Drugs

Martha S. Rosenthal received her master's degree in neuropharmacology from Brown University and her PhD in neuroscience from UCLA before beginning her career at the University of Florida's College of Pharmacy. For over 20 years she has taught at Florida Gulf Coast University. As Professor of Neuroscience and Physiology, she teaches courses in drugs and society, neuroscience, human sexuality, gender, and physiology.

Preface

Thinking Critically About Drugs
Pharmacological Research
Ask Specific Research Questions
Carefully Consider Your Study Population
Choose an Appropriate Method of Investigation
Use Valid and Precise Measurements
Conduct a Safe, Ethical, and Unbiased Study
Maintain Objectivity
Consider the Quality of and Vetting of Information
Techniques in Neuropharmacological Research
Animal Research
Brain Imaging Techniques
Critical Thinking
Recognize Underlying Value Assumptions
Evaluate the Strength of the Argument
Critically Evaluate Graphs and Data
Drugs in the Media
Movies
Television
Music
Advertising

SECTION 1: FOUNDATIONS

Chapter 1. Drugs: Mind, Body, and Society
What is a Drug?
How Prevalent is Drug Use?
Global Drug Use
Demographics of Drug Use in the United States
Most Commonly Used Drugs
Prescription Drugs
Variations in Drug Use over Time
Why Do People Use Drugs?
To Feel Pleasure and to Avoid Feeling Pain
To Change the State of Consciousness
To Enhance Spiritual, Religious, or Mystical Experiences
To Facilitate and Enhance Social Interaction
To Alter and Improve the Body
How Does Drug Use Affect Individuals and Society?
Individual Problems with Acute Use
Individual Problems with Chronic Use
Societal Problems Associated with Drug Use
How Are Drugs Classified?
Drug Types
Drug Naming
Drug Scheduling
How Are New Drugs Developed?
FDA Drug Development and Approval
Direct-to-Consumer Pharmaceutical Advertising
Critical Evaluation: Should pharmaceutical companies be allowed to produce direct-to-consumer ads?

Chapter 2. Drug Laws and Policies
History of Drug Policy
1950s: Increasing Penalties for Drug Crimes
1970 Controlled Substances Act
1984-1988 Drug Abuse Control Acts
The 1990s and Beyond
Current Drug Laws
Federal Agencies that Create and Enforce Drug-Control Laws
Federal Drug Laws
State and Local Drug Laws
International Drug Laws and Policies
Harm Reduction Policies
Reduce Health Risks Associated with Drug Use
Reduce Prison Overcrowding
Focus on Treatment Rather than Punishment
Ramifications of Drug Laws
Individual Ramifications
Societal Ramifications
International Ramifications
Legalization
Critical Evaluation: What is the relationship between drugs and crime?
Factors Considered When Evaluating a Drug's Legal Status
Public Opinion on Drug Laws
Issues Related to Legalizing Drugs
Social Policies Related to Drug Use
Minimum Legal Drinking Age
Critical Evaluation: Should the U.S. minimum legal drinking age be lowered?
Drunk Driving
Drug Use during Pregnancy

Chapter 3. The Nervous System
The Structure and Function of Neurons
Neuronal Transmission
Action Potentials
Actions at a Chemical Synapse
The Peripheral and Central Nervous Systems
The Peripheral Nervous System
The Central Nervous System
Protection of the CNS
Neurotransmitters
GABA
Glutamate
Catecholamines
Serotonin
Acetylcholine
Opioids
Cannabinoids

Chapter 4. Pharmacology: How Drugs Work
Pharmacokinetics
Absorption
Dosage
Route of Administration
Distribution
Metabolism and Biotransformation
Genetic and Racial Factors
Elimination
Pharmacodynamics
Receptors
Drug Expectations and the Placebo Effect
Setting
Effects and Side Effects of Acute Drug Use
Effects of Chronic Drug Use


SECTION 2: LEGALLY RESTRICTED PSYCHOACTIVE DRUGS


Chapter 5. Stimulants: Cocaine and Amphetamines
Cocaine
History of Cocaine
Prevalence of Cocaine Use
Source and Forms of Cocaine
Pharmacokinetics of Cocaine
Mechanism of Action of Cocaine
Acute Effects of Cocaine
Chronic Effects of Cocaine
Critical Evaluation: What are the long-term effects of prenatal cocaine use on children's future behavior?
Cocaine Dependence and Addiction
Treatment of Cocaine Addiction
Amphetamine
History of Amphetamines
Prevalence of Amphetamine Use
Source and Forms of Amphetamines
Pharmacokinetics of Amphetamines
Mechanism of Action of Amphetamines
Acute and Adverse Effects of Amphetamines
Chronic Effects of Amphetamines
Amphetamine Dependence and Addiction
Other Stimulants
Cathinone/Khat
Bath Salts

Chapter 6. Hallucinogens
History of Hallucinogens
History of LSD and Psilocybin
History of Peyote/Mescaline
History of MDMA
History of PCP and Ketamine
Prevalence of Hallucinogen Use
Source and Forms of Hallucinogens
Indoleaminic Psychedelic Hallucinogens
Phenylethamine Psychedelic Hallucinogens
Anticholinergic Deliriants
Dissociative Hallucinogens
Cultural and Religious Influence of Hallucinogens
Literature
Music
Religion
Pharmacokinetics of Hallucinogens
Dosage
Routes of Administration
Absorption, Distribution, Metabolism, and Elimination
Mechanism of Action of Hallucinogens
Psychedelic Hallucinogens
MDMA
Deliriants and Dissociatives
Acute Effects of Hallucinogens
Physiological and Psychological Effects of Psychedelic Hallucinogens
Physiological and Psychological Effects of MDMA
Physiological and Psychological Effects of Deliriant Hallucinogens
Physiological and Psychological Effects of Dissociative Anesthetics
Drug Interactions
Medical and Therapeutic Uses of Hallucinogens
Chronic Effects of Hallucinogens
Tolerance
Adverse Effects of Chronic Use
Critical Evaluation: Is MDMA neurotoxic in humans, and does it cause cognitive damage?
Hallucinogen Dependence and Addiction


Chapter 7. Opioids
History of Opioids
Early Opioid Use
Smoking Opium
Opium Wars
Opioids in the 19th Century
Opioids in the 20th Century
Prevalence of Opioid Use
Prescription Opioids
Heroin
Source and Forms of Opioids
Natural Opiates
Semi-Synthetic Opioids
Synthetic Opioids
Pharmacokinetics of Opioids
Routes of Administration
Absorption, Distribution, Metabolism, and Elimination
Mechanism of Action of Opioids
Opioid Receptors
Endogenous Opioids
Acute Effects of Opioids
Physiological Effects at Low and Moderate Doses
Behavioral and Psychological Effects at Low and Moderate Doses
Drug Interactions
Overdose
Medical and Therapeutic Uses of Opioids
Pain
Cough Suppressant
Diarrhea Treatment
Chronic Effects of Opioids
Tolerance
Adverse Effects of Chronic Use
Opioid Dependence and Addiction
Treatment for Opioid Dependence and Addiction
Withdrawal
Treatments to Aid Withdrawal
Ultra-Rapid Opioid Detoxification
Substitution Opioids
Programs to Help Quit Opioids
Critical Evaluation: Should Needle Exchange Programs Be Funded by the Federal Government?
Needle Exchange Programs

Chapter 8. Sedatives, Hypnotics, and Inhalants
Sedatives and Hypnotics
History of Sedatives and Hypnotics
Prevalence of Sedative and Hypnotic Use
Source and Forms of Sedatives and Hypnotics
Pharmacokinetics of Sedatives and Hypnotics
Mechanism of Action of Sedatives and Hypnotics
Acute Effects of Sedatives and Hypnotics
Medical and Therapeutic Uses of Sedatives and Hypnotics
Chronic Effects of Sedatives and Hypnotics
Other Sedative/Hypnotic Drugs
GHB
Quaaludes
Propofol
Inhalants
History of Inhalants
Prevalence of Inhalant Use
Source and Forms of Inhalants
Pharmacokinetics and Mechanism of Action of Inhalants
Acute Effects of Inhalants
Chronic Effects of Inhalants
Critical Evaluation: Are the cognitive impairments seen in huffers due to inhalant use or to other factors?

Chapter 9. Marijuana
History of Marijuana
17th-19th Century America
20th Century and Beyond
Prevalence of Marijuana Use
Legal and Cultural Issues Related to Marijuana
Legal Issues
Cultural Issues
Source and Forms of Marijuana
Types of Cannabis Plant
Phytocannabinoids
Types of Cannabis Products
Synthetic Cannabinoids
Pharmacokinetics of Marijuana
Routes of Administration and Dosage
Absorption, Distribution, Metabolism, and Elimination
Mechanism of Action of Marijuana
Acute Effects of Marijuana
Physiological Effects at Low and Moderate Doses
Behavioral and Psychological Effects at Low and Moderate Doses
Potential Adverse Effects
Critical Evaluation: Does long-term cannabis use cause cognitive deficits?
Medical and Therapeutic Uses of Marijuana
Analgesia
Nausea, Vomiting, and Appetite
Epilepsy
Glaucoma
Cancer
Brain Injury and Neurodegenerative Disorders
Diabetes
Irritable Bowel Disease
Depression
Reducing Use of Other Harmful Substances
Chronic Effects of Marijuana
Tolerance
Dependence
Withdrawal
Treatment for Cannabis Dependence


SECTION 3: LEGAL PSYCHOACTIVE DRUGS


Chapter 10. Tobacco
History of Tobacco
Tobacco in Colonial America
Mechanization
Tobacco in the 20th Century
Troubled Times for the Tobacco Industry
Prevalence of Tobacco Use
Gender
Race
Education
Employment and Socioeconomic Status
Concurrent Use of Other Drugs
Mental Health
Age
Economics and Social Issues Related to Tobacco
Economics
Advertising
Movies
Source and Forms of Tobacco
Making Tobacco
Smoking Tobacco
Electronic Cigarettes
Smokeless Tobacco
Pharmacokinetics of Tobacco and Nicotine
Dosage, Absorption, and Distribution
Metabolism and Elimination
Drug Interactions
Mechanism of Action of Nicotine
Acute Effects of Tobacco and Nicotine
Physiological Effects at Low and Moderate Doses
Overdose
Behavioral and Psychological Effects at Low and Moderate Doses
Chronic Effects of Tobacco and Nicotine
Tolerance
Withdrawal
Adverse Effects from Chronic Use
Prenatal and Postnatal Effects
Secondhand Smoke
Critical Evaluation: Should tobacco be legal?
Tobacco Dependence and Addiction
Quitting Tobacco
Benefits of Quitting
Methods of Quitting

Chapter 11. Caffeine
History of Caffeine
Coffee
Tea
Chocolate
Soft Drinks and Energy Drinks
Prevalence of Caffeine Use
Source and Forms of Caffeine
Coffee
Tea
Chocolate
Soft Drinks and Energy Drinks
Other Caffeine Sources
How Much Caffeine is in the Substances We Ingest?
Pharmacokinetics of Caffeine
Route of Administration, Absorption, and Distribution
Metabolism, Elimination, and Drug Interactions
Mechanism of Action of Caffeine
Acute Effects of Caffeine
Physiological Effects at Low and Moderate Doses
Behavioral and Psychological Effects at Low and Moderate Doses
Overdose
Medical and Therapeutic Uses of Caffeine
Type 2 Diabetes
Liver
Cognitive Function
Parkinson's Disease
Cardiovascular Disease
Cancer
Mortality
Critical Evaluation: Does caffeine increase or decrease a person's mortality?
Chronic Effects of Caffeine
Tolerance and Dependence
Withdrawal
Adverse Effects from Chronic Use
Effects on the Fetus
Quitting Caffeine

Chapter 12. Alcohol
History of Alcohol
Early Alcohol Use
The Middle Ages to the Early Modern Era
Puritans and Colonial America
Temperance Movements in the United States (19th Century)
Prohibition
Alcohol from WWII to Today
Prevalence of Alcohol Use
Global Alcohol Use
Alcohol Consumption in the United States
Underage Drinking
Drinking by College Students
Source and Forms of Alcohol
Fermented Beverages
Distilled Beverages
Alcohol Content of Standard Drinks
Pharmacokinetics of Alcohol
Dosage
Absorption
Distribution
Metabolism
Elimination
Drug Interactions
Mechanism of Action of Alcohol
GABA
Glutamate
Dopamine
Opioids
Serotonin
Endogenous Cannabinoids
Acute Effects of Alcohol
Physiological Effects
Behavioral and Psychological Effects
Critical Evaluation: Does alcohol increase aggression?
Adverse Effects from Acute Heavy Drinking
Medical and Therapeutic Uses of Alcohol
Chronic Effects of Alcohol
Tolerance
Withdrawal
Adverse Effects of Chronic Heavy Drinking


SECTION 4: COMMONLY USED PRESCRIPTION AND NON-PRESCRIPTION DRUGS


Chapter 13. Drugs for Treating Psychological Disorders
Psychological Disorders in Today's Society
Major Depressive Disorder
Prevalence of Depression
Critical Evaluation: Why have depression rates increased?
Causes of Depression
Symptoms of Depression
Diagnosis of Depression
Prognosis of Depression
Antidepressant Treatments
Critical Evaluation: Does antidepressant drug use increase or decrease the rate of suicide?
Other Treatments for Depression
Bipolar Disorder
Prevalence of Bipolar Depression
Causes of Bipolar Depression
Symptoms of Bipolar Depression
Treatment of Bipolar Depression
Schizophrenia
Prevalence of Schizophrenia
Causes of Schizophrenia
Neurochemical Abnormalities
Symptoms of Schizophrenia
Prognosis of Schizophrenia
Treatments for Schizophrenia
Other Treatments for Schizophrenia
Anxiety Disorders
Prevalence of Anxiety Disorders
Causes of Anxiety
Symptoms and Types of Anxiety Disorders
Treatment of Anxiety Disorders
Trauma and Stressor-Related Disorders
The Future of Drugs Used to Treat Mental Illness

Chapter 14. Performance-Enhancing Drugs
Anabolic-Androgenic Steroids
History of Performance-Enhancing Drugs
Prevalence of Performance-Enhancing Drugs Use
Forms of Performance-Enhancing Drugs
Pharmacokinetics and Mechanism of Action of Anabolic-Androgenic Steroids
Acute Effects of Anabolic-Androgenic Steroids
Critical Evaluation: Does roid rage exist?
Medical and Therapeutic Uses of Anabolic-Androgenic Steroids
Anabolic-Androgenic Steroid Tolerance and Dependence
Prevention and Treatment of Anabolic- Androgenic Steroid Abuse
Drugs to Treat Attention-Deficit/Hyperactivity Disorder
Symptoms and Diagnosis of ADHD
Prevalence of ADHD
Causes of ADHD
Consequences of ADHD
Pharmacological Treatments for ADHD
Critical Evaluation: Does long-term use of ADHD medications lead to academic improvement?
Nonpharmaceutical Treatments for ADHD

Chapter 15. Over-the-Counter (OTC) Drugs
OTC Drugs: Regulation and Dangers
History of OTC Regulations
Dangers of OTC Drugs and Self-Care
Critical Evaluation: Should OTC drugs be more or less available than they currently are?
Non-Narcotic Analgesics
History of Non-Narcotic Analgesics
Prevalence of Non-Narcotic Analgesic Use
Pharmacokinetics of Non-Narcotic Analgesics
Mechanism of Action of Non-Narcotic Analgesics
Acute Effects and Medical Benefits of Non-Narcotic Analgesics at Low and Moderate Doses
Adverse Effects of Non-Narcotic Analgesics
Side Effects Associated with Non- Narcotic Analgesics
Use during Pregnancy
Drug Interactions
Overdose
Cough, Cold, and Allergy Products
Components of Cough and Cold Medications
OTC Drugs to Treat Gastrointestinal Ailments
Drugs to Treat Heartburn, Gastric Reflux, and Peptic Ulcer
Drugs to Treat Diarrhea
Laxatives
OTC Weight Loss Aids
OTC Sleep Aids
Dietary Supplements

Chapter 16. Sex and Reproductive Drugs
Hormonal Contraceptives
Oral Contraceptives
Other Forms of Hormonal Contraceptives
Emergency Contraception
Hormonal Contraceptives and Society
Contraception for Men
Fertility Drugs
How an Egg Is Fertilized
Infertility
Drugs to Treat Infertility
Hormone Replacement Therapy
HRT in Women
HRT in Men
Viagra and Other Drugs to Treat Erectile Dysfunction
Mechanism of Action of Drugs to Treat Erectile Dysfunction
Side Effects and Drug Interactions of Erectile Dysfunction Drugs
Viagra for Women
Aphropdisiacs and Anaphrodisiacs
Herbs and Plants
Alcohol and Other Drugs
Anaphrodisiacs
Gardasil
Critical Evaluation: Should the HPV Vaccine Be Required for Enrollment in Schools?


SECTION 5: ADDICTION, PREVENTION, AND TREATMENT


Chapter 17. Problematic Drug Use and Addiction
Definitions of Dependence and Addiction
Prevalence of Addiction
Addiction and Race
Addiction and Age
Addiction and Gender
Recognition, Diagnosis, and Assessment
Critical Evaluation: Is addiction a disease?
Factors Underlying Drug Abuse and Addiction
Biological Factors
Psychological and Interpersonal Factors
Social and Environmental Factors
Societal Views on Drug Addiction
Attitudes about Addiction Based on Gender
Attitudes about Addiction Based on Occupation
Attitudes about Addiction Based on Survey Question Wording
Why Do People's Beliefs About Addiction Matter?
Attitudes about Problematic Drinking and Other Compulsive Behaviors

Chapter 18. Prevention and Treatment of Drug Use and Abuse
Types of Prevention
Primary Prevention
Secondary Prevention
Tertiary Prevention
Universal Prevention
Selective Prevention
Indicated Prevention
School-Based Prevention Campaigns
Ineffective K-12 School-based Methods of Drug Abuse Prevention
Effective School-based Methods of Drug Abuse Prevention
Family and Community Involvement
Alcohol and Drug Prevention Programs at Colleges and Universities
Advertising Campaigns to Prevent Drug Use
Anti-Drug Ads
Anti-Tobacco Ads
Drug Testing
Who is Subject to Drug Tests?
When Do Drug Tests Typically Occur?
What Process is Used for Drug Testing?
For Which Drugs Are Tests Run?
How Long after Using a Drug will Someone Test Positive?
What Types of Drug Tests Are Used?
How Accurate Are Drug Tests?
How Effective Are Drug Tests?
Prevalence of Treatment for Alcohol and Drug Addiction
The Stages of Recovery
Methods of Treatment
Pharmacological Treatments for Addiction
Psychosocial Therapeutic Treatments for Addiction
Critical Evaluation: Is total abstinence the only solution for drug or alcohol abuse?
Characteristics of Effective Addiction Treatments
Relapse

Appendix
Answers
Glossary
Endnotes
Credits
Index