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NIDA Home > Drug Facts Chat Day > Frequently Asked Questions of NIDA's Drug Facts Chat Day

Frequently Asked Questions of NIDA's
Drug Facts Chat Day

General Questions About Drug Abuse

What are your thoughts on the rap industry's references to drug use, specifically snoop dogg's lyrics "hey hey hey. Smoke weed every day."

Some people argue that songs and other forms of entertainment only reflect behaviors that are already present in society, while others suggest that the media can influence how people think and behave. There is some research to support the latter, which led to efforts to reduce the amount of cigarette smoking in movies and on TV.

While definitive evidence is still needed, music can reinforce the notion that drug use is common and acceptable and may send a message that drugs are more widely used than they really are. However, it's also important to recognize the efforts of the musicians who are out there trying to provide a realistic picture of drug use. Finally, it's important to acknowledge that drug references have been in various kinds of music and entertainment for decades and this is not solely a rap industry issue.

Which age group usually takes the most drugs?

Drug use is most common among young adults who are 18 to 25 years old. Rates of current (past month) use of illicit drugs in 2007 were higher for young adults aged 18 to 25 (19.7 percent) than for youths aged 12 to 17 (9.5 percent) and adults aged 26 or older (5.8 percent). Among these young adults, 16.4 percent used marijuana, 6.0 percent used prescription-type drugs nonmedically, 1.7 percent used cocaine, and 1.5 percent used hallucinogens. See http://www.oas.samhsa.gov/nsduh.htm for the latest information from the National Survey on Drug Use and Health.

If a mother or father was addicted to drugs and then had a child, would it affect the child? Would the child have medical problems, or even be addicted to the drug?

It depends on the individual situation. There are a number of the reasons why the child of addicted parents might have medical problems or become addicted. For example, if a mom is addicted to opiate drugs (like heroin, morphine, or prescription painkillers like Vicodin or OxyContin) while pregnant, her baby could be born addicted to that drug and go through a period of withdrawal. Usually this can be managed medically, but it is not a pleasant experience for the newborn (or the mom).

Researchers are also looking into whether or not exposure to other drugs before birth can make you more likely to get addicted to drugs when you are older. So far, one researcher has found that if a mother smokes cigarettes while she is pregnant, her child is more likely to use tobacco as a teenager, and to become addicted if they do use it. The child may also have a higher risk of other medical problems like asthma, and possibly behavioral problems too. For all these reasons, we recommend that pregnant women not use alcohol or drugs, including cigarettes, during pregnancy. It they having trouble stopping drug use, they should ask their doctor for help.

Two more things that can affect your risk of addiction are genetics and family environment. If your parents are addicted to drugs, you might have a higher risk for becoming addicted yourself if you start using them. So it is especially important for kids of parents who were addicted to avoid using drugs. But the good news is if you avoid drugs, you can protect yourself from ever becoming addicted!

Can diseases be inherited?

Absolutely. All diseases have some heritable component (this means that you can inherit them), but how much can vary. Here's an example. Huntington's disease is caused by a genetic defect that, if passed on, causes a person's offspring (their child) to be affected. That means that Huntington's is 100% genetic. Inheritance, in the form of genes, plays a large role in drug addiction also. BUT.....while genes play a big role, they are only part of the picture. Other factors, like having friends who don't use drugs, or being involved in sports and other recreational activities, also affect your risk of trying drugs and of becoming addicted to them. Researchers are trying to find the genes that make you vulnerable or resistant to addiction, in order to find ways to improve treatment and prevention approaches. Want more information on genes, addiction and teens? Check out NIDA's website, http://www.teens.drugabuse.gov/

How many people die each year from drug usage?

About 570,000 people die annually due to drug use. That breaks down to about 440,000 from disease related to tobacco, 85,000 due to alcohol, 20,000 due to illicit (illegal) drugs, and 20,000 due to prescription drug abuse. If you want more information, check out NIDA's site at www.drugabuse.gov.

I think that when a school teaches students about drugs, some students like me, who are not aware of those drugs, learn a lot more about what's out there. So, why are they teaching students all about drugs?

While trying drugs and alcohol might not have occurred to you until seeing all these messages from authority figures in school, many kids do get exposed to drugs and drug opportunities outside of the classroom, including on the internet. School systems know this, and figure that they had better equip you with knowledge about the risks of trying drugs and alcohol--to counter some of the misinformation that you might pick up elsewhere. However, your point is very important, and this is why we try hard to make our messages "age-appropriate" so as to maximize the usefulness of the information while minimizing the likelihood of its misuse.

Has drug use risen or declined among teens in the last five years?

For the most part, teens are taking better care of themselves today than in the past, and they are well informed about the downsides to drug taking. According to NIDA's Monitoring the Future Study--a national survey of 8th, 10th, and 12th graders--past month use of any illicit drug declined by 24% in the three grades combined between 2001 and 2007. This is driven, in large part, by declines in marijuana use. Also notable is the decrease in tobacco use, which is now at the lowest rate in the survey's history for all three grades.

However, there are areas that cause concern, particularly the non-medical use of prescription and over-the-counter medications, which can be quite dangerous and addictive. For example, 5.2% of seniors reported non-medical use of the opiate pain reliever OxyContin within the past year. And, the pain reliever Vicodin was abused by nearly one in ten 12th graders, second only to marijuana. In 2007, nearly 6% of 12th graders reported abusing over-the-counter cough and cold medicines at least once in the past year to get high.

What's the most commonly abused drug by teens?

According to the National Survey on Drug Use and Health (NSDUH), the most commonly abused substance among teens is alcohol, followed by tobacco. The most commonly abused illegal drug is marijuana. In 2006, 16.6% of 12 to 17 year olds had abused alcohol, 10.4% had abused cigarettes, and 6.8% had abused marijuana in the month prior to the survey.

You can learn more about drug abuse trends and statistics at: http://www.drugabuse.gov/DrugPages/Stats.html

How many young people are addicted to drugs?

According to the National Survey on Drug Use and Health, in 2006, 8.0% of youth in the United States (that's more than 2 million) between the ages of 12 and 17 met diagnostic criteria for abuse or dependence (addiction) on illicit drugs or alcohol. Of these only 181,000 youths received treatment at a specialty facility--about 8.7 percent of youths who needed treatment.

Are there any medical benefits of illegal drugs?

For some yes, but before giving you specific examples it may be useful to outline how drugs (or more generally, what we call controlled substances) are classified. According to the law we recognize five different drug categories, or schedules, which determine whether or not it is legal to use a drug and under what circumstances.

  • Schedule I includes drugs with high abuse potential but no currently accepted medical applications, therefore no prescription can be written for any Schedule I substance. Some of the drugs in this category are heroin, GHB, ecstasy, LSD, and cannabis (i.e. marijuana).
  • In contrast, Schedule II drugs also have high potential for abuse but have, in addition, accepted and approved medical applications. In this class, we can find various stimulants (e.g., cocaine, amphetamines), opiates (opium, methadone, oxycodone), and dronabinol (Marinol), which contain the main active ingredient in marijuana (THC).
  • Schedule III drugs, like anabolic steroids, buprenorphine, hydrocodone, and ketamine, have in general less abuse potential than Schedule I or II drugs and have accepted medical uses.
  • Schedule IV (e.g., benzodiazepines and barbiturates) and Schedule V (e.g., cough suppressants containing small amounts of codeine) drugs, have decreasingly lower potential for abuse than Schedule III drugs and also well accepted medical uses.

As you can see, dividing drugs based on their legal status is not very helpful in answering your question: indeed, there are legal substances that can be abused but have no approved medical use (e.g., tobacco, alcohol) while, conversely, many substances that are illegal under certain circumstances do offer medical benefits when used properly and under the supervision of a physician. Opiates, for example include both morphine and other pain relievers, and are used by physicians to provide pain relief to millions of people. Also, amphetamine (speed) and methylphenidate are legitimate treatments for Attention Deficit Hyperactivity Disorder (ADHD). Doctors who prescribe these drugs are well trained to evaluate if and when a person needs them, and how much is safe for a specific person to take. Prescription medications, when properly used, are of invaluable help in the treatment of serious medical conditions, but their use becomes dangerous and illegal when not under the supervision of a physician--even if they are taken for their intended purposes--to relieve pain, increase attention, or lose weight. Of course their abuse to get high, to improve mental or physical performance is also dangerous and illegal.

If a person has a penny in their mouth when taking a breathalyzer test will it impact the results of the test?

No, pennies will not affect the test. Holding batteries, tongue studs, braces, dentures, or anything else (except alcohol) in your mouth will not influence the results of a breathalyzer test.

What Is Date Rape?

Date rape is unwanted sexual contact from someone you know, may have just met, and/or thought you could trust. A number of drugs have been used in date rape because they can be slipped into someone's drink and have no taste or smell; these include ketamine, rohypnol and gamma hydroxybutyrate (GHB). These drugs can sedate a person and make them forget what happens to them. Rohypnol and GHB are predominantly central nervous system depressants and can be very dangerous, even fatal, because of their effects on the respiratory system.

To learn more about the side effects and medical consequences of these drugs, visit: http://www.drugabuse.gov/infofacts/RohypnolGHB.html.

If you have experienced any sexual assault report the attack by calling 911. You can also call 1-800-656-4673 to speak with a counselor at any time. More information can be found at http://www.4women.gov/faq/rohypnol.htm.

Consequences of Drug Use

What makes drugs so bad for you?

Drugs can be bad for you in lots of ways. Even occasional or experimental drug use can be dangerous, since drugs can have unexpected adverse health effects even with one use; and drugs affect your ability to exert good judgment--making it more likely that you might engage in risky behaviors that can have serious consequences, such as driving while intoxicated. Prolonged drug abuse can cause all sorts of medical problems--like lung cancer, heart disease, liver disease, and addiction. When someone is addicted to drugs, they become the most important thing in that person's life, causing them major problems at school, home, and work.

Are teens particularly vulnerable to becoming addicted to drugs?

Teens are in a period of tremendous upheaval regarding how their bodies are changing and their brains as well. In fact, scientists only recently learned how much brain development goes on during the adolescent years and well into early adulthood. This means that the teen brain is wired somewhat differently from the adult brain and that exposure to drugs (or other important stimuli) during this phase can affect how the brain develops. We know that teen decision making is often different from that of adults, and can involve more risk-taking. Some of this is good--helping teens learn who they are and what they want to be, but some risks can have serious negative consequences as well--a factor that's less impressive to the teen brain. What we do know is that early drug use is associated with later drug problems--whether this is because of changes in the brain that are especially prominent during adolescence, or other factors, such as co-occurring depression or anxiety, or exposure to trauma or stress is not yet clear.

Does doing one drug (e.g., cigarettes, marijuana) lead to abuse of other drugs?

That's not a simple question to answer. For example, most people who use marijuana do not go on to abuse other illicit drugs, but most people who abuse other drugs have previously used marijuana. For those people, did the marijuana use lead to the use of other drugs? Possibly, and for a number of different reasons. Being exposed to peers who use drugs, having greater access to drugs, greater problems in the first place that led to the initial drug use, or persistent effects of the drug on the brain could all make other drug use more likely. The latter, in fact, is supported by some research done in animals.

If you use drugs at a young age, does it screw up your life?

We know from scientific research that the earlier you start using drugs, the more likely you are to become addicted and suffer serious social and medical consequences. The reasons for this are complex--first, drugs affect the brain, and the brain is still developing until early adulthood. So, it's possible for drugs to alter the normal developmental pattern--research is still ongoing to help us figure this out. Second, people who use drugs when they are very young often have other problems that led to their drug use in the first place. For example, they may have difficult family situations or problems with depression or anxiety, etc. and attempt to use drugs to help them cope. Unfortunately, drug abuse just makes things worse in the long run, and doesn't address the problems that led to its use. Third, using drugs can interfere with success in school, in sports, and in relationships with friends and family, further creating problems down the road.

So the bottom line is that early drug use can lead to later drug and other problems, and the best advice is to never start. But, if you have started using already, you should know that the earlier you stop, the more likely you will be to avoid addiction and the other harmful consequences associated with it.

For more information, see http://www.drugabuse.gov/scienceofaddiction/addiction.html.

Can drugs make you mentally ill?

Drug abuse and addiction and other mental disorders are intimately related, so this question is like a coin that can be looked at from two different sides. On one hand, we have known for a long time that people who abuse drugs, in general, have higher rates of many mental illnesses. In fact, there is evidence that drug abuse early in life may increase the risk of psychiatric disorders or accelerate their course. On the other hand, it is equally true that persons with mental illnesses are more likely to use drugs than other people. For example, children and adolescents with conduct disorders, attention deficit hyperactivity disorder (ADHD), and learning disabilities are at higher risk of abusing drugs than other youth, particularly if the mental illness is left untreated.

The reasons why addiction and other mental disorders are so closely linked and often coincide (or co-occur) in the same person are not fully understood. But scientists believe there may be at least three different reasons for this:

  1. Drug abuse may cause one or more symptoms of another mental illness, through long term negative changes in brain structure and function. For example, repeated cocaine use can cause panic attacks, which can then persist even when a person stops using cocaine.
  2. Mental illnesses may lead to drug abuse, if, for example a mentally ill person begins to abuse a drug in an attempt to self medicate (i.e., to reduce or manage the symptoms of the disorder or those caused by a medication prescribed for the disorder). The high rates of tobacco addiction in people with schizophrenia may be linked to reducing the cognitive disturbances of schizophrenia or countering medication side effects.
  3. Drug abuse and other mental disorders may be both caused by common factors, such as underlying brain deficits or early exposure to stress or trauma. NIDA-supported investigators are using neuroimaging, genotyping, statistical modeling, and other tools to better understand the interplay of risk factors in the development of such disorders.

For further information see: http://www.drugabuse.gov/NIDA_notes/NNvol21N2/DirRepVol21N2.html

Can depression be a reason to use drugs?

People who are depressed sometimes turn to using illicit drugs to feel better, but that would be a temporary solution at best. More typically it is asking for more serious trouble. Illicit drugs can make you feel high for a little while soon after you take them, but when they leave your body you won't feel any better--and you may feel worse--than before you took them. With continued drug abuse, the period of feeling good grows shorter and the subsequent bad feelings get worse. If you or someone you know feels depressed, talk to a doctor. There are many treatments for depression. There are medications that have been tested and approved by the FDA, and there are psychosocial or behavioral treatments that can help improve feelings of depression that do not involve taking medications.

Addiction

What exactly is dopamine?

The human brain is regarded by many as the most complex "thing" in the entire universe. Whether you consider it a machine, an organ, the seat of the mind, or a sophisticated computer, the secret to its vast complexity lies in the humongous number of brain cells (aka, neurons) combined with their amazing capacity to connect, process, and send information to each other. Therefore, the ability to transmit information between neurons is the absolute key to a healthy brain that performs properly. Who's in charge of such a delicate yet fundamental task? Neurotransmitters, of course--the chemicals that deliver the messages from one neuron to the next! There are several classes of neurotransmitters, each performing very specific functions.

Dopamine--one of many known neurotransmitters--is intimately involved in important aspects of brain function, which makes it a key player in drug abuse and addiction. Dopamine is present in regions of the brain that control movement, emotion, thought, motivation, and feelings of pleasure. In fact, when you have a nice meal or listen to your favorite music dopamine signals your brain that something important has happened that needs to be remembered, prompting you to repeat the behavior. Drugs can cause a much more powerful release of dopamine so that such natural pleasures can no longer compete because they cannot produce the same "high" that drug abusers remember and seek to repeat. Eventually, people become focused on obtaining and using drugs at every opportunity--although recreating the initial high becomes nearly impossible. Dopamine is also involved in other brain disorders that have nothing to do with drug abuse: the tremors and other symptoms that characterize Parkinson's disease, for example, are the direct result of the loss of neurons that make dopamine.

What is addiction and how does it happen?

Addiction is a disease characterized by uncontrollable drug craving, drug seeking, and drug use that persist even in the face of extremely negative consequences, such as losing your job, doing poorly in school, getting arrested, or getting sick. Addiction develops because of changes to the brain caused by drug use. Initially, all drugs of abuse, either directly or indirectly, increase the activity of the chemical dopamine in the brain's reward centers, which is what makes people feel good. However, with continued drug use and excessive activation of dopamine neurons, the brain starts to adapt to the good feeling, so more drug is needed to achieve it. This causes people to become dependent on the drug, to feel bad when it is not in their system, and to seek and take the drug compulsively--without even thinking about it. Another way that drugs change the brain is to affect the ability to make decisions, such as judging what's important, what's healthy, and what's dangerous. The compulsive seeking and using of drugs even in the face of potentially devastating consequences is the essence of addiction.

That said, drug addiction is a treatable disease—with medications (in some cases) and behavioral or psychosocial therapies. Treatment should focus on a person's individual needs, since many people who are addicted to drugs also have other serious problems, including other mental illnesses. Drug addiction is often chronic (long-term), with relapses possible even after long periods of abstinence but relapse doesn't mean failure, just that treatment needs to be reinstated or adjusted to ensure long-term recovery.

To learn more, check out "The Science of Addiction" at http://www.nida.nih.gov/scienceofaddiction/.

Why do some people get addicted to drugs and others don't?

Some people are more likely to become addicted than others. The fact is that addiction is a very complex disease, which means that the overall risk of becoming addicted—once you start using drugs—is made up of a huge number of contributing risk factors at both the biological and environmental levels. These include the genes you inherit, the conditions during your prenatal development, the experiences of your early childhood, the parenting style at home, the nurturing quality of your school and neighborhood, the level of stress you are exposed to, and any vulnerability to or co-occurrence of other mental disorders you may have; all these just to name a few! This high level of complexity explains why it is so difficult to predict who will become addicted and who won't. This difficulty notwithstanding, there are well-known risk factors that help us to identify those who are most vulnerable and focus our prevention efforts. For example, addictions tend to run in families: if your parents smoke, you're more than twice as likely to smoke as someone whose parents do not smoke. Also, if somebody suffers from certain mental illnesses he or she is also more likely to abuse certain drugs and become addicted.

What drug is the most addictive?

This question calls for a rather complicated answer, so it may be helpful to reframe it in terms of a more familiar subject instead of answering it right from the get go. So let's consider, first, the similar question of: what food is the most fattening? It is easy to see that the answer should be: "it depends." The fact is that some people can eat bread and pasta till they drop, without gaining an ounce of weight, while others on strict diets can't even look at a plate of lasagna without putting on a couple of extra pounds. The huge differences in how people assimilate various foods hinges partly—of course—on genetics. Indeed, some lucky people have such efficient metabolisms that they can burn calories as soon as they are ingested, and others, less lucky, don't seem to find a way to get rid of them. Age is another important factor: dietary fats have very different fates if consumed by adults or by children. Finally, it should be fairly obvious that lifestyle and the life choices we make every single minute, like walking or driving, taking the elevator or the stairs, TV watching or working out, will also have a tremendous impact on how "fattening the foods we eat are."

For very similar reasons, scientists are reluctant to rank drugs in terms of their addictiveness. There are just too many moving parts (variables) in the equation that would need to be considered: genetic (e.g., drug metabolism), environmental (e.g., drug availability) and developmental (e.g., age), all of which play important and changing roles in determining to what extent (in fact, even whether) abuse of a particular drug will lead to addiction.

The fact that it is impossible or at least ill-advised to rank drugs according to their addictiveness value, does not mean that we cannot identify factors that contribute to or influence the addictiveness of a particular drug. We can offer a nice example from the world of stimulants, where different routes of administration (i.e., how you take it) can have a profound impact on the ultimate risk of harm and addiction. Smoking cocaine (crack) delivers large quantities of the drug to the lungs, producing effects comparable to intravenous injection. These effects are felt almost immediately, are very intense, but do not last long. The high from smoking cocaine may last from 5 to 10 minutes. The high from snorting cocaine on the other hand comes on slower and can last for 15 to 20 minutes. There is evidence that suggests that users who smoke or inject cocaine may be at greater risk of causing harm to themselves-including becoming addicted-than those who snort the substance, because the drug reaches its brain targets so much faster. And route of administration is but one of many factors to consider just in relation to the drug itself--the dosage, combination with other drugs, setting in which a drug is taken, and pattern of drug taking are other variables to consider along with those noted above related to the individual and his/her environment.

Treatment

How can I encourage my friend to stop taking drugs and get her some help?

The first thing you can do is listen to what she has to say about her drug use and about why she is using. It is always a good idea to encourage your friend to confide and seek advice from a trusted adult. If she doesn't realize the negative health effects drugs have on her body, brain and life, there is a lot of information you can share with her that can be found on NIDA's website (www.drugabuse.gov). If she is already aware of the negative consequences drugs have on her health, school, family, etc., she may be prepared to make a change and seek treatment. You can help her find a doctor, therapist, support group or treatment program by visiting the website www.findtreatment.samhsa.gov, or calling 1-800-662-HELP. If your friend is not ready yet to get help, don't give up on her. Keep reaching out, and hopefully some day soon she will be ready. Helping her go through the process of starting treatment, keeping in touch with her while she is in treatment, and supporting and encouraging her while she is in recovery are the best things you can do for your friend struggling with addiction.

I think my friend is on drugs, but he won't talk to me. What do I do?

It's hard to be in this situation, seeing a friend going down a dangerous path or suffering, and not being sure what you can do to help. First, let your friend know that someone cares about him. You can let him know you are concerned without being judgmental, and that there are people he can talk with in confidence. He may be more open to talk to a trusted adult or a medical professional if he feels that his privacy would not be violated. There are some resources for him that are anonymous - for example, the National Suicide Prevention Lifeline at 1-800-273-TALK. They don't just talk about suicide; they can help with a lot of issues including drug abuse, and can connect your friend with a professional close by. There is also a website with information about treatment programs: http://findtreatment.samhsa.gov/. Because talking with someone about his or her drug use can be uncomfortable, you may want to ask an adult you trust, like a teacher or coach, to help you figure out how best to help your friend.

How effective is drug treatment? Why do celebrities go back to rehab again and again?

There are lots of different kinds of treatments for drug abuse and addiction, and some work better than others. Research has shown that some treatments successfully help people stop using drugs, and also help to solve other problems that tend to go along with drug abuse. It's hard to say why some celebrities keep going back to treatment. What we do know is that people who finish a treatment program that uses evidence based practices tend to have a much better chance of staying off drugs for good--but that often involves major changes in lifestyle -- changing where you hang out and who you hang out with. If people aren't willing to make those changes, they can easily fall back into using drugs. And even those people who do become abstinent can remain at risk for relapse for a very long time, and may require ongoing support from community groups like Alcoholics Anonymous or Narcotics Anonymous, or multiple rounds of drug treatment. Addiction can be a chronic disease -- it involves changes in the brain that can persist even after a person stops using drugs. This can make a person vulnerable to relapse, and if that happens it becomes important to get them back into treatment as soon as possible, so that they can eventually recover fully, and regain productive lives.

If you were once addicted to a drug and then stopped using it, will you always have the urge to go back to that drug again?

Not everyone has the same feelings after stopping drugs, but many say that they have a continuing urge to use, especially in the early days after quitting. And in some cases the triggers for this urge or craving, may not even be consciously realized--passing by a place where drugs were once purchased or used, seeing an old friend with whom drugs were taken. One of the things that treatment does is help people to deal with the urges to use. And over time, these urges to use can weaken and become less frequent.

Tobacco

How can you stand up to peer pressure if all your friends are pressuring you to smoke?

Peer pressure can be really difficult to handle. Here are a few tips. Remember that it's your body and at the end of the day, you live with the consequences of your choices. So, be assertive about what you want (tell them to back off). You may want to give them reasons such as "I don't want to be addicted to cigarettes" or "Cigarettes can lead to cancer, why would I want to smoke?" or even "I can't come home smelling like cigarettes." You may have to ask yourself if your friends are really acting like "friends" if they keep asking you to do something that you don't want to do--especially when it is something that's harmful to you. Stay strong.

Which affects your body more chewing or smoking tobacco?

This is a really good question! Both chewing and smoking tobacco can negatively affect your body. It's hard to say which will affect your body more, because so much has to do with each person's biology and the amount they smoke or chew, but we do know the more someone uses tobacco (in any form) the greater the effects can be on their body.

Overall, chewing tobacco can cause damage to gum tissue and even loss of teeth. It also reduces a person's ability to taste and smell. Most importantly, smokeless tobacco contains cancer causing-chemicals that can cause cancers of the mouth, pharynx, larynx, and esophagus. This can even happen in very young users who chew tobacco. In fact, most people who develop these cancers used to chew tobacco. Inhaling cigarette smoke pulls more than 4,000 chemicals into a person's lungs. The most dangerous chemicals in cigarette smoke are tar and carbon monoxide. Tar causes lung cancer, emphysema, and bronchial diseases. Carbon monoxide causes heart problems; smokers are at high risk for heart disease.

Whether someone smokes, chews, or sniffs tobacco, he or she is delivering nicotine to the brain and increasing their chances of becoming addicted. Once addicted, it is very difficult to quit, in spite of the severe health consequences.

For more information on smoking or tobacco please go to: http://teens.drugabuse.gov/facts/facts_nicotine1.asp#what_is_it

Marijuana

Can someone overdose on marijuana?

If you mean can they overdose and die from marijuana--the answer is no, its not very likely. But they can experience extreme anxiety (panic attacks) or psychotic reactions (where they lose touch with reality and may become paranoid). And people can and do injure themselves because of marijuana's effects on judgment, perception, and coordination. For example, marijuana affect the skills you need to drive (e.g., concentration, reaction time) so people can injure themselves and others if they drive while under the influence. For more information on marijuana, see: http://www.drugabuse.gov/ResearchReports/Marijuana/default.html.

I thought marijuana was all-natural, how can it hurt your body if it's natural?

Many drugs of abuse come from plants, and therefore can be considered "natural." For example, heroin comes from poppy plants and cocaine comes from the coca plant. That doesn't mean they are healthy--think tobacco. Similarly, marijuana comes from a plant that contains THC, which is "psychoactive" (it affects mood and behavior) and can be addictive. For more information on mariijuana see http://teens.drugabuse.gov/facts/facts_mj1.asp and http://www.nida.nih.gov/MarijBroch/Marijteens.html.

There are kids in my school who smoke pot and they seem okay. What is the big deal?

Marijuana, like most other drugs, affects the parts of the brain that allow us to make plans, solve problems, and make decisions. So although these kids might seem ok, they are altering their brain chemistry in ways that can have both short term and long term effects In the short term--they run the risk of doing something dangerous when they are high--like driving and getting into an accident, or not studying and having their grades drop, or seeing their athletic performance decline, and getting kicked off a team. But in the longer term they also risk becoming addicted. Repeated drug use changes the brain (and the body) and could one day lead to addiction and other serious medical consequences. Interestingly, one of our researchers surveyed people that had used marijuana regularly for many years. The marijuana users reported diminished life satisfaction and more physical and mental health problems, which they attributed to the marijuana. They also had poorer academic and job outcomes and lower salaries than a group of adults from comparable backgrounds who did not smoke marijuana.

So don't believe just what you see on the outside--some of these changes take time to happen, and some people are more vulnerable to problems associated with drug abuse than others. We don't know all the reasons why, but genetics and a host of other factors--age of first use, other mental health problems, stress, family difficulties, peers that use drugs--all contribute to someone's likelihood of becoming addicted or developing other health problems because of repeated drug use.

You can read more about marijuana at http://www.nida.nih.gov/MarijBroch/Marijteens.html or
http://teens.drugabuse.gov/facts/facts_mj1.asp.

I've been smoking pot for 7 years. For 4 of those years I smoked every day. I quit smoking for about 3 weeks but everything I do now seems boring without weed. Is there anything you can suggest for me?

What you describe sounds like a no-win situation: life with weed or a boring life. But in fact, there is a way out. It is just hard for you to see it now, because it sounds like you are addicted to marijuana. Most people don't even realize that you can get addicted to it, but one of the hallmark features of any addiction is that not only does the drug itself become less reinforcing than it used to be (i.e., you need more to get the same effect), but so do most things in life that used to make you happy. In addition, someone who smokes marijuana daily is likely to experience withdrawal symptoms when they stop. For marijuana, this can include irritability, loss of appetite, difficulty sleeping, and mood swings. These can last for several weeks after you stop taking the drug. But, the situation does improve if you can stay off of the drug.

Here's my suggestion: Talk with someone who can help you get the help you need. If you can, talk to your parents. If you can't talk to your parents, then try a school counselor or another trusted adult and tell them that you'd like to get professional help. You can also call 1-800-662-HELP to find out where to get treatment. Or, you can call a hotline, like 1-800-272-TALK just to talk. Whatever you choose, you should know that life without drugs doesn't have to be boring - it can be interesting, happy and fulfilling. And you should also know that there ARE effective treatments available.

You should be proud of yourself for deciding and having been able to quit for 3 weeks (that is a hard thing to do for people that are addicted to any drug, and it is a very good start!). But going 3 weeks without weed (after 7 years with it) is not enough time for your system to recover so that you can feel how good life can be when you are free of the influence of the drug. You've taken a good first step and I encourage you to build on it in spite of the sure to come ups and downs.

Have most teens tried marijuana at least once?

Although it may seem that everyone smokes marijuana that's not the case. In fact, a majority of teens do not use. In a national school survey last year, about 15% of 8th graders, 32% of 10th graders, and 42% of 12th graders reported having used marijuana at least once in their lifetime.

What are the long-term effects of smoking marijuana?

Using marijuana can produce adverse physical, mental, emotional, and behavioral changes, and, contrary to popular belief, it can be addictive. Chronic or long-term exposure to marijuana smoke, just like cigarette smoke, can harm the lungs. The use of marijuana can impair short-term memory, verbal skills, and judgment, and can also distort perception. Not surprisingly, students who regularly smoke marijuana get lower grades and are less likely to graduate from high school, compared with their nonsmoking peers. In addition, marijuana has been associated with a number of mental conditions, including schizophrenia (psychosis), depression, anxiety although we do not know yet whether marijuana can cause mental illness, particularly in healthy people who are not otherwise vulnerable to these disorders. There is good news, however, since there is evidence that if an individual quits marijuana, even after long-term or heavy use, their cognitive abilities (learning, memory) can recover.

For more information on marijuana, see: http://www.drugabuse.gov/ResearchReports/Marijuana/default.html

Does marijuana affect your ability to drive?

Yes. Studies show that 10 to 22 percent of drivers involved in vehicle crashes, used drugs often in combination with alcohol. In fact, we know that a moderate dose of marijuana can impair driving performance (i.e., reaction time, visual search frequency--driver checking side streets--or perceiving/responding to changes in speed of other vehicles); and that even a low dose of marijuana combined with alcohol markedly increased driving impairment over either drug alone.

You might find some interesting information on this very issue at: http://www.drugabuse.gov/Infofacts/driving.html

Can marijuana be used as a medicine?

The Food and Drug Administration (FDA), which is responsible for ensuring the safety of everything from cosmetics to human and animal medications to our nation's food supply has not approved marijuana to treat any medical illness. That is because smoking marijuana has not been shown in rigorously conducted clinical trials to have medical benefits that exceed its risks--the same standard used to approve any medication. However, the FDA has approved certain medications that contain ingredients found in marijuana. These medications are usually prescribed to relieve symptoms in seriously ill patients, such as reducing nausea for cancer patients on chemotherapy or helping AIDS patients to eat more. Also, there is some new and exciting research looking at the biology of cannabinoids, the general class of molecules related to THC, the active ingredient in marijuana. This research suggests new ways of treating pain and other illnesses without the dangers of becoming addicted or the health liabilities linked to smoking marijuana.

See http://www.nida.nih.gov/MarijBroch/Marijteens.html for more information.

Is smoking marijuana more harmful than smoking cigarettes?

Unfortunately, the answer is not so simple. On one hand, it is true that marijuana tar contains about 50% higher concentration of chemicals linked to lung cancer, compared with tobacco tar, and that smoking marijuana deposits four times more tar in the lungs than smoking an equivalent amount of tobacco. This is because marijuana smokers hold the smoke in their lungs longer than tobacco smokers do, allowing more time for extra fine particles to be deposited in the lungs. As a result, the lungs of marijuana smokers show some of the same pre-cancerous changes as the lungs of tobacco smokers, and marijuana smokers suffer some of the same respiratory problems as cigarette smokers--i.e., chronic cough, bronchitis, etc. Despite this, the verdict is still out on whether smoking marijuana increases the risk of developing lung cancer later in life. In a way this paradoxical observation illustrates why it would be ill advised to rank different drugs with respect to their differential ability to cause health problems. This is because there are many factors, some of which are drug-specific, and some which are biological, developmental, or even environmental that can contribute to the net effect of abusing any given substance.

I can tell you however, that both the nicotine in tobacco and the THC in cannabis are addictive and that the smoke you inhale from both is bad for your lungs. The smoke in cigarettes, made from either tobacco or marijuana, contains literally thousands of compounds, many of which are toxic.

For more information about smoking, go to: http://www.smoking.drugabuse.gov/ For more information about marijuana, go to http://www.marijuana-info.org/

Cocaine

What's the difference between cocaine and crack?

Powder cocaine and crack cocaine are simply two different chemical forms of cocaine. Powder (also called hydrochloride) cocaine dissolves in water and, when abused, can be administered by intravenous (by vein) injection or by snorting (through the nose). Crack cocaine is the street name given to a form of cocaine that has been created by dissolving powder cocaine in water, mixing it with baking soda, and heating it to form a hard but volatile (i.e., smokable) mass. The name "crack" comes from the crackling sound that this form makes when it's smoked.

In spite of these differences, cocaine, in any form, produces the same effects once it reaches the brain. It produces similar physiological and psychological effects, but the onset, intensity and duration of its effects are related directly to the method of use and how rapidly cocaine enters the brain. Smoking crack or injecting cocaine intravenously produce the quickest and highest levels in blood and in the brain, and the effects also wear off the fastest. Repeated cocaine use, no matter how you take it, can produce addiction and other adverse health consequences, especially to the cardiovascular system.

How does cocaine make you feel?

Cocaine belongs to a class of drugs called "stimulants," because they usually make you feel euphoric, energetic, hyperstimulated, and mentally alert. The high from snorting may last 15 to 20 minutes, while smoking may last 5 to 10 minutes. Cocaine can also make you feel hypersensitive to touch, sights, and sounds. Some cocaine abusers report feelings of restlessness, irritability and anxiety. Some of the immediate effects after using cocaine include constricted blood vessels, dilated pupils, increased heart rate and blood pressure. Heavy doses can lead to violent behavior and users may experience tremors, vertigo, muscle twitches, and paranoia. As a user begins to increase the dose and/or the frequency of drug taking the duration and intensity of the high may lessen, and once it is over, users can feel very tired and depressed. Cocaine is a powerfully addictive drug, and while it can make you feel high when you first use it, addiction is a very real albeit unpredictable possibility. Naturally, the wisest move is never to start.

See http://www.drugabuse.gov/ResearchReports/Cocaine/Cocaine.html for more information.

What can happen if you mix alcohol and other drugs, such as cocaine?

Research has revealed a potentially dangerous interaction between alcohol and cocaine. Taken in combination, the two drugs are converted by the body to cocaethylene. Cocaethylene has a longer duration of action in the brain and is more toxic than either drug alone. It is noteworthy that the mixture of cocaine and alcohol is often seen in emergency room (ER) visits that involve drugs. In fact, cocaine is the drug most often mentioned in combination with alcohol in these cases.

Ecstasy

How does ecstasy affect the brain and what are some of its long term effects?

Ecstasy, also known by its chemical name methylenedioxymethamphetamine (or MDMA, for short), is a type of amphetamine, but it also produces effects similar to some hallucinogens. MDMA affects the brain by increasing the activity of at least three neurotransmitters (the chemical messengers of brain cells): serotonin, dopamine, and norepinephrine. MDMA causes these neurotransmitters to be released from their storage sites in neurons, resulting in increased neurotransmitter activity.

We know from studies in animals that MDMA can produce long-lasting damage to serotonin neurons. Serotonin is important in regulating mood, sleep, body temperature, pain and other critical functions. In fact, some of the medications used to treat depression directly target this system. From imaging the brains of people, we find that there are changes in this system too, but we do not know how long those changes last. People who abuse MDMA tend to get depressed or anxious and to have trouble remembering recent events. These effects can be short-lived or longer-lasting depending on how much drug is used, how often, and whether or not other drugs are also being abused (marijuana is fairly common in MDMA users). Some people who use MDMA also have other difficulties with their abilities to make decisions and with their sleeping patterns. Of course, you will likely suffer more severe problems if you use MDMA often or in large amounts.

Mushrooms

What chemicals are in 'shrooms and how do they impact the body?

The active chemical in "shrooms" is psilocybin. This is a hallucinogen obtained from certain types of mushrooms that are native to tropical and subtropical regions of South America, Mexico, and the United States. The use of psilocybin has also been 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. The psychological side effects of psilocybin use include hallucinations and an inability to distinguish fantasy from reality. Panic attacks and psychosis may also occur, particularly if a user ingests a large dose. Also associated with the ingestion of psilocybin is the risk of poisoning if one of the many varieties of poisonous mushrooms is incorrectly identified as a psilocybin mushroom.

Please check out this website for additional information: http://www.drugabuse.gov/about/welcome/messagepsilocybin706.html.

Prescription Drug Abuse

How addictive are prescription drugs?

It turns out that prescription drugs can be very addictive if not taken as prescribed to treat a medical condition. This is particularly true of some classes, like opiate analgesics (e.g., Vicodin for the treatment of chronic pain); stimulants (e.g., Ritalin, used to treat attention deficit disorders); and depressants (e.g. Xanax, used to treat anxiety or sleep problems). Long-term prescribed use of these medications or their abuse to get high can lead to physical dependence and in some people, addiction. These are not the same thing--physical dependence occurs because the body gets used to the effects of a drug and reacts if the drug is suddenly stopped or even reduced--withdrawal symptoms result, and these vary according to the drug being used. This can occur even in someone who is taking a drug as prescribed, and is one of the reasons why it is so important that prescription drugs be taken under the close supervision of a physician, who can monitor for any signs of potential problems and take proper action to minimize or avoid them. Addiction on the other hand is the compulsive, often uncontrollable use of drugs in spite of the negative consequences, which may or may not accompany physical dependence.

For more information, specifically on prescription drugs, you might want to check out: http://www.nida.nih.gov/ResearchReports/Prescription/Prescription.html

If OxyContin is so addictive why do doctors prescribe it?

Virtually every medication presents some risk of undesirable side-effects, sometimes even serious ones. One of the constant challenges that doctors face is weighing the potential benefits and risks of any medical treatment they prescribe to their patients. OxyContin is a powerful and long-acting pain reliever, prescribed to help patients with certain types of pain, usually chronic pain or pain caused by cancer. Before prescribing this medication, doctors should know a patient's complete medical history, including what other health problems they currently have, what other medications they take, and whether they have a history of problems with addiction or other mental illnesses. All of these contribute to the risks involved in prescribing a medication, and help a doctor determine what is the best approach for an individual patient. If a patient is prescribed OxyContin (or other pain medications), they should also be monitored for any change in their condition or response to the medication, so that corrective actions can be taken to minimize the risk and avert the development of addiction.

Steroids

What do steroids do to you?

The steroids that doctors can prescribe to treat medical conditions and that some people abuse are human-made substances related to male sex hormones. As you probably know, some athletes abuse anabolic steroids to enhance their performance by boosting muscle size and reducing body fat. But there is a down side when steroids are used for such non-medical purposes, because they disrupt the normal production and balance of hormones in the body, and can lead to a long list of alterations, such as reduced sperm production, shrinking of the testicles, male-pattern baldness and breast development in men. In the female body, anabolic steroids abuse can cause masculinization. This means that females may experience decreases in body fat, coarsening of the skin, and deepening of the voice. Women may also experience excessive growth of body hair (chest, chin, back, etc.) and lose the hair on their head. Examples of other effects are increased risk of blood clots and damage to heart muscle. Most important, with continued steroid use, some of these effects can become irreversible.

How are anabolic steroids different from the steroids doctors prescribe for things like swelling or asthma?

Not all steroids are what we call "anabolic steroids." The anabolic steroids specifically build up muscle mass (although not as much as you might think) and reduce fat development. But your body produces other steroids that do not have those properties. For instance, estrogen and progesterone are produced in the ovaries and are important for retaining feminine bodily characteristics, like menstrual periods and breast development. Other steroids, made mostly in your adrenal glands, called corticosteroids or cortisol help you to deal with stress. Cortisol also has other important regulatory functions, such as helping to adjust the salt and water content of the body. All of the normal functions of steroids are maintained properly with tiny amounts of these hormones, which your body naturally makes and needs to remain healthy. Years ago it was discovered that higher doses of corticosteroids produce anti-inflammatory effects--for this reason they are often prescribed for swelling and for asthma. However, as with any prescribed medication, taking more than what is recommended can be dangerous and can upset the normal balance of various bodily systems.

Wouldn't steroids have the same effects regardless of whether they are prescribed by a doctor or used illegally?

The effects of anabolic steroids are going to depend not only on the exact type and amount of drug that is used, but, very importantly, on the person that is taking them. When steroids are abused, they are usually ingested or injected at much higher doses (10-100 X) than what is prescribed by a doctor. Moreover, steroids are usually prescribed to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence. In other words, they are prescribed to correct low levels of the hormone. As one would expect, steroids' effects will be very different in someone with normal levels of the testosterone. For example, if a healthy young adolescent administers steroids, the resulting abnormally high levels could signal his or her bones to stop developing, leading to stunted growth. Such hormonal disruptions will have different effects in males and females.

Can I get addicted to steroids?

Every user has different feelings and experiences when using or when coming off a drug, including anabolic steroids. When someone stops using steroids, they can experience a variety of withdrawal symptoms some of which have been associated with addiction. These can include mood swings, fatigue, restlessness, loss of appetite, insomnia, the desire to take more, depression, and suicidal thoughts. Evidence for steroid addiction is certainly not as strong as it is for other drugs like cocaine or heroin. Still, it is clear that some people develop a tolerance to the effects of steroids--that is, they need more of a drug to achieve the same effect; and some people endure severe negative health and other consequences but continue using them, both of which are signs of drug addiction.

You can find a lot of information on the effects of steroids at http://www.steroidabuse.gov

Alcohol

Is it okay to still be a light drinker?

Drinking alcohol lightly has both risks and benefits. Older adults who drink a little bit (like a drink or two a day at most) tend to live longer than people who don't drink at all, and also live longer than people who drink way too much. This may be because alcohol (or byproducts of the manufacturing process) influences blood clotting, thereby reducing the risk of heart attacks. The risk associated with light alcohol drinking, of course, is that a drinker may start drinking more, and lose control over the drinking behavior. New research suggests that this is more likely to happen to adolescents compared to adults.

There is another big added risk for teenagers drinking alcohol, and that is that the brain is still fine-tuning and developing until the mid 20's. Drinking while the brain is still forming is like riding a bicycle over the sidewalk when the cement has just been poured and is still drying, versus riding over it later after the cement has hardened. Just as you are likely to leave lasting impressions and ruin the sidewalk when you run over it while it is still fresh, so too you can disrupt the final wiring of your brain when you drink alcohol as a teenager.

Why don't they change the age limit for being able to drink?

Since raising the drinking age from 18 to 21, many thousands of lives have been saved through decreases in automobile accidents. In fact, one report showed that by 2002 over 20,000 lives had been saved. (See http://www-nrd.nhtsa.dot.gov/Pubs/809860.PDF.) Also, we know that the earlier you start using drugs, including alcohol and cigarettes, the more likely you are to develop drug problems when you get older. There are likely many reasons for this, but you should know that the brain is still developing during the teen years, and drugs may affect that development.

HIV/AIDS

How could you get HIV/AIDS from abusing drugs?

The best known way to get HIV is the sharing of needles and other injection equipment such as cotton swabs, rinse water, and cookers. However, another way people may be at risk for HIV is simply by using drugs--regardless of whether a needle and syringe are involved--because drug abuse can disrupt the ability to make good decisions. This can lead people to engage in risky sexual (and other) behaviors that put them and others in danger of contracting or transmitting HIV.

More information on the linkages between drug abuse and HIV can be found at http://hiv.drugabuse.gov/index.html.

Can a baby be born with HIV if the father has it, but not the mother?

No, the virus cannot be given to an unborn baby by the father directly. HIV can be transmitted to a baby from the mother while in the womb, during delivery, or while breastfeeding. However, it should be noted that even if the mom has HIV, there are medications to prevent transmission to the child.

I once saw on a show that if a person kisses someone on the cheek or hugs a person with HIV they can get the virus from them. Is that true?

No. In order for HIV to be transmitted there needs to be the exchange of bodily fluid (e.g., blood, saliva). It is not possible to spread HIV through casual contact like hugging or kissing on the cheek, as long as bodily fluids are not shared.

For more information on HIV, visit http://www.hiv.drugabuse.gov.

Inhalants

Can you get high off of sharpies?

Yes, sharpies contain volatile solvents--and when inhaled these solvents can produce a "high." The effects of inhalants (including Sharpies) can be similar to those of alcohol, and include slurred speech, lack of coordination, euphoria, and dizziness. Inhalants can be very dangerous, particularly in children, some of whom have been known to die after a single session of inhaling chemical fumes. For more information on inhalants, visit: http://teens.drugabuse.gov/facts/facts_inhale1.asp#who.

What do inhalants do to your body?

The lungs rapidly absorb inhaled chemicals into the bloodstream, quickly spreading them throughout the body, including the brain. Within minutes of inhalation, users can feel a "buzz" or "high." The effects are similar to those produced by alcohol and may include slurred speech, lack of coordination, euphoria, and dizziness. Inhalant users may also experience lightheadedness, hallucinations, and delusions. The high usually lasts only a few minutes. But with repeated inhalations, many users feel less inhibited and less in control. Some may feel drowsy for several hours and experience a lingering headache. The most important effects occur in your brain. Inhalants often contain more than one chemical. Some chemicals leave the body quickly, but others can remain for a long time, because they stick to fatty tissues in the brain and central nervous system. One of these fatty tissues is myelin, a protective cover that surrounds many of the body's nerve fibers (axons). Myelin helps nerve fibers carry their electric messages to and from the brain. Damage to myelin can slow down communication between nerve fibers. Long-term inhalant use can break down myelin. When this happens, nerve cells are not able to transmit messages as efficiently, which can result in muscle spasms and tremors or even permanent difficulty with basic actions like walking, bending, and talking. These effects are similar to what happens to patients with multiple sclerosis--a disease that also affects myelin.

Inhalants also affect other parts of your body, especially when used repeatedly. They can cause serious harm to vital organs, including the heart, kidneys, and liver. Inhalants can cause heart damage, liver failure, and muscle weakness. Certain inhalants can also cause the body to produce fewer blood cells, which may result in a condition known as aplastic anemia (in which the bone marrow is unable to produce blood cells). Frequent long-term use of certain inhalants can cause a permanent change or malfunction of peripheral nerves, called polyneuropathy.

People have told me that if you "huff gas" even one time, you can die or have serious brain damage. Is this true, if so why does huffing do this?

Yes, it is possible to die or develop serious brain damage after a single exposure to gasoline (or other) fumes. If you inhale too much gas, it can push the oxygen out of your lungs, so you can suffocate. But the other important thing inhalants do is alter the fat (lipid) composition of neurons and glia, which are types of cells in your brain--this can slow down function in important brain sites. For example, your brain is in charge of functions that happen automatically without your even noticing, like breathing and making your heart beat regularly. If you interfere with the parts of your brain that control these functions, there can be serious consequences.

For more information on the effects of inhalants, visit www.inhalants.drugabuse.gov.

Do people use inhalants for breathing problems?

No, they use inhalers, which usually contain a type of steroid that reduces inflammation in the airways. Or they can be bronchodilators, which open the breathing passages. Inhalers are very safe when used as prescribed by doctors. Inhalants, on the other hand, are common household chemicals that contain a volatile component which can be abused. There is no safe way to abuse inhalants. For more information, please see www.inhalants.drugabuse.gov.

LSD

What do you think is the most dangerous aspect of LSD?

Its unpredictable psychological effects. People can experience delusions and visual hallucinations that can be frightening. In fact, "bad trips" can include terrifying thoughts and nightmarish feelings of anxiety and despair that include fears of insanity, death, or losing control. For more information about LSD, visit NIDA's website at http://www.nida.nih.gov/DrugPages/ACIDLSD.html.

Over-the-Counter Drugs

Can over the counter drugs be as bad as the illegal drugs?

Yes. All drugs have potentially dangerous effects--it depends on how much you take, and how you take them. Generally, the amount of over-the-counter drugs you need to take for the intended action (like getting rid of an allergy) is much less than would produce a harmful effect. That is why the FDA allows these drugs to be sold without a prescription. But if you take a larger amount, the drug could very well cause harmful effects and even death, particularly if combined with other drugs or alcohol.

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