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COMMONLY ABUSED DRUGS AND WITHDRAWAL SYMPTOMS DRUG NAME WITHDRAWAL SYMPTOMS Marijuana Irritability Trouble sleeping Decreased appetite Anxiety Prescription Opioids Restlessness Muscle and bone pain Insomnia Diarrhea Vomiting Cold flashes with goose bumps Leg movements Prescription Seizures Sedatives & Shakiness Tranquilizers Anxiety Agitation Insomnia Overactive reflexes Increased heart rate, blood pressure, and temperature with sweating Hallucinations Severe cravings Prescription Depression Stimulants Tiredness Sleep Problems Steroids Mood swings Tiredness Restlessness Loss of appetite Insomnia Lowered sex drive Depression Tobacco Irritability Attention problems Sleep problems Increased appetite

Withdrawal symptoms can be severe. Patients experiencing withdrawal from these substances, especially prescription and illicit opioids, should seek immediate medical attention. COMMONLY ABUSED DRUGS WWW.DRUGABUSE.GOV/RESEARCHERS

COCAINE HEROIN INHALANTS LSD MARIJUANA (CANNABIS) MDMA (ECSTASY/MOLLY) PRINCIPLES OF EFFECTIVE TREATMENT DESCRIPTION A powerfully addictive stimulant drug made An opioid drug made from morphine, a natural Solvents, aerosols, and gases found in household A hallucinogen manufactured from lysergic Marijuana is made from the hemp plant, A synthetic, psychoactive drug that has similarities 1. Addiction is a complex but treatable disease from the leaves of the coca plant native to substance extracted from the seed pod of the products such as spray paints, markers, glues, acid, which is found in ergot, a fungus that Cannabis sativa. The main psychoactive (mind- to both the stimulant amphetamine and the that affects brain function and behavior. South America. various opium poppy plant. and cleaning fluids; also nitrites (e.g., amyl grows on rye and other grains. LSD is an altering) chemical in marijuana is delta-9- hallucinogen mescaline. MDMA is an abbreviation For more information, see the Cocaine For more information, see the Heroin nitrite), which are prescription medications for abbreviation of the scientific name lysergic tetrahydrocannabinol, or THC. of the scientific name 3,4-methylenedioxy- 2. No single treatment is appropriate Research Report. Research Report. chest pain. acid diethylamide. For more information, see the Marijuana methamphetamine. for everyone. For more information, see the Inhalants For more information, see the Hallucinogens Research Report. For more information, see the MDMA (Ecstasy) Research Report. and Dissociative Drugs Research Report. Abuse Research Report. 3. Treatment needs to be readily available. STREET NAMES Blow, Bump, C, Candy, Charlie, Coke, Crack, Brown sugar, China White, Dope, H, Horse, Poppers, snappers, whippets, laughing gas Acid, Blotter, Blue Heaven, Cubes, Microdot, Blunt, Bud, Dope, Ganja, Grass, Green, Herb, Joint, Adam, Clarity, Eve, Lover’s Speed, Peace, Uppers 4. Effective treatment attends to multiple needs Flake, Rock, Snow, Toot Junk, Skag, Skunk, Smack, White Horse Yellow Sunshine Mary Jane, Pot, Reefer, Sinsemilla, Skunk, Smoke, of the individual, not just his or her drug use With OTC cold medicine and antihistamine: Cheese Trees, Weed or misuse. Hashish: Boom, Gangster, Hash, Hemp 5. Remaining in treatment for an adequate COMMERCIAL NAMES Cocaine hydrochloride topical solution No commercial uses Various No commercial uses Various brand names in states where the sale of No commercial uses period of time is critical. (anesthetic rarely used in medical procedures) marijuana is legal White powder, whitish rock crystal White or brownish powder, or black sticky Paint thinners or removers, degreasers, dry- Tablet; capsule; clear liquid; small, decorated Greenish-gray mixture of dried, shredded leaves, Colorful tablets with imprinted logos, capsules, 6. Behavioral therapies —including individual, COMMON FORMS substance known as “black tar heroin” cleaning fluids, gasoline, lighter fluids, correction squares of absorbent paper that liquid has been stems, seeds, and/or flowers; resin (hashish) or powder, liquid family, or group counseling —are the most fluids, permanent markers, electronics cleaners added to sticky, black liquid (hash oil) commonly used forms of drug use disorder and freeze sprays, glue, spray paint, hair or treatment. deodorant sprays, fabric protector sprays, aerosol computer cleaning products, vegetable oil sprays, 7. Medications are an important element of butane lighters, propane tanks, whipped cream treatment for many patients, especially aerosol containers, refrigerant gases, ether, when combined with counseling and other chloroform, halothane, nitrous oxide behavioral therapies. COMMON WAYS TAKEN Snorted, smoked, injected Injected, smoked, snorted Inhaled through the nose or mouth Swallowed, absorbed through mouth tissues Smoked, eaten (mixed in food or brewed as tea) Swallowed, snorted (paper squares) 8. An individual’s treatment and services plan must be assessed continually and modified DEA SCHEDULE II I Not scheduled I I I as necessary to ensure that it meets his or Narrowed blood vessels; enlarged pupils; Euphoria; dry mouth; itching; nausea; vomiting; Confusion; nausea; slurred speech; lack of Rapid emotional swings; distortion of a person’s Enhanced sensory perception and euphoria Lowered inhibition; enhanced sensory perception; her changing needs. SHORT-TERM increased body temperature, heart rate, and analgesia; slowed breathing and heart rate. coordination; euphoria; dizziness; drowsiness; ability to recognize reality, think rationally, or followed by drowsiness/relaxation; slowed increased heart rate and blood pressure; muscle 9. Many drug-addicted individuals also have blood pressure; headache; abdominal pain and disinhibition, lightheadedness, hallucinations/ communicate with others; raised blood pressure, reaction time; problems with balance and tension; nausea; faintness; chills or sweating; sharp other mental disorders. nausea; euphoria; increased energy, alertness; delusions; headaches; sudden sniffing death heart rate, body temperature; dizziness; loss of coordination; increased heart rate and appetite; rise in body temperature leading to kidney failure insomnia, restlessness; anxiety; erratic and due to heart failure (from butane, propane, appetite; tremors; enlarged pupils. problems with learning and memory; anxiety. or death. 10. Medically assisted detoxification is only the violent behavior, panic attacks, paranoia, and other chemicals in aerosols); death from first stage of addiction treatment and by psychosis; heart rhythm problems, heart asphyxiation, suffocation, convulsions or itself does little to change long-term drug attack; stroke, seizure, coma. seizures, coma, or choking. use and misuse. Nitrites: enlarged blood vessels, enhanced sexual pleasure, increased heart rate, brief sensation of 11. Treatment does not need to be voluntary to heat and excitement, dizziness, headache. be effective. LONG-TERM Loss of sense of smell, nosebleeds, nasal Collapsed veins; abscesses (swollen tissue Liver and kidney damage; bone marrow damage; Frightening flashbacks (called Hallucinogen Mental health problems, chronic cough, Long-lasting confusion, depression, problems with 12. Drug use during treatment must be damage and trouble swallowing from snorting; with pus); infection of the lining and valves in the limb spasms due to nerve damage; brain damage Persisting Perception Disorder [HPPD]); ongoing frequent respiratory infections. In rare cases, attention, memory, and sleep; increased anxiety, infection and death of bowel tissue from heart; constipation and stomach cramps; liver or from lack of oxygen that can cause problems with visual disturbances, disorganized thinking, risk of recurrent episodes of severe nausea impulsiveness less interest in sex. monitored continuously, as lapses during decreased blood flow; poor nutrition and kidney disease. thinking, movement, vision, and hearing. paranoia, and mood swings. and vomiting. treatment do occur. weight loss; lung damage from smoking. Nitrites: increased risk of pneumonia. 13. Treatment programs should test patients for OTHER HEALTH- Pregnancy: premature delivery, low birth Pregnancy: miscarriage, low birth Pregnancy: low birth weight, bone problems, Unknown Youth: May impair brain development and Unknown the presence of HIV/AIDS, Hepatitis B and C, RELATED ISSUES weight, deficits in self-regulation and attention weight, neonatal abstinence syndrome. delayed behavioral development due to brain learning functions. in school-aged children prenatally exposed. problems, altered metabolism and body tuberculosis, and other infectious diseases, EFFECTS POSSIBLE HEALTH Risk of HIV, hepatitis, and other infectious diseases Pregnancy: babies born with problems with composition. provide risk-reduction counseling, and link Risk of HIV, hepatitis, and other infectious from shared needles. attention, memory, and problem solving. patients to treatment if necessary. diseases from shared needles. IN COMBINATION Greater risk of cardiac toxicity than from either Dangerous slowdown of heart rate and breathing, Unknown Unknown Increased heart rate, blood pressure; further MDMA decreases some of alcohol’s effects. Alcohol WITH ALCOHOL drug alone. coma, death. slowing of mental processing and reaction time. can increase plasma concentrations of MDMA, which may increase the risk of neurotoxic effects. The Drug Enforcement WITHDRAWAL Depression, tiredness, increased appetite, Restlessness, muscle and bone pain, insomnia, Nausea, tremors, irritability, problems sleeping, Unknown Irritability, trouble sleeping, decreased Fatigue, loss of appetite, depression, aggression, Administration (DEA) schedule SYMPTOMS insomnia, vivid unpleasant dreams, slowed diarrhea, vomiting, cold flashes with goose bumps and mood changes. appetite, anxiety. trouble concentrating. indicates the drug’s movement, restlessness. (“cold turkey”). MEDICATIONS There are no FDA-approved medications to Methadone There are no FDA-approved medications to There are no FDA-approved medications to There are no FDA-approved medications to There is conflicting evidence about whether MDMA acceptable medical use and its treat cocaine addiction. Buprenorphine treat inhalant addiction. treat addiction to LSD or other hallucinogens. treat marijuana addiction. is addictive. There are no FDA-approved medications potential for abuse or dependence. Naltrexone (short- and long-acting forms) to treat MDMA addiction. The most up-to-date scheduling BEHAVIORAL • Cognitive-behavioral therapy (CBT) • Contingency management, or More research is needed to find out if behavioral More research is needed to find out if behavioral • Cognitive-behavioral therapy (CBT) More research is needed to find out if behavioral THERAPIES • Contingency management, or motivational incentives therapies can be used to treat inhalant addiction. therapies can be used to treat addiction to • Contingency management, or therapies can be used to treat MDMA addiction. information can be found motivational incentives, including vouchers • 12-Step facilitation therapy hallucinogens. motivational incentives on the DEA website. • The Matrix model • Motivational Enhancement Therapy (MET) • Community-based recovery groups, • Behavioral treatments geared to adolescents such as 12-step programs • Mobile medical application: reSET® TREATMENT OPTIONS TREATMENT • Mobile medical application: reSET® COMMONLY ABUSED DRUGS WWW.DRUGABUSE.GOV/RESEARCHERS

METHAMPHETAMINE PCP SYNTHETIC CANNABINOIDS SYNTHETIC CATHINONES (“BATH SALTS”) TOBACCO ALCOHOL DESCRIPTION An extremely addictive stimulant A dissociative drug developed as A wide variety of herbal mixtures containing An emerging family of drugs containing one or more Plant grown for its leaves, which are Ethyl alcohol, or ethanol, is an intoxicating Additional Resources: amphetamine drug. an intravenous anesthetic that has man-made cannabinoid chemicals related to synthetic chemicals related to cathinone, a stimulant dried and fermented before use. ingredient found in beer, wine and liquor. It is For more information, see the been discontinued due to serious THC in marijuana but often much stronger and found naturally in the khat plant. Examples of such For more information, see the produced by the fermentation of yeast, sugars, • Substance Abuse and Mental Health Services Methamphetamine Research Report. adverse effects. Dissociative drugs more dangerous. Sometimes misleadingly called chemicals include mephedrone, methylone, and Tobacco/Nicotine Research Report. and starches. are hallucinogens that cause the user “synthetic marijuana” and marketed as a “natural,” 3,4-methylenedioxypyrovalerone (MDPV). Administration (SAMHSA) Treatment Locator: to feel detached from reality. PCP is “safe,” legal alternative to marijuana. For more information, see the Synthetic Cathinones http://www.findtreatment.samhsa.gov; an abbreviation of the scientific name, For more information, see the Synthetic (“Bath Salts”) DrugFacts. 1-800-662-HELP. phencyclidine. Cannabinoids DrugFacts. For more information, see the • The “Find a Physician” feature on the Hallucinogens and Dissociative American Society of Addiction Medicine Drugs Research Report. (ASAM) website: STREET NAMES Crank, Chalk, Crystal, Fire, Glass, Go Fast, Angel Dust, Boat, Hog, Love Boat, K2, Spice, Black Mamba, Bliss, Bombay Blue, Bloom, Cloud Nine, Cosmic Blast, Flakka, Ivory Wave, None Booze, Juice, Sauce, Brew Ice, Meth, Speed Peace Pill Fake Weed, Fire, Genie, Moon Rocks, Skunk, Lunar Wave, Scarface, Vanilla Sky, White Lightning http://www.asam.org/for-the-public-treatment. Smacked, Yucatan, Zohai • The Patient Referral Program on the American COMMERCIAL NAMES Desoxyn® No commercial uses No commercial uses No commercial uses for ingested “bath salts” Multiple brand names Various Academy of Addiction Psychiatry website: COMMON FORMS White powder or pill; crystal meth looks White or colored powder, tablet, Dried, shredded plant material that looks like White or brown crystalline powder sold in small plastic or Cigarettes, cigars, bidis, hookahs, Beer, wine, liquor/spirits/malt beverages http://www.aaap.org/patient-resources. like pieces of glass or shiny blue-white or capsule; clear liquid potpourri and is sometimes sold as “incense” foil packages labeled “not for human consumption” and smokeless tobacco (snuff, spit tobacco, “rocks” of different sizes sometimes sold as jewelry cleaner; tablet, capsule, liquid chew) • The Child and Adolescent Psychiatrist COMMON WAYS TAKEN Swallowed, snorted, smoked, injected Injected, snorted, swallowed, smoked Smoked, swallowed (brewed as tea). Swallowed, snorted, injected. Smoked, snorted, chewed, vaporized. Ingested by drinking Finder on the American Academy of Child & (powder added to mint, parsley, oregano, Adolescent Psychiatry Web site: or marijuana) http:// http://www.aacap.org/aacap/Families_ DEA SCHEDULE II I, II I I (Some formulations have been banned by the DEA) Not Scheduled Not scheduled; illegal for purchase or use by and_Youth/Resources/CAP_Finder.aspx. those under age 21 SHORT-TERM Increased wakefulness and physical Delusions, hallucinations, paranoia, Increased heart rate; vomiting; agitation; Increased heart rate and blood pressure; euphoria; Increased blood pressure, breathing, Injuries and risky behavior, including drunk • The Surgeon General’s Report on Alcohol, activity; decreased appetite; increased problems thinking, a sense of distance confusion; hallucinations, anxiety, paranoia; increased sociability and sex drive; paranoia, agitation, and heart rate. driving and inappropriate sexual behavior; Drugs, and Health: breathing, heart rate, blood pressure, from one’s environment, anxiety. increased blood pressure. and hallucinations; violent behavior; sweating; nausea, impaired judgement, coordination, and reflexes; https://addiction.surgeongeneral.gov/ temperature; irregular heartbeat. Low doses: slight increase in breathing vomiting; insomnia; irritability; dizziness; depression; slurred speech, memory problems. panic attacks; reduced motor control; cloudy thinking. rate; increased blood pressure and heart • For clinical trials information, go to rate; shallow breathing; face redness and sweating; numbness of the hands or feet; www.clinicaltrials.gov. problems with movement. High doses: nausea; vomiting; flicking up and down of the eyes; drooling; loss of balance; dizziness; violence; seizures, For More Information: coma, and death. LONG-TERM Anxiety, confusion, insomnia, mood Memory loss, problems with speech and Unknown Death Greatly increased risk of cancer, especially Irregular heartbeat, stroke, high blood pressure; The NIDA website, www.drugabuse.gov, problems, violent behavior, paranoia, thinking, loss of appetite, anxiety. lung cancer when smoked and oral cirrhosis and fibrosis of the liver; mouth, throat, has information on a variety of drugs and hallucinations, delusions, weight loss, cancers when chewed; chronic bronchitis; liver, breast cancer. severe dental problems (“meth mouth”), emphysema; heart disease; leukemia; related information. intense itching leading to skin sores cataracts; pneumonia. from scratching. Some publications, including these charts, OTHER HEALTH- Pregnancy: premature delivery; separation PCP has been linked to self-injury. Use of synthetic cannabinoids has led to an increase Risk of HIV, hepatitis, and other infectious diseases Pregnancy: miscarriage, low birth weight, Pregnancy-related: fetal alcohol spectrum are available in print, free of charge. of the placenta from the uterus; low birth in emergency room visits in certain areas. from shared needles. stillbirth, learning and behavior problems. disorders (FASD) POSSIBLE HEALTH EFFECTS POSSIBLE HEALTH RELATED ISSUES Risk of HIV, hepatitis, and other infectious weight; lethargy; heart and brain problems. diseases from shared needles. To order print copies, call the DRUGPubs Risk of HIV, hepatitis, and other infectious Research Dissemination Center diseases from shared needles. at 1-877-NIH-NIDA or IN COMBINATION Masks the depressant effect of alcohol, Unknown Unknown Unknown Unknown N/A go to drugpubs.drugabuse.gov. WITH ALCOHOL increasing risk of alcohol overdose; may increase blood pressure. WITHDRAWAL Depression, anxiety, tiredness. Headaches, increased appetite, Headaches, anxiety, depression, irritability. Depression, anxiety. Irritability, attention and sleep problems, Trouble sleeping, shakiness, irritability, SYMPTOMS sleepiness, depression. depression, increased appetite. depression, anxiety, nausea, sweating. MEDICATIONS There are no FDA-approved medications There are no FDA-approved medications There are no FDA-approved medications to treat There are no FDA-approved medications to treat Bupropion (Zyban®) Naltrexone, acamprosate, disulfiram. to treat methamphetamine addiction. to treat addiction to PCP or other synthetic cannabinoid addiction. addiction to synthetic cathinones. Varenicline (Chantix®) dissociative drugs. Nicotine replacement (gum, patch, lozenge) BEHAVIORAL • Cognitive-behavioral therapy (CBT) More research is needed to find out if More research is needed to find out if behavioral • Cognitive-behavioral therapy (CBT) • Cognitive-behavioral therapy (CBT) • Cognitive-behavioral therapy (CBT) THERAPIES • Contingency management, or behavioral therapies can be used to treat therapies can be used to treat synthetic • Contingency management, or motivational incentives • Self-help materials • 12-Step facilitation therapy OPTIONS motivational incentives addiction to dissociative drugs. cannabinoid addiction. • Motivational Enhancement Therapy (MET) • Mail, phone, and Internet quit resources • Mobile medical application: reSET® TREATMENT • The Matrix model • Behavioral treatments geared to teens • 12-Step facilitation therapy • Mobile medical application: reSET®