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Ages & Stages


Cocaine and Crack

The use of cocaine, the scourge of the prosperous 1980s, crashed resoundingly by the end of the decade, as did a number of those who abused it. Ironically, when the stimulant first attracted the attention of the baby boomer generation, it had been touted as harmless and non-habit-forming. A recreational drug.

Hardly. Even now, with cocaine use less than half of what it once was, addiction to the drug accounts for more admissions to publicly funded rehabilitation programs than any other form of substance abuse, with the exception of alcohol.

At the height of the mid-1980s surge in cocaine abuse, roughly one in eight high-school seniors had used the drug in the previous year. Another one in twenty-five had tried the new smokable permutation crack, which is made by mixing the powdered “salt” cocaine with a dangerously flammable chemical to convert it back to its original “freebase” form. Smoking the small rocks of hardened paste produces an immediate, more intense high. (The name refers to the crackling sound the drug makes when freebased.) Crack is more addictive than powdered cocaine and also more affordable. However, the effect is short-lived: five to ten minutes, as opposed to the fifteen-to-thirty-minute high from cocaine. Thus teenagers who are dependent on crack need hits more frequently.

The hazards of coke and crack received massive news coverage. Presumably, the reports scared off a sizable portion of young substance abusers, because both drugs took a tumble in popularity. Use of other stimulants has also dipped sharply from the 1981 high of one in four twelfth-graders. In 1998, only one in ten admitted to having taken uppers.

MDMA (Ecstasy)

Sometimes a substance arrives linked to a cultural phenomenon, as with Ecstasy, also called “Adam” or “XTC” on the street. The amphetamine is frequently taken in preparation for attending large late-night dances called raves, supposedly to enhance the experience. Ecstasy is an analog, one of the “designer drugs” synthesized by underground chemists in an attempt to evade the Controlled Substance Acts.

An analog closely resembles another chemical structurally, but the clandestine laboratories alter the formula just enough to render it a different compound and thus not covered under the law. The Drug Enforcement Administration (DEA) began adding these modified drugs to its list of controlled substances in 1984, but new analogs promise to keep materializing on the street.

Disciples of Ecstasy, a synthetic amphetamine with hallucinogen-like properties, insist that it breaks down barriers of communication, enhances music and promotes warm, tranquil vibes—echoing the claims once made about LSD.

Ecstasy is a dangerous chemical and should not be used. However, one in twelve high-school seniors who responded to the 1999 Monitoring the Future Study (a national survey that tracks drug-use trends among America’s adolescents) admitted to having tried MDMA, an increase of nearly 40 percent over the year before.

Some young people have gravitated toward herbal ecstasy, which is marketed as a “natural” alternative and is available over the counter in most states. “Many of the herbal ecstasy products are junk,” Dr. Schwartz says bluntly. “They have no effect.

“Other brands, though, contain an ancient Chinese herb called ephedra, or ma huang. The active chemical in ephedra is ephedrine, a stimulant. It can elevate blood pressure, but it also dries you out by preventing sweating and salivation. That combination can cause heat stroke and a number of other problems.” Ephedrine-laced dietary supplements have been implicated in seventeen deaths and hundreds of adverse reactions, leading several states to ban the products.


Methamphetamine is the only other stimulant besides Esctasy to have widened its hold on young people. It has been approved for attention deficit hyperactivity disorder in children, though it is often difficult to obtain. Physicians prescribe the powdered form sparingly, though, because meth, or “speed,” is extraordinarily addictive.

Like cocaine, the drug can be processed illegally into smokable clear crystallike chunks sold on the street as “ice.” Either form propels users on an intense high lasting anywhere from two to twenty-four hours. But once the effects wear off, they come crashing down into an oppressive psychological low that can linger for days. Chronic methamphetamine abusers may experience hallucinations and emotional disturbances virtually indistinguishable from schizophrenia, a major mental disorder.

Related Paraphernalia

    • Vials
    • Resealable plastic bags
    • Syringes
    • Cotton balls
    • Matches
    • Butane lighters
    • Spoons, bottle caps and other implements for “cooking” the drug over a flame
    • Straws, rolled-up dollar bills, for snorting


    • Mirrors
    • Razor blades
    • Straws, small plastic tubes, rolled-up dollar bills, for snorting
    • Scales
    • “snow seals” (folded pieces of white paper) and foil strips, for storing
    • Tiny plastic bags
    • Syringes
    • Matches
    • Butane lighters
    • Glass vials
    • Glass pipes
    • Bottles of ether, sodium bicarbonate or ammonia, used in freebasing
    • Ceramic mortar and pestle, for crushing rock cocaine

Legal or Illegal

Cocaine, amphetamines and methamphetamine are available only with a written prescription.

Signs of Stimulant Use

    • Excitability
    • Mental clarity
    • Euphoria
    • Talkativeness
    • Restlessness
    • Aggressive behavior
    • Following the high, a “crash,” or depression, marked by irritability, anxiety, paranoia, agitation
    • Dilated pupils
    • Visual and auditory hallucinations
    • Rapid, irregular heart rate
    • Elevated blood pressure
    • Fever
    • Convulsions
    • Dry nose and mouth
    • Stuffy nose and sniffing, from snorting cocaine

Effects of Ecstasy

    • Confusion
    • Depression
    • Sleep disturbances
    • Drug craving
    • Severe anxiety and paranoia during and sometimes weeks after taking mdma (psychotic episodes have been reported)
    • Muscle tension
    • Involuntary teeth-clenching
    • Nausea
    • Blurred vision
    • Rapid eye movement
    • Faintness
    • Chills or sweating
    • Increased heart rate and blood pressure

Possible Long-Term Effects of Stimulants

    • Violent or erratic behavior
    • Hallucinations
    • Drug-induced psychosis
    • Appetite loss
    • Insomnia
    • Impaired sexual performance
    • Chronic respiratory problems
    • Nosebleeds, ulceration of the mucous membrane of the nose and perforation of the nasal septum, from snorting cocaine
    • Blockage of the tear ducts from snorting cocaine, leading to serious eye infections and eventually the destruction of the bone in the eye sockets cardiac or respiratory arrest
    • Irregular menstruation
Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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