Street Drugs - Do you know what you're getting?

In general, a drug is defined as any substance, other than food, which is taken to change the way the body and/or mind function. Drugs can come from plants growing wild in fields or planted as a crop, or they can be manufactured in laboratories. Drug use is often described as legal or illegal. Legal drugs include alcohol, tobacco, and prescriptions sold for medicinal purposes such as pain-killers. Illegal drugs are grown or produced to be sold on the street; prescription drugs are sometimes sold illegitimately on the street.

Buying drugs on the street is fraught with danger, the primary reason is that you simply can’t know what you are getting. For example, MDMA or ecstasy sometimes doesn’t even contain M at all but instead is cut with other chemicals, such as caffeine, amphetamine, LSD, PMA, and ketamine. Drugs like “street oxy,” heroin, or cocaine can be cut with fentanyl, so you could end up ingesting this dangerous substance without even knowing it.[1] An individual can overdose from fentanyl by ingesting only a few grains.

 

Let’s look at three of the main categories of drugs: stimulants, depressants, and hallucinogens:

Stimulants

Stimulants affect the central nervous system. Examples of stimulants  include cocaine, methamphetamine (crystal meth), Ritalin (and diet pills), nicotine and caffeine. In low doses, all stimulants boost energy, raise the heart rate and blood pressure, increase respiration, and reduce appetite and thirst. They also make the user more alert, active, confident, anxious, restless, and aggressive. Stimulants can produce severe psychological dependence. Let’s take a closer look at cocaine, methamphetamine (speed, crystal meth), and prescription stimulants.

Cocaine: There are two forms of cocaine: the white powder which can be snorted, injected, or swallowed, and crack cocaine which looks like opaque crystals which make a popping noise when smoked.[2] Within minutes of snorting, your brain is flooded with dopamine, (Dopamine is a neurotransmitter that helps control the brain's reward and pleasure centers causing feelings of euphoria and stimulation).[3] After the effects have worn off, people find themselves having extreme cravings for that high.[4] This is because cocaine changes the reward pathway of the brain and, over time, more and more is needed to get the same effect.[5] Some people even go on cocaine binges where they take cocaine every 10-30 minutes in order to avoid the negative side effects, such as depressed mood and energy.[6]

Besides potentially causing dependence and addiction, cocaine can have other unwanted effects. The high from smoking lasts between 5-10 minutes while snorting effects last for 15-30 minutes. Other health effects of cocaine include:

  • Increase in heart rate and blood pressure [7]

  • Constriction of blood vessels [8]

  • Chest pain [9]

Those who binge on cocaine can experience a “crash” in mood and energy: depression, craving, anxiety, and even paranoia. [10]

Methamphetamine: Also known as speed, uppers, meth, crystal meth, side, chalk, ice, glass, Christmas tree, and crank, this drug can be unpredictable, addictive, and lethal. It can be smoked, snorted, injected, or taken orally. Immediately after smoking the drug or injecting it, the user experiences an intense pleasurable rush that lasts only a few minutes. Snorting or oral ingestion produces euphoria, but not an intense rush.   

eople who abuse methamphetamines feel like they don’t need to sleep and full of energy. But with repeated use methamphetamines are very damaging to the body and brain. Chronic abuse can result in heart problems, progressive social deterioration, and psychotic symptoms (paranoia, delusions, mood disturbances).[11]

Prescription stimulants: These include methylphenidate (ex. Ritalin, Concerta) and amphetamine (ex. Adderall). Even though they’re prescriptions, these drugs come with the risk of dependence and addiction, [12] especially if they are abused. Prescription stimulants abuse can occur in many forms. These pills can be taken orally, but sometimes they are crushed up and snorted or injected. Crushing or snorting can alter how the drug behaves in our bodies, and can increase risk of abuse and dependence.[13]

Prescription stimulants are often used as “study drugs” or academic enhancers. Students use these drugs to study, help with concentration, and increase alertness.[14] But do they actually help you concentrate and learn? The research says “no”, stimulant drugs do not work as “enhancers.” [15] Only those with attention or learning deficits, such as those with diagnosed ADHD, are helped.[16]

Stimulant drug use can be dangerous. Negative side effects from taking large amounts of these drugs are: [17]

  • irregular heart rate

  • increase in blood pressure

  • trouble sleeping

  • paranoia and hostility

  • loss of appetite

  • very high body temperatures

  • seizures can occur at very high doses

 

Depressants

Included in this category of drugs are opioid analgesics (codeine, morphine, heroin, fentanyl, methadone, oxycodone), alcohol, inhalants, benzodiazepines, barbiturates and other sleeping pills. These drugs all cause a slowing down or depression of the central nervous system. At low doses they produce a feeling of calm, drowsiness, and well-being. Let’s take a closer look at fentanyl and oxycodone since both have been in the news a lot in recent years.

Fentanyl: Fentanyl is a synthetic opioid that is 100 times more powerful than morphine.[18] Typically, it is used in hospitals as analgesic or for pain management in the form of fentanyl patches. In its prescription form, Fentanyl is known by such names as Actiq®, Duragesic®, and Sublimaze®.

entanyl is finding its way onto our streets either through the street trade of legitimate prescription patches, through illicitly manufactured fentanyl made into pill form to look like OxyContin, or it is cut into cocaine and heroin to create a more intense high.[19] When dealers cut it into street drugs, users have no idea of the level of purity or the potency of what they take.

Fentanyl works in the brain to change how the body feels and responds to pain. Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain's reward areas, producing a state of euphoria and relaxation.[20] Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death.[21] The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl. The RCMP estimates a lethal dose of pure fentanyl to be in the realm of two milligrams for a typical adult… no more than a few grains of salt.[22]

Fentanyl very quickly creates a tolerance to high doses, so a dose that is adequate for the intended high one week will probably not create that intended high even a few days later.[23] If you’re not tolerant, it is a lot more likely to cause serious toxicity and even death. It severely depresses breathing and heart rate so that combined with alcohol or other drugs that slow the central nervous system, it becomes even more dangerous.[24] Numerous fentanyl overdoses are occurring in casual or recreational users who use a different drug such as cocaine, which has fentanyl inside of it.[25]

Oxycodone: This is a narcotic (OxyContin, Percocet and Percodan are the most frequently used and abused) prescribed to relieve pain that is twice as potent as morphine. OxyContin is a time-release version of oxycodone that is snorted or injected. Used as a substitute for heroin, abusers use the drug to relieve pain, alleviate withdrawal symptoms, and gain euphoric effects. Police say that virtually every pill stamped as OxyContin (CDN 80) sold on the street today actually contains fentanyl which is very cheap to manufacture and thus lucrative for drug dealers.[26]

 

Hallucinogens

Hallucinogens have been used for thousands of years in religious and spiritual ceremonies. These drugs alter one’s perception of reality and can make users experience things that aren’t real. They work by activating certain chemicals in your brain, mainly serotonin, affecting the way you experience the world.[27] We can find hallucinogens both in the lab (e.g. MDMA) and in nature (e.g. magic mushrooms, LSD, DMT).

Ecstasy or MDMA: or 3,4-methylenedioxymethamphetamine produces energizing effects like the stimulant amphetamine, but also acts as a hallucinogenic similar to mescaline.[28] Made in the lab, ecstasy usually comes in the form of a colourful pill, often with cartoons and icons stamped into them.[29] Nowadays MDMA is rarely ever pure, and sometimes don’t contain any at all.[30] In 2007, Health Canada found only 3% of tablets analyzed contained pure MDMA.[31] It is one of the most popular drugs when it comes to partying, often found at raves, music festivals, and dance parties for its stimulating and enhancing effects.[32]

When you pop a pill, your brain in flooded with two main chemicals: serotonin and dopamine.[33] You may experience feelings of euphoria, increased energy and sexual arousal.[34] Some people have a distorted sense of time and report feelings of closeness with others. Negative feelings can also be felt too, including anxiety, dizziness, headaches, and sweating.[35] While your brain is being flooded with serotonin and dopamine, your body is experiencing other effects. These include: [36]

  • High body temperatures, which can lead to serious liver, heart, and kidney problems

  • Sweating

  • Nausea and vomiting

  • Teeth grinding/ jaw clenching

  • Increased risk of having unprotected sex

  • Increased blood pressure and heart rate

  • Muscle tension

MDMA causes you to go to the bathroom more. Combine that with a stuffy club, dancing, and hyperthermia, you can easily become extremely dehydrated, which can cause muscle breakdown and organ failure.[37] Long term there’s a lot of evidence that MDMA use can cause neuron damage that may last for many years. You could have difficulty concentrating, memory problems, impulsivity, and depression. [38]

Psychedelics: Psychedelics are known for their mind-altering effects. It’s hard to know how you’ll experience these drugs, especially since it depends hugely on your expectations and the environment.[39] These drugs produce hallucinations, meaning you could see, smell, taste, or feel things that aren’t actually happening. You may experience altered time sense, visual hallucinations, or even “seeing” a sound.[40]

Using these drugs can be one roller-coaster of a ride: from feeling euphoric and on top of the world one minute, to being anxious and paranoid the next.[41] So if you’re in a bad mood or suffer from depression and anxiety, these feelings can make you have a very unpleasant trip. Hallucinogens do crazy things to our minds, but they can also have effects on our bodies, including:[42,43,44]

  • Increased heart rate and blood pressure

  • Dilated pupils

  • Mood swings

  • Nausea and dizziness

  • Sweating

  • Tremors

  • Psychosis

Three examples of psychedelics are:

  • LSD, commonly know as acid. LSD was originally made from a fungus that grows on rye. It takes action in about 20 minutes and lasts for up to 10-12 hours.[45] It usually comes on small squares of blotter paper or in sugar cubes or liquid. Using large amounts of LSD can cause flashbacks, usually brought on by a bad trip, and can occur for up to a year after using.[46]

  • Magic mushrooms. The active ingredient psilocybin is found in certain kinds of mushrooms. They come fresh or dried, and are eaten. The effects hit after about 20-30 minutes and last for 4-6 hours.[47]

  • DMT is found in many different plants, especially in South America. DMT effects start within minutes and last between 20 minutes to an hour.[48] It usually comes in a tablet or powder and is injected, inhaled, or smoked.

 

A closer look… combining drugs

Many drugs become more dangerous when mixed. Some people may combine drugs intentionally to enhance the effects, or to counteract undesirable side-effects, or they may use a hazardous combination of drugs without intending to do so. For example, they may take sleeping medications after drinking alcohol without being aware that using these drugs together is hazardous.

Even if someone is aware that mixing drugs is dangerous, they may do so anyway. Many people will mix alcohol with other drugs with adverse effects. A mixture of heroin (a depressant) and cocaine (a stimulant), for example, increases the risk of death from respiratory depression. People who use illegal drugs may mix drugs because they do not know what they are taking.

Many drugs taken together have the potential to interact with one another to produce greater effects than either drug taken by itself. When two depressant drugs are taken -- alcohol, opioid analgesics (like codeine), barbituates (like Secondal) and benzodiazepines (like Valium) – the result may be confusion, injuries from falls, depressed breathing, coma, and death.

 

Fast Facts

  • Cocaine is one of the most addicting street drugs out there. Lab rats will self-administer cocaine until death.[49]

  • More teens die from prescription drugs than heroin/cocaine combined. [50]

  • Between 1.4 - 4.9% of youth have used prescription stimulants in the past year in Canada. Of those, up to 40% says they abused them.[51]

  • Drug abuse is a leading cause of premature deaths. The Government of Saskatchewan’s Department of Health found that young people who use illegal drugs are 11 times more likely to commit suicide or overdose.[52]

  • Hallucinogens are almost exclusively used by teen and young adults between the ages of 15 and 24. 3.9% of youth say they used, compared to only 0.4% of adult.[53]

  • If you think it is safe to buy drugs on the street, consider this: Even prescription drugs that appear to be sealed in original packaging can be knock-off home-made products. Many dealers are motivated to substitute potentially toxic ingredients in place of drugs to save money. It is not uncommon to find bleach, cleansers, toxins or other materials in illegal drugs. [54]

  • If you think it is safe to buy drugs over the internet, consider this: you could be dealing with anyone from an international black market broker to a neighbour. Drugs that are bought online may be counterfeit, homemade or stolen, and are often illegal. Despite the increasing popularity and convenience, illegally buying drugs, whether online or on the street, can have dangerous consequences. [55]

 

  1. Geoff McKee, MD, Ashraf Amlani, MPH, Jane A. Buxton, MBBS, MHSc, FRCPC. Illicit fentanyl: An emerging threat to people who use drugs in BC. BCMJ, Vol. 57, No. 6, July, August, 2015, page(s) 235 — BC Centre for Disease Control.

  2. Egred, M. Cocaine And The Heart. Postgraduate Medical Journal 2005, 81, 568-571.

  3. Walters, C.; Kuo, Y.; Blendy, J. Differential Distribution Of CREB In The Mesolimbic Dopamine Reward Pathway. Journal of Neurochemistry 2003, 87, 1237-1244.

  4. Nestler, E. Historical Review: Molecular And Cellular Mechanisms Of Opiate And Cocaine Addiction. Trends in Pharmacological Sciences 2004, 25, 210-218.

  5. Carlezon Jr., W. Regulation Of Cocaine Reward By CREB. Science 1998, 282, 2272-2275.

  6. Gawin, F. Cocaine Addiction: Psychology And Neurophysiology. Science 1991, 251, 1580-1586.

  7. Breiter, H.; Gollub, R.; Weisskoff, R.; Kennedy, D.; Makris, N.; Berke, J.; Goodman, J.; Kantor, H.; Gastfriend, D.; Riorden, J. et al. Acute Effects Of Cocaine On Human Brain Activity And Emotion. Neuron 1997, 19, 591-611.

  8. Kloner, R.; Hale, S.; Alker, K.; Rezkalla, S. The Effects Of Acute And Chronic Cocaine Use On The Heart. Circulation 1992, 85, 407-419.

  9. Egred, M. Cocaine And The Heart. Postgraduate Medical Journal 2005, 81, 568-571.

  10. Gawin, F. Cocaine Addiction: Psychology And Neurophysiology. Science 1991, 251, 1580-1586.

  11. Davis, Kathleen. "Methamphetamine: Side Effects, Health Risks and Withdrawal." Medical News Today. MediLexicon International, Web.

  12. Smith, M.; Farah, M. Are Prescription Stimulants “Smart Pills”? The Epidemiology And Cognitive Neuroscience Of Prescription Stimulant Use By Normal Healthy Individuals. Psychological Bulletin 2011, 137, 717-741.

  13. Teter, C.; McCabe, S.; LaGrange, K.; Cranford, J.; Boyd, C. Illicit Use Of Specific Prescription Stimulants Among College Students: Prevalence, Motives, And Routes Of Administration. Pharmacotherapy 2006, 26, 1501-1510.

  14. Ibid.

  15. Lakhan, S.; Kirchgessner, A. Prescription Stimulants In Individuals With And Without Attention Deficit Hyperactivity Disorder: Misuse, Cognitive Impact, And Adverse Effects. Brain Behav 2012, 2, 661-677.

  16. Ibid.

  17. Klein-Schwartz, W. Abuse And Toxicity Of Methylphenidate. Current Opinion in Pediatrics 2002, 14, 219-223.

  18. Muijsers, R.; Wagstaff, A. Transdermal Fentanyl. Drugs 2001, 61, 2289-2307.

  19. Gatehouse, Jonathon, and Macdonald, Nancy. “Fentanyl: The King of All Opiates, and a Killer Drug Crisis,” Macleans.ca. 21 Sept. 2015. Web.

  20. Gutstein H, Akil H. Opioid Analgesics. In: Goodman & Gilman’s the Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill; 2006.

  21. Ibid.

  22. "RCMP Releases Video on the Dangers of Fentanyl." Government of Canada, Royal Canadian Mounted Police. 13 Sept. 2016. Web.

  23. "Signs and Symptoms of Fentanyl Abuse." Narconon International. Web.

  24. Gatehouse, Jonathon, and Macdonald, Nancy. “Fentanyl: The King of All Opiates, and a Killer Drug Crisis,” Macleans.ca. 21 Sept. 2015. Web.

  25. "Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Oct. 2015. Web.

  26. Stewart, Eric. "RCMP Gazette." Government of Canada, Royal Canadian Mounted Police. 24 June 2016. Web.

  27. Hill, S.; Thomas, S. Clinical Toxicology Of Newer Recreational Drugs. Clinical Toxicology 2011, 49, 705-719.

  28. Freese, T.; Miotto, K.; Reback, C. The Effects And Consequences Of Selected Club Drugs. Journal of Substance Abuse Treatment 2002, 23, 151-156.

  29. Gahlinger, P. M. (2004). Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine. American Family Physician, 69(11), 2619–26. -

  30. Hudson, A.; Lalies, M.; Baker, G.; Wells, K.; Aitchison, K. Ecstasy, Legal Highs And Designer Drug Use: A Canadian Perspective. Drug Science, Policy and Law 2013, 1.

  31. Ibid.

  32. Gahlinger, P. M. (2004). Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine. American Family Physician, 69(11), 2619–26. 

  33. Montoya, A.; Sorrentino, R.; Lukas, S.; Price, B. Long-Term Neuropsychiatric Consequences Of "Ecstasy" (MDMA): A Review. Harv Rev Psychiatry 2002, 10, 212-220.

  34. Ibid.

  35. Teter, C.; Guthrie, S. A Comprehensive Review Of MDMA And GHB: Two Common Club Drugs. Pharmacotherapy 2001, 21, 1486-1513.

  36. Gawin, F. Cocaine Addiction: Psychology And Neurophysiology. Science 1991, 251, 1580-1586.

  37. Baylen, C.; Rosenberg, H. A Review Of The Acute Subjective Effects Of MDMA/Ecstasy. Addiction 2006, 101, 933-947.

  38. Montoya, A.; Sorrentino, R.; Lukas, S.; Price, B. Long-Term Neuropsychiatric Consequences Of "Ecstasy" (MDMA): A Review. Harv Rev Psychiatry 2002, 10, 212-220.

  39. Nichols, D. Hallucinogens. Pharmacology & Therapeutics 2004, 101, 131-181.

  40. Passie, T.; Seifert, J.; Schneider, U.; Emrich, H. The Pharmacology Of Psilocybin. Addiction Biology 2002, 7, 357-364.

  41. Cunningham, N. Hallucinogenic Plants Of Abuse. Emerg Med Australas 2008, 20, 167-174.

  42. (146) Passie, T.; Seifert, J.; Schneider, U.; Emrich, H. The Pharmacology Of Psilocybin. Addiction Biology 2002, 7, 357-364.

  43. Cunningham, N. Hallucinogenic Plants Of Abuse. Emerg Med Australas 2008, 20, 167-174.

  44. Passie, T.; Halpern, J.; Stichtenoth, D.; Emrich, H.; Hintzen, A. The Pharmacology Of Lysergic Acid Diethylamide: A Review. CNS Neuroscience & Therapeutics 2008, 14, 295-314.

  45. Nichols, D. Hallucinogens. Pharmacology & Therapeutics 2004, 101, 131-181.

  46. Abraham, H. The Psychopharmacology Of Hallucinogens. Neuropsychopharmacology 1996, 14, 285-298

  47. Passie, T.; Seifert, J.; Schneider, U.; Emrich, H. The Pharmacology Of Psilocybin. Addiction Biology 2002, 7, 357-364.

  48. Haroz, R.; Greenberg, M. New Drugs Of Abuse In North America. Clinics in Laboratory Medicine 2006, 26, 147-164.

  49.  Gawin, F. Cocaine Addiction: Psychology And Neurophysiology. Science 1991, 251, 1580-1586.

  50. “The Truth About Prescription Drug Abuse." Foundation for a Drug-Free World. Web.

  51.  Health Canada,. Canadian Alcohol And Drug Use Monitoring Survey: Summary Of Results For 2012; 2014.

  52. "Teen Drug Abuse Facts & Their Implications." Canadian Centre for Addictions. 19 Aug. 2016. Web.

  53.  Health Canada,. Canadian Alcohol And Drug Use Monitoring Survey: Summary Of Results For 2012; 2014.

  54.  "The Dangers of Buying Street Drugs." Drug Addiction Help. 13 June 2011. Web.

  55. "Dangers of Getting Drugs from a Dealer." Drug Rehab Experts. Web.