Types of Addiction
While drug and alcohol use often begins as a way to seek recreation, the addictive properties of drugs quickly turn a perceived outlet for fun into a constant need to remain high. This compulsion is uncontrollable and may interfere with a person’s everyday life. The National Institute on Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences [addiction is also referred to as severe substance use disorder]. It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
Here at Choice House, we treat many types of addiction. And realizing that they are all different, we address each one with unique recovery methods. Thanks to science and years of research, our understanding of addiction and how it involves both the mind and body has helped us develop successful treatment approaches. Below you will find a list of the different types of addiction that we can treat at Choice House, Ladies’ House or The Lookout Boulder. If you or someone you know is suffering from alcohol or drug addiction, please contact us if you would like to discuss treatment options.
The information on this page comes from the National Institute on Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Drug Policy Alliance and DrugAbuse.com. There is a lot of information on drugs and addiction on the internet so we have compiled some of the most important information here to make your research easier. As always, please feel free to contact us if you have questions about addiction and recovery.
Click on the following to jump to a particular section: Alcohol, Marijuana, Prescription Drugs and Over-the-Counter Medications, Stimulants, Heroin, Depressants, Inhalants, Hallucinogens, Anabolic Steroids.
People drink to socialize, celebrate, and relax. Alcohol often has a strong effect on people and throughout history, people have struggled to understand and manage alcohol’s power. Why does alcohol cause people to act and feel differently? How much is too much? Why do some people become addicted while others do not? Here’s what is known:
Alcohol’s effects vary from person to person, depending on a variety of factors, including:
- How much you drink
- How often you drink
- Your age
- Your health status
- Your family history.
While drinking alcohol is itself not necessarily a problem, drinking too much can cause a range of consequences, and increase your risk for a variety of problems. Alcoholism can take many forms and isn’t always defined as someone who constantly drinks alcohol. It can also include people who binge drink, people who need alcohol at certain times of the day or when something stressful occurs, and people who drink in secret. Because alcohol is legal, many people don’t consider it to be as serious of a problem as it often is. However, excessive alcohol use, including underage drinking and binge drinking (drinking five or more drinks on a single occasion for men or four or more drinks on an occasion for women), can increase a person’s risk of developing serious health problems, including brain and liver damage, heart disease, hypertension, and fetal damage in pregnant women.
Drinking too much – on a single occasion or over time – can take a serious toll on your health. Here’s how alcohol can affect your body:
- Brain: Alcohol interferes with the brain’s communication pathways, and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination.
- Heart: Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including: Cardiomyopathy – Stretching and drooping of heart muscle, arrhythmias (irregular heart beat), stroke and high blood pressure Research also shows that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease.
- Liver: Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including: Steatosis (fatty liver), alcoholic hepatitis, fibrosis, cirrhosis.
- Pancreas: Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
- Cancer: Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the: Mouth, esophagus, throat, liver, breast.
- Immune System: Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.
- Oral Health: Alcohol leads to tooth decay because of the high sugar amounts. Frequent alcohol consumption de-mineralizes and weakens the enamel on your teeth, which will lead to serious tooth and gum issues. Chronic alcoholics often vomit from drinking too much, which leads to added enamel removal through the stomach acid in the vomit coming up and into the mouth. Those who binge on alcohol, throw up, and then pass out for the night are allowing the sugar and stomach acid to stew in their mouths. Paired with not brushing after this happens, your teeth are going to decay at an extreme rate. For more information on the dental problems associated with alcohol, visit: www.emergencydentistsusa.com/substance-abuse-and-dental-care/.
For more information on alcohol’s effects on the body, visit the website for the National Institute on Alcohol Abuse and Alcoholism or download their publication on alcohol and health effects.
Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa. The plant contains the mind-altering chemical delta-9-tetrahydrocannabinol (THC) and other related compounds. It’s the most commonly used illicit drug in the U.S. and while its use is widespread among young people, the legalization of marijuana in many states means that people of all ages have begun using it. Marijuana can be smoked in a joint or bong, it can be vaporized, and it can be baked into foods known as edibles. The popularity of edibles increases the chance of harmful reactions because they take longer to digest and produce a high. Therefore, people may consume more to feel the effects faster, leading to dangerous results.
The marijuana that is available today is much higher in THC than that of decades ago and therefore the harmful effects have become worse. They include: breathing problems, increased heart rate, and problems with child development during pregnancy. Long-term mental effects include: temporary hallucinations and/or paranoia, depression, anxiety, and suicidal thoughts. It can also worsen the symptoms of schizophrenia and other mental illnesses.
Other physical effects of marijuana include (from WebMD):
- Shallow breathing
- Red eyes and dilated pupils
- Dry mouth
- Increased appetite
- Slowed reaction time (If you drive after using marijuana, your risk of being in a car accident more than doubles.).
In addition to affecting your health, marijuana use can also affect your life. Compared to those who don’t use marijuana, those who use heavily more often report the following:
- Lower life satisfaction
- Poorer mental health
- Poorer physical health
- More relationship problems.
People also report less academic and career success. For example, marijuana use is linked to a higher likelihood of dropping out of school. It is also linked to more job absences, accidents, and injuries. Because of the legal restrictions, not much actual research has been done on the actual long-term effects, either good or bad, with regards to marijuana.
For more information, visit the website for The National Institute on Drug Abuse.
Some medications have psychoactive (mind-altering) properties and, because of that, are sometimes abused—that is, taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed. In fact, prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older. Commonly abused classes of prescription drugs include opioids (for pain), central nervous system (CNS) depressants (for anxiety and sleep disorders), and stimulants (for ADHD and narcolepsy).
Opioids include: Fentanyl (Duragesic®), Hydrocodone (Vicodin®), Oxycodone (OxyContin®), Oxymorphone (Opana®), Propoxyphene (Darvon®), Hydromorphone (Dilaudid®), Meperidine (Demerol®), Diphenoxylate (Lomotil®)
Central nervous system depressants include: Pentobarbital sodium (Nembutal®), Diazepam (Valium®), Alprazolam (Xanax®)
Stimulants include: Dextroamphetamine (Dexedrine®), Methylphenidate (Ritalin® and Concerta®), Amphetamines (Adderall®)
The most commonly abused OTC drugs are cough and cold remedies, but they can also be pain medications like Acetaminophen or sleep medications. Cough and cold medicines are usually sold in liquid syrup, capsule, or pill form. They may also come in a powder. Young people are often more likely to misuse cough and cold medicines containing DXM (dextromethorphan) than some other drugs because these medicines can be purchased without a prescription. Also known as: Robotripping, Robo, Tussin, Triple C, Dex, Skittles, Candy, Velvet, and Drank
Millions of Americans take cough and cold medicines each year to help with symptoms of colds, and when taken as instructed, these medicines can be safe and effective. However, several cough and cold medicines contain ingredients that are psychoactive (mind-altering) when taken in higher-than-recommended dosages, and some people misuse them. These products also contain other ingredients that can add to the risks.
Two commonly abused cough and cold medicines are:
- Cough syrups and capsules containing dextromethorphan (DXM). These OTC cough medicines are safe for stopping coughs during a cold if you take them as directed. Taking more than the recommended amount can produce euphoria (a relaxed pleasurable feeling) but also dissociative effects (like you are detached from your body).
- Promethazine-codeine cough syrup. These prescription medications contain an opioid drug called codeine, which stops coughs, but when taken in higher doses produces a “buzz” or “high.”
Read more about prescription drugs and what happens to the brain and body when someone misuses them.
People often think that prescription and OTC drugs are safer than illicit drugs because they are legal and regulated. But they can be as addictive and dangerous and put users at risk for other adverse health effects, including overdose—especially when taken along with other drugs or alcohol. Prescription and OTC drugs may be abused in one or more of the following ways:
- Taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing their unused pain relievers with their family members.
- Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects.
- Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.
Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs. For example, stimulants such as Ritalin® achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin® attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and Rohypnol®. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences. When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.
For more information, see the website for the National Institute for Drug Abuse.
Stimulants are a type of drug that works on the body’s central nervous system to produce enhanced brain activity. Various types of stimulants exist including those that are legal and many that are considered illegal. Many legal stimulants are only legal with a prescription to possess the drug while others are considered safe for consumption and do not have any serious laws or regulations attached to them. Illegal stimulants tend to have no known medical use, are highly dangerous and pose serious threats of drug dependence if they are used repeatedly. People who use stimulants are usually looking for improved alertness or function. According to the National Institute on Drug Abuse, various types of stimulants work to increase energy, elevate the mood of the user, pump up the heart rate and otherwise stimulate the user.
The most common legal stimulants include: Amphetamines such as Dexedrine or dextroamphetamine, ephedrine, caffeine and nicotine. Even so-called “natural” ingredients like guarana, ginseng and taurine—common ingredients in energy drinks like Monster and Red Bull—are stimulants that can lead to addiction, as well as various health problems with the heart and nervous system. Stimulant abuse overall can lead to many health problems, both short and long term. In the short term, stimulant abuse can cause irregular heartbeat, dangerously high body temperatures, and the potential for heart failure and seizures.
Some of the common effects of stimulants, according to NIDA Teen include:
- Euphoric high
- Increased focus and attention
- Increased blood pressure
- Increased heartbeat
- High body temperatures
- Decreased sleep and insomnia
- Decreased appetite
- Weight loss and malnourishment
The most common illegal types of stimulants include: methamphetamine (meth), cocaine, crack cocaine, and MDMA, also known as ecstasy or molly. All of these drugs carry a high potential for abuse and addiction. These drugs are illegal in all senses, and are used mainly for the high they produce. Cocaine is snorted, crack is smoked, meth is either injected or smoked, and MDMA usually comes in pill form. All of these drugs carry very negative consequences.They can produce tolerance in chronic users that requires users to take more and more of the drug to feel the same effects, which contributes to dependence and addiction. Meth, cocaine, and even prescription stimulants can cause homicidal and suicidal behavior in those who abuse them long enough and in high enough doses, a result of stimulant-induced psychosis that also includes hallucinations and extreme paranoia.
Methamphetamine is a stimulant drug usually used as a white, bitter-tasting powder or a pill. Crystal methamphetamine is a form of the drug that looks like glass fragments or shiny, bluish-white rocks. It is chemically similar to amphetamine [a drug used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy, a sleep disorder. Other common names for methamphetamine include chalk, crank, crystal, ice, meth, and speed.
Because the “high” from the drug both starts and fades quickly, people often take repeated doses in a “binge and crash” pattern. In some cases, people take methamphetamine in a form of binging known as a “run,” giving up food and sleep while continuing to take the drug every few hours for up to several days.
A history of methamphetamine: Amphetamine was first synthesized in 1887, and methamphetamine was discovered in 1919. By 1943, both drugs were widely available to treat a range of disorders, including narcolepsy, depression, obesity, alcoholism and the behavioral syndrome called minimal brain dysfunction, known today as attention deficit hyperactivity disorder (ADHD). Following World War II, during which amphetamine was widely used to keep combat duty soldiers alert, both amphetamine (Adderall, Benzedrine, Dexidrine) and methamphetamine (Methedrine, Desoxyn) became more available to the public. In 1971, Congress passed the Comprehensive Drug Abuse Prevention and Control Act, which classified amphetamine and methamphetamine as Schedule II drugs, the most restricted category for prescription drugs. In response to an ever-increasing demand for black market stimulants, their illegal production, especially that of methamphetamine, increased dramatically.
Some facts about Meth:
- Methamphetamine can be swallowed, snorted, smoked and injected by users. The effects usually last from four to eight hours or more, depending on dosage.
- Like amphetamine, methamphetamine increases activity, decreases appetite and causes a general sense of well-being. Increased or prolonged use of methamphetamine can cause sleeplessness, loss of appetite, increased blood pressure, paranoia, psychosis, aggression, disordered thinking, extreme mood swings and sometimes hallucinations.
- Methamphetamine production is a relatively simple process, especially when compared to many other recreational drugs.
- Pharmaceutical methamphetamine is still available legally under the brand name Desoxyn, but only infrequently prescribed to treat severe obesity, narcolepsy and ADHD.
- Contrary to a common misperception, methamphetamine is not “instantly addictive” for most people who use it. Most people who use methamphetamine do not develop an addiction. For those individuals who do develop an addiction, treatment for methamphetamine addiction is similar to that for cocaine and other stimulants and just as likely to succeed.
Taking even small amounts of methamphetamine can result in many of the same health effects as those of other stimulants, such as cocaine or amphetamines. These include:
- Increased wakefulness and physical activity
- Decreased appetite
- Faster breathing
- Rapid and/or irregular heartbeat
- Increased blood pressure and body temperature.
Methamphetamine increases the amount of the natural chemical dopamine in the brain. Dopamine is involved in body movement, motivation, pleasure, and reward (pleasure from natural behaviors such as eating). The drug’s ability to release high levels of dopamine rapidly in reward areas of the brain produces the “rush” (euphoria) or “flash” that many people experience. Because of this, it is incredibly addictive.
Long-term methamphetamine use has many other negative consequences, including:
- Extreme weight loss
- Severe dental problems (“meth mouth”)
- Intense itching, leading to skin sores from scratching
- Sleeping problems
- Violent behavior
- Paranoia—extreme and unreasonable distrust of others
- Hallucinations—sensations and images that seem real though they aren’t.
In addition, continued methamphetamine use causes changes in the brain’s dopamine system that are associated with reduced coordination and impaired verbal learning. In studies of people who used methamphetamine over the long term, severe changes also affected areas of the brain involved with emotion and memory.2 This may explain many of the emotional and cognitive problems observed in those who use methamphetamine.
Most people are familiar with the term “meth mouth,” which is characterized by broken, discolored, and even rotting teeth. Meth itself dries out your salivary glands and lets the mouth’s acid run rampant and destroy the enamel on your teeth. This leads to multiple cavities and serious tooth decay. Also, meth is composed of numerous chemicals that not only affect dopamine secretion, but are capable of stripping tooth enamel in a matter of weeks. Methamphetamine addiction can cause those who use it to stay awake for days at a time without eating, which augments the process of tooth decay.
Another issue is that once meth gets into your system—whether it be through smoking or snorting it—the blood vessels shrink and limit the needed blood supply to the mouth. This is a serious problem because this blood flow is needed for a healthy mouth. Over a period of time, even if it’s a short one, the vessels will continue to shrink and die at a very quick rate. Once this happens, the oral tissues will begin to decay, the mouth will go dry, multiple cavities will quickly develop, and the teeth will rot.
Meth addicts are also prone to other destructive habits, such as grinding their teeth, that compound the dental problems. Many have a very poor diet because of their addiction, which usually consists of junk food high in sugars. This diet, combined with poor dental care, paves the way for tooth decay and eventually complete rot. For more information about these dental issues, visit: www.emergencydentistsusa.com/substance-abuse-and-dental-care/.
For more information on meth, visit www.drugabuse.gov/drugs-abuse/methamphetamine.
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. Although health care providers can use it for valid medical purposes, such as local anesthesia for some surgeries, cocaine is an illegal drug. As a street drug, cocaine looks like a fine, white, crystal powder. Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. People snort cocaine powder through the nose, or they rub it into their gums. Others dissolve the powder in water and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball.
Short-term health effects of cocaine include:
- Extreme happiness and energy
- Mental alertness
- Hypersensitivity to sight, sound, and touch
- Paranoia—extreme and unreasonable distrust of others
- Constricted blood vessels
- Dilated pupils
- Raised body temperature and blood pressure
- Faster heartbeat
- Tremors and muscle twitches
Cocaine can also cause dental problems over time. Cocaine strips your entire body of calcium and vitamin C, which are vital for a healthy mouth. Cocaine can also suppress the appetite. Because healthy teeth and gums thrive on these two vitamins and minerals, which are stripped by the cocaine and then not replaced because the individual has no appetite, the impact of drug abuse on the mouth is twofold. Gingivitis, tooth loss and decay, and loss of bone structure are very common with cocaine abuse. It often only takes a few months for oral health problems to start to develop.
As with other drugs, repeated use of cocaine can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction. The reward circuit eventually adapts to the excess dopamine brought on by the drug. As a result, people take stronger and more frequent doses to achieve the same high and feel relief from initial withdrawal. Withdrawal symptoms include:
- Increased appetite
- Unpleasant dreams and insomnia
- Slowed thinking.
One of the biggest dangers of cocaine is the possibility of overdosing. Death from overdose can occur on the first use of cocaine or unexpectedly thereafter. Many people who use cocaine also drink alcohol at the same time, which is particularly risky and can lead to overdose. Others mix cocaine with heroin, another dangerous—and deadly—combination. Some of the most frequent and severe health consequences leading to overdose involve the heart and blood vessels, including irregular heart rhythm and heart attacks, and the nerves, including seizures and strokes.
For more information on cocaine, visit www.drugabuse.gov/publications/drugfacts/cocaine.
Crack cocaine is the crystal form of cocaine, which normally comes in a powder form. It comes in solid blocks or crystals varying in color from yellow to pale rose or white and it is heated and smoked. It is so named because it makes a cracking or popping sound when heated. Crack is the most potent form in which cocaine appears and is also the riskiest. It is between 75% and 100% pure, far stronger and more potent than regular cocaine. Smoking crack allows it to reach the brain more quickly and thus brings an intense and immediate—but very short-lived—high that lasts about fifteen minutes. And because addiction can develop even more rapidly if the substance is smoked rather than snorted (taken in through the nose), an abuser can become addicted after his or her first time trying crack.
Because of cocaine’s high cost, it has long been considered a “rich man’s drug.” Crack, on the other hand, is sold at prices so low that even teens can afford to buy it—at first. The truth is that once a person is addicted, the expense skyrockets in direct ratio to the increasing amount needed to support the habit. (www.drugfreeworld.org/drugfacts/crackcocaine.html)
Cocaine, in any form, is a powerfully addictive drug, and addiction seems to develop more quickly when the drug is smoked—as crack is—than snorted, as powdered cocaine typically is. In addition to the usual risks associated with cocaine use (constricted blood vessels; increased temperature, heart rate, and blood pressure; and risk of cardiac arrest and seizure), using crack is bad for your health in a number of ways, not least of which is the possibility of becoming addicted.
The many health consequences of smoking crack include:
- High blood pressure
- Kidney damage
- Heart attack
- Tooth decay (similar to cocaine)
Damage to the lungs is one of the more serious outcomes of crack use. The collective symptoms of damaged lungs from crack is called crack lung syndrome. Smoking crack causes inflammation in the lungs, as well as irritation and damage that impacts how much oxygen gets to the rest of the body. Crack lung can also lead to pneumonia, which can be fatal. A fatal overdose is possible with any drug, but crack users are particularly susceptible to dying this way. It hooks users quickly and leaves them chasing a greater and greater high. They develop a tolerance to the drug quickly and need to use more and more just to get the same pleasant sensation of the first experience with the drug. This dangerous chase can lead to an overdose.
For more information on crack, visit: drugabuse.com/library/crack-abuse/.
Club drugs tend to be used by teenagers and young adults at bars, nightclubs, concerts, and parties. Club drugs include GHB, Rohypnol®, ketamine, and MDMA (Ecstasy). The most popular of these—3,4-methylenedioxy-methamphetamine or MDMA—is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception. MDMA was initially popular in the nightclub scene and at all-night dance parties (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly. People who use MDMA usually take it as a capsule or tablet, though some swallow it in liquid form or snort the powder. The popular nickname Molly (slang for “molecular”) often refers to the supposedly “pure” crystalline powder form of MDMA, usually sold in capsules.
MDMA’s effects last about three to six hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience:
- Impulsiveness and aggression
- Sleep problems
- Memory and attention problems
- Decreased appetite
- Decreased interest in and pleasure from sex.
MDMA also increases the activity of three brain chemicals, which can cause lasting health effects, including:
- Dopamine—causes a surge in euphoria and increased energy/activity
- Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
- Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
Other health effects include:
- Muscle cramping
- Involuntary teeth clenching
- Blurred vision
Added Risk of MDMA
Adding to MDMA’s risks is that pills, capsules, or powders sold as Ecstasy and supposedly “pure” Molly may contain other drugs instead of or in addition to MDMA. Much of the Molly seized by the police contains additives such as cocaine, ketamine, methamphetamine, over-the-counter cough medicine, or synthetic cathinones (“bath salts”). These substances may be extremely dangerous if the person does not know what he or she is taking. They may also be dangerous when combined with MDMA. People who purposely or unknowingly combine such a mixture with other substances, such as marijuana and alcohol, may be putting themselves at even higher risk for harmful health effects.
Research results vary on whether MDMA is addictive. Experiments have shown that animals will self-administer MDMA—an important indicator of a drug’s abuse potential—although to a lesser degree than some other drugs such as cocaine. Some people report signs of addiction, including the following withdrawal symptoms:
- Loss of appetite
- Trouble concentrating.
For more information on MDMA and ecstasy, visit: teens.drugabuse.gov/drug-facts/mdma-ecstasy-or-molly or www.drugpolicy.org/drug-facts/mdma-ecstasy-molly-facts.
Heroin is a highly addictive drug made from morphine, a psychoactive (mind-altering) substance that is extracted from the resin of the seed pod of the opium poppy plant. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Other common names for heroin include dope, horse, junk, and smack. Heroin is mixed with water and injected with a needle. It can also be smoked or snorted. Some people mix heroin with crack cocaine, called a speedball.
Heroin is part of a class of drugs called opioids. Other opioids include some prescription pain relievers, such as codeine, oxycodone (OxyContin), and hydrocodone (e.g. Vicodin). These drugs are chemically similar to endorphins, which are opioid chemicals that the body makes naturally to relieve pain (such as after exercise). Because of where opioid receptors are located in the brain, heroin and other opioid drugs also activate the brain’s reward center, causing the “high” that puts the user at risk for addiction.
Historically opioids have been prescribed by doctors to relieve pain, including hydrocodone, oxycodone, morphine, and codeine. While many people benefit from using these medications to manage pain, prescription drugs are frequently diverted for improper use. As people use opioids repeatedly, their tolerance increases and they may not be able to maintain the source for the drugs. This can cause them to turn to the black market for these drugs and even switch from prescription drugs to cheaper and more risky substitutes like heroin. Repeated use greatly increases the risk of developing an opioid use disorder. The use of illegal opiate drugs such as heroin and the misuse of legally available pain relievers such as oxycodone and hydrocodone can have serious negative health effects.
Short-term effects of heroin include a rush of good feelings and clouded thinking. These effects can last for a few hours, and during this time people feel drowsy, and their heart rate and breathing slow down. When the drug wears off, people experience a depressed mood and often crave the drug to regain the good feelings. Regular heroin use changes the functioning of the brain and will result in tolerance, dependence and addiction, where the user requires the drug constantly just to feel normal.
Some of the short-term effects of heroin include:
- Severe itching and flushing of the skin
- Dry mouth
- Heavy feelings in the hands and feet
- Clouded mental functioning
- Going “on the nod,” a back-and-forth state of being conscious and semi-conscious
- Coma—a deep state of unconsciousness
- Dangerously slowed (or even stopped) breathing that can lead to overdose death
- Increased risk of HIV and hepatitis (a liver disease) through shared needles.
Long-term effects include:
- Infectious disease (e.g., HIV, hepatitis B and C)
- Collapsed veins
- Bacterial infections
- Dental problems (similar to meth)
- Infection of heart lining and valves
- Arthritis and other rheumatologic problems
- Liver and kidney disease.
Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly. Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements. Major withdrawal symptoms peak between 24–48 hours after the last dose of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months (drugabuse.com references).
Like many other chronic diseases, heroin addiction can be treated. Medications are available to treat heroin addiction while reducing drug cravings and withdrawal symptoms, improving the odds of achieving abstinence. There are now a variety of medications that can be tailored to a person’s recovery needs while taking into account co-occurring health conditions. Medication combined with behavioral therapy is particularly effective, offering hope to individuals who suffer from addiction and for those around them.
For more information, visit: www.drugabuse.gov/publications/research-reports/heroin/letter-director.
Central nervous system (CNS) depressants, a category that includes tranquilizers, sedatives, and hypnotics, are substances that can slow brain activity. This property makes them useful for treating anxiety and sleep disorders. The following are among the medications commonly prescribed for these purposes (drugabuse.gov):
- Benzodiazepines, such as diazepam (Valium®), clonazepam (Klonopin®), and alprazolam (Xanax®), are sometimes prescribed to treat anxiety, acute stress reactions, and panic attacks. Clonazepam may also be prescribed to treat seizure disorders. The more sedating benzodiazepines, such as triazolam (Halcion®) and estazolam (Prosom®) are prescribed for short-term treatment of sleep disorders. Usually, benzodiazepines are not prescribed for long-term use because of the high risk for developing tolerance, dependence, or addiction.
- Non-benzodiazepine sleep medications, such as zolpidem (Ambien®), eszopiclone (Lunesta®), and zaleplon (Sonata®), known as z-drugs, have a different chemical structure but act on the same GABA type A receptors in the brain as benzodiazepines. They are thought to have fewer side effects and less risk of dependence than benzodiazepines.
- Barbiturates, such as mephobarbital (Mebaral®), phenobarbital (Luminal®), and pentobarbital sodium (Nembutal®), are used less frequently to reduce anxiety or to help with sleep problems because of their higher risk of overdose compared to benzodiazepines. However, they are still used in surgical procedures and to treat seizure disorders.
Most CNS depressants act on the brain by increasing activity at receptors for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Although the different classes of depressants work in unique ways, it is through their ability to increase GABA signaling—thereby increasing inhibition of brain activity—that they produce a drowsy or calming effect that is medically beneficial to those suffering from anxiety or sleep disorders.
Despite their beneficial therapeutic effects, benzodiazepines and barbiturates have the potential for misuse and should be used only as prescribed. The use of non-benzodiazepine sleep aids, or z-drugs, is less well-studied, but certain indicators have raised concern about their psychoactive properties as well.
During the first few days of taking a depressant, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug and tolerance develops, these side effects begin to disappear. If one uses these drugs long term, he or she may need larger doses to achieve the therapeutic effects. Continued use can also lead to dependence and withdrawal when use is abruptly reduced or stopped (see “Understanding Dependence, Addiction, and Tolerance” on drugabuse.com). Because all sedatives work by slowing the brain’s activity, when an individual stops taking them, there can be a rebound effect, resulting in seizures or other harmful consequences.
Although withdrawal from benzodiazepines can be problematic, it is rarely life threatening, whereas withdrawal from prolonged use of barbiturates can have life-threatening complications. Therefore, someone who is thinking about discontinuing a sedative or who is suffering withdrawal from CNS depressants should speak with a physician or seek immediate medical treatment.
Although many parents are appropriately concerned about illicit drugs such as marijuana, cocaine, and LSD, they often ignore the dangers posed to their children from common household products that contain volatile solvents or aerosols. Products such as glues, nail polish remover, lighter fluid, spray paints, deodorant and hair sprays, whipped cream canisters, and cleaning fluids are widely available yet far from innocuous. Many young people inhale the vapors from these sources in search of quick intoxication without being aware that using inhalants, even once, can have serious health consequences. Although other substances that are misused can be inhaled, the term inhalants refers to the various substances that people typically take only by inhaling.
Inhalants are various products easily bought and found in the home or workplace—such as spray paints, markers, glues, and cleaning fluids. They contain dangerous substances that have psychoactive (mind-altering) properties when inhaled. People don’t typically think of these products as drugs because they’re not intended for getting “high,” but some people use them for that purpose. When these substances are used for getting high, they are called inhalants. Inhalants are mostly used by young kids and teens and are the only class of substance used more by younger than by older teens. Inhalants also include: Laughing gas (nitrous oxide), Snappers (amyl nitrite), Poppers (amyl nitrite and butyl nitrite), Whippets (fluorinated hydrocarbons), Bold (nitrites), and Rush (nitrites). Parents and children need to know that even sporadic or single episodes of inhalant abuse can be extremely dangerous. Inhalants can disrupt heart rhythms and cause death from cardiac arrest, or lower oxygen levels enough to cause suffocation. Regular abuse of these substances can result in serious harm to vital organs, including the brain, heart, kidneys, and liver.
People who use inhalants breathe them in through the mouth (huffing) or nose in various ways:
- Sniffing or snorting fumes from a container or dispenser (such as a glue bottle or a marking pen)
- Spraying aerosols (such as computer cleaning dusters) directly into the nose or mouth
- “Huffing” from a chemical-soaked rag in the mouth
- Sniffing or inhaling fumes from chemicals sprayed or put inside a plastic or paper bag (bagging)
- Inhaling from balloons filled with nitrous oxide, often called laughing gas.
Although the high that inhalants produce usually lasts just a few minutes, people often try to make it last by continuing to inhale again and again over several hours.
Most inhalants affect the central nervous system and slow down brain activity. Short-term effects are similar to alcohol and include:
- Slurred or distorted speech
- Lack of coordination (control of body movement)
- Euphoria (feeling “high”)
People may also feel light-headed or have hallucinations (images/sensations that seem real but aren’t) or delusions (false beliefs). With repeated inhalations, many people feel less self-conscious and less in control. Some may start vomiting, feel drowsy for several hours, or have a headache that lasts a while.
Long-term effects of inhalant use may include:
- Liver and kidney damage
- Hearing loss
- Bone marrow damage
- Loss of coordination and limb spasms (from nerve damage)
- Delayed behavioral development (from brain problems)
- Brain damage (from cut-off oxygen flow to the brain).
Long-term use of inhalants can break down myelin, a protective layer on the brain that protects nerve cells. When this happens the nerve cells are not able to transmit messages as efficiently, which can cause muscle spasms and tremors or even paralysis and permanent difficulty with mobility, and speech. These effects are similar to what happens to patients with multiple sclerosis, which is also a disease that also affects myelin. This permanent brain damage limits life as the toxic chemicals can severely damage the frontal lobe of the brain that make learning, planning and problem solving a major difficulty and dramatic life change. Treatment options for you or someone you know who is suffering from abusing inhalants, rehabilitation sessions are the best treatment options available to assist in relieving the problem before major damage from the toxic chemicals take a large toll on your body.
In addition, because nitrites are misused for sexual pleasure and performance, they can lead to unsafe sexual practices or other risky behavior. This increases the chance of getting or spreading infectious diseases such as HIV/AIDS or hepatitis.
Although it’s not very common, repeated use of inhalants can lead to addiction, a form of substance use disorder (SUD). An SUD develops when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. An SUD can range from mild to severe, the most severe form being addiction.
Those who try to quit inhalants may have withdrawal symptoms that include:
- Loss of appetite
- Problems sleeping
- Mood changes.
For more information, visit: www.drugabuse.gov/publications/research-reports/inhalants/what-are-inhalants.
Hallucinogens are a diverse group of drugs that alter perception (awareness of surrounding objects and conditions), thoughts, and feelings. They cause hallucinations, or sensations and images that seem real though they are not. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be human-made. People have used hallucinogens for centuries, mostly for religious rituals. Common hallucinogens include the following:
- Ayahuasca is a tea made from one of several Amazonian plants containing dimethyltryptamine (DMT), the primary mind-altering ingredient. Ayahuasca is also known as Hoasca, Aya, and Yagé.
- DMT is a powerful chemical found in some Amazonian plants. Manufacturers can also make DMT in a lab and the drug is usually a white crystalline powder. A popular name for DMT is Dimitri.
- D-lysergic acid diethylamide (LSD) is one of the most powerful mood-changing chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other grains. LSD has many other names, including Acid, Blotter, Dots, and Yellow Sunshine.
- Peyote (mescaline) is a small, spineless cactus with mescaline as its main ingredient. Peyote can also be synthetic. Buttons, Cactus, and Mesc are common names for peyote.
- 4-phosphoryloxy-N,N-dimethyltryptamine (psilocybin) comes from certain types of mushrooms found in tropical and subtropical regions of South America, Mexico, and the United States. Other names for psilocybin include Little Smoke, Magic Mushrooms, Purple Passion, and Shrooms.
Some hallucinogens also cause users to feel out of control or disconnected from their body and environment. Common examples include the following:
- Dextromethorphan (DXM) is a cough suppressant and mucus-clearing ingredient in some over-the-counter cold and cough medicines (syrups, tablets, and gel capsules). Robo is another popular name for DXM.
- Ketamine is used as a surgery anesthetic for humans and animals. Much of the ketamine sold on the streets comes from veterinary offices. While available as an injectable liquid, manufacturers mostly sell it as a powder or as pills. Other names for ketamine include K, Special K, or Cat Valium.
- Phencyclidine (PCP) was developed in the 1950s as a general anesthetic for surgery. It’s no longer used for this purpose due to serious side effects. While PCP can be found in a variety of forms, including tablets or capsules, liquid and white crystal powder are the most common forms. PCP has various other names, such as Angel Dust, Hog, Love Boat, and Peace Pill.
- Salvia divinorum (salvia) is a plant common to southern Mexico and Central and South America. Other names for salvia are Diviner’s Sage, Maria Pastora, Sally-D, and Magic Mint (www.drugabuse.gov/publications/drugfacts/hallucinogens).
The effects of hallucinogens are varied, but research suggests that they work at least partially by temporarily disrupting communication between brain chemical systems throughout the brain and spinal cord. Some hallucinogens interfere with the action of the brain chemical serotonin, which regulates: mood, sensory perception, sleep, hunger, body temperature, sexual behavior and muscle control. Other hallucinogens interfere with the action of the brain chemical glutamate, which regulates: pain perception, responses to the environment, emotion, learning and memory.
The effects of hallucinogens can begin within 20 to 90 minutes and can last as long as 6 to 12 hours. Salvia’s effects are more short-lived, appearing in less than 1 minute and lasting less than 30 minutes. Hallucinogen users refer to the experiences brought on by these drugs as “trips,” calling the unpleasant experiences “bad trips.” Along with hallucinations, other short-term general effects include:
- Increased heart rate
- Intensified feelings and sensory experiences
- Changes in sense of time (for example, time passing by slowly).
Specific short-term effects of some hallucinogens include:
- Increased blood pressure, breathing rate, or body temperature
- Loss of appetite
- Dry mouth
- Sleep problems
- Mixed senses (such as “seeing” sounds or “hearing” colors)
- Spiritual experiences
- Feelings of relaxation or detachment from self/environment
- Uncoordinated movements
- Excessive sweating
- Paranoia—extreme and unreasonable distrust of others
- Psychosis—disordered thinking detached from reality.
Little is known about the long-term effects of hallucinogens. Researchers do know that ketamine users may develop symptoms that include ulcers in the bladder, kidney problems, and poor memory. Repeated use of PCP can result in long-term effects that may continue for a year or more after use stops, such as:
- Speech problems
- Memory loss
- Weight loss
- Depression and suicidal thoughts.
With regards to addiction, evidence indicates that certain hallucinogens can be addictive or that people can develop a tolerance to them. Use of some hallucinogens also produces tolerance to other similar drugs. For example, LSD is not considered an addictive drug because it doesn’t cause uncontrollable drug-seeking behavior. However, LSD does produce tolerance, so some users who take the drug repeatedly must take higher doses to achieve the same effect. This is an extremely dangerous practice, given the unpredictability of the drug. In addition, LSD produces tolerance to other hallucinogens, including psilocybin. On the other hand, PCP is a hallucinogen that can be addictive. People who stop repeated use of PCP experience drug cravings, headaches, and sweating as common withdrawal symptoms. Scientists need more research into the tolerance or addiction potential of hallucinogens.
Anabolic steroids are synthetic variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers. Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders abuse these drugs to boost performance or improve their physical appearance.
People who abuse anabolic steroids usually take them orally or inject them into the muscles. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions. Steroids are also applied to the skin as a cream, gel, or patch. Some athletes and others who abuse steroids believe that they can avoid unwanted side effects or maximize the drugs’ effects by taking them in ways that include:
- Cycling—taking doses for a period of time, stopping for a time, and then restarting
- Stacking—combining two or more different types of steroids
- Pyramiding—slowly increasing the dose or frequency of abuse, reaching a peak amount, and then gradually tapering off.
There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.
Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not trigger rapid increases in the brain chemical dopamine, which causes the “high” that drives people to abuse other substances. However, long-term steroid abuse can act on some of the same brain pathways and chemicals—including dopamine, serotonin, and opioid systems—that are affected by other drugs. This may result in a significant effect on mood and behavior.
Abuse of anabolic steroids may lead to mental problems, such as:
- Paranoid (extreme, unreasonable) jealousy
- Extreme irritability
- Delusions—false beliefs or ideas
- Impaired judgment.
Extreme mood swings can also occur, including “roid rage”—angry feelings and behavior that may lead to violence.
Aside from mental problems, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.
Anabolic steroid abuse may also lead to serious, even permanent, health problems such as:
- Kidney problems or failure
- Liver damage
- Enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people.
Several other effects are gender- and age-specific:
- Shrinking testicles
- Decreased sperm count
- Development of breasts
- Increased risk for prostate cancer
- Growth of facial hair or excess body hair
- Male-pattern baldness
- Changes in or stop in the menstrual cycle
- Enlarged clitoris
- Deepened voice
- Stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
- Stunted height (if teens use steroids before their growth spurt)
Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.
For more information, visit: www.drugabuse.gov/publications/drugfacts/anabolic-steroids.
Other drugs (synthetic, bath salts)
Synthetic cannabinoids refer to a growing number of man-made mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked (herbal incense) or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices (liquid incense).
These chemicals are called cannabinoids because they are related to chemicals found in the marijuana plant. Because of this similarity, synthetic cannabinoids are sometimes misleadingly called “synthetic marijuana” (or “fake weed”), and they are often marketed as “safe,” legal alternatives to that drug. In fact, they may affect the brain much more powerfully than marijuana; their actual effects can be unpredictable and, in some cases, severe or even life-threatening.
Synthetic cannabinoids are included in a group of drugs called “new psychoactive substances” (NPS). NPS are unregulated psychoactive (mind-altering) substances that have become newly available on the market and are intended to copy the effects of illegal drugs. Some of these substances may have been around for years but have reentered the market in altered chemical forms or due to renewed popularity.
Manufacturers sell these herbal incense products in colorful foil packages and sell similar liquid incense products, like other e-cigarette fluids, in plastic bottles. They market these products under a wide variety of specific brand names; in past years, K2 and Spice were common. Hundreds of other brand names now exist, such as Joker, Black Mamba, Kush, and Kronic. Synthetic cannabinoid products are often labeled “not for human consumption,” and labels often claim that they contain “natural” material taken from a variety of plants. However, the only parts of these products that are natural are the dried plant materials. Chemical tests show that the active, mind-altering ingredients are cannabinoid compounds made in laboratories.
Users usually smoke the dried plant material sprayed with synthetic cannabinoids. Sometimes they mix the sprayed plant material with marijuana, or they brew it as tea. Other users buy synthetic cannabinoid products as liquids to vaporize them in e-cigarettes.
|Synthetic cannabinoid users report some effects similar to those produced by marijuana:
||Psychotic effects include:
People who have used synthetic cannabinoids and have been taken to emergency rooms have shown severe effects including:
- Rapid heart rate
- Violent behavior
- Suicidal thoughts
Synthetic cannabinoids can also raise blood pressure and cause reduced blood supply to the heart, as well as kidney damage and seizures. Use of these drugs is associated with a rising number of deaths.
Synthetic cannabinoids can be addictive. Regular users trying to quit may have the following withdrawal symptoms:
For more information about synthetic cannabinoids, read: www.dea.gov/druginfo/drug_data_sheets/K2_Spice.pdf.
Synthetic cathinones, more commonly known as “bath salts,” are synthetic (human-made) drugs chemically related to cathinone, a stimulant found in the khat plant. Khat is a shrub grown in East Africa and southern Arabia, and people sometimes chew its leaves for their mild stimulant effects. Synthetic variants of cathinone can be much stronger than the natural product and, in some cases, very dangerous (Baumann, 2014).
Synthetic cathinones are included in a group of drugs that concern public health officials called “new psychoactive substances” (NPS). NPS are unregulated psychoactive (mind-altering) substances that have become newly available on the market and are intended to copy the effects of illegal drugs. Some of these substances may have been around for years but have reentered the market in altered chemical forms or due to renewed popularity.
Synthetic cathinones are marketed as cheap substitutes for other stimulants such as methamphetamine and cocaine, and products sold as Molly (MDMA) often contain synthetic cathinones instead (see Synthetic Cathinones and Molly on the drugabuse.gov website).
Synthetic cathinones usually take the form of a white or brown crystal-like powder and are sold in small plastic or foil packages labeled “not for human consumption.” Also sometimes labeled as “plant food,” “jewelry cleaner,” or “phone screen cleaner,” people can buy them online and in drug paraphernalia stores under a variety of brand names, which include: Flakka, Bloom, Cloud Nine, Lunar Wave, Vanilla Sky, White Lightning, and Scarface. People typically swallow, snort, smoke, or inject synthetic cathinones.
Much is still unknown about how synthetic cathinones affect the human brain. Researchers do know that synthetic cathinones are chemically similar to amphetamines, cocaine, and MDMA. These drugs can cause a range of effects including lowered inhibition, anxiety, and depression.
People who have taken synthetic cathinones have reported energizing and often agitating effects. Synthetic cathinones can also raise heart rate and blood pressure. Synthetic cathinones can produce effects that include:
- Paranoia—extreme and unreasonable distrust of others
- Hallucinations—experiencing sensations and images that seem real though they are not
- Increased sociability
- Increased sex drive
- Panic attacks
- Excited delirium—extreme agitation and violent behavior
Nosebleeds, sweating, and nausea are some other health effects of synthetic cathinones. People who experience excited delirium often suffer from dehydration, breakdown of skeletal muscle tissue, and kidney failure. Intoxication from synthetic cathinones has resulted in death. The worst outcomes are associated with snorting or needle injection.
Synthetic cathinones can be addictive. Animal studies show that rats will compulsively self-administer synthetic cathinones. Human users have reported that the drugs trigger intense cravings—uncontrollable urges to use the drug again. Taking synthetic cathinones often may cause strong withdrawal symptoms that include:
- Problems sleeping
If you have any questions about a substance not listed here that you or someone you know may be addicted to, please call us at 1-877-234-4770 and we would be happy to answer your questions and give you options for treatment.