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| Substance Abuse Basics |
Messages for Teenagers: Here are the straight facts...
Know the law. Methamphetamines, marijuana, hallucinogens, crack,
cocaine, and many other substances are illegal. Depending on where you
are caught, you could face high fines and jail time. Alcohol is illegal to buy or
possess if you are under 21.
Be aware of the risks. Drinking or using drugs increases the risk of injury.
Car crashes, falls, burns, drowning, and suicide are all linked to drug use.
Keep your edge. Drug use can ruin your looks, make you depressed, and
contribute to slipping grades.
Play it safe. One incident of drug use could make you do something that you
will regret for a lifetime.
Do the smart thing. Using drugs puts your health, education, family ties, and
social life at risk.
Get with the program. Doing drugs isn't "in" anymore.
Think twice about what you're advertising when you buy and wear T-shirts,
hats, pins, or jewelry with a pot leaf, joint, blunt, beer can, or other drug
paraphernalia on them. Do you want to promote something that can cause
cancer? make you forget things? or make it difficult to drive a car?
Face your problems. Using drugs won't help you escape your problems, it
will only create more.
Be a real friend. If you know someone with a drug problem, be part of the
solution. Urge your friend to get help.
Remember, you DON'T NEED drugs or alcohol. If you think "everybody's
doing it," you're wrong! Over 86% of 12-17 year-olds have never tried
marijuana; over 98% have never used cocaine; only about half a percent of
them have ever used crack. Doing drugs won't make you happy or popular
or help you to learn the skills you need as you grow up. In fact, doing drugs
can cause you to fail at all of these things.
Marijuana - Marijuana is the most widely used illicit drug in the United
States and tends to be the first illegal drug teens use.
The physical effects of marijuana use, particularly on developing
adolescents, can be acute.
Short-term effects of using marijuana:
sleepiness
difficulty keeping track of time, impaired or reduced short-term memory
reduced ability to perform tasks requiring concentration and coordination,
such as driving a car
increased heart rate
potential cardiac dangers for those with preexisting heart disease
bloodshot eye
dry mouth and throat
decreased social inhibitions
paranoia, hallucinations
Long-term effects of using marijuana:
enhanced cancer risk
decrease in testosterone levels for men; also lower sperm counts and
difficulty having children
increase in testosterone levels for women; also increased risk of infertility
diminished or extinguished sexual pleasure
psychological dependence requiring more of the drug to get the same effect
Marijuana blocks the messages going to your brain and alters your
perceptions and emotions, vision, hearing, and coordination. A recent study
of 1,023 trauma patients admitted to a shock trauma unit found that
one-third had marijuana in their blood.
Cigarette Smoking - Although many people smoke because they
believe cigarettes calm their nerves, smoking releases epinephrine, a
hormone which creates physiological stress in the smoker, rather than
relaxation. The use of tobacco is addictive. Most users develop tolerance
for nicotine and need greater amounts to produce a desired effect.
Smokers become physically and psychologically dependent and will suffer
withdrawal symptoms including: changes in body temperature, heart rate,
digestion, muscle tone, and appetite. Psychological symptoms include:
irritability, anxiety, sleep disturbances, nervousness, headaches, fatigue,
nausea, and cravings for tobacco that can last days, weeks, months, years,
or an entire lifetime.
Risks associated with smoking cigarettes:
diminished or extinguished sense of smell and taste
frequent colds
smoker's cough
gastric ulcers
chronic bronchitis
increase in heart rate and blood pressure
premature and more abundant face wrinkles
emphysema
heart disease
stroke
cancer of the mouth, larynx, pharynx, esophagus, lungs, pancreas, cervix,
uterus, and bladder
Cigarette smoking is perhaps the most devastating preventable cause of
disease and premature death. Smoking is particularly dangerous for teens
because their bodies are still developing and changing and the 4,000
chemicals (including 200 known poisons) in cigarette smoke can adversely
affect this process. Cigarettes are highly addictive. One-third of young
people who are just "experimenting" end up being addicted by the time they
are 20.
Alcohol - Alcohol abuse is a pattern of problem drinking that results in
health consequences, social, problems, or both. However, alcohol
dependence, or alcoholism, refers to a disease that is characterized by
abnormal alcohol-seeking behavior that leads to impaired control over
drinking.
Short-term effects of alcohol use include:
distorted vision, hearing, and coordination
altered perceptions and emotions
impaired judgment
bad breath; hangovers
Long-term effects of heavy alcohol use include:
loss of appetite
vitamin deficiencies
stomach ailments
skin problems
sexual impotence
liver damage
heart and central nervous system damage
memory loss
How Do I Know If I, or Someone Close, Has a Drinking Problem?
Here are some quick clues:
Inability to control drinking--it seems that regardless of what you decide
beforehand, you frequently wind up drunk
Using alcohol to escape problems
A change in personality--turning from Dr. Jekyl to Mr. Hyde
A high tolerance level--drinking just about everybody under the table
Blackouts--sometimes not remembering what happened while drinking
Problems at work or in school as a result of drinking
Concern shown by family and friends about drinking
If you have a drinking problem, or if you suspect you have a drinking
problem, there are many others out there like you, and there is help
available. Talk to school counselor, a friend, or a parent.
Methamphetamine - Methamphetamine is a stimulant drug chemically
related to amphetamine but with stronger effects on the central nervous
system. Street names for the drug include "speed," "meth," and "crank."
Methamphetamine is used in pill form, or in powdered form by snorting or
injecting. Crystallized methamphetamine known as "ice," "crystal," or
"glass," is a smokable and more powerful form of the drug.
The effects of methamphetamine use include:
increased heart rate and blood pressure
increased wakefulness; insomnia
increased physical activity
decreased appetite
respiratory problems
extreme anorexia
hypothermia, convulsions, and cardiovascular problems, which can lead to
death
euphoria
irritability, confusion, tremors
anxiety, paranoia, or violent behavior
can cause irreversible damage to blood vessels in the brain, producing
strokes
Methamphetamine users who inject the drug and share needles are at risk
for acquiring HIV/AIDS.
Methamphetamine is an increasingly popular drug at raves (all night
dancing parties), and as part of a number of drugs used by college-aged
students. Marijuana and alcohol are commonly listed as additional drugs of
abuse among methamphetamine treatment admissions. Most of the
methamphetamine-related deaths (92%) reported in 1994 involved
methamphetamine in combination with at least one other drug, most often
alcohol (30%), heroin (23%), or cocaine (21%). Researchers continue to
study the long-term effects of methamphetamine use.
Cocaine and Crack Cocaine - Cocaine is a white powder that comes
from the leaves of the South American coca plant. Cocaine is either
"snorted" through the nasal passages or injected intravenously. Cocaine
belongs to a class of drugs known as stimulants, which tend to give a
temporary illusion of limitless power and energy that leave the user feeling
depressed, edgy, and craving more. Crack is a smokable form of cocaine
that has been chemically altered. Cocaine and crack are highly addictive.
This addiction can erode physical and mental health and can become so
strong that these drugs dominate all aspects of an addict's life.
Physical risks associated with using any amount of cocaine and crack:
increases in blood pressure, heart rate, breathing rate, and body
temperature
heart attacks, strokes, and respiratory failure
hepatitis or AIDS through shared needles
brain seizures
reduction of the body's ability to resist and combat infection
Psychological risks:
violent, erratic, or paranoid behavior
hallucinations and "coke bugs"--a sensation of imaginary insects crawling
over the skin
confusion, anxiety and depression, loss of interest in food or sex
"cocaine psychosis"--losing touch with reality, loss of interest in friends,
family, sports, hobbies, and other activities
Some users spend hundred or thousands of dollars on cocaine and crack
each week and will do anything to support their habit. Many turn to drug
selling, prostitution, or other crimes. Cocaine and crack use has been a
contributing factor in a number of drownings, car crashes, falls, burns, and
suicides. Cocaine and crack addicts often become unable to function
sexually. Even first time users may experience seizures or heart attacks,
which can be fatal.
Hallucinogens - Hallucinogenic drugs are substances that distort the
perception of objective reality. The most well-known hallucinogens include
phencyclidine, otherwise known as PCP, angel dust, or loveboat; lysergic
acid diethylamide, commonly known as LSD or acid; mescaline and peyote;
and psilocybin, or "magic" mushrooms. Under the influence of
hallucinogens, the senses of direction, distance, and time become
disoriented. These drugs can produce unpredictable, erratic, and violent
behavior in users that sometimes leads to serious injuries and death. The
effect of hallucinogens can last for 12 hours.
LSD produces tolerance, so that users who take the drug repeatedly must
take higher and higher doses in order to achieve the same state of
intoxication. This is extremely dangerous, given the unpredictability of the
drug, and can result in increased risk of convulsions, coma, heart and lung
failure, and even death.
Physical risks associated with using hallucinogens:
increased heart rate and blood pressure
sleeplessness and tremors
lack of muscular coordination
sparse, mangled, and incoherent speech
decreased awareness of touch and pain that can result in self-inflicted
injuries
convulsions
coma; heart and lung failure
Psychological risks associated with using hallucinogens:
a sense of distance and estrangement
depression, anxiety, and paranoia
violent behavior
confusion, suspicion, and loss of control
flashbacks
behavior similar to schizophrenic psychosis
catatonic syndrome whereby the user becomes mute, lethargic, disoriented,
and makes meaningless repetitive movements
Everyone reacts differently to hallucinogens--there's no way to predict if you
can avoid a "bad trip."
Inhalants - Inhalants refer to substances that are sniffed or huffed to give
the user an immediate head rush or high. They include a diverse group of
chemicals that are found in consumer products such as aerosols and
cleaning solvents. Inhalant use can cause a number of physical and
emotional problems, and even one-time use can result in death.
Using inhalants even one time can put you at risk for:
sudden death
suffocation
visual hallucinations and severe mood swings
numbness and tingling of the hands and feet
Prolonged use can result in:
headache, muscle weakness, abdominal pain
decrease or loss of sense of smell
nausea and nosebleeds
hepatitis
violent behaviors
irregular heartbeat
liver, lung, and kidney impairment
irreversible brain damage
nervous system damage
dangerous chemical imbalances in the body
involuntary passing of urine and feces
Short-term effects of inhalants include:
heart palpitations
breathing difficulty
dizziness
headaches
Remember, using inhalants, even one time, can kill you.
According to medical experts, death can occur in at least five ways:
1. asphyxia--solvent gases can significantly limit available oxygen in the air,
causing breathing to stop
2. suffocation--typically seen with inhalant users who use bags;
3. choking on vomit
4. careless behaviors in potentially dangerous settings
5. sudden sniffing death syndrome, presumably from cardiac arrest
OxyContin® - Numerous media reports have identified an apparent
increase in the abuse and addiction of OxyContin®, a potent painkiller
frequently prescribed for terminal cancer patients. The medication is a
semi-synthetic opioid narcotic that is legitimately prescribed to those in
need of long lasting pain relief. The medications active ingredient is
oxycodone, which is also found in drugs like Percodan and Tylox. The
benefit of the medication to chronic pain sufferers is that they generally need
to take the pill only twice a day because its time-release formula provides
up to 12 hours of pain relief.
However, according to a recent New York Times article, illicit dealers have
used suffering patients as well as fakers to "doctor shop" to obtain
OxyContin for resale "on the street". Abusers favor the drug because they
crush the tablet and ingest or snort it, or dilute it in water and inject it.
Crushing or diluting the tablet circumvents the time-release protection of the
medication resulting in a sudden, powerful morphine-like high.
The degree of OxyContin abuse in some locations is alarming. The National
Institute on Drug Abuse (NIDA) has reported that pharmacies and homes in
some rural areas have been robbed by individuals seeking the drug. NIDA
has also reported that in response to concerns over OxyContin abuse, an
alliance of hospitals in the greater Cincinnati has generally restricted the
use of OxyContin to cancer patients. Also, according to a recent bulletin
from the National Drug Intelligence Center, a drug outpatient treatment
facility in Virginia identified that 80% of its 290 people named OxyContin as
their primary drug of abuse.
Taken as prescribed, opioids such as OxyContin can be used to manage
pain effectively without untowards side effects. However, abuse of opioids
can result in tolerance to the drug, physical dependence, and may lead to
addiction. Withdrawal symptoms can include restlessness, muscle and
bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps,
and involuntary leg movements. Individuals who are addicted are more likely
to overdose on the drugs, which could be fatal.
Parents can help by learning the facts and educating their families about the
dangers of abusing Oxycontin and other opioids. Additional information on
opioids and other drugs is available on NIDA's web site at www.nida.nih.gov
Know the law. Methamphetamines, marijuana, hallucinogens, crack,
cocaine, and many other substances are illegal. Depending on where you
are caught, you could face high fines and jail time. Alcohol is illegal to buy or
possess if you are under 21.
Be aware of the risks. Drinking or using drugs increases the risk of injury.
Car crashes, falls, burns, drowning, and suicide are all linked to drug use.
Keep your edge. Drug use can ruin your looks, make you depressed, and
contribute to slipping grades.
Play it safe. One incident of drug use could make you do something that you
will regret for a lifetime.
Do the smart thing. Using drugs puts your health, education, family ties, and
social life at risk.
Get with the program. Doing drugs isn't "in" anymore.
Think twice about what you're advertising when you buy and wear T-shirts,
hats, pins, or jewelry with a pot leaf, joint, blunt, beer can, or other drug
paraphernalia on them. Do you want to promote something that can cause
cancer? make you forget things? or make it difficult to drive a car?
Face your problems. Using drugs won't help you escape your problems, it
will only create more.
Be a real friend. If you know someone with a drug problem, be part of the
solution. Urge your friend to get help.
Remember, you DON'T NEED drugs or alcohol. If you think "everybody's
doing it," you're wrong! Over 86% of 12-17 year-olds have never tried
marijuana; over 98% have never used cocaine; only about half a percent of
them have ever used crack. Doing drugs won't make you happy or popular
or help you to learn the skills you need as you grow up. In fact, doing drugs
can cause you to fail at all of these things.
Marijuana - Marijuana is the most widely used illicit drug in the United
States and tends to be the first illegal drug teens use.
The physical effects of marijuana use, particularly on developing
adolescents, can be acute.
Short-term effects of using marijuana:
sleepiness
difficulty keeping track of time, impaired or reduced short-term memory
reduced ability to perform tasks requiring concentration and coordination,
such as driving a car
increased heart rate
potential cardiac dangers for those with preexisting heart disease
bloodshot eye
dry mouth and throat
decreased social inhibitions
paranoia, hallucinations
Long-term effects of using marijuana:
enhanced cancer risk
decrease in testosterone levels for men; also lower sperm counts and
difficulty having children
increase in testosterone levels for women; also increased risk of infertility
diminished or extinguished sexual pleasure
psychological dependence requiring more of the drug to get the same effect
Marijuana blocks the messages going to your brain and alters your
perceptions and emotions, vision, hearing, and coordination. A recent study
of 1,023 trauma patients admitted to a shock trauma unit found that
one-third had marijuana in their blood.
Cigarette Smoking - Although many people smoke because they
believe cigarettes calm their nerves, smoking releases epinephrine, a
hormone which creates physiological stress in the smoker, rather than
relaxation. The use of tobacco is addictive. Most users develop tolerance
for nicotine and need greater amounts to produce a desired effect.
Smokers become physically and psychologically dependent and will suffer
withdrawal symptoms including: changes in body temperature, heart rate,
digestion, muscle tone, and appetite. Psychological symptoms include:
irritability, anxiety, sleep disturbances, nervousness, headaches, fatigue,
nausea, and cravings for tobacco that can last days, weeks, months, years,
or an entire lifetime.
Risks associated with smoking cigarettes:
diminished or extinguished sense of smell and taste
frequent colds
smoker's cough
gastric ulcers
chronic bronchitis
increase in heart rate and blood pressure
premature and more abundant face wrinkles
emphysema
heart disease
stroke
cancer of the mouth, larynx, pharynx, esophagus, lungs, pancreas, cervix,
uterus, and bladder
Cigarette smoking is perhaps the most devastating preventable cause of
disease and premature death. Smoking is particularly dangerous for teens
because their bodies are still developing and changing and the 4,000
chemicals (including 200 known poisons) in cigarette smoke can adversely
affect this process. Cigarettes are highly addictive. One-third of young
people who are just "experimenting" end up being addicted by the time they
are 20.
Alcohol - Alcohol abuse is a pattern of problem drinking that results in
health consequences, social, problems, or both. However, alcohol
dependence, or alcoholism, refers to a disease that is characterized by
abnormal alcohol-seeking behavior that leads to impaired control over
drinking.
Short-term effects of alcohol use include:
distorted vision, hearing, and coordination
altered perceptions and emotions
impaired judgment
bad breath; hangovers
Long-term effects of heavy alcohol use include:
loss of appetite
vitamin deficiencies
stomach ailments
skin problems
sexual impotence
liver damage
heart and central nervous system damage
memory loss
How Do I Know If I, or Someone Close, Has a Drinking Problem?
Here are some quick clues:
Inability to control drinking--it seems that regardless of what you decide
beforehand, you frequently wind up drunk
Using alcohol to escape problems
A change in personality--turning from Dr. Jekyl to Mr. Hyde
A high tolerance level--drinking just about everybody under the table
Blackouts--sometimes not remembering what happened while drinking
Problems at work or in school as a result of drinking
Concern shown by family and friends about drinking
If you have a drinking problem, or if you suspect you have a drinking
problem, there are many others out there like you, and there is help
available. Talk to school counselor, a friend, or a parent.
Methamphetamine - Methamphetamine is a stimulant drug chemically
related to amphetamine but with stronger effects on the central nervous
system. Street names for the drug include "speed," "meth," and "crank."
Methamphetamine is used in pill form, or in powdered form by snorting or
injecting. Crystallized methamphetamine known as "ice," "crystal," or
"glass," is a smokable and more powerful form of the drug.
The effects of methamphetamine use include:
increased heart rate and blood pressure
increased wakefulness; insomnia
increased physical activity
decreased appetite
respiratory problems
extreme anorexia
hypothermia, convulsions, and cardiovascular problems, which can lead to
death
euphoria
irritability, confusion, tremors
anxiety, paranoia, or violent behavior
can cause irreversible damage to blood vessels in the brain, producing
strokes
Methamphetamine users who inject the drug and share needles are at risk
for acquiring HIV/AIDS.
Methamphetamine is an increasingly popular drug at raves (all night
dancing parties), and as part of a number of drugs used by college-aged
students. Marijuana and alcohol are commonly listed as additional drugs of
abuse among methamphetamine treatment admissions. Most of the
methamphetamine-related deaths (92%) reported in 1994 involved
methamphetamine in combination with at least one other drug, most often
alcohol (30%), heroin (23%), or cocaine (21%). Researchers continue to
study the long-term effects of methamphetamine use.
Cocaine and Crack Cocaine - Cocaine is a white powder that comes
from the leaves of the South American coca plant. Cocaine is either
"snorted" through the nasal passages or injected intravenously. Cocaine
belongs to a class of drugs known as stimulants, which tend to give a
temporary illusion of limitless power and energy that leave the user feeling
depressed, edgy, and craving more. Crack is a smokable form of cocaine
that has been chemically altered. Cocaine and crack are highly addictive.
This addiction can erode physical and mental health and can become so
strong that these drugs dominate all aspects of an addict's life.
Physical risks associated with using any amount of cocaine and crack:
increases in blood pressure, heart rate, breathing rate, and body
temperature
heart attacks, strokes, and respiratory failure
hepatitis or AIDS through shared needles
brain seizures
reduction of the body's ability to resist and combat infection
Psychological risks:
violent, erratic, or paranoid behavior
hallucinations and "coke bugs"--a sensation of imaginary insects crawling
over the skin
confusion, anxiety and depression, loss of interest in food or sex
"cocaine psychosis"--losing touch with reality, loss of interest in friends,
family, sports, hobbies, and other activities
Some users spend hundred or thousands of dollars on cocaine and crack
each week and will do anything to support their habit. Many turn to drug
selling, prostitution, or other crimes. Cocaine and crack use has been a
contributing factor in a number of drownings, car crashes, falls, burns, and
suicides. Cocaine and crack addicts often become unable to function
sexually. Even first time users may experience seizures or heart attacks,
which can be fatal.
Hallucinogens - Hallucinogenic drugs are substances that distort the
perception of objective reality. The most well-known hallucinogens include
phencyclidine, otherwise known as PCP, angel dust, or loveboat; lysergic
acid diethylamide, commonly known as LSD or acid; mescaline and peyote;
and psilocybin, or "magic" mushrooms. Under the influence of
hallucinogens, the senses of direction, distance, and time become
disoriented. These drugs can produce unpredictable, erratic, and violent
behavior in users that sometimes leads to serious injuries and death. The
effect of hallucinogens can last for 12 hours.
LSD produces tolerance, so that users who take the drug repeatedly must
take higher and higher doses in order to achieve the same state of
intoxication. This is extremely dangerous, given the unpredictability of the
drug, and can result in increased risk of convulsions, coma, heart and lung
failure, and even death.
Physical risks associated with using hallucinogens:
increased heart rate and blood pressure
sleeplessness and tremors
lack of muscular coordination
sparse, mangled, and incoherent speech
decreased awareness of touch and pain that can result in self-inflicted
injuries
convulsions
coma; heart and lung failure
Psychological risks associated with using hallucinogens:
a sense of distance and estrangement
depression, anxiety, and paranoia
violent behavior
confusion, suspicion, and loss of control
flashbacks
behavior similar to schizophrenic psychosis
catatonic syndrome whereby the user becomes mute, lethargic, disoriented,
and makes meaningless repetitive movements
Everyone reacts differently to hallucinogens--there's no way to predict if you
can avoid a "bad trip."
Inhalants - Inhalants refer to substances that are sniffed or huffed to give
the user an immediate head rush or high. They include a diverse group of
chemicals that are found in consumer products such as aerosols and
cleaning solvents. Inhalant use can cause a number of physical and
emotional problems, and even one-time use can result in death.
Using inhalants even one time can put you at risk for:
sudden death
suffocation
visual hallucinations and severe mood swings
numbness and tingling of the hands and feet
Prolonged use can result in:
headache, muscle weakness, abdominal pain
decrease or loss of sense of smell
nausea and nosebleeds
hepatitis
violent behaviors
irregular heartbeat
liver, lung, and kidney impairment
irreversible brain damage
nervous system damage
dangerous chemical imbalances in the body
involuntary passing of urine and feces
Short-term effects of inhalants include:
heart palpitations
breathing difficulty
dizziness
headaches
Remember, using inhalants, even one time, can kill you.
According to medical experts, death can occur in at least five ways:
1. asphyxia--solvent gases can significantly limit available oxygen in the air,
causing breathing to stop
2. suffocation--typically seen with inhalant users who use bags;
3. choking on vomit
4. careless behaviors in potentially dangerous settings
5. sudden sniffing death syndrome, presumably from cardiac arrest
OxyContin® - Numerous media reports have identified an apparent
increase in the abuse and addiction of OxyContin®, a potent painkiller
frequently prescribed for terminal cancer patients. The medication is a
semi-synthetic opioid narcotic that is legitimately prescribed to those in
need of long lasting pain relief. The medications active ingredient is
oxycodone, which is also found in drugs like Percodan and Tylox. The
benefit of the medication to chronic pain sufferers is that they generally need
to take the pill only twice a day because its time-release formula provides
up to 12 hours of pain relief.
However, according to a recent New York Times article, illicit dealers have
used suffering patients as well as fakers to "doctor shop" to obtain
OxyContin for resale "on the street". Abusers favor the drug because they
crush the tablet and ingest or snort it, or dilute it in water and inject it.
Crushing or diluting the tablet circumvents the time-release protection of the
medication resulting in a sudden, powerful morphine-like high.
The degree of OxyContin abuse in some locations is alarming. The National
Institute on Drug Abuse (NIDA) has reported that pharmacies and homes in
some rural areas have been robbed by individuals seeking the drug. NIDA
has also reported that in response to concerns over OxyContin abuse, an
alliance of hospitals in the greater Cincinnati has generally restricted the
use of OxyContin to cancer patients. Also, according to a recent bulletin
from the National Drug Intelligence Center, a drug outpatient treatment
facility in Virginia identified that 80% of its 290 people named OxyContin as
their primary drug of abuse.
Taken as prescribed, opioids such as OxyContin can be used to manage
pain effectively without untowards side effects. However, abuse of opioids
can result in tolerance to the drug, physical dependence, and may lead to
addiction. Withdrawal symptoms can include restlessness, muscle and
bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps,
and involuntary leg movements. Individuals who are addicted are more likely
to overdose on the drugs, which could be fatal.
Parents can help by learning the facts and educating their families about the
dangers of abusing Oxycontin and other opioids. Additional information on
opioids and other drugs is available on NIDA's web site at www.nida.nih.gov
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