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