Drug Abuse and Addiction: Drugs of Choice
Addiction begins with drug abuse when an
individual makes a conscious choice to use drugs, but addiction is not just "a
lot of drug use." Recent scientific research provides overwhelming evidence that
not only do drugs interfere with normal brain functioning creating powerful
feelings of pleasure, but they also have long-term effects on brain metabolism
and activity. At some point, changes occur in the brain that can turn drug abuse
into addiction, a chronic, relapsing illness. Those addicted to drugs suffer
from a compulsive drug craving and usage and cannot quit by themselves.
Treatment is necessary to end this compulsive behavior.
Information on the drugs listed below will help give you a better understanding of what they are and the health hazards that come along with their abuse.
Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater. Both drugs have some medical uses, primarily in the treatment of obesity, but their therapeutic use is limited.
Methamphetamine is made in illegal laboratories and has a high potential for abuse and dependence. Street methamphetamine is referred to by many names, such as "speed," "meth," and "chalk." Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as "ice," "crystal," and "glass."
Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. It also appears to have a neurotoxic effect, damaging brain cells that contain dopamine and serotonin, another neurotransmitter. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson's disease, a severe movement disorder.
Methamphetamine is taken orally or intranasally (snorting the powder), by intravenous injection, and by smoking. Immediately after smoking or intravenous injection, the methamphetamine user experiences an intense sensation, called a "rush" or "flash," that lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria - a high, but not a rush. Users may become addicted quickly, and use it with increasing frequency and in increasing doses.
Animal research going back more than 20 years shows that high doses of methamphetamine damage neuron cell-endings. Dopamine- and serotonin-containing neurons do not die after methamphetamine use, but their nerve endings ("terminals") are cut back and re-growth appears to be limited.
The central nervous system (CNS) actions that result from taking even small amounts of methamphetamine include increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, and euphoria. Other CNS effects include irritability, insomnia, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness. Hyperthermia and convulsions can result in death.
Methamphetamine causes increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes. Other effects of methamphetamine include respiratory problems, irregular heartbeat, and extreme anorexia. Its use can result in cardiovascular collapse and death.
Steroids (Anabolic-Androgenic) Anabolic-androgenic steroids are man-made substances related to male sex hormones. "Anabolic" refers to muscle-building, and "androgenic" refers to increased masculine characteristics. "Steroids" refers to the class of drugs. These drugs are available legally only by prescription, to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence. They are also used to treat body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass. Abuse of anabolic steroids, however, can lead to serious health problems, some irreversible.
Today, athletes and others abuse anabolic steroids to enhance performance and also to improve physical appearance. Anabolic steroids are taken orally or injected, typically in cycles of weeks or months (referred to as "cycling"), rather than continuously. Cycling involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. In addition, users often combine several different types of steroids to maximize their effectiveness while minimizing negative effects (referred to as "stacking").
The major side effects from abusing anabolic steroids can include liver tumors and cancer, jaundice (yellowish pigmentation of skin, tissues, and body fluids), fluid retention, high blood pressure, increases in LDL (bad cholesterol), and decreases in HDL (good cholesterol). Other side effects include kidney tumors, severe acne, and trembling. In addition, there are some gender-specific side effects:
- For men--shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer.
- For women--growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
- For adolescents--growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.
Scientific research also shows that aggression and other psychiatric side effects may result from abuse of anabolic steroids. Many users report feeling good about themselves while on anabolic steroids, but researchers report that extreme mood swings also can occur, including manic-like symptoms leading to violence. Depression often is seen when the drugs are stopped and may contribute to dependence on anabolic steroids. Researchers report also that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.
Research also indicates that some users might turn to other drugs to alleviate some of the negative effects of anabolic steroids. For example, a study of 227 men admitted in 1999 to a private treatment center for dependence on heroin or other opioids found that 9.3 percent had abused anabolic steroids before trying any other illicit drug. Of these 9.3 percent, 86 percent first used opioids to counteract insomnia and irritability resulting from the anabolic steroids.
Inhalants Inhalants are breathable chemical vapors that produce psychoactive (mind-altering) effects. A variety of products commonplace in the home and in the workplace contain substances that can be inhaled. Many people do not think of these products, such as spray paints, glues, and cleaning fluids, as drugs because they were never meant to be used to achieve an intoxicating effect. Yet, young children and adolescents can easily obtain them and are among those most likely to abuse these extremely toxic substances. Parents should monitor household products closely to prevent accidental inhalation by very young children. Inhalants fall into the following categories:Solvents
- Industrial or household solvents or solvent-containing products, including paint thinners or removers, degreasers, dry-cleaning fluids, gasoline, and glue
- Art or office supply solvents, including correction fluids, felt-tip-marker fluid, and electronic contact cleaners
- Gases used in household or commercial products, including butane lighters and propane tanks, whipping cream aerosols or dispensers (whippets), and refrigerant gases
- Household aerosol propellants and associated solvents in items such as spray paints, hair or deodorant sprays, and fabric protector sprays
- Medical anesthetic gases, such as ether, chloroform, halothane, and nitrous oxide ("laughing gas")
- Aliphatic nitrites, including cyclohexyl nitrite, an ingredient found in room odorizers; amyl nitrite, which is used for medical purposes; and butyl nitrite (previously used to manufacture perfumes and antifreeze), which is now an illegal substance
Health Hazards Although they differ in makeup, nearly all abused inhalants produce short-term effects similar to anesthetics, which act to slow down the body's functions. When inhaled via the nose or mouth into the lungs in sufficient concentrations, inhalants can cause intoxicating effects. Intoxication usually lasts only a few minutes.
However, sometimes users extend this effect for several hours by breathing in inhalants repeatedly. Initially, users may feel slightly stimulated. Successive inhalations make them feel less inhibited and less in control. If use continues, users can lose consciousness.
Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death within minutes of a session of prolonged use. This syndrome, known as "sudden sniffing death," can result from a single session of inhalant use by an otherwise healthy young person. Sudden sniffing death is particularly associated with the abuse of butane, propane, and chemicals in aerosols.
High concentrations of inhalants also can cause death from suffocation by displacing oxygen in the lungs and then in the central nervous system so that breathing ceases. Deliberately inhaling from an attached paper or plastic bag or in a closed area greatly increases the chances of suffocation. Even when using aerosols or volatile products for their legitimate purposes (i.e., painting, cleaning), it is wise to do so in a well-ventilated room or outdoors.
Chronic abuse of solvents can cause severe, long-term damage to the brain, the liver, and the kidneys.
Harmful irreversible effects that may be caused by abuse of specific solvents include:
- Hearing loss: toluene (spray paints, glues, dewaxers) and trichloroethylene (cleaning fluids, correction fluids)
- Peripheral neuropathies, or limb spasms: hexane (glues, gasoline) and nitrous oxide (whipping cream, gas cylinders)
- Central nervous system or brain damage: toluene (spray paints, glues, dewaxers)
- Bone marrow damage: benzene (gasoline)
Serious but potentially reversible effects include:
- Liver and kidney damage: toluene-containing substances and chlorinated hydrocarbons (correction fluids, dry-cleaning fluids)
- Blood oxygen depletion: aliphatic nitrites (known on the street as poppers, bold, and rush) and methylene chloride (varnish removers, paint thinners)
Abuse of amyl and butyl nitrites has been associated with Kaposi's sarcoma (KS), the most common cancer reported among AIDS patients. Early studies of KS showed that many people with KS had used volatile nitrites. Researchers are continuing to explore the hypothesis of nitrites as a factor contributing to the development of KS in HIV-infected people.
IMAGES PROVIDED BY:
Medically reviewed by Avrom Simon, MD; Board Certification in Preventive Medicine/Occupational Medicine August 17, 2017
Portions of the above information has been provided with the kind permission of the National Institute on Drug Abuse (www.drugabuse.gov)