In addition to the physical and social problems caused by dependence on drugs such as alcohol, people who become dependent on an illegal substance risk penalties for violating drug control laws and their personal safety when procur-
ing drugs. Those who use unsterilized needles also risk exposure to HIV, hepati- tis, and other sexually transmitted diseases that are transmitted through contam- inated blood. More than other addictive substances, illegal drugs are a powerful force behind criminal activity that destroys families and neighborhoods, and overwhelms prisons.
If you feel you are unable to stop using illegal drugs on your own, you will need professional help to quit. Although quitting is something only you can do, it is not likely that you can quit by yourself. Talk to your doctor, or call your local hospital or clinic to ask about their drug treatment programs.
Cocaine Whether sniffed as a powder, injected as a liquid, or smoked (free- basing), cocaine acts as both a stimulant and a local anesthetic, producing a rush of euphoria and energy. Its effects wear off quickly, often leading users to take another dose in a short time. Cocaine is derived from the leaves of the South American coca bush. Crack cocaine, the purest form of the substance, is espe- cially lethal because its effects are more intense and can lead to cardiac arrest.
The euphoria caused by cocaine use is intense but short-lived and usually fol- lowed by depression as the drug wears off. The drug causes the coronary arteries to constrict, boosting blood pressure and, with it, the risk of heart attack, stroke, and seizures. Regular use of cocaine often causes nervousness, insomnia, inabil- ity to concentrate, fatigue, depression, or anxiety; some people become aggres- sive, violent, or paranoid. Side effects include nausea and vomiting, bleeding of mucous membranes, and cold sweats. Cocaine also can cause hallucinations, abnormal heart rhythm, coma, and death.
A very ill person who is dependent on cocaine may need to be hospitalized. All people who are addicted to cocaine should seek counseling and rehabilitation to overcome their addiction.
Club Drugs So-called club drugs such as ecstasy, rohypnol, GHB, and keta- mine are synthetic drugs made in illegal production facilities. These drugs are being used increasingly by teens and young adults as part of a nightlife scene at nightclubs, bars, and “raves.” Many young people experiment with a variety of these drugs together. Combining any of these drugs with alcohol can lead to severe reactions and death.
Ecstasy comes in pill form and also can be inhaled or injected. The effects of ecstasy are similar to those of amphetamines and cocaine. Psychological effects include confusion, depression, sleep problems, severe anxiety, and paranoia. Physical effects include muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating. Use of the drug is associated with increases in heart rate and blood pressure. Ecstacy also has been linked to long-term damage to those parts of the brain that are critical to thought, memory, and pleasure.
Rohypnol, GHB, and ketamine depress the central nervous system, inducing a state of dazed relaxation. They have been implicated in cases of date rape; because they are often colorless, tasteless, and odorless, they can be slipped eas- ily into an unsuspecting victim’s drink. Rohypnol can be fatal when mixed with alcohol or other depressants. Abuse of GHB can produce withdrawal effects such as insomnia, anxiety, tremors, and sweating, and can cause coma and seizures, especially when combined with ecstacy. Sometimes ketamine is used as an alternative to cocaine and usually is snorted.
Heroin Heroin is an opiate, which means it comes from the opium poppy. Like other opiates, it can be eaten, inhaled, smoked, or injected. Because the body quickly builds up a tolerance to heroin, users can become addicted rapidly. The euphoric and tranquilizing effects of heroin come at a high price: regular use can lead to kidney dysfunction, pneumonia, lung abscesses, and brain disorders, depending on how the drug is taken. Those who inject the drug also risk skin abscesses, phlebitis (inﬂammation of a vein, often accompanied by formation of a blood clot), scarring, hepatitis, and HIV infection.
The drug methadone, itself addictive but much less so than heroin, is often used to treat heroin addiction; the person may need to take it for the rest of his or her life. Methadone treatment is usually given on an outpatient basis under a physician’s supervision.
Marijuana The most widely used illegal drug is marijuana, made from the leaves of the hemp plant. The drug is typically smoked in joints (cigarettes). Peo- ple use marijuana to feel good and to relax. The drug can cause a distorted sense of time and a reduced ability to think and communicate clearly. Other side effects can include problems with depth perception and short-term memory, impaired motor abilities, bloodshot eyes, dry mouth, and—with chronic use— paranoia, panic, and hallucinations.
Like cigarette smoke, marijuana smoke impairs the lung’s defenses against infection and can lead to bronchitis and emphysema. Smoking marijuana may pose even more of a cancer danger than cigarettes because marijuana smoke contains more of a potent cancer-causing substance than tobacco smoke and because people who smoke marijuana inhale the smoke more deeply into their lungs.
Heavy, long-term use of marijuana can cause a psychological addiction that can lead to loss of energy, ambition, and drive. People who are psychologically addicted to marijuana tend to have difﬁculty dealing with normal, everyday stress.
LSD Lysergic acid diethylamide (LSD) is a powerful hallucinogen that induces a wide range of psychological effects, which can be enjoyable, terri-
fying, or both. “Bad trips” can cause paranoia and panic, but even ordinary episodes of LSD use can involve:
• depressed appetite
• loss of sexual desire
• distorted perceptions
• difﬁculty communicating
• feelings of paralysis
• dilated pupils
• increased heart rate and blood pressure
In whatever form it is taken (blotter paper, sugar cubes, gelatin squares, or small tablets) the effects of LSD are unpredictable, in part because it is impossi- ble to know the exact dose you are getting and in part because the effects are inﬂuenced by the user’s personality and mood. A single dose of LSD can last for
12 to 18 hours, and many users experience ﬂashbacks—recurring memories of some aspects of their experiences using the drug—for up to a year.
LSD is not considered to be addictive but, like addictive drugs, LSD can pro- duce tolerance, which causes people who use the drug regularly to take increas- ingly higher doses to get the same effects. In susceptible people, LSD use may contribute to the development of mental disorders such as schizophrenia and severe depression.