Ingested, smoked, and vaporized.

Medical uses Amelioration of nausea and vomiting, stimulation of hunger in 

chemotherapy and patients living with HIV/AIDS, lowered intraocular 

eye pressure, treatment of spasticity from multiple sclerosis, as well as 

general analgesic effects (pain reliever).

Legal status Marinol, the active ingredient found in the marijuana plant, can 

be prescribed for the control of nausea and vomiting caused by 

chemotherapeutic agents used for cancer treatment. Marijuana is also 

illegal federally.
14

Club Drugs

Products include GHB (gammahydroxybutyric acid), MDMA 

(methylenedioxymethamphetamine), and flunitrazepam (Rohypnol).

Street Names GHB: Liquid ecstasy, liquid X, G, grievous bodily harm, soap, scoop, 

goop, and Georgia home boy.

MDMA: Ecstasy, E, X, XTC, Adam, clarity, Eve, lover’s speed, peace and 

uppers, Molly.

Flunitrazepam: R-2, roofies, roach, forget-me pill, Mexican Valium, 

Roche, roofinol, rope, rophies and “the date rape drug.”

Symptoms of use GHB: Drowsiness, nausea, headache, disorientation, loss of coordination 

and memory loss.

MDMA: Mild hallucinogenic effects, dilated pupils, increased tactile 

sensitivity, empathic feelings, lowered inhibition, anxiety, chills, 

sweating, teeth clenching and muscle cramping. 

Flunitrazepam: Sedation, muscle relaxation, confusion, memory loss, 

dizziness and impaired coordination.

Potential 

consequences

Impaired judgment and coordination can result in greater risk for injury, 

self-inflicted injury, violent behavior, paranoia, depression, anxiety, 

and unpredictable flashbacks. In addition, consequences for MDMA use 

include sleep disturbances, depression, impaired memory, hypothermia 

and addiction; Flunitrazepam use can result in addiction; and GHB can 

result in unconsciousness, seizures and comas.

How used Ingested and sniffed.

Medical uses None.

Legal status Illegal.
15

Dissociative Drugs

Products include Ketamine, PCP and analogs, Salvia divinorum, and DXM 

(dextromethorphan).

Street Names Ketamine: cat Valium, K, Special K, and vitamin K.

PCP and analogs: Angel dust, angel mist, animal tranquilizer, boat, 

hog, love boat and peace pill.

Salvia divinorum: Salvia, Shepherdess’s Herb, Maria Pastora, 

magic mint, and Sally-D.

DXM: Robotripping, robo, and triple C.

Symptoms of use All dissociative drugs: Feelings of being separate from one’s body and 

environment and impaired motor function.

Ketamine: Analgesia, impaired memory, delirium, and 

respiratory depression.

PCP and analogs: Analgesia, psychosis, aggression, violence, slurred 

speech, loss of coordination, and hallucinations.

DXM: Euphoria, slurred speech, confusion, dizziness and distorted 

visual perceptions.

Potential 

consequences

Anxiety, tremors, numbness, memory loss, nausea, and death.

How used Injected, ingested, sniffed, chewed, and smoked.

Medical uses Ketamine: Used as an injectable, short-acting anesthetic in humans 

and animals.

DXM: Market cough suppressant.

Legal status Ketamine: Legal by prescription.

PCP and analogs: Illegal.

DXM: Not a controlled substance.
16

Hallucinogens

Products include LSD, mescaline, psilocybin, DMT (dimethyltryptamine), MDA 

(methylenedioxyamphetamine), and STP (dimethoxymethamphetamine).

Street Names LSD: Acid, blotted, cubes, microdot, yellow sunshine, blue heaven, A, 

and windowpane. 

Mescaline: Buttons, cactus, mesc, and peyote.

Psilocybin: Magic mushrooms, purple passion, shrooms, little smoke, 

and mushrooms. 

Symptoms of use All hallucinogens: Altered states of perception and feeling, 

hallucinations, and nausea. 

LSD and mescaline: Increased body temperature, heart rate and blood 

pressure; loss of appetite; sweating; sleeplessness; impulsive behavior; 

weakness; rapid shifts in emotion; and tremors.

Psilocybin: Nervousness, paranoia, and panic.

Potential 

consequences

“Flashbacks” or replays of the drug experience, and 

prolonged depression.

How used Ingested, smoked, and absorbed through mouth tissues.

Medical uses None.

Legal status Illegal.
17

Nonprescription Opioids

Products include Heroin and opium.

Street Names Heroin: Smack, horse, brown sugar, dope, H, junk, skag, skunk, white 

horse, and China white.

Opium: Big O, black stuff, block, gum, and hop.

Symptoms of use Euphoria, drowsiness, impaired coordination, dizziness, confusion, 

nausea, sedation, feeling of heaviness in the body, and slowed or 

arrested breathing.

Potential 

consequences

Constipation, endocarditis, hepatitis, HIV, addiction and fatal overdose.

How used Ingested, smoked, and injected intravenously.

Medical uses None.

Legal status Illegal.
18

Other Compounds

Products include Anabolic steroids: Anadrol, Oxandrin, Depo-Testosterone, 

and Equipoise.

Inhalants: Solvents (paint thinners, gasoline, glues, organic solvents, 

nail polish remover); gases (butane, propane, aerosol propellants, 

nitrous oxide, hair spray; and nitrites (isoamyl, isobutyl, and cyclohexyl).

Street Names Anabolic steroids: Roids, juice, gym candy, and pumpers.

Inhalants: Laughing gas, poppers, snappers, glue, bang, huff, kick, 

sniff, Texas shoeshine, and whippets.

Symptoms of use Anabolic steroids: No immediate intoxication effects.

Inhalants: While symptoms vary by chemical, potential symptoms 

include loss of inhibition, stimulation, headache, nausea or vomiting, 

slurred speech, loss of motor coordination, and wheezing.

Potential 

consequences

Anabolic steroids: Hypertension; blood clotting and cholesterol 

changes; liver cysts; hostility and aggression; acne; premature growth 

stoppage in adolescents; prostate cancer, reduced sperm production, 

shrunken testicles and breast enlargement in males; and menstrual 

irregularities, as well as development of beard and other masculine 

characteristics in females. 

Inhalants: Cramps, muscle weakness, depression, memory impairment, 

damage to cardiovascular and nervous systems, unconsciousness, and 

sudden death.

How used Anabolic steroids: Injected, ingested and applied to skin.

Inhalants: Inhaled through nose or mouth.

Medical uses Anabolic steroids: used to help people with certain kinds of anemia 

and men who don’t produce enough testosterone. 

Nitrous oxide (inhalant): used for anesthesia.

Legal status Most inhalants are available in retail stores. Anabolic steroids are illegal, 

except by prescription.
19

Prescription Medications

Products include CNS depressants: Barbiturates (Amytal, Nembutal, Seconal and 

Phenobarbital); benzodiazepines (Ativan, Halcion, Librium, Valium and 

Xanax); and sleep medications (Ambien, Sonata and Lunesta). 

Opioids and morphine derivatives: Codeine (Empirin with Codeine, 

Fiorinal with Codeine, Robitussin A-C, and Tylenol with Codeine); 

morphine (Roxanol and Duramorph); methadone (Methadose and 

Dolophine); fentanyl and analogs (Actiq, Duragesic, and Sublimaze); 

tramadol products; and other opioid pain relievers such as oxycodone 

HCL, hydrocodone, bitartrate, hydromorphone, oxymorphone, meperidine 

and propoxyphene (Tylox, OxyContin, Percodan, Percocet, Vicodin, Lortab, 

Lorcet, Dilaudid, Opana, Numporphan, Numorphone, Demerol, Meperidine 

Hydrochloride, Darvon and Darvocet).

Stimulants: Amphetamines (Biphetamine, Dexedrine and Adderall); and 

methylphenidate (Concerta and Ritalin).

Other: Dextromethorphan (DXM).

Street Names Barbiturates: Barbs, reds, red birds, phennies, tooies, yellows, and 

yellow jackets.

Benzodiazepines: Canday, downers, sleeping pills and tranks.

Sleep medications: Forget-me pill, Mexican Valium, R2, Roche, roofies, 

roofinol, rophies.

Codeine: Captain cody, cody, schoolboy, and (when mixed with 

glutethimide) doors and fours, loads, and pancakes and syrup.

Morphine: M, Miss Emma, monkey, white stuff, mojo, mud, Mary, Murphy, 

and Mister Black.

Methadone: Fizzies, amidone, dollies, and (with MDMA) chocolate 

chip cookies.

Fentanyl and analogs: Apache, China girl, China white, dance fever, 

friend, goodfella, jackpot, murder 8, TNT, and tango and cash.
Street Names

Continued

Other opioid pain relievers: Oxy, O.C., oxycotton, oxycet, hillbilly 

heroin, percs, vike, Watson-387, juice, smack, D, footballs, dillies, biscuits, 

blue heaven, blues, Mrs. O, octagons, stop signs, O bomb, demmies, and 

pain killer.

Amphetamines: Bennies, black beauties, crosses, hearts, LA turnaround, 

speed, truck drivers, and uppers.

Methylphenidate: JIF, MPH, R-ball, skippy, the smart drug, and vitamin R.

Dextromethorphan (DXM): Robotripping, robo, and triple C.

Symptoms of use Depressants: Sedation/drowsiness, reduced anxiety, feelings of 

well-being, lowered inhibitions, slurred speech, poor concentration, 

confusion, dizziness, and impaired coordination and memory.

(For barbiturates specifically: euphoria, unusual excitement, fever, 

and irritability.)

Opioids and morphine derivatives: Pain relief, euphoria, drowsiness, 

dizziness, sedation, weakness, nausea, impaired coordination, confusion, 

dry mouth, itching, sweating, clammy skin, and constipation.

Stimulants: Feelings of exhilaration; increased energy; and 

mental alertness.

DXM: Euphoria and slurred speech. 

Potential 

consequences

Depressants: Lowered blood pressure, slowed breathing, withdrawal, 

addiction, increased risk of respiratory distress, and death when combined 

with alcohol.

(For barbiturates specifically: Life threatening withdrawal in chronic users.)

Opioids and morphine derivatives: Slowed or arrested breathing, 

lowered pulse and blood pressure, high potential for addiction, heart or 

respiratory problems, mood swings, chronic constipation, tremors, toxic 

psychosis, HIV infection, unconsciousness, coma and death. Risk of death 

is increased when combined with alcohol or other CNS depressants.

(For oxycodone specifically: Muscle relaxation that is twice as potent as 

analgesic or morphine, and high abuse potential.)

(For methadone specifically: Significant overdose risk when 

used improperly.)

20
Potential 

consequences

Continued

Stimulants: Increased heart rate, blood pressure and metabolism; 

chronic sleep problems; anxiety or nervousness; decreased emotional 

control; severe depression; reduced appetite; weight loss; nutritional 

deficiency; insomnia; seizures; heart attack; stroke; and death from heart 

failure or suicide. 

(For amphetamines specifically: Delirium, panic, paranoia, hallucinations, 

impulsive behavior, aggressiveness, and addiction.)

(For methylphenidate specifically: Increase or decrease in blood pressure, 

digestive problems, loss of appetite, and weight loss.)

DXM: Increased heart rate and blood pressure, dizziness, nausea, 

vomiting, confusion, paranoia, distorted visual perceptions, and impaired 

motor function.

How used Depressants: Injected, ingested and sniffed.

Opioids and morphine derivatives: Injected, ingested, smoked, sniffed, 

chewed, and via suppositories.

Stimulants: Injected, ingested, smoked and sniffed.

DXM: Ingested.

Medical uses CNS depressants: Used to treat anxiety and sleep problems.

Opioids: Used to treat pain.

Stimulants: Used to treat ADHD and narcolepsy.

DXM: Used in some cough and cold medicines.

Legal status Select CNS depressants and opioids are legal by prescription only. DXM is 

not a controlled substance.

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Stimulants

Products include Cocaine, amphetamine, methamphetamine, Desoxyn, Dexedrine, 

Ionamin, methcathinone, biphetamine, and Tenuate.

Street Names Cocaine: Coke, snow, blow, toot, C, candy, flake, bump, Charlie, crack, 

rock, and dust.

Crack cocaine: Crack, rock, base, sugar block, and Rox/Roxanne.

Amphetamines: Bennies, black beauties, crosses, hearts, LA 

turnaround, speed, truck, drivers, and uppers.

Methamphetamines: Meth, ice, crank, chalk, crystal, fire, grass, go 

fast, and speed.

Symptoms of use Anxiety, excitability, euphoria, insomnia, sweating, tremors, dry mouth 

and lips, bad breath, weight loss, talkativeness, increased pulse rate, 

dilated pupils, paranoia, agitation, and hallucinations. 

Potential 

consequences

High risk for addiction, violent or erratic behavior, hallucinations, high 

blood pressure, anxiety or nervousness, decreased emotional control, 

severe depression, cocaine psychosis, eating or sleeping disorders, 

impaired sexual performance, respiratory problems, collapse of the nasal 

septum, and death from cardiac arrest, respiratory arrest or suicide.

How used Sniffed, injected, ingested and smoked.

Medical uses For narcolepsy, obesity, and hyperkinesis.

Legal status Cocaine: Rarely used in hospital settings.

Amphetamines: Pharmaceutical products are available only through a 

prescription that cannot be refilled. 

Methamphetamine: Desoxyn is the only legal meth product and is 

available only through a prescription that cannot be refilled.
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Synthetic Drugs

Products include Synthetic cannabinoids or marijuana: K2/Spice.

Synthetic stimulants: MDPV and mephedrone.

Street Names K2/Spice: Bliss, black momba, Bombay blue, fake week, genie, Spice, and zohai.

MDPV and mephedrone: Meow meow, MCAT, drone, plant feeder, bubbles, 

bliss, blue silk, cloud nine, energy-1, ivory wave, lunar wave, ocean burst, pure 

ivory, purple wave, red dove, snow leopard, stardust, vanilla sky, white dove, 

white night, and white lightning.

Symptoms of use K2/Spice: Euphoria, sociability, and relaxation.

MDPV and mephedrone: Increased alertness, sexual arousal, anxiety, 

agitation, diminished desire for food and sleep, euphoria, sociability, stimulation, 

and hallucinations.

Potential 

consequences

K2/Spice: Anxiety, paranoia, headache, vomiting, psychosis, diaphoresis, 

increased blood pressure and heart rate, and seizures.

MDPV and mephedrone: Tachycardia, hypertension, vasoconstriction, 

diaphoresis, seizures, panic attacks, inability to open mouth, loss of appetite, 

increase in body temperature and sweating, increased blood pressure and heart 

rate, dehydration, insomnia, hallucinations, delusions, psychosis, depression, 

suicidal ideation, abstinence syndrome, and psychosis with high doses or 

frequent use. 

How used K2/Spice: Smoked and ingested.

MDPV and mephedrone: Sniffed, ingested, smoked, injected and 

via suppositories.

Medical uses K2/Spice: None.

MDPV and mephedrone: Found in retail products including “bath salts,” and 

has no approved medical use. 

Legal status K2/Spice: Available in convenience stores, at gas stations and on the internet; 

five synthetic cannabinoids are currently placed into Schedule I of the Controlled 

Substances Act. 

MDPV and mephedrone: Found in retail products including “bath salts.” 
Tobacco

Products include Nicotine (cigarettes, cigars, bidis, smokeless tobacco, e-cigarettes, 

vaporizers, and hookah).

Street Names Cigarettes: Smokes, cancer sticks, butts, and squares. 

Chewing tobacco: Dip, chew, snuff, and spit tobacco.

Symptoms of use Smelly hair, clothes, and breath; yellowing of teeth; coughs; increased 

asthma attacks; shortness of breath; increased blood pressure and heart 

rate; and poorer athletic performance. 

Potential 

consequences

Addiction; respiratory problems such as emphysema and chronic 

bronchitis; heart and cardiovascular disease; stroke; acute myeloid 

leukemia; adverse pregnancy outcomes; and cancer of the lung, larynx, 

pharynx, stomach, cervix, esophagus, bladder, pancreas, kidney, 

and mouth. 

After only a few weeks, users of spit tobacco can develop cracked lips, 

white spots, sores, and bleeding in the mouth.

How used Smoked (traditional, vaping, e-cigarette, or hookah), sniffed, and 

absorbed through mouth tissues.

Medical uses None.

Legal status Illegal for youth under 19 in Alabama, Alaska, and Utah. Illegal for youth 

under 18 in all remaining States.

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For more information, visit http://www.samhsa.gov.

Substance Abuse and Mental Health Services Administration

5600 Fishers Lane

Rockville, MD 20857

SAMHSA’s Store 

877-SAMHSA-7 or 877-726-4727 (English and Español)

800-487-4889 (TTY)

240-221-4292 (FAX)

http://store.samhsa.gov

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Additional Resources

“Talk. They Hear You.” App

http://www.samhsa.gov/underage-drinking/mobile-application

KnowBullying App

http://store.samhsa.gov/apps/knowbullying/

Stop Underage Drinking

https://www.stopalcoholabuse.gov/default.aspx

Too SMART To START

http://www.toosmarttostart.samhsa.gov

Sound of Your Voice

Guide: http://store.samhsa.gov/product/Talking-With-Your-College-Bound-Young-AdultAbout-Alcohol/SMA15-4897

Video: https://www.stopalcoholabuse.gov/townhallmeetings/tips-resources/sound-of-yourvoice-video-guide.aspx
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HHS Publication No. (SMA) 17-3772

First printed 2002. Revised 2017