ASREC : Drug Facts to Share With Others
Accurate information about drugs and drug problems is necessary for the public to
get a true picture of what role drugs play in the health of the public.
The following facts are based upon the scientific wisdom of the Center's faculty
members. For most, there are scientific references available. For others, the
"facts" are the result of cumulative knowledge in the areas of addiction science and
pharmacology.
To find information on a specific topic, please
user our search function available on our home page.
Please note that the dates in parenthesis reflect the date in which the fact was first
published on this site.
*Copyright-protected. These sections cannot be printed or down-loaded without permission of the
Director: erickson.carl@mail.utexas.edu.
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300. A recent news story talked about a hurricane placing an "added
strain on people who may have been walking the line between moderate use
and addiction". What does this mean? The description suggests,
erroneously, that stress can increase a person's drug use from "moderate
use", leading them to use more and become addicted. We know that
increasing the amount of drug use does not lead to dependence. It would
be more accurate to state, "more drug use may lead to more drug-related
problems". Educate your local journalists! (September 26, 2005)
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299. Is direct-to-consumer advertising (advertisements in popular magazines) for prescription drugs ethical? Even for medications to treat chemical dependence,
such as Zyban and Campral, some researchers have questioned the propriety of enticing consumers to suggest drugs that they want prescribed by their physician. The
reason is that physicians should choose the best drug for a patient based upon effectiveness and anticipated side effects. Other experts say that patients have the
right to suggest to the physician medications with which they feel comfortable. (September 19, 2005)
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298. Could ecstasy reduce immune system function? Animal studies suggest that it might, but any anecdotal increase in infections in human ecstasy users are more
likely related to other factors, such as the venues where ecstasy is used, general health and nutritional status of the user, and cleanliness of the "manufacturing
equipment". More studies are needed to confirm any direct negative effect of the pure drug itself on immune system function. (September 12, 2005)
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297. Basic research in mice suggests that nicotine can increase the motivation to seek food. This goes against the commonly held belief that smoking reduces
appetite, which is the reason given by smokers for not wanting to stop. Also, some young women often take up smoking to hold down their weight. If these results
are confirmed, it suggests that smoking and nicotine might have opposite effects, or that the weight gain seen when some smokers quit may be due to a factor that is
not directly related to nicotine's effects on the brain's appetite center. (September 5, 2005)
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296. A new neuropeptide called orexin (hypocretin) seems to be involved
in the same brain reward pathway as chemicals such as dopamine, serotonin,
endorphin, and others. In animal studies, this chemical affects the
craving for morphine, cocaine, and food. It appears to act by influencing
communication between the lateral hypothalamus and the mesolimbic areas of
the nucleus accumbens and the ventral tegmental area. More research will
confirm or refute the importance of this chemical in potential new
treatments for chemical dependence. (August 29, 2005)
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295. Which is a worse drug problem in the United States - marijuana or methamphetamine? Federal emphasis is on prevention of marijuana use in adolescents, yet
emergency rooms are seeing more and more methamphetamine users. It is well-known that marijuana use is more prevalent than meth use, but the dangers associated with
meth use are much higher and more dramatic. To maintain perspective, drug use histories in the United States show us that most drugs have cycles in their use. We have
had, in the past, "epidemics" of LSD, cocaine, crack, methamphetamine (!), ecstasy, and many others. Exceptions to these epidemics are continued high use of alcohol,
marijuana, and cigarettes (nicotine). Bottom line: Do we want to have an epidemic-reactive policy or a policy against all drugs, regardless of their amount of danger
to the public? (August 22, 2005)
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294. Is the new treatment for opioid dependence, buprenorphine, better than methadone? Both methadone
and buprenorphine are powerful pain relievers, through their mechanism of activating opioid receptors
in the central nervous system. Buprenorphine, however, has a quality of limiting its own action,
making it more difficult to get "high" with increasing doses. Also, buprenorphine is a schedule 3
medication according to the Drug Enforcement Administration, compared to methadone's schedule 2
classification. This indicates that buprenorphine has less "abuse potential". (August 15, 2005)
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293. Recently, the quality of research and the integrity of scientists
have been questioned. For example, a report in the Journal of the
American Medical Association stated that 16 percent of published studies
were contradicted by later studies. In addition, another 16 percent of
studies saw their findings weakened by subsequent discoveries. Although
every professional field has its share of weak or shoddy workers (even
medicine and law!), most published scientific studies are peer reviewed
for quality control and represent merely steps along the path toward
truth. It is reasonable for studies to contradict each other, since
single findings are often not strong enough to form a solid, irrefutable
conclusion. However, many studies over time will provide a clearer
picture of whether a particular hypothesis has been proven or disproved.
(August 8, 2005)
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292. Can a single dose of methamphetamine harm the fetus? Some animal
studies suggest this is the case, especially when focusing on long-term
neurodevelopment. Some scientists suggest that methamphetamine can harm
DNA. The general consensus is that multiple doses of methamphetamine in
the mother may harm the fetus. But more research is needed to determine
whether the single dose studies in animals are replicable in humans, what
percentage of babies are affected (if at all), and who might be at highest
risk. In the meantime, pregnant women are best advised not to used
methamphetamine. (August 1, 2005)
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291. At this writing, we appear to have a methamphetamine epidemic in the U.S., with escalating emergency room and treatment admissions for
methamphetamine users. Pharmaceutical companies have had to reformulate over-the-counter cold remedies to remove pseudoephedrine, a key chemical in the
manufacture of meth. Pharmacies have had to take the remedies off the shelf and place them under controlled access. What's the problem? Meth is easy
to make, there is large profit in its manufacture and sale, it is highly euphoric, the penalties for its use and sale are not as great as for heroin and
other drugs, and it is the "in drug" for people to use. The downside? It is almost as dependence-producing as cocaine, more dependence-producing than
alcohol, it can fairly easily lead to overdose, and it may have long-lasting effects on brain function. (July 25, 2005)
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290. Is it possible that anti-Parkinson's drugs that increase dopamine
function could increase "addictive" behaviors (for example, gambling,
increased alcohol use, hypersexuality)? While this phenomenon sounds
reasonable, such drugs would have to increase dopamine in the mesolimbic
dopamine system in addition to the basal ganglia, the site of pathology of
Parkinsonism. More importantly, an increase in alcohol consumption,
gambling, sex, and other pleasurable behaviors would be expected when
Parkinson's patients feel better, so it would be critical to rule out such
a simple answer. (July 18, 2005)
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289. There are now reports that the sustained-release patches containing
fentanyl are being abused. Fentanyl is a painkiller used for relief of
chronic and post-operative pain. Everyone has heard of the abuse of
OxyContin, Vicodin, and other pain relievers. Is this a problem with the
drugs, or a problem with being able to control the behavior of
recreational drug users? Obviously, anytime a new medication becomes
available, especially one that is in a new form that provides more drug
when abused, people are going to try to use it. This is obviously a
societal problem, not a pharmacology problem. (July 11, 2005)
- 288. It is pretty clear that the reason people with schizophrenia smoke cigarettes is that they are self-medicating with nicotine. A recent study
showed that schizophrenics are up to three times more likely to smoke as non-schizophrenics. One of the reasons they smoke appears to be that nicotine
increases attention and short-term memory. This makes sense when we look at old research showing that nicotine can enhance memory in animals. (July 4, 2005)
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287. Does the use of one drug, such as marijuana, lead to the use of
other drugs, such as heroin, amphetamines, or cocaine? Some studies
suggest this happens, even in animals. But this phenomenon is difficult
to measure, especially in humans. Do people who use marijuana "progress"
to heroin because of the effects of marijuana on the brain? Or do people
who use marijuana have greater risk-taking behaviors that include the use
of "stronger" drugs? It will take awhile to sort out the cause-and-effect
aspects of this question. (June 27, 2005)
- 286. If it becomes more difficult to smoke and you provide free
nicotine patches to smokers in a given city, will overall smoking rates
decrease? The answer is "yes" in New York City, where they have done just
that. Almost 200,000 fewer people are puffing two years after the city
banned indoor smoking and raised cigarette taxes. Remember, however, that
not all smokers will respond to such measures, especially those smokers
who are pathologically dependent on nicotine. (June 20, 2005)
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285. The new era of endocannabinoid pharmacology (development of medications that affect the naturally-occurring marijuana-like chemicals in
the brain) is as exciting as the 1980's era of endorphin pharmacology (which produced medications that affect the morphine-like chemicals in
the brain). The new drug rimonabant is the frontrunner of medications that antagonize brain endocannabinoids. Rimonabant (not yet approved
in the U.S.) is effective in reducing food hunger and is a smoking cessation aid. It is also being tested for its possible anti-craving
effects for other drugs such as alcohol and cocaine. (June 13, 2005)
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284. It appears that providing methadone treatment in a primary care setting works. Heroin dependent patients who are stable on methadone have healthy
outcomes, according to a recent study. The study says that primary care facilities can get successful results in helping patients recover from heroin
dependence, while providing treatment for other health problems and improving physician attitudes about addiction. (June 6, 2005)
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283. If OxyContin causes many overdose deaths and cases of addiction, shouldn't it be banned nationwide? Anyone who believes this is
grossly overreacting. First, does OxyContin cause more overdose deaths than other opioids? The answer is no, since all opioids are
related to overdoses, especially in combination with other drugs. Second, does OxyContin cause more addiction than other opioids? There is
no evidence for this, even though OxyContin can be abused just as much as other opioids. Third, this medication is much better than most
other opioids for reducing pain. Therefore, the benefit of the drug greatly outweighs its risks. (May 30, 2005)
- 282. A recent Canadian study has suggested that so-called "light" or "mild" cigarettes
have all of the nicotine and most of the toxins found in regular cigarettes. Six types of light
cigarettes were compared to regular brands and found to have 5 percent more nicotine. Out of 44
toxins measured, the lights contained all but four. One Canadian executive has stated that the
terms mild and light should be banned altogether, since there is no benefit whatsoever of these
brands to public health. (May 23, 2005)
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281. We don't hear much about oxycodone, yet it is an important drug. Oxycodone, a powerful
pain reliever, is the main ingredient in OxyContin, which people HAVE heard about. There have
been overdose deaths with oxycodone, but the available evidence indicates that oxycodone deaths
are usually caused by interactions with other brain depressant drugs such as morphine or alcohol.
(May 16, 2005)
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280. Some people use medications but are neither willful "abusers" nor
"dependent" as defined by psychiatric assessment criteria. They
consciously believe that they are better off when taking a drug every day
to make their lives more comfortable (for example, they sleep better with
a mild hypnotic drug, or they relieve mild to moderate pain with regular
use of non-opioid analgesics such as ibuprofen). This unlabeled class of
drug users was formerly called "habitual drug users", but now might be
called "comfort seekers". More research is needed on this class of drug
users. (May 9, 2005)
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279. Are there a significant number of girls using anabolic steroids? One recent report suggests that approximately
7% of high school girls are using (muscle-building) steroids, perhaps to "tone up" their bodies to make them look better. If so, the question about how many are
"addicted" to steroids cannot be far behind. Interestingly, there is little attention paid to the "addictiveness" of steroids, in spite of the fact that recent
animal studies indicate that animals will self-administer testosterone. Such a test is somewhat predictive of the abuse or addiction potential of drugs. But 7%
seems high to begin with, so we need a LOT more research on the abuse and dependence potential of steroids. (May 2, 2005)
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278. Do laws limiting sales of over-the-counter cold medications (containing pseudoephedrine, for example) to fight the production of methamphetamine work? Laws such as this make illegal
methamphetamine makers work harder to find their ingredients, thereby producing only a temporary fix to the problem. We can expect to see a decrease in methamphetamine production for a
short time after such laws are passed, but then the meth pushers will find other ways to get their chemicals. Often laws such as this drive up criminal activity of a different type, such
as stealing chemicals, or obtaining them from other states that have no such laws. (April 25, 2005)
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277. Can nicotine change the genetic susceptibility to disease in children of smokers? One recent study indicated that women who smoke during pregnancy might produce genetic damage that
can cause their grandchildren to develop asthma. The researchers speculated that grandmothers who smoke might have altered their children's mitochondrial (inside the cell) DNA, which in
turn could diminish immune function and raise susceptibility to asthma - traits that they could pass along to their children. This study, however, needs to be replicated, and other studies
are needed to determine the exact cause of the asthma in such grandchildren. (April 18, 2005)
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276. Does a ban on smoking in bars and restaurants reduce establishments'
business and profits? A recent study in Massachusetts has shown that bars
not only got cleaner air but a boost in sales and profits after a
statewide ban went into effect. In a study of 27 bars and restaurants,
levels of dangerous airborne toxins fell 93%. In addition, alcohol sales
appeared to remain steady, and food sales at the bar appeared to increase.
The most important benefit? One restaurant owner stated he could now wear
a shirt two days in a row. (April 11, 2005)
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275. Some people are arguing during states' deliberations regarding the
legalization of marijuana that use of the drug is linked to violent crime.
There is no scientific or other evidence that the pharmacological effects of
marijuana relate to violence. In fact, just the opposite is true - marijuana
calms people. In addition, legalizing marijuana is likely to cause a reduction
of crime, since greater availability and less illegality of the drug would not
leave room for black market peddlers and users. Does this mean marijuana
should be legalized? No, since another intoxicating agent that will promote
driving a vehicle under the influence is not a good idea! (April 4, 2005)
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274. About 2/3 of smokers believe that smoking-cessation aids such as
patches and gum can be just as dangerous to health as cigarettes
themselves. Poor education of the public about the causes of
cigarette-induced lung cancer and heart disease may be responsible for
this misperception. Obviously nicotine, carbon monoxide, tars, and other
ingredients in smoke will be much more harmful than nicotine alone
(patches, gum). (March 28, 2005)
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273. Several studies indicate that students who take prescription
stimulant medications (Ritalin, Adderall, etc.) to treat attention-deficit
hyperactivity disorder (ADHD) have relatively low rates of tobacco,
alcohol, marijuana, and ecstasy use compared to students who illegally use
prescription stimulants. Since stimulants taken therapeutically in this
way also produce lower incidences of dependence than stimulants used
illegally, parents need not be concerned about the benefits of stimulants
in treating ADHD. (March 21, 2005)
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272. How "addicting" is methamphetamine? Available studies suggest that about 11% of users become dependent, although more studies are needed to confirm
this number. We also need more research on the rate of dependence in people of different ages, as well as the dependence rates with different forms of
methamphetamine administration. (March 14, 2005)
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271. Why is methamphetamine abuse so popular? First, methamphetamine is easy to make. Second, it is profitable. Third, there are people who will buy
methamphetamine from any available source. Such people are often looking for a cheap high, a way to lose weight, a way to fit in with their peers, and they
falsely believe the drug is not harmful. (March 7, 2005)
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270. Many scientists and clinicians are beginning to agree that chemical
dependence is a chronic, long-term medical problem that should be treated
for a long time, with monitoring of improvement or for signs of relapse
for the life of the patient. In fact, there are two programs that already
have this long-term treatment philosophy: 12-step programs and methadone
maintenance programs. (February 28, 2005)
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269. The Canadian government recently suspended sales of Adderall (amphetamines) because of concerns about deaths and strokes
linked to the drug. Adderall use other than by prescription is also a problem in the United States, where students often use it
and Ritalin (another amphetamine stimulant) to increase alertness and study time. Is such use harmful? Absolutely, since
non-therapeutic use, especially in high doses, can lead to elevated heart rate and blood pressure, and perhaps a
hemorrhagic-type stroke. (February 21, 2005)
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268. A study of heroin users in Scotland concluded that many succeeded in using controlled amounts of the drug for extended periods, holding down jobs,
maintaining relationships, and doing well in school. These people had been using heroin for an average of seven years and had not sought addiction treatment.
Given that only about one-fourth of heroin users become dependent, this is not surprising. But should heroin use be part of a person's lifestyle? This is
something for each person/community/country to decide. (February 14, 2005)
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267. Methamphetamine is a major abused drug in many parts of the United States. It is also one of the dependence-producing drugs whose victims are
the most difficult to treat. There are no known medications that will reduce a person's craving for methamphetamine, so psychosocial treatments
(counseling, 12-step programs) are the only ones available at this time. (February 7, 2005)
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266. What ingredients in tobacco are "addictive"? Obviously, nicotine,
which is one of the most dependence-producing chemicals in existence.
What about tars? Nope. What about other components of smoke? Nope.
What about carbon monoxide? Nope. Since nicotine is such an addictive
chemical, searching for other substances in tobacco that are
dependence-producing is only an academic exercise. So is searching for
other "reasons" for tobacco addiction. Yet some tobacco company
executives are refusing to state that smoking is addictive, because they
are "not sure" that nicotine is the only reason that smokers become
addicted! (January 31, 2005)
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265. Is sugar a "drug"? This somewhat humorous question is actually a serious one when asked by
people in recovery from alcohol and other drug dependence. The reason is that sugar is related to a
very strong "craving" in some people. So much so that people state that sugar must affect the same
brain pathways as "addicting" drugs. However, so far, the research on sugar and where it acts on
specific brain pathways is almost nonexistent. (January 24, 2005)
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264. Marijuana is now thought to work on the brain's cannabinoid (CB) receptors. Naturally-occurring chemicals in the brain, called
endocannabinoids, also act on these receptors. Drugs are being developed to change the brain's natural endocannabinoids to regulate the
craving for food, nicotine, and possibly other drugs such as alcohol and cocaine. Stay tuned for more research! (January 17, 2005)
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263. "Rapid detox" of heroin users is very controversial. The procedure involves injecting patients with a
cocktail of anti-opioid medications under sedation, and promises detoxification within 24 hours rather than the
weeks of agony suffered when patients go "cold-turkey". A recent clinical study from Columbia University found
that the three-month success rate for rapid detox was no better than for two other, more traditional detoxification
methods. Further, deaths have occurred with rapid detox and the procedure is quite expensive. (January 10, 2005)
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262. How can a drug be made "less addicting"? It can't, although drugs can be made "less abusable". A perfect example
is OxyContin, which is a sustained release form of oxycodone, an excellent pain reliever. The abuse potential of
OxyContin is high when recreational users destroy the release formulation through tablet crushing and subsequent
intravenous injection. The formulation can be made less abusable by adding naloxone that can block the intravenous
effects of oxycodone, or by producing a capsule that cannot release oxycodone if it is destroyed. (January 3, 2005)
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261. "Laughter is a drug" is a thought that some people believe describes how sick people feel better when they laugh.
Recent brain scans have shown that the same brain areas affected by cocaine can be "tickled" by witty cartoons. One
particular brain reward circuit, the nucleus accumbens, lit up seconds after a rib-tickler but did not change after a
boring cartoon. This does not mean that laughter is "addicting"! (December 27, 2004)
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260. A chemical known as gamma-vinyl GABA (GVG) is being tested clinically to treat methamphetamine and cocaine
dependence. This GABA derivative is the latest in a long list of compounds that have been tested as anti-craving agents
for amphetamines and cocaine. Whereas dopamine is the main brain chemical affected by cocaine and amphetamines,
medications that affect dopamine have not proven effective in clinical treatment of dependence on these drugs. (December
20, 2004)
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259. According to a recent report, town and city police chiefs feel that drug problems are greater today than in the past and that the war
on drugs is failing. Street drug prices are at their lowest in 20 years. These reports indicate that drug supplies are up, and that law
enforcement personnel are concerned that they don't know what to do about it. Many people believe it is time for a shift to "demand
reduction", which means more education, treatment, and research attention to drug problems. Scientists and advocacy groups have been
saying this for years. (December 13, 2004)
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258. How do we get rid of a dangerous drug like nicotine? One way is to put strict
controls on it and to change public perception about its value. To this end, Peru
has become the 40th country (of 128 countries who have signed a treaty) to ratify the
worldwide Framework Convention on Tobacco Control. With 40 countries on board, the
treaty that limits advertising and requires other tobacco controls is more likely to
be implemented. (December 6, 2004)
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257. Recently the president indicated he would give Columbia more money to fight drug traffickers and dealers. This
money is part of the "War on Drugs" that is designed to reduce drug supply to the U.S. Whereas money is needed to reduce
drug problems through several methods, people who believe in reducing the demand for drugs through prevention, treatment,
research, and education are wondering why they can't get much more funding for what they do. It seems logical that if the
demand for drugs were reduced, then less money would be needed to fight drug suppliers. We didn't cut off the source of
cigarette supplies, we reduced the demand for cigarettes through education, research, and quit smoking programs.
(November 29, 2004)
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256. Several studies on a new drug called rimonabant (Acomplia) suggest that this drug is not only useful for weight loss and helping
people
stop smoking, it might also reduce alcohol and cocaine craving. This is one of a new type of drugs that block the effects of
endocannabinoids (naturally-occurring cannabinoids) on the brain's reward system. Although the practical effects of endocannabinoid
blockers are yet to be established, such studies are exciting in that they present a new approach to treating drug dependence. (November
22, 2004)
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255. Are the new "membrane stabilizers" addicting? Membrane stabilizers such as gabapentin and other anticonvulsant drugs are quite new
but have found many uses in pain reduction, mood stabilization, and anti-seizure medications. Some have even been used in clinical
studies to reduce craving for drugs associated with chemical dependence ("addiction"). These drugs, like antidepressants and
antischizophrenic medicines, do not appear to be "addicting", or able to produce dependence. More research is necessary to determine
whether they do or do not lead to dependence. (November 15, 2004)
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254. Newer marijuana research is examining its possible medical uses in treating a variety of
disorders, such as Lou Gehrig's disease, Parkinson's disease, obesity, strokes, and multiple
sclerosis. This new research is taking advantage of recent basic research on the cannabinoid
receptors in the body, as well as relatively new science concerning the endocannabinoid (natural
cannabinoid substances) systems of the brain. (November 8, 2004)
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253. Many states are pushing medical marijuana and marijuana decriminalization
laws, in spite of federal insistence on the illegality of the drug in U.S. society.
This is truly an area where emotions run high. What is projected to happen is that
some states will make changes in how marijuana is handled, forcing Congressional or
Supreme Court action one way or the other. Until then, the issue will not go away.
Marijuana advocates see this as the greatest chance in recent history for marijuana
reform. Marijuana, like any drug, has both advantages and disadvantages to its use.
(November 1, 2004)
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252. "Huffable" substances include typewriter correction fluid, paint solvent, air freshener, cooking sprays, and deodorants. These
are legal, cheap, easily available, and difficult to detect when used. One method is to paint fingernails with correction fluid
instead of nail polish and then sniff. Other kids pour solvents on their shirtsleeves and huff without anyone knowing it. (October
25, 2004)
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251. What is "huffing"? Huffing (inhalant abuse) occurs when fumes or vapors are inhaled through the mouth to get a quick
high. Huffing is now being seen in fourth graders and deaths from this practice occur in kids as young as 10. Inhalants head
the list of most commonly abused substances in 12- and 13-year-old children. (October 18, 2004)
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250. News on the vaccine development front! There are three anti-drug vaccines currently in clinical studies: cocaine, nicotine,
and methamphetamine. These vaccines are being developed in the hopes that antibodies to the drugs will block their effect in
people who are trying to stop using these drugs. These "anti-addiction" drugs do not really overcome addiction; they reduce the
likelihood that people in therapy will be less likely to use the drugs if they understand that there will be no response if they
"slip". (October 11, 2004)
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249. What do we know about the "addictive" effects of inhalant chemicals? Almost nothing, compared to more common drugs such as alcohol. Thus it
is encouraging when scientists publish studies about the "addictiveness" of inhalants. A new study suggests that vigabatrin (a drug that affects
the brain transmitter GABA) may block the addictive effects of toluene, a substance found in many household products commonly used as inhalants.
The weakness in such a study, however, is that toluene has never been conclusively proven to be "addicting" (more accurately, to produce chemical
dependence). (October 4, 2004)
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248. The decriminalization of marijuana is gaining momentum in several states, with an attitude of relaxation of penalties for possession. Over half the
states have laws that allow marijuana joints to be used for medical purposes. Most importantly, Canada has already relaxed its attitudes against marijuana
users and growers, which some in the United States have seen as an invitation for organized crime. This is the greatest threat to the illegality of
marijuana that has been seen in the U.S. over the past several decades. (September 27, 2004)
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247. What is a marijuana "blunt"? A "blunt" is a street name for a marijuana and tobacco cigar. The term comes from Phillies Blunt, a cigar brand popularly used to mix pot and tobacco. Royal Blunt is being sold as
a flavored cigar paper (one of many brands on the market) for people who like to roll their own cigars (and now marijuana) with flavors that include sour apple, chocolate, watermelon, black cherry, and cognac. The
problem? Someone is trying to make money with a product that can be appealing to young tobacco and pot users. (September 20, 2004)
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246. Why is it so difficult to find a powerful pain-killing medication that does not produce addiction? Over the years, pharmaceutical companies have tried to
separate these two pharmacological qualities. Perhaps because the brain areas involved with pain reduction and those involved with drug dependence are connected, it
has been almost impossible to find powerful "non-addicting" painkillers that block pain transmission. On the other hand, perhaps dependence on drugs and analgesia
(pain reduction) are two different phenomena that will someday be separated, as more refined research evolves in this important area. (September 13, 2004)
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245. If the number of deaths related to methadone use increases (according to one report), does this mean that methadone should not be used for treating heroin dependence? Of course
not, since methadone is also frequently used for reducing pain. An increased number of deaths simply means that the drug's use for all purposes is increasing, and may have nothing to
do with its use in heroin treatment. People who are against methadone use for treating heroin dependence will use this fact to suggest otherwise. However, more research is needed to
find the true reasons for increasing deaths, and whether this is simply a blip in reporting of the drug's increased usage. (September 6, 2004)
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244. Since marijuana is certainly dependence-producing ("addictive", occurring in about 8% of marijuana users), the question is whether higher-potency pot is more
addictive. The answer is no, since potency of a drug does not determine its dependence potential. However, the greater euphoria of higher-potency marijuana can lead to
more marijuana use and abuse, and more side effects. (August 30, 2004)
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243. I'm sure that many people wish that marijuana had never been discovered in the first place. Recent studies on this highly controversial weed are beginning
to show more potential medical uses for either the joints or the active ingredient tetrahydrocannabinol (THC). Such uses include treatment for multiple
sclerosis, epilepsy, and brain cancer. Instead of getting too excited about such research, we have to keep in mind that single studies don't make truth, so the
research has to be replicated before it becomes more than just "interesting". We also have to deal with the fact that marijuana and THC are illegal for such
uses, according to the federal government. (August 23, 2004)
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242. Could genes be related to cocaine dependence? Recently, an interesting study reported that two mouse genes might help to explain how a genetic susceptibility (combined with
environmental factors) could lead to "addiction". The two genes appear to control how brain cells talk to each other. When either one of the genes was absent in the mice, the mice were
more susceptible to cocaine withdrawal. Similar responses were not seen in mice given caffeine or heroin. (August 16, 2004)
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241. A new federal study says that emergency-room visits related to club drugs (those used in "rave" parties) either leveled off or declined in 2002. The
report found that ER visits associated with GBH fell by a third between 2000 and 2002. LSD visits also declined, while ecstasy and ketamine visits did not
change substantially in recent years. Such annual cycles are not uncommon, and relate more to popularity of drugs on the street than to formal education and
prevention programs. (August 9, 2004)
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240. What is "ephedra"? This is an herbal supplement that produces a euphoria ("high") like an amphetamine, but is less potent in doing so. Manipulation of its
structure led, in the past, to the discovery of amphetamines, so it has an interesting history. Recently, the Food and Drug Administration's attempt to regulate
supplements led to the banning of products containing ephedra. The FDA claims that ephedra has been linked to numerous deaths. (August 2, 20
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239. A new brain-scan study shows that methamphetamine can permanently damage brain cells. We must be cautious about believing a single study, however, since such studies need replication before the truth is known.
It is never easy to make a strong conclusion on a single study. For example, what were the controls in the study? What other factors might have been involved in people who were being studied? Nevertheless, such a
study is consistent with animal studies on methamphetamine. (July 26, 2004)
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238. Xanax and Vicodin are often called street drugs, but they are better characterized as "prescription drugs used
illegally". The true street drugs are ecstasy, LSD, heroin, and others that have no approved therapeutic use. (July 19,
2004)
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237. Doping can be a big problem in athletes. While drug screens can pick up most illegal drugs in an athlete's urine,
some newer growth-enhancing steroids cannot be detected. There will always be drugs discovered that will take time for
drug screens to be developed, since the need to excel in some sports overwhelms the chances of getting caught and punished.
(July 12, 2004)
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236.
Why do people smoke banana peels to get high? They don't. This is a myth.
(July 5, 2004)
(July 5, 2004)
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235. A form of OxyContin that cannot be abused would be a helpful addition to our medical armamentarium. This has now
been developed. This sustained release form of oxycodone produces an inactive form of the drug when the pill is broken or
crushed, which is how drug abusers like to take the drug. (June 28, 2004)
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234. The use of marijuana is associated with the onset of schizophrenia in a surprising number of people. Marijuana's use is also associated with panic attacks. However, whether marijuana causes these two
mental disorders is still open to question. For example, people prone to schizophrenia or panic attacks might be one type of a group of people who smoke marijuana. (June 21, 2004)
B
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233. Some studies are beginning to show that MDMA ("ecstasy") can act as a chemical stressor in people, since the drug seems to have a negative effect on the human immune system. (June 14, 2004)
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232. Children born of mothers who smoke during pregnancy are more prone to Sudden Infant Death Syndrome (SIDS). At least one study puts this risk as second to SIDS caused by placing a sleeping baby on its
stomach in a crib. (June 7, 2004)
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231. New research has shown that newborns go through withdrawal (reduced mental function) when they are born of mothers who smoke during pregnancy. Whether this reduced mental function is temporary or
permanent is still to be determined. (May 31, 2004)
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230. A relatively new area of study regarding marijuana is the discovery of "endocannabinoids". These brain chemicals are natural chemicals that activate the brain's "cannabinoid receptors", discovered many
years ago. It appears as if there is more than one endocannabinoid in the brain, illustrating the complexity of the cannabinoid receptors. (May 24, 2004)
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229. If an adolescent is brought to an emergency room with a first-time seizure, there should be a drug screen run to determine if cocaine
was involved. Cocaine and other stimulants such as methamphetamine can cause seizures if the dose is too high or if the person is very
sensitive to the effects of such drugs. (May 17, 2004)
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228. OxyContin is a highly abused drug, mainly because many drug abusers like it. It does not, however produce a greater incidence of dependence
("addiction") than other powerful pain-killers such as morphine. When abused, OxyContin tablets are crushed and ingested, giving a high that the
manufacturer did not intend. (May 10, 2004)
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227. Morphine comes from the opium poppy seed pod. Some derivatives of morphine are semi-synthesized (made from morphine), while others are totally
synthesized (made from scratch with other chemicals). The one common characteristic of morphine and morphine-like compounds is that they are powerful,
dependence-producing pain-killers. (May 3, 2004)
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226. Three types of brain imaging techniques used in the study of drug abusers are positron emission tomography (PET),
single photon emission computerized tomography (SPECT), and magnetic resonance imaging (MRI). Often there is research on
fMRI (functional MRI), in which computers can highlight certain brain areas involved with changes in function, cognition,
memory, etc. Such brain imaging techniques may some day show us the exact site(s) of pathology of dependence disease,
provide us with better diagnosis of the disease, or show us the long-term effects of treatment. (April 26, 2004)
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225. There are reasons that babies born of mothers who smoke during
pregnancy are smaller and lighter than other infants. The main reason is
that these babies are deprived of oxygen during their fetal growth period.
When a person smokes, they inhale tars and carbon monoxide. Both of these
reduce oxygen in the blood, leading to long-term effects on the person.
Imagine how sensitive a developing fetus can be to such an effect! (April
19, 2004)
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224. Are steroids "addicting"? Although steroids ("roids", testosterone
derivatives, precursors such as androstenedione, and others) produce a
sense of well-being, there is little evidence that they produce chemical
dependence in a similar way as heroin, cocaine, or amphetamines (although
research is lacking on this). But they are powerful agents that can be
abused and are toxic in some people. Major detrimental effects are on the
liver and hormone manufacturing organs of the body. (April 12, 2004)
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223. According to some research, regular exposure to secondhand smoke can increase a person's risk of heart disease
by two times. Anyone who has been in the house of a smoker can understand the lingering smoke odor that permeates
fabrics and hangs on walls, floors, etc. This residue contains tars and remnants of smoked tobacco that can be
dangerous. When this material floats in higher concentrations in the air during active smoking, they can be inhaled
by others and cause many of the same detrimental effects experienced by the active smoker. (April 5, 2004)
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222. While not much is known about marijuana's long-term effects, more is known about its short-term actions. For
example, after marijuana is smoked, it has residual effects on thinking, making judgments, and decision-making ability
("cognitive functions") for up to 48 hours. (March 29, 2004)
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221. The old-time barbiturates that have mostly been replaced by newer
drugs were powerful sedatives and hypnotics. That is, they greatly
depressed the nervous system by as-yet-unknown mechanisms. They caused a
lasting hangover when used to promote sleep, with a great impairment in
functioning the day after they were given. They were also highly
dependence-producing, which is the main reason they are no longer
therapeutically used. (March 22, 2004)
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220. Therapeutic nitroglycerin is used to dilate blood vessels in the heart to increase blood flow and reduce
the symptoms of angina. Some people recreationally use amyl nitrite "poppers" in which a thin glass vial
containing the drug is broken in a cloth, producing a "high" due to increased blood flow in brain vessels.
This can adversely affect blood pressure. (March 15, 2004)
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219. In the United States, herbal drugs can be marketed without proof of safety or effectiveness. While some of these
products might be useful in treating conditions such as insomnia, depression, memory loss, and aging, their effects are
usually so subtle that they are difficult to differentiate from a placebo (inactive treatment in which people might feel
better). The problem is that there is little evidence regarding side effects, interactions with other medications, or
long-term toxicity. Thus, "buyer beware!" (March 8, 2004)
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218. Researchers and clinicians are requesting that terms such as "crack baby", "crack addicted baby", "meth baby", and "ice
baby" not be used, since there is no scientific evidence for such terms. These are pejorative terms that inaccurately
describe babies whose mothers have probably used not just one drug, but several. In addition, the use of such terms often
prevents babies from getting proper help because of stigma and prejudice against the mother. (March 1, 2004)
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217. Lithium, used for the treatment of bipolar illness, is an interesting drug. It is not addicting, perhaps
because people understand that it is highly toxic if the dose is not
regulated carefully. More importantly, it probably does not produce
a "high" for those who like to use drugs for that reason. (February 23, 2004)
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216. Is caffeine dangerous? Caffeine is one of the safest "drugs" known. It is not addicting, the lethal dose is very high, and
it has no toxic effects on body organs. People who are sensitive to caffeine, however, can have altered heart rate with higher
doses. (February 16, 2004)
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215. According to anecdotal reports of those working in treatment centers
and emergency rooms, methamphetamine and ecstasy are major problems among
adolescent and adult street drug users, even gaining the label of an
"epidemic". The use of marijuana and alcohol continues to be high among
those populations, whereas smoking is on the decline (not research data).
(February 9, 2004)
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214. Tolerance to LSD occurs very quickly, but can disappear in about 1-2
weeks if no more drug use occurs. LSD's tolerance is a type of
"tachyphylaxis", which means "quick adaptation", and can actually occur
during a single use of the drug. Each time a person takes a dose of LSD,
subsequent doses during the same use period will have diminishing effects,
so that the person has a tendency to increase doses to get a similar
effect. (February 2, 2004)
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213. Morphine has several characteristics: a) it is an old, powerful analgesic (the "prototype" pain
killer); b) it is obtained from the opium poppy seed; c) it is as useful today as it has been for over a
century for the treatment of pain; d) it has powerful cousins such as Dilaudid, Demerol, and oxycodone;
and e) it is the product of the breakdown of heroin. (January 26, 2004)
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212. Marijuana can reduce memory function because there are many tetrahydrocannabinol (THC)
receptors in a part of the brain called the hippocampus. The hippocampus is traditionally known as
the "memory center" of the brain. (January 19, 2004)
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211. Using dextromethorphan along with decongestants can dramatically increase blood pressure. Both of these drugs
(dextromethorphan and decongestants) are found in cough medicines, but in usual therapeutic doses they are not usually a
problem. It is when people trying to get "high" abuse cough medicines that problems can arise. There are reports that young
people are buying cough medicines to abuse them. Caution: these are not without danger, especially in people sensitive to
these ingredients. (January 12, 2004)
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210. Dimethyltryptamine (DMT) is an hallucinogen, but it is not as potent as LSD (potency relates to the size of the dose to
produce an effect). DMT, which at usual doses is reportedly stronger than LSD in its subjective effects, is called a
"businessman's special", because its effects do not usually last longer than one hour - making it suitable for a lunch "trip".
(January 5, 2004) (Revised November 1, 2007)
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209. LSD produces hallucinations that are primarily visual, and one of
the major effects is a sense of separation from one's body. When an
overdose or a "bad trip" occurs, there is unfortunately no antidote to
LSD, and the experience cannot be stopped. Thus, the only recourse is to
stay with the person, provide comfort, and "talk them down" while the drug
disappears from the body. (December 29, 2003)
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208. Ever wonder why there are emergencies (and sometimes deaths) when
ecstasy is used in rave parties with dancing and crowds? Ecstasy (MDMA)
elevates body temperature and causes dehydration when high-dose users
perform high-level physical activities in hot environments. (December 22,
2003)
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207. Although steroids used by athletes do not technically fulfill the criteria for "drugs of addiction", users of such drugs develop a compulsive reliance on them. "Anabolic"
steroids are the most often used because they are felt to build muscle and enhance performance. Even though the body produces its own steroids for other purposes, the use of
synthetic steroids can have devastating effects on sex hormones, liver, and heart. The athlete who contemplates using such drugs must consider the side effect possibilities and the
illegality of such drugs versus their possible performance-enhancing benefits. (December 15, 2003)
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206. Anabolic (body-building) steroids are dangerous drugs about which we know very little. Some people have called
them "addictive" but they are generally not included in the lists of addicting (dependence-producing) drugs such as
heroin and cocaine. We do know that they can be very toxic to some people and the choice that must be made by
athletes is "are these drugs worth the risk of toxicity compared to their performance-enhancing effects?" In other
words, are the short-term gains worth possible long-term detrimental effects on the quality of life? More research is
desperately needed on these drugs. (December 8, 2003)
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205. What are the differences between an hallucinogen, a psychotomimetic
drug, and a psychotropic drug? The term "psychotomimetic" is an old term
that has been replaced by the term "hallucinogen", meaning a drug that
produces hallucinations. The term "psychotropic" simply relates to any
chemical that causes a change in perception, behavior, or mood. For
example, LSD is a psychotropic drug as well as an hallucinogen. Prozac,
however, is a psychotropic drug. (December 1, 2003)
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204. Why is heroin such a bad drug? Pharmacologically, it's not any "worse" than morphine or other opioid compounds. What's "bad"
about heroin is the way that people use and abuse it. Heroin is very potent (less drug is needed to produce an effect), which makes it
easier to package and transport. It is often smoked or injected, and the "rush" that it produces by these methods is very compelling to
drug users. However, if people did not abuse it, it could possibly be used as a powerful pain-killer therapeutically. (November 24,
2003)
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203. Buprenorphine, a powerful analgesic newly-approved by the FDA for heroin dependence treatment, has the advantage that dependent patients cannot increase the dose to
get high, during moments of intense craving for heroin. Some methadone advocates have indicated that this is a weakness of the newly-approved drug, since the ability to
get reinforcement from methadone is one of the motivators for people to stay on methadone. The answer is simple: one drug is best for some patients, the other is best for
other patients - just like there is no one drug that works for people with (for example) depression, anxiety, or schizophrenia. (November 17, 2003)
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202. How do nicotine patches help people stop smoking? The patches (and gum) substitute for the nicotine
in cigarettes, and when a quitter uses the patches or gum the intent is to reduce the nicotine amounts
over a period of several weeks, to the point where the person no longer requires nicotine. In other
words, patches and gum reduce the discomfort of withdrawal from nicotine. They also temporarily reduce
the craving for nicotine in cigarettes by replacing the nicotine until the person can be weaned off the
drug. (November 10, 2003)
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201. The drug LAAM (levomethadyl acetate hydrochloride, the so-called "long-acting methadone") is being taken off the market
because of excessive negative side effects involving the heart. This leaves only methadone and the newly-approved
buprenorphine available to help heroin dependent patients. (November 3, 2003)
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200. Some people believe that the best way to "cure" heroin dependence is to withdraw the drug from the person. This has led
to many "detoxification" methods, some of which are very uncomfortable, others of which are comfortable (that is, the person is
sedated or asleep during withdrawal). Unfortunately, none of these methods alone is effective, since the "craving" for heroin
is extraordinary for several days after withdrawal. This is the time of greatest chance for relapse and requires intense
clinical attention to help the person stay off heroin. (October 27, 2003)
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199. Lithium is an interesting drug that is used in the treatment of bipolar illness. It is a simple element (like sodium or gold),
yet it has major therapeutic effects due to an action on the membranes of nerve cells. While scientists do not yet understand exactly
how lithium works to help patients, we do know that lithium does not produce dependence ("addiction"). (October 20, 2003)
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198. Drugs affecting brain function usually act on receptors on nerve cells to alter chemical transmission between nerve cells. The
drug effect observed ("pharmacological action") depends on the types of receptors affected, the neurotransmitter systems altered
during the process, and the major part of the brain where the drug exerts its effects. (October 13, 2003)
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197. What causes withdrawal? Withdrawal (seen most often when the use of
depressant drugs such as opioids, benzodiazepines, alcohol, nicotine, etc. is stopped) is a "rebound
hyperexcitability". When such drugs are used in high amounts over a long period of time, the body's functions are depressed (made less active), and the body adapts to the
presence of the drug over time. When the person stops using the drug, the body attempts to normalize itself and mechanisms kick in to restore the normal state. This
"normalization" process pushes bodily systems to become more active, and in so doing causes a state of hyperexcitability until normal function is restored. (October 6, 2003)
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196. Why can't chocolate be called a "drug"? Technically, drugs are usually pure chemicals (heroin, cocaine, alcohol, amphetamine, etc.). So a food
(like chocolate) can contain a drug (caffeine) but one would not call the food itself a "drug". Food nourishes, "drugs" act on specific sites in the
body to cause a change in physiology. This "pharmacology" of the drug could produce specific beneficial or detrimental effects on the body, depending
upon the drug's toxicity or specific action on cellular function. (September 29, 2003)
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195. Several drinks and foods contain caffeine, although the amounts will vary depending upon the manufacturer.
These include (approximate amounts): coffee (100 mg), tea (50 mg), hot chocolate (4 mg), chocolate milk (5 mg),
milk chocolate candy bar (6 mg), dark chocolate candy bar (20 mg), Baker's chocolate (26 mg), chocolate flavored
syrup, 1 ounce (4 mg). (September 22, 2003)
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194. Opiates are drugs derived from opium. These include morphine, codeine, and semisynthetic compounds derived
from them, such as heroin. The term "opioid" includes all compounds with morphine-like activity, including
naturally-occurring and synthetic opioid peptides, such as endorphins. (September 15, 2003)
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193. Opioids are often referred to as "narcotics" because they produce sleep or a dreamlike state that is known as a
"nod" or stupor. The Harrison Narcotic Act of 1914 included opiates, cocaine, and marijuana (the latter two not
being narcotic in any manner); thus, the word "narcotic" is often used erroneously and is very much understood. The
use of this word should therefore be abandoned. (September 8, 2003)
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192. One of the drug-use trends that occurred in the past was the use of typewriter correction fluid, which contains
trichloroethane and trichloroethylene. Use of this product is known at "whiting out", and it still occurs today, although not as
frequently. Inhalation of fumes of this product has been known to produce sudden death. (September 1, 2003)
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191. How do drugs affect the brain? All drugs that affect the brain act at the cellular (that is, nerve cell) level. Nerve cells talk to one another
through chemicals called neurotransmitters. Neurotransmitters are made, destroyed, and cause a "connection" between nerve cells through their release
during electrical firing of individual nerve cells. Most drugs that affect the brain (to cause either unwanted or therapeutic effects) act by changing the
neurotransmitters' actions. (August 25, 2003)
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190. Is methamphetamine a form of cocaine? No. They are two different
drugs, both called "central nervous system stimulants". Cocaine (coke) is
mainly a naturally occurring ingredient in a certain plant, whereas
methamphetamine (meth) is synthetic (made from other chemicals). The
reason they are often confused is they both are a white powder, and can be
taken by injection, smoked, or by "snorting". One of the street names for
meth is "crank", while one of the street names for coke is "crack" - which
adds to the confusion.
(August 18, 2003)
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189. What is this deal with kids dipping marijuana joints in formaldehyde (embalming fluid) to get a
better "high"? While reasons may vary, people who do such things are thrill-seekers trying to find a
way to set themselves apart by trying different things. What they don't understand, however, is that
formaldehyde is very toxic. What is not burned off during smoking can cause long-term toxicity,
particularly on the retina of the eye. (August 11, 2003)
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188. There are receptors for drugs in the brain - for opioids (such as morphine), for marijuana (called the
"cannabinoid" receptor), for nicotine (called the "nicotinic" receptor), and others. Why are these receptors in the
brain? Are they there because nature prepared us for the possibility of using drugs? No, the real answer is that drugs
activate receptors that are used by naturally-occurring chemicals in the brain. Thus, endorphins (naturally-occurring
morphine-like substances) are released during stress or pain, activate the opioid receptors, and affect stress and pain
thresholds during daily life events. Likewise, other brain receptors are needed for chemical balance to maintain
certain emotions or feelings that people have in their lives. (August 4, 2003)
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187. A basic pharmacological concept is that potent drugs (such as LSD or Xanax) require fewer molecules to produce a therapeutic or toxic effect in people
than less potent drugs (such as Soma or ethanol). Non-pharmacologists often confuse "potency" (amount of action on a cell, receptor, or tissue produced by a
fixed amount of drug) with "dose" (the amount of drug to produce an effect). People can change doses of a drug but they cannot change the potency of a drug.
(July 28, 2003)
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186. Recent research on marijuana indicates an association between marijuana use
and schizophrenia. However, an open question is whether the overuse of marijuana
causes schizophrenia, or whether the use of marijuana triggers the disease in
people who are "pre-psychotic" and who would have developed the disease later in
life. A third possibility is that some people may have mild symptoms of
schizophrenia that are enhanced by marijuana use. (July 21, 2003)
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185. Medical uses of marijuana include the treatment of nausea and vomiting in cancer patients, and enhancement of appetite in people (such as AIDs
patients) who have severe weight loss. The FDA-approved medicine (Marinol) for such indications uses the active ingredient in marijuana,
delta-9-tetrahydrocannabinol (THC). Other alleged medical uses are in the treatment of pain, asthma, and glaucoma, for which there is incomplete
scientific evidence. (July 14, 2003)
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184. What is a "placebo effect"? Almost every drug (especially those that affect brain function) has a placebo effect. This is an unexplained
therapeutic (or counter-therapeutic) effect that does not involve the drug's pharmacology. If a large group of people is given a sugar pill for anxiety,
depression, pain relief, etc., approximately 30% of the people will have a reduction in anxiety, depression, or pain. The reasons are not entirely
clear, but one thought is that people given any medical attention will expect to get better. Good research on new treatments, then, should include a
"control" (inactive medication or treatment) to determine how many positive placebo responders are in the experiment. Only treatments that are
significantly better than placebo should be marketed. (July 7, 2003)
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183. Why were the old "remedies" peddled by "snake oil" salesmen so popular? Because people did not have the
well-respected pharmaceutical products available today to take care of common ills, and they were often desperate for
relief. Thus, people selling products that could "cure" many of the remedies of the day (constipation, toothache, upset
stomach, sleeplessness, and many others) were able to sell such products. These medicines usually contained alcohol,
opium, and other (minor) ingredients that sounded impressive to those who looked at the containers. Many of these
products often produced positive placebo effects, which enhanced their reputation (and that of the salesmen!). (June
30, 2003)
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182. Compounds such as gamma butyrolactone (GBL), which is converted in the body to gamma hydroxybutyrate (GHB, a common "club drug") are marketed
for their ability to increase sleep, growth hormone, sexual activity, and athletic performance, as well as overcoming depression and prolonging life.
This is remindful of the old "snake oil" salesmen who used to travel the country preying on people desperate for miracle drugs! Are these really
"drugs"? Absolutely. Anything that produces a pharmacological (or toxicological) effect is a "drug", according to traditional pharmacology. (June
23, 2003)
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181. GHB (gamma hydroxybutyrate), as sold on the street, is a dangerous
"date rape" drug, especially when mixed with alcohol. It is an illegal
drug, allegedly because of its serious toxicity. However, not much is
known about this substance, as evidenced by the lack of discussion about
it in the "bible" of pharmacology, Goodman and Gilman's Pharmacological
Basis of Therapeutics. (June 16, 2003)
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180. Can prescription drugs be abused? Absolutely. Can prescription drugs produce dependence? Absolutely. But how
and why people overuse therapeutic drugs is still incompletely understood. The reasons are probably multiple, and
more research is needed to determine exactly how therapeutic use becomes overuse, abuse, and dependence, and in whom
these occur. (June 9, 2003)
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179. Why is the use of methamphetamine so prevalent in some societies? No one knows for sure, but this drug is made cheaply and provides great
profit for illegal sellers of the drug. Anytime money can be made by the sale of a drug, large quantities become available and people (many
unsuspecting of the terrible adverse effects of the drug) begin using it, and often sell it to others. Thus a profitable "network" is set up
involving a large number of users. (June 2, 2003)
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178. What is "weed"? This is one of many street names for marijuana. Most drugs of abuse have multiple street names, and users make
more up every day. This makes it very difficult for law enforcement personnel (and pharmacologists!) to keep up with drug use patterns.
Also, different countries have different names for drugs. For example, smokable methamphetamine in the U.S. is known as "ice". In New
Zealand the same drug is known primarily as "P" (for the "pure" form of methamphetamine). (May 26, 2003)
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177. Based upon several neurotransmitter systems that seem to be dysregulated ("not working right") in the medial forebrain bundle ("pleasure pathway") of
the brain, scientists are speculating that there may be different treatments in the future for different types of alcohol dependence. Thus naltrexone
works on the endorphin system, ondansetron (in clinical study) works on the serotonin system, and acamprosate (in clinical study) works on the glutamate
and/or GABA systems. (May 19, 2003)
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176. Phencyclidine, as well as ketamine, are "dissociative anesthetics". When used for animal surgery, the animal's eyes are open but
it is under complete anesthesia. Thus we observe a "dissociation" between the animal appearing to be awake and the actual state of
anesthesia. (May 12, 2003)
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175. Is vitamin K addicting? No! Unfortunately, some people think this,
because one of the street names for ketamine, a veterinary anesthetic that
does produce dependence, is "vitamin K". This is how misinformation comes
about! (Other street names for ketamine are "Special K" - not the cereal -
and "K".) (May 5, 2003)
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174. Is toluene (one of the inhalants) a drug? Technically, a "drug" is a
chemical that people take for some pharmacological effect. There are therapeutic
drugs and there are illegal drugs. Toluene falls into neither of these categories.
Toluene is an organic solvent that can be abused (usually by teenagers) because
they feel a "high" when they inhale it. But it is extremely toxic, when abused.
It is best called a "poison". (April 28, 2003)
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173. Which drugs kill brain cells? Obviously the research on this subject
is incomplete, but so far only alcohol, MDMA (ecstasy), methamphetamine
("ice", "P"), and inhalants have been shown to kill brain cells. With alcohol,
large amounts over years are needed to kill brain cells. With the other drugs,
the quantities and amounts in humans are unknown, since studies showing cell
death have only been done in animals. (April 21, 2003)
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172. What is "LAAM"? This is an acronym for the chemical name of a drug like
methadone. It does, however, last longer than methadone when given to heroin
dependent patients, and only needs to be given every three days instead of
daily, like methadone. (April 14, 2003)
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171. Is methadone effective for the treatment of heroin dependent
patients? Yes, this drug, while controversial, is the most effective
treatment available for treating such patients. It does not, however,
often lead to complete abstinence from all opioid drugs. (April 7, 2003)
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170. Needle exchange programs are effective intervention strategies that
save peoples' lives. Not only do clean needles reduce the transmission of
diseases among drug-injecting people, but such programs allow counselors
to provide such people with information about the harmful effects of drug
injection, plus possible treatment options. And these occur without
increasing the number of addicts! (March 31, 2003)
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169. Are antidepressants "drugs"? Technically, yes. But the word
"drugs" conjures up a picture, in most people, of an illegal chemical such
as heroin. A better term for antidepressants is "medicines" or
"therapeutic drugs". (March 24, 2003)
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168. We often hear of "substance abuse". What is a "substance"? The
word "substance" presumably arose from the observation that some people
became "addicted" to food, as well as chemicals (drugs). This is
erroneous, since science has never classified food as an "addictive "
substance. In fact, there are no other substances that are not
chemicals, so the best descriptor is "chemical abuse", or "drug abuse".
(March 17, 2003)
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167. Are inhalants "addicting"? We don't know, since very few people
(usually young people) take them long enough for us to determine whether
the users become dependent. These drugs are highly toxic, and many kids
die when they use inhalants. In most cases, the use of these drugs is a
passing fad, since long-term use is rare. (March 10, 2003)
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166. How can heroin, which is usually injected, be smoked? Most drugs
can be "processed" into any form that is needed by a drug abuser. Heroin,
like cocaine, comes in a solid form that can be dissolved in water for
injection. However, by processing the solid form, it can be made into a
smokable preparation that prevents the use of dirty needles during
injection. Be careful, though - all forms of heroin can produce
dependence in susceptible people! (March 3, 2003)
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165. What are the bad effects of LSD? Although there are no documented
fatalities from LSD use, fatal accidents and suicides have occurred during
or shortly after intoxication. In addition, "bad trips" can occur, which
consist of severe anxiety, intense depression and suicidal thoughts.
(February 24, 2003)
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164. Are sex and gambling" addicting" like heroin and cocaine are "addicting"? In
the popular use of the word "addiction", people do appear to lose control over
sexual activity and gambling. However, there is insufficient evidence to
scientifically diagnose sex and gambling as "dependence" as defined by the
Diagnostic and Statistical Manual of Mental Disorders, the diagnostic "bible" in
use today. Whereas cocaine and heroin easily satisfy the criteria for dependence
(the new term for "addiction"), sex and gambling may more accurately be described
as pathological or compulsive behaviors. To call them "addictions" is probably
inaccurate at this time. (February 17, 2003)
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163. Can opioids such as morphine and oxycodone produce dependence when
used to reduce pain in the hospital? Yes, but the probability is lower
than when such drugs are used recreationally by people without pain. The
prime example is heroin, which produces a "high", along with its pain
reducing action. Researchers have yet to explain why opioids produce more
dependence in recreational users than in patients being given the drug to
reduce pain. (February 10, 2003)B B
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162. Can stimulants such as Ritalin and other amphetamines produce
dependence when used to treat children with Attention Deficit Disorder
(ADD)? Yes, but the probability is low. In properly diagnosed children
with ADD, these medicines are less likely to produce dependence than when
the drugs are used recreationally in later life by adolescents or adults
who do not have ADD. This is a clinical observation, and there is no firm
answer to this phenomenon. (February 3, 2003)
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161. How dangerous are prescription drugs? Not very dangerous, when used under the supervision of a physician. These medications are designed to be
used without danger (except in the case of powerful anti-cancer, anti-AIDS medications, and a few others) by most people. However, a small number of
people do not react "as expected" to some medicines, and these medications may also interact with other drugs (including alcohol) being taken. Some
recent studies indicate that teenagers are misusing prescription medications such as opioids and stimulants. Prescription drugs can be very dangerous,
and dependence-producing, when used illegally. (January 27, 2003)
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160. Why are Oxycontin and cocaine both "legal", if they both produce massive chemical
dependence ("addiction")? Both of these drugs have federally accepted therapeutic uses:
Oxycontin for pain relief, and cocaine as an anesthetic for eye surgery. As long as the
distribution (sale) of these drugs is regulated, they are deemed to have more positive
medical effects than detrimental effects. Practically, both are excellent drugs, if we
could just control their distribution in society. Where society breaks down is in its
ability to regulate the illegal use or abuse of these medications. (January 20, 2003)
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159. The three most dangerous drugs or drug classes with respect to
negative effects on organ systems are (in descending order):
inhalants, nicotine, and alcohol. Inhalants are poisons in every
sense of the word - taking them in through the mouth and nose can not
only cause instant death (for example, as in airway freezing with
aerosols), but they can also cause heartbeat irregularities,
breathing stoppage, and (with long term use) kidney, heart, liver,
and brain damage. Nicotine is well-known for its ability to produce
lung cancer and heart disease with long-term use, and alcohol
produces liver cirrhosis, heart disease, brain changes,
gastrointestinal problems, pancreatitis, and many other effects in
long-term heavy drinkers. (January 13, 2003)
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158. Marijuana is the great imposter! It is a low-toxicity drug that has no known lethal dose, it produces less "out of control"
behavior than alcohol, it produces less lung cancer and heart disease than tobacco (more research is needed on this), and it is
less addicting than alcohol or nicotine - two legal drugs. But should it be decriminalized or legalized? This is highly
controversial, but those who believe it should NOT be legalized point to how it messes up driving skills, how it probably reduces
motivation and learning in adolescents, and some recent studies suggesting an increase in anxiety and depression in daily marijuana
users. We simply need more marijuana research to answer this hot political question! (January 6, 2003)
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157. Wouldn't getting rid of drugs in the world reduce chemical dependence? Probably, except that the brain "dysregulation" related to chemical
dependence would still be present, and might cause the person to express some other compulsive behavior. More research must be done to confirm this
suggestion, however. (December 30, 2002)
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156. If chemical dependence is a brain disease, what's wrong with the brain? It appears as if there is a neurochemical abnormality (perhaps caused by
abnormal genes) in the mesolimbic dopamine system ("pleasure pathway") of the brain. One or more of several neurotransmitter systems may be "dysregulated"
(not working normally) in the pleasure pathway. Thus a drug helps to "fix" a specific neuro-dysregulation, leading the person to subconsciously be unable
to stop using a drug without help. (December 23, 2002)
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155. How do drugs cause addiction? Recent research findings indicate that drugs don't cause addiction. To appreciate this, people must understand that
chemical dependence (the scientific word for "addiction") is a brain disease. This brain disease is expressed through the compulsive use of drugs. Thus
if a person never takes an "addicting" drug, the disease will not be seen. (December 16, 2002)
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154. Can herbal products be misused? Many herbal products are misused (or "abused"). Misuse occurs any time people take more
of the product than recommended, especially over long periods of time. Although the short-term and long-term effects of herbal
products are not known, most products appear to have mild side effects or toxicity. However, in some people with pre-existing
health problems (for example, high blood pressure), products like St. John's Wort or ephedra-containing products could produce
negative side effects. (December 9, 2002)
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153. Are there any herbal products that are addictive? No, otherwise their sale would be controlled by a federal agency. Even
preparations that contain ephedra, a mild stimulant, have never been shown to produce "addiction" (newer term: dependence).
(December 2, 2002)
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152. What is buprenorphine? This drug (brand name, Buprenex) is a powerful analgesic.
Recently, the Food and Drug Administration approved it for the treatment of heroin
dependence. It is unique because, unlike methadone, it has an opioid "antagonist" effect,
which means that it is less likely to be abused by heroin addicts in treatment (that is,
they are less likely to get "high" on it during slips in recovery). Its brand name for this
purpose is Suboxone, and it can be given sublingually (under the tongue) for quick action.
Unlike methadone, it can be prescribed by any properly-trained physician for treating heroin
dependent patients. (November 25, 2002)?
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151. Do illegal drugs have approved therapeutic effects? Yes, some
do. Heroin has none, since it is totally illegal in the United
States. However, it has powerful pain-relieving properties (but it
breaks down in the body to morphine, which is used instead). Cocaine
has an approved use as a local anesthetic for eye surgery, but
possession and use of the drug for other purposes is illegal.
Marijuana (actually, the active ingredient in pill form, THC) is
approved for the treatment of nausea and vomiting, and for its
anti-wasting (appetite-increasing) effect in AIDS patients. All
other alleged medical uses of marijuana (pain relief, anti-asthma,
anti-glaucoma) are unapproved. (November 18, 2002)
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149. What are the differences between a "sedative", "tranquilizer",
"anxiolytic", and "neuroleptic"? They are all related. The word
"sedative" is a general (older) term for anything that calms people down.
"Tranquilizer" is a more specialized (older) term for a drug that reduces
anxiety ("minor" tranquilizer) or reduces psychotic symptoms ("major"
tranquilizer). These terms have mostly been replaced by "anxiolytics"
(anxiety reducers) and "neuroleptics" (anti-schizophrenic drugs).
(November 4, 2002)
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148. Part of the variability in response to drugs from person to person is due to "set" and "setting".
The "set" is the expectation of the drug's effect by the user. The "setting" is the environment in which
drug is taken. An example of this is that someone will get higher smoking marijuana when they have a
positive attitude about it than if they were raised to believe that marijuana is harmful. Also, a person
will generally get a better response using a drug with other people than using it alone. (October 28,
2002)
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147. Why do some drugs make us feel better and some drugs make us feel
worse? There is a complex answer to this, but the probable answer is that drugs affect each person
differently, and, depending upon the situation, some drugs can help people who want to feel better, and the
same drugs work in an opposite way for other people. (October 21, 2002)
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146. There are an enormous number of chemicals in the world. Why do people use some to get "high"? Perhaps
the normal human desire is to feel better, and when normal every-day activities fail to satisfy people, they
use drugs to feel better. (October 14, 2002)
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145. We hear a lot about "methadone maintenance", which is a controversial treatment for heroin dependence. But what about "nicotine
maintenance", where people stop smoking cigarettes but continue to use nicotine in the form of patches or gum. These people believe
that they are reducing their chance of lung cancer or heart disease because they are no longer exposing themselves to carbon monoxide,
tars, and other harmful effects of cigarette smoke. But nicotine itself is highly toxic, and will likely have lethal effects with
long-term exposure over many years in the person who cannot stop using nicotine in pure form. (October 7, 2002)
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144. Nicotine, given to animals, is extremely toxic. Why can humans smoke nicotine in cigarettes? Well, when cigarettes are smoked, much of the nicotine is
"vaporized" (broken down), so the toxic effects are reduced. People smoke because of the calming, or (in some cases) energizing effects. Doesn't it make
sense that people who smoke for such effects are sacrificing their health? We do the same with food, but the toxic effects of nicotine are much greater than
the toxic effects of food. (September 30, 2002)
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143. How long does the effect of Rohypnol (date rape drug) last? Although the research is incomplete, all indications are that the effects of Rohypnol last
about 4-6 hours. This is similar to the duration of action of Xanax, another benzodiazepine that has significant central nervous system anti-anxiety action.
Both drugs have significant dependence liability. But why is one approved by the FDA, and the other one not approved (Rohypnol is only approved for
prescription use in Mexico)? We need more research on these drugs! (September 23, 2002)
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142. All of the inhalants that children use are extremely dangerous.
Inhalants include correction fluid ("white out"), lighter fluid, paint
thinner, gasoline, toluene, spray paint, acetone, marking pens, hair
spray, and many other chemicals. These can damage the heart, liver,
respiratory tract, brain, kidneys, and they can produce a number of
diseases. They are poisons and should never be used for "recreational"
purposes. (September 16, 2002)
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141. What is the cause of death in LSD and marijuana users? Interestingly, these two drugs have no known lethal dose in humans. Certainly, if a person took
enough LSD or delta-9-tetrahydrocannabinol (the active ingredient in marijuana), that person could die. But the amount of drug required to cause death would be
extremely high, and would no doubt differ from person to person, as it does with other drugs. The cause of death is really only an academic question, since there
are no overdose cases to examine. (September 9, 2002)
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140. Some people become dependent on cocaine with the first use of the drug, according to reports of people undergoing
treatment. In a recent scientific study, 5-6% of cocaine users became dependent ("addicted") within the first year of use.
Of course, some people who use cocaine never become dependent. (September 2, 2002)
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139. The following drugs are all equally dependence-producing: heroin, nicotine, cocaine powder, crack cocaine,
morphine, Oxycontin (oxycodone), Demerol (meperidine), Dilaudid (hydromorphone), and alcohol. All other opioids
(methadone, codeine, Darvon, Vicodin, etc) are less dependence-producing than the powerful opioids. (There are
many myths regarding which drugs are more likely to produce dependence, and which drugs produce more serious
dependence.) (August 26, 2002)
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138. If a person becomes tolerant (needs increasing doses) to a drug, does it mean they are "addicted"? No! "Addiction"
(newer term: dependence) relates to an array of symptoms that are related to "the inability to stop using the drug without
help". Tolerance is only one of the dependence symptoms. Thus, without the other symptoms, tolerance is not the same as
dependence ("addiction"). (August 19, 2002)
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137. With respect to drugs, what is "dope"? The word "dope" is a general term that covers many drugs: narcotics,
opiates, sedatives, barbiturates, speed (amphetamines), hallucinogens, and marijuana. It is probably most often applied
to marijuana. The term "narcotic" is no longer in vogue, since it was used to describe (in the 1914 Harrison Narcotic
Act) several drugs: opiates, cocaine, and marijuana - the "natural" drugs obtained from plants. The term literally
means "a drug that causes a state of drowsiness". Cocaine obviously is not a narcotic. (August 12, 2002)
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136. Which neurotransmitter(s) does marijuana affect in the brain? Marijuana has its own receptor in the brain, called the cannabinoid receptor. Therefore,
it may not be necessary for marijuana to affect other neurotransmitters to produce its pharmacological effects. There are a few studies suggesting that
marijuana may affect transmitters such as serotonin to produce mood changes, or dopamine to produce the pleasurable effects of the drug. These studies are very
sparse however, and are not the final answer. (August 5, 2002)
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135. What is the "addictive personality"? This phrase actually has two
meanings: 1) a personality which exists in young people that predicts who
may be at high risk for "addiction" later in life, and 2) a set of
behavioral characteristics that is common among all "addicts" taking
drugs. In the latter case, some people have suggested that addicts behave
in a similar manner under the influence of drugs. Scientists have never
identified the "addictive personality", regardless of how it is defined.
(July 29, 2002)
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134. Is Xanax addicting? Alprazolam (Xanax) is a benzodiazepine
anti-anxiety drug that can lead to dependence ("addiction") in
individuals with a susceptibility to dependence. It appears to have
a greater ability to produce dependence than other benzodiazepines.
While it can produce a long-lasting withdrawal that is uncomfortable,
the simple phenomenon of withdrawal does not mean it has produced
dependence ("addiction") in that person. Most people who use Xanax
over a long period of time will experience withdrawal, but relatively
few become pathologically dependent as defined by DSM criteria.
(July 22, 2002)
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133. Is phenobarbital addicting? Phenobarbital is an old-time barbiturate with the least
addiction potential. In fact, it is used as a substitute for benzodiazepines during benzodiazepine
withdrawal, since it more comfortable for patients to withdraw from phenobarbital than from
their benzodiazepine drug of choice. Phenobarbital is also still used for treating epilepsy. (July
15, 2002)
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132. Should marijuana be legalized? This is a controversial issue whose answer lies more in
the cultural arena than the scientific arena. In the Netherlands, for example, the Dutch have
legalized marijuana and noticed a drop in marijuana trafficking and crime, without an increase
in marijuana addicts, driving under the influence incidents, or drug-related deaths. Would such
a policy work in the United States? There is no way to know, since only a large population
"study" will provide the long-term answers. The majority of the U.S. population probably
would not agree to legalize the drug because of a traditional anti-drug bias. (July 8, 2002)
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131. What is the difference between powdered cocaine and "crack"? They are the same
drug, with different potencies and routes of administration. Crack is made from cocaine
freebase, which is an intermediate form of cocaine made by heating cocaine with sodium
bicarbonate and water. Upon further heating with ether and more sodium bicarbonate, a waxy
form of pure cocaine is formed, called "crack", for the crackling sound it makes when
smoked. By the way, there is no evidence that crack is more "addicting" than cocaine
powder. (July 1, 2002)
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130. Which drugs can cause death in overdoses? Most people understand that people can
overdose on heroin (cause = respiratory depression), cocaine (stroke or heartbeat
abnormalities), alcohol (respiratory depression or drowning on vomit), and amphetamines
(convulsions). However, there are two drugs for which the lethal dose is not known: marijuana
and LSD. This does not mean that these drugs should be legalized, however, for they both
have harmful mood-altering effects. (June 24, 2002)
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129. The term "narcotic" is outmoded. Formerly used to describe analgesic opioids,
marijuana, and cocaine, the word now seems to be misunderstood by people who use it. The
term narcotic literally means "drugs that produce sleep or grogginess", but the new, more
accurate terms for sleep-inducers are "sleep aids" and "hypnotics". (June 17, 2002)
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128. What is "dope"? We hear the terms "smoking dope", "dope fiends", and "using dope". Obviously,
"dope" is a pejorative term for illegal drugs, including marijuana, heroin, and perhaps all other illegal
drugs. The term obviously does not apply to alcohol and nicotine. Reducing the use of the term
"dope" will help to reduce the stigma associated with public misunderstanding of what these drugs do to
the brain. (June 10, 2002)
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127. Nicotine is such a dangerous drug, yet it is legal for people over the age of 21. Since marijuana is illegal, it
must be more dangerous - right? Not necessarily. Although the acute effects of marijuana are similar to those of
nicotine (mood alteration and physiological effects), the long-term effects of marijuana are inconclusive. There is
some scientific concern over the effects of marijuana on the immune and hormonal systems, but there is insufficient
research on such long-term effects. It does, however, have detrimental effects on driving skills. The main reason
marijuana is illegal is that it was included in the Harrison Narcotic Act of 1914, and there has so far been
insufficient government interest in making it legal. (June 3, 2002)
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126. There is a new "Nico Water" on the market containing small amounts of nicotine. What
is the purpose of this product? Some smokers who are trying to quit can use nicotine patches,
gum, and low-nicotine devices to try to wean themselves off nicotine. Nico Water is marketed
as a way to help people with "nicotine cravings" who are trying to quit. The value of such a
product is in question, however, because of the potential use by people (children?) who are not
smokers. No one knows whether such a product could produce nicotine dependence. (May
27, 2002) (Note: As of July 2002, the FDA has not approved this product for sale.)
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125. How many people who use marijuana become dependent ("addicted")? According to one recent
study, 8% of marijuana users will become dependent over a 10-year period of use. This compares with
12-13% for alcohol and 15-16% with cocaine. The bad news? Marijuana is addicting. The good news?
Not as many people become addicted to marijuana as to cocaine or alcohol. (May 20, 2002)
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124. The term "substance abuse" is vague, weak, misleading, and inaccurate in many cases. People
often use this term when they mean "substance dependence", and the vague "substance" term is used as a
catch-all for food, chemicals, and drugs. In many "substance abuse treatment centers", people are also
being treated for sex or gambling addictions, which are certainly not substances. In addition, "abuse" is
rarely treated in dependence treatment centers, so the term tends to be misleading. (May 13, 2002)
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123. What is the difference in the use of the terms "drug", "chemical", and "substance"? A drug
(example: aspirin) is a chemical that produces a pharmacological and a toxicological effect in the body.
Most drugs produce therapeutic or unwanted effects on the body. A chemical (example: toluene) is an
organic or inorganic substance that produces more of a toxicological (poisonous) effect on the body than
a drug. A substance (examples: gasoline, food) is something that is a catch-all term, but when used with
"abuse" is generally a very vague term. Thus there is overlap among these terms, but they should not be
used synonymously. (May 6, 2002)