1

Review Questions 3
Chapter 13:
1. What two chemicals are extracted from the opium poppy?
Morphine and codeine.
2. What was the significance of De Quinceys writing about opium eating?
Regular use of opium has a long history of being viewed unfavorably by certain
members of society, and this view was prevalent even when De Quincey wrote
about his opium experiences.
3. What were the approximate dates and who were the combatants in the Opium Wars?
The approximate dates of the war were 1839-1841, and the British and Chinese
were involved.
4. How is it possible that heroin was at first sold as a nonaddicting pain reliever?
The basis for the failure to find dependence probably was the fact that heroin was
initially used as a substitute for codeine, which meant oral doses of 3 to 5 mg used
for brief periods of time.
5. How did the typical opioid abuser change from the early 1900s to the 1920s?
The typical opioid user of this period was a 30- to 50- year-old white woman who
functioned well and was adjusted to her life as a wife and mother. She bought
opium or morphine legally at the local store, used it orally, and caused few, if any,
social problems.
6. Why and when did private physicians and public clinics stop maintaining dependent
individuals with morphine and other opioids?
Clinics for the treatment of opioid dependence were closed during the 1920s
under pressure from federal officials.
7. What were some of the lessons learned about heroin dependence as a result of the Vietnam
experience?
In retrospect the Vietnam drug-use situation was making a mountain out of a
mole-hill, but much was learned. An excellent follow-up study of veterans who
returned from Vietnam in September 1971 showed that most of the Vietnam
heroin users did not continue heroin use in this country.
8. What is the effect of a narcotic antagonist on someone who has developed a physical
dependence on opioids?
Both naloxone and the longer- lasting naltrexone have been given to dependent
individuals to prevent them from experiencing a high if they then use heroin.
9. What are the enkephalins and endorphins, and how do they relate to plant- derived opioids
such as morphine?
Enkephalins are morphine-like neurotransmitters found in the brain and adrenals
and endorphins are endogenous morphine-like substances that are also found in
brain tissue and have potent opioid effects.
10. Explain why taking opioids in combination with sedatives is not advised.

Because the majority of opioid overdoses occur in combination with other

sedatives, mainly alcohol.

Chapter 14:
1. What are the distinctions among phantastica, deliriants, psychedelics, psychotomimetics,
entheogens, and hallucinogens?
Phantastica are drugs that can create in our minds a world of fantasy. Psychedelic
(mind- viewing) drugs allow users to see into their own minds. Psychotomimetic
drugs are capable of producing hallucinations and some altered sense of reality, a
state that could be called psychotic. Entheogen is used to describe substances ( e.
g., sacred mushrooms) that are thought to create spiritual or religious experiences,
whereas entactogen, meaning to produce a touching within, is used to describe
substances, such as MDMA, that are said to enhance feelings of empathy.
Deliriants have somewhat more of a tendency to produce mental confusion and a
loss of touch with reality. All of these drugs classify as hallucinogens.
2. Why was LSD used in psychoanalysis in the 1950s and 1960s? How does this relate to its
proposed use by the Army and the CIA?
Research found that a single dose of LSD decreased problem drinking to a greater
extent than a control drug (ephedrine, amphetamine, or placebo).
3. Describe the dependence potential of LSD in terms of tolerance, physical dependence,
and psychological dependence.
Physical dependence to LSD or to any of the hallucinogens has not been
demonstrated.
4. What is the diagnostic term for flashbacks?
The term flashback has been replaced in the DSM-IV-TR by the phrase
Hallucinogen Persisting Perception Disorder.
5. What is the active agent in the magic mushrooms of Mexico, and is it an indole or a
catechol?
The primary active agent in this mushroom is psilocybin, an indole that the
discoverer of LSD, Albert Hofmann, isolated in 1958 and later synthesized.
6. Besides the psychological effects, what other effects are reliably produced by peyote?
Similar to the indole hallucinogens, the effects obtained with low doses, about 3
mg/ kg body weight, are primarily euphoric, whereas doses in the range of 5 mg/
kg give rise to a full set of hallucinations.
7. Contrast MDMA and PCP in terms of how they appear to make people feel about being
close to others.
MDMA comes in a pill form whereas PCP comes in a liquid form. MDMA makes
people feel more connected with others whereas PCP has the opposite effect.
8. Which of the hallucinogenic plants was most associated with witchcraft?

Belladonna, the species name, meaning beautiful woman, comes from the use
of the extract of this plant to dilate the pupils of the eyes and is associated with
witchcraft.
9. What can be concluded from the evidence regarding the neurotoxic effects of MDMA?
Some evidence suggests that Ecstasy may be neurotoxic, affecting serotonin
neurons in the brain.
10. Which hallucinogen acts as an agonist at kappa opiate receptors?
Salvinorin A is a kappa opioid receptor agonist. The drug produces no effect on
the serotonin- 2A receptor, the main target for classic hallucinogens such as LSD,
mescaline, and DMT.

Chapter 15:
1. What are the major differences between C. sativa and C. indica?
C. sativa that is cultivated for use as hemp grows as a lanky plant up to 18 feet
high. C. indica plants cultivated for their psycho-active effects are more compact
and usually only two or three feet tall.
2. How are hashish and sinsemilla produced?
Hashish, or hasheesh, is a substance widely known around the world and in its
purest form is pure resin. Removal of male plants increases the potency of the
female plants and produces high- grade marijuana known as sinsemilla.
3. When and where was the earliest recorded medical use of cannabis?
The earliest reference to Cannabis is in a pharmacy book written in 2737 BC by
Chinese emperor Shen Nung.
4. What were the general conclusions of the 1944 LaGuardia Commission?
Mayor LaGuardia asked the New York Academy of Medicine to study marijuana,
its use, its effects, and the necessity for control. The report, issued in 1944, was
extensive and drew conclusions that were not popular. It seems as though the
strong negative reactions by some authorities were motivated by factors other
than the actual data.
5. What is meant by cannabinoid, and about how many are there in Cannabis? What is the
cannabinoid found in brain tissue?
There are more than 400 chemicals in marijuana, but only about 70 of them are
unique to the Cannabis plant these are called cannabinoids. One of them, delta9- tetrahydrocannabinol ( THC), was isolated and synthesized in 1964 and is
clearly the most pharmacologically active. The major active metabolite in the
body of THC is 11-hydroxy-delta-9-THC.
6. How is the action of THC in the brain terminated after about 30 minutes, when the halflife of metabolism is much longer than that?
Peak mood-altering and cardiovascular effects occur together, usually within 5 to
10 minutes. The THC remaining in the blood has a half- life of about 19 hours,

but metabolites (of which there are at least 45), primarily 11- hydroxy-delta- 9THC, are formed in the liver and have a half-life of 50 hours.
7. What are the two most consistent physiological effects of smoking marijuana?
One of the most consistent acute physiological effects of both smoked marijuana
and oral THC is an increase in heart rate. Other consistent acute effects of smoked
marijuana are reddening of the eyes and dryness of the mouth and throat.
8. What two medical uses have been approved by the FDA for dronabinol?
Dronabinol has helped cancer chemotherapy patients gain weight, and in 1993 the
FDA also approved its use for stimulating appetite in AIDS patients.
9. What evidence suggests that attitudes about the regulation of marijuana have changed?
Thus, whether the discussion focuses on legalizing marijuana for medical use,
previous use of the drug by public officials, or decriminalizing its recreational
use, attitudes have changed.

Chapter 16:
1. What was the first type of stimulant drug reported to be used by boxers and other athletes
in the 1800s?
Strychnine.
2. What was the first type of drug known to be widely used in international competition and
that led to the first Olympic urine-testing programs?
Amphetamines.
3. When and in what country were the selective anabolic steroids first developed?
1992 in England.
4. Do amphetamines and caffeine actually enhance athletic performance? If so, how much?
With amphetamines, improvements have been seen both in events requiring brief,
explosive power (shotput) and in events requiring endurance, such as distance
running. In laboratory studies, increases have been found in isometric strength
and in work output during endurance testing on a stationary bicycle (the subjects
rode longer under amphetamine conditions). This endurance improvement could
be due to the masking of fatigue effects, allowing a person to compete to utter
exhaustion.
5. How was ephedrine used by athletes, and what happened to it?
Ephedra is the herbal source of ephedrine, and it was the ephedrine molecule that
was modified in the 1920s to produce amphetamine. In 2003, Baltimore Orioles
pitcher Steve Bechler died after col-lapsing during practice due to sufficient
amounts of ephedrine and so the FDA banned it after this.
6. What muscle effect do we know for certain that anabolic steroids can produce in healthy
men?
Androgenic effects are masculinizing actions: Initial growth of the penis and other
male sex glands, deepening of the voice, and increased facial hair are examples.
This steroid hormone also has anabolic effects.

7. What is meant by roid rage, and what double-blind studies have been done on this
phenomenon?
Roid rage is a kind of manic rage that has been reported by some steroid users.
There are a sufficient number of reports of violent feelings and actions among
steroid users for us to be concerned and to await further research.
8. What specific effect of anabolic steroids might be of concern to young users? to females?
In young users who have not attained their full height, steroids can cause
premature closing of the growth plates of the long bones, thus limiting their adult
height. Because women usually have only trace amounts of testosterone produced
by the adrenals, the addition of even relatively small doses of anabolic steroids
can have dramatic effects, in terms of both muscle growth and masculinization.
9. Why do pituitary giants often die at an early age?
These giants usually die at an early age because their internal organs continue to
grow.
10. How does creatine increase strength?
There is clear evidence that creatine helps regenerate ATP, which provides the
energy for muscle contractions.

Chapter 17:
1. What is the distinction between secondary and tertiary prevention?
2. What is the knowledge- attitudes- behavior model, and what information first called it
into question?
3. Explain what is meant by value- free values clarification programs, and why they fell
out of favor in the 1980s.
4. When the Drug- Free Schools programs began in 1986, the emphasis shifted away from
curriculum to what?
5. What were the five successful components of the social influence model for smoking
prevention?
6. In Project ALERT, what was the impact of using teen leaders to assist the instructors?
7. What distinguishes DARE from other similar programs based on the social influence
model?
8. What do ALERT and Life Skills Training have in common, besides their effectiveness?
9. What are some of the parenting skills that might be taught and practiced in a prevention
program?
10. What is the most common component of drug-free workplace plans?
Chapter 18:
1. List at least 8 of the 12 steps of Alcoholics Anonymous.
2. What are the four stages of change listed in the text?
3. Describe the kinds of contingencies used in contingency management: What happens if
the client has several clean urine samples in a row? What happens if the client fails one
of the urine sample tests?

4. Give one example for each: agonist/ substitution therapy, antagonist therapy, and
punishment therapy.
5. What drugs are typically used to reduce withdrawal symptoms during alcohol
detoxification?
6. Compare and contrast the use of disulfiram (Antabuse) versus either naltrexone or
acamprosate for alcohol dependence.
7. List four of the five types of available nicotine-replacement therapy.
8. How are methadone and buprenorphine similar to each other and different from
naltrexone as treatments for opioid dependence?
9. The effort to develop drugs to treat cocaine dependence has targeted which
neurotransmitter systems?
10. How big a problem is cannabis dependence, and what seems to be the most promising
drug treatment currently being studied?