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Alternative namesThe use of illicit drugs or the abuse of prescription or over-the-counter drugs for purposes other than those for which they are indicated or in a manner or in quantities other than directed. See also drug abuse first aid and drug abuse and dependence .
, AND EFFECTS OF DRUGS OR DRUG CATEGORIES
About 1 in 3 Americans has used marijuana at least once and approximately 10% of the population uses it on a regular basis. Next to tobacco, and alcohol in some areas, marijuana is the most popular substance chosen by young people for regular use.
The source of marijuana is the hemp plant (cannabis sativa) and its content of THC (delta-9-tetrahydrocannabinol) and other cannaboids found in the leaves and flowering shoots of the plant.
Hashish is a resinous substance, taken from the tops of female plants, which contains the highest concentration of THC. The drug dose delivered from any particular preparation of marijuana greatly varies. The concentration of THC may vary as much as a hundred fold, due to diluents or contaminants in the sample.
Because the effects are felt almost immediately by the smoker, further inhalation can be stopped at any time and the effect therefore regulated. In contrast, those ingesting marijuana experience effects that are slower to develop, cumulative, longer lasting, and more variable, making unpleasant reactions more likely with this method of administration.
Unpleasant effects that may occur include depersonalization, changed body image, disorientation and acute panic reactions or severe paranoia . Some cases of severe delirium and hallucinations have also been reported. Such cases should raise suspicion that the marijuana may have been laced with another agent such as PCP.
Learning may be greatly affected because the drug diminishes one's ability to concentrate and pay attention. Studies have shown that learning may become "state-dependent" meaning that information acquired or learned while under the influence of marijuana is best recalled in the same state of drug influence.
Other marijuana effects may include blood-shot eyes; increased heart rate and blood pressure ; bronchodilatation, or in some users, bronchial irritation leading to bronchoconstriction and/or bronchospasm; pharyngitis , sinusitis , bronchitis , and asthma in heavy users; possible detrimental effects upon the immune system.
The active component in cannabis is believed to have medical properties. Many maintain that it is effective in the treatment of nausea caused by chemotherapy in cancer patients.
Others claim that cannabis stimulates appetite in patients with AIDS or is useful in the treatment of glaucoma. While the active ingredient in marijuana has been approved as a synthetic medication by the FDA (dronabinol) for these purposes, use of whole marijuana remains hugely controversial. Currently, cannabis is illegal even for medical use under federal law.
It is difficult to estimate the current use of phencyclidine in the United States because many individuals do not recognize that they have taken it. PCP is frequently laced with other illicit substances (such as marijuana) and the buyer not made aware of its presence.
A 1986 National Institute of Drug Abuse survey of high school seniors revealed that over 12% of the students had used hallucinogens and that many of these drugs probably contained PCP.
PCP use grew during the mid-1970s primarily because of different packaging (sprinkling on leaves that are smoked) and marketing strategies. During the 1980s it was established as the most commonly used hallucinogen, with the majority of users 15 to 25 years old.
Although phencyclidine was initially developed by a pharmaceutical company searching for a new anesthetic, it was not suitable for human use because of its psychotropic side effects.
PCP is no longer manufactured for legitimate, legal purposes. Unfortunately it can be made rather easily and without great expense by anyone with a basic knowledge of organic chemistry, making it a prime drug for the illicit drug industry. It is available illegally as a white, crystalline powder that can be dissolved in either alcohol or water.
Sprinkled over dried parsley, oregano, or marijuana leaves, it can be smoked and effects noted within 2 to 5 minutes, then peaking at 15 to 30 minutes. Taken orally, in the pill form or mixed with food or beverages, PCP's effects are usually noted within 30 minutes and tend to peak at about 2 to 5 hours.
Large doses may produce paranoia, auditory hallucinations, psychosis similar to schizophrenia . Massive doses, more commonly associated with ingesting the drug, may cause cardiac arrhythmias , seizures , muscle rigidity , acute renal failure , and death. Because of the analgesic properties of PCP, users who incur significant injuries may not feel any pain.
Ketamine, a compound related to PCP, has grown in popularity in recent years. It is commonly referred to as Special K.
The use of naturally occurring hallucinogens, specifically for religious rites, has been documented for centuries. Mushrooms containing psilocybin were used by the native people of Mexico and peyote use was common amongst some Southwest American Indian tribes.
In contrast, LSD is a man-made substance, first developed by a legitimate pharmaceutical company in 1938. Today, most hallucinogens are used experimentally rather than on a regular basis, with only single or several uses per year reported by most users.
Hallucinogens are commonly associated with panic attacks at the height of the drug experience ("bad trips"). Unsolicited repetitions of the drug experience, without further ingestion of the drug ("flashbacks"), may also occur in rare cases. Such experiences typically occur during times of increased stress and tend to decrease in frequency and intensity if the individual abstains from use of the drugs.
Through a simple chemical procedure, cocaine may be changed into a smokeable form known as freebase or "crack." Smoking produces an instant and intense euphoria attractive to abusers. Other effects include local anesthesia, potent CNS stimulation, feelings of increased confidence, energy, accompanied with decreased inhibitions.
Both tolerance and dependence may occur with chronic use of cocaine. . Regular users may exhibit mood swings, depression , sleep problems, memory loss, social withdrawal, and loss of interest in school, work, family, and friends. Because heavy use may cause paranoia, cocaine users may become violent.
During the 1950s through 1960s, amphetamines were commonly prescribed for conditions such as fatigue , obesity , and mild depression. Such use has ceased as their highly addictive potential became apparent and they have been categorized as controlled substances.
Over-the-counter (OTC) amphetamine look-alike drugs (typically containing caffeine and/or phenylpropanolamine and marketed as appetite suppressants or stay awake/alert aids) are commonly abused.
If taken in high doses, these OTC drugs may cause the same high and other effects associated with amphetamines. Regular users may exhibit irritability, restlessness , sleep disturbances , tremors , dilated pupils, skin flushing , and weight loss over time.
The chemicals are poured into a plastic bag or soaked into rags, then inhaled. Since the drugs are absorbed through the respiratory tract an altered mental state is noted within 5 to 15 minutes.
Adverse effects which have been associated with inhalant abuse include liver or kidney damage , convulsions , peripheral neuropathy , brain damage, and sudden death. Most inhalant use occurs amongst teens or preteens who do not have access to illicit drugs or alcohol.
These include heroin, oxycodone, hydromorphone , meperidine, propoxyphene, and methadone. All of these substances, natural or synthetic, are considered narcotics. As analgesics these drugs produce an altered interpretation of painful stimuli , decrease anxiety, and promote sedation.
Because heroin is commonly used intravenously, the associated health concerns specific to IV drug use and sharing needles or using contaminated needles (such as hepatitis , HIV infection, and AIDS ) must be considered.
Support groups and counseling should be tried first -- as with any other area of medicine, the least intensive treatment should be the starting point.
Comprehensive residential treatment programs monitor and address potential withdrawal symptoms/behaviors; incorporate behavior recognition and modification programs; include psychotherapeutic treatments both for the person (and perhaps family) and in group settings; have a prolonged after-care component; and facilitate peer support.
Drug addiction is a serious and complicated health condition that requires both physiological and psychological treatment and support.
Update Date: 3/8/2002Benoit Dubé, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT