Table of Contents

1. Amphetamines

2. Methamphetamine and Drug Tests

3. A Meth Addict’s Brain

4. Meth Mouth - The Effects of Methamphetamines on Teeth

5. Cocaine

6. Effects and Health Issues

7. Cocaine and Methamphetamine

8. What is Marijuana?

9. The Diseases of Alcohol Abuse

10. Alcohol and the Liver

11. Narcotics (Opiates)

12. Methadone

13. Hypnotics and Tranquilizers

14. Hallucinogens (Otherwise known as psychedelics)

Amphetamines

The amphetamines are potent psychomotor stimulants. The most common pharmaceutical preparations are (or were) amphetamine sulphate (brand name Benzedrine), dextroamphetamine (dexadrine), methamphetamine (Desoxyn), and benzphetamine (Didrex). Their use causes a release of the excitatory neurotransmitters dopamine and norepinephrine from storage vesicles in the central nervous system. The release of dopamine typically induces a sense of aroused euphoria which last several hours: whereas cocaine almost completely metabolizes in the body, amphetamines don’t.

Following the euphoric affects, there is an intense mental depression and fatigue because amphetamines deplete the neuronal stores of dopamine in the mesolimbic pleasure centers of the brain.

Occasional light and infrequent use is probably relatively harmless; but heavy chronic use can lead to stereotypes of behavior, depressive disorders, "meth bugs" akin to cocaine-induced formication, strain on the cardiovascular system, and the unofficial diagnosis of "amphetamine psychosis."

Amphetamine psychosis can include delusions, hallucinations and thought disorders. This is thought to be largely due to the increase in dopamine activity in the mesolimbic pathway of the brain caused by amphetamine-like drugs, although other factors such as chronic sleep deprivation obviously plays a part. The link between amphetamine and psychosis is one of the major sources of evidence for the dopamine hypothesis of psychosis. The DSM IV (Diagnostic and Statistical Manual of Mental Disorders) doesn’t include "amphetamine psychosis." Rather, it comes under the rubric of Substance-Induced Psychotic Disorder. Since the other amphetamines aren’t in use today, we’ll focus on Barstow’s (and much of the rest of the country’s) main drug of choice--methamphetamine, which isn’t really methamphetamine.

What is Methamphetamine?

The pharmaceutical brand name is Desoxyn, with the chemical names of methylamphetamine or desoxyephedrine. Desoxyn is the only methamphetamine. What cooks are making today in clandestine drug labs isn’t methamphetamine.

Meth, pharmaceutical or otherwise, is reported to attack the immune system, resulting in increased susceptibility to a variety of opportunistic infections, including MRSA, streptococcus, pseudomonads, and other bacterias and yeasts). This may simply be a result of long-term sleep deprivation, chronic malnutrition and/or effects of chronic exposure to stress hormones.

Meth often inhibits pain and always increases metabolism, which allows a person to push muscles to points of failure that would otherwise be harder or impossible to reach. Other side effects include twitching, jitteriness, repetitive behavior, and jaw clenching or teeth grinding.

Meth addicts often lose their teeth abnormally fast, a result of a condition known as methmouth, which include jaw clenching, dry mouth, and/or neglect of personal hygiene and nutrition. Meth causes decreased production of acid-fighting saliva and increased thirst, resulting in increased risk for tooth decay, especially when thirst is quenched by high-sugar drinks. Smoking methamphetamine might speed this process by leaving a crystalline residue on the teeth.

Users may exhibit sexually compulsive behavior and may engage in extended sexual encounters with one or more individuals, often strangers. As it is symptomatic to continue taking the drug to combat fatigue, an encounter or series of encounters can last for several days. This compulsive sexual behavior is believed to have created a link between meth use and sexually transmitted disease (STD) transmission, especially HIV and syphilis. This caused great concern among larger gay communities, particularly those in Atlanta, Miami, Chicago, New York City, and San Francisco, leading to outreach programs and rapid growth in 12-step organizations such as Crystal Meth Anonymous.

Common side effects of meth use include:

* Hypertension

* Elevated body temperature

* Dilated pupils

* Diarrhea and nausea

* Paranoia

* Skin Rash

* Anorexia

* Insomnia

* Restlessness

* Weight loss

* Compulsive fascination with useless repetitive tasks

* Severe psychological addiction

* Acne

* Depression

* Formication (false sensation of flesh crawling with bugs, with compulsive picking and infected sores)

* Erectile dysfunction "Crystal cock"

* Long-term cognitive impairment due to neurotoxicity

* Damage to immune system

* Staphylococcus infection

* Severe side effects (with chronic use) include:

* Persistent anhedonia (absence of pleasure or the ability to experience it)

* Amphetamine psychosis

* Clinical depression

* Kidney damage

* Liver damage

* Death

Contraindications

The use of methamphetamine should be avoided in persons with the following:

* Glaucoma

* Hypertension

* Cardiovascular disease

* Methamphetamine should not be taken within 14 days of taking a non-reversible MAOI. (If in good health, it can be safely combined with reversible MAOI's such as moclobemide.)

Addiction

Meth is a highly psychologically addictive drug. The mental and social consequences of quitting can be severe and extremely difficult for the addict. As with all addictions, relapse is common. To combat relapse, many recovering addicts attend 12 Step meetings, such as Crystal Meth Anonymous.

Individuals with ADHD are often at especially higher risk for addiction to meth, because the drug often increases the user's ability to focus and reduces impulsivity, creating a mechanism by which one is better able to cope. For this reason, drugs like this should be used only under the supervision of a physician. The individual with ADHD is susceptible to meth's adverse effects , so prescription stimulants such as methylphenidate (Ritalin®), dextroamphetamine (Dexadrine®) and amphetamine salt (Adderall®) are overwhelmingly indicated. Controversy exists over this.

With long-term methamphetamine use, enough dopamine will have flooded the brain to cause chemical cell damage. This often leads to depression and slow thinking (which in turn requires that the addict use meth to 'fix' it). This is known colloquially as "The Vampire Life." However, in a small unscientific study, researchers were able to reverse many of the addict's symptoms by treatment with fish oil, which contains omega-3 fatty acids. This study has encouraged further research into the recuperative effects of omega-3 supplements on the psychological recovery of meth addicts.

Very serious long-term meth abuse correlates highly with poor hygiene and general lack of self-care, and many of the health risks inherent in administering the drug are often severely exacerbated by this. Poor hydration and infrequent dental hygiene strongly increase the risks of damage to teeth from smoking or snorting, while infrequent bathing increases the chance that minor skin rashes or irritations on the arm from needle use will progress to infection and complications. Generally poor maintenance of living conditions can increase the general risk of exposure to illness through a wide variety of malaise-causing agents, such as bacteria that may grow in poorly cleaned living spaces. Finally, if meth does in fact attack the immune system, it follows that the ability of the individual to resist any illness is compromised, and that heavy meth users, over time, become more susceptible to poor health and illness in general. Severe cases of addiction are often marked by many of these symptoms and hallmarks, which can work in combination to almost completely destroy the user's health.

Methamphetamine and Drug Tests

Urine Testing

Amphetamines are detectable in urine for 1-3 days after use. Methamphetamines stay in the system slightly longer, 3-5 days.

Test Information

The Amphetamine test is a one step competitive immunoassay that is used to screen for the presence of amphetamine in urine. It is a chromatographic absorbent device in which drug or drug metabolites in a sample compete with drug conjugate immobilized on a porous membrane for a limited number of binding sites. This test is a rapid, qualitative immunoassay for the detection of amphetamine in urine. The cutoff concentration for this test is 1000 ng/ml, as recommended by the Substance Abuse and Mental Health Services Administration and NIDA."

Hair Testing

Methamphetamine is detectable with hair tests and is included in the standard set of substances tested for with these tests. Hair tests generally take the most recent 1.5 inches of growth and use those for testing. That provides a detection period of approximately 90 days. If an individual's hair is shorter than 1.5 inches, this detection period will be shorter.

Blood Testing

Methamphetamine is detectable in blood for 1-3 days. Levels over 100 ng/ml are considered consistent with abuse.

Substances or Conditions which can cause false positives:

Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine (Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc). Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil. Over-the-counter diet aids with phenylpropanolamine (Dexatrim & Accutrim).

Over-the-counter nasal sprays (Vicks inhaler & Afrin). Asthma medications (Marax, Bronkaid tablets & Primatine Tablets). Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,.phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine,

dexdenfluramine, Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine,

amineptine, Pholedrine, hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex,

fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine, methphenidate, Ritalin,

pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone).Kidney infection, kidney disease, liver disease & diabetes.

A Meth Addict's Brain

No surprise, methamphetamines cause serious brain damage

Methamphetamine addicts can have pretty serious neurological problems, like motor skills and verbal memory. Researchers at the UCLA School of Medicine wanted to map out the shape of a meth addict's brain and find connections between these problems and brain shape.

What the researchers wanted to know: What does the brain of a methamphetamine abuser look like? Does the structure of a methamphetamine abuser's brain reflect learning disability or memory loss?

What they did: Researchers recruited 43 HIV negative people for the study–21 control people and 22 methamphetamine abusers. All the participants underwent physical examinations to make sure that they were relatively healthy (no diseases, no psychoactive drugs, etc.). The methamphetamine abusers had been using the drug for an average of 10.5 years, and six of them also smoked more than one joint a day or had a history of dependence on pot. Researchers, therefore, studied the results of the tests with and without these six participants. Both the methamphetamine users and the control group took surveys about their drug use. The researchers tested both groups for their abilities to remember pictures and words, analyzed the participants for depression, and performed MRI scans of their brains. An image analyst outside the study (who did not know what he was looking for) mapped the images of the participants' brains.

What they found: The methamphetamine abusers' brains looked pretty different. The right hemispheres had serious deficits of gray matter, the kind of brain tissue that contains nerve cells. This part of the brain controls emotions and craving, and when meth users lose cells in this area, they end up needing more meth to feel satisfied. They also lose some memory capacity. The ventricles in the right side also became bigger, a typical feature of certain neurological disorders. The average meth user had a smaller hippocampus and increased white matter in the brain. White matter is the part of the brain that contains nerve fibers, and it increases because brain damage causes the tissue to swell. When users stop taking meth, the swelling seems to go away. The smaller the hippocampus size, the worse the participants tended to do in remembering words. The transformations of the brain size of the methamphetamine abusers were similar to or worse than typical changes in the brains of people with dementia or schizophrenia. The methamphetamine abusers were also more likely to describe themselves as depressed in the surveys.

What this means to you: Methamphetamines cause serious damage in your brain, so maybe you shouldn't do them. Not to mention the jail time.

Caveats: Researchers still aren't sure how the changes in the brains of methamphetamine abusers occur or if they can be fixed. There were many more smokers in the methamphetamine group than in the control group, so maybe tobacco is playing some role is brain damage.

Meth Mouth - The Effects of Methamphetamines on Teeth

"Meth Mouth" is a term commonly used to describe the mouth of a methamphetamine user because of the rampant tooth decay that often occurs with the use of this drug. The decay is often so bad, that the teeth cannot be saved and must be pulled instead. Some dentists are even comparing "meth mouth" to "bottle mouth" which is a term sometimes used for the mouths of children who have been sent to bed with a bottle of milk or juice repeatedly, causing severe tooth decay.

Studies have shown the following reasons for the detrimental effects of methamphetamine use on teeth.

* During the "high" produced by this drug, users usually experience cravings for sugary carbonated beverages.

* The "high" from this drug lasts about 12 hours, during which time users will probably not brush or floss, therefore leaving the sugary substances on their teeth for long periods of time.

* The acidic make up of this drug.

* Common ingredients include battery acid, lantern fuel, antifreeze, hydrochloric acid, drain cleaner, lye and over-the-counter cold medications containing ephedrine.

* Users of methamphetamines usually tend to clench and / or grind their teeth.

* Methamphetamines dry up protective saliva around the teeth.

Unfortunately, there is very little that a dentist can do for a patient with "meth mouth."

Cocaine

Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. It is a CNS stimulant (ask if anyone remembers what CNS is an acronym for). It’s also an appetite suppressant, creating what has been described as a euphoric sense of happiness and increased energy. Though most often used recreationally for this effect, cocaine is also a topical anesthetic used in eye, throat, and nose surgery. Cocaine highly addictive psychologically, and its possession, cultivation, and distribution is illegal for non-medicinal and non-government sanctioned purposes in virtually all parts of the world. The name comes from the name of the coca plant plus the alkaloid suffix -ine.

The stimulating qualities of the coca leaf were known to the ancient peoples of Peru and other Pre-Columbian South American societies. In modern Western countries, cocaine has been used recreationallly for well-over a century. There is a long-list of prominent intellectuals, artists, and musicians who have used the drug -- names ranging from Sir Arthur Conan Doyle (mystery writer in the 20s), Sigmund Freud, and United States President Ulysses S. Grant.

In the late 1800s, in the United States, cola drinks came onto the market with other carbonated or phosphated (fizzy) drinks. Coca-cola, one of the first and most popular, contained extracts of both the coca plant (cocaine) and the kola nut (caffeine)--but by the early 1900s, with the realization of cocaine’s dangers, this was removed and replaced by additional caffeine.

Effects and Health Issues

Acute (Having a rapid onset and following a short but severe course)

The initial signs of stimulation are hyperactivity, restlessness, increased blood pressure and heart rate, and euphoria. Euphoria is sometimes followed by feelings of discomfort and depression and a craving to experience the drug again. Sexual interest and pleasure can be amplified. Side effects can include twitching, paranoia, and impotence, which usually increases with frequent usage.

With excessive dosages the drug can produce hallucinations, paranoid delusions, tachycardia, itching, and formication. Overdose causes tachyarrhythmias and a marked elevation of blood pressure. These can be life-threatening, especially if the user has existing cardiac problems.

Toxicity results in seizures, followed by respiratory and circulatory depression of medullar (brain) origin. This may lead to death from respiratory failure, stroke, cerebral hemorrhage, or heart-failure. Cocaine is also highly pyrogenic, because the stimulation and increased muscular activity cause greater heat production. Heat loss is inhibited by the intense vasoconstriction. Cocaine-induced hyperthermia may cause muscle cell destruction and myoglobinuria resulting in renal failure.

Cocaine's primary acute effect on brain chemistry is to raise the amount of dopamine and serotonin in the nucleus accumbens (the pleasure center in the brain); this effect ceases, due to metabolism of cocaine to inactive compounds and particularly due to the depletion of the transmitter resources (tachyphylaxis). This can be experienced acutely as feelings of depression, as a "crash" after the initial high. Further mechanisms occur in chronic cocaine use.

Chronic (Of long duration; continuing)

With chronic cocaine use, brain cells functionally adapt (or respond) to strong imbalances of transmitter levels in order to compensate extremes. Chronic cocaine use contributes considerably to depressed mood states. Finally, a loss of vesicular monoamine transporters appears to indicate a long term damage of dopamine neurons.

All these effects contribute to the rise in an abuser's tolerance thus requiring a larger dosage to achieve the same effect. The lack of normal amounts of serotonin and dopamine in the brain is the cause of the dysphoria (an emotional state characterized by anxiety, depression, or unease) and depression felt after the initial high. The diagnostic criteria for cocaine withdrawal is characterized by a dysphoric mood, fatigue, unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation, and anxiety.

Cocaine abuse also has multiple physical health consequences. It is associated with a lifetime risk of heart attack that is seven times that of non-users. During the hour after cocaine is used, heart attack risk rises 24-fold.

Side effects from chronic smoking of cocaine include chest pain, lung trauma, shortness of breath, sore throat, hoarse voice, dyspnea (Difficulty in breathing), and an aching, flu-like syndrome. A common misconception is that the smoking of cocaine chemically breaks down tooth enamel and causes tooth decay. However, cocaine does often cause involuntary tooth grinding, known as bruxism, which can deteriorate tooth enamel and lead to gingivitis (Inflammation of the gums). Chronic intranasal usage can degrade the cartilage separating the nostrils, leading eventually to its complete disappearance.

Cocaine may also greatly increase this risk of developing rare autoimmune or connective tissue diseases such as lupus, Goodpasture's disease (symptoms associated with acute glomerulonephritis and pulmonary hemorrhage), and vasculitis (Inflammation of a blood vessel). It can also cause a wide array of kidney diseases and renal failure. While these conditions are normally found in chronic use they can also be caused by short term exposure in susceptible individuals.

There have been published studies reporting that cocaine causes changes in the frontal lobe of the brain. The full extent of possible brain deterioration from cocaine use is not known.

Cocaine and Methamphetamine

Group 1. Negative Medical Effects

1. _____ Physical deterioration

2. _____ General health failure

3. _____ Loss of energy

4. _____ Insomnia

5. _____ Sore throat

6. _____ Nose bleeds

7. _____ Need for plastic or nasal repair surgery

8. _____ Headaches

9. _____ Voice problems

10. _____ Sinus problems

11. _____ Runny nose

12. _____ Lost sex drive

13. _____ Poor or decreased sexual performance

14. _____ Trembling

15. _____ Seizures or convulsions

16. _____ Nausea or vomiting

17. _____ Can't stop licking lips or grinding teeth

18. _____ Constant sniffing or rubbing nose

19. _____ Loss of consciousness

20. _____ Trouble breathing or swallowing

21. _____ Heart palpitations (flutters)

22. _____ Decreased interest in personal health or hygiene

23. _____ Other (specify)____________________________________

How severe are these problems?

__________ Mild

__________ Moderate

__________ Severe

__________ No real problem

Group 2. Negative Psychiatric/ Psychological Effects

1. _____ Jitteriness

2. _____ Anxiety

3. _____ Depression

4. _____ Panic

5. _____ Fears

6. _____ Irritability

7. _____ Delusions (false beliefs)

8. _____ Suspiciousness

9. _____ Paranoia

10. _____ Concentration problems

11. _____ Hearing voices in head

12. _____ Other hallucinations

13. _____ Loss of interest in friends

14. _____ Loss of interest in non-drug related activities

15. _____ Memory problems

16. _____ Thoughts of suicide

17. _____ Attempting suicide

18. _____ Blackouts

19. _____ Compulsive behaviors (combing hair, straightening tie)

20. _____ Must ingest some chemical to calm down

21. _____ Decreased interest in appearance

22. _____ Other (specify) ____________________________________

Group 3. Dependence

1. _____ Think you are addicted

2. _____ Real need for cocaine or speed

3. _____ Significant distress without it

4. _____ Can't turn it down when it is available

5. _____ Unable to stop using for one month

6. _____ Trying to force self to limit use

7. _____ Binge use (24 hours or more of continuous use)

8. _____ Use of drugs resulting in missing work or breaking a date or family/social obligation

9. _____ Prefer drugs to talking to friends

10. _____ Prefer drugs to family activities

11. _____ Prefer drugs to sex

12. _____ Prefer drugs to food

13. _____ Use drugs in a.m. before breakfast

14. _____ Use of drugs has led to need for excuses

15. _____ Reduced focus on work and promotion

16. _____ Borrowing from friends and family

17. _____ Dealing

18. _____ Other illegal activity to support habit

19. _____ Fear of being discovered as a user

20. _____ Usually use drugs alone

21. _____ Work absenteeism

22. _____ Loss of control over drugs

23. _____ If you stop using, you get depressed or crash or lose energy or motivation

Group 4. Social and Other Problems

1. _____ Arrests because of the drug

2. _____ Unusual behavior while intoxicated

3. _____ Job/career problems

4. _____ Loss of job

5. _____ Loss of spouse or loved one(s)

6. _____ Traffic violations due to drugs

7. _____ Traffic accidents due to drugs

8. _____ Loss of friends

9. _____ Fighting or arguments due to drugs

10. _____ Impaired coordination or injuries due to drugs

11. _____ Court case pending

12. _____ Loss of pre-drug use values

13. _____ Threats of separation or divorce

14. _____ Threats of being thrown out of the house

Group 5. Adverse Opinions

1. _____ People telling me I'm scandalous

2. _____ Wife/husband/lover objects to amount of use

3. _____ Feel guilty of effect I'm having on others

Group 6. Finances (as a result of drug use)

1. _____ In debt

2. _____ No money left

3. _____ Used 50% or more of savings

4. _____ Caused me to steal or borrow without repaying

5. _____ Stole from work

6. _____ Stole from family or friends

What is marijuana?

Marijuana (grass, pot, weed) is the common name for a crude drug made from the plant Cannabis sativa. The main mind-altering (psychoactive) ingredient in marijuana is THC (delta-9-tetrahydrocannabinol), but more than 400 other chemicals also are in the plant. A marijuana "joint" (cigarette) is made from the dried particles of the plant. The amount of THC in the marijuana determines how strong its effects will be. The type of plant, the weather, the soil, the time of harvest, and other factors determine the strength of marijuana. The strength of today's marijuana is as much as ten times greater than the marijuana used in the early 1970s. This more potent marijuana increases physical and mental effects and the possibility of health problems for the user. Hashish, or hash, is made by taking the resin from the leaves and flowers of the marijuana plant and pressing it into cakes or slabs. Hash is usually stronger than crude marijuana and may contain five to ten times as much THC. Pure THC is almost never available, except for research. Substances sold as THC on the street often turn out to be something else, such as PCP.

What are some of the immediate effects of smoking marijuana?

Some immediate physical effects of marijuana include a faster heartbeat and pulse rate, bloodshot eyes, and a dry mouth and throat. No scientific evidence indicates that marijuana improves hearing, eyesight, and skin sensitivity. Studies of marijuana's mental effects show that the drug can impair or reduce short-term memory, alter sense of time, and reduce ability to do things which require concentration, swift reactions, and coordination, such as driving a car or operating machinery.

Are there any other adverse reactions to marijuana?

A common bad reaction to marijuana is the "acute panic anxiety reaction." People describe this reaction as an extreme fear of "losing control," which causes panic. The symptoms usually disappear in a few hours.

What about psychological dependence on marijuana?

Long-term regular users of marijuana may become psychologically dependent. They may have a hard time limiting their use, they may need more of the drug to get the same effect, and they may develop problems with their jobs and personal relationships. The drug can become the most important aspect of their lives.

What are the dangers for young people?

One major concern about marijuana is its possible effects on young people as they grow up. Research shows that the earlier people start using drugs, the more likely they are to go on to experiment with other drugs. In addition, when young people start using marijuana regularly, they often lose interest and are not motivated to do their schoolwork. The effects of marijuana can interfere with learning by impairing thinking, reading comprehension, and verbal and mathematical skills. Research shows that students do not remember what they have learned when they are "high".

How does marijuana affect driving ability?

Driving experiments show that marijuana affects a wide range of skills needed for safe driving -- thinking and reflexes are slowed, making it hard for drivers to respond to sudden, unexpected events. Also, a driver's ability to "track" (stay in lane) through curves, to brake quickly, and to maintain speed and the proper distance between cars is affected. Research shows that these skills are impaired for at least 4-6 hours after smoking a single marijuana cigarette, long after the "high" is gone. If a person drinks alcohol, along with using marijuana, the risk of an accident greatly increases. Marijuana presents a definite danger on the road.

Does marijuana affect the human reproductive system?

Some research studies suggest that the use of marijuana during pregnancy may result in premature babies and in low birth weights. Studies of men and women may have a temporary loss of fertility. These findings suggest that marijuana may be especially harmful during adolescence, a period of rapid physical and sexual development.

How does marijuana affect the heart?

Marijuana use increases the heart rate as much as 50 percent, depending on the amount of THC. It can cause chest pain in people who have a poor blood supply to the heart - and it produces these effects more rapidly than tobacco smoke does.

How does marijuana affect the lungs?

Scientists believe that marijuana can be especially harmful to the lungs because users often inhale the unfiltered smoke deeply and hold it in their lungs as long as possible. Therefore, the smoke is in contact with lung tissues for long periods of time, which irritates the lungs and damages the way they work. Marijuana smoke contains some of the same ingredients in tobacco smoke that can cause emphysema and cancer. In addition, many marijuana users also smoke cigarettes; the combined effects of smoking these two substances creates an increased health risk.

Can marijuana cause cancer?

Marijuana smoke has been found to contain more cancer-causing agents than is found in tobacco smoke. Examination of human lung tissue that had been exposed to marijuana smoke over a long period of time in a laboratory showed cellular changes called metaplasia that are considered precancerous. In laboratory test, the tars from marijuana smoke have produced tumors when applied to animal skin. These studies suggest that it is likely that marijuana may cause cancer if used for a number of years.

How are people usually introduced to marijuana?

Many young people are introduced to marijuana by their peers - usually acquaintances, friends, sisters, and brothers. People often try drugs such as marijuana because they feel pressured by peers to be part of the group. Children must be taught how to say no to peer pressure to try drugs. Parents can get involved by becoming informed about marijuana and by talking to their children about drug use.

What is marijuana "burnout"?

"Burnout" is a term first used by marijuana smokers themselves to describe the effect of prolonged use. Young people who smoke marijuana heavily over long periods of time can become dull, slow moving, and inattentive. These "burned-out" users are sometimes so unaware of their surroundings that they do not respond when friends speak to them, and they do not realize they have a problem.

How long do chemicals from marijuana stay in the body after the drug is smoked?

When marijuana is smoked, THC, its active ingredient, is absorbed by most tissues and organs in the body; however, it is primarily found in fat tissues. The body, in its attempt to rid itself of the foreign chemical, chemically transforms the THC into metabolites. Urine tests can detect THC metabolites for up to a week after people have smoked marijuana. Tests involving radioactively labeled THC have traced these metabolites in animals for up to a month.

The Diseases of Alcohol Abuse

Malnutrition: is frequently found in middle-stage alcoholism and is almost always present in chronic alcoholism. Deficiencies in vitamins, minerals and proteins occur because alcohol is high in calories and satisfies hunger. It is completely void of food value. The alcoholic drinks, but doesn’t eat.

Ulcers: Peptic ulcers are crater-shaped erosions occurring in the lining of the stomach and duodenum. Alcohol is extremely irritating to the stomach, and causes an over secretion of stomach acids and enzymes. This abnormally increased acidity causes ulcers, and prevents healing of existing ulcers. The medical complications of peptic ulcers (perforation, obstruction and hemorrhaging of the stomach) are serious emergencies. No ulcer patient should drink.

Cirrhosis: The liver responds to a chemical injury, such as an overdose of alcohol, by developing scar tissue among its cells. This scarring of the liver is called cirrhosis. Patients may appear well in early stages of this disease, but as the liver is progressively destroyed by scarring, they suffer from weight loss, nausea, vomiting, weakness, loss of sex drive, abdominal pains, bloating, and bleeding. Death results from liver failure or internal hemorrhaging. Until hepatitis C came along, alcohol was the leading cause of cirrhosis.

Pancreatitus: The pancreas is a small organ lying in the uppermost portion of the abdomen, stretching from the duodenum on the right to the spleen on the left. The pancreas produces insulin and digestive enzymes, and is vital to life. Inflamation of the pancreas (pancreatitis) is a serious illness characterized by severe abdominal pains, nausea and vomiting. Alcohol is directly poisonous to the pancreas, and 40% of all pancreatitis patients are alcoholics.

Pneumonia: The lifestyle of alcoholics, combined with the medical complications of alcoholism, reduces resistance to infections. An illness once described as lobar pneumonia of drunkards may result. The term lobar indicates that the entire lobe or division of the lung is infected. Onset of illness is usually sudden, with a shaking chill, sharp pains in the chest, cough with rusty colored sputum, fever and shortness of breath. Delirium may accompany alcoholic pneumonia.

Delirium Tremens (Dts): Hard core withdrawal from alcohol, known as delirium tremens, can cause physical and emotional suffering worse than withdrawal from heroin. The DTs begin with tremors, sweating, and nausea. They progress to insomnia, profound depression, delusions, confusion, hallucinations and sometimes convulsions. Unless good medical treatment is given, delirium tremens may be fatal approximately 10% of the time.

Convulsions: Epilepsy affects about one out of 200 persons and occurs slightly more frequently in male than females. Alcohol may be a direct precipitator of seizures in epileptics. Seizures may also occur in certain non epileptic alcoholics because of the toxic effect of alcohol on the brain. A typical seizure is characterized by an outcry, loss of consciousness, falling and alternating movements of the muscles of the body. The attack usually lasts from two to five minutes, and may be followed by deep sleep, headache or muscle soreness.

Accidents: According to insurance statistics, alcohol is a factor in 20% of falls, 20% of accidental asphyxiations, 20% of drownings, 20% of deaths from freezing, 25% of deaths attributed to choking on foods, and 50% of all fatal automobile accidents. These stats probably underestimate the role of alcohol, but they do make their point.

Brain Damage: Excessive use of alcohol causes a progressive loss of brain function. This is caused by the poisonous action of alcohol on the brain together with nutritional deficiencies found in alcoholism. Studies indicate that even one single episode of deep intoxication causes some irreversible brain damage. Autopsy examinations of brains from alcoholic persons, frequently reveal a diseased condition called "wet brain."

* Cerebral Edema: Otherwise known as wet brain, cerebral edema is an accumulation of excessive fluid in the substance of the brain. The brain is especially susceptible to injury from edema, because it is located within a confined space and cannot expand. Symptoms can include headaches, loss of coordination (ataxia), weakness, and decreasing levels of consciousness.

* Korsakoff’s Syndrome: A syndrome of severe mental impairment characterized by multiple neuritis, confusion, disorientation, and amnesia in which memory of recent events is especially impaired, often causing the patient to attempt to compensate through confabulation.

Impotency: The belief that alcohol is an aphrodisiac or sex stimulant is nonsense. Alcohol is one of the most frequent causes of impotency. Impotency may occur in acute alcoholism because of the depressant effect of alcohol. In chronic alcoholism it may be caused by neuritis, liver damage, malnutrition and other medical complications too numerous to mention.

Cancer of the Esophagus: Difficulty swallowing foods because of a sensation of blockage somewhere behind the sternum is usually the first sign of cancer of the esophagus. Diagnosis is confirmed by X-ray. Surgery is the only treatment and the cure rate is low. Because of an unknown chemical quality in alcoholic beverages, alcoholics have a far greater chance of developing cancer of the esophagus than non-alcoholics.

Alcoholic Neuritis: is a condition caused by the direct poisonous effect of alcohol on the nerves of the body, as well as by certain vitamin deficiencies seen in alcoholism. Neuritis patients complain of tingling, pins-and-needles sensations, burning, itching, and numbness. Weakness and paralysis follow in the late stages of. Treatment involves complete abstinence from alcohol, improved nutrition, and vitamin supplementation.

Varicose Veins of the Esophagus: The esophagus is the food tube leading from the throat to the stomach, and its blood supply is channeled through the liver. Alcoholics suffering from cirrhosis develop an increase in blood pressure in the veins of the esophagus because of their liver disease. This increased pressure causes the veins to become stretched and dilated (varicose). Death from internal hemorrhaging may occur if these thin, ballooned-out veins rupture.

Alcohol and the Liver

True or false

* Many victims of liver disease are not alcoholics?

* Even moderate social drinkers may risk liver damage?

* People who never drink alcoholic beverages may still get serious liver problems?

All statements are true.

Does alcohol cause liver disease?

Yes, but it is only one of many causes, and the risk depends on how much you drink and over how long of a period. There are more than 100 liver diseases.

Are there dangers from alcohol besides consuming large amounts over a long period of time?

Yes. Even moderate amounts of alcohol can have toxic effects when taken with over-the-counter drugs containing acetaminophen. Combining any drugs with alcohol should be avoided.

What kinds of liver diseases are caused by too much alcohol?

Alcoholic hepatitis is an inflammation of the liver that lasts one to two weeks. Symptoms include loss of appetite, nausea, vomiting, abdominal pain and tenderness, fever, jaundice, and sometimes mental confusion. It is believed to lead to alcoholic cirrhosis over a period of years.

Can social drinkers get alcoholic hepatitis?

Yes. Alcoholic hepatitis is frequently discovered in alcoholics, but it also occurs in people who are not alcoholics, usually moderate drinkers. People vary greatly in the way their liver reacts to alcohol.

Are men or women more likely to get alcoholic hepatitis?

Women appear to be more likely to suffer liver damage from alcohol. Even when a man and woman have the same weight and drink the same amount, the woman generally has a higher concentration of alcohol in the blood because she has relatively more body fat and less water than a man, and her body handles alcohol differently.

Do all alcoholics get alcoholic hepatitis and eventually cirrhosis?

No. Some alcoholics may suffer seriously from the many symptoms of alcoholism but escape serious liver damage. Alcoholic cirrhosis is found among alcoholics about 10-25 % of the time.

How can alcoholic hepatitis be diagnosed?

Alcoholic hepatitis is not easy to diagnose. Sometimes symptoms are worse for a time after drinking has stopped than they were during the drinking episode. While the disease usually comes on after a period of fairly heavy drinking, it may also be seen in people who are moderate drinks, making it difficult to diagnose. Blood tests may help in diagnosis, but proof is established best by liver biopsy. This involves taking a tiny specimen of liver tissue with a needle and examining it under a microscope. The biopsy is usually done under local anesthesia.

Is alcoholic hepatitis different from fatty liver?

Yes. Anyone who drinks alcohol heavily, even for a few days, will develop a condition in which liver cells are swollen with fat globules and water. This condition is called fatty liver. It may also result from diabetes, obesity, certain drugs or severe protein malnutrition. Fatty liver caused by alcohol is reversible when drinking of alcohols is topped.

Does alcoholic hepatitis always lead to cirrhosis?

No. It usually takes many years for alcoholic hepatitis to produce enough liver damage to result in cirrhosis. If alcoholic hepatitis is detected and treated early, cirrhosis can be prevented.

Is alcoholic hepatitis dangerous?

It could be fatal, especially if the patient has had previous liver damage. Those who have had nutritional deficiencies because of heavy drinking may have other ailments. These medical complications may effect almost every system in the body. It is important to recognize and treat alcoholic hepatitis early, so that these life-threatening consequences are prevented.

How can alcoholic hepatitis be prevented and treated?

The best treatment is to stop drinking. Treatment may also include prescribed medication, good nutrition and rest. The patient may be instructed to avoid various drugs and chemicals.

Is cirrhosis different from alcoholic hepatitis?

Yes. Hepatitis is an inflammation of the liver. In cirrhosis, normal liver cells are damaged and replaced by scar tissue. This scarring keeps the liver from performing many of its vital functions.

What causes cirrhosis?

There are many causes of cirrhosis. Long term alcohol abuse is one. Chronic hepatitis is another major cause. Many patients who require liver transplants suffer from biliary cirrhosis. We do not yet know what causes this illness, but it is not in any way relate to alcohol consumption. Cirrhosis can also be caused by hereditary defects in iron or copper metabolism or prolonged exposure to toxins.

Narcotics (Opiates)

Drugs derived from opium--the dried juice of the oriental poppy seed. The pharmacologically active substances, which constitute approximately 25% of the extract, are the alkaloid’s morphine and codeine. The newer synthetic compounds which resemble morphine in their action are called opioids, which include meperidine (brand name Demerol), hydromorphone (Dilaudid), oxycodone (Oxycontin & Percodan), hydrocodone (Vicodin & Tussionex), and dolophine (Methadone) among others.

Repeated ingestion of these CNS drugs, in which the effect produced by the original dose no longer occurs, results in tolerance. To produce the original effect, it is necessary to increase the dose.

Effects on the Respiratory System

Opiates slow down nerve transmissions which causes the breathing to slow down. As more of the drug is used, breathing becomes even slower. When too much is used, breathing stops. When this happens, OD means Obviously Dead!

Effects on the Heart

Opiates slow down the heart and lowers blood pressure.

Effects on the Stomach and Intestines

Opiates slow down the nerve transmissions to the intestines and this action makes these drugs useful for treating diarrhea. When these drugs are abused, however, it can cause constipation. Opiates initially upset the stomach, but with repeated use the user’s body adapts. Junkies rarely have upset stomachs or constipation.

Methadone

Methadone, a long-acting synthetic narcotic analgesic, was first used in the maintenance treatment of drug addiction in the mid 1960s. Methadone is widely used throughout the world, and is supposedly the most effective known treatment for heroin addiction. The goal of methadone maintenance treatment (MMT) is to reduce illegal heroin use and the crime, death, and disease associated with heroin addiction. Methadone can be used to detoxify heroin addicts, but most junkies who detox using methadone or any other method, return to heroin use. Therefore, the goal of MMT is to reduce and even eliminate heroin use among addicts by stabilizing them on methadone for as long as is necessary to help them avoid returning to previous patterns of drug use. The benefits of MMT have supposedly been established by hundreds of scientific studies, and there are almost no negative health consequences of long-term methadone treatment, even when it continues for twenty or thirty years. For that matter, there are almost no negative health consequences of long-term addiction to any of the opiates. The only deleterious effects would come from whatever else is in the preparation.

Hypnotics and Tranquilizers

This branch of depressants have three categories; hypnotics which induce sleep; sedatives which do not induce sleep but produce a relaxing effect to help one fall asleep, and tranquilizers, which are used to alleviate anxiety, tension, and relax muscles, which are more recently being prescribed for sleep.

Hypnotics

Of the 2500 varieties of barbiturates known, roughly 50 of these are marketed for a variety of medicinal applications. Of these 50, only a little over a dozen has been used. Of them, the most predominant up to about 1995, are secobarbital (brand name Seconal), pentobarbital (Nembutal), butabarbital (Butisol), and Tuinal is a combination of secobarbital and amobarbital--what we used to call the grand-daddy of them all, and of course the hardest to get.

Barbiturates have a wider and more powerful effect on the central nervous system than the other sedatives. The barbiturates can produce varying degrees of depression of the CNS, ranging from mild sedation to general anesthesia. In low doses barbiturates have a calming effect, and some of the barbiturates (e.g., phenobarbital) have demonstrated selective anticonvulsant properties. In moderate doses they produce a drunken euphoric state, similar to alcohol. Sedation and sleep result from increased doses, and even higher doses produce surgical anesthesia. Because of their ability to produce sedation and decrease sleep latency, barbiturates were popular in the treatment of insomnia prior to the advent of benzodiazepines. However, because of the high incidence of tolerance and physical dependence following chronic use and the relatively high danger of overdose, these drugs are rarely used today for the treatment of anxiety or sleep disturbances.

There are also non-barbiturate based hypnotic depressants such as methaqualone (brand name quaalude), glutethimide (Doriden), chloral hydrate (Noctec), and etchchlorvynol (Placidyl).

Tranquilizers

Some of the following tranquilizers also fall under the rubric of hypnotics. Listed here are only the most common of the family of drugs known as the benzodiazapines: diazapam (Valium), alprazolam (Xanax), clorazapate (Tranxene), lorazapam (Ativan), and Chlordiazepoxide (Librium), which is often prescribed for detoxing alcoholics.

Benzodiazepines share the sedative-hypnotic properties, but produce fewer side effects than barbiturates. Like barbiturates, benzodiazepines have also been reported to produce anticonvulsant effects. In addition, these drugs are used clinically as muscle relaxants, antiepilieptic agents, and to produce sedation before operative procedures. The antianxiety effects of benzodiazepines are more selective than those of other sedative-hypnotics -- they relieve anxiety at lower doses and thus produce minimal sedation and motor impairment. The benzodiazepines are currently the most important class of drugs for treatment of anxiety and sleep disorders.

Withdrawal from the benzodiazepine tranquilizers, and especially from the barbiturates, is very hazardous and potentially lethal, sometimes taking from five to eight days. These withdrawal symptoms include delirium, hallucinations, anxiety, tremors, weakness, abdominal cramps, nausea, spatial and time disorientation, seizures, respiratory failure, and heart failure, sometimes resulting in death.

Hallucinogens (Otherwise known as Psychedelics)

Certain drugs can effect the subjective qualities of perception, thought, or emotion, resulting in altered interpretations of sensory input, alternate states of consciousness, or hallucinations. This general group of drugs can be divided into three broad categories: psychedelics, dissociatives, and deliriants (Asthmadore). We’ll focus on two psychedelics, LSD and PCP since dissociatives and deliriants aren’t drugs of abuse.

LSD

LSD or lysergic acid diethylamide alkaloid is synthesized from lysergic acid, which is found in the fungus ergot (Claviceps purpurea). It is a hallucinogenic drug that intensifies sense perceptions and produces hallucinations, mood changes, and changes in the sense of time. It also can cause restlessness, acute anxiety, and occasionally depression. Although lysergic acid itself is without hallucinogenic effects, lysergic acid diethylamide, one of the most powerful drugs known, is weight for weight 5,000 times as potent as the hallucinogenic drug mescaline and 200 times as potent as psilocybin mushrooms.

Other physical reactions to LSD are highly variable and may include the following: uterine contractions, hyperthermia (increase in body temperature), elevated blood sugar levels, dry-mouth, goose bumps, heart-rate increase, jaw clenching, nausea, perspiration, pupil-dilation, salivation, mucus production, sleeplessness, and tremors. Cramps and muscle tension or soreness have also been reported, but rather than being direct effects of LSD in the bloodstream, these symptoms are more likely a result of physical exertions and distortions while under the influence.

LSD affects an enormous number of receptors in the brain, including all dopamine receptor subtypes, all adrenoreceptor subtypes as well as many others. LSD also binds to most serotonin receptor subtypes. Although LSD is generally considered nontoxic, it may temporarily impair the ability to make sensible judgments and understand common dangers, thus making the user susceptible to accidents and personal injury. There are some cases of LSD inducing or triggering a psychosis in people that were apparently healthy prior to taking LSD. In most cases, the psychosis-like reaction is of short duration, but in other cases it may be chronic. It is difficult to determine if LSD in itself induces these reactions or if it merely triggers latent conditions that would have manifested themselves otherwise.

PCP

A moderate amount of PCP will cause users to feel detached, distant, and estranged from their surroundings. Numbness, slurred speech, and loss of coordination may be accompanied by a sense of strength and invulnerability. A blank stare, rapid and involuntary eye movements, and an exaggerated gait are alleged to be among the more observable effects. Acts of violence have been committed by people high on the drug.

According to the National Institute on Drug Abuse: at high doses of PCP, blood pressure, pulse rate, and respiration drop. This may be accompanied by nausea, vomiting, blurred vision, nystagmus, drooling, loss of balance, and dizziness. High doses of PCP can also cause seizures, coma, and death (though death more often results from accidental injury or suicide during PCP intoxication). High doses can cause symptoms that mimic schizophrenia, such as delusions, hallucinations, paranoia, disordered thinking, a sensation of distance from one’s environment, and catatonia. Speech is often sparse and garbled.