Substance Use Ch. 10-18

One of SAMHSA’s model community prevention programs
Works for changes in alcohol policies and ordinances.
The DARE program stands for
Drug Abuse Resistance Education
Beginning in 1986, the federal government launched a massive campaign based on anti-drug policies, locker searches, etc., to promote
“Drug-Free” schools
In discussing what we should be doing in drug prevention, the text says, “above all”
Avoid sensational scare stories and preachy approaches
Having students discuss their reactions to various moral and ethical dilemmas as a means to help them clarify their own values was one example of the general prevention approach known as
affective education
Tertiary prevention programs are aimed at
People who have completed treatment for dependence and need relapse prevention or follow up
Teaching students relaxation or meditation techniques was seen as one possible way of providing
Alternatives to drug use
The textbook pointed out that drug prevention and what else might have different goals and use different approaches.
prevention of relapse
According to the text, the ultimate goal of workplace drug prevention programs is to
Prevent drug use by making clear that it is not condoned.
One study of the Life Skills Training program found significantly lower use of
marijuana, alcohol, and tobacco after 6 years
Project ALERT and Life Skills Training were included as examples of
Programs that Work, according to the Center for Substance Abuse Prevention
Primary prevention programs are aimed at
Young people who have not tried drugs
In the early 1970s, the Knowledge-Attitudes-Behavior model began to be questioned when it was learned that
Students with more knowledge about drugs had a more positive attitude toward drugs
Which of these is NOT one of the successful components included in the social influence model?
Discussing the penalties for getting caught with cigarettes
Which of these is NOT one of the Institute of Medicine’s classifications for prevention programs?
affective prevention
Out-of-school peer programs include peer influence approaches, as well as
Peer participation programs, such as community service
The ad campaign Above the Influence targets which age group?
12-17
DARE is one of the most widespread drug prevention programs in schools. Research on DARE has shown that
It has not produced lasting reductions in drug or alcohol use
The social influence model grew out of a 1976 paper describing a successful prevention approach aimed at
Cigarette smoking
The most consistent feature of workplace drug prevention programs has been
random urine testing
In the public health model, programs designed to reach people who have started using some substances and to prevent them from abusing these substances or moving to more dangerous substances, would be classified as
secondary prevention
Which of these was NOT discussed as an effective family-based drug prevention approach?
parenting, interactions and support (These are the effective family-based drug prevention approaches)
CBT approaches to treatment
Have the clients identify people, places, and behaviors associated with drug use.
Because of the potential danger of alcohol withdrawal symptoms, these symptoms are often prevented or treated by administering
Benzodiazepines
Besides methadone, another substitute medication has recently been approved for maintaining opioid dependent patients. It is
Buprenorphine
Giving the user rewards for drug-free urine samples
Is a form of contingency management
Which one of these is an agonist therapy?
methadone, nicotine replacement
Because most opioid dependent people prescribed naltrexone stop taking it,
researchers are testing a depot form that blocks heroin’s effects for up to 6 weeks.
Motivational enhancement therapy has as its goal
has as its goal helping the user move to another “stage of change.”
Both drug agonist (substitution) and antagonist treatments are included in the __________ phase of treatment.
maintenance
Although many medications have been tested for treating cocaine dependence, most have shown little promise and none has yet been approved. The most promising results have been found with
modafinil.
Is treatment for drug dependence effective?
Statistically, treatment does reduce crime and increase employment.
Which of these has NOT received FDA approval for use during the maintenance phase of alcohol
disulfiram(Antabuse), naltrexone, and acamprostate(calcium acetyl) THESE ARE USED IN THE MAINTENANCE
Rapid opioid detoxification is based on
Anesthetizing users and administering an antagonist, so that withdrawal occurs while they are asleep
substance that accounted for the most admissions in the Treatment Episode Data Set from 2009 was
opioid?
The most common form of medical treatment for opioid dependence is
methadone maintenance
Before we can evaluate the success of a drug treatment program, we have to understand the program’s
Goals
Which of these is NOT an FDA-approved form of nicotine replacement therapy?
THESE ARE APPROVED: transdermal nicotine patch, gum, nasal spray, vapor inhaler, lozenge.
Studies of court-ordered referrals to Alcoholics Anonymous versus other types of interventions have
Not found differences in effectiveness between AA and other approaches
Although naltrexone has been used to treat alcohol dependence, it
Is an opioid antagonist, and it is not clear how it works with alcohol users.
The “therapeutic workplace” is an example of what approach to drug treatment?
Contingency management
Although no medication has yet received FDA approval for treating cannabis dependence, one has shown effectiveness in relieving cannabis withdrawal symptoms. That medication is
oral THC
Varenicline, approved in 2006 for smoking cessation.
Is a partial nicotine-receptor agonist.
Prevention of withdrawal symptoms using medications would be considered part of the ____________ process.
Detoxification
Which of these was NOT one of the three reasons given for why we focus so much attention on drug use by athletes?
Athletes make so much money
One of the early types of stimulant drug reported to be used by boxers and others was
strychnine.
In the 1800s, the French cycling team endorsed Mariani’s “wine for athletes” that contained
cocaine.
Stimulant drugs like caffeine, amphetamines, and cocaine are sometimes considered to increase energy output and are, therefore, called __________ drugs.
ergogenic
The International Olympics Committee first established rules disqualifying competitors who failed or who refused to take drug tests in
1968.
After the National Football League banned the distribution of amphetamines in 1971,
individual players could still get a prescription and use amphetamines if they wanted.
During and after World War II, it was found that malnourished people could gain weight more rapidly if they were treated with
testosterone.
An American physician came back from the 1956 Olympic games after learning about the Soviets’ use of a steroid drug and helped to develop and test more selective ____________ steroids.
anabolic
The 2003 BALCO scandal involved a laboratory that was
selling a previously undetectable steroid to baseball players
One side effect of the tougher 2006 drug testing policies in Major League Baseball is that
more players are diagnosed with ADHD so they can have therapeutic-use exemptions to take stimulant drugs.
College athletes who want to avoid failing a drug test
have to be very careful, because there are more than 3,000 products containing banned substances.
Extensive testing of the effects of amphetamines has concluded that they
can improve performances by a few percentage points.
Laboratory studies of endurance on stationary bicycles have found that caffeine
can significantly improve work output at doses of 300-500 mg.
One ingredient in dietary supplements was banned by the FDA in 2004 after a Major League Baseball pitcher died from heat stroke after using it. The ingredient was
ephedrine.
Although testosterone and related anabolic steroids clearly increase muscle mass during puberty, it has been more difficult to determine scientifically whether adult men with normal testosterone can get much stronger from extra steroids, partly because
it would be unethical to expose research participants to the high doses of multiple steroids reportedly used by athletes.
It has been difficult to do double-blind, placebo-controlled studies on the effects of steroids because
they produce detectable psychological effects.
Which of these was NOT mentioned as one of the psychological side effects of high doses of steroids?
A. memory loss
B. psychological dependence
C. mood swings
D. increased aggressiveness (“‘roid rage”)
memory loss
Women who use steroids to increase their strength might produce some irreversible effects, including
increased facial hair growth.
As part of the Omnibus Crime Control Act of 1990, anabolic steroids were
listed as Schedule III controlled substances, with limited prescription refills
So-called “pituitary giants” often die at an early age because their internal organs continue to grow due to excessive production of
human growth hormone.
Clenbuterol was first detected in Olympic athletes in 1992. Originally developed as a bronchodilator for treating asthma, this drug is
a beta-2 agonist
One widely-used legal dietary supplement that has been shown to increase strength is
creatine.
Some bodybuilders are trying to appear not only big and strong, but also lean. This is sometimes referred to as looking
cut, ripped, or shredded.
An ideal body fat range for a healthy male is
14 to 20 percent
Which of the following stimulant drugs have been used as performance enhancers in athletic competitions
A. Strychine
B. Cocaine
C. Caffeine
The origin of the word “dope” is derived from the Dutch word used in South Africa to refer to
a cheap brandy used to impair the performance of racing horses
Most of the resin is in which part of the cannabis plant?
flowering tops.
Cannabis indica has more psychoactive potency, whereas Cannabis sativa is more associated with
hemp.
The primary active ingredient in marijuana is
delta-9 tetrahydrocannabinol (THC).
Hashish refers to
pure cannabis resin.
The flowering tops (buds) of unpollinated female cannabis plants produce a high-grade marijuana known as
sinsemilla.
The American public began to take interest in the new drug menace known as marijuana
after a New Orleans newspaper in 1926 associated its use with crime.
The 1944 LaGuardia report of the New York Academy of Medicine concluded that “those who have been smoking marihuana for a period of years . . .”
showed no mental or physical deterioration
The 70 chemicals that are known to be unique to the cannabis plant are called
cannabinoids.
The natural substance in the body that has marijuana-like effects is called
anandamide.
In a study of heart rate changes following smoked marijuana with 4 percent THC or 20 mg oral THC
the peak effects were similar, but smoking produced a faster onset of effects.
The abuse potential of THC
is higher for smoked than for oral THC
A consistent cognitive effect of marijuana, seen both in frequent users and in less experienced users, is
slowing of cognitive processing.
A great number of studies have consistently reported that smoked marijuana and oral THC both produce
increased total daily food intake
Studies show that marijuana increases which of the following?
Nonverbal social interactions.
In 1985, the FDA approved the sale of dronabinol (Marinol), which
is a capsule containing THC
The 1999 report from the Institute of Medicine suggested that marijuana cigarettes should
be allowed for no more than six months for patients with intractable pain or vomiting
Tolerance to the effects of smoked marijuana
allows experienced marijuana users to obtain euphoric effects with minimal cognitive impairment.
Studies of the effects of marijuana on automobile driving show
significant impairments when inexperienced users are studied in a laboratory environment.
Which of the following has NOT been found as an effect of regular marijuana use?
Increased testosterone levels in men
Which of the following did NOT occur in the late 1960s and throughout the1970s in the United States?
Marijuana use among high school students reached an all-time low.
The current shift in the U.S. public’s attitude towards marijuana laws is probably partly related to which of the following?
Increasing evidence that marijuana is relatively innocuous
A desire to spend federal funds more wisely and gain tax revenue
Rimonabant is currently available as an anti-obesity agent. What is its primary mechanism of action?
CB1 receptor antagonist
As of mid-2012, at least _____ states and Washington, D.C. have passed ballot initiatives allowing the use of medical marijuana.
17
In hunter-gatherer societies, the shaman or medicine man (or woman) was important not only for understanding what we now call medicine, but also because he or she was
a spiritual, or religious leader.
One name that has been used for hallucinogenic drugs is psychedelic, which means
mind-viewing, and implies a beneficial, visionary effect.
One major grouping of hallucinogens typically allows the user to remain in some touch with the real world and to remember much of what he or she experienced. This group of drugs was referred to as the
phantastica.
LSD and psilocybin belong to the chemical grouping of
indoles.
LSD was synthesized from alkaloids derived from
ergot fungus.
The psychological effect of LSD was first reported by
Albert Hofmann, the Swiss chemist who developed the drug.
The major thrust of early research on LSD was for its
supposed ability to access the subconscious mind.
During the 1950s, one U.S. government agency that conducted research with LSD was the
Central Intelligence Agency.
The early LSD researcher who was fired from his academic job, became a proponent of hallucinogenic drug use, and started a religion in which LSD was the sacrament is:
Timothy Leary.
LSD is considered to be the most potent psychoactive agent known to man because
it produces effects at such low doses.
. Although LSD has complex effects in the brain, the best evidence indicates that its hallucinogenic properties are due to stimulating
serotonin-2A receptors.
The sensation of experiencing sounds as pictures, or of seeing movements produced by musical rhythms, is known as
synesthesia.
In rare cases, people who have used LSD experience similar symptoms weeks or months later. The common term for this has been
flashbacks.
Psilocybe mexicana and Psilocybe cubensis are examples of
hallucinogenic mushrooms.
A close relative of LSD, d-lysergic acid amide, is found naturally in
morning glories and Hawaiian baby woodroses
DMT, a short-acting hallucinogen that is usually ineffective when taken orally, is found in
Cohoba snuff.
The combination of two plants, one containing DMT and the other containing harmaline (an MAO inhibitor), was originally used by indigenous cultures in South America and is called,
ayahuasca
The Native American Church includes aspects of Christianity and uses __________ as a sacrament.
peyote
Besides hallucinations, mescaline also produces
pupil dilation, increased heart rate and blood pressure.
The catechol hallucinogens include mescaline plus a variety of synthetic derivatives of
amphetamine.
A drug that has been reported to produce an increase in sociability and euphoria, as well as an increase in blood pressure, body temperature, and pulse is:
MDMA
PCP was patented as Sernyl and first tested as
a dissociative anesthetic.
The PCP experience differs from LSD and mescaline experiences in that PCP users
report more changes in body perception
Peace pill and angel dust have been street names for
PCP
Atropa belladonna is also known by the name
deadly nightshade
The anticholinergic plant with a forked root that is mentioned in the Bible is
mandrake.
The red and white speckled mushroom that has been associated with an early Christian cult as well as with other religions all over the world is
amanita muscaria.
The indole originally found in toad skins, that turns out not to be a very potent hallucinogen, is
bufotenin.
Which of the following hallucinogens has NOT received recent scientific interest as a psychotherapeutic agent?
PCP
Which of the following most accurately describes recent psilocybin research?
the acute effects on mystical experiences
When evaluating drug-related data from animal studies, which of these questions should be asked?
A. Was the dosing regimen used similar to that used by humans?
B. Was the route of administration similar to that used by humans?
C. Was the drug self-administered by the animal
In 2009, the Family Smoking Prevention and Tobacco Control Act
authorized the FDA to regulate tobacco products in specific ways.
One big factor associated with lower rates of cigarette smoking among adults is
Higher level of education
Per capita sales of cigarettes in the U.S. began to decline
after the 1964 Surgeon General’s report
Reynolds was unable to market Premier, a plastic cigarette containing catalytic crystals coated with tobacco extract, because
the FDA considered them a “nicotine delivery device” rather than an agricultural product
The major commercial species of Nicotiana that is grown for tobacco products is
Nicotiana tobacum.
People who switch to low tar and nicotine brand cigarettes
typically take more and deeper puffs and probably get no safety benefit.
90 percent of all U.S. cigarettes sold are now
Filter cigars
Tobacco use became popular in European culture because:
it was associated with wealth and status
During the 18th century, which method of use of tobacco increased in England
Snuff
In 2000, the U.S. Supreme Court ruled that the FDA
Had no authority to regulare tobacco products
Chewing was the most popular form of tobacco use until about 1900, but by 1920 the most popular form was
cigars
The biggest health concern for users of smokeless tobacco has been
cancer of the mouth, pharynx, and esophagus.
As a potent poison, nicotine causes death by
increasing blood pressure until a stroke occurs.
Recent research on the dependence produced by nicotine has focused on genetic differences related to:
acetylcholine receptors
One recent fad in tobacco use has been
hookahs (water pipes)
Gum, patches, lozenges, and inhalers are all various forms of
nicotine replacement therapy
Although lung cancer is not common, about _______ percent of all lung cancers occur in smokers.
85
In 1993, the Environmental Protection Agency declared that
secondhand smoke is a known carcinogen that increases lung cancer risk.
Nicotine acts in the brain by
first stimulating and then blocking cholinergic receptors
In July 2011, the nicotine vaccine NicVax was
found to be no better than placebo.
The psychological effect of cigarette smoking is
arousal and activation–a mild stimulant effect
calm and relaxation–a mild antianxiety effect.
In 2006, the FDA approved a nicotine partial agonist drug as a smoking treatment. The drug is
varenicline (Chantix)
Annual “smoking attributable mortality” in the U.S. is estimated at
440,000
About 90 percent of the more than 40 million former smokers in the U.S. report that
they quit smoking without a treatment program.
One of the most consistent and best-documented effects of cigarette smoking during pregnancy is
low birth weight
In 1970, Americans drank more coffee than any other nonalcoholic beverage product. By 2009,
Americans drank approximately twice as many gallons of soft drinks as compared to coffee
Most regular brewed teas have about how much caffeine per cup?
40-60 mg (about half the amount in coffee)
_____________ is prescribed to asthma sufferers because it relaxes bronchial passages.
theophylline
The early history of coffee included a 1674 pamphlet from England titled
The Women’s Petition Against Coffee.
Theobroma, the genus name for the cacao tree, is Latin for
food of the gods
The largest exporters of coffee to the U.S. are
Colombia, Brazil, Guatemala, and Mexico.
Green, black, and oolong tea are all prepared from leaves of
Camellia sinensis
In the 18th century, English coffeehouses were referred to as
penny universities
The legend of the discovery of coffee relates to
Kaldi and his dancing goats
The world’s greatest per-capita consumers of tea are found in
Turkey
All of the xanthines have similar effects. But which one has the greatest overall effect?
caffeine
According to current FDA rules on “cola” drinks
they cannot contain more than 6 mg caffeine per ounce
One important determinant of the behavioral effects of caffeine is
whether the person is a regular user
The most consistent withdrawal symptom after chronic caffeine use is
headache
In 1909, the FDA seized some Coca-Cola syrup and filed charges against the company partly because
the syrup contained caffiene
Often people who drink too much alcohol attempt to “sober up” by drinking coffee. Several studies support the idea that caffeine
is likely to lead to increased arousal, but the drinker is still impaired
Caffeine has been shown to be an effective treatment for
migraine headaches
The unique xanthine in chocolate is
theobromine
Drinking 5 or more cups of coffee per day
doubles the risk of heart attack
Caffeine works in the brain by
blocking adenosine receptors
The main active ingredient in Red Bull and other energy drinks is
caffeine
Caffeine is thought to relieve headaches because it is
a vasoconstrictor.
The maximum CNS effect of caffeine is reached about _____ after drinking coffee.
2 hours
The 1994 Dietary Supplement Health and Education Act
expanded the definition of dietary supplements and restricted the FDA’s regulatory authority over them.
What dietary supplement ingredient has been tested for its ability to improve memory in Alzheimer’s disease, but has produced only small and unreliable improvements in published research?
Ginkgo biloba
Starting in 2007, the only FDA-approved OTC weight-control ingredient is
orlistat (alli).
The FDA was given additional authority over dietary supplements in 2006 to set up
an “Adverse Events Reporting” process.
Because of the way the FDA reviews and approves OTC drugs,
various brands of a given type of remedy usually contain the same few active ingredients
Many of the capsules, pills, and powders that look like drugs and that consumers think of as drugs are actually classified by the FDA as
food products
If you buy a bottle of St. John’s wort 300 mg tablets, each tablet will contain 300 mg
total tablet weight, with an unknown amount of plant material or ingredients
The U.S. market for over-the-counter drug products totals about
$18 billion
The only active ingredient the FDA allows in OTC stimulants is
caffeine
The 2006 revised PATRIOT Act required that products containing __________ be kept “behind the counter,” and buyers must show identification and sign for their purchase.
pseudoephedrine
SAMe (S-adenosyl-L-methionine) is a dietary supplement that has some research support for its possible use in treating
depression
Why would you want dextromethorphan in a cold remedy?
It acts as a cough suppressant
NSAID stands for
non-steroidal anti-inflammatory drug
Suppose you have a cold and you choose to take Tylenol Cold to treat your symptoms (runny nose, congested nasal passages, and fever). Which of these ingredients in this OTC product is unnecessary?
dextromethorphan
There has been some reported abuse by young people of products containing _________, which they take in high doses to produce visual and auditory hallucinations
dextromethorphan
The generic name for Tylenol and Datril is
acetaminophen.
Acetylsalicylic acid was developed in the Bayer laboratory in Germany in 1898 and sold under the brand name
Aspirin
Aspirin should not be used with children who have a viral infection because of increased risk of
Reye’s syndrome
The textbook suggests that consumers are best able to choose from among the wide variety of OTC products by
knowing a fairly small number of ingredient names.
Suppose you had a fever, a headache, and a swollen knee. Which medication would be most appropriate to treat all three symptoms?
dextromethorphan
Besides analgesia (pain relief), another important effect of aspirin is as a(n)
antipyretic (reduces fever)
The acronym GRAS stands for
generally recognized as safe
Cold viruses are usually transmitted
by being picked up on the hands and touching your eyes or nose
The earliest recorded use of opium as a medicine was probably by
Egyptians, around 1500 BC
The 16th century European physician Paracelsus, and later Dr. Thomas Sydenham promoted the use of
laudanum.
In 1898, Bayer laboratories marketed diacetylmorphine tablets under the brand name
Heroin
The two major active chemicals in opium are
morphine and codeine.
Papaver somniferum is the scientific name for
the opium poppy
Heroin became the drug of choice for many opioid users
during the 1920s, because it was easier to smuggle the small amounts needed for an effective dose.
One thing that apparently contributed to the spread of opium smoking in China was
a 1644 edict from the emperor forbidding tobacco smoking.
By the beginning of the 20th century, a greater percentage of Americans were dependent on opioids than at any time before or since. Opium smoking and medical use of injected pure morphine were important contributors to this, along with
Patent medicines containing opium extracts or morphine
Possession of opium, morphine, or heroin without a prescription was made a crime by
a 1915 Supreme Court decision.
The Opium War of 1839-1842 resulted, among other things, in
the island of Hong Kong becoming a British possession.
“Black tar” is
a name given heroin from Mexico that is brown or black in its pure form
At the current time, most of the heroin in the U.S. originates from poppy fields in
Colombia and Mexico.
Vicodin and OxyContin are examples of
prescription opioids that are being misused at relatively high rates.
Which of these opioids is about 100 times as potent as morphine?
fentanyl
Naloxone, nalorphine, and naltrexone are examples of
opioid antagonists.
Enkephalins, endorphins, and dynorphins are
three classes of endogenous chemicals that have effects similar to morphine
Although pain relief is now the major medical use for opioids, they have been used to save many lives (especially in underdeveloped countries) because of their ability to
treat diarrhea
Siegel and his colleagues have shown in animal studies that tolerance to opioids
is partly due to conditioned responses
The textbook says that opioid withdrawal is similar to
a bad case of intestinal flu
The fact that animals with no history of opioid withdrawal will press a lever to self-administer low doses of intravenous morphine or heroin demonstrates the importance of ____________ in developing opioid dependence.
positive reinforcement
In a heroin user, negative reinforcement of drug-taking behavior can occur when
withdrawal symptoms are alleviated by another injection
Long-term exposure to opioid drugs
has not been clearly shown to produce damage to any tissue or organ system
Heroin is more potent than morphine because
it more readily crosses the blood-brain barrier

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