1. OTC and Prescription Drug Abuse Slideshow Pictures
2. Health Risks of Alcohol Abuse Slideshow Pictures

Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Gamma-hydroxybutyric acid, or GHB, is a hypnotic depressant known on the street by several names: easy lay, Georgia home boy, liquid X, liquid ecstasy, liquid E, grievous body harm, Gib, G-riffic, natural sleep-500, gamma-oh, cherry meth, scoop, soap, salty water, organic Quaalude, fantasy, sodium oxybate, somatomax, and gamma hydrate. GHB is perhaps most commonly known as the date-rape drug.

• What it looks like: GHB usually comes in a liquid form that can be mixed with other liquids. Recipes for home synthesis are available on the Internet. 3-butyrolactone and 1,4 butanediol are derivatives of GHB that are converted to GHB after ingestion. They are often purchased by body builders at health food stores for their purported muscle-building and fat-burning qualities. GHB is less commonly available in the capsule form.
• What it does: GHB is a nervous system depressant similar to gamma-aminobutyric acid. Its effects range from drowsiness, forgetfulness, and loss of muscle tone to seizure like activity, slowed heartbeat and breathing, and coma. The coma lasts one to two hours, with full recovery usually occurring by eight hours. In the date-rape scenario, it is often slipped into an unwitting victim's drink. By January 2000, the U.S. Drug Enforcement Agency had reported 60 deaths associated with GHB use. High school kids have been reported to use this substance as an alternative to alcohol. It leaves no odor for parents to detect, and the effects are gone by the time users return home from a night out.
• Harmful effects: Effects of the drug begin 15-60 minutes after use and typically last up to six hours. It can be detected in the urine up to 12 hours after ingestion. Tolerance (progressive decreased susceptibility to a drug's effects), dependence (compulsion to take a drug to experience its psychic effects or to avoid the discomfort of its absence), and withdrawal reactions have been reported with GHB use. Respiratory depression can be severe enough to require life support on a ventilator or breathing machine until the drug effects wear off.

Rohypnol (generic name, flunitrazepam) a potent benzodiazepine (a class of tranquilizing agents), is known as Mexican Valium, circles, roofies, la rocha, roche, R2, rope, and forget-me pill. It is available in more than 60 countries in Europe and Latin America, where its legitimate use includes preoperative anesthesia. This drug is not available in North America for sale or prescription. It is usually brought into the United States by mail. Florida, California, and Texas are the states that have had the most confiscations of rohypnol.

• What it looks like: The pills usually include a single score, the Roche imprint, and "1" or "2" to denote the tablet strength. The tablets are usually 1 or 2 mg in strength and are relatively cheap at only $5 per pill. Flunitrazepam is 10 times more potent than diazepam (the generic name for Valium) and is thus considered a cheap high. Rohypnol is odorless and colorless, making it easy to slip into someone's drink. Rohypnol has been associated with date rape.
• What it does: Rohypnol in low doses is a sedative and muscle relaxant. In higher doses, it can cause lack of muscle control, amnesia, loss of inhibitions, and loss of consciousness. The effects are usually worsened with alcohol. Sedation occurs within 30 minutes after ingestion, with peak effects at two hours. As little as 1 mg can impair an individual for eight to 12 hours.
• Harmful effects: Adverse effects include low blood pressure, dizziness, confusion, visual disturbances, inability to urinate fully, and, in some users, aggressive behavior. Dependence on flunitrazepam can occur. Withdrawal produces symptoms such as headache, tension, extreme anxiety, restlessness, muscle pain, light sensitivity, numbness and tingling of arms and legs, and even seizures.
• Detection: Benzodiazepines are easily detectable on most urine drug screens. However, flunitrazepam is used in such small doses and is so rapidly metabolized that it is not detected on standard drug screens, although it can be detected by specialized laboratories.

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