Index

A personality types and, 50 Absorption relapse and diagnosis, 16-17,26-27 , 106 use of term, 13-14 , 142-144 Addictive personality, genetic factors, , 163 60-61 Abstinence Adoption studies, alcoholism, 4, 57-58 continuation of symptoms, 327-331 Adrenergic blocking agents, sexual re• reasons for, 327, 329 sponse and, 95 treatment, 330-331 Adrenocortical function, alcoholism types of damage, 327-330 and,69 Abstinence syndrome Adrenomedullary function, alcoholism characteristics of, 110 and,69 hallucinations in, 79-80 Adulteration of drugs, 2 as mimic of psychiatric disorders, 110 cocaine and, 156 Abuse Advertisements use of term, 11-12, 138-139 alcohol-related, 346 versus dependence, 11-12 lowered-exposure as prevention, 349 Acetaldehyde, 107 AIDS Acetic acid, 107 IV drug use and, 234 Acetylcholine polysubstance addict and, 219 drugs affecting actions of, 308, 322, Alcohol 324 absorption, 106 functions of, 308, 310 animal aversion to, 108 Acquired tolerance, 107-108 blood levels, 106 Acute brain syndrome, marijuana use dilution, percentage of, 106 and,200-201 dopamine and, 33-34, 35 Acute tolerance, 107, 161-162 elimination of, 106-107 Addiction, see also Dependence gamma-aminobutyric acid and, 35 compulsive use and, 15 pharmacological effects, 5 criteria for, 14-18 physiological basis for tolerance, 27 definition of, 295 serotonin and, 35, 49 versus dependence, 12-14,28,40,78 Alcohol/drug interactions, 287-288 diagnosis of, 77-78 cocaine in, 288 drive states and, 38-39, 40 common side effects, 287 limbic system and, 6-7 marijuana in, 287-288

351 352 Index

Alcohol/drug interactions (cont.) legal restrictions, 114, 115, 118 opiates in, 288 neurochemical aspects, 120-121 phencyclidine in, 288 neurotransmitters and, 113, 119-121 Alcoholic hallucinosis, 79-80 patterns of use, 114-115 Alcoholics Anonymous, 342 physiological effects, 115-116 Alcoholics Anonymous, 168, 169, 182, prevalence of use, 113-114 236,237,330 psychosis induced by, 117 disease model of alcoholism and, 335, reasons for use, 118-119 336 recovery period, 120 focus of treatment, 335 relationship to catecholamines, 113 as follow-up to treatment, 341-342 tolerance, 119-120 steps of program, 336-340 types of, 114-115 Alcoholism vulnerable population, 117-118 alcoholic paranoia syndrome, 3 withdrawal, 116, 120 cerebral atrophy and, 70, 327-328 Anabolic-androgen steroids compulsive use in, 34-36 diagnosis, 129 dependence, 29, 109-110 drug testing for, 130 drug dependence with, 102, 103 drugs to control side effects, 126 duration of, 102-103 history of, 125 early diagnosis and, 103 intoxication effects, 128-129 effects of, 337-338 neurochemical aspects, 127-128 locations of alcoholics, 103-104 other drugs used and, 126, 129 as medical illness, 101 patterns of use, 126 multiple addictions and, 1-2 pharmacokinetics, 128 patterns of use, 102-105 physiological effects, 128-129 pharmacodynamic tolerance, 108-109 prevalence of use, 126 pharmacological treatment, 225 psychological effects, 129, 130 prevalence of, 101-102 stacking, 126 prison population and, 104 tolerance, 129 psychiatric population and, 104 treatment of addiction, 130 sexual response and, 95, 96, 99 use by younger population, 126 suicide and, 45-52 withdrawal syndrome, 129 tolerance, 105-109 Androgens, 127 treatment of withdrawal, 319 (table) Angel dust: see Phencyclidine withdrawal, 3,17-18,40,110 Antabuse: see Disulfiram Alpha waves, 59 Anticholinergic agents, sexual response , 133, 134, 142, 143, 144 and,95 Alzapam: see Amanita muscaria, 176 drug interactions, 282-284 American Occupational Medication As• in treatment of cocaine addiction, 224 sociation, 291 , effects of, 254 Amotivational syndrome, marijuana use drugs, sexual response and,201 and,95-96 Amphetamines Anti-social personality, 61 acute intoxication, 115-116 heroin addict, 229 addictive potential of, 118 polysubstance addict, 220 characteristics of chronic use, 116-117 Anxiety chemical structure, 113 abstinence and, 83 diagnosis, 117-119 addiction and, 79, 83, 84 Index 353

withdrawal, 138 Benzphetamine, 115 characteristics of, 79 Beta-endorphin, function of, 309, 311 cocaine use and, 159 Biopsychiatric model, 307, 311 marijuana use and, 207 Blood, in drug testing, 298, 304 pharmacological treatment, 83 Blood pressure signs of, 79 alcoholism and, 63-64 withdrawal and, 83 cocaine and, 158 Aphrodisiacs, 93 phencyclidine and, 260 Aspirin, effects of, 253-254 Brain, cerebral atrophy, 70,327-328 Ativan: see Lorazepam , 266 Auditory hallucinations, 80, 110 Bromocriptine, 98, 320, 321 treatment of cocaine addiction, 224 Butyrophenones, drug interactions, 285, B 286 , 313 , 311, 313; see also Seda- tives/ C classification of, 266 , effects of, 254 poisoning, signs of, 273-274 Calories, alcohol, 67 Barbituric acid, 266 Cancer, alcoholism and, 71-72 Benzedrine: see Amphetamines : see Marijuana Benzodiazepines, 265, 266, 268, 311, Cardiomyopathy, alcoholism and, 64- 313; see also /hyp• 65 notics Cardiovascular effects absorption, 142-144 alcohol use, 63-65 central nervous system effects, 137 cocaine use, 157-158, 160 chemical structure, 142 marijuana use, 205 clinical uses, 137 Catapres: see in cocaine withdrawal, 168 Catecholamines, 98 cross-tolerance to alcohol, 140 amphetamines and, 113, 121 dependence, 140-141 catecholamine blockade, 320 detoxification routine, 147-149 Catechol-O-methyltransferase, 313 diagnosis, 138-139 Central nervous system, sedatives/hyp• drug interactions, 286-287 notics and, 268-269, 272-273 metabolism of, 144 Cerebral atrophy, alcoholism and, 70, as most prescribed drug, 133, 134, 327-328 136-137 Children of alcoholics, EEG studies, 59; neurochemistry, 145 see also Genetic factors in alco• other drug use and, 145-146 holism patterns of use, 134-137 Chloralhydrate, 265, 266, 268, 313 pharmacokinetics, 141-144 , 318 physiological effects, 137 , 262 prevalence of use, 134 Chronic tolerance, 107-108, 162 sleep and, 137-138 Cigarette-smoking, alcoholism and, 71- storage phenomena, 329 72; see also Nicotine tolerance, 139-140 Cirrhosis, alcoholism and, 66-67 treatment of addiction, 146-149 Clonidine, 98, 322 treatment of withdrawal, 318, 320 nicotine withdrawal, 246 withdrawal, 138, 141-142, 145 , 133, 143, 144 354 Index

Cocaine Compulsive use absorption, 163 diagnosis and, 15,26 acute intoxication, 157-159 meaning of, 15 addiction, 162-163 Control, loss of, 16 adulterants and, 156 Controlled Substance Act, 115 chronic effects, 3 Crack, 154, 155, 167, 175, 179 chronic intoxication, 159-161 Crash, cocaine withdrawal, 160, 161, cocaine paste, 155 168 compulsive use, 33-34 Craving, 36-37 crack, 154, 155, 167, 175, 179 alcohol and, 37 dependence, 162 anti-craving drugs, 224-225 dopamine and, 33-34 cocaine and, 37,158 drug testing, 303-304 Cross-tolerance, 109 epidemics of use, 154-155 alcohol/benzodiazepines, 140 freebase, 155 Cutoff levels, drug testing, 298-299 half-life, 164 Cytochrome P-450 system, sedatives/ hierarchy of drug use and, 167 hypnotics and, 270 historical view, 153-154 interaction with alcohol, 288 intoxication, signs/symptoms of, 315 D (table) Dalmane: see legal restrictions, 154 Darvon: see Propoxyphene metabolism of, 163-164 Delirium tremens neurochemical aspects, 164-166 causes of death in, 110 neuroleptic blockade and, 33 characteristics of, 110 neurotransmitters and, 165-166 hallucinations, 80 other drug use and, 166-167 mortality rate, 110 patterns of use, 155-156 Delusions, see also Paranoid delusions pharmacokinetics, 163-164 addiction and, 80 pharmacological effects, 6 Demerol: see Neperidine pharmacological treatment, 168- Denial,9 169 addiction and, 80-81 physiological basis for tolerance, characteristics of, 80-81 27-28 diagnostic difficulty and, 3, 15, 19, physiological effects, 157-158, 160 147 preoccupation, 32-33 marijuana use, 202 psychological effects, 158, 159 pervasiveness of, 19 psychological treatment, 168-169 1Welve Step Program and, 336 routes of administration, 156-157 Dependence sexual response and, 95, 96, 99 versus abuse, 11-12 sources of, 155 versus addiction, 12-14,28,40,78 sudden death from, 164-165 alcohol,29 terms related to, 155 behavioral definition of, 30 tolerance, 161-162 benzodiazepines, 140-141 vasoconstriction, 163 clinical dependence syndrome, 12 withdrawal, 5-6, 160, 161, 168 cocaine, 162 Cocaine Anonymous, 168 criteria for, 16-18 , 232 in criteria for addiction, 16-18 Colonic cancer, alcoholism and, 72 in criteria for dependence, 140-141 Index 355

definition of, 105 drug testing in, 295-296 hallucinogens, 180 loss of control and, 16 inhalants, 189 multiple addictions and, 2-3, 4, 20 marijuana, 201, 202, 203 preoccupation in, 14, 15,26 mild form of, 110 relapse and, 16-17,26-27 multiple addictions, 5-7 research needs and, 18-19 nicotine, 244-245 Diagnostic and Statistical Manual of addiction, 231, 233 Mental Disorders (DSM-III-R): over-the-counter medications, 252- see DSM-III-R 253 , 133, 134, 143, 144 pharmacological dependence, 109- Diethylproprion, 115 110,140,141,271 Differential diagnosis, difficulty of, 222- phencyclidine, 261 223 , 110 Dilaudid: see Hydromorphone physiological events in, 31 Diphenoxylate, 232 relationship to tolerance, 105-106 Disease model, AA and, 335, 336 sedatives/hypnotics, 271, 272 Dispositional tolerance, 106 versus underlying disorders, 141 Disulfiram, alcoholism treatment, 225, use of term, 12-13 287 withdrawal and, 110 L-dopa, 98 Depression Dopamine abstinence and, 83 alcohol and, 33-34, 35 addiction and, 78-79, 83 amphetamines apd, 120, 121 cocaine use, 34, 35, 159 cocaine and, 33-34, 165-166 marijuana and, 203, 206-207 deficiency, 33, 34, 37 neurotransmitters and, 49-50 dopamine agonists, 34 pharmacological treatment, 83 dopamine reward system, 33, 34, 37, self-medication for, 51 120 signs of, 78-79 drugs affecting actions of, 308, 313, suicide and, 46, 49, 79 314,316,324 Designer drugs function of, 33, 309, 310 MDMA (ecstasy), 179-180 relapse and, 37 MPTP,180 Doriden: see Desipramine, 320-321 Doriglute: see Glutethimide in cocaine withdrawal, 168 Drive states Detoxification addiction and, 38-39,40 benzodiazepines, 147-149 limbic system and, 37, 38 opioid addiction, 234-236 Drug Abuse Warning Network, 134, Dexamethasone Suppression Test, 338 136,217,294 Dexedrine: see Dextroamphetamine Drug interactions Dextroamphetamine, 114 common interactions Diacetylmorphine, 232 antidepressants, 282-284 Diagnosis, 40-41 benzodiazepines, 286-287 biopsychiatric model and, 307 lithium, 284-285 compulsive use in, 15,26 monoamine oxidase inhibitors, 283- denial and, 3, 15, 19 284 difficulty of, 296-297, 307 neuroleptics, 285-286 difficulty of differential diagnosis, diagnosis of, 270-280 222-223 history of, 279 356 Index

Drug interactions (cont.) E increases, reasons for, 280-281 Ecstasy (MDMA), 179-180 misdiagnosis, reasons for, 279-280 Electroencephalograph (EEG) pharmacokinetics/pharmaco- children of alcoholics study, 59 dynamics, 282 psychedelics and, 316 Drugs of abuse, most common sedatives/hypnotics and, 269, 273- opiates, 314 274 phencyclidine, 316 Elimination time, drug testing, 298 psychedelics, 314, 316 Employment, marijuana use and, 208- sedatives/tranquilizers, 311-313 209 stimulants, 313-314 Endocarditis, and, 233 Drug testing, 19 Endocrinological system anabolic-androgen steroids, 130 alcoholism and, 68-70 cutoff levels, 298-299 marijuana use, 205, 207 as diagnostic tool, 295-296 Environment, alcoholism, 56-57, 59-60 drugs of interest in, 294 Enzyme immunoassay (EIA), drug test• elimination time, 298 ing, 297, 302-303 enzyme immunoassay (EIA), 297, Ephedrine, 114 302-303 Epidemiological Catchment Area study, Enzyme Multiplied Immunoassay 45,101,217,218 Technique (EMIT), 302 Epinephrine, 254 false positives/negatives, 299-300 Equanil: see gas chromatography/mass spectrome• Esophageal cancer, alcoholism and, 72 try, (GC/MS), 300, 302 Esophageal reflux, alcoholism and, 65 gas-liquid chromatography (GLC), , 265, 311, 313 301-302 Euphoria high-pressure liquid chromatography cocaine use, 159, 162 (HPLC),302 relationship to tolerance, 108 history of, 291-292 Excitement phase, sexual response, 89- indications for, 292-294 90 radioimmunoassay (RIA), 302-303 Extrapyramidal reactions, neuroleptics, sensitivity/specificity of method, 297 286 specimen, 297-298 thin-layer chromatography (TLC), 297,300,301 F usefulness of, 303-304 Fagerstrom Tolerance Questionnaire, Drug-use disorders, use of term, 10-11 244 DSM-II1-R, substance-dependence dis- False positives/negatives, drug testing, orders 99-300 abuse versus dependence, 11-12 Family illness, alcoholism and, 340-341 addiction versus dependence, 12-14 Family therapy, cocaine addiction, 169 class name, 9, 10-11 Flurazepam, 133, 143 criteria for substance dependence, 9, Flushing reaction, Orientals, to alcohol, 14-18,22-23,220-222 59,107 diagnostic difficulty, 20-21 Folic acid deficiency, alcoholism and, 67 issues not addressed, 9 Follicle-stimulating hormone, 97 tolerance/dependence criteria, 16-18 Follicle-stimulating hormone releasing Duration, as criteria for addiction, 19- factor, 97 20 Fragmentation pattern, of drug, 302 Index 357

Freebase, 155 delirium tremens, 80 Frontal lobe, relapse and, 38 hallucinogens, 176 marijuana, 200-201 phencyclidine, 260-261 G visual,80 Gamma-aminobutyric acid (GABA), 97, Hallucinogens 98, 120 causes of death, 17S alcohol and, 35 chemical structure, 173-174 drugs affecting actions of, 308, 311, chronic effects, 3-4 313,316,324 classes of, 117 (table) function of, 308-310 dependence, ISO sedatives/hypnotics and, 272-273 diagnosis, ISO-lSI Gas chromatography/mass spectrometry, effects of, 176, 17S drug testing, 300, 302 history of, 173 Gas-liquid chromatography (GLC), drug "ice," 17S-179 testing, 301-302 legal restrictions, 175 Gastrointestinal tract LSD, 173, 176, lSI alcoholism and, 65-67, 287 MDMA (ecstasy), 179-lS0 opioids and, 233 medical conditions worsened by, 179- Genetic factors, 55-61 ISO adoption studies, 4, 57-58 mescaline, 176 alcoholism, 4-5, 39 MPTP, ISO diagnostic factors, 55-56 mushrooms, 176 versus environment, 56-57, 59-60 neurochemical effects, lSI, 314, high risk studies, 4, 58 316 historical view, 55 nutmeg, 176 multiple addictions, 5 other drug use and, 176, IS0-181 personality, 60-61 patterns of use, 175-176 tolerance/dependence, 58-59 personality disturbances and, 4 twin studies, 4, 56-57 prevalence of use, 175 Gluconeogenesis, alcoholism and, 70 route of administration, 175 Glue: see Inhalants satrale, 176 Glutethimide, 265, 268, 311, 313 tolerance, ISO Gonadal function, alcoholism and, 69 toxicity related to, 17S Group therapy, cocaine addiction, 168- treatment of withdrawal, 181,322 169 withdrawal, ISO, 181 Haloperidol, 117,262,322-323 Hangover, characteristics of, 110 H Harrison Narcotic Act, 154 , 142, 144 Hedonism, 12 Halcion: see ltiazolam Hepatitis, alcoholism and, 66 Haldol: see Haloperidol Heroin addiction: see Opioid addiction Half-life, cocaine, 164 High-pressure liquid chromatography Hallucinations (HPLC), drug testing, 302 addiction and, 79-S0, S4-S5 High risk studies, alcoholism, 4, 58 alcoholic hallucinosis, 79-S0, 110 Hippocampus amphetamines, 116-117 memory/recall and, 32, 33 auditory, SO relapse and, 37 cocaine, 159 Hopelessness, suicide and, 49 358 Index

Hormonal effects K alcohol, 68-70 Ketosis, alcoholism and, 70 marijuana use and, 205, 207 Korsakoff syndrome, 71 Hormones, sexual response and, 97-98 Horn's Reason for Smoking Test, 244 Hydromorphone, 229, 230, 232 L 5-Hydroxytryptamine, cocaine and, 166 Laxatives, effects of, 254 Hypersensitivity reactions, sedatives/ Libido, 96-97 hypnotics, 275-276 cocaine use and, 158, 159 Hypertension Librium, in cocaine withdrawal, 168; see alcoholism and, 63-64 also Chlordiazepoxide cocaine and, 158 Limbic system phencyclidine and, 260 addiction and, 6-7 Hypoglycemia, alcoholism and, 70 drive states, 37, 38 recall mechanisms and, 37 Lipophore diffusa, 176 I Lipophore williams;;, 176 , in cocaine withdrawal, 168 Lithium, drug interactions, 284-285 Infectious disease, alcoholism and, 72 Liver Inhalants alcoholism and, 66, 72 administration of, 188 anabolic steroids and, 128 at-risk groups, 187 breakdown of alcohol, 106-107 causes of death, 188 opioids and, 233 dependence, 189 Lorazepam, 133, 142, 143, 144, 322 diagnosis, 189 LSD, 173, 176, 181; see also Hallucino• effects of, 186, 188-189 gens history of, 185 Luteinizing hormone, 97 intoxication, 188-189 Luteinizing hormone releasing factor, other drug use and, 186, 187 97 pathology caused by, 193-194 (table) patterns of use, 186-188 prevalence of use, 185-186 M products containing organic solvents, Malabsorption, alcoholism and, 66, 67 187-188 Malnutrition, alcoholism and, 67-68 side effects, 189 Mania, stimulant intoxication, 3 tolerance, 189 Manic-depressive, drinking pattern of, toxicities, 190-192 (table) 82-83 treatment of addiction, 192, 194-195 Marijuana withdrawal, 189 accidents/trauma and, 208 Innate tolerance, 107 causation of addiction, 202, 203 Interpersonal relationships denial and, 202 marijuana use and, 208 dependence, 201,202,203 polysubstance addict and, 220 depression and, 203, 206-207 Intravenous drug use diagnosis, 201-204 AIDS and, 219, 234 drug testing, 302 medical complications of, 233 effects of, 200-201, 328-329 IQ history of, 199 alcoholism and, 70 interaction with alcohol, 287-288 reduced in addicted, 328 moral dilemma related to, 201-202 Iron deficiency, alcoholism and, 68 other drug use and, 199-200 Index 359

pharmacological effects, 6 history of, 215-216 physiological effects, 205-206 intoxication, 3-4 psychological effects, 206-208 neurological basis of, 6-7 reasons for use, 203 overdose, management of, 223-224 signs of intoxication, 29 patterns of, 1-2 sociological complications, 208-209 patterns of use, 218-219 storage phenomena, 328-329 personality disturbances and, 2 tolerance, 201 pharmacological treatment, 224-225 withdrawal, 29 physiological effects, 219-220 Mazindol, 115 prevalence of, 216-218 MDMA (ecstasy), 179-180 psychological effects, 220-221 Medical effects of addiction treatment of, 223-225 cancer, 71-72 younger population and, 102 cardiovascular system, 63-65 Mushrooms, hallucinogenic, 176 endocrinological system, 68-70 Myoglobinuria, alcoholism and, 71 gastrointestinal system, 65-67 Myopathy, alcoholism and, 71 infectious disease, 72 Myristicin, 176 nervous system, 70-71 nutritional problems, 67-68 Mellaril: see N Menstrual abnormalities, 98 Naloxone, 321 Meprobamate, 265, 266, 267-268, 311, Naltrexone, in opioid detoxification, 313 236; see also 'frexan Mescaline, 176; see also Hallucinogens Narcan: see Naloxone Metaphetamine, ice, 178-179 Narcotics: see Opioid addiction Methadone Narcotics Anonymous, 168-169, 182, in detoxification, 235 236,237 in maintenance treatment, 236 Nasal effects, cocaine use, 160 opiate addiction treatment, 225 National Household Survey on Drug Methamphetamine, 114 Abuse, 134, 135, 154 , 268, 313 National Institute on Drug Abuse, 134, Methedrine: see Methamphetamine 216,242,294 Methyldopa, 98 National Prescription Audit, 134 Methyltestosterone, 128 National Youth Polydrug Study, 217 , 265, 268 Neperidine, 230 Miltown: see Meprobamate Nervous system Monoamine oxidase inhibitors, drug in- alcoholism and, 70-71 teractions, 283-284 sexual arousal and, 92-93 Mood Neuramate: see Meprobamate alcohol effects, 82-83 Neuroleptics, drug interactions, 285-286 drug/alcohol use and, 329 Neurological effects, marijuana use and, hallucinogens and, 178 205-206 : see Opioid addiction Neurotransmitters, see also specific MPTP, 180 neurotransmitters Multiple addiction, see also Polysub- acelylcholine, 308, 310 stance addiction amphetamines and, 119-121 alcoholism and, 1 beta-endorphin, 309, 311 dependence/tolerance, 5-7 cocaine and, 165-166 diagnosis, 2-3, 4, 20, 221-223 depression, 49-50 family history and, 5 dopamine, 309, 310 360 Index

Neurotransmitters (cant.) classes of opioids, 229 (table), 232 gamma-aminobutyric acid (GABA), dependence, 231,233 310-308 detoxification, 234-236 hallucinogens and, 181 diagnosis, 230-231 norepinephrine, 308, 310 effects of, 232-234 serotonin, 309, 311 history of, 227-228 Nicotiana tabacum, 241 medical addicts, 228-229 Nicotine methadone maintenance, 236 dependence, 244-245 neurochemical aspects, 233 diagnosis, 244 other drugs used, 230 effects of, 243-244 overdose, 232, 234 forms of, 242 patterns of use, 228-230 history of, 241 pharmacological treatment, 236 medical complications of, 242-243 prognosis for addict, 229-230 neurochemical aspects, 243, 245-246 psychological treatment, 236-237 other drugs used, 246 sources of drugs, 230 patterns of use, 242-243 tolerance, 231-232, 233 pharmacokinetics, 245 withdrawal, 231-232, 234-236 prevalence of use, 242 Opium, history of use, 227 tolerance, 244-245 Oral cancers, alcoholism and, 71-72 treatment of withdrawal, 246 Orgasmic phase, sexual response, 90- withdrawal, 245, 246 91,92 Nicotine gum, 246 Orientals, flushing reaction, 59, 107 Nitrates, 98 Overdose Nodular: see Methyprylon multiple addiction, management of, , 144 223-224 Norepinephrine, 120, 254 opioid addiction, 232, 234 cocaine and, 165-166 Over-the-counter medications drugs affecting actions of, 308, 313, adverse effects, 250-251 314,316,321,324 common problems treated, 250 (ta- function of, 308, 310 bles) Norpramin: see Desipramine dependence, 252-253 Notec: see Chloralhydrate diagnosis, 251 Nutmeg, 176; see also Hallucinogens efficacy of, 249 Nutritional problems, alcoholism and, ethanol content, 206-207 (Thble) 67-68 history of, 249 Nystagmus, phencyclidine and, 260 intervention/treatment, 254, 257 neurochemical aspects, 253-254 patterns of use, 249-250 o prevalence of use, 252 Occupational Safety and Health Act, sources of information about, 291 254 Opiates tolerance, 252-253 interaction with alcohol, 288 toxicities of, 251-252, 253 (table) neurochemical effects of, 314 treatment of toxic reactions, 255 treatment of withdrawal, 321-322 (table) Opioid addiction withdrawal, 253 adverse physiological effects, 233-234 , 144 at-risk groups, 228 Oxycodone, 228-229 Index 361 p guidelines for, 85 Pancreatic cancer, alcoholism and, opioid addiction, 236 72 phencyclidine, 262 Pancreatitis, alcoholism and, 65-66 psychiatric disorders, 84-85 Papaver somni/erum, 227 Phencyclidine Paradoxical excitement, sedatives/hyp• classification of, 259 notics, 274-275 dependence, 261 , 265, 268, 313 effects of, 260-261 Paranoia, alcoholic paranoia syn• history of, 259 drome, 3 interaction with alcohol, 288 Paranoid delusions, 80, 110 neurochemical effects of, 316 cocaine use, 159 other drug use and, 261-262 hallucinogens and, 178 patterns of use, 259-260 Parlodel: see Bromocriptine pharmacokinetics, 261 Parol: see Paraldehyde pharmacological management, 262 Paxipam: see Halazepam prevalence of use, 259 PCP: see Phencyclidine psychological management, 263 Peer pressure, alcohol use, 348 routes of administration, 259-260 Pentazocine, 228, 232, 233 superhuman strength and, 316 , 267 tolerance, 261 Percodan: see Oxycodone treatment of psychosis induced by, Personality development 262 arrest of in addiction, 220-221 treatment of withdrawal, 322, 324 phencyclidine and, 261-262 veterinary use of, 259 Personality disorders Phendimetrazine, 115 definition of, 81 Phenmetrazine, 117 types of, 81 , 267, 317 Personality disturbances Phenobarbital challenge test, 318 addiction and, 80 Phenothiazines, drug interactions, 285- hallucinogens and, 4 286 marijuana and, 208 Phentermine, 115 mUltiple addiction and, 2, 220 Phenylephrine, 114 phencyclidine and, 261 Phenylpropanolamine, 115 progressive nature of, 80 effects of, 254 reversibility of, 80 Phobia, alcoholism and, 3, 79 sedatives/hypnotics and, 270 Pituitary function, alcoholism and, 69- types of, 80 70 Personality type, addiction and, 50 Placidyl: see Ethchlorvynol Pertofrane: see Desipramine Plateau phase, sexual response, 90 Pharmacodynamic tolerance, 271 Pleasure centers, brain, 33 Pharmacokinetic tolerance, 106,270- Polypharmacy 271 drug addicts and, 281 Pharmacological dependence, 140, 141, physicians and, 280-281 271 Polysubstance abuse: see Multiple addic• Pharmacological treatment tions addiction, 83, 85 , 143, 144 alcoholism, 225 Preoccupation with substance anti-craving drugs, 224-225 diagnosis and, 14, 15,26 cocaine addiction, 168-169 neurological basis, 32-33 362 Index

Prevention,lowered media exposure in, REM sleep 349 benzodiazepines and, 137-138 Prison population, alcoholism, 104 marijuana and, 202-203 Prolactin, 98 sedatives/hypnotics and, 269-270 Prolactin-inhibiting factor, 97 Reproduction, marijuana and, 205 Propoxyphene, 228 Research, needs related to, 18-19 Propranolol, 98 Reserpine, 98 Psychedelics: see Hallucinogens Resolution phase, sexual response, 91 Psychiatric effects of addiction Restoril: see anxiety, 79, 83, 84 delusions, 80 denial, 80-81 S depression, 78-79, 83 Satrale, 176; see also Hallucinogens diagnosis, 77-78, 84 , nicotine withdrawal, 246 hallucinations, 79-80, 84-85 Script doctors, 230 induced versus idiopathic illness, 81- , 267, 269 83 Sedatives/hypnotics intervention, 84 . addiction of medical patient, 268 personality disturbances, 80 barbiturate poisoning, signs of, 273- pharmacological treatment, 84- 274 85 classification of, 265-266 systemic illness and, 81 dependence, 271,272 Psychological treatment effects of, 268-270 cocaine addiction, 168-169 history of, 265, 266 phencyclidine users, 263 hypersensitivity reactions, 275-276 Psychosis neurochemical effects, 272-274, 311- amphetamine induced, 117 313 marijuana and, 200-201 other drug use and, 267, 272 phencyclidine and, 261, 262 paradoxical excitement, 274-275 Pulmonary effects, marijuana, 205 patterns of use, 267-268 Pyridoxine deficiency, alcoholism and, prevalence of, 266-267 67-68 routes of administration, 268 tolerance, 268, 270-271, 272 treatment of withdrawal, 274, 316- R 318,320 Radioimmunoassay (RIA), drug testing, withdrawal syndrome, 268, 271-272 302-303 Seizures Rebound phenomena, sedatives/hypnot• phencyclidine and, 260 ics and, 270 sedatives/hypnotics and, 271 Relapse Self-administration, reinforcing ability cocaine addiction, 161 of drug and, 243 craving, 36-37 Self-help groups, 168,223; see also Al• diagnostic importance, 15 coholics Anonymous dopamine deficiency and, 37 Self-medication, 12, 34, 36 frontal lobe and, 38 for depression, 51 hippocampus and, 37 limitations of concept, 82 marijuana and, 204 study of, 50-51 neurochemical model, 36-38 Sensitivity/specificity of method, drug research related to, 36 testing, 297 Index 363

Serax: see Oxazepam denial and, 9, 19 Serotonin DSM-III-R criteria, 9, 14-18,22-23, alcohol and, 35,49 220-222 cocaine and, 166 duration criteria, 19-20 drugs affecting actions of, 308, 314, nosology, 9, 10 316,324 other states and, 20-21 function of, 309, 311 polysubstance diagnosis, 20-21 hallucinogens and, 181 research investigations, 18-19 Sexual dysfunction and addiction Suicide alcohol effects, 95-96, 99 addiction and, 45-46 diagnostic categories, 96 characteristics of suicidal addicts, 46- disinterest, 93 49 dose of substance and, 93, 95, 96 clinical management, 51-52 drug effects, 98 depression and, 46, 49, 79 impaired satisfaction, 96 hallucinogens and, 178 marijuana use and, 207 meaning of, 45 neurochemical aspects, 96-98 risk factors, 47-48 (tables) performance factors, 93, 95-96 underlying factors, 49-51 prevalence of, 93 Sympathomimetics, effects of, 254 treatment of, 98-99 Sexual response, normal excitement phase, 89-90 T general physical reactions, 91-92 Thchycardia, phencyclidine and, 260 hormones and, 97-98 Thlking down, hallucinogens and, 181 libido and, 96-97 Thlwin: see Pentazocine nervous system and arousal, 92-93 Thpering schedule, benzodiazepine with• neural components, 96-98 drawal, 318, 320 orgasmic phase, 90-91, 92 Thrdive dyskinesia, 33, 37 neuroleptics, plateau phase, 90 286 resolution phase, 91 Temazepam, 133, 144 Silkworth, Dr. William, 336 , 127, 128, 130 Sleep (THC), storage benzodiazepines and, 137-138 phenomena, 328-329; see also marijuana use and, 202-203 Marijuana sedatives/hypnotics and, 269-270 Thiamine deficiency, alcoholism and, 68 Smith, Dr. Robert, 336 Thin-layer chromatography (TLC), drug Smokeless tobacco, 241, 242, 243 testing, 297, 300, 301 Social factors, alcohol use, 347-348 Thioridazine, 262 Speed ball, 230 , drug interactions, 285 "Speed kills," meaning of, 178 Thorazine: see Chlorpromazine Spontaneous abortion, 98 Thyroid function, alcoholism and, 69 Stimulants, see also specific substances Thyroid-Releasing Stimulation test, 338 neurochemical effects of, 313-314 Tobacco: see Nicotine treatment of withdrawal, 320-321 Tolerance Storage phenomena, 328-329 acquired tolerance, 107-108 Substance-dependence disorders acute tolerance, 107, 161-162,271 abuse versus dependence, 11-12 alcohol, 105-109 addiction versus dependence, 12-14 physiological basis, 27 class name, 9, 10-11 amphetamines, 119-120 364 Index

Tolerance (cont.) V anabolic-androgen steroids, 129 Valium: see Diazepam behavioral definition of, 30 Visual hallucinations, 80, 110 benzodiazepines, 139-140 Vitamin A deficiency, alcoholism and, chronic tolerance, 107-108, 162 68 cocaine, 161-162 Vitamin D deficiency, alcoholism and, physiological basis, 27-28 68 in criteria for addiction, 16-18 Vitamin K deficiency, alcoholism and, cross-tolerance, 109, 140 68 definition of, 105 Vitamins dispositional tolerance, 106 adverse effects, 251-252 genetic factors, 58-59 disorders aggravated by, 253 (table) hallucinogens, 180 mechanisms of toxicity, 252 (table) inhalants, 189 Volatile solvents: see Inhalants innate tolerance, 107 loss of tolerance, 108 marijuana, 201 W mechanisms of, 105-106 Wernicke-Korsakoff syndrome, alcohol- nicotine, 244-245 ism and, 68, 70-71 opioid addiction, 231-232, 233 Wernicke's syndrome, 71 over-the-counter medications, 252- Wilson, Biel, 336 253 Withdrawal pharmacodynamic tolerance, 108- alcoholism, 3, 17-18,29,40, 110 109,271 amphetamines, 116, 120 pharmacokinetic tolerance, 106, 270- anabolic-androgen steroids, 129 271 anxiety and, 83 phencyclidine, 261 benzodiazepines, 138, 141-142, physiological events in, 31 145 relationship to addiction, 139 characteristics of, 110 relationship to dependence, 105-106 cocaine, 5-6, 161, 168 relationship to euphoria, 108 definition of, 105 sedatives/hypnotics, 268, 270-271, 272 hallucinogens, 180, 181 , 187, 189 inhalants, 189 'franquilizers: see Benzodiazepines; Sed- marijuana, 29 atives/hypnotics nicotine, 245, 246 Tranxene: see Clorazepate opioid addiction, 231-232, 234-236 'frauma, marijuana use and, 208 over-the-counter medications, 253 'frexan: see Natrexone sedatives/hypnotics, 268, 271-272 , 133, 143, 144 symptoms of, 18 'friclofos, 265 use of term, 14 Triclos: see Triclofos Withdrawal treatment 'fricyclic antidepressants, in cocaine alcohol, 319 (table) withdrawal, 168 hallucinogens, 181,322 1\vin studies, alcoholism, 4, 56-57 opiates, 321-322 1Yramine, 284 phencyclidine, 322, 324 sedatives/hypnotics, 274, 316-318, 320 U stimulants, 320-321 Urine, in drug testing, 297-298 Women, addiction and, 101, 102, 104 Index 365

X decreasing drug use in, 136 Xanax: see Alprazolam hallucinogens, 175 inhalant use, 186-187 multiple addiction, 102 Y peer pressure in, 348 Younger population addiction and, 101, 102 alcoholism, progression of, 219 z anabolic-androgen steroids, 126 deficiency, alcoholism and, 68 chemical structure, 127