LEARN THE FACTS

You Can Enjoy Life Above the High… Know the Facts!

Tobacco

Tobacco contains nicotine, a toxic colorless or yellowish oily liquid that is the chief active ingredient of tobacco that can lead to addiction, which is why so many people who use tobacco find it difficult to quit. There are also many other potentially harmful chemicals found in tobacco or created by burning it.

Nicotine is the primary addictive ingredient in tobacco. It causes a surge of adrenaline when inside the blood system or breathed in through tobacco smoke or vaporizers. Nicotine additionally triggers the part of the brain that makes people happy. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. The same can be said for smokeless forms of tobacco, such as snuff and chewing tobacco.

Vaping devices, also known as e-cigarettes, e-vaporizers, or electronic nicotine delivery systems, are battery-operated devices that people use to inhale an aerosol, which typically contains nicotine, which is sometimes flavored, and other chemicals. They can resemble traditional tobacco cigarettes, cigars, or pipes, or even everyday items like pens or USB memory sticks. Regardless of their design and appearance, these devices generally operate in a similar manner and are made of similar components. More than 460 different e-cigarette brands are currently on the market.

In addition to the unknown health effects, early evidence suggests that vaping might serve as an introductory product for preteens and teens who then go on to use other nicotine products, including cigarettes, which are known to cause disease and premature death.

Slang Terms:
  • E-cigs
  • Juul
  • E-hookah
  • Vape Stick
  • Vape Pen
  • Puff

Alcohol

Alcohol is a drug classified as a Central Nervous System (CNS) depressant, which means that drinking organs in the body. Alcohol is one of the most widely used substances in the world that affects how the brain works. When someone consumes large quantities of alcohol, especially more than the body can handle, the result is depressant effects.

The excessive use of alcohol can be harmful to yourself and others around you. Harmful use of alcohol can also result in negative health repercussions, social and economic burden on the individual, their family and society as a whole. A large amount of the disease burden credited to harmful alcohol consumption stems from unintentional and intentional injuries (i.e., traffic crashes, violence and suicides). Over consumption of alcohol can lead to alcohol poisoning and potentially death. The risk of danger increases with alcohol consumption when used with other drugs, including medications as the outcomes are unpredictable.

Slang Terms:
  • Booze
  • Brewski
  • Sauce
  • Spirit
  • Juice
  • Poison

Over-the-Counter Drugs

Over-the-counter (OTC) medications are those that can be sold directly to people without a prescription. OTC medications are largely safe. They treat a variety of illnesses and their symptoms, including pain, coughs and colds, diarrhea, constipation, acne, and others. Some OTC medicines have active ingredients with the potential for misuse and abuse. They are powerful drugs that must be taken responsibly; otherwise they can negatively impact your health and lead to addiction, overdose, and death if used improperly.

Although OTC medicines are affordable, easily accessible, and effective does not necessarily mean they are harmless. The Federal Drug Administration counts 178,000 hospitalizations a year associated with nonprescription drug use or misuse. Some adverse effects include: impaired functioning, dizziness, confusion, nausea, increased heart rate, increased blood pressure, impaired judgment, and decision-making.

The two most commonly used OTC medicines are Dextromethorphan (DXM), a cough suppressant, and Loperamide, an anti-diarrheal. Brand names of OTC medicines that include DXM are DayQuil, Nyquil, Delsym, Robitussin, etc. Brand names of OTC medicines that include Loperamide are Imodium, Pepto Diarrhea Control, Anti-Diarrheal, etc.

Slang Terms:
  • Dex
  • Lean
  • Drank
  • Tussin
  • Syrup
  • Robo
  • Triple C’s
Avoid Misuse and Abuse
  • Always read the drug’s labels. Make sure you understand the purpose, warnings, and directions.
  • Ask the pharmacist which over-the-counter drug is best for your symptoms and risk factors, including age and other medical conditions.
  • Organize and keep track of your medication. Know what medications you have and how much is in each package/bottle.
  • Keep all your medications in one place. Consider a location other than the bathroom, where they are not so easily accessible.
  • Be sure to properly dispose of expired, unwanted and unused medications.

Marijuana

Marijuana, a drug classified as cannabis, refers to the dried leaves, flowers, stems, and seeds from the hemp plant. The plant contains the mind-altering chemical tetrahydrocannabinol (THC) and other related compounds. It contains close to 500 chemicals that may negatively impact health. THC acts on specific brain cell receptors that react to natural THC-like chemicals. These natural chemicals play a role in normal brain development and function. Marijuana effects areas of the brain that involve memory, concentration, perception and movement.

Marijuana is consumed in hand-rolled cigarettes, in pipes or water pipes, in blunts, and by using vaporizers that pull THC from the marijuana. In recent years, there has been an increase in marijuana consumption through edibles (such as brownies, cookies, and candy, or brewed as a tea). and extracts. These forms of marijuana use deliver a large amount of THC and can be potentially more dangerous.

Marijuana is the most commonly used psychoactive drug in the United States, after alcohol. Its use is widespread among people of all ages. People ages 18-25 have the highest rate of use. Today’s marijuana is stronger than ever before, having three times the concentration of THC compared to 25 years ago. This is likely contributing to increased rates of marijuana-related emergency room visits.

Contrary to popular belief, marijuana is addictive. Research shows that:

  • 1-in-6 people who start using the drug before the age of 18 can become addicted.
  • 1-in-10 adults who use the drug can become addicted.
Slang Terms:
  • Gas
  • Fire
  • Smoke
  • Loud
  • Bud
  • Good Good
  • Kush
  • Runtz
  • Pressure
  • Exotic
  • Cookies
  • Broccoli
  • Dab
  • Cart

New Marijuana Laws in Virginia Effective July 1, 2021

Illegal:

  • It will remain illegal for anyone under the age of 21 to consume, purchase, or possess marijuana, or to attempt to consume, purchase or possess any amount of marijuana.
  • Existing safety measures will remain in place, including prohibiting use of marijuana while driving a motor vehicle or while being a passenger in a motor vehicle being driven; possessing marijuana on school grounds, while operating a school bus, in a motor vehicle transporting passengers for hire, or in a commercial vehicle.
  • It is illegal to consume marijuana in public.
  • It will remain illegal for anyone to possess more than one ounce of marijuana. Individuals found guilty of possessing more than one ounce, but not more than one pound of marijuana are subject to a civil penalty of not more than $25. Individuals convicted of possessing more than one pound are guilty of a felony.
  • It will remain illegal to distribute or sell marijuana, and/or to possess any amount of marijuana with the intent to distribute or sell it. This prohibition applies equally to businesses, which will not be permitted to sell, “gift,” or in any other way distribute marijuana.

Legal:

  • Adults 21 years and older will be allowed to possess not more than one ounce of marijuana for personal use.
  • Adults 21 years and older will be allowed to use marijuana in private residences. However, nothing prohibits the owner of a private residence from restricting the use of marijuana on its premises.
  • Adults 21 and over will be allowed to grow up to four plants per household (not per person).
  • Plant cannot be visible from a public way.
  • Take precautions to prevent access to those by persons under 21 years of age.
  • Requirements for plant to be tagged with name, DL or ID#, notation plant is being grown for personal use.
  • “Adult sharing” or transferring one ounce or less of marijuana between persons who are 21 years or older without remuneration will be legal. “Adult sharing” does not include instances in which marijuana is given away contemporaneously with another reciprocal transaction between the same parties; a gift of marijuana is offered or advertised in conjunction with an offer for the sale of goods or services; or a gift of marijuana is contingent upon a separate reciprocal transaction for goods or services.

Stimulants

Stimulants are a class of drugs that include illicitly produced drugs such as methamphetamine, cocaine, and methcathinone as well as prescription drugs such as Adderall, Concerta, Ritalin and many others. These drugs result in increased activity within the body. When taking stimulants prescribed by a doctor they can make a person feel more awake, alert or energetic. (Doctors may find and prescribe alternative methods that do not include drugs)

When prescribed by a doctor for a specific health condition, stimulants can be relatively safe and effective but there is still a risk of dependence and addiction. When misused (taking more than the prescribed dose, taking someone else’s prescription, mixing your prescription with alcohol, etc.) the risk for dependence and addiction increases which could lead to a fatal or non-fatal overdose.

Methamphetamine usage is a growing concern in Southwest and Central Virginia. It is a powerful and highly addictive stimulant that affects the part of the body that involves breathing, walking, thinking, and feeling. Also known as meth, it takes the form of a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. Methamphetamine comes in several forms and can be smoked, snorted, injected, or orally ingested.

Long-term methamphetamine abuse has many negative consequences, including addiction. In addition to being addicted to methamphetamine, people who use methamphetamine long term may exhibit symptoms that can include significant anxiety, confusion, insomnia, mood disturbances, and violent behavior.

Slang Terms:
  • Snow
  • Speed
  • Addys
  • Blow
  • Nose Candy
  • Coke
  • Meth
  • White
  • Crank
  • Chalk
  • Ice

Opioids

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others. These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain.

Opioid pain relievers are generally safe when taken for a short time, as prescribed, and monitored by a doctor.  However because they can produce euphoria in addition to pain relief, they have a high risk for misuse (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence. When misused, opioid pain relievers can lead to overdose emergencies and deaths. (National Institute on Drug Abuse)

How We Got Here

In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could, indeed, be highly addictive.(3,4) Opioid overdose rates began to increase.

In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin and illicitly manufactured fentanyl, a powerful synthetic opioid.(1) That same year, an estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive).(5) Here is what we know about the opioid crisis:

Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
(drugabuse.gov, 6)

Between 8 and 12 percent develop an opioid use disorder.
(drugabuse.gov,
79)

An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.(
(drugabuse.gov, 79)

About 80 percent of people who use heroin first misused prescription opioids.
(drugabuse.gov, 7)

This issue has become a public health crisis with devastating consequences including increases in opioid misuse and related overdoses, as well as the rising incidence of neonatal abstinence syndrome due to opioid use and misuse during pregnancy. The increase in injection drug use has also contributed to the spread of infectious diseases including HIV and Hepatitis C.

Fentanyl

  • In 2021, Fentanyl accounted for 2,033 overdose deaths in Virginia. This represents 76.5% of all overdoses in Virginia.
  • Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl is potentially lethal in small amounts, making it a major contributor to fatal and nonfatal overdoses in unsuspecting users. In fact, only 2mg of fentanyl – about the size of a grain of salt – can be lethal. Government health officials and law enforcement have warned that it is so deadly that even touching it is enough to cause an overdose.
  • Fentanyl may be prescribed by a doctor to treat severe pain, post-surgery pain, or advanced-stage cancer. However, Fentanyl is also illicitly made and distributed through street drug markets for its heroin-like effects.
  • It is commonly mixed in other drugs such as heroin, methamphetamine, cocaine and even marijuana to increase profits for illegal drug traffickers.
  • Illicitly manufactured fentanyl can come in different forms such as liquid or powder. The powder form is most common and looks very similar to other illegal substances that are white and powder-like. In liquid form, fentanyl has been known to be mixed into eye drops, nasal sprays, or onto paper candies.
  • Counterfeit pills have become increasingly more common in recent years, resulting in an increase in overdose deaths. Counterfeit pills are pressed and laced with fentanyl to resemble other prescription medications.
  • Fentanyl laced drugs are extremely dangerous, and many people are unaware that their drugs are, in fact, laced with lethal amounts of fentanyl. Drugs that contain deadly amounts of fentanyl are undetectable by the average person unless it is tested in a lab. You cannot see it, taste it or smell it.
  • If you suspect someone is suffering from a fentanyl overdose it is crucial that you act quickly. The most important step is to call 911 so that the person can receive immediate medical attention. See ‘Risk of Overdose’ section.
  • Also, if you believe that you have found something that could possibly be contaminated with fentanyl, contact Poison Control at 1-800-222-1222 or contact your local Law Enforcement so they can properly dispose of the substance.
Slang Terms:
  • Apache
  • Dance Fever
  • Friend
  • Goodfellas
  • Jackpot
  • Murder 8
  • Tango & Cash

Risk of Overdose

Why Do People Overdose?

Opioid overdose can occur when a patient misunderstands the directions for use, accidentally takes an extra dose, or deliberately misuses a prescription opioid or any illicit drug such as heroin, cocaine, methamphetamines, etc.  Also at risk is the person who takes medications prescribed for someone else, as is the individual who combines drugs — prescribed or illicit — with alcohol, certain other medications and even some over-the-counter products that depress breathing, heart rate and other functions of the central nervous system.

With opioids, overdoses occur because there are too many opioids in the body. When this occurs the victim is not responsive to touches (sternum rub), being shook, loud sounds, and their breathing is extremely slow or they are not breathing at all. If the victim is not breathing or having difficulty breathing, this can cause oxygen levels in the blood to decrease and the victim’s lips and fingers will turn blue. These effects can lead to coma, unconsciousness, and/or death.

With stimulants, overdoses occur because there are too many stimulants within the body. Stimulant drugs raise heart rate, blood pressure, body temperature and speed up breathing. All of these reactions to the stimulant drug can lead to stroke, heart attack and/or death.

Responding to an Overdose

If you think someone may be overdosing, call 911 immediately.

For a stimulant overdose:
  • Help the person stay calm.
  • Get them into a lying position.
  • Clear their airway while protecting their head.
For an opioid overdose:
  • Shake, shout, and rub their sternum with knuckles.
  • If no response, call 911.
  • Start rescue breaths (if the person is not breathing). Plug the person’s nose and give two rescue breaths.
  • Administer Narcan if you have it and have been trained how to use it.
  • Continue to give rescue breaths until help has arrived.
Do Not
  • Leave the person alone
  • Inject them with speed, milk, salt water, etc.
  • Put them in ice or cold water
  • Move them to another location

How to Obtain Naloxone

If someone in your life is struggling with opioid addiction, visit your local pharmacist to obtain Naloxone and keep it on hand for possible overdose emergencies. Naloxone is a medication that can reverse an overdose that is caused by an opioid drug (i.e. prescription pain medication or heroin). When administered during an overdose, Naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. In November 2016, Virginia implemented a statewide standing order for Naloxone. A standing order serves as a prescription for all Virginians who would like to obtain Naloxone. Virginia residents can now request Naloxone directly from the pharmacy without having to visit their doctor or medical provider first. More information on Naloxone can be found at www.getnaloxonenow.org.

Be Prepared to SAVE a Life — Attend a REVIVE Training

REVIVE! is the opioid overdose and naloxone education program for the Commonwealth of Virginia. provides training to professionals, stakeholders, and community members on how to recognize and respond to an opioid overdose emergency using naloxone. Horizon Behavioral Health is currently offering free monthly trainings virtually via Zoom. Two doses of Narcan and a REVIVE! kit is offered at no cost to all those that attend one of Horizon’s trainings.
Central Virginia

For more information call 434-477-5464 or email mhealth@horizonbh.org

Proper Storage and Disposal

Properly Store Medications

As a parent, grandparent, or family member, it’s important that you organize and keep track of your medication. It’s also an excellent idea to lock up any controlled substances that have been prescribed for you. These include medications such as hydromorphone (Dilaudid®), oxycodone (OxyContin® and Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®).The theft and abuse of prescription medications is a serious problem.

You play a big role in keeping these powerful medications out of the hands of those who shouldn’t have them. Since it is dangerous, as well as illegal, for anyone but you to use a controlled substance prescribed for you, a locked storage area can help keep a stranger or someone else from gaining access to them.   By keeping track of and locking up your medications you are helping to prevent an accidental injury, as well as do your part to stop the possible abuse of prescription medications.

Medication Drop Boxes

Medication take-back programs are a good way to safely dispose of most types of unneeded medications. The U.S. Drug Enforcement Administration (DEA) and our local law enforcement agencies periodically hosts Prescription Drug Take-Back events (typically in April and October) where collection sites are set up in our local communities for safe disposal of prescription drugs. Several of our local law enforcement agencies also have medication drop boxes at the police/sheriff’s departments that can be accessed anytime during regular business hours. For more information, please contact your local law enforcement agency.

Permanent Medication Drop Box/Drug Disposal Locations

Disposal in Household Trash

If no medication take-back programs or DEA-authorized collectors are available in your area, you can now obtain free drug disposal bags from the local health department. The bags allow for you to safely deactivate and dispose of medications in the privacy of your own home.  If there are no specific disposal instructions on the label, you can also follow these simple steps to dispose of most medications in the household trash:

  1. Mix medication (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee grounds;
  2. Place the mixture in a container such as a sealed plastic bag
  3. Throw the container in your household trash;
  4. Scratch out all personal information on the prescription label of your empty pill bottle or empty medication packaging to make it unreadable, then dispose of the container
  5. For needles or sharps place used or unused needles in your laundry detergent container (such as a large Tide container) and throw away as normal

Horizon Behavioral Health offers free medication lock boxes and disposal bags to the community.  For more information call 434-477-5464. 

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