Joshua Rivera

Synthetic cathinones are lab-made stimulant drugs related to cathinone, a stimulant found in khat. The term “bath salts” is a misleading marketing label and does not refer to ordinary bathing products.

Synthetic cannabinoids such as K2 or Spice are lab-made chemicals that act on cannabinoid receptors but are not the same as cannabis. Their unpredictable potency and composition can cause severe and sometimes life-threatening effects.

Cannabis withdrawal can occur after heavy or long-term cannabis use is stopped or substantially reduced. Common symptoms include irritability, anxiety, sleep problems, reduced appetite, restlessness, depressed mood, and physical discomfort.

Cannabinoid hyperemesis syndrome is a condition linked to long-term heavy cannabis use that causes recurring episodes of severe nausea, vomiting, and abdominal pain that typically improve only after cannabis is stopped.

Heavy nitrous oxide use can cause peripheral neuropathy, myelopathy, gait instability, weakness, numbness, and subacute combined degeneration by creating functional vitamin B12 deficiency.

Nitrous oxide can oxidize and inactivate vitamin B12, creating a functional deficiency even when the blood B12 level looks normal. This can disrupt nerve function and raise methylmalonic acid and homocysteine.

Nitrous oxide misuse involves inhaling the gas for intoxication, often from whipped-cream chargers called “whippets.” Repeated or heavy use can inactivate vitamin B12 and cause serious neurologic injury.

Both gabapentin and pregabalin can be misused and can cause dependence, but research generally finds stronger misuse signals for pregabalin, particularly among people with other substance use disorders.

Pregabalin can be misused and can cause physical dependence and withdrawal. Misuse risk appears higher in people with other substance use disorders, particularly opioid use disorder.

Gabapentin can be misused and, in some people, repeated use can lead to dependence and withdrawal. Risk is higher in people with other substance use disorders and when gabapentin is combined with opioids or other sedatives.