GATEWAY DRUGS

The definition of a gateway drug is a habit forming drug, which may not be addictive itself, but
could lead to the use of other, more addictive drugs. The theory that consuming softer drugs can
lead to using stronger substances has existed for decades. Countless studies suggest that this
transition is real. Educating youths and identifying treatment options can help avoid and
overcome drug use.

Gateway drugs are substances that when consumed give way to harder, more dangerous drugs.
These milder substances, such as nicotine or alcohol, are believed to open the door to drugs such
as meth, heroin and cocaine, which can lead to addiction.
Gateway drugs boost dopamine levels, which increases pleasure. Therefore, this class of drugs
prepares the brain for a response to other substances, a process known as cross-sensitization.
This heightens brain activity and could make users crave stronger substances.

HISTORY OF GATEWAY DRUGS

The idea that drug use can occur in stages took root in the mid-20th century. TV shows such as
The Terrible Truth suggested marijuana use led to heroin addiction. Researchers began using
the term gateway drug in the 1980s to describe substances that initiate these stages.
Studies were conducted soon thereafter. In 1985, a report published in the Journal of Youth and
Adolescence found alcohol to be a steppingstone to use of heavier drugs. Research on gateway
drugs blossomed during the next three decades.
Since then, educators have warned students about the dangers of gateway drugs. National anti-
drug programs such as Drug Abuse Resistance Education (D.A.R.E.) specifically outline the
consequences of three potential gateway drugs: marijuana, alcohol and tobacco.
Through the years, middle school health educators have made gateway drugs a staple in their
teachings. However, the controversy surrounding the concept has led some to reconsider using
the term.
THE GATEWAY DRUG HYPOTHESIS
For decades, supporters and critics have argued that certain substances, such as marijuana, are
gateway drugs. Critics claim no evidence exists to support the claim. They also cite other risk
factors that influence whether a person abuses illicit drugs:

Certain reports support this argument. For example, the majority of marijuana users do not go on
to use harder drugs, per the National Institute on Drug Abuse. In fact, most young users quit the
drug upon entering adulthood.
DEPRESSANTS
Sometimes called downers, these drugs come in multicolored tablets and capsules or in liquid
form. Some drugs in this category, such as Zyprexa, Seroquel and Haldol, are known as major
tranquilizers or antipsychotics, as they are supposed to reduce the symptoms of mental
illness. Depressants such as Xanax, Klonopin, Halcion and Librium are often referred to as
benzos (short for benzodiazepines1). Other depressants, such as Amytal, Numbutal and
Seconal, are classed as barbituratesdrugs that are used as sedatives and sleeping pills.
DEPRESSANTS: SHORT-TERM EFFECTS
Slow brain function Fever
Slowed pulse and breathing Sluggishness
Lowered blood pressure Visual disturbances
Poor concentration Dilated pupils
Confusion Disorientation, lack of coordination
Fatigue2 Depression
Dizziness Difficulty or inability to urinate
Slurred speech Addiction
Higher doses can cause impairment of memory, judgment and coordination, irritability,
paranoia,3 and suicidal thoughts. Some people experience the opposite of the intended effect,
such as agitation or aggression.

Using sedatives (drugs used to calm or soothe) and tranquilizers with other substances,
particularly alcohol, can slow breathing and the heart rate and even lead to death.

DEPRESSANTS: LONG-TERM EFFECTS

Tolerance to many depressants can develop rapidly, with larger doses needed to achieve the
same effect. The user, trying to reach the same high, may raise the dose to a level that results in
coma or death by overdose.

Long-term use of depressants can produce depression, chronic fatigue, breathing difficulties,
sexual problems and sleep problems. As a dependency on the drug increases, cravings, anxiety or
panic are common if the user is unable to get more.

Withdrawal symptoms include insomnia, weakness and nausea. For continual and high-dose
users, agitation, high body temperature, delirium, hallucinations and convulsions can occur.
Unlike withdrawal from most drugs, withdrawal from depressants can be life-threatening.

These drugs can also increase the risk of high blood sugar, diabetes, and weight gain (instances
of up to 100 pounds have been reported).

In a study conducted by USA Today, based on Food and Drug Administration data over a four-
year period, antipsychotics (a type of depressant) were the prime suspects in forty-five deaths
caused by heart problems, choking, liver failure and suicide.

NARCOTIC

Narcotic analgesics (also called opiates, opioid analgesics, or narcotics) are a group of medicines
that relieve acute and chronic severe pain by binding to opioid receptors. There are at least four
opioid receptors: mu, delta, kappa and opioid receptor like-1 (ORL1) receptor. These influence
the opioid system which controls pain, reward and addictive behaviors. Opioid receptors are
most abundant in the brain but are also found elsewhere in the body, including the digestive tract,
respiratory tract and spinal cord.
Narcotics are also called opioid pain relievers. They are used only for pain that is severe and is
not helped by other types of painkillers. When used carefully and under a health care provider's
direct care, these drugs can be effective at reducing pain. Narcotics work by binding to receptors
in the brain, which blocks the feeling of pain.You should not use a narcotic drug for more than 3
to 4 months, unless you are under direct care of your provider.

NAMES OF NARCOTICS

Codeine
Fentanyl -- available as a patch
Hydrocodone
Hydromorphone
Meperidine
Morphine
Oxycodone
Tramadol
TAKING NARCOTICS
These drugs can be abused and habit-forming. They have been associated with accidental
overdose deaths. Always take narcotics as prescribed. Your provider may suggest that you take
your medicine only when you feel pain.
Or, your doctor may suggest taking a narcotic on a regular schedule. Allowing the medicine to
wear off before taking more of it can make the pain difficult to control.
Taking narcotics to control the pain of cancer or other medical problems does not itself lead to
dependence.Store narcotics safely and securely in your home.
You may need a pain specialist to help you manage long-term pain.

SIDE EFFECTS OF NARCOTICS

Drowsiness and impaired judgment often occur with these medicines. When taking a narcotic, do
not drink alcohol, drive, or operate heavy machinery.
You can relieve itching by reducing the dose or talking to your doctor about switching
medicines.To help with constipation, drink more fluids, get more exercise, eat foods with extra
fiber, and use stool softeners. If nausea or vomiting occur, try taking the narcotic with food.
Withdrawal symptoms are common when you stop taking a narcotic. Symptoms include strong
desire for the medicine (craving), yawning, insomnia, restlessness, mood swings, or diarrhea. To
prevent withdrawal symptoms, your doctor may recommend you gradually lower the dosage
over time. Hallucinogens are a diverse group of drugs that alter perception (awareness of
surrounding objects and conditions), thoughts, and feelings. They cause hallucinations, or
sensations and images that seem real though they are not. Hallucinogens can be found in some
plants and mushrooms (or their extracts) or can be human-made. People have used hallucinogens
for centuries, mostly for religious rituals. Common hallucinogens include the following:
 Ayahuasca is a tea made from one of several Amazonian plants
containing dimethyltryptamine(DMT), the primary mind-altering ingredient. Ayahuasca is
also known as Hoasca, Aya, and Yag.
DMT is a powerful chemical found in some Amazonian plants. Manufacturers can also
make DMT in a lab. The drug is usually a white crystalline powder. A popular name for
DMT is Dimitri.
D-lysergic acid diethylamide (LSD) is one of the most powerful mood-changing chemicals.
It is a clear or white odorless material made from lysergic acid, which is found in a fungus
that grows on rye and other grains. LSD has many other names, including Acid, Blotter,
Dots, and Yellow Sunshine.
Peyote (mescaline) is a small, spineless cactus with mescaline as its main ingredient. Peyote
can also be synthetic. Buttons, Cactus, and Mesc are common names for peyote.
4-phosphoryloxy-N,N-dimethyltryptamine (psilocybin) comes from certain types of
mushrooms found in tropical and subtropical regions of South America, Mexico, and the
United States. Other names for psilocybin include Little Smoke, Magic Mushrooms, Purple
Passion, and Shrooms.

Some hallucinogens also cause users to feel out of control or disconnected from their body and
environment. Common examples include the following:
Dextromethorphan (DXM) is a cough suppressant and mucus-clearing ingredient in some over-
the-counter cold and cough medicines (syrups, tablets, and gel capsules). Robo is another
popular name for DXM.
Ketamine is used as a surgery anesthetic for humans and animals. Much of the ketamine sold on
the streets comes from veterinary offices. While available as an injectable liquid, manufacturers
mostly sell it as a powder or as pills. Other names for ketamine include K, Special K, or Cat
Valium.
Phencyclidine (PCP) was developed in the 1950s as a general anesthetic for surgery. Its no
longer used for this purpose due to serious side effects. While PCP can be found in a variety of
forms, including tablets or capsules, liquid and white crystal powder are the most common
forms. PCP has various other names, such as Angel Dust, Hog, Love Boat, and Peace Pill.
Salvia divinorum (salvia) is a plant common to southern Mexico and Central and South America.
Other names for salvia are Diviner's Sage, Maria Pastora, Sally-D, and Magic Mint.

How do hallucinogens affect the brain?

Research suggests that hallucinogens work at least partially by temporarily disrupting

communication between brain chemical systems throughout the brain and spinal cord. Some
hallucinogens interfere with the action of the brain chemical serotonin, which regulates:

mood
sensory perception
sleep
hunger
body temperature
sexual behavior
muscle control
Other hallucinogens interfere with the action of the brain chemical glutamate, which regulates:

pain perception
responses to the environment
emotion
learning and memory

Short-Term Effects

The effects of hallucinogens can begin within 20 to 90 minutes and can last as long as 6 to 12
hours. Salvia's effects are more short-lived, appearing in less than 1 minute and lasting less than
30 minutes. Hallucinogen users refer to the experiences brought on by these drugs as "trips,"
calling the unpleasant experiences "bad trips."

Along with hallucinations, other short-term general effects include:

increased heart rate

nausea
intensified feelings and sensory experiences
changes in sense of time (for example, time passing by slowly)

Specific short-term effects of some hallucinogens include:

increased blood pressure, breathing feelings of relaxation or detachment

rate, or body temperature from self/environment
loss of appetite uncoordinated movements
dry mouth excessive sweating
sleep problems panic
mixed senses (such as "seeing" paranoiaextreme and unreasonable
sounds or "hearing" colors) distrust of others
spiritual experiences psychosisdisordered thinking
detached from reality

Long-Term Effects
Little is known about the long-term effects of hallucinogens. Researchers do know that ketamine
users may develop symptoms that include ulcers in the bladder, kidney problems, and poor
memory. Repeated use of PCP can result in long-term effects that may continue for a year or
more after use stops, such as:

speech problems
memory loss
weight loss
anxiety
depression and suicidal thoughts
 INHALANTS

Inhalants are volatile substances that produce chemical vapors that can be inhaled to induce a
psychoactive, or mind-altering, effect. Although other abused substances can be inhaled, the term
"inhalants" is used to describe a variety of substances whose main common characteristic is that
they are rarely, if ever, taken by any route other than inhalation. This definition encompasses a
broad range of chemicals that may have different pharmacological effects and are found in
hundreds of different products. As a result, precise categorization of inhalants is difficult. One
classification system lists four general categories of inhalants volatile solvents, aerosols,
gases, and nitrites based on the forms in which they are often found in household, industrial,
and medical products.

Volatile solvents are liquids that vaporize at room temperature. They are found in a multitude of
inexpensive, easily available products used for common household and industrial purposes.
These include paint thinners and removers, dry-cleaning fluids, degreasers, gasoline, glues,
correction fluids, and felt-tip markers.

Aerosols are sprays that contain propellants and solvents. They include spray paints, deodorant
and hair sprays, vegetable oil sprays for cooking, and fabric protector sprays.

Gases include medical anesthetics as well as gases used in household or commercial products.
Medical anesthetics include ether, chloroform, halothane, and nitrous oxide (commonly called
"laughing gas"). Nitrous oxide is the most abused of these gases and can be found in whipped
cream dispensers and products that boost octane levels in racing cars. Other household or
commercial products containing gases include butane lighters, propane tanks, and refrigerants.

Nitrites often are considered a special class of inhalants. Unlike most other inhalants, which act
directly on the central nervous system (CNS), nitrites act primarily to dilate blood vessels and
relax the muscles. While other inhalants are used to alter mood, nitrites are used primarily as
sexual enhancers. Nitrites include cyclohexyl nitrite, isoamyl (amyl) nitrite, and isobutyl (butyl)
nitrite and are commonly known as "poppers" or "snappers." Amyl nitrite is used in certain
diagnostic procedures and was prescribed in the past to treat some patients for heart pain. Nitrites
now are prohibited by the Consumer Product Safety Commission but can still be found, sold in
small bottles labeled as "video head cleaner," "room odorizer," "leather cleaner," or "liquid
aroma."

Generally, inhalant abusers will abuse any available substance. However, effects produced by
individual inhalants vary, and some users will go out of their way to obtain their favorite
inhalant. For example, in certain parts of the country, "Texas shoeshine," a shoe-shining spray
containing the chemical toluene, is a local favorite.