Drug-Free Campuses Act

Alcohol

Ethyl alcohol (ethanol) is the intoxicating ingredient found in beer, wine, and liquors.  It depresses (slows down) the central nervous system, slowing thought, speech, and reactions.  

Under normal circumstances, alcohol is broken down by the liver.  Dehydration, health conditions, medications, and other drugs can slow this process down, allowing alcohol to build up in the system.  Normal alcohol metabolism is approximately one standard drink per hour, broken down.  High-alcohol beers (>5% alcohol by volume), heavy pours, and high proof (greater than 80 proof/40% alcohol by volume) all increase the amount of alcohol a single drink contains.  When too much alcohol builds up in the body, alcohol poisoning can result.  Alcohol poisoning can involve vomiting, blacking out, and death.

Moderate, Binge & Heavy Drinking

According to the Center for Disease Control and Prevention, excessive drinking includes binge drinking, heavy drinking, and any drinking by pregnant people or people younger than the age of 21.

Moderate Drinking

For those over 21 who choose to drink, moderating drinking is the best way to lower the risks associated with consuming alcohol.  Moderate drinking for women is no more than 1 drink per day, while moderate drinking for men is no more than 2 drinks on any given day.

Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of high-risk drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 or above.

This typically happens when men consume 5 or more drinks or women consume 4 or more drinks in about 2 hours.

Heavy Drinking

For women, heavy drinking is defined as consuming 8 or more drinks per week, while for men heavy drinking is defined as consuming 15 or more drinks per week.

Risks of Alcohol Use

Short term risks of alcohol use in any amount include slowing reactions, slowed thinking, and impaired reasoning.  The ability to drive or operate heavy or complicated machinery is impaired, increasing risks.  The risks for injury and legal consequences associated with alcohol use exists with even small amounts consumed.  

Academic and athletic performance are also negatively affected by alcohol use.  Studies tell us that students who consume alcohol in excess have worse grades, increased risk of dropping out, and more trouble reaching their potential.  This effect increases the more alcohol a student consumes, and the more time they spend drinking excessively.  

Tobacco & Nicotine

Tobacco is a plant grown for its leaves, which are dried and fermented before being put in tobacco products. Tobacco contains nicotine, an ingredient that can lead to addiction, which is why so many people who use tobacco find it difficult to quit. There are also many other potentially harmful chemicals found in tobacco or created by burning it.

How do people use tobacco?

People can smoke, chew, or sniff tobacco. Smoked tobacco products include cigarettes, cigars, bidis, and kreteks. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip, and snus; snuff can also be sniffed.

How does tobacco affect the brain?

The nicotine in any tobacco product readily absorbs into the blood when a person uses it. Upon entering the blood, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with drugs such as cocaine and heroin, nicotine activates the brain’s reward circuits and also increases levels of the chemical messenger dopamine, which reinforces rewarding behaviors. Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain.

What are other health effects of tobacco use?

Although nicotine is addictive, most of the severe health effects of tobacco use come from other chemicals. Tobacco smoking can lead to lung cancer, chronic bronchitis, and emphysema. It increases the risk of heart disease, which can lead to stroke or heart attack. Smoking has also been linked to other cancers, leukemia, cataracts, Type 2 Diabetes, and pneumonia. All of these risks apply to the use of any smoked product, including hookah tobacco. Smokeless tobacco increases the risk of cancer, especially mouth cancer.

Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Smoking while pregnant may also be associated with learning and behavioral problems in exposed children.

People who stand or sit near others who smoke are exposed to secondhand smoke, either coming from the burning end of the tobacco product or exhaled by the person who is smoking. Secondhand smoke exposure can also lead to lung cancer and heart disease. It can cause health problems in both adults and children, such as coughing, phlegm, reduced lung function, pneumonia, and bronchitis. Children exposed to secondhand smoke are at an increased risk of ear infections, severe asthma, lung infections, and death from sudden infant death syndrome.

Electronic cigarettes, also known as e-cigarettes or e-vaporizers, are battery-operated devices that deliver nicotine with flavorings and other chemicals to the lungs in vapor instead of smoke. E-cigarette companies often advertise them as safer than traditional cigarettes because they don't burn tobacco. But researchers actually know little about the health risks of using these devices.

For many who use tobacco, brain changes brought on by continued nicotine exposure result in addiction. When a person tries to quit, he or she may have withdrawal symptoms, including:

• irritability
• problems paying attention
• trouble sleeping
• increased appetite
• powerful cravings for tobacco

Both behavioral treatments and medications can help people quit smoking, but the combination of medication with counseling is more effective than either alone.

The U.S. Department of Health and Human Services has established a national toll-free quitline, 1-800-QUIT-NOW, to serve as an access point for anyone seeking information and help in quitting smoking.

Behavioral Treatments

Behavioral treatments use a variety of methods to help people quit smoking, ranging from self-help materials to counseling. These treatments teach people to recognize high-risk situations and develop strategies to deal with them. For example, people who hang out with others who smoke are more likely to smoke and less likely to quit.

 Nicotine Replacement Therapies

Nicotine replacement therapies (NRTs) were the first medications the U.S. Food and Drug Administration (FDA) approved for use in smoking cessation therapy.

Current FDA-approved NRT products include chewing gum, transdermal patch, nasal sprays, inhalers, and lozenges. NRTs deliver a controlled dose of nicotine to relieve withdrawal symptoms while the person tries to quit.

Other Medications

Bupropion (Zyban^®) and varenicline (Chantix^®) are two FDA-approved non-nicotine medications that have helped people quit smoking. They target nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people start smoking again.

Can a person overdose on nicotine?

Nicotine is poisonous and, though uncommon, overdose is possible. An overdose occurs when a person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. Nicotine poisoning usually occurs in young children who accidentally chew on nicotine gum or patches used to quit smoking or swallow e-cigarette liquid. Symptoms include difficulty breathing, vomiting, fainting, headache, weakness, and increased or decreased heart rate. Anyone concerned that a child or adult might be experiencing a nicotine overdose should seek immediate medical help.

Prescription Misuse

Misuse is defined  as any one, or a combination of, three behaviors:

• Intentionally taking medicine in a way or dose other than prescribed

• Taking a medication that was prescribed to another person

• Taking a medication for a purpose other than what it was prescribed for

Commonly Misused Medications

• Opioids: usually prescribed to treat pain
• Central Nervous System (CNS) Depressants: used to treat anxiety (includes tranquilizers, sedatives, and hypnotics)
• Stimulants: most often prescribed to treat attention-deficit hyperactivity disorder (ADHD)

Prescription Opioids

What are common prescription opioids?

• hydrocodone (Vicodin^®) oxycodone (OxyContin^®, Percocet^®)

• oxymorphone (Opana^®)

• morphine (Kadian^®, Avinza^®)

• codeine

• fentanyl

What are some possible effects of prescription opioids on the brain and body?

In the short term, opioids can relieve pain and make people feel relaxed and happy. However, opioids can also have harmful effects, including:

• drowsiness

• confusion

• nausea

• constipation

• euphoria

• slowed breathing

Opioid misuse can cause slowed breathing, which can cause hypoxia, a condition that results when too little oxygen reaches the brain. Hypoxia can have short- and long-term psychological and neurological effects, including coma, permanent brain damage, or death. Researchers are also investigating the long-term effects of opioid addiction on the brain, including whether damage can be reversed.

What are the other health effects of opioid medications?

Older adults are at higher risk of accidental misuse or abuse because they typically have multiple prescriptions and chronic diseases, increasing the risk of drug-drug and drug-disease interactions, as well as a slowed metabolism that affects the breakdown of drugs. Sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases, such as HIV, and from unprotected sex.

Can a person overdose on prescription opioids?

Yes, a person can overdose on prescription opioids. An opioid overdose occurs when a person uses enough of the drug to produce life-threatening symptoms or death. When people overdose on an opioid medication, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, which can result in coma, permanent brain damage, or death.

How can an opioid overdose be treated?

If you suspect someone has overdosed, the most important step to take is to call 911 so he or she can receive immediate medical attention. Once medical personnel arrive, they will administer naloxone. Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs.

Can the use of prescription opioids lead to addiction?

Yes, repeated misuse of prescription opioids can lead to a substance use disorder (SUD), a medical illness that ranges from mild to severe and from temporary to chronic. Addiction is the most severe form of an SUD. An SUD develops when continued misuse of the drug changes the brain and causes health problems and failure to meet responsibilities at work, school, or home.

People addicted to an opioid medication who stop using the drug can have severe withdrawal symptoms that begin as early as a few hours after the drug was last taken. These symptoms include:

• muscle and bone pain

• sleep problems

• diarrhea and vomiting

• cold flashes with goose bumps

• uncontrollable leg movements

• severe cravings

These symptoms can be extremely uncomfortable and are the reason many people find it so difficult to stop using opioids. 

Prescription CNS Depressants

Central Nervous System (CNS) depressants are medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders.

CNS depressants cause drowsiness; sedatives are often prescribed to treat sleep disorders like insomnia and hypnotics can induce sleep, whereas tranquilizers are prescribed to treat anxiety or to relieve muscle spasms.

Examples of CNS Depressants

• diazepam (Valium^®)

• clonazepam (Klonopin^®)

• alprazolam (Xanax^®)

• triazolam (Halcion^®)

• estazolam (Prosom^®)

• zolpidem (Ambien^®)

• eszopiclone (Lunesta^®)

• zaleplon (Sonata^®)

How do CNS depressants affect the brain?

Most CNS depressants act on the brain by increasing the activity of gamma-aminobutyric acid (GABA), a chemical that inhibits brain activity. This action causes the drowsy and calming effects that make the medicine effective for anxiety and sleep disorders. People who start taking CNS depressants usually feel sleepy and uncoordinated for the first few days until the body adjusts to these side effects. Other effects from use and misuse can include:

• slurred speech

• poor concentration

• confusion

• headache

• light-headedness

• dizziness

• dry mouth

• problems with movement and memory

• lowered blood pressure

• slowed breathing

If a person takes CNS depressants long-term, he or she might need larger doses to achieve therapeutic effects. Continued use can also lead to dependence and withdrawal when use is abruptly reduced or stopped. Suddenly stopping can also lead to harmful consequences like seizures.

Can a person overdose on CNS depressants?

Yes, a person can overdose on CNS depressants. An overdose occurs when a person uses enough of a drug to produce life-threatening symptoms or death.

When people overdose on a CNS depressant, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.

How can a CNS depressant overdose be treated?

The most important step to take is to call 911 so a person who has overdosed can receive immediate medical attention. Flumazenil (Romazicon^®) is a medication that medical personnel can use to treat benzodiazepine overdose and has also been shown to be effective in treating overdose from sleep medicines. The drug might not completely reverse slowed breathing and can lead to seizures in some patients who are taking certain antidepressants. Flumazenil is short-acting, and the patient may need more of it every 20 minutes until he or she recovers. For barbiturates and nonbenzodiazepines, body temperature, pulse, breathing, and blood pressure should be monitored while waiting for the drug to be eliminated.

Can prescription CNS depressant use lead to addiction and substance use disorder?

Yes, use or misuse of prescription CNS depressants can lead to problem use, known as a substance use disorder (SUD), which takes the form of addiction in severe cases. Long-term use of prescription CNS depressants, even as prescribed by a doctor, can cause some people to develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects. A SUD develops when continued use of the drug leads to negative consequences such as health problems or failure to meet responsibilities at work, school, or home, but despite all that, the drug use continues.

Those who have become addicted to a prescription CNS depressant and stop using the drug abruptly may experience withdrawal. Withdrawal symptoms, which can begin as early as a few hours after the drug was last taken, include:

• seizures

• shakiness

• anxiety

• agitation

• insomnia

• overactive reflexes

• increased heart rate, blood pressure, and temperature with sweating

• hallucinations

• severe cravings

People addicted to prescription CNS depressants should not attempt to stop taking them on their own. Withdrawal symptoms from these drugs can be severe and, in the case of certain medications, potentially life—threatening.

Prescription Stimulants

Study Drugs

Study drugs are typically defined as any prescription stimulant that is used without a prescription to increase energy and concentration. Amphetamine is typically prescribed to manage attention-deficit hyperactivity disorder (ADHD). Ritalin and Adderall are the two most commonly misused study drugs.

In addition to study drugs, some students may also use anti-anxiety medications like Xanax. If you choose to use study drugs, prescription medications, or other substances, it’s important to know that many street and counterfeit drugs are laced with fentanyl.

Use alternative strategies to study

Fentanyl is a powerful synthetic (lab-created) opioid that is similar to morphine and heroin but up to 100 times more potent.  Fentanyl is used legally to treat cancer-related and other severe pain and illegally as a drug of abuse.  

Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. In 2017, 59 percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.

The illegally used fentanyl most often associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.

Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose.

Carfentanyl

Carfentanyl is a fentanyl analogue, meaning it has very similar properties as fentanyl.  It is approximately 10 times more potent than fentanyl, making even a very tiny dose lethal.  

Fentanyl Overdose

An overdose occurs when a drug produces serious adverse effects and life-threatening symptoms. When people overdose on fentanyl, their breathing can slow or stop. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to a coma and permanent brain damage, and even death.

As mentioned above, many drug dealers mix the cheaper fentanyl with other drugs like heroin, cocaine, MDMA and methamphetamine to increase their profits, making it often difficult to know which drug is causing the overdose. Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone.

Because of this, if you suspect someone has overdosed, the most important step to take is to call 911 so they can receive immediate medical attention. Once medical personnel arrive, they will administer naloxone if they suspect an opioid drug is involved.

Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN^® and KLOXXADO^®).

People who are given naloxone should be monitored for another two hours after the last dose of naloxone is given to make sure breathing does not slow or stop.

California has passed laws that allow pharmacists to dispense naloxone without a personal prescription. Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.

Hallucinogens are a diverse group of drugs that alter a person’s awareness of their surroundings as well as their own thoughts and feelings. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Both types of hallucinogens can cause sensations and images that seem real, though they are not. 

Some hallucinogens are extracted from plants or mushrooms, and some are synthetic (human-made). Historically, people have used hallucinogens for religious or healing rituals. More recently, people report using these drugs for social or recreational purposes.

Common classic hallucinogens include the following:

• LSD (D-lysergic acid diethylamide) is one of the most powerful mind-altering 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. 
• Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) comes from certain types of mushrooms found in tropical and subtropical regions of South America, Mexico, and the United States. 
• Peyote (mescaline) is a small, spineless cactus with mescaline as its main ingredient. Peyote can also be synthetic. 
• DMT (N,N-dimethyltryptamine) is a powerful chemical found naturally in some Amazonian plants. Ayahuasca is a tea made from such plants, and when taken in this form it is also known as hoasca, aya, and yagé. People can also make DMT in a lab. Synthetic DMT usually takes the form of a white crystalline powder that is smoked.
• 251-NBOMe is a synthetic hallucinogen with similarities both to LSD and MDMA (see DrugFacts: MDMA) but that is much more potent. Developed for use in brain research, when sold illegally it is sometimes called N Bomb or 251.

• PCP (Phencyclidine) was developed in the 1950s as a general anesthetic for surgery, but it is no longer used for this purpose due to serious side effects. PCP can be found in a variety of forms, including tablets or capsules; however, liquid and white crystal powder are the most common.
• Ketamine is used as a surgery anesthetic for humans and animals. Much of the ketamine sold illegally come from veterinary offices. It mostly sells as a powder or as pills, but it also available as an injectable liquid. Ketamine is snorted or sometimes added to drinks as a date-rape drug. 
• Dextromethorphan (DXM) is a cough suppressant and mucus-clearing ingredient in some over-the-counter cold and cough medicines (syrups, tablets, and gel capsules). 
• Salvia (Salvia divinorum) is a plant common to southern Mexico and Central and South America. Salvia is typically ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves of salvia can also be smoked or vaporized and inhaled. 

Hallucinogens as Medicine

Ketamine was approved many years ago as an anesthetic for painful medical procedures. In March 2019, the medicine esketamine (called “Spravato” by the manufacturer) was approved by the Food and Drug Administration as a treatment for severe depression in patients that do not respond to other treatments. Esketamine is closely related to the drug ketamine which is used illicitly and so there are concerns about the potential for misuse of this newly approved medication. In response, esketamine will be limited to administration in medical facilities.

Unlike a prescription that can be taken home and might be diverted into recreational use, esketamine will be administered in a medical office as a nasal spray. Patients must wait at least 2 hours under medical supervision to ensure proper management of potential side effects. It is a rapid-acting medication, so improvements may be seen immediately or within the first few weeks of treatment (unlike most other antidepressants, which can take weeks to begin to show an effect). Traditional antidepressants target the neurotransmitters serotonin, norepinephrine or dopamine. Esketamine affects the receptor for a different brain chemical called glutamate and so it represents a new approach to treating depression.

There is also some evidence that psilocybin may be effective in treating depression and anxiety. The FDA has granted “Breakthrough Therapy” designation for two formulations of psilocybin being studied for safety and efficacy as a medical treatment for depression. It’s important to note that during such studies, psilocybin is always taken under medical supervision.

Effects of Classic Hallucinogens

Short-Term Effects

Classic hallucinogens can cause users to see images, hear sounds, and feel sensations that seem real but do not exist. The effects generally begin within 20 to 90 minutes and can last as long as 12 hours in some cases (LSD) or as short as 15 minutes in others (synthetic DMT). Hallucinogen users refer to the experiences brought on by these drugs as "trips." If the experience is unpleasant, users sometimes call it a "bad trip."

Along with hallucinations, other short-term general effects include:

• increased heart rate

• nausea

• intensified feelings and sensory experiences (such as seeing brighter colors)

• changes in sense of time (for example, the feeling that time is 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

• spiritual experiences

• feelings of relaxation

• uncoordinated movements

• excessive sweating

• panic

• paranoia—extreme and unreasonable distrust of others

• psychosis—disordered thinking detached from reality

• bizarre behaviors

Long-Term Effects

Two long-term effects have been associated with use of classic hallucinogens, although these effects are rare.

• Persistent Psychosis—a series of continuing mental problems, including:

  • visual disturbances

  • disorganized thinking

  • paranoia

  • mood changes

• Hallucinogen Persisting Perception Disorder (HPPD)—recurrences of certain drug experiences, such as hallucinations or other visual disturbances. These flashbacks often happen without warning and may occur within a few days or more than a year after drug use. These symptoms are sometimes mistaken for other disorders, such as stroke or a brain tumor.

Both conditions are seen more often in people who have a history of mental illness, but they can happen to anyone, even after using hallucinogens one time. For HPDD, some antidepressant and antipsychotic medications can be used to improve mood and treat psychosis. Behavioral therapies can be used to help people cope with fear or confusion associated with visual disturbances.

Effects of Dissociative Hallucinogens

Dissociative drug effects can appear within a few minutes and can last several hours in some cases; some users report experiencing drug effects for days.

Effects depend on how much is used. In low and moderate doses, dissociative drugs can cause:

• numbness

• disorientation and loss of coordination

• hallucinations

• increase in blood pressure, heart rate, and body temperature

In high doses, dissociative drugs can cause the following effects:

• memory loss

• panic and anxiety

• seizures

• psychotic symptoms

• amnesia

• inability to move

• mood swings

• trouble breathing

Long-Term Effects of Dissociative Drugs

More research is needed on the long-term effects of dissociative drugs. Researchers do know repeated use of PCP can result in addiction. Other long-term effects may continue for a year or more after use stops, including:

• speech problems

• memory loss

• weight loss

• anxiety

• depression and suicidal thoughts

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America.

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. They may also mix it with other drugs such as the stimulant amphetamine or synthetic opioids, including fentanyl. Adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realize it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine.

3,4-methylenedioxy-methamphetamine (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 increases the activity of three brain chemicals:

• Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
• 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.

Health Effects of MDMA

• nausea
• muscle cramping
• involuntary teeth clenching
• blurred vision
• chills
• sweating

• irritability
• impulsiveness and aggression
• depression
• sleep problems
• anxiety
• memory and attention problems
• decreased appetite
• decreased interest in and pleasure from sex

It's possible that some of these effects may be due to the combined use of MDMA with other drugs, especially marijuana.

High doses of MDMA can affect the body’s ability to regulate temperature. This can lead to a spike in body temperature that can occasionally result in liver, kidney, or heart failure or even death.

• smoking
• swallowing (pill)
• snorting
• injecting the powder that has been dissolved in water/alcohol

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.
Methamphetamine increases the amount of the natural chemical dopamine in the brain. Dopamine is involved in body movement, motivation, and reinforcement of rewarding behaviors. The drug’s ability to rapidly release high levels of dopamine in reward areas of the brain strongly reinforces drug-taking behavior, making the user want to repeat the experience.

Health Effects of Methamphetamine

• increased wakefulness and physical activity
• decreased appetite
• faster breathing
• rapid and/or irregular heartbeat
• increased blood pressure and body temperature

People who inject methamphetamine are at increased risk of contracting infectious diseases such as HIV and hepatitis B and C. These diseases are transmitted through contact with blood or other bodily fluids that can remain on drug equipment. Methamphetamine use can also alter judgment and decision-making leading to risky behaviors, such as unprotected sex, which also increases risk for infection.
Methamphetamine use may worsen the progression of HIV/AIDS and its consequences. Studies indicate that HIV causes more injury to nerve cells and more cognitive problems in people who use methamphetamine than it does in people who have HIV and don't use the drug.¹ Cognitive problems are those involved with thinking, understanding, learning, and remembering.

Long-term methamphetamine use has many other negative consequences, including:

• extreme weight loss
• addiction
• severe dental problems
• intense itching, leading to skin sores from scratching
• anxiety
• changes in brain structure and function
• confusion
• memory loss
• 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. This may explain many of the emotional and cognitive problems seen in those who use methamphetamine.

Although some of these brain changes may reverse after being off the drug for a year or more, other changes may not recover even after a long period of time. A recent study even suggests that people who once used methamphetamine have an increased risk of developing Parkinson's disease, a disorder of the nerves that affects movement.

Overdose

An overdose occurs when a person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death.

In 2017, about 15 percent of all drug overdose deaths involved the methamphetamine category, and 50 percent of those deaths also involved an opioid, with half of those cases related to the synthetic opioid fentanyl. It is important to note that cheap, dangerous synthetic opioids are sometimes added to street methamphetamine without the user knowing.

Because methamphetamine overdose often leads to a stroke, heart attack, or organ problems, first responders and emergency room doctors try to treat the overdose by treating these conditions, with the intent of:

• restoring blood flow to the affected part of the brain (stroke)
• restoring blood flow to the heart (heart attack)
• treating the organ problems

Addition

Methamphetamine is highly addictive. When people stop taking it, withdrawal symptoms can include:

• anxiety
• fatigue
• severe depression
• psychosis
• intense drug cravings

• cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations likely to trigger drug use.
• motivational incentives, which use vouchers or small cash rewards to encourage patients to remain drug-free

Research also continues toward the development of medicines and other new treatments for methamphetamine use, including vaccines, and noninvasive stimulation of the brain using magnetic fields. People can and do recover from methamphetamine addiction if they have ready access to effective treatments that address the multitude of medical and personal problems resulting from long-term use.

Heroin is an opioid drug made from a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Short-Term Effects

People who use heroin report feeling a "rush" (a surge of pleasure, or euphoria). However, there are other common effects, including:

• dry mouth
• warm flushing of the skin
• heavy feeling in the arms and legs
• nausea and vomiting
• severe itching
• clouded mental functioning
• going "on the nod," a back-and-forth state of being conscious and semiconscious

Long-Term Effects

• insomnia
• collapsed veins for people who inject the drug
• damaged tissue inside the nose for people who sniff or snort it
• infection of the heart lining and valves
• abscesses (swollen tissue filled with pus)
• constipation and stomach cramping
• liver and kidney disease
• lung complications, including pneumonia
• mental disorders such as depression and antisocial personality disorder
• sexual dysfunction for men
• irregular menstrual cycles for women

Other Effects

Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see "Injection Drug Use, HIV, and Hepatitis").

Heroin is regularly mixed with fentanyl or carfentanyl to increase potency.  Due to improper and inexpert mixing, the amount of fentanyl per heroin dose can vary widely from hardly any to a fatal dose.  

Addiction

Heroin is highly addictive.  Users develop tolerance quickly, necessitating larger doses to get the same effect.  Substance use disorder can occur when a user continues to take the drug despite negative health or social consequences.  

Those addicted to heroin who stop abruptly may have severe withdrawal.  Symptoms can begin as early as a few hours after the last dose and can include:

• restlessness
• severe muscle and bone pain
• sleep problems
• diarrhea and vomiting
• cold flashes with goose bumps ("cold turkey")
• uncontrollable leg movements ("kicking the habit")
• severe heroin cravings

Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain’s white matter associated with heroin use, which may affect decision-making, behavior control, and responses to stressful situations.

Heroin addiction is a treatable medical condition.  Medications can be given to reduce withdrawal symptoms and improve comfort, while psychological therapy can help with cravings, anxiety, and depression.

Overdose

A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. Heroin overdoses have increased in recent years.

When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.

Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed. 

California has passed laws that allow pharmacists to dispense naloxone without a prescription from a person’s personal doctor.

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 to get high, they are called inhalants. 

People who use inhalants breathe in the fumes through their nose or mouth, usually by sniffing, snorting, bagging, or huffing. It’s called different names depending on the substance and equipment they use.

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.

Health Effects of Inhalants

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)
• dizziness

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) 

Overdose

An overdose occurs when a person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death.

These symptoms can cause seizures and coma. They can even be deadly. Many solvents and aerosol sprays are highly concentrated, meaning they contain a large amount of chemicals with a lot of active ingredients. Sniffing these products can cause the heart to stop within minutes. This condition, known as sudden sniffing death, can happen to otherwise healthy young people the first time they use an inhalant. Using inhalants with a paper or plastic bag or in a closed area may cause death from suffocation (being unable to breathe).

Because inhalant overdose can lead to seizures or heart failure, emergency treatment is focused on stopping the seizures and attempting to restart the heart.  

Any substance derived from the Cannabis sativa or Cannabis indica plant that contains the mind-altering chemical THC is considered a cannabinoid.  This can include the dried leaves, flowers, stems and/or seeds of the plant or extracted oils and resins of the plant that are further processed.  

Short-Term Effects

Once THC enters the bloodstream, it distributes throughout the brain and other tissues where they are quickly absorbed.  The brain contains receptors that naturally react to THC-like compounds, causing a feeling of euphoria.  Other effects include:

• altered senses (for example, seeing brighter colors)
• altered sense of time
• changes in mood
• impaired body movement
• difficulty with thinking and problem-solving
• impaired memory
• hallucinations (when taken in high doses)
• delusions (when taken in high doses)
• psychosis (risk is highest with regular use of high-potency marijuana)

Long-Term Effects

Marijuana and THC affect brain development.  When people start using THC as teenagers, their memory, concentration, and learning are all negatively affected.  Researchers are still studying the full extent of the long-term effects of THC use.  It is, however, known that the younger a person is when they start using THC and the more they use, the more negative consequences a person can experience, some of which may be permanent.

THC Concentration

THC levels in marijuana have been rising steadily over the years as new strains of Cannabis are bred.  This means a new user today will likely not have the same experience as they would have 10 years ago.  Increased concentrations also increase the risk of harmful reactions and side effects.

Health Effects

Marijuana use may have a wide range of effects, both physical and mental.

Physical Effects

• Breathing problems. Marijuana smoke irritates the lungs, and people who smoke marijuana frequently can have the same breathing problems as those who smoke tobacco. These problems include daily cough and phlegm, more frequent lung illness, and a higher risk of lung infections. Researchers so far haven't found a higher risk for lung cancer in people who smoke marijuana.
• Increased heart rate. Marijuana raises the heart rate for up to 3 hours after smoking. This effect may increase the chance of a heart attack. Older people and those with heart problems may be at higher risk.
• Problems with child development during and after pregnancy. One study found that about 20% of pregnant women 24-years-old and younger screened positive for marijuana. However, this study also found that women were about twice as likely to screen positive for marijuana use via a drug test than they stated in self-reported measures. This suggests that self-reported rates of marijuana use in pregnant females are not an accurate measure of marijuana use and may be underreporting their use. Additionally, in one study of dispensaries, nonmedical personnel at marijuana dispensaries were recommending marijuana to pregnant women for nausea, but medical experts warn against it. This concerns medical experts because marijuana use during pregnancy is linked to lower birth weight and increased risk of both brain and behavioral problems in babies. If a pregnant woman uses marijuana, the drug may affect certain developing parts of the fetus's brain. Children exposed to marijuana in the womb have an increased risk of problems with attention, memory, and problem-solving compared to unexposed children. Some research also suggests that moderate amounts of THC are excreted into the breast milk of nursing mothers. With regular use, THC can reach amounts in breast milk that could affect the baby's developing brain. Other recent research suggests an increased risk of preterm births. More research is needed. 
• Intense nausea and vomiting. Regular, long-term marijuana use can lead to some people to develop Cannabinoid Hyperemesis Syndrome. This causes users to experience regular cycles of severe nausea, vomiting, and dehydration, sometimes requiring emergency medical attention.

Mental Effects

Long-term marijuana use has been linked to mental illness in some people, such as:

• temporary hallucinations
• temporary paranoia
• worsening symptoms in patients with schizophrenia—a severe mental disorder with symptoms such as hallucinations, paranoia, and disorganized thinking

Marijuana use has also been linked to other mental health problems, such as depression, anxiety, and suicidal thoughts among teens. However, study findings have been mixed.

Marijuana use can lead to the development of a substance use disorder, a medical illness in which the person is unable to stop using even though it's causing health and social problems in their life. Severe substance use disorders are also known as addiction. Research suggests that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder. People who begin using marijuana before age 18 are four to seven times more likely than adults to develop a marijuana use disorder.

Many people who use marijuana long term and are trying to quit report mild withdrawal symptoms that make quitting difficult. These include:

• grouchiness
• sleeplessness
• decreased appetite
• anxiety
• cravings

Adventist Feather River, Paradise:  530-876-2547

Aegis Treatment Centers, Chico:  530-342-3950

Aegis Treatment Centers, Oroville:  530-534-7500

Butte County Behavioral Health, Chico:  530-897-3950

Butte County Behavioral Health, Oroville:  530-538-7277

Feather River Tribal Health, Oroville:  530-534-5394

Mangrove Medical Group, Chico: 530-345-0064

Northern Valley Indian Health, Chico:  530-896-9400

Oroville Pain Mgmt. Center, Oroville:  530-538-5620

Therapeutic Solutions, Chico:  530-899-3150

Bright Heart Health, telemedicine:  1-800-892-2695

The Substance Abuse and Mental Health Services Administration (SAMHSA) is part of the U.S. Department of Health and Human Services dedicated to reducing the impacts of substance use and improving mental health.  Click this link to use their Treatment Program Locator to find specialized treatment in an area that's convenient.

Funded by the National Institutes of Health, the Alcohol Treatment Navigator is a resource to learn about the options for treatment and to find help.  

Alcoholics Anonymous provides anonymous support to help stop drinking.  Based on decades of research and experience, the Alcoholics Anonymous program is caring, supportive, and effective.

Al-Anon is for the friends, family, and loved ones of those dependent on drugs and alcohol.  They won't teach you how to get someone to quit using (nobody can make a user quit), they'll teach you how to worry less and reclaim some control of your life.

The Truth Initiative provides resources and information about tobacco and vape dependence as well as resources to help quit.