Beyond the Gateway

Stimulants the fast track downhill

Cocaine is one of the most addictive drugs on the street and in many ways the most dangerous. It directly stimulates pleasure centers in the brain, creating an overwhelming desire for the same experience again and again. Its powerful jolt to the central nervous system also triggers a rapid heart rate, constricted blood vessels and elevated blood pressure. Even in young, well-conditioned bodies, these events can cause stroke, seizures or cardiac arrest.

When the drug wears off, cocaine users become anxious, irritable, depressed and desperate for the next dose. Bigger and more frequent doses are needed to produce the same effect and progression from first use to desperate addiction can be rapid.

All of cocaine"s routes of entry into the body pose unique hazards. Snorting cocaine up the nose can lead to destruction of the septum (the structure separating the two nasal passages) and eventual collapse of the bridge of the nose. Injecting cocaine into the veins can transmit dangerous microorganisms, including the viruses that cause hepatitis and AIDS, when needles or syringes are shared with other users. The cheapest form of cocaine, at five to 15 dollars per dose, is crack, which produces a response so sudden and powerful that addiction frequently begins with the first dose. Crack is a form of freebase cocaine, a purified version of the drug that can only be smoked. (When heated, it produces a crackling sound; hence its name.)

Amphetamines ("speed") and their derivatives, whether swallowed, smoked or injected, rev up the central nervous system and produce a sense of energy, excitement and invincibility. But with this come a number of serious risks and consequences. Excitement may deteriorate into excitability, irritability, paranoia, delusions and even violent behavior. When these drugs wear off, profound fatigue and depression are left in their wake. Tolerance results in a need for higher doses, and so addiction is not unusual. Chronic use leads to physical deterioration caused by malnutrition (from decreased interest in food) and loss of sleep. Heavy use can result in permanent brain damage, stroke or heart attack.

The potential for abuse of these drugs has recently increased for two reasons. First, the widespread use of Dexedrine and Ritalin in treating attention deficit/hyperactivity disorder (ADHD) has placed more of these stimulants in circulation, thus increasing the likelihood of potential misuse through sharing with or selling to others. (Those with ADHD who receive proper doses of these drugs appear to have little risk of addiction to them.)

Second, and more important, the abuse of a form of amphetamine known as methamphetamine (also called "ice," "crank," "crystal meth," and "poor-man"s coke," among other names) has reached epidemic levels. Methamphetamine is relatively cheap to manufacture in home laboratories, and an inexpensive dose gives users a more sustained high than cocaine. Teenagers and young adults use this drug to boost mood and self-confidence, suppress appetite to lose weight and enhance sexual experiences. But ongoing use commonly leads to insomnia, agitation, psychosis and violent behavior. Methamphetamine-induced emergency-room visits, crimes and deaths have increased dramatically, and some experts fear use of this drug will become a plague dwarfing the cocaine epidemic that began in the 1980s.

Sedatives and hypnotics escapes to the land of nod These agents in small doses produce a pleasant sense of relaxation and sleepiness. In some cases they may be misused to offset the sleepless excitation from stimulants taken earlier in the day. Prolonged use usually leads to psychological and physical dependence.

High doses of these medications, particularly when combined with other drugs (especially alcohol), can produce stuporous intoxication, depression of the drive to breathe, coma and death. Withdrawal can be hazardous, with symptoms including anxiety, tremors, panic and seizures.

A few decades ago, barbiturates were commonly prescribed by physicians as sedatives and sleeping pills. Because of problems with overdoses, abuse and withdrawal, few doctors recommend them, so they are more widely marketed on the street than in pharmacies. Two exceptions are phenobarbital, used to treat seizure disorders, and butalbital, which is combined with caffeine and aspirin in headache remedies such as Fiorinal and Esgic. Despite their relative safety, both of these forms are still potentially habit-forming. Benzodiazepines (Valium, Librium, Xanax, Tranxene, Klonopin and others) are widely prescribed to treat anxiety disorders. More sedating forms (Dalmane, Restoril and Halcion) are often used to induce sleep. These drugs are not commonly sold on the street, but legitimate prescriptions can be misused or overused and lead to dependence.

An extremely potent, fast-acting benzodiazepine called Rohypnol produces significant short-term memory loss. This drug, which is sold legally in Europe, has been implicated in numerous date rapes in the United States. Sexual predators slip Rohypnol tablets (called "roofies") into an unsuspecting victim"s drink; this leads to rapid onset of deep sleep and amnesia for whatever happens during the next few hours. Rohypnol has become the rapist"s best friend obliterating the victim"s ability to resist or remember who did what.

A newer drug of abuse, gamma-hydroxybutyrate or GHB, is unrelated to traditional prescription sedatives. Identified with a colorful variety of street names ("blue nitro," "cherry fx bombs," "nature"s Quaalude," and many others), this compound has been advertised in body-building magazines, health food stores and on the Internet as a muscle builder, weight loss aid, aphrodisiac and mood elevator. It has also been popular among those who frequent nightclubs and all-night "rave" parties. Unfortunately, GHB is highly dangerous. Variability in the product manufactured by homegrown labs, a wide range of individual sensitivity and a narrow margin for error in dosing can lead to disastrous consequences. The drug can rapidly bring on a severely altered mental state and seizurelike activity, progressing to coma or even death in some cases. Because of its powerful sedative effects, it has been used by some sexual predators as a "date-rape drug." Needless to say, manufacture and sale of GHB is now illegal in the United States.

Narcotics painkillers with a hook

Derivatives of opium, known as opiates, such as codeine, hydrocodone (Vicodin, Lortab and others), oxycodone (Percodan, Percocet and others) and morphine are used widely in medicine to relieve pain. But they can also create a general sense of well being and relief from psychological pain, leading to long-term use and dependence. Adults are more likely than teenagers to have problems with narcotic prescriptions for chronic problems such as headache or back pain.

Adolescents involved in high-risk drug behavior may be drawn into the snare of heroin, a derivative of morphine that is injected into the vein to produce an intense euphoria. Repeated use always leads to addiction, as well as to the perpetual risk for accidental overdose and transmission of hepatitis and AIDS viruses from contaminated needles and syringes.

Narcotic addicts deprived of their drug experience a host of unpleasant symptoms they will desperately seek to avoid. These include sweats, cramps, vomiting and diarrhea. As miserable as narcotic withdrawal may feel, it is far less dangerous than abruptly stopping a long-term barbiturate or benzodiazepine habit, which can lead to convulsions.

Hallucinogenic drugs checking out of reality

LSD (lysergic acid diethylamide), which seemed to be a faded relic of the psychedelic 60s, has made a disturbing comeback. Tiny amounts swallowed or licked off paper can produce intense hallucinations, which may be exhilarating or terrifying. The worst of the "bad trips" can bring on profound anxiety, confusion, panic or self destructive behavior, such as jumping off a building or stepping in front of oncoming traffic. Mescaline, peyote and other hallucinogens have similar effects and risks. Long term use can damage the brain, resulting in defects in memory and abstract thinking.

Phencyclidine (PCP, "angel dust"), originally formulated as an animal tranquilizer, is an extraordinarily dangerous hallucinogen. It can induce profound alterations of all sensory perceptions (sight, sound, touch, smell and taste), essentially jerking its users far from normal consciousness. But this dissociation from reality can also provoke marked anxiety, depression, paranoia and acts of horrific violence against oneself or others. An agitated PCP user may demonstrate incredible strength and no apparent sensation of pain, making him extremely dangerous to those who might try to restrain him.

Physical consequences of large doses of PCP can be severe heart failure, seizures, coma and lethal strokes. Users also risk direct brain damage, leading to alterations of speech, loss of memory and intellectual function, and in some cases, psychosis. PCP can be swallowed or smoked (if sprayed onto tobacco or marijuana). It can also be injected, at times with tragic results.

Designer drugs the worst of all worlds

The incredibly misguided creativity of those who seek new and different drug experiences has led to the synthesis of a variety of powerful, addictive and extremely hazardous substances. Most of these are spin-offs of other drugs such as PCP, amphetamines or meperidine (Demerol, a potent painkiller). Those who experiment with ecstasy (the most well-known designer drug) and the other designer drugs literally play Russian roulette with their brains every time they swallow, snort or inject. These drugs come aboard with the dangerous baggage of their parent compounds and then add unpredictable side effects. Irreversible brain damage, with long-term disabilities such as tremors, paralysis and speech disturbances can be the pathetic legacy of a season of thrill seeking with designer drugs.

Background Information

Questions and Answers

Stories

If you've been through a experience related to this topic, we invite you to share your story with others.
Share Your Story

Other Things to Consider

RelationshipsBlended Families, Parents and Adult Children

TransitionsPreparing for Adolescence, Empty Nest