DRUG ABUSE: ALTERED STATES
DISCUSSION GUIDE
On PBS (Check local listings)
A half hour special from In the Mix, the award winning
PBS series
Drug abuse among young people in the U.S. has become a
fact of life. Teenagers in urban, suburban, and rural
areas alike are experimenting with and getting addicted
to a growing variety of substances beginning at younger
and younger ages, knowing less and less about the
dangerous realities of drug use. In this program, Dr.
Alan Leshner, Director of the National Institute on
Drug Abuse (NIDA), gives viewers the hard truth about
how drugs affect the mind and body, breaking down
common myths and misconceptions. Also featured are
teens speaking candidly about the lasting – and
sometimes tragic – consequences of substance abuse on
their lives. The aim is to present a gritty, unfiltered
look at the often devastating consequences of drug
abuse without being judgmental, and to help young
people understand that the sooner they know the facts,
the sooner they can make the right decisions about
their lives.
How to Use this Program:
Studies conducted by RMC Research on earlier In the Mix
specials have shown that these programs engage the
interest of teenagers, deliver information, catalyze
discussion on critical issues, as well as promote
analytical thinking and a greater sense of selfefficacy among teens. The aim is to encourage thought
and allow teens to generate their own creative
solutions.
In this guide, we have outlined specific questions
based on the program’s content, with answers; these
questions can be used to open up more analytical
discussion about related concepts. Also included are
in-class activities and longer-term projects which are
presented in bold type.
Did you know?
* In 1998, nearly a quarter (22%) of all eighthgraders, and nearly half (49%) of all 12th-graders said
they had tried marijuana.
* In 1998, 40% of 8th-graders did not see a great
risk in regular use of LSD.
* Use of illicit drugs by 12th-graders climbed from
27.1 % in 1992 to 42.4% in 1997.
* Marijuana use among teenage girls is increasing
faster than it is among boys; girls’ drug violations
also increased by more than 13,000 from 1991 to 1996,
most of which were for possession of marijuana.
In the Mix Awards
•1999 Academy of Television Arts and Sciences Honor
Roll of Quality Youth Programming
•1997 International Prix Danube for Children's
Television
•1997 New York Emmy for Children's Programming
•1996 Finalist, The New York Festivals
•1994 National Emmy for Community Service Programming
•1993 Finalist, Prix Jeunesse
•1992 CPB Gold Award
Drug Abuse: Altered States contains four major
sections, plus a reference summary of drug types and
their effects, as well as a list of resources.
SECTION ONE
USING AND ABUSING
Question:
Name some of the drugs mentioned by teens in the show.
(alcohol, marijuana, cocaine, heroin, crack, dust
(PCP), mushrooms, acid (LSD), peyote, Ecstasy)
What are some other drugs you’ve heard of?
(crystal meth, inhalants, etc.)
Related Activity:
Divide the class into teams and assign each a different
type of commonly abused substances: Marijuana; Opiates;
Inhalants; Hallucinogens; Stimulants. Have them
research the characteristics of each category of
substance, including the ways they affect the brain and
body, and which commonly known drugs fall into which
category. Share results on a blackboard or have teams
present their findings.
Question:
Many of the teens in the show talk about the influences
around them that contributed to their drug use. What
are these influences?
(the image of models, movie stars and rock stars doing
drugs leads to the idea that it makes you "cool"; use
by friends or classmates can make you feel like you
have to act like them; parties and other gatherings
where it’s assumed drugs are the only way to have a
good time)
Further Discussion:
Where have you heard about these drugs in the media? In
movies and on television? Music lyrics? Books?
Magazines? Discuss some specific examples.
Further Discussion:
One teen talks about "peer pressure" and "selfpressure". What’s the difference between these? Why is
it hard to tell the difference sometimes? Is one more
likely to lead people to bad choices?
Further Discussion:
Several of the teens talk about parents who may know
there’s drug use going on in their homes. Why do you
think parents ignore drug use or aren’t able to stop
it? Do you think they are in denial about what’s going
on, or that they feel they can’t control this type of
activity? Are these parents responsible for what
happens to these teens? Do they have an obligation to
intervene or alert authorities? Why or why not? What do
you think of "host laws" that allow parents to be
prosecuted or sued if drug use goes on under their
roof, whether they’re aware of it or not?
Question:
Beth and Melissa, the two girls who talk about their
drug use, live in a suburban area. Did it surprise you
to see that? Do you think that there’s anywhere in this
country where a teenager has no exposure or access to
drugs? How prevalent is it – or how prevalent do you
think it is — in your town or school?
(the reality is, if a teenager anywhere wants to try
drugs, they can find a way to obtain some)
Related Activity:
Assign students or groups of students a country other
than the United States. Include a cross-section of
countries from Europe, Asia, South America, etc. Have
students research statistics and trends about drug use
in their assigned country. Compare the findings as a
class and discuss.
Question:
These teens talk about how they and their friends never
considered the risks involved in doing drugs. Based on
their comments and your own experiences, why do you
think this happens?
(drugs cause you to be focused on the moment and unable
to think about what will happen tomorrow, let alone
months or years in the future; kids don’t get the right
information; there are many existing myths and
misconceptions that get passed by word of mouth; if
people see one person use drugs without it seeming to
affect them, they might think drug experimentation is
harmless and won’t lead to addiction)
SECTION TWO
PHYSICAL EFFECTS
Question:
Art Alexakis from Everclear admits that he used drugs
from the time he was 8 until the age of 23. How will
his drug abuse stay with him forever?
(he gets panic attacks and severe depression, part of a
permanent chemical imbalance caused by his former drug
abuse)
Related Activity:
Art makes the point that you need help if you are
addicted and want to kick the habit—you simply can’t do
it alone. Have students research where teens can get
help in your community, as well as what to do if a
friend is addicted. Compile a handbook of resources and
guidelines to be distributed and available at the
school and other local facilities, such as the library
or youth centers.
Question:
Dr. Alan Leshner from the National Institute on Drug
Abuse shows CAT scans that demonstrate how cocaine can
produce negative feelings and emotions after you’ve
stopped it. Based on the pictures he shows, why does
this happen?
(drugs reduce brain activity)
Related Activity:
(on Marijuana)
Explain to students that marijuana use affects the five
senses, heart rate, emotions, memory, and judgement.
Ask students to randomly select (for example, draw from
a hat) the name of an occupation, and ask them to act
out for the class how marijuana use might specifically
affect the performance of a person in the occupation.
For example, an airline pilot, professional basketball
player, doctor, truck driver, etc.
Question:
How have Beth and Melissa’s lives been affected
physically by their use?
(they can’t remember large stretches of time; they
suffer from depression and are in therapy)
Question:
Dr. Leshner talks about the brain getting "hijacked" by
drugs. Based on what Donna at the Treatment Center
describes, do you think that’s an accurate description
of what happened to her?
(she talks about acting only on impulses, that your
brain tells you that it’s not functioning without drugs
and you must get some to feel better)
Question:
Is addiction a mental thing or a physical thing?
(physical)
Are people who are addicted to drugs just short on
"will power" or "too weak" to control their urges?
(no; the craving for a drug becomes a physical need,
much like the body’s need for food and water; because
the drugs actually change the way your brain functions)
Question:
How did Donna’s addiction affect the rest of her body
as she went through withdrawal?
(she felt sharp pains throughout her body; she’d be
cold one minute, then break into a sweat)
Question:
According to Dr. Leshner, does everyone have the same
physical risk of getting addicted to drugs?
(no; some people are more vulnerable to it, but you’ll
never know if you will get addicted more quickly than
others)
Further Discussion:
Why do people feel like they have to "experiment" with
drugs? Are there other things you can "experiment" with
to feel like you’ve had an adventure, that you’ve
accomplished something, that you’ve met a challenge and
really "lived"? Name something you’ve done in your life
that you consider an "experiment". Are you glad you
tried it?
Question:
Why do some people suffer from depression after drug
use?
(if you’re at risk for depression because of your genes
or life situation, some drugs can push you into serious
clinical depression)
Question:
Nora, the young woman in the hospital found out that
she’s someone who is at risk. How did she discover
that? How is she still feeling the effects of her
experimentation with LSD?
(after just two uses, she suffered a disorienting
"flashback"; got very depressed and had low energy,
experienced mood swings; couldn’t communicate; had to
be admitted to a hospital; will be on medication for
months)
Question:
What is an LSD flashback? Why might a flashback be
dangerous?
(Acid gets stored in fat tissue, and since there are
fat tissues in your brain, the LSD can sit there for a
long time and leak out unexpectedly, causing
hallucinations at any random time; flashbacks may occur
while driving or other circumstances that may put you
in danger)
Further Discussion:
Many people think that a flashback is like an extra
"surprise trip" and something to look forward to, but
in reality can be embarrassing, traumatic, and can
cause psychological problems. What are some other myths
that surround drug use?
Related Activity:
As a class, put together a list of commonly assumed or
often-heard facts relating to drug use that might be
misconceptions. Then divide the class into teams and
assign each team one or more "myths" to research as
true or false. Have teams report their findings to the
class.
Related Activity:
Based on the teams created for the five categories of
substances in the previous section, ask each group of
students to research their assigned category and create
a "Did You Know" poster for each type of drug.
Encourage students to discover some "surprising"
information to include on their poster, and ask that
each poster contain a minimum of 10 new and/or unusual
facts. Students can use the library, Internet, or other
resources. Display the finished posters in school
and/or hand out as flyers.
SECTION THREE
SOCIAL CONSEQUENCES
Question:
What is Boot Camp like for David, John, and Donald?
(no freedom; can’t go outside at will; have to ask for
permission to do everything; have to keep everything
clean; have to wake up early; have to learn discipline)
Question:
David says that even though he’s serving time for
criminal possession of crack and marijuana, originally
he never thought he’d be a crack user and actually
looked down on people who did. What do you think could
have led him to where he is now?
(he probably tried it once or twice as
"experimentation"; he got addicted; before he knew it
he was using regularly)
Question:
David talks about what happened one night after he and
his friends were out drinking, and he thought he was
okay to drive home. Does he feel that drinking too much
that night was what led him directly to jail?
(no; the drinking led to bad choices; he chose to drive
while drunk; got into a car accident that killed his
friends but left him uninjured)
Further Discussion:
How else is David going to be "paying" for his mistake
for the rest of his life? Do you think that guilt and
grief over injuring or killing someone else is worse
than spending time in prison? Do you think that people
consider their responsibilities to others when engaging
in dangerous activities?
Question:
Donald used to get drugs on credit, and John used to
sleep late and party all day. How did this behavior
ultimately get them into trouble and change their
lives?
(Donald didn’t pay back his drugs right away and the
dealers threatened his life; John would get violent and
arrested again and again, got probation but violated it
when he failed a drug test)
Related Activity:
Through a local police department or juvenile detention
center, arrange to have a young person who is serving
time for a drug-related crime speak to the class about
his or her experiences. Ask a police officer to explain
the legal consequences of being caught with drugs.
Question:
Dr. Leshner says that heroin slows down the way your
mind is processing information, and Donna talks about
how sniffing heroin kept her from being able to think,
feel, or react to her surroundings normally.
Ultimately, how did this change her life?
(Donna was raped; she felt it happening but was unable
to do anything about it; she still doesn’t know who the
rapist was)
Further Discussion:
The fact that Donna was raped is an example of how the
lack of control that comes with drug use can lead to
many unseen dangers and traumas. What are some other
situations that could take place when drug use is
involved—situations that many people don’t usually
consider?
Question:
The two suburban girls, Beth and Melissa, never had to
serve time in a boot camp, but how have their lives
been changed forever?
(Melissa ruined her reputation; she had to have her
mother supervise her attendance at a school dance; Beth
suffers from chronic depression; has family problems;
has to repeat classes and won’t graduate on time)
Question:
What hard lessons have the boys at the Boot Camp
learned from their experiences?
(they lost years when they could have been doing
something important and positive; the price of getting
high can mean losing everything you have; they finally
learned to stop making bad choices)
Further Discussion:
What could have been done differently in these young
people’s lives to keep them from ending up serving time
or in rehab? What do you think works when it comes to
teaching young people the dangers of drug use and
helping them make better choices?
Related Activity:
Pair students up and ask them to role-play a situation
where one student is a parent, teacher, or counselor.
Give the role-playing student five minutes (or less) to
give the other essential information and advice that
might help them choose to abstain from drug use.
SECTION FOUR
STRAIGHT EDGE
Please note: This segment was included on the broadcast
special but may not be on the distributed video.
Question:
What is Straight Edge?
(a growing popular movement/counterculture; not an
organization or "cult"; it’s been around since 1981,
started by a hardcore music group called Minor Threat;
it’s a philosophy that promotes abstaining from drugs,
alcohol, and smoking)
Further Discussion:
The Straight Edge teens talk about being "different"
and "veering off from the crowd" because of their
attitudes about smoking, drinking, and drug use. In
what situations would you find it preferable to be
different from everyone else?
Questions:
These teens say that they are "rebelling". What or who
are they rebelling against?
(they are rebelling against the myths that it’s "cool"
to smoke, drink, or use drugs; their music and dress
are alternative so they are still rebelling against
some conventions)
Question:
Can you be "Straight Edge" if you don’t like hardcore
music or don’t want to dress the way these kids do?
(yes; all these kids say that the Straight Edge
philosophy is something inside you; focus on who you
are and what you feel, rather than labeling yourself)
Further Discussion:
Is Straight Edge becoming a common term to describe
teens who don’t use drugs? Is it something you can say
if you’re offered drugs?
Question:
How are the teens on the show going to avoid drug use
in the future?
(they won’t spend time with friends who still use
drugs; they won’t put themselves in situations where
drug use is expected; they’ll make an active effort to
make the right choices)
REFERENCE GUIDE
MARIJUANA (also Hash)
Short-term effects:
* Sleepiness
* Difficult keeping track of time, impaired or
reduced short-term memory
* Reduced ability to perform tasks requiring
concentration and coordination, such as driving a car
* Increased heart rate
* Potential cardiac dangers for those with preexisting heart disease
* Bloodshot eyes
* Dry mouth and throat
* Decreased social inhibitions
* Paranoia, hallucinations
Long-term effects:
* Enhanced cancer risk
* Decrease in testosterone levels for men; also
lower sperm counts and difficulty having children
* Increase in testosterone levels for women; also
increased risk of infertility
* Diminished or extinguished sexual pleasure
* Psychological dependence requiring more of the
drug to get the same effect
STIMULANTS
(Cocaine, Crack Cocaine)
Physical risks:
* Increases in blood pressure, heart rate,
breathing rate, and body temperature
* Heart attacks, strokes, and respiratory failure
* Hepatitis or AIDS through shared needles
* Brain seizures
* Reduction of the body’s ability to resist and
combat infection
Psychological risks:
* Violent, erratic, or paranoid behavior
* Hallucinations and "coke bugs" – a sensation of
imaginary insects crawling over the skin
* Confusion, anxiety and depression, loss of
interest in food or sex
* "cocaine psychosis" – losing touch with reality,
loss of interest in friends, family, sports, hobbies,
and other activities
Methamphetamine (Crystal Meth), Amphetamines (Speed)
Effects:
* increased heart rate and blood pressure
* increased wakefulness; insomnia
* increased physical activity
* decreased appetite
* respiratory problems
* extreme anorexia
* hyperthermia, convulsions, and cardiovascular
problems, which can lead to death
* irritability, confusion, tremors
* anxiety, paranoia, or violent behavior
* can cause irreversible damage to blood vessels in
the brain, producing strokes
HALLUCINOGENS
PCP (Angel Dust); LSD (Acid); Mescaline; Peyote;
Mushrooms
Physical risks:
* increased heart rate and blood pressure
* sleeplessness and tremors
* lack of muscular coordination
* sparse, mangled and incoherent speech
* decreased awareness of touch and pain that can
result in self-inflicted injuries
* convulsions
* coma; heart and lung failure
Psychological risks:
*
*
*
*
*
*
a sense of distance and estrangement
depression, anxiety, and paranoia
violent behavior
confusion, suspicion, and loss of control
flashbacks
behavior similar to schizophrenic psychosis
* catatonic syndrome whereby the user becomes mute,
lethargic, disoriented, and makes meaningless
repetitive movements
INHALANTS
Chemicals found in consumer products such as aerosols
and cleaning solvents.
Single-time use risks:
* sudden death by asphyxia, suffocation, choking on
vomit, careless behaviors in dangerous setting, cardiac
arrest
* visual hallucinations and severe mood swings
* numbness and tingling of the hands and feet
Short-term effects:
*
*
*
*
Heart palpitations
Breathing difficulty
Dizziness
headaches
Prolonged use risks:
*
*
*
*
*
*
*
*
*
*
*
Headache, muscle weakness, abdominal pain
Decrease or loss of sense of smell
Nausea and nosebleeds
Hepatitis
Violent behaviors
Irregular heartbeat
Liver, lung, and kidney impairment
Irreversible brain damage
Nervous system damage
Dangerous chemical imbalances in the body
Involuntary passing of urine and feces
RESOURCES
Organizations
National Institute on Drug Abuse
1-888-644-6432
1-888-NIH-NIDA (INFOFAX)
* http://www.nida.nih.gov
National Clearinghouse for Alcohol and Drug Information
1-800-729-6686 or 1-800-487-4889 (TDD)
*http://www.health.org
Office of Science Education
National Institutes of Health
301-402-2828
Society for Neuroscience
Education Program
202-462-6688
*http://www.sfn.org
On the World Wide Web
Partnership for a Drug Free America
http://www.drugfreeamerica.org
Resources for parents and teens, information about
current drugs street names and effects. Programs and
initiatives and other anti-drug programs.
http://www.drugfree/
National Institute on Drug Abuse
http://www.nida.nih.gov
Information on drugs of abuse, NIDA publications and
communications, agency events, and links to other drugrelated Internet sites.
National Clearinghouse for Alcohol and Drug Information
http://www.health.org
Information on publications, calendars, and related
Internet sites, as well as "For Kids Only" materials
including games, "really cool" links, and an "Are you
Curious? Ask US!" page that allows visitors to ask
experts questions about drugs.
Snapshots of Medicine and Health
National Center for Alcohol and Substance Abuse at
Columbia University (CASA)
http://www.casacolumbia.org
Provides information about recent publications, current
research, and online resource links.
The American Council for Drug Education
http://www.acde.org
Offers an extensive library of substance abuse
education and prevention information for kids and
adults, as well as a resource list of prevention
materials and videos.
Community Anti-Drug Coalitions of America (CADCA)
A meeting place for individuals and organizations
looking for information on current substance abuse
policy and public affairs.
http://www.cadca.org
Neuroscience for Kids
http://weber.u.washington.edu/~chudler/neurok.html
Answers to commonly-asked questions about the brain and
neuroscience, with information on brain and spinal cord
anatomy and physiology, neurotransmission, and the
effects of specific drugs on the nervous system.
Society for Neuroscience Brain Briefings
http://www.sfn.org/briefings
Access to Society for Neuroscience publications
covering topics such as addiction, opiate receptors,
and the effects of various drugs on the brain and
behavior.
MedWeb
http://www.gen.emory.edu/medweb
Extensive lists of Internet resources and links to
Internet sites devoted to neuroscience and drugs of
abuse.
Wisconsin/Michigan State Brain Collections
http://www.neurophys.wisc.edu
A visual tour of photos and brain sections of mammalian
brains, with related information on brain anatomy,
brain functions, and neuroanatomy.
Straight Edge
Http://www.straight-edge.com
Http://www.straight-edge.net
Publications
Brain Facts: A primer on the
Brain and Nervous System,
Society for Neuroscience, 1993.
How your Brain Works, by
Anne D. Novitt-Morino, M.D., ZiffDavis Press, 1995.
Explorations in Neuroscience
for Children and Adults, Baylor
College of Medicine, WOW
Publications, Inc., 1997.
For information about In the Mix, including show
descriptions and schedules, visit our home on the World
Wide Web at www.pbs.org/mix, or e-mail us at
InTheMix@pbs.org.
A special Altered States section on our website serves
as an online companion to this program, featuring.
Drug Abuse: Altered States carries one-year off-air
taping rights and performance rights. Check your local
PBS listings for airtimes.
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c 1999 In the Mix. Drug Abuse: Altered States is a
production of Castle Works Inc. In the Mix was created
by WNYC Radio. This special was funded by the
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