HealthTeacher

Primer on Drugs

These six major concepts about alcohol and other drug use are appropriate for all children. Adapt the information as needed for your students.

Legal and Illegal Drugs
Drugs are chemical substances that affect body systems and can change behavior. Drugs that are legal for adult use include:

alcohol, found in beer, wine, wine coolers, whiskey , etc.
nicotine, found in cigarettes and pipe and chewing tobacco

Other legal drugs include chemicals that are found in over-the-counter and prescription medicines. Illegal drugs include cocaine, marijuana, heroin, LSD, PCP, and crack (a form of cocaine). Drugs are helpful or harmful depending on their use. For example, car crashes are often caused by alcohol, a legal drug for adults, and many cancers are caused by smoking (also legal for adults). Note that both these drugs are illegal for minors.

Positive and Negative Consequences of Drugs
If given or prescribed by a physician and used correctly, a drug may have very positive effects on an illness or in controlling pain or managing symptoms. Even prescribed drugs, however, may be misused and may have life-threatening consequences if used inappropriately. For example, many people are allergic to penicillin and may die if administered this drug.
Physicians prescribe medicines for particular people and very specific problems. If the person is seeing more than one physician for medicines, the physicians should be in contact with each other, because medicines may interact in ways that are harmful. Many pharmacists offer advice and cautions about drug interactions for their clients.

Nature of Drug Effects
Drugs are powerful and at times, unpredictable. Some drugs slow people down and some speed people up. A drug that affected someone one way last year may affect her or him differently this year. Effects of any drug depend on people's age, weight, gender, medical history, and the setting where the drug is used. Sometimes people take two or more drugs at the same time. The effects of this may be an unexpected tripling or quadrupling of the power of the drugs involved.

Reasons People Take Drugs
People take drugs to feel better, to feel different, to help them cope, to socialize, etc. Some people try drugs because they are curious as to what it will feel like. This is why some young people sniff gasoline, airplane glue, etc. Others want to impress their friends with how daring they are. Others simply do not feel there are any non-drug alternatives to feeling good. One of the goals in drug education at all ages is to get people "hooked on life highs" as opposed to drug highs.

Tolerance, Dependence and Addiction
Children must realize that it is much easier not to start taking drugs than it is to stop. After a while, it may take more of a certain drug to produce the same effect (tolerance). With certain drugs, the body begins to physically crave more (addiction) and/or the people taking them believe they need the drug (dependence). When people are addicted or dependent upon a drug, they go through very uncomfortable, sometimes painful, periods when the drug is not available to them (withdrawal).

Drug Dealers
Children often ask why dangerous drugs are allowed if they get people addicted or dependent. Explain that some people have chosen to sell these drugs to make money and these people do not care if the drugs hurt the person or their family. This is why it is important to tell a trusted adult if you see or hear of someone trying to sell drugs to somebody.

Types of Drug Use

In the past, people would say that legal drugs were good, illegal drugs were bad, and prescription drugs were helpful. However, we know that penicillin, a lifesaving drug, has also been responsible for more than 200,000 deaths due to allergic reactions.

In a discussion of drugs, "good" or "bad" are not appropriate designations. Drugs may be helpful or harmful, depending on how they are used.

People often take aspirin for a headache. Aspirin has several main effects, including

pain relief
fever reduction
control of swelling
reduction of inflammation
also reduces the risk of heart attack and stroke among senior citizens

However, like all drugs, aspirin has side-effects (about thirty), things that happen because drugs affect many body systems. For example, aspirin causes the stomach lining to bleed just a little bit of blood. A person with arthritis who is taking twenty aspirin a day has to be careful about anemia and ulcers.
This is the essential paradox of drug use-many drugs have the potential to help or to harm. Therefore, there are three main categories of drug use-use, misuse or abuse.

Drug Use refers to taking a drug correctly for a legitimate medical reason.

Examples:

aspirin for headaches
insulin for diabetes
morphine for pain relief

Drug Misuse refers to taking a legal drug inappropriately.

Examples:

using drugs with an expired shelf life
swapping pills (someone giving a friend or relative some pain pills left over from his or her recent surgery)
accidentally taking the wrong drug (taking a blood pressure medication instead of a heart medication)
taking a drug incorrectly (If two Tylenol are good, maybe five will be better for my headache)

Drug Abuse refers to taking a legal or illegal drug in a way that damages some aspect of the user's life (mental, physical, social relationships, occupational performance).

Examples:

taking a drug for a purpose unrelated to a medical need
taking a drug to create a state of euphoria
taking a potent pain reliever like heroin simply to get high
using any drug to create altered consciousness
underage drinking

Marijuana Facts

Marijuana is produced from the dried leaves and flowers of the cannabis plant. The active ingredient is THC (tetrahydrocannabinol), a fat-soluble drug, which produces marijuana's psychoactive effects. Fat-soluble means that the drug will be distributed to those areas of the body with high fat content, such as the brain, lungs and reproductive system. It also means that THC will stay in the body for several weeks. Unlike alcohol, THC is not water soluble and cannot leave the body quickly. A person who uses marijuana may be under its effects several days later, even though the "high" has worn off.

How It's Used
Marijuana can be smoked, ingested or taken as a pill. When smoked, much more THC enters the bloodstream. It is used to achieve a state of calmness or euphoria, although other short-term effects include increase in heart rate, reddening of the eyes, talkativeness and giddiness. Marijuana causes some users to become quiet and reflective. Almost all users report a change in how they perceive time. Larger doses may produce anxiety and feelings of paranoia.

Medical Uses of THC
When made synthetically and given orally, THC can lessen the nausea associated with chemotherapy. Synthetic THC may also help people with AIDS to regain their appetite. Synthetic THC can also be used to treat glaucoma, which is the build-up of pressure on the eyeball. Synthetic THC produces very little euphoria.

Effects of Marijuana Use

The Brain
THC works by binding to specific receptors in the brain called "cannabinoid receptors," which are located throughout the following brain structures:

Cerebellum: By binding with the cannabinoid receptors, THC interferes with the normal function of the cerebellum, which controls balance, posture and coordination.
Hippocampus: THC activates cannibinoid receptors in the hippocampus. This affects memory by decreasing nerve cell activity in this area. Short-term memory is the first to be affected. Studies on lab animals show conclusive long-term memory damage.
Cerebral Cortex: THC affects areas in the cerebral cortex that are responsible for sensory perception. As a result of marijuana use, sense of taste, sight, smell, hearing and touch may be altered.
Limbic System: Recent studies in animals suggest that THC produces changes in the limbic system, which governs our emotions. These changes, which are most evident during withdrawal from THC, are similar to those observed after long-term use of cocaine, heroin and alcohol.

The Lungs
Marijuana leaves contain more coal tar than tobacco leaves, which increases the potential for chest colds, bronchitis and lung cancer. Because they are smoked further down and the smoke is held in the lungs longer, two marijuana cigarettes are estimated to have the same carcinogenic potential as a pack of regular cigarettes.

The Reproductive System
Because it is fat soluble, THC binds to areas of the body with high fat content, such as the testes and ovaries. In males, marijuana may decrease testosterone production to the point that female secondary characteristics, such as breast tissue, may be observed.

Personality
A lack of motivation appears among many chronic users of marijuana. Called the "amotivational syndrome," this symptom is marked by lethargy, lack of focus and an inability to concentrate on future goals. Some chronic marijuana users become aggressive when questioned about their use. When threatened with loss of their drug, some marijuana users become violent, suggesting dependency.

Inhalants and Their Effects

Inhalants are commonly used household products such as fingernail polish remover, gasoline, glues, cigarette lighter fluid and paint thinner. Other inhalants include fluorinated hydrocarbons found in aerosol products such as whipped cream, paint spray, hair spray and even computer cleaners. Nitrous oxide, a commonly used gas, is also an inhalant. When the fumes from these products are sniffed, a type of mind-altering sensation can be experienced. Unlike alcoholic beverages, which all contain the same mind-altering drug (alcohol), inhalants contain many different types of chemicals. This factor makes it difficult to predict how someone will be affected by inhalant use.

Inhalant Effects
Inhalants cause chemical changes in the brain and nervous system. Some of these effects disappear after a short time; others may be permanent. For example, frequent use of certain inhalants can cause irreversible damage in nerves in the back and legs (polyneuropathy). In addition, the direct effect of inhalant use on the cerebellum and the cortex may result in abnormalities in movement and in thinking.

Inhalant users are also at risk for Sudden Sniffing Death (SSD). Death actually occurs through suffocation, when the inhaled fumes take the place of oxygen in the lungs and central nervous system. Certain inhalants may disrupt the heart's rhythm and cause cardiac arrest. Muscle weakness and hepatitis also frequently develop in chronic users of inhalants.

Certain inhalants decrease the number of red and white blood cells in the body, which can result in potentially fatal aplastic anemia. Benzene found in gasoline is related to the development of leukemia, a cancer of the white blood cells. Obviously, lead poisoning is connected to sniffing certain gasoline.

The most commonly used inhalants usually do not result in the development of tolerance to the chemicals or physical dependence on the chemicals. Many inhalant users, however, develop a psychological dependence that is difficult to overcome.

How They Work
Because they are breathed, inhalants enter the bloodstream rapidly and are then distributed throughout the body. Both the central nervous system (CNS) and the peripheral nervous system (PNS) are subsequently affected. Magnetic imaging techniques show that long-term users of inhalants have marked reduction in certain brain structures, including the cortex, cerebellum and brainstem. The resulting losses in reasoning abilities and difficulties in balance and coordination attest to these alterations.

Many researchers now believe that the dangers of inhalants are compounded by their attraction to fatty tissue such as myelin. Myelin is a fatty tissue that insulates and protects the branches (axons) of nerve cells, much like insulation around an appliance's electrical cord. The chemicals in inhalants break down the myelin and thereby slow the speed of nerve cell transmissions. The nerve cells' branches (the axons) may also be destroyed. Unfortunately, damaged nerve cells do not regenerate.

Dependency
The most commonly used inhalants usually do not result in the development of tolerance to the chemicals or physical dependence on the chemicals. Many inhalant users, however, develop a psychological dependence that is difficult to overcome.

How Psychoactive Drugs Affect the Brain

Nerve cells in the brain are called neurons. These neurons "talk" to each other by passing chemicals back and forth, just like passing notes in class. The neurons' "notes" are called neurotransmitters, and they are manufactured in vesicles in the nerve cell. Neurotransmitters include serotonin, acetylcholine, norepinephrine, dopamine, histamine and about two dozen others.
The nerve cells are separated by a small space called a "synapse." When a message moves down the axon of the pre-synaptic neuron, neurotransmitters are released from the vesicle. These chemicals (or notes) cross the synapse to the post-synaptic neuron, where they bind with receptors specifically designed to receive them, much as a key is designed to fit into a specific lock.
Many nerve cells have receptors that are sensitive to various drugs. These drugs operate on the "lock-and-key" principle, where the drug can be thought of as the "key" that either (1) fits into the "lock," causing the nerve cell (neuron) to discharge its chemicals, or (2) "jams" the lock, preventing the nerve cell from discharging.

Influences of Psychoactive Drugs
Drugs are often made more tempting when portrayed by users as magical or possessing special properties. For example, in the 1960s, LSD was considered by many to be a "mind expanding drug." Quaaludes were called "peace pills," "love drugs," and "super zoom," etc. These attractive descriptors likely helped persuade others to experiment.

Today's drugs of abuse are no different. PCP is called "angel dust," pure methamphetamine is sold as "ice," and MDMA, a designer drug, is called "ecstasy." No matter what type of nickname a psychoactive drug possesses, it basically produces its effect by altering the powerful neurotransmitters in the brain.

When students can describe scientifically how this process occurs with different types of drugs, they are less likely to be impressed by glamorous "street names" given to these substances. They are also much less likely to think that a psychoactive (mood-altering) drug can confer magical abilities or powers on the user.

The influence of psychoactive drugs is almost entirely limited to changes in the synapse. The exception would occur where the drug itself produced changes in other parts of the neuron, such as the cell membranes. For example, hallucinogens are believed to cause synesthesia ("seeing" sounds, "hearing" colors) by mimicking serotonin, acetylcholine and norepinephrine.

Drug Mechanisms
The mechanisms of drug action include: