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Drug Free Youth-Stimulants Back to Course Index







Substance Abuse and Mental Health Services Administration/Center of Substance Abuse Prevention (SAMHSA/CSAP) identified information dissemination/education as one of their initiatives to reduce alcohol and other drug use among youths.  The goal of this initiative is to provide awareness and knowledge of the nature and extent of substance use, abuse, and addiction and their effects on individual, families, and communities.  This initiative is also intended to provide knowledge and awareness of available prevention programs and services.  Information dissemination is characterized by one-way communication from the source to the audience whereas the education focus involves two-way communication and is distinguished from the information dissemination strategy by the fact that interaction between the educator/facilitator and the participants is the basis of its activities.  Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, coping and problem solving skills, critical analysis and systematic judgment abilities.


To achieve the greatest impact, educational programs must be appropriate to each audience, geared to specific needs, and used in conjunction with other strategies.   Programs components for educational initiatives may consist of family management training, alcohol, tobacco and other drug (ATOD) curricula, health and wellness curricula, violence prevention training and skills training. 


This continuing education course is intended to provide general information and instruction to help keep our youth drug free.  The early sections are general and not necessarily substance specific.  However, the final section is specific to stimulants and provides parents/caregiver, clinicians, and others information they can use to educate youth regarding stimulats.  Subsequent Parts of this CEU series “Drug Free Youth” will deal with other drugs.




Researchers have concluded that recent trends in youth drug use have stabilized. Unfortunately, the rate of use remains at a high level and many youths are adversely affected by their choice to use.  Many youths encounter problems with their family, community, law enforcement and loose interest in school activities.  Also, the risk of injury increases almost exponentially when they choose to use and then operate a motor vehicle.  The risk increases because a youth under the influence is less inhibited and more easily persuaded to take higher risks; consequently, the self-induced mental distortions coupled with limited driving experience often results in tragedy.


Researchers have also concluded that the earlier drug use is initiated, the more likely a person is to develop drug problems later in life. Youth substance abuse may lead to many other problems that affect not only the youth, but also the youths family and community.


When examining this situation it becomes clear that the parents/home environment is the first line of defense against drug use.  As President George W. Bush stated: it is essential that our parents understand that theyre the childs most important teacher, and that the message of the parents must be unequivocal: dont use drugs. Parents are the most important role models in their childrens lives.  What they say and do about drugs matters a lot when it comes to the choices their children make.  For example parents can:


       Be a positive example by avoiding all alcohol, tobacco, and other drugs (ATOD) use he home and in the presence of their children.


       Be a positive example by never involving their children in any adults use of ATOD; parents should never use with the children.


       Talk early and often about illicit drugs.  The parents must be aware of the latest trends and the best way to combat them.


       Discuss the consequences of drug use; focus on teen pregnancy, school dropout, safety, violence and other antisocial consequences.


       Create clear, consistent expectations and enforce them.



Parents should stay involved in their childrens lives and show that they care about the choices they make about drugs. Parents should always remember that children learn by example.  Children and adolescents adopt the values the parents demonstrate in their lives.  It should be noted that good values are modeled, as well as bad and we owe children every positive value that can be offered to help them avoid the pitfalls associated with drug use.





Early Adolescence


For many parents and other caregivers it may seem too early to discuss drugs with this age group, but the attitudes and habits that they form during this phase of their life will have an important bearing on the decisions they make when they are older. Most psychologists support the early education concept.  For example, psychologists believe that an individuals value/belief system reflects his/her perception of self and represents values, judgments and myths that he/she believes to be true.  The psychologists go on to say that a persons value/belief system is fairly well established by about age seven and is refined and honed by lifes experiences to make them into the persons they are at any given time in their life.   The value/belief system is the major psychological control and decision-making guide and helps the youth to choose between right and wrong and things we do versus things we dont do.  Most youths have a value/belief system about:


       Good and bad conduct; playing fair; being helpful


       Drug use


       Religion/Church activities/Sunday School


       Peer pressure/social acceptance


       Social involvement


       Family roles



If a substance abuse or behavioral problem is encountered, then the clinician, counselor or parent/caregiver should explore a youths value/belief system to better understand what they believe about various topics (including topics related to drug use).  An area I like to explore is the environment they were exposed to during their early life.  For example, I want to determine if their parents or caregivers had a permissive attitude toward drugs.  I also want to know if the youth had friends who used drugs and what was the norm regarding use in their community.  Also, one may also want to explore other issues to determine what boundaries, if any, were established for the youth.  For example:


       Were limits or restrictions imposed on the youth?


       Were the youth allowed to experiment with tobacco, alcohol, and other drugs in the home?


       At what age did the youth start to drink, smoke or use other drugs?


       Was there a permissive attitude regarding social activities?


       Did the youth have a detailed schedule?


       Did the parents involve themselves with the youths friends?


       Did the parents monitor school and other activities?



Obviously, this exploration is an attempt to assess the variables that help the youth to establish his or her value/belief system.  Generally, a permissive attitude and environment will provide early opportunities to experiment with alcohol, tobacco and other drugs.  This liberal, permissive environment enables a young person to form a flawed image of most activities (no boundaries or limits) and/or to establish a distorted mental picture of specific activity (such as use of drugs).   To give an example of how our /value/belief system works in the life of a drug user, lets suppose a youth forms a concept of a problem user as one who is a dropout and has trouble with the law.  Now, lets suppose this individual is a user but does not meet his or her pre-programmed characteristics of how they perceive a user to act and be.  In this case, the individual would test his or her situation against his or her value/belief system and would conclude he or she does not have a problem.  The cycle may be repeated until there is a match between his/her behavior and his/her pre-programmed value/belief system about drug use.  It should also be noted that an individuals value/belief system about drug use might change in response to his or her own experiences and influences from clinicians and other treatment providers.  The cycle may also be disrupted by other factors (generally a crisis) in the users life.


The aforementioned concepts are presented in support of and to promote early family discussions regarding ATOD.  Again, most professionals agree that to wait until a drug problem is encountered or until about age 16 is much too late (the value/belief system is already in place and, in most cases, the kid down the street will have more influence at this age than the parents).  Mental health professionals should encourage parents, caregivers, teachers and others to get involved early and stay focused on the negative consequences of ATOD use and abuse.  Also, it needs to be highlighted that youths key in on inconsistency.  For example, a child is often confused when the parent says one thing and then does differently.  Youth also sometimes pit parents against each other and then migrate toward the most liberal parent.  This concept should be well discussed in family counseling.  The parents should present a unified front and resolve any difference in private.



We have put a heavy load on the parents/caregivers and have not offered any preventative measures the youth can take to help themselves.  Here are some considerations that will help the child or adolescent to shape and mold themselves (or to be shaped and molded by others) into well-adjusted young citizens that have developed age appropriate coping and problem solving skills.  Hopefully, they will also be capable of making good decisions about most aspects of their lives (what should and should not go into their bodies, social activities, peers, school, hobbies, etc.).  Remember, at this age, they are generally eager to know and memorize rules, and they want your opinion on whats good and whats bad.  Although they are old enough to understand that using drugs is bad for them, they generally are not ready to take on complex facts about drugs.  So here are some ways to help the youth make good decisions, have a high self-esteem and to develop age appropriate coping and problem solving skills:


       The youth should eat healthy foods (parents/caregiver should discuss food types and inform them how certain foods help build healthy bodies.


       Build strong bonds of trust though dedicated activities and discussion times between parent and child.  Focus on the childs likes and dislikes and complement them when possible on their choices.  Let them know that you enjoy spending special time with them and doing activities they like.  Also, let them know that you love them and want them.


       Encourage and enforce fair play; provide guidelines for sharing toys and telling the truth so that the youth knows what kind of behavior is expected of them.  Be consistent especially when playing games.  Its challenging to hold the line when both the child and parents want the child to win.   However, one must remember the goal is to help shape a well rounded youth that can cope with both winning as well as loosing.  To bring up a child in an environment where they always get their way and/or win can yield a child with antisocial behavior patterns and is a high risk for poor coping skills such as bullying.


       Encourage your child to follow directions and to ask questions if he or she doesnt understand the instructions.  Encourage the youth to verbalize the situation as opposed to acting out.


       Encourage the child to be self-sufficient.  For example, let them choose their clothing as this reinforces their ability to make decisions and also helps their self-esteem.  Look for opportunities to compliment (or praise) the child; remember to praise in public and instruct in private.



Most adolescents are naturally curious and want to learn new things and to experiment.  They are gaining their independence in so many ways.  This curiosity is normal and presents teachers, counselors and especially parents an opportunity to open conversations that can benefit the youth.  For example, the parent have likely identify substances commonly found in the home, such as bleach, kitchen cleansers and furniture polish that could be harmful to the children and told them to stay away from these.  However, parents frequently don’t want to bring up a conversation about what an adolescents friends might ask them to try to do with many of these same substances.  They don’t want to “put the idea in their head”.    It can be pointed out to parents that a child or adolescents curiosity will be satisfied one way or the other.  The youths natural curiosity offers parents/caregivers opportunities to explain why its okay for adults do a certain thing and not okay for children.  For example, when questions come up about ATOD its a good time to introduce the concept that adults may choose to drink in moderation,  but children may not.   




The adolescence years are exciting and challenging and this is the time when peer pressure becomes very important, as most youths desperately want to fit in.  Also, there are encounters with older youths that may have already begin to use alcohol, tobacco and other drugs and may think they are cool and self-assured.  This environment may tempt your youth to try drugs to.  It should be every parents goal to make sure a youths life is structured in such a way that drugs have no place in it.  The following actions are recommended to help to keep adolescence drug-free:


       Ensure that they are well versed in the reasons why they should avoid use of ATOD.  Parents should go beyond because I said so and get age appropriate educational material and videos for them to digest.  There is loads of material on the Internet from website like National Institute of Drug Abuse (NIDA) that is free and readily available.


       Make the home youth friendly.  Get acquainted with the parents of other childrens friends and learn about their childrens interests and habits.  Get to know the parents of your youths friends and exchange phone numbers and addresses.  Agree to forbid each others youth from consuming alcohol, tobacco, and other drugs in their homes, and pledge that you will inform each other if one of you becomes aware of a youth who violates this pact. If it seems that a youth is attracted to those with bad habits, reiterate why drug use is unacceptable.


       If possible, provide adult supervision for the youth.  Its never good for them to be left on there on for long periods of time.  It is essential that parents/caregivers arrange to have their youth looked after and engaged in the after-school hours. An acceptable alternative is that the youth can get involved with reputable youth groups, arts, music, sports, community service and academic clubs.


       If it is mandatory to leave the youth alone make sure the youth feels the adult’s presence.  Give them a schedule and set limits on their behavior.  Give them household chores to accomplish and enforce strict “phone-in-to-you” policy.

       Make it easy for the youth to leave a place where substances are being used.  Discuss with them in advance how o contact you or another designated adult in order to get a ride home.  If another adult provides the transportation, be available to talk to your youth about the situation when he or she arrives home.


       Set age appropriate curfews and enforce them.


       Encourage open dialogue with the youth about their experiences.  Tell the child, I love you and trust you, but I dont trust the world around you, and I need to know whats going on in your life so I can be a good parent to you.



Public and private schools have a responsibility to educate and protect all students; consequently, there should be nothing confusing or contradictory in what children learns about drugs from the parents and in the school system. For example, school policies need to reflect the same attitude toward use and abuse of ATOD as is express in the home:  Drug use is not acceptable.   Its critical that youth understand that drugs diminish their ability to concentrate and follow through on academic responsibilities, they cause absenteeism and loss of motivation, and students who use them can be disruptive and drain teachers time and energy. The best way to ensure that the anti-drug policies at a childs school are strong is for parents to be involved.  Parents can:


       Learn about the current policy regarding ATOD at your school.  If there is not an anti-drug policy in place, schedule a meeting with the school administration to help develop a policy.  The policy should specify what constitutes an ATOD offense, spell out the consequences for failing to follow the rules and describe procedures for handling violations.


       Know the drug education program at your school.  Staff should be trained about ATOD use and abuse and how to recognize symptoms in those who choose to use and abuse.  Drug education should be taught in an age appropriate way throughout the school year rather than once during a special week.  All teachers should incorporate anti-drug information into their classes.  The school program should be based on current research.  If the drug activity is high in your school you may want to become more involved and inform the school administration that there is a need for improvement in this area.


       Study the schools drug education program at home.  You should examine any existing material to ensure that they contain clear messages that ATOD use is wrong and harmful.  You should also verify that the information is accurate and up to date.


        Ask about the consequences for those who are caught abusing drugs.   Does the school offer a list of referrals for students who need substance abuse counseling?


       Determine if your school drug program is effective.  Research indicates that some of the most effective programs emphasize the value of life skills training such as coping with anxiety, problem solving, being assertive and feeling comfortable socially.  When these lessons are combined with drug education, students confronted with drugs are better equipped to resist them.





Drug addiction has been labeled a disease of the brain; consequently, lets take a look at the brain and how it functions to begin our study how to keep our youth drug free.  This material is from the National Institute of Drug Abuse (NIDA).


The brain is the command center of the body. It weighs about three pounds, and has different centers or systems that process different kinds of information. The brain stem is the most primitive structure at the base of your brain and controls heart rate, breathing, and sleeping; it does the things you never think about.


Various parts or lobes of the brain process information from your sense organs: the occipital lobe receives information from your eyes, for example. And the cerebral cortex, on top of the whole brain, is the “thinking” part of you. That’s where you store and process language, math, and strategies: It’s the thinking center. Buried deep within the cerebral cortex is the limbic system, which is responsible for survival: It remembers and creates an appetite for the things that keep you alive, such as good food and the company of other human beings.


The cerebellum is responsible for things you learn once and never have to think about, such as balance when walking or how to throw a ball.


The brain’s job is to process information. Brain cells called neurons receive and send messages to and from other neurons. There are billions of neurons in the human brain, each with as many as a thousand threadlike branches that reach out to other neurons.


In a neuron, a message is an electrical impulse. The electrical message travels along the sending branch, or axon, of the neuron. When the message reaches the end of the axon, it causes the release of a chemical called a neurotransmitter. The chemical travels across a tiny gap, or synapse, to other neurons.


Specialized molecules called receptors on the receiving neuron pick up the chemical. The branches on the receiving end of a neuron are called dendrites. Receptors there have special shapes so they can only collect one kind of neurotransmitter.


In the dendrite, the neurotransmitter starts an electrical impulse. Its work done, the chemical is released back into the synapse. The neurotransmitter then is broken down or is reabsorbed into the sending neuron.


Neurons in your brain release many different neurotransmitters as you go about your day thinking, feeling, reacting, breathing, and digesting. When you learn new information or a new skill, your brain builds more axons and dendrites first, as a tree grows roots and branches. With more branches, neurons can communicate and send their messages more efficiently.


What Do Drugs Do to the Brain? Some drugs work in the brain because they have a similar size and shape as natural neurotransmitters. In the brain in the right amount or dose, these drugs lock into receptors and start an unnatural chain reaction of electrical charges, causing neurons to release large amounts of their own neurotransmitter.  Some drugs lock onto the neuron and act like a pump, so the neuron releases more neurotransmitter. Other drugs block reabsorption or reuptake and cause unnatural floods of neurotransmitter.


All drugs of abuse, such as cocaine, and marijuana, primarily affect the brain’s limbic system. Scientists call this the “reward” system. Normally, the limbic system responds to pleasurable experiences by releasing the neurotransmitter dopamine, which creates feelings of pleasure.


What Happens if Someone Keeps Using Drugs?  Think about how you feel when something good happens-maybe your team wins a game, you’re praised for something you’ve done well, or you drink a cold lemonade on a hot day-that’s your limbic system at work. Because natural pleasures in our lives are necessary for survival, the limbic system creates an appetite that drives you to seek those things.


The first time someone uses a drug of abuse, he or she experiences unnaturally intense feelings of pleasure. The limbic system is flooded with dopamine. Of course, drugs have other effects, too; a first-time smoker may also cough and feel nauseous from toxic chemicals in a tobacco or marijuana cigarette.


But the brain starts changing right away as a result of the unnatural flood of neurotransmitters. Because they sense more than enough dopamine, for example, neurons begin to reduce the number of dopamine receptors. Neurons may also make less dopamine. The result is less dopamine in the brain: This is called down regulation. Because some drugs are toxic, some neurons may also die.


How Many Times Does Someone Have To Take a Drug To Become an Addict? No one knows how many times a person can use a drug without changing his or her brain and becoming addicted.


A person’s genetic makeup probably plays a role. But after enough doses, an addicted teen’s limbic system craves the drug as it craves food, water, or friends. Without a dose of the drug, dopamine levels in the drug abuser’s brain are low. The abuser feels flat, lifeless, depressed. Without drugs, an abuser’s life seems joyless. Now the abuser needs drugs just to bring dopamine levels up to normal levels. Larger amounts of the drug are needed to create a dopamine flood or high, an effect known as tolerance.


By abusing drugs, the addicted teen has changed the way his or her brain works. Drug abuse and addiction lead to long-term changes in the brain. These changes cause addicted drug users to lose the ability to control their drug use. Drug addiction is a disease.


If Drug Addiction Is a Disease, Is There a Cure?  There is no cure for drug addiction, but it is a treatable disease; drug addicts can recover. Drug addiction therapy is a program of behavior change or modification that slowly retrains the brain. Like people with diabetes or heart disease, people in treatment for drug addiction learns behavioral changes and often take medications as part of their treatment regimen.





What Are Stimulants?


Stimulants are drugs that can cause the heart to beat faster, and blood pressure and metabolism to increase. They are often used to increase alertness, relieve fatigue and often cause a person to be more talkative and anxious and to experience feelings of euphoria.  Stimulants also elevate mood, increase feelings of well-being, and increase energy and alertness.  Examples of stimulants include cocaine, crack cocaine, amphetamines, Methamphetamine, methylphenidate (Ritalin(r)), nicotine, and MDMA (3-4 methylenedioxyMethamphetamine, better known as Ecstasy).


Cocaine is a hydrochloride salt, made from the leaf of the coca plant, and comes in the form of a white powder. Crack is a smokeable form of cocaine that is processed with ammonia or baking soda and water, and heated to remove the hydrochloride.


Amphetamines are sometimes prescribed by doctors for medical problems, but these pills are also abused for their effects on the brain. Methamphetamine is a powerful form of amphetamines that comes in clear crystals or powder and easily dissolves in water or alcohol. It is often made in illegal laboratories with inexpensive and readily available ingredients (such as drain cleaner, battery acid, and antifreeze).


Methylphenidate (Ritalin(r)) is a medication prescribed for individuals (usually children) with attention-deficit hyperactivity disorder (ADHD). Numerous studies have shown its effectiveness, when used as prescribed, in the treatment of ADHD. When it is abused or not used as prescribed, however, methylphenidate can lead to many of the same problems seen with other stimulants.


Nicotine and MDMA also are considered stimulants and are covered in separate topics on this Web site.


What Are the Common Street Names?


Cocaine is generally sold on the street as a fine, white, crystalline powder, known as “coke,” “C,” “snow,” “flake,” “blow,” “bump,” “candy,” “Charlie,” “rock,” and “toot.”   “Crack,” the street name for the smokeable form of cocaine, got its name from the crackling sound made when it’s smoked.  A “speedball” is cocaine or crack combined with heroin or crack and heroin smoked together.


Street names for amphetamines include “speed,” “bennies,” “black beauties,” “crosses,” “hearts,” “LA turnaround,” “truck drivers,” and “uppers.”


Methamphetamine is commonly known as “speed,” “meth,” “chalk, and “tina.” In its smokable form, it’s often called “ice,” “crystal,” “crank,” “glass,” “fire,” and “go fast.” 


Street names for methylphenidate include “rits,” “vitamin R,” and “west coast.”


What Are the Differences Between Cocaine and Methamphetamine?


Although cocaine is quickly removed and almost completely metabolized, methamphetamine has a much longer duration of action. The longer presence of methamphetamine in the brain ultimately leads to prolonged stimulant effects.  Both stimulants cause an accumulation of the neurotransmitter dopamine in the brain. This excessive dopamine concentration appears to produce the stimulation and feelings of euphoria experienced by the user.



What Are the Short-Term Effects of Cocaine Use?


The short-term effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter, usually because of disrupted heart rhythms.


What Are the Long-Term Effects of Cocaine Use?


Large amounts of cocaine intensify the high, but may also lead to bizarre, erratic, and violent behavior. Heavy users may experience tremors, vertigo, muscle twitches, or paranoia. Some cocaine users report feelings of restlessness, irritability, and anxiety. This may result in panic attacks or even full-blown paranoid psychosis, in which the individual loses touch with reality and hears sounds that aren’t there (auditory hallucinations). Different ways of using cocaine can produce different adverse effects. For example, regularly snorting cocaine can lead to swallowing problems, hoarseness, loss of the sense of smell, nosebleeds, and a chronically runny nose. Cocaine that is eaten can cause reduced blood flow, leading to bowel problems.


How Long Can Stimulants, Such as Cocaine and Methamphetamine, Be Detected In the User’s Body?


There is no hard and fast rule for how long a drug will be detectable in one’s system. Generally, traces of these stimulants can be detected by standard urine testing methods several days after use. The exact length of time varies from person to person and from test to test. It can also depend on the amount of drug used.


What Happens If a Person Drinks Alcohol and Uses Cocaine at the Same Time?


Taken in combination, alcohol and cocaine are converted by the body to a substance called cocaethylene. Cocaethylene lasts longer in the brain and is more toxic than either drug alone. The mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.


Are Stimulants Addictive?


Cocaine, methamphetamine, and amphetamines are highly addictive. After trying stimulants, an individual may have difficulty predicting or controlling the extent to which he or she will continue to use the drug. The stimulant and addictive effects are thought to be primarily a result of the drugs’ ability to inhibit the reabsorption of dopamine by nerve cells.


Can a user develop tolerance to Cocaine?


Many cocaine addicts report that they seek but fail to achieve as much pleasure as they did from their first experience, suggesting tolerance to some effects of cocaine. Some users increase their doses to intensify and prolong the euphoric effects. Users can also become more sensitive to cocaine’s anesthetic and convulsant effects over time. This increased sensitivity may explain why some deaths occur after apparently low doses of cocaine.


If a Pregnant Woman Uses Stimulants, Will It Hurt the Baby?


Doctors advise pregnant women not to use any drugs because they could harm the growing fetus. Cocaine’s direct impact on pregnant women and fetuses is still not completely known. Scientists are now finding that exposure to cocaine during fetal development may lead to subtle but significant deficits later in life, including deficits in some aspects of information processing and attention to tasks-abilities that are important for success in school.  Fetal exposure to methamphetamine also is a significant problem in the United States. At present, research indicates that methamphetamine abuse during pregnancy may result in increased rates of babies who weigh less than normal at birth, whether or not they are born prematurely. Methamphetamine use during pregnancy may also result in altered behaviors in newborns, such as increased stress and unusual cry patterns. Ongoing research continues to study the developmental progress of children exposed before birth to methamphetamine as they get older.


What Treatments are Available for Stimulant Abusers?


Many behavioral therapies are effective. These approaches are designed to help modify the patient’s thinking, expectations, and behaviors and to increase skills in coping with various stresses in life. Methamphetamine and cocaine recovery support groups also appear to be effective additions to behavioral therapies. Currently, no medications are available to treat individuals who are addicted to stimulants.  NIDA distributes a five-part series of cocaine treatment guides Geared to drug treatment professionals; the manuals incorporate a variety of behavioral treatment regimens to meet the needs of patients.


How Are They Used?


Stimulants can be taken in several ways:


Swallowed in pill form


“Snorted” in powder form, through the nostrils, where the drug is absorbed into the bloodstream through the nasal tissues


Injected, using a needle and syringe, to release the drug directly into a vein


Heated in crystal form and smoked (inhaled into the lungs).   Compared to stimulants that are swallowed or snorted, those that are injected or smoked are absorbed into the bloodstream more quickly, intensifying the effects of the drug. It is also important to note that sometimes these drugs are diluted with other toxic substances.


Cocaine is snorted or injected (called “mainlining”), or it can be rubbed onto mucous tissues, such as the gums. Street dealers generally dilute cocaine with other substances (such as cornstarch, talcum powder, or sugar); with active drugs (such as procaine, a chemical that produces local anesthesia); or with other stimulants (such as amphetamines). Crack cocaine is smoked in a glass pipe.


Amphetamines are usually swallowed in pill form. Methamphetamine is swallowed, snorted, injected, or smoked. “Ice,” a smokeable form of Methamphetamine, is a large, usually clear crystal of high purity that is smoked, like crack, in a glass pipe.


How Many Teens Use Them?


A 2004 NIDA-funded study reported that the following percentages of 8th-, 10th-, and 12th-graders had tried these drugs at least once:


Cocaine: 3.4 percent of 8th-graders, 5.4 percent of 10th-graders, and 8.1 percent of 12th-graders


Crack: 2.4 percent of 8th-graders, 2.6 percent of 10th-graders, and 3.9 percent of 12th-graders


Amphetamines: 7.5 percent of 8th-graders, 11.9 percent of 10th-graders, and 15.0 percent of 12th-graders [


Methamphetamine: 2.5 percent of 8th-graders, 5.2 percent of 10th-graders, and 6.2 percent of 12th-graders


Twelfth-graders regularly reported the highest rate of use for all three drugs. Conversely, eighth-graders reported a drop in use for all three drugs, with a significant drop in Methamphetamine use, from 3.9 percent in 2003 to 2.5 percent in 2004.


What are the Common Effects?


Stimulants such as cocaine and methamphetamine can produce euphoric effects. Smoking or injecting these drugs cause an intense, immediate “rush” that lasts just a few minutes. Snorting or swallowing these drugs produces a high that is less intense but lasts longer.


Stimulants can cause the heart to beat faster and blood pressure and metabolism to increase. They also can cause users to become more talkative, energetic, and anxious.


Repeated use of stimulants can lead to feelings of hostility or paranoia in some users. Single high doses can produce dangerously high body temperatures and an irregular heartbeat.


Cocaine causes the body’s blood vessels to become narrow, constricting the flow of blood. This forces the heart to work harder to pump blood through the body. The heart may work so hard that it temporarily loses its natural rhythm. This is called fibrillation, and it can be very dangerous because it stops the flow of blood through the body. [1] Physical symptoms of cocaine overdose may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions, and coma.


Methamphetamine can also cause a variety of heart problems, including rapid heart rate, irregular heartbeat, and irreversible, stroke-producing damage to small blood vessels in the brain. [4] It can also cause high blood pressure, shortness of breath, nausea, vomiting, and diarrhea. Methamphetamine can also increase body temperature, which can be lethal if not treated rapidly.


How Stimulants Produce Euphoria


Stimulants change the way the brain works by changing the way nerve cells communicate. Nerve cells, called neurons, send messages to each other by releasing special chemicals called neurotransmitters. Neurotransmitters work by attaching to key sites on neurons called receptors.



There are many types of neurotransmitters, but the transmitter dopamine is the one most affected by stimulants and many other drugs. Dopamine is what makes people feel good when they do something they enjoy, like eating a piece of chocolate cake or riding a roller coaster. Stimulants cause dopamine to build up in the brain and make users feel intense pleasure and a heightened state of increased energy. But with repeated use, stimulants can decrease some of the brain’s dopamine receptors, dampening users’ ability to feel pleasure at all. Then users need to take more and more of the drug to experience the same pleasure.


Long-Term Effects


As with many other drugs of abuse, long-term stimulant abuse can result in addiction, a chronic, relapsing disease characterized by compulsive drug-seeking and drug use and accompanied by functional and molecular changes in the brain.  Some cocaine users report panic attacks and feelings of restlessness, irritability, and anxiety. Users may also experience a full-blown paranoid psychosis in which they lose touch with reality and hear voices that are not there (auditory hallucinations). [2]


Use of methamphetamine over time may cause violent behavior, anxiety, confusion, and insomnia. Heavy users may also display a number of psychotic features, including paranoia, auditory hallucinations, mood disturbances, and delusions (for example, the sensation of insects creeping on the skin, called “formication”). The paranoia can result in homicidal as well as suicidal thoughts.   Some users believe that methamphetamine can increase their sex drive. However, research indicates that long-term methamphetamine use may be associated with decreased sexual functioning, at least in men. 


Lethal Effects


Using cocaine or crack-whether snorted, injected, or smoked-can lead to overdose, which can cause acute emergencies with the heart or brain, sometimes resulting in sudden death. In rare instances, sudden death can occur with the first use of cocaine. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.


People who abuse both cocaine and alcohol compound the danger each drug poses. NIDA-funded researchers have found that when the human liver is exposed to both cocaine and alcohol, it manufactures a third substance, cocaethylene, which intensifies cocaine’s euphoric effects, possibly increasing the risk of sudden death.


Hyperthermia (elevated body temperature) and convulsions occur with methamphetamine and cocaine overdoses, and if not treated immediately, can result in death.