High

by David Sheff

  Because of the abuse of this drug, more states are regulating cough syrups and cold tablets and gel caps that contain DXM, but some have yet to do so. And while some adults can’t imagine kids abusing cough syrup to get high, the reports of middle school and high school kids showing up in emergency rooms after drinking cough syrups that contain the chemical DXM are on the rise.

  Another problem is that cough medicines containing DXM usually have other ingredients such as acetaminophen, which can be very dangerous when taken in large quantities, potentially causing liver damage. DXM is also sometimes abused in combination with other drugs or alcohol, which can increase the dangerous physical effects. “Lean” or “purple drank” is another way kids get high. Users mix medications that contain codeine, such as Robitussin AC, with soda and candy to make lean.

  ROHYPNOL AND GHB

  Colorless and tasteless medications like rohypnol (an antianxiety medication) and GHB (an anesthetic) are dissociative drugs with a sedative effect that cause amnesia.

  Rohypnol is called by many names: circles, the forget pill, the forget-me pill, roach, roofies, rophies, and wolfies, among others. It’s a powerful sedative that depresses the central nervous system. Roofies, swallowed as pills, dissolved in a drink, or snorted, are sometimes taken to enhance a heroin high or to mellow or ease the experience of coming down from cocaine or crack.

  Used with alcohol, the drug creates a sleepy, relaxed, and drunk feeling that lasts two to eight hours. Other effects may include blackouts, with a complete loss of memory; dizziness; dangerously slow breathing; disorientation; nausea; and difficulty with motor coordination and speech. Rarely, users of these drugs fall into comas, and some die.

  These pills are also used in the perpetration of crimes of robbery or sexual assault. The offender slips the drug into a victim’s drink in order to render them unconscious, or at least too hazy to be in their right minds. Because of this, experts advise people at parties or concerts, in crowded bars, or in similar social situations to keep an eye on their drinks.

  GHB, another central nervous system depressant, is used similarly. It is also manufactured as a clear liquid or a white powder, or in tablet and capsule forms. The ingredients in GHB are more commonly used as floor-stripping solvents and drain cleaners.

  Bodybuilders have been known to abuse GHB to stimulate muscle growth. It is also commonly abused as a recreational drug, particularly among partygoers in the club scene. Combining it with other drugs, such as alcohol, can result in nausea, loss of muscle control, and difficulty breathing. GHB may also produce withdrawal effects, including insomnia, anxiety, tremors, and sweating.

  As the dose increases, the sedative effects may result in unconsciousness and eventual coma or death. Other effects include difficulty thinking, hallucinations, slurred speech, headaches, and amnesia.

  STEROIDS

  Anabolic steroids mimic the effects of the hormone testosterone. They activate cell growth, particularly in muscles, and help maintain or increase male physical traits. They are also prescribed for conditions such as wounds that won’t heal, pulmonary and bone marrow disorders, and muscle loss.

  Though steroids are classified as a schedule III controlled substance—meaning that not only must they be prescribed by a doctor, but also that extra rules are in place to prevent their abuse—they are still subject to misuse by teenagers. The hope is that these drugs will help build muscle, strength, and speed for athletic pursuits or improve users’ physical appearance in other ways. Though boys tend to be the most frequent abusers of steroids, girls have been known to abuse them as well.

  Unfortunately, the use of steroids comes with the risk of damaging physical effects, many of which are irreversible. These can include high blood pressure and cholesterol levels, heart and liver abnormalities, fertility issues, and acne. Male users may suffer from shrinkage of the testes and growth of breast tissue. Girls may grow facial and body hair or have issues with their menstrual cycles.

  In many cases, users will suffer from mood swings and an increase in anger and aggressive behavior, damaging not just their bodies but their relationships with their loved ones and others. It’s helpful to note, too, that much of what users hope to accomplish by taking steroids can be more safely accomplished through normal weight training, diet, and a sensible course of exercise.

  MIXING MISTAKES

  It’s probably no surprise that prescription drugs that are dangerous on their own are more dangerous when they’re mixed with other drugs, including alcohol.

  A father told us a horrifying story about his son, Patrick, who went to what was called a Skittles party, where kids all kick in a variety of prescription drugs stolen from parents’ dresser drawers and medicine cabinets, bought from friends, and prescribed by the psychiatrists treating their friends for depression, ADHD, bipolar disorder, sleeplessness, and anxiety.

  Every party’s assortment of Skittles is different. That night, the mix at the party included Adderall, Xanax, Prozac, and a few OxyContins. Friends held the bowl of “Skittles” in two hands, offering it to one another as if it were a bowl of chips. Each kid would dip in, pluck out one or a few, and swallow them down with cup of punch—a mix of cranberry juice cocktail, Red Bull, and vodka, served over ice.

  An hour after taking a few pills, Patrick passed out on a couch alongside a girl named Annie. She lay semiconscious, curled up against him.

  After doing some tequila shots in the kitchen with some other kids, a boy wandered into the living room and noticed that Patrick and Annie were still asleep. They hadn’t moved in a while, so he went to check on them.

  They didn’t seem to be breathing.

  He tried to wake them. Patrick stirred a little, but Annie didn’t. She seemed to be having a difficult time breathing.

  The boy tried to feel Annie’s pulse, but he didn’t really know what he was doing. Fear shot through him, sobering him up fast. He rushed through the house, telling everyone to take off, to grab their drugs and booze and go.

  Someone grabbed the bowl of pills. Then the boy gathered the leftover drugs and flushed them down the toilet. The room was still a mess, so he grabbed a garbage bag and tossed in trash and paraphernalia, including empty beer cans and pipes, which he carried outside to a bin. Once back inside, he dialed 911.

  “There’s a girl here. I think she’s overdosing.”

  The EMTs arrived in less than fifteen minutes. The boy whose home it was let them in. Trying to keep it together, he made excuses—Annie must have had some drugs—but a paramedic pushed him aside.

  The paramedic saw that Patrick was breathing but Annie wasn’t. He attempted CPR while his partner filled a syringe with naloxone, a drug that can reverse an opiate overdose. He injected Annie but got no response.

  At the same time, the police arrived and, a moment later, another ambulance crew. Patrick was placed on a gurney and wheeled to an ambulance. After supplying Annie’s name, the boy who hosted the party was arrested. A police officer searched Annie’s cell phone for the number of a relative. He called Annie’s parents. And then he called the coroner.

  CHAPTER NINE

  Heroin, Cocaine, Meth, and Other Illegal Drugs

  I think if you were Satan and you were settin around tryin to think up somethin that would just bring the human race to its knees what you would probably come up with is narcotics.

  —CORMAC MCCARTHY, NO COUNTRY FOR OLD MEN

  HEROIN

  In our experience talking to teens and adults around the country, we’ve never heard anyone say they planned to try heroin. It has a bad reputation even among those who say they were curious about other drugs. However, most people don’t know that heroin is an opioid, like OxyContin and Vicodin.

  People who have no problem popping pills often could never imagine sticking a needle in their arm. But all too often, one drug leads to another. More and more people turn to shooting heroin as a way to capture the high of prescription pills they can no longer afford or obtain.

  A
recent report called heroin “the deadliest drug worldwide,” and noted that there are more than a million heroin users in the United States. In 2016, over 16,000 people in this country died of heroin overdoses, and the numbers continue to rise.

  Synthesized from the opium poppy for the first time in 1874, heroin mimics a neurotransmitter in the body related to pain relief. Like OxyContin and other prescription opiates, heroin can cause breathing to slow and eventually stop. Most deaths from heroin ODs are caused by respiratory failure. The drug can also cause heart attack and asphyxiation—people suffocate by choking on their own vomit.

  Just as we’ve never heard anyone say they set out to try heroin, we’ve never heard anyone say they set out to inject heroin. Most say that when they decided to try it, they decided to snort it—just once—and would never, ever consider injecting it. (This is true of methamphetamine, too.)

  As Nic says, “Heroin was the last hard drug I tried. I stayed away from it for a long time because of its reputation. But at a certain point, I no longer cared. Addiction had brought me to a place where I would do anything to feel better—heroin, needles: they were just part of the process.”

  Joe is a pretty typical eighteen-year-old kid. At a party, he took a pill for the first time—an OxyContin. It felt, he says, “amazing—like warm maple syrup through my body. I had no idea what I’d been missing. I had no idea you could feel this good.”

  So it’s not surprising that Joe wanted to do it again. “It’s all I thought about.” He bought pills from kids at school—ten dollars for a Vicodin, twenty dollars for an OxyContin. (Now, in some cities, “Oxys” go for as much as fifty dollars for a single pill.) He had savings, so money wasn’t a problem for a while. But pretty soon he didn’t get that “syrupy” feeling from one pill. He’d take one and a half. Then two. Then three.

  Pills weren’t always easy to find. A boy who sold him pills said that he could get him a hit of heroin for ten dollars. Joe felt a little nervous about saying yes, but he thought he’d try it once—not a big deal.

  He snorted the heroin and threw up. He couldn’t believe he’d done something so stupid. But then he felt better. And better. That warmth he’d felt for the first time on Oxy—here it was again.

  And so.

  He got more. Shooting up wasn’t a calculated decision. The guy he bought from just asked if Joe wanted him to shoot him up, and he felt that same fear he’d felt when he said he wanted to try heroin the first time. But he was curious, too. And he thought, Just this once. What the hell.

  The guy prepared the drug and injected it into Joe’s arm. After that rush, there was no going back to snorting. His life became an endless cycle of having to keep from getting sick. As the heroin left his system, his body would start to cramp up, his muscles aching painfully, his nose running. He’d start to vomit and have uncontrollable stomach spasms until he could get the next shot—which, even then, wasn’t really getting him high anymore, but only served to make him feel “well” for a short period of time. And then it started all over again.

  Joe is in rehab now. “It feels like it was all a dream,” he says. “How did I get here? I woke up in the emergency room. I just don’t remember anything after shooting up.”

  For far too many of us, these moments fall together like dominoes—one choice that doesn’t even feel like a choice leads to another that leads to another that leads to jail, the emergency room, or the morgue.

  When the actor Cory Monteith died in July 2013 of an accidental overdose of heroin and alcohol, people were shocked because the thirty-one-year-old actor, well known for his portrayal of a high school athlete on the TV show Glee, didn’t fit the stereotype of a heroin user. We think heroin users are like the ones we see in the movies—strung out in alleys, passed out in doorways. But people addicted to heroin look like everyone else. Like people we all know.

  COCAINE

  Cocaine, methamphetamine, and other amphetamines act directly on the dopamine system, causing an intense release of the chemical in the brain, which is why people on these drugs feel so good, at least for a while.

  Cocaine is extracted from the leaves of the coca plant. It is a potent brain stimulant and one of the most powerfully addictive drugs.

  On the street, cocaine is distributed in two main forms: a white crystalline powder that is usually snorted (it’s also dissolved in water and injected) and “crack,” cocaine that’s been processed with ammonia or baking soda and water, forming chunks or “rocks” of what look like crystals, which are usually smoked, though may be melted down and injected as well.

  Short-term effects of cocaine include increased temperature, heart rate, and blood pressure; insomnia; loss of appetite; and feelings of restlessness, irritability, and anxiety. How long cocaine’s immediate euphoric effects—which include energy and a deceptive sense of mental clarity—last depends on how it is used. The faster the absorption, the more intense the high. When the high ends, the user can experience depression, irritability, and fatigue. Cocaine can also trigger paranoia. Smoking it can produce particularly aggressive paranoia.

  When people take cocaine, they’re twenty-four times more likely than normal to have a heart attack within an hour. In fact, almost six thousand people die of cocaine-induced heart attacks per year.

  METH AND OTHER AMPHETAMINES

  In an interview, Stephan Jenkins, the lead singer of Third Eye Blind, said that meth makes you feel “bright and shiny.” It also makes you paranoid, delusional, destructive, and self-destructive. Then you may do unconscionable things to feel bright and shiny again.

  Nic says, “I pretty much became addicted to meth the first time I tried it.” Earlier he wrote that it made him feel like a superhero—“super confident, super strong”—but then he said, “Once I started doing crystal meth, my life spiraled out of control in a flash.”

  Meth or crystal meth, nicknamed crank, tweak, glass, ice, crystal, and shard, among many other terms, causes an intense and long-lasting rush, but it is also one of the most toxic and addictive drugs there is.

  Meth can be taken as a pill, but more often is snorted, smoked, or injected. Whichever way it’s ingested, it is quickly absorbed. Once it reaches the bloodstream, it’s a near instant waterslide ride to the central nervous system. Meth triggers ten to twenty times the normal level of the brain’s neurotransmitters, primarily dopamine, but others, too. It then blocks the release of those neurotransmitters, which means it’s harder and harder for a person to feel pleasure, even when they take more of the drug over time.

  Research now shows that high doses of methamphetamine damage nerve-cell endings, and this leads to long-term memory and cognitive deficits. Meth can lead to anorexia, mood disturbances, violent behavior, confusion, paranoia, delusions, convulsions, and insomnia. It can also cause severe depression and high levels of anxiety. The drug increases breathing rates, body temperature, and blood pressure and can cause strokes and heart attacks.

  As many as half of all meth users “tweak,” meaning that at some point they experience a type of meth psychosis—that is, they really do go out of their mind for a while.

  Not only is creating and selling meth illegal, but producing it also damages the environment. The manufacture of one pound of the drug creates six pounds of corrosive liquids, acid vapors, heavy metals, solvents, and other harmful materials, which are then dumped into the surroundings.

  The health effects of meth are disastrous. Nic came close to dying of an overdose on meth. Meth can cause the body temperature to rise sharply, leading to lethal convulsions, death from hyperthermia, and “arrhythmic sudden death”—when the heart no longer has a functional beat. It can also cause a fatal aneurysm—a burst artery that supplies blood to the brain. Those who don’t overdose on the drug may still die from it, either in fatal accidents, from a heart attack, or by suicide prompted by the incredibly potent depressive effects of the drug.

  Nic

  What crystal meth did to me was make me completely crazy. There was even
a point where I was talking to people who weren’t there and heard voices that weren’t there. The feeling of these psychotic breaks was like my mind was a dog digging for a bone, but the bone just kept getting deeper and deeper and deeper and I couldn’t stop digging.

  It was impossible to break free of the obsessive thoughts. As a result, I would get trapped taking apart electronic equipment, or trying to play a song on guitar till my fingers were bleeding and blistered, or looking for things on the street, or repeating any number of insane, pointless, and maddening behaviors. It was incredibly frustrating and scary to be so out of control. But I kept doing it over and over and over again and it almost killed me.

  Earlier we mentioned the show Breaking Bad, about a meth cook. Its depictions of meth addicts—most of them emaciated, with sores all over their faces and bodies, exhibiting psychotic behavior—aren’t exaggerations.

  ECSTASY

  Ecstasy is a synthetic drug with amphetamine-like and hallucinogenic properties. Forms of the drug, also known as Molly, Adam, E, roll, X, XTC, and MDMA, comes in powder, capsule, or liquid form but is most often seen as tablets branded with different shapes or logos. It is well known for its use at raves, clubs, and other parties where users dance and feel a range of intensely pleasurable (though temporary) effects, like feelings of closeness with others, that are often followed by a devastating crash that can leave users in a deep, sometimes suicidal depression. Other effects can include involuntary teeth clenching, a loss of inhibitions, nausea, blurred vision, and chills and/or sweating. Increases in heart rate and blood pressure and seizures are also possible.