• Men drinkin alcohol
    Substance use

Substance Use

Psychoactive substances are various natural or synthetic compounds that act on the nervous system causing alterations in the functions that regulate thoughts, emotions and behavior.

There are regulations for the control and supervision of the use of these substances, either for recreational use, such as alcohol or tobacco; for drug use, such as tranquilizers or opioid analgesics, or general use, such as industrial solvents. There is a group whose use is considered illegal and authorized only for medical or research purposes, as in the case of cocaine and its derivatives. The use of psychoactive substances always involves a degree of risk of adverse effects on different organs and systems, which can occur in a short term, as in the case of poisoning, which increases the risk of injuries or aggression, and unsafe sexual behavior. Repeated or prolonged use in time of these substances, favors the development of dependence disorders that are chronic and recurrent disorders characterized by severe need of substance and loss of the ability to control their consumption, despite adverse consequences of health status, interpersonal, family, academic, occupational, or legal operation.

Key facts
  • Dependence is a brain disorder and people with drug dependence have altered brain structure and function. Dependence is expressed in the form of compulsive behavior, but this behavior is strongly related to changes in the brain occurring over time, with repeated abuse of drugs. 
  • Drug dependence is difficult to control due to compulsive drug use and craving, leading to drug seeking and repetitive use, even in the face of negative health and social consequences. 
  • Investing in evidence-based treatment for substance dependence decreases negative health consequences and social effects (e.g. crime, economic burden, and HIV infection).
  • Treatment is proven to be cost-effective in both developed and developing countries. For every dollar spent on treatment 7 dollars are returned in cost-savings. It costs less than imprisonment.
  • The possible short and long term consequences of substance abuse include mortality, morbidity, comorbidity, social isolation, and stigma. People with substance dependence are among the most marginalized in societies and are in need of treatment and care. To incarcerate offenders for drug abuse and dependence is not an effective prevention or treatment strategy
  • There is no magic solution in treating substance dependence. It is a long process, with varying services, not always adequately available or provided. This is a chronic recurring illness, needing repeated treatments until abstinence is achieved. Aftercare is essential to successful recovery, as well as compliance and responsibility of the patients themselves.
Fact sheet

The damage associated with the use of psychoactive substances, short or long term, depends on the interaction of a set of factors such as the type of substance and form of consumption, personal, physical and psychological characteristics of consumers, but also the social context in which consumption occurs.

Numerous interventions based on scientific evidence that are effective in reducing substance abuse and its impact on health, either by preventing the use, early addressing the population at risk, trying dependency or adverse consequences of the use and promoting recovery in the medium and long term. Treatment should be accessible, especially for the most vulnerable, suited to the needs and profile of the user population, maintained in the long term, focusing on the recovery and protected from human rights groups.

PAHO Response

The project for the development and implementation of a proposal for the "comprehensive approach to Substance Abuse Disorders and other mental and behavioral disorders concurrence, in Latin America," is part of the agreements developed among the Pan American Health Organization (PAHO/WHO), the Government of Spain and the National Institute of Psychiatry (WHO Collaborating Center), to strengthen the public health approach in addressing problems related to substance use in the countries of the Americas.

To provide technical support to this project a working group (Task Force) has been established, integrated by experts from Spain and countries of the Americas, and coordinated by PAHO/WHO with collaboration from the National Institute of Psychiatry "Ramon de la Fuente Muñiz", WHO Collaborating Center in Mexico, and the Government Delegation for the National Drug Plan of Spain (DGPNSDE) through the Spanish Society of Dual Pathology (EDPS).

Health consequences by type of drug

Globally, cannabis—more commonly known as marijuana—is the most widely used illicit drug. Classified as a hallucinogen, cannabis is associated with a number of health risks. Although overdose and toxicity are possible, cannabis carries a very low risk of causing death. In combination with other drugs, however, the likelihood may increase.

Acute intoxication of cannabis is associated with an increased risk of:

  • Anxiety
  • Dysphoria
  • Impaired attention and memory
  • Increased risk of accident and injury
  • Nausea
  • Panic
  • Paranoia

Smoking cannabis regularly creates many of the same cancer risks as tobacco. Risks include lung cancer and the upper respiratory system and cancer of the digestive system. Regular use increases the risk and/or the severity of:

  • Asthma.
  • Bronchitis
  • Cancer of the digestive system
  • Cancer of the lungs and upper respiratory system
  • Depression
  • Emphysema
  • Heart disease
  • High blood pressure
  • Impaired memory
  • Impaired problem-solving ability
  • Loss of motivation
  • Reduced libido
  • People with a personal or family history of schizophrenia are also at increased risk of experiencing psychosis 

Use of cocaine, a stimulant, is associated with a wide range of physical and mental health problems and with risky behavior including participating in unsafe sex, which in turn increases the likelihood that users and their sexual partners will contract sexually transmitted diseases and blood-borne viruses. Repeatedly using high doses of cocaine can lead to psychosis. There is also a significant risk of toxic complications, overdose and sudden death, usually due to heart failure. Combination with alcohol significantly increases cardiovascular and liver toxicity.

The most common physical problems associated with using cocaine include:

  • Clammy skin
  • Exhaustion
  • Headaches
  • Increased risk of accident and injury
  • Numbness and/or tingling
  • Reduced immunity to infection
  • Repetitious scratching or picking at skin
  • Weight loss

Psychological problems may include:

  • Anxiety
  • Depression
  • Difficulty sleeping
  • Mood swings
  • Impaired memory
  • Paranoia
  • Violent or aggressive behavior 

The effects of amphetamine-type stimulants—amphetamine, dexamphetamine, methamphetamine, and ecstasy—are similar to cocaine although the pharmacological profiles of these drug classes differ 

Health problems and risks include: 

  • Brain hemorrhage
  • Cardiovascular stress, which can lead to sudden death
  • Dehydration
  • Difficulty sleeping
  • Headaches
  • Impaired resistance to infection
  • Irregular heartbeat
  • Jaw clenching
  • Liver damage
  • Loss of appetite, resulting in weight loss
  • Muscle pain
  • Shortness of breath
  • Tremors

Mental health effects include:

  • Agitation
  • Difficulty concentrating
  • Hallucinations
  • Impaired memory
  • Mood swings including anxiety, depression, exhilaration, panic, and mania
  • Paranoia
  • Violent or aggressive behavior

Using high doses of methamphetamines over a long span of time also increases the risk of malnutrition and can cause permanent damage to brain cells.

Sedatives, hypnotics and sleeping pills include benzodiazepines and related compounds. All are depressants. They are typically prescribed to help people sleep, or to manage anxiety or other mood disorders, or cope with muscle pain, seizures, and trauma. Sedatives and hypnotics can cause problems, particularly when used more frequently or at higher doses than prescribed. Symptoms of withdrawal include severe anxiety and panic, insomnia, depression, headache, sweating and fever, nausea, vomiting and convulsions. Benzodiazepines are extremely unlikely to cause death from overdose, even when very large doses are consumed. However, when combined with substances such as alcohol, other depressant drugs or opioids, the risk of overdose and death increases significantly.

Use of sedatives and sleeping pills may be associated with:

  • Confusion, drowsiness, and dizziness.
  • Depression
  • Headaches
  • Impaired balance, unsteady gait, and increased risk of falling
  • Nausea.

Opiates are compounds extracted from the poppy seed. Opioids have a morphine-like action in the body and reduce pain by slowing the central nervous system functions. Both legally prescribed opioids and the “street” version—heroin and opium—can create numerous health problems. People who use prescription opioids are particularly at risk if they use the drugs more frequently or at higher doses than prescribed. An overdose occurs when the amount of opioid depresses the respiratory system, which can cause the user to slip into a coma and die. The risk of overdose is significantly higher if a user also consumes alcohol or takes other sedatives.

Effects of short-term use include:

  • Constipation
  • Difficulty concentrating
  • Drowsiness
  • Impaired memory
  • Itching
  • Nausea and vomiting
  • Shallow breathing or difficulty breathing

Effects of long-term use include:

  • Depression
  • Impotence
  • Irregular menstrual periods in women
  • Reduced libido
  • Respiratory failure, resulting in death

Withdrawal symptoms include diarrhea, stomach cramps, and vomiting; high blood pressure and rapid pulse; racing thoughts; sweating and/or goosebumps; yawning, runny nose and teary eyes.

Inhalants, or volatile solvents, are classified as depressants. They are found in many homes and workplace products: cigarette lighters, refill canisters, aerosols, solvent-based glues, chemical thinners, correction fluids, and dry-cleaning fluids. Inhalants are associated with range of severe effects, both short- and long-term. Inhaling large quantities can cause confusion and disorientation, delusions, slurred speech, weakness, tremors, and visual hallucinations. Ultimately, using inhalants can cause a coma or death from a heart attack.

Effects of short-term use include:

  • Anxiety or other mood disorders
  • Blurred vision
  • Coma
  • Death from heart failure
  • Delirium
  • Diarrhea
  • Disorientation and drowsiness
  • Headaches
  • Impaired coordination and responsiveness
  • Loss of self control
  • Muscle pain
  • Nausea and vomiting
  • Reduced oxygen supply to the body
  • Seizures
  • Unpredictable and sometimes dangerous behavior
  • Unconsciousness

Long-term use can cause:

  • Aggressive behavior.
  • Chronic headaches, sinus problems, nosebleeds, persistent coughing, and red, watery eyes
  • Depression
  • Extreme tiredness.
  • Flu-like symptoms
  • Indigestion and stomach ulcers
  • Memory loss and confusion
  • Organ damage (to heart, lungs, liver, and kidneys)
  • Trembling and tremors

The effects of hallucinogens are unpredictable and can vary among users or on different occasions. Hallucinogens can cause flashbacks —spontaneous recurrences of the effects of using hallucinogens in the past. Long-term use may increase the effects of mental health problems such as schizophrenia.

Using hallucinogens can cause:

  • Changes to the senses: auditory, visual, olfactory and tactile
  • Difficulty sleeping
  • Hallucinations
  • Increased heart rate and blood pressure
  • Mood swings, including anxiety, panic, exhilaration, and paranoia
  • Muscle weakness
  • Nausea and vomiting
  • Numbness
  • Seizures
  • Tremors and twitching

Ecstasy (MDMA), both a hallucinogen and an amphetamine-type stimulant, is associated with a range of very rare but life-threatening conditions including:

  • Brain hemorrhage
  • Disturbances to the body’s salt and water balance
  • Liver damage
  • Hyperthermia (very high body temperature)

Ecstasy may also lead to chronic mental health problems including impaired memory, depression, panic disorders, delusions, and “flashbacks.” There is growing evidence that ecstasy is a neurotoxin, causing nerve damage to the brain.

Latest news

Documents

Communication Materials

Mandates and Strategies

Events