General Alcohol & Drug Information

      Brain:

      Alcohol can interfere with the brain’s communication pathway, causing changes in mood, behavior, and increased difficulty with clear thinking and coordination.

      Heart:

      Excessive drinking or binge drinking can cause heart conditions such as cardiomyopathy (stretching and drooping of the heart muscle), arrhythmias (irregular heart rhythms), stroke, and high blood pressure.

      Liver:

      Excessive drinking can lead to a variety of liver problems such as fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis.

      Pancreas:

      Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion. 

      Immune System:

      Excessive alcohol use can weaken your immune system, making your body more susceptible to diseases such as pneumonia and tuberculosis.

      Cancer:

      Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the mouth, esophagus, throat, liver, and breast. 

      Dangers of alcohol use and driving

      Alcohol use slows reaction time, impairs judgement and coordination, all skills used to drive a car safely. The more alcohol that was consumed, the greater the effects of impairment. 

      The Legal Limit for Driving

      The legal limit for drinking is the alcohol level above which a person is subject to legal penalties. This could include arrest, fines, a loss of a driver’s license and placement of a DUI (Driving Under the Influence) charge on your record.

      All states in the US have adopted 0.08% (80 mg/dL) as the legal limit for operating a motor vehicle for drivers 21 or older. Drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.

      Legal limits do not define a level below which it is safe to operate a vehicle. Impairment because of alcohol use begins at levels well below the legal limit. 

      Alcohol is classified as a ‘sedative hypnotic’ drug, which means it acts to depress the nervous system. At low doses, alcohol can act as a stimulant, inducing feelings of euphoria and talkativeness, but at higher doses, alcohol can lead to drowsiness, respiratory depression, coma, or death. ​

      Alcohol (ethanol or ethyl alcohol) is the ingredient found in beer, wine and spirits that causes drunkenness. As a legal drug, alcohol is part of our culture, however excessive drinking can have serious health consequences. ​

      According to the National Institute on Alcohol Abuse and Alcoholism​, binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08% or more. This pattern of drinking usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women, generally within about 2 hours.

      Binge drinking is associated with many health problems, including:

      • Unintentional injuries such as car crashes, falls, burns, and alcohol poisoning.
      • Violence including homicide, suicide, intimate partner violence, and sexual assault.
      • Sexually transmitted diseases.
      • Unintended pregnancy and poor pregnancy outcomes, including miscarriage and stillbirth.
      • Fetal alcohol spectrum disorders.
      • Sudden infant death syndrome.
      • Chronic diseases such as high blood pressure, stroke, heart disease, and liver disease.
      • Cancer of the breast, mouth, throat, esophagus, liver, and colon.
      • Memory and learning problems.
      • Alcohol dependence.​

      ​If you ever notice any of the signs of alcohol poisoning, it’s critical that you get help right away. Call an ambulance, dial 9-1-1 – don’t wait.

      Signs of alcohol poisoning:

      • Confusion or disorientation 
      • Vomiting
      • Hypothermia                                                              
      • Inability to stay conscious
      • Cold or clammy skin                                                 
      • Lack of physical coordination/can’t walk
      • Irregular Pulse                                                            
      • Depressed breathing
      • Seizure                                                                        
      • Choking
      • Loss of bowel or bladder control                           
      • Blue-tinged skin, especially around the lips  or fingertips​

      No matter what you do, though, never – ever – let a person “sleep it off” if you suspect that they have alcohol poisoning. Try to keep them awake and moving, or get medical attention right away. If you let them sleep, they may never wake up. 

        • Seizures
        • Breathing problems
        • Risk of Heart Attack
        • Extreme weight loss
        • Dependence to cocaine​
        • Death
        • High blood pressure 
        • Increased heart rate
        • Decreased appetite
        • Nausea and vomiting
        • Nose bleeds
        • Anxiety
        • Convulsions

        Cocaine increases levels of the natural chemical messenger dopamine in brain circuits related to the control of movement and reward.

        The brain normally recycles dopamine back into the cell that released it. However, cocaine prevents dopamine from being recycled, causing large amounts to build up in the space between nerve cells and stopping their normal communication. This flood of dopamine in the brain’s reward circuit strongly reinforces drug-taking behaviors, because it eventually adapts to the excess of dopamine caused by cocaine and becomes less sensitive to it. 

        As a result, people take stronger and more frequent doses in an attempt to feel the same high, and to obtain relief from withdrawal. 

        Cocaine is a drug made from the leaves of the South American coca plant. Crack is created using cocaine and several additional chemicals. It is snorted, injected, or smoked​

          Low to Moderate Doses:

          • Numbness
          • Disorientation, confusion, and loss of coordination
          • Dizziness
          • Nausea and vomiting
          • Hallucinations
          • ​Changes in Perception
          • Detachment
          • Increased blood pressure, heart rate 

           

          High Doses:

          • Hallucinations
          • Memory loss
          • Anxiety
          • Fear
          • Paranoia
          • Aggression
          • Respiratory distress
          • Physical distress, including dangerous changes in blood pressure, heart rate, respiration and body temperature

          Research shows that repeated PCP use can lead to development of tolerance and eventually substance use disorder that includes withdrawals when the drug is stopped. 

          Other long-term effects of PCP use include persistent speech difficulties, memory loss, depression, suicidal thoughts, anxiety and social withdrawal that can last for a year or more after chronic use stops.

          The long-term use of most dissociative drugs is needing more systematic investigation. 

          LSD and use of hallucinogenic drugs produce tolerances that require increasingly larger doses to produce similar effects, and also produces tolerance to other drugs in this class. Use of classic hallucinogens do not produce tolerance to drugs that act on different receptors in the brain, such as marijuana, amphetamines, or PCP, among others. Tolerance for hallucinogens are short-lived, and physical withdrawal symptoms are not typically experienced.

          Two long-term effects—persistent psychosis and Hallucinogen Persisting Perception Disorder (HPPD)—have been associated with use of classic hallucinogens, although occurrence of either is rare. Both conditions are more often seen in individuals with a history of psychological problems but can happen to anyone, even after a single exposure.​

          Hallucinogens are a class of drugs that cause hallucinations and profound distortions in a person’s perceptions of reality. Hallucinogens are found in some plants and mushrooms, and can be man-made. Hallucinogens are divided into two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Under the influence of either type of drug, people report rapid, intense emotional swings and seeing images, hearing sounds, and feeling sensations that seem real but are not.​

            • ​Weight gain from increased appetite
            • Risk of oral cancer
            • Weakened immune system
            • Depression
            • Psychological Dependence
            • Chest and lung problems, including emphysema, bronchitis and chest colds​

            Marijuana use can actually shrink parts of your brain including your hippocampus (the part of your brain that controls memory) and your amygdala (the part that helps with emotions and memory)​​​​

             

            • Increased appetite
            • Inability to concentrate
            • Red eyes and dry mouth​
            • Delusions
            • Insomnia
            • Loss of consciousness
            • Dilated pupils 
            • Bloodshot eyes
            • Sleepy appearance
            • Reduced motivation
            • Overeating
            • Smell on clothing, in room, or car​

            THC takes just seconds to go to your head and attach itself to your brain’s receptors – which help the brain communicate with the rest of your body. Once it's in your brain, the THC activates these receptors, called neurotransmitters, and gives you the feeling of being high. In short, marijuana changes the physical and chemical balance in your brain and this is what people refer to as a 'high'."

            Marijuana can be compact, green buds, or dry, shredded green and brown mix of leaves, flowers, seeds and stems.

            How is it used?

            Marijuana is usually smoked in joints, pipes, bongs, blunts, and hookahs. It can also be mixed in food or brewed as a tea.​

            Edible marijuana is usually created in three ways: mixing it in food such as brownies, cookies, or candy, brewing it as a tea or creating a pill form. Many people underestimate the strength of edibles made from marijuana. It’s also difficult to gauge how much THC is left behind in the grease. Many people who make their own edible marijuana have difficulty in keeping it consistent. When ingested, THC is converted to another chemical in the liver that is even more potent. 

            In Colorado, where the recreational use of marijuana is legal, an estimated 45% of marijuana sales involve edible marijuana, including THC-infused food, drink, and pills. In addition to being more potent as an edible form than smokes, there is a relatively slow onset of effect, and can take a person one to two hours to feel any effects. ​

            Marijuana comes from the hemp plant Cannabis Sativa and it also contains hundreds of chemicals, including delta-9-tetrahydrocannabinol (THC), which is the drug’s main mind altering ingredient. Extracts can be made from the cannabis plant, and are called edibles. 

            Second to alcohol, marijuana is the most commonly used recreational drug in the United States, with an estimated 19.8 million users

            Under California law, on January 1, 2018, it became legal for adults 21 and over to use, carry, and grow cannabis or buy recreational cannabis without a physician’s recommendation or county-issued medical marijuana ID. It is illegal for youth under 21 years old to use recreational cannabis. 

            In order to buy medicinal cannabis, you must be 18 or older and have a physician’s recommendation, county-issued medical marijuana ID, or be a Primary Caregiver as defined in the Health and Safety Code Section 11362.7(d) or 11362.5(e), with a valid physician’s recommendation for the patient. In addition, consistent with the Compassionate Use Act, you may possess or cultivate any amount that is reasonably related to your current medical needs. Medical cannabis is illegal to use for youth under 18 years of age. 

            The new California law, known as the Medicinal and Adult-Use Cannabis Regulation and Safety Act, includes information about where you can use cannabis, how much you can possess, and the penalties for illegal use.

            Click here for more information on legal cannabis use.​ ​

            Medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. The FDA has not recognized or approved the marijuana plant of medicine. 

            Currently, the two main cannabinoids from the marijuana plant that are of medical interest are THC and CBD. THC can increase appetite and reduce nausea. THC may also decrease pain, inflammation (swelling and redness), and muscle control problems.

            Unlike THC, CBD is a cannabinoid that doesn't make people "high." These drugs aren't popular for recreational use because they aren't intoxicating. It may be useful in reducing pain and inflammation, controlling epileptic seizures, and possibly even treating mental illness and addictions. 

            The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. So far, researchers haven't conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it's meant to treat.

            Don’t Panic. Anxiety can be worsened by marijuana. Many people experience paranoia – extreme and unreasonable distrust of others. Try to remain calm.

            Depending on how much THC you ingest, hallucinations may be anywhere from mild to extreme. Remembers the hallucinations are not real. 

            Call a trusted person to come get you. Tell them you make have accidentally ingested a THC-infused food item. Under no circumstances should you attempt to drive.

            There is no lethal dose of marijuana, so there is no need to call poison control or 911 unless there is another medical emergency caused by eating marijuana-infused food or drink. 

              Yes, you can die from MDMA use. MDMA can cause problems with the body’s ability to control temperature, especially when it is used in active, hot settings (like dance parties or concerts). On rare occasions, this can lead to a sharp rise in body temperature (known as hyperthermia), which can cause liver, kidney, or heart failure or even death​​.

              A person may experience the intoxicating effects of MDMA within 45 minutes or so after taking a single dose. Those effects include an enhanced sense of well-being, increased extroversion, emotional warmth, empathy toward others, and a willingness to discuss emotionally-charged memories. In addition, people report enhanced sensory perception as a hallmark of the MDMA experience.

              However, MDMA can also cause a number of acute adverse health effects. For example, while fatal overdoses on MDMA are rare, they can potentially be life threatening—with symptoms including high blood pressure (hypertension), faintness, panic attacks, and in severe cases, hyperthermia (increased body temperature) a loss of consciousness and seizures.​

              Some users experience unpleasant withdrawal symptoms after regular (daily or almost daily) use of the drug is reduced or stopped, such as:

              • fatigue
              • loss of appetite
              • depression
              • trouble concentrating

              Sleep disturbances, lack of appetite, concentration difficulties, depression, heart disease, and impulsivity have been associated with regular use of MDMA. In addition, heavy MDMA use over a 2-year period of time is associated with decreased cognitive function.​

              MDMA, also known as Ecstasy, Molly, or X, is a man-made drug that produces energizing effects similar to the stimulants called amphetamines, as well as psychedelic effects, similar to the hallucinogens mescaline and LSD. MDMA is known as a “club drug” because of its popularity in the nightclub scene, at “raves” (all-night dance parties), and music festivals or concerts. MDMA’s effects generally last from 3 to 6 hours.

              Most people who take MDMA take it in a pill, tablet or capsules. Sometimes they are different colors and have cartoon-like images on them. Even though MDMA refers to the pure crystalline powder, most “Molly” contains other harmful and deadly drugs in addition to MDMA. Frequently, MDMA is mixed with synthetic cathinones, the chemicals in “bath salts”. Some MDMA pills have been found to have dextromethorphan (found in cough syrups), amphetamines (meth), PCP, or cocaine.​

                Meth is made of synthetic chemicals including battery acid and antifreeze.​

                • Paranoia
                • Hallucinations and delusions
                • Poor healing sores
                • Violent, Aggressive Behavior
                • Acne
                • Poor dentition
                • Tolerance to methamphetamine​
                • Brain damage
                • Twitching and convulsions
                • Stroke and death
                • Loss of appetite 
                • Increased heart rate, blood pressure and body temperature
                • Insomnia
                • Depression and anxiety
                • Hallucinations
                • Convulsions, seizures and death

                Methamphetamine increased the amount of the natural chemical dopamine in the brain, which is involved in body movement, motivation, and reinforcement of rewarding behaviors. When you take methamphetamine high levels of dopamine are released into the brain, reinforcing drug-taking behaviors and making the user want to repeat the experience. 

                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 is a synthetic stimulant that affects the central nervous system. Meth usually comes in the form of a white or yellowish powder. It can be smoked, snorted, swallowed and injected.​

                  •  Nausea and vomiting 
                  •  Bloating​
                  •  Constipation​
                  •  Liver damage
                  •  Tolerance Development 
                  •  Brain damage from prolonged breathing depression
                  •  Dependence to opioids
                  • Pain Relief 
                  • Cough Suppression
                  • Drowsiness 
                  • Sedation
                  • Feelings of Euphoria
                  • Lethargy
                  • Paranoia
                  • Slowed Breathing
                  • Nausea​​

                  Opioids are a class of highly addictive drugs that come from the opium poppy plant. Opioids are made to mimic feel good receptors in the brain and are most commonly used as prescription painkillers.  Users typically smoke, short, inject, ingest or chew forms of opioids.​
                  Opioids take many forms including a while powder, liquid, pills and even lollipops. ​​

                  Opioids work by fusing to the body’s opiate receptors, the areas of the brain that control pain and emotions. When opiate drugs fuse to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation.​

                  Opioids are effective for treating short-term pain. They are generally not effective for chronic, long-term pain. ​

                    Yes, a person can overdose on cold medicines containing DXM or loperamide. An overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death.

                    As with other opioids, when people overdose on DXM or loperamide, 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 and death.

                    Misuse of over the counter drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). 

                    Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms including pain, coughs and colds, diarrhea, constipation, acne, and others. Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages.​

                    Dextromethorphan, or DXM, is found in over 120 different kinds of over-the-counter cough medicines. When taken as directed, it relieves coughing, but large amounts of DXM can cause hallucinations, dizziness, confusion, vomiting, liver damage, and heart attacks. These symptoms can worsen if you take DXM with other drugs. 

                    Loperamide is an opioid designed not to enter the brain. However, when taken in large amounts and combined with other substances, it may cause the drug to act in a similar way to other opioids.

                    Meclizine is found in OTC medications to ease upset stomach. Taking too much of this ingredient can cause hallucinations, as well as brain, liver, kidney and stomach damage. It’s hallucinogenic ingredient is usually known by its brand name, Dramamine.

                      Yes, prescription drugs that effect the brain, including opioid pain relievers, stimulants, and depressants, can cause physical dependence that could lead to addiction. Medications that affect the brain can change the way it works—especially when they are taken over an extended period of time or with escalating doses. They can change the reward system, making it harder for a person to feel good without the drug and possibly leading to intense cravings, which make it hard to stop using.

                      This dependence on the drug happens because the brain and body adapt to having drugs in the system for a while. A person may need larger doses of the drug to get the same initial effects. This is known as “tolerance.” When drug use is stopped, uncomfortable withdrawal​ symptoms can occur. When people continue to use the drug despite a range of negative consequences, it is considered an addiction. When a person is addicted to a drug, finding and using that drug can begin to feel like the most important thing—more important than family, friends, school, sports, or health. 

                      Carefully following the doctor’s instructions for taking a medication can make it less likely that someone will develop dependence or addiction, because the medication is prescribed in amounts and forms that are considered appropriate for that person. However, dependence and addiction are still potential risks when taking certain types of prescription drugs. These risks should be carefully weighed against the benefits of the medication and patients should communicate any issues or concerns to their doctor right away.

                      Other kinds of medications that do not act in the brain, such as antibiotics used to treat infections, are not addictive.

                      Yes, more than half of the drug overdose deaths in the United States each year are caused by prescription drug misuse. Deaths from overdoses of prescription drugs have been increasing since the early 1990s, largely due to increases in misuse of prescription opioid pain relievers. 

                      Mixing different types of prescription drugs can be particularly dangerous. For example, benzodiazepines mixed with opioids increase the risk of overdose. Also, combining opioids (pain relievers) with alcohol can make breathing problems worse and can lead to death.

                       

                      Depressants 

                      Sometimes referred to as central nervous system (CNS) depressants or tranquilizers, slow down (or “depress”) the normal activity that goes on in the brain and spinal cord. Doctors often prescribe them for people who are anxious or can't sleep.

                      When prescription depressants are taken as prescribed by a doctor, they can be relatively safe and helpful. However, dependence and addiction are still potential risks. These risks increase when these drugs are misused. 

                      Depressants can be divided into three primary groups: barbiturates, benzodiazepines, and sleep medications. ​

                      As depressants slow down brain activity, they cause other effects:

                      • slurred speech
                      • shallow breathing, which can lead to overdose and even death.
                      • sleepiness
                      • disorientation
                      • ​l​ack of coordination​

                      These effects can lead to serious accidents or injuries. Misuse of depressants can also lead to physical dependence, another reason they should only be used as prescribed. Dependence means you will feel uncomfortable or ill when you try to stop taking the drug, and it can lead to addiction. 

                      Depressants should not be combined with any medicine or substance that causes sleepiness, like prescription pain medicines, certain over-the-counter cold and allergy medicines, or alcohol. If combined, they can slow both the heart rate and breathing increasing the risk of overdose and death.​

                      Prescription stimulants increase—or "stimulate"—activities and processes in the body. This increased activity can boost alertness, attention, and energy. It also can raise your blood pressure and make your heart beat faster. When prescribed by a doctor for a specific health condition, they can be relatively safe and effective. However, dependence and addiction are still potential risks when taking prescription stimulants. These risks increase when these drugs are misused. Taking someone else's prescription drugs or taking the drugs to get “high” can have serious health risks.

                      There are two commonly misused types of stimulants: amphetamines (e.g., Adderall) and methylphenidate (e.g., Ritalin). In the past, stimulants were used to treat a variety of conditions, including asthma and other breathing problems, obesity, and health problems that affect your nervous system. Now, because the risk for misuse and addiction is better understood, doctors prescribe them less often and only for a few health conditions. They are still prescribed for attention deficit hyperactivity disorder (ADHD), narcolepsy (a sleep disorder), and, in some instances, depression that has not responded to other treatments.

                      Stimulants 
                      ​  Type Conditions  They  Treat​
                      ​​Amphetamines (Adderall and Dexedrine)     ​ADHD, Narcolepsy (sleep disorder)​​
                      ​Methylphenidate (Ritalin and Concerta)​   ​Depression​​ 

                      Stimulant use can have side effects, even when prescribed by a doctor. Misuing them can be especially dangerous. Taking high doses of a stimulant can cause:​

                      • increased blood pressure
                      • irregular heartbeat
                      • dangerously high body temperatures
                      • decreased sleep
                      • lack of interest in eating, which can lead to poor nutrition
                      • intense anger or paranoia (feeling like someone is going to harm you even though they aren’t)
                      • risk for seizures and stroke at high doses

                      Prescription drug misuse can have serious medical consequences. Misuse of prescription opioids, central nervous system (CNS) depressants, and stimulants is a serious public health problem in the United States. Unintentional overdose deaths involving opioid pain relievers have more than quadrupled since 1999 and have outnumbered those involving heroin and cocaine since 2002.​​

                      Opioids - used to relieve pain, such as Vicodin, OxyContin, or codeine

                      Depressants - used to relieve anxiety or help a person sleep, such as Valium or Xanax

                      Stimulants - used for treating attention deficit hyperactivity disorder (ADHD), such as Adderall and Ritalin

                      Prescription drug misuse has become a large public health problem, because misuse can lead to addiction, and even overdose deaths. Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). 

                      How Prescription Drugs are Misused

                      Taking someone else’s prescription medication. Even when someone takes another person’s medication for its intended purposes (such as to relieve pain, to stay awake, or to fall asleep) it is considered misuse.

                      Taking a prescription medication in a way other than prescribed. Taking your own prescription in a way that it is not meant to be taken is also misuse. This includes taking more of the medication than prescribed or changing its form—for example, breaking or crushing a pill or capsule and then snorting the powder.

                      Taking a prescription medication to get high. Some types of prescription drugs also can produce pleasurable effects or “highs.” Taking the medication only for the purpose of getting high is considered prescription drug misuse.

                      Mixing it with other drugs. In some cases, if you mix your prescription drug with alcohol and certain other drugs, it is considered misuse and it can be dangerous.

                      Click here for more information on prescription drug use. 

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