This document summarizes the side effects and consequences of various drugs, including ethanol (alcohol), marijuana, amphetamines, methamphetamine, cocaine, opioids, PCP, ecstasy, tobacco smoking, LSD, benzodiazepines, inhalants, and acetaminophen. It describes both short-term and long-term effects, risks of overdose, addiction and withdrawal symptoms for each drug class. Health issues range from impaired judgment and coordination to organ damage, infections, cancer, heart disease and death. The last section mentions additional risks like accidental poisoning and date rape drugs.

1. DRUGS
Side Effects and Consequences
Sara Dobbs MD

2. Ethanol
• Beer 3-8% alcohol, Wine 10-15%, “hard alcohol” 40-
50%. Also cold remedies, paint removers, perfumes.
• Central Nervous System Depressant and Gastric
Irritant.
• Initial exhilaration/disinhibition
• Poor judgment, high risk situations
• Slurred speech, incoordination, vomiting
• Coma, shock, seizures,
• Lethal dose 3g/kg

3. Ethanol
• Long term use – addiction
• Liver damage, gastric ulcers, pancreatitis,
impairment of brain function
• Withdrawal symptoms – hallucinations,
tremors, seizures

4. Ethanol

5. Marijuana
• Smoking can produce state of relaxation or
euphoria.
• Can compromise ability to perform complex
tasks (driving, work). Concern re short term
memory
• High doses can cause paranoia/psychosis
• Concern about tainted products (e.g.PCP).
• Can be addicting, can lower sperm counts,
Carcinogens

6. Marijuana
Lung Cancer

7. Marijuana

8. Amphetamines
• Stimulate release of norepinephrine to directly
stimulate central and respiratory systems and
enhances dopamine.
• Used by prescription for ADHD
• Used to elevate mood, stay awake, decrease appetite
• Recreational use much higher dose than prescribed
use – much more serious side effects - addiction
• Can lead to agitation, confusion, seizures,
hallucinations, cerebral hemorrhage, MI

9. Amphetamines

10. Amphetamines

11. Methamphetamine
• In the amphetamine class
• Highly addictive drug of abuse
• Used to elevate mood, increase energy
• Causes anorexia, meth mouth, skin picking, strokes,
seizures, hallucinations, paranoia
• Long term constant dopamine release causes
neurologic damage – memory loss, Parkinson’s
disease.

12. Methamphetamine

13. Meth Mouth

14. Cocaine
• Used as a topical local anesthetic during surgery
• HIGHLY addictive – causes dopamine to accumulate
in synaptic cleft – eventually causes down regulation
of dopamine receptors resulting in tolerance and
addiction
• Used for feelings of euphoria, increased energy
• Side effects seizures, strokes, heart attacks,
perforated nasal septum (vessel constriction)
• Depression, body aches, lethargy, suicidal thoughts
when not on cocaine

15. Cocaine
perforated nasal septum

16. Cocaine
blood vessel infarction

17. Opioids
• Extracted from the poppy plant
• Targets specific receptors in brain and body to control pain
and enhance pleasure, enhance dopamine release
• Morphine and Codeine and others often used for pain control
• Heroin – more addictive because of rapid brain penetration
• Cause decrease respiration, constipation, pinpoint pupils,
coma, itching
• Develop tolerance, physical addiction – withdrawal see fevers,
diarrhea, nausea, insomnia, muscle cramps (kicking the habit)
and hairs standing on end (cold turkey)
• Associated with blood infections from needles (HIV, hepatitis,
bacteria)

18. Opioids
poppers and track marks

19. PCP
“angel dust, rocket fuel”
• Dissociative anesthetic; effects the levels of several
neurotransmitters
• Can be used to taint marijuana
• Distorted, bizarre, violent behavior and thought
patterns, “out of body” feeling
• High doses can cause seizures, coma, muscle rigidity,
rhabdomyolysis, death
• Death usually caused by physical harm while on the
drug

20. PCP

21. PCP

22. Ecstasy
• MDMA – synthetic amphetamine analogue
• Can induce euphoria, increase intimacy, decrease
anxiety, increase self confidence, manic state
• Aftereffects – anxiety, irritability, fatigue, depression,
insomnia, impaired concentration, aches and pains
• Overdose can cause hallucinations, hypertension,
stroke, MI, kidney failure, hyperthermia, seizures,
coma, death

23. SMOKING
• Tobacco use causes almost 1 in 5 deaths in USA
• 18% high school students smoking in 2011
• Smoking causes 30% of all cancers – some examples
are lung (87% caused by smoking), oral cavity,
esophageal, stomach, kidney, AML, pancreas,
bladder, larynx, pharynx
• Heart disease, bronchitis, emphysema, stroke
• Increase risk of birth defects, SIDS
• Shorten women’s life by 14.5 years and men’s by
13.2 years (CDC study)

24. SMOKING

25. SMOKING

26. LSD
• Hallucinogenic – alters serotonin and
dopamine activity in the brain
• Can appear anxious, fearful and exhibit bizarre
behavior, combative and self destructive
• Can have flashbacks months or years later

27. LSD

28. Benzodiazepams
• GABA enhancer, sedative hypnotic, anxiolytic,
relaxant, anticonvulsant
• Short, intermediate or long acting
• Develop tolerance and dependence
• Can see respiratory depression, coma, rarely death
• Withdrawal can include tremors, insomnia, agitation,
muscle spasm, depression, suicidal activities,
psychosis, seizures

29. Inhalants
• A variety of substances including glues, paints, gas
• Can inhale through a bag our soaked towel
• Transient feeling of euphoria, light-headedness
• Can cause heart arrhythmias, respiratory distress,
• Chronic use can lead to muscle wasting, ataxia,
tremors, rashes near the mouth and nose and kidney
damage

30. What Else?
• Acetaminophen (tylenol) - too much can
cause severe liver damage
• Drugs slipped into your drinks –
benzodiazepams or sedatives
• Pill parties

31. Alcohol and Substance Abuse
Amy Winehouse