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Highlights .From .the .History .of .Drug .Use .in .Sports .- .CORRECT .ANSWER- • .B.C.: .Greek .athletes .eat .hallucinogenic .mushrooms .during .ancient .Olympic .Games •1886: .Welsh .cyclist .dies .from .a .combination .of .opiates .and .cocaine .during .cross-country .race •1956: .Steroids .become .the .norm .in .modern .Olympics •1988: .Gold .medalist .sprinter .Ben .Johnson .disqualified .after .a .positive .drug .test .during .the .Seoul .Olympics •1990: .Anabolic .Steroid .Control .Act -Moves .steroids .to .Schedule .3, .jurisdiction .from .FDA .to .DEA -Penalties .up .to. 5 .year .prison .term, .$250,000 .fine •2000: .Anti-doping .pledge .inserted .into .Olympic .Oath •2004: .Allegations .of .designer-steroid .use .(THG) .made .against .U.S. .track .and .field .athletes, .also .pro .baseball .players •2009: .WADA .and .Anti-Doping .Code/Standards
Anabolic-Androgenic .Steroids .- .CORRECT .ANSWER- •Androgenic: ."Man- Changing" -Promoting .masculinizing .changes .in .the .body •Anabolic: ."Upward-Changing" -Promoting .growth .and .muscular .development •Anabolic -Androgenic .Steroids -Patterned .after .testosterone, .producing .anabolic .and .androgenic .effects
- Anabolic .Steroids -Short .name .for .anabolic-androgenic .steroids •Ergogenic: ."Performance-Enhancing"
Patterns .of .Steroid .Abuse .- .CORRECT .ANSWER- •Use .can .be: .Oral, .intramuscular .injection .or .transdermal .patch •Hard .to .study, .because .dosages .people .use .vary -Can .be .5-29 .times .therapeutic .dosages .when .abused •Examples -"Shotgunning": .Combining .multiple .oral .and .injectable .steroids -"Cycling": .Taking .steroids .for .4-18 .week .periods, .separated .by ."off" .periods -"Pyramiding": .Increasing .steroids .dosage .over .several .weeks .prior .to .a .competition, .then .tapering .off .before .to .avoid .detection
Anabolic .Steroid .Effects .in .Men .- .CORRECT .ANSWER- •Most .mimic .effects .of .testosterone, .so:
-Shrunken .testicles -Diminished .sperm .count -Enlarged .breasts .(Gynecomastia) -Frequent, .sustained, .painful .erections .(called ."Priapism") -Acne .on .shoulders .and .back -Increased .facial .hair, .accelerated .balding
Anabolic .Steroid .Effects .in .Women .- .CORRECT .ANSWER- •Irreversible .effects: -Lower .voice -Increased .facial .and .body .hair -Increased .loss .of .scalp .hair -Enlarged .clitoris •Reversible .effects -Increased .aggressiveness -Diminished .menstruation -Increased .sex .drive -Increased .appetite .and .decreased .body .fat -Decreased .breast .size
Psychological .Problems .with .Steroids .- .CORRECT .ANSWER- •Mood .swings, .or ."Roid .Rage" -Mixed .evidence, .but... •A .double-blind .study .found: -Increased .manic .behavior -Feelings .of .aggressiveness -Aggressive .outbursts -Extreme .euphoria -Decreased .need .for .sleep
Steroid .Dependence? .Muscle .Dysmorphia .- .CORRECT .ANSWER- •Perception .of .one's .body .as .small .and .weak .and .one's .musculature .as .inadequately .developed -Despite .evidence .to .the .contrary •A .form .of .body .dysmorphic .disorder .sometimes .called ."Reverse .Anorexia"
Human .Growth .Hormone .(HGH) .- .CORRECT .ANSWER- •HGH .is .a .pituitary .hormone -Responsible .for .normal .growth .in .teens -Originally .obtained .from .cadavers -Medically .used .in .rare .cases .of .stunted .growth •Use .increases .risk .of .Acromegaly -The .head .is .enlarged -Hands .and .feet .are .misshapen -Various .internal .organs .are .damaged •Hard .to .detect .because .of .its .short .half-life -Widely .available, .cheaper .than .others
Dietary .Supplements .as .Ergogenic .Aids .- .CORRECT .ANSWER- •Androstenedione .(andro-steen-di-own)
-Induce .sleep, .anti-anxiety .(by .sedation) -Ex: .Barbiturates •Anti -anxiety .(tranquilizers) -Not .by .sedation -Ex: .Benzodiazepines •Inhalants .(i.e. .breathable .vapors) -Depressants, .anesthetic, .analgesic -Ex: .Solvents, .nitrous .oxide, .ether
Patterns .of .Barbiturate .Abuse .- .CORRECT .ANSWER- •More .common .in .1950-60s •Survey .of .High .School .seniors: -10% .ever .used .in .their .lifetime -7% .used .within .the .past .year --These .rates .are .down .roughly .40% .from .the .peak .in. 1975 •Intended .to .induce .sleep -Create .quick .tolerance .and .dependence -Withdrawal .can .be .dangerous -What .is .R.E.M. .Rebound?
Acute .Effects .of .Benzodiazepines .- .CORRECT .ANSWER- •Anti -anxiety .drugs .(not .by .sedation) -Developed .in .the .1950's -Specifically .for .relaxation, .stress .reduction •Relatively .safe .(unlike .barbiturates) -Unless .combined .with .alcohol -Do .not .affect .brain's .respiratory .centers --don't .reduce .overall .body .functioning -Quickly .absorbed .into .bloodstream --But .not .directly .from .stomach .like .Barbiturates
How .Benzodiazepines .Work .in .the .Brain .- .CORRECT .ANSWER- •Increase .the .action .of .GABA .receptors -Increasing .GABA's .effect .inhibits .activity .level .in .the .neurons .involved --This .slows .the .brain .down •Toleran ce? -Not .when .used .for .anxiety, .but --Possible .when .used .for .insomnia •Dependence? -Some .withdrawal, .but .slow .effects, .sos .little .feeling .of .a ."rush"
Examples .of .Early .Inhalants .- .CORRECT .ANSWER- •Petrochemical .Fumes -Inhalation .induced .trances .at .the .Oracle .of .Delphi .in .ancient .Greece •Nitrous .Oxide .(laughing .gas) -Discovered .by .Sir .Humphrey .Davy .in. 1798 .(used .in .dental .anesthesia .now) •Ether: .Introduced .by .Friedrich .Hoffmann .in .early .1700's -Nerve .tonic: .For .pains, .cramps, .etc
Glue, .Solvent, .and .Aerosol .Inhalation .- .CORRECT .ANSWER- •Appeared .only .since .the .late .1950's
•Includes: -Glues, .paint .thinners, .lighter .fluid -Stain .removers -Aerosol .products --Hair .sprays, .deodorants, .spray .paints •Legitimate .practical .uses, .therefore .easily .available .and .cheap
Acute .Effects .of .Glues, .Solvents .and .Aerosols .- .CORRECT .ANSWER- •Depressant .drugs: -Central .nervous .system .inhibited .after .use -Brain .waves .slow .down -Feel .intoxicated .within .minutes --Giddiness, .euphoria, .dizziness .and .slurred .speech, .lasting .from .15-45 .minutes -Then, .1-2 .hours .of .drowsiness -Loss .of .consciousness .possible
Accounting .for .the .Abuse .Potential .of .Inhalants .- .CORRECT .ANSWER- •Why .would .younger .kids .be .attracted .to .these? -Effect .is .quicker .than .drinking .alcohol -Packaging .makes .it .easy .to .carry .and .conceal .from .others -Easily .available .in .Hardware .stores, .pharmacies, .and .supermarkets -Can .be .bought .cheaply .or .stolen
Dangers .of .Inhalant .Abuse .- .CORRECT .ANSWER- •Toxic .effects .on .body .organs -Nerve .and .muscle .damage, .cancers, .etc •Euphoria .and .recklessness .(accidents) •Potential .hypoxia .and .asphyxiation -from ."huffing" .or ."bagging" •Potential .frozen .throat .when .in .contact .with .inhaled .Freon
Patterns .of .Inhalant .Abuse .- .CORRECT .ANSWER- • 4th .highest .drug .for .experimentation .among .high .school .students -Surpassed .only .by .alcohol, .tobacco .and .marijuana --Often .used .by .11-13 .year .olds --8th .graders: .17% .lifetime .use ---10% .used .inhalants .within .the .past .year ---5% .used .within .the .past .month •P overty .and .emotional .challenges .predict .chronic .abuse -Tolerance .and .dependence .common, .but .often .a .short-term .duration .of .abused
Depressants .and .Drug-Facilitated .Sexual .Assault .- .CORRECT .ANSWER- •DSFA: .Use .of .alcohol/other .drug .to .compromise .and .individual's .ability .to .consent .to .sexual .activity -To .minimize .resistance .and .later .memory •1 .in. 5 .women .have .been .victims .of .sexual .violence -Many .have .also .voluntarily .consumed .alcohol •Drugs .include -Ecstasy, .ketamine, .GHB, .Rophypnol -Many .are .tasteless, .colorless; .hard .to .detect
•Increased .likelihood .of .cardiac .arrhythmia •Reduction .in .REM .sleep .(other .depressants .too) •Risk .of .toxicity .to .fetus .during .pregnancy •Adverse .interactions .with .other .drugs
Acute .Behavioral .Effects .of .Alcohol .- .CORRECT .ANSWER- •Initial .excitement, .talkativeness •Then .slurred .speech, .irritability, .drowsiness -Blackouts .possible --More .likely .with .rapid .consumption -Impaired .driving .skills, .eye-hand .coordination --As .low .as ..03 .BAC .(10,000+ .DWI .fatalities) -Increased .tendency .for .violence .and .aggression --Two .possible .explanations
- .Disinhibition .Theory .(Pharmacological)
- .Cognitive-Expectations .Theory .(learned)
Testing .Cognitive-Expectations .Effects .- .CORRECT .ANSWER- •A ."balanced .placebo" .design .uses. 4 .groups Group .1: .Told .they .drank .alcohol -Actually .did .drink .alcohol Group .2: .Told .they .drank .a .non-alcohol .substitute -Actually .did .drink .alcohol Group .3: .Told .they .drank .alcohol -Actually .drank .non-alcohol .substitute Group .4: .Told .they .drank .a .non-alcohol .substitute -Actually .drank .a .non-alcohol .substitute •Conclusions: .Expectations .matter .more .in .aggression -But .these .kinds .of .studies .only .work .for .BAC .under .. -After .that .people .know .if .they .have .been .given .alcohol .or .not
Alcohol, .Violence .and .Aggression .Studies .- .CORRECT .ANSWER- •50 -60% .of .murders .committed .when .the .killer .had .been .drunk •60 -70% .of .male-instigated .domestic .violence .was .when .the .offender .was .drunk •60% .of .child .molestations .involve .drunkenness •But, .does .alcohol .MAKE .you .do .these? -For .example, .some .criminals .drink .to .get .the .courage .to .do .crimes .they .already .want .to .do
Health .Benefits .of .Moderate .Alcohol .Consumption .- .CORRECT .ANSWER- •Higher .HDL .cholesterol .= .less .risk .of .heart .disease •Reduced .risk .of... -Diabetes .Mellitus -Stroke -Dementia •NOTE: .Benefits .are .associated .with .MODERATE .levels .of .alcohol .consumption .only
The .Social .History .of .Alcohol .Abuse .- .CORRECT .ANSWER- •1785: .Benjamin .Rush .warns .of .dangers .of .alcohol .use •1830 -1850: .American .Temperance .Society .and .similar .groups .active .until .Civil .War •1919: .National .Alcohol .Prohibition .begins -1933: .Prohibition .ends
- 1966: .Mississippi .repeals .state .prohibition -The .last .U.S. .state .to .do .so
Criteria .for ."Alcoholism" .- .CORRECT .ANSWER- •Called .the ."Hidden .Addiction" .(legal .drug) •Clinical .term .is ."Alcohol .Dependence"
- .Problems .caused .by .preoccupation .with .drinking -Symptomatic .drinking, .loss .of .control .over .drinking
- .Emotional .problems .(depression)
- .Vocational, .social, .and .family .problems
- .Physical .problems .(organ .damage) •Estimated .societal .cost .is .$200 .billion .per .year .in .the .U.S. -Health .care, .lost .productivity, .injuries, .treatment, .etc
Alcohol .Withdrawal .Symptoms .- .CORRECT .ANSWER- •First .cluster: .Alcohol .withdrawal .syndrome -Insomnia, .vivid .dreams .(REM .rebound) -Severe .hangovers, .tremors, .anxiety, .nausea, .increased .heart .rate/blood .pressure --Lasts .24-36 .hours .after .stopping, .done .in. 48 .hours •Second .cluster: .Delirium .Tremens .(DTS) -Very .dangerous: --Extreme .disorientation, .frightening .hallucinations --Sweating, .fever, .dehydration, .possible .heart .failure, .suicide -Peaks .3-4 .days .after .stopping
Liver .Disease .From .Chronic .Alcohol .Abuse .- .CORRECT .ANSWER- •"Fatty .Liver" -Fat .deposits .in .the .liver •Alcoholic .Hepatitis -Liver .inflammation •Alcohol .Cirrhosis -Scarring .and .deterioration .of .liver .cells
Cardiovascular .Disease .and .Cancer .Risks .Among .Alcoholics .- .CORRECT .ANSWER- •1 .in. 4 .alcoholics .develops .cardiovascular .problems .due .to .the .chronic .consumption •Chronic .alcohol .abuse .linked .to .increased .risk .of .cancer .of .the... -Pharynx, .Larynx, .Liver .and .Breast .(in .women)
Alcoholic .Dementia .and .Wernicke-Korsakoff .Syndrome .- .CORRECT .ANSWER- •Alcoholic .Dementia: -Structural .changes .in .the .brain, .less .brain .mass -Lower .IQ, .decline .in .verbal .learning .and .memory
- .Enabling: .Attempts .to .make .personal .sacrifices .in .an .effort .to .improve .the .alcoholic's .condition/behavior
Deaths .Per .Year .from ."Drugs" .- .CORRECT .ANSWER- •Tobacco: .480, •Alcohol: .83, •Cocaine: .6, •Heroin/Morphine: .33, •NIDA .(2015): .33,000+ .Opiate .deaths -Up .4x .since. 1999 •Even .with .recent .Opioid .crisis, .Tobacco .itself .killed .12x .more .people .than .cocaine/opiates
Legalizers .V .Prohibitionists .- .CORRECT .ANSWER- •Legalizer's .Claim: -Legal .Drugs .(Alcohol, .Tobacco) .are .more .dangerous .than .we .admit --If .illegal .drugs .kill .fewer .people, .why .waste .resources .keeping .them .illegal? ---...And .ruining .people's .lives .(incarceration) --"Civil .Libertarian" .Idea: .Let .people .do .what .they .want, .if .it .is .not .harming .anyone .else .(Laissez .Faire) --Goode .says .it's .not .a .logical .argument ---Maybe .should .make .all ."drugs" .illegal, .not .legalize .them .all •Prohibitionists' .Claim -Illegality .suppresses .use .(is .this .the .only .thing?)
Further .Claims .by ."Legalizers" .- .CORRECT .ANSWER- •If .drugs .were .legal: -Dosages .could .be .standardized; .impurities .removed -Clean .needles/condoms .distributed .(HIV) -More .treatment .could .be .available •All .this .would .reduce .the .numbers .of ."illegal .drug" .deaths, .below .where .they .are .now -Legalizers .estimate .about .3,500 .deaths .(why .so .low?) --Levinthal's .chart .showed .at .least .22,500 .(39,500) --But ."legalizers" .want .you .to .think .its .not .that .many .(not .a .big .deal)
Moral .v .Empirical .Issue .in .the .Legalizer's .Claims .- .CORRECT .ANSWER- •Moral .Issue: .Is .un-resolvable .("fair"=opinion) -"It's .unfair .to .punish .illegal .drug .users, .when .users .of .legal .drugs .cause .(more?) .harm, .too" --May .or .may .not .be .true, .but .Goode .says ."So .what?" •Empirical .Issue: .us .easily .observable -"Legal .drugs .are .deadlier .than .illegal .ones" --True: .By .raw .numbers .of .deaths ---Legal .drugs .kill .many .times .more .people --But .this .is .misleading, .for .several .reasons...
Goode: ."Apples .and .Oranges" .- .CORRECT .ANSWER- •4 .Problems .with .comparing .numbers .of .deaths
- .Legal .drugs, .we .count .the .whole .country .and .all .causes .of .death -Legal .drug .deaths: .Mostly .chronic .illnesses -Illegal .drug .deaths: .Mostly .ODs .and .in .cities
- .Effect .of .legalization .on .numbers .is .unknown -Could .dramatically .increase .number .of .users
- .Must .compare .deaths .per .user, .not .raw .numbers
- .Need .to .consider ."years .of .life" .lost •Extent .and .Frequency .of .Use -60-70 .billion .doses .of .alcohol/year --Heroin/cocaine .use .estimate: .1/10th .this .(6-7 .billion .doses) -500 .billion .cigarettes/year --Heroin/Cocaine .use .estimate: .about .1/100th .this .(6-7 .billion .doses) •Years .of .life .lost -Legal .drugs .kill .older .victims, .so .fewer ."years .of .life" .lost --Alcohol/tobacco .tend .to .kill .people .in .their .50s .to .70s --Heroin/Cocaine .tend .to .kill .people .in .their .20s .to .30s
Primary .v .Secondary .Harm .- .CORRECT .ANSWER-1. .Primary: .Direct .effect .of .the .drug .use -Example: .Tobacco .smoke .gives .you .cancer -Prohibitionists .seek .to .avoid .this .kind .of .harm
- .Secondary: .Effect .of .illegal .status -Example: .No .needle .exchange .leads .to .HIV .infection -Legalizers .seek .to .avoid .this .kind .of .harm •Would .legalization .lead .to .more .use .and .more .(primary) .harms? .Goode .believes ."YES" -But .we .don't .know .what .would .really .happen --We .might .start .to .get .some .ideas .from .MJ .legalization .now
The ."Scorecard" .- .CORRECT .ANSWER- •Per .Use: ."Illegal .drugs .are .more .dangerous" .(ex: .chances .of .OD), .esp. .lately •Chronic .disease: .Alcohol/Tobacco .are .far .more .dangerous .(ex: .risk .of .cancers) •Goode: .Drug .addicts .lead .dangerous .lives -Ex: .Risky .sex, .crimes, .poor .health, .etc. --Legalization .will .not .change .most .of .this -Legalization .will .also .likely .increase .use .and .the .number .of .users .(at .least .somewhat) --And .mroe .drug .use .will .make .them .more .reckless
What .Should .We .Do .- .CORRECT .ANSWER- •Illegal .drugs .are .dangerous... -Legalizing .them .is .likely .a .bad .idea, .but.. -What .about .further .limiting ."Legal .Drugs" .to .reduce .their .harms? •Proposed .controls .for .alcohol .and .tobacco -Delay .onset .of .smoking .in .teens -Increased .taxes .(but .could .eventually .lead .to ."black .markets") -Increase .negative .advertising .(ex: .Faces .of .Meth, .theTruth.com) -Ban .overseas .sales .of .tobacco .(to .reduce .company .profits) -Criminalize .sale .of .tobacco .to .minors .and .public .smoking -Increase .DUI .enforcement -Restrict .alcohol .sales .(ex: .on .campus, .sports, .happy .hour)
-Larynx:. 27 .times .greater, .or .27000% .higher .risk -Mouth .or .lip:. 13 .times .higher .risk -Kidney, .uterine, .bladder, .and .pancreas: .2-5 .times .higher .risk
American .Lung .Association .- .CORRECT .ANSWER- •Suggest .that .80% .of .women .and .90% .of .men .that .have .lung .cancer .are .due .to .smoking -About .100,000 .people .die .per .year
Special .Health .Concerns .for .Women .- .CORRECT .ANSWER- •Genetics, .differences .in .lung .tissue .and .excretion .of .carcinogens .all .play .a .role •For .women, .tobacco .use .increases .risk .of: -Dying .from .stroke .due .to .brain .hemorrhage --2-3 .times .more .likely .(100-220% .more .likely) .than .men -Dying .from .a .heart .attack --2 .times .more .likely •Increased .risk .is .greater .when .women .also .use .birth-control .pills -About. 22 .times .greater .(2200% .more .likely)
Hazard .of .Environmental .Smoke .- .CORRECT .ANSWER- •Called ."2nd .Hand" .(or ."sidestream .smoke") -In .an .average .room, .3/4 .of .the .Nicotine .coming .from .the .cigarettes .being .smoked .up .ends .up .in .the .atmosphere -Non-smoking .wives .of .husbands .who .smoke: --30% .greater .risk .of .lung .cancer .than .women .whose .husbands .do .not .smoke -Also .increases .cancer .in .pets .(dogs, .cats, .birds)
Smoking .Patterns .- .CORRECT .ANSWER- •18% .of .adults .smoke .cigarettes -42 .million .Americans -Men .more .likely, .Asians .lowest .likelihood •Peak .years .for .starting .are .the .6th .or .7th .grade -8% .of .8th .graders .have .tried .cigarettes .in .lifetime --Only .about .2% .are .daily .smokers -80-90% .of .regular .smokers .began .by .age. 18 -14% .of .college .students .and .16% .of .HS .students .smoke -Social .attitudes: .Less .accepting, .use .rates .down
Hazards .of .Cigar .Smoking .- .CORRECT .ANSWER- •Nicotine .in .cigar .smoke .is .absorbed .directly .through .tissues .lining .the .mouth •5 .times .higher .risk .of .lung .cancer .than .from .cigarettes •2 .times .higher .cancer .risk .in .mouth, .smoke, .throat .and .esophagus •45% .higher .risk .of .COPD •27% .higher .risk .of .Coronary .Heart .Disease
Trouble .Signs: .Smokeless .Tobacco .- .CORRECT .ANSWER- •Lumps .in .jaw .or .neck •Color .changes .inside .the .lips •Leukoplakia -White .patches .in .mouth, .on .neck .or .lips •Erythroplakia:
-Red .spots .or .sores .on .lips .or .gums •R epeated .bleeding .in .the .mouth •Difficulty .in .speaking .or .swallowing
A .Fatal .Case .of .Oral .Cancer .- .CORRECT .ANSWER- •About .31,000 .cases .of .oral .cancer .per .year .(2006) •Almost .5,000 .men .and .2,500 .women .die .from .oral .cancer .per .year .(2006) •8 -10 .dips/day .is .the .same .amount .of .nicotine .as .30-40 .cigarettes/day •Average .age .of .first .use .is. 10 .years .old •Long .term .use .increases .risk .of .cheek .and .gum .cancers .by .50% •Chewing .tobacco .contains. 28 .carcinogens... .arsenic, .formaldehyde, .nickel, .cadmium .and .polonium .(which .is .radioactive)
E-Cigarettes .and .Nicotine .Toxicity .- .CORRECT .ANSWER- •E -Cigarettes .(Vaping) .highly .popular -Non-tobacco .products .consisting .of .propylene .glycol .infused .with .nicotine -Advertising .for .e-cigarettes .is .reversing .the .effects .of .the .negative .smoking .campaigns --People .think .it .is .safe -Liquid .nicotine .is .dangerous .and .lethal -Health .effects .of .additives .are .unknown
Regulatory .Policy .for .Tobacco .Control .- .CORRECT .ANSWER- •Since .2009, .authority .for .regulating .tobacco .belongs .to .the .FDA •3 .Categories .of .regulatory .activity:
- .Taxation .(roughly .27% .of .price/pack) -10% .increase .in .tax .leads .to .7% .less .use
- .Reducing .access .by .young .people -Vending .machine, .marketing .restrictions
- .Public .education .on .tobacco's .negative .effects -Graphic .warning .labels, .commercials
Categories .of .Crimes .that .Involve .Illicit .Drugs .- .CORRECT .ANSWER- •Dug - defined .offenses: -Violation .of .laws .against .drugs -Drug .possession, .DUI, .drug .trafficking -Half .of .federal .prisoners, .1.5 .million .arrests •Drug -related .offenses: -Offenses .where .the .drug .contributed .to .the .crime --Crime .done .under .the .influence, .or .to .get .money -Robbery, .murder, .assault
Possible .Drug-Crime .Connections .- .CORRECT .ANSWER-1. .Drug .use .causes .crime .(Goldstein) -(Psycho) .pharmacological .explanations -Economic .explanations -Systemic .violence
- .Crime .causes .drug .use
- .Drugs .and .crime .reinforce .one .another
--Ship .cash .overseas, .deposited .there ---Electronically .transferred .back .to .U.S. -Retail ."front" .businesses --Cash .businesses: .Laundromats, .car .washes --Also .use .Business ."loans", .casino .winnings, .etc
