The most common drug types

Heroin is considered one of the most common and hardest narcotic substances. Like other opiates, it quickly (after two or three uses) leads to the strongest mental and physical dependence, which is very difficult to cure. Only a few days without heroin cause severe withdrawal syndrome. Biochemically, withdrawal syndrome occurs due to the fact that as a result of the constant use of heroin, the brain stops producing its own natural opiates (endorphins, enkephalins), essential for the normal functioning of the nervous system. Therefore, the patient gets completely dependent on the dose of the drug, otherwise the specific symptoms of withdrawal quickly develop: anxiety, disturbance, depression, a strong desire to take the drug. Symptoms like running nose, increased lacrimation, severe headache, aches in the abdomen with diarrhea and vomiting, pains in the muscles and lower back, chills, sneezing, cough, etc. appear. The patient's suffering is so bad that after that he will be ready to do anything just to avoid another attack.

The administration routes of heroin include taking through the nose, smoking, intravenous and intramuscular injections; heroin addicts are forced to inject the drug several times a day. When injected intravenously, heroin enters the bloodstream and reaches the brain very quickly. In 1-3 minutes, the patient experiences typical short-term effects: a surge of pleasurable sensation ("rush"), the feeling of warmth and relaxation, euphoria.

Pure heroin looks like a white powder with a bitter taste, "street" heroin can be white and brown due to blending compounds and impurities. In such powder there can be not only harmless substances like starch or sugar, but also other potent chemicals such as morphine, codeine, etc., that may cause death as a result of an overdose.

Signs of heroin addiction are easy to recognize: pinhole pupils with the lack of pupillary light reflex, retarded movements, impaired coordination and psychological reaction to what is happening around ("disconnection" from the outer world), lengthy speech, incoherent answers to questions, motiveless mood swings, sudden drowsiness, depressed respiration, decreased pain sensitivity (the patient can burn himself without noticing); the patient's skin is basically warm, pale and dry (a strong indication to opiate intoxication).

Patients with heroin dependence also develop sweet cravings, while other foods can cause nausea and vomiting. Scratches on the skin are also often seen due to constant itching (facial area, upper half of the body), patients' skin is usually pale and the lips are red. Over time, sleep-wake rhythm disturbances appear, as well as impaired visual acuity; immune deficiency inevitably causes a range of somatic impairments. Heroin, like other opiates, has a negative effect on calcium metabolism, so the organs that contain or are connected with the bone tissue - like teeth or joints - get damaged.

Thrombosis of large vessels, inflammation and then destruction of the heart valves, dysfunction of the liver, lungs, brain; erectile dysfunction and infertility, spontaneous abortions, septic complications due to the non-sterility of the drug itself, as well as of the needles and syringes; HIV infection, syphilis, hepatitis B and C - these all are the tragic consequences of heroin addiction. In average, such patients live 7-10 years after the onset of heroin abuse.

The presence of foil pieces or injection syringes in a person's room or pockets may be interpreted as a sign of heroin use.

Cocaine is a psychoactive substance from the group of stimulants, an alkaloid originally obtained from the leaves of a plant Erythroxylum coca. It is basically produced as cocaine paste (base – pronounced like “bah-say”), or as a hydrochloride salt form. The substance looks like white powder, generally it is inhaled through the nose from a smooth surface like glass (mirror) through a straw or a small tube. Since the salt form of cocaine can be easily dissolved in water, it can sometimes be taken through the mouth or injected intravenously (the latter often causes overdose).

Regardless of the way of administration, the psychomotor action of cocaine reveals itself immediately. As soon as the particles of powder reach the nasal mucosa, the person experiences so-called “high feels” (or “gets stoned”). This is the feeling of euphoria, complete almightiness and superiority, the peak of physical and mental abilities. The person is excited but extremely concentrated, the intellect works fast and clearly, a powerful surge of energy boosts endurance and causes insomnia.

The physical signs of cocaine use

include: dilated pupils, rapid heartbeat, tense muscles and clenched jaws.

The effect of simulation lasts for a rather short time – 10-40 min; then comes the state of depression, anxiety and panic. The first withdrawal syndrome may be rather mild, not more unpleasant than a hangover due to alcohol. This is an insidious feature of cocaine abuse: the abuser may not feel the “boomerang effect” so he may have a desire to experience the euphoria again and without fear will take a new dose - this will initiate the process of habituation.

With the time being, the syndrome of withdrawal will turn more severe, along with depression the person will develop aggression, paranoid suspiciousness, delirium and hallucinations. Generally, hallucinations are accompanied by specific tactile sensations: the patient feels as if worms and insects are crawling along his body, getting under his skin. The patient tries to “get them out”, that's why his skin gets covered with deep scratches.

The long-term cocaine abuse leads to severe permanent consequences: deep impairments of the cardiovascular system, including coronary vessel and vessels of the brain, the liver, kidneys and lungs; nose bleeding and blood spitting; deafness; inflammation of the nasal mucosa; the loss of odor (anosmia) and taste (ageusia) senses. But the worst complication of cocaine abuse is personality changes, such as cocaine psychosis that manifests in insomnia, depression, loss of the will to live, paranoia, delusion of persecution, visual, audial and tactile hallucinations.

Crack cocaine is a sort of cocaine, the cheapest and most potent and dangerous one. The name “crack cocaine” was given to it due to the peculiar sound it makes: when it’s being smoked, the crystals of the substance melt and produce a cracking noise. In the course of smoking, the active substance penetrates into the bloodstream through the entire surface of the lung air cells, so psychological and physical dependence appears even sooner than in case of intravenous injections.

So -called “speedball” (a mixture of crack cocaine and heroin) is the most dangerous form due to the countering action of a stimulant and a sedative drug. Such combination causes a cross-dependence with a very distressful withdrawal syndrome. In patients abusing speedball, the risk of getting an overdose and a heart attack is very high.

Amphetamine (methamphetamine, ephedrone, pervitin, preluden, phenmetrazine, methylphenidane, dexamphetamine, phenmetrazine) is a drug with an action very alike to the one of psychostimulant cocaine. The difference is that amphetamines cause less euphoria, but more excitation. Amphetamine is a synthetic chemical that stimulates the central nervous system in a similar way to adrenaline and noradrenaline. However, while in the body, amphetamine doesn't contribute to the natural energy production, like, for example, the food does, but the other way around - it recruits the energy that already exists in the body. It sharply suppresses the appetite, causes the constriction of blood vessels and the increase of blood pressure.

Due to amphetamines the person feels elation, mood improvement , gets rid of fatigue; his state of mind turns vivacious, energetic and clear; he feels strong and confident in his abilities. For these reasons, amphetamines have become ones of the most popular drugs. There are certain groups of risk, such as: women who want to lose weight; students eager to overcome learning difficulties; long-haul truck drivers and other workers whose professional needs include fighting exhaustion and sleepiness. Moreover, as the drug activates erectile function and helps to release inner tension and confusion, it is often used to achieve sexual disinhibition, to improve the quality of sex.

When used correctly in therapeutic doses, the drugs of the amphetamine category can serve as an effective treatment for diseases like narcolepsy (excessive drowsiness), depression, some complications of inflammatory diseases of the brain, etc. But high doses of amphetamines lead to the development of psychological and physical dependency. Initially its manifest itself as generalized weakness , weariness, grumpiness, and the patient is forced to soothe these feelings with another dose of the drug. Patients develop amphetamine dependency rather soon - after 2 weeks of use already the tolerance grows, so they can't “get high” unless they increase the dose or the frequency of drug intake. The specific “two-stage“ action of the drug is being formed. When the raise of spirits (the “high feel”) is over (it basically happens abruptly in 6-8 h), euphoria comes. The patient is excited and overly active, annoyed or sometimes aggressive, extremely talkative, is constantly moving, gets self-assertive and overestimates his own abilities. Euphoria is followed by trembling in the whole body, sweating, fever, high blood pressure, heart arrhythmia, sometimes with acute cardiac pain, pains in the abdomen; nausea and vomiting occur when the person looks at the food.

The drug is administered through the mouth, intravenously or through the airwaves. If the use had been stopped sharply, the withdrawal syndrome occurs. The signs of it include the sense of general weakness, rapid fatigability, insomnia at nighttime and sleepiness at daytime, hypotension, depression, ideas of self-condemnation, suicidal attempts. In few cases, symptoms can be different: fretfulness, hysteria, aggression, resentfulness. Amphetamine withdrawal syndrome usually last for 2-3 weeks.

Among the consequences of a chronic amphetamine dependence, addiction specialist mention: steady insomnia, anorexia as a result of the loss of appetite, hypertension , acute psychosis (similar to the one in case of schizophrenia - with delirium and hallucinations). Constant dose increase or overdose at any time may cause a seizure, breathing and heartbeat disruptions, intracerebral hemorrhage. All these events may be fatal for the patient.

LSD is an abbreviated version of Lysersaure Diethylamid - the German name of lysergic acid diethylamide, a semi-synthetic psychoactive drug that causes mind alteration and distortion of perception. LSD is considered one of the most potent drugs that had originated from the psychedelic youth subculture. Such drugs are also called “recreational” as they generally are used rather rarely is a part of transcendental experiences (i.e., meditation, psychonautics), popular in particular social groups.

In the middle of the 20th century, the interest towards the drug rose dramatically - it was supposed to have a bright future in the treatment of mental diseases. Eventually the use of it slipped out of control - LSD became cult-favourite and legendary drug and a true disaster in the Western countries. Finally, the use of it was completely prohibited for medical, spiritual or any other kinds of practice.

LSD (or “acid”) has a look of a powder without any smell or color, with a slightly bitter taste. The substance is highly active: 1 g of it contains about 5,000 doses. LSD gets quickly absorbed by the walls of the digestive organs and the oral mucosa, so LSD users take it in pills or so-called “stamps” - pieces of special kind of paper, soaked in LSD solution, that are put under the tongue. The effect of LSD arises in 10 minutes and may last for up to 12 hours. The psychological effects (“trips”) of LSD are impossible to predict as they depend on the patient's initial state of mind, current mood, environment and, of course, on the dose. If they manifest in frightening hallucinations, the patient may not want to experience them again - and this will save him from getting addicted. If the drug causes some pleasant dreams and visions, then most likely the person will choose to try it again.

LSD abuse doesn't lead to physical dependence, so many users don't even recognize LSD as a drug. Moreover, it gets excreted from the body very quickly - sometimes even laboratory screening of the use of it is unsuccessful. But even without physical symptoms of hangover, just like any psychoactive drug, LSD is able to cause strong addiction. The person will be falling deeper and deeper into the imaginary parallel world and one day may fail to find the way out.

Since this psychedelic boosts the processes of the subconscious mind, it may provoke latent (hidden) mental problems like schizophrenia or epilepsy. Chronic LSD abuse causes severe mental impairments, like the well-known “dropout syndrome”, which manifests in long-lasting apathy, pronounced depression, disinterest towards himself and the world around. Acute psychotic and panic attacks are often accompanied by outbursts of anger, aggression, suicidal attempts or murder bids. Even in weeks and months of withdrawal, the narcotized state of mind may occur again (“flashbacks”), so the patient starts to suffer from hallucinations, paranoic mania of persecution. Such manifestations are considered consequences of the cerebral tissue damage.

The physical symptoms of LSD abuse are: dilated pupils, shivering of the hands and muscles, piloerection, thickening of the saliva, palpitations, increased blood pressure and body temperature. Mental disturbances include excessive excitation, panic, confused speech, loss of self-control, impaired sense of time, direction and distance. In such a state of mind, the person is unable to think clearly and estimate the danger. A person under LSD may start driving a car, walk out on the roof of a building, fall out of the window, stand in the middle of the highway... Such accidents constitute other risky consequences of LSD abuse.

Ecstasy is the drug most popular among the young people, it is included into the list of the most dangerous psychoactive substances as even a single use of it has often cause death of the user. Ecstasy comes in coloured pills or capsules with logotypes, it contains about 150 mg (30-60%) of a synthetic stimulant methylenedioxymethamphetamine (MDMA). MDMA has a brain activating and psychedelic effect, and which leads to dependence. The other components of ecstasy may refer to the substances of amphetamine group, LSD, heroin, caffeine or any other psychoactive or neutral chemicals. The pill may include ammonia, quinine, paracetamol, aspirin, etc., sometimes with poisonous traces. That's why ecstasy is recognized as an unpredictably dangerous drug.

The main mode of its action is connected with the release of serotonin in the brain - a hormone that influences most human emotions - that's why the drug provokes bright psychological reactions. A wave of emotional and physical energy emerges in the person using ecstasy, the spirits rise, euphoria comes with the feelings of joy, happiness and love. Under the effect of the drug, the person is able to endure any kinds of work overload without getting tired or need to sleep. Ecstasy stimulates the release of oxytocin, a hormone naturally produced in big amount during sex (that's why ecstasy is also called “a pill of love”). In 5-6 hours, the effects of the drug comes to end and the person starts to feel physically and emotionally devastated; apathy, frustration, severe fatigue, drowsiness appear. This condition may be present within days as the body of the ecstasy user is trying to recover after a forced boost. Unfortunately, it is much easier to take another pill (this is already the onset of addiction).

That researches have found that due to the effects of MDMA, the cerebral serotonin system gets damaged. The chronic lack of serotonin causes the onset of depression which can lead to suicide. MDMA affects the mechanisms of thinking and memory, that's why chronic ecstasy users suffer from an inability to learn and to remember the information. The drug may also have a negative impact on the genetic code. Physical exhaustion and the dystrophy of inner organs also develop in response to ecstasy abuse. Fatal outcomes are seen mostly as a result of acute cardiac renal failure, muscle ruptures, the inability of the body to properly react to high temperatures or dehydration.

The most common symptoms of withdrawal are: increased blood pressure, palpitations and cardiac arrhythmia, fever, dilated pupils, tightened muscles, teeth grinding, labouring breath, excitation, anxiety, sweating, nausea, dry mouth, dizziness, insomnia, hallucinations.

Sodium hydroxybutyrate (sodium oxybate, gamma hydroxybutyrate, GHB, liquid ecstasy) are the names of a “club drug” – a substance often used at discos and night clubs. Sodium hydroxybutyrate is considered the best alternative to alcohol and is also commonly used as an effective substitute for energy drinks as it causes mood improvement without hangover. In addition, sex lovers recognize it as an effective aphrodisiac, and bodybuilders and athletes as an ideal anabolic.

It is the anabolic property of the drug (it stimulates the production of growth hormone, which helps build muscles) that led to its widespread distribution as a dietary supplement for bodybuilders. Some time ago, it was sold over-the-counter and taken uncontrolledly. Even then, 25 years ago, this food supplement for athletes began to be used not for its intended purpose, but as a substance provoking the state of narcotic euphoria. Gradually collected by the physicians data on poisoning and complications of the GHB use led to a ban on its over-the-counter sales and tight restrictions to its turnover.

The substance has a look of a white or yellowish powder, soluble in alcohol and water. In clinical practice, sodium oxybutyrate is used as a depressant with a relaxing, sedative, hypnotic, anti-shock and nootropic action. It is utilized as an anesthetic in surgery, finds its use in psychiatry, neurology and ophthalmology. As a pharmaceutical, in medical practice sodium oxybutyrate is considered promising. The medicine is available in the form of powders or ampoules. But likewise, sodium oxybutyrate is synthesized at clandestine manufactures, often mixed with extremely toxic substances, although drug dealers advertise it as a "refined" and "safe" product.

A small dose of a drug (usually it is poured into a plastic bottle cap and then added into alcohol) causes relaxation, mind elation, euphoria, a sense of security, a desire to socialize. The action begins in 15-20 minutes and lasts in average for 1-2 hours. Since there is no hangover effect, many users do not stop at the trial dose and continue their experiments with sodium oxybutyrate. As a result, tolerance to the substance develops.

The average dose (2 ml) causes relaxation of the whole body, broken speech, desire to move, dance. Higher doses plunge the user into a deep sleep for several hours. When the concentration of GHB in the liver reaches critical values, the body is no longer able to cope with such a portion of toxins and starts a reaction of the central nervous system inhibition: drowsiness, apathy, indifference to the things happening around. 5 ml of the substance are enough to make the person fall into a deep narcotic sleep. In this condition, since the body is trying to remove the toxicants, vomiting can occur, which may lead to death due to asphyxia. Several doses of the drug can cause a coma, 13-15 year old users can develop cardiorespiratory arrest. A point to keep in mind is that only one dose for an inexperienced GHB consumer (often a teenager) who cannot estimate it correctly can be the last.

Drug dealers try to impose a stereotype on the young ones that GHB helps the shy people to draw out, get rid of embarrassment and barriers in communication. However, indeed a person simply loses self-control, makes an exhibition of himself, acts thoughtlessly, follows his instincts. Sometimes teenagers for a joke deliberately add GHB to alcohol to a friend (or a girlfriend) to see their peer drugged. They do not even fancy that an "innocent" joke can turn into a tragedy. In nine cases out of ten, the consumption of sodium oxybutyrate along with alcohol causes an unpredictable effect instead of the expected "high feel". The person can become aggressive and in this state harm himself and the others, to the extent of fatal accidents (there are a lot of videos on this subject posted on the Internet by the police).

But the risks of GHB abuse are not confined to its unpredictability only. The states of deep narcotic sleep cause irreversible changes in the mental health. The consequences include memory blackouts, inexplicable fears, anxiety and paranoia. Very quickly personal degradation develops. Sodium oxybutyrate has a destructive effect on the whole body: liver, heart, lungs, reproductive organs in particular; the person literally becomes disabled.

The signs of withdrawal syndrome include: severe dizziness and anxiety, insomnia, chest pains.

Spice is a smoking blend of dried herbs or leaves, processed with a prohibited chemical JWH-018 and some non-addictive substances in order to conceal the presence of the drug in the mixture.

More recently, corner shops selling spices were not difficult to spot on the streets. They used to trade off phytogenic smoking blends, the names of exotic herbs were listed on bags, such as: salvia divinorum (“sage of fortune tellers”), nymphaea caerulea (blue lotus), leonotis leonurus (“lion's tail”), Hawaiian rose, dwarf skullcap, etc. Mixed in certain proportions, these herbs can cause a mild stimulating or hallucinogenic effect.

Today, natural herb blends nearly cannot be found. There are no kiosks that sell them: spices are excluded from the list of legal products. It turned out that, in addition to the "harmless" plant primary products, they contained a synthesized analogue of cannabis, JWH-018 - a drug much more dangerous than natural psychoactive substances derived from cannabis. It is just nominally referred to the category of cannabinoids, in fact it has an absolutely different structure and acts in a different manner, completely blocking and destroying the receptors of the central nervous system - actually disintegrating the brain tissue and leading to dementia. Since spices are crafted in a manual way, the manufacturers, in order to strengthen the effect of the drug, tend to change the formula of the cannabinoid and use a variety of chemicals for its impregnation. Their action is unpredictable, and even if the consumers are aware that “silver” is the softest and the safest sort of spice, “gold” is of average strength and “diamond” is twice as strong as the "gold” one, this is not a guarantee of trustworthy information on the drug bought at an illegal joint. It is unknown how to a person having another "smoke" is going to end - this is like playing the Russian roulette.

In the Autumn of 2014, when the vending of smoking blends in Latvia had already been banned legally, Riga was literally covered by a wave of spice poisoning: people of the age of 17-23 years old were admitted to hospitals daily with severe symptoms like hallucinations, split personality, memory blackouts, epileptic seizures. Some patients were undergoing resuscitation procedures right in the ambulance as they were diagnosed apparent death. It turned out that they have smoked spice mixes containing substances that cannot be identified - there were no matchable diagnostic agents. This story again shows how dangerous the purchase of illegal substances is and how difficult it is in such cases to provide medical care and to save human lives.

The spice dependence first appears as psychological one. Besides, in adolescents, it is formed much faster than in adult smokers. The first red flags are increased nervousness and irritability, frequent depressive episodes and the red colour of the eyes, like the one after a sleepless night. Since the spice contains cannabinoid synthetics JWH-018, physical dependence also develops. At this stage, serious irreversible mental disorders appear: hallucinations, anxiety attacks, panic fears are becoming frequent. Very often, with such symptoms spice users are admitted to a psychiatric department.

Euphoria due to the drug use quickly turns into a state of chronic "hangover", the body affected by the drug requires 8-10 doses per day, because when cancelling, terrible headaches occur, along with uncomfortable sensations in the bones and muscles. Under such conditions, overdoses are inevitable, causing acute cardiac and respiratory failure. Sadly, in the cases of long-term intoxication, doctors have little chance of saving the patient’s life. The states leading to fatal outcomes generally occur already during the first year of dependence on spice blends.

The drug affects not single organs and organ systems, but the entire body. It destroys the heart and blood vessels, the liver, kidneys, spleen, lungs, the nervous system including the brain. Therefore, the consequences of dependence are present in the person until the end of his days. It is impossible to restore the cells of the brain killed by the drug and the damaged blood vessels, the patient acquires permanent disability.

Because of some similarities between spice and cannabis, the signs of the use of them are also somewhat alike, but the effect of spice blends is more pronounced. The most characteristic signs are: visual and auditory hallucinations; the loss of self-control (desultory actions, movements); altered mind and thinking (the loss of body feeling, divorce from reality, sometimes loss of consciousness); amnesia (memory failures, inability to remember what happened the day before); eye redness is one of the most obvious symptoms.