Drugs & Alcohol - Effects

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Nearly any substance in existence can be abused; however there are certain types that are more prone to misuse than others.  What follows is a list of the most commonly abused substance types, and the effects of their misuse.

Types of Intoxicants
Alcohol
Amphetamines
Barbiturates
Benzodiazepines
Cannabis
Club Drugs
Cocaine
GHB
Hallucinogens
Inhalants
MDMA
Methamphetamine
Nicotine
Opioids
Over-the-Counter (OTC) Medications
Prescription Drugs
Steroids
Stimulants

Specific Intoxicants
Absinthe
Adderall
Caffeine
Codeine
Crack Cocaine
Crystal Meth
Diet Pills
DXM
Ecstasy
Ephedrine
Hashish
Heroin
Hookah
Jimson Weed
Ketamine
LSD
Marijuana
Mushrooms
Nitrous Oxide
Oxycontin
PCP
Peyote
Prescription Painkillers
Quaaludes
Ritalin
Rohypnol
Soma
Speed
Valium
Vicodin


Alcohol
Street names: booze, brew, brewskis, cold ones, the drink, hard stuff, liquor, liqueur, malt liquor, adult pop, hooch, moonshine; beer, ale, wine, wine coolers, whiskey, scotch, bourbon, rye, gin, vodka, rum, schnapps, vermouth, bitters, absinthe, everclear

Method of ingestion: orally, in liquid form

Desirable effects: feelings of relaxation; temporary "forgetfulness" of problems; increased confidence; lowered inhibitions; "feel no pain"

Other effects: loss of coordination, slurred speech, blurred/double vision, nausea, vomiting, dehydration, slowed reaction time, inability to reason, lowered heart rate, lowered blood pressure, lowered breathing rate, depression, memory loss, extreme drowsiness

Legitimate uses: in very small doses can help relax and numb the body's muscles to help suppress symptoms such as a cough; little to no legitimate modern medical use

Overdose/long-term effects: loss of consciousness, ulcers, cirrhosis of the liver, liver failure, kidney failure, heart failure, infertility, permanent memory loss, cancer, anemia, malnutrition, high blood pressure, respiratory arrest, stroke, coma, death

Alcohol is the most commonly abused drug in our society, in large part because it is legal for people 21 years of age or older.  From wine coolers to hard liquor, alcohol comes in just about any color, flavor, and strength imaginable.  Banana, licorice, coconut, peach, peppermint, chocolate, coffee, and other "designer" flavors permeate just about every bar menu and store liquor aisle.  Strength ranges from about 2% alcohol (wine coolers) up to as much as 95% alcohol (everclear).

A specialized alcoholic beverage, absinthe, is created using an extract from wormwood.  It is widely rumored to have strong psychoactive effects (thus the common reference to "the Green Fairy"), and is often abused by users seeking such an experience.  It has a very high alcohol content (typically 50-75%, or 100-150 proof), which may be the reason for the historically reputed hallucinogenic experiences.

Binge drinking, or consuming five or more drinks in a two-hour period, is the most common cause of alcohol poisoning (overdose).  Often done in a social setting, this is much more common among young drinkers at parties, usually under or just over the legal drinking age; older drinkers are less prone to binge drinking.  Drinkers of all ages are prone to long-term alcohol abuse, with people who start drinking at a younger age being more likely to develop alcoholism.  Young drinkers such as teenagers also suffer more serious short- and long-term effects of drinking, due to their bodily systems being still in devlopment and not yet fully able to properly process alcohol and other substances.

Alcohol dependency, or alcoholism, affects about 1 in 7 drinkers and is as common as hypertension among the American population.  Alcoholics suffer not just physical but serious social effects as well, such as poor grades, loss of employment, isolation from family and friends, and more, many of which often drive the alcoholic to drink even more.  In addition, many alcohol users don't know or don't believe that it can be dangerous when combined with other drugs, sometimes leading to life-threatening or fatal overdose.

Withdrawal from alcohol (when a heavy drinker, defined as consuming 15 or more drinks per week or 5 or more drinks per day for an extended period of time, suddenly stops drinking) can be life-threatening and usually requires medical intervention; withdrawal typically begins within 5-10 hours of the last drink but may be delayed up to 7-10 days.  Symptoms include heart arrythmias, heart attack, seizures, rapid emotional changes, hallucinations, insomnia, clammy skin, and fever.

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Amphetamines
Street names: poppers, uppers, speed, crank, marathons, bumble bees, pep pills, jelly beans, rippers, wake ups, eye openers, dexies, dominoes, mollies, co-pilots, amps; Adderall, Vyvanse, Dexedrine

Method of ingestion: usually orally, in pill form; sometimes inhaled, in powder form

Desirable effects: burst of energy; feelings of euphoria; sense of well-being; confidence

Other effects: talkativeness, inability to "settle," dry mouth, insomnia, headache, dizzyness/loss of coordination, dilated pupils, dry/itchy skin, blurry vision, fever/flushing, sweating, numbness, impaired speech, rapid breathing, aggression, paranoia, delusions, schizophrenia, ulcers, weight loss, confusion/memory loss, depression, irregular heartbeat, increased blood pressure, convulsions

Legitimate uses: often prescribed for the treatment of insomnia, attention-deficit hyperactivity disorder, and various central nervous system disorders

Overdose/long-term effects: overdose is common, often fatal; nausea, tremors/convulsions, vomiting, difficulty breathing, involuntary grinding of teeth, muscle spasms (such as severely exaggerated arching of the back), lack of urine output, high body temperature, heart arrhythmia, elevated blood pressure followed by a dramatic drop in blood pressure, permanent brain damage, heart attack, coma, death

Amphetamines are a class of stimulant drugs, legitimately used to treat various central nervous system disorders as well as insomnia and ADHD.  These drugs gained popularity among recreational users in the 1940s-1960s as a way to get a high similar to that of cocaine but at a much lower price.  Due to their widespread legitimate use, they are relatively easy to obtain and are still quite popular today.

Adderall is one of the most commonly abused prescription forms of amphetamine, in part because it is one of the most widely prescribed (used to treat ADHD), and in part because the average age of the Adderall-prescribed patient is in the adolescent to young adult range.  A similar drug used to treat ADD/ADHD, Ritalin, is also commonly abused.

A variant of amphetamine, methamphetamine, has gained notoriety as an extremely addictive recreational drug; however it has only extremely limited legitimate use.

Recreational users of amphetamines quickly find that they need a higher and higher dose to get the same high.  The user's rapidly increasing tolerance to the drug often will cause him or her to overcompensate, resulting in overdose.

These drugs, even when legitimately prescribed, can be dangerous when taken in combination with certain substances.  These include monoamine oxidase inhibitors (MAOIs), alcohol, over-the-counter (OTC) cold medications, and other stimulants.  In addition, people with hyperthyroidism, heart disease, high blood pressure, glaucoma, arteriosclerosis (hardened arteries), and certain other conditions should not take amphetamines as they can cause life-threatening complications.

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Barbiturates
Street names: downers, down-lows, blue heavens, barbs, yellowjackets, bluebirds, tooties, goofballs, seccies; Seconal, Amytal, Mebaral, Butisol, Nembutal, Brevital, Luminal, Fiorinal, Alurate, sodium pentothal, phenobarbital

Method of ingestion: usually orally, in pill form

Desireable effects: feelings of euphoria and contentment; loss of inhibitions; loss of anxiety; general relaxation

Other effects: respiratory depression, lowered blood pressure, fatigue, fever, unusual excitement, irritability, dizziness, nausea/vomiting, poor concentration, sedation, confusion, impaired coordination, impaired judgment

Legitimate uses: treatment for anxiety and epilepsy, and occasionally insomnia and headaches; treatment of withdrawal symptoms; sedative use; anesthesia; occasional use as "truth serum"; used in euthanasia, capital punishment, and physician-assisted suicide

Overdose/long-term effects: sluggishness, staggering/loss of coordination, involuntary eye movement, difficulty in thinking, slowness of speech, drowsiness, hypersomnia, shallow breathing, respiratory arrest, seizures, coma, death

Barbiturates are a class of synthesised drugs that act as depressants on the central nervous system.  Largely replaced by benzodiazepines, barbiturates are highly addictive; as such they are classified as controlled substances under Schedules II, III, and IV (depending on the particular drug).

While other safer and less-addictive drugs have been developed for long-term use, barbiturates are still widely used to induce anesthesia in surgical settings, for the treatment of epilepsy and other convulsive disorders, and for euthanasia of animals.  They are also frequently used for treatment during withdrawal from various other substances, including alcohol.

Barbiturates are extremely dangerous when taken in combination with certain other drugs, particularly alcohol, opioids, benzodiazepines, and antipsychotic drugs, as these combinations greatly increase the chances of seizure or respiratory arrest, often leading to death.

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Benzodiazepines
Street names: roofies, bennies, benzo, roche, downers, nerve pills, tranks, xanies, vals; Ativan, Valium, Rohypnol, Librium, Xanax, Restoril, Seresta, ProSom

Method of ingestion: orally, in pill form; sometimes taken intravenously

Desirable effects: relaxation/sense of calm; mild euphoria; often used in combination with alcohol to increase its effects or as a "come down" from stimulant drugs; sometimes used as a "date rape" drug

Other effects: drowsiness, dizziness, loss of coordination, decreased libido, impotence, short-term memory loss, decreased blood pressure, changes in appetite, depersonalization, nightmares

Legitimate uses: treatment for insomnia, seizure disorders, tetanus, anxiety, and panic disorder, as well as during withdrawal from other substances; anesthesia; widespread veterinary use

Overdose/long-term effects: depression, loss of inhibition, irritability, confusion, liver toxicity, aggressive/violent behavior, suicidal behavior, altered perception of reality, depression, loss of interest in various activities, socially-debilitating psychoses (such as agoraphobia), slurred speech, involuntary muscle movements, respiratory depression or arrest, heart attack, coma, death; when taken intravenously gangrene, abcesses, cellulitis, deep vein thrombosis

The successor to barbiturates, benzodiazepines are a class of central nervous system depressant drugs that are common in medical use today.  They are safer and less addictive than barbiturates, and for certain conditions may be used for long-term use.

Benzodiazepines are not without their dangers however.  While less addictive than their barbiturate cousins, benzodiazepines are still considered to be highly addictive, and as such are regulated around the world as controlled substances.  In addition, while overdosing on benzodiazepines alone is not usually fatal, most abusers of this type of drug commonly take it in combination with other drugs as well; for these users, called "poly-drug abusers," overdose on benzodiazepines can be fatal.  In particular these drugs are highly dangerous when combined with alcohol, barbituratesopioids, or certain antidepressants.  Some benzodiazepines have negative interactions with "inert" drugs as well, such as antibiotics, antifungals, and birth control pills.

One benzodiazepine, Rohypnol, has gained notoriety as a "date rape" drug, though it is much less popular for this purpose than GHB.  Rohypnol is not legal in the United States, and even those from other countries with legitimate prescriptions may not import it for their own personal use.

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Cannabis
Street names: weed, grass, pot, herb, mary jane, blunt, bowl, green, chronic, stress, wacky tobaccy, skunk, joint, jive, a-bomb, ju-ju, ashes, bud, leaf, ganja, loco, roach, sticks, blue sage, magic smoke, buddha, monte, O.J., panama gold, cocoa puff, cripple, primo, laughing grass, rag weed, rasta weed, reefers, don juan, rockets, doobie, rough stuff, blueberries, green flowers, shotgun, grasshopper, fingers, spliff, fine stuff, stems, seeds, gangsta, ghana, bang; marijuana, hashish/hash, hemp, kief

Method of ingestion: usually inhalation of smoke from burning cannabis; sometimes inhalation of vapors; sometimes orally, by mixing into food; occasionally chewed (hashish); occasionally orally, by brewing as tea; in rare cases inhaled, in powder form (kief)

Desirable effects: relaxation; psychoactive/psychedelic effects (hallucinations); mild euphoria

Other effects: increased appetite, dry mouth/"cotton" mouth, reddened eyes, decreased blood pressure, increased heart rate, slowed reaction time, slowed sense of passage of time, impaired psychomotor activity, sensation of hot or cold, decreased energy levels, altered sensory perception, inability to pay attention

Legitimate uses: treatment of chronic pain, glaucoma, severe nausea, and severe insomnia; used as a counteractant to side effects of certain cancer drugs; used as an appetite stimulant in cancer and AIDS patients; only synthesised versions of the active chemicals are approved for use in U.S.

Overdose/long-term effects: short-term memory loss, anxiety, paranoia, schizophrenia, loss of motivation, loss of interest in various activities, respiratory disease (when smoked)

Cannabis is one of the oldest and most debated drugs today.  Evidence of its use as fiber dates back as far as 10,000 BC, and of inhalation as far back as the third millenium BC.  It has been widely touted through the ages as a medicinal herb, from the Scythians of the 5th-2nd centuries BC to modern times, for the treatment of a vast range of ailments.

Banned in the United States in 1937, cannabis is today illegal in most parts of the world, with the notable exception of the Netherlands.  It has long been touted as a "gateway drug," meaning that users are more likely to progress to use of other, more dangerous drugs such as cocaine or heroin, than non-users of cannabis.

Marijuana, the most common form of cannabis ingested, is usually rolled into a cigarette ("joint") or cigar ("blunt"), or packed into the bowl of a regular pipe or water pipe ("bong"), and smoked.  It is occasionally heated to release the active chemicals into a vapor, which is then inhaled, or mixed with food and eaten.  A resinous form of cannabis, hashish, can be chewed, and its derivative oil (hash oil) can treat cigarettes or cigars or be mixed into food or drink.  In rare cases, a powdered form of cannabis, known as kief, is inhaled much like cocaine or speed.

Cannabis is also sometimes combined with other drugs as well, usually those with a stimulant effect such as methamphetamine or crack cocaine.  "Dirty blunts" or marijuana cigarettes rolled with pieces of meth or crack are sometimes sold on the street to users who want a more intense high with an eased "come down."  Joints and blunts are also occasionally dipped in PCP for easier ingestion of that drug.

Fatal overdose with cannabis is extremely rare, if even possible; however overdose can produce other rather unpleasant effects, such as extreme paranoia or disorientation, very rapid heart rate, decreased blood pressure, and severe cough.  In addition, the "hangover" experienced after a heavy dose of cannabis can be worse than that after a night of very heavy drinking.

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Club Drugs
So-called "club drugs" or "designer drugs" are substances that are typically ingested by people at parties or dance clubs, seeking to intensify their enjoyment of the environment.  Ecstasy (MDMA), methamphetamine, ketamine, quaaludes, GHB, and even cocaine all fall under this category, as well as a host of other substances developed as a means of getting around drug laws while providing similar effects.

Most club drugs produce some sort of stimulant effect, with many also either enhancing sensory experience (such as MDMA's effect of increased sensitivity to touch) or having a mild hallucinogenic effect.  Some club drugs, such as BZP, are banned in countries such as the U.S. and New Zealand, but are legally available to varying degrees in other countries such as Canada, sometimes marketed as "dietary supplements."  In the case of BZP, the drug is frequently marketed as an "herbal high" or a "natural" stimulant, when in fact it is entirely synthesized.

Many of these designer drugs are marketed as "safe alternatives" to such drugs as methamphetamine and cocaine, though most of the available research indicates that they are no safer than their alternatives.  In addition, with many of these drugs (most notoriously ecstasy), pills are often "cut" with other substances such as speed, or even made up of other chemicals entirely, in an effort by manufacturers and dealers to cut costs and boost profits.  Some "mimic" pills produce similar effects to the drug they impersonate, while some produce no effect whatsoever or even cause great harm to the user.  Unfortunately for the user, there is generally no way to tell which pills are legitimate and which ones are adulterated or fake until it's too late.

Typical effects of club drugs include: increased heart rate, increased breathing rate, increased sensory sensitivity, increased energy, increased appreciation for music and color, desire to socialize and/or dance, mild hallucinogenic effects, increased sexual arousal, feelings of calm and euphoria, increase in body temperature, dilated pupils, involuntary grinding of teeth, insomnia, headache, dehydration, nausea, and tingling sensations.  Effects of overdose include loss of appetite, extreme thirst, hyponatremia (low blood sodium) due to water intoxication, heart arrythmia, heart attack, hyperthermia (extremely high body temperature), hyperventilation, vomiting, unconsciousness, renal failure, psychosis, seizures, brain damage, coma, and death.  Combining any club drug with other substances, including alcohol or energy drinks, can greatly exacerbate the negative effects of either drug, and is the usual cause of lethal overdose.

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Cocaine
Street names: coke, blow, snow, candy, nose candy, base, freebase, crack, rock, big C, flake, caine, blizzard, bump, caviar, chalk, white lady, cola, stardust, pimp, nummies, gummers, rush, sniff, pebbles, freeze, gravel, happy trails, snow bomb, tornado, wicky stick, perico

Method of ingestion: inhaled, in powder form; inhalation of smoke from burning cocaine "rocks"; occasionally orally, by brewing leaves as tea; rarely taken intravenously; historically taken orally, in liquid form or mixed into food

Desirable effects: intense "rush" and feelings of euphoria; feelings of confidence; increased sexual interest; increased sociability; burst of energy; extreme mental alertness; sometimes taken with alcohol to intensify the high

Other effects: talkativeness, nervousness/"jumpiness," dry mouth, dilated pupils, decreased appetite, anxiety, irritability, paranoia, insomnia, diminished decision-making capability, dizziness, muscles twitches/spasms, tremors, blurred vision, abdominal pain, nausea, impotence, fever, increased heart rate, increased blood pressure, nose bleeds, violent behavior, loss of self-control; allergic reaction or poisoning from foreign substances used to "cut" or "cook" cocaine

Legitimate uses: occasionally used as an anesthetic in ocular and nasal surgery; used in Australia as an anesthetic for nose and mouth ulcers; historically used as a local anesthetic, as treatment for a variety of ailments from obesity to depression, and as a general "pick-me-up"

Overdose/long-term effects: headaches, chronic runny nose, chronic sore throat, altered heart rhythm, very high or very low blood pressure, difficulty breathing, chronic bronchitis, asthma, involuntary grinding of teeth, compulsive and repetative behaviors, mood disturbances, psychosis, severe depression, suicidal thoughts, tactile and auditory hallucinations, vertigo, sexual dysfunction, infertility, disruption of menstrual cycle, cartilage deterioration resulting in separation of the septum, brain infections, gangrene in bowels and other body parts, weight loss, malnourishment, increasingly insatiable hunger (during a crash), incontinence, chest pain, seizures, heart infection, collapsed lungs, respiratory arrest, heart attack, kidney failure, bleeding in brain, stroke, coma, death

Cocaine has a long history in South America, where the coca plant from which it is obtained grows naturally.  For over a thousand years natives have chewed the leaves for medicinal purposes, for increased energy, and for religious rites.  The leaves have also been brewed as tea in coca producing countries, even in modern times, often touted as a remedy for general malaise, air sickness, and jet lag.  In the late 1800s so-called "coca-wines," wines laced with cocaine, became commercially popular; even Pope Leo XIII was rumored to always carry a hip-flask of coca-wine.  Coca-cola's original formulation had from 9-60mg of cocaine per serving, and many medicinal tonics and patent medicines containing cocaine were sold in drug stores, available right off the shelves.

Inhalation of the powdered form of cocaine was the most popular for abuse from the late 1800s up until the 1970s, when "freebasing" (a method of concentrating cocaine powder, usually using ether) was developed, though during the 1940s to the early 1970s cocaine use dropped off as cheaper amphetamines became widely available.  Freebasing dramatically dropped the price of a dose of cocaine and increased the speed and intensity of the high achieved, but was highly dangerous due to the risk of explosion from the fumes.  In the early 1980s crack cocaine, a lower-quality form of freebase without the potential for explosion, was developed and brought cocaine - formerly restricted to upper- and middle-class users - to the masses, dropping the price per dose from around $20 for powdered cocaine to around $5 for crack.

Powdered cocaine produces effects within minutes, with the peak of the high occuring 10-30 minutes after inhalation.  Effects from injected cocaine are felt almost instantly, with the peak occuring within minutes.  Freebase and crack cocaine produce effects within 10-15 seconds, and peak around 1.5 minutes.  Due to the extreme speed and intensity of the high from smoked cocaine, many users become addicted after the first dose.  Its low cost further exacerbates the addiction, as it it is easier for most people to part with a few bucks than with $20 or more.

Cocaine has an extreme vasoconstrictor effect, meaning that is severely constricts the body's blood vessels.  As a result, hypoxia (lack of oxygen to the body) often results, sometimes resulting in major, permanent damage after chronic cocaine use.  In addition, users with ADD or ADHD often find that cocaine has a "calming" effect, enabling them to focus more readily on tasks and complete them more easily; in these users overdose is common, and the combination of cocaine and prescription drugs for ADD or ADHD can be deadly.

Cravings for cocaine begin sometimes as soon as the first hit has worn off, and are so intense as to cause chronic users to alienate family, friends, work, and every other social norm in favor of seeking the next hit.  Many turn to crime to support their habit, or end up indigent as they sell all their belongings and give up their home in order to further support their addiction.

Overdose is common, as users find their tolerance for the drug increasing rather quickly with continued use.  Cocaine is particularly dangerous when combined with other drugs, most notably alcohol (the combination of alcohol and cocaine produces a toxic compound in the body) and other drugs with a stimulant effect (such as amphetamines or diet pills).  Often times the drug is "cut" with other substances such as baking soda or speed (powdered cocaine), or contains impurities such as ether (freebase or crack), which can lead to allergic reaction or poisoning depending on the compound and amount used.  Cocaine overdose is often fatal without immediate medical intervention.

Cocaine is commonly misclassified as a narcotic; however the term "narcotic" actually refers to the opioid class of drugs.

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GHB
Street names: g, liquid e, liquid x, liquid ecstasy, gamma-oh, georgia home boy, grievous bodily harm, great hormones at bedtime, water, scoop, soap, easy lay, salty water, jib, organic quaalude, fantasy, GBH, everclear (often confused with the alcoholic beverage of the same name); Remforce, Blue Nitro, Revitalize Plus, Serenity, Enliven, Cherry fX Bombs, Lemon fX Drops, Orange fX Rush, Gamma G, Firewater, Invigorate, G.H. Revitalizer, Insom-X

Method of ingestion: usually orally, in liquid form; occasionally inhaled, in powder form or orally, in pill form; rarely intravenously

Desirable effects: increased energy; feelings of euphoria; feelings of sensuality; enhanced sexual experience; general body relaxation; increased muscle mass; desire to socialize; decreased inhibition

Other effects: nausea, vomiting, headache, drowsiness, loss of consciousness, difficulty concentrating, amnesia, loss of motor control, loss of gag reflex, shortness of breath/respiratory distress, urinary incontinence, numbness/tingling, loss of physical sensation

Legitimate uses: treatment for cataplexy and narcolepsy; in some countries used as an anesthetic and for treatment during alcohol withdrawal; historically used as an anesthetic during childbirth and as a sleeping aid, as well as for treatment of clinical depression; currently undergoing trials for treatment of fibromyalgia

Overdose/long-term effects: conscious paralysis, aspiration of vomit, asphyxiation, seizures, respiratory arrest, heart attack, death; long-term effects unknown

GHB is a naturally-produced compound in the human body.  Unofortunately, this has led many to believe that it is safe - in fact the opposite is generally true.  In very small doses, GHB does have some legitimate medical benefits for the treatment of cataplexy (involuntary complete relaxation of body muscles, usually brought on by emotions) and narcolepsy.  However, the typical recreational dose is much higher than the theraputic dose, and unlike theraputic doses, which are divided over the course of a day, recreational doses are taken all at once.  GHB also has a very steep dose curve, meaning that the window between the dose needed to get the desired effect and overdose is very narrow, making it very easy to overdose.

Though Rohypnol is more well-known as the "date rape drug," GHB is actually much more commonly used for this purpose.  It's combination of aphrodesiac qualities and amnesia/loss of consciousness effects make it ideal for such activity.  In addition, GHB is very easy to slip into a drink unnoticed as it looks like water and has only a slightly salty taste, which is easily covered up by the flavor of the drink itself.

While GHB itself can be lethal, it is particularly dangerous when combined with other drugs, notably alcohol, barbituates, benzodiazepines, other depressants, and most stimulants.  Addiction, while not common, can occur if taken frequently and regularly throughout the day, and withdrawal can be fatal.  The combination of GHB and depressant substances can lead to rapid unconsciousness, respiratory depression, heart attack, and death, while the combination of GHB and stimulant substances can lead to seizures, brain damage, and death.  GHB is one of the most notoriously lethal club drugs available, especially since it is often combined with alcohol; this combination typically produces a "delayed" effect, causing the user to think they didn't take enough.  The second dose generally kicks in at or near the same time as the first, "delayed" dose, resulting in substantial overdose.

Two substances, known as GBL and BD, are "prodrugs" that convert to GHB in the body when ingested.  These two substances are commonly found in many industrial products, including paint thinners, drain cleaners, and floor strippers.  In addition, many products containing GBL and BD have been marketed as "dietary supplements" for bodybuilding, obesity, and sleeplessness, though they have been banned by the FDA for inclusion in such products domestically, and cannot legally be imported.

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Hallucinogens
Street names: varies depending on drug; most common are acid, tabs, shrooms, magic mushrooms, caps, divine green, sage, buttons, payola, prickles, Jimmy's tea, jimmies, angel dust, embalming fluid, embalming stick, sherm, sherm stick, dippa, happy stick, wet stick, superman; LSD, psilobyn/psilocybin, salvia divinorum, peyote, datura, PCP

Method of ingestion: orally, either in powdered or liquid form or rarely intravenously (LSD); orally, by eating or brewing into tea (mushrooms); inhalation of smoke from burning or occasionally orally, by mixing with food (salvia divinorum); orally, by eating or brewing into tea, or in encapsulated powder form (peyote); orally, usually by brewing into tea (datura); usually inhaled, by treating cigarettes with liquid and inhalation of the smoke or occasionally inhaled, in powder form (PCP)

Desirable effects: disassociation; hallucinations; psychedelic experiences

Other effects: varies depending on drug; side effects may range from hunger and dry mouth to extreme psychosis and inability to feel pain

Legitimate uses: little to no legitimate medical use for most hallucinogens, with the notable exception of datura (used as a sedative and for treatment of spasmodic disorders, as well as in homeopathic medicine for ailments from asthma to impotence); some used in religious rites (peyote, salvia divinorum)

Overdose/long-term effects: little to no known long-term effects for most drugs; overdose usually results in toxicosis due to over-ingestion of poisonous chemicals in the drug, sometimes leading to severe nausea/vomiting, loss of consciousness, liver failure, kidney failure, respiratory arrest, heart attack, sepsis, coma, death

Hallucinogens are a broad class of drugs, usually found naturally occuring in plants (with the notable exceptions of LSD, which is synthesised from a rye fungus, and PCP).  While the individual qualities and effects of each drug may vary greatly, the general desired effect is the same: to experience a "trip" of a psychedelic or disassociative nature.  The six most common hallucinogens are described here; however there are a great number more that may be available, including some prescription drugs such as ketamine.

Some hallucinogens are relatively safe medically speaking, such as peyote (which has traditionally been used in Native American religious rites) and salvia divinorum (a type of sage).  Some have mixed effects depending on the user and the dosage, such as LSD.  Others, such as PCP and mushrooms, can have moderate to moderately severe side effects depending on the dosage taken.  Datura, on the other hand, is extremely toxic.  Medical effects aside however, all hallucinogens can have negative and severe psychological effects, due to the unpredictable nature of these drugs.

Most of these drugs have no known long-term effects, with the exception of LSD; habitual LSD users may find themselves having "flashbacks" of previous trips, even when not under the influence of the drug.  These flashbacks can be extremely frightening and lead to permanent psychosis, as well as cause the user to behave irrationally or violently as they endure the flashback.

Overdose is not common with most of these drugs, as a user's tolerance rarely builds and requires them to take increasingly higher doses; in addition, while users may be habitual, they rarely become addicted to the drug.  Users who overdose typically do so by taking a second dose in response to a delayed effect of the first dose, causing them to think they didn't take enough.  Users of datura overdose much more easily, due to the plant's highly toxic nature.  Some hallucinogens, most notably PCP, are often combined with other drugs such as marijuana or crack cocaine, sometimes leading to other serious side effects or overdose.

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Inhalants
Street names: laughing gas, whippets, snappers, poppers, highball, hippie crack, poor man's pot, quicksilver, air blast, moon gas, oz, huff, boppers, Texas shoe shine, liquid gas; nitrous oxide, chloroform, ether, halothane, volatile solvents, aerosols, amyl nitrite, butyl nitrite, cyclohexyl nitrite

Method of ingestion: inhalation of fumes

Desirable effects: giddiness; strong feelings of intoxication (similar to heavy alcohol consumption); psychedelic experiences; sexual enhancement

Other effects: nausea, headache, lightheadedness, drowsiness, oxygen deprivation/hypoxia, slurred speech, poor reflexes, loss of energy, nerve damage, loss of consciousness, poor coordination, loss of sensation, muscle weakness, confusion, delerium, heart attack, death

Legitimate uses: some gases used in anesthesia, such as nitrous oxide, halothane, and chloroform; amyl nitrite used in some heart diagnostic procedures; most have no legitimate medical use

Overdose/long-term effects: weight loss, disorientation, dementia, hearing loss, vision loss, irregular or increased heart rate, lung damage, heart damage, bone marrow damage, liver damage (including cirrhosis), kidney damage, nerve damage, brain damage, brain shrinkage, heart attack, coma, death

Inhalants are a loose group of drugs that, while they may also fall into other categories such as stimulants or hallucinogens, are almost exclusively inhaled as a means of ingestion.  In general, inhalants are incredibly easy and inexpensive to obtain, as over 1,000 common household products contain substances that can be abused in this manner.  Paint thinner, correction fluid, glue, gasoline, hairspray, permanent markers, hair dye, brake cleaner, paint (both spray paint and the kind in buckets), cleaning solvents, shoe polish, engine degreaser, leather cleaner, lighter fluid, and even whipped cream and cooking spray can be abused by inhalant users.

Nearly every home, school, and workplace has multiple items that have legitimate use but are easily abused, making control nearly impossible.  In addition, because these items have legitimate, common, every-day use by a vast majority of consumers, legal regulation is extremely impractical.  The ease of access to these items, in combination with the lack of special equipment or techniques required to use them, makes experimentation very easy from a young age; 1 in 5 children will have tried inhalants by the time they reach 8th grade.

Use of inhalants is extremely dangerous.  Users can easily become hooked, leading rapidly to serious damage to major organs and systems in the body.  Long-term users often suffer severe nerve and brain damage, and even suffer from brain shrinkage.  In addition, death from inhalant use is very common, and can occur at any time (over 20% of inhalant-related deaths occur the first time a person uses).  This phenomenon, known as Sudden Sniffing Death Syndrome (SSDS), occurs when a user has a sudden spike in epinephrine (adrenaline), usually from being startled for some reason (such as being caught using) or from a particularly exciting or frightening hallucination, resulting in massive, lethal heart arrythmia.

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MDMA
Street names: ecstacy, E, X, XTC, adam, empathy, molly, hug drug, lover's speed, rolls, disco biscuit, candy pills

Method of ingestion: orally, in pill form

Desirable effects: decreased fear, anxiety, and insecurity; altered state of consciousness; euphoria and mood lift; feelings of empathy and compassion; feelings of intimacy and love; sense of peace with oneself and the world at large; intensification of sensory perception; increased energy, alertness, and endurance; increased sexuality and improved sexual experiences; mild psychedelic experiences; decreased sensitivity to pain

Other effects: dry mouth/excessive thirst, increased body temperature, chills/sweating, muscle tension, involuntary clenching of jaws, loss of appetite, difficulty concentrating, irritability, fatigue, headache, dizziness/lightheadedness, vertigo, muscle aches from excessive exertion, short-term memory loss

Legitimate uses: none; recently began studies investigating its effectiveness in treating post-traumatic stress disorder and anxiety in terminally-ill patients; historically used in psychotherapy

Overdose/long-term effects: insomnia, high blood pressure, depression, loss of motivation, impaired cognition, loss of consciousness, dehydration, hyponatremia (low blood sodium) due to water intoxication, difficulty breathing, disorientation, confusion, anxiety, paranoia, panic attacks, depersonalization, hallucinations, amnesia, serotonin toxicity, brain damage, chest pain, heart arrythmia, heart damage, heart attack, seizures, organ failure, stroke, death

Ecstasy is one of the most popular club drugs today.  Though it is considered by its proponents to be relatively harmless, little research has been done as to its effects, and thus not much is known about how harmful this drug may be.  It is a combination of a mild hallucinogenic with a stimulant.  Its chemical name, methylenedioxymethamphetamine, shows that it is related to regular methamphetamine, but it does not share the same high addiction potential (however addiction can and frequently does occur).

MDMA (the abbreviation for ecstasy's chemical name) can be difficult to recognize.  Often resembling little candies, the pills can come in any color, shape, and even flavor.  Most ecstasy pills are stamped with a design, of which there are hundreds ranging from shapes to cartoon characters to various symbols and phrases.

The main dangers relating to MDMA come not so much from the drug itself, but from contaminants in the pills and the habits of the users themselves.  Many pills are "cut" with speed, caffeine, meth, PMA (an extremely neurotoxic chemical with similar effects to MDMA), or other drugs in an attempt to stretch a supply and boost profits, or they may contain no MDMA at all.  The unregulated existence of MDMA and the lack of knowledge about it make it very difficult for a user to know the purity and composition of the pills they have (though testing kits are available and can detect the presence of common cutting agents).

Many, if not most, MDMA users are "poly-drug" users, meaning that MDMA isn't the only thing they take on a regular basis or at a single time.  While a serious or lethal overdose from MDMA itself is quite rare, overdose from combining MDMA with other drugs is much more common, and is the usual cause of MDMA-related overdose and death.  In addition, over-compensating for the side effects of MDMA (such as drinking too much water to alleviate the thirst produced) can have serious and sometimes lethal consequences as well.  MDMA can also cause severely adverse and sometimes lethal reactions in people who take certain medications, such as MAOIs.

There have been multiple accounts of long-term users of MDMA whose cognitive and memory abilities have been severly impaired; they are described as having their "brains fried."  Brain scans of such individuals have shown varying degrees of deterioration, appearing on scan images as "holes" in the brain, though it is not known if this is due to MDMA use or other factors, such as poly-drug use.

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Methamphetamine
Street names: crystal, crystal meth, meth, ice, tweak, crank, poor man's coke, zip, chalk, glass, red rock, P2P, C.R., prope dope; Desoxyn

Method of ingestion: usually inhalation of vapors from heating; occasionally orally, in pill form

Desirable effects: intense "rush" or feeling of euphoria; intense burst of concentration

Other effects: dry mouth, halitosis (bad breath), restlessness, irritability, headache, dilated pupils, increased breathing rate, increased blood pressure, cracked teeth, insomnia, anxiety, depression, paranoia, heavy sweating, loss of appetite, nausea, vomiting, diarrhea, depressed immune system, sores and skin infections, unpredictable/violent behavior, seizures, homicidal or suicidal thoughts

Legitimate uses: treatment for narcolepsy, attention-deficit disorder (ADD), and obesity

Overdose/long-term effects: overdose is common, usually during binge cycles; inattention to personal hygiene, tooth decay/loss of teeth, weight loss, acne, extreme psychotic/violent behaviors, liver damage, kidney damage, brain damage (similar to Alzheimer's or Parkinson's), high blood pressure, paranoia, lead poisoning, stroke, heart attack, seizures, death

Methamphetamine is a variant of amphetamine.  Both are synthesised stimulants, though unlike amphetamines methamphetamine has only extremely limited legitimate uses.  It is classified as a Schedule II drug, meaning that it has a high potential for abuse, and therefore prescriptions for it are not refillable.

The drug has become quite popular in America over the past 30 or so years, partly because it produces similar effects to cocaine but is much cheaper and longer-lasting, and partly because it is relatively easy to produce (though production is highly dangerous).

Home-based meth labs have cropped up all over the country, particularly in smaller rural towns where neighbors are spaced further apart.  While some of the individual ingredients needed to manufacture methamphetamine have become more tightly controlled (such as pseudoephedrine, commonly found in OTC cold medications), they are still relatively cheap and easy to get from places like Mexico, where regulations are much more lax.  Meth labs are highly dangerous due to the toxic fumes produced by meth production, and can explode at any moment.  Those who live in a home containing a meth lab frequently suffer serious medical problems, such as nerve damage, brain damage, heart and kidney failure, collapsed lungs, and more.  In addition, each pound of methamphetamine produced results in five to six pounds of toxic waste, often flushed down the drain where it contaminates the local water supply for years to come.

Methamphetamine users typically put between one and three crystals of meth, known as "rocks," into a specially designed glass pipe that looks like a straw with a sphere at one end.  The sphere containing the rocks is then heated to vaporize them, and the resulting vapor is inhaled.  Alternatively, pill forms of meth are available, but they are generally found in pharmacological (prescription) use.  Occasionally small rocks are rolled with marijuana into a joint or blunt and then smoked (called a "dirty blunt").

One of the stereotypes of the meth user is the habit of quickly and completely disassembling and reassembling complex machinery or electronic items, such as car engines and computer circuit boards.  This is due to the burst of energy and focused concentration that many meth users experience, and during a binge this burst can last for several hours or days.  Unfortunately, the longer the binge, the worse the crash - sometimes the post-binge crash is more dangerous than the drug itself.

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Nicotine
Street names: smokes, cigs, fags, zips, snuff, chew, chaw, snus, goza, the patch; cigarettes, cigars, chewing tobacco, pipe tobacco, hookah

Method of ingestion: inhalation of smoke from burning tobacco; orally, by chewing on tobacco leaves or nicotine gum; occasionally inhalation of vapors from heated tobacco; occasionally via absorption through the skin; occasionally orally, in pill or lozenge form; rarely inhaled, via medical inhaler or nasal spray

Desirable effects: modest stimulant effect; stress reduction; increased alertness and ability to concentrate

Other effects: sore/dry throat, halitosis (bad breath), stained teeth, increased heart rate, increased blood pressure, shortness of breath, mild hypoxia, nausea

Legitimate uses: none, except during treatment for nicotine addiction; historically used as insecticide

Overdose/long-term effects: headaches, joint pain, mouth ulcers, pulmonary disease, asthma, chronic bronchitis, depressed immune system, heart disease, high blood pressure, cancer (multiple types, particularly lung, throat, mouth, esophogeal, breast, laryngeal, cervical, bladder, pancreatic), stroke, emphysema, heart attack, death

Nicotine, despite its legal status and social acceptibility, is one of the most addictive substances abused, comparable with the addictive qualities of cocaine and heroin.  At the relatively low doses administered in tobacco that is chewed or smoked, it can hook a user very quickly.  It is a poisonous, naturally-occuring alkaloid that is most commonly found in tobacco; trace, pharmacologically-insignificant amounts also exist in a variety of vegetables and fruits, including tomatoes, potatoes, and eggplants.

Tobacco is the most common source of nicotine, whether smoked in a cigarette, cigar, or pipe, chewed or sucked, or mixed with honey or molasses and flavorings and smoked (hookah).  Other sources are available as well, designed to help ease withdrawal from the drug for users, such as patches, pills, lozenges, gums, and inhalers, though these sources typically have gradually decreasing doses from the level found in tobacco.

In addition to being one of the most addictive, it is one of the deadliest.  While nicotine rarely spontaneously kills a user (i.e., overdose), it almost always has terminal effects on long-term users, including cancer, emphysema, severe ulcers (internal sores), and more.  Quitting smoking can eventually allow a user to return to normal health; however the greatly increased risk for some diseases (such as cancer) may be irreversible.

High doses of nicotine can have serious acute effects, such as nausea, difficulty breathing, and heart rate problems such as arrythmia or palpitations.  In fact, high doses have historically been used as insecticides, as well as in darts designed to bring down elephants.  In extremely high doses, nicotine and the accompanying chemicals found in tobacco can produce a hallucinogenic effect, though the dose required for such generally results in severe overdose.

There has been some research speculation that nicotine itself is not very addictive, but that when combined with the naturally-occuring MAOIs also found in tobacco, addiction can be swift and strong.  However, most medical experts agree that an addiction to nicotine is one of the deadliest and most difficult to break.

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Opioids
Street names: dope, smack, horse, painkillers, M, Miss Emma, OC, oxy, percs, narcs, chill pills, hillbilly heroin, cotton dragon; heroin, morphine, opium, codeine, oxycodone, hydrocodone, fentanyl, methadone; Vicodin, OxyContin, Percoset, Percodan, Demerol, Darvon, Darvocet

Method of ingestion: usually orally, in pill form (prescription opioids); intravenously (heroin); occasionally inhalation of smoke (heroin, opium) or powder (heroin, prescription opioids)

Desirable effects: sense of well-being; decreased sensitivity to pain

Other effects: drowsiness, lightheadedness, constricted pupils, depression, constipation, nausea, vomiting, drooling, flushed skin, itchy skin, rash, lack of interest, decrease in breathing rate, loss of appetite, sweating; allergic reaction or poisoning from "cutting" agents

Legitimate uses: short-term pain relief; long-term pain management; cough suppressants; treatment for diarrhea; methadone and naloxone used for treatment of opioid addiction

Overdose/long-term effects: chronic and/or severe constipation, mood swings, irregular menstruation, decreased libido, heart infections, liver disease, abscesses, pulmonary complications (such as pneumonia), peripheral edema (swelling, usually in the lower limbs), delerium, low blood pressure, decreased body temperature, heart arrythmia, seizures, respiratory arrest, coma, death

The term "narcotic" has come to be an all-encompassing name for illicit drugs in general; however narcotics, when properly defined, are strictly opioids.  Heroin, opium, and a number of prescription painkillers fall into this category.  Natural opioids are derived from certain species of poppy flowers, and many semi-synthetic and fully-synthetic opioids have been developed as well.  From the historical practice of opium smoking ("chasing the dragon"), to the stereotypical injection of heroin by addicts ("shooting up" or "smacking"), to the popping of pills by addicts young and old alike, the methods of ingestion are as varied as the forms of the drug.

Due to their relaxed euphoric effects, opioids are at a high risk for abuse.  While legitimately used to treat acute and chronic pain without any significant risk of abuse, users who take the drugs recreationally can become hooked after only a few doses.  Withdrawal symptoms, including severe muscle or bone pain, excessive tear production (lacrimation), runny nose, and severe stomach cramps, can onset within only a few hours of the last dose taken, leading users to seek more of the drug to ease the symptoms.  In addition, a user's tolerance to narcotics increases fairly rapidly but drops off almost as rapidly, leading to increasingly high chances of overdose if the user stops for longer than normal.

Hospitals are keenly aware of the potential for narcotics abuse, and thus have trained their emergency room and outpatient staff to recognize "drug seekers."  Many opioid addicts will go from hospital to hospital, clinic to clinic, feigning severe pain (often a migraine or other headache) in an effort to get the drug prescribed to them.  While more typical among users who prefer intravenous administration (due to its more rapid onset and intense effects), this also occurs among those wishing to accumulate a supply of pills, whether for personal use or for sale.

Unlike many other drug addictions, addiction to narcotics is often treated with other, longer-lasting narcotics such as methadone or naloxone to ease the symptoms of withdrawal.  Also unlike other addictions, withdrawal symptoms from opioids are typically more severe but less commonly fatal.

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Over-the-Counter (OTC) Medications
Many OTC medications can be and are abused, most notably those in the cough-and-cold aisle.  Decongestants (such as pseudoephedrine, found in medications such as Sudafed), antihistamines (such as diphenhydramine, found in medications such as Benadryl), and cough suppressants (such as dextromethorpham, found in medications such as Robitussin DM and Dimetapp) are all commonly abused for their various effects.  Many other medications, such as sleep aids and wake-up aids, are also abused.  Of particular note:

Pseudoephedrine is a decongestant that has a mild stimulant effect in clinical doses, which is what gives normal users the feeling of "medicine head."  In recreational doses, it has a much stronger stimulant effect, on a level comparable to speed.  It is one of the necessary ingredients in the manufacture of methamphetamine; due to this fact and the potential for abuse of the drug itself, the federal government passed legislation in 2006 that restricted the sales of medications containing pseudoepehdrine.  Many states have enacted similar laws, and in some states (notably Oregon) a prescription is necessary to obtain the drug.  Ephedrine (a stimulant) and phenylpropanolamine (a decongestant) were also restricted in the same manner under the federal law.

Diphenhydramine, a common antihistamine found in many allergy relief medications as well as some sleep aids, has a sedative effect that can become habit-forming.  In addition, recreational doses (higher than the recommended clincal dose) can sometimes produce psychotic effects, such as delerium and hallucinations.  While sales of products containing diphenydramine or other OTC antihistamines by themselves are not regulated in the same manner as pseudoephedrine, many allergy relief products contain both drugs and thus are kept behind the pharmacy counter.  Many other OTC antihistamines have similar effects to diphenhydramine and are also abused.

Dextromethorpham (DXM) is a common cough suppressant found in many cough syrups.  Available without a prescription, DXM is related to opioids.  It has some opioid-like effects, and is sometimes considered to be a "pseudo-opioid."  While clinical doses have a theraputic effect, the all-too-common recreational practice of "robo-tripping" (also called "dive-bombing" or "d-bombing," named for the practice of downing an entire bottle of cough syrup at once; common street names are "robo," "skittles," or "poor man's PCP") produces a hallucinogenic and disassociative effect comparable to ketamine or PCP, as well a euphoric effect.  Many recreational users of DXM combine it with alcohol or marijuana to intensify the psychological effects of the drug.  Continuous dosage (taking moderate doses every few hours) can result in a temporary psychosis, in which users experience vivid, realistic, and sometimes frightening audio and visual hallucinations, as well as a complete disconnect from reality (most users who experience this psychosis describe it as "unpleasant," and are unwilling to repeat the experience).

Sleep aids are commonly abused by users who desire a sedative or "drunk" effect, and often produce effects similar to those of opioids.  Euphoria, relaxation, and even hallucinations are commonly experienced at the high recreational doses, and even at clinical doses sleep aids can become physically addictive when taken long-term.  Certain sleep aids, such as Tylenol PM and other pain-relieving sleep aids, can be very dangerous when taken in higher doses than the label recommends; the acetaminophen in these sleep aids builds up in the liver, causing liver toxicity and sometimes fatal overdose (see below in this section).

Anti-sleep pills, such as NoDoz, typically contain 100-200mg of caffeine per pill, the same as in a cup of coffee.  When taken as the label recommends, they have little consequence to a user's health.  However, with the prevalence of coffee and energy drinks in modern society, for most people taking just one or two of these pills can produce a mild caffeine overdose, resulting in jitters, heart arrythmias, nausea, and more.  In addition many users take multiple pills at once or throughout the day as a means to "get through" or even to lose weight, and quickly become hooked on this legal drug.  (Note: the average age of a caffeine abuser is 21, most likely owing to the pressures of high school and college work.)  People who abuse caffeine are likely to be unable to function without it after a short time (just a few weeks), and may suffer from hypersomnia (excessive sleep) for several weeks or months if they try to quit.

Energy drinks, much like caffeine pills, can be quite dangerous, especially due to the ease of combining them with other drugs (such as washing down a few Valiums or Vicodins with an energy drink).  Natural compounds and extracts such as guarana, taurine, and ginseng have a mild stimulant effect, and most energy drinks combine one or more of these substances with caffeine to insensify the effect.  The popularity of drinks like Red Bull has led to bars across the country adding energy drink concoctions to their menus, which can lead to dangerous alcohol overdose (due to the stimulant effects of the energy drink masking the depressant effects of the alcohol).  In addition, the small "energy shots" are easily "stacked," or multiple doses taken in rapid succession, sometimes leading to severe stimulant overdose.

Diet pills, which may be available over-the-counter or by prescription, are also commonly abused due to their stimulant effect.

Certain OTC drugs, particularly of the pain-relieving or sleep aid varieties, are sometimes used by those wishing to commit suicide.  While downing an entire bottle of certain drugs such as ibuprofen is not likely to do anything more than make the user very sick and possibly cause intestinal bleeding, drugs such as acetaminophen (commonly found in Tylenol and Excedrin, for example) can very easily have fatal results due to high doses accumulating in the liver faster than the drug(s) can be metabolised, resulting in liver toxicity.  In addition, sleep aids in high doses can depress the central nervous system to the point where the user's breathing stops, resulting in death a few minutes later.

Many OTC drugs are dangerous for people with certain conditions (for example, pseudoephedrine and other decongestants in people with high blood pressure or heart problems), or when combined with certain medications (such as the combination of DXM with MAOIs, selective serotonin reuptake inhibitors (SSRIs), or opioids).  Of particular note are OTC drugs that are combined with other drugs with an "opposite" effect, such as decongestants with opioids, as this can create unpredictable and potentially dangerous reactions in the body.  Even though OTC medications are generally deemed to be "safe," when taken other than in the manner directed the potential for severe and even fatal overdose does exist, and such is not uncommon.

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Prescription Drugs
Many prescription drugs have a potential for abuse, including amphetamines, barbiturates, benzodiazepines, and steroids.  However there are others that don't neatly fall into any of those categories, such as ketamine and quaaludes, that are still commonly abused.

Ketamine is a disassociative hypnotic/anesthetic used in human and veterinary medicine.  It is widely abused by partygoers, giving it a broad reputation as a club drug.  It produces effects of sensory impairment, impaired balance, impaired sense of time, personal detachment, relaxation, drowsiness, decreased sensitivity to pain, and other effects similar to mild depressants and opioids.  Higher doses often produce auditory and visual hallucinations, and can even have an effect similar to full-blown schizophrenia.  Long-term use and overdose can lead to psychosis, memory loss, urinary tract disease, renal damage, memory loss, and death.  The psychological effects can reverse themselves once ketamine use is stopped; however the physical effects may be permanent.  Common street names for ketamine include K, special K, vitamin K, ket, mean green, and rockmesc.

Quaaludes are a type of depressant drug that was commonly used from the 1950s until the 1970s, both for medical and underground uses.  One of the original club drugs, quaaludes are also generally considered to be the original date rape drug.  A sedative-hypnotic, quaaludes were originally prescribed for the treatment of insomnia as well as for use as a sedative and muscle relaxant.  The drug became quite popular during the 1950s and 1960s as a safer alternative to barbiturates, and by the 1970s "luding out" was a popular pastime among young adults.  While much less common than other drugs, quaaludes are still seen in illicit use today.  Effects of quaaludes include relaxation, euphoria, increased sexual arousal and sensation, drowsiness, numbness in the fingers and toes, decreased heart rate, decreased breathing rate, headache, slurred speech, and photophobia (pain in the eyes when exposed to light).  Effects of overdose include vomiting, delerium, convulsions, hypertonia (abnormally tight muscles and an inability to stretch), renal failure, respiratory arrest, heart attack, coma, and death.  Common street names include ludes, Q, quails, and mandies (in reference to the brand name Mandrax).

Ritalin (also sold under the brand name Concerta) is a psychostimulant with similar effects to Adderall and other amphetamines as well as cocaine (though generally weaker), and is commonly used to treat ADD/ADHD in children.  Broadly available due to its widespead medical use, it is commonly abused by those seeking a "safe" stimulant high, particularly those new to drug experimentation/abuse or those trying to wean themselves off of "harder" drugs such as cocaine or methamphetamine.  Common effects of Ritalin use include increased energy, increased ability to focus, improved concentration, increased heart rate, increased breathing rate, nervousness, insomnia, headaches, nausea, loss of appetite, chest pain, dilated pupils, dizziness, drowsiness, and sweating.  Effects of overdose and long-term use include heart arrythmia and palpitations, stunted growth, abdominal pain, lethargy, psychosis, hyperthermia, high blood pressure, heart arrythmias, depression, thoughts of suicide, seizures, and in some cases possibly heart attack or death.  Common street names include rits, riders, kiddie pills, vitamin R, kiddie cocaine, pineapple, smarties, smart drug, and kibbles and bits.

Muscle relaxants, such as Soma and Pavulon (among others), are increasingly popular among abusers in recent years.  While these drugs fall into a variety of classes, they all have a few basic commonalities.  Muscle relaxants are believed to act on the synaptic reflexes of the skeletal system, thus helping the attached muscles to relax.  As a result, all muscle relaxants have a common sedative effect, sometimes severe enough to interfere with breathing (at least one muscle relaxant has been pulled from the market by the FDA due to this reason).  In higher doses, these drugs can give the user a "buzzed" feeling, including mild euphoria, mood enhancement, and pleasant "misperceptions."  Side-effects and long-term/overdose effects can vary from drug to drug, ranging from a change in urine color to liver toxicity to cardiorespiratory collapse.  As the effects of this drug are often subtle in that they relax the body rather than actively inhibit pain, some users may decide to take more than the prescribed dose, increasing the chances of overdose (particularly among those new to muscle relaxants or who have switched brands).

Of particular note: Piperidine, a natural compound found in pepper and other plants, is used in the synthesis of a variety of drugs, including Ritalin, Demerol, and PCP.  It is unique in this regard, as it is not limited to one class of drugs but rather a wide variety (Ritalin being a stimulant, Demerol an opioid, and PCP a hallucinogen).  Therefore, it is particularly dangerous to combine piperidine-based drugs, not only due to the combination of effects (sometimes opposing), but also due to the cumulative effects common to each drug due to being piperidine-based.

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Steroids
Street names: roids, juice, anabolics, A's, Arnies, balls, bulls, gym candy, pumpers, stackers, weight trainers, gear

Method of ingestion: orally, in pill form or occasionally in liquid form; injected, either intravenously or intramuscularly; occasionally via absoption through the skin, in gel or cream form

Desirable effects: increased muscle mass; improved speed; reduced muscular healing time

Other effects: halitosis (bad breath), nausea, vomiting, jaundice (yellowing of eyes and skin), increased sexual arousal, irregular or absent menstruation, violent tendencies, mood swings, manic attacks ("roid rage")

Legitimate uses: treatment for delayed onset of puberty, testosterone deficiency, asthma, anemia, breast cancer, allergic reactions to certain skin contaminants (such as poison ivy), and loss of muscle mass due to diseases such as AIDS

Overdose/long-term effects: undesirable physical changes in sexual organs, development of female-like breasts in males, deepened voice and growth of facial/chest hair in females, permanently stunted growth in adolescents, sterility, severe acne, increased cholesterol levels, severe changes in mood, arteriosclerosis (hardened arteries), liver damage, cancer (particularly liver, prostate, brain), massive heart attack, stroke, death

Steroids are natural chemicals found all throughout nature, including plants and fungi.  While the vast majority of steroids, such as cholesterol, estrogen, or those used to treat asthma, present little to no likelihood of or use for abuse, anabolic steroids (also called anabolic-androgenic steroids) are frequently used by bodybuilders and athletes to improve physical appearance and overall performance.  This class of steroids is what most people are referring to when they use the general term "steroids."

Due to the unfair advantage that illicit steroid use (use other than that prescibed by a doctor) gives to competitors, nearly every sports organization, school, and professional team has banned their use by participating athletes.  Steroids not only help the body eliminate fat and increase lean muscle mass, but also enable muscles to heal much more quickly from workouts or injuries, allowing users to train more and train harder.  While a strict diet and workout plan will produce the same results in time, many users are impatient and turn to steroids as a shortcut.

Anabolic steroids have serious negative effects however; as they are naturally-derived or synthesised forms of the male sex hormone testosterone, changes to a users' sexual organs and reproductive system sometimes develop, both in males and females.  Women find their voices deepening and hair growing on their face and chest; men find themselves developing female-like breast tissue on top of their already muscular pectoral muscles.  Major, undesirable physical changes to the sex organs (testicular shrinkage in men, sometimes to the size of peanuts; clitoral lengthening in women) can also develop, and are typically permanent.

Most users of anabolic steroids "cycle," or take two different steroids in an alternating pattern.  Many are also poly-drug users, presenting a host of other medical effects and complications as well.  As with any injectable drug, infections at the injection site can develop, sometimes becoming life-threatening.

While there is little research on the long-term effects of steroids, there is plenty of anecdotal evidence from former users to indicate that the non-medical use of these drugs can have severe consequences, many of which may not become apparant until years after a person stops using (such as in the case of former Mr. America Steve Michalek, who suffered a heart attack, stroke, and liver cancer related to steroid abuse years after he stopped using).

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Stimulants
Street names: (see amphetamines)

Method of ingestion: usually orally, in pill form

Desirable effects: increased energy; wakefulness; improved mood; weight loss

Other effects: increased heart rate, shortness of breath, loss of appetite, insomnia, headache, increased blood pressure, dizzyness, dry mouth, dilated pupils, increased body temperature, high blood sugar, dehydration

Legitimate uses: treatment for depression, asthma, obesity, narcolepsy, ADD/ADHD, and daytime sleepiness caused by sleep apnea or other disorders

Overdose/long-term effects: nausea, vomiting, weight loss, high body temperature, involuntary grinding of teeth, malnutrition, seizures, dangerous fluctuations in blood pressure, respiratory distress, heart arrythmia, heart attack, brain damage, coma, death

Stimulants include a wide variety of substances, including nictoine, caffeine, amphetamines, methamphetamine, cocaine, many inhalants, and even ecstasy, as well as several other prescription and over-the-counter drugs with similar effects.  Energy drinks also fall under this class.

The most commonly abused non-presciption stimulant drugs, after nicotine and caffeine, respectively, are diet pills.  In fact, diet pill abuse is so prevalent that the FDA began aggressively regulating what diet pills can be prescribed, to whom, and how many at a time.

Ephedrine, a commonly found substance in many diet pills, has gained notoriety for its dangerous side effects of heart arrythmia and heart attacks, extremely high blood pressure, stroke, and even death when taken in excessive doses.  Due to this fact, the FDA banned the sale of any dietary supplements containing ephedrine in 2004 (though it is still legally available for other medical purposes, such as the treatment of asthma or colds, or traditional Asian medicinal use).  In addition, sales of ephedrine-containing products are regulated just like pseudoephedrine due to their use in methamphetamine production.

Many diet pills, including the infamous prescription Fen-Phen combination from the 1990s, have been aggressively marketed and just as aggressively removed from the market, due to both their dangerous side effects and their potential for abuse.  Other OTC diet pills come with strong warnings about dosing, or even FDA-mandated "black box" labels.  While many abusers of diet pills don't take them for the stimulant "high" produced but rather for the resulting weight loss, the complete loss of appetite can lead to dangerous and severe malnutrition and dehydration, resulting in the shut-down of major organs and body systems and eventually leading to coma and/or death.

As with any drug, stimulants are particularly dangerous for people with certain medical conditions, such as high blood pressure, glaucoma, or heart disease, or those taking certain prescription medicines such as MAOIs.  In these users, stimulant use can very easily lead to stroke, heart attack or death.

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