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ALL   ​ [](https://myhealth.alberta.ca/) [Health Information and Tools](https://myhealth.alberta.ca/Pages/HealthInfoToolsDefault.aspx) \> [Health A-Z](https://myhealth.alberta.ca/health/Pages/default.aspx) \> Common drugs: Caffeine [Substance Use: Common drugs](https://myhealth.alberta.ca/alberta/pages/Substance-use-caffeine.aspx) Barbiturates ## Barbiturates Page Content ​​​​​​​​​​​​​​​​​​​​​​Barbiturates are a group of drugs that are sometimes used to treat people who have seizures or other health problems. Some examples are primidone and phenobarbital. ​Barbiturates are not prescribed often. Barbiturates are “downers." They work by making your brain and body less active. This makes you feel sleepy or calm. Barbiturates can affect your memory and judgment. They can also make you feel depressed, angry, very tired, and cause mood swings.​​ ### Dangers of barbiturates Barbiturates are dangerous when they aren't used as prescribed. If you take too much (overdose), barbiturates slow your breathing and heart rate. People have died from taking too much.​ ### Tolerance and dependence When you use barbiturates often, you build up a tolerance, which means you need to use more to get the same effects. If you stop using them suddenly, you can have problems sleeping, feel restless, or be irritable. The effects of suddenly stopping barbiturates may need to be treated in hospital. ### Mixing with other substances​ Mixing substances is never a good idea. It's very dangerous to take barbiturates with alcohol or heroin. Alcohol, heroin, and barbiturates all make your brain and nervous system less active. Your nervous system controls things like breathing, so if you mix substances, you are more likely to stop breathing and die. ### Long-term use Using barbiturates regularly, at higher doses, and for a long time can cause liver damage, muscle weakness, and bone pain. ### Questions If you're concerned about your or someone else's barbiturate use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Caffeine ## Caffeine Page Content ​​​​​​​Many people don't know that caffeine is a drug. It's a stimulant that's found in coffee, tea, energy drinks, some pain medicines, as well as in foods and drink. ​ ### Products with caffeine Some common products with caffeine amounts are: - coffee (250 mL or 1 cup): 40 to 180 mg - decaf (250 mL or 1 cup): 2 to 5 mg - tea (250 mL or 1 cup): 10 to 110 mg Other products that have caffeine include: - caffeine stimulants (1 tablet): 100 to 250 mg - energy shots or drinks (60 to 360mL): 4 to 240 mg - some painkillers (1 tablet): 30 to 100 mg - cola drinks (355 mL or 12 oz.): 30 to 60 mg - dark chocolate (56 g or 2 oz.): 40 to 70 mg - milk chocolate (56 g or 2 oz.): 3 to 20 mg - snacks with caffeine (for example, gum, fruit chews, jelly beans): 30 to 50 mg ### Medical use Caffeine can be used to treat some types of headaches, including migraines. Some pain medicines have caffeine. Your doctor or pharmacist can tell you if caffeine might work for you. ### Short-term effects Less than 200 mg of caffeine (1 or 2 cups of coffee) can make you more alert, put you in a better mood, and make you feel less tired. It can also improve physical work and thinking. The effects usually start within half an hour and can last up to 12 hours. Some people are sensitive to caffeine, and even small amounts can make them feel sick. Small amounts of caffeine might make your blood pressure go up, increase your heart rate, and make you pee more. If you have caffeine close to bedtime, you may have trouble falling asleep, sleep for a shorter time, or not sleep as deeply. Larger amounts of caffeine (600 mg or more) can: - cause shaking - cause trouble sleeping - make you agitated - cause a fast, irregular heartbeat (heart racing) - make your blood pressure go up and then drop to very low levels - make you feel irritable, restless, and nervous ### ​Caffeine and health problems People with anxiety disorders or heart problems shouldn't use large amounts of caffeine because it can make their condition worse. It's rare for adults to die from having very large amounts of caffeine (overdose). People born with heart problems have died from drinking large amounts of energy drinks that contain caffeine and herbal stimulants. ### Long-term effects Most healthy adults that use low to moderate amounts of caffeine (up to 3 cups of coffee) every day don't seem to have any long-term effects.​​ Regular use of more than 600 mg of caffeine a day might cause long-term effects such as sleep problems, thinning of bones and fractures, more anxiety, and stomach acidity. It can also increase blood pressure, and if you already have high blood pressure, it can get worse. ### Pregnancy and breastfeeding More than 300 mg of caffeine (about 2 to 3 cups of coffee) in a day may be linked to miscarriages and low-birth weight in babies. Caffeine is passed​ through breastmilk, which might make your baby irritable or have trouble sleeping. If you're pregnant or breastfeeding you may want to limit or not have any caffeine.​ ### Caffeine and alcohol Caffeine doesn't help you sober up if you drink too much alcohol. Mixing caffeine and alcohol puts you at higher risk of drinking and driving or getting into a vehicle with someone who has been drinking. You might not realize the person has had too much alcohol, and the caffeine or energy drink might mask the drowsiness from alcohol. You might also drink more than normal if you combine alcohol and caffeine (such as mixing alcohol with an energy drink). The more alcohol you drink, the higher the risk that you may pass out or have an alcohol-related injury. ​​ ### Caffeine and young people Some products with caffeine, such as some energy drinks, have higher than the recommended doses of caffeine for children and teens. Because children and teens weigh less than adults, even a low amount of caffeine may harm them. Children who drink pop or energy drinks with caffeine ​may feel restless, have behaviour problems, be irritable, have trouble sleeping, or wet the bed. Children can get very sick from even small amounts of caffeine. Some teens who use a lot of caffeine may have health problems such as an increased or abnormal heart rate and chest pain. If this happens, they may have to go to the hospital or need an ambulance. College and university students might use lots of caffeinated products (such as coffee, energy drinks, caffeine pills) to stay awake and study longer. Lack of sleep and stress from school might make the effects of caffeine worse. It's important to find healthy ways to manage stress and get enough sleep.​ ### Tolerance and dependence As your body gets used to caffeine, you need more and more of it to get the same effect (tolerance). As the amount of caffeine you have goes up so does the risk of side effects. You can become mildly dependent on caffeine from drinking 350 mg (about 2 to 4 cups of coffee) a day. You might feel like you can’t function without it, or that you aren’t fully awake until you’ve had caffeine. ### Withdrawal If you suddenly stop drinking caffeine, you might have withdrawal symptoms such as: - headaches - problems sleeping - feeling irritable, tired, and depressed - lack of energy - feeling down - having trouble focusing or concentrating Withdrawal symptoms begin 12 to 24 hours after you stop caffeine. Most symptoms go away within a few days.​ ### Questions If you're concerned about your or someone else's caffeine use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only).​​ ​ Gravol ## Gravol Page Content ​​​​​Gravol is the brand name for the non-prescription medicine dimenhydrinate. There is also a Gravol brand with ginger. This information is only about Gravol with dimenhydrinate. Gravol is used to prevent and treat nausea and vomiting. But it is sometimes used in other ways, because in large doses it can give a "high" and cause hallucinations (seeing, hearing, or feeling things that are not there). If you take high doses every day, your brain gets used to Gravol, and you need to take more to get the same effect. At high doses, Gravol can change your heart rhythm and cause seizures. Pharmacists may keep Gravol and other dimenhydrinate brands behind the counter. ### Short-term effects When you use Gravol at usual doses as recommended, common short-term side effects include: - drowsiness - dizziness - blurred vision - dry mouth - feeling unusually nervous or excited - trouble concentrating or moving as usual Younger children will feel all these effects more than adults. Older adults are more sensitive to these effects, especially if they have delirium or dementia. Be careful using Gravol if you are driving or doing other things where you have to be alert. Be careful if you take Gravol when exercising or on a hot day, because it can make you sweat less so your body cannot cool down as usual. You should **not** take Gravol if you have glaucoma or lung diseases such as bronchitis or emphysema. ### Long-term effects Using large amounts of Gravol for a long time can cause problems such as: - depression - feeling confused - having no energy - vomiting - trouble urinating (peeing) - trouble thinking or socializing When you stop using Gravol after using it for a long time, the withdrawal symptoms may include: - excitability - weakness - discomfort - poor appetite - stomach cramps - nausea ### Mixing Gravol with other substances Mixing Gravol with alcohol, codeine, cannabis, or sleeping pills can have unexpected effects. You may become too drowsy and not be able to walk or talk normally. Large doses (overdose) can cause: - sluggishness - paranoia - agitation - memory loss - increased blood pressure and heart rate - trouble swallowing or speaking - hall​ucinations​ ### Overdose An overdose can happen when you take ​more than the maximum recommended dose of Gravol. It can cause: - confusion - unusual behaviour​ - loss of muscle coordination - trouble breathing - high fever - convulsions or seizures - coma Children will have these symptoms at lower doses than adults. They are especially prone to seizures. **You can die from an overdose of Gravol.** If you think you or someone else has taken too much Gravol, call the Poison and Drug Information Service at 1-800-332-1414(Alberta only). Staff are specially trained in overdoses and poisoning.​ ### Questions If you're concerned about your or someone else's Gravol use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). An overdose may be life threatening. Anyone who thinks they (or someone else) has taken too much Gravol, please call PADIS (Poison and Drug Information Service) at **1-800-332-1414 (Alberta)**.​ ​ Magic Mushrooms ## Magic Mushrooms Page Content ​​​Magic mushrooms (also called shrooms or mushrooms) are a type of mushroom that contain the chemicals psilocybin or psilocin. These chemicals cause you to see, hear, and feel things that are not real (hallucinations). Magic mushrooms come in fresh, dried, or powder form. Magic mushrooms can be taken as a tea, cooked with food, or added to fruit juice. A person can take psilocybin legally by being in a research study or getting special permission from Health Canada with the support of their doctor. Otherwise, it is illegal to grow, sell, or carry magic mushrooms in Canada. ### Short-term effects Magic mushrooms affect everyone differently depending on: - how much you take - where you are - what you expect - your age and weight - what you've had to eat around the same time - past and present substance use - your personality You can feel the effects of magic mushrooms about 30 minutes after taking them. The effects last about 3 to 6 hours and are strongest (the peak) during the first 3 to 4 hours. Magic mushrooms can change the way you see, smell, hear, taste, and touch. For example you might think you can see music or hear colours. Your body might feel very heavy or very light. You might feel like you are having a magical or religious experience. While taking magic mushrooms, you might also:​ - have high blood pressure - have a faster heart rate - feel dizzy or light-headed - shiver and have the chills - feel anxious - have an upset stomach (nausea) or vomit - have a numb tongue and mouth ### Long-term effects The long-term effects of magic mushrooms may include flashbacks. This is when a bad trip comes back later when you are not using. Taking mushrooms with other drugs or alcohol may put you at higher risk ​for other health problems.​ ### Tolerance and dependence You can build up a tolerance to magic mushrooms after using every day for as few as 3 or 4 days. This means you need to take more and more to feel the same effects as the first time. If you use magic mushrooms for several days in a row, you can develop a complete tolerance. ​ If you use magic mushrooms regularly, you can become mentally dependent on the way they make you feel. ### Bad trip The effects of magic mushrooms can be overwhelming and scary, called a bad trip. If someone is having a bad trip, try to help them with calm reassurance in a quiet area. It is OK to call 911 for help and the [Poison and Drug Information Service](https://www.albertahealthservices.ca/topics/page11975.aspx) for advice at 1-800-332-1414. If you're concerned about your or someone else's magic mushroom use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Opioids ## Opioids Page Content ​​​​​​Opioids are very strong painkillers. Opioid medicines include codeine, morphine (MS-Contin), hydromorphone (Dilaudid), oxycodone (OxyNeo), fentanyl (Duragesic),​ meperidine (Demerol), tramadol, and diamorphine (medical heroin). Some opioids may be comb​ined with drugs like Aspirin (ASA) and acetaminophen (Tylenol) to give more pain relief. Opioids often come as a tablet that you swallow. When used in ways they weren't meant to be used, they may also be injected, inhaled (snorted), or smoked. Taking opioids with alcohol or other drugs such as antidepressants or sleeping pills is dangerous—you can have trouble breathing and go into a coma. You can be fined or go to jail for making or selling opioids, carrying opioids without a prescription, and prescription shopping (getting more than 1 opioid prescription from different doctors without telling them). Using opioids can create an unsafe environment for your baby or child. Exposure to even a tiny amount of any drugs, including ecstasy, methamphetamines, cocaine, heroin, and fentanyl, can make your baby or child very sick or cause death. Exposure can happen in different ways, ​like: - ​breathing in second-hand smoke or vapour from drugs - being exposed through breastfeeding or breastmilk - transferring from clothing, hands, or skin to a baby or child’s body, toys, soothers, bottles, and other items - during diaper changes - accidentally eating or touching drugs Babies and children are in contact with their caregivers and everything in their environment, so exposure can happen in many places, like: - ​in your home and other homes - in vehicles - in public places - in parks and playgrounds Keep all drugs and drug-related items, like bongs, pipes, lighters, needles, spoons, and fentanyl patches, locked up, out of sight, and out of reach of children. Anyone who comes in contact with drugs or drug-related items should: - wash their hands before handling or feeding a baby or child - wash their hands before touching toys or other items - change their clothes before handling a baby or child ### ​Short-term effects Besides pain relief and strong feelings of excitement and pleasure, opioids can cause: - nausea and vomiting - constipation (trouble having a bowel movement) - drowsiness - tiny pupils - vision problems (such as blurry vision, or trouble seeing in the dark) - anxiety - trouble concentrating - decreased appetite​ Low doses of opioids can affect your driving. Higher doses can lower your heart rate, blood pressure and breathing. Very high doses can cause disorientation, convulsions, and hallucinations (seeing, hearing, or feeling things that aren't there). ### Long-term effects Using opioids for a long time can cause many problems, including: - depression - trouble concentrating and sleeping - ​sexual problems - very serious constipation - lower levels of endorphins (your body's natural painkillers), so even minor pain feels very bad Using opioids with ASA for a long time can cause stomach bleeding. Using opioids with acetaminophen for a long time can cause kidney and liver damage.​ ### Dependence If you use a lot of opioids, you may need to use more and more to feel the same effects. Your body and mind can become dependent (addicted) to how opioids make you feel. If you are dependent on opioids while pregnant, your baby could go through withdrawal and be very sick after they're born. You have a higher chance of becoming dependent on opioids if you have a history of alcohol use or other substance use. Talk to your doctor or pharmacist so you can get right choice of medicines for pain control. ​ ### Withdrawal If you are dependent on opioids and you stop using them, you may have withdrawal symptoms such as: - craving (a strong desire to use the opioid) - runny nose and yawning - sweating - trouble sleeping - weakness - nausea or vomiting - stomach cramps and diarrhea - muscle spasms or bone pain - chills or goose bumps - irritability Mild withdrawal symptoms usually start between 12 and 30 hours after the last time the drug was taken. The worst symptoms pass within a few days, but it can take months to feel normal. Withdrawal can be painful. A healthcare provider can help you withdraw safely. ### Opioid poisoning Opioid poisoning (overdose) can cause you to **stop breathing and die**. If you're at risk of opioid poisoning, never use alone and have [naloxone](https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_opioids_naloxonekit_inst_adult) available. Naloxone reverses the poisoning effects and keeps you breathing until you get emergency medical help. ### Questions If you're concerned about your or someone else's opioid use, or you want to learn more about substance use, call the Addiction and Mental Health 24 Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ PCP ## PCP Page Content ​​​​​PCP (angel dust, supergrass, rocket fuel) is one of many illegal substances called hallucinogens. PCP is often sold as a white powder. The powder can be inhaled (snorted) or mixed with tobacco or cannabis and then smoked. It can also come as a liquid that can be injected with a needle or a capsule or tablet that can be swallowed. You can become dependent on PCP. Using more makes you want more. A person craving PCP will make bad choices that can harm themselves and others. When you use PCP, it's impossible to know how strong the PCP is or what its effects will be. ### Effects on behaviour Like all hallucinogens, PCP affects the mind and the senses. You may see, hear, and feel things that aren't really there. Hallucinogens also affect your emotions and ability to think clearly. PCP may cause you to feel joy or anxiety and panic. Sometimes this panic can lead to violent behaviour. You may believe things that aren't true (delusions), feel like someone is out to get you (paranoia), or feel separated from your environment and yourself. ### Effects on the body PCP causes many body changes: - faster breathing and heart rate - blurry vision - numbness in the legs and arms - changes to blood pressure - vomiting - confusion - dizziness - less ability to feel pain Large amounts can cause convulsions, coma, and death. Even a small dose mixed with alcohol or some other drugs can lead to a coma. ### Long-term effects The long-term effects of PCP aren't well understood. We know some people who have used PCP for a long time have: - memory loss - speech problems - long-term anxiety and depression - trouble enjoying social situations PCP can also cause flashbacks. This is when you feel the effects of PCP even though you haven't used it lately. A flashback can happen days, weeks, or months after it was last used. ### Questions If you're concerned about your or someone else's PCP use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta wide). ​ Ritalin ## Ritalin Page Content ### ​​​​​​​​​​​​​​​​​​​​​​What is Ritalin? Ritalin is a brand name of a stimulant medicine called methylphenidate. Concerta and Biphentin are other brand name medicines with methylphenidate. ### What does Ritalin do? Ritalin is used to treat attention deficit hyperactivity disorder (ADHD) in children and adults. However, it's not usually recommended for children younger than 6 years old. It helps people who have ADHD pay attention to tasks. Ritalin may also help people be less impulsive and hyperactive. In adults Ritalin is used to treat narcolepsy (extreme sleepiness).​​ ### Ritalin u​se Some people use Ritalin without a prescription in ways it was not meant to be used—to get high. It can be crushed into a powder and inhaled (snorted) or dissolved and injected (with a needle). College or university students might use Ritalin in this way because they think it will help them focus better on their studies. ### Effects on the body Using Ritalin in ways it was not prescribed can cause you to feel high or excited. Using Ritalin in this way can make people feel more alert. Often you may feel awake right after you take it, but then you get very tired. Using Ritalin in ways it is not meant to be used can cause: - headache or feeling dizzy - trouble sleeping - no appetite - nausea or vomiting - a fast, irregular heart beat - feeling nervous or shaky If high doses of Ritalin are taken, it can cause: - feeling agitated or confused - believing that people are out to get you (being paranoid) - seeing, hearing, or feeling things that aren't really there (hallucinating) - dry mouth or vomiting - shaky or twitching muscles - big pupils - heart might beat faster and harder - fever and sweating Very high doses can make you very agitated, restless, and confused (delirious). You could have seizures, serious heart rhythm changes, and even end up in a coma.​ ### Long-term use The most common side effects of using Ritalin for a long time are: - feeling nervous - trouble sleeping - no appetite - stomach ache - headache - dizziness People who use high doses of Ritalin not as prescribed every day can become paranoid or hallucinate. This seems to go away when they stop using Ritalin, but it may take some time. Sometimes these effects don't go away completely. Ritalin pills contain fillers that don't dissolve when they're crushed. When inhaled, these fillers can get into the lungs and cause breathing problems or lung disease. When injected these fillers can cause pain, blockage, and disease in the veins. ### Tolerance and dependence Long-term use of Ritalin in ways it was not prescribed can cause tolerance. This means you need to take more to get the same effects. You can get dependent on the way it makes you feel. You may panic if you can't get more and crave it if you try to stop using it. You can also become physically dependent. When you stop using, you can feel very tired and depressed.​ ### Legal issues It's against the law to have methylphenidate if you don't have a prescription. It is also against the law to sell methylphenidate. You can be fined, get a criminal record, or go to jail.​​ ### Questions If you're concerned about your or someone else's Ritalin use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Current as of: June 1, 2023 Author: Poison & Drug Information Service, Alberta Health Services This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use. Include Images Large Print

Barbiturates Barbiturates ​​​​​​​​​​​​​​​​​​​​​​Barbiturates are a group of drugs that are sometimes used to treat people who have seizures or other health problems. Some examples are primidone and phenobarbital. ​Barbiturates are not prescribed often. Barbiturates are “downers." They work by making your brain and body less active. This makes you feel sleepy or calm. Barbiturates can affect your memory and judgment. They can also make you feel depressed, angry, very tired, and cause mood swings.​​ Dangers of barbiturates Barbiturates are dangerous when they aren't used as prescribed. If you take too much (overdose), barbiturates slow your breathing and heart rate. People have died from taking too much.​ Tolerance and dependence When you use barbiturates often, you build up a tolerance, which means you need to use more to get the same effects. If you stop using them suddenly, you can have problems sleeping, feel restless, or be irritable. The effects of suddenly stopping barbiturates may need to be treated in hospital. Mixing with other substances​ Mixing substances is never a good idea. It's very dangerous to take barbiturates with alcohol or heroin. Alcohol, heroin, and barbiturates all make your brain and nervous system less active. Your nervous system controls things like breathing, so if you mix substances, you are more likely to stop breathing and die. Long-term use Using barbiturates regularly, at higher doses, and for a long time can cause liver damage, muscle weakness, and bone pain. Questions If you're concerned about your or someone else's barbiturate use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Caffeine Caffeine ​​​​​​​Many people don't know that caffeine is a drug. It's a stimulant that's found in coffee, tea, energy drinks, some pain medicines, as well as in foods and drink. ​ Products with caffeine Some common products with caffeine amounts are: coffee (250 mL or 1 cup): 40 to 180 mg decaf (250 mL or 1 cup): 2 to 5 mg tea (250 mL or 1 cup): 10 to 110 mg Other products that have caffeine include: caffeine stimulants (1 tablet): 100 to 250 mg energy shots or drinks (60 to 360mL): 4 to 240 mg some painkillers (1 tablet): 30 to 100 mg cola drinks (355 mL or 12 oz.): 30 to 60 mg dark chocolate (56 g or 2 oz.): 40 to 70 mg milk chocolate (56 g or 2 oz.): 3 to 20 mg snacks with caffeine (for example, gum, fruit chews, jelly beans): 30 to 50 mg Medical use Caffeine can be used to treat some types of headaches, including migraines. Some pain medicines have caffeine. Your doctor or pharmacist can tell you if caffeine might work for you. Short-term effects Less than 200 mg of caffeine (1 or 2 cups of coffee) can make you more alert, put you in a better mood, and make you feel less tired. It can also improve physical work and thinking. The effects usually start within half an hour and can last up to 12 hours. Some people are sensitive to caffeine, and even small amounts can make them feel sick. Small amounts of caffeine might make your blood pressure go up, increase your heart rate, and make you pee more. If you have caffeine close to bedtime, you may have trouble falling asleep, sleep for a shorter time, or not sleep as deeply. Larger amounts of caffeine (600 mg or more) can: cause shaking cause trouble sleeping make you agitated cause a fast, irregular heartbeat (heart racing) make your blood pressure go up and then drop to very low levels make you feel irritable, restless, and nervous ​Caffeine and health problems People with anxiety disorders or heart problems shouldn't use large amounts of caffeine because it can make their condition worse. It's rare for adults to die from having very large amounts of caffeine (overdose). People born with heart problems have died from drinking large amounts of energy drinks that contain caffeine and herbal stimulants. Long-term effects Most healthy adults that use low to moderate amounts of caffeine (up to 3 cups of coffee) every day don't seem to have any long-term effects.​​ Regular use of more than 600 mg of caffeine a day might cause long-term effects such as sleep problems, thinning of bones and fractures, more anxiety, and stomach acidity. It can also increase blood pressure, and if you already have high blood pressure, it can get worse. Pregnancy and breastfeeding More than 300 mg of caffeine (about 2 to 3 cups of coffee) in a day may be linked to miscarriages and low-birth weight in babies. Caffeine is passed​ through breastmilk, which might make your baby irritable or have trouble sleeping. If you're pregnant or breastfeeding you may want to limit or not have any caffeine.​ Caffeine and alcohol Caffeine doesn't help you sober up if you drink too much alcohol. Mixing caffeine and alcohol puts you at higher risk of drinking and driving or getting into a vehicle with someone who has been drinking. You might not realize the person has had too much alcohol, and the caffeine or energy drink might mask the drowsiness from alcohol. You might also drink more than normal if you combine alcohol and caffeine (such as mixing alcohol with an energy drink). The more alcohol you drink, the higher the risk that you may pass out or have an alcohol-related injury. ​​ Caffeine and young people Some products with caffeine, such as some energy drinks, have higher than the recommended doses of caffeine for children and teens. Because children and teens weigh less than adults, even a low amount of caffeine may harm them. Children who drink pop or energy drinks with caffeine ​may feel restless, have behaviour problems, be irritable, have trouble sleeping, or wet the bed. Children can get very sick from even small amounts of caffeine. Some teens who use a lot of caffeine may have health problems such as an increased or abnormal heart rate and chest pain. If this happens, they may have to go to the hospital or need an ambulance. College and university students might use lots of caffeinated products (such as coffee, energy drinks, caffeine pills) to stay awake and study longer. Lack of sleep and stress from school might make the effects of caffeine worse. It's important to find healthy ways to manage stress and get enough sleep.​ Tolerance and dependence As your body gets used to caffeine, you need more and more of it to get the same effect (tolerance). As the amount of caffeine you have goes up so does the risk of side effects. You can become mildly dependent on caffeine from drinking 350 mg (about 2 to 4 cups of coffee) a day. You might feel like you can’t function without it, or that you aren’t fully awake until you’ve had caffeine. Withdrawal If you suddenly stop drinking caffeine, you might have withdrawal symptoms such as: headaches problems sleeping feeling irritable, tired, and depressed lack of energy feeling down having trouble focusing or concentrating Withdrawal symptoms begin 12 to 24 hours after you stop caffeine. Most symptoms go away within a few days.​ Questions If you're concerned about your or someone else's caffeine use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only).​​ ​ Gravol Gravol ​​​​​Gravol is the brand name for the non-prescription medicine dimenhydrinate. There is also a Gravol brand with ginger. This information is only about Gravol with dimenhydrinate. Gravol is used to prevent and treat nausea and vomiting. But it is sometimes used in other ways, because in large doses it can give a "high" and cause hallucinations (seeing, hearing, or feeling things that are not there). If you take high doses every day, your brain gets used to Gravol, and you need to take more to get the same effect. At high doses, Gravol can change your heart rhythm and cause seizures. Pharmacists may keep Gravol and other dimenhydrinate brands behind the counter. Short-term effects When you use Gravol at usual doses as recommended, common short-term side effects include: drowsiness dizziness blurred vision dry mouth feeling unusually nervous or excited trouble concentrating or moving as usual Younger children will feel all these effects more than adults. Older adults are more sensitive to these effects, especially if they have delirium or dementia. Be careful using Gravol if you are driving or doing other things where you have to be alert. Be careful if you take Gravol when exercising or on a hot day, because it can make you sweat less so your body cannot cool down as usual. You should **not** take Gravol if you have glaucoma or lung diseases such as bronchitis or emphysema. Long-term effects Using large amounts of Gravol for a long time can cause problems such as: depression feeling confused having no energy vomiting trouble urinating (peeing) trouble thinking or socializing When you stop using Gravol after using it for a long time, the withdrawal symptoms may include: excitability weakness discomfort poor appetite stomach cramps nausea Mixing Gravol with other substances Mixing Gravol with alcohol, codeine, cannabis, or sleeping pills can have unexpected effects. You may become too drowsy and not be able to walk or talk normally. Large doses (overdose) can cause: sluggishness paranoia agitation memory loss increased blood pressure and heart rate trouble swallowing or speaking hall​ucinations​ Overdose An overdose can happen when you take ​more than the maximum recommended dose of Gravol. It can cause: confusion unusual behaviour​ loss of muscle coordination trouble breathing high fever convulsions or seizures coma Children will have these symptoms at lower doses than adults. They are especially prone to seizures. **You can die from an overdose of Gravol.** If you think you or someone else has taken too much Gravol, call the Poison and Drug Information Service at 1-800-332-1414(Alberta only). Staff are specially trained in overdoses and poisoning.​ Questions If you're concerned about your or someone else's Gravol use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). An overdose may be life threatening. Anyone who thinks they (or someone else) has taken too much Gravol, please call PADIS (Poison and Drug Information Service) at **1-800-332-1414 (Alberta)**.​ ​ Magic Mushrooms Magic Mushrooms ​​​Magic mushrooms (also called shrooms or mushrooms) are a type of mushroom that contain the chemicals psilocybin or psilocin. These chemicals cause you to see, hear, and feel things that are not real (hallucinations). Magic mushrooms come in fresh, dried, or powder form. Magic mushrooms can be taken as a tea, cooked with food, or added to fruit juice. A person can take psilocybin legally by being in a research study or getting special permission from Health Canada with the support of their doctor. Otherwise, it is illegal to grow, sell, or carry magic mushrooms in Canada. Short-term effects Magic mushrooms affect everyone differently depending on: how much you take where you are what you expect your age and weight what you've had to eat around the same time past and present substance use your personality You can feel the effects of magic mushrooms about 30 minutes after taking them. The effects last about 3 to 6 hours and are strongest (the peak) during the first 3 to 4 hours. Magic mushrooms can change the way you see, smell, hear, taste, and touch. For example you might think you can see music or hear colours. Your body might feel very heavy or very light. You might feel like you are having a magical or religious experience. While taking magic mushrooms, you might also:​ have high blood pressure have a faster heart rate feel dizzy or light-headed shiver and have the chills feel anxious have an upset stomach (nausea) or vomit have a numb tongue and mouth Long-term effects The long-term effects of magic mushrooms may include flashbacks. This is when a bad trip comes back later when you are not using. Taking mushrooms with other drugs or alcohol may put you at higher risk ​for other health problems.​ Tolerance and dependence You can build up a tolerance to magic mushrooms after using every day for as few as 3 or 4 days. This means you need to take more and more to feel the same effects as the first time. If you use magic mushrooms for several days in a row, you can develop a complete tolerance. ​ If you use magic mushrooms regularly, you can become mentally dependent on the way they make you feel. Bad trip The effects of magic mushrooms can be overwhelming and scary, called a bad trip. If someone is having a bad trip, try to help them with calm reassurance in a quiet area. It is OK to call 911 for help and the [Poison and Drug Information Service](https://www.albertahealthservices.ca/topics/page11975.aspx) for advice at 1-800-332-1414. If you're concerned about your or someone else's magic mushroom use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Opioids Opioids ​​​​​​Opioids are very strong painkillers. Opioid medicines include codeine, morphine (MS-Contin), hydromorphone (Dilaudid), oxycodone (OxyNeo), fentanyl (Duragesic),​ meperidine (Demerol), tramadol, and diamorphine (medical heroin). Some opioids may be comb​ined with drugs like Aspirin (ASA) and acetaminophen (Tylenol) to give more pain relief. Opioids often come as a tablet that you swallow. When used in ways they weren't meant to be used, they may also be injected, inhaled (snorted), or smoked. Taking opioids with alcohol or other drugs such as antidepressants or sleeping pills is dangerous—you can have trouble breathing and go into a coma. You can be fined or go to jail for making or selling opioids, carrying opioids without a prescription, and prescription shopping (getting more than 1 opioid prescription from different doctors without telling them). Using opioids can create an unsafe environment for your baby or child. Exposure to even a tiny amount of any drugs, including ecstasy, methamphetamines, cocaine, heroin, and fentanyl, can make your baby or child very sick or cause death. Exposure can happen in different ways, ​like: ​breathing in second-hand smoke or vapour from drugs being exposed through breastfeeding or breastmilk transferring from clothing, hands, or skin to a baby or child’s body, toys, soothers, bottles, and other items during diaper changes accidentally eating or touching drugs Babies and children are in contact with their caregivers and everything in their environment, so exposure can happen in many places, like: ​in your home and other homes in vehicles in public places in parks and playgrounds Keep all drugs and drug-related items, like bongs, pipes, lighters, needles, spoons, and fentanyl patches, locked up, out of sight, and out of reach of children. Anyone who comes in contact with drugs or drug-related items should: wash their hands before handling or feeding a baby or child wash their hands before touching toys or other items change their clothes before handling a baby or child ​Short-term effects Besides pain relief and strong feelings of excitement and pleasure, opioids can cause: nausea and vomiting constipation (trouble having a bowel movement) drowsiness tiny pupils vision problems (such as blurry vision, or trouble seeing in the dark) anxiety trouble concentrating decreased appetite​ Low doses of opioids can affect your driving. Higher doses can lower your heart rate, blood pressure and breathing. Very high doses can cause disorientation, convulsions, and hallucinations (seeing, hearing, or feeling things that aren't there). Long-term effects Using opioids for a long time can cause many problems, including: depression trouble concentrating and sleeping ​sexual problems very serious constipation lower levels of endorphins (your body's natural painkillers), so even minor pain feels very bad Using opioids with ASA for a long time can cause stomach bleeding. Using opioids with acetaminophen for a long time can cause kidney and liver damage.​ Dependence If you use a lot of opioids, you may need to use more and more to feel the same effects. Your body and mind can become dependent (addicted) to how opioids make you feel. If you are dependent on opioids while pregnant, your baby could go through withdrawal and be very sick after they're born. You have a higher chance of becoming dependent on opioids if you have a history of alcohol use or other substance use. Talk to your doctor or pharmacist so you can get right choice of medicines for pain control. ​ Withdrawal If you are dependent on opioids and you stop using them, you may have withdrawal symptoms such as: craving (a strong desire to use the opioid) runny nose and yawning sweating trouble sleeping weakness nausea or vomiting stomach cramps and diarrhea muscle spasms or bone pain chills or goose bumps irritability Mild withdrawal symptoms usually start between 12 and 30 hours after the last time the drug was taken. The worst symptoms pass within a few days, but it can take months to feel normal. Withdrawal can be painful. A healthcare provider can help you withdraw safely. Opioid poisoning Opioid poisoning (overdose) can cause you to **stop breathing and die**. If you're at risk of opioid poisoning, never use alone and have [naloxone](https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_opioids_naloxonekit_inst_adult) available. Naloxone reverses the poisoning effects and keeps you breathing until you get emergency medical help. Questions If you're concerned about your or someone else's opioid use, or you want to learn more about substance use, call the Addiction and Mental Health 24 Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ PCP PCP ​​​​​PCP (angel dust, supergrass, rocket fuel) is one of many illegal substances called hallucinogens. PCP is often sold as a white powder. The powder can be inhaled (snorted) or mixed with tobacco or cannabis and then smoked. It can also come as a liquid that can be injected with a needle or a capsule or tablet that can be swallowed. You can become dependent on PCP. Using more makes you want more. A person craving PCP will make bad choices that can harm themselves and others. When you use PCP, it's impossible to know how strong the PCP is or what its effects will be. Effects on behaviour Like all hallucinogens, PCP affects the mind and the senses. You may see, hear, and feel things that aren't really there. Hallucinogens also affect your emotions and ability to think clearly. PCP may cause you to feel joy or anxiety and panic. Sometimes this panic can lead to violent behaviour. You may believe things that aren't true (delusions), feel like someone is out to get you (paranoia), or feel separated from your environment and yourself. Effects on the body PCP causes many body changes: faster breathing and heart rate blurry vision numbness in the legs and arms changes to blood pressure vomiting confusion dizziness less ability to feel pain Large amounts can cause convulsions, coma, and death. Even a small dose mixed with alcohol or some other drugs can lead to a coma. Long-term effects The long-term effects of PCP aren't well understood. We know some people who have used PCP for a long time have: memory loss speech problems long-term anxiety and depression trouble enjoying social situations PCP can also cause flashbacks. This is when you feel the effects of PCP even though you haven't used it lately. A flashback can happen days, weeks, or months after it was last used. Questions If you're concerned about your or someone else's PCP use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta wide). ​ Ritalin Ritalin ​​​​​​​​​​​​​​​​​​​​​​What is Ritalin? Ritalin is a brand name of a stimulant medicine called methylphenidate. Concerta and Biphentin are other brand name medicines with methylphenidate. What does Ritalin do? Ritalin is used to treat attention deficit hyperactivity disorder (ADHD) in children and adults. However, it's not usually recommended for children younger than 6 years old. It helps people who have ADHD pay attention to tasks. Ritalin may also help people be less impulsive and hyperactive. In adults Ritalin is used to treat narcolepsy (extreme sleepiness).​​ Ritalin u​se Some people use Ritalin without a prescription in ways it was not meant to be used—to get high. It can be crushed into a powder and inhaled (snorted) or dissolved and injected (with a needle). College or university students might use Ritalin in this way because they think it will help them focus better on their studies. Effects on the body Using Ritalin in ways it was not prescribed can cause you to feel high or excited. Using Ritalin in this way can make people feel more alert. Often you may feel awake right after you take it, but then you get very tired. Using Ritalin in ways it is not meant to be used can cause: headache or feeling dizzy trouble sleeping no appetite nausea or vomiting a fast, irregular heart beat feeling nervous or shaky If high doses of Ritalin are taken, it can cause: feeling agitated or confused believing that people are out to get you (being paranoid) seeing, hearing, or feeling things that aren't really there (hallucinating) dry mouth or vomiting shaky or twitching muscles big pupils heart might beat faster and harder fever and sweating Very high doses can make you very agitated, restless, and confused (delirious). You could have seizures, serious heart rhythm changes, and even end up in a coma.​ Long-term use The most common side effects of using Ritalin for a long time are: feeling nervous trouble sleeping no appetite stomach ache headache dizziness People who use high doses of Ritalin not as prescribed every day can become paranoid or hallucinate. This seems to go away when they stop using Ritalin, but it may take some time. Sometimes these effects don't go away completely. Ritalin pills contain fillers that don't dissolve when they're crushed. When inhaled, these fillers can get into the lungs and cause breathing problems or lung disease. When injected these fillers can cause pain, blockage, and disease in the veins. Tolerance and dependence Long-term use of Ritalin in ways it was not prescribed can cause tolerance. This means you need to take more to get the same effects. You can get dependent on the way it makes you feel. You may panic if you can't get more and crave it if you try to stop using it. You can also become physically dependent. When you stop using, you can feel very tired and depressed.​ Legal issues It's against the law to have methylphenidate if you don't have a prescription. It is also against the law to sell methylphenidate. You can be fined, get a criminal record, or go to jail.​​ Questions If you're concerned about your or someone else's Ritalin use, or you want to learn more about substance use, call the Addiction and Mental Health Helpline, any time of the day or night, at 1-866-332-2322 (Alberta only). ​ Current as of: June 1, 2023 Author: Poison & Drug Information Service, Alberta Health Services