What is Methadone?

Methadone is a long-acting synthetic opioid used primarily in medication-assisted treatment (MAT) for opioid use disorder and, less commonly, as a pain-management medication. It works by binding to the same receptors as heroin and other opioids but does so in a slower, controlled way that reduces withdrawal symptoms and cravings without producing the intense euphoria associated with illicit opioids. Medical methadone is dispensed in tightly regulated clinical settings, often as a liquid but also in tablet or wafer form.

Illicitly obtained methadone may appear as pills or liquid diverted from treatment programs or prescriptions. When misused, it is taken orally, though some may attempt to inject it. Recreational use is risky because methadone’s long half-life can lead to delayed overdose, respiratory depression, and dangerous accumulation in the body. Its potency, duration, and interaction with other depressants (alcohol, benzodiazepines) significantly increase the risk of fatal outcomes.

In point-of-care toxicology programs, methadone is monitored because it is both a legitimate treatment drug and a substance with high misuse potential. Differentiating prescribed use from non-medical use is essential in clinical, workplace, and criminal-justice settings.

Effects:

• Relief of opioid withdrawal symptoms

• Reduction of cravings for heroin or other opioids

• Sedation or drowsiness

• Slowed breathing

• Constipation

• Nausea or vomiting

• Impaired coordination or slowed reaction time

• Sweating or dizziness

• Risk of overdose, especially when mixed with depressants

• Potential for dependence with long-term use

What are Cannabinoids?

Cannabinoids are a group of chemical compounds naturally found in the cannabis plant. Among the most well-known are THC (tetrahydrocannabinol), Delta-9 THC, and CBD (cannabidiol). THC and Delta-9 are psychoactive, meaning they produce the “high” associated with marijuana use, while CBD is non-intoxicating and used primarily for therapeutic or wellness purposes. These substances interact with the body’s endocannabinoid system, affecting mood, perception, appetite, and pain signaling.

Cannabinoids appear in many forms depending on the product:

• Plant material: dried green/brown flower/bud for smoking or vaporizing

• Concentrates: oils, waxes, shatter, resins used in vape cartridges or dab rigs

• Edibles: gummies, baked goods, beverages

• Tinctures and oils: droppers taken orally or sublingually

• Topicals: lotions, balms (typically CBD-focused)

• Capsules or softgels: regulated CBD or medicinal cannabis products

THC/Delta-9 are typically inhaled or consumed orally. CBD products are widely available in non-intoxicating formulations and often marketed for anxiety, pain, or sleep support.

Medicinal Use: Certain forms of THC and CBD are legally prescribed or sold through regulated medical marijuana programs for conditions such as chronic pain, nausea, seizures, and muscle spasms. FDA-approved CBD medication (Epidiolex) is used for rare seizure disorders.

Recreational Use: THC and Delta-9 are widely used recreationally for their euphoric, relaxing, or sensory-enhancing effects. Potency varies significantly depending on strain, extraction method, and product type.

Effects:

• Altered perception and changes in sensory awareness

• Relaxation and reduced anxiety (varies by user)

• Increased appetite

• Impaired short-term memory

• Slowed reaction time and reduced coordination

• Euphoria or enhanced mood

• Dry mouth and red eyes

• Potential anxiety or paranoia at higher doses

• Impaired decision-making

• Sedation or drowsiness (especially with high-THC or some CBD formulations)

What is Amphetamine?

LSD is a powerful synthetic hallucinogen that alters perception, mood, and cognition by stimulating serotonin receptors in the brain. It is known for producing intense sensory distortions, changes in thought patterns, and vivid visual hallucinations. LSD has no accepted medical use in the United States and is classified as a Schedule I controlled substance, indicating high potential for abuse and no approved therapeutic application.

LSD is typically sold in liquid form, which is then distributed onto blotter paper—small squares decorated with colorful designs. It can also appear as tablets (“microdots”), gelatin squares (“window panes”), or as a pure liquid in small vials. Users usually place blotter paper under the tongue or swallow it, though some ingest tablets or liquid directly. Its effects can last 8–12 hours.

Effects:

• Visual hallucinations and distorted perceptions

• Altered sense of time (time speeding up or slowing down)

• Intensified colors, sounds, and sensory experiences

• Emotional swings ranging from euphoria to anxiety

• Impaired judgment and reduced ability to assess risk

• Increased heart rate and blood pressure

• Dilated pupils

• Sweating or chills

• Difficulty concentrating or communicating

• Possibility of panic reactions or “bad trips”

What is Ketamine?

Ketamine is a dissociative anesthetic that affects the central nervous system by blocking NMDA receptors, producing pain relief, sedation, and a sense of detachment from one’s body or surroundings. Medically, ketamine is FDA-approved primarily as an anesthetic in surgical and emergency settings and is also used in controlled clinical environments for treatment-resistant depression. In these cases, it is administered as a clear injectable liquid or, in the case of esketamine (a related compound), as a nasal spray.

Recreational ketamine typically appears as a white or off-white powder, crystals (“K-crystals”), or diverted liquid intended for injection. It is commonly snorted, but may also be swallowed, injected, or placed in beverages. Recreational use induces dissociation, hallucinations, impaired coordination, and memory disruption, and at high doses can result in the “K-hole,” a state of extreme disconnection and immobilization. Illicit ketamine use carries significant risks including bladder damage, cognitive impairment, dependence, and dangerous interactions with alcohol or other depressants.

Effects:

• Dissociation or feeling detached from one’s body

• Hallucinations or altered perception

• Reduced sensitivity to pain

• Impaired motor coordination

• Confusion or memory loss

• Elevated heart rate and blood pressure

• Nausea or vomiting

• Slowed breathing at high doses

• Risk of dependence with repeated use

• Long-term bladder issues (“ketamine bladder”)

What is Heroin?

Heroin is a powerful illegal opioid derived from morphine and sold in several forms, including powder and tar. Because it enters the brain rapidly, heroin produces a strong euphoric “rush,” followed by deep relaxation and sedation. The absence of any medical use and the high risk of addiction classify heroin as a Schedule I substance under U.S. federal law.

Recreational use involves injecting, snorting, or smoking the drug, each carrying significant health dangers—including infection, collapsed veins, severe withdrawal, and a high likelihood of overdose. The increasing prevalence of fentanyl-laced heroin has further elevated overdose deaths, as users often have no awareness of the added potency. Long-term heroin use alters brain chemistry, leading to compulsive drug-seeking behavior and profound physical dependence.

In drug-monitoring environments, heroin presents unique challenges because its metabolites, particularly 6-monoacetylmorphine (6-MAM), have a short detection window. Nevertheless, its legal status and public health impact ensure that heroin remains a core target in nearly all modern toxicology programs.

Effects:

• Intense euphoria followed by heavy sedation

• Warm, flushed skin and slowed breathing

• “Nodding off” — alternating drowsiness and wakefulness

• Severe itching

• Nausea and vomiting

• Constricted (“pinpoint”) pupils

• Slowed heart rate and decreased blood pressure

• High risk of overdose and respiratory arrest

• Rapid development of tolerance and dependence

• Long-term cognitive decline and impaired decision-making