N e u r o s c i e n c e F o r K i d s

Alcohol and the Brain

Alcohol may be the world's oldest known drug. Fermented grain, fruit juice and honey have been used to make alcohol (ethyl alcohol or ethanol) for thousands of years. The production of products containing alcohol has become big business in today's society and the consumption and abuse of alcohol has become a major public health problem. On this page, only the effects of alcohol on the brain and behavior will be discussed. For further information about other effects of alcohol, see the links at the bottom of this page.

Alcohol is a central nervous system depressant. Factors that influence how alcohol will affect a person include:

age gender physical condition amount of food eaten other drugs or medicines taken

The Path of Alcohol in the body

1. Mouth: alcohol enters the body.2. Stomach: some alcohol gets into the bloodstream in the stomach, but most goes on to the small intestine.3. Small Intestine: alcohol enters the bloodstream through the walls of the small intestine.4. Heart: pumps alcohol throughout the body.5. Brain: alcohol reaches the brain.6. Liver: alcohol is oxidized by the liver at a rate of about 0.5 oz per hour.7. Alcohol is converted into water, carbon dioxide and energy.

Effects of Alcohol

In low doses, alcohol produces:

a relaxing effect reduces tension lowers inhibitions impairs concentration slows reflexes impairs reaction time reduces coordination

In medium doses, alcohol produces:

slur speech cause drowsiness alter emotions

In high doses, alcohol produces:

vomiting breathing difficulties unconsciousness coma

Effects of Alcohol on the Nervous System

As mentioned above, alcohol is a central nervous system depressant. It acts at many sites, including the reticular formation, spinal cord, cerebellum and cerebral cortex, and on many neurotransmitter systems. Alcohol is a very small molecule and is soluble in "lipid" and water solutions. Because of these properties, alcohol gets into the bloodstream very easily and also crosses the blood brain barrier. Some of the neurochemical effects of alcohol are:

Increased turnover of norepinephrine and dopamine Decreased transmission in acetylcholine systems Increased transmission in GABA systems Increased production of beta-endorphin in the hypothalamus

Chronic drinking can lead to dependence and addiction to alcohol and to additional neurological problems. Typical symptoms of withholding alcohol from someone who is addicted to it are shaking (tremors), sleep problems and nausea. More severe withdrawal symptoms include hallucinations and even seizures.

Chronic alcohol use can:

Damage the frontal lobes of the brain Cause an overall reduction in brain size and increase in the size of the ventricles Lead to alcoholism (addiction to alcohol) and result in tolerance to the effects of alcohol and variety of health problems Cause a vitamin deficiency. Because the digestion system of alcoholics is unable to absorb vitamin B-1 (thiamine), a syndrome known as

"Wernicke's Encephalopathy" may develop. This syndrome is characterized by impaired memory, confusion and lack of coordination. Further deficiencies of thiamine can lead to "Korsakoff's Syndrome." This disorder is characterized by amnesia, apathy and disorientation. Widespread disease of the brain is a feature of both Wernicke's and Korsakoff's Syndromes.

Drinking and Driving Don't Mix

The following tables are used with the permission of the Pennsylvania Liquor Control Board. They illustrate the effects of alcohol consumption on blood alcohol levels and driving skills. These data should be used only as a general reference for the effects of alcohol because body weight and other variables may influence the results. Also, some states define the limit of legal intoxication at a lower blood alcohol level (0.08%).

Calculating blood alcohol concentrations (Reference: Winek, C., in Forensic Sciences, edited by C.W. Wecht, Matthew Binder Press, New York, 1984):

Another consequence of alcohol use is Fetal Alcohol Syndrome (FAS). Inside the mother, a fetus is fed through the placenta. Because alcohol passes easily through the placenta, every time the mother drinks alcohol, the developing fetus gets a dose of alcohol. Alcohol disrupts normal brain development - THAT IS A FACT!!! Fetal exposure to alcohol can impair the development of the corpus callosum (the main connection between the right and left hemispheres of the brain), reduce the size of the basal ganglia and damage the cerebellum and cerebral cortex.

Compared to normal babies, babies born with FAS have:

smaller heads and brains some degree of cognitive impairment poor coordination hyperactivity abnormal facial features

Did you know?

Americans drink the equivalent of 500 million gallons of pure alcohol each year. (Statistic from Prevention's Giant Book of Health Facts, 1991.)

Alcohol consumption by college students is linked to at least 1,400 student deaths and 500,000 unintentional injuries each year.>(Statistic from the National Institute on Alcohol Abuse and Addiction, Alcohol Alert, 58:1-4, 2002.)

The 18th Amendment to the US Constitution was passed in 1919 and was made effective in 1920. This started the period known as prohibition. The 18th Amendment declared that alcohol could not be manufactured, sold, imported, exported or transported in the United States. In 1933, the 21st Amendment to the Constitution was passed which repealed the 18th Amendment and made alcohol legal again

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B a t h S a l t s

"Bath salts" are a dangerous new class of synthetic drugs with no relation to the scented granules you may use to unwind in the tub. Other common street names for these drugs include "plant food," "vanilla sky," and "purple wave."

Similar to amphetamines and cocaine, bath salts are stimulants, meaning that they improve mood and energy levels and make users feel more alert by increasing levels of the neurotransmitter dopamine in the brain. This increase in dopamine also means that bath salts can be addictive. Users commonly swallow, inhale, or inject the drug. The effects are felt after about 15 minutes, and users feel high for at least 4-6 hours.

The term bath salts doesn't refer to just one drug, but rather a group of chemically-related substances that are similar to the naturally-occurring stimulant cathinone, a substance derived from the khat plant. Unlike cathinone, however, bath salts aren't found in nature - they're concocted by amateur chemists.

Most often bath salts contain the chemicals mephedrone, methylone, or the tongue-twister 3,4-methylenedioxypyrovalerone (known simply as MDPV), but current estimates suggest there may be over 100 different chemicals being marketed as bath salts. That means that when you take bath salts, you don't really know what you're putting into your body, or how it's going to affect your brain.

Until recently, bath salts were legal, but only because they weren't included in current laws. But that changed when a recent spike in use caused the Drug Enforcement Agency (DEA) to take emergency action. Across the United States, poison control centers received just over 300 calls related to the drug in 2010, but more than 6,000 calls in 2011. In September of 2011, the DEA banned three of the common components of bath salts, and earlier this year a law was enacted that makes producing, selling, or possessing 28 of these substances illegal.

However, banning the drugs has been only partially effective because drug makers can avoid the law by making subtle changes to the composition of these drugs. Another trick used to avoid breaking the law is by labeling the drugs "not for human consumption."

Because bath salts are relatively new, not a lot is known about their effects. But what is known is troubling. Use of bath salts can produce life-threatening effects such as:

elevated heart rate (tachycardia) and blood pressure (hypertension)

increased body temperature (hyperthermia) chest pain delusions and hallucinations severe agitation paranoia combative behavior suicide nausea and vomiting dizziness

Nora Volkow, M.D., Director of the National Institute on Drug Abuse, warned about the hazardous effects of bath salts last year. These drugs are particularly dangerous, she said, because their chemical composition and long-term effects are largely unknown.

Cocaine

Coca Leaf

From the plant called Erythroxylon coca, cocaine is a local anesthetic and central nervous system stimulant. It can be taken by chewing on coca leaves, smoked, inhaled ("snorted") or injected.

Coca Plant

History of Cocaine

Early Spanish explorers noticed how the native people of South America were able to fight off fatigue by chewing on coca leaves. A medical account of the coca plant was published in 1569. In 1860, Albert Neiman isolated cocaine from the coca leaf and described the anesthetic action of the drug when it was put on his tongue. Angelo Mariani, in the early 1880s produced a "medicinal" wine, called Vin Mariani, that contained 11% alcohol and 6.5 mg of cocaine in every ounce. The famous psychotherapist, Sigmund Freud, in 1884, recommended cocaine for a variety of illnesses and for alcohol and morphine addictions. Unfortunately, many of his patients went on to become addicted to cocaine! In 1886, John Pemberton developed Coca Cola, a drink that contained cocaine and caffeine. Cocaine was REMOVED from Coca Cola in 1906 (but it still has the caffeine). The Harrison Narcotic Act in 1914 made cocaine illegal. Finally, in 1985, crack cocaine was introduced and rapidly became a major drug problem.

Coca Wine

Crack

Effects of Cocaine on the Nervous System

A dose of between 25 to 150 mg of cocaine is taken when it is inhaled. Within a few seconds to a few minutes after it is taken, cocaine can cause:

a feeling of euphoria excitement reduced hunger a feeling of strength

After this "high" which lasts about one hour, users of cocaine may "crash" into a period of depression. This crash causes cocaine users to seek more cocaine to get out of this depression and results in addiction. Withdrawal from cocaine can cause the addict to feel depressed, anxious, and paranoid. The addict may then go into a period of exhaustion and they may sleep for a very long time.

Various doses of cocaine can also produce neurological and behavioral problems like:

dizziness headache movement problems anxiety insomnia

Cocaine

depression hallucinations

Emergency Room Visits due to Cocaine and Heroin

Image courtesy of the Office of National Drug Control Policy

Death caused by too much cocaine (an overdose) is not uncommon. Cocaine can cause large increases in blood pressure that may result in bleeding within the brain. Constriction of brain blood vessels can also cause a stroke. An overdose of cocaine can cause breathing and heart problems that could result in death. This is what killed the University of Maryland basketball player, Len Bias, in 1986. Comedian John Belushi also died from a cocaine/heroin overdose in 1982.

Cocaine is highly "reinforcing": when it is given to animals, they will give it to themselves. In fact, if animals are given the choice, they will put up with electrical shocks and give up food and water if they can get cocaine.

Cocaine acts by blocking the reuptake of the neurotransmitters dopamine, norepinephrine and serotonin in the brain. Therefore, these neurotransmitters stay in the synaptic cleft for a longer time. Research has also shown that cocaine can also cause the release of dopamine from neurons in the brain.

Cocaine can also affect the peripheral nervous system. These effects include constriction of blood vessels, dilation of the pupil and irregular heart beat.

The Brain on Cocaine

These two images of the brain are positron emission tomography (PET) scans of a normal person (picture on the left) and of a person on cocaine (picture on the right). The PET scan shows brain function by seeing how the brain uses glucose, the energy source for neurons. In these scans, the red color shows high use of glucose, yellow shows medium use and blue shows the least use of glucose. Notice that many areas of the brain of the cocaine user do not use glucose as effectively as the brain of the normal person. This can be observed by the lower amounts of red in the right PET scan.

Image courtesy of the National Institute on Drug Abuse; used with permission.

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E c s t a s y

The American Heritage Dictionary defines ecstasy as "intense joy or delight." Despite its peppy name, the illegal drug ecstasy can damage nerve cells in the brain. Ecstasy, also known as 3,4 methylenedioxymethamphetamine or "MDMA" for short, is a stimulant related to the drugs mescaline and amphetamine. Other names for MDMA are "Adam," "XTC," "Doves" or just "E."

MDMA was first synthesized and patented in 1914 by the German drug company called Merck. Scientists thought that this drug could be used as an appetite suppressant. In the 1970s, MDMA was given to psychotherapy patients because it helped them open up and talk about their feelings. This practice was stopped in 1986 when animal studies showed that ecstasy caused brain damage.

Some users say they take ecstasy because it lowers their inhibitions and relaxes them. MDMA is also said to increase awareness and feelings of pleasure and to give people energy. However, some people report side effects after taking MDMA such as headaches, chills, eye twitching, jaw clenching, blurred vision and nausea. Some doses of MDMA can cause dehydration, hyperthermia and seizures. The effects of MDMA send some people to the emergency room (see graph on right). Unlike the drug LSD, MDMA in low doses does not cause people to hallucinate. Ecstasy gained national attention when it was the drug of choice at club parties, called "raves." In a survey taken in 2005, 3.0% of 12th graders, 2.6% of 10th graders and 1.7% of 8th graders reported that they had used MDMA at least once within the year.

MDMA appears to have several effects on the brain. MDMA can:

cause the release of the neurotransmitter called serotonin.

block the reuptake of serotonin by the synaptic terminal that releases it.

deplete the amount of serotonin in the brain.

Data suggest that MDMA may be toxic to the brain. Dr. George Ricaurte, an associate professor of neurology at Johns Hopkins University, analyzed brain scans of people who had used ecstasy. The study included people who had used ecstasy an average of 200 times over five years. Although the behavior of these people appeared normal, brain scans showed that the drug had damaged their brains. In fact, those who used the drug more often had more brain damage than less frequent users. Moreover, memory tests of people who have taken ecstasy as compared to non-drug users have shown that the ecstasy users had lower scores.

Specifically, the drug damaged cells that release the neurotransmitter called serotonin. Using an imaging technique called positron emission tomography (PET), Ricaurte noted a 20-60% reduction in healthy serotonin cells in the drug users. Damage to these cells could affect a person's abilities to remember and to learn.

At this point, scientists do not know if this damage is permanent, or if those damaged cells will replace themselves. Also, it is not known if this loss of cells affects behavior or the ability to think. Ricaurte is conducting other studies to gauge ecstasy's effect on mood, memory, cognition, and behaviors such as eating and sleeping. In 2003,German researchers used PET scans to study the brains of current and past users of ecstasy. This research demonstrated that ecstasy users had lower levels of serotonin activity in several brain areas. However, ecstasy users who stopped using the drug 20 weeks before the scan showed some recovery in serotonin function.

Information from brain scans of people is valuable, but it is difficult to control the different variables when using human subjects. Perhaps some of the students didn't report their drug use accurately. Maybe they didn't remember how many times they had used ecstasy. To be able to control the variables more carefully in a study, Ricaurte looked for help from animal experiments. In an article published in The Journal of Neuroscience (June 15, 1999), Ricaurte compared the data from monkeys who were given ecstasy dissolved in a liquid twice a day for four days to other monkeys who received the same liquid WITHOUT the ecstasy twice a day for four days. The study showed that the monkeys who were given ecstasy had damage to the serotonin-containing nerve cells. This damage was still visible seven years later!. Areas that were especially affected were the frontal lobe of

the cerebral cortex, an area in the front part of the brain that is used in thinking, and the hippocampus, an area deep in the brain that helps with memory. Although damage was still observed seven years later, it was less severe than when it was observed two weeks after drug use. This suggests that some regrowth could have occurred, but that it is far from complete.

Effect of MDMA on serotonin neurons in the monkey brain.

Image courtesy of the National Institute on Drug Abuse.

Effect of MDMA on serotonin neurons in the monkey brain.

Image courtesy of the National Institute on Drug Abuse.

Now scientists must tease out what these results from monkeys mean to humans. Although the specifics are lacking, at this point, the evidence points to loss of memory and cognitive ability among ecstasy users.

 Hear It!

Amphetamine Serotonin

 Did you know?

In 2002, Dr. Ricaute published a paper in Science that showed neurotoxic effects of MDMA on neurons that use the neurotransmitter called dopamine. However, he had to retract this paper when he found out that the drug he gave to monkeys and baboons was methamphetamine, not MDMA.

Gamma hydroxybutyrate (GHB)

Gamma hydroxybutyrate: An Overview

Have you heard of GHB? You may not have yet, but its use is increasing. Once limited to large warehouse scenes such as "raves," GHB is showing up at parties, perhaps in neighborhoods like yours. It gives the user a feeling of euphoria, that everything is fine. GHB, like alcohol, is a central nervous system depressant that takes only minutes to make a user lose control, forget what is happening, or lose consciousness. GHB is colorless, odorless, and has a slightly salty taste. The synthetic form of GHB contains some of the same ingredients as floor stripper and industrial cleaners.

The same dose of GHB can have variable effects in different people. A dose that makes one person feel euphoric can make another person sick. The US Drug Enforcement Agency has linked GHB to 58 deaths since 1990 and there have been at least 5,700 overdoses recorded

since then. Moreover, there are some reports that GHB can cause dependence. Treatment of GHB overdoses is difficult because it is difficult for emergency room doctors to detect the drug.

Possible symptoms of GHB use:

Dizziness | Vomiting | Seizures | Coma | Drowsiness

GHB was first developed as a general anesthetic, but because it did not work very well to prevent pain, its use as an anesthetic declined. The observation that GHB may cause the release of growth hormone led some people, especially athletes and body-builders, to take it because they thought it would increase muscle development. At the time, GHB was available as a dietary supplement and as such was not regulated by the US Food and Drug Administration. In 1990, after numerous reports that GHB caused illness, the FDA began investigating the drug. It is now classified as an illegal substance. Research is being conducted to investigate the use of GHB in the treatment of the sleep disorder called narcolepsy.

GHB has been grouped with other drugs in the "date-rape drug" category such as Rohypnol, because it can be slipped easily into a drink and given to an unsuspecting victim, who often does not remember being assaulted. GHB is especially dangerous when combined with alcohol.

GHB and the Brain

Although GHB can be made in the laboratory, it is also produced normally in the brain through the synthesis of a neurotransmitter called GABA. Some of the greatest concentrations of GHB are found in the substantia nigra, thalamus and hypothalamus. When GHB is ingested by a user, it affects several different neurotransmitter systems in the brain:

GHB can increase acetylcholine levels. GHB can increase serotonin levels. GHB can reduce dopamine activity, especially in the basal ganglia. This action is

probably the result of the inhibition of the release of dopamine from synaptic terminals. Some studies show that GHB first inhibits the release of dopamine, then causes the release of dopamine. The effect on the dopamine system may depend on the dose of GHB.

GHB can activate GHB receptors and GABA receptors on neurons in the brain.

Unfortunate Events Lead to a Tragedy

One case of GHB use ended in tragedy. On January 16th, 1999, three girls told their parents they were going to a movie, but instead they ended up at a party at someone's house. Some kids were drinking alcohol and some were smoking marijuana. One of the girls, ninth-grader Samantha, asked for a Mountain Dew. A 19-year old boy got it for her. At one point, she told her friend the soda tasted "gross," but she drank it. A few minutes later she vomited and passed out. She was moved onto the bathroom floor, beside another 14-year-old girl, Melanie, who also passed out after having a drink. Once the boys became concerned that they could not wake the girls, they took them to the hospital. Both girls fell into comas. Melanie recovered, but Samantha never regained consciousness and died in the hospital.

In February 2000 the four males involved (ages 18, 19, and 26) went on trial for the death of Samantha and the poisoning of the other girls, one of whom ingested some GHB but had no symptoms. This was the first trial of a GHB-related death. The younger males were found guilty of involuntary manslaughter and lesser charges of poisoning. The 26-year-old was convicted of being an accessory to manslaughter, poisoning, and possession of marijuana and GHB. The jail time for the manslaughter convictions is up to 15 years; the jail time for the poisoning convictions can be up to 5 years.

Law Enacted

On February 18, 2000, President Clinton signed federal legislation (H.R. 2130) making the possession of GHB illegal. It was a controlled substance, a so-called Schedule 1 drug, just like heroin. However, in July 2002, a form of GHB was designated as a Schedule III Controlled Substance. A Schedule III substance can be used for medical purposes, but it cannot be sold, distributed, or provided to anyone other than for its prescribed use. The Controlled Substances Act ranks drugs from 1 to 5 based on how harmful they are; a ranking of 1 means that the drug has a high potential for abuse. The new scheduling of GHB was made in response to new research showing that GHB may help treat some symptoms of narcolepsy.

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Heroin

HORSE - CRANK - JIVE - SMACK -JUNK - SHAG - DOPE

You can even spell it by its chemical name: diacetylmorphine. It doesn't matter which way you spell it, it still means HEROIN.

Heroin is an illegal opiate drug made from the opium poppy, Papaver somniferum. The opium poppy is a plant found in the Middle East, Southeast Asia and parts of Central and South America. To harvest opium, the seed pod of the poppy is cut and a juice flows out. The main ingredient that is extracted from raw opium is morphine. Morphine is easily converted to heroin by a chemical process.

In 1973, scientists discovered that the brain had receptors for opiates. In other words, there are places on neurons that recognize opiates. These receptors were located in parts of the brain important for breathing, pain and emotions. The discovery of opiate receptors in the brain raised the question as to why neurons would have such receptors. Two years later, scientists found the answer: the brain manufactures its own opiates known as "endorphins." Endorphins are always in the brain, but they are released in greater amounts when people and animals are in pain or under stress.

Records indicate that opium was used by the ancient Egyptians, Greeks and Romans. The poppy even appears on Egyptian art dating back 6,000 years. Opium was imported to China around 800 A.D. By the 1600s, opium smoking was widespread throughout China. In 1680, a famous English physician named Thomas Syndenham introduced opium to the medical field.

In the 17th century, many people in Europe were treated for a variety of health problems with opium. In 1729, opium smoking was made illegal in China and soon the importation of opium was banned. This ban upset the British who were in charge of trading this valuable product. Opium was still smuggled into China and this caused the "Opium Wars" (1839-1842 and 1856-1860) between the British and the Chinese.

In the US, opium was used to treat soldiers during the Civil War (1861-1865). During the late 1800s, doctors prescribed "tonics" containing opiates for many conditions. Rarely did these medicines list opiates as one of the ingredients. In fact, heroin was marketed as a cough medicine and a cure for morphine addiction. However, many physicians had concerns about possible addiction to these medicines.

1803 - morphine was isolated from opium by Frederick Serturner. 1832 - codeine was extracted from opium. 1853 - the hypodermic needle was invented.1874 - heroin was first produced from morphine.1898 - The Bayer Company introduced heroin as a substitute for morphine.1906 - Pure Food and Drugs Act - required medicines to be labeled with the materials that they contained.1914 - Harrison Narcotic Act - added a tax on opiate distribution.1922 - Narcotic Import and Export Act - restricted the importation of crude opium except for medical use.1924 - Heroin Act - made manufacture and possession of heroin illegal.1930 - Federal Bureau of Narcotics was created.1970 - Controlled Substances Act was passed - divided drugs into categories, set regulations and penalties for narcotics.

The purity of heroin can vary greatly. Heroin can be mixed with powdered milk, sugar, baking soda, procaine and lidocaine (local anesthetics) or even laundry detergent, talc, starch, curry powder, Ajax cleaner or strychinine. All of these "additives" are dangerous if they are injected into the bloodstream. Heroin is smoked or inhaled as a powder or it can be mixed with water, heated, then injected. Heroin crosses through the blood brain barrier 100 times faster than morphine because it is highly soluble in lipids.

Injecting heroin into a vein (intravenous use) produces effects in 7 to 8 seconds. Injecting heroin into a muscle (intramuscular use) or under the skin (subcutaneous use) can produce effects in 5 to 8 minutes. Addicts sometimes inject themselves up to 4 times in one day.

Effects of Heroin

The overall effect of heroin is a depression of the central nervous system.

Short Term Effects

Analgesia (reduced pain) Brief euphoria (the "rush" or feeling of well-being) Nausea Sedation, drowsiness Reduced anxiety Hypothermia Reduced respiration; breathing difficulties Reduced coughing Death due to overdose - often the exact purity and

content of the drug is not known to the user. An overdose can cause respiration problems and coma

Long Term Effects

Tolerance: more and more drug is needed to produce the euphoria and other effects on behavior.

Addiction: psychological and physiological need for heroin. People are driven to get more heroin and feel bad if they do not get it. People begin to crave heroin 4 to 6 hours after their last injection.

Withdrawal: About 8-12 hours after their last heroin dose, addicts' eyes tear, they yawn and feel anxious and irritable. Excessive sweating, fever, stomach and muscle cramps, diarrhea and chills can follow several hours later. These withdrawal symptoms can continue for 1 to 3 days after the last dose and can last 7 to 10 days. In some cases, full recovery can take even longer.

In addition to the direct dangers of heroin, this powerful drug also carries the risk of:

HIV/AIDS - due to sharing of needles Poisoning - from the addition of toxin to the drug Hepatitis - liver damage Skin infections - from repeated intravenous injections Other bacterial and viral infections Increase risk of stroke Collapsed veins Lung infections

Not all of the mechanisms by which heroin and other opiates affect the brain are known. Likewise, the exact brain mechanisms that cause tolerance and addiction are not completely understood. Opiates stimulate a "pleasure system" in the brain. This system involves neurons in the midbrain that use the neurotransmitter called "dopamine." These midbrain dopamine neurons project to another structure called the nucleus accumbens which then projects to the cerebral cortex. This system is responsible for the pleasurable effects of heroin and for the addictive power of the drug. Other neurotransmitter systems, such as those related to endorphins, are also likely to be involved with withdrawal from and tolerance to heroin.

 Inhalants 

QUESTION: What do nail polish, paint and glue have in common?

ANSWER: They can:

be found at home or school be inhaled by people looking for a quick high cause damage to the body including the brain STINK.

Inhaling (also called "huffing" or "sniffing") chemicals is a problem for many people including teenagers. Inhalants are cheap and can be found everywhere - in kitchens, garages and schools. There are hundreds of different materials that can be abused by people who inhale these dangerous chemicals. Inhalants not only damage the nervous system, but other organs such as the lungs, liver, heart and kidney can be injured permanently.

DANGERExtremely Flammable

Harmful or Fatal If SwallowedVapors May Cause Fire

DANGER: Keep away from heat and flame. If swallowed or if excessive inhalation occurs resulting in abnormal reactions including dizziness or nausea, contact a physician. Intentional misuse by deliberately concentrating and inhaling contents may be harmful or fatal.

(From a warning label on waterproofing spray)

Variety of Inhalants

Product Chemical Content

Hair Spray Fluorinated hydrocarbons; propane; isobutane

Nitrous Oxide Nitrous Oxide

Cleaning Fluids Chlorinated hydrocarbons; naphtha

Typewriter Correction Fluid Trichloroethane; trichloroethylene

Nail Polish Remover Acetone; aliphatic acetates; benzene

Gasoline Hydrocarbons; tetraethyl lead

Glue; rubber cement Toluene; acetone, benzene; xylene; ethanol; chloroform

Paint/Paint Thinner Toluene; methylene chloride; benzene, ethanol

Lighter Fluid Hydrocarbons

Room Deodorizers Amyl, butyl and isobutyl nitrite

Marker pens Toluene; xylene

Effects of Inhalants on the Nervous System

When vapors are inhaled (1), they are absorbed through the lungs (2) and enter the bloodstream (3). Once in the bloodstream, the chemicals travel to the brain (4) and other tissues throughout the body. Most inhalants that are abused depress the functioning of the nervous system. However, the effects of each inhalant are difficult to determine because each product in made up many different chemicals and each person may breathe in different amounts of each chemical. Nevertheless, these chemicals do have significant effects on the nervous system.

Some of the effects of inhalants are simliar to those of alcohol. The immediate effects of inhalants include:

relaxation slurred speech euphoria hallucinations drowsiness dizziness

nausea vomiting DEATH - from heart failure or suffocating on plastic bags or vomit.

Long term use of inhalants can cause:

memory loss concentration problems visual disturbances; blindness motor problems peripheral nerve damage

Nervous System Targets of Inhalants

Inhalants may affect different parts the brain and nervous system and may cause a variety of sensory, motor, psychological and emotional problems. One major effect of inhalants is the destruction of the myelin sheath that surrounds neurons. This can result in problems in the normal transmission of impulses through neurons and cell death.

Specific areas of the brain targeted by inhalants include:

1. Cerebral cortex: damage can cause changes in personality, memory loss, hallucinations and learning problems.2. Cerebellum: damage can cause problems in balance and movement.3. Hippocampus: damage may result in the memory problems.4. Visual System: damage to the peripheral nerves may cause visual disturbances.

LSD

Lysergic acid diethylamide, better known as LSD, is a chemical that alters a user's mood, thoughts or perceptions. For this reason, LSD is grouped into a class of drugs known as hallucinogens or psychedelics. These drugs can cause auditory, visual or somatosensory hallucinations, paranoia or dream-like states.

LSD PillsImage courtesy of the Indiana Prevention Resource Center

LSD was first synthesized from a fungus that grows on rye and other grains. In 1938, Albert Hofmann working in the Swiss pharmaceutical company called Sandoz, produced LSD for the first time. He was hoping that this new drug could be used to stimulate circulation and respiration. However, the tests he conducted were all failures and he forgot about LSD for 5 years. In 1943, Hofmann accidentally ingested (or somehow absorbed) a bit of LSD and experienced some of the psychedelic effects of this chemical: dizziness, visual distortions and restlessness. A few days later he prepared 0.25 mg of LSD in water and drank it. He again experienced the mood and thought altering effects of LSD.

Effects of LSD on the Nervous System

LSD is water soluble, odorless, colorless and tasteless - it is a very powerful drug - a dose as small as a single grain of salt (about 0.010 mg) can produce some effects. Psychedelic effects are produced at higher doses of about 0.050-0.100 mg. The effects of LSD depend on a user's mood and expectations of what the drug will do and last several hours. The behavioral effects that LSD can produce include:

Feelings of "strangeness" Vivid colors Hallucinations Confusion, panic, psychosis, anxiety Emotional reactions like fear, happiness or sadness Distortion of the senses and of time and space "Flashback" reactions - these are the effects of LSD that occur even after the user has not taken

LSD for months or even years. Increases in heart rate and blood pressure Chills Muscle weakness

Tolerance to the effects of LSD develops quickly and users must increase their intake of LSD to get the same effects. The exact neural pathways that are affected by LSD are not completely known. LSD has a chemical structure that is very similar to the neurotransmitter called serotonin. It is thought that the effects of LSD are caused by stimulation of serotonin receptors on neurons, perhaps in the brain area called the raphe nuclei. However, it is still not clear what produces all the effects of LSD.

Did you know?

The Controlled Substances Act of 1970 states that the mandatory penalty for possession of 1 gram of LSD is 5 years in prison.

Albert Hofmann, the Swiss chemist who discovered the psychoactive drug LSD in 1938, died on April 29, 2008. He was 102 years old.

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Neuroscience For Kids

marijuana

Marijuana is one of the world's most commonly used illegal drugs. There are approximately 300 million users worldwide and 28 million users in the United States (Diaz, 1997). Marijuana comes from a plant called "Cannabis sativa." The chemical in this plant that produces the altered states of consciousness is called "delta-9 tetrahydrocannabinol" or "THC." Marijuana is usually smoked like a cigarette, but it can also be cooked into baked goods like brownies or cookies or brewed like a tea. THC is also contained in "hashish" (hash) which is the resin from the marijuana plants. Hash is usually smoked in a pipe. Other names for marijuana include: grass, pot, reefer and weed.

Effects of Marijuana on the Nervous System

THC acts on cannabinoid receptors which are found on neurons in many places in the brain. These brain areas are involved in memory (the hippocampus), concentration (cerebral cortex), perception (sensory portions of the cerebral cortex) and movement (the cerebellum, substantia nigra, globus pallidus). When THC activates cannabinoid receptors, it interfers with the normal functioning of these brain areas. In low to medium doses, marijuana causes:

relaxation reduced coordination reduced blood pressure sleepiness disruption in attention an altered sense of time and space...a good reason not to drive or operate machinery while under the influence.

In high doses, marijuana can cause:

hallucinations delusions impaired memory disorientation.

Scientists have known for a long time that THC interacted with cannabinoid receptors in the brain, but did not know why the brain would have such receptors. They thought that the brain must make some kind of substance that naturally acted on these receptors. In 1992, they found the answer...anandamide. Anandamide is the brain's own THC (just like "endorphin" is the brain's own morphine). Still, scientists are not sure what the function of anandamide is in the normal brain.

The effects of marijuana start as soon as 1-10 minutes after it is taken and can last 3 to 4 hours or even longer. Experiments have shown that THC can affect two neurotransmitters: norepinephrine and dopamine. Serotonin and GABA levels may also be altered.

Whether marijuana can produce addiction is controversial. Also controversial is whether marijuana causes long-term mental abnormalities. Only future research will give us the answers. It is interesting to note that there are NO documented cases of a fatal overdose produced by marijuana. However, because there is a high level of tar and other chemicals in marijuana, smoking it is similar to smoking cigarettes. The lungs get a big dose of chemicals that increase the chances of lung problems and cancer later in life.

How long does THC stay in your body and for how long can it be detected after you use marijuana?

The amount of time depends on several factors such as how much a person has smoked, how long a person has smoked for, and the method used to detect THC or its metabolites. Marijuana can be detected in urine, blood and saliva using methods called thin layer chromatography, high pressure liquid chromatography, gas chromatography, enzyme immunoassay and radioimmunoassay. The most psychoactive ingredient in marijuana is delta-9-tetrahydrocannabinol (THC). THC is broken down into several other compounds that are also psychoactive. The half-life of THC is about 24 hours. However, the metabolites of THC can be detected for 45 to 60 days after the last use.

According to Maistro et al., in the book Drug Use and Misuse (1991):

"Approximately half of the THC is excreted over several days, and the remainder by the end of about a week. However, some metabolites of the THC, a number of which may still be active in the system, can be detected in the body at least thirty days following ingestion of a single dose and, following chronic use, in the urine for several weeks."

Did you know?

In 1969, the Journal of the American Medical Association (JAMA, vol. 207, pages 1349-1350, 1969) published a paper that described the psychoactive effects of catnip in people. People who smoked catnip were said to become happy and relaxed. Catnip (from the plant Nepeta cataria) DOES cause most cats to act strangely: they roll around, shake their heads, rub against things, and try to get the plant all over their bodies. Interestingly, cats are only affected when they smell it - it has NO EFFECT if they eat it. It appears that catnip has little or no psychoactive effects in people. Actually, in the 1969 JAMA paper, the authors mislabeled the pictures of marijuana and catnip. They labeled the pictures of marijuana as catnip and that of catnip as marijuana.

THC was identified as the major psychoactive chemical in marijuana in 1964. Marijuana contains more than 400 different chemicals.

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Anandamide Cannabinoid

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Neuroscience For Kids

Nicotine and the Brain

A complete list of the reasons to avoid smoking and chewing tobacco is not necessary here, but for starters, how about lung cancer, lip cancer, throat cancer, respiratory problems, heart disease and bad breath?

Tobacco contains nicotine. Nicotine is a drug. Therefore, when people smoke or chew tobacco, they are using a drug.

Brief History of Tobacco

Christopher Columbus and his crewman on their voyage to the "New World" were the first Europeans to see tobacco smoking. The tobacco plant is called Nicotiana tabacum and is named after an early importer named Jean Nicot. A water/nicotine mixture has been used as an insecticide since 1746. In 1828, nicotine was isolated from the leaves of the tobacco plant.

Effects of Nicotine on the Nervous System

In tobacco smoke, nicotine "rides" on small particles of tar. When the smoke with this nicotine/tar mixture gets to the lungs, the nicotine is absorbed quickly - nicotine reaches the brain about eight seconds after the smoke is inhaled. American cigarettes contain about 9 mg of nicotine, but because much of the nicotine is burned off, a smoker gets about 1 mg of nicotine in every cigarette. Nicotine reaches the central nervous system in about 3-5 minutes when tobacco is chewed.

Smoking can be stimulating or relaxing - it depends on a person's mood and dosage of nicotine. Nicotine acts on the central and peripheral nervous

system. The rapid effects of nicotine include:

Increases in blood pressure and heart rate Faster respiration Constriction of arteries Stimulation of the central nervous system.

Percentage of Cigarette Smokers in the United States (over the age of 18 years)

Image: Morbidity and Mortality Weekly Report, October 10, 2003, Vol. 52 No. 40

Long term exposure to tobacco and nicotine increases the chances of cancer and results in addiction and dependence. Exactly how nicotine produces addiction and dependence is not clear, but there are some theories. In the brain, limbic pathways that use the neurotransmitter dopamine are affected by nicotine and may be responsible for some of the addictive properties. It is clear though, that nicotine is one of the most addicting substances known...just ask anyone who has tried to quit smoking. Common withdrawal symptoms in people who are

trying to "kick the habit" of tobacco include:

Anxiety Depression Headaches Fatigue

"To cease smoking is the easiest thing I ever did. I ought to know, because I've done it a thousand times." - quote from Mark Twain

Did you According to the World Health Organization, there are 1.1 billion smokers worldwide and 6000 billion cigarettes are smoked

know?

every year. According to the US Centers for Disease Control, there are about 46.2 million adult cigarette smokers in the US. Moreover,

tobacco use in the US results in more than 440,000 deaths each year (about 1 in 5 deaths.) The economic costs (medical costs and lost productivity) of tobacco use are more than $150 billion.

The New Straits Times (August 11, 1997) reported on a "smoking contest" between two young men (ages 19 and 21 year old). These two men wanted to see who could smoke the most cigarettes at a single sitting. The result was tragic: the 19 year old died after smoking 100 cigarettes and the 21 year old was seriously poisoned after smoking 80 cigarettes. It goes without saying, "Don't try this at home!"

"Bidi" cigarettes are NOT safe alternatives to regular cigarettes. A bidi cigarette has THREE times more nicotine and carbon monoxide and FIVE times more tar than a regular American cigarette. (Statistic from Yen et al., Archives of Pediatric and Adoles. Medicine, 154:1187-1189, 2000.)

The cost of a pack of cigarettes in New York is about $7.00. Therefore, a person who smokes one pack of cigarettes each day will spend $2,555.00 each year on tobacco. (Reference: Associated Press story, "With packs hitting $7, smokers try to kick habit" reprinted in the Seattle Times, July 13, 2002.)

More than 100 chemicals are added to tobacco to make cigarettes. These chemicals include benzaldehyde, butyric acid, decanoic acid, ethyl acetate, hexanoic acid, 3-methylbutyraldehyde, methylcyclopentenolone, and tolualdehydes. (Reference: Philip Morris USA.)

PCP - Phencyclidine

What is PCP?

"Angel Dust," "Hog," "Rocket Fuel," "DOA," "Peace Pill" - these are other names for the illegal drug phencyclidine (PCP). PCP was developed in the 1950s as an anesthetic. However, the use of PCP as an anesthetic was stopped after some people experienced psychotic reactions after using the drug. PCP is now made illegally and has found its way onto the street, often contaminating other street drugs. In fact, PCP is often sold in place of drugs such as LSD and mescaline. According to the Monitoring the Future survey of drug trends, 2.3% of 12th graders in the United States used PCP sometime during the year 2000.

PCP is classified as a dissociative anesthetic because users appear to be "disconnected" from their environment: they know where they are, but they do not feel as if they are part of it. The drug has different effects on different people. It can act as a stimulant, a depressant, an analgesic (decreasing pain) or a hallucinogen depending on the dose and route of administration. The effects produced by PCP are different from those caused by hallucinogens such as LSD. Rather than producing visual hallucinations, PCP causes changes in body image. In addition to these distortions of reality, PCP can cause frightening side effects such as feelings of terror and confusion.

PCP (Image courtesy of the Indiana

Prevention Resource Center)

Behavioral Effects of PCP

PCP can be eaten, snorted, injected or smoked. Depending on how a person takes the drug, the effects are felt within a few minutes (2-5 minutes when smoked) to an hour. PCP can stay in a person's body for a long time; the half-life of PCP ranges from 11 to 51 hours. Furthermore, because PCP is made illegally under uncontrolled conditions, users have no way of knowing how much PCP they are taking. This makes PCP especially dangerous.

PCP users are often characterized as violent or suicidal. However, this portrait of a PCP user may not be accurate. Dr. Jaime Diaz, a professor in the Department of Psychology at the University of Washington, reviewed many of the published reports of PCP use in his book, How Drugs Influence Behavior. A Neuro-Behavioral Approach (Upper Saddle River (NJ): Prentice Hall, 1997). He states that PCP use rarely results in violence and concludes that:

"Phencyclidine does not cause aggression or criminal behavior."

Dr. Diaz believes that the reported violent behavior is not due to the pharmacological effect of PCP, but rather is the result of the way people under the influence of PCP perceive things and are subsequently treated by law enforcement personnel. People under the influence of

% of 12th Graders Who Have Used PCP Sometime During Their Lifetime

(Source: Monitoring The Future Survey)

PCP may not feel pain and their perception of sensory stimuli may be altered, possibly causing police officers to use stronger methods to control such individuals.

Dose Effect

Low Feelings of euphoria (well-being), relaxation, numbness, sensory distortions, feelings of detachment from one's own body, anxiety, confusion, amnesia, illogical speech, blurred vision, blank stare

Medium Confusion, agitation, analgesia, fever, excessive salivation, "schizophrenic-type" behavior

High Seizures, respiratory failure, coma, fever, stroke, DEATH

Tolerance and dependence on PCP are possible. Withdrawal symptoms include diarrhea, chills, tremors.

Effects of PCP on the Brain

PCP affects multiple neurotransmitter systems in the brain. For example, PCP inhibits the reuptake of dopamine, norepinephrine and serotonin and also inhibits the action of glutamate by blocking NMDA receptors. Some types of opioid receptors in the brain are also affected by PCP. These complex effects on multiple chemical systems in the brain most likely underlie the behavioral effects of PCP.

Rohypnol

What is Rohypnol?

"Roofies." Sounds like a cartoon character or a piece of candy. However, nothing could be further from the truth about Roofies, also known as the drug Rohypnol.

Rohypnol (Flunitrazepam) is a type of benzodiazepine, a class of drugs that depresses the central nervous system. You may have heard of Valium and Xanax. These are also benzodiazepines used as sedatives and antianxiety agents. Rohypnol was developed as a sleeping aid. It is also used in therapy settings to relax patients and to get them talking. Rohypnol is manufactured in Europe and Latin American and is sold in many countries around the world. However, it is illegal in the United States and Canada. The pills are round, white and smaller than aspirin.

Because Rohypnol is inexpensive, it is becoming popular with high school and college students. In the US, Rohypnol is used mostly at parties, and usually taken with alcohol. It has a synergistic effect with other drugs such as alcohol. This means that one drug increases the effect of the other.

Rohypnol Tablets

Image courtesy of theU.S. Department of Justice

Behavioral Effects of Rohypnol

Rohypnol can produce amnesia (memory loss) and muscle relaxation and make people lower their inhibitions. An inhibition is when you feel like you can't do something. When inhibitions are lowered, people feel as if an obstacle has been removed. Therefore, they can talk more freely and feel less shy.

Because Rohypnol is colorless, odorless and flavorless, it can be slipped into drinks unnoticed. This is one reason this drug is so dangerous. People may consume it without knowing it. It dissolves quickly and takes effect in 20-30 minutes. Its effects can last 8-12 hours. Within the past few years, Rohypnol has become known as the "date rape" drug. People will come home from a party and have no idea what happened to them because they unknowingly ingested Rohypnol, passed out, and woke up several hours later with no memory of the evening. To address this new use, Congress passed the "Drug-Induced Rape Prevention and Punishment Act of 1996" to increase federal penalties for the use of any controlled substance to aid in a sexual assault.

Continued, repeated use of Rohypnol may result in addiction and although Rohypnol is a sedative, it can cause aggressive behavior in some people. Withdrawal symptoms may occur and include headaches, sore muscles, hallucinations, convulsions, and possibly seizures 1-2 weeks after quitting the drug.

Although overdoses are rarely fatal, emergency services are sometimes required because Rohypnol can cause a person to vomit, hallucinate, have

trouble breathing and fall into a coma. When Rohypnol is combined with alcohol the outcome is usually worse.

Street names for Rohypnol include rophies, ruffies, R2, roofenol, Roche, la rocha, rope, roopies, ropies, and rib.

Effects of Rohypnol on the Brain

The benzodiazepines influence behavior by interacting with receptors on neurons in the brain that use the neurotransmitter called GABA. When GABA binds to receptors, it usually inhibits a neuron and acts to reduce neuronal activity. When benzodiazepines attach to GABA receptors, they increase GABA binding to other receptors. In this way, benzodiazepines enhance the effects of GABA and reduce brain activity.

The fact that there are receptors for benzodiazepines in the brain suggests that the brain makes its own type of benzodiazepine. The brain has been found to make its own morphine, the endorphins, but the brain's own benzodiazepine has not yet been discovered.

Neuroscience For Kidsmarijuana

Marijuana is one of the world's most commonly used illegal drugs. There are approximately 300 million users worldwide and 28 million users in the United States (Diaz, 1997). Marijuana comes from a plant called "Cannabis sativa." The chemical in this plant that produces the altered states of consciousness is called "delta-9 tetrahydrocannabinol" or "THC." Marijuana is usually smoked like a cigarette, but it can also be cooked into baked goods like brownies or cookies or brewed like a tea. THC is also contained in "hashish" (hash) which is the resin from the marijuana plants. Hash is usually smoked in a pipe. Other names for marijuana include: grass, pot, reefer and weed.

Effects of Marijuana on the Nervous System

THC acts on cannabinoid receptors which are found on neurons in many places in the brain. These brain areas are involved in memory (the hippocampus), concentration (cerebral cortex), perception (sensory portions of the cerebral cortex) and movement (the cerebellum, substantia nigra, globus pallidus). When THC activates cannabinoid receptors, it interfers with the normal functioning of these brain areas. In low to medium doses, marijuana causes:

relaxation reduced coordination reduced blood pressure sleepiness disruption in attention an altered sense of time and space...a good reason not to drive or operate machinery while under the influence.

In high doses, marijuana can cause:

hallucinations delusions impaired memory disorientation.

Scientists have known for a long time that THC interacted with cannabinoid receptors in the brain, but did not know why the brain would have such receptors. They thought that the brain must make some kind of substance that naturally acted on these receptors. In 1992, they found the answer...anandamide. Anandamide is the brain's own THC (just like "endorphin" is the brain's own morphine). Still, scientists are not sure what the function of anandamide is in the normal brain.

The effects of marijuana start as soon as 1-10 minutes after it is taken and can last 3 to 4 hours or even longer. Experiments have shown that THC can affect two neurotransmitters: norepinephrine and dopamine. Serotonin and GABA levels may also be altered.

Whether marijuana can produce addiction is controversial. Also controversial is whether marijuana causes long-term mental abnormalities. Only future research will give us the answers. It is interesting to note that there are NO documented cases of a fatal overdose produced by marijuana. However, because there is a high level of tar and other chemicals in marijuana, smoking it is similar to smoking cigarettes. The lungs get a big dose of chemicals that increase the chances of lung problems and cancer later in life.

How long does THC stay in your body and for how long can it be detected after you use marijuana?

The amount of time depends on several factors such as how much a person has smoked, how long a person has smoked for, and the method used to detect THC or its metabolites. Marijuana can be detected in urine, blood and saliva using methods called thin layer chromatography, high pressure liquid chromatography, gas chromatography, enzyme immunoassay and radioimmunoassay. The most psychoactive ingredient in marijuana is delta-9-tetrahydrocannabinol (THC). THC is broken down into several other compounds that are also psychoactive. The half-life of THC is about 24 hours. However, the metabolites of THC can be detected for 45 to 60 days after the last use.

According to Maistro et al., in the book Drug Use and Misuse (1991):

"Approximately half of the THC is excreted over several days, and the remainder by the end of about a week. However, some metabolites of the THC, a number of which may still be active in the system, can be detected in the body at least thirty days following ingestion of a single dose and, following chronic use, in the urine for several weeks."

Did you know?

In 1969, the Journal of the American Medical Association (JAMA, vol. 207, pages 1349-1350, 1969) published a paper that described the psychoactive effects of catnip in people. People who smoked catnip were said to become happy and relaxed. Catnip (from the plant Nepeta cataria) does cause most cats to act strangely: they roll around, shake their heads, rub against things, and try to get the plant all over their bodies. Interestingly, cats are only affected when they smell it - it has no effect if they eat it. It appears that catnip has little or no psychoactive effects in people. Actually, in the 1969 JAMA paper, the authors mislabeled the pictures of marijuana and catnip. They labeled the pictures of marijuana as catnip and that of catnip as marijuana.

THC was identified as the major psychoactive chemical in marijuana in 1964. Marijuana contains more than 400 different chemicals.

Amphetamines

Amphetamines are drugs such as dextroamphetamine and benzedrine. Amphetamines were originally developed to treat asthma, sleep disorders (narcolepsy) and hyperactivity. In 1920, a drug called

"ephedrine" was used to treat asthma. In China, the ma huang plant (Ephedra vulgaris) had been used for centuries to treat people with asthma. It is no wonder that the plant worked...the ma huang plant contains ephedrine. In 1932, synthetic ephedrine was sold "over-the-counter" and was available without a prescription until 1954. During World War II, amphetamines were given to soldiers and pilots to keep them alert and to fight off fatigue.

Amphetamine Effects on the Nervous SystemAmphetamines are stimulants of the central nervous system and sympathetic division of the peripheral nervous system. It appears that the main action of amphetamines is to increase the

synaptic activity of the dopamine and norepinephrine neurotransmitter systems. Amphetamines can:

1. cause the release of dopamine from axon terminals.2. block dopamine reuptake.3. inhibit the storage of dopamine in vesicles.4. inhibit the destruction of dopamine by enzymes.

All of these actions result in more dopamine in the synaptic cleft where it can act on receptors.

Many of the effects of amphetamines are similar to cocaine. Addiction to and withdrawal from amphetamines are both possible. Amphetamine use also causes tolerance to its effects. This means that more and more amphetamine must be used to get "high." Amphetamine withdrawal is characterized by severe depression and fatigue. Users will go to extreme measures to avoid the "downer" that comes when the effect of amphetamines wears off.

Short-term effects of amphetamine use include:

Increased heart rate Increased blood pressure Reduced appetite Dilation of the pupils Feelings of happiness and power Reduced fatigue

Long term use of amphetamines can result in:

Insomnia, restlessness "Paranoid psychosis" Hallucinations Violent and aggressive behavior Weight loss Tremors

How Is Methamphetamine Abused? Methamphetamine is taken orally, smoked, snorted, or dissolved in water or alcohol and injected. Smoking or injecting the drug delivers it very quickly to the brain, where it produces an immediate, intense euphoria. Because the pleasure also fades quickly, users often take repeated doses, in a “binge and crash” pattern.

How Does Methamphetamine Affect the Brain? Methamphetamine increases the amount of the neurotransmitter dopamine, leading to high levels of that chemical in the brain. Dopamine is involved in reward, motivation, the experience of pleasure, and motor function. Methamphetamine’s ability to release dopamine rapidly in reward regions of the brain produces the euphoric “rush” or “flash” that many users experience. Repeated methamphetamine use can easily lead to addiction—a chronic, relapsing disease characterized by compulsive drug seeking and use.

Is Meth a Prescription Drug? Methamphetamine can be prescribed by a doctor to treat attention deficit hyperactivity disorder and other conditions, although it is rarely used medically, and only at doses much lower than those typically abused. It is classified as a Schedule II drug, meaning it has high potential for abuse and is available only through a prescription that cannot be refilled. People who use methamphetamine long-term may experience anxiety, confusion, insomnia, and mood disturbances and display violent behavior. They may also show symptoms of psychosis, such as paranoia, visual and auditory hallucinations, and delusions (for example, the sensation of insects crawling under the skin). Chronic methamphetamine use is accompanied by chemical and molecular changes in the brain. Imaging studies have shown changes in the activity of the dopamine system that are associated with reduced motor skills and impaired verbal learning. In studies of chronic methamphetamine users, severe structural and functional changes have been found in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in these individuals. Some of these brain changes persist long after methamphetamine use is stopped, although some may reverse after being off the drug for a sustained period (e.g., more than 1 year).

What Are the Other Health Effects of Methamphetamine? Taking even small amounts of methamphetamine can result in many of the same physical effects as those of other stimulants, such as cocaine or amphetamines. These include increased wakefulness, increased physical activity, decreased appetite, increased respiration, rapid heart rate, irregular heartbeat, increased blood pressure, and increased body temperature. Long-term methamphetamine use has many negative consequences for physical health, including extreme weight loss, severe dental problems (“meth mouth”), and skin sores caused by scratching. Methamphetamine use also raises the risk of contracting infectious diseases like HIV and hepatitis B and C. These can be contracted both by sharing contaminated drug injection equipment and through unsafe sex. Regardless of how it is taken, methamphetamine alters judgment and inhibition and can lead people to engage in these and other types of risky

behavior. Methamphetamine use may also worsen the progression of HIV/AIDS and its consequences. Studies indicate that HIV causes more injury to neurons and greater cognitive impairment in individuals who are HIV-positive and use methamphetamine than it does in HIV-positive people who do not use the drug.