Psychiatric & Addiction Resources

• Use Of Alcohol And Other Drugs By Women
• Consumption Rates, Patterns & Trends
• Health Issues For Women With Addicitions
• Dual Diagnoses And Women
• The Impact Of Drugs On The Pregnant Woman And Her Unborn Child
• Availability Of Illegal Drugs To Women
• Deaths From Drug Abuse
• Increase In Drug Episodes Among Women
• Arrests And Sentencing
• The Effects Of Alcohol On Women And Men
• College Women And Drinking
• Addiction & Older Women
• Prescription Drug Abuse And Women
• Eating Disorders
• Women And Treatment
• The Effect Of Commonly Available Illicit Drugs On The Body
• Quick Facts

Health Issues For Women With Addictions

• The death rate among women alcoholics is higher than among men because of their increased risk for suicide, alcohol-related accidents, cirrhosis and hepatitis (Journal of the American Medical Association news release, 3/12/96).
• Women develop cirrhosis of the liver at a much lower cumulative dose of alcohol than do men; moreover, women remain at increased risk of disease progression, even after abstinence (J Maher, "Exploring Alcohol's Effects on Liver Function," AHRW, Vol. 21, No. 1, 1997, p. 10).
• The frequency of menstrual disturbances, spontaneous abortions and miscarriages increases with level of drinking; problem drinking has adverse effects on fertility and sexual function (Ninth Special Report, op. cit., p. 160)
• In one large study, the death rate from breast cancer was 30 percent higher among middle-aged and elderly women reporting at least one drink daily than among nondrinkers (MJ Thun, et al.., "Alcohol Consumption and Mortality Among Middle-Aged and Elderly US Adults," New England Journal of Medicine, Vol. 337, No. 24, 12/11/97, p. 1711).

Seventy percent of AIDS cases among women are drug-related ("Women & Drug Abuse: You And Your Community . .," op. cit., p. 7).



Dual Diagnoses And Women

A SAMHSA report on females admitted to treatment with a dual diagnosis of a substance-abuse problem and a psychiatric disorder found that almost half (46 percent) had alcohol as a primary substance of abuse. The report also found that dually diagnosed female admissions were more likely to have had prior treatments than non-dually diagnosed female admissions (72 percent versus 60 percent).



The Impact Of Drugs On The Pregnant Woman And Her Unborn Child

When a pregnant woman uses drugs, she and her unborn child face serious health problems. During pregnancy, the drugs used by the mother can enter the baby's bloodstream. The most serious effects on the baby can be HIV infection, AIDS, prematurity, low birth weight, sudden infant death syndrome, small head size, stunted growth, poor motor skills and behavior problems.
A mother's continuing drug use puts her children at risk for neglect, physical abuse and malnutrition.
However, NIDA research shows that providing care and treatment to the pregnant drug abuser can reduce many of the negative effects on her baby. (Source: National Institute on Drug Abuse).



Availability Of Illegal Drugs To Women

The 2002 National Survey on Drug Use and Health asked respondents how easy it was to obtain illegal drugs. Females ages 12–17 were more likely than males ages 12–17 to report that marijuana, cocaine, crack, heroin and LSD were fairly or very easy to obtain.7
According to data from the Arrestee Drug Abuse Monitoring (ADAM) Program, a median of 68% of adult female arrestees tested positive for cocaine, marijuana, methamphetamine, opiates or PCP during 2003. Approximately 24% of female arrestees were positive for more than one of these drugs. The ADAM data were compiled by testing female arrestees in 25 U.S. sites.



 Deaths From Drug Abuse

A National Vital Statistics Report found that 21,683 people died of drug-induced causes in 2001. Of the drug-induced deaths, 7,439 (34 percent) were females. Drug-induced deaths include deaths from dependent and nondependent use of drugs (legal and illegal use) and poisoning from medically prescribed and other drugs. It excludes accidents, homicides and other causes indirectly related to drug use. Also excluded are newborn deaths due to a mother’s drug use.



Increase In Drug Episodes Among Women

The Drug Abuse Warning Network (DAWN) collects data on drug-related visits to emergency departments (ED) nationwide. In 2002, there were 670,307 ED episodes. Of these episodes, 308,098 involved females, a 22 percent increase from the 252,128 female ED episodes in 1995. In 2002, there were 1,209,938 ED drug mentions reported to DAWN, 553,874 of which involved females. (Note: a drug episode describes an emergency-department visit that was induced by or related to the use of drugs. A drug mention refers to a substance that was recorded during an emergency department episode. Because up to four drugs can be reported for each drug abuse episode, there are more mentions than episodes.)



Arrests And Sentencing

• According to the Federal Bureau of Investigation, there were 199,361 state and local female arrests in 2002 for drug-abuse violations.
• In fiscal year 2001, the U.S. Marshals Service arrested and booked 17,249 female suspects for federal offenses, representing 14.3% of the total arrests made by the U.S. Marshals Service. Of the U.S. Marshals Service arrestees booked on drug-offense charges, 15.3% were female. Also in 2001, the Drug Enforcement Administration (DEA) arrested 5,452 females, representing 16.6% of the DEA arrests. Approximately 28% (1,528) of the female DEA arrests in 2001 involved methamphetamine.
• A Bureau of Justice statistics report found that about half of women offenders confined in state prisons had been using alcohol, drugs or both at the time of the offense for which they were incarcerated. About six in 10 women in state prison described themselves as using drugs in the month before the offense, and five in 10 described themselves as daily users of drugs. Nearly one in three women serving time in state prisons said they had committed the offense which brought them to prison in order to obtain money to support their need for drugs.

The Effects Of Alcohol On Women And Men

• For women, two drinks a day is above what the Dietary Guidelines for Americans call “moderate:” no more than one drink a day for women and no more than two drinks a day for men.
• Alcohol passes through the digestive tract and is dispersed in the water in the body. The more water available, the more diluted the alcohol. As a rule, men weigh more than women. In addition, pound for pound, women have less water in their bodies than men, so a woman’s brain and other organs are exposed to more alcohol before it is broken down. These differences play a role in both the short- and long-term effects of alcohol on women
• Hormonal fluctuations in women may affect how alcohol is metabolized. Some women report feeling the effects of alcohol more quickly or strongly when they drink at certain times during their cycle. Post-menopausal women who take hormone replacement therapy have higher blood-alcohol levels when they drink.
• Studies show that women are more prone than men to alcohol-related organ damage. Health problems may include
  • Alcoholic liver disease: Women develop alcoholic liver disease more quickly and after drinking less alcohol than men. Women are more likely than men to develop alcoholic hepatitis (liver inflammation) and to die from cirrhosis.
  • Brain disease: Most alcoholics have some loss of mental function, reduced brain size and changes in the function of brain cells. Research suggests that women are more vulnerable than men to alcohol-induced brain damage.
  • Cancer: Many studies report that heavy drinking increases the risk of breast cancer. Alcohol is also linked to cancers of the head and neck (the risk is especially high in smokers who also drink heavily) and of the digestive tract.
  • Heart disease: Chronic heavy drinking is a leading cause of cardiovascular disease. Among heavy drinkers, men and women have similar rates of alcohol-related heart disease, even though women drink less alcohol over a lifetime than men
  • Drinking increases the risk that a woman will be assaulted physically or sexually

College Women And Drinking

• In 2001, approximately two in five (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous three surveys.
• In spite of aggressive campaigns to expose the risks of binge drinking on college campuses, very little change occurred at the individual college level.
• A sharp rise (from 5.3% in 1993 to 11.9% in 2001) in frequent binge drinking was noted among women attending all-women’s colleges, and a lesser, but still significant, increase of the same behavior for women at coeducational schools.

Addiction & Older Women

• Substance abuse, including addiction to cigarettes, alcohol and psychoactive prescription drugs (sedatives, tranquilizers and other drugs), is at epidemic levels for American women 60 years old and older, according to a recent study.
• Older women are more susceptible to alcohol or drug addiction because tolerance levels decrease as people age. Some studies suggest that older women get addicted faster using smaller amounts than any other group.
• Alcohol use among nursing and retirement home patients, and for older persons who live alone, is often very high and tends to go undetected.

Prescription Drug Abuse And Women

• Dependence on prescription drugs is a major health problem for women. Two-thirds of all tranquilizers, including Valium, Librium and Xanax, are prescribed to women.
• Other examples of prescription drugs used frequently by women are sedatives like Halcion and ProSom, analgesics like Demerol or other types of painkillers such as Percodan or codeine, and stimulants such as Ritalin, Meridia and Dexedrine.
• Many women start taking a medication for a health problem like anxiety, muscle spasms or pain. Dependence can develop when the prescriptions are used longer or in greater amounts than intended or without close supervision by a health-care professional.

When they are misused, prescription drugs can cause a variety of health problems other than addiction, including headaches, confusion, drowsiness, fainting and lowered or elevated blood pressure. Adverse effects can increase dramatically when medications are mixed with alcohol; in fact, some combinations can be deadly.

Eating Disorders
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own. Women are much more likely than men to develop an eating disorder. Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders.1

In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure which may lead to death. Therefore, recognition of eating disorders as real and treatable diseases is critically important.

There are two main types of eating disorders: Anorexia Nervosa and Bulimia Nervosa; and a third type, Binge-Eating, has been suggested but has not yet been approved as a formal psychiatric diagnosis.

Anorexia Nervosa

Symptoms of anorexia nervosa include:

• Resistance to maintaining body weight at or above a minimally normal weight for age and height
• Intense fear of gaining weight or becoming fat, even though underweight
• Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
• Infrequent or absent menstrual periods (in females who have reached puberty)

Bulimia Nervosa

Symptoms of bulimia nervosa include:

• Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
• Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting or misuse of laxatives, diuretics, enemas, or other medications (purging); fasting; or excessive exercise
• The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
• Self-evaluation is unduly influenced by body shape and weight
  Binge-Eating Disorder
  Symptoms of binge-eating disorders include:
• Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
• The binge-eating episodes are associated with at least 3 of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of being embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty after overeating
• Marked distress about the binge-eating behavior
• The binge eating occurs, on average, at least 2 days a week for 6 months

The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise)

_{1. American Psychiatric Association Work Group on Eating Disorders. Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 2000; 157(1 Suppl): 1-39.}



Women And Treatment

Women with alcohol problems are less likely than men to seek help initially from alcoholism or other chemical-dependency services. Instead, women prefer consulting physicians or mental-health clinic staff, settings in which their drinking problem is less likely to be diagnosed (L Beckman, "Barriers to Alcoholism Treatment for Women," AHRW, Vol. 18, No. 3, 1994, p. 208).

• Nearly 30% (29.5% or 363,127) of the clients admitted for treatment of alcohol or drug-related problems in 1995 were women. Alcohol, or alcohol in combination with another drug, was the primary reason for admission in 42% of these cases; smoked cocaine in 18%; and heroin in 16%. Distinct patterns of use also are evident among certain ethnic/age groups: 50% of African-American women ages 30 to 34 smoked cocaine/crack; 63% of Mexican-American origin women ages 40 to 44 used heroin; 16% of women from other racial/ethnic groups, which includes Asian-American women, ages 20-24 used methamphetamine (SAMHSA, National Admissions to Substance Abuse Treatment Services, Advance Report No. 12, 2/97, pp. 2-3, 30, 34).
• Women make up 34% of the Alcoholics Anonymous (AA) membership. Among AA members aged 30 and under, 38% are women (General Services Branch of Alcoholics Anonymous, Inc., 1998 Membership Survey).
• During 2002, 565,354 females were admitted to treatment facilities in the United States, representing 30.1% of total treatment admissions. Admissions in which smoked cocaine was the primary substance of abuse represented 12.8% of the female admissions during 2002.
• Alcohol and drug addictions are chronic illnesses. Once established, the person is at risk of relapse throughout his or her life. Using proven methods, substance dependence can be treated and the risk of relapse reduced.
• Women face significant barriers to treatment for their substance dependence. For instance, childcare responsibilities may make a woman reluctant to admit she has a problem, thus interfering with the time required to attend treatment. Furthermore, the stigma of being weak rather than sick, and the view of some people that abstinence is just a matter of will power, is rarely helpful to the person afflicted with addiction.
• Two decades of research have shown that many treatment issues are different for women than for men. At one time, treatment programs were designed to address only the patterns and reasons behind men’s substance dependency issues, since men comprised 75 percent of any treatment group. Women’s issues—such as emotional, psychological or physical abuse; lack of self-esteem; and family responsibilities—tended to slip through the cracks. Depression and anxiety disorders are more common in women than men, and are also risk factors for alcohol and drug abuse, including cigarette smoking. Treating depression and anxiety disorders can be one of the keys to recovery from addiction. Because of the differences in patterns of addiction and treatment needs, single-sex programs are increasingly available, making treatment more successful for many women. Some programs offer childcare, parenting classes and therapy for children of substance users.
• Drug abuse and addiction are treated in specialized treatment facilities and mental-health clinics by a variety of health-care professionals, including certified drug-abuse counselors, physicians, psychologists, nurses and social workers. Treatment is delivered in outpatient, inpatient and residential settings. In the U.S., more than 11,000 specialized drug-treatment facilities provide rehabilitation, counseling, behavioral therapy, medication, case management and other types of services to persons with drug-use disorders.
• Women for Sobriety (WFS) is an alternative to the well-known Alcoholics Anonymous 12-step program. Founded in 1976, WFS is based on the belief that women require a different kind of recovery program than those used primarily by men. Thirteen positive “statements” guide the WFS program, which remains for women only. The “New Life” WFS program encourages independence, self-reliance and leaving the past behind. The National Institutes of Health (www.nih.gov) and the Substance Abuse and Mental Health Services Administration (www.samhsa.gov) are federal institutions with missions of understanding, preventing and treating alcohol and drug dependence. They can be important sources of information about addiction.
• Finding a support group or therapy that feels right can take some time. Doing whatever it takes to stay drug-free is the goal. The key to successful treatment is that it should be individualized, because each woman’s issues are different. Lifestyle changes that reduce exposure to drug abusers and access to the drug are often critical. Similarly, emotional problems and disorders such as depression, anxiety and insomnia, should be treated to improve the chances of recovery.
• Behavioral therapy and medication are used to treat addiction. They are most effective when used in combination. In fact, combining these approaches can be critical to their success. Behavioral therapies can include counseling, psychotherapy, support groups and family therapy. Medications offer help in suppressing withdrawal symptoms and drug craving and in blocking the effects of drugs.
• The following medications may be used to treat drug addiction:
  • Methadone is a synthetic opioid drug, generally a pill or liquid, used mainly in the treatment of heroin addiction. Studies show that treatment for heroin addiction using methadone, combined with behavioral therapy, reduces death rates and many health problems associated with heroin abuse. However, methadone itself can be abused and is linked to a number of overdose deaths, usually when used in combination with other drugs, including alcohol, or when injected
  • Buprenorphine is the most recently approved medicine for treating heroin and related opioid disorders. It is related to morphine but does not produce the same high, dependence or withdrawal syndrome as morphine. It is long-lasting, less likely to cause respiratory depression and well-tolerated by addicts. Buprenorphine is now available in office-based settings and will significantly increase the number of patients receiving treatment. . To find doctors trained and certified to use the medication, check with the Substance Abuse and Mental Health Services Administration (SAMHSA) at www.samhsa.gov.
  • Disulfiram, sometimes called Antabuse, is a prescription medication used to help people avoid alcohol and thus overcome addiction to or dependence on alcohol. If a person uses disulfiram and drinks alcohol, the medication causes severe unpleasant symptoms that can last several hours, including flushing, rapid or irregular heartbeat, dizziness, nausea, vomiting, difficulty breathing and headache. When taken according to the prescribed schedule, the medication is used to discourage someone from drinking again once they’ve stopped.
  • Naltrexone is used to help narcotic addicts who have stopped taking narcotics to stay drug-free. It is also used to help alcoholics stay alcohol-free. This drug is used as part of an overall program that may include counseling, support-group meetings and other treatment recommended by your health-care professional. Naltrexone works by blocking the effects of narcotics, especially the "high" feeling that makes addicted people want to use them. When used along with behavioral treatments, it can reduce the craving for alcohol and help people avoid relapse. It does not, however, block the effects of alcohol.
• In general, the more treatment a patient pursues, the better the results are. If a woman is working to overcome an addiction, she may require other services as well, such as medical and mental-health services and HIV-prevention services. Women who stay in treatment longer than three months usually have better outcomes than those who stay less time. Long-term and even life-long treatment at some level may be necessary for some people. Even after the formal treatment has ended, the risk of relapse is high. Thus, individuals trying to recover from addiction need to be prepared for a life-long commitment to avoid pressures to resume drug use. Just a single exposure to their drug of choice can lead to a full-blown relapse—even after many years of abstinence.
• The ultimate goal of all drug-abuse treatment is to enable the user to achieve lasting abstinence. But the immediate goals are to reduce drug use, improve ability to function, and minimize the medical and social complications of drug abuse.
• There are several types and combinations of drug-abuse treatment programs.
  • Short-term methods last less than six months and include residential therapy, medication therapy and drug-free outpatient therapy.
  • Longer-term treatment may include, for example, methadone or levomethadyl acetate, which is similar to methadone in many ways but has a longer duration of action, allowing patients to visit the treatment program less frequently. In maintenance treatment for heroin addicts, people in treatment are given an oral dose of methadone or levomethadyl acetate, administered at a dosage sufficient to block the effects of heroin and stave off the craving for opiates. In this stable state, the patient is able to break free from drug-seeking and related criminal behavior and, with appropriate counseling and social services, become a productive member of her community.
  • Outpatient drug-free treatment does not include medications and encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group counseling. Patients entering these programs are abusers of addictive drugs other than opiates or are opiate abusers for whom maintenance therapy is not recommended, such as those who have stable lives and only brief histories of drug dependence.
  • Therapeutic communities (TC) are highly structured programs in which patients stay at a residence, typically for six to 12 months or longer. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal activities or seriously impaired social functioning. The focus of the TC is on helping the patient make the transition to a drug-free, crime-free lifestyle.
  • Short-term residential programs, often referred to as chemical-dependency units or sober-living homes, usually involve a three- to six-week inpatient treatment phase followed by extended outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous, Alcoholics Anonymous or Cocaine Anonymous

The Effect Of Commonly Available Illicit Drugs On The Body

Heroin. Also known on the street as smack, horse, H, junk or scag, heroin is the most frequently abused narcotic. Narcotics are derivatives of the opium poppy (an annual poppy cultivated as the source of opium) or chemically similar synthetics created in a lab. Heroin was a commonly prescribed medicine in the early 20th century, until its addictive potential was realized. It breaks down to morphine in the body.

Like most other drugs that are abused, narcotics can create a sense of euphoria, contentment and physical relaxation. The “high” usually lasts about three to four hours. When heroin is injected or smoked, the abuser experiences an instant period of intense pleasure known as a “rush.” The more narcotics are used, the more tolerant the body becomes, requiring more frequent and higher doses to achieve the same results. This frequently leads to death.

Street heroin is sold in powder form and has a bitter taste. Heroin is generally inhaled or injected and sometimes smoked. There is a high prevalence of HIV and AIDS among heroin users due to sharing of contaminated syringes, which has resulted in a decline in the number of intravenous (IV) users. Today, many heroin addicts sniff the powder into their nostrils or heat it on foil to inhale the vapors. Heroin is also sometimes mixed with tobacco or marijuana and smoked in a pipe or cigarette.

The consequences of heroin use include:

• Dry, itchy skin, skin infections and abscesses
• Constipation and loss of appetite
• Menstrual irregularity
• Fluctuating blood pressure and slow or irregular heartbeat
• Dependence, addiction
• Hepatitis and AIDS caused by use of dirty needles
• Stroke and heart attack caused by blood clot
• Cardiac arrest, coma and death from accidental overdose

Heroin cannot be prescribed in the U.S., but the legal medical use of other narcotics is common. Codeine, for example, is also a natural ingredient of opium, although it is less potent than heroin. Codeine is found in prescription cough medicines and pain relievers. Other opium-like derivatives that may be prescribed for moderate to severe pain and are sometimes abused include: hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin, Percodan, Percocet), hydrocodone (Vicodin, Lortab, Lorcet), tramadol (Ultram), propoxyphene (Darvon) and diphenoxylate (Lomotil). When used according to directions approved by the U.S. Food and Drug Administration (FDA), these drugs are safe and effective for the relief of pain and rarely lead to addiction. When not used properly, however, they result in addiction and death, especially when used in combination with alcohol or other drugs.

Cocaine. One of the oldest known drugs, cocaine has been commonly abused, especially in the 1980s and 1990s. It comes in two chemical forms: powdered hydrochloride salt and crack, a smokable form produced through a reaction of an alkaline substance like baking soda. Powdered cocaine can be inhaled, or “snorted,” through the nose or dissolved in water and injected into a vein. When sold by drug dealers, it is often diluted by sugar, starch or other substances. The highly potent and addictive crack variety, also referred to as “free-base” cocaine, looks like white chunks, rocks or chips and makes cracking sounds when it’s heated, typically in a pipe. Crack is less expensive to produce and buy than powdered cocaine. When users inhale the fumes from the pipe, its effects are more immediate (starting in less than 10 seconds, according to the National Institute on Drug Abuse) and more intense. Perhaps because of these rapid and intense effects, addiction appears to develop more quickly in persons using crack than other forms of cocaine.

Cocaine stimulates the nervous system, causing heart rate and blood pressure to increase and blood vessels to constrict. This is why abusers often suffer heart attacks and strokes. The initial effects of cocaine use are increased alertness, energy, self-confidence and loss of appetite. However, as these effects wear off, the user is left feeling depressed, fatigued, jumpy, fearful and anxious.

The consequences of cocaine abuse are:

• Irregular heartbeat, heart attack and heart failure
• Strokes and seizures
• Fluid in the lungs and other lung disorders
• Paranoia, depression, anxiety disorders and delusions
• Aggressive, violent behavior
• Pregnant women who use cocaine are at risk for miscarriage and premature labor, and their babies suffer from low birth weight and developmental problems such as mental retardation.
• An increased risk of hepatitis and HIV for users who inject the drug intravenously
• Increased and indiscriminate sexual activity often accompanies use and addiction, further increasing risk of HIV and other STD infection.

Marijuana. “Pot” is by far the most commonly used illegal drug, and it may also be the most insidious, because most people don’t realize how dangerous it is. The mind-altering ingredient in marijuana is THC (delta-9-tetrahydrocannabinol). Since the 1990s, most marijuana has contained between two to 10 times as much THC as the same amount of marijuana commonly used in the 1960s and 1970s. Thus, the effects of smoking part of a single 21st-century marijuana cigarette produces more profound and debilitating effects than smoking several marijuana cigarettes in the 1970s.

Marijuana is usually smoked, either in a pipe or a loosely rolled cigarette known as a “joint.” Sometimes, usually unknown to the buyer, it is laced with other drugs like the potent hallucinogen PCP. Marijuana can also be brewed into tea or mixed in baked products like cookies or brownies.

The effects of smoking marijuana are usually felt in a few minutes and peak in 10 to 30 minutes. They include dry mouth and throat, increased heart rate, impaired coordination and balance, delayed reaction time, and diminished short-term memory. Marijuana can impair driving and lead to accidents, and its effects may be worse in combination with alcohol. Larger doses can cause more intense reactions such as paranoia.

The most familiar long-term effect of marijuana use is impaired learning ability. Research shows that marijuana use limits the ability to absorb and retain information. In testing, users often show a reduced ability to memorize information and demonstrate lower math and verbal skills.

Aside from the mind-altering effects of marijuana, it also carries consequences similar to cigarette smoking. According to some studies, smoking one joint exposes the user to the same amount of cancer causing chemicals as five tobacco cigarettes.

The health consequences of marijuana use include:

• Chest colds, bronchitis, emphysema, asthma and sinusitis
• Regular use can delay the onset of puberty and reduce the sperm count of men; women who use pot may develop abnormal menstrual cycles and irregular ovulation; pregnant women risk having babies with low birth weights, health problems and developmental delays.
• Impaired perception, diminished short-term memory, loss of concentration and coordination, impaired judgment and decreased ability to judge distance and speed -- all of which lead to increased risk of accidents
• Anxiety, panic attacks and paranoia
• Damage to respiratory, reproductive and immune systems
• Increased risk of cancer

Methamphetamine. Also known as speed, crank, meth, crystal-meth and glass, methamphetamine is a powerful stimulant that produces increased alertness and elation. Its effects are similar to cocaine, but longer lasting. Easily made with inexpensive over-the-counter ingredients in makeshift laboratories, methamphetamine is cheaper to produce than cocaine.
Methamphetamine can be swallowed, smoked, snorted or injected. In powder form it can be mixed with water and injected in the veins or sprinkled on tobacco or marijuana and smoked. Chunks of clear, high-purity methamphetamine are called ice, crystal or glass. It looks like rock candy and is smoked like crack cocaine.

Low doses of methamphetamine can make the user feel alert and energetic. With continued use, the pleasurable feelings can disappear. The user soon needs to take higher doses more often to achieve the same effects. Someone who is using methamphetamine is easily agitated. One minute she is calm and content; the next, she is angry and fearful. Addicts may pick at imaginary bugs on their skin and become obsessed with repetitive actions.

The crash that follows a methamphetamine binge involves agitated depression and an intense craving for more of the drug. These feelings soon give way to exhaustion and long, deep sleep—again followed by severe depression. During this last phase, the potential for suicide is very high.

The consequences of methamphetamine use includes:

• Sleep disturbances, weight loss, nausea, vomiting, diarrhea and elevated body temperature
• Skin sores and infections as a result of picking at imaginary bugs
• Paranoia, epression, irritability and anxiety
• Increased blood pressure, chest pain, headaches, stroke and heart attack
• Permanent brain damage
• Pregnant women risk premature labor, low-birth-weight babies and babies born with brain damage.
• For IV drug users the risk of HIV and hepatitis infection is substantial.

Ecstasy or MDMA (3,4-methylenedioxymethamphetamine) has, in recent years, become increasingly popular with teenagers in club or dance settings. It is a synthetic, illegal drug that has characteristics of both stimulants and hallucinogens. It is typically produced in capsule or tablet form and is usually taken orally, although health-care professionals have documented cases of administration by injection and snorting. The drug interferes with learning and memory, and it may produce detrimental changes in brain structures and chemistry. It increases heart rate and blood pressure, and can disable the body's ability to regulate its own temperature. There is now a large body of evidence that links heavy and prolonged MDMA use to confusion, depression, sleep problems, persistent elevation of anxiety and aggressive/impulsive behavior. Because of its stimulant properties, when it is used in club or dance settings, it can enable users to dance vigorously for extended periods, but can also lead to severe rises in body temperature (hyperthermia), as well as dehydration, hypertension, and even heart or kidney failure in susceptible people.

Researchers at the University of Amsterdam, studying brain blood flow patterns in male and female chronic users of ecstasy, found that women who use the drug may be more likely to develop neurological dysfunction than their male counterparts.

 Quick Facts

• Today, more than four million women in the U.S. use illegal drugs. Nine million women have used illegal drugs in the past year. During the past year, 3.7 million women have taken prescription drugs non-medically. More than 28,000 (70%) of the AIDS cases among women are drug-related.
• Almost half of all women ages 15 to 44 have used drugs at least once in their lifetime. Of these women, nearly two million have used cocaine and more than six million have used marijuana within the past year. Most women drug abusers use more than one drug.
• Moderate alcohol use is not harmful for most adults. Moderate use is up to one drink per day for women and two drinks per day for men (a standard drink is one 12-ounce bottle of beer or wine cooler, one five-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits).
• Women who use alcohol and drugs develop substance-abuse-related health problems faster than men. Women also use drugs and alcohol differently than men:
• Women are more likely than men to use a combination of alcohol and prescription drugs.
• Women often begin to abuse alcohol and drugs following depression, to relax on dates, to feel more adequate, to lose weight, to decrease stress or to help them sleep at night. Men usually develop their addiction in the context of heavy drinking with their friends or by themselves.
• These conditions may increase the risks for developing a substance abuse/dependency problem: a history of physical or sexual abuse; depression, panic disorder or anxiety; and a family history of substance abuse.
• Alcohol is absorbed faster in women’s bodies because women’s stomachs absorb alcohol more rapidly than men’s. Women who drink tend to have more concentrated levels of alcohol in their bloodstream than men. Monthly hormonal fluctuations in women may affect how alcohol is metabolized.
• Women who drink heavily die an average of 15 years earlier than non-drinking women.
• Younger women, especially teenagers, are now drinking as much as their male peers. Teenagers who drink are more likely to be sexually active and not protect themselves against sexually transmitted diseases.
• A recently published study noted a sharp rise (from 5.3% in 1993 to 11.9% in 2001) in frequent binge drinking among women attending all-women’s colleges, and a lesser, but still significant, increase of the same behavior for women in coeducational schools.
• Having more laws restricting underage drinking or governing the volume of sales and consumption of alcohol is associated with less drinking among underage students.
• Women of any age who drink are more likely to be the victims of violence, to attempt suicide or to overdose than those who do not drink.
• Substance abuse and addiction to cigarettes, alcohol and psychoactive prescription drugs (tranquilizers and other drugs that affect the mind or behavior) are at epidemic levels for American women 60 years old and older, according to a recent study. Older women are more susceptible to alcohol or drug addiction because tolerance levels decrease as people age.