Brain Disorders/Illnesses

Mental Illness is the term that refers collectively to all diagnosable mental disorders. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.

A mental health problem is the term used to describe signs and symptoms of insufficient intensity or duration to meet the criteria for any mental disorder. Almost everyone has experienced mental health problems in which the distress one feels matches some of the signs and symptoms of mental disorders. Mental health problems may warrant active efforts in health promotion, prevention, and treatment.

MENTAL HEALTH ISSUES DO NOT DISCRIMINATE. THEY ARE REAL FOR MANY PEOPLE—CHILDREN AND ADOLESCENTS, MEN, WOMEN AND OLDER ADULTS.

People who suffer from mental illness experience biologically based brain disorders. They cannot be overcome through willpower and are not related to a person's character or intelligence. They are medical conditions that disrupt a person’s thinking, feeling, mood, daily functioning and ability to relate to others. People affected can be of any age, race, religion or income. According to the National Alliance on Mental Illness (NAMI), it is estimated that nearly 1 in 5 families are affected by mental illness in the United States alone.

The good news about mental illness is that recovery is possible. Early identification and treatment is of vital importance. Recovery and resiliency enable adults and children with serious mental illness to recover and to live, work, and participate fully in their communities.

The cost of leaving mental illnesses untreated is immense.
Without treatment, the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, and wasted lives. The economic cost of untreated mental illness is more than $100 billion each year in the United States.

When mental health services are inaccessible to those in need, the impact is felt in all areas of Ohio’s economy and society:

• Missed educational opportunities and failure in school—58 % of children with mental illness do not graduate from high school.
• Lost productivity and unemployment—Employees who are depressed are twice as likely to miss work and seven times more likely to be less productive on the job. Yet, treatment for clinical depression has a high success rate.
• Increased crime and incarceration—more than half of Ohio’s inmates have some type of mental illness; 12 percent are diagnosed with a severe mental illness. Most youth in juvenile justice facilities have a diagnosable mental disorder.
• Inappropriate use of hospital emergency departments—Comprehensive community-based mental health services can cut public hospital admissions and lengths of stay.
• Premature deaths:

—Americans who have major mental illnesses die an average of twenty-five 25 years earlier than the general population (NASMHPD, 2006 and other sources). 
—In Ohio, more than 1,300 lives are lost to suicide each year.

Sources:
U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.

The Surgeon General 

Some facts and figures:

• In 2011, there were an estimated 45.6 million adults aged 18 or older in the United States with any mental illness (AMI) in the past year. This represents 19.6 percent of all adults in this country; 11.5 million (5.0 percent) had serious mental illness (SMI) in the past year.
• In 2011, an estimated 8.5 million adults (3.7 percent) aged 18 or older had serious thoughts of suicide in the past year. The estimated number and percentage remained stable between 2008 (8.3 million, 3.7 percent) and 2011.
• Among youths aged 12 to 17 in 2011 who had past year major depressive episode (MDE), 36.0 percent used illicit drugs in the past year compared with 17.4 percent among youths who did not have past year MDE.
• The link between untreated behavioral health and suicide is demonstrated by the fact that approximately 30% of deaths by suicide involved alcohol intoxication, 50% who die by suicide were afflicted with major depression, and 90% had a mental disorder.
• The 154 U.S. military suicides in the first 155 days of 2012 translates to 50% more troops dying from suicide than were killed in action in Afghanistan.
• Combined 2008 and 2009 data indicate that adults aged 18 or older with any mental illness (AMI) or major depressive episode (MDE) in the past year were more likely than adults without these mental illnesses to have high blood pressure, asthma, diabetes, heart disease, and stroke

• Use of cigarettes in the past month was more likely among adults with mental illness than among those who did not have mental illness (36.1 vs. 21.4 percent); the average number of cigarettes smoked in the past month was also higher (331 vs. 310 cigarettes)

Sources:

Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-45, HHS Publication No. (SMA) 12-4725. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

Ohio Association of County Behavioral Health Authorities (OACBHA). Behavioral Health: Developing a Better Understanding. Suicide: We Need to Talk (July 2012).

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (April 5, 2012). The NSDUH Report: Physical Health Conditions among Adults with Mental Illnesses. Rockville, MD.

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (February 5, 2013). The NSDUH Report: Smoking and Mental Illness. Rockville, MD.

Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, and keep focused on an important speech. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder.  

FIVE MAJOR TYPES OF ANXIETY DISORDERS ARE:

GENERALIZED ANXIETY DISORDER (GAD) is an anxiety disorder characterized by chronic anxiety,exaggerated worry and tension, even when there is little or nothing to provoke it. People with generalized anxiety disorder can't seem to shake their concerns. Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, and hot flashes.

OBSESSIVE-COMPULSIVE DISORDER (OCD)is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. People with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. They may be obsessed with germs or dirt, and wash their hands over and over. They may be filled with doubt and feel the need to check things repeatedly. 

PANIC DISORDER is an anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. During a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have nausea, chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control.

POST-TRAUMATIC STRESS DISORDER (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.  People with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. They may experience sleep problems, feel detached or numb, or be easily startled.

SOCIAL PHOBIA, OR SOCIAL ANXIETY DISORDER is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation—such as a fear of speaking in formal or informal situations, or eating or drinking in front of others—or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school, and other ordinary activities. Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, nausea, and difficulty talking. 

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) is one of the most common mental disorders that develop in children. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood. Symptoms of ADHD will appear over the course of many months, and include impulsiveness, hyperactivity and inattention.

AUTISM SPECTRUM DISORDERS (ASD), also known as Pervasive Developmental Disorders (PDDs), cause severe and pervasive impairment in thinking, feeling, language, and the ability to relate to others. These disorders are usually first diagnosed in early childhood and range from a severe form, called autistic disorder, through pervasive development disorder not otherwise specified (PDD-NOS), to a much milder form, Asperger syndrome. They also include two rare disorders, Rett syndrome and childhood disintegrative disorder.

Parents are usually the first to notice unusual behaviors in their child. In some cases, the baby seemed "different" from birth, unresponsive to people or focusing intently on one item for long periods of time. The first signs of an autism spectrum disorder can also appear in children who had been developing normally. When an affectionate, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or indifferent to social overtures, something is wrong.

BIPOLAR DISORDER, also known as manic-depressive illness, is a serious medical illness that causes shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. Bipolar disorder causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

BORDERLINE PERSONALITY DISORDER (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with BPD suffer from a disorder of emotion regulation. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. 

These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse. Distortions in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, gender identity, and values. Sometimes people with BPD view themselves as fundamentally bad, or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone. People with BPD often have highly unstable patterns of social relationships. 

DEPRESSION is a serious medical illness; it’s not something that you have made up in your head. It’s more than just feeling "down in the dumps" or "blue" for a few days. It’s feeling "down" and "low" and "hopeless" for weeks at a time. Depression is characterized by a persistent sad, anxious, or "empty" mood; feelings of hopelessness, pessimism; feelings of guilt, worthlessness, helplessness; and loss of interest or pleasure in hobbies and activities that were once enjoyed.

THERE ARE SEVERAL FORMS OF DEPRESSIVE DISORDERS. THE MOST COMMON ARE MAJOR DEPRESSIVE DISORDER AND DYSTHYMIC DISORDER:

MAJOR DEPRESSIVE DISORDER, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

DYSTHYMIC DISORDER, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

SOME FORMS OF DEPRESSIVE DISORDER EXHIBIT SLIGHTLY DIFFERENT CHARACTERISTICS THAN THOSE DESCRIBED ABOVE, OR THEY MAY DEVELOP UNDER UNIQUE CIRCUMSTANCES. THEY INCLUDE:

PSYCHOTIC DEPRESSION, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

POSTPARTUM DEPRESSION, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.(1)

SEASONAL AFFECTIVE DISORDER (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.(2)

EATING DISORDERS are marked by extremes, present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

TYPES OF EATING DISORDERS INCLUDE:

ANOREXIA NERVOSA is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas. Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished.

BULIMIA NERVOSA is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise. Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. 

BINGE-EATING DISORDER is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating.

SCHIZOPHRENIA is a chronic, severe, and disabling brain disorder that can include hallucinations, delusions, disordered thinking, movement disorders, flat affect, social withdrawal, and cognitive deficits. People with schizophrenia sometimes hear voices others don’t hear; believe that others are broadcasting their thoughts to the world; or may believe other people are reading their minds, controlling their thoughts, or plotting to harm them.  People with schizophrenia may not make sense when they talk. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking. 

These experiences can make them fearful and withdrawn and cause difficulties when they try to have relationships with others. This can terrify people with the illness and make them withdrawn or extremely agitated. Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help.

Schizophrenia affects about 1.1 percent of the U.S. population age 18 and older in a given year. Symptoms usually develop in men in their late teens or early twenties and women in the twenties and thirties, but in rare cases, can appear in childhood.

Substance use disorder—a general term used to refer to conditions arising from the abuse of alcohol and/or psychoactive drugs—is an illness that can affect anyone: rich or poor, male or female, employed or unemployed, young or old, and any race or ethnicity. Nobody knows for sure exactly what causes it, but the chance of developing a substance use disorder depends partly on genetics—biological traits passed down through families. A person’s environment, psychological traits, and stress level also play major roles by contributing to the use of alcohol or drugs. Researchers have found that using drugs for a long time changes the brain in important, long-lasting ways. It is as if a switch in the brain turned on at some point. This point is different for every person, but when this switch turns on, the person crosses an invisible line and becomes dependent on the substance. People who start using drugs or alcohol early in life run a greater risk of crossing this line and becoming dependent. These changes in the brain remain long after a person stops using drugs or drinking alcohol.

THE EFFECTS OF A PERSON’S STRUGGLE WITH ALCOHOL AND/OR DRUG USE REACH BEYOND THE INDIVIDUAL PERSON, IMPACTING THEIR FAMILY AND FRIENDS AND THE OVERALL WELL-BEING OF THEIR COMMUNITIES.

We know that that by treating mental health and substance use disorders other social ills are reduced—criminal activities, child abuse, school drop-out rates, homelessness, suicide rates, unemployment and other physical health disorders and complications.  Still, sometimes people run into barriers when they try to get help. As reported in Results from the 2008 National Survey on Drug Use and Health: National Findings (September 2009), a staggering 20.8 million people needed but did not receive treatment in 2008. Reasons people give for not receiving treatment include a lack of health insurance coverage and the inability to afford it; worries about possible negative effects on one’s job; and concerns that receiving treatment might cause neighbors and the community to have a negative opinion of the person.

Some facts and figures:

• In 2011, an estimated 22.5 million Americans aged 12 or older were current (past month) illicit drug users. This estimate represents 8.7 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically.
• Marijuana was the most commonly used illicit drug. In 2011, there were 18.1 million past month users. Between 2007 and 2011, the rate of use increased from 5.8 to 7.0 percent, and the number of users increased from 14.5 million to 18.1 million.
• In 2011, there were 6.1 million persons (2.4 percent) aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month. These estimates were lower than the estimates in 2010 (7.0 million or 2.7 percent).
• There were an estimated 9.7 million underage (aged 12 to 20) drinkers in 2011, including 6.1 million binge drinkers and 1.7 million heavy drinkers.
• The rate of current alcohol use was 64.3 percent for full-time employed adults aged 18 or older in 2011, which was higher than the rate for unemployed adults (54.1 percent). Of the 19.9 million current illicit drug users aged 18 or older in 2011, 13.1 million (65.7 percent) were employed either full or part time.
• ED visits involving misuse or abuse of pharmaceuticals increased from 2004 (626,470 visits) through 2011 (1,428,145 visits); the most commonly involved drugs were anti-anxiety and insomnia medications and narcotic pain relievers (160.9 and 134.8 visits per 100,000 population, respectively) .
• The number of emergency department (ED) visits involving energy drinks doubled from 10,068 visits in 2007 to 20,783 visits in 2011; more than half involved energy drinks only (58 percent), and the remaining 42 percent involved other drugs.

Sources:

Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. The DAWN Report: Highlights of the 2011 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. Rockville, MD.

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (January 10, 2013). The DAWN Report: Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern. Rockville, MD.

Street names include "Whippets", "poppers", and "snappers", and "laughing gas".

COCAINE is a powerfully addictive stimulant drug. The powdered hydrochloride salt form of cocaine can be snorted or dissolved in water and then injected. Crack is the street name given to the form of cocaine that has been processed to make a rock crystal, which, when heated, produces vapors that are smoked. The term “crack” refers to the crackling sound produced by the rock as it is heated.

Street names include "coke", "snow", "flake", "blow".

CLUB DRUGS is a general term used to describe a pharmacologically heterogeneous group of psychoactive compounds that tend to be abused by teens and young adults at a nightclub, bar, rave, or trance scene. 

SOME COMMON “CLUB DRUGS” ARE GHB, ROHYPNOL, KETAMINE, AND ECSTASY:

GAMMA HYDROXYBUTYRATE (GHB) is a central nervous system (CNS) depressant that was approved by the Food and Drug Administration (FDA) in 2002 for use in the treatment of narcolepsy (a sleep disorder). This approval came with severe restrictions, including its use only for the treatment of narcolepsy, and the requirement for a patient registry monitored by the FDA. GHB is also a metabolite of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA); thus, it is found naturally in the brain, but at concentrations much lower than doses that are abused.

Street names include "G", "liquid ecstasy", and "soap".

ROHYPNOL started appearing in the United States in the early 1990s. It is a benzodiazepine (chemically similar to Valium or Xanax), but it is not approved for medical use in this country, and its importation is banned. Street names include "roofies".

KETAMINE is a dissociative anesthetic, mostly used in veterinary practice. Street names include "Vitamin K", "Special K", and "Jet".

MDMA (ECSTASY) is a synthetic, psychoactive drug that is chemically similar to the stimulant methamphetamine and the hallucinogen mescaline. MDMA produces feelings of increased energy euphoria, emotional warmth, and distortions in time perception and tactile experiences.

METHAMPHETAMINE is a central nervous system stimulant drug that is similar in structure to amphetamine. Due to its high potential for abuse, methamphetamine is classified as a Schedule II drug and is available only through a prescription that cannot be refilled. Although methamphetamine can be prescribed by a doctor, its medical uses are limited, and the doses that are prescribed are much lower than those typically abused. Most of the methamphetamine abused in this country comes from foreign or domestic “super-labs” although it can also be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment.

Street names include "speed", "meth", "chalk", "ice", "crystal", and "glass."

KHAT (pronounced “cot”) is a stimulant drug derived from a shrub (Catha edulis) that is native to East Africa and southern Arabia. The main psychoactive ingredients in khat are cathine and cathinone, chemicals that are structurally similar to, but less potent than, amphetamine, yet result in similar psychomotor stimulant effects. The khat plant itself is not scheduled under the Controlled Substances Act; however, because one of its chemical constituents, cathinone, is a Schedule I drug, the Federal Government considers its use illegal.

BATH SALTS contain manmade chemicals related to amphetamines that often consist of mephedrone, methylenedioxypyrovalerone (MDPV), and methylone. It is a designer drug of the phenethylamine class, and is structurally related to cathinone, an active alkaloid found in the khat plant, methamphetamine, and MDMA (Ecstasy).They are available as capsules, tablets and in powder form to be injected, swallowed, snorted, or dissolved into food or drinks. Use of bath salts is associated with increased heart rate and blood pressure, extreme paranoia, hallucinations, and violent behavior, which causes users to harm themselves or others. On October 21, 2011, DEA exercised its emergency scheduling authority to control some of the synthetic substances used to manufacture bath salts; these synthetic stimulants are now designated as Schedule I substances. 

Street names include "Ivory Wave," "Purple Wave," "Red Dove," "Blue Silk," "Zoom," "Bloom," "Cloud Nine," "Ocean Snow," "Lunar Wave," "Vanilla Sky," "White Lightning," "Scarface," and "Hurricane Charlie".

HALLUCINOGENS are drugs which cause distorted perceptions of reality and feeling and which can produce flashbacks. Hallucinogens have powerful mind-altering effects. They can change how the brain perceives time, everyday reality, and the surrounding environment. They affect regions and structures in the brain that are responsible for coordination, thought processes, hearing, and sight. They can cause people who use them to hear voices, see images, and feel sensations that do not exist. 

COMMON TYPES OF HALLUCINOGENS ARE LSD, PSILOCYBIN, PCP AND PEYOTE:

LSD is one of the most potent mood-changing chemicals. It was discovered in 1938 and is manufactured from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains. Peyote is a small, spineless cactus in which the principal active ingredient is mescaline. This plant has been used by natives in northern Mexico and the southwestern United States as a part of religious ceremonies. Mescaline can also be produced through chemical synthesis.

Street names include "acid", "blotter", and "dots".

PSILOCYBIN is obtained from certain types of mushrooms that are indigenous to tropical and subtropical regions of South America, Mexico, and the United States. These mushrooms typically contain less than 0.5 percent psilocybin plus trace amounts of psilocin, another hallucinogenic substance.

PCP was developed in the 1950s as an intravenous anesthetic. Its use has since been discontinued due to serious adverse effects. Street names include "angel dust", "ozone", "wack", and "rocket fuel".

PEYOTE is a small, spineless cactus in which the principal active ingredient is mescaline. This plant has been used by natives in northern Mexico and the southwestern United States as a part of religious ceremonies. Mescaline can also be produced through chemical synthesis.

HEROIN is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown powder or as a black sticky substance, known as “black tar heroin.”

Street names include "smack", "H", "ska", and "junk".

MARIJUANA is the most commonly abused illicit drug in the United States. It is a dry, shredded green and brown mix of flowers, stems, seeds, and leaves derived from the hemp plant Cannabis sativa. The main active chemical in marijuana is delta-9-tetrahydrocannabinol; THC for short.

Street names include "pot", "weed", "grass", "420", "dope", and "ganga".

SPICE is used to describe a diverse family of herbal mixtures that contain dried, shredded plant material laced with substances (synthetic cannabinoids) that users claim mimics THC, the primary psychoactive active ingredient in marijuana that is responsible for its mind-altering effects. Spice mixtures are sold in many countries in head shops, gas stations, and via the Internet, although their sale and use are illegal throughout most European countries. Easy access has likely contributed to Spice’s popularity. While Spice products are labeled “not for human consumption,” they are marketed to people who are interested in herbal alternatives to marijuana (cannabis).

Street names include "K2", "fake marijuana", "Yucatan Fire", "Skunk", and "Moon Rocks."

SALVIA is an herb common to southern Mexico and Central and South America. The main active ingredient in Salvia, salvinorin A, is a potent activator of kappa opioid receptors in the brain. These receptors differ from those activated by the more commonly known opioids, such as heroin and morphine. Traditionally, S. divinorum has been ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves of S. divinorum can also be smoked as a joint, consumed in water pipes, or vaporized and inhaled. Although Salvia currently is not a drug regulated by the Controlled Substances Act, several States and countries have passed legislation to regulate its use.The Drug Enforcement Agency has listed Salvia as a drug of concern and is considering classifying it as a Schedule I drug, like LSD or marijuana.

NICOTINE (TOBACCO) Cigarettes and other forms of tobacco—including cigars, pipe tobacco, snuff, and chewing tobacco—contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked. Through the use of tobacco, nicotine is one of the most heavily used addictive drugs and the leading preventable cause of disease, disability, and death in the U.S. Cigarette smoking accounts for 90% of lung cancer cases in the U.S., and about 38,000 deaths per year can be attributed to secondhand smoke. Cigarettes and chew tobacco are illegal substances in most U.S. states for those under 18; a handful of states have raised the age to 19.

ALCOHOL ( Ethyl alcohol or ethanol) is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. A standard drink equals 0.6 ounces of pure ethanol, or 12 ounces of beer; 8 ounces of malt liquor; 5 ounces of wine; or 1.5 ounces (a "shot") of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey).

PRESCRIPTION MEDICATIONS such as pain relievers, central nervous system (CNS) depressants (tranquilizers and sedatives), and stimulants are highly beneficial treatments for a variety of health conditions. Pain relievers enable individuals with chronic pain to lead productive lives; tranquilizers can reduce anxiety and help patients with sleep disorders; and stimulants help people with attention-deficit hyperactivity disorder (ADHD) focus their attention. Most people who take prescription medications use them responsibly. But when abused—that is, taken by someone other than the patient for whom the medication was prescribed, or taken in a manner or dosage other than what was prescribed—prescription medications can produce serious adverse health effects, including addiction.

ALTHOUGH MANY PRESCRIPTION MEDICATIONS CAN BE ABUSED, OPIOIDS, CNS DEPRESSANTS AND STIMULANTS ARE MOST COMMONLY ABUSED:

OPIOIDS are usually prescribed to treat pain. Among the compounds that fall within this class are hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin—an oral, controlled-release form of the drug), morphine, fentanyl, codeine, and related medications. Morphine and fentanyl are often used to alleviate severe pain, while codeine is used for milder pain. Other examples of opioids prescribed to relieve pain include propoxyphene (Darvon); hydromorphone (Dilaudid); and meperidine (Demerol), which is used less often because of its side effects. In addition to their effective pain-relieving properties, some of these medications can be used to relieve severe diarrhea (for example, Lomotil, also known as diphenoxylate) or severe coughs (codeine).

CNS DEPRESSANTS (e.g., tranquilizers, sedatives) are medications that slow normal brain function and are used to treat anxiety and sleep disorders. In higher doses, some CNS depressants can be used as general anesthetics or preanesthetics.
CNS depressants can be divided into three groups, based on their chemistry and pharmacology:

Barbiturates, such as mephobarbital (Mebaral) and sodium pentobarbital (Nembutal), are used as preanesthetics, promoting sleep.

Benzodiazepines, such as diazepam (Valium), alprazolam (Xanax), and estazolam (ProSom), can be prescribed to treat anxiety, acute stress reactions, panic attacks, convulsions, and sleep disorders. For the latter, benzodiazepines are usually prescribed only for short-term relief of sleep problems because of the development of tolerance and risk of addiction.

Newer sleep medications, such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta), are now more commonly prescribed to treat sleep disorders. These medications are nonbenzodiazepines that act at a subset of the benzodiazepine receptors and appear to have a lower risk for abuse and addiction.

STIMULANTS (e.g. amphetamines [Adderall, Dexedrine] and methylphenidate [Concerta, Ritalin]) are medications that increase alertness, attention, and energy and are prescribed to treat ADHD and narcolepsy. They also increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system. Historically, stimulants were prescribed to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. As their potential for abuse and addiction became apparent, the prescribing of stimulants by physicians began to wane. Now, stimulants are prescribed for treating only a few health conditions, most notably ADHD, narcolepsy, and, in some instances, depression that has not responded to other treatments.

Similarly, some Over-The-Counter (OTC) medications, such as cough and cold medicines containing dextromethorphan, have beneficial effects when taken as recommended; but they can also be abused and lead to serious adverse health consequences. Parents should be aware of the potential for abuse of these medications, especially when consumed in large quantities, which should signal concern and the possible need for intervention.

STEROIDS (ANABOLIC-ANDROGENIC) are synthetically produced variants of the naturally occurring male sex hormone testosterone. “Anabolic” refers to muscle-building, and “androgenic” refers to increased male sexual characteristics. “Steroids” refers to the class of drugs. They are taken orally or are injected. These drugs can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, as well as diseases that result in loss of lean muscle mass, such as cancer and AIDS. Some people, especially athletes, abuse anabolic steroids to build muscle and enhance performance. Abuse of anabolic steroids can lead to serious health problems, some of which are irreversible.

Street names include "juice", "gym candy", "pumpers", and "stackers".

Free Resources Available

The Ohio Clearinghouse, funded by the Ohio Department of Alcohol and Drug Addiction Services and managed by the Drug-Free Action Alliance, is available to assist with information needs relative to prevention and treatment of substance use disorders. All materials are available at no cost to Ohio citizens, and there is no shipping or handling costs. Materials can be viewed via an online catalog or firsthand at the agency. 

Go to www.DrugFreeActionAlliance.org and select “Ohio Clearinghouse” under programs to view the online catalog of more than 700 different items. Follow the prompts to view materials and download an order form.  The materials can also be viewed from 9:00 a.m. to 5:00 p.m., Monday through Friday, at the Drug-Free Action Alliance, 6185 Huntley Road, Suite P, Columbus, Ohio 43229; (614) 540-9991.

The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers a wide range of publications at no cost. Information on a variety of issues, conditions, disorders and substances is available, in addition to information on many treatment, prevention, recovery, professional and research topics. To view and order publications, visit http://store.samhsa.gov/home