Big White Lies www.scholastic.com /HEADSUP

At first, cocaine made Miguel feel powerful. But the drug’s promises turned out to be lies.

If you’d met Miguel Flores

CLOSE-UP: COCAINE

when he was in junior high school, you’d have met a young man who listened to his mother and did

By Cate Baily

well in school. If you’d met him in high school, you’d have met a different person—a teenager who cut classes and got left back, a son who screamed obscenities at his mom. Drugs changed him. When we talked to Miguel, he was a resident at Odyssey House, a drug treatment program in New York City’s East Village. Now 19, he told Scholastic how he got there. When Miguel started high school in Brooklyn, New York, he fell in with a new crowd— the wrong crowd. To make a long story short, he started smoking marijuana, drinking, and failing classes. Finally, he got arrested and spent a night in a crowded cell on Rikers Island, a New York City jail.

powerfully addictive drug. Derived from the leaves of the coca plant, it has many names on the street, including coke, C,

Cocaine in powdered form

snow, flake, and blow. Coke comes in the form of white powder and is generally inhaled or snorted. Miguel joined only a small percentage of his peers when he snorted the potentially deadly powder. According to a 2002 NIDA-funded study, only 3.6 percent of 8th-graders, 6.1

COCAINE & YOUR BRAIN ocaine interferes with the brain’s normal handling of dopamine, a brain

C

chemical, or neurotransmitter, involved with feelings of pleasure. Like all neurotransmitters, dopamine travels from one brain cell, or neuron,

to another by crossing a synapse, or gap, between cells. It then sends its message by binding to a dopamine receptor on the next cell. When finished, it returns into the synapse, where a transporter carries it back to the first brain cell for reuse. Cocaine binds to and blocks dopamine transporters, preventing them from picking up dopamine for recycling. “The transporter is like a pump in a swimming pool that recycles water to keep the water at a certain level,” explains NIDA’s Dr. Grant. “Cocaine clogs the pump, allowing dopamine levels to rise to abnormally high levels, just like a clogged water pump will make a swimming pool overflow and produce a flood.” Scientists believe that this dopamine “flood” is behind the cocaine high. And just like a literal flood, it can cause a lot of damage. With repeated exposure to cocaine, the brain becomes unable to

NOT READY TO STOP

process dopamine normally. “Many

Given a choice by a judge between jail and getting help, Miguel opted for an outpatient drug treatment program. But he clearly wasn’t ready to commit to the challenge of staying off drugs. In fact, it was during the time he was legally bound to this program that he began using cocaine. Cocaine is a stimulant and a

cocaine users report that they have less ability to experience pleasure in life,” says Dr. David Gorelick of NIDA.

In the synapse, or

To try to feel

space between neurons

good, they return

(area of detail),

to the drug, again

cocaine binds to

and again, while

dopamine transporters,

the joys of real

causing a “flood” of

life pass them by.

dopamine in the brain.

2 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

FO

COCAINE KILLS emember Chris Farley? The Saturday

R

Night Live comedian was found dead in

his luxury New York City apartment on

December 18, 1997. He was only 33 years Cocaine starts as coca leaves.

old. The cause of death was a morphineand-cocaine-induced heart attack.

Miguel Flores

STEPHEN KRONINGER(ILLUSTRATIONS 2); 5W INFOGRAPHICS(DIAGRAM); JOHN RENSTEN/ALAMY(COCAINE); PHOTODISC/GETTY IMAGES(COCAINE LEAVES); STEVE GRANITZ/RETNA LTD. USA(FARLEY).

ORMER COCAI NE AB USER/ IN TR EATME NT

percent of 10thgraders, and 7.8 percent of 12thgraders have ever tried cocaine. “I wanted to see how it felt,” he said. “It was a different kind of high. Cocaine makes you feel like you have a lot of power. It makes you feel invincible.” “Feelings of being powerful and invincible are not only typical, but were some of the earliest reported effects of cocaine,” says Dr. Steven Grant of the National Institute on Drug Abuse [NIDA]. But such feelings are short-lived. For Miguel, they only lasted about 20 minutes. The high faded away, and he began to feel like he was “nobody.” He vowed not to take cocaine again. He’d heard that cocaine could make him have a stroke. He’d also read articles about people dying of cocaine overdoses.

MOM’S TEARS In other words, Miguel knew that cocaine was dangerous. But less than two months after he first snorted coke, his resolve weakened, and he snorted the white powder again—and then again and again. The stimulant took its toll. Miguel’s heart pumped hard. He was nervous and paranoid. He even became violent.

“The more you use cocaine, the less high you will get, but it becomes more likely that you will experience these unpleasant effects,” says Dr. Grant. What Miguel experienced, he explains, is because of changes in the brain that happen in response to repeated exposure to cocaine. But more painful to Miguel than any side effect is the memory of seeing his mom cry when she discovered the truth about his cocaine use.

Chris Farley

Cocaine played a role in the death of this talented comic, and the drug has had a hand in many other deaths. Cocaine can trigger fatal heart attacks and strokes—even in healthy young people. Here’s how cocaine can cause a heart attack: “Cocaine increases the amount of oxygen needed by the heart because it stimulates the heart to beat faster and stronger,” explains NIDA’s Dr. Gorelick. “At the same time, cocaine is decreasing the amount of blood flowing to the heart muscle, or blocking blood flow completely.” This is because the drug constricts blood vessels. Dr. Gorelick also explained how cocaine induces strokes. “In one type of stroke, blood flow is stopped because the blood vessel is constricted and/or blocked,” he says. “In another type, the blood vessel leaks or bursts, and blood no longer flows beyond the point of damage.” In 2001, there were 193,034 hospital emergency-department cases involving cocaine nationwide, or 10 percent more than in 2000 (according to the Drug Abuse Warning Network, 2002). The irony is that

REAL STRENGTH

some young people try cocaine for thrills and excitement. How exciting

Drug users often must go through several treatment cycles before they are successful. When Miguel’s mandatory urine tests repeatedly came up positive, he was again given a choice—this time between jail and a residential treatment program. He chose Odyssey House, and although it’s been difficult, he has stuck to his commitment. When we spoke, he’d been clean for 10 months. If you meet Miguel today, you see a young man who feels “strong,” but not because there’s cocaine in his body. He feels strong because he’s resisted drugs. You also see that the respect for his mother has returned. In fact, he credits her with his recovery. “I did it for my mom,” he says. Someday, perhaps he’ll realize that he really did it for himself.

is it to end up in the emergency room . . . or dead?

Don’t Be “Shaky” on the Facts! ocaine is just one of many stimulants

C

that can do a number on your head and

heart. Stimulants are drugs that speed up activity in the central nervous system (brain and spinal cord). They make the heart beat faster and cause blood vessels to narrow—which can make you feel nervous and jittery. The caffeine that gives your latte its kick is a stimulant. Any stimulant—even caffeine, to a mild degree—can become addicting. Other dangerous stimulants:

• Crack is cocaine in a form that is smoked. • Amphetamines are pills that have some legitimate medical uses only when prescribed by doctors. They’re also called “speed.”

• Methamphetamine is a long-acting and highly addictive •

stimulant. It comes in many forms including crystals (“crystal” or “ice”) and powder (called “crank”). Ecstasy, or methylenedioxymethamphetamine (MDMA), usually taken in pill form, is part stimulant and part hallucinogen. (Turn the page for an article on hallucinogens.)

FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 3

“E” Is for Empty /HEADSUP

Daniel Oerum,

By Laura D’Angelo

17, of San Clarita Valley, California, wanted prom night to be special. So, he reached into his tuxedo pocket and took out pills stamped with images of Tweety Bird and Buddha. Ecstasy (also called E, X, XTC, Adam, hug, love drug, and beans) looked harmless enough. But Daniel found out the hard way how dangerous it can be. “My heart was racing so fast. I thought I was having a heart attack,” Daniel said. A friend helped him into the prom because his legs wouldn’t stop trembling. The dance floor was located on a Hollywood movie set. Daniel tingled from head to toe. “Then I hit a peak,” he said. “I felt like a movie star.” Later at a friend’s house, Daniel crashed into gloom and confusion. He swallowed two more “E” pills. Taking

multiple doses within a relatively short time multiplies the toxic risks of any drug. With ecstasy, “stacking,” or doubling the dose, carries especially high risk. The level of ecstasy builds and the user’s body can’t keep up with the amount of drug in his or her blood. That’s what happened to Daniel. “I lay down and couldn’t lift my head,” he said. “My legs were rocking back and forth.” The following weekend,

Daniel dropped “E” at a rave where some 200 kids danced on a dirt clearing. Before long Daniel was selling ecstasy. “I’d walk into raves and yell ‘E’ and people would crowd around. I felt a sense of power.” With the profits, he bought more ecstasy which he took often, always with other kids. “I did drugs so I didn’t have to feel alone,” he said. When Daniel’s father worked nights, friends flocked to his house. Adorned with glow-in-the-dark shirts and beads, they danced to trance music and chewed pacifiers to keep their teeth from grinding.

LIVES DESTROYED Soon Daniel was dropping up to five “E” pills a day. Desperate to feed his habit, he started selling

CASUALT Y OF ECSTASY ineteen-year-old Melissa Ross died after trying ecstasy for the first time. The Emory University sophomore had hoped to dance the night away with friends at an Atlanta club. Instead, she ended up in the morgue. News of her death shocked Bill Gentry, a close friend who remembers singing and playing piano with Melissa in their dorm lobby. “Melissa was probably one of the cleanest people I’d ever known. She didn’t do drugs, smoke, or even drink. She probably wanted to try ecstasy and see what it was like,” he said. “I’m sure if she knew ecstasy could kill, she never would have taken it.” Melissa died from a fatal heat reaction, known as hyperthermia. Part stimulant, ecstasy acts on the brain’s hypothalamus. It ramps up heart rate and blood pressure and disrupts the brain’s ability to regulate body temperature. A brain unable to cool off an overexerted body on a jam-packed dance floor spells disaster. “The body sweats and the extreme loss of water causes dehydration,” says Dr. Glen Hanson, Acting Director of the National Institute on Drug Abuse (NIDA). “Users tend to ignore some of these symptoms, partly because the drug masks them, and partly because they’re distracted by the social setting.”

N

8 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

FORME

EROWID.ORG(PILLS); GREG SMITH/AP WIDE WORLD PHOTOS(RAVE)

Ecstasy use left Daniel feeling worthless and alone.

CLOSE-UP: ECSTASY

www.scholastic.com

FAQS ON X TC 1

5

What is it?

Do the neuron fibers grow back?

Ecstasy, or methylenedioxymethamphetamine (MDMA),

Sometimes they do grow back, but not necessarily in the

is part hallucinogen and part stimulant.

same parts of the brain. “It’s like cutting off a limb of a

2

How many teens use ecstasy?

fruit tree,” says Hanson. “The tree’s still alive and can

According to a 2001 NIDA-funded study, 5.2% of 8th-

sprout a new limb somewhere else, but it may not bear

graders had tried ecstasy; 8% of 10th-graders had

as much fruit as the old one,” says Hanson.

tried the drug; and 11.7% of 12th-graders.

Daniel Oerum ER ECS , 17 TASY A

BUSER /IN TR EATME NT

3

How does it make a user feel?

In the short term, ecstasy can make some

Serotonin Transmission in the Brain

users feel confident, blissful, and uninhibited. Users may also have negative

STEPHEN KRONINGER(ILLUSTRATIONS 2); 5W INFOGRAPHICS(DIAGRAM)

experiences, like anxiety attacks.

cocaine and methamphetamine as well as ecstasy. “I was skinny. My skin was the color of paper. My teeth were rotting out,” Daniel said. “I would steal anything I could get my hands on. I stole valuables from my dad. I didn’t see anything wrong with the way I was acting.” Once, a friend’s mother wanted to buy drugs from Daniel. When he delivered the bag of speed to the house, Daniel watched his friend’s face crumple in sadness. “I felt really bad. I saw lives being destroyed because of what I was doing,” he said. On New Year’s Eve, Daniel’s girlfriend called him a “drug addict” and a “lowlife.” He jumped out of her car. “Staring at the city hotels and gas stations, I thought ‘I’m going to be living alone in the streets’ and that scared the daylights out of me,” Daniel recalled. The next morning, he went to his father and said, “Dad, I need help.”

4

What are the side effects?

“E” can damage a user’s brain. “Moderate to heavy ecstasy users are likely to have memory and sleep problems and experience depression,” says Dr. Hanson. How does that happen? Ecstasy can “x-out” the fibers of neurons that carry serotonin, a chemical messenger that plays a big role in mood, pain, sleep, memory, and thinking.

months. He’s gained weight, and he cares about himself again. But he worries about ecstasy’s effects. “I feel like I’ve suffered brain damage,” he said. “Sometimes I get stuck in conversations, because I can’t find a word.” Other times he walks the unit and stops in horror, forgetting where he’s going. Daniel is trying to understand his past and piece his life back together. “I got into drugs because I felt like no one liked me. Then nobody wanted to be around me because of the drugs, and I ended up completely alone,” he said. “I feel like a new person now.”

Beware of Club Drugs cstasy and other so-called club drugs emerged from the underground rave scene. Some produce a sense of detachment from the user’s surroundings or self—or even real unconsciousness. Because of these “dissociative” effects, these drugs are often used in date rapes. All club drugs can cause serious health consequences or, in some cases, death. Combining them with alcohol is especially dangerous. GHB or Gamma-hydroxybutyrate (aka G, liquid ecstasy, and Georgia Home Boy) has euphoric, sedative, and anabolic (body building) effects. A liquid or powder with a salty taste, it may be added to spring water or concealed in mouthwash bottles. With flavorings, it can be passed off as a high-carb drink. Ketamine (aka Special K or K) is a dissociative drug commonly used as a horse tranquilizer. A powder or liquid, it is snorted, sprinkled onto cigarettes, injected, or hidden in drinks. Methamphetamine (aka speed, ice, chalk, and meth), a stimulant, excites the central nervous system. It is a white, odorless, bitter-tasting crystalline powder that is snorted or smoked, or dissolved in water or alcohol and injected or swallowed. LSD or Lysergic Acid Diethylamide (aka acid) is a hallucinogen, or drug that causes hallucinations. It may be distributed in breath-mint vials, treated sugar cubes, gel wafers called “windowpanes,” pills, or decorated blotter paper that is chewed or swallowed.

E •

•

•

•

NEW YEAR/NEW BEGINNING A resident of Phoenix House, a drug-treatment center in Lake View Terrace, California, Daniel has been clean for six

Serotonin travels through the healthy brain by jumping from cell to cell along the fibers of neurons (brain cells). But ecstasy use damages the terminals (ends) of neuron fibers. Chemical messages relating to mood, sleep, memory, and more are disrupted.

a national PBS weekly series for teens

Real teens talk about ecstasy in an upcoming episode of the awardwinning reality series for teens. Check your local PBS listings or inthemix.org

FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 9

Hooked on Heroin

CLOSE-UP: HEROIN

/HEADSUP

By John DiConsiglio

For a Baltimore teen, one experience with heroin led to a living nightmare

Judy was no stranger to drugs. By the time she was 15, she smoked pot on a daily basis. She even tried ecstasy at a party or two. The Baltimore teen thought she was tough enough to handle anything that came her way. But this was like nothing she’d ever experienced. And, suddenly, Judy was scared. She was pressed into the mosh pit at an Incubus concert. The music was loud and she couldn’t hear what her boyfriend said as he passed her a joint. Or, at least, she thought it was a joint. But, after a few puffs, Judy knew something was wrong. “I felt this warm sensation flood over me, and then I went numb,” says Judy, who is now 17 and asked that we not use her last name or picture. “The crowd was pushing me against the stage. I knew that I was getting squashed but I couldn’t feel a thing. That’s what really freaked me out.”

The next morning, her boyfriend told her that he hadn’t given her marijuana. It was heroin.

HIGH-RISK HIGH Judy had always been a little afraid of heroin. She’d seen the hollow, zombielike faces of friends who were strung out on the drug. She even knew a few people who had died from heroin overdoses. So it shocked Judy to hear herself say, “I want to do it again.” “It wasn’t even 24 hours later,” she says, “and I was already craving it.” Call it smack. Or H. Or skag or junk. By any name, heroin is dangerous, addictive,

and illegal. About 3 million Americans have used heroin— including nearly 2 percent of 8th-, 10th-, and 12th-graders, according to the National Institute on Drug Abuse (NIDA). “It can be snorted, smoked, or injected,” says Dr. Cathrine Sasek, coordinator of NIDA’s science education program. “But in all forms, it can lead to an intense addiction, dangerous behavior, and health risks that range from heart infections, liver disease, and breathing problems to lethal overdoses.” Or, as Judy puts it, “When you are on heroin, your whole life is getting high, getting sick, and then doing anything to get more drugs.”

FAST TRACK TO ADDICTION The day after she first smoked heroin, Judy found herself snorting white lines of the drug with her boyfriend. “I never felt anything like it. It just made me all warm and numb

THREE DEADLY METHODS

H

eroin users take the drug in three different ways: They

heroin is going to hook

may inject it directly into their veins or muscles with

you. That’s just a fact.”

syringes; they may snort lines of it in powdered form; or they may smoke it in rolled, marijuana-like joints.

The more heroin you take, the more you need.

Most users inject heroin, believing it leads to a more

Typically, an addicted individual uses it four times a day. Since

intense high. But smoking and snorting have become popular

the drug may be cut with anything from powdered milk to rat

among young people. That’s because many mistakenly believe

poison, users don’t know how much they’re really taking. That

that heroin is only addicting when it is injected.

makes it easy to overdose. Too much of the drug will slow your

“That is a total myth,” says Dr. Sasek. “Any way you take

respiratory system—until you stop breathing and die.

14 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

© GOODSHOOT/SUPERSTOCK(HEROIN TOOLS); © BRUCE AYRES/GETTY IMAGES(HEROIN SMOKERS); © ANDREW MOUNTER/GETTY IMAGES(POPPY FIELD)

www.scholastic.com

STEPHEN KRONINGER(ILLUSTRATION); 5W INFOGRAPHICS(DIAGRAM); © PHOTODISC/SUZA SCALORA/GETTY IMAGES(WOMAN’S PROFILE)

Heroin binds to opiate receptors on neurons (brain cells) in several parts of the brain. This creates a signal for the increased release of dopamine, a brain chemical linked to feelings of pleasure. The action of the drug triggers different responses in different parts of the brain.

and sleepy” she says. Judy, 1 “But even that 7 HEROI N ABUS ER/IN second time, I didn’t RECOV ERY feel the same rush as the first. And then I started needing more and more of it to get high.” so wild. It wasn’t me.” Only a few hours after a Just nine months after she heroin high wears off, addicted first tried the drug, Judy was people, like Judy, often start breaking into houses to steal craving more of the drug. Their anything she could trade for bodies turn on them, and they heroin. “I never turned to suffer through nausea, vomiting prostitution, but I knew I was and diarrhea. going down that line,” she says. “It’s like the worst flu you’ve ever had—and then 10 times GETTING A LIFE worse than that,” Judy says. Finally, Judy and her “You think you are going to die. boyfriend decided to get clean Even when you aren’t sick, together. They checked into you’re always a little pukey. Your separate drug treatment skin feels uncomfortable on facilities. And while Judy has you and you’re always picking at been drug-free for more than two it. The only thing that months at the Lois E. Jackson makes you feel better Unit in Cumberland, Md., is more heroin.” her real struggles Within just a are just beginning. few weeks, Judy Even talking about progressed from heroin during her sampling counseling sessions heroin on the makes her want to weekends to a start using again. daily habit. She Judy knows that dropped out of she’ll always be an school and spent all addict. But she’s of her time with her mending fences with her boyfriend and his heroinfamily and planning on going addicted mother. On the rare back to school to study occasions when she was home, accounting or interior design. “I Judy fought with her family. want a life. I want a family. I “My mother tried to get me to want children,” she says. “I want admit that I needed help, and I my parents to be proud of me. just beat her up,” Judy says. “I And the only way to do all that is can’t believe I did that. But I was to get off this stuff.”

THE LIMBIC SYSTEM controls emotions and feelings of pleasure. Heroin acts here to produce an intense rush, which people addicted to the drug seek compulsively. THE BRAIN STEM controls basic bodily functions, like heartbeat and breathing. Here, heroin can depress respiratory activity to the point that the user stops breathing and dies.

heroin

opiate receptor

dopamine

dopamine receptor

IN THE SPINAL CORD, heroin has an analgesic (pain-relieving) effect. It blocks the transmission of pain messages between neurons, preventing them from reaching the brain.

HEROIN AND YOUR BRAIN eroin is an opiate, a kind of drug that’s culled from the seed of a

H

poppy plant. Other opiates, like morphine, are used as powerful medications to relieve the intense pain of some illnesses, like cancer.

Depending on how the drug is taken, heroin can enter the brain very rapidly, leading to an intense rush. Within minutes—even seconds—heroin travels through the bloodstream to the brain. There, it latches on to opiate receptors located on neurons (see diagram). These cells help the body relieve pain, but can be overstimulated by drugs, such as heroin. “Heroin floods the receptors,” NIDA’s Dr. Sasek says. “Eventually, the receptors become used to this overstimulation and need more heroin just to work normally.” If an addicted person stops using the drug, withdrawal symptoms result—such as fevers, sweating, shaking, and chills. This is because of changes that have happened in the brain and body in response to repeated exposure to heroin. Without treatment, the withdrawal symptoms will subside after a week or so. But the cravings can remain for years.

Added Risk: Deadly Infections

A

ddiction and overdose aren’t the only dangers of heroin. It can also put you at risk of being infected with HIV, the virus that causes AIDS.

HIV is spread through bodily fluids, like blood. Heroin users who share needles can pass the virus to each other. They can also spread other blood-based diseases like hepatitis C and tuberculosis. Even heroin users who don’t inject can become infected with HIV. The overpowering addiction makes them take crazy risks, like having unsafe sex. “When your whole life revolves around getting drugs, you may do anything for them,” says Dr. Sasek. “If that means sharing needles or trading sex for drugs, then that’s what many will do.”

FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 15

“I’m Losing My Mind”

CLOSE-UP: LSD

/HEADSUP

Sometimes when Amanda Contadino

moves her hand in front of her face, she sees trails behind it, like the mark of smoke a skywriter leaves. Sometimes when she’s sitting perfectly still, the wind and birds seem to swirl around her at dizzying speeds. But there are no trails and there is no whipping wind. These sensory bloopers may be related to the LSD Amanda took when she was 16. LSD, also known as acid, is a hallucinogen, or drug that can cause hallucinations. In other words, it can make someone see, hear, and feel things that aren’t really there. It is sold on the street in many forms, including capsules, liquid, treated sugar cubes, and gel wafers called windowpanes. Often, it’s added to decorated blotter paper and divided into small squares which are then chewed and swallowed.

We talked to Amanda, now 21 and a resident of the Phoenix Academy of Long Island drug treatment center in East Hampton, New York.

NEVER GOOD ENOUGH

ake a look at this trend. According to a NIDA-

funded study, the percentage of teens using LSD dropped

significantly from 2001 to 2002. These are the lowest rates for high school seniors

By Cate Baily

W

ith some drugs of abuse, it can be a little tough to tell what’s what. LSD, psilocybin, and mescaline (see FAQs,

right) cause hallucinations and are therefore classified as hallucinogens. The club drug MDMA (ecstasy) has both hallucinogenic and stimulant properties. That’s a double whammy of potential dangers. Some other drugs that are not technically hallucinogens have some similar effects. These include:

• PCP or angel dust. This drug changes make the user feel detached from the

It all started when Amanda was 13 years old. “I always had a problem being accepted,” she said. So, when she saw some friends smoking a joint, she asked to try it, thinking that drugs were a way to bond. She also thought that her drug use—which soon included ecstasy and cocaine—would numb her pain. “I never felt like I was good enough,” she says.

Not Worth It

T

WHAT’S WHAT

perceptions of sight and sound and can

MONITORING THE FUTURE, 2002

www.scholastic.com

A young woman’s experience with the hallucinogenic drug LSD

in 27 years. Maybe teens are getting the message that it’s just not worth it.

One day when Amanda was 16 and home alone, she decided to take LSD, or drop acid. After about an hour, she started laughing hysterically. That was the first of many trips, as the drug’s highs are called. Amanda’s LSD use ramped up from occasional weekend use, taking one or two doses, to daily use at school, taking six or seven doses. Experts say that Amanda’s daily use of LSD is rare. Because the drug isn’t addictive like heroin or cocaine, people generally stop taking it after a few experiences. Perhaps it’s bad trips that turn them off.

BAD TRIPS The term bad trip refers to unpleasant—even terrifying— feelings and sensory experiences while high on LSD. Amanda told

4 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

FAQs ON LSD

W

LSD is often sold in the form of treated blotter paper.

Hallucinogens are drugs that dramatically alter perceptions.

Some hallucinogens are produced solely by nature. These include psilocybin, found in

Amanda Contadi no FORME R LSD environment and the self. It’s called a

hat are hallucinogens?

ABUSE R

certain mushrooms (“magic mushrooms”

Some mushrooms contain natural hallucinogens.

or “shrooms”) and mescaline, the chemical found in the peyote cactus. LSD is semi-synthetic, or artificial.

“dissociative” drug because of the sense of dissociation it creates. PCP, usually sold as a powder or liquid, is addictive and in high doses can kill.

•

unproductive. “I went nowhere,” says Amanda. “I did nothing but worry about getting acid.”

Ketamine or “vitamin K.” This odorless,

Where does LSD come from? LSD (lysergic acid diethylamide) was invented by a chemist in 1938. Working in a lab in Switzerland, Albert Hofmann was trying to create medicine out of a fungus. He ended up with

tasteless powder is a dissociative drug

NOT MENTALLY THE SAME

LSD. Five years after he created it, Hofmann accidentally ingested the drug

that can cause amnesia, depression, and

Today, Amanda isn’t worried about getting acid but about the damage it may have done to her brain. The trails and other perception problems haven’t gone away, and it’s been three years since her last hit of LSD. In a way, though, Amanda got lucky. She used to call tripping “losing my mind.” For some of her friends, the made-up term may have turned out to be real. “I’ve had friends who’ve never come back from it,” she says. “They’re not mentally the same. They’re in psychiatric units.” According to Dr. Geraline Lin of the National Institute on Drug Abuse (NIDA), psychotic breaks are associated with LSD use, but it’s unclear whether or not the drug directly causes mental illness. In fact, scientists are still struggling with many unanswered questions about LSD and the brain. Amanda now aspires to become a drug counselor to help others out of a life ruled by drugs. She wants to share what she says she has learned: “You can experience life in all its beauty without drugs.”

and took the first bad trip: “A demon had invaded me,” he said. “[It] had

learning problems. Like LSD and ecstasy, both PCP and ketamine are associated with the young adult

STEPHEN KRONINGER(ILLUSTRATIONS 2); 5W INFOGRAPHICS(DIAGRAM); EROWID.COM(BLOTTER PAPER); DAVID HOFFMAN/ALAMY(KETAMINE); GEOFFREY MORGAN/ALAMY(MUSHROOMS); REUTERS/CORBIS(MAGIC MUSHROOMS).

rave scene.

Ketamine

us about one particularly awful hour she spent tripping or “bugging out,” as she put it. It was the day before Easter and many family members were milling around her house. She had dropped acid with friends downstairs and was feeling panicked about getting caught. She sat behind her drum set rocking back and forth, holding a glow-in-the-dark star. That star “seemed like my only friend in the world,” she says. As it turns out, she may have been right. “The friends I got high with,” she says now, “weren’t my real friends.” As soon as she left drugs behind, they dropped her. Amanda and her so-called friends believed they’d reached “a higher plane,” or some form of enlightenment, on acid. In reality, they were stagnant and

taken possession of my body, mind, and soul.” What are the short-term effects of LSD? LSD and other hallucinogens powerfully distort the functioning of the five senses, as well as one’s sense of time and space. Some users even report a blending of the senses—seeing sounds and hearing colors—known as “synesthesia.” An LSD trip may include terrifying experiences and inspire dangerous behavior on a user’s part. What are the long-term effects of LSD? Two long-term effects reported by former users are psychosis and hallucinogen persisting perception disorder (HPPD). Psychosis is a severe mental illness, in which a person loses contact with reality. HPPD (often but less accurately called “flashbacks”) is a disorder that includes ongoing perception problems, like the nonexistent trails Amanda sees. How does LSD work? LSD binds to and activates a specific receptor for serotonin, a brain chemical involved in emotions and the senses. It especially affects two brain regions: the cerebral cortex—involved in mood, cognition, and perception—and the locus ceruleus, which receives sensory signals.

LSD strongly affects areas of the brain involved in sensory perception, mood, and cognition.

If LSD isn’t addictive, why is it dangerous? “The main reason LSD is dangerous is because it’s unpredictable in its effects,” says NIDA’s Dr. Jerry Frankenheim. “The most dangerous thing that can happen is that someone has a complete break with reality and thinks they can fly or stop traffic.”

FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 5

Photo credits: brain map courtesy of Paul Thompson, Kiralee Hayashi, Arthur Toga, and Edythe London/UCLA; rock methamphetamine ©DEA/AP Wide World; methamphetamine-making device ©The Grundy County Herald, C.E. Jones/AP Wide World.

METHAMPHE

Toxic. Addictive . Devastating .

Get the Facts! Also known as “meth” or “ice,” this highly addictive and brainaltering drug is a threatening scourge on individuals, families, and communities. Heads Up: Methamphetamine Alters the Brain’s Structure Researchers have established that methamphetamine abuse causes changes in brain structure. The most affected areas are those that control memory, emotion, and reward. From the image at right, we can see differences in the amount of change in a methamphetamine abuser’s brain as compared with a nonuser’s:

AREAS OF GREATEST CHANGE

Emotion, reward (limbic system) 0 Less Change

3%

5% More Change

Memory (hippocampus)

Methamphetamine as a rock crystal—“ice.”

B

ig Heads Up: Across the United States, methamphetamine is leaving widespread damage in its path.

Make no mistake: this is a highly toxic, addictive, and devastating substance that poses serious health risks both to individuals who use it and to those who never do. Families, neighbors, communities, innocent children, the environment— all are affected by methamphetamine and the highly toxic chemicals that are used to produce it.

2 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

WWW.SCHOLASTIC.COM/HEADSUP

TAMINE WHAT DOES IT LOOK LIKE?

Often referred to as “meth,” methamphetamine can be a white powder that easily dissolves in water. Another form of the drug, in clear chunky crystals, is called “crystal meth” or “ice.” The drug can also come in the form of small, brightly colored tablets known by the name “yaba.” Methamphetamine abusers inject, snort, smoke, or swallow the drug.

A SPREADING THREAT: Whether teens live in the city or in the country, they are increasingly likely to be faced with methamphetamine. Until recently, methamphetamine in the United States was concentrated in a few cities and towns, most of them in the West. But now, health and law-enforcement officials see methamphetamine spreading to rural areas, cities, and towns across the nation.

WIDE DEVASTATION:

Squalid-looking device used for making methamphetamine.

Few substances are as harmful as methamphetamine. From the ravages facing abusers whose bodies, brains, and actions become altered, to burns, explosions, and toxic spills resulting from the chemicals used to produce methamphetamine, this is one dangerous drug. According to Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), methamphetamine is “a stimulant drug that can have devastating medical, psychiatric, and social consequences.” Partly because of the spread of methamphetamine across the country, NIDA has stepped up its research relating to the drug. Scientists are working to understand how the drug affects abusers and how best to treat people suffering from the disease of methamphetamine addiction.

1 lb of

methamphetamine = 5 lbs of toxic waste Manufacturing methamphetamine always produces toxic waste. Ingredients might include toluene, iodine, red phosphorus (used in road flares), sodium hydroxide, lithium/sodium metal, hydrochloric acid, anhydrous ammonia (a fertilizer), drain cleaner, battery acid, lye, pool acid, and antifreeze—many of which are severe eye, nose, and throat irritants or cause skin burns or breathing difficulty. A “meth lab” is an illegal site where the drug is manufactured. Meth labs have been found in garages, kitchens, vehicles, hotel and motel rooms, storage lockers, campgrounds, abandoned dumps, restrooms, and mobile homes. Children who grow up in places where methamphetamine is manufactured are at risk for acid burns and respiratory problems from exposure to toxic chemicals. One in five of these sites is discovered because of chemical explosions. Because of the possibility of explosions and direct contact with toxic fumes and hazardous chemicals, law-enforcement officers who raid clandestine drug labs are required to take (continued on p. 4)

3 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

METHAMPHETAMINE HOW IS METHAMPHETAMINE HARMFUL? (continued from p. 3)

special training to handle hazardous materials (HAZMAT). Firefighters who respond to fires at these sites also risk serious injury from toxic fumes and gases. Toxic contamination remains behind from the manufacturing process on surfaces in the meth lab itself, including furniture, curtains, bedspreads, flooring, air vents, eating surfaces, and walls. Cleaning up a meth lab site requires hazardous waste protection and costs an average of $3,000—but can cost more than $100,000. In 2004 alone, there were more than 10,000 meth lab cleanups at a cost of $18.6 million.

Photo credit: ©Mark Humphrey/AP Wide World.

Leftover chemicals and by-product sludge from methamphetamine manufacture have been found along highways, in parks and forests, in the ground and groundwater, and in sewer systems. These solvents and other toxic by-products pose long-term hazards to communities because they can persist in soil and groundwater for years. Of particular concern are labs in agricultural areas, because the hazardous wastes are often dumped where crops are grown and in the water sources used to nourish those crops.

Scientists know that methamphetamine can change the structure of a person’s brain; it can change behavior; and it can even change feelings and emotions—effects that can last a long time. It can also cause people to do risky, disastrous things—things they’d never do if they weren’t under the influence of the drug. There’s even something called “meth mouth,” which results from methamphetamine constricting blood vessels in certain areas of the mouth. The reduced blood flow over time can weaken the teeth and lead to tooth decay. Methamphetamine abusers can experience a wide range of other potentially devastating effects for themselves—and others. These include violent behavior as well as anxiety, depression, confusion, insomnia, paranoia, auditory hallucinations, and delusions.

BRAIN CHANGE: Recently, Dr. Paul Thompson, a NIDA-sponsored researcher at the University of California, Los Angeles, used Magnetic Resonance Imaging (MRI) to look inside the

brains of long-term methamphetamine abusers. “The methamphetamine abusers Thompson studied experienced structural changes in the limbic regions of their brains— this is the area responsible for feelings, emotions, and cravings,” explains Dr. Steve Grant, acting chief of NIDA’s Clinical Neuroscience Branch, Division of Clinical Neurosciences, Development and Behavioral Treatments. The hippocampus, responsible for making new memories, also showed structural changes. Not surprisingly, those addicted to methamphetamine scored very poorly on memory tests.

TRICKING BRAIN CELLS: Methamphetamine’s effects—and some of the brain changes they ultimately cause—stem from the fact that the drug’s chemical structure is similar to dopamine. Dopamine is the natural chemical released in certain areas of the brain in response to pleasurable experiences—like laughing with friends or dancing with a girlfriend

This law-enforcement officer wears a protective suit as he clears away bottles of toxic chemicals used to produce methamphetamine.

4 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Wake-Up Call: Loss of Motor Skills and Memory

Normal Control

Methamphetamine Abuser (I month abstinent)

Researchers have found that long-term methamphetamine abuse is associated with a reduction in dopamine transporters, and that this damage appears to be linked to impaired motor skills and memory. The brain image on the left above is from a person who has never used methamphetamine. The brain on the right is from a methamphetamine abuser who abstained for 1 month. Yellow and red areas indicate the distribution of dopamine transporters (DATs), with red indicating higher distribution. Dopamine is released naturally in the brain in response to pleasure; it helps the brain control movement, mood, and memory. There is a slight recovery of DATs after 1 month of abstinence (see the light resurgence in red), and the researchers saw much more recovery after 14 months—but motor skills and memory had not returned to normal.

IMMUNE SYSTEM RISKS: Immune system cells are the blood cells that help your body resist infections. Animal and test tube studies show that methamphetamine may suppress killer T cells, a type of white blood cell that fights off germs. On top of that, a recent long-term study found that, all other things being equal, people who abuse methamphetamine are twice as likely as nonusers to contract HIV if exposed to it.

IS JUST ONE USE SAFE? The answer is NO. To start with, people under the influence of methamphetamine may lose their normal inhibitions and sense of good judgment. As a result, they might take dangerous risks. In animal studies, even a single high dose of methamphetamine can damage nerve terminals in

dopamine-containing regions of the brain. In humans, a big dose can raise your body temperature so high that your life can be in danger—it can lead to convulsions and coma. Also, says Dr. Volkow, a single dose of methamphetamine can cause “irreversible strokeproducing damage to small blood vessels in the brain.”

SMART CHOICE: All in all, for the sake of your brain cells, your immune cells, and all your other cells—as well as for the sake of your family, neighbors, children, and the environment— the smart choice is never to try methamphetamine. Not even once.

For help with a drug problem or to locate treatment centers, go to www.findtreatment.samhsa.gov, or call the national hotline at 1-800-662-HELP.

Photo credit: NIDA Notes, Vol. 17, No.1 (April 2002), www.drugabuse.gov/NIDA_notes/NNvol17N1/Methamphetamine.html

or boyfriend. Dopamine also helps the brain control movement, mood, and memory. Methamphetamine tricks brain cells into pumping out very high, unnatural levels of dopamine. You won’t be surprised to learn that these increases in dopamine make methamphetamine abusers feel great. But then comes a crash. This causes users to crave more of the drug— setting the stage for the chronic disease we call addiction. Ironically, even though methamphetamine ups the amount of dopamine in the brain at first, it ultimately hinders the brain’s ability to make and respond to dopamine. Brain imaging studies conducted by Dr. Volkow show that long-term methamphetamine abusers have lower-than-normal numbers of dopamine receptors and dopamine transporters in the brain. Receptors and transporters are important parts of normal brain communication. This lower number of dopamine transporters results in not being able to perform simple actions as well. In one study, participants with the fewest transporter molecules had a tough time recalling simple word lists and were slower in walking a straight line. “In fact, the lower the levels of the dopamine transporter, the worse the performance,” Dr. Volkow says. They had developed problems with the striatum, a part of the brain associated with control of movement, attention, motivation, and reward.

5 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Behind the Bulk /HEADSUP

One young man’s story of steroid addiction, body obsession, and getting clean

Every time he passed a mirror,

CLOSE-UP: STEROIDS

Craig Costa flexed his muscles. He wanted to look “insanely big—like an action figure.”

By Cate Baily

“When I walked into a room, I wanted heads to turn,” he says. People did notice Craig’s 225pound, 5-foot 9-inch frame. But what they didn’t see was the physical damage and psychological turmoil going on inside. The story behind the bulk was five years of steroid abuse and a struggle with muscle dysmorphia, a condition

in which a person has a distorted image of his or her body (see sidebar). Men with this condition think that they look small and weak, even if they are large and muscular.

ILLEGAL AND GRIM It all started when Craig was 18. Before a trip to Walt Disney World in Orlando, Fla., he was

LOOKS CAN BE DECEIVING teroids unquestionably work extremely well—no denying it,” says Dr.

“S

Harrison Pope of McLean Hospital in Belmont, Mass. “But they will probably shorten your life expectancy. By how much, we still don’t know.”

On the outside, steroid abusers look big and strong, but on the inside, they’re weak. Their organs take a beating, and their bodies turn on them in all kinds of ways. Here’s some of the tough stuff that anabolic steroid users may encounter. MOOD SWINGS Steroids disrupt the functioning of the brain’s limbic system, which influences mood.

BALDNESS

CONFUSED HORMONES Steroids confuse the hypothalamus, the part of the brain that controls sex hormones. Boys can develop breasts; girls can get deep voices and facial hair. Both sexes risk reproductive problems, including infertility. HEART ATTACK; STROKE STUNTED GROWTH Steroids can trick the brain into signaling the bones to stop growing. Teens who use steroids may never reach their full adult height. LIVER CANCER; TUMORS AND CYSTS

INFECTION Nonsterile injection techniques and sharing needles put abusers at risk for life-threatening diseases, including HIV and hepatitis B and C.

KIDNEY DAMAGE

ACNE

feeling overweight. He wanted to look good with his shirt off, so he resolved to get fit. A student at Bristol Community College, in Fall River, Mass., he started going to a nearby gym. Running on the treadmill, he slimmed down fast, losing 20 pounds in a month. But lean wasn’t Craig’s ideal. “My whole priority was, I wanted people to say, ‘That guy’s huge.” He lifted weights and experimented with steroidal supplements, also called dietary supplements. These drugs promise to build muscles. Despite potential risks and unclear effectiveness, they can be bought legally over the counter at many stores. But what Craig was looking for couldn’t be bought in a store. So he turned to anabolic steroids, drugs derived from the male sex hormone testosterone. Under a doctor’s supervision, anabolic steroids have some legitimate medical uses, as do corticosteroids, a different type of steroid used to reduce swelling. But to use steroids as Craig did, for muscle-building in a healthy body, is illegal. This didn’t stop him. Neither did the many grim potential side effects (see sidebar, left). Craig thought he knew exactly what he was getting into. And like 4 percent of high

12 FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

© DAVID MADISON/GETTY IMAGES(STEROID USER); 5W INFOGRAPHICS(DIAGRAM)

www.scholastic.com

ROID RAGE teroids can mess with your head. They can even make you violent.

S

Dr. Harrison Pope said, “I have consulted on several cases where previously non-violent individuals committed murders when under

the influence of steroids.” In 2000, Dr. Pope conducted a NIDA-supported study which showed that, along with violent behavior, high doses of steroids can cause

Craig C osta

FORME R STER OID A BUSER

school seniors (according to a 2002 NIDAfunded study) and an estimated hundreds of thousands of adults, he took steroids anyway.

popped up all over his back; his face swelled. Then, something even more serious happened: He started having chest pains. Craig was having heart problems of the emotional sort, too. “I don’t even remember how much of a jerk I was,” he says.

© STEVE ALLEN/BRAND X/ALAMY(BOTTLES); STEPHEN KRONINGER(ILLUSTRATIONS 2)

HEART PROBLEMS Craig’s appearance was that important to him. “The scale was my enemy. Every pound meant so much to me,” he says. Craig constantly compared himself to others. He drove his friends and family crazy asking, “Is that guy bigger than me? What about that guy?” He never had complete satisfaction. “Some days, I’d be arrogant, wearing shorts to show off my quads. Other days, I’d be a disaster. On a non-lifting day, I’d have to wear big, baggy clothes.” Craig’s steroid use escalated over time. He had begun by taking oral steroids (pills) exclusively. But when he heard that injectable steroids were more effective, he overcame a fear of needles. At his worst, he was injecting three to four times a day and taking 10 pills on top of that. The drugs took their toll. Craig’s hair fell out; acne

extreme fluctuations in emotions, from euphoria (bliss) to rage. These psychiatric symptoms may be a result of steroids’ effect on the brain. Steroids act on the limbic system, which is involved in mood, memory, and learning. There, the drug disrupts the normal functioning of neurons—hence, the overly aggressive behavior and mood swings.

More Than a Bad Hair Day

E

ver had a bad hair day or a pimple and felt that you couldn’t focus on anything else? Imagine if a small flaw (real or imagined) took

over your life. That’s what it’s like for an estimated one to two

NEW PRIORITIES There was a lot of screaming and yelling at home, and ultimately, the end of his marriage and a custody battle over his 1-year-old son, Jake. Craig’s wife said that Craig, then 25, couldn’t see their child until he passed a drug test. That was the moment when everything changed for Craig. He knew he had to quit. On Father’s Day, 2001, Craig went cold turkey. He knew he needed help, so his parents found him a psychiatrist, who treated him through the better part of a year. Today, Craig’s priorities have changed. He still wants to be a head-turner, but for a different reason. “Now I’d rather be walking into a room with my son [who is now 2] and have people thinking, ‘Wow, he’s the greatest dad in the world.”

percent of Americans with body dysmorphic disorder, or BDD. Like anorexia nervosa, the eating disorder that causes people to see themselves as fat even as they starve their bodies into dangerous thinness, BDD involves a distortion in body image. In extreme cases, people with BDD can spend hours glued to a mirror or even become suicidal. As you’ve read, the disorder can also lead to steroid abuse. We talked to Dr. Roberto Olivardia, the psychiatrist who treated Craig and Dr. Pope’s co-author, to find out more. Q: What is BDD?

self-esteem is wrapped up in

A: It’s when you’re very, very

how I look? Does it prevent me

bothered by a part of your

from going to school? Am I still

appearance. Craig focused

hanging out with friends?

on his muscularity, but BDD can be a preoccupation

Q: How can I get help for BDD?

with any body part—your hair,

A: The best treatment

skin, nose.

for the disorder is psychotherapy (counseling).

Q: What causes BDD? A: We live in a culture that praises a perfect appearance. But that’s only part of the picture. There are also deeper psychological roots. Q: How do I know if I have BDD? A: Ask yourself: How much of my

a national PBS weekly series for teens

Check your local PBS listings or inthemix.org for a program on steroids, airing May 3-10.

FROM SCHOLASTIC AND THE SCIENTISTS OF THE NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 13