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Drugs
of Abuse
This
web page contains the following eight sections:
From the book
How to Quit Drugs for Good:
(For more on book, click here)
Drugs
of Abuse
"The
universal human need for liberation from...mundane existence is satisfied
by experiencing altered states of consciousness. ...Some follow the paths
of prayer or meditation in their quest for spiritual insight, while others
are transported to the higher planes by way of ecstasies induced by art,
music, sexual passion or intoxicating substances."
-Richard Rudgley
"Everything
is a dangerous drug except reality, which is unendurable."
-Cyril Connolly
In
our society we have available to us a wide array of substances. From the
corner drugstore to the dealer in the streets, we can find almost
anything. But what makes some substances more attractive than others? Why
do some become “drugs of abuse?”
Every
substance with psychoactive traits has the potential to become a drug of
abuse. A psychoactive substance, when we take it, changes our
consciousness. That is, it changes the way things appear to us or the way
we feel.
Of
course, this result can hold a powerful attraction for us. How completely
compelling! If the world seems dull, we merely need to take some magic
potion to make things come alive again. Simple. Easy.
Perhaps
too easy.
Perhaps
too compelling. We humans can become addicted to substances such as these.
We can find ourselves loving the magic so much that we keep coming back
for more.
Which
many of us do. In our lifetimes nearly every one of us will try at least
one psychoactive substance. Most of us will stick to drugs that are legal.
For example, the mild stimulant caffeine, found in coffee, tea, chocolate,
and soft drinks, has become one of the most widely used psychoactive
substances in the world.
But in
our lifetimes, about 35% of us in the United States will try at least one
illicit drug—marijuana, cocaine, heroin, PCP, methamphetamine, an
inhalant, a hallucinogen, or the non-medical use of a psychotherapeutic
(e.g., stimulant, sedative, tranquilizer, or analgesic). About 11% of us
report that we have used at least one of these illicit drugs during the
past year, and 6.1%, or more than 13 million, are “current users.”
Top
Marijuana
comes from the hemp plant, Cannabis sativa. This plant contains hundreds
of chemicals, including more than 60 cannabinoids. The most potent of the
cannabinoids is delta-9-tetrahydrocannabinol, or THC.
Except
for the cannabinoids, marijuana smoke and tobacco smoke are remarkably
similar. Both contain the toxic compounds tar, carbon monoxide, and
cyanide in comparable levels. Both also contain benzopyrine, a known
cancer-causing chemical. This chemical appears in greater concentrations
in marijuana smoke than in tobacco smoke, although marijuana smoke
contains none of the nitrosamines found in tobacco.
Options
Marijuana.
This product is made of the dried clippings from the hemp plant that may
include any combination of leaves, stems, seeds, and buds. It can vary
greatly in potency, depending on the type of plant, the climate in which
it was grown, and the specific mix of clippings in a given batch. The
typical THC concentrations in marijuana are 2% to 5%. This runs somewhat
higher than the THC content in the marijuana of the 1960s, which averaged
between 0.5% and 3%. More potent forms, such as sinsemilla, can contain 7%
THC. Marijuana is also known as (AKA): Cannibis, Pot, Grass, Reefer, Ace,
Sinse, Ganja, Weed, Giggle Weed, Tea, Bhang, Doobie, M.J., Mary Jane,
Columbian, Acapulco Gold, Mexican, Maui Wowie, Panama Red, Thai Sticks,
Indian.
Hashish.
People make hashish by separating the resin of a cannabis plant from the
plant material. This product averages 5% to 12% THC concentration, and
some varieties run as high as 20%. AKA: Hash, Tar.
Hash
oil. This oil is produced by extracting the cannabinoids from the pot
plant through the use of a solvent such as alcohol. The thick, waxy
liquid—which varies in color depending on the solvent used—contains
anywhere from 15% to 70% THC. AKA: Honey Oil, Weed Oil.
Synthetic
THC. Scientists have developed dronabinol, a product containing synthetic
THC, for use with cancer patients in controlling nausea or vomiting caused
by chemotherapy agents and to stimulate the appetites of AIDS patients.
Trade name: Marinol.
Combinations.
Some users will smoke marijuana in combinations with hash or hash oil,
with tobacco, or with numerous other drugs. Other drugs (along with street
names for the combination) include: phencyclidine (Angel Dust, Angel Poke,
Supergrass, Killer Weed), opium (O.J.), heroin (Atom Bomb, A-Bomb), and
cocaine or crack (Juice Joint, Lace, Fry Daddy, Cocoa Puff).
How It’s Used
Most
people get their THC buzz by smoking, that is, by setting flame to their
marijuana, hash, or hash oil and inhaling. However, some people will take
time to cook one of these three substances into brownies, cakes, or
pudding and then eat the results. The user who smokes will experience a
high within two to 10 minutes, while the high from eating may take as long
as 90 minutes. Synthetic THC (dronabinol) comes in tablets.
Popularity
Somewhere
between 30% and 34% of Americans have tried marijuana. About 8.6% have
used it within the past year, and 4.7% have used it within the past month.
That’s the equivalent of about 10.1 million people using pot within the
past month. Of these current users, 1.6 million were aged 12 to 17, and
3.7 million were aged 18 to 25.
The Joy of It
There
are probably as many different experiences on pot as there are people who
have used it, but the high has two distinguishing features: intellectual
and emotional. Most people experience one or the other type of high, and
some people experience a little of both.
The
intellectual type of high can be described as a heightening of awareness.
The perceptions from all five senses become more vivid. Everything we see,
hear, smell, taste, and touch takes on a greater intensity or somehow
seems more meaningful. We become certain that our thoughts are more
profound. Our mind appears to make more connections than usual, some of
which seem downright funny. We often feel as though we’re gaining a
greater insight into reality.
The
emotional high affects our feelings. Everything we feel becomes
exaggerated or all-encompassing. The world becomes a ball of fluff.
Pleasures become ecstasies, joys become wonders, smiles become laughs. We
like being in the company of others. Talking with others becomes
interesting, even mesmerizing. Our moods deserve exploring. People who
experience the emotional high enjoy doing things, much more so than those
who experience the intellectual high. Perhaps that’s because physical
activity generates more emotion.
However,
the more potent the weed, the more likely that the user will experience
some mind-warping effects, such as delusions, hallucinations, or
cartoon-like visions. These imaginary sequences come more easily with the
eyes closed but, at higher concentrations of THC, can occur with the eyes
open. Sometimes, when the images soar, the body feels as if it weighs a
ton. At these times, the body can demonstrate a perfect reluctance to make
any movement whatsoever. Perhaps this is the original meaning of the term
“stoned.”
The Problems It Causes
Panic.
Many users experience panic attacks. These usually occur in public places
where we can be seen by others. Often the panic has a hint of paranoia.
For example, users might fear that other people are out to get them, that
somehow their behavior will betray to others that they’re high, or that
the police are coming to bust them for possession. After a moderate period
of heavy use (about a year or so) or a longer period of moderate use, the
panic response can generalize. In other words, it begins to happen even
when the user is not high, and this can continue for years after the user
has gotten completely straight.
Anxiety.
Many users also experience anxiety. This is similar to the panic attacks,
except that it has no object. We can feel jittery, nervous, and tense, and
we’re not sure why. It appears as a gnawing feeling in the pit of the
stomach or a shaky uncertainty within the brain. This anxiety generalizes
as well and can continue for years after a user gets straight.
Interestingly,
people who get the intellectual kick usually feel more anxious when they
use, whereas those who experience the emotional high usually feel less
anxious when using.
Learning
and memory impairment. Animal studies show that THC causes significant
deficits in the brain’s ability to store new memories so that learning
becomes impaired. This probably happens in humans as well, especially
heavy users. Because you wouldn’t be able to remember details very well,
trying to study while high on pot wouldn’t be recommended.
Disruption
of logical thought. Trying to do math while high on pot also wouldn’t be
recommended. Many studies show that pot disrupts our ability to think
logically, in other words, to perceive what follows what in sequential
events or number patterns. Events run together, and causes and effects
become blurred. This problem also generalizes. In the long term, moderate
to heavy users lose some of their capability for logic, even when not
toking up. This problem can last for years after getting straight,
although it typically shows considerable improvement after the first few
months.
Psychosis.
A small but significant percentage of chronic heavy users will become
psychotic. For them, logical thought almost completely disappears.
Delusions and hallucinations replace reality. The most typical psychosis
for this group is paranoid schizophrenia. In other words, they have
persistent notions that people are out to do them some kind of harm but
they commonly get all mixed up as to who exactly is out to get them, for
what reason, and what it is these people will do.
At the
local mental health clinic, I counsel many clients who have been
“dual-diagnosed” (i.e., with both a psychosis and an addiction). About
15% of the chronic clients—those who remain mentally ill even after
breaking their drug and alcohol addictions—remember their pot use as
playing a key role in the onset of the mental illness. They believe that
pot use triggered their original break from reality. A few of the acute
clients—those in short-term care—have been dual-diagnosed with a
psychosis and just one addiction: cannabis dependence. Once these clients
quit using pot, their delusions and mental confusions begin to disappear.
Often within a month their logical thought improves noticeably, and within
a year their overall functioning approaches “normal.”
Reduced
motivation. Some studies link pot smoking to reduced motivation, or
amotivational syndrome. Users
experiencing amotivation will procrastinate, forget, or simply choose not
to do certain things. They begin to shirk some of life’s key
responsibilities. They might do poorly in school or find it difficult to
hold a job.
Lung
problems. Pot smoking definitely damages the lungs. The lungs of long-term
heavy users show decreased airflow compared to the lungs of nonusers. In
addition, long-term heavy pot smoking leads to chronic bronchitis and most
likely causes lung cancer.
Harm
from accidents. Marijuana impairs the user’s driving ability and affects
actual performance behind the wheel. Each year, thousands of accidents are
reported in which the driver at fault was high on marijuana. In some of
these accidents, people were killed.
Withdrawal
When
coming off pot, you can expect to become irritable, restless, or tense,
and when feeling this way you’ll crave marijuana. This anxiety response
will be mild, moderate, or heavy, depending on whether your habit was
mild, moderate, or heavy. It will continue at least for weeks, usually for
a few months, or perhaps even longer than a year. As part of the anxiety
response, you might also experience insomnia, vivid dreams, or both.
In
early recovery, you might experience sweating, mild nausea, or lack of
appetite. This can last a few days or as long as a week.
THC
remains in the fatty deposits in the body. Because of this, THC and its
metabolites can be detected in the body as long as 3 weeks after smoking
just one joint and can remain in the body for months after a period of
heavy use.
Top
Cocaine
comes from the coca plant, Erythroxylon coca. Its green leaves contain the
nutrients thiamine, riboflavin, and vitamin C and the psychoactive
alkaloid cocaine.
For
centuries, the indigenous people of the Andes Mountains have eaten coca
leaves. They mix the leaves with an alkali (lime) that helps release the
cocaine from the roughage. About 90% of the Indians indulge—some of them
all day long—but the total amount of stimulant they ingest compares to
the amount of stimulant Americans get from drinking coffee. The Indian who
chews two ounces of leaves gets about 0.7 grains of cocaine per day. A
typical cocaine abuser might take six to eight grains per day, or about 10
times what the Indian ingests.
Options
Cocaine.
People make cocaine (known technically as cocaine hydrochloride) through a
lengthy process using various chemicals and solvents. Starting with coca
leaves and sulfuric acid, producers draw off the liquid and then add more
acid, along with lime, water, gasoline, potassium permanganate, and
ammonia. This creates a paste that is further refined by using kerosene,
methyl alcohol, and more sulfuric acid. The result is the white
crystalline powder that has a bitter, numbing effect when tasted. AKA:
Coke, Snow, Snow White, Charlie, Toot, Nose Candy, C, C-Dust, Girl, Lady,
Lady-Caine.
Crack.
Crack is a form of “freebase” but is safer to produce than the
original freebase, which required the chemical ether. Crack is made by
boiling powdered cocaine with sodium bicarbonate. This “frees” the
cocaine “base” from the cocaine hydrochloride. The base separates from
solution as chunks of crack. AKA: Rock, Hard Rock, Pebbles, Stones,
Gravel, Baby T, Cookies, Fries, Fifty-One, One-Fifty-One, Pony, White
Ghost, Sleet.
Combinations.
Some users will inject a combination of cocaine and heroin (AKA:
Speedball, Dynamite, Murder One, Whizz-Bang). Some users will smoke crack
with other smokable substances, such as tobacco (AKA: Coolie), marijuana
or hashish (see previous section), PCP (AKA: Space Dust), opium, or
amphetamines.
How
It’s Used
Most
people go for the coke high by snorting, that is, by inhaling cocaine
hydrochloride into the nose. Some users dissolve this substance in water
and inject it. Others smoke crack.
The
high from snorting begins within three to five minutes, peaks at 20 to 30
minutes, and lasts 40 to 50 minutes overall. For those who shoot, the
“rush” hits within a few seconds and peaks within two to three
minutes. Smoking delivers great quantities of cocaine—from lungs to
blood to brain—within seconds, providing a rush that is similar to
shooting up. Those with a needle habit might shoot up every 10 to 20
minutes for hours on end, and dedicated “crack stars” might toke up
every five to 10 minutes for hours. Users refer to their continued,
repetitive use over long periods of time as “missions” or “runs.”
Popularity
Between
9% and 11% of Americans have tried cocaine. About 1.9% have used it within
the past year, and 0.8% have used it within the past month. That’s
almost 1.8 million people who are current users.
When
asked specifically about crack, about 2.2% of Americans say they’ve
tried it. About 0.6% have used it within the past year, and 0.3% have used
it within the past month. That’s equivalent to about 668,000 current
users.
The
Joy of It
Cocaine
acts as a stimulant. It exhilarates. It brings on feelings of intense
pleasure and euphoria. It wakes us up.
When
high, we feel full of energy and confidence. Often we become more
talkative, more physically active, or both. Cocaine depresses our appetite
while heightening our sense of potency. We might feel more potent
sexually, physically, or mentally.
When
injecting cocaine, different people get different effects. Some might feel
nauseous or experience upset stomach. Others might experience physical or
even mental distress. Yet, almost universally, any unpleasant side effects
will give way to an overpowering high or “rush.” Users variously
describe this rush as “sheer pleasure,” “a total body
orgasm,” or “body electrification.” Crack smokers report the same
kind of riveting sensations from the rush. However, on a single run each
successive shot or toke becomes less electrifying. Nevertheless, the user
remembers that initial blast and keeps trying to replicate it. This is
called “chasing the high.”
In his
1967 book Pimp: The Story of My Life, “Iceberg Slim” described the
rush from cocaine injection as follows:
“I
shivered when it daggered in.... I saw the blood-streaked liquid draining
into me. It was like a ton of nitro exploded inside me. My ticker went
berserk. I could feel clawing up my throat. It was like I had a million
‘swipes’ in every pore from head to toe. It was like they were all
popping off together in a nerve-shredding climax.
“I
was quivering like a joker in the hot seat at the first jolt. I tried to
open my talc-dry mouth. I couldn’t. I was paralyzed. I could feel a hot
ball of puke racing up from my careening guts. I saw the green, stinking
puke rope arch into the black mouth of the waste basket....
“I
felt like the top of my skull had been crushed in. It was like I had been
blown apart and all that was left were my eyes. Then tiny prickly feet of
ecstasy started dancing through me. I heard melodious bells tolling softly
inside my skull.
“I
looked down at my hands and thighs. A thrill shot through me. Surely they
were the most beautiful in the Universe. I felt a superman’s surge of
power.”
The
Problems It Causes
Heart
problems. Cocaine increases the blood pressure and heart rate in every
user. In many users, it causes irregular heartbeat (arrhythmia).
Lung
problems. Cocaine dilates the bronchioles (the breathing tubes in the
lungs). In fact, this action can offer temporary relief of asthma
symptoms. However, symptoms of asthma increase when coming off cocaine,
even among people who don’t have asthma. In other words, the bronchioles
become more restricted than usual, and breathing becomes strained.
If you
smoke crack, your lungs take an extra hard hit because of the direct
effects of the smoke. Some symptoms include constant hacking cough,
bronchitis, coughing up blood (hemoptysis), and excessive fluid in the
lungs (pulmonary edema). Also, recent studies have linked crack smoking
with lung cancer.
Nose
and throat problems. If you snort coke, your chances of getting nose and
throat problems increase significantly. Symptoms include inflammation of
the lining of the nose (rhinitis), nasal bleeding, thinning of the lining
of the nasal passages (nasal mucosa atrophy), inflammation of the sinuses
(sinusitis), hoarseness, and difficulty swallowing.
Danger
of infection. If you shoot up coke, you run the risk of various
infections. These include infections on the skin (abscesses) or infections
under the skin (cellulitis) at injection sites, infection of the liver
(hepatitis B), infection of the heart valves (bacterial endocarditis),
AIDS, and the spread of infection throughout the body (sepsis).
Gastrointestinal
problems. Cocaine raises the blood sugar by causing the liver to convert
glycogen into glucose. Over a long period of time, this can lead to
malfunction of the liver or pancreas. The pancreas produces insulin to
regulate blood sugar. In every user, cocaine depresses the appetite, which
over time can lead to weight loss. Coke also depletes the body’s store
of vitamins, causing various vitamin deficiencies. On using, it often
causes dry mouth and in some users causes vomiting or diarrhea.
Sexual
dysfunction. When injected or smoked, cocaine can produce a spontaneous
ejaculation. However, having sex while high is generally more difficult.
Men find it hard to maintain an erection. Women typically cannot reach
orgasm.
Anxiety.
Prolonged use of coke can lead to anxiety. Those who are affected become
nervous, fidgety, and tense. Also this can generalize. We can experience
the symptoms of anxiety long after we stop using.
Depression.
Every time we come off cocaine, we get depressed. The longer the run and
the more we used on the run, the deeper our depression becomes. It also
generalizes. We can experience depression for months, even years, after
breaking a long-term cocaine addiction. As part of our depression, we
often find that nothing feels pleasurable anymore. That’s why, during a
bout of depression, our coke cravings are highest. We can remember how
much pleasure we felt when using. But in recovery, we gradually experience
greater and greater pleasure in our lives as our brain chemistry slowly
returns to normal.
Mental
illness. Cocaine can precipitate a mental illness or can cause us to
appear mentally ill for a period of time. Coke commonly fills us with
paranoia. We might begin thinking that someone’s at the door or at the
window. We think we hear them. We might start looking out the curtains
every few seconds. Some of us experience paranoid fears after just two
hits of crack or two shots of coke. But the longer the run, the more
likely we are to get paranoid fears, and the worse the fears become. They
usually go away within a few days after we stop using. However, a small
percentage of long-term heavy users fall into a paranoid psychosis that
remains for life. Aside from delusions (such as the idea that “people
are out to get me”), users can also hallucinate. These can be visual
(seeing things that aren’t there), auditory (hearing things), or tactile
(feeling things). One type of tactile hallucination induced by cocaine is
sometimes called “coke bugs,” the feeling that bugs are crawling on
your skin.
Seizure
and stroke. Research proves that cocaine use causes seizures in some
people and strokes in others. Although grievous, these side effects are
rare, occurring in a small percentage of people.
Danger
of overdose. In significantly high doses, cocaine can kill in one of two
ways: by causing heart attack or by causing respiratory failure. What’s
a significantly high dose? Some experts figure the fatal dose of cocaine
to be about one gram. This might be enough to take the life of a newcomer,
but there are reports of heavy users having survived more than 20 grams.
Occasionally,
a famous person dies of cocaine overdose, someone such as Len Bias, who
makes the front page and becomes the lead story on the television news.
Yet for every well-publicized cocaine death, there are hundreds more about
which we never hear. It does happen, but, compared to overdose deaths from
other substances such as heroin, death from cocaine overdose is relatively
rare.
Withdrawal
When
coming off coke, you can expect to be tired, depressed, and hungry. You
might also have little patience, become easily irritated, or have a
negative outlook on life.
You’ll
almost certainly feel intense cravings for more substance. The longer and
heavier your use, the longer it’ll take these cravings to go away. In
recovery, cravings can remain intense for months. Gradually, the intensity
and frequency of cravings decrease, but even years later a craving might
occasionally pop up.
Top
People
have used hallucinogens for millennia. For one thing, they’re
everywhere. Mind-bending biochemicals can be found in thousands of plant
species all over the world and even in some animals. For another thing,
they bring on a powerful “consciousness expanding” experience. People
using them see the world in a different way. Reality becomes more multivariate
or more profound than what we imagined. Throughout human history, people
of different cultures have adopted various, locally available
hallucinogens for healing or spiritual purposes.
In
addition to the naturally occurring hallucinogens, you can now find many
chemically developed synthetics. As you’ll soon see, there’s a
veritable alphabet soup of these new “designer hallucinogens.”
Options
Lysergic
acid diethylamide (LSD). This product is synthesized from chemical
derivatives of a fungus, ergot, that grows on rye and other grains. Usual
doses on the street vary from 100 to 700 micrograms (one microgram is a
millionth of a gram). One ounce of LSD provides about 300,000 doses. AKA:
Acid, Blotter Acid, Big D, Microdot, Yellow Sunshine, Trips, Purple Haze,
Window Pane.
Psilocybin.
This is the psychoactive ingredient of various species of mushrooms
commonly found in Central America and in the warmer climates of the United
States. Anywhere from four to 12 mushrooms equal one trip. The
hallucinogenic alkaloid 4-hydroxydimethyltryptamine (psilocybin) can also
be synthesized in a lab. AKA: Magic Mushrooms, Sacred Mushrooms, Shrooms,
Silly Putty.
Mescaline.
This psychoactive substance occurs naturally in the cactus peyote. People
most commonly use the tops of the plant, known as the “buttons.”
Laboratory enthusiasts have been able to extract the hallucinogenic
alkaloid from the peyote cactus and sell it in capsule form. AKA: Mesc,
Mescal, Big Chief, Buttons, Moon, P, Peyote.
Morning
glory seeds. The seeds of three species of morning glory (trade names:
Heavenly Blues, Flying Saucers, Pearly Gates) contain amides of lysergic
acid that produce a high similar to that of LSD. It takes about 300 seeds
to produce effects similar to 200 to 300 micrograms of LSD.
DMT,
5-MeO-DMT, DET, AET. Dimethyltryptamine (DMT) can be found in a variety of
plants worldwide. Many South American tribes make it into a snuff called
yopa or cohoba. DMT has also been synthesized and is most often available
in the United States as a pure compound (AKA: Businessman’s Special or
Businessman’s High, both terms deriving from the relative short duration
of the trip, about 45 minutes, which could easily fit a businessman’s
scheduled lunch hour). A similar compound, 5-methoxy-dimethyltryptamine
(5-MeO-DMT), is found in the skin of some toads and in the seeds of
various trees. It has been used for centuries by indigenous peoples and
recently found its way onto the streets. Some analogs (compounds with
similar chemical structure) have similar hallucinogenic properties. These
include diethyltryptamine (DET) and alpha-ethyltryptamine (AET).
Amphetamine-based
hallucinogens. Producers with a little chemical savvy have synthesized
many variations of mescaline and amphetamine compounds. The first of these
to hit the streets in force was DOM (4-methyl-2, 5-dimethoxyamphetamine).
This became known in the 1970s as STP (“Scientifically Treated
Petroleum”), after a brand name of motor oil additive, but the initials
quickly came to stand for the words “Serenity, Tranquility, and Peace”
or “Street Trucking People.” Other combinations include MDA
(methylenedioxyamphetamine), DOB (4-bromo-2, 5-dimethoxyamphetamine), DMA
(dimethoxyamphetamine), TMA (trimethoxyamphetamine), MDMA
(methylenedioxymethamphetamine), and MDEA
(methylenedioxyethylamphetamine). AKA for MDMA: Ecstasy, X, XTC, Love
Drug, M & M, Adam. AKA for MDEA: Eve.
Belladonna
alkaloids. A large group of “organic” hallucinogens derive from a
family of plants (Solanaceae) that contains about 3,000 members. These
include species of mandrake, henbane, and belladonna. Some of the
belladonna alkaloids, such as atropine, act as poisons and are lethal in
high doses; other alkaloids, such as scopolamine, act as hallucinogens.
The most common plant on the U.S. scene is Datura stramonium, known
variously as jimsonweed, stinkweed, thorn apple, and devil’s apple.
Combinations.
Some users will smoke marijuana with hallucinogens to calm themselves or
to boost the hallucinogenic effect. Some will use sedatives to slow things
down or to calm an otherwise rocky trip. A few users will combine
hallucinogens with stimulants such as cocaine, crack, or amphetamines. AKA
for combining LSD and crack: Sheet Rocking.
How
They’re Used
Most
commonly, people take hallucinogens orally. LSD is swallowed in tablets,
tiny squares of gelatin (called “window pane”), or premeasured drops
on blotter paper. Users trip on psilocybin by eating the mushrooms and on
mescaline by eating the dried cactus buttons or by taking either of these
chemicals in tablet or capsule form. Some users take mescaline by first
soaking the buttons in water and then drinking the liquid. Morning glory
trippers usually grind the seeds into a flour and swallow them with water
or soak the flour in water for a period of time and then drink it. The
leaves and seeds of jimsonweed and other plants bearing belladonna
alkaloids can be eaten directly. Some users make a tea from these plants
and drink that. The high from this group of substances lasts from six to
12 hours, with LSD and mescaline falling on the high end (10 to 12 hours)
and morning glory seeds on the low end (six to eight hours).
The
tryptamines (DMT, DET, AET, and 5-MeO-DMT) are most often sniffed or
smoked. When taken orally, these compounds metabolize too fast to produce
a psychoactive effect—except for 5-MeO-DMT, which can be milked from the
glands of the toads and ingested. The trip duration for all these is
brief: a half hour to an hour and a half.
Users
commonly take the mescaline-like amphetamines orally, in tablet form,
although sometimes they’re snorted. The high from this group of drugs
typically lasts six to eight hours.
Popularity
About
9.7% of Americans have tried hallucinogens. About 1.7% have used one of
the hallucinogens within the past year, and 0.6% have used one within the
past month. That’s more than 1,300,000 people who have used
hallucinogens within the past month. Of these current users, 454,000 were
aged 12 to 17, and 627,000 were aged 18 to 25.
The
Joy of It
The
experiences that people get from hallucinogens vary more than what people
get from any other class of drugs. Even one person using the same
hallucinogen can have vastly different experiences with each use.
The
types of experiences that a given person will have depends on set and
setting. Set refers to the person—to what the person expects to get out
of the trip. It also refers to the person’s mood at the outset—to his
or her previous experiences while tripping—and to personality; for
example, whether the person is introverted or extroverted, intellectual or
emotional, was subjected to childhood trauma or had a carefree childhood.
Setting refers to the external details—whom the person is with, where
the person is, and what’s going on in the immediate environment.
Tripping in a crowded bar with friends has an entirely different feel to
it than tripping quietly alone in one’s room.
The
fun derived from hallucinogens comes primarily from the profound changes
that it causes in our perceptions and moods. However, because each trip is
so unpredictable, some users get top jollies simply by hopping a wild ride
into the realm of the unexpected.
The
effects from different hallucinogens vary. All produce vast changes in
perception or mood. However, some are more perception or mind oriented,
such as LSD, psilocybin, mescaline, morning glory seeds, and the
tryptamine group; others are more mood or body oriented, such as the
amphetamine-based hallucinogens (MDMA became known as Ecstasy or the Love
Drug for good reason) and the belladonna alkaloids.
All
hallucinogens distort our perception of time. Time appears to slow down. A
moment can become an eternity. And all hallucinogens distort our
perception of space. Boundaries appear to dissolve. Edges become fuzzy.
When we’re observing a tree against a background of sky, the tree
becomes sky, and the sky blends into the tree. The two can even fuse
together as one. Sometimes everything around us can appear to be pulsating
or vibrating, one thing turning into another. The small becomes large, the
large small. Shapes can magically change. Sounds can undulate so deep
within us that we experience them in the belly. We can hug the earth and
actually feel it rumbling.
In
addition, hallucinogens have the power to dissolve the ego. The boundary
between self and others disappears. The boundary between self and world
disappears. Sometimes we can have an out-of-body experience (OOB). We
might feel as if we left our body and that we’re somewhere else in the
room watching what we’re doing. Some of us even imagine that we’re
traveling astrally during an OOB and going elsewhere in the universe. And
sometimes, we imagine that we’ve actually met with God or Buddha or
Jesus or some other key spiritual figure.
Indeed,
tearing down the walls of the ego often becomes a spiritual experience. It
can leave us feeling more connected with “the whole”—with God, with
others, or with the world around us. It feels as if we’re opening
ourselves to something greater, something more than what’s inside. This
occurs in a common hallucination. When tripping, many imagine themselves
as a bud on a lush, leafy stem that opens into a brilliant flower.
Hallucinogens,
like marijuana, bring on two types of high: intellectual (head trip) or
emotional (body trip). Which type you get depends on set and setting and
the particular hallucinogen you use.
On a
head trip, we experience heightened awareness. Everything about the world
becomes more vivid, more ecstatic. The senses become paramount. The world
becomes extravagant. We can see, hear, taste, touch, and smell in more
wondrous detail than we’ve ever known.
On a
body trip, we experience a deeper sense of connection with ourselves or
others. We feel love. We might imagine that we become love. We begin to
understand others or ourselves as we never have before. We might
experience our feelings as all-encompassing. We feel whole, complete. We
might enjoy sex as a beautiful spiritual union.
The
Problems It Causes
Physical.
For LSD, psilocybin, mescaline, and morning glory seeds, the problems from
physical side effects include some nausea; increased body temperature,
heart rate, and blood pressure; some muscle weakness or tremor; and
occasionally diarrhea. The tryptamines lead to similar problems but in
addition cause greater muscle weakness, sometimes to the point of
temporary paralysis. The amphetamine-based hallucinogens and the
belladonna alkaloids bring about the greatest physical dangers. They cause
severe changes in heart rate, breathing, and body temperature. In
addition, the amphetamine group causes amphetamine-like hyperactivity, and
at least one of this group, MDMA, often causes users to clench their
teeth.
Brain
damage. Studies show that MDMA causes irreversible damage to nerve cell
endings, which contain serotonin in their storage vesicles. Other
amphetamine-based hallucinogens may cause this serious problem as well.
Currently, more research is needed to know for sure.
Bad
trips. A trip can be deep, frightening, dark or light, euphoric, and airy.
It can even change from one to the other quickly. Nonetheless, some users
accept bad trips, believing them to be enlightening. Even venturing into
dark spaces can bring insight.
However,
other users find bad trips a reason to quit using hallucinogens. A trip
might have caused fears that are too intense to bear. Of course, tripping
does bring unconscious memories into full awareness, and because of this a
trip can produce deep psychic pain. It can bring forth memories of
childhood trauma in all-too-vivid detail.
Indeed,
any feelings can explode into difficulties. A feeling of sadness can bring
us to our knees in tears, something disgusting can become outrageously
gross, and a simple fear can transform itself into our worst nightmare.
A trip
can also induce panic attacks. Another person, an object, or the whole
world can take on such a frightening, eerie air that it can scare us half
to death. We might imagine ourselves being killed in some frightening way,
such as being buried alive. When in a crowd, we might imagine that each
person is a poisonous snake attempting to strike at us. We might imagine a
shadow on the wall to be a roaring locomotive heading straight at us.
Loss
of ego. Although ego dissolution can be enlightening to some, it can be
psychologically damaging to others. The ego is a protective device. It
helps define who we are. When it is dissolved, we become vulnerable. We
can feel completely lost. Our sense of direction in life—our ability to
pursue goals—can be shattered; this happens to a significant percentage
of users. Although the ego will never be the same, it will heal reasonably
well after a few months to a year or so of abstinence.
Flashbacks.
Also called post-hallucinogenic perceptual disorder (PHPD), flashbacks
refer to the recurrence of a hallucinogenic experience at a time when
you’re not taking the drug. It can be one of two things: a memory of
something that happened while you were tripping or a brief period during
which you perceive things as if you were tripping. Flashbacks last
anywhere from a few seconds to 10 minutes or more. They’re unpredictable
and can be an annoying inconvenience because, when they occur, they’re
so completely distracting.
A
memory flashback is usually triggered by a person, an object, or an event
that reminds you of something that occurred while tripping. This trigger
can bring forth an entire memory sequence, complete with the vivid detail,
hallucinations, or feelings that you experienced in the original scene.
A
perceptual flashback might have you experiencing altered visual images,
the blending of images and sounds, a pulsating visual field, fuzzy images,
a tingling sensation on the skin, or tracers (trails of light). Perceptual
flashbacks can occur because the brain has actually been changed by the
hallucinogenic drug. Research on people who had recently used LSD showed
that their visual systems continued to respond to stimuli after the
stimuli had been removed. The change was slight but measurable. This
suggests that LSD might alter the brain’s perceptual hardware, at least
for a period of time.
About
60% of heavy LSD users (those who’ve tripped more than 20 times) report
that they’ve experienced some amount of flashbacks. About 40% of heavy
users report none.
Flashbacks
diminish over time after a user is abstinent. They usually disappear after
a few months, although they persist in some people for more than a year.
Psychosis.
Many researchers in the 1960s and 1970s called hallucinogens
“psychotomimetic” drugs because they mimicked a psychotic state in
those who used them. For one thing, hallucinogens cause hallucinations in
most users. For another, they make many users feel split off from reality.
These are two hallmark symptoms of the psychosis schizophrenia. Because of
this, you would think that hallucinogens would make many people psychotic,
but hallucinogens trigger psychosis in only a small percentage of users
(0.1% to 0.5%). Still, this is significant, especially if you’re one of
the users who was affected this way.
Harm
from accidents. Occasionally, people will hurt themselves while tripping.
Usually, this stems from users’ hallucinations or errors of judgment.
Some users have jumped out of windows or off roofs fully thinking that
they can fly. Some have hurt themselves when escaping from hallucinated
monsters. Some have made mistakes while driving. Every so often, someone
dies from a hallucinogen-induced accident.
Danger
of overdose. Most of the hallucinogens are safe in high doses, but a few
can be toxic. Deaths due to cardiac arrest have occurred in people using
MDMA and have been recorded in users of MDEA. The use of 5-MeO-DMT can
also kill. The skin of a single toad contains enough of this substance to
be fatal. Finally, thousands of deaths throughout history can be
attributed to belladonna poisoning. The belladonna alkaloids are probably
the most dangerous of the hallucinogens because the dose that causes the
desired effects—hallucinations and mild delirium—is very near the
lethal dose.
Withdrawal
For a
couple of days after a trip, a user can feel worn out and become
reflective or contemplative. Other than this short period of recuperation,
there is no significant withdrawal syndrome for the hallucinogens.
Top
Through
the wizardry of modern chemical science, we now have available dozens of
substances that produce psychoactive vapors. There’s nothing natural
here. These substances are purely the product of industry. Among the
inhalants are three remarkably different types of substances: nitrous
oxide and other anesthetic gases, nitrites, and solvents and aerosols.
Options
Nitrous
oxide and other anesthetic gases. Nitrous oxide, also known as laughing
gas, has a medical use as a dental anesthetic. It’s also used as the
propellant in whipped-cream containers. It comes in small metal cylinders
called “whippets” by those in the drug culture. Some users inhale this
gas from balloons or from special pipes called “buzz bombs.” Other
anesthetic gases that people sometimes abuse are ether, chloroform, and
halothane. However, none of these is as common on the street.
Nitrites.
The nitrites are yellow, flammable liquids that have a fruity odor. The
best known of these, amyl nitrite, can be obtained by prescription for
alleviating heart pain (angina). It comes in ampoules that, when broken,
release the fumes (AKA: Poppers, Snappers, Amies, Pearls). Other nitrites
include butyl nitrite (which until 1995 was sold legally as room
deodorizers and liquid incense) and isobutyl nitrite. AKA for butyl
nitrite: Rush, Kick, Locker Room, Locker Popper, Jock Aroma, Satan’s
Scent, Toilet Water. AKA for isobutyl nitrite: Bolt, Bullets, Climax.
Solvents
and aerosols. This group includes gasoline, lighter fluid, glues,
refrigerants, paint, lacquers, paint thinners, paint sprays, degreasers,
cleaning solutions, correction fluids, felt-tip marker fluid, fabric
protector sprays, and hair or deodorant sprays. Users can inhale these
chemicals directly or by using a soaked rag. Another method involves
saturating a cotton ball or rag, placing it in a paper or plastic bag, and
inhaling the contents. This is called “bagging.” AKA for breathing
solvents and aerosols: Huffing.
How
They’re Used
All
these substances are inhaled through the nose or mouth. Users simply
breathe the fumes.
Each
substance in this category produces a brief high—lasting from two to
five minutes with each inhalation. A deeper high, to the point of delirium
or intoxication, comes from continuous inhalation over a short period of
time. Nevertheless, once the user stops inhaling, the high begins to fade
and usually ends within five minutes for nitrites and gaseous anesthetics
and within 10 to 20 minutes for solvents and aerosols.
Popularity
About
5.6% of Americans have used one or more of the inhalants at some time in
their lives. About 1.1% have used one or more during the past year, and
0.4% have used within the past month. That’s about 961,000 current
users. Of these, 391,000 were aged 12 to 17, and 289,000 were aged 18 to
25.
The
Joy of It
Nitrous
oxide and the gaseous anesthetics. Nitrous oxide is the mildest of the
gaseous anesthetics. It reduces pain and increases the sense of
euphoria. It can also lower inhibitions while increasing mental
exhilaration, so things often seem funnier than usual. At higher
concentrations, it causes drowsiness. The other gaseous anesthetics
produce these effects as well but at higher concentrations cause major
sedation.
Nitrites.
The nitrites relax the smooth muscles of the body—those that control
blood vessels, the bladder, the anus, and other tissues. Users often feel
as if their bodies go limp. They might also feel light-headed or faint.
Indeed, after popping, some users collapse into a giddy heap on the floor.
Because
the nitrites relax the muscles that regulate the blood vessels, they
produce an increased heart rate along with a drop in blood pressure. Most
users feel sensations of pleasure and warmth, and some take nitrites to
boost the pleasure of sex. Some users report that when they’re high they
feel that their orgasms last longer. The nitrites gained favor among gay
men for this reason and for the added reason that these drugs relax the
anal sphincter muscle, making penetration easier.
Solvents
and aerosols. This group of chemicals produces an intoxication similar to
that of alcohol. Users experience reduced inhibitions, increased mental
energy or exhilaration, and feelings of physical calm. Continued huffing
in a single session leads to drowsiness, numbness, and even
unconsciousness. Continued use can also cause dizziness, disorientation,
delusions, and hallucinations. Users might “see” shooting stars,
ghosts, or angels and “hear” deafening explosions, unusual voices, or
music from the center of the universe. Some of the reported delusions
include feeling as if you can fly, feeling as if you’re a supremely
powerful hero or villain, or feeling as if you can walk through walls.
The
Problems It Causes
Nitrous
oxide. Users sometimes experience injuries to the mouth, trachea, or lungs
because of the cooling effects of expanding gas. Users also run the risk
of death by asphyxiation if they don’t ensure a supply of oxygen-rich
air. This happens occasionally when someone falls into unconsciousness and
breathes only nitrous oxide. Long-term users have problems with vitamin
B12 deficiency. Nitrous oxide inactivates B12, which causes the
destruction of nerve fibers (neuropathy). Physical symptoms of this damage
include weakness, tingling sensations, decreased sense of touch,
abnormalities in gait, decreased ankle and knee reflexes, and bladder and
bowel dysfunction. Psychological symptoms include loss of memory,
depression, confusion, and delirium.
Nitrites.
Side effects of using nitrites include headaches, flushing of the skin,
cold sweats, dizziness, and the potential to drop briefly into
unconsciousness. Some users get crusty lesions on the skin around the
mouth, nose, penis, and scrotum. Some users get skin rashes or irritations
of the throat and eyes. Nitrites also cause a decrease in the blood’s
ability to carry oxygen (methemoglobinemia). This can be serious enough to
cause coma or death. The early signs of methemoglobinemia are
breathlessness combined with the lips, tongue, and hands turning blue.
This condition becomes most serious when nitrites have been swallowed
rather than inhaled.
Solvents
and aerosols. Among all the drugs of abuse, solvents and aerosols might be
the most dangerous. Once inside the body, these chemicals wreak
destruction. They cause serious damage to the liver, kidneys, muscles,
gastrointestinal system, and cardiovascular system and to the brain and
nervous system. In long-term moderate users and short-term heavy users,
damage to the kidneys, the nervous system, and the brain can be
irreversible.
Studies
show that these chemicals have caused thousands of deaths. The term
“sudden sniffing death” (SSD) refers to death from cardiac arrest.
Inhaling coolants (such as freon), propellants from hair spray or spray
paint, and fuel gases (such as butane and propane) often lead to heart
arrhythmias that can end in cardiac arrest. About 50% of all inhalant
deaths are SSDs. Another significant percentage of sniffers die from
suffocation. This occurs when a user becomes unconscious and falls on a
rag containing one of the solvents or becomes unconscious when huffing
from a plastic bag placed over the head. A small percentage who use
aerosol products have died from freezing of the airways (laryngospasm).
Another small percentage of sniffers and huffers have died from inhalation
of vomit after falling into an unconscious or a semiconscious state. A
large percentage of deaths from inhalant use can be attributed to
accidents. One broad-based study of 1,239 inhalant deaths showed that 26%
were due to accidents.
Withdrawal
There’s
no documented abstinence syndrome for nitrous oxide and the nitrites. Some
long-term heavy users of solvents and aerosols experience a withdrawal
syndrome that includes stomach cramps, chills, hallucinations, and
delirium tremens (DTs). However, this syndrome is rare.
Top
Heroin
and the opiates derive from the poppy plant, Papaver somniferum, which
displays a beautiful flower when in full bloom. Opium is the sticky, tarry
substance produced within this plant’s seed pod.
For
the past 6,000 years, the opium poppy has been cultivated for use in
various medicinal preparations. Some of the earliest medicinals from this
plant were probably in the form of teas. We have evidence that people
began smoking opium about 3,000 years ago in areas of Asia, Egypt, and
Europe. In the Middle Ages, a preparation of opium called laudanum gained
popularity in Europe. In 1803 the psychoactive substance morphine was
isolated from an opium base, and in 1898 the semisynthetic heroin was
refined from morphine.
The
opiates have many medical uses, and many have been used for years as
painkillers (analgesics). Also, because they cause respiratory depression
and constipation, various preparations have been used as cough
suppressants or antidiarrheals. To meet medical demands each year, the
U.S. pharmaceutical industry imports more than 500 tons of opium or its
equivalent in poppy straw concentrate for the production of prescription
opiates.
Today
we have dozens of opiates. Some, such as heroin, are produced and sold
illegally; others are produced legally but find their way into illegal
markets on the streets. The opiates fall into three general categories:
naturally occurring (opium, morphine, codeine, and thebaine),
semisynthetic (heroin, hydromorphone, oxycodone, hydrocodone, and
buprenorphine), and synthetic (meperidine, methadone, LAAM,
dextropropoxyphene, fentanyl, and pentazocine).
Options
Opium.
This product is made from the thick, glue-like liquid that oozes from the
plant’s seed pod. Producers dry it into a ball (gum opium) or pound it
into a powder (opium powder). Opium is the active ingredient in various
medicines used for the treatment of diarrhea (trade names: Paregoric,
Parepectolin, Donnagel-PG). It’s also available in a couple of pain
remedies (trade names: Pantopon, B&O Supprettes). AKA: O, Big O, Zero,
Dreams, Gem, Hop, Tar, Skee, Toys, Chinese Molasses, Gong, Black Stuff,
Black Pills. AKA for paregoric: Blue Velvet.
Morphine.
This substance was named after Morpheus, the Greek god of dreams who was
often depicted with a handful of opium poppies. Morphine is the principal
psychoactive chemical in opium, ranging in concentrations from 4% to 21%.
It is probably the most effective painkiller (analgesic) known to humans.
In fact, it provides a standard against which new analgesics are measured.
Morphine is prescribed mainly for the treatment of pain and sometimes as
an adjunct to anesthesia. Trade names: Morphine Sulphate, Morphine
Sulphate Injection, MS Contin, Oramorph SR, Duramorph, Roxanol. AKA: M,
Morph, M.S., Dreamer, Miss Emma.
Codeine.
This psychoactive alkaloid occurs in opium in concentrations ranging from
0.7% to 2.5%. Compared to morphine, it produces less sedation and
respiratory depression and less analgesia. It is prescribed for relief of
moderate pain or as an effective cough suppressant. Codeine has become the
most widely used naturally occurring opiate in medical treatment in the
world. Trade names: Codeine Phosphate Injection, Acetaminophen with
Codeine, Aspirin with Codeine, Fiorinal with Codeine, Phenaphen with
Codeine, Synalgos, Tylenol with Codeine, Robitussin AC, Empirin with
Codeine. AKA: Schoolboys, Pops.
Thebaine.
This chemical occurs in small quantities in opium. It’s similar
chemically to morphine and codeine but has stimulant rather than
depressant effects. Thebaine has no therapeutic value but is the precursor
to a variety of other psychoactive or therapeutic compounds. These include
hydrocodone, oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, and
buprenorphone.
Heroin.
This drug was first synthesized from morphine in 1898 by the Bayer Company
in Germany. It got its name from the German heroisch, which means
“powerful.” This semisynthetic enters the brain more quickly than
morphine because chemically it’s more soluble in fat. Once in the brain,
it turns back into morphine. Heroin is most commonly available in powder
form. Its color varies from pure white to dark brown. Sellers package it
by the “bag,” each of which contains one dose equal to about 100
milligrams. In recent years, the purity of heroin on the street has
improved. In 1980, the national average purity of heroin was 3.6%. In
1993, it was 37%. Another form of heroin known as “black tar” has hit
the streets in recent years. Some varieties are gummy and sticky, whereas
others are as hard as coal. It ranges in color from brown to black. This
product hails from Mexico, where crude processing methods prevail, thus
the dark color. Its purity ranges from 20% to 80%. AKA: H, Big H, Horse,
Smack, White Lady, White Stuff, Junk, Dope, Mojo, Downtown, Brown, Mexican
Brown, Mud.
Hydromorphone.
This semisynthetic opiate has an analgesic potency two to eight times that
of morphine. Trade names: Dilaudid, Dilaudid-HP Injection, Hydromorphone
Hydrochloride. AKA: D, Dilly, Fours, Lords.
Hydrocodone.
This semisynthetic opiate works as an analgesic and as a cough remedy
(antitussive). Trade names: Anexsia, Hycodan, Hycomine, Lorcet, Lortab,
Tussionex, Vicodin.
Oxycodone.
This substance is more potent than codeine and more addictive. Trade
names: Percodan, Percocet, Tylox.
Meperidine.
Compared to morphine, this synthetic opiate produces similar analgesia but
has a shorter duration of action and reduced antitussive and antidiarrheal
effects. Trade name: Demerol.
Fentanyl.
This synthetic opiate acts as a highly potent form of heroin. It has
medical uses as an analgesic and as an anesthetic (trade name for
anesthetic fentanyl: Sublimaze). At least 12 analogs of this drug have
been created. Some have medical uses as analgesics, such as alfentyl
(trade name: Alfenta) and sufentanil (trade name: Sufenta). Drug marketers
have produced numerous fentanyls that are sold on the street. Some of
these are 100 times more potent than street-quality heroin. AKA: China
White, Tango and Cash.
Pentazocine.
This synthetic provides mild analgesia. Trade names: Talwin, Talacin.
Methadone
and related synthetics. Methadone acts like heroin or morphine but
doesn’t resemble the opiates in chemical form. Medically, it’s used in
heroin detoxification and maintenance programs. Methadone’s effects last
longer than heroin’s—up to 24 hours—so it’s ideal for once-a-day
maintenance doses (AKA: Dollies, Dolls, Wafers, Ten-Eight-Twenty). A
chemical cousin to methadone, levo-alphacetylmethadol (LAAM) produces
similar effects to methadone but lasts even longer. In 1994 this drug was
approved as an alternative treatment for narcotics addiction (trade name:
ORLAAM). Currently, researchers are testing yet another drug, the
semisynthetic opiate buprenorphine, for use in treatment of narcotics
addiction (trade name: Buprenex). Another relative of methadone,
propoxyphene, acts as a weak analgesic and is not much stronger than
aspirin (trade names: Darvon-N, Darvon Compound-65, Darvocet-N 100,
Wygesic). AKA: Pinks-and-Greys.
Other
synthetics. This group includes alphaprodine (trade name: Nisentil), which
is prescribed for pain; diphenoxylate (Lomotil) for diarrhea; levorphanol
(Levo-Dromoran) for pain; loperamide (Immodium) for diarrhea; buteorphanol
(Stadol) for pain; and nalbuphine (Nubain) for pain.
Combinations.
Users have combined this group of drugs with many other substances. Some
of the more popular combinations (along with the street names for each)
include heroin and cocaine (Speedball, Whizz Bang, Dynamite, Murder One),
heroin and tobacco (Duster), heroin and marijuana (Atom Bomb, A-Bomb),
heroin or another opiate with amphetamines, opium with marijuana (O.J.),
Talwin with the antihistamine pyribenzamine (T’s
and Blues).
How
They’re Used
A
large percentage of heroin users go for the high by injection, either
intravenously (“mainlining”), subcutaneously (“skin popping”), or
intramuscularly. As the purity of heroin has increased, however, more
occasional users, called “chippers,” have entered dreamland by
snorting or smoking the powder. Opium users almost always smoke the
substance.
Hardcore
heroin addicts will seek most any analgesic when the smack supply runs
short. A favorite is Dilaudid. If the substance comes in tablet form, as
Dilaudid does, users will often grind it into powder, dissolve it in
water, and shoot it. Otherwise, both chippers and hardcore addicts will
take analgesics the way they were intended, that is, orally in tablets,
capsules, or liquid preparations.
The
high from most of the opiates lasts from two to six hours. However, at one
extreme fentanyl lasts only an hour or so, and at the other LAAM lasts a
couple of days. The high from fentanyl injection is the quickest of all
the analgesics to reach peak levels in the brain (two to four seconds).
Heroin is slower, taking a couple of minutes, and morphine takes about
five minutes. The high from snorting heroin takes even longer to reach
peak levels, and anyone who takes analgesics orally must wait the longest
for the high to hit, about a half hour or so.
Researchers
find two patterns of abuse. In one pattern, users start on the streets
with illicit opiates. These users start as chippers, some of whom graduate
to greater and greater use and some of whom don’t. Typically, they begin
by snorting, smoking, pill popping, or drinking liquid preparations such
as cough syrups or Paragoric. Those who graduate go to skin popping or
mainlining. In the other pattern, users get started on analgesics in a
medical setting and, over a period of time, develop “a habit.” They
become addicted to their prescribed medication. Typically, these users
begin “doctor shopping.” They bounce from doctor to doctor seeking
scripts for painkillers, often faking symptoms with the premeditated poise
of great actors and actresses. Many who follow this pattern of addiction
will, at some point, begin seeking illicit opiates on the street.
Popularity
About
5.5% of Americans have used illicit analgesics. About 2.1% have used
illicit analgesics within the past year, and about 0.9% have used them
within the past month. That’s about 1.9 million current users.
About
2.5 million Americans have used heroin at some time in their lives. About
455,000 have used it within the past year.
The
Joy of It
When
we take opiates, it’s as if Morpheus enters our very being. Everything
becomes dream-like. Our cares and troubles float away. Our eyelids, like
those of the meditating Buddha, rest serenely in a half-closed position.
We feel comfortable. We become drowsy and sleepy, and sometimes we nod off
into our very own slumberland. We feel as if we’ve entered a warm, safe
place—a place where we’re protected, cared for, and tenderly held—a
place very much like the womb.
Mainliners
get a rush, a climactic sensation that some compare to orgasm. Although
this rush resembles the jolt from cocaine or methamphetamine, it’s not
as powerfully orgasmic. Mainliners also typically experience a period of
nausea along with, or just after, the rush. This discomfort is sometimes
resolved by dedicating a few minutes to the act of vomiting.
The
opiates were originally called “narcotics,” a word derived from the
Greek narcotikos, meaning “benumbing” or “causing sleep.” These
numbing sensations, the absence of pain, and the warm, dreamy feelings
create a powerful attraction for the recreational use of these drugs.
The
Problems It Causes
Lung
problems. The opiates cause a decrease in breathing rate and depth. In
fact, breathing becomes dangerously impaired at higher doses. In addition,
if you smoke opiates, you increase your chances of smoke-related lung
problems. You might experience hacking cough, bronchitis, and other
difficulties.
Gastrointestinal
problems. The opiates cause constipation. Many heavy users can’t move
their bowels for days and sometimes go for even a week or more without any
bowel movements. This problem resolves with abstinence.
Sexual
dysfunction. Users experience a decreased sexual desire and a decreased
ability to perform sexually. Males often can’t get an erection
(impotence). This problem usually resolves when opiates are discontinued.
However, a small percentage who used opiates addictively, and in
combination with other substances, report that their impotence continued
long after they had quit all the drugs. Female addicts can experience lack
of menstrual period (amenorrhea), which resolves when opiates are
discontinued.
Malnutrition.
Heavy users tend to be malnourished or undernourished. The reason is
uncertain. It may happen because heavy users don’t attend to the
body’s need for food or because they spend too much time and energy
acquiring more of the drug.
Danger
of infection. If you shoot heroin or other opiates, you run the risk of
various infections. These include infections on the skin (abscesses) or
under the skin (cellulitis) at injection sites, infection of the veins
(thrombophlebitis), inflammation of the veins (often caused by injecting
particles that were not ground fine enough to completely dissolve),
infection of the liver (hepatitis B), infection of the heart valves
(endocarditis), AIDS, and brain and lung abscesses.
Danger
of overdose. With opiates, the danger of overdose looms large. The problem
arises mainly because these drugs depress the respiration. Death from
depressed respiration usually occurs within minutes after an injection.
The user falls into a coma and never revives.
Usually,
overdose occurs after a single injection. It happens because the dose from
that injection is higher than the user could tolerate. With street heroin
varying in purity from 10% to 80%, this becomes a real problem. Also with
fentanyl and its analogs the danger is even greater because of the greater
potency of these synthetics. Since fentanyl came on the scene, it has
caused many deaths from overdose. Methadone, too, has led to many overdose
deaths due to use in non-medical settings. A note on Darvon: It has numerous toxic side effects and, as
reported by medical examiners in the United States, is one of the top 10
drugs in causing drug abuse deaths.
Withdrawal
Withdrawal
begins with a runny nose, watery eyes, yawning, and sweating. Then you
experience chills and goose bumps (where the term “cold turkey” came
from), along with flu-like symptoms, including nausea, vomiting, and
diarrhea. You also get muscle aches and spasms and the typical leg-kicking
response due to leg spasms (which gave rise to the phrase “kicking the
habit”). You also feel pains in the muscles and bones. You’re unable
to sleep. You might feel anxiety, tension, anger, or hostility. Finally,
you feel like nothing is enjoyable in life, and you crave opiates.
The
physical symptoms peak at two to four days and disappear within seven to
10 days. The mental symptoms—feeling like nothing’s enjoyable and the
craving of opiates—will continue. In fact, these two symptoms are
connected. You know that opiates will take away any bad feelings and make
life enjoyable again. You know this at a
gut level. It happens in your mind, but it feels as if your whole body
craves. These mental symptoms will last a few months at least, maybe even
a year or more. However, they continue to diminish in frequency and
intensity as long as you remain in recovery.
Top
Amphetamines,
diet pills, methylphenidate (Ritalin), and phenylpropanolamine are
products of the laboratory. All have been synthesized within the past 125
years. Other stimulants that occur naturally in plants have been used by
indigenous peoples for thousands of years. These organic stimulants
include cathinone, found in the leaves of the khat plant; ephedrine, found
in Chinese ephedra shrubs; caffeine, found in coffee beans, tea leaves,
cola nuts, and yerba mate; and nicotine, found in tobacco. (Cocaine is
also a stimulant and is covered in a separate section in this chapter.)
Options
Amphetamines.
Amphetamine (or amphetamine sulfate) was first available as an
over-the-counter inhaler in the 1930s. Called the Benzedrine inhaler, it
was recommended for treatment of nasal congestion. Benzedrine was later
marketed, in the form of a pill, for the treatment of narcolepsy and for
“minimal brain dysfunction” (MBD), which is now called “attention
deficit hyperactive disorder” (ADHD). Trade name: Benzedrine. AKA:
Uppers, Bennies, Peaches, Whites.
Dextroamphetamine
(or dextroamphetamine sulfate) is marketed under the trade name Dexedrine
(AKA: Dexies, Co-pilots, Oranges, Footballs). It’s also available in
combination with amphetamine under the trade name Biphetamine (AKA: Black
Beauties, Black Mollies, Blackbirds).
Methamphetamine
hydrochloride, the pharmaceutical product, comes in tablet form (trade
name: Desoxyn). The methamphetamine appearing on the street is most often
the product of clandestine chemical laboratories. It comes in the form of
a crystalline powder (AKA: Speed, Crank, Meth, Crystal Meth, Crystal).
Operators of clandestine labs have also produced a crystallized version of
methamphetamine hydrochloride that can be smoked (AKA: Ice, Quartz).
Methcathinone
is the structural analog of methamphetamine and cathinone, the
psychoactive stimulant found in the khat plant. This compound is also the
product of clandestine labs. AKA: Cat, Khat, Goob, Crank.
Diet
pills. Pharmaceutical companies have developed amphetamine congeners
(chemicals that are similar in nature) into today’s prescription diet
pills. They are milder than the amphetamines yet stronger than caffeine.
These include (along with trade names): benzphetamine (Didrex),
diethylpropion (Tenuate, Tepanil), fenfluramine (Pondimin), mazindol
(Mazanor, Sanorex), phendimetrazine (Bontril, Plegine, Prelu-2, Trimstat),
phenmetrazine (Preludin), and phentermine (Adipex-P, Ionamin, Fastin).
Methylphenidate.
Manufactured under the trade names Ritalin and Methylphenidate
Hydrochloride, this synthetic stimulant has a lower potential for abuse
than the amphetamines. Although similar in action to the amphetamines, it
packs a weaker punch. Currently, this medication is prescribed for ADHD
and for the treatment of narcolepsy.
Phenylpropanolamine.
This mild stimulant can be found in many prescription and over-the-counter
medications. It’s a common ingredient, sometimes in combination with
caffeine, in over-the-counter diet pills (trade names: Acutrim,
Appendrine, Dexatrim, Ordinex). It also appears in various
over-the-counter cough, cold, and allergy remedies (trade names: Alka
Seltzer Plus, Contac, Coricidin-D, Naldecon, Sinarest).
Khat.
For centuries, people in Arabia and East Africa have cultivated the shrub
Catha edulis for the production of khat. This product consists of the
fresh, young leaves of the khat plant. These are chewed to produce a mild
stimulant effect. For the full effect, the leaves must be consumed
quickly, usually within 48 hours of picking, because the psychoactive
stimulant cathinone converts to a significantly milder stimulant (cathine)
as the leaves dry.
Ephedrine.
This mild stimulant derives from Chinese ephedras. It has been used for
centuries in China for the treatment of hay fever, asthma, and nasal
congestion. In recent years, this herbal stimulant has become available
through legal, over-the-counter markets in the United States.
Caffeine.
This psychoactive chemical occurs naturally in many plants all over the
world. It’s both legal and widely available. Served in coffees, teas,
and carbonated soft drinks as well as chocolate and cocoa concoctions,
this mild stimulant acts as a social lubricant or “alertness booster”
in low doses. In higher doses, it can turn anyone into a nervous wreck.
What’s a low dose? One to two cups of coffee, two to three cups of tea,
or two to three caffeinated sodas per day—a little more if you’re
younger, a little less if you’re older.
But
there’s a problem. Caffeine is highly addicting. It’s not easy to
curtail our consumption. We tend to press ourselves to our personal limit,
to get that caffeine buzzing deep inside yet managing to hold the high
just short of nervous frenzy. However, some of us can’t hold it there
and repeatedly overconsume, venturing fitfully into the fray of nervous
system overstimulation. This is the group of us who become flat-out
caffeine addicts. It’s primarily to this group that other caffeine
products appeal, such as over-the-counter caffeine tablets (trade names:
NoDoz, Vivarin), diet pills, headache remedies and cold medications, and
prescription headache remedies.
Nicotine.
This popular, widely available substance acts as a mild stimulant. It
might very well be the single most addicting drug in the world. Few people
can use it in moderation. For example, not many can limit their smoking to
just a couple of cigarettes a week. In fact, more than 90% of people who
use this drug use it addictively, and using tobacco addictively can be a
major undertaking. Smokers light up a cigarette anywhere from five to 80
times a day and, with each one, draw in anywhere from 15 to 30 lungfuls of
smoke. So that’s doing anywhere from 75 to 3,200 “hits” a day. What
power this drug has to control our behavior!
In one
broad-spectrum study, people rated the difficulty they had quitting
various drugs. When the scores were averaged, nicotine ranked the highest,
beating out alcohol, heroin, cocaine, and all the other drugs of abuse.
(Note:
Although the methods in this book will help you quit smoking, the book was
not intended for that purpose. The entry for nicotine has been included
here so you’ll know that it’s a mild stimulant and a powerfully
addicting drug. You'll find more on nicotine in Chapter 6, “How to Break a
Habit,” and Chapter 7, “Healing Through Diet.”)
Combinations.
Some users inject methamphetamine with heroin in a variation of a
speedball. Some smoke ice with other smokables: tobacco, marijuana, or
opium. Some use amphetamines in combination with cocaine. However, the
most typical combination is the upper-downer combo, pairing stimulants
with depressants or analgesics or using the stimulants throughout the day
and the depressants in the evening to help with sleep.
How
They’re Used
Amphetamines
can be taken orally, snorted, injected, or, in the case of ice, smoked.
The effects of amphetamines—especially the two illegally manufactured
powders methamphetamine and methcathinone—are similar to that of
cocaine, but the high lasts much longer. The amphetamine high lasts four
to five hours and the coke high only 15 to 30 minutes.
The
pharmaceuticals—diet pills, methylphenidate, and
phenylpropanolamine—are almost always taken in their manufactured form:
pills, capsules, or liquids. All these drugs create a pick-me-up that
lasts a few hours.
It’s
rare to find fresh khat leaves on U.S. streets, but it’s becoming more
common to find its psychoactive constituent cathinone. Users usually snort
cathinone, although some inject it and some take it orally. Users who go
for the herbal stimulant ephedrine usually take it orally in powders or
capsules, although many sip it in the form of tea.
People
go for the caffeine buzz by pounding cup after cup of coffee, tea, or
soda. Heavy users sometimes add various over-the-counter pills and
preparations to their menu of caffeine delights.
Popularity
About
4.7% of us have used illicit stimulants at some time in our lives. About
0.9% have used illicit stimulants within the past year, and 0.4% have used
within the past month. That’s 763,000 who are current users. These
figures don’t include legally prescribed stimulants, over-the-counter
stimulants, and caffeine.
The
Joy of It
Stimulants
give us energy. They keep us alert. Even the mild stimulants can keep us
awake all night. This makes them favorites among truckers hauling
overnight loads and students pulling pre-exam all-nighters.
All
stimulants decrease our appetite. Mild to moderate stimulants, when used
over a period of time, can cause weight loss, thus the market for diet
pills. Mild to moderate stimulants can also boost our mental
concentration. Methylphenidate helps many people with ADHD to become more
focused, in other words, to have an increased capacity for paying
attention.
The
stronger stimulants pack too much of a wallop to help us pay attention in
any sustained sort of way. They get us buzzing with intense sensations of
pleasure. They make us feel more like partying than applying our minds to
a single task. Like cocaine, the powerful stimulants boost our sense of
confidence around others and our feelings of potency within.
Also
like cocaine, methamphetamine and methcathinone, when injected, provide a
rush. It’s blast-off time. Many users describe the rush as a “total
body orgasm.” In fact, males can experience spontaneous ejaculation
during liftoff. Ice, like crack, produces an overwhelming rush of pleasure
shortly after the smoke fills the lungs. The rush from ice compares to
what we experience from methamphetamine injection.
The
Problems They Cause
The
problems caused by amphetamines compare nearly identically to those caused
by cocaine. (see the subsection “The Problems It Causes” under the
“Cocaine” section).
Other
stimulants cause the same problems, but the milder the stimulant, the less
severe the effect. For example, caffeine causes a rise in blood pressure
and heart rate, but to a lesser extent than methamphetamine. And, although
overdosing on mild stimulants is rare, some people have done it simply by
taking too much on a given occasion.
More
on caffeine: I’ve counseled dozens of clients with severe caffeine
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