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Module 6
Drugs in the News
Background
STEROIDS
Anabolic steroids are artificial versions of testosterone, a hormone that all individuals have naturally in their bodies. Anabolic steroids, the most frequently abused of all steroids, are taken orally or injected to enhance athletic performance, increase stamina, and improve physical appearance. Anabolic means “muscle-building.” Steroids are often taken in cycles of weeks or months rather than continuously.
This is called “cycling.” “Stacking” refers to the use of several different types of steroids successively; this practice is thought to maximize their benefits while minimizing negative effects. Users think this will have a greater effect, but there is no scientific evidence for this.
Slang terms for steroids include Arnolds, gym candy, pumpers, stackers, weight trainers, and juice.
Effects of Steroids on the Body
Steroids have very dangerous side effects, including damage to the liver and kidneys as well as risk of high blood pressure and heart problems. In some cases, steroid use has led to death. Although steroids are effective in building lean muscle, strength, and endurance, no studies have documented that they enhance athletic performance.
While anabolic steroids can make some people look stronger on the outside, the immune system—the body’s defense against germs and diseases—is significantly weakened. Aggression and other psychiatric side effects may also result from abuse of anabolic steroids. Although users may report feeling good while on anabolic steroids, extreme mood swings can occur, with the potential for violence (this is often referred to as “roid rage”). Users may also suffer from paranoid jealousy, irritability, delusions, impaired judgment, and depression.
In addition, steroid use can impact sexual development (cessation of menstruation in girls, shrinking of the testicles and impotence in boys), and cause severe acne, loss of scalp hair, and hair growth on the body and face. Liver cancer and heart disease are among other serious side effects of steroid use that can occur in both males and females of all ages. Steroids can permanently stop the bones from growing, meaning that a teenage steroid user will not grow to full adult height. Although more boys than girls abuse steroids, these drugs are equally dangerous for both genders. People who inject anabolic steroids put themselves at higher risk of contracting HIV/AIDS or hepatitis, a disease that seriously damages the liver.
Steroids and Neurotransmission
After a person takes steroids, the drugs are distributed to many regions of the brain, including the hypothalamus. Testosterone is naturally produced in the hypothalamus, which controls appetite, blood pressure, moods, and reproductive ability. Steroids alter the normal functioning of the hypothalamus, resulting in changes in the amount of testosterone that is sent throughout the body. Because testosterone plays a role in many body functions, this can result in the many effects seen with steroid abuse.
Steroids can also disrupt the functioning of neurons in the limbic system, the part of the brain responsible for emotional regulation. This disruption can lead to aggressive behavior, mood swings, violent behavior, impairment of judgment, and even psychotic symptoms like personality changes or paranoia.
METHAMPHETAMINE
Methamphetamine is an illegal stimulant that speeds up the brain’s functioning. It can be smoked, snorted, injected, or taken orally. Methamphetamine is produced as pills, powders, or chunky crystals. The crystal form, nicknamed “crystal meth,” looks like small fragments of glass or shiny, blue-white rocks. When swallowed or snorted, methamphetamine gives the user an intense high. Injections cause the person to feel a quick high called a “rush” or “flash” that lasts an especially long time.
Slang terms for methamphetamine include speed, uppers, meth, crystal meth, ice, and crank.
Methamphetamine and neurotransmition
Methamphetamine acts by altering levels of the neurotransmitters dopamine and norepinephrine in synapses in various brain regions. Because methamphetamine has a similar chemical structure to dopamine and norepinephrine, it can be picked up by neurons that normally recycle these neurotransmitters. It can also enter neurons by passing directly across the cell membrane. Once methamphetamine enters a neuron, it causes the neuron to release large amounts of both dopamine and norepinephrine into the synapse. The high concentrations of dopamine result in feelings of euphoria and pleasure. Norepinephrine most likely causes the alertness seen with methamphetamine use. When a person stops using methamphetamine, the reduction of dopamine in the synapse results in intense cravings for the drug.
Effects of Methamphetamine on the Brain and Body
Methamphetamine can cause addiction, stroke, violent behavior, nervousness, confusion, paranoia, auditory hallucinations, mood disturbances, and delusions. Some of these effects may be long-lasting. Research has also shown that even several years after methamphetamine abuse has stopped, users may still have a reduction in their ability to transport dopamine from the synapse back into the neuron, indicating that there can be long-term impairment following the drug abuse. The damage to the dopamine system from methamphetamine is similar to the damage seen in Parkinson’s disease, where it occurs naturally.
Methamphetamine Withdrawal
Although methamphetamine is a highly addictive drug, no acute symptoms are evident at the time of methamphetamine withdrawal. Withdrawal symptoms can often take 30 to 90 days to occur, and can include depression, cravings, lack of energy, and even suicidal thoughts. New research suggests that brain abnormalities similar to those seen in people with depression and anxiety disorders can occur when a person stops using methamphetamine. Methamphetamine abuse has a very high relapse rate; more than 90 percent of individuals in treatment return to drug abuse.
The Impact of Methamphetamine on Communities
Dramatic increases in the production and use of methamphetamine have led to broad media coverage of this drug. Methamphetamine is made illegally with fairly inexpensive and readily available ingredients, such as drain cleaner, battery acid, and antifreeze. As a result, a majority of the methamphetamine produced in the United States is made in home labs. Methamphetamine is highly addictive, creating a high demand for the drug and the labs that supply it. These labs are a major problem for the community. Methamphetamine labs have the potential to contaminate drinking water, soil, and air. In addition, methamphetamine use often increases crime and violent acts, such as domestic violence or child abuse, in affected individuals and communities.
See the “Science in the Spotlight” article in the Module 6 magazine for more on the impact of methamphetamine on society.
GHB, ROHYPNOL, MDMA, AND KETAMINE (“CLUB DRUGS”)
Four club drugs are GHB (gamma hydroxybutyric acid), flunitrazepam (Rohypnol), MDMA (3-4 methylenedioxymethamphetamine), and ketamine. These drugs are called club drugs because of their association with use in party situations (note: methamphetamine is also considered a club drug).
GHB has three forms: a colorless, odorless liquid, a white powder, and a pill. Rohypnol is a pill that dissolves in liquids.
Some forms of Rohypnol are undetectable in liquids, while newer Rohypnol pills cause color changes in the liquid. MDMA, often known as ecstasy, comes in a tablet or capsule form. Ketamine is a white powder.
GHB is also known as "Georgia home boy". Rhypnol is also known as "roofies". Slang terms for MDMA include "ecstasy", "XTC", "e", "x", and "adam". Ketamine is sometimes refered to as "special K".
GHB and Rohypnol are also known as "date rape drugs" because of their effect on memory and their use in sexual assault situations. Student materials do not offer this terminology. Determine whether your students are ready for this level of discussion before presenting this terminology to them, if you decide to at all.
GHB can cause memory loss, relaxation, drowsiness, dizziness, nausea, difficulty seeing, unconsciousness, seizures, breathing problems, tremors, sweating, vomiting, decreased heart rate, a dreamlike feeling, coma, and possible death.
Rohypnol can cause memory loss, lower blood pressure, sleepiness, muscle relaxation or loss of muscle control, a drunk feeling, nausea, slurred speech, difficulty with motor movements, loss of consciousness, confusion, problems seeing, dizziness, and stomach problems.
MDMA can cause increases in heart rate and blood pressure, muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating. In high doses, MDMA can lead to a sharp increase in body temperature (hyperthermia) that results in liver, kidney, and cardiovascular system failure.
Ketamine can cause hallucinations, lost sense of identity and time, distorted perceptions of sight and sound, feeling out of control, impaired motor function, problems breathing, convulsions, vomiting, out-of-body experiences, a dreamlike feeling, numbness, loss of coordination, aggressive or violent behavior, and slurred speech.
GHB, Rohypnol, MDMA, and Ketamine in the Brain
GHB and Rohypnol affect the neurotransmitter GABA (gamma amino butyric acid). Normally, GABA inhibits the ability of neurons to send messages to neighboring neurons; in other words, it stops or slows the communication between neurons. When a person abuses GHB or Rohypnol, the drugs enhance the effects of GABA, further decreasing communication between neurons. This decreased communication, or depressant effect, causes drowsiness and confusion, and can have even more serious effects such as sleep, coma, or death.
MDMA causes an increase in activity associated with the neurotransmitters serotonin, dopamine, and norepinephrine. It does this by preventing the reuptake of the neurotransmitters. MDMA can also cause the reuptake sites to work in reverse, so they release even more serotonin into the synapse. Serotonin plays an important role in the regulation of mood, sleep, pain, emotion, and appetite. The excess serotonin found in synapses as a result of MDMA use likely causes the euphoric effects of the drug. Because the drug depletes large amounts of this important neurotransmitter, it also contributes to the negative aftereffects that users often experience days after use.
Ketamine disrupts the functioning of receptors for the neurotransmitter glutamate, known as NMDA (N-methyl-D-aspartate) receptors. This can cause the stupor observed in a person who has abused ketamine as well as problems with learning, memory, awareness, and judgment. Ketamine can also disrupt the actions of the neurotransmitter dopamine.
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Contact Information
For questions regarding NIDA's Science Education Program and Materials, contact Cathrine Sasek, Ph.D., e-mail: csasek@nih.gov.
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