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Inhalant Abuse

The use of inhalants is becoming more and more popular. The act of using inhalants is sometimes referred as “drug sniffing” or “choofing”. Using inhalants, even if they are common household products, can be very dangerous and parents are often not really aware that it is happening. It is often young teenagers who use them. Find out more about what inhalants are, the health problems from using them and how best to help your children.

What are inhalants?

  • Inhalants are usually common products, easy to obtain, with some kind of “fumes” or gas that can be breathed in and cause changes in the body and/or mind.
  • They are usually not banned drugs; rather they are legal products that are quite safe if they are used as intended by the manufacturer.
  • Most inhalants are depressants. Depressants are substances that slow down the brain.
  • When people “choof” or “sniff” a volatile substance (something that evaporates into the air), the chemicals move very quickly into the lungs. From there they then go into the bloodstream, around the body and to the brain.
  • The chemicals in the blood slow down the messages in the brain and through the central nervous system. This is what gives the feeling of a “high”.

How are inhalants used?

  • Inhalants are breathed in through the nose or mouth.
  • Sometimes the inhalant is sprayed onto a cloth and inhaled from the cloth; othertimes it is inhaled from a container.
  • Some young people breathe the fumes from a plastic bag. It is very dangerous to breathe anything from a plastic bag – it can result suffocation.

What do people use to inhale?

The following are some of the things that are easily obtained by young people and which are dangerous to inhale:

  • Petrol (gasoline)
  • Glue (adhesives)
  • Paint and paint thinners
  • Hair spray
  • Cleaning fluid
  • Gas from lighters or barbecues (butane)
  • Nail polish remover
  • Felt pens
  • Cooking spray
  • Typewriter correction fluid
  • Oven cleaners

Nitrous oxide

Nitrous oxide is an inhalant that parents may not be aware of. Nitrous oxide is used by doctors and dentists as an anesthetic. It is also used in the food industry, as a propellant for some foods such as cream, which is sprayed on to cakes etc, and young people may be able to obtain nitrous oxide from these sources. It comes in small silver canisters. Nitrous oxide gives a “high” feeling because it depresses the nervous system. It also can cause dizziness, numbness, ringing in the ears, raised body temperature and unusual sensations. A person who loses consciousness and is still sniffing nitrous oxide (e.g. using it in a small space) can die very quickly. The gas replaces oxygen in the blood and affects the part of the brain that is responsible for breathing. If the person does not become unconscious and stops sniffing the nitrous oxide they can recover quickly. Long term use of nitrous oxide can cause deficiency in vitamin B12, anemia and nerve problems.

Effects from using inhalants occur very rapidly and may include feeling:

  • slightly drunk
  • less inhibited
  • excited and happy – followed by feeling sleepy
  • nervous and “jumpy”
  • sick
  • reckless – taking risks without thinking about the dangers.

Effects of inhalants on the lungs and throat

  • If the inhaled substance is in a pressurized can when the gas is released from the container, its temperature drops quickly, so if it is inhaled straight from the container it can cause freezing damage to the mouth, nose, throat and even the lungs. It can cause nosebleeds or bleeding, and soreness to other parts of the skin.

Other possible effects

  • Vomiting
  • Headache
  • Dizziness
  • Slurred speech
  • Sore eyes or double vision
  • Diarrhea
  • Loss of appetite
  • Flu-like symptoms – runny nose, sneezing, coughing
  • Unpleasant breath – you may be able to smell the inhalant on their breath
  • Nosebleeds
  • Hallucinations (seeing or hearing or feeling things that are not there)
  • Sores around the mouth and nose.

Long term effects

Inhalants can do serious damage to the body if they are used over time. Over time users need to use more and more to get the same high feeling.

  • Ongoing feelings of tiredness, depression, confusion, irritability, or thinking that other people are against them (paranoia)
  • Brain damage
  • Hearing loss
  • If leaded petrol is used; the lead in the petrol can build up in the body and damage internal organs, particularly the brain.
  • Lack of co-ordination – not being able to use your body very well, e.g. write, hit a ball.
  • Damage to the liver and kidneys.
  • Drinking alcohol while using inhalants can make the damage to the body worse.

Inhalants can cause death by:

  • suffocation from inhaling from a plastic bag
  • choking on their own vomit
  • heart failure from hard exercise or a sudden shock after inhaling. This is one of the main causes of death from inhalants. The chemicals make the heart beat faster and the beat is not regular, then it can suddenly stop – cardiac arrest
  • injuries due to risk taking (such as lying on a road)
  • asphyxia – the inhaled gases can cause a person to die from lack of oxygen
  • suicide – from feeling depressed after a high.

Withdrawal effects

Most inhalant damage stops when the person stops using them. Withdrawal effects don’t usually happen unless the person has been using them very heavily. However petrol, cleaning fluids and aerosol sprays can cause permanent damage.

GHB Abuse

GHB – Gama Hydroxybutyric Acid
GHB AbuseGHB is used by athletes to regulate human growth hormone. It also has limited medical use for treating narcolepsy. GHB is also a popular recreational drug as it acts as a depressant and a strong intoxicant. Users find that it enhances their experience while at a club or partying.

GHB produces widely varying effects witch can range from:

  • Mild to Extreme Inebriation
  • Euphoria
  • Sedation
  • Visual Disturbances
  • Loss of Consciousness
  • Memory Loss
  • Inhibition
  • Loss of Coordination
  • Addiction
  • Coma
  • Death

GHB has been labeled a “date rape” drug similar to benzodiazepines like Rohypnol (roofies). In large doses it can produce a deep sleep state with memory loss. The drug is often slipped into an unaware victims drink or food. It can have such a profound effect that the user will have no control over themselves and no memory of what they have done.

GHB is sometimes called “G”, “Georgia Home Boy”, “Liquid E”,” Lollipops”, “Fubar”, “Great Household Bargain”, “Black Rain” or other street names.

Cough Syrup Abuse

DXM, Dextromethorphan Cough Syrup, Robo Tripping

Dextromethorphan or DXM is the active ingredient in non-narcotic, over the counter cough syrup. In small doses DXM acts as an antitussive to relieve symptoms of cold and cough. In higher doses the drug can have a variety of effects users seek to achieve when using the drug recreationally.

  • Euphoria
  • Visual Disturbances
  • Stimulation
  • Inebriation/ Inhibition
  • Sedation
  • Vivid Hallucinations
  • Audio Distortions/ Hearing Voices, etc.
  • Numbing to Full Body Disassociation
  • Out of Body Experience
  • Time Disturbances
  • Body Distortions

Other than DXM most cough medicines contain analgesics, nasal decongestants, expectorants and loads of sugar (glucose). Users will normally consume entire bottles or several packets of pills to get high. This can pose a risk due to extreme amounts of glucose hitting the pancreas at once.

Once they are high, users will be extremely out of it and have trouble sensing the environment around them. They can go long periods of time without eating or drinking and can become agitated easily. When the trip wears off it is followed by a strong urge to use again. With an addicted user you may find many empty cough syrup bottles hidden or in the trash.

Spice Abuse

Synthetic Marijuana – Spice, K2, etc.

Synthetic marijuana or Spice refers to a class of drugs that has similar effects to marijuana. The Drug was first popularized because it got users high without showing up on a drug test.Spice was also legal and was sold in stores. Although the drug has been scheduled by the DEA it may still be available in smoke shops, gas stations or convenience stores. It is also sold on the street.

Synthetic MarijuanaThe active chemical in Spice is JWH 018, JWH 073 or a variety of other synthetic cannabinoids. The chemicals are usually sprayed on dried leaves and sold in foil packets. Make no mistake; Spice is an extremely harmful drug. While the immediate effects are similar to marijuana, there can be other devastating consequences as well. Some of these are:

  • Addiction
  • Intoxication
  • Erratic behavior
  • Psychosis
  • Heart attack

Bath Salts Abuse

Bath Salts – Mephadrone, Methylenedioxypyrovalerone (MDPV)

Bath Salts, Mephadrone or Methylenedioxypyrovalerone is a new, designer drug that started becoming popular in 2004. Prior to 2011, Bath Salts were legal in the US. They were commonly sold at gas stations, head shops, specialty stores and other locations as recreational drugs. In 2011 the drug became classified by the Drug Enforcement Agency as a Schedule 1 drug.

Bath Salts is a very dangerous drug. It is both highly addictive and extremely toxic. There have been many cases in the media were users have suffered grave consequences. The following is a list of the more common effects:

  • Euphoria
  • Increased Alertness
  • Increased Wakefulness and Arousal
  • Increased Energy
  • Increased Sociability
  • Diminished Requirement For Food and Drink
  • Dehydration
  • Tachycardia and Hypertension
  • Headache
  • Panic Attacks
  • Intense Cravings and Impulse to Re-administer
  • Addiction
  • Psychosis
  • Heart, Kidney, Liver Failure
  • Breakdown of Skeletal Muscle Tissue
  • Violent Behavior
  • Suicide

Bath Salts are sold in packets online and have names like “Zoom”, “Cloud Nine”, “Wave”, and “Vanilla Sky”. This drug is also produced in clandestine labs and may be sold in place of methamphetamine or another drug.

Ecstasy Abuse

Ecstasy AbuseEcstasy, also called MDMA, thizzle, skittles, rolling, etc is a semi-synthetic chemical compound. In its pure form, it is a white crystalline powder. It is usually seen in capsule form, in pressed pills, or as loose powder. The average cost ranges from $10-$30 ( U.S.) a dose. The most common routes of administration are swallowing or snorting, although it can be smoked or injected as well. Currently, Ecstasy is on the U.S. Schedule I of controlled substances, and is illegal to manufacture, possess, or sell in the United States. Most other countries have similar laws.

Ecstasy is a psychoactive drug possessing stimulant and hallucinogenic properties. It possesses chemical variations of the stimulant amphetamine or methamphetamine and a hallucinogen, most often mescaline. Ecstasy was first synthesized in 1912 by a German company possibly to be used as an appetite suppressant. Chemically, it is an analogue of MDA, a drug that was popular in the 1960s. In the late 1970s, Ecstasy (MDMA) was used to facilitate psychotherapy by a small group of therapists in the United States. Ecstasy use was not popular until the late 1980s and early 1990s.

Ecstasy is taken orally, usually in tablet or capsule form. The effects of ecstasy last approximately four to six hours. Users of the drug say that it produces profoundly positive feelings, empathy for others, elimination of anxiety, enhancement of the senses, and extreme relaxation. Ecstasy is also said to suppress the need to eat or sleep, enabling users to endure two- to three-day parties. Consequently, ecstasy use sometimes results in severe dehydration or exhaustion. While it is not as addictive as heroin or cocaine, ecstasy can cause other adverse effects including nausea, hallucinations, chills, sweating, increases in body temperature, tremors, involuntary teeth clenching, muscle cramping, and blurred vision. Ecstasy users also report aftereffects of anxiety, paranoia, and depression. An ecstasy overdose is characterized by high blood pressure, faintness, and panic attack. A more severe overdose can cause loss of consciousness, seizures, and a drastic rise in body temperature. Ecstasy overdoses can be fatal, as they may result in heart failure or extreme heat stroke.

The most common location for ecstasy use are late-night parties called “raves,” nightclubs, and rock concerts. As the rave and club scene expands to metropolitan and suburban areas across the country, ecstasy use and distribution are increasing as well. Ecstasy is often used in combination with other substances. Once a person begins using ecstasy or begins frequenting events where ecstasy is widely used, a vast array of drugs become accessible as well. Ecstasy users often seek to increase their high by combining their pill with a dose of marijuana, LSD, ketamine, GHB, amphetamines, cocaine, or heroin. Often times this experimentation can lead to addiction.

 

Oxycontin Abuse

OxyContin is the brand name for an opioid analgesic containing the active ingredient oxycodone (also found in Percocet and Percodan). OxyContin is a legal narcotic that is available by prescription to treat severe pain. OxyContin is a controlled-release medication that, when used correctly, provides extended relief of pain associated with cancer, back pain, or arthritis. However, often when the drug is abused, the tablets are crushed and snorted, chewed, or mixed with water and injected. This eliminates the time-release factor and allows for a quick and intense rush of the drug to the brain. This practice can lead to overdosing on OxyContin’s active ingredient, oxycodone, by releasing too much of the medication into the bloodstream too quickly. OxyContin is highly addictive which means that higher doses of the drug must be taken when a tolerance develops. Illicit use of the drug has risen drastically and steadily over the last few years.

OxyContin is also known as Oxy, OxyCotton, Oxy 80 (for the 80mg dose), or OC.

What Does OxyContin Look Like?

    

OxyContin most commonly exists in tablet form. These round pills come in 10mg, 20mg, 40mg, 80mg, and 160mg dosages. OxyContin also comes in capsule or liquid form.

Short-term Effects

The most serious risk associated with OxyContin is respiratory depression. Because of this, OxyContin should not be combined with other substances that slow down breathing such as alcohol, antihistamines (like some cold or allergy medication), barbiturates, or benzodiazepines. Other common side effects include constipation, nausea, sedation, dizziness, vomiting, headache, dry mouth, sweating, and weakness. Toxic overdose and/or death can occur by taking the tablet broken, chewed, or crushed. People who abuse the drug (by removing the time-release coating) will experience effects for up to 5 hours. The high that is felt is opiate-like and produces a sedate, euphoric feeling.

Long-term Effects

Using OxyContin chronically can result in increased tolerance to the drug in which higher doses of the medication must be taken to receive the initial effect. Over time, OxyContin will be come physically addictive, causing a person to experience withdrawal symptoms when the drug is not present in their system. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements.

Cocaine Abuse

Cocaine AbuseCocaine is a stimulant, which means it speeds up the brain and nervous system. The effects that people get from cocaine are related to the amount they have, which can vary significantly. Cocaine has both a pain killing effect because it blocks the transmission of pain impulses from the nerves to the brain, and a “high” because it stimulates and energizes people to greater alertness, intensifying their mood. Cocaine looks like white powder and can be smoked, snorted and injected.

What is Cocaine?

The narcotic drug cocaine comes from the leaves of the Bolivian coca plant (Erythroxylumcoca) or the Peruvian coca plant (Erythroxylum novgranatense) which is processed to make the drug.

Street cocaine

Cocaine hydrochloride is the product (in various strengths and forms) known as street cocaine. The product is extracted from coca paste by the addition of hydrochloric acid, and produces a fine powder used for snorting or injecting. It is estimated that street cocaine can be “cut” anywhere from one to eight times. Cutting means adding chemicals such as glucose and lactose to make it go further and therefore make more profit. The great variability in strength of “street cocaine” adds to the risk of overdose, due to not knowing how much cocaine is in the powder.

Crack cocaine

Crack cocaine is cocaine made into a form that can be smoked. The process of making crack cocaine involves treating cocaine with various products and chemicals that free the cocaine base from the hydrochloride and lower the temperature at which the cocaine can be melted. It is then removed and allowed to dry and broken into “rocks”. Each rock usually ranging from one tenth to half a gram. Crack is white to light brown or beige in color, and is in the form of slivers or crystalline rocks. Cocaine treated in this way is known as free base and the process is called freebasing. Crack gets its name because when it is smoked, the baking powder residue left in it makes a crackling sound. Crack is extremely addictive because smoking causes its effects to be felt within 10 seconds after use.

Other names

Cocaine is also known as Bump, Coke, Snow, Toot, Lady, Flake, “C”, Candy, Charlie, Sherbert, Charles, Blow, Dust, Bernice, Dream, Nose Candy. Crack is also known as Rocks, Wash, Freebase.

Absorption by the body

Smoking

Cocaine is usually smoked in a pipe and the vapor is inhaled into the lungs where it is then absorbed into the bloodstream. Cocaine users who smoke the drug achieve maximum physiological effects approximately two minutes after inhalation. When cocaine is administered as an inhalant (heated to allow vaporization) it is absorbed almost immediately into the bloodstream, taking around 20 seconds to reach the brain.

Snorting/Sniffing

When cocaine is snorted, cocaine powder is inhaled through the nostrils and absorbed into the bloodstream. The effects are felt more slowly than when it is smoked.

Injecting

Cocaine powder is sometimes dissolved in water and injected directly into the bloodstream. When the levels of cocaine in the body start to decrease, the user can start to feel “the crash” which involves feeling sad, frustrated, depressed, anxious and sometimes suicidal. Often people become dependent on cocaine because they take it again before these symptoms start to avoid the “crash”.

Effects on the body

Because cocaine is a stimulant, the effects after taking it can, possibly cause a person to:

  • feel good and confident
  • be excited or upset
  • take more risks than usual
  • feel aggressive
  • be less hungry
  • feel alert and energetic
  • want to have sex

Initially the effects of cocaine will lead to a high feeling for the user, but continued use will result in tolerance for the drug. Cocaine and crack are highly addictive drugs. Cocaine brings about strong feelings of ecstasy, creating a craving for the drug. Some of the effects of long term use include the following:

  • Aggressive and violent behavior
  • Psychosis
  • Paranoia
  • Anxiety disorders
  • Memory problems
  • Hallucinations
  • Depression
  • Snorting cocaine can cause a stuffy or runny nose and chronic snorting can cause a rupture of the membrane in the nose causing blood noses
  • Cocaine may also harm the health and development of infants born to women who use cocaine during pregnancy
  • Injecting cocaine puts the user at risk of contracting AIDS, bacterial infections, hepatitis and other diseases, particularly when injecting equipment is shared or not sterile

People using cocaine and crack put themselves at risk of death every time they use. Cocaine can kill a person in the following ways:

  • Heart attack – cocaine raises the heart rate and constricts the arteries. The heart has less oxygen than it needs to operate and this may cause a heart attack.
  • Stroke – cocaine increases blood pressure and may cause the blood vessels in the brain to burst. This is a stroke.
  • Cardiac arrest – Cocaine can disrupt the brain’s electrical message to the heart. The heart beats inconsistently and cannot be regulated, resulting in a possible cardiac arrest.
  • Overdose – drop in heart rate, slowing of breathing and circulation, unconsciousness. The amount needed for an overdose is unknown and is different for everyone.

Some research has shown that if a woman who is pregnant uses cocaine, her developing baby is more likely to have delayed development and learning problems, which continue during school. Other research has not shown a developmental problem.

Detoxification

Withdrawal from cocaine may produce similar symptoms to those of someone withdrawing from amphetamines, but for a shorter period. Withdrawal symptoms may include depressed mood, fatigue, disturbed sleep or dreaming, and suicidal thoughts. Cocaine withdrawal symptoms are gone after nearly 24 hours. However, the person may experience a few days of feeling depressed, guilt, and craving for the drug.

Because cocaine is so addictive, it will make giving up very difficult. If you want to stop, talk to someone you can trust (who is not using) about wanting to give up. If there is no one close to you that you can talk to, see a counselor and ask for advice on dealing with quitting. You do not have to give up alone. There may even be a support group or organization to help you through.

Marijuana Abuse

Marijuana is the most commonly abused illicit drug in the United States. It is a dry, shredded green and brown mix of flowers, stems, seeds, and leaves derived from the hemp plant Cannabis sativa. The main active chemical in marijuana is delta-9-tetrahydrocannabinol; THC for short.

How is Marijuana Abused?

Marijuana AbuseMarijuana is usually smoked as a cigarette (joint) or in a pipe. It is also smoked in blunts, which are cigars that have been emptied of tobacco and refilled with marijuana. Since the blunt retains the tobacco leaf used to wrap the cigar, this mode of delivery combines marijuana’s active ingredients with nicotine and other harmful chemicals. Marijuana can also be mixed in food or brewed as a tea. As a more concentrated, resinous form it is called hashish, and as a sticky black liquid, hash oil.* Marijuana smoke has a pungent and distinctive, usually sweet-and-sour odor.

How Does Marijuana Affect the Brain?

Scientists have learned a great deal about how THC acts in the brain to produce its many effects. When someone smokes marijuana, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to the brain and other organs throughout the body.

THC acts upon specific sites in the brain, called cannabinoid receptors, kicking off a series of cellular reactions that ultimately lead to the “high” that users experience when they smoke marijuana. Some brain areas have many cannabinoid receptors; others have few or none. The highest density of cannabinoid receptors are found in parts of the brain that influence pleasure, memory, thoughts, concentration, sensory and time perception, and coordinated movement.

Not surprisingly, marijuana intoxication can cause distorted perceptions, impaired coordination, difficulty in thinking and problem solving, and problems with learning and memory. Research has shown that marijuana’s adverse impact on learning and memory can last for days or weeks after the acute effects of the drug wear off.2 As a result, someone who smokes marijuana every day may be functioning at a suboptimal intellectual level all of the time.

Research on the long-term effects of marijuana abuse indicates some changes in the brain similar to those seen after long-term abuse of other major drugs. For example, cannabinoid withdrawal in chronically exposed animals leads to an increase in the activation of the stress-response system and changes in the activity of nerve cells containing dopamine. Dopamine neurons are involved in the regulation of motivation and reward, and are directly or indirectly affected by all drugs of abuse.

Addictive Potential

Long-term marijuana abuse can lead to addiction; that is, compulsive drug seeking and abuse despite its known harmful effects upon social functioning in the context of family, school, work, and recreational activities. Long-term marijuana abusers trying to quit report irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which make it difficult to quit. These withdrawal symptoms begin within about 1 day following abstinence, peak at 2–3 days, and subside within 1 or 2 weeks following drug cessation.

Marijuana and Mental Health

A number of studies have shown an association between chronic marijuana use and increased rates of anxiety, depression, suicidal ideation, and schizophrenia. Some of these studies have shown age at first use to be a factor, where early use is a marker of vulnerability to later problems. However, at this time, it not clear whether marijuana use causes mental problems, exacerbates them, or is used in attempt to self-medicate symptoms already in existence. Chronic marijuana use, especially in a very young person, may also be a marker of risk for mental illnesses, including addiction, stemming from genetic or environmental vulnerabilities, such as early exposure to stress or violence. At the present time, the strongest evidence links marijuana use and schizophrenia and/or related disorders6. High doses of marijuana can produce an acute psychotic reaction, and research suggests that in vulnerable individuals, marijuana use may be a factor that increases risk for the disease.

What Other Adverse Effect Does Marijuana Have on Health?

Effects on the Heart

One study found that an abuser’s risk of heart attack more than quadruples in the first hour after smoking marijuana. The researchers suggest that such an outcome might occur from marijuana’s effects on blood pressure and heart rate (it increases both) and reduced oxygen-carrying capacity of blood.

Effects on the Lungs

Numerous studies have shown marijuana smoke to contain carcinogens and to be an irritant to the lungs. In fact, marijuana smoke contains 50 to 70 percent more carcinogenic hydrocarbons than tobacco smoke. Marijuana users usually inhale more deeply and hold their breath longer than tobacco smokers do, which further increases the lungs’ exposure to carcinogenic smoke. Marijuana smokers show dysregulated growth of epithelial cells in their lung tissue, which could lead to cancer; however, a recent case-controlled study found no positive associations between marijuana use and lung, upper respiratory, or upper digestive tract cancers. Thus, the link between marijuana smoking and these cancers remains unsubstantiated at this time.

Nonetheless, marijuana smokers can have many of the same respiratory problems as tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, a heightened risk of lung infections, and a greater tendency toward obstructed airways. A study of 450 individuals found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than nonsmokers. Many of the extra sick days among the marijuana smokers in the study were for respiratory illnesses.

Effects on Daily Life

Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person’s existing problems worse. In one study, heavy marijuana abusers reported that the drug impaired several important measures of life achievement including physical and mental health, cognitive abilities, social life, and career status.11 Several studies associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.

Alcohol Abuse

Alcohol affects people differently depending on their size, sex, body build, and metabolism. General effects of alcohol are a feeling of warmth, flushed skin, impaired judgment, decreased inhibitions, lack of muscular in coordination, slurred speech, and memory and comprehension loss. In states of extreme intoxication, vomiting is likely to occur and may be accompanied by incontinence, poor respiration, and a fall in blood pressure. In cases of severe alcohol poisoning coma and death can occur.

Drinking heavily over a short period of time usually results in a “hangover” – headache, nausea, shakiness, and sometimes vomiting. These side effects begin from 8 to 12 hours later. A hangover is due partly to poisoning by alcohol and other components of the drink, and partly to the body’s reaction to withdrawal from alcohol.

Combining alcohol with other drugs can make the effects of these other drugs much stronger and more dangerous. Many accidental deaths have occurred after people have used alcohol combined with other drugs. Cannabis, tranquillizers, barbiturates, sleeping pills, or antihistamines (in cold, cough, and allergy remedies) should not be taken with alcohol. Even a small amount of alcohol with any of these drugs can seriously impair a person’s ability to drive a car or make sound decisions.

People who drink on a regular basis become tolerant to many of the unpleasant effects of alcohol, and thus are able to drink more before suffering these effects. Yet even with increased consumption, many such drinkers don’t appear intoxicated. Because they continue to work and socialize reasonably well, their deteriorating physical condition may go unrecognized by others until severe damage develops. It may take hospitalization for unrelated reasons for alcohol abuse to show up as they suddenly experience alcohol withdrawal symptoms.

Psychological dependence on alcohol may occur with regular use of even relatively moderate daily amounts. It may also occur in people who consume alcohol only under certain conditions, such as before and during social occasions. This form of dependence refers to a craving for alcohol’s psychological effects, although not necessarily in amounts that produce serious intoxication. For psychologically dependent drinkers, the lack of alcohol tends to make them anxious and in some cases even panicky.

Physical dependence occurs in consistently heavy drinkers. Since their bodies have adapted to the presence of alcohol, they suffer withdrawal symptoms if they suddenly stop drinking. Withdrawal symptoms may include jumpiness, sleeplessness, sweating, and poor appetite, to tremors (the “shakes”), convulsions. hallucinations. and sometimes death.

Alcohol abuse can take a negative toll on people’s lives, fostering violence or a deterioration of personal relationships. Alcoholic behavior can interfere with school or career goals and lead to unemployment.

Long term alcohol abuse poses a variety of health risks, such as liver damage and an increased risk for heart disease. Fetal Alcohol Syndrome may result from a pregnant woman’s use of alcohol. This condition causes facial abnormalities in the child, as well as growth retardation and brain damage. Fetal Alcohol Syndrom is often manifested by intellectual difficulties or behavioral problems.

It is the concentration of alcohol in the blood that causes the effects. In the following table, the left-hand column lists the number of milligrams of alcohol in each deciliter of blood – that is, the blood alcohol concentration, or BAC. (For example, an average person may get a blood alcohol concentration of 50 mg/dL after two drinks consumed quickly.) The right-hand column describes the usual effects of these amounts on normal people – those who haven’t developed a tolerance to alcohol.