What is tobacco?

Tobacco comes from a plant that contains nicotine, a highly addictive drug. Nicotine works as both a stimulant and a depressant, affecting the brain and body in different ways. It is the main addictive substance in all tobacco products and is one of the most addictive drugs in the world.

Tobacco and Nicotine are also known as:

• Cigarettes

• Smokes

• Cigs or butts

• Chew

• Dip

• Spit tobacco

• Snus or snuff

Risks include:

• Lung disease, coronary heart disease, and stroke

• Cancer in the lungs, larynx, esophagus, mouth, and bladder

• Can contribute to cancer of the cervix, pancreas, and kidneys

• Smoking during pregnancy can result in adverse birth outcomes such as infant death, low birth weight, and a variety of infant health disorders

• Secondhand smoke can cause lung cancer, heart disease, and strokes

The nicotine in tobacco smoke travels quickly to the brain, where it acts as a stimulant and increases heart rate and breathing. Tobacco smoke also reduces the level of oxygen in the bloodstream, causing a drop in skin temperature. People who are new to smoking are likely to experience dizziness, nausea, and coughing or gagging.

Withdrawal symptoms may include:

• Irritability and anxiety

• Restlessness, difficulties concentrating or sleeping, and fatigue

• Cravings, increase in appetite and weight gain

Withdrawal symptoms typically last from a few days to several weeks, with the most intense symptoms occurring within the first week.

What is it marijuana?

Cannabis, more commonly known as marijuana, refers to the dried leaves, flowers, stems, and seeds of a ‘cannabis sativa’ plant. The cannabis plant contains over 100 different chemicals including delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD)

Risks include:

• Increase heart rate and lowered blood pressure

• Increase in anxiety, fear, panic, and distrust

• Altered perception of reality and impaired thinking, memory, and body movement

• Smoking cannabis products can cause respiratory issues such as lung hyperinflation and chronic bronchitis

• Gastrointestinal issues such as nausea, vomiting, acid reflux, pancreatitis, and peptic ulcer disease

The minimum amount of THC required to have a perceptible psychoactive effect is about 10 micrograms per kilogram of body weight.

According to the Drug Enforcement Administration (DEA), there have been no reported deaths from marijuana overdoes.

Classification

While many psychoactive drugs clearly fall into the category of either stimulant, depressant, or hallucinogen, cannabis exhibits a mix of all properties, perhaps leaning the most towards hallucinogenic or psychedelic properties, though with other effects quite pronounced as well. Though THC is typically considered the primary active component of the cannabis plant, various scientific studies have suggested that certain other cannabinoids like CBD may also play a significant role in its psychoactive effects.

Long Term Effects

Given the limitations of the research, scientists still debate the possibility of cannabis dependence; the potential of cannabis as a "gateway drug"; its effects on intelligence and memory; its effect on the lungs; and the relationship, if any, of cannabis use to mental disorders such as Schizophrenia, Psychosis, Depersonalization disorder, and Depression.

How it can be consumed:

• Smoking dried plant material in joints similar to cigars or cigarettes, in pipes, or bongs (water pipe)

• Vaped in dry herb vaporizers or vape pens

• Mixed in or added to foods such as baked goods, candies, gummies and beverages

• Cannabis compounds may be extracted to make oils and concentrates used for vaping or e-cigarettes

• Cannabis infused alcohol or oil placed under the tongue or added to foods and drinks containing large amount of THC

Withdrawal symptoms may include:

• Aggression and anger

• Decreased appetite

• Anxiety and nervousness

• Headaches

• Shakiness and excessive sweating

• Abdominal pain, nausea and vomiting

• Sleep issues such as insomnia, and disturbing dreams or nightmares

Withdrawal symptoms typically last from a few days to several weeks, with the most intense symptoms occurring within the first 24 to 48 hours.

What is cocaine?

Cocaine is a highly addictive drug stimulant deriving from the South American coca plant.

Cocaine is also known as:

• Blow or bump

• C, coke, crack

• Candy

• Charlie

• Flake or snow

• Freebase

• Rock

Risks include:

• Increased heart rate, blood pressure and body temperature, that could result in cardiac arrest, seizures or death

• Paranoia, delusions and hallucinations

• Irritability and physical aggression

• Hyperawareness and hypervigilance which can cause a distorted perception of reality

• “Crack lung” occurring within 48 hours of use is an acute pulmonary syndrome which may include shortness of breath, chest pain, wheezing, and respiratory failure

Long term effects may include:

• “Cocaine nose” from snorting leads to the break down of nasal passage tissue leading to frequent nose bleeds, irritation, infection and even nasal collapse

• Hepatitis C from sharing snorting straws

• Blood borne infections from using unclean needles

• Increased risk of blood clots and strokes

• May cause prolonged lack of appetite leading to malnutrition and being underweight

• Cognitive impairment and memory loss

Cocaine’s addictive nature lies in how it affects the brain’s reward system. Even after only a few uses, it can rewire the brain, making users crave the drug intensely. As tolerance builds, the euphoric effects diminish, driving users to consume more, increasing the risk of dependence, health problems, and overdose.

Ways it may be consumed:

• Snorting, sniffing or blowing allows cocaine to be absorbed into the mucus membranes of the nasal passage, desired effects of cocaine happen within 15 minutes of snorting and last 60-90 minutes

• Injected

• Smoked

• Traditionally used for medicine purposes by being chewed, brewed into tea or mixed into food

Withdrawal symptoms may include:

• Muscle aches or pains, chills, tremors

• Agitation, restlessness and mood swings

• Anxiety and panic attacks

• Depression

• Insomnia, fatigue and exhaustion

Withdrawal symptoms can range from a few days to several weeks, depending on the level of physical and psychological dependence.

While cocaine withdrawal is typically not life-threatening, the psychological risks should not be underestimated. It can trigger intense depression, feelings of hopelessness, and even suicidal thoughts. Cravings can be powerful and persistent, making relapse likely without support. Medical or therapeutic supervision during the early stages of recovery can provide the tools and guidance needed to manage withdrawal symptoms and build a foundation for lasting sobriety.

What is heroin?

Heroin is a highly addictive opioid drug made from morphine, a natural substance derived from the opium poppy plant. Due to the high risk of dependence, heroin is illegal in most countries and is classified as a Schedule I controlled substance in the U.S. meaning it has no accepted medical use and a high potential for abuse.

Heroin provides an initial “rush” of pleasure, relaxation and relief from emotional or physical pain, making it an escapism drug.

Heroin is also known as:

• Black tar (specific to the sticky, dark form)

• Brown sugar

• Dope

• Gear

• H, horse, white horse (for the white powder form)

• Junk

• Skag

Risks include:

• Overdoes. Please know this is an immediate risk from first time use, multiple uses or addiction do not need to be present for an overdoes to occur.

• Nausea and vomiting; choking may occur as a result if the person is unconscious

• Flushed skin and itching

• Dry mouth, heavy limbs, clouded thinking

• Slowed heart rate and breathing leading to oxygen deprivation in brain and body

Long term effects may include:

• Addiction and dependence. The brain rewires itself to crave heroin, making quitting very difficult.

• Problems with memory, decision making and impulse control from cognitive decline

• Long term risks from injection include: collapsed veins, skin infections, infectious diseases such as HIV or hepatitis

• Damage to liver, kidneys, and lungs

• Hormonal imbalances leading to sexual dysfunction and menstrual irregularities

• Tolerance drops after quitting increasing the risk of overdose if a relapse occurs

Other long term issues may include strain on relationships, inability to maintain a job, financial issues due to the high cost of heroin and legal issues when caught using. Heroin damages not just the body, but disrupts nearly every aspect of a person’s life.

Ways heroin may be consumed:

• Injection; most common and dangerous

• Snorting

• Smoking from a pipe or heated on foil

• Orally; least common as it is least effective when chasing a high

Withdrawal symptoms may include:

• Anxiety, restlessness, irritability

• Sweating and chills

• Insomnia

• Dilated pupils, watery eyes and blurry vision

• Rapid heartbeat, high blood pressure

• Fatigue, low energy, depression and mood swings

• Severe nausea, vomiting and diarrhea that may lead to dehydration

• Intense cravings

Withdrawal symptoms often begin within 6-12 hours after the last dose- withdrawal symptoms include high anxiety but heroin provides a low heart rate and relaxes the body, this is why heroin is so addictive, just one more hit can ease the withdrawal.

Peak withdrawal symptoms occur 1-3 days after last use and can last up to a week. Medical supervision is highly encouraged for heroin detox due to risk of dehydration, spike in blood pressure and increased heart rate. While people can withdrawal without help, medical supervision makes the detox safer, more comfortable and more successful.

What is meth?

Methamphetamine is a lab made (synthetic) stimulant. Common ingredients for making meth include pseudoephedrine and ephedrine found in some cold and allergy medications, solvents such as acetone, lithium often found in batteries and other household chemicals such as hydrochloric acid (toilet bowl, tile, grout cleaners), sulfuric acid (drain cleaners, battery acid) and anhydrous ammonia (all purpose cleaners).

Meth affects the central nervous system and increases levels of dopamine in the brain leading to intense euphoria, energy, alertness and sense of confidence. Meth is a Scheduled II stimulant making it legally available in the United States through nonrefillable prescriptions for attention deficit disorder (ADHD) and short-term obesity control.

Meth is also known as:

• Crystal, ice or glass for the crystalized form that is usually smoked

• Tina

• Crank

• Speed

Risks include:

• Increased heart rate, blood pressure and body temperature

• Insomnia, hyperactivity, erratic behavior

• Anxiety, paranoia, or agitation that may cause violent behavior

• Loss of appetite leading to rapid weight loss and malnutrition

• Impaired judgment

• Overdoes from large doses

Long term effects may include:

• Addiction and dependence

• “Meth mite” hallucinations leading to excessive scratching and skin sores

• Long-lasting, even after quitting, paranoia, hallucinations and psychosis

• Cognitive issues such as difficulty learning, remembering or making decisions

• Heart, liver, and kidney damage

• Injection risks may include: collapsed veins, blood borne diseases such as HIV or hepatitis

• Snorting risks may include: nasal tissue damage, sinus problems and nosebleeds

Due to meth’s dependence, cognitive issues and paranoia, social and life consequences often coincide with use. Ability to maintain a job or succeed in schooling are at risk. Relationships are often affected due to impaired judgment such as unsafe sex, accidents or violence. Neglecting personal responsibilities and hygiene can affect one’s ability to thrive in their local community. Meth use effects every part of one’s life.

Ways meth may be consumed:

• Smoking in a pipe or heated on foil

• Snorting through a powder

• Injection when meth is dissolved in water

• Oral consumption through a pill or powder

Withdrawal symptoms may include:

• Extreme fatigue, lack of energy, oversleeping

• Slowed movements or speech

• Headaches or body aches

• Depressions, anxiety, irritability

• Paranoia or agitation

• Increased appetite and weight gain

Withdrawal symptoms typically occur within 24 hours of last using. While peak withdrawal symptoms occur 2-4 days after last use, symptoms tend to improve within 1-2 weeks. Cravings, depressions, and sleep issues may persist for months.

A supervised detox is not necessary for meth as meth withdrawals are not usually life-threatening. Benefits to having a medical professional include monitoring heart rate, blood pressure and other vital signs, managing psychological symptoms such as depression and intense cravings that could trigger a relapse or cause suicidal thoughts, provide a safe environment with routine monitoring and peer support which improve chances for a long-term recovery.

What is ecstasy?

Ecstasy is a synthetic stimulant and psychedelic drug that is made fully in a lab. Originally made as part of research for chemicals that could be used to create medication and later used in psychotherapy believed to help patients be more open and able to talk about their emotions in the 1970s. In 1985 ecstasy became a Schedule I controlled substance in the United States meaning it has no accepted medical use and a high potential for abuse. Today, there is research on if ecstasy could be used to help treat PTSD and certain mental health conditions, but remains unobtainable to the public through prescriptions.

Ecstasy has become widely used as a party drug as the side effects begin within 30-45 minutes of consumption and can last 3-6 hours and give off euphoric sensations such as increased energy, empathy and pleasure.

Ecstasy is also known as:

• X, XTC, E

• Molly or many in the UK

• Adam

• Scooby Snacks

• Love/Hug drug

Because ecstasy is illegal and unregulated, the tablet or pills may come in an array of colors or with different logos on them. Names for certain pills may vary and do not guarantee what other substances may be in the pill.

Risks include:

• Increased heart rate and blood pressure

• Anxiety, agitation, panic attacks, paranoia or confusion

• Distorted perception of reality, time and senses

• Difficulty concentrating or remembering things

• Nausea, blurred vision, sweating, chills, or muscle cramps

• Jaw clenching and teeth grinding

• Risk of ecstasy being laced with other substances such as methamphetamine, bath salts or opioids make side effects unpredictable and increases the risk of overdoes

Long term effects may include:

• Mood disorders such as depression, anxiety and irritability

• Reduced serotonin, the “feel good” chemical in our body, function

• Liver and kidney damage

• Dental issues from jaw clenching and teeth grinding

• Difficulty falling or staying asleep

• Memory problems

Ways it may be consumed:

• Pills or tablets swallowed whole or sometimes crushed as swallowed as powder

• Capsules containing the powdered substance, often referred to as “molly”

• Powder or crystals that may be snorted or dabbed on gums

Withdrawal symptoms may include:

• Depression or sadness

• Anxiety, panic, irritability or restlessness

• Poor concentration, memory issues or a mental “fog”

• Fatigue, low energy, loss of appetite

Withdrawal symptoms may occur within 24-72 hours of last use and may cause ongoing mood swings and lack of energy for a week. While ecstasy does not commonly cause withdrawal symptoms similar to alcohol or other opioids, users often will experience a difficult comedown or psychological withdrawal especially after frequent or heavy use.

While ecstasy may not appear to be an addictive and dangerous substance, please note it is highly illegal and may be laced with other substances that are addictive or greatly increase the risk of overdose.

Brain Functions:

The human body naturally produces its own opiate like substances and uses them as neurotransmitters. These substances include endorphins, enkephalins, and dynorphin, often collectively known as endogenous opioids. Endogenous opioids modulate our reactions to painful stimuli. They also regulate vital functions such as hunger and thirst and are involved in mood control, immune response, and other processes.

The reason that opiates such as heroin and morphine affect us so powerfully is that these exogenous substances bind to the same receptors as our endogenous opioids. There are three kinds of receptors widely distributed throughout the brain: mu, delta, and kappa receptors.

These receptors, through second messengers, influence the likelihood that ion channels will open, which in certain cases reduces the excitability of neurons. This reduced excitability is the likely source of the euphoric effect of opiates and appears to be mediated by the mu and delta receptors.

This euphoric effect also appears to involve another mechanism in which the GABA-inhibitory interneurons of the ventral tegmental area come into play. By attaching to their mu receptors, exogenous opioids reduce the amount of GABA released (see animation). Normally, GABA reduces the amount of dopamine released in the nucleus accumbens. By inhibiting this inhibitor, the opiates ultimately increase the amount of dopamine produced and the amount of pleasure felt.

Chronic consumption of opiates inhibits the production of cAMP, but this inhibition is offset in the long run by other cAMP production mechanisms. When no opiates are available, this increased cAMP production capacity comes to the fore and results in neural hyperactivity and the sensation of craving the drug.

Types of Opiates

•Morphine

•Hydrocodone

•Oxycodone

•Vicoden

•Heroin

•Opana

•Oxycotin

A Little More About Opiates

The human body naturally produces its own opiate-like substances and uses them as neurotransmitters. These substances include endorphins, enkephalins, and dynorphin, often collectively known as endogenous opioids. Endogenous opioids modulate our reactions to painful stimuli. They also regulate vital functions such as hunger and thirst and are involved in mood control, immune response, and other processes.

The reason that opiates such as heroin and morphine affect us so powerfully is that these exogenous substances bind to the same receptors as our endogenous opioids. There are three kinds of receptors widely distributed throughout the brain: mu, delta, and kappa receptors.

These receptors, through second messengers, influence the likelihood that ion channels will open, which in certain cases reduces the excitability of neurons. This reduced excitability is the likely source of the euphoric effect of opiates and appears to be mediated by the mu and delta receptors.

This euphoric effect also appears to involve another mechanism in which the GABA-inhibitory interneurons of the ventral tegmental area come into play. By attaching to their mu receptors, exogenous opioids reduce the amount of GABA released (see animation). Normally, GABA reduces the amount of dopamine released in the nucleus accumbens. By inhibiting this inhibitor, the opiates ultimately increase the amount of dopamine produced and the amount of pleasure felt.

Chronic consumption of opiates inhibits the production of cAMP, but this inhibition is offset in the long run by other cAMP production mechanisms. When no opiates are available, this increased cAMP production capacity comes to the fore and results in neural hyperactivity and the sensation of craving the drug.

What is GHB?

Gamma-Hydroxybutyrate, or GHB, is a central nerbous system depressant that can have sedative, euphoric, and muscle-relaxing effects. GHB is a clear, odorless liquid or white powder.

GHB occurs naturally in the brain and other tissues, it is considered a neurotransmitter or neuromodulator. Naturally occuring GHB helps regulate sleep and body temperature, is a neuroprotection and influences mood and memory.

Originally synthesized in the 1960s for research into anesthesia and neurotransmitters, GHB was later used medically for sleep disorders and alcohol withdrawal. Its liquid form gained notoriety for recreational use and involvement in date rapes. Today, GHB is a Schedule I controlled substance in the U.S., except for approved medical forms, which are Schedule III.

GHB is also known as:

• G, G-Juice

• Georgia Home Boy

• Liquid Ecstasy

Risks include:

• Drowsiness, dizziness, confusion or unconsciousness

• Loss of coordination

• Respiratory depression such as slowed or stopped breathing

• Seizures, coma or death

Long term risks may include:

• Poor concentration

• Memory loss or black outs

• Difficulty learning or retaining new information

• Depression, anxiety, paranoia or mood instability

Ways it may be consumed:

• Orally in a clear, colorless, ordorless liquid or sometimes in a powder

Withdrawal symptoms may include:

• Anxiety, panic attacks

• Tremors or seizures

• Delirium or hallucinations

• Difficulty sleeping

GHB withdrawal can last for several days to weeks and is considered more intense, difficult and dangerous than alcohol or benzodiazepine withdrawal due to how GHB affects the brain and body overtime. Withdrawal from GHB can be life-threatening without medical support, if you or someone you know is considering quitting, it is critical to seek professional medical support.

What is a hallucinogen?

Hallucinogens are a category of psychoactive substances that cause change in perception, mood, thought, and consciousness.

Hallucinogens have a rich history of cultural, spiritual, and medicinal use. For example, psilocybin mushrooms were central to religious rituals in Mesoamerican societies, peyote was traditionally used in Native American vision quests and healing practices, and ayahuasca has long been consumed by Indigenous Amazonian tribes for spiritual insight and therapeutic purposes.

In the 1950s, scientists began exploring the potential therapeutic benefits of hallucinogens, with LSD being studied as a treatment for alcoholism, depression, and end-of-life anxiety. However, most of this research came to a halt in the 1970s following the global criminalization of these substances.

In the United States, hallucinogens are classified as Schedule I substances, indicating a high potential for abuse and no currently accepted medical use. However, recent years have seen a resurgence of interest in psychedelic-assisted therapy for mental health, alongside growing efforts to decriminalize and legalize certain hallucinogens.

Hallucinogens are also known as:

• LSD, acid, tabs

• Blotter

• Lucy or Sid

• Magic mushrooms or shrooms

• Ketamine, Special K, K, Vitamin K

• PCP, angel dust, or sherm

• Peyote, San Pedro or Buttons

Risks include:

• Dialted upils, increated heart rate and blood pressure

• Sweating or chills

• Nausea or vomiting

• Diziness, tremors, or lack of coordination

• Distorted perceptions of time, space, and reality

• Visual and auditory hallucinations

• Paranoia or panic attacks

• Impaired judgment and dissociation

Long term effects may include:

• Ongoing hallucinations, delusions, or paranoia - more likely in people with a personal of family history of schizophrenia or bipolar disorder

• Recurring visual distortions even after only one use

• Depression, anxiety, panic disorders or flashbacks

• Bladder damage or organ strain from ketamine or PCP use

Ways hallucinogens may be consumed:

• Swallowed in pill or capsule

• Mushrooms may be eaten raw, dried, or brewed into tea

• Inahlation via smoke or vapor

• Snorting a powder synthetic form such as ketamine

Withdrawal symptoms may include:

• Anxiety or mood swings

• Fatigue or sleep issues

• Confusion or restlessness

The majority of hallucinogens do not produce physical dependence, and as a result, withdrawal symptoms are uncommon. However, certain synthetic hallucinogens, particularly when used heavily or over extended periods, may lead to withdrawal effects. These symptoms are generally mild and typically do not require medical supervision.

Although addiction to hallucinogens is considered rare and withdrawal symptoms are typically mild or nonexistent, the potential long-term psychological consequences—such as persistent perceptual disturbances or recurring hallucinatory episodes—can be significant. These risks may outweigh the short-term effects users seek, such as euphoria, insight, or altered states of consciousness.

What is an inhalant?

Inhalants refer to a group of volatile substances whose chemical vapors, when inhaled, produce psychoactive effects similar to those of alcohol, sedatives, or anesthetics. Although the euphoric effects are brief, inhalants remain a common drug of abuse among adolescents due to their accessibility in household, school, and workplace products such as aerosol sprays, adhesives, and markers.

Inhalants may also be known as:

• Whippets

• Poppers

• Huff/huffing

• Snappers

Risks include:

• Dizziness

• Slurred speech and lack of coordination

• Headaches, nausea or vomiting

• Sudden Sniffing Death Syndrom (SSDS), or heart failure after just one use, especailly with aerosols or butane

Long term risks may include:

• Brain damage

• Difficulty concentrating or learning

• Memory or hearig loss

• Liver, kidney, bone marrow or nerve damage

Ways inhalants may be consumed:

• Sniffing or snorting vapors directly from an open container

• Spraying an aerosol directly into the nose or mouth

• “Bagging”- spraying or pouring a substance into a bag and inhaling the fumes

• “Huffing”- soaking a cloth in a chemical and holding it up to the mouth or nose to inhale

Withdrawal symptoms may include:

• Nausea or vomiting

• Sweating, muscle cramps or tremors

• Increased heart rate

• Depression, anxiety or panic attacks

• Irritability or aggression

• Difficulty sleeping and insomnia

Although inhalants aren’t usually seen as addictive, frequent or heavy use can lead to dependence, and detox may require medical supervision.

What is rohypnol?

Rohypnol (flunitrazepam) is a strong sedative and central nervous system depressant. While banned in the United States, some countries use rohypnol to treat insomnia and as a preanesthetic medication.

Rohypnol is also known as:

• Roofies

• Forget-Me Pill

• Mexican Valium

• R2, Roach-2, La Rocha

Risks include:

• Extreme drowsiness or sedation

• Confusion, disorientation, memory loss, or amnesia

• Loss of motor coordination and balance

• Impaired judgment, lowered inhibitions, paralysis , or inability ro respond

• Risk of overdoes, especially when combined with alcohol or other depressants

Long term effects may include:

• Chronic memory problems and cognitive impairment

• Liver damage

• Tolerance, physical dependence and addiction

• Increased risk of accidents and risky behaviors leading to social and occupational difficulties

Ways rohypnol may be consumed:

• Oral ingestion such as tablets swallowed whole or crushed and mixed into food or drinks

• Dissolving in drinks

• Snorting crushed tablets

Withdrawal symptoms may include:

• Headaches, muscle cramps or stiffness

• Sweating, tremors or shaking

• Nausea or vomiting

• Rapid heartbeat or seizures

• Anxiety or panic attacks

• Depression, irritability or agitation

• Confusion

Individuals who have used Rohypnol heavily or over a long period should detox under medical supervision. Withdrawal can be risky and potentially life-threatening, especially if seizures, severe anxiety, or delirium arise. Healthcare professionals can administer medications to manage symptoms, prevent complications, and monitor both vital signs and mental health closely.

What is a steroid?

Steroids refer to a range of chemical substances, but the term typically describes either anabolic steroids or corticosteroids.
Anabolic steroids are synthetic versions of testosterone, commonly used to increase muscle mass, boost athletic performance, or speed up recovery from injuries. In the United States, they are classified as Schedule III controlled substances, meaning they have limited medical use and require a prescription. Corticosteroids, on the other hand, are prescription medications used to reduce inflammation in conditions such as asthma, arthritis, autoimmune disorders, and allergic reactions.

Steroids are also known as:

• Roids

• Gear

• Juice

• Gym Candy

• Pumpers

Risks include:

• Rapid muscle gain

• High blood pressure

• Liver strain and elevated enzymes

• Acne and oily skin

• Hair loss

• Mood swings, aggression, irritability, anxiety, or paranoia

• Testosterone suppression

• Shrinking of testlicles and breast development in men

• Menstrual irregularities, deepened voice and facial hair in women

Long term effects may include:

• Increased risk of heart attack or stroke

• High cholesterol

• Enlarged heart

• Persistent anxiety or paranoia

• Severe depression and suicidal thoughts or behavior

• Infertility

• Low libido or erectile dysfunction

• Liver damage or liver tumors

• Kidney damage

• Stunted growth in teens

• Tendon injuries

Ways steroids may be consumed:

• Orally by pill, tablets, or liquids

• Injected directly into muscle using a needle and syringe

• Topical creams or gels applied to the skin and absorbed into the body

• Transdermal patches for a slower release of steroid into the bloodstream

Withdrawal symptoms may include:

• Depression or suicidal thoughts

• Fatigue and insomnia

• Irritability or anxiety

• Loss of muscle mass or strength

• Hormonal imbalace

• Low sex drive

Steroid addiction rarely presents as physical dependence, but psychological addiction is significantly more common. Misuse is often driven by body image disturbances, including muscle dysmorphia, and reinforced by societal expectations, media influence, and athletic performance demands. While medical supervision is typically not needed during steroid detox, working with a mental health professional to explore the underlying reasons for steroid misuse is highly recommended.

What are over the counter drugs?

Over-the-counter (OTC) drugs refer to medications you can purchase without a perscription from a doctor. They are considered safe and effective for the general public as long as they are consumed as directed on the label.

OTC medications are frequently misused by individuals attempting to manage pain, anxiety, or sleep difficulties on their own, or to induce effects like euphoria, hallucinations, or dissociation. These drugs tend to be more affordable than illicit substances, widely accessible, and carry less social stigma and legal risk compared to illegal drugs.

Over-the-counter drugs may include:

• Acetamionphen (Tylenol)

• Ibuprofen (Advil, Motrin)

• Aspirin

• Diphenhydramine (Benadryl)

• Loratadine (Claritin)

• Pseudoephedrine (Sudafed)

• Dextromethorphan (cough suppressant)

Risks include:

• Nausea and vomiting

• Dizziness or drowsiness

• Rapid heartbeat or high blood pressure

• Impaired judgment and coordination

• Mood swings, agitation, or anxiety

• Hallucinations or delirium

Long term effects may include:

• Liver and kidney damage or failure

• Gastrointestinal ulcers or bleeding

• Cognitive impairment or memory problems

• Increased risk of heart attack or stroke

Ways different drugs may be consumed:

• Orally in pills, tablets, capsules, liquids, or chewable forms

• Topical such as creams, ointments, gels, or lotions

• Nasal sprays or drops

• Inhalataion with inhalers or vapor rubs

Withdrawal symptoms may include:

• Muscle aches or joint pain

• Insomnia or sleep disturbances

• Depression, mood changes, anxiety, or agitation

Withdrawal from OTC drugs is generally less intense than withdrawal from opioids or alcohol but can still cause significant discomfort and difficulties. Certain OTC medications, like cough suppressants, have the potential to cause psychological dependence and cravings, and medical supervision may be necessary during detoxification if use has been extensive or long-term.