Dear Ann Landers,
The effects vary from person to person and one individual can experience a wide variety of trips. The effects of LSD depend on the emotional stability of the user, the dosage taken and the quality of the acid. If the dose is taken by mouth, the person begins to feel the effects in about thirty minutes. If it is injected into a vein, it takes less than half that time. The "bummers" or "bad trips" usually occur because the user takes too much acid in the hope that he will have an unusually groovy trip. "Bad trips" also are related to the user's emotional stability. Individuals with a history of mental illness can be seriously damaged by the use of LSD and the damage may last for months or even years. Most users remain conscious throughout a trip and will respond to ques-tions. The responses are often illogical, but there is evidence that the tripper hears voices and is aware of the presence of others. The impact of LSD on the visual senses is striking. The user may notice a sharp intensification of color. Pink appears to be flaming red, lavender is de-scribed as "passionate purple," pastel green becomes "brilliant emerald." The outline of objects becomes liquid. The frame of a picture suddenly appears to be wavy. The colors in a painting seem to run together. Ordinary objects take on a luminous glow. In several interviews, users who were thousands of miles apart insisted that they had spoken with Jesus or the Virgin Mary and de-scribed a glowing halo around the head, "just like in the religious paintings." Persons under the influence of LSD often laugh uproariously for no appar-ent reason, or they can become very sad, weep uncontrollably and sink into a deep depression. The tripper may become paranoid, convinced that someone is trying to control him. (This is because he has lost control of himself.) The danger of accidental death is ever-present during a trip. The possibility of an accident is 404 THE ANN LANDERS ENCYCLOPEDIA so well known that most trippers provide themselves with a "guide"- someone who will stay with them to see that no harm will come. But even the presence of a "guide" is no sure safeguard against trouble. A guide may be able to prevent a tripper from jumping out a window or rushing into traffic, but he can't prevent death from an overdose of acid to which a lethal foreign substance has been added. LSD distorts the user's sense of time. The person who returns from a trip may believe he has been out of this world for several months. Other users, after a twelve-hour trip, express disappointment that "it lasted only a few sec-onds." Often a tripper will become fascinated with a single object such as a vase or a bowl of fruit, and rave endlessly about the extraordinary beauty of it. When the drug wears off, he may or may not notice anything unusual about the object. The mental picture of one's own body frequently becomes grossly dis-torted. Arms and legs seem to be separated from the body and the victim is convinced that the dismemberment is permanent. According to several researchers, this experience is unique to LSD users. These fears can be so ter-rifying that they produce a severe and prolonged state of anxiety. One of the most dangerous aspects of LSD is that it creates delusions of super-strength and indestructibility. Several deaths have occurred because trippers thought they could fly and leaped out of high-rise buildings to prove it. Others have walked into heavy traffic, convinced they could stop oncom-ing vehicles with their bare hands. One acid head told his companions he could twist a railroad train "like a toy." He ran out of the house before he could be stopped, raced down the tracks to catch the train, and was killed in-stantly. Does LSD increase creativity or self-understanding? People who have ex-perimented with LDS often claim the drug expanded their consciousness and opened new worlds to them, but there is no evidence to support these claims. Comparative studies of the writing and painting of LSD users proved to be, in most instances, not superior but inferior after drug use. The acid head is in the same boat as the lush or the user of marijuana who believes that his drug makes him witty, brilliant and charming, or a better musician or a more sen-sitive poet. The mind-altering agents remove inhibitions, but this in no way enhances the personality; in fact, it often brings out unguarded traits which can be crude and unattractive. One thing is certain-a person who is under the influence of alcohol or any other drug is no judge of how he appears to others. Does LSD produce deformed babies? A number of reputable scientists, no-tably Dr. Joshua Lederberg, Nobel Prize-winning geneticist of Stanford Uni-versity, have reported chromosomal fragmentation in connection with LSD exposure in the test tube in animals and in man. A number of highly capable THE ANN LANDERS ENCYCLOPEDIA 405 scientists have been unable to confirm these findings. So one must say, in all honesty, that this question remains, as of now, unsettled. The answer is "per-haps LSD produces deformed babies." Until further research throws addi-tional light on the subject, medical authorities warn that the drug must be considered a definite risk in this regard. Women of childbearing age should be aware of the possible dangers. In this connection, I was interested to see if Grade Slick, the singer with the Jefferson Airplane (now Starship), would produce a normal child when she became pregnant by a musician with the group. Grace referred frequently to her use of LSD and other drugs, but announced she was laying off all dope during her pregnancy. Gracie produced a normal child. Does LSD have any medical value? So far, there is no evidence that LSD has medical value, but it is still under investigation and some optimistic researchers claim it is too early to tell. Some scientists say LSD is potentially valuable in psychotherapy. Under proper conditions, a controlled and measured dose of LSD can release long- buried, deep-seated wishes and bring them to the conscious level. This expo-sure might make it possible for the patient to recognize and then, hopefully, to deal with the true nature of his problem. But to date, no solid evidence of successful use of LSD in medicine or psychiatry has been produced. Is LSD dangerous? The answer is yes. LSD is a powerful drug which is still under investigation. Flashbacks are a frightening side effect which users re-port with increasing frequency. Some users who have not touched LSD for as long as six months report unexpected trips after smoking one marijuana ciga-rette, or after taking an antihistamine pill for hay fever. Former users who have sworn off all drugs have experienced unexpected trips during periods of emotional strain-such as a death in the family, a divorce or the loss of a job. Increasing numbers of acid heads are seeking psychiatric help from private physicians, campus counselors and mental health clinics. The University of California at Los Angeles studied seventy LSD users under treatment at its medical center. The findings revealed that, in every case, the LSD user had experienced one or more severe reactions after the effects of the drug should have worn off. This supports other evidence that LSD may cause serious psy-chiatric disorders. Dr. Roy Menninger, President of the Menninger Foundation in Topeka, Kansas, had this to say: "The use of LSD is declining because more and more users are experienc-ing unpleasant results. There is no question but what LSD must be consid-ered a dangerous drug because of its total unpredictability. The person who is about to trip, even though he has tripped before, has no way of knowing whether he will have a pleasant journey, or hit a 'bummer' which might lead to serious injury or death." 406 THE ANN LANDERS ENCYCLOPEDIA LSD use seems to decrease with age. Most people who use it give it up as they mature because of the unpredictability of its effects and because sooner or later they have a scary experience. BABY WOOD ROSE SEEDS The following item appeared in the action column of the Chicago Sun- Times on June 29, 1976: My son sent for some Baby Wood Rose Seeds not long ago. He got a paper explaining how to plant and care for them. There was a history of the plant that said East Indian natives used the seeds for ceremonial purposes. To produce a relaxed and euphoric feeling, it said, they would wash, crush and eat four to ten seeds. Sometimes the drug-like effect would be strong enough to cause hallucinations. Is this legal? The paper that came with them said, "These seeds are being sold as a novelty." That doesn't sound all that novel, d.h., Burbank We asked the Illinois Drug Abuse Program (IDAP) your questions. While its director, Dr. Edward Senay, told us a chemical analysis of the seeds would be required for positive identification, the effects probably are similar to those of nutmeg or LSD. These can cause pleasurable feelings and possible hallucinations, if the dosage is high enough. "What the flyer accompanying the seeds does not tell you," Senay said, "is that the natives (in the East Indies where the seeds originated) had cultural and psychological controls that protected them from lasting harmful effects. [A strong "national" religion such as Hinduism can be a cultural control.] Unfortunately, we do not have such cultural controls in our society. There-fore, your son should be advised that the potential risks have not been identified in the flyer. Certainly, large numbers of these seeds should not be taken, if indeed they are to be taken at all." But what about the legality? The IDAP's lawyer said it is legal to mail the seeds. According to High Times, a magazine read by people who want to know the latest on drugs (prices, availability, etc.), Baby Wood Rose Seeds sell for $300 a pound. (A pound is approximately four thousand seeds. Twenty seeds is enough for a trip.) MESCALINE OR PEYOTE Mescaline or peyote comes from the buttons of a cactus plant. It is usually ground into powder and taken orally. For centuries mescaline has been used in religious ceremonies by the Indian tribes of Central America, and by some tribes in the southwest of the United States. The first references to "cactus magic" describe the plant that can "take a person to another world." THE ANN LANDERS ENCYCLOPEDIA 407 Mescaline has been used in experimental psychiatry to produce a state of semiconsciousness during which a person will remain for hours with his limbs in a fixed position. Psychotic patients sometimes enter this state (it is called catalepsy). Researchers have discovered that mescaline also can pro-duce this condition. Mescaline, like LSD, is a hallucinogen. It can result in a high and some-times a trip. The major danger from mescaline is not the development of de-pendence, either physical or psychological. It is the bad trip, during which the user may endanger his life. Mescaline is illegal in the United States and Canada, but the law-enforcing agencies have had a difficult time keeping it out of the hands of users because it grows wild near the harmless cactus plants and can easily be obtained in the raw state. PHENCYCLIDINE (PCP) (angel dust) Phencyclidine, developed in the 1950s, is now legally manufactured as a veterinary anesthetic under the trade name Semylan. The street name is angel dust. Since 1967, it has also been produced in "underground" laboratories, fre-quently in dangerously contaminated forms. Although most angel dust is snorted, taken orally or injected, it is most often sprinkled on marijuana, mint leaves or parsley, then smoked. This dangerous drug is sometimes sold to unsuspecting consumers as LSD, THC or mescaline. In low doses the experience usually proceeds in three stages: First there is a change in body image, sometimes accompanied by feelings of separation from one's self. Next the visual distortions occur- hallucinations take place and the user "sees" and "hears" things that do not exist. Finally, the feeling of "I don't care about anything" takes over. The angel dust experience often produces drowsiness, inability to verbalize, and feelings of emptiness or "nothingness." Reports of difficulty in concen-trating and making decisions are common. This is sometimes followed by a preoccupation with death. Many users have reacted to its use with an acute psychotic episode. Com-mon side effects of angel dust include profuse sweating, the inability to feel pain, involuntary eye movements, muscular inco-ordination, double vision, dizziness, high blood pressure, nausea and vomiting. The person may report later that he could feel nothing and was unable to talk. The most serious as-pect of using angel dust is that the user can commit some heinous crime, such as murder, and later he has no recollection whatsoever of what he has done. Prolonged psychotic reactions of repeaters has been noted. These patients require many months of treatment before any improvement takes place. There is no question about the fact that this drug is extremely dangerous. 408 THE ANN LANDERS ENCYCLOPEDIA MORE ADVICE TO PARENTS Here is a sensible answer to a question that has appeared in my mail fre-quently these last several years. The question: "If your teenage child came home and said, 'I am going to take one of the three-booze, cigarettes, or marijuana, which one would you choose?" The answer was provided by Dr. Robert L. DuPont, who was the director of the National Institute on Drugs in 1975: "Marijuana use, an issue once marked by emotionalism and scare tactics, is today being examined thoughtfully. Much remains to be understood; mari-juana does not lend itself to simple answers. "Marijuana has been used for over three thousand years as a medicine. It comes from a plant called Cannabis sativa, which grows as a weed in many regions of the world. Some of marijuana's properties-notably its psychoac-tivity-are undesirable for most medicinal purposes. But marijuana has one highly desirable property: there is no known lethal dose, and even after very large doses, the user does not die. "Although it now seems unlikely that marijuana will ever be used widely in modem medicine, recent research suggests that specific chemical components of marijuana may be useful in the treatment of severe medical illnesses such as glaucoma, asthma, and for the nausea and vomiting often produced by an-ticancer agents. "Recreational use of marijuana provokes the fear of progression from one drug to another, from marijuana to more dangerous drugs. Recent studies show that indeed there are stages in the onset of drug-using behavior as adolescence progresses. But drugs for most young people do not begin with marijuana. "For the majority of illicit drug users, however, marijuana is indeed a step on a staircase. It appears that adolescents typically begin their drug consump-tion with beer and wine. The next step is to cigarettes or hard liquor. If the young person goes on to further drug use, it is almost inevitably marijuana. "The next step is to other illicit drugs-most often to "pills" such as tran-quilizers, amphetamines and barbiturates. Then-for those comparatively few who go on-the next drug used is LSD and other hallucinogens, followed by final progression to the use of what is generally known as the most dan-gerous drug, heroin. "Currently, 33.6 million Americans have used marijuana and 13.3 million continue to use it on a regular basis. Clearly many of these people will not progress beyond marijuana; in fact, many will give up marijuana altogether. "Marijuana may be less harmful than cigarettes or alcohol. But since marijuana is an illegal substance, the parents of the more than 50 percent of the teenagers in America who have tried it face a tough dilemma. Should THE ANN LANDERS ENCYCLOPEDIA 409 they condone their child's use of marijuana or condemn it, perhaps even turning the child in to the nearest police station? "My view is that a parent has to approach the drug problem as a whole and not pick out any particular drug for special condemnation. One should recognize the fact that most adolescents are going to be exposed to a wide va-riety of substances. It is important for the parent not to get too uptight about whether the child does or does not use a particular drug once or twice, or even a number of times, recreationally. "The parent should talk with the young person about the consequences of the decisions that he or she is making, in the context of his adolescence. "Personally, my advice with respect to any of these substances would be, 'If you are not using them, I would recommend that you not begin. Drug use is expensive, it's messy, it's of very limited value in terms of the person's life-style, and there are serious health risks associated with all the drugs.' "One reasonable position parents can take is to realize that no drug use is always better than some drug use, but that if the youngster is to use any drug he should use as little as possible. "Unfortunately, everybody does not have the ability to control their con-sumption. This is the point I was making about marijuana earlier, about the likelihood of going on to heavy stuff. The same thing is true of alcohol. Before they start drinking, [there is no way for them to know] if it will have a disastrous effect. They may not be able to control their consumption. So I would say this is one of the things I'm concerned about. "If a young person uses any of these drugs, I want to help him in a non-hysterical, non-scary way. We must remain calm and not become hysteri-cal. I've heard people say, 'Well, if my child used one marijuana cigarette, I'd throw him out of the house.' I think this is ridiculous. "Although we need to know more about the health consequences of marijuana use, we already have two areas of major concern. The first is im-pairment of co-ordination in the marijuana smoker which-like drunkenness -may lead to car accidents. The second is the tendency for a sizable minor-ity of marijuana users to use the drug very frequently and to let their lives revolve around the drug. I would add the risk of developing the same lung problems as cigarette smokers have. " 'Decriminalization' has become a scare word that polarizes people and in-duces a fighting and contentious attitude. That is probably the biggest prob-lem we have right now. We should step back and ask simply: What do we re-ally want to do with the person, young or old, who is caught by the police with a small amount of marijuana? Put him in prison and label him with a criminal record? "Locking up marijuana users makes little sense to me. Neither does it make sense to treat marijuana as we now treat alcohol and tobacco. "A modest fine for marijuana use seems to make the most sense. "A fine signals to the public that society is opposed to the use of 410 THE ANN LANDERS ENCYCLOPEDIA marijuana, but that we do not consider the possession of small quantities for personal use a problem to be dealt with by putting people in prison." The key principle for parents assessing their child's drug use is the suc-cess or failure of his or her general adaptation. How well is he doing in school? How well does he or she socialize? Do they have reasonably healthy future goals toward which they are able to work? If things are all right in general, probably the parents should not hassle the child. But if drug use is frequent and doses are clearly affecting adaptation, then there is a problem. In general, the real dialogue with children ought to be about adaptation, not about a specific behavior such as infrequent marijuana use. But use of heroin or other high risk drugs, such as barbiturates or diazepam (Valium), should be cause for concern. GLUE-SNIFFING Many preteen drug abusers go for glue-sniffing because the stuff is easy to obtain. No pushers. No needles. No big outlay of money. Neat. This is especially distressing because preteens cannot possibly comprehend the risks they run or the extent of the physical and mental damage that can result from such recklessness. Although model airplane glues are the best-known compounds having or-ganic solvents that will produce a high, there are approximately thirty other substances which will also produce intoxication and exhilaration. The most popular are fingernail polish remover, cigarette lighter fluid, lacquer and var-nish thinner, gasoline, antifreeze and cleaning fluids, such as naphtha, ben-zene, and carbon tetrachloride. At this writing some manufacturers of glues are trying to find less toxic and less volatile materials. The feeling of excitement and exhilaration is fairly prompt. The sniffer feels as if he were intoxicated from alcohol. In addition to the exhilaration, there is a sensation of detachment, disorientation and confusion. One ten- year-old girl said, "I thought I was Peter Pan. It was like I was floating in air." Blurred vision, dizziness, slurred speech and a ringing in the ears are com-mon symptoms of sniffing. The judgment is impaired and often the sniffer has delusions of superior strength or unusual athletic ability. These delusions have resulted in serious accidents and some deaths. The earlier phases of in-toxication usually last from thirty minutes to one hour, depending on the strength and amount of the substance inhaled and the physical tolerance of the user. The feeling of intoxication is often followed by a period of drow-siness which lasts about an hour. When a heavy amount of inhalant is used, the sniffer could have convulsions, or slip into a stupor, or unconsciousness. The final result in some cases is death. Solvents when inhaled in large amounts can cause severe kidney and liver damage and heart trouble. They can also damage the central nervous system. THE ANN LANDERS ENCYCLOPEDIA 411 There have been several cases of permanent brain damage due to lack of oxy-gen. Deaths from glue-sniffing have been reported in almost every one of the fifty states. Like LSD, abuse of solvents is more frequent among younger age groups. As youngsters mature, they tend to give up use of solvents, although a few cases are known in which solvent abuse for over a decade has been re-ported. Solvent abuse is dangerous. The most effective prevention is to remove dangerous solvents from commercial preparation. I am grateful to the U. S. Department of Justice (Drug Enforcement Ad-ministration) for providing me with literature on which this portion of the Encyclopedia is based. Glossary of Slang Terms for Drugs Amphetamines-Beans, Bennids, Black Beauties, Blackbirds, Black Mol-lies, Bumblebees, Cartwheels, Chalk, Chicken Powder, Co-pilots, Crank, Crossroads, Crystal, Dexies, Double Cross, Eye Openers, Hearts, Jelly Beans, Lightning, Meth, Minibennies, Nuggets, Oranges, Pep Pills, Speed, Roses, Thrusters, Truck Drivers, Turnabouts, Uppers, Ups, Wake-ups. Barbiturates-Bars, Block Busters, Bluebirds, Blue Devils, Blues, Christ-mas Trees, Downers, Green Dragons, Marshmallow Reds, Mexican Reds, Nebbies, Nimbies, Peanuts, Pink Ladies, Pinks, Rainbows, Red and Blues, Redbirds, Red Devils, Reds, Sleeping Pills, Stumblers, Yellow Jackets, Yel-lows. Cocaine-Bernice, Bemies, Big C, Blow, C, Coke, Dream, Flake, Girl, Gold Dust, Heaven Dust, Lady, Nose Candy, Paradise, Rock, Snow, White. Glutethimide-C.D., Cibas. Hashish-Black Russian, Hash, Kif, Quarter Moon, Soles. Heroin-Big H, Boy, Brown, Brown Sugar, Caballo, Chinese Red, Chiva, Crap, Doojee, H, Harry, Horse, Junk, Mexican Mud, Powder, Scag, Smack, Stuff, Thing. LSD-Acid, Beast, Big D, Blue Cheer, Blue Heaven, Blue Mist, Brown Dots, California Sunshine, Chocolate Chips, Coffee, Contact Lens, Cupcakes, Haze, Mellow Yellows, Microdots, Orange Mushrooms, Orange Wedges, Owsley, Paper Acid, Royal Blue, Strawberry Fields, Sugar, Sunshine, The Hawk, Wedges, White Lightning, Window Pane, Yellows. Marijuana-Acapulco Gold, Broccoli, Bush, Dry High, Gage, Ganga, Grass, Griffo, Hay, Hemp, Herb, J, Jay, Jane, Mary Jane, Mota, Mutah, Panama Red, Pod, Pot, Reefer, Sativa, Smoke, Stick, Tea, Weed. MDA-Love Drug. Mescaline-Beans, Buttons, Cactus, Mesc, Mescal, Mescal Buttons, Moon. Methamphetamines-Crystal, Meth, Speed. Methaqualone-Quas, Quads, Soapers, Sopes. Morphine-Cube, First Line, Hocus, Miss Emma, Morf, Morpho, Morphy, Mud. 412 THE ANN LANDERS ENCYCLOPEDIA Phencyclidine-Angel Dust, DOA (Dead On Arrival), Hog, Killer Weed (when combined with marijuana or other plant material), PCP, Peace Pill. Psilocybin/Psilocyn-Magic Mushroom, Mushroom. Tetrahydrocannabirol-THC, TIC, TAC. DEATH FROM DRUGS Drug abusers die of pneumonia, hepatitis, overdoses, hotshots, violence and traffic accidents. Fatal doses may be accidental or intentional. Accidental deaths occur when the addict unknowingly gets a stronger dose of drugs than he had been accustomed to taking. It is impossible to know how much the drug has been cut or if the peddler has added milk, sugar, arsenic or strych-nine. If an addict accustomed to taking 5 percent heroin takes a dose containing 75 percent heroin, it will kill him. It is not unusual for an addict to deliber-ately take an overdose. When a junkie realizes that his health is ruined, and the future looks black, he may choose death as a welcome release. Criminal dealers have been known to add poison to the drugs they sell to customers they suspect of giving information to the police. These poison mix-tures are known as hotshots. Recently in Los Angeles a heroin addict was found dead, sitting on the edge of his bed with the needle still in the vein of his leg, indicating almost instant death. Hotshot or overdose-who can say? The drug addict faces other dangers. Pain, which the body uses as a warn-ing signal that something is wrong, is deadened by the effect of drugs. An ad-dict may develop acute appendicitis or some other serious illness and, since he is unable to feel the warning pain, he fails to get treatment-which could be fatal. Drug addicts are often burned seriously when they drop off to sleep while smoking. They are also subject to falls and other accidents while in a stupor. The prolonged use of narcotics gradually causes an impairment of the ad-dict's memory and destroys his initiative. He has a very short attention span and is unable to concentrate or reason. Self-respect disappears as well as honesty. Regardless of whether the mental and moral breakdown is a result of the chemical action of drugs on the brain, or because addicts stop using their minds for normal thinking and behavior, the result is the same- disaster. The following facts were reported after a thorough investigation of the two thousand drug-related deaths in Chicago, Cleveland, Dallas, Los Angeles, Miami, New York, Philadelphia, San Francisco and Washington. Of the two thousand drug-related deaths, nearly two thirds were among males and were associated with narcotics, homicide and other forms of vio-lence. Female drug-related deaths were more often associated with barbitu-rates and suicides. There were more Whites than Blacks. THE ANN LANDERS ENCYCLOPEDIA 413 Approximately one third of the victims were unemployed. Over 50 percent had been arrested at least once, and one third had been convicted of felonies. Over 70 percent were heavy drinkers and heavy smokers. Except for Cleveland, Dallas and Miami, narcotics or barbiturates were in-volved in the majority of the deaths. Narcotics-related death victims were generally poorer than the users of other drugs. They were more involved in street buys and most often died ac-cidentally from drug overdose. People whose deaths were barbiturate-related tended to be older, more often they obtained their drugs by legal prescriptions and frequently they used these drugs to commit suicide. Barbiturate users were shown to have less involvement with heavy drinking than narcotics users and fewer records of arrest. Depression, divorce and marital separation were the most frequently noted stresses or problems. Suicide victims more often lived alone. SOME GOOD ANSWERS TO COMMON QUESTIONS From Special Action Office for Drug Abuse Prevention Washington, D.C. Why are drugs used? There are many reasons, ranging from the belief that "medicines" can solve all problems, to "peer pressure," the wish to be accepted by the group that uses drugs. How can misuse of legally obtained drugs be controlled? The medicine chest at home may be the first source of drugs misused by young children and teenagers. All members of the family should use drugs only as prescribed by a physician. These drugs should be destroyed when they are no longer needed. Doctors and druggists should pay close attention to the renewal of prescriptions that might cause dependence. Is it possible to seek help for drug problems without risking getting into trouble with the law? Doctors, psychologists or drug treatment centers can assure patients that their record of treatment will be kept strictly confidential. There are impor-tant legal safeguards for the confidentiality of patients who undergo treat-ment. Federal law requires that patient records be kept confidential. However, under certain conditions the federal law allows information to be disclosed but the patient must give written consent. Information can be given, however, to authorized researchers, auditors, or program evaluators, but they are required to keep the information confi- 414 THE ANN LANDERS ENCYCLOPEDIA dential. It is possible to obtain information by a court order, but courts must show good cause for requesting such information. It may be necessary for the doctor who is treating the patient to see the background information. Also, it needs to be seen by authorized personnel for obtaining benefits (such as insurance). In any event-repeat-permis-sion, in writing, must be given by the patient. State laws may provide additional protection for the patient, but the state law cannot reduce the protection provided by federal law. What is the effect of drugs on sexual response? Very little reliable information exists on this subject. No drug seems to be a "true" aphrodisiac (that is, capable of "creating" sexual desire), although various substances have been considered to be aphrodisiacs throughout his-tory. Present knowledge suggests that the expectation of the user is probably more important than the action of the drug itself. If the user is convinced that a certain substance will improve his (or her) sexual performance, it might do so. Some drugs, such as narcotics and alcohol, are known to hinder sexual performance. Is it unsafe to use drugs during pregnancy? Women should be extremely cautious about taking any drug during preg-nancy. Some babies born to narcotic- and barbiturate-dependent mothers have shown withdrawal symptoms. Excessive use even of socially and legally acceptable drugs such as tobacco and alcohol may be harmful to the unborn child. What is drug overdose, and what can I do about it? An "overdose" of drugs can be defined as an amount of drugs taken which causes a severe and unexpected reaction to the user. A drug overdose can often be recognized even by a non-medical observer because it often produces stupor or coma, and sometimes serious breathing difficulties. Medical help should be sought immediately if any of these symptoms occur. First-aid measures that can be taken while waiting for medical help to arrive include artificial respiration to restore breathing. Sometimes hallucinogens, marijuana or stimulants will produce a so-called panic reaction. The person may be frightened, and suspicious. He may be-lieve someone is attempting to hurt him. It is very important that all con-cerned remain calm and reassure the person that his fears are drug-related and will subside. I repeat-help should be sought as soon as possible. It is usually available from community drug hotlines, drug crises or treatment cen-ters, and hospital emergency rooms. What is wrong with taking any drug so long as no one else is hurt by it? It is difficult for an individual to do something to himself that will not affect others. The drug abuser touches the lives of those who are close to him- especially those who depend on him. Society is affected as well. People who THE ANN LANDERS ENCYCLOPEDIA 415 become physically or emotionally disabled as a result of drug abuse are gen-erally dependent upon society for their subsistence. Even more important, a drug-dependent person usually represents a human loss to himself, to his family and to his community. What are the legal distinctions between possession, dealing and trafficking in drugs? What are the penalties for each? Legally there are distinct differences between these three terys. Illegal pos-session means that the drugs were not obtained from a doctor, or from a pharmacist by virtue of a valid prescription. A dealer is a drug supplier on a small scale. A drug trafficker manufactures and sells illicit drugs on a much larger scale. Possession of small amounts of legal drugs unlawfully obtained, or of an illicit drug, generally calls for lesser penalties than dealing or trafficking. Penalties in these instances vary widely from state to state. WHERE TO GO FOR HELP Hundreds of drug abuse clinics have been set up in the United States and Canada. They are waiting to serve individuals who want to kick the habit. Many of these treatment centers are government-funded. Others are run by organizations such as the Salvation Army, Family Service or church-spon-sored groups. It would be impossible to list these centers, their addresses and their telephone numbers, but let me assure you they do exist, and can point to a remarkable record of success. Many large cities have hotlines for emer-gency situations. Call Information or the Police Department if you need help in a hurry. If you or someone close to you is on drugs, and wants to get off, I urge you to call your city, county, or state mental health organization. Look in the Yellow Pages of your phone book under Mental Health or Drug Abuse and Addiction. You can also call any hospital connected with a university. Al-most all these hospitals have an excellent drug abuse treatment center, or someone in the medical school who can direct you to one. The important thing to know is this: There is free help available for any-one who wants to get off drugs. Most of it is paid for by your tax dollars, so don't feel as if you are freeloading. If you need it, get it! credits: Mr. Peter Bensinger, Chief, U. S. Department of Justice, Drug En- forcement Administration. Edward C. Senay, M.D., Associate Professor, Depart-ment of Psychiatry, University of Chicago; Executive Director, Substance Abuse Services, Inc. (A special word of thanks to Dr. Senay, who put in more hours than I want to think about. He read my material, corrected the errors and added infor-mation on his own. Once again I saw living proof of that old adage, "If you want to get something done, ask a busy person to do it.") Additions by David Simpson, Medical Technician, Coffey County Hospital, Burlington, Kansas. 416 THE ANN LANDERS ENCYCLOPEDIA Therapeutic Drugs FOR EMOTIONAL ILLNESS Physical illness was once regarded as punishment for sins. Even today some superstitious attitudes continue towards illness, especially mental ill-ness. For the past twenty-five years, medications have been available to treat many psychological disorders and there is increasing evidence that there is a physical cause for such diseases. At least one in every five persons has a psy-chiatric disorder during his or her lifetime and probably half the population will be given one of the "minor tranquilizers" at one time or other. Decisions about who should be treated and with what medications (also for how long) should be decided by a physician. The descriptions of drugs given here is to help you understand what they do. This is not a substitute for a visit to your doctor. Never take drugs given to you by a well-meaning friend who had "similar" symptoms. This is asking for trouble. If you have been helped by a particular drug but more than six months have passed since you have seen the doctor, go back. Your condition may have changed or a better and more effective medication that wasn't available on your last visit may have been developed. Also, some drugs may produce side effects not known about when the medication was first prescribed. VALIUM, LIBRIUM, SERAX AND TRANXENE We all suffer from anxiety, tension or nervousness from time to time. ("Will I get the job?" "Will I be fired?" "Will the blind date turn out to be what I had hoped for?" "Will our child be born normal?" "Will the person I love recover from his or her illness?") Frequently "help" for stress can be provided by a minister, a social worker, a counselor, a psychologist or a psychiatrist. Discussing the reasons for the anxiety and ways of dealing with it may be sufficient. When the anxiety is so overwhelming that the patient can talk of nothing but the symptoms (difficulty in getting to sleep, the shortness of breath, the perspiring, pains for which no physical cause can be found, the diarrhea, the loss of appetite, the irritability, etc., etc.) a physician should be consulted. A medication such THE ANN LANDERS ENCYCLOPEDIA 417 as Valium can provide relief of the symptoms-then something constructive can be done in psychotherapy. A certain amount of anxiety is a normal and healthy part of life. To take medication to relieve the first signs of anxiety would be to misuse the medica-tion. How should the decision be made as to whether medication should be given? If the discomfort is so intense it becomes impossible for the person to work effectively or to be an adequate father, mother, husband or wife, medi-cation may prevent a bad situation from becoming worse. Most patients will respond to Valium (as they will to any of the so-called "minor tranquilizers"). At times, Valium, instead of reducing tension and anxiety, may cause additional stimulation-a rapid heartbeat and insomnia or, at other times, excessive sleepiness or cause an allergic reaction. In such cases, one of the other "minor tranquilizers" may work better. Valium comes in a variety of doses ranging from one milligram to ten mil-ligrams. Some people believe that the less medication they take the better off they will be. At times this kind of thinking results in taking so little medica-tion that it is not effective. The dose of Valium (or whatever drug is given) should be sufficient to relieve the anxiety or there is no point in taking it. The opposite error is based on the concept that if a little medication is good, more is better. This reasoning can be dangerous since the side effects are often greater at higher doses. In addition, the procedure is self-defeating since tolerance develops fairly rapidly and the higher doses are no more effective than the ones prescribed. It is therefore of great importance to take the medications as prescribed. If you find that the dose prescribed begins to lose its effectiveness, do not increase the amount of medication without orders from your doctor. Increas-ing the dose may result in your becoming dependent on the medication. The time of day at which the medication is given is important. For some conditions a divided dose taken every three or four hours is most effective. In other circumstances, the dose may be given once or twice a day. Sometimes the medication is prescribed only at bedtime, in which case it may serve as a sleeping aid. Patients undergoing operations do better if their anxiety level can be re-duced. For this reason, Valium is frequently used just before surgery. DALMANE Some people get along well on three or four hours of sleep, while others require nine or ten. Most of us have a fairly set pattern. Certain individuals are slow to get started in the morning, while others wake up rapidly and cheerfully. If fatigue and sleepiness occur after a normal night's sleep, there may be 418 THE ANN LANDERS ENCYCLOPEDIA some underlying illness such as anemia. It is wise to consult a physician if you are in this category. If you have trouble getting to sleep and wake up tired, sleeping medication pay be indicated. Insomnia may be the result of anxiety. If this is so, medica-tion can help. One of the best medications for sleep is Dalmane. At one time, barbiturates such as Seconal and Tuinal, were very widely used. Barbiturates tend to be cumulative and also they may produce confu-sion. Dalmane (and related drugs) does not present these problems as often. In a number of studies it has been shown that the number of individuals who die from overdose of sleeping medications (whether deliberate or accidental) has been greatly reduced (to about 25 percent of the old number) since Dal-mane and related drugs have come into use in place of barbiturates. One of the reasons for overdosage is that the person using a sleeping medi-cation often loses track of time. The person who is half-asleep may believe he has slept for several hours, when in fact he has slept only ten minutes. He may then take another sleeping pill before the previous one has a chance to work. If this confused dosing occurs three or four times during the night, the combined dosage may be enough to cause serious trouble or even death. This is often made worse by the addition of alcohol, which should never be used with sleeping medications. The only really safe procedure is to put on the night table only the maxi-mum number of sleeping pills allowed and then put the bottle back in the medicine chest. Under no circumstances should more sleeping medication be taken than has been prescribed by the doctor. The increased dose may work for a few nights but then tolerance develops and the dosage would have to be increased once again. This often leads to dependence. Another caution-if a sizable dose of medication is being used, it should not be abruptly discontinued since it may produce withdrawal symptoms. MAJOR TRANQUILIZERS Thorazine, which is the brand name for chlorpromazine, was the first of a group of drugs of which there are now eight or ten offshoots available. The decision as to which one ought to be used depends on how agitated the pa-tient is, how sensitive he or she is to side effects, and a variety of other fac-tors which the physician must consider. Since chlorpromazine is often used to treat serious mental and emotional disorders, the person for whom it is prescribed may conclude that there must be something seriously wrong. This is not correct. Thorazine can also be used for much less serious illnesses. One major use of chlorpromazine is in the treatment of schizophrenia. The diagnosis of schizophrenia at times is more frightening than the disease. With presently available treatment, many of these patients are able to live a normal THE ANN LANDERS ENCYCLOPEDIA 419 existence, hold a job and have families. At times, the physician is reluctant to tell the family or the patient of the diagnosis. Medication is not indicated for all schizophrenics, but when it is needed, it is especially important. Experience has shown that, when patients go off med-ication, they may get along satisfactorily for a few weeks or months but even-tually the number who must be readmitted to the hospital is four times as great as for those patients who remain on medication as it is prescribed. Chlorpromazine is also used for any marked or uncontrolled degree of ex-citement or agitation. For instance, it might be used for an acutely disturbed and excited state in a manic-depressive. Such individuals sometimes have epi-sodes of feeling excessively good (high) and as a result may behave in a foolish and even dangerous manner. There are also a variety of other uses for chlorpromazine and other medi-cations in the same group. For instance, a closely related medication, Com-pazine, can be applied for the uses above. It is also very useful in the treat-ment of nausea and vomiting. Some of the drugs in this group, known as phenothiazines, are sedating (chlorpromazine for one). Others, to varying degrees, may be less sedating or even somewhat stimulating. The medication should not make you feel "zonked out" or so "dopey" that you cannot per-form. There should be a decrease in agitation, anxiety and overactivity, but not to a degree that incapacitates you. Certainly there may be a period of a few days when you first start taking the medication that you are definitely slowed down, but if this persists beyond a week, it is important for you to let the doctor know, so he can change the medication or dosage if it is needed. The reverse is also true. If the medication does not relieve the anxiety or overactivity, it is equally important to have the amount of medication adjusted. To give up "in disgust" because the effect is not immediate, or be-cause there are some annoying side effects, is a bad mistake. Some dryness of the mouth is extremely common. Occasionally a patient will develop an allergic rash and, if the diet is not watched carefully, there may be weight gain. There is one side effect which you may not connect with the medication. The clinical term to describe this condition is akathisia-the patient's inabil-ity to sit quietly. Patients with akathisia are extremely restless and will often spend most of their waking hours pacing about. When they sit, they keep shifting their legs about and jiggling their feet. There may be tremors of the hands, legs or even the lips. In severe cases, the movements of the hand may interfere with writing or eating. These symptoms can easily be removed. One other occasional symptom in this group is muscular rigidity, which can be frightening unless you know that it is related to the medication. Like the other symptoms described, this can be cleared up within a few hours by using any of the anti-Parkinson medications. In the extreme case, the muscu-lar rigidity may affect the neck or tongue. In such cases, an intravenous in-jection of the same medication will bring relief in a matter of minutes. None 420 THE ANN LANDERS ENCYCLOPEDIA of these conditions are dangerous, but they can be extremely uncomfortable. Be sure that you let the doctor know should any of these occur, since they are easily corrected. One less dramatic symptom can be more serious-constipation. This con-dition is correctable but can cause real trouble, especially in older people, if something is not done about it. Your doctor should be notified. Another effect of the medication which may be overlooked is sensitivity to sun. This is more true of chlorpromazine than with other members of the same group, and, should it occur, all that is required is a change in medica-tion. Other medications such as antibiotics can, at times, cause a similar reac-tion. Be careful if you are on vacation that you do not stay too long in the sun the first time, even though in the past you had no trouble. An overheated kitchen, boiler room or similar overheated environment may also bring on a rash. As is the case with all medications, one must balance the advantages to be gained against possible undesirable effects. This is true with chlorpromazine and the other phenothiazine derivatives, since in a small percentage of pa-tients a persistent side effect may develop for which at the present time we have no adequate treatment. LITHIUM Lithium is a natural element like sodium or potassium. It is an excellent drug for treating certain types of emotional disorders. Even more remarkably it can reduce or eliminate the symptoms of other conditions when taken regu-larly. However, it must be taken under medical supervision since the dosage is not the same for everyone. Too small a dose may be useless and too large a dose may cause serious side effects. A blood test can determine whether the amount of lithium is in the safe and effective range. The first major use is for the treatment of manic conditions. A person in a manic state has the problem of feeling "too good." As a result of this feeling of abnormal elation, the person's thinking and acting may become so severely distorted that eventually they are out of touch with reality. There is a very special problem treating these patients, especially in the earlier, milder stages of the disease when the patient is hypomanic (just below being manic). The difficulty is that the person feels extraordinarily well and often will not believe that there is anything wrong. Often such pa-tients will spend much more money than they can afford, will monopolize the conversation, become irritable and angry if anyone contradicts them and will wear everyone else out since often they can get along with only a few hours of sleep every night. In extreme cases, the patient may even have auditory hallucinations (hear voices that aren't'there) and suffer from a variety of delusions. Frequently, THE ANN LANDERS ENCYCLOPEDIA 421 the delusion is that they are actually a very important person-the reincar-nation of one of the saints or even Jesus Himself. Since the patient does not usually recognize when he or she is becoming hypomanic, it is extremely useful if a friend or family member who knows the situation can be on hand to monitor the situation. Since it is almost impossi-ble to convince the patient that something is wrong, the best way of handling the problem is to try to persuade the patient to go see a doctor and let him make the decision. Since such episodes tend to recur, an agreement to go to the doctor can often be worked out after treatment or hospitalization from the first episode. In the early stages the patient can be treated with lithium, which usually takes from four to ten days to become effective. Under medication the pa-tient's mood gradually returns to normal and, by remaining under treatment, it is usually possible to prevent a recurrence. If the condition is moderately advanced or the onset is rapid, it may be necessary to use other medication along with the lithium at the beginning. The usual dose of lithium is three capsules or tablets, but this can vary from one patient to another. Usually, but not always, older people do not need as much medication. Sometimes, six or eight medications a day may be necessary to control the situation. If the dosage is properly regulated, there are usually very few side effects. Occasional patients feel lightheaded and there are some who develop sleepi-ness, but this usually disappears after a few days. If it does not, the doctor should be promptly notified. If the dose is too high, the usual effect is to pro-duce thickness of speech and an unsteady gait. In those individuals who have a tendency to low thyroid, the condition may become exaggerated after the patient has been on medication for several months. Therefore it is important to see the doctor regularly and report any changes. Some patients also develop extreme thirst and have to urinate frequently. This is not dangerous and is not a reason for discontinuing treatment. USE IN PREVENTING MOOD SWINGS Most of us undergo mood swings-periods of a few days or even weeks when we feel better than usual, and other periods when we tend to be gloomy, lack energy and have less interest in what is happening. It is possible for these mood swings to become exaggerated and reach a point where they interfere with normal functioning. Such patients are labeled manic-depres-sive. Lithium, in addition to its usefulness in treating manic states, has also been found valuable in preventing their recurrence. Interestingly it is not the best treatment for a person who is in a depression, but if given when the pa-tient has recovered it will often prevent another depression from occurring. The ability of a drug to prevent these extreme mood swings is of great im-portance. It obviously is better to prevent a disorder than to treat it after it 422 THE ANN LANDERS ENCYCLOPEDIA occurs. In addition, a patient with these marked ups and downs is unable to plan for the future since he does not know how he will be feeling. DRUGS FOR DEPRESSION The most frequent of all psychological disorders is depression. This pre-sents a particular problem since all of us become depressed from time to time as a normal part of existence. In fact, to distinguish it from the disease (which can be treated with medications) we will refer to this condition as existential depression (which should not be treated with medications). There are ways of distinguishing the two types of depression. First, let us look at the characteristics which most depressions have in common. This is important because often the early symptoms are such that frequently the fact that someone is depressed can be overlooked. The typical picture of sadness, dejection, slow movement and gloomy or even suicidal thoughts occurs fairly late in the course of the disorder. The earliest symptom is usually anhedonia, which means the absence of joy and pleasure in those things which in the past provided great satisfaction. Food, sports, company and even friends and family leave the patient feeling indifferent so that they don't really care one way or the other. Another of the early symptoms of depression is fatigue, especially if no other medical reason can be found to account for it. Less commonly recog-nized as a symptom of depression is difficulty in concentrating and also difficulty in making decisions. Anxiety, irritability as well as forgetfulness may also occur. There is a tendency to think about the past, remembering things that one should have done and didn't do or regretting things which had been done. At times the situation may seem hopeless and life not worth living. Even though the person doesn't think of committing suicide, he or she may wish "that I won't wake up in the morning." In more severe cases not only does the patient neglect personal appearance but may even believe he has a fatal disease which the doctors and the family won't discuss. In the most severe cases the patient may even hear voices that aren't there and be convinced that all sorts of terrible things are about to happen. It cannot be too strongly emphasized that every normal human being expe-riences depression from time to time. Often this is due to a particular life sit-uation.

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