nose. Its effect is much shorter than that of amphetamines, and occasionally the abuser may inject or snort cocaine every few minutes in an attempt to maintain a constant stimulation and prevent depression experienced during withdrawal (come- down). Overdose is very possible, often resulting in convulsion and death. The physical symptoms observed in the cocaine abuser will be the same as those observed in the amphetamine abuser. HALLUCINOGEN INTOXICATION The group of drugs that affect the central nervous system by altering the user’s perception of self and environment are commonly known as hallucinogens. Included within this group are lysergic acid diethylamide (LSD), mescaline, dimethoxymethyl- amphetamine (STP), phencyclidine (PCP), and psilocybin. They appear in several forms: crystals, powders, and liquids. The symptoms of hallucinogenic drugs include dilated pupils, flushed face, increased heartbeat, and a chilled feeling. In addition, the person may display a distorted sense of time and self, show emotions ranging from ecstasy to horror, and experience changes in visual depth perception. Although no deaths have resulted from the drugs directly, hallucinogen-intoxicated persons have been known to jump from windows, walk in front of automobiles, or injure themselves in other ways because of the vivid but unreal perception of their environment. Even though no longer under the direct influence of a hallucinogenic drug, a person who has formerly used one of the drugs may experience a spontaneous recurrence (flashback) of some aspect of the drug experience. The most common type of flashback is the recurrence of perceptual distortion; however, victims of flashback may also experience panic or disturbing emotion. Flashback may be experienced by heavy or occasional users of hallucinogenic drugs, and its frequency is unpredictable and its cause unknown. CANNABIS INTOXICATION Cannabis sativa, commonly known as marijuana, is widely abused and may be classified as a mild hallucinogen. The most common physical appearance of marijuana is as ground, dried leaves, and the most common method of consumption is smoking, but it can be taken orally. A commercially prepared product of the active ingredient in marijuana, tetrahydro- cannabinol (THC), is dronabinol (Marinol R) available in the U.S. as a controlled Schedule II drug. Dronabinol is used for the treatment of nausea and vomiting in chemotherapy patients. It may also be useful in the treatment of acute glaucoma, asthma, and nausea and vomiting from other chronic illnesses. The individual response to the recreational use of marijuana varies and depends on the dose, the personality and expectation of the user, and the setting. Unexpected ingestion, emotional stress, or underlying psychiatric disorders can increase the possibility of an unfavorable reaction. After a single inhaled dose of marijuana, a subjective “high” begins in several minutes and is gone within four hours. Marijuana causes decreased pupil size and conjunctivitis (reddening of the white of the eye). Smoking marijuana can increase the heart rate (tachycardia) for about two hours. It can slightly increase systolic blood pressure in low doses and can lower blood pressure in high doses. An increased appetite and dry mouth are common complaints after marijuana use. Social setting influences the psychological effects associated with “usual doses” of marijuana smoking. Smoking in a solitary setting may produce euphoria, relaxation, and sleep. In a group setting, increased social interaction, friendliness, and laughter or giddiness may be produced. Subjectively, time moves slower, images appear more vivid, and hearing seems keener. High doses can cause lethargy, depersonali- zation, pressured speech, paranoia, hallucinations, and manic psychosis (imagining everything is wonderful in a way that is out of reality). INHALANT INTOXICATION Inhalants are potentially dangerous, volatile chemicals that are not meant for human consumption. They are found in consumer, commercial, and industrial products intended for use in well-ventilated areas. The vapors they produce can be extremely dangerous when inhaled inadvertently or by design. Substances in this category include adhesives (synthetic “glues”), paint, wet markers, lighter fluids, solvents, and propellants in aerosol spray cans, and air fresheners. Inhalants can be abused by “sniffing” 5-20