Health Concerns
Using drugs might seem harmless, especially if you know people who use drugs and don’t appear to suffer any consequences. The truth is that drug use can present a wide range of risks and dangers, and staying informed can be an important first step to staying safe.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2013, 24.6 million (or 9.4 percent) people aged 12 or older in the United States had used illegal drugs in the past month. Of them, SAMHSA found, 6.9 million were drug-dependent or abusing drugs. They also found:
Marijuana is the most popular illicit drug, following by nonmedical use of prescription pharmaceuticals such as opiate painkillers.
People aged 16-34 were more likely to use drugs (over 10 percent of Americans aged 12 and up), with people 18-25 using drugs at the highest rates (over 20 percent of Americans aged 12 and up).
Over 22 percent of full-time college students aged 18-22 use illegal drugs (26 percent of males and 19 percent of females).
Rates of drug use are lower among people who are college graduates (about 7 percent) compared to people who have not graduated from college (10-12 percent).
About 9 percent of people who are employed use illegal drugs compared to 18 percent of people who are unemployed.
Drug use is most prevalent in the western United States and least prevalent in the southern United States.
Misuse of drugs and alcohol caused nearly 2.5 million emergency room visits in 2011, SAMHSA reports. The Centers for Disease Control and Prevention (CDC) found that 43,982 people died of drug overdose in 2013, and the CDC also found that over double that number – about 88,000 – die from excessive alcohol consumption each year.
Overdose isn’t the only risk associated with drug use – drugs can also impact your physical, psychological, and behavioral health in a wide variety of ways.
Risks of drug use
Although the risk of addiction exists for any drug user, most people who use drugs successfully avoid becoming addicted. However, this doesn’t mean that they aren’t taking other risks when trying drugs.
The method of use may carry a range of inherent health risks:
Drinking
Edibles
Snorting
Smoking
Injecting
Drinking alcohol greatly increases the risk of developing cancers of the digestive tract.
Many drugs loosen inhibitions, impair judgment, or impair coordination and reflexes. This can cause:
Engaging in unsafe sexual behavior, such as having sex with strangers or unprotected sex
Increased risk of injuries from accidents, such as falls or burns
Increased risk of experiencing violence
Overdose can manifest in a variety of ways depending on the type of drug used:
Stimulants (such as cocaine, methamphetamine, ecstasy, or bath salts) can overexcite the brain, causing seizures, or the cardiovascular system, causing heart attack or stroke.
Depressants (such as alcohol, opiates, or benzodiazepines) can lower the body’s breathing levels to the point where breathing stops, or slow the heart until it stops. They can also directly cause unconsciousness, coma, and death.
Some drugs (such as alcohol and opiates) can cause both vomiting and unconsciousness, which can be a lethal combination. If someone vomits while unconscious, they can choke on the vomit and suffocate. If you encounter someone who you suspect has overdosed on drugs, roll them onto their side to reduce the risk of this happening while you call emergency services.
General health concerns of drug abuse
Physical concerns
Psychological concerns
Behavioral concerns
Dependence or withdrawal symptoms (when attempting to quit)
Weakened immune system
Lung, liver, or cardiovascular disease
Cancer
Malnourishment
Addiction and the brain
Drugs can work in one of two ways: by mimicking the effects of one of the brain’s own signaling chemicals, or by causing nerve cells in the brain to release extra signaling chemicals. Either way, the receptors for these chemicals get flooded with signals. In the case of chemicals that signal pleasurable feelings – such as dopamine, serotonin, endorphin, or endocannabinoid – this flood produces a euphoric rush or high.
To defend themselves against this onslaught, the brain’s nerve cells will reduce the number of receptors they have for the signaling chemicals, quieting the incoming signal. This means that, without the drugs, levels of the signal become too low for the brain to function properly. The result can be a crash, hangover, or, when the user has become dependent on the drug in order to function, full-blown withdrawal symptoms. Over time, the rewarding effects of the drug become lower, and eventually the user winds up using drugs simply in order to stave off the effects of withdrawal rather than for the high they once felt.
A review of research in the Proceedings of the National Academy of Sciences found that people who are addicted to drugs show a substantially reduced dopamine response to drug use. However, they have an increased dopamine response in the reward pathway when exposed to cues associated with drugs, which in turn predicts the strength of drug cravings. They also have lower levels of dopamine receptors in the orbitofrontal cortex and anterior cingulate gyrus, which are associated with self-control and inhibition.
Concerns of drug use, abuse, and addiction by drug
Alcohol can be safe to consume in moderation, but heavy drinking over time can cause:
Liver disease
Inflammation of the pancreas
Cardiovascular problems, such as high blood pressure and stroke
Damage to the brain, particularly areas related to movement, mood, thinking, and judgment
Alcohol also remains, by far, the most common date-rape drug. Brown University reports that 90 percent of all campus rapes occur when the assailant or the victim has used alcohol.
Barbiturates such as phenobarbital, if used in the long-term, can cause:
Irritability
Memory loss
Changes in alertness
Loss of functioning
Bath salts (cathinones) include mephedrone, methylone, and MDPV, as well as many others. They may be sold as ecstasy (MDMA or “Molly”) due to their chemical similarities to the drug. Their use can cause:
Cardiovascular problems
Racing heartbeat
High blood pressure
Chest pain
Paranoia and panic attacks
Kidney failure
The long-term effects of bath salts are not yet fully understood, but NIDA reports that their addictive potential may be as high as methamphetamine's.
Benzodiazepines include Xanax, Ativan, Klonopin, and Valium. Long-term use of benzodiazepines can cause:
Memory problems
Clouded thinking
Mood swings
Sleep problems
Irritability or aggression
Headaches
Dizziness
Lethargy
Cocaine poses risks when used in a binge pattern, and its abuse may lead to:
Restlessness
Irritability
Agitation
Anxiety
Insomnia
Mood disturbances
Heavy cocaine users are at risk for experiencing acute, severe paranoia, losing touch with reality, and falling into a temporary state of psychosis.
Cough medicine (DXM) is safe to use as directed, but in high doses can cause:
Impaired coordination
Numbness
Nausea or vomiting
Raised blood pressure and heart rate
Agitation
Raised body temperature
Building of acid in body fluids
Cough medicines may also be dangerous to use in high doses because of their other ingredients, such as:
Pseudoephedrine, which increases blood pressure
Acetaminophen, which can cause liver damage
Antihistamines, which can damage the brain and heart
Ecstasy (MDMA) abuse can cause:
Irritability
Anxiety
Impulsiveness
Sleep disturbances
GHB abuse can cause:
Depression
Mood swings
Damage to memory, judgment, and decision-making abilities
Vision problems
Slurred speech
Since GHB is odorless and tasteless and can produce inhibition and unconsciousness, it can be used as a date-rape drug.
Heroin and prescription opiates slow the heart and breathing. They include codeine, morphine, Vicodin (hydrocodone), Percocet/OxyContin (oxycodone), Dilaudid (hydromorphone), and Demerol (meperidine). Although prescription opiates are safe to use as a doctor prescribes, using them in higher doses or more frequently can be dangerous, risking coma or death.
Inhalants
Hydrocarbon Inhalants include solvents, glues, gases, and aerosols. Their use can cause:
Nerve damage
Tremors
Permanent movement problems
Liver or kidney damage
Amyl nitrites can cause lipoid pneumonia, a form of lung inflammation caused by the drugs entering the lungs.
Nitrous oxide inactivates vitamin B12 in the body, a nutrient necessary for maintaining the nervous system. Long-term B12 depletion can cause nerve damage.
K2/Spice, also known as “fake weed,” is sold as a legal alternative to marijuana. However, it can contain a wide range of cannabinoid-like compounds with unreliable effects. Acute problems from spice use can include:
Nausea and vomiting
Agitation and confusion
Hallucinations
Elevated heart rate
Reduced blood supply to the heart
Heart attacks
The long-term effects of spice are not yet known.
Ketamine abuse over time can cause:
Impairments in cognition and memory
Loss of coordination
Blurred vision
Marijuana (cannabis) abuse is associated with an increased risk of:
Depression
Anxiety
Schizophrenia and related disorders (among those with a pre-existing disposition)
Cardiovascular problems (when combined with alcohol)
PCP abuse can cause:
Memory loss
Speech difficulties
Depression
Anxiety
Suicidal thoughts
Prescription stimulants include amphetamine (Adderall, Dexedrine) and methylphenidate (Ritalin, Concerta). Although these drugs can be used safely under a doctor’s guidance, their use is considered abuse if they are used more frequently or in higher doses than a doctor recommends, or are used without a prescription. Abuse of prescription stimulants can cause:
Weight loss
Malnutrition
Anxiety
Paranoia
Hostility
Psychosis
High body temperature
Elevated blood pressure
Irregular heartbeat
Seizures
Heart attack
Psychedelics include LSD, magic mushrooms (psilocybin), peyote cactus (mescaline), and ayahuasca (DMT), as well as a wide range of newer synthetic drugs. Long-term health consequences of using psychedelics can include:
Hallucinogen persisting perception disorder (HPPD), also known as “permafry.” HPPD causes psychedelic users to experience hallucinations or other perceptual distortions for weeks, months, or even years after they have stopped using hallucinogens. They may also experience “flashbacks,” or re-experience memories from their psychedelic use.
Persistent psychosis, characterized by disorganized thinking, mood swings, hallucinations, and paranoia.
A “bad trip,” in which the user’s psychedelic experience has themes of fear, loss of control, feeling overwhelmed, or other such negative states. The drugs can cause these feelings to last long after the drugs have worn off, leaving depression or anxiety that can last for weeks, months, or years.
Speed abuse can cause:
Impaired cognition and memory
Mood disturbances
Anxiety
Insomnia
Irritability
Confusion
Paranoia
Aggression
Hallucinations
Weight loss and malnourishment
Damage to the brain, heart, liver, kidneys, or lungs
Dental damage (from dry mouth and grinding teeth)
Skin sores (from scratching or picking)
Steroids, specifically androgenic anabolic steroids, can cause:
Liver damage
Cardiovascular disease
High blood pressure
Decreases in HDL (“good” cholesterol)
Increases in LDL (“bad” cholesterol)
Enlarged heart
Stiffened arteries
Additional effects for males:
Baldness
Shrunken testicles
Reduced sperm count
Infertility
Increased risk for prostate cancer
Development of breasts
Additional effects for females:
Growth of facial and body hair
Baldness
Altered or stopped menstrual cycle
Enlarged clitoris
Deeper voice
Tobacco is inherently carcinogenic, apart from the carcinogens produced by smoking it. Use of smokeless tobacco, such as e-cigarettes, chewing tobacco, or snuff, is still associated with:
Cancer of the mouth, tongue, gum, cheek, throat, esophagus, stomach, and pancreas
Increased risk of heart disease, heart attack, or stroke
Mouth sores
Receding gums
Tooth damage
Drugs and pregnancy
When a pregnant woman uses drugs, so does the developing fetus. If the drugs are addictive, whether legal or illegal, then the child can be born addicted to them. If medical professionals do not manage this condition properly, then the child can experience neonatal abstinence syndrome, or neonatal withdrawal. This includes the same withdrawal symptoms that an adult would experience, which can be much more severe in a newborn.
Use of drugs while pregnant can also cause a variety of effects.
Alcohol
Miscarriage or stillbirth
Premature delivery
Cerebral palsy
Fetal alcohol spectrum disorders, including fetal alcohol disorder, characterized by:
Low birth weight
Learning problems
Problems with speech and cognition
Problems with attention and behavior
Problems with balance and movement
Poor muscle tone
Poor growth
Heart, kidney, or lung defects
Changes to the shape of the face
Tobacco
Miscarriage
Separation of the placenta from the lining of the womb
Premature birth
Low birth weight
Increased risk of sudden infant death syndrome (SIDS)
Increased risk for ADHD, conduct disorder, and obesity
Increased risk of being smokers as adults
Marijuana
Abnormal fetal brain development
Impairments in problem solving, planning, attention, and memory
Impulsivity
Depression
Increased risk of using tobacco or marijuana later in life
Cocaine
Low birth weight
Smaller head size
Shorter birth length
Subtle but significant differences in attention, organization skills, language, self-control, and abstract thinking
Methamphetamine
Detachment of the placenta from the lining of the womb
Premature delivery
Low birth weight
Heart and brain defects
Sleep and wakefulness problems
Increased sensitivity to stress
Subtle but significant impairments in attention
Heroin
Miscarriage
Detachment of the placenta from the lining of the womb
Restricted fetal growth
Premature delivery