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Chapter 1 Drug Use: An Overview
“The Drug Problem”
Use is Not Abuse
Every Drug Has Multiple Effect
Amount Matters
Psychoactive Drug Effects Are Powerfully Influenced by the User’s History and Expectations
Drugs, Per Se, Are Not Good or Bad How Did We Get Here?
Drugs and Drug Use Today
Extent of Drug Use
Populations of Users
Trends in Drug Use
Correlates of Drug Use
Risk and Protective Factors
Deviant Drug Use
Race, Gender, and Level of Education
Personality Variables
Genetics
Antecedents of Drug Use
Gateway Substances
Motives for Drug Use
Summary
Review Questions
References
Check Yourself: Do Your Goals and Behaviors
Match?
Chapter 2 Drug Use as a Social Problem
Land of the Free?
Toxicity
Categories of Toxicity
Drug Abuse Warning Network
How Dangerous Is the Drug?
Blood-Borne Diseases
Substance Dependence: What Is It?
Three Basic Processes
Changing Views of Addiction
Which Is More Important, Physical Dependence or Psychological Dependence?
Broad Views of Addiction
Is Addiction Caused by the Substance?
Is Dependence Biological?
Is There an “Addictive Personality”?
Is Dependence a Family Disorder?
Is Substance Dependence a Disease?
Crime and Violence: Does Drug Use Cause Crime?
Why We Try to Regulate Drugs
Summary
Review Questions
References
Check Yourself: Are You Hooked on an Activity?
Check Yourself: What’s Your Risk of Drug Toxicity?
Chapter 3 Drug Policy
The Beginnings
Reformism
Issues Leading to Legislation
1906 Pure Food and Drugs Act
Harrison Act of 1914
Two Bureaus, Two Types of Regulation
Regulation of Pharmaceuticals
Purity
Safety
Effectiveness
Marketing a New Drug
Dietary Supplements
Controlled Substances
After the Harrison Act
Narcotic Control Act of 1956
Drug Abuse Control Amendments of 1965
Comprehensive Drug Abuse Prevention and Control Act of 1970
Anti-Drug Abuse Acts of 1986 and 1988
State and Local Regulations
Federal Support for Drug Screening
Military and Federal Employees
Transportation Workers
Private Employers
Public Schools
Testing Methods
The Impact of Drug Enforcement
Budget
International Programs
Other Federal Agencies
Other Costs
Effectiveness of Control
Summary
Review Questions
References
Check Yourself: Consider the Consequences
Chapter 4 The Nervous System
Homeostasis
Components of the Nervous System
Neurons
Glia
Neurotransmission
Action Potential
The Nervous System(s)
Somatic Nervous System
Autonomic Nervous System
Central Nervous System
The Brain
Chemical Pathways Implicated in Reward
Structures
Drugs and the Brain
Life Cycle of a Neurotransmitter
Examples of Drug Actions
Chemical Theories of Behavior
Brain Imaging Techniques
Structural Imaging
Functional Imaging
Word of Caution
Summary
Review Questions
References
Chapter 5 The Actions of Drugs
Sources and Names of Drugs
Sources of Drugs
Names of Drugs
Categories of Drugs
Drug Effects
Nonspecific (Placebo) Effects
Dose-Response Relationships
Potency
Time-Dependent Factors in Drug Actions
Getting the Drug to the Brain
A Little “Chemistry”
Routes of Administration
Transport in the Blood
More about the Blood-Brain Barrier
Mechanisms of Drug Actions
Effects on All Neurons
Effects on Specific Neurotransmitter Systems
Drug Deactivation
Mechanisms of Tolerance and Withdrawal
Symptoms
Summary
Review Questions
References
Chapter 6 Stimulants
Cocaine
History
Coca Wine
Local Anesthesia
Early Psychiatric Uses
Early Legal Controls on Cocaine
Forms of Cocaine
Contemporary Legal Controls on Cocaine
Mechanism of Action
Absorption and Elimination
Beneficial Uses
Causes for Concern
Supplies of Illicit Cocaine
Current Patterns of Cocaine Use
Amphetamines
History
Basic Pharmacology
Beneficial Uses
Causes for Concern
Summary
Review Questions
References
Chapter 7 Depressants and Inhalants
History and Pharmacology
Before Barbiturates
Barbiturates
Meprobamate
Methaqualone
Benzodiazepines
Nonbenzodiazepine Hypnotics
Mechanism of Action
Beneficial Uses
Anxiolytics
Sleeping Pills
Anticonvulsants
Causes for Concern
Dependence Liability
Toxicity
Patterns of Abuse
Inhalants
Gaseous Anesthetics
Nitrites
Volatile Solvents
Gamma Hydroxybutyric Acid
Summary
Review Questions
References
Chapter 8 Medication for Mental Disorders
Mental Disorders
The Medical Model
Classification of Mental Disorders
Treatment of Mental Disorders
Before 1950
Antipsychotics
Atypical Antipsychotic Drugs
Antidepressants
Electroconvulsive Therapy
Mood Stabilizers
Consequences of Drug Treatments for Mental Illness
Summary
Review Questions
References
Check Yourself: Track Your Daily Mood Changes
Chapter 9 Alcohol
Alcoholic Beverages
Fermentation and Fermentation Products
Distilled Products
Beer
Wine
Distilled Spirits
Alcohol Use and “The Alcohol Problem”
The Temperance Movement in America
Prohibition
Prohibition Worked!
Prohibition Is Repealed
Regulation after 1933
Taxation
Who Drinks? And Why?
Cultural Influences on Drinking
Trends in U.S. Alcohol Consumption
Regional Differences in the United States
Gender Differences
Drinking among College Students
Alcohol Pharmacology
Absorption
Distribution
Metabolism
Mechanism(s) of Action
Behavioral Effects
Time-out
Driving under the Influence
Sexual Behavior
Blackouts
Crime and Violence
Physiological Effects
Alcohol Toxicity
Alcohol Poisoning
Hangover
Chronic Disease States
Fetal Alcohol Syndrome
Alcohol Dependence
Withdrawal Syndrome
Alcohol Use Disorder
Summary
Review Questions
References
Check Yourself: Do You Have a Drinking Problem?
Chapter 10 Tobacco
Tobacco History
Early Medical Uses
The Spread of Tobacco Use
Snuff
Tobacco in Early America
Chewing Tobacco
Cigars
Cigarettes
Tobacco under Attack
The Quest for “Safer” Cigarettes
Electronic Cigarettes
Tobacco Products and the FDA
Current Cigarette Use
Smokeless Tobacco
Hookahs
Causes for Concern
Adverse Health Effects
Secondhand Smoke
Smoking and Health in Other Countries
Smoking and Pregnancy
Pharmacology of Nicotine
Absorption and Metabolism
Physiological Effects
Behavioral Effects
Nicotine Dependence
How to Stop Smoking
Summary
Review Questions
References
Check Yourself: Test Your Tobacco Awareness
Chapter 11 Caffeine
Caffeine: The World’s Most Common Psychostimulant
Coffee
Tea
Chocolate
Other Sources of Caffeine
Soft Drinks
Energy Drinks
Over-the-Counter Drugs
Caffeine Pharmacology
Time Course
Mechanism of Action
Physiological Effects
Behavioral Effects
Causes for Concern
Cancer
Reproductive Effects
Heart Disease
Caffeinism
Summary
Review Questions
References
Check Yourself: How Much Caffeine Do You Consume?
Chapter 12 Dietary Supplements and Over-the- Counter Drugs
Dietary Supplements
Some Psychoactive Dietary Supplements
Saint John’s Wort
SAMe
Ginkgo biloba
Weight-Control Products
Over-the-Counter Drugs
FDA Regulation of OTC Products
Simplifying Labels
Over-the-Counter versus Prescription Drugs
Behind-the-Counter Drugs?
Some Psychoactive OTC Products
Stimulants
Weight-Control Products
Sedatives and Sleep Aids
Analgesics
People and Pain
Aspirin
Acetaminophen
Ibuprofen and Other NSAIDs
Cold and Allergy Products
The All-Too-Common Cold
Treatment of Cold Symptoms
Allergy and Sinus Medications
Choosing an OTC Product
Summary
Review Questions
References
Check Yourself: Can You Guess What These OTC Products Are Used For?
Chapter 13 Opioids
History of Opioids
Opium
Morphine
Heroin
Opioid Abuse before the Harrison Act
Abuse after the Harrison Act
Abuse of Prescription Opioids
Pharmacology of Opioids
Chemical Characteristics
Mechanism of Action
Beneficial Uses
Pain Relief
Intestinal Disorders
Cough Suppressants
Causes for Concern
Dependence Potential
Toxicity Potential
Misconceptions and Preconceptions
Summary
Review Questions
References
Chapter 14 Psychedelics
Animism and Religion
Terminology and Types
Indoles
Catechols
N-Methyl-DL-Aspartate (NMDA) Antagonists
PCP
Anticholinergic Hallucinogens
Amanita Muscaria
Salvia Divinorum
Summary
Review Questions
References
Check Yourself: Hallucinogens from Plants
Chapter 15 Cannabis
Cannabis, the Plant
Preparations from Cannabis
Extracts
Edibles
History
Early History
Harry Anslinger’s Case against Marijuana
The Marijuana Tax Act of 1937
After the Marijuana Tax Act
Pharmacology
Cannabinoid Chemicals
Absorption, Distribution, and Elimination
Mechanism of Action
Physiological Effects
Behavioral Effects
Medical Uses of Cannabis
Causes for Concern
Abuse and Dependence
Toxicity Potential
Marijuana and American Society
Summary
Review Questions
References
Chapter 16 Performance-Enhancing Drugs
Historical Use of Drugs in Athletics
Ancient Times
Early Use of Stimulants
Amphetamines
International Drug Testing
American Football
Steroids
The BALCO Scandal
The Battle over Testing
Stimulants as Performance Enhancers
Steroids
Psychological Effects of Steroids
Adverse Effects on the Body
Regulation
Other Hormonal Manipulations
Beta-2 Agonists
Creatine
Getting “Cut”
Summary
Review Questions
References
Chapter 17 Preventing Substance Abuse
Defining Goals and Evaluating Outcomes
Types of Prevention
Prevention Programs in the Schools
The Knowledge-Attitudes-Behavior Model
Affective Education
Antidrug Norms
Development of the Social Influence Model
DARE
Programs That Work
Peers, Parents, and the Community
Peer Programs
Parent and Family Programs
Community Programs
Prevention in the Workplace
What Should We Be Doing?
Summary
Review Questions
References
Check Yourself: Do Your Goals and Behaviors Match?
Chapter 18 Rethinking Drug Policy: What Works, What’s Possible, and What’s Feasible
Impetus for Change
Drug Decriminalization
Uncommon Strategies to Enhance Public Health and Safety
Drug Purity-Testing
Heroin-Assisted Treatment
Safe Drug Consumption Sites
Concluding remarks
Summary
Review Questions
References
Appendix A Drug Names
Appendix B Resources for Information and Assistance
Glossary
Photo Credits
Index
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