tap, teles F. total Hofstra University

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1 tap, T H I R D - E D I T I O N teles F. total Hofstra University

2 PART 1: Drugs in Society/Drugs in Our Lives 1 Chapter 1 Drugs and Behavior Today 1 Chapter 2 Drug-Taking Behavior: The Personal and Social Concerns Chapter 3 How Drugs Work in the Body and on the Mind 52 Point/Counterpoint: Should We Legalize Drugs? PART 2: Legally Restricted Drugs in Our Society 77 Chapter 4 The Major Stimulants: Cocaine and Amphetamines 77 Chapter 5 The Major Narcotics: Opium, Morphine, and Heroin 100 Chapter 6 LSD and Other Hallucinogens 124 Chapter 7 Marijuana 147 Chapter 8 Anabolic Steroids and Drug Abuse in Sports 167 Point/Counterpoint: Should Marijuana Be Available for Medicinal Purposes? 184 PART 3: Legal Drugs in Our Society 185 Chapter 9 Alcohol: Social Beverage/Social Drug 185 Chapter 10 Chronic Alcohol Abuse and Alcoholism 207 Chapter 11 Nicotine and Tobacco 233 Chapter 12 Caffeine 258 Chapter 13 Glues, Solvents, and Other Inhalants 275 Point/Counterpoint: Should Alcoholism Be Viewed as a Disease? 287 PART 4: Medicinal Drugs 288 Chapter 14 Prescription-Drugs, Over-the-Counter Drugs, and Dietary Supplements Chapter 15 Sedative-Hypnotics and Antianxiety Drugs 309 Chapter 16 Drugs for Treating Schizophrenia and Mood Disorders 327 Point/Counterpoint: How Do We Get Orphan Drugs Adopted? PART 5: Treatment, Prevention, and Education 345 Chapter 17 Prevention and Treatment: Strategies for Change 345 Chapter 18 Prevention and Education: Schools, Community, and Family Point/Counterpoint: Do We DARE or Don't We?

3 The DAWN Reports 30 Drug Tolerance 34 QUICK CONCEPT CHECK 2.2: Understanding Behavioral Tolerance through Conditioning 35 Physical and Psychological Dependence 35 Physical Dependence 36 Psychological Dependence 36 Psychiatric Definitions 37 Special Problems in Drug Abuse 38 Drug Abuse in Pregnancy 38 HEALTH LINE: Effects of Psychoactive Drugs on Pregnant Women and Newborns 39 Drug Abuse and AIDS 40 Drugs, Violence, and Crime 40 Pharmacological Violence 41 Economically Compulsive Violence 42 Systemic Violence 43 Governmental Policy, Regulation, and Laws 44 Efforts to Regulate Drugs, PORTRAIT: HarryJ. Anslinger America's First Drug Czar 45 Rethinking the Approach toward Drug Regulation 46 Enforcement of Drug Laws on a Local and International Scale 46 HEALTH LINE: Harm Reduction as a Drug-Abuse Policy 48 Summary 49 Key Terms 50 Endnotes 50 \Jj How Drugs Work in the Body and on the Mind 52 How Drugs Enter the Body 53 Oral Administration 53 Injection 54 Inhalation 54 Absorption through the Skin or Membranes 55 How Drugs Exit the Body 55 DRUGS... IN FOCUS: Ways to Take Drugs: Routes of Administration 56 Factors Determining the Physiological Impact of Drugs 57 Timing 57 Drug Interactions 57 Individual Differences 58 QUICK CONCEPT CHECK 3.1: Understanding Drug Interactions 58 HEALTH ALERT: Combinations That Do More Harm Than Good 59 Introducing the Nervous System 60 The Peripheral Nervous System 60 Sympathetic and Parasympathetic Responses 61 The Central Nervous System 62 Understanding the Brain 63 The Hindbrain 63 The Midbrain 64 The Forebrain 64 QUICK CONCEPT CHECK 3.2: Understanding Drugs and Brain Functioning 64 Understanding the Biochemistry of Psychoactive Drugs 65 Introducing Neurons 65 Synaptic Communication 66 The Major Neurotransmitters in Brief: The Big Six 67 Physiological Aspects of Drug-Taking Behavior 68 The Blood-Brain Barrier 68 Q DRUGS... IN FOCUS: Drug Effects and Synaptic Communication in the Nervous System 69 Biochemical Processes Underlying Drug Tolerance 69 B PORTRAIT: Solomon H. Snyder On the Cutting Edge of Discovery 70 A Physiological Basis for Psychological Dependence 70 Psychological Factors in Drug-Taking Behavior 71 Expectation Effects 71 Summary 73 Key Terms 74 Endnotes 74 ;"POTNt/Cdp'NTERP'blNTi Should We Legalize Drugs? 75 VIII

4 I LEGALLY RESTRICTED DRUGS IN OUR SOCIETY 77. T 1 The Major Stimulants: Cocaine and Amphetamines 77 The History of Cocaine 78 Cocaine in Nineteenth-Century Life 78 Commercial Uses of Cocaine 78 Freud and Cocaine 79 H DRUGS... IN FOCUS: What Happened to the Coca in Coca-Cola? 80 QUICK CONCEPT CHECK 4.1: Understanding the History of Cocaine 81 Acute Effects of Cocaine 81 M HEALTH ALERT: Cocaine after Alcohol: The Increased Risks of Cocaethylene Toxicity 82 Chronic Effects of Cocaine 82 Medical Uses of Cocaine 83 How Cocaine Works in the Brain 83 Present-Day Cocaine Abuse 83 From Coca to Cocaine 84 From Cocaine to Crack 84 Patterns of Cocaine Abuse 85 B HEALTH ALERT: The Physical Signs of Possible Cocaine Abuse 85 Treatment Programs for Cocaine Abuse 86 HEALTH LINE: Seven Rules for Cocaine Abusers Who Want to Quit 87 PORTRAIT: Doc Gooden Triumphs and Tribulations 88 D DRUGS... IN FOCUS: Crack Babies Revisited: Has There Been an Adverse Effect? 89 Amphetamines 89 The History of Amphetamines 89 The Different Forms of Amphetamines 90 How Amphetamines Work in the Brain 91 Acute and Chronic Effects of Amphetamines 91 Patterns of Methamphetamine Abuse and Treatment 92 Present-Day Patterns of Methamphetamine Abuse 92 HEALTH LINE: Methcathinone Abuse: A New Breed of Cat 93 QUICK CONCEPT CHECK 4.2: Understanding Patterns of Stimulant Abuse 94 Medical Uses for Amphetamines and Similar Stimulant Drugs 94 Summary 95 Key Terms 96 Endnotes 97 U The Major Narcotics: Opium, Morphine, and Heroin 100 Opium in History 102 Opium in China 103 Opium in Britain 103 Opium in the United States 104 Morphine and the Advent of Heroin 104 Heroin and Opiate Dependence in American Society 105 Opiate Use after Heroin Addiction in the 1960s and 1970s 106 Heroin and Synthetic Opiates since the 1980s 107 a DRUGS... IN FOCUS: Colombian Heroin Now Dominant in the United States 108 Effects on the Mind and the Body 109 QUICK CONCEPT CHECK 5.1: Understanding the History of Drugs 109 Medical Uses of Narcotic Drugs 110 Beneficial Effects 110 Possible Complications 111 How Opiates Work in the Brain 111 D DRUGS... IN FOCUS: What Do Endorphins Tell Us about Ourselves? 112 Patterns of Heroin Abuse 113 Tolerance and Withdrawal Symptoms 113 The Lethality of Heroin Abuse 114 QUICK CONCEPT CHECK 5.2: Understanding Effects of Administering and Withdrawing Heroin 115 Heroin Abuse and Society 115 DRUGS... IN FOCUS: The Secret and Dangerous Life of a Chipper 116

5 Treatment for Heroin Abuse 117 Opiate Detoxification 117 Methadone Maintenance 117 PORTRAIT: Mother Hale and Her Thousand Babies 119 Behavioral and Social-Community Programs 119 Summary 120 Key Terms 121 Endnotes 121 v 6 LSD and Other Hallucinogens 124 A Matter of Definition 125 Classifying Hallucinogens 126 Lysergic Acid Diethylamide (LSD) 127 B DRUGS... IN FOCUS: Strange Days in Salem: Witchcraft or Hallucinogens? 128 The Beginning of the Psychedelic Era 128 PORTRAIT: Timothy Leary Whatever Happened to Him? 129 Acute Effects of LSD 130 Effects of LSD on the Brain 131 Patterns of LSD Use 131 Facts and Fictions about LSD 132 Will LSD Produce a Dependence? 132 Will LSD Produce a Panic or a Psychosis? 132 HEALTH ALERT: Emergency Guidelines for a Bad Trip on LSD 133 Will LSD Increase Creativity? 13 3 Will LSD Damage Chromosomes? 133 Will LSD Have a Residual Effect? 133 Will LSD Increase Criminal or Violent Behavior? 134 Psilocybin and Other Hallucinogens Related to Serotonin 134 Lysergic Acid Amide (LAA) 135 Dimethyltryptamine (DMT) 13 5 Harmine 135 H DRUGS... IN FOCUS: Bufotenine and the Bufo Toad 136 Hallucinogens Related to Norepinephrine 136 Mescaline 136 H DRUGS... IN FOCUS: Present-Day Peyotism and the Native American Church 137 DOM 137 MDMA (Ecstasy) 138 U HEALTH ALERT: MDMA Toxicity: The Other Side of Ecstasy 138 Hallucinogens Related to Acetylcholine 139 Amanita muscaria 139 The Hexing Drugs and Witchcraft 139 HEALTH LINE: Ibogaine: ATreatment Option for Drug Dependence? 140 QUICK CONCEPT CHECK 6.1: Understanding Variations in Hallucinogens 141 Phencyclidine (PCP) 141 History and Abuse of PCP 141 Patterns of PCP Abuse 142 QUICK CONCEPT CHECK 6.2: Understanding PCP 143 Ketamine 143 Summary 143 Key Terms 144 Endnotes 145 / Marijuana 147 A Matter ofterminology 148 The History of Marijuana and Hashish 149 Hashish in the Nineteenth Century 150 Marijuana and Hashish in the Twentieth Century 150 The Antimarijuana Crusade 150 Challenging Old Ideas about Marijuana 151 Acute Effects of Marijuana 151 Acute Physiological Effects 152 Acute Psychological and Behavioral Effects 153 D DRUGS... IN FOCUS: Can You Control a Marijuana High? 153 QUICK CONCEPT CHECK 7.1: Understanding the Effects of Marijuana 154 Effects of Marijuana on the Brain 154 Chronic Effects of Marijuana 155 Tolerance 155 Dependence 155 Cardiovascular Effects 156 Respiratory Effects and the Risk of Cancer 156 Effects on the Immune System 156 Effects on Sexual Functioning and Reproduction 156 Neural Effects and the Amotivational Syndrome 157

6 The Gateway Hypothesis 158 QUICK CONCEPT CHECK 7.2: Understanding the Adverse Effects of Chronic Marijuana Abuse 159 Medical Uses for Marijuana 159 Glaucoma 159 Asthma 159 PORTRAIT: Kenny and Barbrajenks vs. America's War on Drugs 160 Nausea 160 The Medical Marijuana Controversy 160 Patterns of Marijuana Smoking 161 Current Trends as Causes for Concern 162 DRUGS... IN FOCUS: Street Language for Marijuana 162 The Issue of Decriminalization 162 Summary 163 Key Terms 164 Endnotes 164 Nonsteroid Hormones and Ergogenic Supplements 176 Human Growth Hormone 176 Dietary Supplements as Ergogenic Aids 176 Current Drug-Testing Procedures and Policies 177 Techniques for Drug Testing 178 Sensitivity and Specificity 178 Masking Drugs and Chemical Manipulations 179 Pinpointing the Time of Drug Use 179 QUICK CONCEPT CHECK 8.2: Understanding Drug Testing 180 What Can Be Done about Anabolic Steroid Abuse? 180 Summary 181 Key Terms 181 Endnotes 182 CPOINT/COUNTERPOINT: Should Marijuana Be Available for Medicinal Use? 184 '. O Anabolic Steroids and Drug Abuse in Sports 167 Drug-Taking Behavior in Sports 168 What Are Anabolic Steroids? 168 Anabolic Steroids at the Modern Olympic Games 169 Anabolic Steroids in Professional and Collegiate Sports 170 A Milestone Year in the History of Anabolic Steroids 171 PORTRAIT: Ben Johnson and the Olympic Gold Medal 171 The Hazards of Anabolic Steroids 171 Effects on Hormonal Systems 172 Effects on Other Systems of the Body 172 Psychological Problems 172 QUICK CONCEPT CHECK 8.1: Understanding the Effects of Anabolic Steroids 173 Special Problems for Adolescents 173 Patterns of Anabolic Steroid Abuse 173 The Potential for Steroid Dependence 174 Counterfeit Steroids and the Placebo Effect 174 HEALTH ALERT: The Symptoms of Steroid Abuse 175 LEGAL DRUGS IN OUR SOCIETY, 185 ir Alcohol: Social Beverage/ Social Drug 185 What Makes an Alcoholic Beverage? 186 Alcohol Use through History 187 Alcohol in Early U.S. History 188 The Rise of Temperance in the United States 189 Patterns of Alcohol Consumption Today 189 Overall Patterns of Alcohol Consumption 189 Trends in Alcohol Consumption since the Late 1970s 190 The Demographics of Alcohol Consumption 190 QUICK CONCEPT CHECK 9.1: Understanding Alcoholic Beverages 192 The Pharmacology of Alcohol 192 The Breakdown and Elimination of Alcohol 192 Measuring Alcohol in the Blood 193 XI

7 HEALTH LINE: Gender, Race, and Medication: Factors in Alcohol Metabolism 194 Effects of Alcohol on the Brain 194 Acute Physiological Effects 195 Toxic Reactions 195 Heat Loss and the Saint Bernard Myth 196 Diuretic Effects 196 HEALTH ALERT: Emergency Signs and Procedures in Acute Alcohol Intoxication 196 Cardiovascular Effects 197 Effects on Sleep 197 Interactions with Other Drugs 197 Hangovers 197 Acute Behavioral Effects 198 Blackouts J99 Driving Skills 199 Alcohol, Violence, and Aggression 200 PORTRAIT: Candace Lightner Founder of MADD 201 Sex and Sexual Desire 202 QUICK CONCEPT CHECK 9.2: Understanding the Data from Balanced Placebo Designs 202 Strategies for Responsible Drinking 202 HEALTH LINE: Guidelines for Responsible Drinking 203 Summary 203 Key Terms 204 Endnotes 204 \. I U Chronic Alcohol Abuse and Alcoholism 207 Alcoholism: Stereotypes, Definitions, and Criteria 208 Problems Associated with a-preoccupation with Drinking 208 Emotional Problems 210 Vocational, Social, and Family Problems 210 Physical Problems 210 Hiding the Problems: Denial and Enabling 210 HEALTH LINE: A Self-Administered Short Michigan Alcoholism Screening Test (SMAST) 211 Alcohol Abuse and Alcohol Dependence: The Professional's View 211 QUICK CONCEPT CHECK 10.1: Understanding the Psychology of Alcoholism 212 The History of Efforts to Regulate Chronic Alcohol Abuse 212 The Road to National Prohibition 2 J 3 The Beginning and Ending of a "Noble Experiment" 213 Present-Day Regulation by Taxation 214 Chronic Effects of Alcohol 214 Tolerance and Withdrawal 214 Liver Disease 215 Cardiovascular Problems 216 Cancer 216 Wernicke-KorsakoffSyndrome 216 Fetal Alcohol Syndrome 217 Patterns of Chronic Alcohol Abuse 218 HEALTH LINE: The TWEAK Alcoholism Screening Instrument for Pregnant Women 219 The Demographics of Alcoholism 219 Alcohol Abuse among the Elderly,, 219 The Family Dynamics of Alcoholism: A Systems Approach 220 Children of an Alcoholic Parent or Parents 221 The Genetics of Alcoholism 221 The Concept of Alcoholism as a Disease 222 Approaches to Treatment for Alcoholism 223 Biologically Based Treatments 223 Alcoholics Anonymous 224 B DRUGS... IN FOCUS: Is Controlled Drinking Possible for Alcoholics? 225 PORTRAIT: Bill W. and Dr. Bob-Founders of Alcoholics Anonymous 226 Rational Recovery 226 HEALTH LINE: The Non-Disease Model of Alcoholism and Other Patterns of Drug Abuse 227 Alcoholism in the Workplace 227 QUICK CONCEPT CHECK 10.2: Understanding Alcoholics Anonymous 228 Summary 228 Key Terms 229 Endnotes 229 XII

8 11 Nicotine and Tobacco 233 Tobacco Use through History 234 Politics, Economics, andtobacco 235 Snuffing and Chewing 235 Cigars and Cigarettes 236 Tobacco in the Twentieth Century 236 Health Concerns and Smoking Behavior 237 Tobacco Today: An Industry on the Defensive 238 The Tobacco Settlement 238 Federal Regulation of Nicotine as a Drug 239 Tobacco Regulation and Economics 239 What's in Tobacco? 239 Carbon Monoxide 240 Tar 240 Nicotine 241 The Dependence Potential of Nicotine 241 The Titration Hypothesis of Nicotine Dependence 242 Tolerance and Withdrawal 242 Health Consequences of Tobacco Use 242 Cardiovascular Disease 243 Respiratory Diseases 243 Lung Cancer 244 Other Cancers 245 HEALTH ALERT: Signs oftrouble from Smokeless Tobacco 245 Special Problems for Women 245 M DRUGS... IN FOCUS: Who Has the Right: Smokers or Nonsmokers? 246 The Hazards of Environmental Smoke 246 QUICK CONCEPT CHECK 11.1: Understanding the Effects of Tobacco 246 Patterns of Smoking Behavior and Use of Smokeless Tobacco 247 The Youngest Smokers 247 Attitudes toward Smoking among Young People 247 Use of Smokeless Tobacco 248 Cigars and Flavored Cigarettes 249 Tobacco Use around the World 249 PORTRAIT: Sigmund Freud Nicotine Dependence, Cigars, and Cancer 250 Quitting Smoking: The Good News and the Bad 250 The Bad News: How Hard It Is to Quit 251 B HEALTH LINE: Ten Tips on How to Succeed When Trying to Quit Smoking 252 Nicotine Gums, Patches, Sprays, and Inhalers 252 A Final Word on Quitting 252 Summary 253 Key Terms 254 Endnotes 254 (12 Caffeine 258 Coffee 259 Coffee in Britain and North America 259 Major Sources of Coffee 260 How Coffee Is Made 260 The Caffeine Content in Coffee 261 Tea 261 Q DRUGS... IN FOCUS: Why There Are No (Live) Flies in Your Coffee 261 Tea in Britain and North America 261 The Chemical Content in Tea 262 Chocolate 263 How Chocolate Is Made 263 a HEALTH LINE: Chocolate and Heart Disease: Some Good News 264 The Chocolate Industry Today 264 The Xanthine Content in Chocolate 264 Soft Drinks 264 H PORTRAIT: Milton S. Hershey and the Town Built on Chocolate 265 QUICK CONCEPT CHECK 12.1: Understanding Caffeine Levels in Foods and Beverages 266 Caffeine from Medications 266 The Era of Decaffeination 266 Caffeine as a Drug 267 Effects of Caffeine on the Body 267 Effects of Caffeine on Behavior 267 Health Risks 268 Cardiovascular Effects 268 Osteoporosis and Bone Fractures 268 Breast Disease 268 Cancer 269 Effects during Pregnancy and Breastfeeding 269 XIII

9 Panic Attacks 269 Dependence, Acute Toxicity, and Medical Applications 269 Tolerance 269 Withdrawal 270 Craving 270 Acute Toxicity of Caffeine 270 Medications Based on Xanthines 270 Kids and Caffeine: A Special Concern 271 Summary 271 Key Terms 272 Endnotes 272 (13 Glues, Solvents, and Other Inhalants 275 Inhalants through History 276 Nitrous Oxide 276 Ether 277 Glue, Solvent, and Aerosol Inhalation 277 The Abuse Potential of Inhalants 277 Acute Effects of Glues, Solvents, and Aerosols 278 The Dangers of Inhalant Abuse 278 HEALTH ALERT: The Signs of Possible Inhalant Abuse 279 Patterns of Inhalant Abuse 280 B DRUGS... IN FOCUS: Resistol and Resistoleros in Latin America 280 PORTRAIT: Scott Pecor The Scotchgard High 281 Questions about Chronic Inhalant Abuse 281 A Gateway for Future Drug Abuse? 282 Responses of Society to Inhalant Abuse 282 Amyl Nitrite and Butyl Njtrite Inhalation 283 Patterns of Nitrite Inhalation Abuse 283 Health Risks in Nitrite Inhalation Abuse 284 M QUICK CONCEPT CHECK 13.1: Understanding the History of Inhalants 284 Summary 285 Key Terms 285 Endnotes 285 POINT/COUNTERPOINT: Should Alcoholism Be Viewed as a Disease? 287 \\*T MEDICINAL DRUGS 288/ Prescription Drugs, Over-the-Counter Drugs, and Dietary Supplements 288 How the Regulation of Prescription and OTC Drugs Began 290 H PORTRAIT: Frances Kelsey Saving a Generation of American Babies 291 Procedures for Approving Prescription and OTC Drugs 291 Phases of Clinical Studies for Prescription Drugs 292 HEALTH LINE: Widening the Population during Drug Testing 293 Patents and Generic Forms of Prescription Drugs 293 Speeding up the FDA Approval Process 294 Procedures for Approving OTC Drugs 295 QUICK CONCEPT CHECK 14.1: Understanding the FDA Approval Process 296 HEALTH ALERT: Side Effects of Common Medications 296 Are FDA-Approved Drugs Safe? 296 E3 DRUGS... IN FOCUS: Redux, Fen-Phen, and Obesity 297 Major OTC Analgesic Drugs 298 Aspirin 298 B HEALTH LINE: Expanding Medical Applications for Aspirin 299 Acetaminophen 300 Ibuprofen 301 Naproxen 301 Analgesic Drugs and Attempted Suicide 301 B QUICK CONCEPT CHECK 14.2: Understanding OTC Analgesic Drugs 302 Other Major Classes of OTC Drugs 302 Weight-Loss Aids 302 Sleep Aids 302 Cough-and-Cold Remedies 302 xiv

10 HEALTH ALERT: The Risks of Web Pharmacies 303 The Pharmaceutical IndustryToday 303» DRUGS... IN FOCUS: Pushing Pills: Public Commercials for Prescription Drugs 304 Dietary Supplements 304 Gingko Biloba 305 Ginseng 305 Summary 305 Key Terms 306 Endnotes 306 IU Sedative-Hypnotics and Antianxiety Drugs 309 Barbiturates 310 Categories of Barbiturates 310 Acute Effects of Barbiturates 311 DRUGS... IN FOCUS: Is There Any Truth Regarding "Truth Serum"? 312 M HEALTH ALERT: In Case of a Barbiturate Overdose Emergency Chronic Effects of Barbiturates 313 Current Medical Uses of Barbiturates 313 Patterns of Barbiturate Abuse 313 Nonbarbiturate Sedative-Hypnotics 313 The Development of Antianxiety Drugs 314 Benzodiazepines 315 Medical Uses of Benzodiazepines 316 Acute Effects of Benzodiazepines 317 fl HEALTH LINE: Guidelines for Avoiding the Misuse of Benzodiazepine Drugs 318 Chronic Effects of Benzodiazepines 318 Patterns of Benzodiazepine Misuse and Abuse 318 Cross-Tolerance and Cross-Dependence 319 PORTRAIT: Barbara Gordon A Case History of Valium Withdrawal 320 How Benzodiazepines Work in the Brain 320 fl HEALTH LINE: Rohypnol as a Date-Rape Drug 321 B QUICK CONCEPT CHECK 15.1: Understanding Cross-Tolerance and Cross-Dependence 322 A New Generation of Sedative-Hypnotics and Antianxiety Drugs 322 Zolpidem 322 Buspirone 322 The Risks of Gamma Hydroxybutyrate (GHB) 323 B QUICK CONCEPT CHECK 15.2: Understanding the Abuse Potential in Drugs 323 B HEALTH ALERT: GHB and Date-Rape: Ways to Avoid Trouble 324 Summary 324 Key Terms 325 Endnotes 325 {10 Drugs for Treating Schizophrenia and Mood Disorders 327 The Biomedical Model 328 Antipsychotic Drugs and Schizophrenia 328 The Symptoms of Schizophrenia 329 The Early Days of Antipsychotic Drug Treatment 329 The Nature of Antipsychotic Drug Treatment 330 PORTRAIT: Mark Vonnegut Thorazine and Recovery 331 Typical Antipsychotic Drugs: Side Effects and Risks 331 Atypical Antipsychotic Drugs 332 Effects of Antipsychotic Drugs on the Brain 332 B HEALTH LINE: Hallucinations, Schizophrenia, Drugs, and the Brain 333 Drugs Used to Treat Mood Disorders 334 MAO Inhibitors 334 Tricyclic Antidepressants 335 Atypical Antidepressants 335 B HEALTH LINE: Is There a Dark Side to Prozac? 336 Effects of Antidepressant Drugs on the Brain 336 B QUICK CONCEPT CHECK 16.1: Understanding the Biochemistry of Mental Illness 337 Drugs for Other Types of Mental Illness 337 Panic Attacks 337 Mania and Bipolar Disorder 337 xv

11 Obsessive-Compulsive Disorder (OCD) 338 Off-Label Usage of Psychotropic Medications 338 B HEALTH ALERT: The Risks of Interactions between St.-John's-wort and Prescription Drugs 339 St.-John's-wort: An Herbal Alternative for Treating Depression 339 B DRUGS... IN FOCUS: Psychiatric Drugs and the Civil Liberties Debate 340 Psychiatric Drugs, Social Policy, and Deinstitutionalization 340 Summary 341 Key Terms 342 Endnotes 342 POINT/COUNTERPOINT: How Do We Get Orphan Drugs Adopted? TREATMENT, PREVENTION, AND EDUCATION / Prevention and Treatment: Strategies for Change 345 Ways to Approach Drug-Abuse Prevention 346 B QUICK CONCEPT CHECK 17.1: Understanding Drug-Abuse Prevention Programs 346 B HEALTH LINE: Acupuncture as a Potential Treatment for Cocaine Abuse 347 A Biopsychosocial Strategy for Treatment 347 Incarceration and Other Punitive Measures in the United States 348 Prevention through Law Enforcement 349 m DRUGS... IN FOCUS: Penalties for Crack versus Penalties for Cocaine: A Racial Disparity? 352 Prison-Alternative and Prison-Based Treatment Programs 352 PORTRAIT: Monsignor William O'Brien- Founder of Daytop Village 353 Prevention and Treatment in the Workplace 354 Employee Assistance Programs 354 Drug Testing in the Workplace 354 The Prevalence and Economic Costs of Alcohol and Other Drug Abuse in the Workplace 355 The Impact of Drug-Free Workplace Policies 356 The Personal Journey to Treatment and Recovery 356 Rehabilitation and the Stages of Change 356 Stages of Change and Other Problems in Life 358 B QUICK CONCEPT CHECK 17.2: Understanding the Stages of Change 358 The Importance of Family Systems in Prevention and Treatment 359 Family Dynamics in Drug Abuse 359 M HEALTH ALERT: Coping with a Child's Abuse of Alcohol or Other Drugs: What Parents Should and Should Not Do 359 Enabling Behaviors as Obstacles to Rehabilitation 360 Survival Roles and Coping Mechanisms 360 Resistance at the Beginning, Support along the Way 361 Finding the Right Drug-Abuse Treatment and Prevention Program 361 ]udging the Quality of the Treatment Facility 362 Information Resources 362 Summary 363 Key Terms 364 Endnotes 364 Prevention and Education: Schools, Community, and Family 366 ATOD Prevention: Strategies, Goals, and Objectives 367 Strategies for ATOD Prevention 367 Strategic Goals for ATOD Prevention 368 The Public Health Model of ATOD Prevention 368 B HEALTH LINE: The Public Health Model and the Analogy of Infectious Disease 369 Lessons from the Past: Prevention Approaches That Have Failed 370 Reducing the Availability of Drugs 370 Punitive Measures 370 Scare Tactics and Negative Education 371 Objective Information Approaches 371 XVI

12 Magic Bullets and Promotional Campaigns 371 Self-Esteem Enhancement and Affective Education 372 Hope and Promise: Components of Effective School-Based Prevention Programs 372 Peer-Refusal Skills 372 B HEALTH LINE: Peer-Refusal Skills: Ten Ways to Make It Easier to Say No 373 Anxiety and Stress Reduction 373 Social Skills and Personal Decision Making 373 A Model School-Based Prevention Program: Life Skills Training 373 Drug Abuse Resistance Education (DARE) 374 Resiliency and Primary Prevention Efforts 375 fl QUICK CONCEPT CHECK 18.1: Understanding ATOD Prevention and Education 376 Community-Based Prevention Programs 376 Components of an Effective Community-Based Program 376 Alternative-Behavior Programming 376 The Influence of Mass Media 378 A Model Community-Based Prevention Program: Project STAR 379 Family Systems in Primary and Secondary Prevention 379 Special Roles in ATOD Prevention 380 Dysfunctional Communication within the Family 380 il DRUGS... IN FOCUS: A Test Kit for Drugs in the Home: Whom Can You Trust? 381 Multicultural Issues in Primary and Secondary Prevention 381 Prevention Approaches among Latino Groups 381 Prevention Approaches among African American Groups 381 Yes, You: ATOD Prevention and the College Student 382 Prevention Approaches on College Campuses 383 Where You Can Go for Help 383 PORTRAIT: Meredith Poulten A Counselor on the Front Lines 384 Summary 384 Key Terms 385 Endnotes 385 POINT/COUNTERPOINT: DO We DARE or Don't We? 388 Photo Credits 389 Index 391 xvii