Drug abuse

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STIMULANTS ("speed," "crack," "coke," "snow," "crank," "go," "speedball," "crystal," "cross-tops," "yellow jackets")

Cocaine

The abuse of cocaine increased dramatically in the late 1980s and early 1990s but is now on the decline.

Cocaine may be inhaled through the nose ("snorting"), or dissolved in water and administered intravenously. When mixed with heroin for IV use, the combination is referred to as a speedball.

Through a simple chemical procedure, cocaine may be changed into a smokeable form known as freebase or crack. Smoking produces an instant and intense euphoria (sense of joy), which is attractive to abusers. Other effects include local numbness, powerful stimulation of the central nervous system, and feelings of increased confidence and energy, along with decreased inhibition.

Increased use and addiction to cocaine are probably related to its specific characteristics of producing an extremely pleasurable high that is very short lived. This encourages the user into a more frequent or regular use, to get the desired effects.

Both tolerance (the need to use increasingly larger amounts off the drugs to get the same effect) and dependence may occur with chronic use of cocaine. Regular users may exhibit mood swings, depression, sleep problems, memory loss, social withdrawal, and loss of interest in school, work, family, and friends. Because heavy use may cause paranoia, cocaine users may become violent.

AMPHETAMINES

During the 1950s and 1960s, amphetamines were commonly prescribed for conditions such as fatigue, obesity, and mild depression. Such use has ceased as the drugs have a high potential for addiction, and are now categorized as controlled substances.

Over-the-counter (OTC) amphetamine look-alike drugs are often abused. These drugs typically contain caffeine and other stimulant ingredients, and are marketed as appetite suppressants or stay-awake/stay-alert aids.

If taken in high doses, these OTC drugs may cause the same high and other effects associated with amphetamines. Regular users may exhibit irritability, restlessness, sleep disturbances, tremors, dilated pupils, skin flushing, and weight loss over time.

INHALANTS

Inhalant abuse became popular with young teens in the 1960s with "glue sniffing." Since then, a broader variety of inhalants have become popular. Inhalant use typically involves younger teens or school-age children. Groups of children will use inhalants usually as an experiment.

Commonly abused inhalants include model glue, spray paints, cleaning fluids, gasoline, liquid typewriter correction fluid, and aerosol propellants for deodorants or hair sprays.

The chemicals are poured into a plastic bag or soaked into rags, then inhaled. The drugs are absorbed through the respiratory tract and an altered mental state is noted within 5 - 15 minutes.

Adverse effects associated with inhalant abuse include liver or kidney damage, convulsions, peripheral neuropathy (nerve damage), brain damage, and sudden death. Most inhalant use occurs amongst teens or preteens who do not have access to illicit drugs or alcohol.

OPIATES, OPIOIDS, AND NARCOTICS

Opiates are derived from opium poppies. These include morphine and codeine. Opioids refer to synthetically produced substances that have the same effect as morphine or codeine.

Opiates and opioids include heroin, oxycodone, hydromorphone, meperidine, propoxyphene, and methadone. All of these substances, natural or synthetic, are considered narcotics. Used as pain-killers, these drugs promote sedation, decrease anxiety, and produce a different perception of painful stimuli.

Because heroin is commonly used intravenously (injected into a vein), health concerns related to sharing contaminated needles among IV drug users must be considered. Complications of sharing contaminated needles include hepatitis, HIV infection, and AIDS.

STAGES OF JUVENILE DRUG USE

There are several stages of drug use. Young people seem to progress more quickly through the stages than do adults.

• Experimental use -- typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures.
• Regular use -- the user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feeling; begins to stay apart from friends and family; may change peer group to others who are regular users; takes pride in noting; increased tolerance and ability to "handle" the drug.
• Daily preoccupation -- the user looses any motivation; the user is indifferent toward school and work; behavior changes become obvious; preoccupation with drug use overrides all prior interests, including relationships; the user engages in secretive behavior; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal complications may increase.
• Dependence -- cannot face daily life without drugs; denial of problem; worsening physical condition; loss of "control" over use; may become suicidal; financial and legal complications worsen; may have severed ties with family members or friends by this time.

TREATMENT OVERVIEW

As with any other area of medicine, the least intensive treatment should be the starting point.

Comprehensive residential treatment programs monitor and address potential withdrawal symptoms and behaviors. These programs incorporate behavior modification techniques, and they are designed to get the user to recognize his behavior. Treatment programs include counseling both for the person (and perhaps family), and in group settings. Drug abuse treatment programs have a long after-care component (when the user is discharged from the medical facility), and provide peer support.

Drug addiction is a serious and complicated health condition that requires both physiological and psychological treatment and support. It is important to have an evaluation with a trained professional to determine appropriate care.

CALL YOUR HEALTH CARE PROVIDER

• If you are concerned about the addictive potential of currently prescribed medications
• If you are concerned about possible drug abuse by yourself or a family member
• If you are interested in more information regarding drug abuse
• If you are seeking treatment of drug abuse for yourself or a family member

Also seek out information and support from local 12-step support groups (such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Ala-teen-Alanon) or other support groups like SMART Recovery, Moderation Management, and LifeRing Recovery. See alcoholism - support group, chemical dependence - support group.

Review Date: 05/17/2006
Reviewed By: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.