Substance Abuse 1

Front 1

Cannabis (marijuana), Anabolic Steroids, Inhalants/Organic Solvents and narcotics are also found to be among the ________ commonly abused drugs.

Back 1

Most.

Front 2

Legal instrumental, illegal instrumental, legal recreational and illegal recreational use are the 4 types of drug use according to ____________.

Back 2

Erich Goode. Instrumental drug use refers to using a drug with a specific functional purpose--not for recreation:

Legal Instrumental Use – taking prescribed or over the counter (OTC) drugs for illness.

Illegal Instrumental Use – using drugs to achieve some goal other than the prescribed use, for example taking pills to stay awake and drive all night.

Legal Recreational Use – licit drug use, alcohol, tobacco, caffeine

Illegal Recreational Use – illicit drug use, cocaine, marijuana etc

Front 3

The most common age group to report the most illicit drug use is ____-____.

Back 3

18-25. Males are more likely to use illicit drugs than females and pregnant women are less likely to use drugs than women who are not pregnant.

Front 4

Alcohol, cigarettes, and marijuana are called _________ drugs because their use is often believed to lead to the use of other stronger drugs.

Back 4

Gateway. A typical progression of drug use starts with cigarettes and alcohol, and then marijuana before moving on to the stronger drugs, which is why these drugs are often called "gateway" drugs.

Front 5

According to the National Institute on Drug Abuse, the typical narcotic habit costs _______ per day.

Back 5

$100. It was also revealed that seventy five percent of the prostitutes in major cities are addicted to drugs. Also, heroin addicts must steal about $100,000 per year just to maintain their habit. This is 3 to 5 times the actual cost of the drugs.

Front 6

Examples of __________ drugs, include alcohol, tea, coffee, tobacco and over the counter (OTC) drugs.

Back 6

Licit.

Front 7

There are four principal factors that affect drug use. __________________ factors refer to how the drug actually affects the body.

Back 7

Pharmacological.

Front 8

The most commonly abused types of drugs include alcohol, tobacco, stimulants, ____________ and depressants.

Back 8

Hallucinogens.

Front 9

American Indians / Alaska Natives are the racial ethnic group that report the ____________ illicit drug use for the past month.

Back 9

Highest. 12.1% of American Indian/ Alaska Natives report illicit drug use in the past month. 12% of Two or more races. 8.7% of Blacks. 8.3% of Whites and 8% of Latino.

Front 10

The ________ is the primary federal agency responsible for enforcing U.S. drug laws.

Back 10

DEA (Drug Enforcement Administration).

Front 11

The three types of drug users include: experimenters, compulsive users and _____________.

Back 11

Floaters (or chippers). Floaters (chippers) usually don’t maintain their own supply of drugs but prefer to use other’s drugs.

Experimenters primarily restrict drug usage to recreational settings and are motivated by peer pressure and curiosity. Compulsive users are preoccupied with drug use, talk about drugs constantly and devote lots of time and energy to getting high.

Front 12

_____________ drugs are developed to eliminate the illegality of a drug by modifying a drug into a new compound.

Back 12

Designer. Also known as synthetic drugs or synthetic opioids, these are designed to get around existing drug laws. Often they involve modifying the molecular structure of an existing drug. Ecstasy is an example of a designer drug (today it's illegal and is an illicit drug).

Front 13

According to a recent survey, ______% of Americans have used marijuana in their lifetime.

Back 13

41%. Marijuana is the most commonly used illicit drug. The same survey reported that 15% had used hallucinogens and 15% had used cocaine in their lifetime.

Front 14

____________ dependence involves the need to continue using the drug to avoid withdrawal symptoms which include sickness and discomfort.

Back 14

Physical. Physical dependence is different from psychological dependence in that there's an actual need to take the drug to avoid physical symptoms.

For some drugs, the dependence is mostly psychological, whereas for others, a user may develop a heavy physical dependence on the drug with just a few uses.

Front 15

Because drug use can be found in all parts of society regardless of income, education, occupation, social class, and age, it is called an ________ _____________ affliction.

Back 15

Equal Opportunity.

Front 16

Methods of drug testing include urine, ________, and saliva.

Back 16

Hair. Drug use can be detected in urine for up to 5 days, in saliva for up to 1 day and in hair samples for up to 90 days.

Front 17

Another principal factor that affects drug use is _______________.

Back 17

Contextual. Contextual factors refer to how physical surroundings affect drug use; i.e. being at home vs. being in a rock concert or in a dance club.

Front 18

_______________ drugs are drug compounds (substances) that affect the central nervous system and alter consciousness and/or perceptions.

Back 18

Psychoactive. The two categories of psychoactive drugs are licit (legal) and illicit (illegal).

Front 19

In a recent study, 65.6% of full time employees reported _____________ use within the past month.

Back 19

Alcohol. The same study noted that 7% reported using illicit drugs in the past month and 9.7% of full time employees admitted to using marijuana in the past year. Two consequences of illicit drug use are lost productivity and increased healthcare costs. Illicit drug use costs American businesses billions of dollars each year.

Front 20

The pharmacological term for alcohol is ______________.

Back 20

Ethanol.

Front 21

The remaining two principal factors affecting drug use are social and ____________.

Back 21

Cultural. Social factors refer to things such as peers, family background, subculture, etc. that can influence drug use. Cultural factors refer to broader customs and traditions within the society--i.e. in certain cultures, there may be a culture that encourages or promotes the use of alcohol or other substances.

Front 22

The fourth stage of drug addiction is _______________.

Back 22

Dependency. In the dependency phase (also known as addiction) the user continues to use the drug regardless of physical symptoms (coughing, soreness, blackouts etc).

Withdrawal is considered the fifth and final stage of drug addiction.

Front 23

A ____________ is any substance that modifies mind or body function by distorting enhancing, or inhibiting them.

Back 23

Drug. A drug includes any substance which can impair a person's ability to safely function in society such as:
Illegal controlled substances such as cocaine, heroin and marijuana
Prescription medicines such as valium, and codeine
Alcoholic beverages such as beer, wine, ale and distilled liquors
Chemical solvents such as spray paint, glue and gasoline
Natural Plant Intoxicants such as mescaline, psilocybin and peyote.

Front 24

Drug dependence is made up of both physical and ________________ factors.

Back 24

Psychological. Psychological dependence is mental--it involves a strong craving or desire to use the drug or experience its effects.

Front 25

__________ drugs are illegal to own or use. Some examples are cocaine, LSD and marijuana.

Back 25

Illicit.

Front 26

The ______________ are more likely to use illicit drugs than those who are employed.

Back 26

Unemployed. 18.2% of unemployed persons report illicit drug use compared to only 7.9% of those with full time jobs and 10.7% of part time employees.

Front 27

Synthetic drugs which result from the altered chemical structures of illicit drugs are called _____________ ___________.

Back 27

Structural analogs. The basic molecular skeleton of an illicit drug is modified to form a new compound. PCP and Ecstasy are probably the most well known examples of synthetic drugs.

Front 28

_________ _________ is to use a drug in a situation, manner or amount that it causes social, psychological, physical or occupational problems.

Back 28

Drug Abuse.

Front 29

Generally ____________ refers to the psychological attachment to a drug.

Back 29

Addiction.

Front 30

The first stage of drug addiction is ___________.

Back 30

Relief. In the relief stage, a user experiences satisfaction by escaping from negative feelings such as boredom, anger, stress, fatigue and loneliness.

Front 31

Drug assistance programs for drug-dependent employees are called ______________ _____________ ___________.

Back 31

Employee Assitance Programs or EAPs. EAPs can also be known as Cost of Assistance programs.

Front 32

No prescription is required when purchasing ________ ____ ________ drugs.

Back 32

Over the Counter. Over the counter drugs are often simply referred to as OTC drugs.

Front 33

Drug ___________ is the inappropriate use of OTC or prescription medications.

Back 33

Misuse. Using someone else’s prescription, taking more than the prescribed amount of a medication, using old medicines, mixing drugs and alcohol are all examples of drug misuse.

Front 34

___________ graduates had the lowest rate of current use of illicit drugs.

Back 34

College. 5.2% of college graduates reported current illicit drug use. High School dropouts had the highest rate of current use of illicit drugs (9%).

Front 35

The second stage of drug addiction is increased use, in which the user starts to take increased amounts of the drug. This is followed by _______________, the third stage of drug addiction.

Back 35

Preoccupation. The preoccupation phase is characterized by constant concern about the drug.

Front 36

Urine drug tests are relatively inexpensive screening tests that detect a variety of abused substances or their _____________ in urine.

Back 36

Metabolites. Metabolites refer to the substances that are produced or left over when the body metabolizes (breaks down) the drugs that have been consumed.

Front 37

The most widely used licit social drug is _____________.

Back 37

Alcohol. Legal social drugs, ranked by amount of money spent each year:
Alcohol ($104 billion)
Tobacco ($51.9 billion)
Coffee, Tea and Cocoa ($5.7 billion)

Front 38

Also known as narcotics, __________ are a group of analgesic drugs that cause a dreamlike state; high doses can induce sleep.

Back 38

Opioids. "Opioid" is another word for "opiate". Opiates are drugs that contain opium or one of its derivatives. Common opioids include morphine, codeine, heroin and methadone. Opioids depress the central nervous system (CNS).

Front 39

Another word for analgesic is _______________.

Back 39

Painkiller.

Front 40

Alcohol, barbiturates, inhalants, and sleeping pills and sedatives are all _______________.

Back 40

Depressants. Depressants decrease the rate of various vital physiological activities, especially those of the central nervous system.

Front 41

LSD, PCP and mescaline are ________________.

Back 41

Hallucinogens. These drugs alter perceptions of reality. They can affect sense of taste, smell, hearing and vision. Sometimes they are called psychedelics.

Front 42

______________ include cocaine, amphetamines, methamphetamine, caffeine, and nicotine.

Back 42

Stimulants.

Front 43

Drugs prescribed to control symptoms associated with mental problems are called __________________.

Back 43

Psychotherapeutics.

Front 44

MDMA, also known as ___________, produces both stimulant and hallucinogenic effects.

Back 44

Ecstasy. This drug falls under the category of synthetic or designer drugs.

Front 45

Drugs with a high potential for abuse, no currently accepted medical use in the US, and declared unsafe are listed under Schedule _____.

Back 45

I. All substances with "no medical use" fall under Schedule I. Examples of Schedule I drugs include heroin, LSD, and marijuana.

Front 46

Drugs with a high potential for abuse, with a currently accepted medical use in the US, whose abuse may lead to severe physical or psychological dependence are listed under Schedule ____.

Back 46

II. Examples include cocaine, opium, and amphetamines.

Front 47

A substance that has less potential for abuse than the drugs or other substances in schedules I and II, has a currently accepted medical use in the US, and whose abuse may lead to moderate or low physical dependence or high psychological dependence is listed under Schedule ____.

Back 47

III. Examples of Schedule III substances include anabolic steroids and GHB.

Front 48

A drug is categorized as Schedule ____ if it has a low potential for abuse, a currently accepted medical use in treatment in the United States, and its abuse may lead to limited physical or psychological dependence.

Back 48

V. Schedule IV drugs have a slightly higher chance of abuse than the Schedule V drugs. What most specifically distinguishes Schedule V drugs from the other schedules is that the drugs are regulated but don't require a prescription.

Front 49

The human body strives to maintain its internal environment within a certain range (temperature, blood pressure, etc); this equilibrium is called _______________.

Back 49

Homeostasis.

Front 50

Hormones and ________________ are two types of chemical signals important for maintaining homeostasis.

Back 50

Neurotransmitters.

Front 51

For a drug to be psychoactive, its molecules must be capable of passing through the ________-________ barrier.

Back 51

Blood-brain. The blood-brain barrier is a semipermeable structure that protects the brain from potentially toxic chemicals circulating in the blood. A psychoactive drug is capable of passing this barrier and influencing the brain's activity.

Front 52

Specialized nerve endings that recognize neurotransmitter molecules and cause a change in the electrical activity of the neuron when activated are called _____________.

Back 52

Receptors. In other words, receptors are activated by certain types of neurotransmitter molecules; when they're activated, they change the electrical activity of the nerve that they're part of.

Drugs can either activate or inhibit the neuron depending upon the type of receptor they react with. For example, by inhibiting certain nerve functions, a certain drug can deaden your ability to feel pain, while on the other hand, by activating and stimulating nerve activity, a different drug can cause you to feel things or experience hallucinations.

Front 53

The three components of the nervous system are the central nervous system, the ___________ system, and the autonomic system.

Back 53

Somatic. The somatic system carries sensory information into the CNS and carries motor (movement) information back out. Some examples of the somatic system are: vision, hearing, taste, smell and touch.

Front 54

Heart rate and blood pressure are two of the many functions regulated by the _______________ nervous system.

Back 54

Autonomic. The autonomic nervous system, also referred to as the ANS, regulates the involuntary functions of the body and is divided into sympathetic and parasympathetic branches.

Many psychoactive drugs have autonomic influences on the body. Some examples of ANS reactions to psychoactive drugs include changes in heart rate, blood pressure, pupil dilation/constriction, sweating and breathing rate.

Front 55

Most of the integration of information, learning and memory occur in the _____________ nervous system.

Back 55

Central. The CNS consists of the brain and spinal cord.

Front 56

Parkinson's disease is a degenerative neurological disease involving damage to ____________ neurons.

Back 56

Dopamine. Tremors and rigidity are two symptoms of Parkinson’s disease. Similar damage to the dopamine neurons can occur as a side effect of some psychoactive drugs.

Front 57

All reinforcing drugs (drugs that reinforce their use) stimulate dopamine neurons in the ______________ system.

Back 57

Mesolimbic. The mesolimbic system is suggested to be the primary component responsible for the "reward" properties of electrical stimulation of the midbrain or limbic system. According to this theory, drugs lead to dependence because they stimulate this reward system.

Front 58

The neurotransmitter ___________ is found in most areas of the CNS and exerts generalized inhibitory functions.

Back 58

GABA. Many sedative drugs act by enhancing GABA inhibition.

Front 59

The branch of the autonomic system involved in flight or fight reactions is called the ___________ branch.

Back 59

Sympathetic.

Front 60

The _________________ branch of the autonomic system stimulates digestion, slows the heart, and has other effects associated with a relaxed physiological state.

Back 60

Parasympathetic.

Front 61

The part of the brain which controls muscle tone is called _________ __________.

Back 61

Basal ganglia. When you stand still in a relaxed posture, your leg muscles are not totally relaxed. If they were, you would fall down in a slump. Instead, you remain standing, partly because a certain level of muscular tension, or tone, is maintained by the output of the basal ganglia.

Front 62

Chemicals in the brain that produce effects similar to morphine and other opium derived drugs are called

Back 62

Endorphins. Endorphins relieve pain. They are found in the blood as well as in various places in the brain and not all of their functions are known.

Front 63

Dopamine, acetylcholine, norepinephrine, serotonin, GABA, glutamate, and endorphins are all _________________ associated with the actions of the psychoactive drugs.

Back 63

Neurotransmitters.

Front 64

Damage to the neurotransmitter acetylcholine is associated with _____________ disease.

Back 64

Alzheimer's. Acetylcholine has also been one of the main neurotransmitters studied with regard to the initiation of REM (rapid eye movement) sleep, during which most dreaming occurs.

Front 65

Two brain imaging techniques are PET and __________.

Back 65

MRI. Magnetic resonance imaging (MRI) applies a strong magnetic field and then measures the energy released by various molecules as the field is collapsed.

Using Positron Emission Tomography (PET), a radioactive chemical is injected into the bloodstream and a computerized scanning device then maps out the relative amounts of the chemical in various brain regions.

Front 66

The two major _____________ pathways damaged in Parkinson's disease are acetylcholine and the nigrostriatal pathways.

Back 66

Dopamine.

Front 67

The neurotransmitter that is believed to be important for regulating waking and appetite is _______________.

Back 67

Norepinephrine.

Front 68

__________ is a neurotransmitter associated with aggression and regulation of body weight.

Back 68

Serotonin. Some diet drugs contain serotonin. This neurotransmitter has also been associated with depression, suicide and excessive alcohol consumption.

Front 69

____________ is often referred to as the brain's major excitatory neurotransmitter.

Back 69

Glutamate. Like GABA, Glutamate is found throughout the brain, and nearly all neurons have receptors that are activated by it. But, unlike GABA, stimulation of receptors that respond to glutamate makes cells more excitable (as you recall, GABA has inhibitory effects).

Front 70

___________ are the raw materials from which neurotransmitters are made and are found circulating in the blood supply and generally in the brain.

Back 70

Precursors.

Front 71

The forming of a neurotransmitter by the action of enzymes on precursors is called ________________.

Back 71

Synthesis. After the precursor molecule has been taken up into the neuron, it must be changed, through one or more chemical reactions, into the neurotransmitter molecule. This process is called synthesis.

Front 72

Molecules that assist in either the metabolism (breaking down) or synthesis (creation) of another molecule are called ______________.

Back 72

Enzymes.

Front 73

Most drugs are derived directly or indirectly from ___________.

Back 73

Plants. Many plant-produced chemicals have effects on the intestines or muscles; others alter brain biochemistry. In large doses, the effect is virtually always unpleasant or dangerous, but in controlled doses these chemicals can alter the biochemistry just enough to produce interesting or even useful effects. In primitive cultures, the people who learned about these plants and how to use them safely were important figures in their communities.

Front 74

With sales exceeding $160 billion a year, the _________ ______________ industry is one of the largest and most profitable industries in the United States.

Back 74

Legal pharmaceutical. The active ingredients for half of the prescriptions filled consist of only 200 drugs.

Front 75

_____________ drugs produce wakefulness and a sense of energy and well-being.

Back 75

Stimulant. Some examples of stimulants include cocaine, amphetamines, and caffeine.

Front 76

Most psychoactive drugs can be categorized as stimulants, depressants, opioids, ________________, or psychotherapeutic agents.

Back 76

Hallucinogens.

Front 77

The three types of names that are applied to drugs are the ____________ name, the chemical name, and the brand name.

Back 77

Generic.

Front 78

Another way of saying placebo effect is _____________ effect.

Back 78

Nonspecific. A placebo or nonspecific effect refers to when a patient is given an inactive chemical and it produces a therapeutic effect because the user believes that he is taking an actual drug. At least one-third of psychologically depressed patients treated with placebos show improvement; in some published studies the rates of placebo response have been even higher.

Front 79

The ratio of LD50 to ED50 is one indication of the relative safety of a drug for a particular use or effect and this is called the _______________ index.

Back 79

Therapeutic. The Therapeutic Index (TI) consists of two parts. LD50 indicates the lethal dose for 50 percent of test animals. ED50 is the effective dose for 50 percent of test animals.

Front 80

The dosage difference between an acceptable level of effectiveness and the lowest toxic dose is called the ___________ ___________.

Back 80

Safety margin.

Front 81

The amount of drug that must be given to obtain a particular response is called ____________.

Back 81

Potency. The smaller the amount needed to get a particular effect, the more potent the drug.

Front 82

The timing of the onset, duration, and termination of a drug's effect is called the ________ __________.

Back 82

Time Course. The time course of a drug's action depends on many things, including how the drug is administered, how quickly it is absorbed, and how it is eliminated from the body.

Front 83

The two ways psychoactive drugs achieve their effect is either by altering _________________ of the transmitter or by acting directly on the receptor.

Back 83

Availability. Psychoactive drugs can alter the availability of a neurotransmitter by increasing or decreasing the transmitter chemical's rate of synthesis, metabolism, release from storage vesicles, or reuptake into the releasing neuron.

Or the drug might act directly on the receptor, either to activate it or to prevent the neurotransmitter chemical from activating it.

Front 84

Most psychoactive drugs are taken by one of three basic routes: by mouth, ________, or inhalation.

Back 84

Injection. Injection is the fastest way to get the drug to the brain. With intravenous (IV) injection, the drug is put directly into the bloodstream, so the onset of action is much more rapid than with inhalation, oral administration or with other means of injection.

Front 85

Onset of drug effects via ______________ is quite rapid because the capillary walls are very accessible in the lungs, and the drug thus enters the blood quickly.

Back 85

Inhalation. Inhalation comes after injection in terms of how fast the drug takes effect.

Front 86

______________ __________ occurs after using a nasal spray regularly for longer than the recommended period.

Back 86

Congestion rebound. After using a nasal spray for too long, tissues no longer respond and the sinus passages become almost completely obstructed.

Front 87

The most important drug-metabolizing enzymes found in the liver belong to a group known as the _________ family of enzymes.

Back 87

CYP450. CYP450 enzymes always exist in the liver. CYP450 enzymes eliminate toxic chemicals once they are eaten.

Front 88

___________ are inactive in the original form and become active only after they are altered by the liver enzymes.

Back 88

Prodrugs.

Front 89

A situation where repeated administration of the same dose of a drug results in gradually diminishing effects is called ______________.

Back 89

Tolerance. The three types are drug disposition tolerance, behavioral tolerance, and pharmacodynamic tolerance.

Front 90

Physical dependence is related to ________________ tolerance.

Back 90

Pharmacodynamic. Pharmacodynamic tolerance occurs when the brain attempts to maintain homeostasis by altering the nervous system’s sensitivity. The brain compensates for the effect of a drug by reducing the amount of the inhibitory neurotransmitter GABA that is released, or by reducing the number of inhibitory GABA receptors.

If the supply of the drug is abruptly cut off the result is physical withdrawal symptoms (wakefulness, nervousness, hallucinations, seizures etc).

Front 91

_______ is one of the most potent psychoactive drugs.

Back 91

LSD. Potency refers only to the amount of drug that must be given to obtain a particular response. The smaller the amount needed to get a particular effect, the more potent the drug. The effective dose (ED50) for LSD is many thousands of times smaller than that of other psychoactive drugs.

Front 92

One of the most important factors which determine the potency of CNS drugs is the _________ _____________ of the molecules.

Back 92

Lipid solubility. Lipid solubility is the tendency of a chemical to dissolve in fat, as opposed to in water. Only lipid-soluble substances can pass the blood brain barrier.

Front 93

The buildup of a drug in the body after multiple doses taken at short intervals is called _______________ effect.

Back 93

Cumulative.

Front 94

Drug _______________ occur when a drug enhances or inhibits the effect of another drug.

Back 94

Interactions. For example, when alcohol and sleeping pills combine to slow down breathing.

Front 95

In a __________ _________ procedure, neither the patient nor the doctor know whether the subject is receiving a placebo or an experimental drug.

Back 95

Double blind.

Front 96

________________ is the process by which sugar is converted into alcohol through the biochemical action of yeast.

Back 96

Fermentation. Fermentation forms the basis for all alcoholic beverages. Fruits and grains are fermented to create beverages which include beer and wine. Through fermentation, the alcohol concentration is limited to 15%. Fermented beverages have existed since approximately 6400BC.

Front 97

When alcohol is heated and the vapors are condensed into liquid form again, the process is called _______________.

Back 97

Distillation. Whiskey, Scotch, and Brandy are examples of distilled beverages. They are also called “spirits”. Distillation is the way alcohol concentration is able to get above 15%. Distillation is believed to have originated in Arabia in about AD 800.

Front 98

One half the _________ number is the percentage of alcohol by volume.

Back 98

Proof. Seventy proof whiskey is 35 percent alcohol.

Front 99

________ is created by adding barley malt to cereal grains.

Back 99

Beer.

Front 100

Other alcohols and oils contained in alcoholic beverages are called _____________.

Back 100

Congeners.

Front 101

95% pure alcohol is called _________ ___________ spirits.

Back 101

Grain neutral. This type of alcohol can be added to gasoline to reduce pollution, used in cleaners and solvents, as well as in medical research. It is also used when making blended Scotch Whiskey.

Front 102

Originally, the _______________ movement supported the drinking of beer and wine but was strongly opposed to distilled spirits.

Back 102

Temperance. This concept was first proposed in 1784 by Dr. Benjamin Rush who noted madness, liver disease, and seizures among patients who drank distilled alcohol. By the 1850s, the temperance movement supported not only a ban on distilled spirits but also a ban on all alcoholic beverages.

Front 103

Federal laws which prohibited the sale of alcohol from 1920 to 1933 are called ____________.

Back 103

Prohibition. National Prohibition of alcohol was successful in reducing alcohol consumption and alcohol-related problems, but also led to a loss of alcohol taxes and increased law breaking.

Front 104

The concentration of alcohol found in the blood is called the ________.

Back 104

Blood Alcohol Concentration (BAC). BAC is expressed as a percentage and determines physical and behavioral responses to alcohol. This is also called blood alcohol level. A BAC of 0.05 results in lowered alertness and a BAC of 0.4 results in death (lethal dose).

Front 105

_________ is drinkable, is the psychoactive ingredient in alcoholic beverages, and is also known as grain alcohol.

Back 105

Ethanol

Front 106

According to a 1997 report, alcohol is involved in more than __________ deaths in the US each year.

Back 106

100,000. Alcohol is the second leading substance abuse related cause of premature death among Americans (tobacco is first). Social and health problems related to alcohol cost the US approximately $167 billion a year.

Front 107

_________ alcohol is made from wood. It is poisonous and small amounts cause blindness while larger amounts result in death.

Back 107

Methyl. Methyl alcohol is added to grain alcohol for industrial use to prevent drinking.

Front 108

___________ _________ alcohol is poisonous and is a primary ingredient of antifreeze.

Back 108

Ethylene glycol.

Front 109

When an alcoholic learns to modify his behavior to compensate for motor impairments associated with being intoxicated this is called ____________ _____________.

Back 109

Behavioral tolerance. Examples include slowing down of speech or movements to hide the fact that the individual is drunk.

Front 110

_____________ is a liver disease which results from alcohol abuse and is the seventh leading cause of death in the U.S..

Back 110

Cirrhosis. Usually it takes approximately 10 years of heavy drinking of the equivalent of a pint or more of whiskey a day to develop cirrhosis of the liver.

Front 111

The use of alcohol has decreased since ________ and its consumption varies greatly in different regions of the US and among different cultural groups.

Back 111

1980. Whites are more likely to drink than blacks, northerners more than southerners, younger adults more than older. Catholics and Jews more than Protestants, nonreligious more than religious, urban more than rural, big city dwellers more than small city dwellers and people with college educations more than high school or grade school educated persons.

Front 112

The ___________ of alcohol by the liver occurs at a constant rate that is not much influenced by body size.

Back 112

Metabolism. The amount of alcohol that can be metabolized by the liver is about 0.25 to 0.30 ounces per hour.

Front 113

The exact mechanism by which alcohol exerts its effects in the central nervous system is unknown, but it is believed that its interactions with the _______ receptor are important.

Back 113

GABA. GABA is a very widespread inhibitory neurotransmitter and alcohol tends to have widespread inhibitory effects on neurons in the brain.

Front 114

It is possible to estimate an individual’s blood alcohol content (BAC) by knowing their weight, __________, and amount of alcohol consumed.

Back 114

Gender. Gender affects BAC because the average female has a higher proportion of body fat and therefore, for a given weight has less volume in which to distribute the alcohol. This means that for an average 100 pound female 1 can of beer would result in a BAC of 0.045 while a 100 pound male would achieve a BAC of 0.037.

Front 115

If all of the following consumed the same amount of alcohol at the same speed, which one would have the highest BAC? (120 pound woman, 135 pound woman, 150 pound man, 170 pound man). ______ _________ ______

Back 115

120 pound woman. Given the same amount of alcohol, the lower your weight, the higher your Blood Alcohol Concentration. Also, given a man and a woman of equal weight, the woman would generally have a higher BAC.

Front 116

In laboratory studies, the _______________ ____________ design is used to separate the pharmacological effects of alcohol from the alcohol expectancy effects.

Back 116

Balanced Placebo. In a balanced placebo study, half of the group is given drinks which contain alcohol and the other half are given drinks which look alcoholic but contain no alcohol. The responses of both groups are then compared.

Front 117

Alcohol __________, is the tendency for someone under the influence of alcohol to focus on the here and now and to pay less attention to long term consequences.

Back 117

Myopia. Alcohol myopia might explain why some people are more violent after drinking, while others become more helpful even if there is personal risk or cost involved.

Front 118

Traffic fatalities involving alcohol have _________ since 1980.

Back 118

Decreased. The total number of traffic deaths in 1980 was over 50,000, but by 1983, that had dropped nearer to 40,000, where it has remained since.

Front 119

Most studies show that alcohol is involved in about _________ of all suicides.

Back 119

One-third. The use of alcohol is statistically associated with homicide, assault, family violence and suicide.

Front 120

Alcohol is the drug most often associated with ___________ crimes; in many cases, it is present in both the assailant and the victim.

Back 120

Violent.

Front 121

Several studies have found a lower incidence of _________ ___________ in moderate drinkers than in abstainers.

Back 121

Heart attacks. Although chronic heavy drinking can lead to brain damage, as well as damage to the heart and liver, light drinking can reduce heart attacks. Scientific evidence supports only a beneficial effect of alcohol on heart attacks, with an optimal effect occurring at about one drink per day.

Front 122

________ __________ syndrome is a collection of physical and behavioral abnormalities that seems to be caused by the presence of alcohol during development of the fetus.

Back 122

Fetal Alcohol. FAS is a condition affecting children born to alcoholic mothers, characterized by facial deformities, growth deficiency, and mental retardation.

Front 123

The four stages of alcohol withdrawal are tremors, hallucinations, delusions and ____________.

Back 123

Seizures. The withdrawal symptoms do not develop all at the same time or immediately after the alcoholic stops drinking. Some withdrawal symptoms can last for up to several weeks.

Front 124

The idea that alcohol dependence is a disease goes back at least to the ________.

Back 124

1700s. Alcohol dependence as a disease is also known as disease model of alcohol dependence and this concept did not become really popular until Alcoholics Anonymous began to have a major influence in the 1940s and 1950s.

Front 125

Considerable evidence supports the idea that some degree of vulnerability to alcohol dependence might be ___________.

Back 125

Inherited. Many studies have indicated a possible genetic link to susceptibility to alcohol dependence, but this has never been definitively proven.

Front 126

Adopted sons whose _____________ fathers were alcohol dependent have a much greater than average chance of becoming alcohol dependent than adopted sons of non-alcoholic fathers.

Back 126

Biological. The father was an alcoholic, but since these children were adopted, the alcoholic father was not around to influence their upbringing. This seems to indicate a genetic link to alcoholism.

Front 127

Poisonous alcohols include __________, ethylene glycol and isopropyl.

Back 127

Methyl. Methyl alcohol is made from wood, ethylene glycol is an ingredient in antifreeze and isopropyl alcohol is used as antiseptic.

Front 128

BAC level in an individual is influenced by drinkers body type, food in the stomach, concentration of alcohol, and _______ of consumption.

Back 128

Rate. If your rate of alcohol intake equals your rate of metabolism, you will maintain a stable BAC. An average person can metabolize one drink (1 beer, 1 shot, or 1 glass of wine) every two hours.

Front 129

Alcoholic fatty liver, alcoholic ___________, and cirrhosis are all liver disorders associated with heavy use of alcohol.

Back 129

Hepatitis. Alcohol has pervasive effects on the major organs and fluids of the body. Every part of the brain and nervous system is affected and can be damaged by alcohol.

Front 130

Severe alcoholism often results in ______________ as a result of decreased caloric intake by alcoholics.

Back 130

Malnutrition. Many heavy drinkers do not eat well because alcohol provides empty calories, and chronic malnutrition causes tissue damage.

Front 131

The process where the body rids itself of drugs and alcohol is called ______________.

Back 131

Detoxification. Alcohol withdrawal symptoms are more severe and more likely to cause death than withdrawal from heroin. In untreated advanced cases, mortality (rate of death) can be as high as 15 percent.

Front 132

_____________ __________ is another term for alcohol withdrawal symptoms, especially fever, trembling and hallucinations.

Back 132

Delirium tremens.

Front 133

A key belief of ____________ _____________ is that alcohol dependence is an incurable, progressive disease characterized by a loss of control over drinking.

Back 133

Alcoholics Anonymous. They are saying that there's a difference between people who have this disease and those that don't. Those with the disease are different even before they take their first drink; they do not have the potential to control their drinking. There is no cure; the only treatment is to abstain from drinking.

Front 134

Some studies have reported both behavioral improvement and noticeable regrowth of __________ ___________ in long term alcoholics after several months of abstinence.

Back 134

Brain tissue.

Front 135

___________ is a drug used for treating alcoholics. It makes them extremely sick if they drink even a small amount of alcohol.

Back 135

Antabuse. This type of drug is called a deterrent and is used to prevent impulse drinking.

Front 136

CNS depressants that cause drowsiness and promote sleep are called ____________.

Back 136

Hypnotics.

Front 137

CNS depressants that promote relaxation and relieve anxiety are called _____________.

Back 137

Sedatives.

Front 138

Because their effect varies depending on the dose, CNS depressants are said to be _______ ____________.

Back 138

Dose dependent. At low doses, CNS depressants relieve anxiety (sedatives). Higher doses are used to promote sleep and cause drowsiness (hypnotics), and even higher doses are used during surgery for anesthesia.

Front 139

Diphenhydramine, hydroxyzine and promethazine are examples of OTC and prescription _______________ used as CNS depressants.

Back 139

Antihistamines. Antihistamines are found in OTC medication and are used to relieve flu and cold symptoms.

Front 140

The most widely used depressant is ____________.

Back 140

Alcohol.

Front 141

Benzodiazepines are the most widely prescribed types ___________-___________.

Back 141

Sedative-Hypnotics. In 2003, 4 of the top 40 best selling prescription drugs were benzodiazepines. They are the most frequently prescribed CNS depressants for anxiety and sleep.

Front 142

Benzodiazepines are classified by their ____________ of action.

Back 142

Duration. Short acting drugs are used as hypnotics to treat insomnia and long acting drugs are used as sedatives to give prolonged relief from anxiety

Front 143

The SSRI ____________ is the most widely prescribed antidepressant drug.

Back 143

Fluoxetine (Prozac). It’s safer than tricyclic antidepressants as it is less likely to lead to overdose death.

Front 144

CNS depressants include: alcohol, antihistamines, opioids, benzodiazepines and __________.

Back 144

Barbiturates. Benzodiazepines have largely replaced barbiturates because barbiturates are associated with problems with tolerance, dependence and lethal overdose. All CNS depressants act on the brain by decreasing neural activity.

Front 145

Occasionally drugs can have _________ effects--an opposite effect to what is normally expected.

Back 145

Paradoxical. With benzodiazepines, paradoxical effects include bizarre uninhibited behavior, rage, hostility and paranoia. It is unknown what causes these reactions in some people.

Front 146

For many years, _______________ sleeping pills were the drug of choice for people wishing to commit suicide.

Back 146

Barbiturate. In high doses or if combined with alcohol, barbiturates can stop a person’s breathing. Accidental overdoses occurred when sleeping pills were taken after heavy drinking.

Front 147

Drugs used to relieve anxiety are called _______________.

Back 147

Anxiolytics. Benzodiazepines are commonly prescribed for anxiety disorders.

Front 148

The names of barbiturates all end in _____.

Back 148

Al. More than 2,500 barbiturates have been synthesized. Some examples include: phenobarbital (Luminal), amobarbital (Amytal), pentobarbital (Nembutal) and secobarbital (Seconal).

Front 149

Both barbiturates and benzodiazepines affect the neurotransmitter ________.

Back 149

GABA.

Front 150

Drugs are more likely to produce psychological dependence if they have a __________ onset.

Back 150

Rapid. Psychological dependence develops most rapidly when the drug hits the brain quickly. A drug that has a rapid onset of action will be more likely to produce psychological dependence than a slow-acting drug.

Front 151

______________ symptoms are more likely to develop with drugs that leave the system quickly.

Back 151

Withdrawal. Physical dependence happens when the drug leaves the system more rapidly than the body can adapt. As a result, drug detoxification often relies upon substitution, where a longer acting drug is used to offset the withdrawal symptoms associated with a shorter acting depressant.

Front 152

CNS depressants, including barbiturates, inhalants and benzodiazepines all have effects similar to __________.

Back 152

Alcohol. A person under the influence of CNS depressants will appear drunk. Intoxicating effects include drowsiness, slurred speech, and staggering.

Front 153

_____ is a clear, colorless, odorless liquid associated with date rape.

Back 153

GHB. GHB is a synthetic CNS depressant with amnesiac and sedative properties. GHB is most well-known for its use in substances that disable users and make them vulnerable to sexual assault. Rohypnol is another drug of this type.

Front 154

The symptoms for withdrawal from any sedative hypnotic is similar to symptoms for __________ withdrawal.

Back 154

Alcohol. These symptoms include anxiety, insomnia, tremulousness, weakness, anorexia, nausea, vomiting, convulsions, delusions, visual and auditory hallucinations.

Front 155

Sleeping pills are unhealthy because they interfere with _________ sleep.

Back 155

REM. REM sleep is the sleep phase associated with dreams. Lack of REM sleep will cause a person to wake up feeling tired and anxious.

Front 156

There are several FDA approved prescription drugs used to treat insomnia, but only ____________ has been approved for long term use.

Back 156

Lunesta (eszopiclone). Other approved prescription drugs for insomnia include Zolpidem (Ambien) and triazolam (Halcion), but eszopiclone is the only one that's approved for long term use.

Front 157

Medical uses of __________ include muscle relaxants, sleeping pills, treatment for convulsive disorders (epilepsy), alcohol detoxification, and preoperative anesthesia (amnesiac).

Back 157

Benzodiazepines.

Front 158

Drugs which cause a loss of memory are called _______.

Back 158

Amnesiacs. Amnesiac and anesthesia effects are common among hypnotics when used in high doses. This property allows a patient to undergo surgery without pain or memory of the event.

Front 159

______-acting barbiturates or benzodiazepines are commonly prescribed to prevent Alcohol withdrawal symptoms.

Back 159

Long. Examples of these depressants include Phenobarbital, chlordiazepoxide (Librium), and diazepam (Valium).

Front 160

The category of ____________ substances includes adhesives (glues), aerosols (hair spray, spray paint), fuels (gasoline, propane), and office supplies (felt tip markers).

Back 160

Volatile. Volatile substances will evaporate at low temperatures.

Front 161

Another word for intoxicating is _______________.

Back 161

Euphorigenic.

Front 162

Commonly called "laughing gas", ___________ _________ is a gaseous anesthetic first used in the early 1800s in medicine and surgery.

Back 162

Nitrous oxide. It is used by dentists for light anesthesia and can be found as a propellant in whipped cream dispensers.

Front 163

There are more than ______ products currently abused as inhalants.

Back 163

1,000.

Front 164

Inhalant abuse is usually a problem among children and _______________.

Back 164

Adolescents. Inhalants are among the most commonly abused drugs by adolescents. Almost 20 percent of 8th graders have abused an inhalant sometime in their life.

Front 165

Because inhalants are so readily available, they present a special problem for _____________.

Back 165

Prevention.

Front 166

An irregular heart beat is called ___________.

Back 166

Arrhythmia. Cardiac arrhythmia is a condition that occurs during sudden sniffing death syndrome (SSDS). SSDS can happen during or immediately after inhaling substances, even to first time users.

Front 167

Permanent brain damage, loss of muscle control, damage to the liver, heart, blood, and bone marrow are all possible consequences of _____________ abuse.

Back 167

Inhalant. In addition, inhalant abuse kills hundreds of children in the US each year. Inhalant abuse can begin as early as preschool.

Front 168

___________ professionals and their staff are the most likely to abuse nitrous oxide

Back 168

Medical. Nitrous oxide (laughing gas) is often used as an anesthetic for outpatient procedures by doctors and dentists. It has stimulant, hallucinogenic and depressant effects.

Front 169

The 3 groups of inhalants include volatile substances, anesthetics and _____________.

Back 169

Nitrites. Nitrites are sometimes called “poppers” and come in small vials or tubes. The drug is available by prescription to treat angina (a heart condition).

Front 170

Headaches, ______________, nausea, drunken appearance and watery eyes are all signs of inhalant abuse.

Back 170

Nosebleeds.

Front 171

Inhalant abuse can cause ____________, a state of oxygen deficiency in the body.

Back 171

Hypoxia.

Front 172

____________ is the psychoactive chemical found in many commonly abused inhalants such as glues, paints, thinners and nail polish.

Back 172

Toluene. Toluene has no medical uses. It can cause heart arrhythmia as well as particular damage to kidneys and liver.

Front 173

____________ brought tobacco to Europe after his voyage to the Americas.

Back 173

Columbus. Columbus was presented tobacco by natives of San Salvador in 1492 and he brought it with him back to Spain. Tobacco was used by Native Americans long before it was introduced in Europe.

Front 174

At first, tobacco was almost universally accepted as a _____________.

Back 174

Medicine. In 1574, a book describing New World plants listed tobacco as an infallible cure for 36 different maladies.

Front 175

Not everyone praised the use of tobacco; many ____________ it.

Back 175

Opposed. Death penalties for smoking were imposed in Turkey, Russia and China in the 1600s. King James of England wrote a antitobacco pamphlet and he taxed tobacco to attempt to limit its use.

Front 176

The predominant style of tobacco use went from pipes to snuff to ____________ to cigars to cigarettes.

Back 176

Chewing.

Front 177

Since 1956, the leaf tobacco content in cigarettes has been reduced by approximately ______ percent.

Back 177

25.

Front 178

The primary psychoactive ingredient in tobacco is ___________.

Back 178

Nicotine. Nicotine is the dependence producing chemical found in tobacco. When given low-nicotine cigarettes, smokers adjust by taking more puffs and inhaling more deeply. When nicotine is removed, smokers report experiencing no satisfaction at all.

Front 179

Nicotine is often thought of as being a mild _____________, but it also seems to have some of the relaxant properties of a low dose of a depressant.

Back 179

Stimulant.

Front 180

Nicotine affects the release of the neurotransmitter ____________ in the reward/pleasure pathways of the brain.

Back 180

Dopamine.

Front 181

Smoking tends to inhibit hunger contractions up to _____ _______.

Back 181

One hour. Smoking also deadens the taste buds and causes a slight increase in blood sugar levels. Smokers often report weight gain when they quit smoking.

Front 182

Nicotine is exceptionally toxic and has been used as an ________________.

Back 182

Insecticide. Nicotine is one of the most toxic drugs known. In humans, 60 mg is a fatal dose, and death follows intake within a few minutes.

Front 183

Smoking during pregnancy is associated with miscarriage, ___________ _______ ________, differences in body size and negative effects on physical / mental development of the child.

Back 183

Reduced birth weight.

Front 184

Some smokers believe that ________ cigarettes are safer than tobacco cigarettes.

Back 184

Clove. The aroma of clove cigarettes hides the negative physical effects of nicotine. In reality, the organic chemical eugenol that gives clove its unique taste deadens the back of the throat and allows deeper inhalation. Clove cigarettes contain 60% more tobacco as well as more tar and nicotine than regular cigarettes.

Front 185

Tobacco is responsible for _______ thousand US deaths each year.

Back 185

440. Tobacco is responsible for more annual deaths than all other drugs combined, including alcohol. Twenty percent of all US deaths are tobacco-related.

Front 186

____________ is a substance that is responsible for more adverse health consequences and death than any other.

Back 186

Nicotine.

Front 187

Smokers die ____-____ years earlier than nonsmokers.

Back 187

13-14.

Front 188

The leading cause of death in the US is ________ ____________.

Back 188

Heart Disease. Smoking is involved in about 30 percent of deaths from cardiovascular disease.

Front 189

A common lung disease caused by smoking is ____________.

Back 189

Emphysema.

Front 190

Cancer causing chemicals contained in tobacco are called ______________.

Back 190

Nitrosamines.

Front 191

When using ________ or chewing tobacco, nicotine is absorbed through the mucous lining of the mouth.

Back 191

Snuff. Snuff is one form of tobacco which is either in power form for taking through the nostrils or ground up for placement in the mouth. When either of these forms of tobacco are placed in the mouth, the nicotine is absorbed into the bloodstream through the tissues in your mouth.

Front 192

_________________ is a precancerous lesion caused by chewing tobacco.

Back 192

Leukoplakia. Leukoplakia is a whitening, thickening, and hardening of the tissue in the mouth and is relatively common among people who chew tobacco.

Front 193

When nonsmokers inhale cigarette smoke from their environment it is called _________ smoking.

Back 193

Passive. This can also be called secondhand smoke or sidestream smoke. The smoke that the smoker inhales through the mouthpiece or filter is called mainstream smoke.

Front 194

Nicotine withdrawal symptoms include craving for tobacco, _____________, restlessness, and anxiety.

Back 194

Irritability. Withdrawal symptoms may begin within hours or days after the smoker quits and may continue for several months.

Front 195

Two OTC smoking cessation aids are nicotine gum and ________.

Back 195

Patches. These are both available without a prescription. Research has indicated that its easier to quit smoking if it's done gradually.

Front 196

Nicotine patches are also known as _______________ nicotine systems.

Back 196

Transdermal. Transdermal literally means "through the skin".

Front 197

Nicotine nasal spray, nicotine inhalers and ___________ are smoking cessation aids which require a doctor’s prescription.

Back 197

Bupropion. Bupropion is an antidepressant used to reduce nicotine withdrawal symptoms. It is typically prescribed for 7 to 12 weeks.

Front 198

There are now more than 40 million former smokers in the United States, and about ____ percent of them report that they quit smoking without formal treatment programs.

Back 198

90.

Front 199

______________ restrictions, smoke-free indoor air, taxes on tobacco products and limiting youth access to tobacco are all examples of tobacco control laws.

Back 199

Advertising.