- Myth: You Can Get Addicted to Heroin the First Time You Use It
- Myth: Alcohol Is Only Dangerous If You Get Addicted
- Myth: You’re “Cured” After You Leave Rehab
- Myth: LSD Is Stored in Spinal Fluid for the Rest of Your Life
- Myth: Prescription Drugs Are Safer Than Street Drugs
- Myth: Drug Users Are Lowlifes
- Myth: Ecstasy Makes Holes in Your Brain
- Myth: Coffee Can Sober You Up If You’re Drunk
Drugs have always been a topic of rumors and urban legends. But sometimes facts get lost in the sensationalism, so having accurate information about drugs is a vital part of understanding abuse and addiction.
Relying on rumor is not a good way to get information about such powerful substances, so we’re here to bust some popular drug myths.
Myth: You Can Get Addicted to Heroin the First Time You Use It
Heroin has an undeniably high addiction potential. But that doesn’t mean that every person who tries heroin gets addicted to it. In fact, only 23% of people who try heroin end up developing a substance use disorder.1
The key word is develop: Addiction isn’t something that happens after a single use. It’s an entire set of behaviors that surround drug use, including a sense of compulsion to use despite negative consequences.
What many people think of as addiction is actually tolerance and dependence. This is when the body and brain become so accustomed to the presence of heroin that the user requires larger and larger doses to experience the same high they first did, and also to avoid withdrawal. With opiates such as heroin, the positive effects may start to diminish after only one dose, but that doesn’t mean that a person is addicted.2
Addiction also develops at different paces for different people, and some users may be more protected from heroin addiction by environmental factors such as temperament, community pride, and having positive, drug-free relationships.3 The bottom line is that it’s hard to predict whether a person will get addicted to heroin or not.
To imply that you will almost certainly become addicted after just a single use may be a well-intended message meant to dissuade those curious about the drug, but it is an oversimplification of the processes involved. Holding such a belief could even be counterproductive, inadvertently promoting dangerous recreational use in those who don’t find themselves instantly transformed into addicts after their first time using the drug.
Myth: Alcohol Is Only Dangerous If You Get Addicted
Alcohol may be a legal drug, but it still carries a set of health and safety risks that must be recognized. It’s important to remember that problematic use patterns don’t always involve addiction—in fact, most people who engage in risky drinking habits (such as frequent binge drinking) are not physically dependent, but they can still suffer negative consequences.4
In fact, alcohol is one of the deadliest recreational substances—even more deadly than cocaine and heroin, by some measures.5 Only 6.4% of people age 12 or older had a diagnosed alcohol use disorder in 2014, yet one study found that alcohol was involved in nearly 20% of global emergency department visits; another found that it was involved in 6% of worldwide deaths.6,7,8
Drinking can result in major health problems, regardless of whether or not a person is struggling with addiction:9
- Heart problems.
- High blood pressure.
- Liver damage.
- Inflammation of the pancreas.
- Lower immune defense.
- Cancer (mouth, throat, esophagus, liver, and breast).
One of the most problematic behaviors related to alcohol is known as binge drinking, which is defined as having 4 or more standard drinks for women and 5 or more drinks for men within a about 2 hours.10 This sends the body and brain through extreme highs and lows, which results in a higher risk of developing negative consequences, such as alcohol dependence, psychiatric disorders, and behavioral problems.11
Alcohol doesn’t just affect physical health, though. It is involved in almost half of sexual assaults, and it contributes to more frequent and more dangerous acts of domestic violence.12-16 Because it lowers inhibitions, a person who is already experiencing thoughts or fantasies about harming someone may be more likely to act upon these feelings when drinking.
Finally, there is the extreme danger drunk driving poses. Outside of the obvious risk to the intoxicated driver and their passengers, nearly 20% of fatal drunk driving crashes kill people outside the vehicle, meaning pedestrians and other people on the road.17
Myth: You’re “Cured” After You Leave Rehab
Recovery from substance abuse involves hard work and dedication. Seeking treatment is merely the first step in the process.
Treatment programs provide a stable routine to begin recovery. They help people learn about their substance use habits and practice resisting temptations to use so that after they complete a program, they are better equipped to cope with life outside the sober haven of rehab.
However, sometimes returning to the original environment where they abused their substance of choice can bring about unanticipated challenges to abstinence, leading the person to use again. Relapse is fairly common: Rates are between 40% and 60%—within the same range as relapse for other health-related issues such as Type I diabetes and high blood pressure.18
Because it takes time for the brain to heal from substance abuse, the road to recovery is longer than many people realize and never perfect. But long-term treatment combined with aftercare, such as 12-step meetings or sober living, and engaging in self-help groups, increase a person’s chance of staying sober longer.19
Myth: LSD Is Stored in Spinal Fluid for the Rest of Your Life
This myth arose from the experience of acid flashbacks following long-term LSD use. A small percentage of users do experience slight visual hallucinations, such as after-images or movement in their peripheral vision, when they are not using LSD after a long period of frequent dosing.20,21 However, it is certainly not the norm and has nothing to do with LSD remaining in the body.
In fact, amounts of LSD peak around an hour and a half after a person takes it, then progressively declines for the next 12 hours. The volume to which it lowers in that 12 hours varies based on the person and their individual physiology, which affects how efficiently their body metabolizes LSD and subsequently rids itself of the substance; a very small percentage of people still showed evidence of the drug 24 hours after ingesting it. Any long-term psychotropic effects that might be attributed to LSD is related to the plasma levels in a person’s cerebrospinal fluid, though the connection is largely theoretical.23
Some people believe that these (admittedly small) potential after-effects mean that a person is “legally insane” after they take LSD a certain number of times, but this is also a misconception.
In a strictly legal sense, the concept of insanity may be introduced as part of a courtroom defense strategy, and in that context, is used to indicate that a person is not mentally present enough to be found guilty of a crime committed.24 It has nothing to do with how many times a person has ingested LSD.
On top of the misconstrued terms, LSD use does not appear to be associated with any long-term psychosis in the average person. While they may experience psychotic-like symptoms (e.g., hallucinations, delusions, paranoia) during the drug experience, these symptoms generally do not last beyond that particular trip.25
Many users report experiencing a “bad trip” characterized by anxiety, paranoia, and the sense that the psychedelic experience will never end. Whether or not a user will experience this frightening sensation is largely unpredictable.26 It is possible that LSD affects receptors in the brain similar to the ones affected by psychotic disorders; whether or not this links LSD to breaks with reality is unknown. However, even for regular users of the drug, a bad trip can happen any time.27,28
Myth: Prescription Drugs Are Safer Than Street Drugs
Many prescription drugs have inherent health risks and dangers despite being legally prescribed for acceptable medical uses. Even if the Drug Enforcement Administration (DEA) doesn’t classify prescription drugs as hazardous, many medications contain strongly addictive substances.
The most highly abused prescription drugs are:29
- Opioids: used to alleviate moderate to severe pain; mechanism of actions similar to heroin.
- Central nervous system (CNS) depressants: prescribed to reduce anxiety and help with insomnia; many exert their sedative effects similarly to alcohol through their interaction with the GABA receptor.
- Stimulants: frequently used to lessen symptoms of attention-deficit hyperactivity disorder (ADHD); mechanisms of action are similar to those of cocaine and methamphetamine.
Opioid medications are a particular problem in the U.S. right now, with nearly 19,000 people dead from prescription opioid overdoses in 2014, a drastic increase from less than 4,000 in 2001.30 Overdose rates for opioid medications were almost twice as high as overdose rates for heroin in 2014.30 Opioids can be dangerous even when taken as prescribed, with the leading risk factors being long-term medical use and non-medical use.31
Use of these potent medications can have long-lasting consequences for the user, regardless of if you take them with a prescription.
CNS depressants—a category that includes the benzodiazepines and barbiturates—are another class of prescription drugs that can harm a user. In 2011, almost 34% of emergency department visits involving nonmedical use of prescription drugs were related to these drugs.32
However, unlike opioids, the biggest risks surrounding the abuse of depressants are not related to overdose, but instead concern the potential to elicit a severe withdrawal syndrome and the dangers of mixing these drugs with other drugs and alcohol. Many people suffer severe health consequences when they use a CNS depressant with alcohol (another depressant) or when they try to quit after extended use.
When a person develops sedative dependence, their brain gets used to a lower level of stimulation because depressants inhibit certain types of brain activity. Once they stop using—especially if it is cold turkey—withdrawal can bring about deadly seizures due to neurological overstimulation. CNS depressants have a high addiction potential, so anyone who abuses them runs a high risk of experiencing life-threatening withdrawal symptoms.
Prescription stimulant medications are commonly abused on college campuses as study aids, but people also use them for weight loss and late-night partying.
But it shouldn’t be looked at as fun and games: acute and chronic misuse of stimulant medications such as Ritalin or Adderall can result in a range of detrimental health effects, including:33
- High blood pressure.
- Cardiovascular injury/disease.
- Elevated body temperature.
- Psychotic symptoms.
Escalating doses may even lead to addiction, which further complicates the risks and consequences of prescription stimulant abuse.
Remember, just because certain drugs are available by physician prescription does not mean that they are safe to use without a legitimate reason or in amounts that exceed therapeutic doses. Abusing these medications can be just as risky and life-threatening as abusing illicit substances.
Myth: Drug Users Are Lowlifes
When people hear the term drug addict, they often think of a person who lives on the streets, perhaps is hungry, strung out, and desperate for their next fix.
While there are certain risk factors that contribute to a person developing an addiction, it is not a simple matter of classifying people with one broad stroke. A substance use disorder can—and does—affect any person from any background.
In fact, many people who struggle with addiction are functioning relatively well in their day-to-day lives, with those around them completely oblivious to their substance abuse. While addiction spans many lifestyles and occupations, often problems develop in high-stress environments, either due to home life or job pressures.34
Having a higher income level has been found to protect against some substance abuse problems, but this only seems to be true in rural areas, not in cities or suburbs.35 High-status occupations are associated with drug abuse disorders, though, and using alcohol and marijuana in young adulthood is linked to growing up in a family with a higher socioeconomic status (SES), which reflects the combination of family members’ wealth, income, and education.35,36
Clearly, the typecast of an addicted person as a street-dwelling lowlife is simply not accurate. Higher SES individuals have the same if not higher risk of engaging in substance abuse and developing a problem with addiction. Most people with addictions also have very similar brain structure and chemistry—substance use disorders don’t care whether you grew up wealthy or not.
Myth: Ecstasy Makes Holes in Your Brain
The rumor that Ecstasy (MDMA) causes physically extensive brain damage is simply unfounded. It originated in one study that examined PET brain scans of former Ecstasy users and non-users; it found a toxic, damaging effect as a result of using the drug.37 Then, media outlets took up the study and began dramatizing and spreading this misinformation.
However, the study had seriously flawed methods that rendered its results inconclusive.38 Not only were many subjects in the study multi-drug users (meaning the results couldn’t be attributed to Ecstasy alone), but the “damaged brain” PET scan image doesn’t even show the brain’s actual structure. PET scans can show differential communication and function within a brain, but they can’t display finely detailed brain structure or faithfully approximate a representation of fine anatomic defects, such as the rumored holes. Only a CT or MRI scan or, perhaps, close brain tissue examination performed during autopsy could reveal such details.
Is Ecstasy Dangerous?
Ecstasy does impact neurons in the brain related to pleasure and reward, but most of the effects don’t last beyond the high. The research that exists on Ecstasy’s long-term effects has examined polydrug users, which means that it is not possible to attribute the observed effects to MDMA alone.38-40 In fact, if the effect of other drug use is minimized, almost no long-term cognitive effects are found.41
But before you run out and decide to give Ecstasy a try, consider the fact that most pills contain a mix of MDMA and other drugs such as ketamine, amphetamine, methamphetamine, and ephedrine.42 These additional mystery substances may create additional negative effects on the user.
On its own, Ecstasy abuse can cause:43,44
- Extremely high body temperature (hyperthermia).
- Extreme dehydration.
- Abnormal heart rhythms.
Ecstasy might not cause holes in your brain, but that doesn’t make it safe, especially if there are other substances mixed in.
Myth: Coffee Can Sober You Up If You’re Drunk
The only true way to sober up is to lower blood alcohol concentration (BAC); the liver handles this duty for us.
We know that coffee can provide a modest boost to your metabolic rate, but can it affect your liver’s alcohol processing speed? The short answer is no. Its effects are exerted mainly in other parts of the body. This means that your BAC will stay the same before and after a cup of coffee, depending on how long it takes you to drink it.45-46
Combining alcohol (a depressant) and coffee or caffeine (a stimulant) can have counteracting effects that make a person subjectively feel like they are less drunk, but motor control, visual reaction time, and BAC will not be affected.45 It takes about one hour to fully process one standard drink (e.g., one 12 oz. of 5% beer, 5 oz. of 12% wine, or 1.5 oz. of 40% hard liquor).47,48
Risks of Mixing Coffee with Alcohol
When coffee starts to exert its effects, a person may begin to experience the alertness and energy increase that comes with caffeine use. The person may believe they are more sober as alcohol’s depressant effects seem to be reduced, but make no mistake: The alcohol is still affecting them just as much as before.45
This combination is especially dangerous should a person begin to drink more alcohol to make up for the caffeine-induced sense of sobriety. This can more quickly lead to alcohol poisoning and other dangerous effects on the body and the brain.49,50
On top of all this, a person who combines alcohol and coffee may be more likely to believe they are capable of driving, putting themselves and many others at risk.
Any potential drug user should learn the facts about any substance they are going to ingest. Many substances come with a set of risks that make trying them simply not worth it. Instead of relying on hearsay for drug information, take some time to read about the effects of the drugs from reputable sources.
Ongoing research is exposing more and more about substances of abuse, debunking many drugs myths one study at a time.
- National Institute on Drug Abuse. (2014). DrugFacts: Heroin.
- Laulin, J.P., Larcher, A., Ce ́le`rier, E., Le Moal, M., & Simonnet, G. (1998). Acute tolerance associated with a single opiate administration: involvement of N-methyl-D-aspartate- dependent pain facilitatory systems. Neuroscience, 84(2), 583–589.
- National Institute on Drug Abuse. (2014). Drugs, brain, and behavior: the science of addiction.
- Centers for Disease Control and Prevention. (2014). Excessive drinking costs U.S. $223.5 billion.
- Lachenmeier, D.K. & Rehm, J. (2015). Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach. Scientific Reports, 5, 1–7.
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. HHS Publication No. SMA 15-4927, NSDUH Series H-50.
- World Health Organization. (2007). Alcohol and injury in emergency departments.
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- National Institute on Alcohol Abuse and Alcoholism. (2010). Beyond hangovers: Understanding alcohol’s impact on your health.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Drinking levels defined.
- Robin, R.W., Long, J.C., Rasmussen, J.K., Albaugh, B., & Goldman, D. (1998). Relationship of binge drinking to alcohol dependence, other psychiatric disorders, and behavioral problems in and American Indian tribe. Alcoholism: Clinical and Experimental Research, 22(2), 518–523.
- Abbey, A., Zawacki, T., Buck, P.O., Clinton, A.M., & McAuslan, P. (2004). Sexual assault and alcohol consumption: What do we know about their relationship and what types of research are still needed? Aggression and Violent Behavior, 9, 271–303.
- Seto, M. C. & Barbaree, H.E. (1995). The role of alcohol in sexual aggression. Clinical Psychology Review, 15, 545–566.
- Testa, M. (2002). The impact of men’s alcohol consumption on perpetration of sexual aggression. Clinical Psychology Review, 22, 1239–1263.
- Foran, H.M. & O’Leary, K.D. (2008). Alcohol and intimate partner violence: A meta-analytic review. Clinical Psychology Review, 28, 1222–1234.
- Graham, K., Bernards, S., Wilsnack, S.C., & Gmel, G. (2011). Alcohol may not cause partner violence but it seems to make it worse: A cross national comparison of the relationship between alcohol and severity of partner violence. Journal of Interpersonal Violence, 26(8), 1503–1523.
- U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA). (2014). Traffic Safety Facts 2013 Data: Alcohol-Impaired Driving. Washington (DC): NHTSA.
- National Institute on Drug Abuse. (2014). Drugs, Brains, and Behavior: The Science of Addiction: Treatment and Recovery.
- Kissin, W., McLeod, C., & McKay, J. (2003). The longitudinal relationship between self-help group attendance and course of recovery. Evaluation and Program Planning, 26, 311–323.
- Halpern, J.H. & Pope, H.G. (2003). Hallucinogen persisting perception disorder: what do we know after 50 years? Drug and Alcohol Dependence, 69(2), 109–119.
- Hermle, L., Simon, M., Ruchsow, M., & Geppert, M. (2012). Hallucinogen-persisting perception disorder. Therapeutic Advances in Psychopharmacology, 2(5), 199–205.
- Abraham, H.D. & Duffy, F.H. (1996). Stable quantitative EEG difference in post-LSD visual disorder by split-half analysis: evidence for disinhibition. Psychiatry Research: Neuroimaging Section, 67, 173–187.
- Dolder, P.C., Schmid, Y., Haschke, M., Rentsch, K.M., & Liechti, M.E. (2016). Pharmacokinetics and Concentration-Effect Relationship of Oral LSD in Humans. International Journal of Neuropyschopharmacology, 19(1), pyv072.
- Cornell University Law School, Legal Information Institute. (2016). Insanity Defense.
- Carhart-Harris, R.L., Kaelen, M., Bolstridge, M., Williams, L.T., Underwood, R., Feilding, A., & Nutt, D. J. (2016). The paradoxical psychological effects of lysergic acid diethylamide (LSD). Psychological Medicine, 46, 1379–1390.
- Ungerleider, J.T., Fisher, D.D., Fuller, M., & Caldwell, A. (1968). The “bad trip” – the etiology of the adverse LSD reaction. The American Journal of Psychiatry, 124(11), 1483–1490.
- Gonzalez-Maeso, J. & Sealfon, S.C. (2009). Psychedelics and schizophrenia. Trends in Neurosciences, 32(4), 225–232.
- Abraham, H.D. & Aldridge, A.M. (1993). Adverse consequences of lysergic acid diethylamide. Addiction, 88(10), 1327–1334.
- National Institute on Drug Abuse. (2014). What are some of the most commonly abused prescription drugs?
- National Institute on Drug Abuse. (2015). Overdose Death Rates.
- Centers for Disease Control and Prevention. (2012). CDC grand rounds: prescription drug overdoses – a U.S. epidemic. MMWR Morbidity and Mortality Weekly Report, 61(1), 10–13.
- Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- Lakhan, S E. & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661–677.
- Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Science, 1141, 105–130.
- Diala, C.C., Muntaner, C., & Walrath, C. (2004). Gender, occupational, and socioeconomic correlates of alcohol and drug abuse among U.S. rural, metropolitan, and urban residents. The American Journal of Drug and Alcohol Abuse: Encompassing All Addictive Disorders, 30(2).
- Patrick, M.E., Wightman, P., Schoeni, R.F., & Schulenberg, J.E. (2012). Socioeconomic status and substance use among young adults: a comparison across constructs and drugs. Journal on the Study of Alcohol and Drugs, 73(5), 772–782.
- McCann, U.D., Szabo, Z., Scheffel, U., Dannals, R.F., & Ricaurte, G.A. (1998). Positron emission tomographic evidence of toxic effect of MDMA (“Ecstasy”) on brain serotonin neurons in human beings. Lancet, 352(9138), 1433–1437.
- Kish, S.J. (2002). How strong is the evidence that brain serotonin neurons are damaged in human users of ecstasy? Pharmacology, Biochemistry, and Behavior, 71(4), 845–855.
- Roberts, C.A., Jones, A., & Montgomery, C. (2016). Meta-analysis of executive functioning in ecstasy/polydrug users. Psychological Medicine, 46(8), 1581–1596.
- Roberts, C.A., Jones, A., & Montgomery, C. (2016). Meta-analysis of molecular imaging of serotonin transporters in ecstasy/polydrug users. Neuroscience and Biobehavioral Reviews, 63, 158–167.
- Halpern, J.H., Sherwood, A.R., Hudson, J.I., Gruber, S., Kozin, D., & Pope Jr., H.G. (2011). Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. Addiction, 106(4), 777–786.
- Tanner-Smith, E.E. (2006). Pharmacological content of tablets sold as “ecstasy”: results from an online testing service. Drug and Alcohol Dependence, 83(3), 247–254.
- Hall A.P. & Henry, J.A. (2006). Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: Overview of pathophysiology and clinical management. British Journal of Anaesthesia, 96(6), 678–685.
- Barrett, P.J. & Taylor, G.T. (1993). ‘Ecstasy’ ingestion: a case report of severe complications. Journal of the Royal Society of Medicine, 86(4), 233–234.
- Ferreira, S.E., de Mello, M.T., Pompeia, S., & de Souza-Formigoni, M.L. (2006). Effects of energy drink ingestion on alcohol intoxication. Alcoholism: Clinical and Experimental Research, 30(4), 598–605.
- Ferre, S. & O’Brien, M.C. (2011). Alcohol and caffeine: the perfect storm. Journal of Caffeine Research, 1(3), 153–162.
- Fritz, B.M., Companion, M., & Boehm II, S.L. (2014). ‘Wired’, yet intoxicated: modeling binge caffeine and alcohol co-consumption in the mouse. Alcoholism: Clinical and Experimental Research, 38(8), 2269–2278.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). What is a standard drink?
- Attwood, A.S. (2012). Caffeinated alcohol beverages: a public health concern. Alcohol and Alcoholism, 47(4), 370–371.
- Reissig, C.J., Strain, E.C., & Griffiths, R.R. (2009). Caffeinated energy drinks—a growing problem. Drug and Alcohol Dependence, 99(1-3), 1–10.