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Facts About Substances

Various pills, pill bottles, and a vape

Drugs and Your Body Have a Toxic Relationship

Drugs change you from the inside out. They damage your organs and affect your mental health. In the wrong combination or in the wrong dose, they can even be deadly.

That goes for certain prescription drugs, too. Misusing prescription medications — like Adderall®, Vicodin®, and Xanax® — can lead to lasting problems like addiction.

Not to mention leaving you vulnerable to an overdose.

Be aware of the risk

Every year, millions of fake pills (also called counterfeit pills) are made to look like real prescription drugs you get from your doctor.Fake pills often contain fentanyl, a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.It only takes a tiny amount to cause a fatal overdose. In 2024, 5 out of 10 pills tested contained a potentially deadly dose of fentanyl.3

Learn more about fake pills. [PDF – 5 MB]

A pill disguised with a pair of glasses with a nose attached

Get the facts about substances

Alcohol

alcohol

Alcohol is the most common substance used by people under 21 in the United States. Alcohol use is more common in teens who have parents that binge drink.3 Underage alcohol use can lead to many physical and mental issues, both from consumption and from the impaired judgement that can occur with drinking. This includes an increased risk of physical harm, slower brain development, and an increased risk of alcohol use disorder.5

About Underage Drinking (CDC)

Cannabis and Cannabidiol (CBD)

A cannabis leaf, a bottle of oil and a puff of smoke

Cannabis—which people also call marijuana, weed, pot, or bud—refers to the dried flowers, leaves, stems, and seeds of the cannabis plant. When individuals take it, they can experience a “high” that has different effects depending on the person. Individuals can consume it in many ways including smoking, vaping, infusing it into food or drinks, and inhaling it through oils and extracts.6

There are risks associated with cannabis use, including impairment and ability to control emotions. Prolonged cannabis use can lead to cannabis use disorder, which is when individuals struggle with controlling their dependency and use. The risk of developing cannabis use disorder is higher in adults who start using as youth.7

About Cannabis (CDC)

Cannabis Health Effects (CDC)

Cannabidiol (CBD) is a compound found in cannabis and often derived from hemp.8 While it doesn’t cause a “high” like cannabis, we are still learning about its other side effects. Learn more about cannabis and CBD:

About CBD (CDC)

Opioids

A round pill

Doctors sometimes prescribe opioids, which are natural or synthetic (made in a lab) substances used to reduce pain.  However, even prescription opioids can lead to addiction, overdose, and death.9 Illegal opioids may contain deadly levels of fentanyl, and you wouldn’t be able to see it, taste it, or smell it.10

Learn more about opioids:

About Prescription Opioids (CDC)

Fentanyl (CDC)

Polysubstance Use

Bottles of alcohol and a round pill

Polysubstance use happens when a person intentionally or unintentionally takes more than one drug at the same time. Mixing drugs like this can be dangerous. This is because we don’t always know how the drugs will affect each other or the person taking them.11 Learn more about polysubstance use:

Stop Overdose: Polysubstance Use (CDC)

Vaping

A vape pen with smoke

Vaping is the use of an electronic device to inhale substances into your lungs. Vapes, also called vape pens or e-cigarettes, usually contain nicotine and come in many shapes and sizes. These devices use heat to create aerosol or small particles for you to breathe in. These particles contain nicotine, which is addictive. They also release heavy metals and other chemicals deep into your lungs where they can cause damage.12 Learn more about vaping:

About E-cigarettes (Vapes) (CDC)

Xylazine

A vial with a frown face on it's label

Authorities are increasingly finding xylazine, a non-opioid sedative,  in the US illegal drug supply.13  Xylazine is not approved for use in people and can slow down the brain and breathing, make the heart beat slower, and lower blood pressure. It is especially dangerous when combined with opioids like fentanyl.13

What You Should Know About Xylazine (CDC)

Additional Facts about Drugs

Drug Index | Just Think Twice

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  1. One pill can kill. Drug Enforcement Administration (DEA). Accessed January 7, 2025. https://www.dea.gov/onepill.
  2. What Is Fentanyl Drug Fact Sheet. Department of Justice. Drug Enforcement Administration. Accessed April 15, 2025. https://www.dea.gov/sites/default/files/2020-06/Fentanyl-2020_0.pdf
  3. Bohm MK, Esser MB. Associations between parental drinking and alcohol use among their adolescent children: findings from a national survey of United States parent-child dyads. Journal of Adolescent Health. 2023 Nov 1;73(5):961-4.
  4. Overdose deaths decline, fentanyl threat looms. Press release. Drug Enforcement Administration (DEA). Published December 16, 2024. Accessed March 20, 2025. https://www.dea.gov/press-releases/2024/12/16/overdose-deaths-decline-fentanyl-threat-looms.
  5. About Underage Drinking. cdc.gov. Accessed April 15, 2025. https://www.cdc.gov/alcohol/underage-drinkingg/
  6. About Cannabis. cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/cannabis/about/index.html.
  7. Cannabis Health Effects. cdc.gov. Accessed April 15, 2025. https://www.cdc.gov/cannabis/health-effects/index.html
  8. About CBD. cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/cannabis/about/about-cbd.html.
  9. Prescription Opioids. cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/overdose-prevention/about/prescription-opioids.html.
  10. Fentanyl. cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/overdose-prevention/about/fentanyl.html.
  11. Polysubstance Use. cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/stop-overdose/caring/polysubstance-use.html.
  12. About E-Cigarettes (Vapes). cdc.gov. Accessed March 11, 2025. https://www.cdc.gov/tobacco/e-cigarettes/about.html
  13. What You Should Know About Xylazine. cdc.gov. Accessed April 15, 2025. https://www.cdc.gov/overdose-prevention/about/what-you-should-know-about-xylazine.html
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