Cannabis, sedatives and stimulants

Alcohol and opioids get most of the attention, but other substances can also cause serious problems. This page covers three groups: cannabis (also called marijuana), sedatives (calming and sleeping pills), and stimulants (drugs that speed up the body, such as cocaine and methamphetamine).

Some of these are legal, and some are medicines a doctor prescribed. That does not make them risk-free. A person with a substance use disorder can have a problem with any of them, and help works for all of them. For the big picture, see substance use and addiction.

Cannabis

Cannabis comes from the cannabis plant. It has more than 100 natural compounds. THC is the one that causes the "high." CBD does not cause a high by itself.⁴ People smoke it, vape it, eat it in food or drinks, or inhale concentrated oils (called dabbing).⁴

In 2024, about 64 million people age 12 and older in the U.S. (22%) used cannabis in the past year.¹ Use among adults 65 and older is lower but real: about 7 in 100 used it in the past month.²

Stronger products and edibles

Many products today are much stronger than the cannabis of past decades. Oils and concentrates are very high in THC. They can also contain additives or contaminants that may be harmful.⁴

Edibles are tricky. Their effects can come late and are hard to predict. That can lead a person to take too much. Edibles and other high-THC products raise the risk of poisoning.⁴ Keep them locked away from children and from people with dementia, who may mistake them for ordinary treats.

Effects and health risks

Cannabis can cause relaxation, but also anxiety, panic or confusion in some people. Over time, health risks can include:

• Cannabis use disorder. About 3 in 10 people who use cannabis have this disorder, and the risk is higher for people who start young or use often.³ Higher-strength products are linked to a greater risk.²
• Psychosis. Psychosis means seeing, hearing or believing things that are not real. Cannabis-related psychosis is more likely in people who started young, use often, use high-strength products, or have a personal or family history of psychosis.² Researchers do not yet fully understand how cannabis and conditions like schizophrenia are linked.³ If you or a loved one has had psychosis, it is safest to avoid cannabis. See schizophrenia and psychosis.
• Cannabis hyperemesis syndrome. This is a pattern of repeated nausea, vomiting and stomach pain in people who use cannabis heavily over a long time.²
• Unsafe driving. Cannabis can slow reaction time, affect coordination and distort how you see things. Mixing it with alcohol adds to the impairment.³

Cannabis in later life

Older adults may turn to cannabis for pain, sleep, grief or loneliness. SAMHSA's 2026 advisory lists car crashes, falls, heart events and lung effects as harms in later life. Taking many medicines also raises the chance of drug interactions.² If you use cannabis for a health reason, tell your doctor and pharmacist, just as you would for any other medicine.

Cannabis withdrawal and treatment

After heavy, long-term use, stopping can bring irritability, anxiety, restless sleep and low mood.² Some people keep using cannabis to avoid these feelings.² Talk with a doctor if your mood drops very low, and call or text 988 if you have thoughts of suicide.

No medicine is approved by the FDA for cannabis use disorder. Talk therapies work best, especially when combined: cognitive behavioral therapy (CBT, which helps you change unhelpful thoughts and habits), motivational enhancement therapy (a short, supportive talk about your own reasons to change), and contingency management (small rewards for meeting goals). Moderate evidence Family-based therapy is advised for teens.²

Sedatives and sleeping pills

Sedatives slow the brain and body. This group includes benzodiazepines such as alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and diazepam (Valium). They are prescribed for anxiety, panic, seizures and sleep.⁵ It also includes "Z-drugs" such as zolpidem (Ambien) and eszopiclone (Lunesta), which are used for insomnia.⁶

Taken for a short time and exactly as directed, these medicines can be useful. The risks grow with longer use. In 2024, about 4.6 million people in the U.S. age 12 and older misused a prescription tranquilizer or sedative.¹ "Misuse" means taking it in a way the doctor did not direct, such as extra pills, or someone else's pills.

Dependence can happen even when you follow directions

The FDA warns that benzodiazepines can lead to misuse, abuse and addiction, even at the doses prescribed. Physical dependence (when the body adjusts to the drug and reacts when it is lowered) can start after several days to weeks of steady use.⁵

Mixing sedatives with other substances

Benzodiazepines taken with opioids or other drugs that slow the body can cause very slow breathing, coma and death.⁵ Alcohol adds to the risk too. If you take any sedative, tell every doctor and pharmacist about all your medicines, including pain pills. Read more at opioids and overdose.

Sleeping pills and the Z-drugs

Zolpidem, eszopiclone and zaleplon carry a boxed warning, the FDA's strongest kind. They can cause "complex sleep behaviors," such as sleepwalking or driving while not fully awake, sometimes with no memory of it. This can happen even after one dose. If it happens, stop the medicine and contact your doctor right away.⁶

For long-lasting insomnia, the American College of Physicians advises starting with cognitive behavioral therapy for insomnia (CBT-I). Strong evidence Medicine can be considered if that is not enough, with a plan to use it only short term. The guideline says there is not enough evidence on the balance of benefits and harms of long-term use.⁷ You can learn the steps in our CBT-I course and read about sleep medicines.

Sedatives in older adults

In studies, sleeping pills are linked to fractures, injuries and, more rarely, dementia, which matter more in later life.⁷ Our page on alcohol, medicines and older adults covers this in more detail. If you or a parent have taken these pills for years, do not stop on your own. Ask the doctor about a slow, safe step-down plan.

Stimulants

Stimulants speed up the brain and body. They raise alertness and energy. In 2024, about 9 million people in the U.S. age 12 and older misused a stimulant, counting cocaine, methamphetamine and prescription stimulants.¹

Cocaine

Cocaine is a powder. Crack is a smokable rock form. Its effects begin almost at once and fade within minutes to an hour. It can cause restlessness, anxiety, paranoia, heart attack, stroke and seizures.⁹ There is no specific antidote for a cocaine overdose, so treatment focuses on the problems it causes.⁹ Stopping after heavy use can bring depression, tiredness, strong hunger, poor sleep and slowed thinking.⁹

Methamphetamine

Methamphetamine ("meth") can bring a rush of good feeling, then restlessness, anger or fear. It can lead to addiction quickly. Health problems include a dangerously high body temperature, severe itching, tooth damage and trouble with thinking and emotions.¹⁰

Misuse of ADHD medicines

Prescription stimulants such as methylphenidate and amphetamine salts are an important treatment for many people with ADHD when taken as directed. See ADHD medicines. But the FDA warns that misuse can lead to addiction, overdose and death, especially with snorting or injecting, or when mixed with alcohol or other drugs.¹¹

To keep people safe, the FDA advises:¹¹

• Take your medicine only as prescribed, and never share it.
• Store it securely, away from children, visitors and anyone who might misuse it.
• Dispose of leftovers at a drug take-back site.
• Do not buy "Adderall" or similar pills from dealers or illegal websites. Counterfeit pills may contain fentanyl or methamphetamine.

Overdose: why naloxone still matters

Stimulant overdoses are common. A federal report found that from January 2021 to June 2024, about 6 in 10 overdose deaths in the U.S. involved a stimulant. About 7 in 10 of those also involved an opioid.⁸ Counterfeit pills may also contain fentanyl.¹¹

Naloxone does not reverse the effects of stimulants. But it can save a life if an opioid is also present.⁸ Keep it at home, learn how to use it, and call 911 whatever the person took. Signs of a stimulant overdose include seizures, a fast or uneven heartbeat, confusion and tremors.¹¹ Stimulant deaths without opioids were more often among people with heart disease.⁸

Treatment for stimulant use

No medicine is approved by the FDA for stimulant use disorder as of the 2025 federal report. The best-supported treatment is behavioral. In particular, contingency management (small rewards for staying drug-free) is recommended. Moderate evidence Cocaine use disorder is also treated with behavioral therapies.^8,9 Read more at treatment and recovery.

Common questions

When to get help

• Call 911 for a seizure, chest pain, trouble breathing, a person who cannot be woken, signs of overdose, or sudden confusion or severe agitation.
• Call or text 988 for thoughts of suicide, or if someone is in a mental health crisis.
• Talk with your doctor soon if you cannot cut down, if a sedative stops working, or if cannabis or a stimulant is hurting your sleep, mood, money or relationships. Read the signs of a substance use problem.
• Call SAMHSA's National Helpline at 1-800-662-4357. It is free, private, open 24/7, and in English and Spanish. It helps you find treatment.¹²

If someone you love is struggling, see helping a family member. Try to speak kindly and without blame. Shame rarely helps anyone change.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.