Substance abuse (patient information)

For the WikiDoc page for this topic, click here

Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Synonyms and Keywords: Drug abuse; Illicit drug abuse; Narcotic abuse; Hallucinogen abuse

Overview
Drug abuse is the use of illegal drugs, or the misuse of prescription or over-the-counter drugs for at least a year with negative consequences.

Marijuana

 * Marijuana is also called "grass," "pot," "reefer," "joint," "hashish," "cannabis," "weed," and "Mary Jane."


 * About 2 in 5 Americans have used marijuana at least once in their life.


 * Marijuana comes from a plant called hemp (cannabis sativa). The main, active ingredient in marijuana is THC (short for delta-9-tetrahydrocannabinol). This and other ingredients, called cannabinoids, are found in the leaves and flowering parts of the marijuana plant. Hashish is a substance taken from the tops of female marijuana plants. It contains the highest amount of THC.


 * How fast you feel the effects of marijuna depend on how you use it:
 * If you breathe in marijuana smoke (such as from a joint or pipe), you may feel the effects within seconds to several minutes.
 * If you eat foods containing the drug (such as "hash brownies,") you may feel the effects with 30 -60 minutes.


 * Marijuana acts on your central nervous system.


 * Low-to-moderate amounts of the drug may cause:
 * Increased appetite ("the munchies")
 * Feeling of joy (euphoria)
 * Relaxed feeling
 * Increased sensations of sight, hearing, and taste


 * Other effects can include:
 * Feelings of panic, or rarely severe paranoia
 * Decreased ability to perform tasks that require a lot of coordination (such as driving a car)
 * Decreased interest in completing tasks
 * Delirium or seeing or hearing things that aren't there (hallucinations)
 * Bloodshot eyes
 * Changes in body image
 * Increased heart rate and blood pressure
 * Infections such as sinusitis, bronchitis, and asthma in heavy users
 * Irritation of the airways causing narrowing or spasms
 * Possibly weakening of the immune system
 * Sore throat
 * Trouble concentrating and paying attention, which can interfere with learning
 * Trouble telling oneself from others
 * Violence (may be related to marijuana that is laced with a drug called PCP)


 * Regular users may have withdrawal effects when they stop marijuana use. These may include:
 * Agitation
 * Anxiety
 * Insomnia
 * Irritability


 * Medical Marijuana:
 * The medical use of marijuana is controversial, yet it's active ingredient (THC) is legal for medical purposes in at least 16 states. (Whole marijuana is illegal, even for medical use.)


 * THC has been approved by the U.S. Food and Drug Administration (FDA) for the following medical purposes:
 * Relieving chronic pain and spasticity
 * Stimulating appetite in patients with AIDS or who have undergone chemotherapy
 * Treating glaucoma
 * Treating nausea caused by chemotherapy in cancer patients

Phencyclidine (PCP, angel dust)

 * PCP is an illegal drug that comes as a white powder, which can be dissolved in alcohol or water. PCP may be smoked, shot into a vein, or taken by mouth.


 * How quickly it affects you depends on how you take it:
 * Shooting up: If given through a vein, PCP's effects start within 2-5 minutes.
 * Smoked: The effects begin within 2 - 5 minutes, peaking at 15 - 30 minutes.
 * Taken by mouth: In pill form, or mixed with food or drinks, PCP's effects usually start within 30 minutes. The effects tend to peak in about 2 - 5 hours.


 * Different doses of PCP will cause different effects:
 * Lower doses of PCP: typically produce feelings of joy (euphoria) and less inhibition, similar to being drunk.
 * Higher doses: cause numbness throughout the body, and perception changes that may lead to extreme anxiety and violence.
 * Large doses: may produce paranoia, "hearing voices" (auditory hallucinations), and psychosis similar to schizophrenia.
 * Massive doses: usually from taking the drug by mouth, may cause acute kidney failure, heart arrhythmias, muscle rigidity, seizures, and even death.


 * Because of the pain-killing (analgesic) properties of PCP, users who get seriously injured may not feel any pain.

Lysergic acid diethylamide (LSD)

 * LSD (lysergic acid diethylamide) is a very strong hallucinogen. Only tiny amounts are needed to cause effects, such as hallucinations.


 * Other commonly abused hallucinogens include:
 * Psilocybin (mushrooms, "shrooms")
 * Peyote (a cactus plant containing the active ingredient mescaline)


 * LSD use may cause:
 * Anxiety
 * Blurred vision
 * Dilated pupils
 * Seeing things that aren't there (hallucinations)
 * Paranoid delusions
 * Tremors


 * Hallucinogens can lead to extreme anxiety and lack of reality, called "bad trips". These experiences can come back as a flashback, even without using the drug again. Such experiences typically occur during times of increased stress, and tend to occur less often and intensely after stopping the drugs.

Cocaine

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


 * Other names to describe different forms of cocaine include "crack," "coke," "snow," and "speedball."


 * Cocaine may be taken in different ways:
 * Snorting: Inhaling it through the nose
 * Shooting up: Dissolving it in water and injected it into a vein
 * Speedball: Mixed with heroin and shot into a vein
 * Smoked: Cocaine may be changed into a smokeable form known as freebase or crack


 * Smoking cocaine produces a nearly instant and intense sense of joy (euphoria), which is attractive to abusers.


 * Other effects include:
 * Feelings of increased confidence and energy
 * Less inhibition
 * Local numbness
 * Powerful stimulation of the central nervous system


 * Regular users of cocaine may need larger amounts of the drug to feel these effects. Regular users of cocaine may have:
 * Loss of interest in school, work, family, and friends
 * Memory loss
 * Mood swings
 * Sleep problems
 * Social withdrawal


 * Heavy use may cause paranoia, which can lead to violence.

Amphetamines

 * Amphetamines are stimulants.


 * Other names used to desrribe amphetamines or methamphetamines include "crystal," "go," "crank," and "cross-tops."


 * Amphetamines are very addictive. Prescription amphetamines are considered controlled substances. Over-the-counter (OTC) amphetamine look-alike drugs are often abused. These drugs typically contain caffeine and other stimulants, and are sold as appetite suppressants or stay-awake/stay-alert aids.


 * Signs and symptoms of stimulant use:
 * Dilated pupils
 * Exaggerated feeling of well-being (euphoria)
 * Fast heart rate
 * Restlessness and hyperactivity
 * Skin flushing
 * Sleep disturbances
 * Tremors
 * Weight loss

Inhalants

 * Inhalant use became popular with young teens in the 1960s with "glue sniffing." Since then, a greater variety of inhalants have become popular.


 * Inhalant use typically involves younger teens or school-age children.


 * Commonly abused inhalants include:
 * Aerosols for deodorants or hair sprays
 * Cleaning fluids
 * Gasoline
 * Liquid typewriter correction fluid
 * Model glue
 * Spray paints


 * Negative effects of inhalant abuse include:
 * Brain damage
 * Convulsions
 * Liver or kidney damage
 * Nerve damage (peripheral neuropathy)
 * Sudden death

Opiates, Opioids and Narcotics

 * Opiates come from opium poppies.


 * These drugs include morphine and codeine. Opioids are artificial substances that have the same effect as morphine or codeine. The term "narcotic" refers to either type of drug.


 * Narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes, feelings of euphoria.


 * These drugs include:
 * Codeine
 * Heroin
 * Hydromorphone (Dilaudid)
 * Methadone
 * Meperidine (Demerol)
 * Opium
 * Oxycodone (Percocet or Oxycontin)


 * Signs and symptoms of narcotic use:
 * Coma, respiratory depression leading to coma, and death in high doses
 * Needle marks on the skin (tracks) if drug use is by injection
 * Rapid heart rate
 * Relaxed or euphoric state
 * Scars from skin abscesses if drug use is by injection
 * Small pinpoint pupils


 * Because heroin is commonly injected into a vein (used intravenously), there are health concerns about sharing contaminated needles among IV drug users.


 * Complications of sharing contaminated needles include hepatitis, HIV infection, and AIDS.

Central nervous system depressants

 * These substances produce a sedative and anxiety-reducing effect, which can lead to dependence.


 * These types of drugs include:
 * Alcohol
 * Barbiturates (amobarbital, pentobarbital, secobarbital), also called "yellow jackets"
 * Benzodiazepines (Valium, Ativan, Xanax)
 * Chloral hydrate
 * Paraldehyde


 * Signs and symptoms of alcohol or other depressant use:
 * Decreased attention span
 * Impaired judgment
 * Lack of coordination
 * Slurred speech

Other drugs

 * Ketamine: a substance related to PCP, commonly called "Special K"


 * Ecstasy or MDMA (3,4-methylenedioxy-methamphetamine)


 * GHB and Rohypnol, also called "date rape," "acquaintance rape," or "drug-assisted assault" drugs

When to seek urgent medical care?

 * If you are concerned about the possibility of getting addicted to any prescribed medications
 * If you are concerned about possible drug abuse by yourself or a family member
 * If you are interested in getting more information on drug abuse
 * If you are seeking treatment of drug abuse for yourself or a family member

Where to find medical care for Substance abuse?
Directions to Hospitals Treating Substance abuse

Support groups

 * There are a number of different support groups available to help those with drug abuse.


 * Alcoholism support group:
 * ALCOHOLICS ANONYMOUS (AA)
 * AL-ANON
 * Alateen
 * SMART recovery; LifeRing recovery and SOS; Women for Sobriety; Moderation Management
 * National Institute on Alcohol Abuse and Alcoholism
 * Substance Abuse and Mental Health Services Administration


 * Chemical dependence support group:
 * International Association for Pain and Chemical Dependency
 * Narcotics Anonymous
 * National Institute on Drug Abuse

Source
http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm