Alcoholic beverages are consumed in most countries of the world. Each nation has laws that regulate their production, sale, and consumption. In particular, such laws specify the minimum age at which a person may legally buy or drink them. This minimum age varies between 16 and 25 years, depending upon the nation and the type of drink. Most nations set this minimum age at 18 years.
The production and consumption of alcohol occurs in most cultures of the world, from hunter-gatherer peoples to nation-states. Alcoholic beverages are often an important part of social events in these cultures. In many cultures, drinking plays a significant role in social interaction — mainly because of alcohol’s neurological effects. Alcohol is a physiological depressant, which accounts for its ability to display similar symptoms to dysthymia or antisocial personality disorder, when the ability to self-regulate is inhibited.
A person using alcohol can develop physiological dependence characterized by evidence of tolerance or symptoms of withdrawal (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000)
Nicotine is a stimulant commonly found in the tobacco plant. Nicotine from the plant is consumed in many different forms, some of which include: cigars, cigarettes, chewing tobacco, and pipe tobacco. Users of nicotine are at risk for nicotine intoxication, abuse, dependence, and withdrawal (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000).
In addition to intoxication, abuse,dependence, and withdrawal, the substance, when smoked (via cigarette, cigar, or pipe tobacco), has been linked to an increased risk for developing many forms of cancer (Herata, Sekino, & Kanda, 2010; Tournier & Birembaut, 2010). There are also several indicated positive effects of nicotine, such as: increased cognitive performance (Herman & Sofuoglu, 2010), increased fine motor abilities, improved alerting-attention accuracy and response time, decreased orienting attention response time, improved short-term episodic memory-accuracy, and decreased working memory response time (Heishman, Kleykamp, & Singleton, 2010).
Amphetamine is a psychostimulant drug that is known to produce increased wakefulness and focus as well as decrease fatigue and appetite. Amphetamine is related to drugs such as methamphetamine and lisdexamfetamine, which are part of a group of potent drugs that act by increasing levels of dopamine and norepinephrine in the brain, inducing euphoria. The group includes prescription CNS drugs commonly used to treat attention-deficit hyperactivity disorder (ADHD). Amphetamine is also used to treat symptoms of traumatic brain injury, the daytime drowsiness symptoms of narcolepsy, Postural Orthostatic Tachycardia Syndrome, and chronic fatigue syndrome. Initially, amphetamine was more popularly used to diminish the appetite and to control weight. Brand names of the drugs that contain, or metabolize into, amphetamine include: Adderall, Vyvanse, and Dexedrine, and Benzedrine (no longer used in treatment). Some of the “street” or slang names for amphetamines include: Speed, Dex, and Crank.
Cannabis is a substance that has mixed effects on the brain. It binds to cannabanoid receptors in the brain, which have different effects in different regions. It stimulates dopamine release in the nucleus accumbens which accounts for addictive quality. Cannabis is a drug that comes from Indian hemp plants such as Cannabis sativa and Cannabis indica. The active chemical in cannabis is THC (delta-9 tetrahydrocannabinol).
Referred to by many different names in the various cultures and communities around the world, cannabis is commonly available in many areas. Usually referred to as weed, grass, dope (which can cause problems given several other drugs share this nickname), or slope; cannabis has also acquired many interesting terms, like Marlboro green, pot,reefer,chronic,tweeds jive ,fire,ganja,kill,sticky,nugget,cheeba,kush,majic clover, or giggle-twig.
THC (delta-9 tetrahydrocannabinol) is the chemical in cannabis that makes you feel ‘high’. This means you experience a change in mood and may see or feel things in a different way. Some parts of the plant contain a higher level of THC, for example, the flowers, or ‘heads’, have more THC than the stems and leaves.
THC is absorbed into the bloodstream through the walls of the lungs (if cannabis is smoked), or through the walls of the stomach and intestines (if eaten). The bloodstream carries the THC to the brain, producing the ‘high’ effects. Cannabis, like other drugs, gets into the bloodstream quicker when inhaled as opposed to ingested.
Although there is evidence concerning significant neuropharmacologic, cognitive, behavioral, and somatic consequences of short and long-term marijuana use effecting memory, concentration, attention span, motivation, and problem solving that negatively effects learning; the debate regarding the legalization of marijuana still exists. New psychopharmacologic information shows that marijuana shares many features with other illicit drugs and contend that legalization would likely trigger an increase in use, and consequently show increases in social, economic and health costs. If legalization occurs there is a serious potential effect not only on adults but adolescents as well. There is research that suggests legalization of marijuana could influence the initial decision to use drugs. Even if marijuana is legalized for adult usages only, direct effects on adolescents because data indicate that easy household access to illicit substances is associated with great risk of marijuana use. It is impossible to have studies that examine the complete effects of legalization of marijuana because no countries have completely legalized the sale, possession, and advertizing of marijuana but examining alcohol and tobacco data suggests that marijuana would have a negative effect on youth (Joffe, Yancy, 2004).
Cocaine and crack are stimulants that act as serotonin reuptake inhibitors and as dopamine reuptake inhibitors. Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine was labeled the drug of the 1980s and ‘90s because of its extensive popularity and use during this period; However, cocaine is not a new drug, in fact, it is one of the oldest known addictive substances. The pure chemical, cocaine hydrochloride, has been an abused substance for more than 100 years. Coca leaves, the source of cocaine, have been ingested for thousands of years. Today, cocaine is a Schedule II drug, meaning that it has high potential for abuse but can be administered by a doctor for legitimate medical uses, such as local anesthesia for some eye, ear, and throat surgeries.
There are two chemical forms of cocaine: the hydrochloride salt and the “freebase.” The hydrochloride salt, or powdered form of cocaine, dissolves in water and when abused can be taken intravenously (by vein) or intranasally (in the nose). The term “freebase” refers to a compound that has not been neutralized by an acid to make the hydrochloride salt. The freebase form of cocaine is smokable.
Cocaine, because of its excitatory qualities, can often cause a person to display symptoms similar to those of the most intense mental disorders, including: antisocial or borderline personality disorder, paranoid personality disorder, or bipolar (with mania being periods on the drug, and depression being the withdrawal phases, both of which can last significant amounts of time in well established users).
Ecstasy is MDMA, or 3,4-Methylenedioxymethamphetamine. It is referred to by users as X, XTC, rolls, or simply E. It belongs to a family of drugs called “entactogens,” which literally means “touching within.” Other drugs in this category include MDA, MDE and MBDB. Before MDMA was made illegal in 1985, MDMA was used by psychiatrists as a therapeutic tool. Studies are currently underway in Spain and Israel assessing MDMA’s effectiveness in the treatment of Post Traumatic Stress Disorder (Doblin, 2002). MDMA is a “mood elevator” that produces a relaxed, euphoric state. It does not produce hallucinations. MDMA takes effect 20 to 40 minutes after taking a tablet, with little rushes of exhilaration which can be accompanied by nausea. 60 to 90 minutes after taking the drug, the user feels the peak effects. When “high” on the substance, the users sensations are enhanced and he/she experiences heightened feelings of empathy, emotional warmth, and self-acceptance.
The effects of ‘real’ ecstasy subside after about 3-5 hours. Users report that the experience is very pleasant and highly controllable. Even at the peak of the effect, people can usually deal with important matters. The effect that makes MDMA different from other drugs is empathy, the sensation of understanding and accepting others. MDMA releases the brain chemical serotonin, elevating mood and acting as a short-term antidepressant. Compulsive users may be unconsciously trying to self-medicate for depression. Effective treatments for depression are available with the proper diagnosis by a qualified physician.
Heroin, or diacetylmorphine (INN), also known as diamorphine (BAN), is a semi-synthetic opioid drug synthesized from morphine, a derivative of the opium poppy. It is the 3,6-diacetyl ester of morphine. The white crystalline form is the hydrochloride salt diacetylmorphine hydrochloride; this is often adulterated, thus dulling the sheen and consistency from that to a matte white powder, resulting in a smokeable or “freebase” form of heroin. 90% of Heroin is said to be produced in Afghanistan.
As with other opioids, heroin is used as both a painkiller and a recreational drug and has an extremely high potential for abuse. Frequent and regular administration is associated with tolerance, moderate physical dependence, and severe psychological dependence.
The German drug company Bayer named its new over the counter drug “Heroin” in 1895. The name was derived from the German word “heroisch” (heroic) due to its perceived “heroic” effects upon a user. The drug was chiefly developed as a morphine substitute for cough suppressants that did not have morphine’s addictive side-effects. At the time the drug went on the market, morphine was recreationally popular, and Bayer wanted to find a similar but non-addictive substitute of morphine to market to the general population. However, contrary to Bayer’s advertising as a “non-addictive morphine substitute,” heroin would soon have one of the highest rates of dependence amongst its users.
LSD (lysergic acid diethylamide), also referred to as acid or tabs, is one of the major drugs making up the hallucinogen class. LSD was discovered in 1938 and is one of the most potent mood-changing chemicals. It is manufactured from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains. LSD, commonly referred to as “acid,” is sold on the street in tablets, capsules, and, occasionally, liquid form. It is odorless, colorless, and has a slightly bitter taste and is usually taken by mouth. Often LSD is added to absorbent paper, such as blotter paper, and divided into small decorated squares, with each square representing one dose. The effects of LSD are unpredictable. They depend on the amount taken; the user’s personality, mood, and expectations; and the surroundings in which the drug is used. Usually, the user feels the first effects of the drug 30 to 90 minutes after taking it. The physical effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth, and tremors. The subjective effects usually revolve around auditory and visual hallucinations, though no sensory system is beyond the effects of the drug.
Users refer to their experience with LSD as a “trip” and to acute adverse reactions as a “bad trip.” These experiences are long, typically beginning to clear after about 12 hours. Some LSD users experience severe, terrifying thoughts and feelings, fear of losing control, fear of insanity and death, and despair while using LSD. Some fatal accidents have occurred during states of LSD intoxication. Most users of LSD voluntarily decrease or stop its use over time. Like many of the addictive drugs, LSD produces tolerance, so some users who take the drug repeatedly must take progressively higher doses to achieve the state of intoxication that they had previously achieved.
There have been reports of users experiencing a ‘relapse’ period in which hallucinations are re-experienced, long periods of time after the cessation of the drug. This, when clinically significant distress is involved, is referred to as Hallucinogen Persisting Perception Disorder. The drug itself, in addition to this “relapse” effect, can lead to users being diagnosed with types of schizophrenia; this diagnosis possibly stems from the lack of control, lack of understanding, and paranoia that accompanies unexpected hallucinations.
Psilocybin mushrooms (magic mushrooms) are fungi that contain the medicinal compounds psilocybin and psilocin. There are multiple colloquial terms for psilocybin mushrooms, the most common being magic mushrooms or shrooms. Biological genera containing psilocybin mushrooms include Agrocybe, Conocybe, Copelandia, Galerina, Gerronema, Gymnopilus, Hypholoma, Inocybe, Mycena, Panaeolus, Pluteus, Psilocybe and Weraroa. There are approximately 190 species of psilocybin mushrooms and most of them fall in the genus Psilocybe. In 1955, Valentina and R. Gordon Wasson became the first Westerners to actively participate in an indigenous mushroom ceremony. The Wassons did much to publicize their discovery, even publishing an article on their experiences in Life in 1957. In 1956, Roger Heim identified the hallucinogenic mushroom that the Wassons had brought back from Mexico as Psilocybe and in 1958, Albert Hofmann first identified psilocin and psilocybin as the active compounds in these mushrooms.
Psilocybin mushrooms are non-addictive although they do create short-term increases in tolerance of users. Poisonous (sometimes lethal) wild picked mushrooms can be easily mistaken for psilocybin mushrooms, but true psilocybin mushrooms are very non-toxic, and the National Institute for Occupational Safety and Health, a branch of the Center for Disease Control, rated psilocybin less toxic than aspirin. When psilocybin is ingested, it is broken down to produce psilocin, which is responsible for the hallucinogenic effects.
As with many psychedelic substances, the effects of psychedelic mushrooms are subjective and can vary quite a bit among individual users. The mind altering effects of psilocybin-containing mushrooms typically last anywhere from 3 to 8 hours depending on dosage, preparation method, and personal metabolism. However, the effects can seem to last much longer due to psilocybin’s ability to alter time perception.
Methamphetamine is a central nervous system stimulant drug that is similar in structure to amphetamine. Due to its high potential for abuse, methamphetamine is classified as a Schedule II drug and is available only through a prescription that cannot be refilled. Although methamphetamine can be prescribed by a doctor, its medical uses are limited, and the doses that are prescribed are much lower than those typically abused. Most of the methamphetamine abused in this country comes from foreign or domestic superlabs, although it can also be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment.
Methamphetamine is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol and is taken orally, intranasally (snorting the powder), by needle injection, or by smoking. Methamphetamine increases the release and blocks the reuptake of the brain chemical (or neurotransmitter) dopamine, leading to high levels of the chemical in the brain—a common mechanism of action for most drugs of abuse. Chronic methamphetamine abuse significantly changes how the brain functions. Noninvasive human brain imaging studies have shown alterations in the activity of the dopamine system that are associated with reduced motor skills and impaired verbal learning.
Ritalin, the trade name for methylphenidate, is a medication prescribed for children with an abnormally high level of activity or with attention-deficit hyperactivity disorder (ADHD) and is also occasionally prescribed for treating narcolepsy. It stimulates the central nervous system, with effects similar to but less potent than amphetamines and more potent than caffeine. Ritalin has a notably calming effect on hyperactive children and a “focusing” effect on those with ADHD. When taken as prescribed, Ritalin is a valuable medicine. Further, research funded by the National Institute of Mental Health has shown that people with ADHD do not get addicted to their stimulant medications at treatment dosages. Because of its stimulant properties, however, in recent years there have been reports of its abuse by people for whom it is not a medication. These prescription tablets can create powerful stimulant effects and serious health risks when crushed and then snorted like cocaine, or injected like heroin.
Alprazolam, also known under the trade names Xanax, Xanor, Alprax, and Niravam, is a highly potent short-acting drug of the benzodiazepine class. It is primarily used to treat moderate to severe anxiety disorders and panic attacks, and is used as an adjunctive treatment for anxiety associated with moderate depression. It is also available in an extended-release form, Xanax XR, both of which are now available in generic form. Alprazolam possesses anxiolytic, sedative, hypnotic, anticonvulsant and muscle relaxant properties. Alprazolam has a fast onset of symptom relief (within the first week). It is the most commonly misused benzodiazepine; however, the majority of prescribed users do not develop a substance use disorder. Tolerance to the therapeutic effects of alprazolam is controversial with one view being that alprazolam is ineffective with long term use and the other view being that tolerance to the therapeutic effects does not occur. A physical dependence commonly occurs as a result of alprazolam treatment, typified by a withdrawal and rebound symptoms necessitating a gradual reduction in dosage to minimise withdrawal effects when discontinuing. An extreme side effect of a drastic withdrawal can induce seizures.