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Mental health services: Substance abuse

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Substance abuse detection and symptoms

Alcohol

Alcohol is one of the most widely used drugs in the world.

One drink contains 12 grams (.5 ounce) of pure alcohol. Examples of standard drinks include:

  • 12 ounces of beer or wine cooler
  • 5 ounces of wine
  • 1.5 ounces of distilled spirits (such as vodka, gin or scotch).

Alcohol is absorbed quickly into your bloodstream. How fast it is absorbed will depend on the type and amount of food in your stomach. Foods high in fat and carbohydrates will slow how fast alcohol is absorbed.

Effects of alcohol use

Alcohol can cause the following:

  • hangover
  • bad breath
  • impaired judgment and behavior
  • altered perceptions and emotions
  • distorted hearing and coordination
  • blurred or distorted vision
  • nausea
  • sweating
  • shakiness
  • anxiety.

Alcohol use can cause liver disease, heart disease, some forms of cancer and pancreatitis.

Signs that you have a drinking problem

Alcohol-related health or behavioral problems indicate that you may have a problem with alcohol use. Too much alcohol can affect your health, causing::

  • blackouts
  • ongoing abdominal pain
  • high blood pressure
  • sleep disorders
  • depression
  • liver problems
  • sexual function problems.

Alcohol can affect your behavior and cause:

  • family problems
  • legal problems
  • poor attendance or performance at work or school
  • accidents
  • injuries.

Signs that you are dependent on alcohol

You may be dependent on alcohol if you:

  • think about drinking most of the time or have a strong urge to drink
  • can't stop drinking once you start
  • drink to prevent withdrawal symptoms that develop when you don't drink (tremors, nausea, sweating or mood swings)
  • have to drink more than you used to to feel the affects of alcohol
  • change plans so you can drink
  • drink in the morning to "steady your nerves."

Source: Allina Health's Patient Education Department, Alcohol, mh-ahc-13735

Information adapted from the National Institute on Alcohol Abuse and Alcoholism and the U.S. Department of Health and Human Services.


Reviewed by: Allina Health's Patient Education Department
First Published: 11/15/2012
Last Reviewed: 11/15/2012

Cocaine

Cocaine is a powerfully addictive stimulant. It was discovered in the mid-1800s from the leaves of coca bushes. In the early 1900s, cocaine was used in tonics and elixirs to treat a variety of illnesses. Today, cocaine is an illegal drug but it can be given by doctors as a local anesthetic for some eye, ear and throat surgeries.

Crack

Crack is the freebase, or crystal, form of cocaine that is smoked. Users mix it with ammonia or baking soda and water, and heat it to remove the hydrochloride salt. The result is a form of cocaine that can be smoked. (The name "crack" comes from the crackling sound heard when the mixture is heated.) Cocaine powder or crack combined with heroin is known as a speedball.

Addiction

Addiction to cocaine or crack can occur after only one use. Cocaine disrupts the way the brain releases dopamine, a chemical that provides pleasure. A build-up of dopamine gives the user feelings of euphoria (pleasure).

When taking cocaine in small amounts, the user feels energetic, talkative and mentally alert. These feelings appear almost right away and disappear within a few minutes or hours. (The euphoric high from crack occurs in fewer than 10 seconds.) The faster the cocaine is absorbed by the body, the more intense the high.

Medical complications

A single dose of cocaine can cause a heart attack, stroke, seizure, respiratory failure or abdominal pain. Snorting can cause nosebleeds, difficulty swallowing, runny nose, hoarseness and loss of sense of smell. Injecting can cause an allergic reaction and put the user at risk for other diseases, such as HIV and hepatitis B and C. Taking cocaine while pregnant puts the baby at risk for a low birth weight, smaller head circumference and shorter length.

Death can occur after the first use or after many years of use.

Effects of cocaine use

Cocaine can cause the following effects.

Short-term:

  • increased energy
  • decreased appetite
  • mental alertness
  • increased heart rate and blood pressure
  • smaller (constricted) blood
  • vessels
  • increased temperature
  • dilated pupils.

Long-term:

  • addiction
  • irritability and mood disturbances
  • restlessness
  • paranoia
  • hallucinations (heard, not seen).

Source: Allina Health's Patient Education Department, Cocaine, mh-ahc-13193

Information adapted from the White House Office of National Drug Control Policy and the National Institute on Drug Abuse.


Reviewed by: Allina Health's Patient Education Department
First Published: 06/01/2004
Last Reviewed: 06/01/2004

Heroin

Heroin is a highly addictive drug. It was first made in 1874 from morphine, a substance taken from seed pods of certain varieties of poppy plants. Heroin became a popular pain reliever in the early 1900s. Today, heroin is an illegal drug and is the most abused and fast-acting opiate. Opiates are sedative narcotics often used as strong pain relievers, including codeine, morphine and methadone. As a street drug, heroin is known as "crank," "H," "junk," "horse," "smack" and "train," among others.

Pure heroin is a white powder. Street dealers generally sell heroin as a white to brown powder that may be injected, snorted or smoked. The color of heroin varies depending on the substance "cut," or mixed, with it. Common substances are sugar, starch, powdered milk, quinine, strychnine or other poisons. Because heroin is mixed with other substances, its purity is unknown. (A black, sticky variety of heroin that comes from Mexico is known as "black tar" heroin.) Users are at an increased risk of overdose because they do not know the strength or contents of the drug.

Addiction

Addiction to heroin can occur after only one use. Heroin actually changes the way the user's brain works. Heroin changes into morphine when it reaches the brain. This causes a "rush" of pleasurable sensations (euphoria).

Effects of heroin use

Heroin can cause the following effects.

Short-term:

  • warm flushing of the skin, dry mouth
  • heavy feeling in the arms and legs nausea, vomiting, severe itching
  • drowsiness for several hours
  • slowed breathing and heart rate
  • clouded mental abilities.

Long-term:

  • collapsed veins
  • infection of the heart lining and valves
  • liver or kidney disease
  • respiratory problems (such as pneumonia and tuberculosis)
  • boils (abscesses) and other soft-tissue infections
  • addiction.

Medical complications

The substances added to heroin can clog blood vessels that lead to the lungs, liver, kidneys or brain. Injecting heroin can cause an allergic reaction and put the user at risk for other diseases, such as HIV and hepatitis B and C. A pregnant woman using heroin is at risk for losing the baby, giving birth early or losing the baby to SIDS (sudden infant death syndrome).


Source: Allina Health's Patient Education Department, Heroin, mh-ahc-13222

Information adapted from the White House Office of National Drug Control Policy and the National Institute on Drug Abuse.


Reviewed by: Allina Health's Patient Education Department
First Published: 07/01/2004
Last Reviewed: 07/01/2004

Marijuana

Marijuana is a green, brown or gray mixture of dried, shredded leaves, stems, seeds and flowers of the hemp plant (Cannabis sativa). Marijuana, a mind-altering drug, has more than 200 slang names on the street, such as "bud," "chronic," "dope," "grass," "herb," "pot," "Mary Jane," "reefer" and "weed," among others. Marijuana is the most commonly used illegal drug in the United States. Most users smoke marijuana in hand-rolled cigarettes (joints), in cigars (blunts), or in pipes/water pipes (bongs). Marijuana may be brewed in tea or mixed with foods. Stronger forms of marijuana made from the cannabis plant include sinsemilla, hashish and hash oil.

Marijuana use interferes with family, school, work and recreational activities. Studies show that students who use marijuana get lower grades and are less likely to graduate from high school than nonsmoking students. Workers who smoke marijuana are more likely than nonsmoking co-workers to miss more work, have more accidents, change jobs more often, leave without permission and daydream.

In 2002, the percentage of youth ages 12 to 17 who used marijuana was 20.6 percent (a slight decrease) and adults age 18 to 25 who used marijuana as 53.8 percent (a slight increase).

Most marijuana used in the United States comes from Mexico. Strong marijuana has also entered the U.S. drug market from Canada. Marijuana can be grown, either indoors or outdoors.

Addiction

Marijuana causes addiction. The active ingredient in marijuana (known as THC) changes the parts of the brain that influence pleasure, memory, thought, concentration, sensory/time perception, and coordinated movement. The amount of THC in marijuana has risen greatly since 1980, meaning that marijuana today is "stronger."

When smoking marijuana, effects begin right away and last from 1 to 3 hours. When eating or drinking marijuana in foods or drink, effects begin in about 30 to 60 minutes and last for 4 hours. Smoking marijuana leads to some of the same changes in the brain similar to those caused by cocaine, heroin and alcohol. As the THC enters the brain, it causes the user to feel euphoric, or high. The user may feel pleasant sensations (such as in a good mood or silly), colors and sounds may be more intense, and time appears to pass slowly. He or she may have a dry mouth, rapid heartbeat, loss of coordination and poor sense of balance.

Marijuana produces anxiety, fear, distrust, panic and short-term memory problems.

The user may have a sudden hunger (the munchies). When coming down from a high, the user may feel sleepy or depressed. Effects depend on how strong the marijuana is, how it’s taken and if other drugs are being taken at the same time.

Some long-term users have withdrawal symptoms (irritability, problems sleeping, anxiety, loss of appetite and shaky hands) when they try to stop using.

A 2002 report by the Substance Abuse and Mental Health Services Administration said the younger children are when they first use marijuana, the more likely they are to use cocaine and heroin and become addicted as adults.

According to the National Survey on Drug Use and Health, 40 percent of Americans ages 12 and older had used marijuana or hashish in their lifetime. In 2001, there were an estimated 2.6 million new marijuana users.

Effects of marijuana use

Marijuana can cause the following effects.

Short-term:

  • respiratory infections
  • impaired short-term memory, learning, attention, coordination, balance and judgment
  • increased heart rate
  • anxiety, panic attacks.

Long-term (regular use):

  • daily cough and phlegm
  • chest colds and bronchitis
  • risk of lung infections (including emphysema)
  • increased risk of cancer of the head, neck, respiratory tract and lungs
  • addiction.

Medical complications

Marijuana use causes depression, anxiety and personality disturbances. It affects the user’s ability to learn and remember. Users who drive while high are at risk for causing accidents.

Marijuana — especially when taken with alcohol — impairs alertness, concentration, perception, coordination and reaction time.

A woman who smokes marijuana during pregnancy puts the baby at risk for development problems. A woman who smokes during the first month of breastfeeding can affect the baby’s development.

A user who ate or drank high doses of marijuana can have hallucinations, delusions and a loss of personal identity.

Source: Allina Health's Patient Education Department, Marijuana, mh-ahc-13223

Information adapted from the White House Office of National Drug Control Policy, U.S. Drug Enforcement Administration and the National Institute on Drug Abuse.


Reviewed by: Allina Health's Patient Education Department
First Published: 07/01/2004
Last Reviewed: 07/01/2004

Methamphetamine

Methamphetamine is a powerfully addictive stimulant. It is a type of amphetamine that is only available by a prescription that cannot be refilled. In the early 1900s, the drug was used in nasal decongestants and bronchial inhalers. Today, it is prescribed for some people who have narcolepsy (sleep disorder), attention deficit disorder and obesity (for weight control).

As a street drug, methamphetamine is known as "chalk," "meth" and "speed." In its smoked form, it is known as "crystal," "crank," "glass" and "ice," among others. Street dealers sell methamphetamine as a fine, white crystalline powder that may be smoked, snorted, injected (with a needle) or ingested (taken by mouth).

Methamphetamine can be made using over-the-counter medicines in homes, garages or apartments. "Meth labs" — which can be taken apart, stored and moved — release poisonous gas into the air.

Making 1 pound of methamphetamine creates 5 to 7 pounds of toxic waste. Many people who run meth labs dump the toxic waste down kitchen drains, in yards or in fields.

Addiction

Methamphetamine is highly addictive.

The drug disrupts the way the brain releases dopamine, a chemical that provides pleasure. A build-up of dopamine gives the user feelings of euphoria (pleasure).

Although similar to amphetamine, the effects of methamphetamine are more severe. It causes increased activity, decreased appetite and a general sense of well-being. The effects of methamphetamine can last 6 to 8 hours. After the initial rush, the user may be easily agitated and can cause violent behavior.

Right after smoking or injecting the drug, the user gets an intense, pleasurable rush that lasts for a few minutes. (The residue from smoking ice can be resmoked. Effects may last for 12 hours or more.) Snorting the drug produces euphoria, which takes effect in 3 to 5 minutes. Taking the drug by mouth produces euphoria, which takes effect in 15 to 20 minutes.

Taken even in small doses, methamphetamine can increase wakefulness and physical activity and decrease appetite. The drug can cause psychotic behavior, brain damage, and withdrawal symptoms (such as depression, anxiety and paranoia) when the user tries to stop. Damage to the brain is similar to damage caused by Alzheimer’s disease, stroke and epilepsy.

Long-term use can cause violent behavior, anxiety, confusion and insomnia. Users can also have paranoia, delusions and hallucinations (heard, not seen).

After the high wears off, the user crashes. Because the pleasurable effects wear off while the drug is still in the bloodstream, users try to keep the high by binging, taking a lot of the drug repeatedly over several days. Some users need more methamphetamine to get the same level of pleasure as the first use. This process is known as tolerance.

The 2003 National Household Survey on Drug Abuse estimates that 8.8 million Americans have tried methamphetamine.

Effects of methamphetamine use

Methamphetamine can cause the following effects.

Short-term:

  • increased attention and activity
  • decreased appetite
  • euphoria and rush
  • increased breathing rate, heart rate and blood pressure
  • increased body temperature (hyperthermia).

Long-term:

  • addiction
  • paranoia, hallucinations, mood disturbances, repetitive motor activity
  • stroke
  • weight loss.

Medical complications

The drug can cause several heart-related problems: rapid heart rate, irregular heartbeat, increased blood pressure, stroke and inflammation of the heart lining. Psychotic symptoms can sometimes last for months or years after using the drug has stopped.

People who inject the drug are at an increased risk for getting HIV and hepatitis B and C. An increase in body temperature and convulsions occur with an overdose.


Source: Allina Health's Patient Education Department, Methamphetamine, mh-ahc-13195
Reviewed by: Allina Health's Patient Education Department
First Published: 06/01/2004
Last Reviewed: 06/01/2004