Eating Disorders

A cancer diagnosis can leave you feeling helpless and out of control and without even thinking, you may look for ways to reclaim control of your life. Some cancer patients may turn to food as a source of control, especially if they have suffered from eating disorders in the past.

Eating disorders are tricky because it can be tough to recognize that you aren’t eating right. It can often be easier to chalk up your way of eating or weight loss to “dieting” or just not feeling hungry.

The specific diet and nutrition guidelines from the Cancer Institute team are important to keep your body and immune system as healthy as possible before, during and after treatment.

Why can’t I take a friend’s/family member’s prescription medication?

It is never safe to take a friend or family member’s prescription medication. When doctors prescribe medicines to their patients, they take many factors into account, including the patient’s age, weight, health history, etc. Even though a friend or family member may have a similar diagnosis, health history, age, or weight, it is still not safe to consume his or her medications, especially now that you are undergoing treatment.

Recreational use and addiction to prescription medications can be boiled down to three different categories:

  • Opioids. These are for pain relief. They include morphine, codeine, OxyContin, Demerol, and Vicodin.
  • Tranquilizers. These are for anxiety and sleep disorders. They include Xanax and Valium.
  • Stimulants. These are for narcolepsy and attention-deficit/hyperactivity disorder. They include Adderal, Dexedrine, and Ritalin.

Some users get these drugs from friends or family who have legitimate prescriptions from their physicians or buy purchasing them from other sources.

People who take prescription drugs without their doctors’ approval face many risks:

  • They don’t have information about dosage, side effects, or other risks of use.
  • The medication may interact with another drug they take.
  • Taking the medication or stimulant may be dangerous because of a condition they have, such as asthma or heart disease.
  • Many of the abused drugs, including painkillers such as OxyContin and Vicodin, are potentially addictive.
  • There’s no guarantee drugs purchased on the Internet are pure, of the stated strength, or manufactured with any quality control.
  • Users, especially teenagers and college students, may not realize the dangers of abusing painkillers and drugs for mental illness. For instance, a student who will take OxyContin or Ritalin may never take a street drug, such as cocaine or heroin.

Signs of addiction include loss of control over taking a medication, hiding pills, obsessively counting them, and finding ways to get more of a medication by making unnecessary emergency room or doctor visits. Other symptoms include taking a drug or medication more often than directed, taking higher doses than instructed, taking it with other drugs or alcohol or, as is often the case with OxyContin, crushing and snorting the pill instead of swallowing it.

Is it safe to experiment with drugs and medicines I can buy at the store?

Just because a drug or medicine is sold at your local pharmacy or supermarket, that doesn’t mean that it is safe for you to use while you are being treated for cancer. Many over-the-counter medicines can interact with cancer-fighting medications. You should always talk to your doctor or nurse before taking any sort of medication.

There is a big misunderstanding among teenagers and adults that it is safer to “abuse” medicines sold at stores than those that are illegal. Although these medicines are safer in that they are made in a controlled, safe environment, not following their dosing instructions or abusing them can have similar outcomes to those of illegal drugs and alcohol.

Cough medicine is a common household medication that is abused by teenagers. The common ingredient in many cough and cold remedies, Dextromethorphan (DXM), (a cough suppressant) is found in at least 70 over-the-counter products, including Alka-Seltzer Plus Cold & Cough Medicine, Coricidin Cough and Cold Tablets, Dimetapp DM, Robitussin cough products, Triaminic cough syrups, Tylenol Cold products, and Vicks NyQuil LiquiCaps.

Used as directed on the label, DXM products are effective at suppressing cough and are safe to use. DXM was approved by the U.S. Food and Drug Administration in 1958 and has no serious side effects when used in small doses—typically, 10 to 20 mg doses every four to six hours, or 30 mg every six to eight hours.

When taken in vastly larger quantities, however, DXM produces a distorted awareness, altered time perception and hallucinations. And if taken along with other drugs—even other over-the-counter medications like acetaminophen—the combination can cause liver damage, heart attack, stroke or death.

You may be surprised to know that the effects of DXM have been compared to PCP (phencyclidine) and the anesthetic ketamine. All three are called dissociative substances: At high doses, they give the abuser a feeling of not being in one’s own body. DXM also produces hallucinations. The effects can last up to six hours, but that can vary, depending on how much DXM is taken and what other drugs or chemicals are taken along with DXM. Other effects of DXM include:

  • Hot flashes
  • Nausea, vomiting and dizziness
  • Lack of coordination
  • Panic attack or seizures
  • Impaired judgment
  • Sweating
  • Lethargy or drowsiness—or hyperactivity
  • Slurred speech
  • High blood pressure
  • Rapid eye movement
  • Rash
  • Racing or pounding heartbeat
  • Paranoia and hallucinations
  • Feeling of floating

Regular abuse of DXM at high doses can lead to toxic psychosis, a toxic condition where the person loses contact with reality and is in a perpetual confused state.

Why should I avoid heroin?

Heroin, horse, smack. By any name, it’s a killer and very addictive drug. It is processed from morphine, a naturally occurring substance found in the seed pod of certain varieties of poppy plants. It is a very addictive opiate. It is typically sold as a white or brownish powder or as the black sticky substance known on the streets as “black tar heroin.” Pure heroin is a white powder. Black-tar heroin is sold to dealers. It is prepared for use by freezing it until it gets hard, then grinding it into a dark-brown dust. Most street heroin varies in color from white to dark brown. The differences in color are because of impurities left from the manufacturing process or additives.

Although purer heroin is becoming more common, most street heroin is “cut” with other drugs such as antihistamines to mask stuffy noses, watery eyes and other signs of use, or with sugar, starch, powdered milk, quinine, strychnine or other poisons. The heroin is then packed into gelatin capsules or folded into small paper “bindles” and stuffed inside very small balloons, which are sold on the street for anywhere from $5 to $25 each. Because heroin abusers do not know the actual strength of the drug or what substance was used to cut it, they are at risk of overdose or death with every dose they take. Overdoses are common. It’s easy to take a dose that was not diluted enough, and too much heroin can suppress breathing or cause users to suffocate in their own vomit.

Users get high by snorting, smoking, or injecting the heroin. Intravenous injection gives a feeling of euphoria seven to eight seconds after injection; intramuscular injection takes five to eight minutes. Sniffing or snorting heroin produces peak effects within 10 to 15 minutes. The availability of high-purity heroin and the fear of infection by sharing needles have made snorting and smoking the drug more common.

In an addicted person, withdrawal occurs within a few hours after the last use. Symptoms of withdrawal can be drug craving, restlessness, muscle and bone pain and vomiting. Symptoms peak between 48 and 72 hours after the last dose and last about a week. They can be very intense, and the addicted person may return to using again if he or she doesn’t receive treatment for withdrawal symptoms and treatment intervention to help break the cycle of addiction.

Why should I avoid GHB?

GHB (gamma-hydroxybutyrate), is a fast-acting, central nervous system depressant once sold as a food supplement. It is now generally called a club drug because of its popularity among teens attending all-night dance parties (raves). GHB also is known as the club drug, Liquid Ecstasy, Grievous Bodily Harm, Georgia Home Boy, Liquid X, Liquid E, GBH, Soap, Scoop, Easy Lay, Salty Water, G-Riffick, Cherry Meth, Nature’s Quaalude, Zonked, Organic Quaalude, G, Jib, and Woman’s Viagra.

GHB was developed as an anesthetic in the 1960s, and subsequently sold in health food stores as a performance enhancer for bodybuilders. The Food and Drug Administration (FDA) banned GHB in 1990. On the street, GHB is used for its ability to produce a feeling of euphoria and hallucinations.

GHB can be made in secret labs with inexpensive ingredients. It’s usually sold as a liquid by the dose (a capful from a bottle or drops). In some cities, GHB is put into water guns and users buy it by the squirt. In other instances, candy, such as a lollipop, is dipped in GHB and sold.

GHB’s effects vary each time a person uses it, and it affects each person differently. In general, the effects begin 15 to 30 minutes after taking the drug and last three to six hours. Taking less than 1 gram produces a feeling of relaxation and reduced inhibitions. At 1 to 2 grams, heart rate and breathing slow down, and balance and coordination are affected. Other effects include vomiting, high blood pressure, mood swings, violent behavior, and vertigo. At higher doses, coordination and speech are strongly affected, and the person may drift into a coma-like sleep. Excessive use also can lead to irregular and depressed respiration, tremors and death.

GHB produces a feeling similar to alcohol, and its effects are intensified when combined with alcohol. The drug is addictive, and its withdrawal symptoms include sweating, insomnia, muscle cramping, tremors and anxiety.

It’s difficult to predict a person’s reaction to GHB; the purity and strength of doses vary. No tests are available to detect GHB use, and many emergency room doctors and nurses are unfamiliar with it, so many GHB incidents go undetected.

GHB is characterized as a “date-rape” drug because, being odorless, colorless and nearly tasteless (except for a slightly salty taste), it’s easily slipped into drinks. It can make a person feel less inhibited, increase sexual feelings and cause amnesia for the period of intoxications, making a charge of date rape harder to establish. The most dangerous feature of GHB is that an overdose can occur within minutes.

Why should I avoid LSD?

LSD (d-lysergic acid diethylamide), also called “acid,” is one of the most commonly used hallucinogens or psychedelic drugs. It affects a person’s perceptions, sensations, thinking, self-awareness and emotions.

In its pure state, LSD is a white, odorless powder. It’s usually sold in liquid form or as tablets or capsules. It’s often added to absorbent paper, such as blotter paper, and divided into small decorated squares, with each square being one dose. It’s very potent, with small amounts causing strong effects.

The effects, which are unpredictable, usually begin 30 to 90 minutes after taking the drug, are at their strongest three to five hours later and last for up to 12 hours.

Typical effects include intense sensory experiences (brighter colors, sharper sounds); mixing of the senses (colors are heard or sounds seen); distorted sense of time and space (minutes can seem as long as hours); and distorted body image (a person feels as if he or she is floating or being pulled down by gravity). Physical effects include dilated pupils, raised body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth and tremors.

While using LSD, or “tripping,” a person may experience strong feelings of anxiety or fear. The hallucinatory effects can be unpleasant, such as spiders crawling on the skin, or they can be so intense the person feels as though he or she is losing control.

Having a bad psychological reaction to LSD and similar drugs is common. The scary sensations may last a few minutes or several hours and be a little scary or terrifying. The user may feel panicked, confused, suspicious, anxious, and helpless. Sometimes taking LSD can reveal mental or emotional problems that were previously unknown to the user.

The negative feelings caused by LSD usually go away when the drug wears off. In some cases, however, users experience hallucinations, bizarre behavior and paranoia for a long time—ranging from several days to weeks or even months. In fact, days, weeks or even years after using the drug, some people have a repeat experience of the effects, which is called a flashback. The user may see intense colors and other hallucinations. The flashback can seem pleasant or produce severe feelings of anxiety. Flashbacks most often occur in people who used LSD over a long period or who have an underlying personality disorder. But even people who occasionally use LSD may have flashbacks. Heavy users sometimes develop signs of brain damage, such as impaired memory and attention span.

LSD’s effects vary from person to person, depending on many factors, including the person’s size, weight and health, how much of the drug is taken, and whether other drugs are taken with it. It’s dangerous to drive after using LSD because sensory and perceptual distortions may cause the user to “see” things that will cause erratic driving.

Why should I avoid cocaine or crack?

Cocaine is a powerfully addictive stimulant that directly affects the brain. It is generally sold on the street as a fine, white, crystalline powder derived from the dried leaves of the coca plant. Cocaine is also known as “coke,” “C,” “snow,” “flake” or “blow.” Street dealers usually dilute it with other substances such as cornstarch, talcum powder or sugar, with active drugs such as procaine (a chemically related local anesthetic) or with amphetamines. The powdered form dissolves in water and can be injected into a vein or snorted into the nose.

“Crack” is the street name given to the drug’s freebase form, which is processed to form a rock crystal that can be heated in a pipe and the vapors smoked. Crack cocaine resembles white or tan pellets. The term “crack” refers to the crackling sound heard when the mixture is smoked. Because crack is smoked, the user experiences a high in less than 10 seconds. The immediate effects and crack’s low cost have made it popular.

Cocaine use ranges from occasionally to compulsively. There is no safe way to use the drug. Any way it’s taken can lead to a heart attack or stroke that could be fatal.

Cocaine is a stimulant. Its effects appear almost immediately after a single dose and disappear within a few minutes or hours. The drug usually makes the user feel euphoric, energetic, talkative, and mentally alert. It also can temporarily decrease the need for food and sleep. The short-term effects also include increased heart rate and blood pressure, constricted blood vessels, increased temperature and dilated pupils. Cocaine also may cause bizarre, erratic and violent behavior.

The health consequences of long-term cocaine abuse include disturbances in heart rhythm, heart attacks, respiratory failure, strokes, seizures, convulsions, and coma. Cocaine abusers are at increased risk for contracting HIV/AIDS, not only due to the sharing of contaminated needles and other drug paraphernalia, but also as a result of engaging in risky sexual behaviors.


Why should I avoid methamphetamine?

Methamphetamine is an illegal drug that is highly addictive and has many names, including speed, meth, tweak, uppers or black beauties. The drug is taken in pill form, or snorted or injected in powdered form. Crystallized methamphetamine, a more powerful form of the drug, is smoked. Methamphetamine causes an immediate feeling of increased activity or a “rush” along with decreased appetite.

Many teens and adults become interested in methamphetamine because they want to get high or a burst of energy to get them through life. When the drug starts to wear off, however, abusers face two options:

  • Suffer through what can be a three-day bottoming-out period of irritability, listlessness, and headaches.
  • Take another dose and risk the beginning of addiction.

Addiction sets in quickly because of the way the drug is taken. Most methamphetamine users either smoke or inject the stimulant; both methods of ingestion rapidly bring on euphoria (extreme happiness). Addiction is closely tied to how quickly a user feels a drug’s effect.

The euphoria is followed by up to 12 hours of overexcited energy. Everything speeds up. Users don’t need sleep. They talk a lot, they have plenty of energy, and they don’t need to eat.

While all of this is going on, methamphetamine coaxes the body to work harder. The heart pumps faster and the metabolism speeds up. The brain’s balance of sedation and activity breaks down. This speed-up can lead to heart failure or aneurysms. (An aneurysm is a balloon-like bulge in an artery that can grow large and burst or dissect. A broken aneurysm causes dangerous bleeding inside the body. A dissection is a split in one or more layers of the artery wall. The split causes bleeding into and along the layers of the artery wall.)

Methamphetamine remains in the body for a long time. People who are chronic methamphetamine abusers can suffer long-term health effects. In particular, areas of the brain that control speed of muscle movement, verbal learning, emotions and memory can be damaged. Some of the damage may be reversed if a person quits abusing the drug, but recovery can take years. Methamphetamine abuse also increases the risk for stroke, and this damage can be irreversible.

I know I need to quit, but I’m not sure how. What should I do?

The first thing you must do in order to kick your drug habit is to admit you have a problem and surround yourself with others who can help you through the quitting process. Those important in your recovery include:

  • Your healthcare team
    It is important that your healthcare team knows about your drug use and what you are doing to quit. Your doctors and nurses can provide you with insight and encouragement while monitoring your cancer treatment and your overall health. Your healthcare team can also put you in touch with therapists or counselors who can help you through the quitting process and help you deal with the feelings or emotions that led to the drug use.
  • Parents and family
    It can be scary to admit to your parents and family that you have a drug problem. Your family wants you to be well and you need to tell them the things you need from them in order to get better—emotionally and otherwise. Your parents and family, along with your healthcare team, can also help you decided on the right substance abuse treatment plan.
  • Friends
    Friends can be a great source of support during tough times. While you are getting your cancer treatment and quitting drugs, it is important to lean on trustworthy friends who can really support you and encourage you to do the right things. Having the “right” friends around you may mean you might have to not speak to friends whom you did drugs with or may not encourage you to do the right thing.

When it comes to treatment programs for drug use, there are a lot of different types of programs. In most cases, programs are decided based on the type of substance used. In your case, the right program for you may also be determined by your cancer treatment. Detoxification (if needed, based on the substance abused) and long-term follow-up management are important features of successful treatment. Long-term follow-up management usually includes formalized group meetings and developmentally age-appropriate psychosocial support systems, as well as continued medical supervision. Individual and family psychotherapy are often recommended to address the developmental, psychosocial, and family issues that may have contributed to and resulted from the development of a substance abuse disorder.

I use drugs pretty regularly. Does that mean I’m addicted?

People who become addicted to drugs or alcohol typically go through predictable stages of abuse. There are five stages of drug and alcohol abuse that can help determine if you are becoming addicted.


Alcohol or drug use starts with experimentation. In this stage, the use is infrequent and the drug is usually obtained from and used with friends. Some people in this stage are able to stop using on their own. Others, however, who believe their substance abuse is solving their problems or making them feel better begin drinking more alcohol or taking more drugs. Once this happens, these people have moved on to “regular use.”


Regular use

This stage is characterized by use on a regular basis. The person may continue to use with friends or acquaintances or may use the substance while alone.


Problem or risky use

During this stage, the user begins to suffer legal, emotional, physical or social problems like bad grades, behavioral problems at home or at school, car crashes or driving tickets.



Someone who is dependent on drugs and/or alcohol will continue to use these substances regularly despite the harm their use is causing.

These are characteristics of dependence:

  • Regular use of alcohol or other drugs that leads to failure to fulfill major responsibilities related to family or school
  • Repeatedly drinking or using drugs in situations that are hazardous, such as driving
  • Development of increased tolerance to use, meaning more of the drug or alcohol is needed to have the same effect
  • Withdrawal symptoms if a person cuts back on use



At this stage, the drug use is compulsive and out of control. Addiction is a medical condition involving psychological and physical changes from repeated heavy use of alcohol, other drugs or both. People who are addicted typically have little to no control over their cravings for and use of alcohol or drugs.

Whether your drug use is at the experimentation phase or the addiction phase, you can get help and you can beat your drug habit. It is very important that you speak with your doctor or nurse about your options for quitting.