Opioids include opium, morphine, heroin, and codeine. Moderate doses relieve pain however prescription pain medications are among the most abused of all drugs. These include Vicodin, Zydone, Lortab, Percodan, Tylox, and OxyContin. 7% of the US has misused at least once. The use of heroin is more common in men with people most often starting with taking prescription pain medicines before use. The increasing use of synthetic opioids like fentanyl have been leading to the most recent wave of deaths since 2013. Prescription pain medications are the most commonly abused opioids with the number of people seeking treatment continuing to increase and has more than doubled between 2005 and 2021. Misuse is slightly higher in men and higher among White Americans compared to other ethnic and racial groups. Nearly 91 people a day died from an opioid overdose in 2015. Opiates produce euphoria, drowsiness, and lack of coordination which leads to the loss of inhibition and increased self-confidence with a severe letdown after about 4 to 6 hours. Heroin and OxyContin have intense feelings of warmth and ecstasy following injection. Opiates stimulate receptors of the body’s opioid system. There is exposure to infectious agents such as HIV through intravenous drug use. Withdrawal may begin within 8 hours after high tolerance develops and causes muscle pain, sneezing, sweating, tearfulness, yawning, and can resemble influenza. Within 36 hours, symptoms become even more severe with uncontrollable muscle twitching, cramps, chills, flushing/sweating, elevated heart rate/blood pressure, insomnia, vomiting, and diarrhea. Withdrawal lasts about 72 hours.
Stimulants include amphetamines, methamphetamines, and cocaine. Amphetamines are synthetic stimulants that block norepinephrine and dopamine with the quick ability to build tolerance. Methamphetamines are most commonly known as “meth” or “ice” and produce a long-lasting high with intensely high cravings which can cause brain damage. Cocaine acts rapidly and induces pleasurable states with a high likelihood of overdose. Amphetamines are synthetic stimulants such as Dexedrine and Adderall that trigger release and block reuptake of norepinephrine and dopamine which can be taken orally or intravenously. Amphetamines cause a person to become alert, euphoric, outgoing, and feel boundless energy and self-confidence. High doses can lead to nervousness, agitation, confusion, suspiciousness, and hostility. Tolerance can develop after only 6 days of use. Cocaine is derived from leaves of coca shrub and be snorted, smoked, swallowed, or injected. It is used predominantly in urban areas and by men but is used less frequently today. Crack is a form of cocaine developed in the 1980’s which is a rock crystal that is heated, melted, and smoked and is cheaper than cocaine. Cocaine acts rapidly on the brain by blocking reuptake of dopamine in mesolimbic areas and inducing pleasurable states causing increased sexual desire, self-confidence, and stamina. Overdose (OD) results in chills, nausea, insomnia, paranoia, hallucinations, and possibly heart attack and death. Not all users develop tolerance which may increase the risk of OD.
LSD effects the serotonin system and is used more often by men and European Americans. It was popular in the 1960’s but regular use has declined with no evidence of withdrawal, but tolerance develops rapidly. Hallucinogen effects take place within 30 minutes and can last up to 12 hours which include experiencing hallucinations, sense of time, mood swings, expanded consciousness, and flashbacks which are visual recurrences of perceptual experiences aftereffects of drugs have worn off. Ecstasy, or molly, is taken in a pill or power form with the average age of first use being 21. It acts primarily on the serotonin system and increases feelings of intimacy, insight, positive emotions, and self-confidence but can also cause muscle tension, nausea, anxiety, depression, confusion, and depersonalization. PCP, or phencyclidine, is angel dust that is used more by men and causes severe paranoia and violence with the possibility of coma and death.