NIDA for Teens: The Science Behind Drug Abuse
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Betty Ford: Shining a Light on Addiction

You might have heard the news that former first lady Betty Ford recently died at the age of 93. Many of you reading this might never have heard of Betty Ford; after all, she became First Lady way back in 1974. But maybe you’ve heard of the Betty Ford Center, a rehab center in Rancho Mirage, California, where many celebrities have gone to seek treatment for their addictions. You also may not know why she built the center.

Not long after Richard Nixon resigned from office during the Watergate scandal, Jerry Ford suddenly became President and the family got thrust into public life. Betty Ford wrote in her memoirs that her family never wanted that level of fame, but accepted it to help the country through difficult times.

Over the years, as the spotlight on Betty Ford and her family grew, she began to drink more heavily on top of a dependency on pain pills, which started in 1964 when she got a prescription to relieve constant pain from a neck injury and a pinched nerve. We now know that mixing pills and alcohol is a big mistake. Once she was First Lady, people began to notice that when she spoke she was slowly slurring her words and she seemed to have no energy. After her husband’s presidency was over, Betty Ford left public life and soon announced she was addicted to pills and alcohol. In her memoirs, she tells the story about how her family confronted her about her addiction, which at first she was not happy about. Later, she thanked them and became a champion for people struggling with the disease.

Her openness about her addiction was shocking to some people. Forty years ago, people tried to hide the fact they had an addiction problem, but she bravely brought it into the light, giving others the courage to ask for help with their own drug abuse and addiction problems. She entered rehab and, with treatment, learned to manage her addictions. A few years later she opened a rehab center in her name to help other people. Today the Betty Ford Center is a thriving treatment center, and because of its closeness to Los Angeles, it has become a rehab center for many famous people, including Drew Barrymore, Robert Downey, Jr., Johnny Cash, Elizabeth Taylor, and many others.

So SBB says thank you Betty Ford for having the courage to use your personal story to educate people about addiction, and for bringing it from the darkness into the light, from shame and despair to treatment and hope.

How did she have the courage to bring her addiction out in the open? She has been quoted as saying, “The public needed to know that this didn’t have to be swept under the rug anymore, that this needed to be open and discussed.”

Betty Ford

“Glee” Star Continues Path to Recovery From Drug Addiction

Recovery from addiction doesn’t mean completing a rehabilitation program and then you are cured. Addiction is a brain disease that requires commitment and effort every single day to stay off drugs.

It can also mean more than one round of treatment—and usually does.

In April 2013, “Glee” star Cory Monteith checked himself into a treatment facility for drug addiction. This is the second time the actor has been in rehab.

When Cory was 19, he went to rehab after developing a severe drug addiction and dropping out of school. He went back to using drugs soon after, and eventually became so desperate he stole money from a family member. His family gave him the choice to either stop using drugs, or they would press charges for the theft.

Cory sought help to stop using drugs and began working with an acting coach. Just 2 years ago, he received his high school diploma, while starring as high school student Finn Hudson on “Glee.”

Now 30 years old, Cory has chosen to refocus on his recovery. We’re not sure if he was using drugs, or if he simply was struggling with the urge to use again. But we do know that he’s making the smart decision to put his health first.

Cory’s out of rehab now, and we wish him the best in his recovery journey. Recovery from addiction is a lifelong journey that sometimes requires multiple treatment episodes, just like some other illnesses like diabetes or heart disease. But if you have a problem, you’re never too young to start addressing it.

NIDA continues to research the science of addiction, so that we can learn how to better prevent, manage, and eventually cure this disease.

What do you think about Cory Monteith’s second stint in rehab?

Cory Monteith

Macklemore Talks Drug Abuse, Addiction, and Recovery

“I wanted to get clean. I knew that my highest potential, the place that I was most spiritual, the place that I was the most rich in terms of my life, and my livelihood, and my art and my creativity, was when I was sober.”

GRAMMY-award winning artist Macklemore is in recovery from drug addiction. In a video for the campaign Half of Us, he tells the story of how he started using drugs, how it damaged his relationships, his journey through recovery, and the pain of losing a friend to a drug overdose.

Half of Us

Half of Us is raising awareness about mental health issues and drug abuse among teens and young adults. Sponsored by mtvU and the Jed Foundation, Half of Us provides facts about depression, bipolar disorder, suicide, eating disorders, anxiety disorders, stress, and addiction in young people, as well as information about how to seek help.

Additional videos feature Mary J. Blige, Brittany Snow, Pete Wentz, and Billy Corgan—in addition to college students who have suffered from mental health problems or addiction.

www.halfofus.com/video/macklemore/

 

Macklemore performing in Toronto during The Heist Tour.

R.I.P Amy Winehouse

While we are still not sure exactly what killed Amy Winehouse, many people are speculating that it had something to do with her admitted drug and alcohol abuse. As we blogged a few weeks ago, Winehouse was booed off the stage in her last concert. Now she may be among what some call the “27 Club”—famous people who died at the age of 27 from drug and alcohol abuse, including Kurt Cobain, Jimi Hendrix, Janis Joplin and Jim Morrison, all major music heroes of their times. Coincidence?

Not really. As their fame and wealth increased, so did their access to drugs and so maybe, too, their belief that they were outside the rules, invincible. But that wasn’t true. By the time they were in their mid-twenties it is likely their bodies started to rebel, screaming enough is enough!

Going to rehab is a smart move, even if it takes several tries. Rehab is hard. It calls for major changes in an addicted person’s life beyond stopping drug use—like a change of friendships (maybe even of a best friend or partner), not to mention a change of lifestyle and even where you live. When you’re “on top,” too much change might be harder to accept.

Still, the alternative is worse—just ask the people who loved Amy Winehouse. She was a great talent who could really have moved the world. To quote one of our 2010 GRAMMY winners from their video "Drug Free State of Mind," "…we all shootin’ stars basically waitin’ to be seen…"

What is your talent that is waiting to be seen? Make a plan not to waste it!

Empty Stage

Sizzurp: It’s Not Cool

In recent months, gossip magazines have reported on Justin Bieber’s erratic behavior, such as wearing a gas mask, fainting at a London concert, and traveling with a monkey. Mixed in with these reports is speculation about Bieber’s alleged use of a drug concoction called “Sizzurp.”

Bieber isn’t the only musician associated with the drink. Back in March and again at the beginning of May, rapper Lil Wayne was admitted to the hospital with seizures, allegedly from his use of Sizzurp (although he denied it).

NIDA works to stay on top of new drugs. If celebrities are involved, it’s even more important for people—especially teens—to know the facts, because sometimes people may think something’s cool just because a star does it.

Facts About Sizzurp

First, it is not cool. In fact, it’s quite dangerous. Sizzurp, also known as "Lean" and "Purple Drank," is a mixture of cough medicine—often prescription strength, containing an opioid called codeine—and soft drinks and candy for flavor. Abuse of cough medicines, especially ones that contain opioids, can cause an overdose leading to coma or even death. Less grave (but still serious) symptoms include nausea, dizziness, impaired vision, memory loss, hallucinations, and seizures like Lil Wayne experienced.

Teens may think that just because something is available from the pharmacy, it won’t harm them—but that’s not true. When not used as directed on the label, cough and cold medicines (even over-the-counter ones) can be dangerous.

Tell us in comments: If a celebrity does something, do you feel the urge to try it? What would you say to a friend who wanted to try Sizzurp?

Doping Disaster: On the Wheels of a Scandal

Cycling legend Lance Armstrong, winner of the Tour de France 7 times, and his teammates from the U.S. cycling team have been under investigation for illegal “doping.” They are accused of taking performance-enhancing drugs like amphetamines, anabolic steroids, or EPO (erythropoietin), a substance that boosts endurance by increasing the body’s oxygen-carrying red blood cells. Using any of these substances can give people an unfair advantage and is considered cheating. The U.S. Food and Drug Administration is looking into these allegations. Although the investigation itself is closed to the public, Armstrong’s former teammate Floyd Landis, who won the Tour de France in 2006 and has admitted to drug use, recently wrote a tell-all book in which he describes drug use in the sport. A Tarnished Legend As the most successful member of the U.S. team, Lance Armstrong was a champion. His wins—and dramatic comeback after being diagnosed and successfully treated for cancer—made him a hero to people around the world. The damage that the doping allegations have done to Armstrong’s reputation and to the sport is major. Society has rules in place to ensure fairness. And so do most professional sports. Parents teach their children to play by the rules, and we expect adults to live up to these standards, too. But the pressure to win—or to get good grades, or to complete a big assignment—can tempt any of us to bend or break the rules. When the stakes are high, and the competition is intense, shortcuts to gain a competitive edge are tempting. But is it worth it in the end?—especially in the case of illegal substance use, which can do long-term damage not just to reputations, but to people’s brains and bodies… What do you think: What does it mean to you to hear that someone you look up to might have been riding to victory not on talent, hard work, and focus alone, but by cheating? What does “playing fair” mean to you? Bicyclist

R.I.P. Cory Monteith

This past weekend, Hollywood was shocked by news of “Glee” star Cory Monteith’s unexpected death. He was only 31 years old.

Back in April, SBB talked about Cory returning to rehab to deal with drug abuse issues that plagued him off and on since his teen years. Unfortunately, autopsy results showed that Cory died of a heroin and alcohol overdose, highlighting in the most tragic way how drug addiction often follows a cycle of recovery and relapse.

From the accounts of people who knew and worked with Cory, he sounds like he was a really great person—a loyal friend and devoted actor. It goes to show that drug addiction doesn’t just happen to “bad” people like some may believe. All types of people—rich and poor, man and woman, old and young—are equally at risk to be hurt if they start using drugs.

The Danger of Relapse

Relapse happens when a person who was addicted to drugs stops taking them for a while and eventually starts up again. Often, people who are recently out of rehab overdose more easily if they relapse because being off the drug for a while lowers their tolerance. They may take the same dose they were accustomed to before rehab and their bodies can’t handle it.

Heroin is especially dangerous. Not only is heroin a strong drug, but every dose a person buys may be a different purity, or strength. So even if a person takes the same amount of heroin, it might be so strong that he or she overdoses.

The fact that Cory had both heroin and alcohol in his system when he died highlights another important fact: Mixing substances is never a good idea. Heroin and alcohol both slow down breathing and heart rate, making the mix particularly hazardous.

A person who is overdosing can be saved if they get medical care in time, since symptoms of overdose are clear—shallow breathing, weak pulse, and loss of consciousness, for example. But if a person is alone at the time, as Cory was, overdose can result in death.

Cory Monteith was a talented actor and singer with millions of young fans. Now is the time for teens to ask questions about drug addiction and overdose—so let us know in comments if you have any and we’ll be happy to answer them.

Cory Monteith

Michael Jackson: News We'd Rather Not Have

After the news hit about the death of Michael Jackson and all the speculation about his possible prescription drug use, the NIDA press office phones rang off the hook. Why? News reporters wanted information on prescription drug misuse and abuse.

We talked to the NIDA Communications Director, Carol Krause (pictured right), about how they handle calls like that.

Sara Bellum Blog (SBB): How many calls does NIDA get when news like this hits?

Carol: Well it depends on the celebrity and how definite the news is. With Anna Nicole Smith, speculation was immediate that drug abuse was involved, so we got a lot of calls from the press right away. With Heath Ledger, people weren’t so sure, and the inquiries came gradually, over a period of weeks.

SBB: And Michael Jackson?

Carol: Within a few hours of his death, the NIDA press office got maybe a dozen calls from major news reporters wanting information on prescription drug abuse. They were doing research in case toxicology reports came back saying that medication misuse contributed to the pop icon’s death.

SBB: And what do you tell them?

Carol: We treat this like any other inquiry. We give them facts. The fact is that between the years of 1999 and 2005, the number of accidental deaths from drug overdoses in this country more than doubled.

SBB: Really? Why?

Carol: The biggest problem is the increased misuse and abuse of prescription painkillers—opioid narcotics like Vicodin and OxyContin.

SBB: Is this a problem with teenagers?

Carol: Absolutely. For the past 5 years, 1 in 10 high school seniors have reported they use Vicodin without a prescription—1 in 20 have used OxyContin.

SBB: Why isn’t the press reporting this?

Carol: Oh they are. The question is—are teens listening?

SBB: I’d like to think teens are smart enough to know that using medications without a prescription can be dangerous. What is the take away lesson from Michael Jackson’s death?

Carol: That we don’t need a tragedy like this to learn how to make smart decisions about your health. The information you need is right here on the NIDA website.

NIDA Communications Director, Carol Krause, sitting at her desk

Amy Winehouse: Death by Misadventure

In October 2011, the coroner who conducted Amy Winehouse’s autopsy declared that the Grammy-winning singer “died by misadventure.” Translation: Amy died of accidental alcohol poisoning. Amy famously battled an addiction to drugs and alcohol, and had returned to rehab only months before her death. She gave up drugs after receiving treatment in 2008 but had trouble staying away from alcohol—in fact, Amy had just resumed drinking a few days before her death after 3 weeks of abstinence from it. Sadly, she drank a lethal amount of alcohol—nearly five times the British drunk-driving limit. What Is Alcohol Poisoning? Alcohol poisoning is when a person has extremely high levels of toxic alcohol in his or her system. According to the National Institute on Alcohol Abuse and Alcoholism, the liver converts toxic alcohol—from beer, wine, or hard liquor—to nontoxic energy at a rate of approximately one drink per hour, depending on factors like gender, size, age, medical conditions (e.g., heart disease), and whether other drugs were used in addition to alcohol. Rapid consumption of a lot of alcohol can overload the liver’s ability to keep up, causing the blood alcohol concentration to rise rapidly. High blood alcohol concentration can lead to slurred speech and lack of muscle coordination. It also “numbs” the part of the brain that controls the heart and lungs, which can lead to coma or death. How Many People Die From Accidental Alcohol Poisoning? It’s actually pretty rare to die from alcohol poisoning alone—about one in a million people. What’s more common is for people to die from combining alcohol and other drugs, which can lead to dangerous medical issues, suicide or self-injury, accidental drowning, or car accidents. Usually when we say someone is “one in a million,” it means that they’re special and talented in a way most people dream of. Amy Winehouse was certainly special and talented for writing and performing her music. Unfortunately, at age 27, Amy Winehouse was also an unlucky “one in a million.” Rest in peace, Amy. Shadow of a liquor bottle

Olympians and Steroids

The lure of Olympic Gold is strong among amateur athletes all over the world. People toil from childhood for the chance to stand atop the podium and hear their national anthem playing in their honor. Unfortunately, the drive to win a medal leads some athletes to use illegal substances to enhance their performance. SBB has talked about doping, or abusing steroids, in cycling and baseball—but now, American track and field Olympians are under fire.

In mid-July, U.S. sprinter Tyson Gay tested positive for banned drugs, according to a drug test conducted by the U.S. Anti-Doping Agency. He has not said what he tested positive for and expects his second sample test results to clear his name. It is believed that he received “anti-aging” treatment—a therapy that uses hormones such as testosterone and human growth hormone—which may have led to the positive test. Such treatments are banned by the Olympics.

Gay isn’t the only Olympian facing this problem. In spring 2013, Jamaica suspended several athletes, including sprinter Asafa Powell, former 100-meter record holder; Veronica Campbell-Brown, a three-time gold medalist in the 200-meter; and Sherone Simpson, 4x100 relay gold medalist, for testing positive for banned substances.

Steroids, Not Worth It

Because of the positive test, Gay withdrew from the World Championships taking place in August. Adidas, his sponsor since 2005, also ended its relationship with Gay. He could be suspended from competing for 2 years.

It would be a big loss for the American Olympic team. Gay is America’s fastest 100-meter male sprinter, having won the 100-meter and 200-meter races in the U.S. Championships in June 2013.

Steroid abuse doesn’t just end with ruined careers and loss of credibility because of cheating. Abusing steroids can cause serious health effects, such as kidney and liver damage; enlargement of the heart and high blood pressure; and changes in blood cholesterol leading to an increased risk of stroke and heart attack, even in young people.

Check out SBB’s interview with 1996 Olympic gold medalist gymnast Kerri Strug and learn how she won the gold without abusing steroids.

What Do You Think?

Why do you think some athletes choose to abuse steroids? What do you think is more important—winning or integrity? Let us know in comments.

Tyson Gay

Real Life: The Choices We Make

A lot of celebrities are making headlines lately for all the wrong reasons. First we hear about tennis star Andre Agassi admitting to meth (a toxic stimulant drug) use when he was on the tennis circuit (what was he thinking?) and now Tiger Woods, with everyone speculating about his personal problems. All of this news has made SBB think a lot about how we make choices in our lives. Why do intelligent, successful people make bad choices when they have so much to lose—even (and maybe especially) superstars?

We look at this question of personal choices and self control a lot at NIDA while we study drug abuse. Initially, taking drugs is a choice. Over time, drug abuse can become a disease we call addiction. But what makes us risk the consequences of making the choice to try drugs? Not everyone becomes addicted to them, but many do, so why do people risk it?

To find answers, scientists are studying the brain chemical called dopamine. Dopamine gives us a feeling of euphoria, a physical surge of pleasure in response to things we enjoy, which are different for different people. From healthy pleasures, like eating a good meal or scoring a goal, to unhealthy ones, like doing drugs or stealing from stores. Once you become addicted to that rush of dopamine it is hard to stop the behavior. And, once you become addicted it is hard to feel pleasure from the simple things in life—like a great piece of music, holding hands with someone you really like, spending a fun day with the family, or having a laugh with friends.

So how do we avoid making bad choices in the first place? SBB suggests focusing on the genuine pleasures in your life. Fill your day with them. Go shopping with your sister, watch a game with friends, join a club at school, see a movie, read a great book…Protect the simple pleasures in your life—and when it comes to drugs, maybe think about what you might lose.

Quote from Harry Potter about our choices and our abilities; Image Courtesy of Garland Cannon

Real Teens Ask: Is Propofol a Drug?

Since the death of Michael Jackson in 2009, “propofol” has been mentioned often in the news. The substance was found to be the cause of his death and was the center of the highly publicized trial of his doctor.

So, it’s no surprise there is a lot of curiosity about propofol. NIDA received questions about it during last year’s Drug Facts Chat Day.

During Chat Day, Cam from California asked about the basics—

Is propofol a drug?

Yes. Propofol is a common type of anesthetic—a drug that doctors use to “put people to sleep” for surgery. It is given to patients through an “intravenous drip,” (called an “IV” for short) that goes through a special needle into a patient’s vein, so the medicine goes directly into the bloodstream.

Doctors who give patients propofol are generally known as “anesthesiologists” and have special training. These experts set up the IV, make sure the patient is “sleeping” comfortably, and then carefully monitor vital signs (like heart rate, breathing, etc.) while the patient has surgery.

Doctors like using propofol because it leaves the body very quickly, which allows the patient to wake up after surgery more rapidly, without bad side effects. Propofol can be a useful drug when it’s given by people who are properly trained. But like many prescription drugs, it can be very harmful if used inappropriately. Propofol should be given only in a hospital setting where the patient can be closely monitored.

A Lost Legend

Michael Jackson died of acute propofol intoxication. Additional drugs found in Michael’s system were the depressants midazolam and diazepam, the painkiller Lidocaine, and the stimulant ephedrine. His doctor, Conrad Murray, was convicted of causing the singer’s death by giving Michael the propofol that caused him to stop breathing. By helping Michael abuse drugs—even if it was to “help him sleep”—he contributed to the loss of a legend. Michael’s untimely death was mourned by millions of people.

Syringe full of Propofol.

Baseball’s Steroid Problem: Why Won’t It End?

On Monday, the news broke that New York Yankees star Alex Rodriguez will be suspended for 211 games for using performance-enhancing drugs (PEDs). He is appealing, but as it stands, this is the longest non-lifetime suspension in baseball to date.

A-Rod is the latest in a long string of high-profile baseball stars whose reputations have been tarnished by PEDs. Others include superstars like Mark McGwire, Barry Bonds, Manny Ramirez, and Roger Clemens.

Baseball has been cracking down on steroid use with more frequent and random testing, but that hasn’t stopped the problem. After all, A-Rod’s suspension comes on the heels of former National League MVP Ryan Braun’s. Why do the big stars keep risking their careers and reputations for drugs? They are all smart enough to know that a short-term gain in strength is likely to be offset by some potentially disastrous long-term health effects, which is why these drugs are banned in the first place.

Part of the problem is that steroid abuse is part of baseball’s culture. As in cycling, so many players are taking PEDs that teammates may feel they have to illegally up their game as well.

There may be a troubling trickle-down effect from high-profile athletes continuing to use these drugs. Although less than 3% of high school seniors used PEDs in 2012 (according to NIDA’s Monitoring the Future study), the company accused of giving A-Rod the illegal substances is allegedly being investigated for selling high school athletes PEDs as well. Teens may start to believe that the only way to go pro is to use these dangerous drugs.

So what’s the answer? Some have suggested that baseball should adopt a “one strike and you’re out policy”—meaning, if a player tests positive even once for illegal substances, he is banned from baseball for good. That is a hefty price to pay—do you think it would solve the steroid abuse problem in the sport?

Tell us: What are your ideas for getting pro sports players to stop using performance-enhancing drugs?

Alex Rodriguez

Eminem and Elton John

Musician Elton John recently said he’s been helping rapper pal Eminem work through his problems with substance abuse. 

Eminem (aka Slim Shady and, before that, Marshall Mathers from Detroit, MI), was in treatment for substance abuse in 2005. Since then, he has abused prescription drugs like Vicodin, Ambien, and Valium. Some bad things happened after 2005, and maybe that led him to start abusing drugs again. In December 2007, he was devastated when his marriage ended and his closest friend and fellow rapper DeShaun “Proof” Holton died.  Eminem was even hospitalized for overdosing on methadone. Then in early 2008, he began a program to recover from his addiction, and he says he’s been off drugs since April 2008.

Skip to now…if you read the lyrics on his latest album, called “Relapse,” Eminem continues to glorify drug use and violence, even while he himself is trying to stay sober.  So, here’s a question for you:

Does artistic expression mean you can say whatever you want, even if you know you could be influencing others to hurt themselves by taking drugs?

Elton John has acknowledged his own problems with substance abuse in the past. He says he wants to be there now to help anyone who has addiction problems. It’s good that Eminem has a more experienced artist like Elton John to guide him through this personal struggle. Wouldn’t it be great if this true friend could also help Eminem use his talents to contribute a positive musical message to the world?

Man with a hoodie over his face in a dark room

Whitney Houston: Legendary Singer Dies After Struggle With Addiction

On February 12, the 54th annual GRAMMY Awards paid tribute to music legend Whitney Houston, who died the previous night at the young age of 48. Early reports suggest that a deadly mix of prescription drugs and alcohol were the cause of Houston’s death, though toxicology results are still pending. It is well known that the six-time GRAMMY winner battled drug and alcohol addiction.

Michael Jackson…Amy Winehouse…and now Whitney Houston. Legendary singers who seemed to have it all—talent, charisma, fame, money, power, family support. And yet, they could not overcome their addiction to drugs. That’s because addiction doesn’t care if you’re famous or rich—once you’re in its grip, the experience is similar for many of the 20 million people in the United States today who struggle with this brain disease.

Why Do People Continue To Take Drugs?

Why do people continue to abuse drugs and, in some cases, combine them with alcohol, when so many others have fallen from doing so? Although Houston entered rehab three times, she is a perfect example of why addiction is defined as “a chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences.”

The initial decision to take drugs is mostly voluntary—but after that, a combination of genetics and environment will write the rest of the story. Some people will become addicted and will find it impossible to stop taking drugs without help. Addiction changes the brain’s structure and how it works. Brain imaging studies from people who are addicted to drugs show physical changes that not only affect feelings of pleasure but also judgment, decision-making, learning, memory, and self-control. That may help explain the compulsive and destructive behaviors that characterize addiction.

What Are the Dangers of Abusing Prescription Drugs?

One of the greatest myths about prescription drugs is that, because doctors prescribe them, they are safer to abuse than illegal drugs. But as prescription drugs have become more available, more people are literally dying from their abuse. In fact, every year in the United States, more people die from an accidental overdose of painkillers than from heroin and cocaine combined.

The word “prescription” is not the same as the word “safe,” especially when alcohol is added, which can affect heart rhythm, slow respiration, and even lead to death.

Resources To Prevent Prescription Drug Abuse

Although we can be saddened by Houston’s passing, we can also take a thoughtful look at her experience and learn from it.

NIDA offers many resources so you can learn the science behind what prescription drug abuse does to your brain and body. Are you curious how the choice to abuse prescription drugs could play out? Check out NIDA’s Choose Your Path videos to put yourself in the shoes of a story’s main character.

We do not yet know exactly how Whitney Houston died. We can only guess that her drug abuse and addiction may have contributed to her death. We do know that addiction was a major blow to her life, career, family, friends, and fans, all of whom are experiencing the sad consequences.

Whitney Houston

Lindsay Lohan on Why Recovery Can Be So Hard

“I’m an addict,” Lindsay Lohan told Oprah in a recent interview.

The actress is speaking publicly about her commitment to recovery from drug and alcohol abuse—after 6 visits to rehab, a stint in jail, 2 drunk driving arrests, and 7 car accidents. This time, LiLo insists, she’s going to stay away from drugs and alcohol.

Beating addiction isn’t easy. Addiction is a disease that causes people to continually seek and use drugs—even when they know the results are dangerous and drug use can change the brain. In fact, the definition of addiction is that people continue to use drugs despite negative consequences.

Many factors may have led Lindsay to use drugs and get addicted. Her family life wasn’t easy: Her parents divorced, and her father has said he’s an alcoholic and spent time in jail for various crimes. Though it’s not a guarantee, children of parents who are addicted to drugs are more likely to become addicted themselves.

Lindsay has openly admitted that her home life was quite chaotic. She thinks drinking alcohol helped to recreate the chaos of her family as she got older. Oprah asked, “Do you think you are—or were—addicted to chaos?”

“I think so. It was a comfortable chaos for me,” Lindsay replied.

People can’t actually be “addicted” to chaos the way they are addicted to drugs—Oprah’s phrase was a figure of speech. But researchers have found that a chaotic home environment “primes the brain” for addiction. Lots of studies show that a challenging family life mixed with drugs and alcohol makes quitting drugs difficult, and not just for celebrities.

As a young movie star, Lindsay moved to Hollywood on her own. Without a stable family, she felt all the ups and downs that every teen goes through. And, she felt the pressure of living under the spotlight of celebrity.

The good news is, drug abuse treatment can be effective when the person is ready to make a change and has the support of friends and family.

Today, Lindsay says she is on the road to recovery. She acknowledged she didn’t like what drinking did to her. “I’m in a different headspace now,” the actress said.

The actress is not alone. It is common for people to fall back into drug use. Relapse rates for addiction are a lot like relapse rates for other diseases, like asthma or high blood pressure. Relapse doesn’t mean treatment failed. Learning to live without drugs or alcohol takes time and practice.

Do you think Lindsay’s on the right track this time? What advice would you give a friend who is struggling with addiction? Tell us in comments.

Lindsay Lohan

What Happened to Mark?

The news story said Mark McGwire's voice "cracked with emotion" when he finally admitted to the world he had used steroids for 10 years, including the season he broke the home run record, hitting 70 slammers in 1998. He is probably not just embarrassed by this, but also concerned about his health, since steroids can cause problems even after you go off them.

There are sometimes medical uses for steroids, such as to help people with cancer or AIDS build up lost muscle mass. But many people-especially those who want to improve their athletic performance-abuse anabolic steroids to "bulk up," typically taking higher doses than people who take them for medical reasons. Steroid abuse among athletes, especially baseball players, has become such a problem that a few years ago the U.S. Congress held a special investigation. Now, major league baseball executives are working to "clean it up," which Mr. McGwire now says is a good thing.

"I wish I had never touched steroids…It was foolish and it was a mistake. I truly apologize. Looking back, I wish I had never played during the steroid era." —Mark McGwire

Taking steroids is not a good bargain. Because even though they might make you stronger in the short-run, the price you pay can be much too high. So what can happen? Here's just a short list of the possible side effects:

  • Stunt your growth and cause bad acne.
  • Cause vicious mood swings (ever heard of "'roid rage"?)
  • For guys, abusing steroids can lead to shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts.
  • For girls, abusing steroids lead to growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, and a permanently deepened voice.

The good news is that steroid use is not a huge problem among teens—as many teens have a healthy game plan. Still, somewhere between 1-2% of high schoolers, many being athletes, have tried them, mostly to enhance sports performance. Did you know that NIDA has a Web section on steroids with information just for teens? Check out Drug Facts - Anabolic Steroids. Also take a look at this YouTube video starring one of our scientists here at NIDA. Mark McGwire has done a lot of good things with his life since leaving baseball. He has a foundation that helps abused children, and he works with the National Kidney Foundation. We will have to wait and see how things turn out for him, as people debate how to handle the many awards he has won over the years and his possible selection into the Baseball Hall of Fame. But scientists at NIDA will be looking at something more important: what are the long-lasting health effects of so much steroid use, and what is the best way to prevent people from abusing steroids in the first place? What do you think?

Baseball player is batting up and the catcher is ready

Whitney Houston: Cocaine and Heart Disease

In March 2012, the Los Angeles County Coroner’s Office reported that Whitney Houston’s official cause of death was accidental drowning. Cocaine use and heart disease were contributing factors in her death.

The coroner believes that cocaine use caused Whitney to suffer heart problems (she already had heart disease), which led her to become unconscious. Bruises on her forehead, chest, and upper lip suggest that she fell into the bathtub, where she drowned.

The six-time Grammy winner also had marijuana, the prescription drugs Xanax and Flexeril, and the over-the-counter medicine Benadryl in her bloodstream, though the coroner does not believe they played a role in her death.

Cocaine Can Lead to Scary Side Effects

Cocaine is a stimulant—a class of drugs that elevate mood, boost feelings of well-being and euphoria, and increase energy and alertness. Stimulants make a person feel good by increasing the amount of dopamine in the brain, but they also have some nasty side effects. Short-term effects can include increased body temperature, heart rate, and blood pressure; dilated pupils; nausea; blurred vision; muscle spasms; and confusion.

With repeated use, cocaine can lead to addiction (something Whitney struggled with for years), which changes how the brain works and makes it more difficult to feel any pleasure at all. People who abuse cocaine are forced to take more and more of the drug to experience the same effects as they did at first. Regularly snorting cocaine can lead to other long-term effects such as a hoarse voice, loss of the sense of smell, nosebleeds, and a chronically runny nose. Whitney’s famous voice was noticeably damaged in recent years, and the autopsy showed she had a hole inside her nose from repeated cocaine use.

Cocaine and Heart Disease

Another long-term effect of abusing cocaine is heart damage. Stimulants cause the body’s blood vessels to narrow, limiting blood flow and forcing the heart to work harder to pump blood through the body. It also restricts blood flow to the heart, killing some of the heart muscle.

Because the effects of cocaine are worse on arteries that are already damaged, people who have heart disease—like Whitney did—suffer most from the effects. The chance of having heart trouble, such as a heart attack, also increases.

Unfortunately, Whitney’s cocaine abuse ultimately led her to suffer the worst effect of the drug—death. We hope that people can learn from her experience and avoid the same tragedy.

Did Whitney’s death change the way you or your friends think about drugs? Tell us in the comments how her death affected you.

Whitney Houston

"Glee" Cast Members Speak Out About Drug Abuse

Earlier this month, the TV show “Glee” aired its tribute episode to Cory Monteith and his character, Finn Hudson. Though it’s known that Cory died from a combination of alcohol and heroin, the show didn’t reveal Finn’s cause of death. As one character says, “Everyone wants to talk about how he died too, but who cares. One moment in his whole life—I care more about how he lived.”

There’s truth in that sentiment—how a person dies doesn’t change how much they are missed by those left behind. By not focusing on the cause of death or even mentioning drug abuse in the episode, the cast was able to celebrate Finn/Cory’s life without getting into a complicated discussion about drug abuse and addiction.

But these are complicated problems. Some people may blame Cory for causing his own death through drug use. However, NIDA research shows that once a person is addicted to a drug or alcohol, using is no longer a choice. Blaming people who use drugs leads to stigma—looking at a person negatively or with judgment.

Costars Speak Out

“Glee” didn’t completely ignore Cory’s drug abuse, however. Immediately after the episode, the following public service announcement (PSA) aired:

Cory’s castmates say that he didn’t look or act like an “addict”—and that’s because addiction can affect anyone, of any age and from any walk of life. Addiction doesn’t just happen to “bad” people. It’s not a punishment. It’s a brain disease.

Other “Glee” PSAs urge anyone struggling with drug abuse to “Get Real” and get treatment so they can live their true lives, free from addiction. If you or someone you know needs help, call the toll-free helpline, 1-800-662-HELP.

Watch all the “Glee” PSAs.

Glee PSA: Addict

Glee PSA: Myths

Glee PSA: Get Real

Glee PSA: Future Plans

Jane Lynch in Glee PSA about addiction

Real Athletes Break Records Not Rules

“You can do it!” and a sprained ankle were what Olympic gymnast, Kerri Strug, took with her to the mat as she landed the vault to help win Team USA’s first women’s gymnastics gold medal at the 1996 Olympics. Nothing could keep this athlete from performing to her fullest ability.

Why should you want to know more about Kerri? This courageous athlete was just 14 and the youngest Olympian at the 1992 summer Olympic Games, who went on to win a Gold medal at the 1996 summer Olympics. Since she was 6 years old, Kerri dreamed of being an Olympian and trained for 12 years to achieve this goal. During those years, she made sacrifices and even moved away from her family and friends to train with her famous coach, Bela Karolyi. Most importantly, each of those 12 years was spent working hard—drug free.

We had the privilege of interviewing Kerri (pictured right) about her journey to Olympic gold and what advice she’d give teens, athletes or not.

Sara Bellum Blog (SBB): Fill in the blank: Participating in sports makes me feel ____.

Kerri Strug: Alive. Being athletic is important because it is good for your long-term health and helps you learn life skills such as dedication, perseverance, and mental toughness.

SBB: What motivated you when you were training?

Kerri: I was motivated by the self-satisfaction I got when I set a goal and attained it.

SBB: What words of motivation can you offer teens?

Kerri: I think teens need to find a passion; set goals, and then go after them.

SBB: What did achieving your goal by winning a gold medal at the 1996 Olympics mean to you?

Kerri: After 12 long years of training and numerous sacrifices…I got what I wanted so badly. There is no better feeling than working hard for something and thinking it is not really possible; and then it becomes a reality.

SBB: Your gold medal was the product of your years of training, hard work, perseverance and passion for the sport—all drug-free. What do you think about professional athletes who have used performance-enhancing drugs?

Kerri: I think a world class athlete is not one that holds a world record; but rather one that shows courage when faced with adversity, leads by example, and puts their team in front of themselves. I do not understand where the athletes that take performance enhancing drugs are coming from. It would never occur to me to cheat or to hurt my body in order to get ahead.

SBB: What advice do you have for teens involved with sports who may feel pressure to use performance-enhancing drugs?

Kerri: Focus on yourself and your capabilities. Not everyone is going to be in the NBA or the Olympics, but being true to yourself is what will matter most for the rest of your life.

SBB: So, where do you go from winning an Olympic Gold Medal at age 18? What are you up to now? Kerri: I am still constantly setting new goals for myself—running marathons, learning to dance, giving back, and hope to one day become a terrific mother and lots of other things.


Today Kerri lives and works in Washington, D.C. In her free time, Kerri enjoys working with charities, traveling the world for special events, and cheering on young athletes as they go after their own dreams.

Kerri Strug

Elton John Reflects on Drug Addiction

Many people who are in recovery from drug abuse tell their story to try and help others. The latest celebrity to talk about his struggles with drugs—cocaine and alcohol—is singer Elton John. He recently gave interviews about the release of his new book. Here are some things Elton said about his life addicted to cocaine, which he quit using in the 1990s.

  • He “wasted” that part of his life because all he was concerned about was the drug: “I was a drug addict and self-absorbed.”
  • In his addicted state, Elton didn’t care about friends or family, even those who were dying of AIDS during the peak of the AIDS epidemic.
  • He made risky decisions about sex—and feels lucky that he isn’t infected with HIV today: “When you take a drug and you take a drink [of alcohol] … you think you're invincible.”
  • Memories still haunt him, even after about 20 years in recovery: “I still dream, twice a week at least, that I've taken cocaine and I have it up my nose. And it's very vivid and it's very upsetting, but at least it's a wake-up call.”
  • When he started using cocaine, Elton thought it would help him overcome his shyness and open up to people; in the end, it isolated him from everyone in his life.

Learn More and Sound Off

NIDA devoted a whole campaign to how drug abuse can lead people to make risky decisions and put themselves at risk for contracting HIV. Read all the facts about the effects of cocaine on the brain and body. Comment! What do you think about celebs who open up about drug abuse?

Elton John

Former “Jersey Shore” Star in Recovery From Painkiller Addiction

Mike “The Situation” Sorrentino recently opened up about his recovery from painkiller addiction.

Mike says he became addicted to the opioid painkillers he was prescribed after an injury he suffered on “Dancing With the Stars.” In an interview with the Associated Press, he recounts the moment when he knew he was addicted. It was during a family trip to Australia in February 2012, when he ran out of his pills. Mike says:

“All I had to do was get dressed for a family function and I couldn’t do that … The shirt was laid out, the belt, the pants, everything. The shower was on. I couldn’t even get out of bed.” He then realized: “If I can’t do that how am I going to continue?”

Soon after, he entered drug abuse treatment.

Medicine To Treat Substance Abuse  

While in treatment, Mike was prescribed Suboxone—a medication used to treat opioid addiction. Suboxone makes withdrawal safer for people addicted to opioids and reduces their cravings for the drug.

Mike says using Suboxone, combined with counseling, has kept him from relapsing and returning to drug abuse. In fact, he is now a paid spokesperson for the drug and continues to take it to maintain his recovery.

Reset Reality

Mike and the drug company that makes Suboxone launched Reset Reality, a campaign to increase awareness about opioid addiction. Reset Reality aims to motivate people addicted to opioids like prescription painkillers to seek treatment and “reset their reality.” The Web site features several videos called “Words of Reality”—personal stories from Mike and others in recovery talking about their addiction and how medication-assisted treatment helped them.

Check out NIDA’s Opioid and Pain Reliever Drug Facts for more information about opioid addiction.

Mike “The Situation” Sorrentino

Celebs & Drugs: A Cycle of Arrests & Rehab

SBB was sad to see that celebrities Paris Hilton and Lindsay Lohan got arrested again for drug possession and drug use. This is an old story by now—a celebrity gets in trouble over and over again for substance abuse, their most recent mug shot is on every gossip Web site, they go into rehab for a few days or a week. Repeat cycle. Paris’ Story In 2006, Paris Hilton was arrested and charged with drinking and driving. She was given probation, but then sentenced to jail for violating her probation. In July 2010, she was detained in South Africa for possession of marijuana, but the case was dropped. And most recently, she was arrested in Las Vegas, when officers witnessed a bag of cocaine fall out of her handbag. The 29-year-old agreed to a plea deal for a fine and community service. She also has to complete a drug rehabilitation program, instead of a 1-year jail sentence. Lindsay’s Story And then there’s Lindsay Lohan. In mid-September 2010, less than a month after being granted an early release from rehab, Lindsay was arrested after she failed a pair of court-mandated drug tests. The 24-year-old actress could face another 30 days in jail for violating her probation. On Twitter, Lindsay wrote, “Substance abuse is a disease, which unfortunately doesn’t go away overnight.” She has checked herself back into rehab—her fifth trip in 3 years. All this brings up the question we hear a lot at NIDA: why don’t celebs seem to learn from their mistakes? Recovery Takes Time Celebrities are no different from anyone else. When you add drugs to the equation, it is harder to make good decisions and get back on the right path. It takes a long time to get clean and stay clean. Here are some things people who want to stop using drugs can do. Seek treatment. A person who uses drugs often needs professional treatment to quit using. This can include medication or "talk therapy" (PDF, 1.19 MB), or a combination of both. Avoid triggers. The science shows that cravings never go away for good, especially when certain “triggers” happen. Your brain remembers the “high” from the drugs and certain experiences can trigger cravings that are hard to control—like seeing a person using cocaine or smelling a marijuana cigarette. Find new friends. It’s important to stop spending time with friends who use drugs. Paris Hilton, for example, was with her boyfriend at the time of her arrest. He was behind the wheel of an SUV when police reportedly smelled marijuana. He failed a field sobriety test and was also arrested. If you’re trying to stay off drugs, hanging out with people who use or in places where drugs are used is not going to get you there. Even if you stop using and get counseling and treatment, it is important not to hang out with your old friends who are still using. Roxy Olin’s Story Some celebrities who have had problems with drugs or alcohol are great role models for being in recovery. At the press conference launching Recovery Month 2010, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), Roxy Olin—an actress on MTV’s “The City” and ABC’s “Brothers and Sisters”—spoke about her drug addiction and her time in rehab. She was there for 9 months and has been in recovery for 3 years. Her parents are supportive, she goes to AA, and she works hard at her recovery. If you or someone you know needs treatment for drugs or alcohol, visit SAMHSA’s online treatment facility locator. To learn more about addiction, see NIDA’s publication, Drugs, Brains, and Behavior—The Science of Addiction. Celebrity

Lance Armstrong: More News We'd Rather Not Have

Hello, you last heard from me when Michael Jackson died, although I’m behind the scenes at NIDA almost every day. This time, I’d like to talk about the news that famous cyclist Lance Armstrong has given up his battle against charges that he used steroids to improve his cycling skills. This is not an admission that he used steroids, but it is major news because the Tour de France will take away all seven of his titles—he will probably return his trophies, and his name will be removed from the official records. Whenever something like this happens, NIDA gets calls from reporters and from the public wanting to learn more about steroid use.

So what’s the fuss about? First of all, everyone agrees Lance Armstrong has done a lot of good in this world. In 1996, he was diagnosed with cancer that had spread to his stomach, lungs, and brain. Doctors were not sure he would live. But he fought back, and when he was better he started a foundation that has raised close to $500 million to help people with cancer.

About the steroids: Only Lance Armstrong knows the full story behind the accusations. But the news gives us all a chance to step back and look at the reasons why people so strongly oppose using steroids to improve athletic ability—especially since so many gifted athletes have admitted to using them, including the St. Louis Cardinal’s Mark McGwire, whose record-breaking 62nd home run made big baseball news in 1998.

SBB has discussed steroids several times, so I don’t need to tell you how much they can hurt your health.

So why do smart and talented athletes risk their health and happiness this way? The same question could be asked about all drugs. Although most teens stay away from steroids, many teens use other drugs like alcohol, cigarettes, marijuana, and stimulants. Do they think they’ll be happier, more popular, or smarter by doing so?

Science shows that taking drugs doesn’t get you any of those things. Even professional athletes who take steroids still have to work out and train 24/7 to get any results. The best way to achieve strength, popularity, or success in school is to work hard, take care of yourself, and be the best person you can be—the real, natural YOU.

As for Lance Armstrong, if he did use steroids, he might experience more health problems as he gets older. For now, he has publicly stated that he wants to move forward with his life to devote himself to raising his five kids, fighting cancer, and attempting to be the fittest 40-year-old on the planet. Now, he says he is drug free and wants to be the best person he can be—naturally. Soon, news reporters will stop calling us about Lance Armstrong, but NIDA will keep working hard to let kids know the truth about steroids and other drugs.

Update:  Since Armstrong was stripped of his Tour de France titles, he cut ties with his Livestrong Charity.  On January 17, 2013 the world saw him openly admit to steroid use in an televised interview with Oprah Winfrey. 

Lance Armstrong

Justin Bieber: A Warning to All Teens

Hello SBB readers. A few years ago, I did a blog post on the death of Michael Jackson—the pop star who seemed to have it all … but who succumbed to a death related to drug abuse. It was a sad tale about a child star who seemed to have grown up without a normal childhood—whose wealth did not protect him from the dangers of drugs. There have been others—Amy Winehouse, Heath Ledger—we could go on and on.

So when Internet-sensation-turned-pop-star Justin Bieber was arrested this week on DUI charges, many of us who keep an eye on these things were saddened by the news. A young man who had everything going for him—who could have been a terrific role model for other teens—seems to instead have chosen a path to self-destruction. Arrested while street racing in a Lamborghini, the star admitted to police in Florida that he had been drinking, smoking marijuana, and taking prescription drugs all at the same time … and then got behind the wheel of a very fast car! Can you imagine? Mixing drugs and alcohol while street racing? This is behavior that turns your car into a dangerous weapon, and people could have been killed, including Bieber himself.

We do not know all the facts of the case—nor have we heard how Bieber will defend what he did—but those of us in the public health world hope that this incident will be a warning to all teens. Being a famous star does not protect you from the dangers of drugs and alcohol—it does not protect you from making stupid decisions. In fact, being a famous star can make you feel invincible—as if you are smarter than everyone else and can even outsmart the drugs you are using. And if you have ever envied someone like Bieber, remember that it is he who should envy all of you who make healthy choices every day, despite all the social pressure.

At NIDA, we will now be handling calls that come into the press office from reporters wanting to know more about mixing alcohol and drugs, or about drugged driving. Bieber’s sad situation will hopefully raise awareness that no one is safe from the dangers of drug abuse. Of course, Bieber deserves a defense, and we will watch what happens with his case. We do hope that if he does need treatment for substance abuse that he is man enough to seek it. Treatment does work—we see it every day. We also know that asking for treatment takes courage and character. How Bieber responds to these charges, and how he seeks to improve his personal situation, will be a test of that character. Maybe then he could truly become a role model of courage.

For more on drugged driving, check out this fact sheet.

Justin Bieber's Mug Shot

With Announcement on Giving Up "Dip," Washington Nationals' Stephen Strasburg's Pitches Hit Home

After major league Hall of Famer Tony Gwynne of the San Diego Padres was diagnosed with parotid cancer, or cancer of the salivary gland, Washington Nationals’ pitcher Stephen Strasburg announced his decision to give up smokeless tobacco, or “dip.” Gwynne was Strasburg’s hero growing up—and he made a conscious decision to copy his hero’s every move as an aspiring professional baseball player, even the “dip” habit.

Just like cigarettes, smokeless tobacco contains nicotine, a highly addictive substance. Whether you smoke or chew it, tobacco has been proven to cause cancer.

Use of dip can lead to mouth cancer affecting the lips and gums, along with glands called the parotid glands, which pump saliva into your mouth. Juices produced from the dip contain heavy metals that, with repeated use, may lead to esophageal and pancreatic cancer—two very aggressive forms of the disease. Treatment can require several surgeries that leave the face and jaw disfigured, and in the most serious cases, it may even require removal of the jaw.

Sounds pretty scary, but not everyone is thinking of the consequences. The biggest appeal for young people to take up the habit is often through sports, kind of ironic since dip is definitely not healthy or good for athletic performance.

Strasburg’s announcement that he wants to give quit the habit may help change this unhealthy part of baseball culture. He doesn’t want young people who may admire his playing skills to think that this addictive habit has anything to do with his game. Strasburg admits that quitting is tough, and is taking things one step at a time. Now it’s Major League Baseball’s turn. Despite the fact that chewing tobacco has already been banned in Little League, high school and college play, the MLB isn’t banning use of dip, yet.

Sometimes, it takes a hero to throw the first pitch and help people understand that winners don’t dip.

Silhouette of a baseball player swining a bat.

Photo of a young man diagramming the effects of tobacco on the body.

Fashion Inspired by Rx Drugs? Mary Kate and Ashley's Pill Bag

Child actresses turned luxury fashion designers Mary Kate and Ashley Olsen recently announced the release of patent Nile crocodile skin backpacks, some of which are covered with fake prescription drugs, as part of their fashion line.

These limited-edition backpacks—only 12 were made—were designed by renowned artist Damien Hirst and will cost an astronomical $55,000 each.

Prescription Drugs as Fashion?

While the price might be outrageous, what about the message? Prescription and over-the-counter drugs are already among the most commonly abused drugs by 12th graders—does this bag glamorize the problem?

In an interesting twist, the retailer has said that a portion of the proceeds from these bags will be donated to UNICEF—a children’s rights organization that works on issues such as immunizations, childhood development, gender rights, and HIV/AIDS transmission around the world—but it is unclear how much will be donated.

What do you think? Fashion is about creativity and expressing one’s individuality, and in the world of couture and high fashion, designers like to push the envelope…so is this “fashion statement” from Mary Kate and Ashley enough to influence how someone thinks about drug abuse? Or, is a purse just a purse? Does the fact that a portion of the proceeds will go to charity influence your opinion?

For more information about prescription drug abuse, check out PEERx.

A black purse.

R.I.P. Philip Seymour Hoffman

We are saddened by the death of award-winning actor Philip Seymour Hoffman from an apparent heroin overdose. Hoffman, who recently appeared in The Hunger Games: Catching Fire, was vocal with his past struggles with prescription pills and cocaine.  For information on how prescription drug abuse can lead to heroin abuse, check out our SBB post originally published May 03, 2012.

You may have heard marijuana referred to as a “gateway drug,” meaning that it can open doors to other kinds of drug abuse. But did you know that prescription painkillers can be gateway drugs to heroin? Some studies show that people who are addicted to heroin often started out abusing prescription painkillers (opioids), like OxyContin or Vicodin. 

Not everyone who abuses a prescription opioid will move on to heroin—but why take the risk? 

It might begin innocently enough—you think that taking a family member’s prescription painkiller is safer than abusing an illicit drug like Ecstasy, and you start using your dad’s prescription to get high. But what if you can’t stop? Prescription painkillers act on the same brain areas as heroin, after all, and can be very addictive. Once the pills run out, what do you do? If you’re addicted, you may look for another source, and sometimes that means buying heroin, a dangerous move, considering the potential consequences

NIDA’s Monitoring the Future survey of teen drug use and attitudes shows that high school students have long seen heroin as one of the most dangerous drugs out there. However, once a person is addicted to prescription painkillers and can’t get them anymore, heroin might not sound like such a bad deal. 

Both prescription opioids and heroin are extremely hard to stop once a person is addicted. A person trying to quit abusing opioids or heroin usually goes through severe withdrawal, which can cause restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goosebumps, and involuntary leg movements. Read more about the dangers of abusing prescription opioids

Curious what could happen if you abuse someone else’s prescription drugs? “Choose Your Path” with NIDA’s interactive videos. The best part is, if you don’t like your outcome, you can go back and try another path!

Philip Seymour Hoffman at the Mission Impossible III opening.

Back to "Rehab" for Amy Winehouse?

Many of you probably heard that the European tour just launched by the talented Amy Winehouse has been canceled after fans watched the diva stumble under the lights in Serbia. Reports say audience members in Belgrade booed her off the stage Saturday night just a few songs into the first concert of the tour when she couldn’t even remember the lyrics to her own songs. The Grammy winner was scheduled for a dream tour—to Istanbul, Athens, Spain, Switzerland, Italy, Austria, Poland, Hungary and Romania—but those dates have all been cancelled. The Serbian media called the concert a "scandal," with Belgrade’s daily newspaper calling it "the worst performance in the history of Belgrade."

It is ironic that Amy Winehouse became famous for her song "Rehab," where she sang: "They tried to make me go to rehab. I said 'No, no, no.'" After the song became a hit, she actually said “yes” to drug and alcohol rehab in London, where she stayed for a month. If she has turned again to drugs, people will ask the same questions about if rehab works, and why big stars risk everything for drugs…

We’ve talked about rehab before, but Amy Winehouse’s struggle highlights what rehab is all about: addiction is a chronic disease, which means it has to be managed throughout your whole life. People relapse to drug addiction just like they do with other chronic illnesses like diabetes, hypertension, and asthma. To successfully treat a chronic disease, you have to change deeply imbedded behaviors—and that takes practice. For example, a diabetic has to learn how to manage a restricted diet, just as a person struggling with addiction has to learn how to manage cravings. Relapse does not mean treatment failure, but that treatment needs to be adjusted or changed altogether.

Sadly, many people are able to hide their addiction from the world and never get help. For famous people, every slip is recorded by fans and posted for millions to see. But famous or not, being successful in recovery takes a lot of support—which it sounds like Amy Winehouse has. Her representative put out this statement: "Everyone involved wishes to do everything they can to help her return to her best and she will be given as long as it takes for this to happen."

R.I.P Amy Winehouse 1983-2011

 

Singer

Rap Music and Molly

NIDA stays up to date on drug use trends. At the end of 2012, we noticed a huge spike in the number of searches on the NIDA for Teens Web site for information on “Molly,” a club drug made from MDMA, the pure form of Ecstasy.

Mostly, Molly is abused at clubs and concerts and is referred to in electronic music. Now, rap and hip hop are mentioning the drug more often.

In 2012, several major artists released songs that referenced Molly:

  • Kanye West, “Mercy”: “Something about Mary, she gone off that Molly / Now the whole party is melted like Dalí.”
  • Trinidad James, “All Gold Everything”: “Popped a Molly and now I’m sweating, woo!”
  • Rihanna, “Diamonds”: “Palms rise to the universe, as we moonshine and Molly / Feel the warmth, we’ll never die / We’re like diamonds in the sky.”

While many of these songs focus on the euphoria Molly can cause, they leave out the dangers it poses to the brain and body. To find out indepth information about how Molly affects the brain, check out this three-part series on MDMA.

Molly may be a hot topic in pop culture, but most teens steer clear of the drug. In 2012, NIDA’s Monitoring the Future survey found that only 7.2% of 12th graders had used Ecstasy in their lifetimes—a 4.5% decrease from 2011.

Tell us: Does rap music influence what you and your friends do, like what you wear? Do references in rap songs make you want to seek out the facts?
 

Philip Seymour Hoffman’s Death and the Terrible Toll of Addiction

In early February, movie fans lost another great talent to heroin. Philip Seymour Hoffman, who starred as Plutarch Heavensbee in The Hunger Games: Catching Fire, died at age 46 of an apparent heroin overdose.

Hoffman’s death is a sad reminder of some of the harsh realities of addiction—a disease that 17.7 million Americans struggle with. His death, coming about 6 months after Cory Monteith’s overdose on heroin and alcohol, also emphasizes that addiction can affect everyone—young and old, rich and poor.

Hoffman’s overdose death is tragic, and we all feel the loss. But we must remember that many overdose deaths don’t make the national news. Every day in America, 105 people die from drug overdose. 

Hoffman’s history with drug abuse also reminds us that addiction is a chronic, relapsing disease. That means it can last for a long time and comes back over and over. Having gotten treatment in his early 20s, Hoffman is reported to have stayed away from drugs for over 20 years. He relapsed recently after developing a prescription drug problem that led to heroin use. He sought treatment for his addiction in May 2013. Drugs change the brain, and even decades of not using drugs may not reverse those changes.

Hoffman’s case also reminds us that, as with any other chronic disease (such as heart disease or diabetes), treatment must often be repeated or may need to be ongoing. In the case of opioid addiction (which includes heroin and prescription painkillers), there are effective medications that can help.

We do not yet know the details of Hoffman’s relapse or what his treatment last year consisted of. We do know, though, that his path from prescription drug use to heroin is more and more common. People who shift from abusing prescription opioids to heroin may be driving the current rise in heroin use being seen across the country, especially in young people.

Here at NIDA, we are committed to continuing to research effective treatments for addiction. To learn more about drug abuse treatment for young people, see our new publication, Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.

Nora D. Volkow, M.D., NIDA Director