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67 Cards in this Set
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Substance Dependence,
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*Three + in 12 month period:
* Tolerance * Withdrawal * Lgr amts, longer periods than intended * Desire/unsuccessful efforts to cut down * Focus on getting substance * Activites red. due to use * Use despite knowing prob caused/worsened by cont. use |
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Substance Abuse
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*One + 12 month period
* failure to fulfill obligations * Use when unsafe (driving) * Legal problems * Social problems * Never met criteria for dependence |
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Most common age of onset of substance use disorders
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Teens and early 20s
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Types of pharmacologic tx
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1) Treat intoxication and withdrawal states
2) Dec. reinforcing side effects 3) Discourage use through unpleasant consequences w/ drug-drug interaction 4) Agonist substitution therapy (methadone maintenence) |
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Psychosocial treatments shown effective with substance use disorders
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1) CBT
2) Behavioral therapies 3) Psychodynamic/Interperosnal therapies 4) Group & family 5) Self-help groups |
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Determining least restrictive setting for substance abuse treatment
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1) Ability to cooperate/benefit
2) Need for structure/support 3) Ability to refrain from use 4) Ability to avoid risk behaviors 5) Need for a specific tx limited to certain settings |
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When is hospitalization appropriate in the treatment of substance use disorders?
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* OD unsafe in OP setting
* Risk of complicated withdrawal * GMC making ambulatory detox unsafe * hx of not engaging/benefiting from less intensive tx * MH impair ability to participate in/benefit from other tx * Danger to self or others |
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When is residential tx appropriate?
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lives/social life focus on use; lack the social/job skills;
no drug free supports for OP setting |
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Alcohol detoxification
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* Sx begin within 4-12 hrs of cessation/reduction of use
* Sx intensity peaks during second day of abstinence * Sx resolve in 4-5 days Complications include seizures, hallucinations, delirium |
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Cocain intoxication
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Hypertension, tachycardia, seizures, paranoid delusions
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Cocaine detoxification
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Following cessation of use, depression and craving are common
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Presentation of opioid Use
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Mild-moderate does not require specific tx
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Severe opioid overdose
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marked by respiratory depression can be fatal and requires tx in hospital/inpatient setting
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Tx of opioid Withdrawal
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Goal to safely ameliorate acute sx and facilitate entry into a long term tx program* Methadone substitution with gradual tapering
* Abrupt dc of opioid, use of meds to suppress withdrawal sx * Important to monitor other substance use- concurrent use of or withdrawal from other substances can complicate the tx of opiod withdrawal |
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Treatment goals
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* Cessation/reduction of use
* Repairing disrupted relationships * Reducing impulsivity * Developing social and vocation skills *Obtaining/maintaining employment |
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Strategies to increase motivation
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* Self help w/ others in recovery
* Drug free peer group/lifestyle * Drug free experiences/roles * No major life changes that inc. chance of relapse * Learn cues * self monitor feeling/thinking * Contingency contracts * Desensitization/relaxation * Alternative coping responses |
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Opioid - Relapse Prevention
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Cognitive behavioral techniques used to develop greater self control to avoid relapse
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Operant Behavioral Therapy
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Involves operant rewarding or punishing for desirable/undesirable behaviors
For example, voucher for a clean UA that can be exchanged for something already agreed upon such as movie tickets |
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Contingency Management
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Positive/negative consequences to reward abstinence or punish drug related behaviors
* Neg consequences- tell courts, employer, family |
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Preferred mode of psychotherapeutic treatment for substance dependent clients
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Group therapies because they are supportive, therapuetic, and educational
They offer the client the opportunity to identify with others Understand the impact of substances on their lives And learn about own feelings, others' feelings and reactions |
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Substances associated with aggression
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Cocaine, hallucinogens, PCP and alcohol
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Substances with withdrawal sx associated with violence
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Alcohol, opioids, hypnotic sedatives
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Common drug combos
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Cocaine & alcohol
Cocaine & heroin Heroin and benzo’s |
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Narcotics- Definition & Common drugs
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*Used to relieve pain
* High potential for abuse * Relaxation w/ immediate rush * Restlessness and nausea Opium, Morphine, Codeine, Heroin, Methadone |
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Narcotics- Sx of overdose
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Slow, shallow breathing
Clammy skin Convulsions Coma |
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Narcotics- Withdrawal syndrom
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Watery eyes, runny nose
Yawning, cramps Loss of appetite, Irritability Nausea, Tremors, Panic Chills, Sweating |
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Narcotics- Indication of possible misuse
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Tracks/scarring from injections
Pin point pupils loss of appetite sniffles, watery eyes, cough Nausea, Lethargy, drowsiness Syringes, bent spoons, needles |
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Depressants- Definitions & Common Drugs
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*For anxiety, irritability, tension
* High abuse/dev. of tolerance * Intoxication like alcohol Barbiturates, Tranquilizers |
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Depressants- Possible Effects
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* Sensory alteration, anxiety reductions, intoxication
* Small amts cause calm, relaxed muscles * Larger amts cause slurred speech, impaired judgement, loss of motor coordination * Newborns can show sx |
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Depressants- Sx of overdose
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Shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma, death
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Depressants - Withdrawal syndrome
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Anxiety, insomnia, tremors, loss of appetite
Abrupt cessation or reduced high dose may cause convulsions, delirium, death |
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Depressants Indications of possible misuse
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Behavior similar to alcohol w/o odor
Staggering, stumbling, lack of coordination, slurred speech Falling asleep while at work, difficulty concentrating Dilated pupils |
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Stimulants- Definitions and common drugs
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Used to increase alertness, relieve fatigue, feel strong and more decisive
Cocaine, amphetamines, methamphetamine, methylphenidates, Ice |
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Stimulants - Possible effects
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Increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite
high doses may cause rapid/irregular heartbeat, loss of coordination, collapse, may cause perspiration, blurred vision, dizziness, and feeling of restlessness, anxiety and delusions |
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Stimulants- Withdrawal syndrome
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Apathy, long periods of sleep, irritability, depression, disorientation
Stimulants- Indications of possible misuse,Excessive activity, talkativeness, irritability, argumentativeness, or nervousness Long periods without sleep/eat Euphoria |
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Hallucinogens- Definitions and common drugs
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* Cause big behavior changes
* No known medical uses * Can block pain sensation; risk of self inflicted injuries PCP, Angel dust, LSD, Acid, Peyote, Ecstacy |
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Hallucinogens- Possible effects
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*Rapidly changing feelings, immediately and much later
*Chronic use can cause depression, violent behavior, anxiety, distorted perception of time *Cause hallucinations, illusions, dizziness, confusion, suspicion, anxiety, loss of control |
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Hallucinogens- Sx of overdose
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Longer, more intense trip episodes, psychosis, coma, death
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Hallucinogens- Withdrawal syndrome
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None known
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Hallucinogens- Indications of misuse
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Extreme changes in behaviors/mood, trance-like states, appearing fearful
Chills, irregular breathing, sweating, trembling |
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Cannabis- Definitions and common drugs
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Hashish is the resinous secreition ofthe cannabis plant
Marijuana is a tobacco-like substance Blubbers, Boom, Gangster, Ganja, Grass, Hashish/Chara, Herb, Pot, Reefer, Weed |
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Cannabis- Possible effects
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Euphoria followed by relaxation
Loss of appetite, impaired memory, concenrtraion and knowledge retention Loss of coordination, more vivid sense of taste sight smell hearing Strong doses can cause fluctuating emotions, fragmented thoughts, disoriented behavior |
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Cannabis- Sx of overdose
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Fatigue, lack of coordination, paranoia
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Cannabis- Withdrawal syndrome
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Insomnia, hyperactivity, sometimes decreased appetite
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Cannabis- Indications of misuse
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Animated behavior, loudtalking, followed by sleepiness
Dilated pupils, bloodshot eyes Distortions in perception, hallucinations Distortions in depth and tiem perception, loss of coordination |
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Alcohol- Possible effects
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Intoxication, sensory alteration, anxiety reduction
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Alcohol- Sx of overdose
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Staggering, odor on breath, loss of coordination, slurred speech, dilated pupils
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Alcohol- Withdrawal syndrome
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Sweating, tremors, altered perception
Psychosis, fear, auditory hallucinations |
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Alcohol- Indications of misuse
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Confusion, disorientation, loss of motor nerve control
Convulsions, shock, shallow respiration Involuntary defecation, drowsiness |
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Steroids- Definition
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Synthetic compounds closely related to male sex hormone, testosterone
Moderate potential for abuse |
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Steroids- Possible effects
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Inc in weight, muscle mass & strength
Enhanced athletic performance, increased physical endurance |
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Steroids- Sx of overdose
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Quick weight adn muscle gains
Extremely aggressive behaviors severe skin rashes impotence, reduced sex drive development of irreversible masculine traits in females |
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Steroids- Withdrawal syndrome
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Significant weight loss, depression, behavioral changes, trembling
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Steroids- Indications for misuse
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Increased combativeness/aggression
Jaundice Purple or red spots on body, unexplained darkness of skin Persistent unpleasant breath odor Swelling of feet/legs |
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Antidepressants
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Antidepressants are a prescription medication used to treat depression and mood disorders like obsessive-compulsive disorder, eating disorders and other anxiety problems. The problem is that some antidepressant drugs can actually carry serious side effects and when used in combination with alcohol or other depressant drugs, can actually make you more depressed.
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Barbiturates
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There are many different types of barbiturates out there, many of which are prescription, and work by depressing the central nervous system. This can cause sedation and anesthesia. While used to treat seizure disorders, insomnia and other problems, they can be abused.
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Cannabis
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Cannabis is also known as marijuana and has psychoactive effects. It is taken into the body in the form of smoke or vapor and can even be consumed and mixed into food or steeped in a tea. While the jury's still out on whether or not marijuana is addictive, it is often believed to act as the "gateway" to other more serious substances
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Depressants
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Depressants are a type of drug that works by reducing the function of the central nervous system. Drugs often included in this category are barbiturates and benzodiazepines.
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Barbiturates
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are drugs that act as central nervous system depressants, and, by virtue of this, they produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, as hypnotics, and as anticonvulsants. They have addiction potential, both physical and psychological
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Benzodiazepine, "benzo", "BZD"
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Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid, which results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant and amnesic action.[2] These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures
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Hallucinogens
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They work by producing sensory hallucinations in users involving any of the five senses. Common substances that fall within this category include LSD, PCP and Peyote
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Inhalants
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, inhalants refer to a group of drugs that are inhaled in the form of a gas or solvent. Potential inhalants can be found just about anywhere and include common products like nail polish remover, gasoline, glue and aerosol cans
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Narcotics
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While the term "narcotics" is often used to refer to any illicit substance, it technically means a substance derived from opium (opiates) or its synthetic replacements. Examples of narcotics include cocaine, morphine and heroin, all of which are highly addictive.
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Opiates
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Opiates are narcotics, and drugs in this category tend to make the user feel sleepy (downers), as opposed to energized (uppers). Many are powerful and can severely "numb" the user.
As medication, opiates are used to relieve moderate to severe pain. The term opiate refers to any of the narcotic alkaloids found in opium, as well as all derivatives of such alkaloids. |
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What is Opiate Addiction?
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A person has an opiate addiction when they develop a dependence on the medication. They continue to take the medication to avoid going through opiate withdrawal symptoms or because they want to continue to experience the euphoric effects of the drug.
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Stimulants
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Stimulants are a class of drugs that boost alertness and increase the activity of the central nervous system. Examples of this type of drug include amphetamines, methamphetamines, cocaine and nicotine, all of which are highly addictive.
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Tobacco
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Tobacco is often smoked in the form of cigarettes or cigars or chewed and contains nicotine, which is a stimulant. It's a highly addictive substance and has been known to cause cancer and other diseases.
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