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Interesting scholarly drug facts

Discussion in 'Pharmacology' started by rxbandit, Aug 24, 2007.

  1. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.
    300 scientifically researched facts about drugs brought to you by the Universtiy of Texas. Not all pharmacology but some interesting real world facts :)


    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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

    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)

    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)

    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)

    236. Why do people smoke banana peels to get high? They don't. This is a myth. (July 5, 2004) (July 5, 2004)

    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)

    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

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    210. Dimethyltryptamine (DMT) is an hallucinogen, but it is not as potent as LSD. DMT 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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    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)

    <A name=09.15.2003>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)

    <A name=09.08.2003>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)

    <A name=09.02.2003>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)

    <A name=08.26.2003>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)

    <A name=08.18.2003>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)

    <A name=08.11.2003>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)

    <A name=08.04.2003>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)

    <A name=07.30.2003>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)

    <A name=07.21.2003>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)

    <A name=07.14.2003>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)

    <A name=07.07.2003>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)

    <A name=06.30.2003>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)

    <A name=06.23.2003>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)

    <A name=06.16.2003>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)

    <A name=06.09.2003>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)

    <A name=06.02.2003>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)

    <A name=05.26.2003>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)

    <A name=05.19.2003>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)

    <A name=05.12.2003>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)

    <A name=05.05.2003>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)

    <A name=04.28.2003>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)

    <A name=04.21.2003>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)

    <A name=04.14.2003>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)

    <A name=04.07.2003>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)

    <A name=03.31.2003>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)

    <A name=03.24.2003>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)

    <A name=03.17.2003>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)

    <A name=03.10.2003>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)

    <A name=03.03.2003>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)

    <A name=02.24.2003>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)

    <A name=02.17.2003>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)

    <A name=02.10.2003>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)

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    <A name=02.03.2003>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)

    <A name=01.27.2003>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)

    <A name=01.20.2003>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)

    <A name=01.13.2003>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)

    <A name=06.01.2003>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)

    <A name=12.30.2002>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)

    <A name=12.23.2002>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)

    <A name=12.16.2002>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)

    <A name=12.09.2002>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)

    <A name=12.03.2002>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)

    <A name=11.25.2002>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)?

    <A name=11.18.2002>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)

    <A name=11.04.2002>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)

    <A name=08.28.2002>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)

    <A name=10.21.2002>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)

    <A name=10.14.2002>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)

    <A name=08.12.2002>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)

    <A name=09.30.2002>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)

    <A name=09.23.2002>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)

    <A name=09.16.2002>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)

    <A name=09.09.2002>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)

    <A name=09.02.2002>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)

    <A name=08.12.2002>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)

    <A name=08.10.2002>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)

    <A name=08.12.2002>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)

    <A name=08.05.2002>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)

    <A name=07.29.2002>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)

    <A name=07.22.2002>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)

    <A name=07.15.2002>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)

    <A name=07.08.2002>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)

    <A name=07.01.2002>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)

    <A name=06.24.2002>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)

    <A name=06.17.2002>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)

    <A name=06.10.2002>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)

    <A name=06.03.2002>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)

    <A name=05.27.2002>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.)

    <A name=05.20.2002>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)

    <A name=05.13.2002>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)

    <A name=05.06.2002>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)

    <A name=04.29.2002>122. The following drugs have low to moderate dependence potential (that is, not as powerful as heroin, cocaine, or alcohol): methadone, benzodiazepines (such as Xanax, Librium), marijuana, and codeine. These drugs, for many pharmacological reasons, do not produce a powerful effect on nerve transmission in the "dependence area" of the brain - the medial forebrain bundle (MFB). The MFB is also known as the mesolimbic dopamine system. (April 29, 2002).

    <A name=04.22.2002>121. The following drugs are not addicting, according to recent research: caffeine, hallucinogens (such as LSD), antidepressants, neuroleptics (used to treat schizophrenia), and lithium (used to treat bipolar disease). Some scientists feel that the reason they are not addicting is because they do not produce a strong and specific effect on the "dependence area" of the brain - the medial forebrain bundle. (April 22, 2002)

    <A name=04.15.2002>120. What percentage of the public is dependent on drugs? These figures vary depending upon the drug, but here are some rough numbers. Approximately 15-16 % of cocaine users develop dependence within the first 10 years of use. The number for marijuana is 8%, and for alcohol 12-13%, according to one recent study. Such information is not known for other drugs like heroin, nicotine, ecstasy, etc. (April 15, 2002)

    <A name=04.08.2002>119. How do "blackouts" occur? Blackouts are an apparent result of depression of activity in the part of the brain known as the hippocampus. The function of this brain area concerns cognitive learning and memory. It is known to be very sensitive to the effects of central nervous system depressant drugs such as alcohol, opioids, anesthetics, and even some stimulants such as cocaine. The rest of the brain is not as sensitive to such drugs, so that an intoxicated person may appear fine - until the next day when certain events of "the night before" are not remembered. (April 8, 2002)

    <A name=04.01.2002>118. Can drugs other than alcohol cause "blackouts"? While the alcohol-induced "blackout" is most well-known, other drugs can cause it. A blackout is nothing more than a brief period of drug-induced short-term amnesia. Thus, some anesthetics used for surgery cause blackouts, but the term is not used with this therapeutic use of drugs, since short-term amnesia of the surgical event is a desired outcome. Other drugs that cause intense intoxication, such as opioids (powerful analgesics such as morphine), cocaine, LSD, and ecstasy can also cause blackouts. (April 1, 2002)

    <A name=03.25.2002>117. What causes LSD flashbacks? No one really knows, since there has not been a lot of LSD research performed over the past 20 years. It is clear that flashbacks (hallucinations occurring months or years after the drug has been used) are not caused by LSD that is still in the body. Flashbacks probably occur because of psychological "triggering" (such as an emotional bad memory), due to cues in the environment. However, this is simply speculation, since research on flashbacks is inconclusive. (March 25, 2002)

    <A name=03.18.2002>116. Is it true that marijuana concentrates in the body fat? Yes, some metabolites (break-down products) of marijuana concentrate in the body fat, but not much of the active ingredient, delta-9-tetrahydrocannabinol (delta-9-THC). These metabolites leak out of the body fat stores slowly, over days or weeks. Thus, urine and blood analyses can tell us that people have used marijuana, but it is very difficult to tell when they used it, since the available urinalysis methods measure primarily the metabolites of marijuana. (March 18, 2002)

    <A name=03.11.2002>115. What is drug "craving"? Drug craving is an urge or desire to continue taking the drug. In the drug research arena, the word "craving" does not have a solid scientific meaning. It is also difficult to measure. When patients are asked to describe drug craving, scientists receive widely different answers. Thus, the words "urge" or "desire" are often more meaningful. Craving is not the same as drug dependence ("addiction"). (March 11, 2002)

    <A name=03.04.2002>114. Which drugs are most dangerous to the organs of the body? Collectively, the inhalants (really chemicals, rather than drugs) are extremely toxic to organs such as the liver, kidney, brain, and heart. Inhalants include chemicals from correction fluid, to gasoline, to model airplane glue and paints, to amyl nitrate "poppers", and propellants in hair sprays etc. These are usually inhaled in dangerous ways as well (as in plastic bags over the face). These chemicals are so dangerous that we don't even know if they're "addicting", since people rarely use them long enough to develop dependence. (March 4, 2002)

    <A name=02.18.2002>112. What do scientists mean by "CNS stimulants" and "CNS depressants"? "CNS" stands for central nervous system, which includes the brain and spinal cord. Drugs affecting the CNS include morphine (CNS depressant) and cocaine (CNS stimulant). Some CNS depressant drugs, such as alcohol, produce "stimulation" in low doses by depressing parts of the brain that normally put brakes on other parts of the brain. Thus, "releasing the brake" causes these other parts of the brain to become excited (apparent stimulation). (February 18, 2002)

    <A name=02.11.2002>111. How do drugs produce "craving"? No one really knows. Craving is a complex phenomenon that scientists have difficulty describing and measuring. We believe that craving is one of the causes of, but not the same as, dependence ("addiction"). Craving probably leads to relapse in recovering people. Craving may arise from brain structures including the medial forebrain bundle (pleasure pathway), the limbic system, the amygdala, and the cerebral cortex. In other words, the precise brain areas involved in craving have not yet been fully studied. (February 11, 2002)

    <A name=02.04.2002>110. How do drugs work on the brain to produce a "high"? This "high", technically known as "euphoria", is an exciting sense of well-being. Some drugs produce a blockbuster euphoria (cocaine, heroin), while others cause a mild euphoria (anti-anxiety benzodiazepines, nicotine, caffeine). This effect seems to be produced through the release of a chemical called dopamine in the pleasure pathway (medial forebrain bundle) of the brain. Euphoria, by the way, is not a cause of chemical dependency. Euphoria is merely the reason for why people use drugs socially. (February 4, 2002)

    <A name=01.28.2002>109. What are the effects of smoking cigarettes? People who smoke report that cigarettes make them more relaxed, or sometimes more energized. Beyond that, there are no beneficial effects of smoking. The detrimental effects of smoking far outweigh the few beneficial effects. The detrimental effects include a) greatly increased risk of lung cancer and heart disease, b) increased incidence of other cancers (particularly oral-pharyngeal), c) halitosis (bad breath), d) early signs of aging (wrinkled skin, etc.), and e) side-stream (second-hand) smoke effects on those around the smoker, which can be particularly detrimental to young children. Smoking is the leading cause of lung cancer. (January 28, 2002)

    <A name=01.21.2002>108. Why do people smoke? Three factors are traditionally cited as being important reasons for beginning to smoke: peer pressure (acceptance), poor education about the negative effects of smoking, and advertising. Thus, teen-age women are the fastest-growing segment of the American population of new smokers. Of these, up to 40% will become dependent (addicted) to nicotine, and will be unable to stop without help: some sort of smoking cessation program will be necessary. (January 21, 2002)

    <A name=01.14.2002>107. What is a rave? A rave (almost the same as a dance party) is a large get-together, mostly of young people. At raves, disc jockeys and synchronized light shows are featured, and drug use is condoned. Drugs used at raves include the so-called club drugs (ecstasy, LSD, methamphetamine, rohypnol, ketamine, and GHB). These are either used alone or in combination with alcohol. Most raves are well-attended (generally 100-500 people), and are advertised on the Internet, in music stores (posters), and by word-of-mouth. While illegal drugs are bought and used at raves, authorities are usually outnumbered at such places, so the number of arrests is relatively small. Research is needed to find out what to do with such parties. (January 14, 2002)

    <A name=01.07.2002>106. What is a "speedball"? "Speedball" is a street name for a drug combination of a central nervous system (CNS) stimulant and a CNS depressant. One of the most popular speedballs is a combination of cocaine and heroin. Another (not usually called a speedball) is amphetamine and alcohol. People take these for one of the following reasons: a) to increase the euphoric effect (sense of well-being) over that achieved with either drug alone (both depressants and stimulants produce a type of euphoria), b) using the second drug to stop the first drug's actions (for example, an amphetamine can "perk up" a person who is drowsy from alcohol), or c) producing a unique euphoric effect that cannot be achieved with either drug alone. In general, mixing such drugs is dangerous, for the effects are not always predictable and the side effects can be additive. (January 7, 2002)

    <A name=12.31.2001>105. Is there a difference between sedatives, hypnotics, and tranquilizers? Technically, a sedative is an agent that calms a person, and it may or may not cause drowsiness. An hypnotic is a drug that increases the probability of sleep. A tranquilizer (often thought to be the same as a sedative) is a drug that specifically reduces anxiety, or (formerly) overcomes schizophrenic symptoms. Today, the terms "anxiolytics", "sedative-hypnotics", and "antipsychotics" are more descriptive of the use of these drugs. All of these drugs can be abused, but only anxiolytics and sedative-hypnotics are capable of producing dependence. (December 31, 2001)

    <A name=12.24.2001>104. We often hear the term "compliance to treatment". How does this relate to addiction treatment? "Compliance" has to do with the regularity with which people continue treatment over time. It is a common medical problem for patients to become less compliant with treatment when they feel better, or when treatment is difficult to obtain. However, recent research suggests that alcoholics and other drug addicts are as compliant with their treatment as are people with more popular diseases such as diabetes, high blood pressure, or asthma. (December 24, 2001)

    <A name=12.17.2001>103. Vaccines are now being developed for the treatment of several drug dependencies: cocaine, nicotine, and methamphetamine. These "polyclonal" and "monoclonal" antibodies have been developed to bind with the parent drug to either prevent the drug from reaching the brain, or from attaching to the brain receptor that produces the drug effect. Thus, an animal or person who is given one of these vaccines will not feel the effects of the drug. Will these be highly useful in addiction treatment? We must wait for the clinical trials to be completed. (December 17, 2001

    <A name=12.10.2001>102. Some drugs are incapable of producing dependence ("addiction") because they do not have a significant effect on the addiction area of the brain, the medial forebrain bundle (also known as the pleasure pathway, or mesolimbic dopamine system). Drugs such as caffeine, hallucinogens (e.g., LSD), lithium, antidepressant drugs, and antipsychotic drugs have so fare not been shown to have a major effect on the medial forebrain bundle. If someone insists that caffeine or Prozac (an antidepressant drug) are addicting, they are using an old definition of addiction. The new definition is embodied in the term "dependence", as defined by accepted psychiatric assessment criteria. (December 10, 2001)

    <A name=12.03.2001>101. The old-time barbiturates were notorious for their addictive qualities. They were particularly dangerous when mixed with alcohol. Thus, people who became drunk, who were so excited that they couldn't sleep, and who knew they had to be "fresh" the next day, often took a barbiturate to help them sleep. The problem is, they often didn't wake up the next day. Several former movie stars accidentally overdosed in this manner. Even though barbiturates have been replaced by the less dangerous benzodiazepines these days, barbiturates are still available on the street. (December 3, 2001)

    <A name=11.26.2001>100. What are the effects of marijuana on driving behavior? While we would expect that the intoxicating effects of marijuana would negatively affect driving behavior (altered perception, altered judgment, etc.), this subject has been incompletely studied. Limited studies even suggest that marijuana can cause more careful (!) driving. This is very characteristic of marijuana research. Opposing studies often cancel one another out, or there is a perception of research bias. Only an extraordinary emphasis on a large number of excellent studies on marijuana pharmacology and toxicology will help us out of this "marijuana facts vacuum". (November 26, 2001)

    <A name=11.19.2001>99. How do drugs produce hallucinations? Even though research is lacking, some scientists believe that drugs such as LSD cause a malfunction of the "filtering mechanism" for stimuli coming into areas at the base of the brain, called the "reticular formation". When this filtering mechanism (however it works) is blocked, all environmental stimuli entering the brain via sight, hearing, touch, smell, etc. are allowed to flood the brain, causing hallucinations (probably in the conscious cortex). This makes sense, but it is old information since not much new research has been performed on how hallucinating drugs produce their effects. (November 19, 2001)

    <A name=11.12.2001>98. Not all drugs that make us feel good are addicting. One of the most controversial is caffeine. Most scientific studies indicate that caffeine is mildly addicting at best, but even this is not completely established. Since addicting drugs probably affect the mesolimbic dopamine system of the brain to produce "addiction", scientists must show that caffeine has a major action on this system. This has not yet been done. In addition, it is not clear that caffeine has the ability to satisfy the necessary dependence criteria of the DSM-IV. (November 12, 2001)

    <A name=11.05.2001>97. What drugs have the greatest addiction potential? As of this writing, the most addicting drugs are heroin, cocaine/crack, and nicotine. There is a large amount of research to support this, but more research might change this conclusion. Right behind these four drugs are alcohol and amphetamines. Other drugs have significant addiction potential, but not as great as these. (November 5, 2001)

    <A name=10.29.2001>96. Why don't we legalize heroin for the treatment of cancer? First of all, heroin is a highly potent, illegal drug with high addiction potential, sold on the street with an enormous black market following. Thus it has a terrible "reputation". Legalizing it will not change its reputation among the public. Pharmacologically, it's broken down (metabolized) to morphine, so there is really no advantage to legalizing heroin. The same effect can be achieved by increasing the dose of morphine. (October 29, 2001)

    <A name=10.22.2001>95. The term "substance abuse" is a poor term when applied to treatment centers and some government agencies. When talking about a "substance abuse treatment center", this is now inaccurate according to the new definition of "addiction" (which is beginning to be replaced by the DSM word "dependence"). Thus a better term is "dependence treatment centers" (this is especially true when sex and gambling disorders are treated, which are not "substances"). Also, the Center for Substance Abuse Treatment (CSAT) sends the wrong message to the public. This agency actually is more involved in supporting programs on dependence treatment. It is important that institutions accurately reflect what they do through the use of accurate and up-to-date nomenclature. (October 22, 2001)

    <A name=10.15.2001>94. We often hear of "substance abuse" rather than "drug abuse". Why do people continue to use the word "substance"? It is imprecise, and not as scientific as the words "drug" or "chemical". Although it is impossible to determine the reason why people use the word "substance", it appears that it is an attempt at being "all-inclusive" - to include not only therapeutic drugs, illegal drugs, alcohol (many people still call alcohol a food), nicotine, chemicals that are inhaled ("inhalants"), foods (to which some people can become "addicted"), and certain plant products (including marijuana and herbs). (October 15, 2001)
    <A name=10.08.2001>93. Whatever happened to meprobamate (Miltown, Equanil)? Like the barbiturates, meprobamate has pretty much been replaced by the safer benzodiazepines. Meprobamate is characterized by its low potency (many milligrams needed to produce an effect), its hangover, and its addiction potential. One drug similar to meprobamate that still gives us trouble is Soma (carisoprodol), used to produce muscle relaxation. Unfortunately, some individuals are abusing Soma, because of its sedative qualities. (October 8, 2001)

    <A name=10.01.2001>92. Whatever happened to the barbiturates? Actually, the good ol' barbiturates are still around. Not as many, and they're not used as much as they used to be, but some of them are still used. One problem is that a few of them are abused by people who want to get "high". These include mephobarbital (Mebaral) and pentobarbital (Nembutal). Thiopental (Pentothal) is still sometimes used intravenously as a pre-anesthetic medication, and phenobarbital (a long-acting, not-very-potent barbiturate) is still used as a sedative and in detoxification of benzodiazepine-dependent individuals. The reduced use of barbiturates is due to their high addiction potential and the fact that benzodiazepines are not as prone to produce overdose. (October 1, 2001)

    <A name=09.24.2001>91. Shall we treat, or punish, drug addicts? Always treat, sometimes punish, if they have committed a crime. Treatment should take place either inside or outside the prison system, depending upon the seriousness of the infraction. If no infraction has occurred other than drug use (even illegal drug use), then punishment is inappropriate. However, addicts should always be held responsible for what they do under the influence. Punishment alone does not overcome the brain chemistry problem leading to impaired control over drug use. (September 24, 2001)

    <A name=09.17.2001>90. When people relapse after being clean and sober for a period of time after treatment, it's called treatment "failure". When people regain symptoms of any other disease after treatment, it's called non-compliance or disease progression (for example, diabetes, hypertension, asthma). Why the difference? Stigma! (September 17, 2001)

    <A name=09.10.2001>89. Do amphetamines such as Ritalin and Adderall lead to addiction when used for reducing the symptoms of Attention Deficit Hyperactivity Disorder (ADHD)? Present evidence indicates that the therapeutic use of these drugs is highly effective in controlling symptoms of this disorder. Furthermore, the benefit of these drugs far outweighs their danger in producing dependence. (Remember that drugs do not cause dependence, it is the person's susceptibility to addiction that leads to the disease.) Clinicians also think that untreated ADHD may lead to increased drug use later in life as the person tries to "self-medicate" the symptoms. (September 10, 2001)

    <A name=09.03.2001>88. Marijuana is a difficult drug to study in the laboratory. There are several problems: a) standard joints cannot easily be smoked in a standard way by laboratory volunteers, b) animals exposed to marijuana smoke often stop breathing, so this is not a good way to give them the drug, c) the active ingredient in marijuana is THC, which is not water soluble. Thus solutions must be made with alcohol, which confounds the findings of the experiments. Finally, marijuana, being a controlled substance, is difficult to obtain by scientists, since a lot of paperwork and experimental controls are needed. For all these reasons, research on understanding the effects of marijuana on the body is very slow. (September 3, 2001)

    <A name=08.27.2001>87. Do drugs destroy brain cells? The only two drugs for which there is solid evidence are ecstasy and alcohol. Alcohol destroys brain cells ("neurotoxicity") only in large, prolonged doses. But with ecstasy (MDMA), the ends of the serotonin nerve cells are simply gone (as seen in animal studies). Not only is the serotonin, gone, but all the other cell components of the nerve terminal have disappeared. Small doses of MDMA apparently produce little or no damage, moderate doses produce damage but some of the serotonin system is still functional, and large doses can completely destroy the nerve terminals. ("Small", moderate", and "large" doses are relative terms; these vary from person to person.) August 27, 2001)

    <A name=08.20.2001>86. Marijuana is an illegal drug, whereas alcohol and nicotine are legal drugs. Since marijuana is a mood-altering drug, it has detrimental effects on driving skills and operation of dangerous machinery. Furthermore, like alcohol and nicotine, it produces dependence (addiction) in susceptible individuals. There are no short- or long-term beneficial effects of using marijuana in normal individuals that cannot be achieved with other drugs or activities. The medicinal effects of marijuana are anecdotal (but strong), so it makes sense that people who are very sick should be allowed to use the drug. However, the lack of public and professional agreement about the risks and benefits of marijuana means that the value of this drug will continue to be debated until scientists accumulate an overwhelming amount of research about its pharmacology and toxicology. (August 20, 2001)

    <A name=08.13.2001>85. Marijuana is a safe drug pharmacologically. It has no known lethal dose in humans, it apparently produces no significant toxicity on organ systems other than the lungs, and it has much less organ toxicity in high doses than alcohol. The long-term effects of high doses of marijuana on body physiology and organs is unknown. (August 13, 2001)

    <A name=08.06.2001>84. There are several ways by which opiates may be administered. These are a) orally (morphine is relatively ineffective when taken orally, but methadone is very effective), b) pulmonary (opium smoking began in China, but is not used much these days), c) insufflation ("snorting" - opium itself is not well absorbed by this route, but heroin can be taken this way), and d) injection (probably the most effective - intravenously, intramuscularly, or subcutaneously). "Intravenous" means into a vein, "intramuscular" means into a muscle, and "subcutaneous" means between the layers of the skin. Injection methods are the most dangerous if the needles are dirty, leading to transmission of hepatitis and HIV from user to user. (August 6, 2001)

    <A name=07.30.2001>83. One of the most potent drugs is LSD, yet it is not toxic to organs in the body. Potency has to do with the number of molecules of the drug that will produce a pharmacologic action. With LSD, only micrograms (millionths of a gram) of the drug are needed to produce hallucinations (most drugs work in milligram doses - thousandths of a gram). There is no known lethal dose for LSD in humans, and LSD is rarely used often enough or long enough by people to tell us which body organ the drug might most adversely affect. (July 30, 2001)

    <A name=07.23.2001>82. According to the National Institute on Drug Abuse, these two barbiturates are still abused in the U.S.: mephobarbital (Mebaral) and pentobarbital (Nembutal). These drugs fall into the sedative-hypnotic category, and have been replaced in therapeutic practice by benzodiazepines such as diazepam (Valium). Other barbiturates still available include secobarbital (Seconal) and phenobarbital (which is a long-acting barbiturate that has low dependence potential). This class of drugs is dangerous because of the high dependence potential and lethal outcomes when combined with alcohol. (July 23, 2001)

    <A name=07.16.2001>81. The amount of nicotine in a typical cigarette is about one milligram, enough to make a person sick if taken in the form of a tablet. However, when smoked, most of a cigarette's nicotine is lost in exhaled or uninhaled smoke. A plug of snuff kept in the mouth for 30 minutes delivers a dose of 3-5 milligrams, but because the absorption is slower than cigarette smoke-nicotine through the lungs, both routes of delivery produce similar peak blood nicotine levels. (July 16, 2001)

    <A name=07.09.2001>80. Drugs that directly affect the pleasure pathway of the brain have the potential to produce dependence ("addiction"). Drugs that have little or no effect on the brain's pleasure pathway are incapable of producing dependence. However, physical withdrawal (also known as physiological dependence, a confusing term) can occur with any drug that is used in high doses over a long period of time. Withdrawal symptoms seen when drug use ceases does not mean that a person is addicted. (July 9, 2001)

    <A name=07.02.2001>79. Lots of drugs are abused: alcohol, caffeine, nicotine, marijuana, benzodiazepines (like Valium), Vicodin, Ritalin, Prozac, LSD, aspirin (and similar pain killers), ecstasy, GHB, and many others. But not all drugs produce dependence (are "addicting"). Some drugs that affect the nervous systems do not produce dependence (or have not yet been proven to be addicting): caffeine, Prozac, LSD, aspirin, anti-parkinson drugs (such as L-dopa), anti-schizophrenic drugs (such as Risperdal), and anti-epileptic drugs (such Depakote or Neurontin). (July 2, 2001)

    <A name=06.25.2001>78. Addiction is not a "too much. Too often, withdrawal disease", it's an "I can't stop without help disease". In other words, one cannot diagnose addiction by looking at the amount and frequency of drug use. Professional assessment of the individual by qualified diagnosticians is necessary for proper diagnosis. (June 25, 2001)

    <A name=06.18.2001>77. Is caffeine addicting or not? The latest diagnostic manual (DSM-IV) does not list caffeine as producing dependence (now interchangeable with "addiction"), and most scientific reviews indicate that there is insufficient evidence to classify caffeine as addicting. Yes, withdrawal from caffeine does occur, but withdrawal is only one of several criteria required to classify a drug as "dependence-producing". (June 18, 2001)

    <A name=06.11.2001>76. Many, but not all, abused drugs are "receptor agonists". An "agonist" (such as heroin) activates a receptor in the brain to produce its effects. An "antagonist" (such as naloxone, Narcan) occupies a receptor site and prevents an agonist from activating the receptor. Thus, when a person overdoses on heroin, Narcan (in sufficient doses) is capable of taking the place of heroin at the receptor and reversing heroin's effects. This is why Narcan is a life-saving drug in heroin overdose situations. Because Narcan does not activate the opioid receptors, it is not addicting. (June 11, 2001)

    <A name=06.04.2001>75. A popularly-abused drug is "Oxycontin". What is this drug? This is the brand name for oxycodone, an orally-active sustained-release opioid drug used for pain control. Its effects are designed to last about 12 hours. Like other opioids (heroin is an opioid), this drug can be abused and is capable of producing dependence ("addiction") in susceptible individuals. (June 4, 2001)

    <A name=05.28.2001>74. A basic pharmacological concept is that drug effects are determined, in part, by the area of the brain that is most affected by a drug. The drugs act on receptors, and these receptors vary in concentration throughout the brain. If there are drug receptors, for example, in the pleasure areas of the brain, then the drug will produce feelings of pleasure. The same drug working at the same receptors in a different area of the brain (for example, the motor areas) might produce a "side effect" of changes in motor activity (movement). (May 28, 2001)

    <A name=05.21.01>73. A basic pharmacological concept is that addicting drugs act on portions of nerve cells to exert their actions. One major cellular site of action is the receptors where the drugs "bind" to cause electrical and chemical changes to occur in the cell. These changes are the beginning of a cascade of electrical and chemical events that make the next nerve cell more likely to carry the message ("excitation"), or less likely to carry the message ("inhibition"). (May 21, 2001)

    <A name=05.14.01>72. LSD is a very interesting drug because of its high potency (only a few micrograms are needed to produce hallucinations), and because there are no known instances of deaths cased by toxic overdoses. Certainly people have died because of the risks they took while intoxicated, but LSD is a pretty safe drug otherwise. Scientists do not fully understand how it acts on the brain to produce hallucinations. (May 14, 2001)

    <A name=05.07.01>71. Causes of death due to overdose with the following drugs are: cocaine (hypertensive stroke or cardiac arrhythmia a.k.a. as irregular beating), heroin (depression of the respiratory center in the brainstem), ecstasy (hyperthermia and seizures), alcohol (same as heroin, or drowning on aspirated vomit), amphetamines (seizures), benzodiazepines (very high doses, same as heroin), inhalants (heart, brain, kidney, and liver damage). Overdoses with marijuana or LSD are rare, unless mixed with other drugs. (May 7, 2001)

    <A name=04.30.01>70. There are several neurotransmitters (cell-communicating chemicals) in the brain that appear to be related to chemical dependence ("addiction"). These are dopamine, serotonin, endorphins, GABA, glutamate, and acetylcholine. It appears that dysregulation of one or more of these chemicals in the brain's pleasure pathway determines the primary drug upon which a person becomes dependent. For example, we might assume that cocaine dependence is related to dopamine dysregulation. Another match-up includes heroin and endorphins. Finally, nicotine dependence might be related to dysregulation of nicotine receptors (acetylcholine system). More research is required to confirm such relationships, however. (April 30, 2001)

    <A name=04.23.01>69. All drugs affecting the brain have a common general mechanism of action. That is, they all affect nerve cells (neurons) in some way. Some brain-affecting drugs reduce nerve cell function, while others increase nerve cell function. But it isn't that simple. When a person falls asleep, some parts of the brain continue to function and are refreshed by the reduced activity of the body. In a similar manner, some brain areas are "disinhibited" when a depressant drug such as heroin is working. The result is an energized feeling. (April 23, 2001)

    <A name=04.16.01>68. Marijuana jargon: blunts are hollowed-out cigars packed with marijuana.? Colas are buds of the cannabis plant, which are preferred by marijuana users because of their higher content of delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana.? Hashish (hash) is the resin of the cannabis plant, when it is separated from the plant material. (April 16, 2001)

    <A name=04.09.01>67. The big challenge in developing medications to treat chemical dependency is to obtain high potency, great specificity, and no significant side effects. This means that new medications must be effective in low doses (e.g., in the 1-4 mg/dose range), they must target only the brain areas involved in dependence (e.g., various parts of the medial forebrain bundle, where addiction occurs), and their effects must not "spill over" into other areas where side effects would be produced. (April 9, 2001)

    <A name=04.02>66. There is a category of abused drugs called "Inhalants". These include nitrites (e.g. amyl nitrite "poppers" that have the same basic effects as nitroglycerin used by angina patients), nitrous oxide and other gas anesthetics ("anesthesia outside of the operating room"), and solvents (a broad category of highly toxic chemicals found in gasoline, glues, paints, and sprays). These are most often used by young people or desperate individuals who cannot afford or cannot obtain other drugs such as alcohol. (April 2, 2001)

    <A name=03.26>65. The term "drugs" includes alcohol, nicotine, illegal drugs, prescription drugs, and chemicals that produce a pharmacological action when ingested. Sometimes the word "drug" has a narrow meaning to some people (such as only "illegal" drugs). Sometimes there is a misunderstanding about what drugs are (alcohol is a drug, not a food; nitrous oxide is a drug, but also a chemical). Generally, foods, vitamins, and minerals are not drugs. (March 26, 2001)

    <A name=03.19>64. Most drugs act at receptor sites in the brain to exert their pharmacological actions. Receptors are specialized proteins or enzymes that are the "lock" in the "lock and key" concept of receptor activation. A drug actually attaches (or binds) to its specific receptor, which creates a change in the receptor shape or activity. The final result of this activation is increased or decreased firing of the nerve cell. When many cells are affected in this way by a drug, the result is called the pharmacological action of the drug, which might be a behavioral change or a therapeutic action. (March 19, 2001)

    <A name=03.12>63. People "abuse" many drugs. A few that we're hearing about these days include Ritalin (see above fact), Vicodin (often used by health professionals and people who begin using it for rational therapeutic reasons such as back pain), club drugs (GHB, rohypnol, ketamine, and others that are taken because of peer group acceptance), Ultram (tramadol, a non-traditional opioid-like analgesic that is abused by health professionals), and codeine (a mild opioid antitussive, or anti-cough medication). Club drugs and codeine, especially, have been taken with other drugs such as alcohol, which makes the complications of their abuse even more problematic. Some of these drugs have a large addiction potential, while some have a low addiction potential. (March 12, 2001)

    <A name=03.05>62. Methylphenidate (Ritalin) is now an abused drug. Patients with Attention Deficit Hyperactivity Disorder (ADHD, also known as ADD) are selling their Ritalin prescriptions to other people who use the drug for increasing alertness and getting high. This even happens with children's prescriptions. Ritalin is an amphetamine-like drug, so it can be just as dependence-producing as methamphetamine in recreational users. Ritalin is also available on the black market. Likely, this will lead to increased restrictions on the availability of the drug for prescription use. (March 5, 2001)

    <A name=02.26>61. Beware of drug dealers (or even non-qualified professionals) telling you what they know about drugs. Only drug experts (unbiased addiction scientists, pharmacologists, addiction medicine specialists, and drug educators) can tell you what drugs really do. For example, it is not true that smokable heroin is non-addicting, or that LSD causes mental illness. Drug myths cause many of the problems with drugs that we have in this country. (February 26, 2001)

    <A name=02.19>60. Some psychoactive drugs are associated with powerful dependence (e.g., cocaine) and some are associated with minor dependence production (e.g., marijuana). This is because their ability to affect the pleasure pathway of the brain varies, for reasons that are incompletely understood. One possible explanation for this variation is the ability of the drugs' receptors to adapt to the presence of the drug to produce sensitization, which is one of the component causes of dependence. (February 19, 2001)

    <A name=02.12>59. Not all psychoactive drugs are associated with dependence ("addiction"). Drugs that produce addiction as a side effect must have a major action on the pleasure pathway (medial forebrain bundle, MFB)) of the limbic system. Drugs such as fluoxetine (Prozac) are non-addicting, because they do not have a major action on the MFB. (February 12, 2001)

    <A name=02.05>58. Caffeine is the least potent of the central nervous system stimulants, and is mainly found in coffee, cola drinks, and other beverages. It is used for its anti-fatigue effects, and excessive use of caffeine leads to headache, stomach upset, and drowsiness upon withdrawal. In spite of such withdrawal, caffeine does not cause significant drug dependence, according to established criteria. The neurochemical mechanism of caffeine on the brain is incompletely understood. (February 5, 2001)

    <A name=01.29>57. Benzodiazepines are effective in reducing anxiety ("anxiolytics") and in promoting sleep ("hypnotics"). Anxiolytic benzodiazepines include alprazolam (Xanax), chlordiazepoxide (Librium), and diazepam (Valium). Hypnotic benzodiazepines include flurazepam (Dalmane), triazolam (Halcion), and temazepam (Restoril). These drugs are thought to increase the function of gamma-amino butyric acid (GABA) in the brain. Since the GABA system is an inhibitory system in the brain, increasing its function will tend to suppress overactivity symptoms, two of which are anxiety and insomnia. (January 29, 2001)

    <A name=01.22>56. There is a nicotine vaccine being tested in animals, as of this date. Like the cocaine vaccine, it is designed to keep the drug from acting on the brain. "Vaccines" are antibodies to the drug molecule that complex with the drug and make the drug less likely to fit its receptor. Such vaccines are designed to treat chemical dependency and/or act as an antidote in overdose situations. (January 22, 2001)

    <A name=1.15>55. How is genetics involved in addiction? Abnormal genes, passed from one generation to another, may cause dysregulation of neurotransmitter function in the "pleasure pathway" of the brain. This neurochemical dysregulation probably causes a potential addict to "connect" with certain drugs in a special way, so that the drug fills a "need" that the individual interprets as "pathological craving" directed toward the drug's pharmacological actions. (January 15, 2001)

    <A name=1.08>54. Is addiction a "genetic" disease? Yes, with qualifications. Although the genetics research in this area is still under development, most scientists believe that the tendency to become addicted is inherited. In other words, addiction is under the control of both genetics and environment, much like other diseases that have a genetic component. (January 8, 2001)

    <A name=1.01>53. All drugs associated with dependence (for example, cocaine, nicotine, heroin) produce withdrawal in many people when they stop after (generally) high drug use over a long period of time. There are two types of withdrawal: a) physical hyperexcitability (the most common) as seen in withdrawal from central nervous system depressants such as heroin, and b) mental "hyper-depression" that follows withdrawal from central nervous system stimulants such as cocaine. A person does not have to be dependent ("addicted") to a drug to have withdrawal. Likewise, not every drug-dependent individual has withdrawal when they stop using. (January 1, 2001)

    <A name=12.25>52. Pharmacotherapy (pharmaceutical treatment) of chemical dependence falls into two general categories: a) those that reduce withdrawal severity and b) those that reduce craving leading to drug seeking/relapse. Examples of products that fall into the first category are nicotine patches and gum (smoking) and clonidine (heroin). Examples of products that fall into the second category are bupropion (smoking) and naltrexone (alcohol). (December 25, 2000)
    <A name=12.18>51. What is GVG? Gamma-vinyl GABA is a derivative of the inhibitory neurotransmitter GABA. Because there is some rationale for the involvement of GABA in the actions of cocaine on the brain, GVG might be useful for the treatment of cocaine dependence. No one knows exactly how it works, but it is a good example of the types of drugs currently being tested for reducing the craving associated with cocaine use. (December 18, 2000)

    <A name=12.11>50. What is buprenorphine? This is a powerful analgesic of the opioid class of drugs, that also seems to reduce the craving for heroin. Unlike methadone, which is a pure "agonist" (receptor activator), buprenorphine has a mixture of agonist and antagonist (receptor blocker) activity. Thus it is difficult to increase the dose of the drug to get a better "high", since at high doses the antagonist effect apparently kicks in and reduces the rewarding effects of the drug. (December 11, 2000)

    <A name=12.04>49. What is bupropion? This is an antidepressant drug that has recently been approved for the treatment of nicotine dependence. Better known as Zyban, it supposedly reduces the withdrawal symptom severity produced when people stop smoking. It might also reduce the craving for nicotine. (December 4, 2000)

    <A name=11.27>48. Is the new smokable heroin addicting? Of course! Changing the way a drug is ingested does not change its ability to produce addiction. Remember: addiction (dependence) is not caused by the drug, otherwise everyone who uses heroin and other drugs would become addicted. Whether or not a person becomes addicted is dependent upon the person's susceptibility to addiction. This susceptibility is determined by genetics, brain sensitivity, and other factors. (November 27, 2000)

    <A name=11.20>47. Are there any drugs that affect the brain and are not addicting? Yes, there are many of them. According to the latest definition of "addiction" (dependence as defined by Diagnostic and Statistical Manual, Edition IV criteria), there is insufficient evidence to demonstrate that caffeine and LSD produce addiction. (This surprises a lot of people.) Also, not all mood-altering drugs produce dependence: antidepressants, presumably because they do not have a direct effect on the pleasure pathway of the brain (the site of dependence production). Other drugs that do not produce dependence are: naltrexone and naloxone (opioid antagonists), chlorpromazine (an anti-schizophrenic drug), lithium (a drug used to treat bipolar disorder), and anti-epileptic drugs such as phenytoin. (November 20, 2000)

    <A name=11.13>46. Does everyone who uses cocaine, heroin, and marijuana become addicted? Absolutely not. Our best estimates are that 18% of people who use cocaine/crack become addicted. Weak evidence indicates that 40% and 4% of people who use heroin and marijuana, respectively, become addicted. However, these are the results of preliminary household surveys, and require more research to come up with more accurate numbers. (November 13, 2000)

    <A name=11.06>45. Which drugs produce the worst Fetal Syndrome when the mother uses them during pregnancy? Alcohol, by far, is the worst drug. It produces the permanent teratologic effects caused by alcohol: abnormal facial characteristics, organ developmental defects, including brain underdevelopment. All other recreational drugs (legal or illegal) produce marked, but temporary, effects on the fetus. However, more research would be helpful in identifying the precise effects of recreational drugs on the fetus. (November 6, 2000)

    <A name=10.30>44. What do we know about LSD? LSD is the classic hallucinogen (produces mostly visual hallucinations). It is used by "acid-heads" who want to have new experiences and insight. It allegedly allows a person to see everything differently, while they are in a state of "high suggestibility". This is why it is difficult to overdose on LSD. While there is no documented human lethal dose of LSD, the drug supposedly can trigger psychotic episodes and people often experience "bad trips" (scary hallucinations). Thus, a "bad trip" is not physiologically dangerous, and the person can be "talked down" from the experience through suggestive statements. (October 30, 2000)

    <A name=10.23>43. How does methamphetamine work? Methamphetamine is a "psychostimulant" that causes a euphoric response almost as intense as cocaine. It acts longer than cocaine (in single doses), but has a slower onset of action. Methamphetamine has therapeutic uses in the treatment of narcolepsy (a sleep disorder), and as an adjunct to obesity control, when prescribed. It appears to increase the release of dopamine from brain cells, which leads to an overall generalized stimulation of the brain. (October 23, 2000)

    <A name=10.16>42. What are "club drugs"? These are mood- and consciousness-altering drugs that can be dangerous, and are often used at "rave parties". They include: methamphetamine (meth, crank, ice), rohypnol (roofies), phencyclidine (PCP, angel dust), LSD (acid), MDMA (ecstasy, X), and ketamine (Special K, vitamin K). Most of these drugs are not new. Some of them are in general use in veterinary medicine due to their severe side effects in humans. Some of them have therapeutic uses but are actually more dangerous when used recreationally than when used therapeutically. (October 16, 2000)

    <A name=10.09>41. Heroin and methadone are called "opioid agonists" because they cause activation of the opioid receptor, which leads to analgesia, euphoria, and (in some people) dependence on these drugs. Newer drugs are being developed to treat heroin dependence. One interesting drug, buprenorphine, is an "agonist-antagonist", which means that it both activates and blocks the opioid receptor. This mixed action has been shown to be effective in helping heroin addicts break free of their dependence on heroin. (October 9, 2000)

    <A name=10.02>40. The use of methadone to treat heroin dependence is highly effective, because the drug reduces the craving for heroin, it "stabilizes" the neurotransmitter dysregulation in the brain associated with heroin craving, and it gets the person out of the crime-related activities associated with the acquisition of heroin. However, many people mistakenly think that methadone treatment is only "replacing one addicting drug with another". People who believe in abstinence-based treatment disagree with the effectiveness of methadone. However, methadone treatment saves lives. (October 2, 2000)

    <A name=9.25>39. Abused drugs are controlled by the Drug Enforcement Administration through categories listed in the Controlled Substances Act of 1970. Schedule I drugs include those that have no accepted therapeutic use (examples: marijuana, heroin, ecstasy). Schedule II includes those drugs that are used therapeutically but which have high potential for abuse, such as cocaine, amphetamines, and potent opioids such as morphine. Schedule III drugs have "some" abuse potential (less than those in Schedule II), such as certain drugs used to treat obesity. Schedule IV drugs have "low" potential for abuse and includes anti-anxiety drugs such as Valium and Xanax. Schedule V drugs are subject to state and local regulation and include low-potency opioid compounds used to treat diarrhea, among others. (September 25, 2000)

    <A name=9.18>38. Marijuana has no federally-approved therapeutic use. The active ingredient, delta-9-tetrahydrocannabinol or THC, is approved in tablet form (dronabinol or Marinol) for the treatment of nausea and vomiting associated with cancer chemotherapy, and for the treatment of wasting syndrome in AIDS. However, some people think marijuana is more effective in joint form than in tablet form, which has never been proven scientifically. They would also like to see the drug approved for other uses; for example, the treatment of pain, glaucoma, asthma, and seizures. (September 18, 2000)

    <A name=9.11>37. Addicting drugs act at the cellular (nerve cell) level by activating "receptors" that help to propagate certain types of signals from cell to cell. When a drug enters the brain, it floods the nerve cells and eventually reaches the "synaptic area" (spaces between nerve cells) where the cells "talk to each other" by way of chemicals. Receptors for drugs and neurochemicals are very specific, being sensitive to only one or a few chemicals. "Activation" means causing an initial change in the receptor which leads to other chemical and enzymatic changes at the micro level. These cause the next nerve cell to become excited or to become less excited. Millions of receptors all doing their own thing can thus easily become disrupted when an addicting drug affects these receptors, especially over a long period of time. (September 11, 2000)

    <A name=9.04>36. "Club drugs" are drugs taken presumably to enhance people's experiences during dance parties and "raves". These drugs include the older drugs MDMA (ecstasy), LSD, and methamphetamine, plus some newer drugs: GHB (gamma-hydroxybutyrate, Liquid ecstasy), rohypnol ("roofies"), and ketamine (special K, vitamin K). In spite of common belief, all these drugs are dangerous and can trigger addiction. These drugs have effects on neurotransmitters in the brain, and most are lethal when mixed with alcohol. (September 4, 2000)

    <A name=8.28>35. The only common property of inhalant drugs is that they are inhaled. The category includes nitrites, anesthetics, solvents, paints, sprays, and fuels. Serious solvent intoxication with these compounds is like that of alcohol, but with greatly increased risk for short-term organ toxicity. The risk of a lethal overdose with solvents is significant, with death occurring because the heart rhythm is disrupted. Other risks include reduced oxygen exchange, accidents, and suicide. A large number of first-time users die from the use of inhalants. (August 28, 2000)

    <A name=8.21>34. There is relatively little research on marijuana, compared to the amount on cocaine, alcohol, and heroin. Marijuana is difficult to study, for several reasons. Marijuana joints on the street cannot easily be duplicated in the laboratory, since the content of the active ingredient (delta-9-tetrahydrocannabinol, THC) varies greatly in street products. Animals cannot easily be exposed to the smoke, and the native form of THC is not water soluble; therefore, it is difficult to administer the compound to animals. Finally, the effects of marijuana on humans varies greatly from one person to another because of expectations of the user ("set") and the type of environment in which it is used ("setting"). (August 21, 2000)

    <A name=8.14>33. The receptor for tetrahydrocannabinol (THC, the active ingredient in marijuana) has been identified in the mammalian nervous system. This receptor has been extensively studied and has been found to be activated by anandamide, a naturally-occurring chemical in the brain. Antagonists (blockers) of anandamide have been used to study withdrawal from marijuana in animals, and may provide a tool to prevent the effects of marijuana in the body. (August 14, 2000)

    <A name=8.07>32. A voucher system is being used to treat cocaine addicts. The vouchers, worth money that can be used to buy anything except drugs, are rewards for having regularly clean urine tests. The vouchers are very effective in helping cocaine-dependent patients remain abstinent during counseling or abstinence-based twelve-step therapy. (August 7, 2000)

    <A name=7.31>31. Vaccines are being developed to treat cocaine and PCP overdose, and perhaps reduce abuse and aid treatment of dependence on these drugs. The vaccines are monoclonal antibodies that attach to drug receptors and prevent their action at receptor sites throughout the brain. This can greatly reduce overdose effects and perhaps save lives. (July 31, 2000)

    <A name=7.24>30. It is generally assumed that addicting drugs do not cause nerve cell death, except in high doses. A few rat/mouse studies have shown that MDMA ("ecstasy") can kill brain cells in the serotonin system of the brain, although this is difficult to observe, of course, in human brains. It is also possible, based upon newer research, that certain drugs such as ketamine ("Special K") and phencyclidine (PCP, "angel dust") might enhance apoptosis, or programmed cell death. If this is the case, then such drugs are much more toxic to the brain than previously believed. (July 24, 2000)

    <A name=7.17>29. What are endorphins? Endorphins are naturally-occurring "morphine-like" substances in the brain and spinal cord that are involved in affecting pain sensitivity in individuals. They are also released in the brain during exercise, certain types of stress, relaxation, and perhaps when people take drugs such as heroin and alcohol. Endorphins work by activating opioid receptors - the same receptors that are affected by opiate pain killers (strong analgesics). (July 17, 2000)

    <A name=7.10>28. What are neurotransmitters? Neurotransmitters are chemicals released at the end of nerve cells (neurons) that help signals pass from cell to cell, thereby making the brain capable of producing behavior, thought, and emotions. There are over 40 specially-identified neurotransmitters in the brain, and probably hundreds more that are only now being discovered. (July 10, 2000) <-- Key words: neurotransmitters, neurons, behavior, thought, emotions -->

    <A name=7.03>27. Drug effects on brain cells are generally associated with specific actions on certain message-carrying chemicals called neurotransmitters. For example, scientists believe that heroin's effects are exerted through chemicals called endorphins; cocaine, through dopamine, and benzodiazepines (such as Xanax) through gamma-amino butyric acid (GABA). (July 3, 2000)

    <A name=6.26>26. "Crack" should not be confused with "crank". These street names refer to smokable cocaine and amphetamine, respectively. Street names for illegal drugs arise from the strangest places. For example, "crack" is apparently named for the crackling sound of burning processed free-base cocaine. "Roofies" is one of the street names for the date rape drug rohypnol, which apparently was used extensively by roofers repairing homes after a hurricane in Florida. (June 26, 2000)

    <A name=6.19>25. What is the "medial forebrain bundle"? This anatomical structure in the brain is the probable site of most drugs' action in producing "euphoria" (sense of well-being, or "high"). It is known as the "pleasure pathway" of the brain, and drugs work on one or several of its four main parts (moving from the center to the front of the brain): ventral tegmental area, lateral hypothalamus, nucleus accumbens, frontal cortex. It is also possible that "craving" for drugs arises in this pathway, as well as the addicts' perceived "need" for drugs (although these last two drug qualities have not been proven to arise here). (June 19, 2000)

    <A name=6.12>24. MDMA (ecstasy, or just "e") is chemically related to amphetamines, but it has different effects on brain chemistry. The main pharmacological action of amphetamines is to increase the release of dopamine (and some norepinephrine and serotonin) from brain cells, to produce increased euphoria and alertness. The action of amphetamines is mainly on the cerebral cortex of the brain. MDMA, on the other hand, causes nerve cells to release serotonin into the synapse, thereby producing continual nerve stimulation. The main site of action of MDMA is probably the limbic system, where mood and emotions are regulated. The amount of high-quality research on MDMA is low; therefore, scientists do not know much about the effects of this "rave" drug. (June 12, 2000)

    <A name=6.05>23. Which drugs produce the greatest tolerance and withdrawal? Heroin and some other opioid (pain killing) drugs generally produce the greatest tolerance. The usual pain-killing dose of an opioid is in the 5-20 milligram range, but addicts often use 3-4 grams (thousands of milligrams) when they become tolerant. LSD produces very rapid tolerance (known as tachyphylaxis), which occurs when sequential doses produce dramatically reduced effects within a very short period of time. Alcohol and the old-time barbiturates can produce powerful withdrawal, characterized by life-threatening seizures and other problems. Heroin's withdrawal is also quite uncomfortable, but not life-threatening. (June 5, 2000)

    <A name=5.29>22. What is physical dependence? Physical dependence occurs when a person uses a drug on a regular basis over time. Gradually, the person's body adapts to the presence of the drug, so that without the drug, the person cannot function normally. When drug use is abruptly stopped in a physically dependent individual, the person goes through "withdrawal", where signs and symptoms opposite to the drug's general effects on the body are seen. Physical withdrawal is not the same as addiction. (May 29, 2000)

    <A name=5.22>21. What is drug tolerance? Tolerance is a reduced response to a drug's action. It can be inborn, in which an individual initially fails to respond to usual doses of a drug, or it can be acquired as a person uses a drug. Most drugs produce some degree of tolerance, which produces a need for higher and higher doses of the drug to produce the same effect as initially. Tolerance occurs in the liver (where enzymes become more active in breaking down the drug), or in the target tissues (where the tissues somehow become less sensitive to the drug's effects). (May 22, 2000)

    <A name=5.15>20. The legality of dangerous drugs such as alcohol and nicotine, and the illegality of marijuana, have been established through cultural and historical traditions over the centuries. In fact, many drugs were legal in the United States until the Harrison Narcotic Act of 1914, which made opioids, marijuana, and cocaine illegal for use outside of medicine. Thus, the term "narcotic" (which literally means "a drug that produces sleep or drowsiness") is actually a useless misnomer. Opioid drugs such as morphine, opium, and codeine have traditionally been called "narcotics", but today the use of the word is declining due to confusion and its lack of scientific accuracy. (May 15, 2000)

    <A name=5.08>19. People are confused by the legal availability of alcohol and nicotine, two highly toxic drugs when used in excess, and the illegality of drugs such as marijuana. In addition, some drugs (hallucinogens) can be used legally by some native Americans in religious ceremonies, and some potentially dangerous drugs (opium, coca leaves) are legal in some parts of the world. No drugs, however, are legal for Americans under the age of 18, except "medicines" prescribed by physicians. These "medicines", on the other hand, include abuseable drug categories such as amphetamines, opioid analgesics, and the anti-anxiety and sleep-inducing benzodiazepines. (May 8, 2000)

    <A name=5.01>18. "Social use" of drugs is more difficult to define with nicotine and illegal drugs than it is with alcohol. Technically, any drug can be used "socially", indicating that people can congregate in groups and use drugs as an aid to socializing. Individuals who use marijuana socially perhaps best fit into this category. However, the toxicity (nicotine) and illegality (heroin, marijuana) of the use of such drugs precludes benign social use of such chemicals. On the other hand, alcohol can be legally used in social situations that benefit the individuals and some groups that depend on restrained use of the drug (as in religious ceremonies). (May 1, 2000)

    <A name=4.24>17. People often wonder how nicotine can be a legal, socially-accepted drug, while other drugs are illegal to possess, sell, or use. Recently an anti-smoking sentiment has arisen among the general public, based primarily upon new research on the addictive and harmful effects of nicotine. Legalization, or at least decriminalization, has been proposed by some as a solution to the high crime rate caused by drug trafficking in the U.S. Tradition and past history play a major role in the acceptance of drugs in society, and only more sociological research on the effectiveness of changing drug availability will help to answer the question. In the meantime, such an issue is primarily political. (April 24, 2000)

    <A name=4.17>16. Illegal drugs (as well as nicotine) are administered into the body by different routes: orally (by mouth), smoking (to the lungs via the trachea from the mouth), the nasal membranes ("snorting"), by vein (intravenously), under the skin (subcutaneously), into a muscle (intramuscularly), by artery (injection into a major neck artery, for example), into the rectum (rectally, as by suppository), and under the tongue (sublingually). Addicts have tried every site of administration imaginable. Sometimes the act of preparing and administering the drug is more exciting than the drug itself (often seen with cocaine use). (April 17, 2000)

    <A name=4.10>15. "Crack babies" are a misnomer. They are misnamed because mothers who produce "crack babies" have been found to use more than just crack or cocaine during pregnancy. In fact, it is difficult to find a pregnant woman who only uses this drug during pregnancy. Most also use other drugs, such as alcohol, marijuana, cigarettes (nicotine), heroin, etc. These women are also poorly nourished and have poor prenatal care. Thus the "crack baby" (a pejorative term) is actually the product of multiple environmental insults, and is best labeled "a baby with multiple birth defects". (April 10, 2000)

    <A name=4.03>14. New anti-craving medications are becoming available for the treatment of chemical dependence. Some of these are older drugs being used for this purpose; others are new drugs designed specifically as abstinence-enhancing drugs, with the intent that they will supplement existing behavioral treatments ("talk therapy"). These pharmacotherapies include bupropion (Zyban, nicotine dependence), naltrexone (ReVia, alcohol dependence), and methadone (Dolophine, heroin dependence). To date, there are no effective pharmacotherapies for treating dependence associated with cocaine, marijuana, benzodiazepine, amphetamine, and miscellaneous drugs (PCP, ketamine, rohypnol). (April 3, 2000)

    <A name=3.27>13. There are two major drug problems in the world, based upon new diagnostic criteria. The first is drug abuse, which is intentional drug overuse or misuse such as seen in the inner cities, or in other cases with poor judgment about using chemicals too much, too often. The main characteristic of drug abuse is that people will moderate or stop using when they decide that the adverse consequences are worse than the desirable effects of using. The second problem is pathological drug dependence, the disease of "addiction". This is a brain-chemistry disease characterized by the inability to consistently stop using, even under adverse consequences. (March 27, 2000)

    <A name=3.20>12. LSD is one of the most potent drugs in existence. The amount required to produce hallucinations is in the microgram range (compared to alcohol, which requires doses in the gram range to produce euphoria). LSD is also quite non-toxic to organs in the body, and is generally considered to be non-addictive, as defined by new diagnostic criteria for drug dependence. (March 20, 2000)

    <A name=3.13>11. What is a drug? A drug is any chemical that produces a therapeutic or non-therapeutic pharmacological action (effect) in the body. Chemicals, on the other hand, are a broad class of substances (including drugs) that may or may not produce noticeable effects in the body. Many chemicals (such as tin, lead, gold) have mainly toxicological (harmful) effects on the body, especially in high doses. Most foods are not drugs. Alcohol is a drug, not a food (in spite of the calories it provides). Nicotine is a chemical that is also a drug. The group of "illegal" drugs includes dangerous chemicals that have only toxic actions (e.g., inhalants). (March 13, 2000)

    <A name=3.06>10. Opioids are drugs that are powerful analgesics (pain killers). This class of drugs includes naturally-occurring opiates such as opium, synthetic opiates such as methadone, and naturally-occurring brain substances such as endorphins. The major side effects of the opioids include dependence (addiction), depression of respiration (in high doses), tolerance (reduction of effect with prolonged use), nausea, constipation, and reduced pupil size in the eyes. Pharmaceutical companies continue to search for new powerful analgesics with few side effects, particularly addiction. (March 6, 2000)

    <A name=2.28>9. Benzodiazepines are drugs that reduce anxiety, enhance sleep, and reduce seizures. Examples of this drug class are Valium, Librium, Xanax, and Tranxene. These drugs are thought to work by enhancing or mimicking the effects of gamma-amino butyric acid (GABA), an inhibitory neurotransmitter, in certain parts of the limbic system. The limbic system is the part of the brain where emotions and "mood" are thought to arise. (February 28,2000)

    <A name=2.21>8. Nicotine is one of the most toxic drugs available. It is readily absorbed through skin and mucous membranes. Much of the nicotine in cigars and cigarettes is vaporized during burning, but enough still remains to cause significant toxicity in the lungs and in organs affected by nicotine in the blood. Nicotine is also highly addictive (as addictive as heroin and alcohol, measured by the number of smokers who become dependent and by the difficulty in stopping the use of the drug). (February 21, 2000)

    <A name=2.14>7. Caffeine is a mild (compared to cocaine and amphetamines) stimulant of the central nervous system. In moderate doses (e.g., 2-3 cups of coffee, but it varies among individuals), caffeine can: increase alertness, alter sleep patterns, reduce fatigue, and cause headaches, nervousness, dizziness, and heart palpitations. According to the new understanding about drug dependency, caffeine does not cause "addiction" (impaired control over consumption). (February 14, 2000)

    <A name=2.07>6. Marijuana is less toxic to the body than alcohol. Some people have interpreted the relative safety and lack of toxicity of marijuana to mean that the drug should be legalized, like alcohol. However, there is a relative lack of research on marijuana's effects, compared to the large number of studies on alcohol pharmacology and toxicology. Both drugs produce dependence in vulnerable individuals, leading to a pattern of chronic compulsive drug-taking behavior that requires treatment. (February 7, 2000)

    <A name=1.31>5. Two dangerous illicit drugs used by risk-takers are phencyclidine (PCP, "angel dust") and ketamine ("Special K", vitamin K"). These are "dissociative anesthetics", that are sometimes used in humans but more often used in animals. Their pharmacologic category describes a state of anesthesia in which the subject cannot feel pain but appears to be awake (eyes open, etc.). The drugs apparently produce an usual dreamy state when taken recreationally. (January 31, 2000)

    <A name=1.24>4. Drugs are generally categorized as medicinal (pharmaceutical, therapeutic), legal (licit), or illegal (illicit). Examples of each of these categories are aspirin, nicotine, and heroin. Sometimes a drug can fall into more than one category depending upon how it is used; for example, cocaine is therapeutic and licit when used as an anesthetic for eye surgery, but is illicit when used to get "high". (January 24, 2000)

    <A name=1.17>3. Marijuana is the general term used to describe several varieties of the plant (or any part of it) known as Cannabis (indicia, sativa, etc.). Cannabis contains delta-9-tetrahydrocannabinol (THC), which is psychoactive. (January 17, 2000)

    <A name=1.10>2. Heroin is called an "opioid agonist", because it is a synthetic compound similar in structure to morphine and activates the opioid receptors in the brain to produce several pharmacological effects. (January 10, 2000)

    <A name=1.03>1. The following drugs are the most highly addicting, according to present-day definitions: alcohol, nicotine, cocaine/free base/crack, heroin, and most of the old-time barbiturates. (January 3, 2000)
    Last edited: Aug 24, 2007
  2. Heretic.Ape.

    Heretic.Ape. Platinum Member & Advisor

    Reputation Points:
    Apr 17, 2007
    Male from U.S.A.
    Looks interesting, but I don't suppose I could persuade you to throw in some line breaks? That's a big mass of interesting facts ;)
  3. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.
    line breaks added. Yeh alot of the facts contain information I havent seen anywhere else, def an interesting read. enjoy!
  4. radiometer

    radiometer bananadine addict Platinum Member & Advisor

    Reputation Points:
    Apr 13, 2005
    Male from U.S.A.
    A name = That's

    A name = so much

    A name = easier to

    A name = read now!

    A name = :beer:
  5. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.

    I spent a good half hour adding some line breaks. I suppose when i get another hour or so I'll take the time to pull out all the <A name>'s. Is there an easier way for tedious mass formatting?
  6. psyche

    psyche Palladium Member

    Reputation Points:
    Feb 28, 2006
    29 y/o Male from finland
    I've never heard of a program for that purpose, but one would be very handy to exist. I usually write a simple qbasic or perl program to tasks such at yours. It isn't that complicated to do after all, and saves time even if the textmass isn't really massive.
  7. KBLSD

    KBLSD Silver Member

    Reputation Points:
    Dec 11, 2006
    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)

    hmm.... i never knew a bad trip on LSD was a overdose, cuz swims had a bad trip on 10 hits and a bad trip on 2 thats so stupid
  8. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.
    i think its supposed to read either an overdose or a bad trip. reffering to an overdose and a bad trip being two seperate entitys that both cant be solved since their is no antidote.

    I dispute the fact that their is infact an antidote to LSD.

    "The antipsychotic effect of quetiapine is thought by some to be mediated through antagonist activity at dopamine and serotonin receptors. Specifically the D1 and D2 dopamine, the alpha 1 adrenoreceptor, and 5-HT1A and 5-HT2 serotonin receptor subtypes are antagonized"

    ". The hallucinogenic effects of LSD are attributed to its strong partial agonist effects at 5-HT2A receptors as specific 5-HT2A agonist drugs are hallucinogenic and largely 5-HT2A specific antagonists block the hallucinogenic activity of LSD.[14] "

    so more or less most antipyschotics are antogonists of 5-HT 2a meaning most antipyschotics WILL stop an LSD trip or any other trip for that matter.
  9. KBLSD

    KBLSD Silver Member

    Reputation Points:
    Dec 11, 2006
    but dont antipyschotics only start working after u take them for awhile, so just givin a person on LSD anti-pyschotics not work? swim knows that if u take anti-depressants for a long peroid of time it can mess with ur trips
  10. psyche

    psyche Palladium Member

    Reputation Points:
    Feb 28, 2006
    29 y/o Male from finland
    I fail to understand why I see this point being made from time to time. Studies about driving while intoxicated on cannabis show only minimal increase in risk, and people tend to compensate for driving more slowly. Many prescription drugs have much greater impairing effect on driving. Not to mention that alcohol is such a huge contributor to traffic accidents that it doesn't really matter that much. Also it is faulty to presume that drug usege would rise permanently after legalization. The rise in accidents is so extremely marginal that I don't know if it even exists. Heck, traffic accidents might even fall as a consequense of more people driving stoned.
  11. Bajeda

    Bajeda Platinum Member & Advisor

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    Jul 13, 2006
    Male from U.S.A.
    Ummmm, no shit. Drink alot of alcohol with anything and you can die. Drink alot of alcohol by itself and you can die.

    But most club drugs are lethal when mixed with alcohol? wtf? I don't think a little bit of alcohol mixed with any of those would kill you, even if it would be a worse idea with some than with others.

    These sound like they were written by students for a class or something.
  12. Broshious

    Broshious Silver Member

    Reputation Points:
    Oct 8, 2006
    Male from U.K.
    You'd think that the fact that mixing alcohol with just about any drug can cause big problems would make ALCOHOL look bad, and not the other drugs. But we must protect our precious Ethanol at all costs.
  13. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.

    Most anti psychotics I've seen are also prescribed in lower doses for insomnia and sleep. They kick in almost instantly and in swims experience they ALWAYS work to stop a trip.

    And to Bajeda, its very possible these were written by students. Some of them are flawed but they are still a hell of alot more factual then what you'd hear out of the average health proffesional on the subject.
  14. augentier

    augentier Gold Member

    Reputation Points:
    Oct 29, 2006
    Female from U.S.A.
    interesting facts..are you 100% on the validity of these?

    p.s. thx for never replying to my PM ..pssh, RUDE :p
  15. rxbandit

    rxbandit Gold Member

    Reputation Points:
    May 19, 2006
    Male from U.S.A.
    You may check the link to investigate validity, as it is under a colleges domain name i think it is likely valid.

    As for the PM, I apologize about my lack of a reply. I am very easily distracted and this is exactly what happened. I am not sure of the source of the picture howeverI have it saved on my computer. In my profile you can find my AIM sn and I'd be pleased to send it to you via AIM.
  16. radiometer

    radiometer bananadine addict Platinum Member & Advisor

    Reputation Points:
    Apr 13, 2005
    Male from U.S.A.

    copy text into WP program

    run "find and replace" routine
  17. Dickon

    Dickon Newbie

    Reputation Points:
    Oct 17, 2008
    Male from U.K.
    Is this a fact?... [When talking about methadone treatment for heroin addiction. no 40 on the above list]

    However, many people mistakenly think that methadone treatment is only "replacing one addicting drug with another".

    If it is a fact, it is only so by dint of the word "only". I think that's misleading. Methadone is an addiction, I don't think anyone disputes that. A safer and less damaging one maybe, but an addiction nevertheless.

    And to KBSLD a random stranger once said to me that he had a dream in which some other random stranger took some LSD, and then decided he didn't want to trip and took an anti-psychotic, and was essentially rooted to his chair not-exactly tripping, not-exactly normal, but certainly not as out there as he'd be without the anti-psychotic. Anti-psychotics like Largactyl (chlorpromazine) & haloperidol do not need regular dosing to produce an effect. One nickname should give that away: "the liquid cosh". A cosh that took a few weeks to work wouldn't be much use! lol.
  18. SoundJunkie

    SoundJunkie Silver Member

    Reputation Points:
    Apr 21, 2011
    Male from U.S.A.
    A bad trip isn't an overdose.
    "when an overdose OR a 'bad trip' occurs"
    They're different. You can have a bad trip on no acid at all. A bad trip is essentially a feeling of overwhelming anxiety and other dark emotions. Put someone alone in a dark room long enough and you'll get the same result as you would with someone who's having a bad "trip".

    As a matter of fact, it's virtually impossible to overdose. Don't see why the word is even in there.
  19. jezz1742

    jezz1742 Newbie

    Reputation Points:
    Apr 28, 2011
    50 y/o Male from U.K.
    Thanks so much for the article. Really interesting. I guess alot of research that comes out can be contradictory so it is never possible to be beyond reproach. But I try to keep up to date with new research and I think that most of what you say is true and I certainly learnt alot - I'm no expert, I just misuse alot of drugs too often and don't want to. I love all the posts on this site about mixing X with Y and how much should I take of Z because it excites me and leads to me taking more drugs. But I'd like alot more on the site about new developments in pharma treatments.

    The posts about line breaks made me laugh out loud! And some comment like "mixing ecstacy and alcohol is dangerous - no shit", suggesting that all your hard work was trite and old hat made me think you must have wished you hadn't bothered. Anyway, I for one thank you for it. Cheers
  20. flowertongue666

    flowertongue666 Titanium Member

    Reputation Points:
    Mar 4, 2010
    Male from U.S.A.
    Great stuff, thanks! I plan on reading the whole list in the near future. It seems to be comprehensive summation of current research, and (from what I read) fairly well informed.

    Looking at the quote above, I have to wonder about the impact our cultural assumptions play in defining our reality. It's amazing that anyone would still believe that the "scheduling" of a drug is somehow related to a valid index of "danger" or "toxicity" of a drug. Marijuana is schedule 1 and, according to this way of thinking, has many more inherent risks and dangers than either methadone or buprenorphine.

    How can the 'scientific' community ignore the science behind all the studies performed and bow to the dogma of 'political' organizations like the DEA and FDA?

    It's unfair to judge the whole body based on one entry- I do think there is a lot of good and interesting work being performed, and I intend on reading more of it to make a more informed assessment.