104 three hundred fraternal and identical twins: Sheff, Clean
average weed smoked today: Caleb Hellerman, “Is Super Weed Super Bad?” CNN, August 9, 2013 (www.cnn.com/2013/08/09/health/weed-potency-levels; October 22, 2017).
105 doubled the risk of causing a collision: McCarton Ackerman, “Pot Use Doubles Car Crash Risk,” TheFix.com, February 10, 2012 (www.thefix.com/content/marijuana-driving-car-crashes9632; October 22, 2017).
poorer outcome in the long term: Joanna Jacobus, PhD, et al., “Neuropsychological Performance in Adolescent Marijuana Users with Co-Occurring Alcohol Use: A Three-Year Longitudinal Study,” May 4, 2015 (www.ncbi.nlm.nih.gov/pmc/articles/PMC4633396; October 22, 2017).
8. PAIN PILLS AND OTHER PRESCRIPTION DRUGS
111 four million teenagers regularly: Foundations for a Drug Free World, “International Statistics” (www.drugfreeworld.org/drugfacts/prescription/abuse-international-statistics.html; October 22, 2017).
increasing the likelihood of overdose: National Institute on Drug Abuse, “Teens Mix Prescription Opioids with Other Substances” (www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-mix-prescription-opioids-other-substances; October 22, 2017).
at least one prescription drug every day: U.S. Department of Health and Human Services, “Health, United States, 2015,” 2015 (www.cdc.gov/nchs/data/hus/hus15.pdf, October 31, 2017).
113 A study showed that more than: The Partnership for Drug-Free Kids, “National Study: Teen Misuse and Abuse of Prescription Drugs Up 33 Percent Since 2008, Stimulants Contributing to Sustained Rx Epidemic,” April 22, 2013.
116 “smaller than a snowflake”: Jack Healy, “Drug Linked to Ohio Overdoses Can Kill in Doses Smaller Than a Snowflake,” New York Times, September 5, 2016 (www.nytimes.com/2016/09/06/us/ohio-cincinnati-overdoses-carfentanil-heroin.html; October 22, 2017).
Deaths from heroin increased 500 percent: Centers for Disease Control and Prevention, “Heroin Overdose Data” (www.cdc.gov/drugoverdose/data/heroin.html; accessed April 27, 2018).
118 students who abuse prescription stimulants: National Institute on Drug Abuse, “Stimulant ADHD Medications: Methylphenidate and Amphetamines,” January 2014 (www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines; October 22, 2017).
119 abuse of these drugs is up 92 percent: Casey Schwartz, “Generation Adderall,” New York Times, October 12, 2016 (www.nytimes.com/2016/10/16/magazine/generation-adderall-addiction.html; October 22, 2017).
9. HEROIN, COCAINE, METH, AND OTHER ILLEGAL DRUGS
133 “deadliest drug worldwide”: Mary Brophy Marcus, “Heroin Use in U.S. Reaches ‘Alarming’ 20-Year High,” CBS News, June 23, 2016 (www.cbsnews.com/news/heroin-use-in-u-s-reaches-alarming-20-year-high; October 22, 2017).
Over 16,000 people in this country died: American Society of Addiction Medicine, “Opioid Addiction 2016 Facts & Figures,” 2016 (www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf, October 31, 2017).
139 In fact, almost six thousand people die: Sheff, Clean, 420.
143 small amount of ecstasy: Science News, “Ecstasy Can Harm the Brains of First-Time Users,” Radiological Society of North America, November 28, 2006 (www.sciencedaily.com/releases/2006/11/061128084458.htm; October 22, 2017).
hippocampus plays an essential role: Bill Hendrick, “LongTerm Ecstasy Use May Damage the Brain,” WebMD, April 7, 2011 (www.webmd.com/mental-health/addiction/news/20110407/long-term-ecstasy-use-may-damage-the-brain; October 22, 2017).
150 For example, it’s been estimated: U.S. Department of Health and Human Services, “Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings,” September 2014 (www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf).
10. USE, ABUSE, AND ADDICTION
162 90 percent of all addictions: CASAColumbia, “National Study Reveals: Teen Substance Use America’s #1 Public Health Problem,” National Center on Addiction and Substance Abuse, June 29, 2011 (www.centeronaddiction.org/newsroom/press-releases/national-study-reveals-teen-substance-use-america%E2%80%99s-1-public-health-problem; October 22, 2017).
166 “Addiction is a chronic disease”: National Institute on Drug Abuse, “Understanding Drug Use and Addiction” (www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction; accessed April 27, 2018).
170 cannot substitute for a full evaluation: National Council on Alcoholism and Drug Dependence, “Self-Test for Teenagers” (www.ncadd.org/get-help/take-the-test/self-test-for-teenagers; October 22, 2017).
12. DRUG-FREE: TREATMENT, RELAPSE, AND RECOVERY
192 “We know that addiction is a disease”: National Institute on Drug Abuse, “Drugs, Brains, and Behavior: The Science of Addiction,” February 2007 (www.naabt.org/documents/NIDA_Science_of_addiction.pdf).
202 “Addiction is the place where”: Sheff, Clean.
Acknowledgments
We’d like to offer our gratitude to Jacqueline Periman for allowing us to retell the painful story of her beloved son, Kevin. She recounts it with the hope that she may help prevent others from having to experience what she’s endured. “Laurel” is the pseudonym of the brave family that allowed David to spend time with them over the course of a trying year and sit in on an intervention. We’re grateful to them and Denise Young Farrell, Pat Aussem, and Denise Mariano with the Partnership for Drug-Free Kids, and the National Institute on Drug Abuse scientists and science writers who reviewed sections of High. Thanks also to researchers, educators, and clinicians Ulrike Heberlein, Jessica Winter, James Flack, Susan Tapert, Joanna Jacobus, Kyle Redford, and especially Drs. Steven Shoptaw and Richard Rawson.
We want to thank Lorin Oberweger, who worked tirelessly and artfully edited and organized High (and us). Her hard work can be seen on every page. We’d also like to thank Lisa Vega, who designed High, and Colleen Fellingham and Alison Miller for their copyediting.
High wouldn’t have happened if not for the book’s champion, Margaret Raymo, our editor at Houghton Mifflin Harcourt. We’re grateful for her vision, guidance, and commitment to helping young adults navigate one of the most challenging stages of life.
—David and Nic Sheff
Credits
Clay Patrick McBride: 2
CDC WONDER: Drug Overdose Deaths: 23
NIDA: Drug Use in High School: 26
NIDA: How Do You Know If a Friend Has a Problem . . . : 69
NIDA: What to Say and Do . . . : 70
CDC: Alcohol Use and Your Health: 86–87
CDC: Blood Alcohol Concentration (BAC) Levels: 88
Drugabuse.gov: Marijuana Use & Educational Outcomes: 106
Drugabuse.gov: Teens and drug abuse: 112
CDC WONDER: Number of Deaths from Prescription Drugs: 113
CDC: Heroin Use Is Part of . . . : 135
CDC: National Overdose Deaths (Heroin): 136
NCADD: Self-Test for Addiction (for Teenagers) reprinted with permission by the National Council on Alcoholism and Drug Dependence, Inc (NCADD), ncadd.org: 168–71
Jasper Sheff: illustration: 181
Shawn Ehlers/Stringer, WireImage: 206
Victor Ochoa (graphics): 23, 26, 32, 33, 35, 37, 45, 46, 47, 48, 49, 52, 62, 63, 65, 69, 70, 82, 85, 86, 87, 88, 89, 93, 94, 96, 99, 100, 106, 108, 112, 113, 114, 117, 119, 121, 124, 126, 127, 133, 135, 136, 138, 139, 142, 144, 145, 146, 147, 149, 150, 172
Index
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
THE LETTER F FOLLOWING A PAGE NUMBER DENOTES A FIGURE.
A
Adderall, 118–19
addiction, 25
anecdote of use, 157–60
definition of, 166
depression after high, 163
effect on behavior, 163
effect on family, 175–77
excuses for use, 216
heroin after other drugs, 1
35
homelessness and, 25
marijuana experience, 103
self-test, 168–70
sobriety after treatment, 202–3
study of, 35
See also alcohol; risk factors
ADHD (attention deficit hyperactivity disorder), 13, 40, 117–18
See also risk factors
adolescents. See teenagers and teenage problems
adolescent treatment centers, 103
alcohol, 223 f
binge drinking, 89–91
dangers of, 88
drinking responsibly, 217–18
effects of, 85–87, 91–93
effects on the brain, 92–94
mixed with other drugs, 127–29
portrayal in media, 22
sexual assault and, 90
society view of, 85
American Psychological Association, 31
amotivational syndrome, 101–2
amphetamines, 138, 229 f
See also cocaine; methamphetamine
B
barbiturates, 120, 229 f
bath salts, 149, 227 f
benzodiazepines, 120, 229 f
brain and nervous system, 143, 163–65
alcohol, effects on, 92–94
depressants, effect on, 120
dopamine in, 47–48, 50–51, 118–19, 138, 140
drug effects, 45–51
ecstasy, effects of, 143
marijuana, effects on, 102, 106
methamphetamine, effects, 140
substance-use disorders (SUDs), 164–65, 211
See also risk factors
brain development
drug effect on teenage brain, 52–53
psychological and developmental forces, 38–39
teenagers’ curiosity, 36–38
Breaking Bad, 7, 142, 183
Bukowski, Charles, 216
C
cannabis derivatives, 101
carfentanil, 116
Cobain, Kurt, 216
cocaine, 7, 79, 223 f
coca plant extract, 138
convulsions, 9
effects of, 138–39
fruit fly experiments, 35
mixed with other drugs, 150–51
codeine, 114, 124, 228 f
Concerta, 118
crack. See cocaine
crystal meth. See methamphetamine
Cyrus, Miley, 143
D
depressants, 119–20
alcohol, 85
GHB, 125
marijuana, 103
detox, 11–12, 215
dissociative drugs, 121–24
dopamine. See brain and nervous system
Downey, Robert, Jr., 20
drug availability, 213–14
drug education, scare tactics, 24–25
drugs, dirty (adulterated), 79
drug use and abuse, 26–27
confrontation plans, 65–68
consequences, 22, 24–25, 80
drug use in high school, 26–27
fruit fly experiments, 35–36
risk factors, 33 f
See also teenagers and teenage problems
dual diagnosis. See mental illness
DXM (dextromethorphan), 123–24, 224 f
E
ecstasy, 7, 79
deaths from, 143
effects of, 38, 142
Eminem, 20
emotional trauma, self-medication, 12–13
exercise, 61–62
F
families of addicts
awareness of genetics, 180
effect on, 175–77
fear of following, 178–79
instability of, 182
intervention anecdote, 189–91
role models and behaviors, 181, 218
sobriety after treatment, 202–3
support and help, 183–85
worry and action, 212–16
fentanyl, 79, 115–16, 228 f
flunitrazepam, 225 f
FOMO (fear of missing out), 60
G
GHB, 124–25, 225 f
Good Samaritan laws, 115
Grissom, Miles, 190–91, 193
H
hallucinogens, 7, 142, 144–45
Hazelden Betty Ford rehab center, 103
co-occurring psychological disorders, 105
Heberlein, Ulrike, 35–36
Hemingway, Ernest, 20
heroin, 9, 79, 225 f
addiction anecdote, 134–37
opioid, 133
opium poppy, 133
overdose deaths, 136
overdoses, 134
homelessness, 7, 25
hydrocodone, 114, 228 f
hydromorphone, 228 f
I
inhalants, 147–48, 227 f
J
Jackie Brown, 102
Jacobus, Joanna, 105
Jenkins, Stephan, 139
K
Kaku, Michio, 46
ketamine, 122–23, 224 f
L
Lady Gaga, 20
Lamott, Anne, 57
“lean” or “purple drank,” 124
LSD, 144, 226 f
M
marijuana, 79–80, 104, 223 f
addiction experiences, 103, 107
brain structure effect, 102, 104
chronic use effects, 101–2
edibles, 100
effect on education, 106
first use, effect, 5–6
gateway drug, 104
legality and danger, 99–100
television and movie portrayal, 21
MDMA, 142–43, 225 f
See also ecstasy
meditation, 61–63
mental illness, 25
bipolar disorder, 12, 40, 196
co-occurring psychological disorders, 25, 105, 195, 198
delay in diagnosis, 105
meperidine, 228 f
mescaline, 145, 226 f
methadone, 228 f
methamphetamine, 75, 79, 224 f
anecdote of use, 7, 9, 141
effects of, 139–41
mixed with other drugs, 80
overdose, 7–8
overdose deaths, 79
stimulant, 118
methylphenidate, 229 f
mixed message on drugs, 19–20
Molly. See ecstasy
Monteith, Cory, 137
morphine, 228 f
N
Narcan (naloxone), 117
National Center on Addiction and Substance Abuse, 25
National Council on Alcoholism and Drug Dependence, 168
National Institute on Drug Abuse, 166
nicotine. See tobacco
O
opioids, drug overdose deaths, 23 f, 116
opium poppy, 133, 226 f
overdoses, 19, 79, 111
consequences, 22–23
deaths from, 80, 116–17, 134
See also heroin; methamphetamine; Narcan (naloxone); OxyContin; prescription drugs; Vicodin
oxycodone. See OxyContin
OxyContin, 7, 111, 134, 228 f
overdose deaths, 22
P
pain pills
codeine, 114
hydrocodone, 114
morphine, 114
roxicodone, 114
use and abuse, 116
Partnership for Drug-Free Kids, 31–32
PCP (phencyclidine), 25, 121–22, 224 f
peer pressure, 22, 33–34, 65–67
peyote, 145
Pink, 24
polydrug use, 150
pot. See marijuana
prescription drugs, 111
availability, 112
deaths from overdoses, 113–14
depressants (tranquilizers), 119–20
misinformation on safety, 113–14
overprescription by doctors, 112–13