This is a very important question to ask, since so much of what's been written on this subject (for and against) is nonsense. I have three qualifications to talk about this subject.
First, I guess you could call me "an old fart who's been around." I lead a very boring and mostly sober life now (ok, sometimes I have a beer or three too many when cooking Sunday dinner and regret it on Monday morning). But back in the day I led a pretty average life for someone of my generation, which is to say I tried just about everything at least once (short of injecting anything) and hung around with lots of people on the wilder side of life.
My second qualification is that I co-authored a medical book on alcohol treatment. I was the non-medical member of the team, but I learned a reasonable amount about the science of substance abuse in the process.
Third, I've just read a lot of stuff on the subject, and learned to sort out the garbage from the real info.
Unfortunately, there's a real shortage of good information about drugs out there. Many people who know something about drugs are afraid to talk because they learned a lot of what they know by taking drugs, which is illegal (I'm so old that some of the illegal drugs I took were legal when I took them!). Also, a lot of people who do talk about the subject are part of the huge industry I call "The War On Some Drugs." Their aim (and most of them are quite sincere) is to convince you that all drugs are bad and the only thing to do is not to take any drugs, ever. This might be good advice if humans were perfect -- just like advice to never have sex until you get married. But in the real world, people -- all of us -- do all kinds of wacky things for all kinds of reasons, often for reasons we don't really understand. "Just say no!" is not very helpful advice because it's not realistic.
I didn't know whether it was a good idea to write all this down, but my long-ago "drug offenses" are now so long ago that people were still wearing platform shoes and dancing to "Saturday Night Fever." And if you've never even heard of platform shoes or "Saturday Night Fever," please read on, because I'm not writing this to amuse people my age. I'm writing this mostly for people who are in the position where I was in the mid 1960s -- young, full of energy and curiosity, and wondering what this drug stuff is all about.
There is so much misinformation on drugs out there that you can be pretty sure that there is a lot you don't know about the subject -- and that a lot of what you think you know is wrong. For solid information on the details of drugs, I'm going to recommend -- strongly recommend -- a pretty boring book, "Illegal Drugs" by Paul Gahlinger. The guy throws in a little more information than the average person would ever need to know, but he really knows his stuff. It's the only book I know of that covers all drugs (except alcohol and tobacco, since they're legal) and really gets it right, including the medical and scientific information. It's not the kind of book you'll sit down and read cover-to-cover (unless you're a very strange person), but it's a great reference. I will discuss some different drugs below, and believe me, I have checked every one of my facts very carefully. But if you really want to dig into the subject, buy the book! Unfortunately, there's not really a similar book on alcohol, so down at the end of this page, I'll try to hit the important points for you.
One of the reasons that it's worth knowing something about drugs is because they're all different. They have different effects and different hazards. For example, LSD is certainly a very powerful drug, but as far as we know, no one has ever died from taking too much LSD, and there seems to be no lethal (deadly) dose. With alcohol, it's a different story. A blood alcohol level of 0.1% (one part in a thousand, basically) will get you pretty darn drunk -- and only 5 times that much gives you a 50/50 chance of dying (something that happens to inexperienced Freshman at the beginning of every college year). The high you get from Nitrous Oxide goes away in a few minutes -- LSD's high can last 12 hours. And so on. So it's really worth understanding what drugs do and how they are different from each other.
I'll give lots more detail towards the bottom of the page, so here I'll just say it again: Alcohol is the most dangerous drug you are likely to run into.
We don't really understand the science behind it yet, but it is really clear that some people become addicted to drugs much more easily than others, just like some people can stuff their faces all day and stay skinny and other people can gain five pounds just looking at a donut. DNA is almost certainly part of the picture, and if you have a lot of close blood relatives who have had substance abuse problems of any kind, you want to be extra careful. And if, when you first take a drug of any kind (including alcohol), your first thought is "You know, this is the first time I've ever really felt ok in my whole life!" you want to be really careful, because almost that exact phrase shows up in the life stories of many many drug addicts and alcoholics (an alcoholic is really just a drug addict who is addicted to alcohol, but I will use the word just to be clear).
We all have our favorite drugs. With me, it's high-quality beer. I would be the perfect person to guard a giant warehouse full of speed or pot: I don't like either drug, and wouldn't be tempted to take a snort or a puff if I was sitting on a mountain of the stuff. But invite me to a party where there's a big keg of ice cold Sierra Nevada Pale Ale and I really have to watch myself to make sure I don't leave the party in a wheelbarrow. And that's what you need to do: be really careful around any drug that you're a little "too" fond of.
With the exception of alcoholism (and addiction to nicotine), drug addiction is not all that common in America (there are plenty of addicts, but in a country of 300 million people, it's a pretty small percentage). But if you do drugs or hang around with people who do drugs (and sometimes even if you don't), you will run into people who are addicted. They can be a real pain. They often lie, cheat, steal, and do all kinds of things that no person in their right mind would do -- and they'll often try to suck you right into doing the same sort of things. It's important to be aware of these people, and whenever possible, to avoid them.
Aside from prescribed drugs like anti-depressants (and they have their downside too according to many who have used them), taking drugs is not a real good way to deal with emotional problems. People have used some drugs like ecstasy and LSD for psychotherapy, but I'm not talking about that. I'm talking about day in day out frequent use of a drug to make the pain go away. Here's the problem: the pain won't really go away and before you know it, you'll be person in pain with a drug habit.
This goes double if you are using alcohol to deal with depression -- an idea so bad that I give it its own little section towards the bottom of the page.
And this goes triple if you have been diagnosed with (or think you might have) a really serious mental illness like bipolar disorder or schizophrenia. Here we are in Catch-22 land, because having a serious mental illness often seriously affects your judgment, including your judgment about whether it's a good idea to take drugs. It's not.
I had a friend once who had a very serious problem with drinking. For years, I tried to get her to do something about it. I reasoned, I pleaded, I raged. It made no difference. She kept right on drinking and I figured she was headed for an early grave. Then one day, all by herself, she just quit. I've never seen her take a drink since and she's never brought up the subject. I tell this story because it shows how little power we have over other people with substance abuse issues. If you know someone with a serious substance abuse problem, it's important to keep lines of communication open, but you also have to realize that it's pretty unlikely that you will be able to make them face their problems. You should be especially careful if it's a romantic relationship. If your comment about your boyfriend is "He'd be a great guy if only he didn't drink so much" I'd seriously consider finding another boyfriend.
When I was in my 20s, I used to get pretty darn drunk most Friday and Saturday nights, and at least a couple of week nights. Sometimes I'd drink until I more or less passed out. The next day, I wouldn't always remember what I'd done or said. That's drug abuse.
Now I usually limit myself to a glass of wine or beer with dinner, and sure, if I go to a party or out to see some music I'll get a little buzz on (as long as someone else is available to drive home). That's drug use.
It's the same way with any drug. If you like to smoke pot and listen to music a couple nights a week, that's drug use. If you toke up before your feet hit the floor in every morning (like those guys down the hall from me Sophomore year), you're in drug abuse territory.
The great 1940s singer Louis Jordan (no, I'm not quite that old!) wrote a funny song called "Beware, Brother, Beware!" warning men about how women were going to try and trap them into marriage. I'll give a more serious warning to women: guys are going to use drugs (and alcohol is the most likely one) to try to get you into bed with them. If you develop an addiction to a drug, you may find yourself with a boyfriend who uses the drug to control you and keep you on a string -- and encourages you to keep taking it so he can keep controlling you.
And even if you don't develop an addiction, as soon as you get to the age when you're out partying unsupervised, guys are going to offer you drinks, joints, lines of cocaine, pills... and guess what they'll have in mind? Uh huh. Just say "No thank you!"
It's one of life's little unfair deals: men pretty much have to pay for their drinks and their drugs, but especially if you're a young and pretty woman, there's always someone around to give you a drink or a line of coke for free. But be careful: sometimes free drinks and free drugs can be the most expensive kind.
We've done this all before and it didn't work then either. When alcohol was illegal from 1920 until 1933 (they called this "Prohibition") people didn't stop drinking. It made some very nasty criminals (including President John F. Kennedy's father) very very rich. There were turf wars and even drive-by shootings (although they didn't call them that yet).
Because alcohol was illegal, the stuff you could get was usually very poor quality and sometimes made with poisonous chemicals. You had to associate with shady people to buy it.
I think this 1931 poem by newspaper columnist Franklin P. Adams does a great job of summing up Prohibition -- and our current War On Some Drugs:
Prohibition is an awful flop.
We like it.
It can't stop what it's meant to stop.
We like it.
It's left a trail of graft and slime,
It won't prohibit worth a dime,
It's filled our land with vice and crime.
Nevertheless, we're for it.
I think that's about where we are with the War On Some Drugs right now. Few people seriously think that drug laws will stop people from taking drugs. It's been a long time since any President talked seriously about "winning." We've got 2 million people in jails and prisons (more than any other country in the world), at least half a million of them on drug-related charges. But the WOSD goes on. Because no one wants to admit it's a failure. Because no one wants to be seen as encouraging drug use. And because a lot of jobs depend on the WOSD -- cops... prison guards... doctors who examine your urine to make sure you're drug free and qualified to get a part-time minimum-wage job at Wal-Mart...
And a lot of people have just never thought it through -- like the former drug cop who once told me how proud he was of all the bad "drug users" he had locked up -- while he pounded down his third beer in 45 minutes! He wasn't a bad person -- although I felt like whacking him upside the head. He was just a person who'd never learned to think for himself.
Thinking for yourself is a good thing to do. Although I should also add this advice: "A smart person learns from their mistakes, but a wise person learns from the mistakes of others."
Do not drive while using drugs. On most drugs, you'll drive like an idiot. If you've smoked pot, you'll drive so slowly and carefully that it's like hanging a sign around your neck that says "I'm high! Please arrest me now!" And if you drive on alcohol, well, I think you know.
Also: do not sharpen your kitchen knives while using drugs, or clean your guns, or drive your boat, operate your woodchipper, or run a bandsaw.
I can't remember who came up with this great idea (but I'm sure someone will remind me), but for any drug (even coffee or tea) it makes sense to think now and then about your relationship with the drug. For example: Can you take it or leave it (no kidding yourself) or are you using it pretty steadily? Are you using more and more to get the same "buzz?" Is it starting to interfere with other things you like to do? Is it interfering with your job? Are you finding that most of your friends are now people who also use the same drug -- a lot?
It's just good to check in on these sorts of things now and then, and be honest with yourself.
Marijuana doesn't seem to be particularly bad for you. Ever since the 1930s, when the first crusade against marijuana use started, armies of people have been working to prove that marijuana causes horrible brain damage, or makes men grow breasts, is horribly addictive, or turns people into homicidal maniacs... and yet it seems the truth is that marijuana doesn't seem to be particularly bad for you. Some people get feelings they don't enjoy when they take pot -- paranoia is the most common complaint. And sure, inhaling smoke of any kind isn't great for your lungs if you do it too much. But... marijuana doesn't seem to be particularly bad for you.
The effects of marijuana seem to vary a lot from person to person, but most people report a greater appreciation of art, movies, and especially music (Reliable sources tell us that "Be-Bop" jazz from the 1950s sounds really great on pot -- maybe because everyone who played Be-Bop was stoned on pot when they recorded it!). Another familiar effect is a sudden desire to eat tons of snack food and sweets -- a terrible affliction we used to call "The Munchies." If this doesn't really sound like a particularly horrible drug, well, right. But they can (and will) still arrest you for using it.
Some people do seem to develop a serious marijuana habit and use it pretty much every day for years. But it doesn't seem to turn them into mush brains, and when long-time users stop, they don't seem to go into a horrible "withdrawal." (Withdrawal is a bunch of unpleasant symptoms you get when you suddenly stop or reduce your use of a drug you are addicted to).
As of summer 2007, the latest marijuana scare story is that it's supposed to increase users' chances of developing schizophrenia and psychotic disorders. It could be true, but given the number of past scare stories that haven't worked out (if it really made guys grow breasts, the kid who sat next to me in 11th grade social studies class would have looked like Dolly Parton) I'm going to remain skeptical.
Like a lot of illegal drugs, marijuana was originally outlawed partly because people were prejudiced against folks who used it. Here's a pretty good article which talks about how prejudice against Mexican-Americans led to marijuana prohibition. Supposedly, they smoked a "small marihuana cigarette" and became homicidal maniacs! Opium, heroin, and the like were made illegal partly because of anti-Chinese prejudice ("Opium Dens" were a popular Chinatown tourist attraction for decades). Alcohol Prohibition came about in part because people hated Catholics, who tended to drink more (or at least be more open about it) than Protestants. And so on...
I'll try not to beat this into the ground, but alcohol is almost certainly the most dangerous drug you will ever encounter. Which is really unfortunate, because it's also the easiest drug to get. It's highly addictive, causes all kinds of health problems, and has a terrible withdrawal that makes it hard for users to stop. Since writing on drugs often mysteriously ignores alcohol ("hey, it's not illegal, so it must not be a drug!") I'll give you lots of info about it in a special section at the bottom of the page.
And if think you know all about alcohol and don't need to read it, you should at least check out "This is Your Brain on Alcohol."
Speed invented in the late 1800s, but was first widely used in World War II. Troops on all sides used it to stay awake and remain alert on long missions. After the war, students used it to do "all nighters," long-distance truckers used it to stay awake, and women took it as a diet drug. For most people who used it, "speed" was an occasional and useful drug, but by the 1960s, it became obvious that some people developed horrible addiction problems with meth very quickly (back when I had hair, we called these people "speed freaks").
Addiction to speed is sort of like a speeded up version of alcoholism. Addicts stop eating properly, their teeth go bad and their skin deteriorates, they become paranoid or lose touch with reality completely (psychosis with hallucinations is a typical effect of long-term meth use). They become human wrecks in pretty short order -- a 30-year-old speed addict can look like a very bad 65. Meth is a big problem in small towns, probably because it's a relatively cheap high that lasts a long time, and partly because it's not all that hard to make (although most American speed now comes from big labs in Mexico). If you're not prone to meth addiction, the odds are that you could take it now and then with no major problems. But because no one knows if they're in danger of becoming an addict until they try it, and because the whole meth scene is so ugly, my personal recommendation would be to stay away.
Yes, you can get high by sniffing certain types of glue or "huffing" a whole variety of solvents, including gasoline. Don't do it! I'll give you two good reasons: 1) These things are really not good for you (cancer, disturbances in your heart rhythms, nerve and brain damage); 2) Do you really want to hang around with people who sniff glue???
Ok, I can't resist. I'll tell you a story about sniffing glue that shows you why glue sniffers get no respect. Guy is sniffing glue and he is really out there, high as a kite. Suddenly he has this horrible feeling -- his head has fallen off! Oh no -- it's even worse! It's fallen inside his body and unless he gets it out of there, he'll be walking around with a stump instead of a head for the rest of his life. So he starts sticking his hand down his neck to try and find his head. Then the glue wears off... and he realizes he's picking his nose.
Cocaine's a really good example of how the propaganda of "The War on Some Drugs" can backfire. It's been around since the early part of the 1900s, but came back into fashion in the 1970s in a big way. Cocaine hadn't really been popular since the 1920s, so most people in the 1970s didn't know much about it. Because there'd been so many ridiculous statements made about drugs over the years, when people started to hear warnings that cocaine was dangerous and addictive, nobody believed it.
But, what do you know -- cocaine actually is dangerous and addictive, even more so if you smoke it (in the form of "crack").
Cocaine's high is similar to speed, but more subtle, and I guess you could say the same thing about the effects of addiction: you don't deteriorate quite as fast as you would with speed, but you end up somewhere pretty similar. Cocaine comes from the coca plant, a small shrub that grows in the mountains of South and Central America. People in Peru have been chewing coca leaves and drinking coca tea for almost 10 thousand years with no problems. And yes, it really did use to be in Coca-Cola, but not for about 100 years. Cocaine wine was also a popular product in the early 1900s -- one brand was endorsed by the Pope!
It seems that a lot of the trouble with cocaine came from taking what was originally a pretty safe drug from a plant, purifying it into a powder, and then putting it in your brain really fast by smoking, snorting or injecting. Faster is not always better in the case of drugs (in fact, faster is usually worse). Since cocaine is absorbed much more slowly through the stomach than through the nose or the lungs, early Coca-Cola and cocaine wine were pretty safe (other than the alcohol in the wine, of course!) and the Indians in Peru are still sipping their coca tea and chewing their coca leaves and doing just fine.
Overall, I'd rate cocaine as a pretty good drug to avoid. It's expensive. The high doesn't last long. Lots of people seem prone to cocaine addiction. And the high is often followed by a horrible depression (which encourages you to take more coke). Crack, is basically the same, but even worse, since it goes into the brain even faster than powdered cocaine. Lots of people who become addicted to coke also become alcoholics, because alcohol helps even out the ups and downs of the coke high. And maybe this is not a very nice way to put it, but cocaine tends to make you feel like a genius and act like an idiot.
Oh, there's one more annoying thing about cocaine that I almost forgot to mention. Occasionally people who use it, well, drop dead. Sometimes this is the result of massive overdoses taken by inexperienced users (that's what happened to the basketball star Lenny Bias back in the 1980s). But cocaine is also hard on the heart and constricts (shrinks) your blood vessels. This raises your blood pressure and may cause serious issues for people who have heart problems -- including ones they may not know about. I knew someone who got a fairly serious stroke (bleeding into the brain) in his early 30s as a result of using cocaine and while he mostly recovered, he was never quite the same. And if early 30s sounds ancient to you, it's not, trust me -- that's a very young age to get a stroke. Your odds of having a stroke or dropping dead when taking coke are pretty darn low, but still, it's another good reason to steer clear.
I've done laughing gas only in a dentist's office -- and boy, it was lots of fun. Sounds and voices were all weird and distorted and I felt really happy in a really "floaty" way that was quite pleasant. The guy could have pulled all my teeth out and I wouldn't have minded it one bit. Nitrous wears off very fast, in no more than 5 minutes, which makes it great for dental surgery. There may be some long-term hazards involving nerve damage that you probably don't need worry about unless you are working in dental office (or unless you start buying your nitrous in big industrial tanks -- which is a bad idea).
As far as occasional recreational use goes, the big hazards are suffocation and accidents. When a dentist gives you nitrous, he or she uses a special mask that also gives you a carefully measured dose of oxygen. And you're lying safely and comfortably in a dental chair with someone watching you closely. If you breathe nitrous directly out of a tank or plastic bag and pass out or become disoriented, you can quickly suffocate (because nitrous contains no oxygen). If you try to walk around while high on nitrous, you could easily have a serious accident.
Large amounts of sugared soda can certainly make you fat in a hurry, but caffeine sort of falls under the same heading as marijuana: people have been trying to prove this stuff is bad for you for decades (if not centuries), and other than possibly giving you insomnia if you drink too much, it just doesn't seem to be bad for you. In fact, recent studies have shown that tea (especially green tea) and coffee contain antioxidants that may help protect you from cancer. My only warning on caffeine is that lots of people consume tons of it in soda without really thinking about it and then wonder why they're always so jittery and can't get to sleep until 3 a.m. Duh!
Caffeine is addictive. If you're used to drinking it and suddenly go without, you'll get a nasty headache and feel quite unpleasant for several days. Caffeine does change the chemistry in your brain in a fairly large number of different ways, which makes some people a bit worried... but again, so far, no one's ever really been able to prove that it's bad for you.
Ecstasy (MDMA) has had two lives (so far). It's sort of a strange drug. Chemically, it's related to speed (methamphetamine), but its effects are sort of like a psychedelic (the class of drugs that includes LSD and “magic mushrooms”). It tends to give people an unusual insight into their personal history and a great feeling of empathy or compassion for themselves and other people. At first, Ecstasy was an obscure (and legal) drug used in psychotherapy. In the 1990s, it became a big "club drug," especially popular for all-night "raves" (basically dance parties with a DJ). Raves were very popular in England, but also in the US and other countries. Because it seemed like people were having fun with ecstasy, it was immediately made illegal (I'm sort of kidding, but only sort of). In England, where the rave scene was really huge, there were also some deaths among ecstasy users. These appeared to be associated with dehydration -- apparently at least for some people, taking a fairly powerful drug and dancing for 12 hours straight is not such a good idea even if you're 17 years old.
There were also some studies with monkeys that supposedly proved that ecstasy caused horrible brain damage -- but it turned out that the most famous monkey study was so poorly designed and run that many people figured that the researcher deliberately faked the study to make esctasy look bad (as you might expect, it's much better for your scientific career to do studies that prove drugs are bad than to do studies that prove they aren't harmful).
Ecstasy is still used as a club drug, but it's now starting to be used again in the way it was originally -- very quietly by psychotherapists. It seems like the ecstasy story is not finished. Since there are still some real questions about its safety, it should be approached with caution, but either ecstasy or perhaps a safer similar drug may yet play a part in therapy. Me, I personally wouldn't take it and go to a rave at this point, but then I'm an old fart.
LSD was discovered by a Swiss scientist during World War II and became popular as a legal drug in the 1950s and early 1960s. It was one of the first man made "psychedelics" -- drugs that produce unusual states of mind and sometimes visual hallucinations. Lots of rich people and celebrities took LSD, thinking that it could offer spiritual and emotional insights (and in my opinion, there's something to this belief). There was some very interesting research done on using LSD to treat mental problems (including alcoholism). Then in the mid-60s, a very clever but not very wise scientist named Timothy Leary came along and did a very successful job of convincing young people that taking "acid" was just a wonderful idea for everyone -- and the more the better!
The resulting hysteria led to LSD being made illegal first in a few states, and finally nationally and around the world (nice job, Tim!).
For drug users, one of the main problems with LSD is that it's not very "user friendly." It lasts a long time (a rather exhausting 12 hours). The results are unpredictable, and can range from a glorious feeling of rapture to spending 12 hours feeling extremely miserable. You can also go from feeling really great to feeling really terrible in an instant -- and then back again. And while you can't overdose on LSD, it's basically impossible to tell how strong a particular batch of LSD is until you (or some other brave soul) has tried it. Interesting stuff, but...
These little guys seem to pop up all over -- different species of magic mushrooms are found very widely around the world. People have taken them for thousands of years, and they were legal in the United Kingdom until just a year or two ago. The effects are similar to LSD, but don't last as long (generally between 2 and 4 hours rather than 12). Mushrooms also seem to be much less likely to cause unplesant experiences ("bad trips" as we geezers used to call them) than LSD, although they are a powerful drug (especially in higher does) and should be treated with great respect. All in all, mushrooms seem to be a drug not associated with a lot of problems, although some South American shamans (a more polite name for what they used to call "witch doctors") say that taking mushrooms makes you age prematurely. I don't know what to make of that, but I just thought I'd pass it along!
I don't mention peyote (a cactus that grows in the desert Southwest and in Northern Mexico) because you are likely to run into it as a street drug, but to make a point. People have been using plant psychedelics as part of their religions for many thousands of years -- pretty much as far back as we know about in human history. The peyote religion probably existed in Mexico for many centuries. It crossed the border into the United States right around the time American Indians were defeated by the U.S. Army and forced to live on reservations (about 1880 or 1890). In America, the religion absorbed parts of Christianity and eventually spread to Native American tribes throughout the United States.
That's right, America is home to a dangerous cult of drug-crazed Indians!
But in over 100 years the peyote religion has caused no real problems, seems to bring people a great feeling of community, and has been helpful to many people with alcohol problems. They say that the spiritual insights provided by peyote help them give up drinking and lead a better life. Peyote has also never become a serious drug of abuse (the fact that it tastes terrible and makes a lot of people throw up probably has something to do with that!). But in an incredibly weird series of decisions, the Supreme Court ended up ruling that this religion, which is definitely a very "real" religion (maybe older than Christianity if you count the history in Mexico) is legal for Indians -- but illegal for everyone else! So yes, in the land of the free and the home of the brave, the government can make a religion illegal if you're not the right race. Maybe if we finally manage to move from Drug War to Drug Peace, we will come up with a more rational approach to the peyote religion.
And as long as I'm making points, let me offer a personal opinion, which some people might disagree with, but so be it. Psychedelics are very very powerful drugs which can change your whole outlook on life, sometimes for the better, and sometimes not. They are not drugs to be taken without careful thought. You don't want to mix them with other drugs. You don't want to take them with just anybody, or in weird or uncontrolled situations. And they aren't "party drugs." Maybe you won't agree with the peyote folks that psychedelics are a religious sacrament -- maybe you don't believe in religion, and that's ok. But even if you don't, you'll have much better luck if you think of psychedelics as very serious drugs to be taken in a serious way. You owe it to yourself.
As for peyote (this was about peyote before I got sidetracked on politics there) Indians who are members of the peyote church say it is a powerful spiritual teacher and guide. I have no personal reason to believe that this is untrue, and in fact suspect that it is true.
Nicotine is definitely a highly addictive drug, but the problems associated with using it appear to be related to tobacco (in other words, nicotine itself doesn't seem to be bad for you). By itself, nicotine sharpens mental focus and may help relieve depression (which could explain why so many people like to smoke). Smoking tobacco, or even chewing tobacco, seems to be a really bad idea, however. It's quite clear that smoking causes heart disease and cancer (among other things), and chewing tobacco (while not as dangerous) can cause mouth and throat cancers. One of the weirder things about nicotine is that nearly everyone seems prone to nicotine addiction: by some estimates 90% of people who use it become addicts. For this reason, it's probably a good idea not to even try it. Just as an odd piece of data, I chew nicotine gum for depression (it works really well, at least for me), and every once in a while, I run into someone else who's doing the same thing, so there seem to be a bunch of us out there.
Opiates include a whole variety of drugs, all of which tend to give users a dreamy feeling of well being. Opium is a natural gummy substance made from poppies. Most pill and powder opiates, legal or illegal, are derived from opium or are similar compounds created in laboratories. Opiates are dangerous and highly addictive drugs, although as with most drugs, it seems that only a certain percentage of users are prone to becoming hardcore addicts. For example, lots of people take "Tylenol-3" (a brand-name painkiller containing the opiate codeine) for sprains and toothaches or use codeine-based cough-syrup now and then without becoming drug addicts.
What's also unclear is why some people become addicted to opiates and manage to lead pretty normal lives (as long as they have a reliable supply of opiates) and other addicts turn into down and out street junkies.
In general, opiates are sort of on the same level as alcohol: potentially dangerous and highly addictive substances that are relatively easy to overdose on and which should be used with great caution or not at all. The one big difference between alcohol and opiates are the health hazards. While both are easy to overdose on, opiates do not lead to the same sort of chronic health problems seen in alcoholics. In other words, opiates don't cause liver damage, heart damage, cancer, brain damage, etc. I wouldn't advise anyone to pursue opiate addiction as a lifestyle, but from a medical point of view, it's certainly an improvement over alcoholism. If you do opiates for 20 years and stop, at least you'll have a brain left (and a liver, and a heart, and...). Many of the health problems people think are caused by opiates are actually caused by the lifestyle of the "street junkie" -- prostitution, sharing needles, etc. But again: I wouldn't advise anyone to pursue opiate addiction as a lifestyle.
There is a point of logic here I don't want to skip over -- because the whole point of this little page is to lay out the facts. In theory, using opiates casually and recreationally should be safer than drinking alcohol -- unless you are prone to opiate addiction. But real life and theory are not always the same. Even though, in a strictly medical sense, opiates are safer than alcohol, the extreme legal and social pressures against opiate use mean that you will end up dealing with a very weird and unpleasant bunch of people if you start messing around with any opiate drug. Back in the early 1900s, before there were drastic laws against opiate use, people did opiates for casual fun -- taking a trip down to Chinatown to smoke opium was known as "kicking the gong around." But until and unless drug laws change, those days are over.
There are a number of really good reasons not to inject drugs. One is that the "rush" you get from injecting a drug directly into your bloodstream is very strongly associated with addiction and tolerance (needing more of a drug to get high). The second is that you can give yourself AIDS or hepatitis or other nasty things by sharing needles. And if that's not enough, do you really want to hang around with people who shoot up? Personally, I think I'd rather hang around with people who sniff glue!
As I said above, I'll give you a little extra information on alcohol both because it's so widely used and easy to get and because most sources on drugs don't discuss alcohol (I guess because it's legal).
If I listed all the health effects of alcohol, you'd fall asleep. Here's what I'll do instead. I'm going to link to a summary my co-author and I wrote of what nurses and doctors should look for when they get a patient they suspect might be an alcoholic. Don't bother to read the whole thing (unless you're a doctor or a nurse) -- just flap it in front of your face and it will give you a small idea of how much damage alcohol addiction can do.
OK, if you want to gross yourself out, read the description of "Boerhaave's Syndrome."
Here's that Link (It's a PDF file).
Estimates of how many people alcohol kills every year vary widely, but the low estimates are about 100,000 in the U.S. -- almost twice as many as the Vietnam War. It's a good bet that the actual total is much much higher because many alcohol-related deaths are due to things like heart disease, cancer, and stroke and aren't counted in the alcohol death statistics.
The fine folks at the Partnership for a Drug-Free America ran an ad years ago (maybe they're still running it -- I don't watch TV any more):
"This is your brain" (picture of an egg)... And this is your brain on drugs!" (picture of an egg frying in a pan).
Well, maybe they were thinking of alcohol. Some of the nastier illegal drugs (like speed) can also cause brain damage over the long term, but alcohol really will eat holes in your brain -- big ones. Granted, it takes a while to eat big holes in your brain (so don't panic yet), but a steady, year-in-year out "bottle a day" habit will turn your brain to mush long before you're old.
Ask anyone who works in a nursing home about their younger patients -- a lot of them are alcoholics with what a very sensitive doctor friend of mine delicately refers to as "squash rot." And really, the fact that chronic alcohol abuse causes serious and irreversible brain damage is no big secret: winos know it well, and refer to it as "wet brain." I know if you're 12 or 15 or 18, reading that something's going to give you horrible brain damage when you're 40 or 50 is sort of like hearing that the sun is going to explode and vaporize the earth in 4 or 5 billion years. But really, one day, you'll probably be 40 or 50 and it will go a lot better if you don't have huge holes in your brain. It's bad enough to be an old fart without huge holes in your brain!
alcoholic's brain on the left, normal brain on the right.
And I'm not joking about giant holes either. The picture above shows an MRI view comparing the brains of an alcoholic and a non-alcoholic (MRIs are similar to X-rays, but show soft tissues like the brain, not just bones). You don't have to be a brain surgeon to see what's wrong with the brain on the left. You can clearly see the holes, especially in the middle, where the spinal column joins the brain. Notice that the folds of the alcoholic's brain also look "eaten away" in comparison to the normal brain on the right -- there's just a lot more "empty space" (hint: this is not good!). Both MRI's are of middle-aged women.
My point is not just to scare you (although being scared of having holes eaten in your brain is not such a bad thing), but to help you understand how dangerous a drug alcohol is. If we made drugs legal or illegal strictly based on scientific information, you'd get a life sentence if you were found with a six pack of beer!
I've asked street cops what percentage of the people they arrest for violent crimes are drunk. I have heard estimates as high as 90 or 95 percent. This is one of the things that's different about alcohol. People have tried to claim that other drugs cause violence. They even tried to say that marijuana turns people into crazed homicidal maniacs (something that would make anyone on marijuana laugh -- or giggle uncontrollably). But it really seems that alcohol is the only drug that has such a strong association with violence, including domestic violence and murder.
Alcohol doesn't have this effect on everyone, but most people sooner or later run into someone who turns nasty and violent when drunk. In fact, some bars become gathering places for people like this. To people like me who just get happy and stupid when drunk, the idea of going to a bar, getting drunk, and then getting into fights makes no sense whatsoever. But the fact that it makes some people violent is yet another reason to be careful with alcohol. If it makes you violent and angry, you simply should not use alcohol, period -- not ever. How would you like to spend the next 30 years in a prison cell for something stupid you did when you were drunk and can't even remember doing? If if makes someone you know violent, you need to think about your own safety first. Avoid the person if at all possible. If it is difficult to avoid the person (for example, it's your husband or wife or a parent), you are in a difficult and potentially life-threatening situation. Start thinking of anyone who could help you or give you advice (teachers, preachers, neighbors, relatives) and do what you have to do.
It sounds weird if you haven't run into it, but people with addictions (including alcohol) often go to incredible lengths to deny that they have problems, or to blame their problems on everything in the world except their drug use. If they get fired, it's because their boss had it in for them -- not because they showed up late 15 times last month and took 3-hour lunches at the bar down the street every day. This is one of the things that makes it so hard to "fix" people's problems with alcohol and other drugs. Unfortunately, I don't have any magic wand solution for dealing with denial, but it's worth knowing about so you won't be confused when you run into it.
The "CAGE Test" is an absolutely brilliant self-diagnostic test for alcoholism you can take in a few seconds:
Even one "yes" answer is a very bad sign. Two or more, very very bad sign.
You're probably an alcoholic -- or at least well on the way -- if you answer "yes" to any of the questions, but a "yes" to number 4 removes all doubt -- you're actually experiencing signs of alcohol withdrawal. You're an alcoholic, physically addicted to the drug.
If you give this test to someone else because you're almost sure they're an alcoholic, be prepared to have them say "Oh, that stupid test doesn't prove anything!" (remember what we just said about denial).
Alcoholics Anonymous is sort of an amazing thing. It's a completely informal volunteer self-help organization for recovering alcoholics. AA members meet in local groups to discuss their lives and their problems and to help support each other. There are those who criticize it for being too religious (although they're always careful to refer to a "Higher Power" instead of God). And you'll occasionally see AA meetings made fun of on TV sitcoms ("Hi, I'm [whatever], and I'm an alcoholic"). But the bottom line is it seems to work and work well for millions of people.
If you think that AA might be right for you or someone you know, here's a good link to more information.
Drug withdrawal is a term used to describe the symptoms you get when you stop or cut back on the use of a drug you are addicted to. Some withdrawals are annoying but not dangerous (missing your morning cup of coffee, as I mentioned above, will give you a really nasty headache that will stick around for days if you don't feed it some coffee). Alcohol withdrawal is particularly nasty. It can even kill you. I co-wrote a book on this subject, so I'll try not to go on too much. Alcohol withdrawal is most dangerous to people who have been drinking heavily for quite a while and have developed other health problems, either from drinking or just as part of the process of getting older. Some of the symptoms of withdrawal, especially increased blood pressure and heart rate, can cause heart attacks, strokes, and other problems if the symptoms are not properly controlled. Some people experience hallucinations and can get violent and hurt themselves or other people.
They make a big deal in all the movies about withdrawal from heroin, which is pretty darn unpleasant. But withdrawal from alcohol is much worse and much much more dangerous. If you've been drinking steadily for a long time, or are advising a friend or relative who is trying to kick the alcohol habit, seek medical advice. And tell your doctor to read our book. And if you can't afford our book and your doctor won't spring for it, send me an email and I'll mail you a free copy (not kidding). Alcohol withdrawal is nothing to mess around with.
Drinking and driving kills about 20,000 people a year in the U.S. -- maybe more. When I was younger, people tended to treat it as sort of a joke, or just something you ended up doing now and then. Don't do it. And don't be a passenger in a car with someone who has been drinking either. If you're going out for drinks, pick a designated driver. If that doesn't work, call a cab, call a friend, call your parents -- do anything but get in a car after drinking. You can end up in jail, you can end up dead, and you can end up killing or injuring someone else. I had a wonderful, intelligent first cousin who was killed by a drunk driver over 20 years ago. It's something you don't forget.
Here's something about alcohol that most people don't know. It is perhaps the world's worst drug for people who are depressed (and in America, about 1/10th of the population is depressed!). Here's why. When you drink alcohol, at first (when the level of alcohol in your blood is going up) it makes you feel much less depressed. Later when the level of alcohol in your blood starts to fall, you feel even more depressed than you were when you started. And what's the easiest way to "fix" it? Why to start drinking again! Which of course starts the whole cycle all over, and it gets worse and worse the longer you keep drinking. Ugh! This is probably the reason that about 10 or 15% of long-term alcoholics end up committing suicide.
If you are depressed, or have been depressed in the past, or think you might be developing a problem with depression, you should consider alcohol a very dangerous drug for you personally. You should certainly not take alcohol when you are suffering from depression, and if you have ever suffered from serious depression, you should be careful around alcohol for the rest of your life.
Alcohol is certainly one of the most common causes of insomnia. What usually happens is you take a few drinks and fall asleep only to wake up 3 or 4 hours later and toss and turn for the rest of the night. What you are feeling is basically a mild form of alcohol withdrawal. When you first take it, alcohol is a depressant and helps you fall asleep. As the alcohol wears off, your body responds by (among other things) dumping adrenalin in your system -- the same chemical that makes you feel "up" for a big sports event or jump if someone walks up behind you and yells "Boo!" This wakes you up and prevents you from getting back to sleep. Since depression also causes insomnia, and drinking makes depression and insomnia worse, one of the worst things you can do is drink to put yourself to sleep when you're depressed. You'll make your insomnia worse and make your depression worse, and then you'll probably get depressed about your insomnia -- or be unable to sleep because you're worried about your drinking. I'm joking (sort of), but really, do not use alcohol to treat insomnia, and if you develop insomnia for no apparent reason, definitely consider the possibility that alcohol is part of the problem.
If you've been reading this whole thing, maybe you've noticed that I keep saying that it's usually better when you absorb drugs more slowly. It's the same way with alcohol as with other drugs. The best way to take alcohol is with meals (and start eating before you start drinking). Alcohol is absorbed much more slowly when you have food in your stomach, and you're much more likely to get a pleasant glow instead of ending up in a drunken stupor.
If you've actually read all the way down here, you may be thinking "so this guy thinks he's so smart, what would he do about the drug problem?"
Well, I am a pragmatist, which means I see the world in terms of what works best. That's not to say that I don't have a spiritual or emotional side, but I think that when you're looking for solutions to practical problems, you should judge things by whether they are likely to work or not and whether they make logical sense.
Clearly, the War On Some Drugs, which is a century old (the first serious drug laws were passed in 1907) makes no logical sense. To name just one example, why are we arresting 100s of thousands of people every year for using marijuana when alcohol is far more dangerous and is legal? The WOSD is not working (been reading about any critical shortages of illegal drugs lately?). And a century is a long time for a program not to work.
As some jokers like to point out, when it comes to the war on drugs, it seems like the drugs are winning.
My conclusion is that we need a big fat dose of Drug Peace. Some people think that if we legalize or decriminalize drugs, there will be a tidal wave of new addicts. OK, everyone who's thinking "Boy, if they would only legalize it, I'd become a heroin addict!" raise your hand.
I thought so.
My belief is that most people who have a tendency to addiction have already found their way into trouble with alcohol or other drugs, regardless of the law. And in many cases they have found their way back out of trouble, either through a program like AA or on their own.
I think the way we regulate alcohol is actually a pretty good example of how a culture should deal with a dangerous drug that some people really like and others really dislike. Our laws on alcohol are kind of a messy patchwork. There are still some places in this country that are "dry" (no alcohol may be legally sold or consumed) and there are others where you can buy a jug of vodka in the supermarket at 3 a.m. Most places are somewhere inbetween. And no one goes to jail for drinking alcohol anymore. They go to jail for doing things associated with drinking that can harm or annoy other people -- getting drunk and driving, getting drunk and getting into a fight... That makes perfect sense to me. If someone's drug use leads to behavior that harms or endangers other people, they should be arrested and prosecuted.
So that would be my solution. A messy bunch of inconsistent laws that would have one thing in common: a vast reduction or elimination of the penalties for using drugs other than alcohol.
I don't think that anyone should be sitting around in jail or prison because they happen to like pot (or even something much more dangerous like speed) more than they like alcohol.
Failing that (and I'm not being entirely serious here), the other obvious thing to do is to make all of our drug laws logical and consistent. Since alcohol is one of the most dangerous drugs on the market, we need to bring back Prohibition and start giving people very serious prison time for drinking. Hey, it worked the first time, right? Oh, well, actually it didn't. And the War On Some Drugs is never going to work either. Which is why, as a pragmatist, I hope that some day our society has the courage and wisdom to admit that the whole thing was a huge mistake.
I am not holding my breath.