59 Substances and Substance Use Disorders

Sonji Nicholas

What you’ll learn to do: describe substance abuse markers and the effect of different substances on the body, and identify resources for information and guidance about substance abuse

Woman talking to people in a substance abuse program.

An overindulgence of anything, even something as pure as water, can intoxicate.

―Criss Jami, author

By the end of this section, you will be able to define substance use disorders and markers for substance use disorder risk and describe the effects of alcohol use and abuse on the body. You will be able to compare the effects of prescription and illegal drug use and abuse on the body. In addition, you will identify resources for further information and guidance about substance use disorders.

Substances and Tobacco

Learning Outcomes

  • Define substance use disorder and markers for substance abuse disorder risk

A drug is a chemical substance that can change how your body and mind work. Drugs of abuse are substances that people use to get high and change how they feel. They may be illegal drugs like marijauna (in some states), cocaine, or heroin. Or they may be legal for adults only, like alcohol and tobacco.

Medicines that treat illness can also become drugs of abuse when people take them to get high—not because they’re sick and following their doctor’s orders. People can even abuse cough or cold medicines from the store if they ignore the directions and take too much at one time.

People use drugs for many reasons:

  • They want to feel good. Taking a drug can feel really good for a short time. That’s why people keep taking them—to have those good feelings again and again. But even though someone may take more and more of a drug, the good feelings don’t last. Soon the person is taking the drug just to keep from feeling bad.
  • They want to stop feeling bad. Some people who feel very worried, afraid, or sad abuse drugs to try to stop feeling so awful. This doesn’t really help their problems and can lead to addiction, which can make them feel much worse.
  • They want to do well in school or at work. Some people who want to get good grades, get a better job, or earn more money might think drugs will give them more energy, keep them awake, or make them think faster. But it usually doesn’t work, may put their health at risk, and may lead to addiction.

According to the The Diagnostic and Statistical Manual of Mental Disorders, when someone develops a substance use disorder, they may have a pathological pattern of behaviors related to the use of the substance. They may fit into different groupings such as the following:

  • Impaired control: the person may take the substance in larger amounts over a longer period of time; express desire to cut down on use and may have difficulty decreasing or stopping use; and spend a great deal of time acquiring the substance, using it, or recovering from its effects. In more severe cases, virtually all the person’s daily activities revolve around the substance.
  • Social impairment: recurrent use of the substance can affect the person’s ability to fulfill obligations at work, school, or home. They continue using even though it has caused interpersonal problems; important social, work, or recreational activities are abandoned or reduced because of the substance use. The person may withdraw from family activities in order to use the substance.
  • Risky use: recurrent substance use in situations where it’s physically hazardous; The person may continue using a substance despite regular physical or psychological problems that result from its use.
  • Pharmacological criteria: the person develops tolerance, which is marked by increased dose of the substance to achieve desired effect or a significantly reduced effect when the typical dose is consumed. Withdrawal symptoms from the substance which may lead the person to consume the substance to relieve the symptoms.[1]

Cigarettes and Tobacco

a hand holding a cigaretteIt might surprise you to learn that cigarettes and other forms of tobacco are drugs. It’s legal to use tobacco once you’re eighteen or nineteen years old, depending on where you live. But it’s not healthy for you at any age. Tobacco contains nicotine, a substance that excites the parts of the brain that make you feel good. You can get addicted to nicotine just like other drugs. When you use tobacco, the nicotine quickly gives you a mild rush of pleasure and energy. But it soon wears off, which makes you want to use it some more. Sometimes, the rush of energy that comes with nicotine can make you nervous and edgy.

Read NIDA’s DrugFacts: Electronic Cigarettes (e-Cigarettes) for information about electronic cigarettes, including how safe they are compared to tobacco cigarettes.

Effects of Cigarettes and Tobacco on the Body and Brain

These are just some of the problems cigarettes and tobacco can cause:

  • Lung diseases: Cigarette smoke causes lung cancer and painful breathing diseases like emphysema and COPD. These diseases can happen to people who smoke, or to others around them who breathe in their smoke.
  • Bad breath, bad teeth, mouth cancer: Cigarettes and other kinds of tobacco stain teeth and cause bad breath. Chewing tobacco can make teeth fall out and lead to mouth cancer.
  • Heart and blood problems: If you smoke, you are more likely to have a heart attack or stroke (sometimes called a “brain attack”).
  • Hurts babies: If a pregnant woman uses tobacco, her baby might be born too early or too small and can cause health problems for the baby.
  • More diseases: Using cigarettes or other kinds of tobacco can lead to heart disease and many kinds of cancer.
  • Addiction: The nicotine in tobacco is what makes you addicted. When you smoke, the effects wear off quickly, which makes you want to keep using tobacco again and again throughout the day. The more you use tobacco, the more your body and brain get addicted to the nicotine. Fortunately, there are medicines, other treatments, and hotlines that can help people quit tobacco.  The Florida Department of Health has no-cost tobacco cessation programs available to help individuals experiencing tobacco addiction.  Check this link to the Department of Health for further information: https://www.floridahealth.gov/programs-and-services/prevention/tobacco-free-florida/index.html

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Alcohol

Learning Outcomes

  • Describe the effects of alcohol use on the body

Drinks like beer, malt liquor, wine, and hard liquor contain alcohol. Alcohol is the ingredient that gets you drunk. Hard liquor—such as whiskey, rum, or gin—has more alcohol in it than beer, malt liquor, or wine. The following drink sizes contain about the same amount of alcohol:

  • 1 ½ ounces of hard liquor
  • 5 ounces of wine
  • 8 ounces of malt liquor
  • 12 ounces of beer

Being drunk can make a person feel very silly, angry, or sad for no reason. Drunkenness can make it hard to walk in a straight line, talk clearly, or drive.

Three glasses of wine

Effects of Alcohol on the Body and Brain

Drinking too much on a single occasion or over time can take a serious toll on your health. Here’s how alcohol can affect your body and brain:

  • Brain: Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination.
  • Heart: Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems such as stroke, high blood pressure, and arrhythmia.
  • Liver: Heavy drinking takes a toll on the liver and can lead to a variety of problems such as alcoholic hepatitis, fibrosis, and cirrhosis
  • Pancreas: Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
  • Cancer: Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the mouth, esophagus, throat, liver, and breast.
  • Immune system: Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections—even up to twenty-hour hours after getting drunk.

Drinking Levels Defined

So how much is drinking too much? The following guidelines are from the National Institute on Alcohol Abuse and Alcoholism:

  • Moderate alcohol consumption: According to the Dietary Guidelines for Americans, moderate drinking is up to one drink per day for women and up to two drinks per day for men.
  • Binge drinking: Binge drinking is a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL, which typically occurs after four drinks for women and five drinks for men within about two hours. Binge drinking has become a major health and safety issue on college campuses.
  • Heavy drinking: Heavy drinking is defined as drinking five or more drinks on the same occasion on five consecutive days or more in the past 30 days.
  • Low risk for developing an alcohol use disorder: For women, low-risk drinking is no more than three drinks on any single day and no more than seven drinks per week. For men, it’s defined as no more than four drinks on any single day and no more than fourteen drinks per week. NIAAA research shows that only about two in 100 people who drink within these limits have an alcohol use disorder.  Even within these limits, you can have problems if you drink too quickly or have other health issues.

Certain people should avoid alcohol completely, including those who

  • plan to drive a vehicle or operate machinery.
  • take medications that interact with alcohol.
  • have a medical condition that alcohol can aggravate.
  • are pregnant or trying to become pregnant.

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Drugs

Learning Outcomes

  • Compare the effects of prescription and illegal drug use on the body

Marijuana

Marijuana is a green, brown, or gray mix of dried, crumbled leaves from the marijuana plant. It can be rolled up and smoked like a cigarette (called a joint) or a cigar (called a blunt). Marijuana can also be smoked in a pipe. Sometimes people mix it in food and eat it. Marijuana can make you feel silly, relaxed, sleepy, and happy—or nervous and scared. It may change your senses of sight, hearing, and touch. It can also make it hard to think clearly.

Effects of Marijuana on the Body and Brain

These are just some of the problems marijuana can cause:

  • Memory problems: Marijuana makes it hard to remember things that just happened a few minutes ago, making it hard to learn in school or to pay attention to your job. A recent study showed that if you begin regular marijuana use as a teen, you can lose an average of eight IQ points, and do not get them back, even if you stop using the drug.
  • Heart problems: Using marijuana makes the heart beat fast and raises your risk of having a heart attack.
  • Coughing and breathing problems: Marijuana smokers can get some of the same coughing and breathing problems as cigarette smokers. Marijuana smoke can hurt your lungs.
  • Drugged driving: Driving when you’re high on marijuana is dangerous, just like driving drunk. Your reactions to traffic signs and sounds are slow. It’s hard to pay attention to the road. And it’s even worse when you’re high on marijuana and alcohol at the same time.
  • You stop caring: Over time, marijuana users can get burnt out. They don’t think about much or do much. They can’t concentrate. They don’t seem to care about anything.
  • Addiction: Although some people don’t know it, you can get addicted to marijuana after using it for a while. This addiction is more likely to happen to people who use marijuana every day, or who started using it when they were teenagers.
  • Mental Illness: Long-term marijuana use has been linked to mental health problems in some people, such as temporary hallucinations, temporary paranoia, and worsening symptoms in patients with schizophrenia—a severe mental disorder with symptoms such as hallucinations, paranoia, and disorganized thinking. There have been reports of increased risk of schizophrenia in people with genetic vulnerability. Marijuana use has also been linked to other mental health problems, such as depression, anxiety, and suicidal thoughts among teens. However, study findings have been mixed.[2][3]

Marijuana has been legalized in many places for medical and/or recreational use. But is it safe? THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana’s psychological effects, itself has proven medical benefits in particular formulations. The U.S. Food and Drug Administration (FDA) has approved THC-based medications prescribed in pill form for the treatment of nausea in patients undergoing cancer chemotherapy and to stimulate appetite in patients with wasting syndrome due to AIDS. In addition, several other marijuana-based medications have been approved or are undergoing clinical trials. Little is known about the long-term effects of medical marijuana and further research will be needed to determine whether people whose health has been compromised by disease or its treatment (e.g., chemotherapy) are at greater risk for adverse health outcomes from marijuana use.[4]

War on Drugs, Legalization of Marijuana, & Black Americans Being Left Behind

While many states in the United States have legalized marijuana, racial inequities still exist. Chicago Lewis reports that, “Even though research shows people of all races are about equally likely to have broken the law by growing, smoking, or selling marijuana, black people are much more likely to have been arrested for it. Black people are much more likely to have ended up with a criminal record because of it. And every state that has legalized medical or recreational marijuana bans people with drug felonies from working at, owning, investing in, or sitting on the board of a cannabis business. After having borne the brunt of the ‘war on drugs,’ black Americans are now largely missing out on the economic opportunities created by legalization.”[5]

The Drug Policy Alliance outlines how race and the drug war fuel racial inequalities in the criminal justice system, how the fentanyl era worsens racial disparities, contributes to widespread detentions and deportations, and produces consequences that can last a lifetime in a variety of areas. The ACLU reports that “Black people are still more likely to be arrested for marijuana possession than white people in every state, including those that have legalized marijuana.”[6]

The Drug Policy Alliance has teamed up with artists Jay-Z and Molly Crabapple to tell the brief history of how the drug war went from prohibition to the gold rush of the legalized cannabis industry.

Cocaine (Coke, Crack)

Cocaine is a white powder. It can be snorted up the nose or mixed with water and injected with a needle. Cocaine can also be made into small white rocks, called crack. It’s called crack because when the rocks are heated, they make a cracking sound. Crack is smoked in a small glass pipe. Cocaine can make a person feel full of energy, but also restless, scared, or angry.

Effects of Cocaine on the Body and Brain

These are just some of the problems cocaine can cause:

  • You feel sick: Cocaine can cause stomach pain and headaches. It can make you shake, throw up, or pass out.
  • No appetite: Cocaine can make you not want to eat. Over time, you might lose a lot of weight and get sick.
  • Heart attack and stroke: Cocaine raises your blood pressure and makes your heart beat faster. These symptoms can hurt your heart. It can give you a heart attack or stroke (brain injury from a blood clot). Some people die because of it.
  • HIV/AIDS, hepatitis: People who inject cocaine can get HIV/AIDS and hepatitis (a liver disease) if they share used needles. People also get these diseases by having unsafe sex. They may forget to use condoms because they’re high on the drug.
  • Addiction: It is easy to lose control over cocaine use and become addicted. Then, even if you get treatment, it can be hard to stay off the drug. People who stopped using cocaine can still feel strong cravings for the drug, sometimes even years later.

Opioids

Opioids are a class of drugs that include heroin, synthetic opioids like fentanyl, and legal pain relievers received through prescriptions such as oxycodone, hydrocodone, codeine, morphine, and others.

Heroin

Heroin is a white or brown powder or a black, sticky goo. It can be mixed with water and injected with a needle. Heroin can also be smoked or snorted up the nose. Heroin causes a rush of good feelings just after it’s taken. But some people throw up or itch after taking it. For the next several hours, you want to sleep and your heart rate and breathing slow down. Then the drug wears off and you may feel a strong urge to take more.

Effects of Heroin on the Body and Brain

These are just some of the problems heroin can cause:

  • Sick and itchy: Heroin can make you throw up and feel very itchy.
  • You stop breathing: Heroin can slow or stop your breathing. It can kill you.
  • HIV/AIDS, Hepatitis: Sharing used needles to inject (shoot up) heroin can give you HIV/AIDS and hepatitis (a liver disease).
  • Overdose: People overdose on heroin because they can’t tell how strong it is until they take it. Signs of a heroin overdose are slow breathing, blue lips and fingernails, cold clammy skin, and shaking. You can die from a heroin overdose. People who might be overdosing should be taken to the emergency room immediately.
  • Coma: Heroin can put you in a coma. That’s when nothing can wake you up, and you may die.
  • Addiction: It is very easy to become addicted to heroin. Then, even if you get treatment, it’s hard to stay away from the drug. People who stopped using heroin can still feel strong cravings for the drug, sometimes years later. Fortunately, there are medicines that can help someone recover from heroin addiction.

Prescription Pain Medicine (OxyContin®, Vicodin®)Pill bottle on its side with pills around it

Pain medicines relieve pain from surgery or injuries. You need a prescription from a doctor to buy some strong kinds of these medicines. Prescription pain medicines are legal and helpful to use when a doctor orders them to treat your medical problem.

But people sometimes take these without a doctor’s prescription to get high or to try to treat themselves or their friends. Drug dealers sell these pills just like they sell heroin or cocaine. Some people borrow or steal these pills from other people. Some people think that prescription pain medicines are safer to abuse than street drugs because they are medicines. Prescription pain medicine abuse can be as dangerous as heroin or cocaine abuse.

Oxycodone is one pain medicine that people often abuse. Sometimes it goes by the brand names OxyContin® or Percocet®. Another one that is often abused is hydrocodone. One of its brand names is Vicodin®. Pain medicines are usually white, round, or oval pills. They can be taken whole, smoked, or crushed into a powder that is snorted or injected. Like heroin, pain pills can cause a rush of good feeling when they’re first taken, but they can also make you want to throw up. They can make you very sleepy, and you can get addicted to them.

Effects of Pain Medicine Abuse on the Body and Brain

These are just some of the problems pain medicine abuse can cause:

  • You stop breathing: Pain medicine abuse can slow down or even stop your breathing.
  • Coma: Pain medicine abuse can put you in a coma. That’s when nothing can wake you up.
  • Addiction: Prescription pain medicines can be as addictive as heroin—especially if they are smoked or injected. Then, even if you get treatment, it’s hard to stay away from the drug. Fortunately, there are medicines that can help someone recover from prescription pain medicine addiction.
  • Overdose: Signs of a pain medicine overdose are cold and sweaty skin, confusion, shaking, extreme sleepiness, trouble breathing, and coma.
  • Death: Many people die from pain medicine overdoses. In fact, more people overdose from pain medicines every year than from heroin and cocaine combined.

Watch this video of how opioid painkillers became an epidemic.

Addicted to Drugs: Who Gets Our Compassion?

While more attention focused on those suffering from addiction is needed, especially now that we’ve seen large increases in fatal opioid drug overdoses during the COVID-19 pandemic,

there has been a painful history in how we treat these addictions differently.

Netherland and Hansen compared media coverage of White, non-medical opioid users with that of Black and Brown heroin users. They found that, “Media coverage of the suburban and rural opioid ‘epidemic’ of the 2000s helped draw a symbolic, and then legal, distinction between (urban) heroin addiction and (suburban and rural) prescription opioid addiction that is reminiscent of the legal distinction between crack cocaine and powder cocaine of the 1980s and 90s. This distinction reinforces the racialized deployment of the War on Drugs and is sustained by the lack of explicit discussion of race in the service of ‘color blind ideology.'”[7]

Lopez also analyzed how racial bias and segregation molded a gentler rhetorical response to the opioid crisis. When he interviewed Ithaca, New York, Mayor Svante Myrick, who’s Black, he was told that this has led to resentment in much of the black community in his predominantly white town. “It’s very real,” he acknowledged. The typical response from his black constituents, he said, goes something like this: “Oh, when it was happening in my neighborhood it was ‘lock ’em up.’ Now that it’s happening in the [largely white, wealthy] Heights, the answer is to use my tax dollars to fund treatment centers. Well, my son could have used a treatment center in 1989, and he didn’t get one.” Still, Myrick added, “I’m as angry about this as anybody. But just because these are now white kids dying doesn’t mean we shouldn’t care, because these are still kids dying.[8]”

Meth (Crank, Ice)

Methamphetamine—meth for short—is a white, bitter powder. Sometimes it’s made into a white pill or a clear or white shiny rock (called a crystal). Meth powder can be eaten or snorted up the nose. It can also be mixed with liquid and injected into your body with a needle. Crystal meth is smoked in a small glass pipe. Meth at first causes a rush of good feelings, but then users feel edgy, overly excited, angry, or afraid. Their thoughts and actions go really fast. They might feel too hot.

Effects of Meth on the Body and Brain

These are just some of the problems meth can cause:

  • You overheat: Meth can make your body temperature so hot that you pass out. Sometimes this increase in body heat can kill you.
  • Crank bugs: Meth can make you feel like bugs are crawling on or under your skin. It makes you scratch a lot. Scratching causes sores on your face and arms.
  • Meth mouth: Meth users’ teeth become broken, stained, and rotten. Meth users often drink lots of sweet things, grind their teeth, and have dry mouth. This is called “meth mouth.”
  • You look old: People who use meth start looking old. Meth users burn a lot of energy and don’t eat well, sometimes making them lose weight and look sick. Their hands or bodies might shake. Their skin looks dull and has sores and pimples that don’t heal. Their mouths look sunken as the teeth go bad.
  • HIV/AIDS, Hepatitis: People who inject meth can get HIV/AIDS or hepatitis (a liver disease) if they share used needles. People also get these diseases by having unsafe sex. They often forget to use condoms because they’re high on the drug.
  • Addiction: Meth use can quickly lead to addiction and hurt different parts of your brain. It can cause thinking and emotional problems that don’t go away or that come back again even after you quit using the drug. For instance, you might feel, hear, or see things that aren’t there. You might think that people are out to get you, or start believing strange ideas that can’t really be true.

Other Drugs of Abuse

There are many other drugs of abuse, including the following.

Ecstasy (X, E, XTC) is a pill that is often taken at parties and clubs. It is sometimes called the “love drug” because it makes people feel very friendly and touchy. It also raises body temperature, heart rate, and blood pressure, and can make you feel sad for days after its effects wear off. Learn more information about ecstasy here.

K2 or Spice (fake weed, Skunk) is a drug made from shredded dried plant materials and chemicals. It is usually smoked. The high feels about the same as the high from marijuana. Spice users sometimes end up in the emergency room with rapid heart rates, vomiting, and other uncomfortable side effects. K2/Spice is illegal. Learn more information about K2/Spice here.

LSD (acid) comes in pills or on small pieces of paper that have been soaked in liquid LSD. It makes you see, hear, and feel things that aren’t there. You might see bright colors, pretty pictures, or things that scare you. Learn more information about LSD here.

PCP (angel dust) is a pill or powder that can be eaten, smoked, or snorted up the nose. It makes people feel far away from the world around them. PCP often makes people feel angry and violent, not happy and dreamy. Learn more information about PCP here.

Inhalants are dangerous chemicals that make you feel high when you breathe them into your lungs (also called huffing or sniffing). These chemicals are found in household cleaners, spray cans, glue, and even permanent markers. Inhalants can make you pass out, stop your heart and your breathing, and kill you. Learn more information about inhalants here.

Club Drugs
As previously described in the Sexual Health section, some drugs are called club drugs because they are sometimes passed around at nightclubs and parties.

Bath Salts are drugs made with chemicals like the upper found in the Khat plant. They are only sold with the name “Bath Salts” to make them look harmless. These drugs can make you high, but they can also make you shaky, afraid, and violent. They look like a white or brown shiny powder and are sold in small packages labeled “not for human consumption.” They can be taken by mouth, by inhaling into the lungs, or with a needle. Some people end up in the emergency room or even die after taking bath salts. Learn more information about bath salts here.

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Where to Go for Help

Learning Outcomes

  • Identify resources for further information and guidance about substance use disorders

Here’s a simple way to think about substance use and substance use disorders: If your use of drugs or alcohol is interfering with your life—negatively affecting your health, work, school, relationships, or finances—it’s time to quit or seek help. People who are addicted to a substance continue to misuse it even though they know it can harm their physical or mental health, lead to accidents, or put others in danger.

Know that the first six weeks of the first semester is an especially critical and vulnerable time for most first-year students. Because lots of students get into the habit of drinking heavily and partying during these early days of college, there’s a risk that excessive alcohol consumption will interfere with successful adaptation to campus life. The transition to college is often difficult, and about one-third of first-year students fail to enroll for their second year.

If you are concerned about your drug or alcohol use, or you need help quitting, visit a health center or talk with your college advisor. These folks are there to help you—it’s their job to provide information and support.

Several resources to help with various mental health and substance abuse issues are available through FSW Cares.  Use the following link to access a multitude of resources for specific mental health and substance abuse challenges: FSW Mental Health and Substance Abuse Resources

There are agencies you can turn to for additional resources such as the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA’s National Helpline 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Additional resources from USA.gov can be found here for mental health and substance use disorders (SUD)—everything from reviewing signs and effects of substances to finding treatment programs for SUD, veterans, and local help centers for alcohol and drug addiction (i.e., support groups). Some of the support groups that people can attend are:

  • Alcoholics Anonymous (A.A.) helps people with problems controlling how much alcohol they drink, and who wish to stop drinking.
  • Al-Anon is for family members and friends who are worried about someone with a drinking problem.
  • Alateen is part of Al-Anon safe group to help teenagers who are affected by someone else’s alcoholism.
  • Narcotics Anonymous (N.A.) helps people who want to stop misusing prescription medications or illegal drugs.
  • NAR-Anon supports people affected by someone misusing drugs.

The COVID-19 pandemic presented unique challenges for people with substance use disorders and in recovery. Fortunately, there have been more options made available for people via telehealth and virtual meetings that people can attend. If you or someone you know needs assistance, the following resources suggested by NIH may help:

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glossary

drug: a chemical substance that can change how your body and mind work

substance use disorder: a condition in which one has a pathological pattern of behaviors related to the use of a substance

 

 

 

 

  1. "Substance Use Disorders." Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association: 2013. ↵
  2. "Marijuana." National Institute on Drug Abuse, 2019, www.drugabuse.gov/publications/drugfacts/marijuana. ↵
  3. "Is There a Link between Marijuana Use and Psychiatric Disorders?" National Institute on Drug Abuse, 13 April  2021, www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders. ↵
  4. "Is Marijuana Safe and Effective as Medicine?" National Institute on Drug Abuse, 13 April 2021, www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine. ↵
  5. Chicago Lewis, A. "How Black People Are Being Shut Out of America’s Weed Boom: White Washing the Green Rush." BuzzFeed News, 16 March 2016, www.buzzfeednews.com/article/amandachicagolewis/americas-white-only-weed-boom ↵
  6. "A Tale of Two Countries: Racially Targeted Arrests in the Era of Marijuana Reform." ACLU, 23 Mar. 2021, www.aclu.org/report/tale-two-countries-racially-targeted-arrests-era-marijuana-reform. ↵
  7. Netherland, J., and H. B. Hansen. "The War on Drugs That Wasn’t: Wasted Whiteness, “Dirty Doctors,” and Race in Media Coverage of Prescription Opioid Misuse." Culture, Medicine and Psychiatry, 2016, vol. 40(4), pp. 664–686. www.doi.org/10.1007/s11013-016-9496-5. ↵
  8. Lopez, G. "When a Drug Epidemic’s Victims Are White." Vox, 4 Apr. 2017, www.vox.com/identities/2017/4/4/15098746/opioid-heroin-epidemic-race. ↵

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Substances and Substance Use Disorders Copyright © 2023 by Sonji Nicholas is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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