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Research Issues --2 Guide to Drug Abuse Research Terminology

u.s. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration Notional Inslitute on Drug Abuse L....t______---""' ______~,· ~---". •

RESEARCH ISSUES SERIES 1. Drugs and Employment 2. Drugs and Sex 3. Drugs and Attitude Change 4. Drugs and Family/Peer Influence 5. Drugs and Pregnancy 6. Drugs and Death 7. Drugs and Addict Lifestyles 8. A Cocaine Bibliography-Nonannotated 9. Drug Themes in Science Fiction 10. Drug Themes in Fiction 11. Predicting Adolescent Drug Abuse 12. Drug Abuse Instrument Handbook 13. Data Analysis Strategies and Designs for Substance Abuse Research 14. Drugs and Personality 15. Cocaine-Summaries of Psychosocial Research 16. The Lifestyles of Nine American Cocaine Users-Summary 17. Drugs and Crime 18. Drug Users and the Criminal Justice System 19. Drugs and Psychopathology 20. Drug Users and Driving Behaviors 21. Drugs and Minorities 22. Research Issues Update, 1978. 23. I nternational Drug Use 24. Perspectives on the History of Psychoactive Substance Use 25. Use and Abuse of Amphetamine and its Substitutes 26. Guide to Drug Abuse Research Terminology 27. Guide to the Drug Research Literature 28. Assessing Marijuana Consequences: Selected Questionnaire Items 29. Drugs and the Family

Cover Illustration by Sumishta Brahmin, copyright 1978. Used by permission of the artist. Further reproduction is prohibited without permission of the artist.

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I ,'J Research Issues 26

Guide to Drug Abuse Research Terminology

Edited by

Jack E. Nelson 89255 U.S. Department of Justice Helen Wallenstein Pearson National Institute of Justice This document has been reproduced exactly as received from the Mollie Sayers pers~n or organization originating it. Points of view or opinions stated In thiS document, ~re tho.~e of the authors and do not necessarily represent the offiCial position or policies of the National Institute of Thomas J. Glynn Justice. Permission to reproduce this CCpfAgPttect material has been .,graT\t.ed bjl • PUD~~C Domaln/U.S. Department 1982 OI1fecrhl1 & H~

to the National Criminal Justice Reference Service (NCJRS).

~urther reproduc,tion outside of the NCJRS system requires permis­ sion of the CQ""nglil Owner.

U.S. OEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse and Mental Health Administration

National Institute on Drug Abuse 5600 Fishers Lane Rockville, M D 20857 r------I

:The U. S. Government does not endorse or favor any specific commercial product or commodity. Trade or proprietary names appearing in this publication are used only because they are con­ sidered essential in the context of the studies reported herein.

Material contained in this volume except for copyrighted material is in the public domain, and may be used and reprinted without obtaining permission from the Institute or the author. Cita­ tion as to source is appreciated. Permission has been obtained from the copyright holders to reproduce certain quoted material. Further reproduction of these quotations is prohibited without specific permission of the copyright holder. Permission to quote has been obtained for the following copyrighted material: (Chaplin 1975)--pp. 12, 13,14,15,21,23,29,31,36,37-38,50,51,52,61,64,71,74,77, 79,80,81,89,94. From Dictionary of Psychology: New Revised Edition by James P. Chaplin. Copyright (c) 1975 by James P. Chaplin. Reprinted by permission of Dell Publishing Co., Inc. (Encyclopedia of Sociology 1981 )--pp. 5, 23, 26, 27, 38, 44, 46, 52, 53, 65, 83, 86, 97, 99. From Encyclopedia of Sociology, New & Updated. Guilford, Conn.: Dushkin Publishing Group, 1981. Copyright (c) 1981 by DPG Reference Publishing, Inc. Reprinted with permission. (Fairchild 1976)--pp. 26, 30, 51, 62, 74, 90, 99. From Fairchild, H.P., ed. Dictionary of Sociology and Related Sciences. Totowa, N.J.: Littlefield, Adams, 1976 (orig. pUb. 1944). Reprinted with permission from Philosophical Library Publishers, copyright holders.

(Lingeman 1969)--pp. lll, 15-16, 21, 43, 49, 71, 72, 83, 84, 86, 99, 100. From Lingeman, R. Drugs From A to Z: A Dictionary. New York: McGraw-Hili, 1969. Copyright (c) 1969. Reprinted with permiSSion from McGraw-H ill Book Company. (Zadrozny 1959)--pp. 26, 27, 45, 46, 74, 80, 82, 86, 99. From Zadrozny, J. Dictionary of Social Science. Washington, D. C.: Public Affairs Press, 1959. Reprinted with permission.

THE EDITORS: Jack E. NeLson, HeLen WaLLenstein Peai$on, and MoLLie Sayeps, of Metpotec, Inc., Washington, D.C., paPticipated in deveLoping this pubLication for the NationaL Institute on Drug Abuse under Contract No. 271-80-3720. Thomas J. GLynn, Ph.D.; Division of ReseaPch, NID~. serv~d as co-editor in deveLopment of the materiaLs, and as NIDA proJect off~cer. CONTENTS

PREFACE v

INTRODUCTION

USE OF GU IDE 2

DRUG ABUSE RESEARCH TERMINOLOGY 4

REFERENCES 101

APPENDIXES 115 Appendix A: Drug Classification 116 Appendix B! Drug Slang Terms 121 Appendix C: Trade Names 121 Appendix D: Acronyms 129

fEB 10 1983

iii

.'''' PREFACE

The first volume of the Research Issues Series was published in November 1974. Since that time, 29 volumes have been published in this series by the Division of Research, National Institute on Drug AbusE". The primary objective of the Research Issues Series is to provide both lay and professional read­ ers comprehensive, yet succinct, information on topics of central interest to the drug abuse field. The approach frequently iJsed has been to r:-rovlde abstracts of the relevant literature on a par­ ticular topic. In other cases materials have been developed and written especially for the series. This volume falls in the latter category and addresses the need for a reference guide to the ter­ minology of the drug abuse field. It is based upon a draft compiled by Gregory Austin of the Southern California Research Institute and reviewed by an editorial board of drug experts whose names and affiliations are listed balow. The board members have not reviewed this extensively revised final edit.ion, and the editors, while gratefully acknowledging the seminal contribution of the board members, take major responsibility for any imprecision or errors that may" occur.

Richard J. Bonnie, J. D. Howard B. Kaplan, Ph.D. University of Virginia Department of Psychiatry School of Law Baylor College of Medicine Charlottesville, Virginia Houston I Texas

Marcelline Burns Dan J. Lettieri, Ph. D. Southern Cal ifornia Research Institute Psychological Sciences Branch Los Angeles, California Division of Research National Institute on Drug Abuse Sidney Cohen, M.D. Rockville,' Maryland Neuropsychiatric Inst:tute University of California--Los Angele:; Mary Macari Documentation ASSOciates, Inc. ·Peter Fehrenbach Los Angeles. Cal ifornia Graduate Student Departm~nt of Psychology Stanton Peele, Ph. D. University of Missouri Department of Health Education Columbia, Missouri Teachers College at Columbia University New York City George J. Huba, Ph.D. Department of Psychology Patricia B. Sutker, Ph. D. University of California--Los Angeles Chief, Psychology Service Veterans Administration Medical Center Bruce Johnson, Ph.D. New Orleans, Louisiana Research Scientist New York State Division of Substance Abuse Services New York City

v

I 6' INTRODUCTION

The drug abuse field consists of an amalgam of medical i social, and psychological disciplines. This, in turn, reflects upon its terminology, which ranges from colorful slan'g to advanced bio­ medical nomenclature. The breadth of drug abuse terms is thus vast and varied--from 4-letter slang to 10-syllable chemicals and from conceptualizations based on street-wise hip to those taken from advanced molecular biomedicine. For example, a SOCiologist in the drug- field may be found observing a street dude who is taking care of business hussling bags of China White so he can cop some real good snow; an epidemiologist may be concerned about the balloon effect likely to occur with implementation of a supply reduction strategy; a doctor may prescribe nepenthes, soporifics, or ergogenics to help patients cope; and a biochemist may "be interested in studying ,the dose-response relationship of cholinergic agents on the parasympathetic nervous system. A vast array of drug users, dealers, clinicians, researchers, teachers, U.<:orists, politicians, and others related to the drug abuse field have produced a large lexicon of terms that vary from the simple, but often clever, to the ultracomplex. Many drug terms are ambiguous, especially slang, and their meanings may vary over time (e.g., blues, black beauties, white stuff, kif, narcotic). Other terms may be deadly concise but are often confUSing to lay readers and professionals alike (e.g., endorphin/enkephalin, agonist/antag-. onist, analgesic/anesthetic, congenerlligand). There frequently are slang and scientific terms for the same concept (e.g., to insufflate/to blow, to inject/to shoot up, diacetylmorphine hydro­ chloride/horse, smack, or junk). Some terms have exotic sounding names (e.g., sinsemilla, khat, etonitazene), and others though widely used are grossly imprecise (e.g., high, addiction, toler­ ance, drug abuse, treatment). Explosive discoveries in the field are producing new and rapidly evolving terms, many of which are not currently defined in dictionaries or other standard reference works. These terms are defined only in the research literature where they are being discussed and debated. Examples of this type. include the constantly expanding list of newly identified endogenous agonists, the newer urinalysis screening techniques, and the newer approaches to treatment. This Guide to Drug Abuse Research Terminology attempts to bring a major segment of the myriad assortment of terms found in the drug abuse field under one cover and to present in glossary form definitions of many of the drug abuse terms that have to date been described only in the research literature. It has been designed and written to serve as a convenient guide for those requiring brief, nontechnical explanations of drug abuse terms. It can, however, also be used as a sourcebook for those interested in exploring drug abuse concepts in further depth through the numerous reference citations included and the cross-references to NI DA 's Research Issues Series. In selecting terms for inclusion, a careful analysis of the field's terminology was undertaken. A primary source was the abstracts and the ind~xes of the NIDA Research Issues Series. Now covering over ',000 documents and 26 volumes, the series deals with almost every aspect of human drug research. In the final selection process, four principal criteria were used: (1) the frequency with which a term appeared in the literature, (2) the importance of the term to the field, (3) the extent to which a term might be unfamiliar to individuals outside certain disciplines; and (4) the extent to which confusion or ambiguity surrounded a term's definition or usage. The definitions provided are intended to reflect preferred or common use at present. They were developed either from the professional drug research literature, particularly that covered by the Research Issues Series, or from specialized dictionaries in the field and in related disciplines. Whenever possible. definitions were drawn direct.ly from the research literature. In these instances, since it was not possible to cite all the materials pertaining to a particular term, topic, or concept, at least one source is cited for the interested reader. 2 USE OF THE GUIDE

The guide consists of the main body of definitions and appendixes containing a general drug classification scheme, a comprehensive collection of slang terms for selected drugs, and a list of the acronyms and abbreviations frequently encountered in the drug abuse field and described in the main body of this volume. Terms are Iisted in alphabetical order. Drugs are defined under their generic names. Brand names (as listed in the 1981 Physician's Desk Reference) are presented in the body of the drug definitions. Users starting out with brand names only are referred to appendix A, where both brand and generic names for all of the drugs contained in this volume ap -'ear. Drug definitions also indicate the drug's classification and common slang names. A complete clas­ sification scheme for the drugs contained in this guide is presented in appendix A. Only the most common and currently used drug slang terms are included in the body of the definition. If the drug is one of those for which a comprehensive list of slang ter:ms is presented in appen­ dix B, the reader is referred there. The inclusion of nondrug slang terms in this volume was done sparingly for the reasons that (1) there are numerous, well-done drug slang dictionaries currently in existence, and (2) the primary emphasis of the guide is on research-literature-based terminology. Only those slang terms are included that are frequently encountered in the literature and/or are conceptually important in understanding drug abuse issues (e.g., rush, booting, chipping). Readers inter­ ested in defining drug slang terms are referred to the bibliography in appendix B. Terms that appear in the body of definitions with all letters capitalized are defined elsewhere in the guide. Terms appearing in the guide that may be useful to the reader of a particular defi­ nition are noted at the end by "See: ... " or "See also ...• " Research Issues Series Volume 27, Guide to the Orug Research Literature, is a cumulative index to the first 26 volumes in the series. If the term being defined is indexed in Research Issues Series Volume 27, the term or related term, the page number, and the number of literature ref­ erence entries to be found there are listed in parentheses at the end of the definition. Terms in the guide that are listed in volume 27 are indicated at the end of individual entries in the following ma'mer: (RI S 27: 300--33 entries)

This entry, for example, refers to Research Issues Series No. 27:page 300--33 entries listed. A reference may also be included for a term that is different from but related to the term being defined. For example: term: anesthetics reference: (anesthetic uses, RIS 27:304--8 entries) The format components for the definitions are explained and demonstrated graphically in figure 1 on the following page.

l Term being defined, listed in word-by-word alphabetical order.

All caps indicates this ~~ Related terms that may word is defined else­ The least potent of the amphetamines, be useful to the reader where in the guide. manufactured as Benzedrine. Synthesized ~ that are defined else­ in 1927, it was first used in 1932 as an where in the guide. . inhaler decongestant and in the treatment '- )of ~~l;;"EDIl. During World War II it was used on troops to counteract fatique. stimulants--primary. m methamphetamine hydrochloride; dex­ troamphetamine suLfate~~~: ..... __...... bennies, benz. (~lr~m1i~, RIS 27: 199--136 entries; Benzedrine, RIS 27:202-- w 12 entries)

Classification of this drug according to the scheme shown in Frequently used slang appendix A. Terms indexed in RIS names. summa ry volume 27-­ "amphetaminesll appears on page 199 and has 136 references; "Benze­ drine," a related com­ pound, appears on page 202 and has 12 references.

FIGURE 1.--Definition components 4

abuse, drug See drug abuse.

abuse potential !hr: ~endeni::y :or a certain percentage of absolute alcohol indiViduals takmg a drug to fall into abuse The calculated amount of ALCOHOL, free patte:rns (Balter 1974); the tendency of a particular drug to be susceptible to abuse. from water and other substances, in bev­ (RIS 21:30--1 entry) erages such as beer, wine, and distilled spirits. (RIS 27:198--118 entries) acetone absorption A volatile ketone HYDROCARBON com­ monly used as a SOLVENT in such prod­ The pa~sage of chemical compounds, such as nutrients or drugs, through bodily ucts as fingernail pol ish remover and plastic cements. Classification: volatile membranes, such as the intestinal lining inhalants. (inhalants, RIS 27:210--5 or the skin, into the bloodstream. entries) abstinence acetylation The total avoidance of a behavior or sub­ The process of introducing an acetyl molec­ stance, especially with regard to food ular group into an organic compound; for intoxicating drinks, or drugs. State ~f example, the acetylation of morphine pro­ being drug free; may apply to a particular duces diacetylmorphine or heroin. drug 0: to all drugs; usually implies illicit, recreational drugs. Abstinence from drug acid use may be accompanied by WITHDRAWAL A type of chemical compound found abun­ SYNDROME. Winick (1974) has nroposed da~tly in nature :md easily synthesized. several basic reasons for tempo~ary or ACI~s range from relatively simple inor­ permanent abstinence from illicit drug use: ganic compounds to ultra-complex organic compounds. Acids combine with ALKALIS 1. External circumstances--drug not avail­ to form salts. able, lack of money, court pressure, leave community, job, response to Also slang. See LSD. threat. acting-out behavior 2. Relationships jeopardized by continued Carrying repressed impulses into action. d~ug use--Ioss of a significant relation­ ship, friends, family difficulties. active ingredient 3. Weariness--hassle exceeds user's thresh­ The ALKALOID or chemical in a plant that produces mind-altering and toxic effects. old, reaching a nadir or "existential Also called "active principle" or "active moment," high not achievable. constituent. " 4. Personality and insight--sense of mal­ adaptiveness of drug, decl ine in coun­ actuarial prediction A set of methods for searching and iden­ terphobic pressures, a sense of move­ tifying homogeneous subtypes or classes ment into psychosis, insight into of individuals, and for predicting or destructive aspects of use, desire to understanding their behavior with a clin­ change life. icall~ ,and socially significant degree of 5. Physical pr'oblem--symptoms of illness precIsion. The methodology is more in the tradition of insurance· research and that are incapaCitating. population surveys than of psychology or See also temperance. (RI S 27: 300--33 sociology, in which one develops actuarial entries) tables in order to predict such attributes as probability of a tobacco smoker's death abstinence syndrome ~t ,a given age. In psychological testing, See withdrawal syndrome. It IS used to predict a diagnostic classi- 5

fication from a series of test scores (Sines to the· OPIATE NARCOTICS. Like the 1976) • popular concept of narcotics, this classical definition emerged in the 19205 out of a acute blending of popular and scientific terminol­ Of short duration and usually of great ogy laden with emotional and imprecise sharpness or intensity. Contrast with meanings. The term lIaddictll began to be chronic. increasingly stigmatized and used by both the scientific and lay communities to addict express that the compulsive use of opiates A nebulous term that generally refers to was not just a bad habit but was worse one who habitually uses drugs, especially both to the individual and society than morphine or heroin, to the extent that other forms of habituation, such as to cessation causes severe physical or psy­ tobacco and alcohol, and resulted in debil­ chological trauma or both (Encyclopedia of ity, insanity, crime, and death. Sociology 1981). Rittenhouse (1977: 243) suggests reserving this term to medical Recent historical and research data have diagnosis describing a physical or psychic shown, however, that the two fundamental dependence (as judged by the diagnosti­ components of this classical definition--that cian). See also addiction. addiction is purely physiological and that opiate narcotics are the sole source of addiction addiction--are not valid ani in fact the From the Latin verb uaddicere,1I to give stereotype of the addict is often fictional or bind a person to one thing or another. (Peele 1977; Johnson 1978). Many heroin Generally used in the drug field to refer users remain chippers (see CHIPPING) or to chronic, compulsive. or uncontrollable controlled occasional users for years drug use, to the extent that a person (Powell 1973; Jacobsen and Zinberg 1975); (referred to as an "addict") cannot or will many users voluntarily give up heroin not stop the use of some drug. Beyond relatively easily under changing circum·" this, the term is ambiguously used with a stances (Robins 1973; Winick 1962), and wide variety of often arbitrary meanings opium has been used for centuries in India and connotations; sometimes interchange­ without a serious addiction problem devel­ ably with, sometimes in contrast to, two oping. Furthermore, it has been shown other ill-defined terms, HABITUATION that some heroin users have believed them- and (DRUG) DEPENDENCE, the former 'selves to be nhysiologically addicted ev:en imprecisely referring to some lesser form though the amounts they consume are much of chronic drug use, the latter capable of too small to have any such effects and being either of psychological or physical that opiate withdrawal syndromes can be a origin, often in varying combinations conditioned response occurring with very depending on the drug. I t usually implies low levels of consumption and even total a strong (PSYCHOLOGICAL) DEPENDENCE absence of opiate use (Fazey 1977: 10) . and (PHYSICAL) DEPENDENCE resulting Many emphasize that addiction cannot be in a WITHDRAWAL SYNDROME when use used solely in regard to the opiates nor of the drug is stopp'ed. Many definitions can it be used solely as a synonym for place primary stress on psychological fac­ physiological dependence: "Addiction can­ tors, such as loss of self-control and over­ not be used interchangeably with physical powering desires; Le., addiction is any dependence. It is possible to be physically state in which one craves the use of a dependent on a drug \yithout being addicted. drug and uses it frequently. Others use It is possible to be addicted without being the term as a synonym for physiological physically dependentll (Jaffe 1975: 285) . dependence; still others see it as a com­ bination. From the 1920s and to the early 1960s an attempt was made to differentiate between The primary popular stereotype, what has ADDICTION and HABITUATION. In the been called the IIclassical definition of mid 1960s the World Health Organization addiction," is that it is an extraordinarily recommended that both terms be abandoned debilitating vice ordisease--even an evil in favor of drug dependence (Eddy et al. and sinful state--rooted in the invariable 1965) • Since then, many authorities have pharmacological effects of a drug on the. recommended that, like the term lIabuse,lI human body, an irrevocable process that the term lIaddictionll has been applied so involves the presence of tolerance and arbitrarily and illogically that its use results in a withdrawal syndrome that can should be entirely abandoned. Neverthe­ be avoided only by total abstinence (Peele less, lIaddiction ll and "addict" are still 1977) . The classical definition of addiction widely used, particularly in regard to the further links this phenomenon particularly opiate narcotics. As Bean (1974) observes, 6

this may be due to the popularity of the adulteration term as well as the fact that it is simply To make a drug inferior or impure by add­ easier to refer to an "addict" than a "drug ing an improper substance. Drugs are dependent person" and that the substitu­ often adulterated by more active substances tions so far recommended, such as "drug in order to increase the desired effects or dependence,1I ha'o';. only marginally affected to make users think they are getting a the underlying dd'initional problems sur­ more potent drug (Helisten 1977). See rounding this word. Others increasingly also dilution; misrepresentation, drug. emphasize that the solution to this defini­ (adulterants, RIS 27:301--9 entries) tional problem is not to avoid all use of "addiction" but to cultivate an understand­ adverse drug reaction ing that addiction is not a purely pharma­ A negative somatic or psychological reaction cological process linked to the opiates or to drug taking. A major problem in drug any other drug. It is not drugs who research has been the lack of agreement addict people but people who become concerning what actually constitutes an addicted to drugs, just as they can and adverse reaction; many studies do not dis­ do become addicted to any compelling tinguish between types of adverse reac­ experience (Laurie 1971; Peele 1976, 1977, tions, or they use subjective or poorly 1978). (addiction careers, RIS 27:301--10 defined definitions. Naditch (1974) empha­ entries; addiction models, RIS 27:301--16 sizes the need to distinguish between acute entries) and chronic adverse rear.:tions. Acute adverse reactions include feelings of losing addiction-prone personal ity control, disintegration, fears of insanity A theory of ADDICTION that states that or death, despair, suicidal thoughts, and only certain kinds of individuals with spe­ strong negative affect. Naditch excludes cific psychological affinities that are satis­ from the definition of this term counter­ fied by opiate narcotics will take favorably normative behavior (i. e., reactions to the to these drugs and will continue to use drug experience that do not precipitate thelT, in the face of severe social opposition. an acute anxiety state) and chronic or More recently the addiction-pre"'.2 theory long-term reactions. Greenblatt and has been discounted by many researchers Shader (1975) state that, "Many clinicians who argue that addicts do not make up a feel that individuals who are emotionally homogeneous group but, rather, reflect stable and well-adjusted benefit most or divergent personality configurations are harmed least by drugs of abuse, v.'hile (Gendreau and Gendreau 1970). (RIS those who are labile of affect and who 27:364--8 entries; personality factors, RIS have difficulty coping with ambiguity, 27:364--86 entries) uncertainty, dysphoric sensations, or dis­ torted perceptions are more likely to Addiction Research Foundation experience adverse drug reactions. II A Canadian nonprofit organization involved Although cases of psychological drug reac­ in drug abuse research and prevention. tions, or so-called "bad trips, II are usually The foundation produces publications, associated in the mind of the public with journals, newsletters, and films and other the use of hallucinogens, they may also audiovisual materials. Address: 33 be caused by the use of AMPHETAMINES, Russell Street, Toronto, Canfia M5S 5S1. anticholinergics, ANTIHISTAMINES, and SEDATIVE-HYPNOTICS. See also effects, additive effect drug; panic reaction; psychosis, toxic; The action obtained when the combined flashback. (RIS 27:301--68 entries; hyper­ effect of two separate entities, such as sensitivity reactions, RI S 27: 346--2 entries) drugs, taken together is the sum of the two separate effe('ts. Contrast with synergistic aerosol effects; potentiation. A chemical compound and a gas propellant in a can with a valve through which the administration, route of SUbstance is dispensed as a suspension of The method by which a drug is introduced ultramicroscopic solid or liquid particles. into the body, such as by oral ingestion, See also volatile inhalants; fluorocarbons; INTRAVENOUS injection, SUBCUTANEOUS sudden sniffing death (SSD) syndrome. injection, I NTRAMUSCULAR injection, (inhalants, RIS 27:710--5 entries) INSUFFLATION, smoking, or absorption through the surface of th( gums, anus, affect or genitalia. See paraphernalia. (RIS A broad class of mental processes refer­ 27: 377--37 entries) ring to a person1s emotional feeling or mood, often used interchangeably with adrenergiC emotion. An immediately expressed and See neurotransmission. observed emotion. Historically, affect has 7

been distinguished from COGNITION and <-ontain about 2 percent to 17 percent alco- . volition. hoi; distilled spirits can contain over 90 percent alcohol (e.g., grain alcohol). aftercare Classification: sedative/hypnotics. See In drug abuse treatment, the package of also absolute alcohol; liquor. Slang names: services provided the client after success­ booze, juice. (RIS 27:198--118 entries) ful discharge from the program. Brown and Ashery (1979:165) define aftercare as A Icohol and Drug Education Service IIthose community interventions designed A Canadian organization involved in drug to permit the client's effective irtegration/ abuse prevention. It maintains a lending reintegration into society. . .. Aftercare library and develops extensive bibliog­ activities can be viewed as a first line of raphies on alcohol and drugs. defense against return to drug use." A ftercare activities would include involve­ Alcohol, Drug Abuse, and Mental ment in activities such as self-help groups, Health Administration (ADAMHA) supported work programs, and staff fol­ An umbrella agency within the Public lowup contacts and inteventions. Health Service of the U. S. Department of Health and Human Services. In addition agitation to its own administrative staff, ADAMHA Ext.:essive restlessness suggestive of severe consists of the National Institute on Alco­ internal tension; manifested by pacing, holism and Alcohol Abuse, the National hand wringing, fidgeting, and other forms Institute on Drug Abuse, and the National of constant motor activity. One of the Institute of Mental Health. Address: 5600 major symptoms of nonfatal drug overdose. Fishers Lane, Rockville, Md. 20857. agonist alcoholism The original Greek meaning of this term ,'" ubiquitously used term with a wide vari­ denotes something involved in a struggle ety of ambiguous meanings about which for victory. Its pharmacological meaning th~re is little consensus. Sometimes used implies a substance that can bind at the narrowly as a synonym for alcohol ADDIC­ molecular level with a receptor site to pro­ T ION; other times used to refer to alcohol duce a pharmacological action. The inter­ abuse, or to any drinking problem. Some­ action of the agonist at the receptor site times viewed as a disease syndrome, other can be displaced by its ANTAGONIST, times not. Sometimes primarily character­ which ha::. the effect of completely or par­ ized by physical dependence, other times tially nullifying the pharmacological action as primarily psychological in origin (Clark of the agonist depending upon the purity 1975; Paredes 1976). As defined by Keller of the antagonist. HEROIN, for exaMple, and McCormick (1968): "A chronic and is an agonist; NAL TREXONE is a pure usually progressive disease, or a symptom antagonist to heroin; CYCLAZOCINE is a of an underlying psychological or physical mixed antagonist to heroin having some disorder, characterized by dependence on slight agonist properties of its own. See alcohol (manifested by loss of control over (narcotic) antagonist; receptors. drinking) for relief from psychological or physical distress or for gratification from alcohol alcohol intoxication itself, and by a con­ Commonly, any beverage that contains sumption of alcoholic beverages sufficiently ethyl alcohol {ethanol}, the intoxicating great and consistent to cause physical or sedative-hypnotic in fermented and dis­ mental or social or economic disability. tilled liquors. Made synthetically or pro­ Or, a learned (or conditioned) dependence duced naturally by FERMENTATION of on alcohol that irresistibly activates resort fruits, vegetables, or grains, alcohol is to alcohol whenever a critical internal or the oldest and the most widely used social environmental stimulUS occurs." Jellinek drug in the world. A eNS depressant, (1969) : "Any use of alcohol ic beverages depending on the concentration consumed, that causes any damage to the individual alcohol acts as an analgesic, tranquilizer, or SOCiety or both." Keller (1960): itA sedative-hypnotic, soporific, intoxicant, chronic disease, manifested by repeated anesthetic, or narcotic. At low <":oses, it implicative drinking, so as to cause injury can act as a stimulant. At high doses it to the drinker's health or his general func­ can create stupor. J se with other depres­ tioning." Dax (1977) defines an "alcoholic" sants, or with antihistamines or solvents, as "a person unable to correct the physio­ can be extremely dangerous. Alcoholic logical and other bodily disturbances which beverages are usually classified into the have accumulated as the result of his fermented drinks BEER and WI NE and drinking." See also substance abuse. DISTILLED SPIRITS. Fermented drinks (RIS 27:303--4 entries) 8

alienation access to cannabis and its derivatives An individual's feeling of dissociation or under existing Federal regulations. estrangement from the surrounding society. Address: P.O. Box 23691, L'Enfant Plaza Alienation may arise from feelings of power­ Station, Washington, D. C. 20024, (202)544- lessness, normlessness, mean ing lessness, 288 11. See also marijuana. depersonalization, isolation, or self- estrangement. See also anomie. (RIS allopathy 27: 303--18 entries) The main system of Western medical prac­ tice based on the philosophy of treating alimentary orgasm illness by counteracting the symptoms of Term coined by S. Rado (1926) referring illness; combating disease by remedies pro­ to the specific fixation point of the opiate ducing effects different from those pro­ narcotic user--the oral, pleasurable experi­ duced by the disease treated. Contrast ence that is diffused throughout the whole with hoi istic. body following the in'gestion of a meal. Rado hypothesized that the addict experi­ altered state of consciousness (ASC) ences a PHARMACOGENIC ORGASM, which A psychological state in which a person's resembles and is patterned on the alimen­ perception of time and space is somehow tary orgasm. influenced by autosuggestion or by the use of a chemical preparation. Any mental alkali state that is recognized as representing a A chemical compound which is caustic, or sufficient deviation in subjective experience base, in nature such as lye. An alkali or psychological functioning from the "cer- and an ACID neutralize each other to form tain general norms for an individual during a salt. alert, waking consciousness" (Ludwig 1972:11). Therefore, a broad, high-level alkaloids abstraction covering a variety of states A diverse group of some 5,000 bitter com­ induced by a variety of methods and pounds of plant origin containing nitrogen agents such as the phases of sleep and as well as carbon, oxygen, and hydrogen, dreaming, intoxication, meditative and that are usually physiologically or phar­ visionary states, delirium, and somnambu­ macologically active (e.g., produce mind­ lence (Bourguignon 1977:7). altering or toxic effects). Most medicinal and toxic plants, as well as hallucinogenic alternatives plants owe their biological activity to alka­ The alternatives concept has developed in loids. Examples include caffeine, mor­ the last decade as a major prevention phine, and nicotine. (THC, the primary approach to drug abuse. The underlying psychoactive ingredient in marijuana, is assumption is that illicit drug use becomes an exception.) The term is also applied a less attractive outlet for individuals who to synthetic (i.e., made by a chemical are involved with constructive activities process) alka~l)ids, which have structures of their own choosing. The key element similar to plant alkaloids. Often a synonym in the alternatives concept is process rather for ACTIVE INGREDIENT. than product. The specific activities and outlets are secondary. Of primary impor­ Alliance for Cannabis Therapeutics (ACT~ tance is the process that takes place within ACT is an alliance of patients, their fami­ the individual of exploring and searching lies and phYSicians, researchers, adminis­ for ways to satisfy inner needs. In the trators, and politicians organized for the words of Allan Cohen (1975), who has purpose of ending the Federal prohibition written extensively on alternatives: ilLog­ against using cannabis for medical applica­ ically, alternatives to drugs should corre­ tions. ACT works to repeal Federal spond to .J-"e motives impelling persons regulations which prohibit the medical toward e'r.crimentation or continued availability of cannabis; encourages and abuse. II See prevention models. supports the enactment of State and Fed­ eral laws which properly define cannabis American Council on Marijuana and as a drug with medical value; encourages Other Psychoactive Drugs, Inc. (ACM) aggressive .and neutral scientific study of A nonpr<>fit organization established to the cannabis plant for its therapeutic help reVf.,·se the epidemic national trends applications; provides' the public with fac­ in drug abuse. The ACM is concerned tual information on cannabis, its history, about all abused psychoactive drugs but medical applications, and the laws govern­ has especially targeted marijuana for a ing its use; helps individuals, phYSicians, concerted countercampaign. The ACM is State agencies, and others regarding the open to membership, sponsors cor.fGrances proper legal procedures used to obtain and symposia on drug abuse, and produces ~------9

publications and audiovisuals. Address: amphetamine relatives 6193 Executive Blvd., Rockville, Md. 20852, Also c::.llp.d lIamphetamine ANALOGUES" or (301)984-5700. "amphetamine CO NGEN ERS. II Synthetic drugs, such as METHYLPHENIDATE HYDRO­ amidon CHLORIDE (Ritalin) and PHENMETRAZINE Original German name for the drug METHA­ HYDROCHLORIDE (Preludin), that have DONE. characteristics similar to the AMPHETA­ MINES, with which they are often used amine interchangeably for recreational purposes. An organic derivative of ammonia and a Classi;'ication: stimulants--primary. basic functional molecular group that is (amphetamines, RIS 27:199--136 entries) one of the fundamental building blocks of biochemistry. It is the basic (caustic) amphetamine sulfate part of amino acid compounds and is a The least potent of the amphetamines, component of many natural and synthetic manufactured as Benzedrine. Synthesized psychodynamic substances ranging from in 1927, it was first used in 1932 as an natural dopamine to synthetic amphetamine. inhaler decongestant and in the treatment of NARCOLEPSY. During World War II it amines, sympathomimetic was used on troops to counteract fatigue. A group of drugs that produce effects Classification: stimulants--primary. See characteristic of those of the sympathetic also methamphetamine hydroc~loride; dex- nervous system (e.g., epinephrine, dopa­ troamphetamine sulfate. Slang names: mine) that prepare the organism for "fight, bennies, benz. (amphetamines, RIS 27: fright, or flight. II Amphetamines are syn­ 199--136 entries; Benzedrine, RIS 27:202-- thetic sympathomimetic amines. 13 entries)

amitriptyline hydrochloride amphetamines A tricyclic ANTIDEPRESSANT, manufac­ A general name given to a class of syn­ tured as Elavil. (RIS 27:199--3 entries) thetic sympathomimetic amines that are similar in some ways to the body's own amobarbital adrenaline (epinephrine) and that act with A common, intermediate-acting BARBITUR­ a pronounced stimulant effect on the cen­ ATE. Manufactured as Amyta! and, in a tral nervous system (Grinspoon and different form, as Amy tal Sodium. Classi­ Hedblom 1975). Chemically there are three fication: sedative/ hypnotics. similar types: racemic amphetamine or AMPHETAMINE SULFATE (Benzedrine), amotivational syndrome DEXTROAMPHETAMINE SULFATE (Dexe­ A phrase coined simultaneously by W. H. drine), and METHAMPHETAMINE HYDRO­ McGlothlin and L.J. West (196B) and David CHLORIDE (Methedrine, Desoxyn), with Smith (1968) to describe a condition associ­ amphetamine sulfate being the least potent ated with regular marijuana use by youths and methamphetamine the most, and dex­ in which the individual adopts an attitude troamphetamine having the fewest side and behavior that is asocial, nondirectional effects. Varying only in the degree of and cops out on established values. The control over peripheral effects and potency, amotivational syndrome is characterized by the amphetamines have been used medically apathy; loss of effectiveness; and a dimin­ as an aid in dieting by depressing appetite, ished capacity to carry out complex, as an energizer and euphoriant, as an long-term plans, endure frustrations, con­ antidepressant, to combat narcolepsy centrate for long periods, follow routines, (involuntary sleep), hyperkinesis, and to or successfully master new material. There promote alertness, retention, and wakeful- is a considerable controversy over whether ness. Widespread use and abuse of the amotivational syndrome does or does amphetamines occurred following World War not exist, but Dr. Sidney Cohen (in press) II when war-time stockpiles became avail­ notes, "A number of health care profes­ able and were marketed on a nonprescrip­ sionals .•. have ..• provided similar tion, over-the-counter basis, with use reports on adolescents and young adults. reaching epidemic proportions in Japan Apathy and loss of goals are mentioned in and Sweden (Ellinwood 1974). Now gener­ connection with consistent marijuana use. ally under Government control, in the It appears that almost every provider of United States amphetamines were first regu­ health care to young people has seen one lated with the DRUG ABUSE CONTROL or a series of such poorly motivated young AMENDMENTS OF 1965. Classification: men and women who have dropped out, or stimulants--primary. See also amphetamine who have had to drop out, of their school­ relatives; psychosis, amphetamine. Slang ing or job because of an inability to keep names: ups, uppers, speed, bennies, Up.1I (RIS 27:304--5 entries) dexies, hearts, pep pills, splash. See

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also appendix B. (RIS 27:199--136 entries; tionally. General anesthetics affect the pep pills, RIS 27:222--1 entry) entire body and may produce loss of con- sciousness. While a number of drugs amyl nitrite (e.g., barbiturates, cocaine) have anes­ A quick-acting volatile inhalant that dilates thetic properties, the principal anesthetics certain small blood vessels (primarily brain are the vaporous CHLOROFORM and ETHER, and h.eart),. lowers high blood pressure and the gaseous NITROUS OXIDE. Classi­ and relaxes the smooth (involuntary) mus­ fication: volatile inhalants. cles of the body. Effects take place within 30 seconds and last only 2 to 3 minutes. anodynes Unlike other inhalants, amyl nitrite is a See analgesics. stimulant rather than a depressant, and may be dangerous for people with low blood anomie pressure, glaucoma, or anemia. Among As initially developed by Emile Durkheim, illicit users, the drug is prized for its the concept referred to a state of society alleged sexual stimulation or prolongation characterized by a condition of relative of orgasm effects. Usually sold in small normlessness, a general breakdown or glass vials. Classification: volatile inhal­ absence of norms governing individual and ants. Slang names: pearls, snappers, group behavior, which developed out of amys, or poppers. instability and change and w~ich was char­ acterized by elements of anxiety, isolation, analeptics and purposelessness. As the utility of Drugs that act as stimulants or restora­ the concept for understanding diverse tives to the central nervous system, such forms of deviant behavior became evident, as caffeine or amphetamine. (Benzedrine, it was extended to refer to a condition of RIS 27:202--13 entries; caffeine, RIS individuals rather than their environment. 27: 202--6 entries) As conceptualized by Riesman (1950) and others, the psychological conception of analgesics anomie signifies a state of mind (not a A major classification of drugs that pro­ state of society) of an individual who no duce relief from, or diminished sensitivity longer has any moral roots or standards, to, pain (analgesia) without loss of cons­ no sense of continuity, folk, or obligation; ciousness; sometimes also called anodynes. the personal disorganization characterized Analgesics may be divided into three basic by an individual's feeling of detachment categories: (1) the OPIATE NARCOTICS-­ from society and its norms. In this usage, e.g., OPIUM, CODEINE, MORPHINE, the term is often used synonymously with MEPERIDI NE HYDROCHLORIDE (Demerol)' ALIENATION. As conceived by Merton HYDROMORPHONE HYDROCHLORIDE (1957:162-163), the sociological concept of (Dilaudid), HEROIN, METHADONE HYDRO­ anomie refers to "a breakdown in the cul­ CHLORIDE (Dolophine); (2) nonnarcotic, tu ral structu re, occurring particularly prescription drugs; (3) nonnarcotic, non­ when there is an acute disjunction between prescription, mild analgesics--e.g., aspirin the cultural norms and go<"ls and the (acetylsalicylic acid), acetaminophen socially structured capacities of members (Tylenol). In contemporary Western cul­ of the group to act in accord with them. II ture, the analgesics have been the major Merton argues that a situation such as objects for drug addiction and there has this leads to a higher rate of deviant been a continuing, as yet unsuccessful, behavior. (RIS 27:304--6 entries) effort to anorectic A drug that decreases appetite; used to analog treat overweight people. (anorexia, RIS A thing or part that is similar or compa­ 27:304--1 entry; obesity, RIS 27:357--8 rable in certain respects with something entries) else; in biology, similar in function but not origin and structure. The OPIOIDS antagonist are often referred to as "opiate analogues. II A drug that blocks or counteracts the See also congener. effect of another drug. See also agonist. anesthetics antagonist, narcotic A class of inhalant drugs that abolish the See narcotic antagonist. sensation of pain; used medically during surgical procedures. Local anesthetics produce loss of sensation only at the area antianxiety tranquilizers of drug injection and are not used recrea- See tranquil izers, antianxiety. 11 antidepressants antitussive A major classification of drugs that were A drug that relieves or prevents coughing. developed recently, are sold only by pre­ scription, and are used medically to anxiety improve mood in severely depressed An emotional feeling of apprehension, or patients. Generally divided into the tri­ threat, that mayor may not be sp~cifically cyclic compounds AMITRIPTYLINE HYDRO­ related to a cause. Often used loosely as CHLORIDE CElavi!) and IMIPRAMINE a synonym for fear and phobia. (RI S HYDROCHLORIDE (Tofranil). and the MAO 27:304--46 entries) IN HI B I TO RS, the antidepressants are rarely used for nonmedical purposes since anxiolytic sedatives they have little immediate pleasurable effect See sedative/hypnotics. on normal mood states (LeDain et al 1973). This varied group of drugs seems to have aphrodisiac a stimulant effect in cases of pathologic Any substance that heightens sexual depression but appears to have little effect arousal or enhances the experience of in normal states. Chronic usage, however, sexual activity. (RI S 27: 305--6 entries) has been shown to have dearly defined stimulatory action (Shulgin 1975). While arecoline some of the STIMULANTS have been medi­ An ALKALOID with CNS-stimulant proper­ cally used as antidepressants, their effects ties found in the BETEL NUT. are inconsistent. (RIS 27:202--1 entry; amitriptyline, RIS 27: 199--3 entries; imipra­ argot, drug subculture mine, RIS 27:210--1 entry) Specialized words and voca::'ulary generated and used by the drug subculture to antihistamines describe unique illicit drug use objects Nonbarbiturate sedative-hypnotics that and phenomena (e.g., "RUSH," "BOOT­ block the effects of the substance histamine ING," and IISPOON"), as opposed to gen­ on effector cells in the nerves and that eral slang drug terms (e.g., "busted" for are used in the treatment of allergies and being arrested or "dealing" for selling). the mitigation of symptoms such as sneez­ Street addict jargon. ing, itching, and runny nose. Usually they are abused with codeine or alcohol army disease because they act synergistically to magnify An expression often used as a synonym the sedative effects of both. Classifica­ for morphine addiction after the Civil War; tion: sedative/hypnotics. (RIS 27:202--1 also called "soldier's illness." During the entry) Civil War the hypodermic needle was first used to inject morphine, which was antipsychotic tranquilizers employed indiscriminately as an ANALGESIC. See tranquil izers, antipsychotic. Because only soldiers were so widely affected, the addiction became known as antisocial personal ity the army disease. A PERSONALITY DISORDER characterized by a basic lack of socialization and by arrest behavior patterns that bring the individual See drug arrest. (RIS 27:306--29 entries) repeatedly into conflict with SOCiety (A Psychiatric Glossary 1975). Also, a diag­ arrest rates nostic category recommended by the Amer­ See drug arrest. (RIS 27:305--34 entries) ican Psychiqtric A.-;sociation (1978) for persons over age 15 who demonstrate a Asklepieion history of "continuous and chronic ANTI­ A form of THERAPEUTIC COMMUNITY SOCIAL behavior in which the rights of established within a penal institution; others are violated. II This diagnosis is named after the temple of the Greek god recommended in place of the older psychi­ of healing. Pioneered by Dr. Martin atric categories "SOCIOPATHIC PERSON­ Groder at the maximum security Federal ALITY disorderll and IIPSYCHOPATHIC prison at Marion, Illinois, in the late 1960s PERSONALITY disorder. II Blaine and and early 1970s, this TC model incorpo­ J ul ius (1977: 5) raise the issue of whether rates concepts from Synanon and transac­ the classification of drug-dependent per­ tional analysis into a self-help microcosm sons as antisocial personalities implies, in of inmates within the prison setting (Jones effect, that such people are unfit to inter­ 1979). relate with "normal" people and are a devi­ ate subgroup for whom there is probably assay little help possible. A procedure for analY,zlng and quantifying

387-396 0 - 82 - 2 QL a I 12 the chemical components of a sUbstance. See also urine testing for drugs. ataractics (ataraxics) See tranquilizers.

ataxia Gross muscular incoordination as in alcohol bad trip intoxication. See pan ic reaction.

at-risk populations bag Subgroups within the population whose Slang. A quantity of leafy or powdered members have been identified as being par­ illicit drug (e.g., marijuana, heroin) that ticularly susceptible to becoming drug comes in a paper or glassine envelope or misusers. These subgroups are usually plastic bag. Local convention and prevail­ targeted by organized drug misuse preven­ ing illicit drug prices determine the quan­ tion efforts and often include groups such tities of drugs sold by the "bag." The as adolescents, the elderly, and middle­ terms "nickel" ($5) and "dime" ($10) bags aged housewives. have long been used as standard street retail units for the packaging of small quantities of drugs, but they have been autonomic nervous system made nearly extinct by inflation over the See nervous system. years. balloon effect automatism, drug Refers to the phenomenon of drug users The consumption of drugs without con­ substituting the use of one type of drug scious awareness of the amount being for another when authorities clamp down taken. This state occurs with heavy users on their original drug of choice; like a of central nervous system DEPRESSANTS balloon, when drug use is squeezed in and it has been suggested that it accounts one direction it often expands in another, for some deaths from BARBITURAT: over­ often with adverse results. For example, dosage. According tQ this theory, the heroin use increased in Southern California drug creates a confused state and the user after Operation Intercept's blockade of does not recall taking the dose; while in Mexican marijuana (Bryant et al. 1973). this condition the individual takes another capsule; this process often continues until bam a lethal overdose has been ingested. Mal­ Slang. Street name for PHENMETRAZINE colm (1971 :151) considers this theory HYDROCHLORIDE (Preludin). entirely speculative and unproven: "If a person takes an overdose of barbiturates barbital he intends either to die or to indicate to One of the long-acting BARBITURATES. certain significant people that his environ­ Manufactured in 1883, barbital was one of ment must change. If his intention is the the first barbiturates used in medicine. latter and he dies, it is accidental, but Manufactured as Veronal. Classification: this accident is not due to automatism." sedative/hypnotics. aversion therapy barbiturates In BEHAVIOR MODIFICATION, the reduc­ The largest and most common group of tion of a behavior through a conditioning the synthetic sedative/hypnotics. In small procedure in which the behavior is associ­ doses they are effective in sedation and ated with real or imagined noxious stimuli in relieving tension and anxiety, and, like (for example, an electric shock), which TRANQUILIZERS, they do not cause much would be avoided if possible (Chaplin drowsiness. In larger doses they are used 1975) . A tr'eCltment that suppresses unde­ as hypnotics (sleep inducers). Certain sirable behavior by associating a painful barbiturates are used for epilepsy and or unpleasant reaction with the behavior intravenous anesthesia. When large dos­ (A Psychiatric Glossary 1975). Aversion ages are not followed by sleep, signs of therapy is frequently used in smoking ces­ mental confusion, euphoria, and even stim­ sation programs. ulation may occur, similar to that produced 13 by ALCOHOL, another sedative/hypnotic. blues, blue heavens (based on the unique Hence barbiturates are often used recrea­ colors of their pharmaceutical capsules); tionally by people seeking similar effects barbs, downers, down, goofball s, sleeping to those produced by alcohol, often com­ pills. See also appendix B. (RIS 27:202-- bining the two. As alcohol potentiates 48 entries; pentobarbital, RIS 27:222--1 (see POTENTIATION) barbiturate effects, entry; phenobarbital, RIS 27 :223--2 this practice is extremely hazardous. Bar­ entries; secobarbital, RIS 27:223--4 biturates are also used in combination with, entries) or as a substitute for other depressants, such as heroin, and are often taken alter­ beer nately with AMPHETAMINES, as they tend An alcoholic beverage obtained by the FER­ to enhance the euphoric effects of ampheta­ MENTATION of barley malt or other grains, mines while calming the overwrought nerv­ often "hoppedll (flavored with hops or ous states they produce. In large dosages other aromatic bitters). Most beers con­ they can cause severe porsoning, deep tain 3 to 6 percent alcohol by volume comas, respIratory and kidney failure, (compared to 25 to 50 percent for distilled and death. Thus barbiturates playa lead­ spirits and 8 to 14 percent for wine). ing role in fatal poisonings and suicides Prior to the 18th century, beer was dis­ in the United States. (DRUG) AUTOMA­ tinguished from ale by being hopped; with TISM has been identified as a potential the industrial ization of brewing in the 18th cause of deaths due to excessive barbitur­ century, all malt liquor gradually became ate use. hopped and beer and ale 'are now generally synonymous. I n the early 19th century, Since first used in 1903, over 2,500 bar­ beer was regarded as a foreign urban drink biturates have been produced, but only in the United States (Keller and McCormick 50 commercial brands are now available 1968) . Classification: sedative/hypnotics. and only 12 are widely used. In 1970, barbiturates and barbiturate substitutes behavior disorder accounted for 28.6 percent of all prescrip­ A broad term that describes a behavior tions for psychoactive drugs in America abnormality believed not to be associated (National Commission on Marihuana and with specific organic causes or symptoms. Drug Abuse 1973:43). Although still con­ I n general, the term is used for abnormal­ sidered indispensible in medicine, their ities that affect general and social adjust­ medical applications .have declined primarily ment, such as drug use, antisocial behavior, due to the availability of other drugs with and crime. similar effects such as the antianxiety tranquil izers and other nonbarbiturate behavior modification sedative-hypnotics. The changing of human behavior through conditioning or other learning techniques; The barbiturates are usually divided into often used as a synonym for BEHAVIOR three categories according to the rate of THERAPY. One of the major concepts speed with which they are eliminated from employed by THERAPEUTIC COMMUNITIES. the body: (1) long-acting (6-24 hours)-­ See also aversion therapy. PHENOBARBITAL (Luminal), BARBITAL (Veronal); (2) short-to-intermediate-acting behavior therapy (3-6 hours)--PENTOBARBITAL SODIUM The systematic application of learning prin­ (Nembutal), SECOBARBITAL SODIUM ciples and techniques to the treatment of (Seconal), Tuinal (a secobarbital sodium/ behavior disorders that focuses on attack­ AMOBARBITAL combination), and BUTA­ ing the symptoms rather than tracing the BARBITAL SODIUM (Butlsol Sodium or history of the problem as in traditional Buticaps); and (3) ultra-short-acting forms of psychotherapy (Chapl in 1975). (under 3 hours)--THIOPENTAL SODIUM BEHAVIOR MODIFICATION is often utilized (Pentothal). The most widelv abused and as a synonym, although the American Psy­ dangerous are the short-to-i"ntermediate­ chological A ssociation views behavior ther­ apy as one method of behavior modification, acting barbiturates. Primarily prescribed along with aversion therapy (Kinkade 1974). to treat sleep disturbances, they are the ones most likely to be used to produce behavioral pharmacology intoxication, to be found on the illicit market, and to be used in suicide attempts. The branch of pharmacology that deals with the effects of drugs on behavior, I tl Great Britain, the suffix lI-aJlI is usually replaced by II-one, lie. g.. barbitone particularly operant behavior processes. instead of barbital. Classification: seda­ See dose-response relationship. tive/hypnotics. Slang names: rainbows, blue devils! reds, yellows, yellow jackets, benzene A toxic, volatile hydrocarbon derived 14

mainly from the carbonization of coal, the The researcher, however, is aware of prolonged inhalation of which results in which treatment is being used. Also called acute poisoning. It is used extensively II single-blind. 1I See also double-blind in the petroleum, plastics, explosives, and study; placebo. pesticide industries and is found most com­ monly in gasoline, in rubber cement, and blockade effect in paint and varnish removers. Most coun­ The prevention by drugs of certain physi­ tries legally regulate the allowable exposure ologic or enzymatic actions; the prevention and concentration of fumes in its industrial of the effects of certain drugs by another use as a SOLVENT because of its ability agent such as the NARCOTIC ANTAGO- to produce leukemia and severe anemias. N ISTS (Dorland's Illustrated Medical Dic­ Also called benzol. Methyl benzene is tionary 1974). known as TOLUENE. Classification: vola- tile inhalants. See also naphtha. blood level The concentration of a drug, such as alco­ benzine hoi, in the blood, usually expressed in See naphtha. percent by weight. benzodiazepines blow A chemical group whose four derivatives Slang. To inhale or SNORT a drug, par­ are used as (ANTIANXIETY) TRANQU ILlZ­ ticularly cocaine (llblow snow") or heroin. ERS and have little difference in their characteristics except duration of action. BNDD The four benzodiazepine derivatives are: See Bureau of Narcotics and Dangerous CHLORDIAZEPOXIDE HYDROCHLORIDE Drugs. (Librium), DIAZEPAM (Valium), OXAZEPAM (Serax), and CHLORAZEPATE DIPOTAS­ Boggs Amendment SI UM (Tranxene). In potency, the benzo­ A 1951 amendment to the HARRISON NAR­ diazepines are intermediate between the COTICS ACT of 1914, the NARCOTIC antianxiety tranquilizer MEPROBAMATE DRUGS IMPORT AND EXPORT ACT OF (Miltown, Equanil) and the (ANTIPSY­ 1922, and the MARIHUANA TAX ACT OF CHOTIC) TRANQUILIZERS derived from 1937. Reflecting the increased concern phenothiazine. Classification: sedative I over drug addiction following World War hypnotics. II, the amendment increased penalties for all drug violations and, for the first time benzphetamine hydrochloride in Federal criminal legislation, lumped A SYMPATHOMIMETIC AMI NE used as an together marijuana and IInarcoticli drugs, ANORECTIC. Manufactured as Didrex. establishing uniform penalties for violations Classification: stimulants--primary. of both the Narcotic Drugs Import and Export Act and the Marihuana Tax Act. betel nut Also for the first time, a mandatory mini­ A nut from the areca palm tree that when mum sentence of 2 years was established combined with catechu gum from the acacia for fi rst IInarcotic" violators and up to 1 0 tree and burnt lime and encased in a betel years imprisonment for repeat offenders leaf has mild stimulant properties. Pro­ (Lingeman 1969). In 1956, the NARCOTIC longed use causes the teeth and gums to DRUG CONTROL ACT further escalated develop dark red stains. The major active penalties. ingredient is arecol ine, an oily colorless ALKALOID. booting Slang. Street procedure when injecting bhang heroin of drawing blood into the syringe The name used in India for MARIJUANA. before injecting its contents to assure that Also the name for a beverage drunk in the needle is in a vein. I ndia that is made with ma rijuana and often contains milk. See also ganja; charas; brain disorder, acute marijuana. A disease SYNDROME resulting from tem­ porary impairment of brain tissue function biphasic dose-response relationship due to drugs, injury, or organic disease. See dose-response relationship. Sometimes called "acute brain syndrome. II Contrast with brain disorder, chronic. blind study An experiment in which the subject does brain disorder, chronic not know which of one or more drugs (one A disease SYNDROME resulting from rela­ of which is often a placebo) is being given. tively permanent, largely irreversible, dif"" 15

fuse impairment of brain tissue function bromides (Chaplin 1975). Sometimes called "chronic Nonbarbiturate sedative drugs that were brain syndrome." Contrast with brain first introduced into medicine in 1857 for disorder, acute. the treatment of epilepsy. Unl ike most DEPRESSANTS, bromides do not effectively breech birth induce sleep in large, single doses. They Delivery of a fetus with the buttocks, were wIdely employed, usually administered knees, or feet appearing first. May be chronically for their cumulative sedative associated with a traumatic delivery and effects. Overdosage of bromides can cause with asphyxia. Breech births occur at a serious mental disturbances similar to significantly higher rate among deliveries ALCOHOLISM and a disturbance of sleep. by narcotic addicted mothers. Replaced since 1900 by the BARBITURATES and other more effective, less toxic drugs, brick bromides are still employed as headache Slang. Compressed, brick-shaped kilogram remedies and nonprescription "sleeping of marijuana, the form in which large pi lis. II Classification: sedative! hypnotics. quantities of marijuana are often shipped. See also kilo. Brompton cocktail An analgesic drug concoction used in Brit­ British system ish HOSPICES to control chronic, intrac­ Most generally, refers to the medically table pain associated with cancer. It con­ oriented treatment of opiate users in Great tains heroin, cocaine, phenothiazine, and Britain, which has allowed users to obtain other drugs such as prochlorperazine, and use opiates legally. This medical, promazine, and chlorpromazine (Zentner noncriminal approach has been credited 1979). Hospital-prepared variations of with limiting heroin use, preventing the the Brompton cocktail have undetermined development of a black market, reducing shelf life stability depending upon pH f drug-related crime, and enabling addicts a!cohol concentration, and other variables. to lead more useful lives,. and has been An oral solution of morphine that contains recommended as a model for implementation 10 mg of morphine sulfate p~r 5 ml in a in the United States. It has been widely nonflavored vehicle that contains 10 per­ praised by advocates of heroin maintenance. cent ethanol has been approved. for com­ (See MAINTENANCE TREATMENT.) How­ mercial distribution in the United States ever, several problems surround the use by Philips Roxane Laboratories. It is of this concept. First, British pol icy has anticipated that this new oral narcotic undergone significant changes in the preparation will have Brompton cocktail­ course of the 20th century. Before 1968 like applications in the United Statli.'~. the Ilsystemll was not a government­ sponsored pt'ogram but rather a policy broom that allowed private physicians to treat A member of the bean family whose blos­ opiate users and prescribe maintenance soms are dried and smoked for their mildly doses. However, in the 1960s when heroin intoxicating effects. The active stimulant use among young ·males began to increase, ingredient in broom is cytisine, a 5ubstanGe this approach was altered and a new that is harmless when smoked but is toxic government-sponsored program was estab­ when taken ora II y . See legal highs. lished that imposed stricter controls on the manufacture, sale, and possession of buprenorphme opiate drugs, and instituted a program of A mixed antagonist/agonist with a long addict notification and treatment through duration of action. It requires less fre­ clinics. Addicts could still get maintenance quent administration than METHADONE; doses of low-cost heroin, but only from appears to block the toxic, euphorigenic, government-authorized treatment centers and dependence-producing effects of opi­ or from licensed physicians. Second, the ates; and acts as a competitive antagonist very nature and effectiveness of British (like NAL TREXONE) while producing cross­ policy before the 1967 act and afterward, tolerance (like methadone). Buprenorphine and its applicability or comparability to itself appears to produce I ittle physical the American situation (particularly the dependence; therefore, maintenance ther­ concept of heroin maintenance) are still apy could easily be terminated. Classifi­ controversial. Wh ile some observers view cation: narcotic antagonists. the clinics as a maintenance system, others maintain they are presently abstinence ori­ Bureau of Drug Abuse Control ented; others observe that the clinics are Enfo":::ement agency created by the DRUG in fact moving from using heroin to using A8U~E CONTROL AMENDMENTS OF 1965 methadone (Austin 1978: 165) • within the U.S. Department of Health, Edu- 16

cation, and Welfare charged with control­ butalbital ling the illegal traffic in certain stimulant, A short-acting BARBITURATE found as. a depressant, and hallucinoge.nic drugs component in many analgesic compounds. (Lingeman 1969). In 1968 these responsi­ Classification: sedative/hypnotics. bi Iities were transferred to the B UREA U OF NARCOTICS AND DANGEROUS DRUGS. butyl nitrite I nhalant drug that first appeared in 1969 Bureau of Narcotics and Dangerous Drugs after AMYL NITRITE was made a prescrip­ (BNDD) tion drug. Like amyl nitrite, inhalation Law enforcement agency created in 1968 produces a brief but intense Jightheaded in the U.S, Department of Just':e in which feeling by lowering blood pressure and were merged the responsibilities of the relaxing the smooth (involuntary) muscles Treasury Department's (FEDERAL) BUREAU of the body. Classification: volatile inhal­ OF NARCOTICS and HEW's BUREAU OF ants. DRUG ABUSE CONTROL. In 1973, the bureau was replaced as the lead agency in drug law enforcement by the DRU G ENFORCEMENT ADMINISTRATION.

Bureau of Narcotics, Federal Agency created in 1930 within the U. S. Treasury Department headed by the Com­ missioner of Narcotics which was respon­ sible for administering and enforcing those caffeine sections of the I nternal Revenue Code tax­ A wirlely used, mild stimulant found natu­ ing NARCOTICS and marijuana, the Opium rally in COFFEE, tea, cocoa, and cola Poppy Control Act of 1942, and the N A R­ beans. A white, bitter, crystalline sub­ COTIC DRUGS IMPORT AND EXPORT ACT stance, it has stimulant effects and con­ OF 1922. Its goal was to investigate, stricts blood vessels in the brain. detect, and prevent violations of laws pro­ Classification: stimulants--secondary. hibiting unauthorized possession, sale, or (RIS 27:202--6 entries; coffee, RIS transfer of opium, opium derivatives, syn­ 27:204--2 entries) thetic opiates, cocaine, and marijuana. (See HARRISON NARCOTICS ACT.) In caffeinism 1968, the agency was transferred to the The excessive ingestion of large amounts Department of Justice and was merged with of caffeine, usually in coffee or tea, for the BUREAU OF DRUG ABUSE CONTROL prolonged periods. This practice is a to create the BUREAU OF NARCOTICS common lifestyle element among certain AND DANGEROUS DRUGS. Canadian Indian yroups (excessive strong tea consumption) (Farkas 1979) and certain burnout types of white collar workers. Term used to describe a condition experi­ enced by chronic users who use a drug I ngestion of 200 mg of caffeine daily (an or drugs (mostly nonnarcotic) to the average cup of tea contains about 65 mg extent that their thought processes become of caffeine) can cause physiological prob­ impaired, and they take on a SPACED OUT lems and dosages in the 370 to 650 mg per or "vegged out" appearance and manner. day range are considered to be indicative Also, the saturation point reached by of physiological and psychological depend­ chronic drug users, particularly addicts, ence (Gilbert 1976; Grenden 1974). when the maladaptive ness of the lifestyle becomes so salient that the "hassle" Toxic reactions to excessive caffeine con­ becomes more important than the satisfac­ sumption are manifold and include (Farkas tion and the dependent person stops tak­ 1979): ing drugs (Winic,k 1978:233). Increasingly, also used among drug counselors or thera­ dizziness hard breathing pists to refer to a point in their career tremu lousness reflex hyperexcitability when they become disillusioned with their apprehension muscle twitching job and the profession in general. insomnia excessive sensibility diarrhea ringing in ears butabarbital sodium headache visual flashes of light One of the intermediate-acting BARBITUR­ lightheadedness heart palpitations A TES. Classification: sedative/hypnotics. breath lessness rapidity of heart action 17

nervousness absence of heart rhythm Alth'.:Jugh the number of leaflets may vary irritability flushing within a species, C. sativa normally has agitation hypotension seven leaflets, C. indica has nine, and C. ruderalis has three:--The leaflet of C. Canada, the drug problem in sativa is narrow, or lanceolate. The C. See Addiction Research Foundation; Alco­ indica leaflet is broad, or oblanceolate. hol and Drug Education Service; Commis­ And the C. ruderalis leaflet is oval, or sion of Inquiry into the Non-Medical Use eliptic, being broadest at the mid-length cf of Drugs (Le Dain Commission). the leaf (Anderson 1974, 1980). cannabidiol (CBD) All three species contain THC; C. indica A nonpsychoactive cannabinoid found in produces the most and C. ruderalis the MARIJUANA. It is currently under study least. for use as an anticonvulsive agent. Cannabis has been cultivated for thousands cannabinoids of years for its intoxicating flowering tops Chemical derivatives unique to the CAN­ and leaves, its fibrous stems and branches, NABIS plant, such as THC and CBD. and its nutritious seeds. A strain that is high in one of these three qualities tends cannabis to be low in the other two. C. indica, for A major classification of drugs derived example, is very low in fiber content but from the botanical plant class of the· same generates the most potent marijuana. C. name ("cannabis" is the Latin word for sativa produces the hemp fibers that have hemp). Both cannabis and marijuana are been used for centuries for making rope often used interchangeably as general and coarse woven products, but races of terms to refer to all of the various associ­ C. sativa high in this quality contain very ated preparations that are consumed for littleTHC (less than 0.5 percent). The their intoxicating properties. seeds of C. sativa can also be harvested for use as animal feed and for producing Botanists have been at odds since the 16th oil that is used in cooking and in making century over whether cannabis consists of paint. only one species (Cannabis sativa) or more than one species. That there are different The psychoactive effects from ingesting strains of cannabis has not been in ques­ cannabis vary considerably depending on tion; whether these strains possess qual­ such factors as potency, the SET (mood ities of a true species or lesser taxonomic and expectations) of the user, and the designations, such as races, ecotypes, environment in which the drug is consumed. cultivars, chemovars, and so on, has been Effects similar to the depressants, stimu­ at issue (Schultes and Hofmann 1980). lants, and hallucinogens have all been observed. Cannabis is, therefore, classi­ Current research indicates the classification fied in this volume as a category of its consists of more than one species. Bota­ own. See also marijuana, sinsemilla. (RIS nists such as Richard E. Schultes at 27:203--21 entries; hashish, RIS 27:205--27 Harvard University and Loran C. Anderson entries; marihuana, RIS 27:211--200 entries) at Florida State University conclude suffi­ cient scip.ntific evidence exists to support carbon tetrachloride three species of cannabis: Cannabis sativa, A highly tOXic, chlorinated hydrocarbon Cannabis indica, and Cannabis ruderarrs:-­ liquid, at one time widely used C. sativa grows to a height of 18 feet, is as a SOLVENT in cleaning fluids, which loosely branched, and thrives in cool, damp when inhaled produces INTOXICATION. cl imates. C. indica grows from 3i to 4 Toxic reactions include headache, confu­ feet, is conical in shape, and thrives i!1 hot, sion, depression, fatigue, nausea, vomiting, dry climates. C. ruderalis grows from 1 and death. Both the vapor and the liquid to 2t feet, is dense and never branches, irritate skin and eyes. Classification: and is found primarily in Russia. volatile inhalants.

There are other distinguishing features as cardiovascular effects well, related to cell and leaf structures. Pertaining to the heart and blood vessels. There are gelatinous fibers in the wood (RIS 27:309--36 entries) and vessels that exist singly or in small groups in C. sativa. C. indka has libri­ career form fibers in~wood and its vessels See effects, drug; career, addiction. occur in large groups. C. ruderalis is mostly intermediary in these characteristics. 18 career, addiction The Center administers national programs Heroin use is often referred to as a career for the prevention and control of commu­ in. that heroin users literally must work at nicable and vector-borne diseases and other maintainin.g their drug supply and their preventable conditions, including the con­ lifestyle and undergo a series of experi­ trol of chilqhood lead-based paint poisoning ences or activities that other heroin users and urban rat control. The Center di rects usually hold in common, such as initia,tion, and enforces foreign quarantine activities obtaining drugs, avoiding arrest, imprison­ and regulations; provides consultation and ment, treatment, and cycles of relapse assistance in upgradi ng the performance and abstinence (Waldorf 1973; Rubington of clinical laboratories, and evaluates and 1967) • The concept of career also is used licenses clinical laboratories engaged in to emphasize that, contrary to the belief interc;tate commerce; and administers a that heroin users are 5€eking escape from nationwide program of research, informa­ responsibility and Psych9!ogical problems, tion, and education in the field of smoking many are engaged in meaningful activities and health. and relationships on a daily basis that are challenging, adventurous, dnd rewarding The Center has also sponsored research (Preble and Casey 1969; Wikler 1973). on the health effects of consuming mari­ (RIS 27:301--10 entries) juana sprayed with the herbicide PARA­ QUAT (Smith and Seymour, in press). case history The information that has been recorded Center for Multicultural Awareness about an individual, family, group, or com­ A project of the National Institute on Drug munity. The term is most often used in Abuse, operated by Development Associates, social work agencies, and in sociological, Inc., as a resource center for black, medical, and psychiatric studies. Native American, Asian American, Puerto Rican, Mexican-American, and Hispanic catecholamine communities. The center identifies, A group of biochemical compounds having develops, and adapts culturally relevant sympathomimetic actions including the materials for drug abuse prevention, and ADRENERCIC agents epinephrine, norepin­ provides technical assistance to State agen­ ephrine, and dopamine. See also neuro­ cies to develop prevention plans, and to transmission. local programs within minority communities. Address: 2924 Columbia Pike, Arlington, causal Va. 22204, (703)979-0100. Carmen Maymi, Two phenomena are said to have a causal Project Director. relationship if the one affects and is inci­ dental to the occurrence of the other, central nervous system (CNS) rather than frequently appearing with but The brain and spinal cord. The primary coincidental to the occurrence of the other. bodily system affected by psychoactive For example, prolonged injection of heroin drugs. See nervous system. has a causal relationship to heroin addic­ tion. Heroin addiction is highly associated centrally acting drugs with liver disease, but there is no causal Drugs that exert effects on the central relationship as in the case of alcohol and nervous system. liver disease. The liver disease associated with heroin use has a causal relationship certified urine with unsanitary injection procedures and A urine specimen produced under observa­ not either the heroin or the addiction per tion by institution staff and certified to se. See corollary. (causal models, RIS be from the subject and not adulterated 27:310--3 entries) in any way.

Center for Disease Control A new technique that has been under The Center for Disease Control was estab­ study as a substitute for the method of lished as an operating health agency within observed urination is based upon the the Public Health Service by the Secretary measurement of urine temperature immedi­ of Health, Equcation, and Welfare on July', ately after the specimen is SUbmitted. 1973, and is the Federal agency charged Judson et al. (1979:198) in their research with protecting the public health of the found that 99 percent of urine measure­ Nation by providing leadership and direc­ ments fell in the range between 32.5 and tion in the prevention and control of 36.7 degrees centigrade using the following diseases and other preventable conditions. procedures: "In our clinic the lavatory Its main offices are located in Atlanta. adjoins the dispensary, with a shuttered 19

window in the wall between the two rooms, chipping through which the patient passes the Slang. Using heroin only occasionally. specimen immediately after urination. See also controlled drug use. (RIS 27:310-- There is no hot water and no electric out­ 3 entries; occasional heroin users, RIS let. Only one patient at a time is allowed 27:290--1 entry) in the lavatory. The patient is given a 60-ml screw-cap polypropylene urine bottle chlordl hydrate (4 cm diameter, 5.5 cm to neck, Riekus Trichloroacetaldehyde, a nonbarbiturate Container Co., Emeryville, California) and sedative-hypnotic derived from ethyl alco­ a Styrofoam insu lating cube measu ring 12 hoI, which was the first widely used syn­ cm on a side. The cube has a hole in thetic sleep-inducing drug. Combined with the center just big enough to hold the alcohol it produces acute intoxication: a urine bottle. Men are instructed to uri­ combination known as a Miclchemotherapy chlorpromazine The therapeutic use of chemical agents An antianxiety tranquilizer derived from for the treatment of disease. May refer phenothiazine, which is used for treating to METHADONE MAl NTENANCE (Deitch severe psychoses, acting to reduce the 1973), and!or the use of NARCOTIC patient's fear and hostility. It also ANTAGONISTS, which block the effects of reduces hallucinations and delusions and opiates (Blumberg 1973). has often been used as an ANTAGONIST in the treatment of LSD-induced panic China White reactions. Manufactured as Thorazine. Slang. Street name for alpha-methyl fentanyl , Classification: sedative! hypnotics. ( RI S a drug that has no recognized medical use 27:203--8 entries) and about which there is little available pharmacological information. It appears chlorprothixene to be a potent morphinelike narcotic anal­ An (ANTIPSYCHOTIC) TRANQUILIZER, gesic drug at least 100 times more potent manufactured as Taractan. than morphine. This extreme potency makes the strength of illegal IIstreetll prep­ cholinergic arations difficult to control, and abuse of See neurotransmission. this drug can result in overdose. Alpha­ methyl fentanyl may produce euphoria, chromosome damage physical dependence, and severe respi ra­ Chromosomes are threadlike materials found tory depression, effects similar to other in the nucleus of a cell that contain the narcotic drugs. The respiratory depres­ genes--the factors responsible for heredi­ sion may be reversed by a narcotic antag­ tary transmission. (RIS 27:310--13 entries) onist such as naloxone (Narcan) • 20

chronic Of long duration; descriptive of diseases The concept of civil commitment developed that progress slowly and persist for long out of the procedures established in the jjeriods. Contrast with acute. middle of the 19th century in which the State committed the mentally ill to public cigarettes asylums where they often remained until See tobacco; substance abuse. "cured." By the turn of the century the procedure had been adopted for the cure circumstantial-situational drug use of "inebriates," meaning chronic users of As defined by the U.S. National Commission alcohol or any other' drug. I n the 1920s' on Marihuana and Drug Abuse, drug use the responsibility for dealing with the that is usually task specific and self-limited. users of prohibited substances was surren­ Use is motivated by the perceived need or dered to the criminal process, but the desire to achieve an effect deemed desir­ "noncriminal" commitment process attracted able to cope with a particular sItuation revived interest in the early 1960s. Civil that is personal or vocational in nature. commitment programs were instituted in Examples would be athletes who use drugs California (the CIVIL ADDICT PROGRAM), to improve performance, and students who New York (the NARCOTIC ADDICTION use drugs wh ile preparing for examinations CONTROL COMMISSION), Massachusetts, (National Commission on Marihuana and and other States, and by the Federal Drug Abuse 1973: 96) . See also experi­ Government (the NARA program), following mental drug use; social-recreational drug the 1962 landmark Supreme Court decision use; intensified drug use; compulsive drug that held that narcotic addiction itself con­ use. (situational drug use, RI S 27: 384-- stituted an illness rather than a crime and 10 entries) could not be punished as a criminal offense. (See ROBINSON v. CALIFORNIA). Civil Addict Prugram, California The California CIVI L COMMITMENT pro­ Although various programs exist employing gram established in 1964. The program different therapeutic techniques, what was enacted in 1961 to provide IInonpuni­ uniquely characterizes all civil commitment tive treatmentll and to control the addict programs is the involuntary manner in "for the prevention of contamination of which addicts are recruited into the pro­ others and protection of the public ll gram through the CRIMINAL JUSTICE SYS­ (McGlothlin 1976; Kramer 1970). The pro­ TEM. An addict who has been arrested gram calls for mandatory periods of con­ for a crime can choose to stand trial or finement for treatment, followed by release enter a rehabilitation program lasting about to close parole supervision with chemical 3 years. I f the addict does not choose to antinarcotic testing. Commitment may take enter the program and is found guilty place in three ways: (1) 7-year commit­ While standing trial, authorities can still ment following conviction for a felony or send the addict to the rehabilitation center. misdemeanor; (2) 7-year commitment for Most programs incorporate provisions for being an addict or lIin imminent danger of the courts to dismiss criminal charges becoming an acjdict"; (3) voluntary, self­ upon successful completion. Civil commit­ commitment for years. Those most suc­ ment programs are not limited just to n addicts charged or convicted of crimes. cessfu
may earn early discharges. McGlothlin (1976) notes that the term llcivil .....rograms generally also include noncrimi­ commitment" is essentially a misnomer as nals (committed on the basis of suspected the system is really an alternative sentenc­ future criminal activity) and volunteers. ing disposition. The main inpatient facility IICommitment" is sometimes referred to as is the California Rehabilitation Center IIcertification" (Waldorf 1973 ~ 1 03) • (CRC) at Corona. Supporters argue that in order for treat­ civil commitment ment to be successful, compulsory con­ A compulsory procedure whereby a drug finement in a drug-free surrounding is addict is involuntarily confined for a speci­ essential and that it is the duty of the fied period in a special treatment facility State to safeguard and treat those who (sometimes only a modified prison) for are unable or unwilling to do so voluntarily. detoxification and rehaf">ilitation. Civil Critics argue that: (1) the program is commitment is not a treatment mechanism not really nonpunitive or different from per se but rather a vehicle for retaining imprisonment; (2) it has caused court con­ individuals while they participate in a given gestion; (3) it is an infringement on the course of treatment. It is this forced and right of noncriminal addicts to be free, prolonged supervision that distinguishes. an inherent contradiction to the notion of it from voluntary programs (Brown individual liberty; (4) it has not been suc­ 1973:132) . cessful in treatment; (5) commitment for treatment that has not been proven effec- 21

tive is cruel and unusual punishment; and jects experience only mild discomfort detox­ (6) the whole program is a subterfuge ifying with clonidine, and its use has been around the protection afforded to a person proposed as a transition drug to bridge accused of a crime but not afforded to the gap in moving addicts from methadone those suffering from an illness (Wicks and treatmlmt to antagonist (e.g., naltrexone) Platt 1977; McGlothlin 1976; Kramer 1970; treatment (Gold et al. 1980, 1978). Abromsky and McCarthy 1977; Beckett and Thomas 1976). See also diversion. (RIS clortermine hydrochloride 27:310--16 entries; civilly committed, RIS A SYMPATHOMIMETIC AMINE used as an 27: 279--18 entries) ANORECTIC. Manufactured as Voranil. Classification: stimulants--primary. clean Not carrying illicit drugs or not using CNS illicit drugs, particularly narcotics. Also See .:entral nervous system. used to describe the process of removing the seed and stems from marijuana (Linge- coca man 1969). Contrast with dirty. A bush (Erythroxylon coca) that is native to the mountainous regions of Central and Client Oriented Data Acquisition South America and whose leaves contain Process (CODAP) the ALKALOID cocaine. Not to be con­ A reporting system that is required to be fused with the cacao plant, which produces used by all federally supported drug abuse cocoa, Coca leaves have been chewed for treatment facilities. CODAP was originally centuries by the mountain Indians of Peru designed and implemented under the direc­ and Bolivia for a wide variety of medicinal, tion of the Special Action Office for Drug social, and religious purposes. Its stimu­ Abuse Prevention (SAODAP) in order to lant and appetite-depressant effects were replace a variety of incompatible Federal sought to counteract fatigue and hunger reports and to provide the single source and cold. Among the Incas, before the of comparable information needed for policy Spanish invasion, coca played a prominent management at the national level. The role in religious customs and ceremonies CODAP system is essentially composed of and was considered a divine plant. In two reports: (1) an Admission Report, the later part of the 19th century, coca which deals with the type of treatment elixirs, lozenges, and teas were commonly assigned to the patient, demographic data, taken in the United States and Europe; prior treatment experience, and drug most popular was Angelo Mariani's Yin usage patterns, and (2) the Discharge Mariani, an infusion of coca leaf and wine. Report, which provides information on In the 1850s, cocaine, the principal active reason for discharge, time in treatment, ingredient of coca, was isolated and was demographic data, and drug use status at hailed by many as a wonder drug. Beside time of discharge. Items from the reports cocaine, coca contains a number of other are included in NIDA Research Issues alkaloids and provides a rich supply of Series volume 12: Drug Abuse Instrument vitamins, prompting some researchers to Handbook. argue that the properties of coca lie in altogether different directions from those clinical of .;ocaine (Aldrich and Barker 1976:6). A method or approach toward the diagno­ Classification: stimulants--prima ry. sis and prognosis of adjustmental disorders and the prescribing of treatment centered cocaine on the investigation of background factors, An alkaloid refined from the coca plant family relationships, tests, etc. Clinical that is a short-acting but powerful stimu­ psychology is that branch of psychology lant pharmacologically similar to the that deals with the psychological knowledge AMPHETAMINES. Isolated in the 1850s, it and practices employed in helping a client was hai~d by many as a wonder drug. who has some behavior or emotional dis­ Freud recommended its use for the treat­ order. It includes training and actual ment of morphine and alcohol dependence, practice in diagnosis, treatment, and pre­ asthma, digestive disorders, depression, vention, as well as research (Chaplin 1975; and fatigue. It was also widely valued English and English 1958). and used as a local ANESTHETIC and nerve-blocking agent. Now stronger anes­ clonidine thetics with fewer stimulant side effects Originally developed as an antihypertensive have virtually eliminated its medical useful­ medicine, clonidine has been found to be ness, including such synthetic cocainel ike an effective nonopiate drug for controlling compounds as procaine (Novocain). By withdrawal from op:"ltes and opioids. Sub- the late 19th centu ry cocaine had also 22

achieved considerable popularity in the CODAP United States as a general tonic and addic­ See Client Oriented Data Acquisition Proc­ tion cure; its exhiiaratiJI~' properties made ess. it a favorite ingredient of medicine, soda pop (including Coca-Cola), and wine (VI N codeine MARIANI). In 1914 its use was controlled The (NATURAL) OPIATE methylmorphine, by the Harrison Narcotics Act, where it an alkaloid of OPIUM, usually extracted was incorrectly classified as a narcotic. from MO RPH IN E, whose effects it resem­ bles, but with only 1/6th to 1/10th the Effects incl ude eup horia, restlessness, analgesic action. I t is most often used as excitement, and a feeling of well-being. a pain reliever and an antitussive agent Users view it as a social drug that facili­ (e.g., in cough medicines). The opioid tates interaction (Petersen 1977:9), and PROPOXYPHENE HYDROCHLORIDE an ideal drug in terms of convenience of (Darvon) has similar effects but without use, bulk, effects, safety, minimal side the side effects of constipation and nausea effects, and no aftereffects (Siegel 1977). that codeine produces. Classification: As with the amphetamines, cocaine users narcotic analgesic agonists. (RIS 27:203-- often go on RU NS and chronic heavy use 3 entries) can lead to a "paranoid syndrome" in which the user is highly suspicious or nervous. coffee Classification: stimu lants--prima ry. See A stimulant beverage that contains 2 per­ also psychosis, cocaine. Slang names: cent CAFFEI NE, made from the beans of Corrine, coke, Bernice, flake, star dust, an evergreen shrub. snow. See also appendix B. (RI S 27:203--78 entries; anesthetic uses, RIS "Heart specialists in recent years have 27:304--8 entries) recogn ized that coffee is a mild poison and find that there is a clear association cocaine freebase between coffee drinking and later develop­ The manufacturing process of converting ment of coronary disease. R!!searchers in street cocaine or cocaine hydrochloride Canada and in Pennsylvania have found a into its "freebase," more purified form. positive correlation between consumption This process involves heating ether, lighter of caffeine and higher fatty acid levels in fluid, or similar flammable solvents and the blood. Thus too many coffee, tea, can be extremely hazardous. and cola breaks could be a factor in cer­ tain kinds of damage to the heart and cir­ Since cocaine in its normal street form is CUlatory system, including changes in not effective when smoked, an elaborate blood pressure" (Green and Levy 1976). do-it-yourself chemical process converts it See also caffeine. (RIS 27:204--2 entries) to a much stronger substance called "free­ base. II This pu rified cocaine base is cognition smoked in a water pipe or sprinkled on a The psychological processes involved in tobacco or marijuana cigarette for a 2- mental processes such as perception, minute, sudden and intense high. The thinking, learning, and reasoning; often substance is rapidly absorbed by the lungs contrasted with AFFECT (feeling) and voli­ and carried to the brain in a few seconds. tion (willing). However, the euphoria quickly subsides into a feeling of restless irritability. The cola freebase posthigh is so uncomfortable that Any stimulant beverage made from the cocaine smokers--in order to maintain the seeds of the kola tree that contains 2 per­ high--often continue smoking until they cent CAFFEI NE. are exhausted or run out of cocaine. cold turkey The smoking of cocaine originated in Peru Slang. To quit using heroin or morphine during the early 1970s. The custom and go through the resulting ABSTI NENCE quickly spread to several other South SYNDROME without the aid of pharmaco­ American countries, eventually traveling logical agents. The term supposedly comes to the United States. The South American from the onset of gooseflesh associated practice involves smoking coca paste, an with abrupt withdrawal. extract produced during the manufacture of cocaine from coca leaves. collapsed vein VENOUS TH ROMBOSIS. A malady, not Slang names: freebase, white tornado, uncommon among veteran heroin users, baseball, snowflake. caused by repeated injections in a vein 23

often precipitated by contaminants in the bling, interferes with the lives of others, injected material and unsanitary procedures. and feels badly about it all." After a regularly used vein collapses, other veins are usually sought in new conditioned abstinence areas of the body, including the arms, See extinction. hands, legs, feet, and neck. conditioning coma A basic learning process in which a given State of unconsciousness from which the stin Jlus comes to be associated with patient cannot be aroused, even by power­ ano.her stimulus or with a response. In ful stimulation. (RIS 27:311--7 entries) classical conditioning I a stimulus precedes and elicits a response. A stimulus that Commission of Inquiry into normally evokes a particular response is the Non-Medical Use of Drugs repeatedly paired with another stimulus The commission appointed by the Canadian that does not normally evoke the response. Government to study and report on the For example, a subject may be conditioned illicit use of drugs in that country. It is to salivate at the sound of a bell rung also known as the LeDain Commission. repeatedly before food is presented. In The commission produced a final report instrumental or operant conditioning, the that presents a comprehensive set of find­ subject first responds to a situation; this ings (LeDain 1973). response then is reinforced, either posi­ tively or n(.lgatively, by a stimulus. Behav­ Comprehensive Drug Abuse iorism has elaborated these forms of con­ Prevention and Control Act of 1970 ditioning into an encompassing account of See Drug Abuse Act of 1910. human behavior, which is seen as being largely the production of conditioning pro­ compulsive drug use cesses (Chaplin 1975). See also reinforce­ A classification of drug use, 3S defined ment, extinction. by the U.S. National Commission on Mari­ huana and Drug Abuse, that is character­ confidentiality ized by both high frequency and high In research, the protection of a respond­ intensity level s of rela tivel y long du ration, ent!s answers as privileged information. producing physiological or psychological Confidentiality, assuring the anonymity of dependence such that the individual cannot participants in drug abuse treatment pro­ discontinue such use at will without expe­ grams, is protected by Federal and vari­ riencing physiological discomfort or psy­ ous individual State regulations. The chological disruption. It is viewed as Federal regulations are contained in part primarily psychologically motivated and 2 of title 42 of the Code of F~deral Regula­ reinforced, stemming from the need to tions. These regulations require that the elicit a sense of security, comfort, or "Records of the identity, diagnosis, prog­ relief related to the person's initial reasons nosis, or treatment of any patient which for regularly using the drug (National are maintained in connection with the per­ Commission on Marihuana and Drug Abuse formance of any drug abuse prevention 1913 :97). See also circumstantial-situational function conducted, regulated, or directly drug use; experimental drug use; intensi­ or indirectly assisted by any department fied drug use; social-recreational drug or agency of the United States • . • be use. confidential. • . ." The content of such records may be disclosed with the prior compulsive gambling written consent of the person involved. Kusyszyn (1978) has identified four ele­ ments that may be used to distinguish be­ conformity tween different types of gamblers: money, A tendency to allow one's thoughts and/or time, other people, and the gambler. behavior to be shaped by prevailing atti­ According to Kusyszyn (1918: 1096), "The tudes and opinions; adherence to norma­ four factors are depicted as relatively inde­ tive behaviors and standards of groups to pendent: a lot of money is either won or which individuals belong. (RIS 27:312--8 It is lost; a lot of time or only a little time entries) is spent on gambling, other people are either interfered with or are not interfered congener with, and the gambler perceives himself A thing closely related to another thing; as healthy or he perceives himself as sick. a chemical substance closely related to . • • One common type of compulsive gam­ another and exerting like or antagonistic bier is depicted as a person who 'loses a effects. See also analog. lot of money, spends a lot of time gam- 24 congenital 6. To record movement off and on the ward Existing at and usually before birth, as on the Sign-In Sheet. distinguished from hereditary qualities or 7. To keep a daily record of requests made conditions fixed at conception (Hoult 1969). of the staff. Often refers to anomalous conditions 8. To seek employment or to work and/or present at birth, e.g., congenitClI malfor­ to seek admission to school or attend mations are birth defects. See also tera­ _lasses. togenic drugs. (congenital defects, RIS 9. To abide by daily pass hour limits. 27:312--16 entries) Beatty (1978) points out three necessary conjugal fami Iy requirements for a contingency contract See family, nuclear. with an outpatient heroin addict: lilt should substantially contribute to (1) main­ connection taining the continued participation of the Slang. A person from whom one can buy client, (2) demonstrating control over or obtain drugs, usually opiate narcotics. drug-taking and drug-related behavior, See also copping. and (3) adding to the client's learning of appropriate and adaptive behavior patterns consensual crimes to enable him/her to eventually function See victimless crimes. drug-free. 11 In either a residential or out­ patient situation, Beatty notes that to contact high achieve success it is essential that both Phenomenon whereby someone who is not the contingent rewa rds and punishments smoking marijuana but is in a confined be meaningful to the person making the area where marijuana is being smoked gets contract. or acts HI G H. control group contingency contract A group of subjects similar to the EXPERI­ A behavior modification procedure struc­ MENTAL GROUP in every respect -except tured to generate specifically agreed-upon for the independent variables with which activities by rewarding its engagement and the experimental group is being tested. punishing the failure to partake in it. In the contingency contract concept, the con­ controlled drug use tinuation of specified rewards and privileges The maintenance of regular, noncompulsive becomes contingent upon continuation of a drug use which does not interfere with set of agreed-upon behaviors, and vice ordinary functioning; also methods for use versa. It has the combined effect of mak­ which minimize untoward drug effects ing the participant practice PROSOCI AL (Harding and Zinberg 1977:111). See chip­ BEHAVIOR while also subjecting the indi­ ping. vidual to a certain amount of behavioral conditioning to reinforce the practice. controlled illicit drug use The persistent use over a period of time Contingency contracting is frequently used of illicit drugs without allowing them to in residential drug abuse treatment settings. bring abusive effects to the user. Prac­ These programs often use several nonnego­ titioners such as Norman Zinberg and tiable expected behaviors, as well as indi­ Wayne Harding point out that valuable vidually agreed-upon items, in their insights can be drawn by distinguishing contingency contracts. One residential between various degrees of drug use. drug abuse treatment program, for example, Their studies (Zinberg et al. 1977) profile uses nine basel ine contingency contract controlled users as individuals who maintain elements (Beatty 1978): regular ties to social institutions, maintain ordinary social relationships with nondrug 1. To refrain from all contact with nonpre­ users, wait for "good" circumstances to scribed drugs. use drugs, adopt group rituals and social 2. To contact staff when the urge to use sanctions that reinforce but limit drug use. drugs occurs, or at least to inform the They found that most of their subjects staff that drug use has occurred. were deviant only by virtue of their illicit 3. To record in a pocket log major events drug use. of the day, especially changes in emo­ tional state and drug urges. There is also growing recognition that 4. To make a weekly list of long- and many addicted persons who complete a short-term goals. treatment regimen and are "rehabilitatedll 5. To come on time to all meetings and later return to the controlled use of the scheduled appointments. same or some other addicting drug. 25

Whether return to functional, controlled any of these substances is a misdemeanor use after treatment should be accepted as on first offense, punishable by 1 year a realistic goal or discouraged outright is imprisonment and a $5,000 fine (Falco currently a controversial issue (American 1975:1-2) • Journal of Drug and Alcohol Abuse 1978). controls, drug controlled substances Any organized effort to influence the ways Most commonly, all PSYCHOACTIVE SUB­ drugs are consumed, distributed, and gen­ STANCES covered by laws regulating their erally dealt with in a society. According sale and possession. The CONTROLLED to Bruun et al. (1975:4), it refers to lIall SUBSTANCES ACT OF 1970 defines the those factors which bear on the legal, eco­ term as including a\l substances subject nomic, and physical (the 'reaJl) availability to the act. The term was developed to of d rugs to the individual embracing all replace the previous opiate-depressant­ efforts whether penal, preventative, educa­ stimulant terminology (Sonnen reich et al. tional, or therapeutic. • • • II While some 1973: 197) and is sometimes used to refer classify DRUG EDUCATION as a control only to nonnarcotic drugs such as halluci­ technique, most limit the term to matters nogens, amphetamines, and barbiturates, of formal controls by institutions and the which were first brought under regulatory law. See also controls, socia\. control with the DRUG ABUSE CONTROL AMENDMENTS OF 1965. controls, social Also called "social sanctions. II The proc­ Controlled Substances Act of 1970 ess by Which society I or any subg"oup The act establishes five IIschedulesll or within society, secures conformity toexpec­ classifications of controlled substances tation on the part of its constituent units, according to their potential for abuse, individuals or groups. Social controls may physical and psychological dependence be coercive formal controls and/or persua­ liability, and currently accepted medical sive informal controls. Coercive control use. Schedule I, the most strictly is handled by government and agencies of controlled category, includes heroin, mari­ law, and is accomplished by force or by juana, and LSD, and other drugs consid­ threat of force, usually in regard to crime ered to have high abuse potential and not deterrence. Persuasive control operates recognized for medical use in the United through va!"ious informal mechanisms that States; they can be obtained only for induce the individual to respond to the limited research purposes under special standards, wishes, and imperatives of t!:te registration requirements. Schedule II larger social group. The formal and drugs (morphine, methadone, and ampheta­ informal aspects of social controls are not mines) are primarily different from Sched­ always consonant (Harding and Zinberg ule I drugs in that they have some 1977:112). Drug taking is said to be currently accepted medical uses. The socially conti'olled when it is permitted manufacture and distribution of these under various legal restraints and routin­ drugs are controlled by production quotas, ized, ritualized, and structured so as to strict security regulations, import and reduce to a minimum any drug-taking export controls, and nonrefillable prescrip­ behavior that the surrounding culture con­ tion requirements. Illicit sale of Schedule siders inadvisabie (Rubin and Comitas I or II narcotic drugs carries a maximum 1976:173). penalty of 15 years imprisonment and a $25,000 fine; for nonnarcC'tic drugs the coping penalty is 5 years and $15,000. Schedule Action that enables one to adjust to envi­ III, IV, and V drugs are considered in ronmental circumstances and forestall, descending order to have less abuse poten­ reduce, or contain the experience of stress. tial and dependence liability. There is The use of psychoactive drugs has been very little difference in the controls that seen as one alternative among many for are imposed on these three schedules, coping with the subjective needs, desires, except Schedule V drugs, which are gen­ and problems of life. (RI S 27: 313--6 erally sold over the counter and not entries) subject to any refill limitations on prescrip­ tions. Title II of the DRUG ABUSE ACT copping OF 1970 requires registration of all per­ Slang. The acquisition of heroin or other sons involved in the legitimate distribution drugs; a series of events in which goods of controlled drugs and detailed record­ or money are exchanged for heroin. "COp­ keeping. Illicit sale of SChedule V drugs ping areas" are drug distribution sites carries a maximum of 1 year imprisonment (Hughes et al. 1971). (RIS 27:313--5 and a $5,000 fine. Illicit possession of entries) 26 corollary intervention outlined by Lehrman et al. Associated with an event but not necessar­ (1980:9-10) include unconsciousness, very ily caused by it. Prior use of marijuana, low breathing rate (8 or fewer breaths for example, is a corollary of heroin addic­ per minute), breathing difficulty, respira­ tion, but prior marijuana use 'has not been tory arrest. high fever, extreme high or rI proven to have a causative relationship low pulse rate (140 or more per minute or \ with heroin addiction. See also causal. below 60 per minute)', vomiting in semicon­ scious or unconscious state, and pro­ countercultu re nounced muscle rigidity. See also talking­ A term coined in the 1960s that described down method. a specific form of culture whose members rejected key norms and values of the larger cross-dependence society. A condition in which one drug can prevent the WITHDRAWAL SYNDROME associated craving with the use of a different drug. See A term implying both physiological and also cross-tolerance. psychological dependence; the user's "desire" or "need" to continue using a cross-tolerance drug. This term is often associated with A condition in which TOLERANCE to one withdrawal and is considered by some to drug often results in a tolerance to ,a be a main defining characteristic of addic­ chemically similar drug; e.g., a person tion (Grinspoon and Hedbiom 1975:164-70). who is used to taking large doses of heroin wi II perceive no effects from small doses criminal commitment of methadone. See also cross-dependence; A compuisory treatment program for the tolerance, reverse. detoxification and rehabilitation of addicts who have been arrested and convicted of cult misdemeanors or felonies. Addicts are A small, highly exclusive group organized confined for a specified period in special around the teachings of a charismatic treatment facilities, which usually are leader; often the memb~rs of a, cult set basically modified prisons. See also civil themselves apart from the rest of the com­ commitment. munity in various ways in order to better practice their unique creed (Zadrozny 1959; criminal justice system Encyclopedia of Sociology 1981). The machinery, procedures, and personnel having to do with the content of the crimi­ cutting nal law and with the arrest, trial, convic­ DILUTION or ADULTERATION of a drug tion, and disposition of offenders. It (e.g., the process of diluting heroin with includes the penal code, the police, the milk suga'r or quinine). prosecutor's office, courts, penal institu­ tions, probation, parole, and the officials cyclazocine charged with administering their defined On~ of the first of the opiate narcotic duties (Fairchild 1976). (RIS 27:317--7 antagonists to be employed in clinical treat­ entries) ment. It is a mixed antagonist, having slight agonist effects. Although long act­ criminogenesis ing and effective orally, its effectiveness A term coined by sociologists to explain has been limited because it, has to be the processes by which powerful policymak­ administered daily, and many patients com­ ing groups in a society create the struc­ plain of unpleasant side effects. Recently tural conditions that cause other people to NAL TREXONE has been advocated as a commit crimes. Some believe that American substitute. Classification: narcotic antago­ social policy tc,ward narcotics is crimino­ nists. (RIS 27:204--1 entry) genic to the extent that it stimulates the organization of illegal industry and markets in commodities that had been heretofore lawfully produced and consumed (Helmer 1977:407-8). crisis intervention, drug The process of diagnosing a drug criSIs situation such as a PAN IC REACTION or a drug OVERDOSE and applying procedures dangerous drugs to arrest the condition. Typical Signs The old statutory label given to nonnar­ indicative of immediate drug crisis medical cotiC, controlled drugs such as hallucino- 27

gens, amphetamines, and barbiturates, decriminal ization which were brought under regulatory con­ The legal process of revIsing drug laws trol with the DRUG ABUSE CONTROL by replacing the criminal penalties (usually AMENDMENTS OF 1965 (National Commis­ imprisonment or the threat of imprisonment) sion on Marihuana and Drug Abuse with civil penalties (most often a fine) for 1973: 18) . The current statutory and pre­ possession of smc:11 amounts of the drug ferred term is CONTROLLED SUBSTANCES. for personal use. Most people feel that marijuana use should be discouraged, but DARP many also feel that imprisonment for use See Drug Abuse Reporting Program. is too harsh a penalty. Eleven States have changed thei r laws to inco rporate civil DAWN fines and, sometimes, mandatory drug edu- See Drug Abuse Warning Network. cation programs for offenders. First offenders usually avoid a criminal record Day top Village under these new laws. See also legaliza­ A 24-hour, live-in THERAPEUTIC COMMU­ tion; National Commission on Marihuana NI TY for the rehabilitation of drug addicts and Drug Abuse. established in 1963 in Staten Island, New York. Day top is short for "Drug Addiction delinquency Treatment for Probationersll and many of In many States, any act that would be a its members are court-referred. Day top crime if committed by an adult, and there­ emphasizes interface with society and .seeks fore a softer synonym for crime. Most to create behavioral changes that will re­ jurisdictions also include a wide variety of integrate the individual into society (Deitch acts which are not illegal if committed by 1973) • See also treatment, community­ adults (Encyclopedia of Sociology 1981). based. Any undesirable conduct on the part of a juvenile that is serious enough to come to DEA the attention of the authorities, including See Drug Enforcement Adminis~ration. truancy. school misconduct, petty offenses, and sometimes serious crimes (Zadrozny dealing, drug 1959). (RIS 27:320--27 entries) Peddling or selling drugs. The seller is called a dealer. Legally, dealing has been deliriants defined to mean lito sell, exchange, give, Substances capable of producing DELIRIUM, or disposell of drugs to another, or lito often used to refer to the VOLATILE offer or agree to do the same II (N. Y. State INHALANTS. Penal Code 1970). See also trafficking, drug. (drug dealers, RIS 27:281--2 delirium entries) Mental disturbance usually of short dura­ tion characterized by excitement, confu­ deaths, drug-related sion, incoherence, ILLUSION, DELUSION, Deaths that result either directly or indi­ and HALLUCINATION. rectly from drug use. Broadly, refers to anything from an overdose suicide to the delirium tremens (DTs) presence of some unspecified drug in a An acute mental and physical disorder pedestrian hit by a truck (Rittenhouse occurring in alcoholics while drinking or 1977:243). In direct deaths, the drug is as an alcohol-withdrawal syndrome. The a sufficient and necessary condition or onset is marked by tremulousne'ss, nausea, cause of death. In indirect deaths, the vomiting, weakness, hallucinations, or col­ drug alone is not sufficient cause for death, lapse due to malnutrition from a prolonged but is a necessary contributor to the death diet of liquor (Keller and McCormick 1968). in conjunction with some other drug, con­ dition, or agent (Lettieri and Backenheimer delusion 1974). In the DRUG ABUSE WARNING A belief that exists in spite of contrary NETWORK (DAWN) system, a drug-involved reason or evidence that would normally be death is defined as (1) any death involving considered sufficient to change it (LeDain a drug overdose in which a toxic level is et al. 1973:431). A firm, fixed idea not found or suspected; and/or (2) any death amenable to rational explanation (A Psy­ in which drug usage is a contributory fac­ chiatric Glossary 1975). See also illusion; tor although not necessarily the sole cause hallucination. - (e.g., accidents, diseased state, with­ drawal symptoms) (Gottschalk et al. 1977). Delysid See also overdose. (RIS 27:318--56 Brand name for LSD-25 marketed by the entries) Swiss pharmaceutical firm Sandoz.

387-396 0 - 82 - 3 QL 3 28 demand reduction strategy tiate clea rly between physical and psycho­ Federal drug abuse policy goals are geared logical dependence. (See discussion under toward reducing both the demand and sup­ ADDICTION.) Most theorists now empha­ ply of illicit drugs. The "demand reduc­ size the predominance of psychological tion strategyll outlines the Government's factors in development of dependency on plan for reducing the demand for illicit any drug. Often used as a synonym for drugs. The main components of the strat­ addiction. egy consist of providing support for treatment and rehabilitation programs, pre­ dependence, psychological vention projects, and research and devel­ In regard to drugs, an ill-defined, broad opment activities in cooperation with State, term generally referring to a craving for local, and privatEi agencies and organ iza­ or compulsion to continue the use of a drug tions. See also supply reduction strategy; that gives satisfaction or a feeling of well­ Federal drug abuse policy. being. Psychological dependence may vary in intensity from a mild preference to a dependence, drug strong craving or compulsion to use the A broad term that came into general use drug. In severe cases, unpleasant psy­ in the mid-1960s as a replacement for chological symptoms may develop if contin­ ADDICTION and HABITUATION to help ued administration of the drug is stopped eliminate the confusions and difficulties (LeDain et al. 1973:433). The World Health inherent in those terms. As defined by Organization defines psychic dependence the WHO Expert Committee, "a state of as "a feeling of satisfaction and a psychic psychic or physical dependence or both, drive that requires periodic or continuous on a drug, arising in a person following administration of the drug to produce a administration of that drug on a periodic desired effect or to avoid discomfort" (Eddy or continuous basis," with the charactel"is­ 1965). In most instances, psychological tic of dependence varying with the drug factors are considered more important than involved (i.e., dependence of the morphine any physical factors in maintaining chronic type, barbiturate type, amphetamine type, drug use (LeDain et al. 1973:45). Also etc.). In this theoretical scheme psychic often called behavioral, psychic, or emo­ or (PSYCHOLOGICAL) DEPENDENCE--lIa tional dependence. Frequently a synonym feeling of satisfaction and a psychic drive for HA~ITUATION. that requires periodic or continuous admin­ istration of the drug to produce pleasure depot preparation or avoid discomfort"--was given the domi­ Any of a number of methods that provide nant place as the effect drugs produce the slow release of a drug within the body that causes people to use them compulsively, over an extended time (e. g., a month to with (PHYSICAL) DEPENDENCE a powerful a year), usually involving 'either an reinforcing influence (Eddy et al. 1965: 722- implanted capsule or some type of unique 723). formulation of the drug itself. dependence, field depressant See field dependence. Any drug that depresses the central nerv­ ous system resulting in sedation and a dependence, physical decrease in bodily activity. Not to be A physiological state of adaptation to a confused with the psychological state of drug no rmally following the development DEPRESSION, these drugs can in fact be of TOLERANCE, and resulting in a char­ mood elevators by lowering inhibitions. acteristic WITHDRAWAL SYNDROME pecu­ Depressants are the largest and most com­ liar to the drug following abstinence monly used of all drug types, including (LeDain et al. 1973:44;432). The extent the narcotic analgesics, alcohol, barbitur­ to which physical dependence occurs in ates, proprietary sedative-hypnotics, the use of certain drugs and its causes tranquilizers, and inhalants. All these are still a matter of considerable contro­ depressant drugs affect the CNS similarly versy. Physical dependence is generally in a progression depending on dosage from most closely associated with opiate narcot­ anxiety reduction to sedation, hypnosis ics, which are believed to produce the (sleep), anesthesia, coma, and even death. most pronounced tolerance and physical Given this similarity in effect, they are dependence of all drugs. However, many classified usually accordin!:f to the specific researchers now emphasize that dependence purposes for which they are most suitable. does occur among users of other drugs Depressants are also additive in their (e.g., barbiturates), it does not always effects; when used together they compound occur the same among all opiate users, the effects of each and greatly increase and that it is often impossible to differen- the risk of death. In this volume we have 29

divided the depressant drugs into the major swift the penalties are, the greater their categories of NARCOTIC ANALGESIC AGO­ deterrent effect (Erickson 1976). This NISTS; SEDATIVE/HYPNOTICS; (ANTIPSY­ has been ca!led the primary and essential CHOTIC) TRANQUILIZERS; and VOLATILE postulate of almost all criminal law systems INHALANTS. (RIS 27:204--5 entries) (Zimring and Hawkins 1973). Recent research has also emphasized the role in depression deterrence of the potential lawbreaker~s When used to describe mood in the normal subjective perceptions regarding the pos­ individual, a state of despondency charac­ sibility of punishment, whether or not terized by feelings such as inadequacy, these perceptions are accurate. (RIS lowered activity, and pessimism about the 27: 322--3 entries) future. In PATHOLOGICAL cases, an extreme state of unresponsiveness to stim­ detoxification uli, together with self-depreciation, delu­ Ridding the organism of drugs through sions of inadequacy, and hopelessness withdrawal and promoting recovery from (Chaplin 1975). As defined by Robins its effects (Keller 1960). While in itself (1974), chronic sadness of several weeks' not considered a very successful treatment duration, plus three or more of the follow­ method, it is an option that permits the ing symptoms: (1) trouble sleeping over dependent drug user to be seen by somt: a period of several weeks; (2) anorexia type of center (usually a hospital), to leading to a weight loss of 8 pounds or receive medical attention, and to reduce more; (3) several weeks of feeling tired the dependence cycle. Detoxffication often for no reason or not able to "get going"; leads to other forms of treatment by refer­ (4) thoughts of dying, or harming oneself; ral {Deitch 1973:161}. The most common (5) worry about losing one's mind; and procedure to relieve the distress ,caused (6) crying spells. (RIS 27:321--61 entries) by heroin WITHDRAWAL SYMPTOMS during deserpidine detoxification is that developed at the PUB­ One of the ALKALOIDS found in the snake­ LIC HEALTH SERVICE HOSPITAL at Lex­ ington, Kentucky. Typically, the patient root plant, Rauwolfia serpentina, used in is started on a dose of METHADONE. con­ a variety of (ANTIPSYCHOTIC) TRAN­ sistent with his or her own heroin habit QUILIZERS (Harmonyl, Enduronyl, Oreti­ (usually 20 mg methadone twice daily or cyl) . See also reserpine. 40 mg once a day), and the dose is desipramine hydrochloride reduced thereafter by 20 percent per day. Discomfort is thereby held down to roughly A tricyclic ANTIDEPRESSANT, manufac­ that experienced in the course of a mild tured as Pertofrane and Norpramin. bout of influenza, AIthou gh hospital ization was once considered essential for the treat­ detection, drug ment of withdrawal symptoms, OUTPATIENT Determining whether a person has been detoxification is now used successfully using a drug. In drug treatment programs, (Brown 1973:133). (RIS 27:322--9 entries; the most frequent method of detection is drug-free treatment, RIS 27:238--8 entries; urinalysis. Blood samples are also often methadone maintenance, RIS 27:351--76 used to detect the presence of d rugs in entries) the system; screening is accomplished by such methods as Kozel ka-Hine spectropho­ deviance, seconda ry tometry and gas chromatography. Other A distinction first drawn by Lemert (1951) methods such as the NARCAN TEST are to show how societal reactions to DEVIANT also used. See also urinalysis. (screen­ BEHAVIOR encourage the individual to ing and detection, RIS 27: 379--39 entries) develop a deviant CAREER, and concomi­ tant self-concept. The situation arises deterrence theory when a person publicly labeled as a devi­ The penological theory that the use or ant for some initial behavior or primary threat of legal sanctions or punishment, deviance, begins to use other deviant the knowledge of which is widely dissemi­ behavior or a ROLE based on it as a means nated, is· the most important method of of defense or adjustment to the overt and preventing crime or socially undesirable covert problems created by the societal acts that might otherwise be committed reactions to his or her initial behavior. (Meier and Johnson 1977: 293-4). Classical Other propollents of the secondary deviance deterrence theory maintains that the likeli­ approach irfc'!ude Alfred Lindesmith and hood of someone engaging in lawbreaking Edwin Schur (Williams 1976; McAuliffe 1975). activity is determined negatively by the See also labeling theory. certainty, severity, and swiftness of pun­ ishment. The more certain, severe, and 30 deviant behavior and Tenuate. Classification: stimulants-­ Generally, behavior that varies markedly primary. from the average or norm, usually PATH­ OLOGICAL in nature, or which elicits con­ differential association demnation in the social setting in which it The distribution of a person1s associations takes place. ·In its widest sense, it is a in a manner different from those of other generic term referring to activities that persons (Fairchild 1976). The fundamental connote a departure by individuals from principle of a general theory of criminal accepted standards of conduct or social behavior constructed by Edwin Sutherland, norms of the dominant group. As defined which holds that criminal behavior is by Jessor et al. (1968: 44), deviant behav­ learned and that a person becomes delin­ ior "must depart substantially from norma­ quent because of an excess of definitions tive standards; the departure must be of favorable to law violations over defi nitions sufficient magnitude to mobilize social con­ unfavorable to law violations. Generally trol responses. II Merton early developed stated, persons who develop criminal behav­ the implications of a general sociological ior diffclr from those who do not develop theory of deviance from Durkheim1s concept crimi nOli behavior in the quantity and qual­ of ANOMIE, arguing that when the legiti­ ity of their associations with criminal pat­ mate means to attain accepted success goals terns and their relative isolation from or aspiration of society, defined in eco­ anti-criminal patterns. The learning of nomic terms, are blocked, frustrated mem­ delinquent roles is due to the availability bers of the lower classes may reject the of delinquent role :odels in a peer group culturally prescribed means and use other (Sutherland and Cressey 1960). Volkman means to achieve success (Merton 1957). and Cressey (1964) tested this theory in In LABEll NG THEORY, deviance is not a regard to opiate users. In methodology, quality of an act a person commits, but is the idea that the amount of correlation defined in terms of a "Iabelingll phenomenon between variables is a function of the popu­ created by the social group that specifies lation studied. those infractions constituting "deviance" (Becker 1963:9). The term lIantisocial dilution behaviorll is preferred by some (Ki nkade The ADULTERATION of a drug by the 1974). See also deviance, secondary. addition of an inactive substance. To (deviance, RIS 27:322--21 entries; deviant make less concentrated or to diminish subcultures, RI S 27: 322--6 entries) strength. Most dilutants have little or no physiological effect (Helisten 1977). See dextroamphetamine sulfate also misrepresentation, drug. (adulterants, A central nervous system stimulant of the RIS 27:301--9 entries) amphetamil)e type considered twice as potent as other amphetamines but with dimethoxymethamphetamine (DOM) fewer side effects. It has been generally Chemical name for the street drug STP, a replaced as an ANTIDEPRESSANT by newer synthetic hallucinogen that is chemically drugs such as AMITRIPTYLI NE HYDRO­ related to AMPHETAMINE and MESCALINE CHLORIDE (Elavi\) and IMIPRAMINE and is said to produce an LSD-like experi­ HYDROCHLORIDE (Tofranil). Used as an ence. Its primary effect is a relentless appetite depressant in dieting, as a mood rush of energy that causes users to trem­ elevator in minor depression, and for alco­ ble. Some hallucinogen users praise STP; holism and narcolepsy. Manufactured as others siOly it carries more risk of psychotic Dexedrine; also found in Dexamyl. Clas­ reactions than any other hallucinogen. sification: stimulants--primary. See also Users negatively report a long IIcome down" amphetamines. Slang names: dexies, period of 2 to 3 days on STP, and thus brownies. (RIS 27:204--11 entries) they prefer to use the shorter-acting LSD. Classification: hallucinogens. diacetylmorphine See heroin. dimethyltryptamine (DMT) A semisynthetic chemical hallucinogen simi­ diazepam lar to PSILOCIN. Parsley or some other An (ANTIANXIETY) TRANQUILIZEK plant is usually soaked in it, dried, and derived from BENZODIAZEPINE. Manufac­ smoked. Effects are similar to LSD and tu red as Val ium. Classification:' sedative I begin almost immediately but last for under hypnotics. (RIS 27:204--9 entries) an hour. Easily synthesized, it is foun", naturally in a number of plants. Classifi­ diethylpropion hydrochloride cation: hallucinogens. A SYMPATHOMIMETIC AMINE used as an ANORECTIC. Manufactured as Tepanil 31 diphenhydramine hydrochloride use. The model is based on studies of An (ANTIANXIETY) TRANQUILIZER, manu- alcohol consumption patterns in large popu­ factured as Benadryl. (RIS 27:205--1 lations in Canada. Findings suggest no entry) clear difference in consumption between social drinkers, heavy drinkers, and alco­ diprenorphine holics. All categories gradually shade into A pure NARCOTIC ANTAGONIST. one another and cannot be clearly distin­ guished. The distribution approach sug­ dirty gests that: (a) the distribution of alcohol Slang. Carrying or using narcotics. Con­ consumption is similar in character from trast with clean. place to place; (b) alcohol consumption relates to liver cirrhosis; and (c) it may dirty urine be necessary to reduce per capita consump­ Positive test results for the presence of tion to reduce alcohol-related problems. drugs in a submitted urine specimen indi­ It has been suggested that this theory cating drug use by the subject. may be applicable to all drugs (Smart 1974:34-35) . disinhibition The temporary removal of inhibition as a Ditran result of introducing an outside or irrele­ A psychedelic HALLUCINOGEN, chemically vant stimulus. Also, a loss of self-control called piperidyl benzilate. Its effects while under the influence of drugs include changes in the user's perception (Chaplin 1975). of time, space, hearing, and color, but it does not precipitate any real hallucinations. disorientation State of mental confusion regarding time, diuretic place, or identity. A drug that increases urine output thereby reducing the body fluid level. distilled spirits Alcoholic liquor obtained by the process diversion of DISTILLATION. Distilled spirits from A criminal justice system reform concept wines and other brews usually contain at of identifying some criminal defenders in least 25 percent alcohol (50 proof) but the earliest stages of the criminal justice may be as high as 50 percent or more. system and diverting them into programs Examples include whisky, brandy, rum, that may not involve incarceration. As gin, and vodka. The discovery of distil·· operationally defined by the American Bar lation has been attributed to either of two Foundation, it is lithe disposition of a com­ Arabs, the alchemist Gerber (c. 800) or plaint without a conviction, the noncriminal the physician Rhazes (c. 900). Regard­ di sposition being conditioned on either the less, the discovery itself marked the major performance of specified obligations by the turning point in the history of alcohol use, defendant, or his participation in counsel­ as it made possible the production of bev­ ing or treatment" (Nimmer 1974:5). As a erages containing several times the alco­ major nonpunitive alternative to CIVI L holic content of the strongest wines and COMMITMENT, the basis for drug offender provided a new, convenient, and concen­ diversion is to remove from the criminal trated source of inebriation, thus greatly justice system those for whom its processes augmenting the problems related to the are thought to be inappropriate or counter- use of beverage alcohol. Distillation productive. Offenders are generally increased the alcoholic power of a given diverted after arrest but before court dis­ drink by 400-500 percent. Although the position; those who are cons ide red eligible first distilled spirits were principally made for diversion are offered the opportunity from wines (such as brandy) and were to "volunteer" to a treatment program. used almost exclusively as medicines, in While the offender is in the diversion pro­ the mid-16th centu ry technological advances gram, the pending prosecution is suspended in the di~tillation of grains made possible or deferred. Upon successful completion the plentiful production of cheap spirits. of treatment, the original charges are gen­ The 18th-centu roy London gin epidemic was erally dismissed. As most drug diversion one of the major social issues of the day programs deal with opiate users, it is also (Austin 1978). Classification: sedative! referred to as addict diversion (Perlman hypnotics. and Jaszi 1976). distribution-of-consumption model The term diversion also refers to the An epidemiological approach first suggested redirection of licit, prescription drugs from by Ledermann (1956) in regard to alcohol the normal pharmaceutical marketing system 32

into the illicit street market (especially The curve may take many shapes. Upward amphetamine and barbiturate drugs). sloping and level curves indicate a direct (diversion programs, RIS 27:323--8 entries) relationship. Downward sloping curves indicate an indirect relationship. Curves DMT that slope up and then down, or vice See dimethyltryptamine. versa, are called biphasic dose-response relationships. Alcohol, for example, at Do It Now Foundation low dosage levels may have a disinhibiting, A nonprofit organization involved in drug enervating effect, but as the dosage abuse prevention. The foundation main­ increases these effects may be reversed tains a National Media Center and the into an inhibiting, stuporous effect. This Institute for Chemical Survival. Address: type of dose-response relationship is, thus, P.O. Box 5115, Phoenix, Ariz. 85010. biphasic. DOM double-blind study See dimethoxymethamphetamine. An experimental design in which neither the subject nor the researcher knows which dopamine of two or more drugs (one of which is often An intermediate biochemical in the bodily a PLACEBO) is being given at the time of synthesis of norepinephrine. See cate- the study. This reduces the potential for cholamine; neurotransmission. both subject and researcher bias. See also blind study. dose (or dosage) The amount or quantity of drug adminis­ downer tered, usually stated in grams (g), milli­ Slang. A BARBITURATE or TRANQUIL­ grams (mg), or milliliters (mI). The term IZER. Also called a downie, often taken "effective dosage" is sometimes used to to counteract the stimulant effects of refer to that dosage which produces a cer­ AMPHETAMINES. Contrast with upper. tain effect in 50 percent of the individuals tested, whereas 25 percent felt the same doxepin hydrochloride effect at a lesser dosage and 25 percent A tricyclic ANTIDEPRESSANT, manufac­ required a higher dosage (Margolis 1978). tured as Sinequan and Adapin. See also therapeutic dose. (RI S 27: 323--34 entries) droperidol An (ANTIPSYCHOTIC) TRANQUILIZER, dose-effect relationship manufactured as Inapsine and Innovar. Consideration of the quantity or dose of the drug involved must be taken into drug r,ccount before specific statements about In a purely biological, scientific sense, drug effects may be made. One of the any substance, natural or artificial, that basic principles of pharmacology. With all by its chemical nature alters structure or drugs, the response differs both in the function in the living organism (Modell intensity and the character of the reaction 1967: 346) • More commonl y, nonfood chem­ according to the amount of the drug admin­ ical substances that have mood-altering istered (LeDain et al. 1973). Also called effects (National Commission on Marihuana the DOSE-RESPONSE RELATIONSHIP. and Drug Abuse 1973: 1 0; LeDain et al. See also effects, drug. 1973: 431). I n general use, there is little consistency in popular conceptions of what dose-response curve a drug is; a multitude of often arbitrary, See dose-response relationship. conflicting definitions of the term "drug" have helped to contribute significantly to dose-response relationship the controversies and confusions surround.,. A major area of study in behavioral phar­ ing drug use. Many equate "drugs" only macology in which observations are made with those illicit substances used recrea­ over time between the dosage of a drug tionally, viewing them as fundamentally administered and some measurable behav­ different and more harmful than the licit ioral activity of the subject. The observed substances used recreationally, such as relationships are frequently plotted graph­ tea, alcohol, and tobacco, or the so-called ically with the dosage level on one axis "medical drugs," such as tranquilizers, and the particular behavior activity level amphetamines, and barbiturates. The con­ on the other. The line drawn to connect fusion is so' great, in fact, that Goode the observations is called the dose­ (1972: 8) proposed that "a drug is some­ response curve. The inability to fit a thing that has been arbitrarily defined by curve indicates a poor relationship. certain segments of society as a drug ." 33

As a result of this confusion, it has become drug beyond medically prescribed necessityll increasingly common to refer to all drugs (Rublowsky 1971l: 1 9); and "use of a drug as "psychoactive substances" in the hope for other than therapeutic purposes" that use of this new term will help to pro­ (Winek 1971 :2-3). Jaffe (1976:7) has mote a greater recognition of the similar­ defined it as "the use, usually by self­ ities among all chemical agents that have administration, of any drug in a manner mood altering effects and dispel the long­ that deviates from approved medical or standing misconception that there is' some­ social patterns within a culture. 1I thing fundamentally different between alcohol, coffee, and tobacco, on the one The fundamental problem with the term is hand, and "drugs" on the other; or that that "abusb" cannot be precisely detined street drugs act according to entirely dif­ in reference to an actual phenomenon. ferent principles from medical drugs What one person or group 'may deem as (National Commission on Marihuana :md harmful or excessive to the individual per­ Drug Abuse 1973: 10-11). sonally or to society in general may not be perceived as problematic by others or drug abuse by the drug consumer. Implicitly, the An unstandardized, value-laden, and highly term "abusell has come to be the current relative term used with a great deal of equivalent of "badness, II or of any use of imprecision and confusion, generally imply­ which one does not approve; this is the ing drug use that is excessive, dangerous, most common component of all definitions or undesirable to the individual or commu­ (National Commission on Marihuana and nity and that ought to be modified. (See Drug Abuse 1973:11-13). As such, the use also DRUG.) For example, "the tendency of this term often depends as much, if of some people to use certain drugs in not more, on political a"nd moral judgments ways which are detrimental to their health, than on considerations of the actual phar­ or to the community in which they live, macological action of a drug on an individ­ or.both" (Archibald 1970:238); drug use ual's health and the impact of drug-using that liposes a serious threat to health or actions on social welfare (Blum 1971: 91l) . tq social or psychological functioning ll (Wei! 1972:37-38). Others, such as Mormons or In fact, some have defined the concept of Christian Scientists, would consider even abuse totally in terms of social disapproval: the use of alcohol and coffee as abusive. "Drug abuse is behavior, as designated Few agree on what defines what is exces­ by professional and other community repre­ sive or dangerous. sentatives, describing the use of particular drugs in particular ways that are contrary Generally, the public and the law have to the agreed-upon rituals in a given com­ defined the recreational use of any illicit mU'1ity at a given point in time" (Einsteil1 PSYCHOACTIVE SUBSTANCE as "abuse"-­ and Garitano 1972). Similarly, Wikler without any demonstration of individual (1958) defined it as lithe use of chemiGai harm or social consequence necessary. agents for purposes considered undesirable Most definitions involve some component of by an observer. II These definitions do nonmedical and/or illicit use, with the clear not purport to be a description of an implication that drug use that is legitimated actual drug-using pattern but shift the by the m.Jdical or legal authorities is better focus to the response to that pattern, and than that which is not. For example: make it clear that "abuse" is a relative the "use, sale, or possession of those sub­ perception. Indeed, for all of its lack of stances which are prohibited by the laws clarity as a descriptor of an actual phe­ of the statell (New Jersey State 1971: 2); nomenon, because lIabuse" has developed use of a drug in amounts hazardous to such a clear connotation of a personal individual health or the safety of the com­ judgment of llbad" or lIdeviant" or "exces­ munity, or when it is illiCit, or when taken sive," it remains an apt word to use i!1 on one's own initiative rather than on the r'eference to an attitudinal response to basis of professional advice (Rappolt 1972: drug use that incorporates these judgments. 126); "the self-administration of. • . drugs without medical supervision and par­ Many authorities suggest that the term ticularly in large doses that may lead to should be avoided entirely as too polemical psychological dependency, tolerance and and value laden, and too inclusive to be abnormal behavior" (American Medical scientifically useful in trying to under­ Association ,1966); "persistent and sporadic stand various degrees of drug use excessive drug use inconsistent or unre­ (National Commission on Marihuana and lated to acceptable medical practice" (Eddy Drug Abuse 1973:13-11l; Johnson 1973:2). 1965:722); use outside accepted medical Smart (1971l:32) emphasizes that only the practice (LeDain et al. 1973); "use of a term "drug use" should be employed, a 34

change which may further draw attention scribed drugs except for personal or family to the need to know mo re about d rug use use or for veterinary purposes (Running and how it relates to specific problems of Press Dictionary of Law 1976). Only use. Johnson (1973:3) suggests that the authorized manufacturers, suppliers, hos­ terms "nonmedical use" (i.e., used for pitals, agencies, physicians, or research­ nonmedical pu rposes) and lIi11icit drug use" ers can sell, deliver, or otherwise dispose (i.e., defined as illegal by Federal or of the proscribed drugs; persons who man­ State laws) would better suggest what is ufacture, process, sell, deliver, or other­ "wrong" with certain kinds of drug use. wise dispose of these drugs must keep Other suggestions inel ude distinguishing records of all drugs so handled; prescrip­ betwebll socially acceptable use and unac­ tions for these drugs are limited to five ceptable use (Josephson 1974:xx) or con­ refills, and none may be refilled after 6 ventional or unconventional use. As abuse months. is a term more appropriately applied to peop'le than drugs, the term "drug mis­ Drug Abuse Council, Inc. usell is also often used as a substitute A nonprofit organ ization that was located (Kaufman 1977). See also substance abuse. in Washington, D. C. It supported an enlightened approach to illicit drug use Drug Abuse Act of 1970 and funded wide-range policy-related Comprehensive Drug Abuse Prevention and research projects on issues related to drug Control Act of 1970, the first major Federal abuse. The DAC is now defunct. drug legislation since the HARRISON NAR­ COTICS ACT of 1914. All the regulations Drug Abuse Epidemiology Data Center advanced since the Harrison Act were The center is part of the Institute for repealed and replaced by this new statute. Behavioral Research, Texas Christian Uni­ Possession penalties were generally versity, Fort Worth, Texas. It maintains reduced, but the act established strict an archive and retrieval system of federally import and export limitations, extended supported studies on drug abuse, including penalties for trafficking, and imposed new the DA RP treatment followup study. See controls on previously unregulated psycho­ Drug Abuse Reporting Program. active drugs. The act was designed to create for the first time a comprehensive drug abuse periodicals framework for the regulation of narcotic See periodicals, drug abuse. and nonnarcotic drugs. Title II of this act is known as the CONTROLLED SUB­ drug abuse policy STANCES ACT and requires registration See Federal drug abuse policy. of every person in the legitimate chain of drug distribution and detailed recordkeep­ Drug Abuse Reporting Program (DARP) ing. See statewide services contract. A national, computerized reporting system that was established in 1968 at Texas Drug Abuse Control Amendments of 1965 Christian University consisting of a Also called Harris-Dodd Act, an amendment research file of data on the admission and 'to U.S. food, drug, and cosmetic legisla­ progress of drug abuse patients receiving tion that classified certain stimulants treatment at federally funded programs. (amphetamines), depressants (barbiturates), Its major purposes are to provide standard­ and hallucinogens as "dangerous drugsll ized program statistics and evaluative and brought them under Federal control, studies of treatment outcomes by various shifting the constitutional basis for drug modalities and for different groups of control from taxing pow~r to interstate patients. The Admission Record provides and commerce powers. Penalties are con­ demographic data for patient classification, siderably more let;lient than those of the developmental background information, and NARCOTIC DRUG CONTROL ACT OF 1956. baseline data at admission on the major The act is intended to crack down on the behavioral outcome criteria of drug and trade in amphetamine and barbiturate drugs alcohol use, employment, criminality, and (and several tranquilizers and nonbarbitur­ family relations. The Status Evaluation ate hypnotics and sedatives), whether Record provides during-treatment informa­ these drugs have been legitimately manu­ tion on these same variables at 2-month factured and diverted into the illicit traffic intervals. This form also records bimonthly or illegitimately manufactured. It is also information on participation in treatment aimed at stopping the underground traffic components and on termination and read­ in hallucinogens, which are mostly manu­ mission to the same program. Items from factured in clandestine laboratories or these records were included in volume 12 smuggled in from abroad. Under the act, of the NI DA Research Issues Series: no person may possess any of the pro- Drug Abuse Instrument Handbook. See

L-______----- 35

also Drug Abuse Epidemiology Data Center. Drug Enforcement Administration (DEA) (RIS 27:324--6 entries) The lead agency in narcotic and dangerous drug suppression programs at the national drug abuse statis'tics and international levels and in Federal drug See statistics, drug abuse. law enforcement; established in the Depart­ ment of Justice in 1973, replacing the Drug Abuse Warning Network (DAWN) BUREAU OF NARCOTICS AND DANGEROUS Started in 1972 by the BUREAU OF NAR­ DRUGS. ,The DEA was created to enforce COTICS AND DANGEROUS DRUGS, DAWN the controlled substances laws and regula­ provides information on medical and psycho­ tions and to bring to the criminal and civil logical problems associated with the effects justice system of the United States or other of drug use; data are received from facil­ competent jurisdiction, those organizations ities in 23 cities that are likely to have and individuals involved in the growing, contact with drug users with these prob­ manufacture or distribution of controlled lems, such as general hospital emergency substance:. appearing in or destined for rooms, medical examiners/coroners, and illicit traffic in the United States. Address: crisis intervention centers. Whereas 1405 I Street, N. W., Washington, D. C. CODAP (CLIENT ORIENTED DATA ACQUI­ 20537. SITION PROCESS) describes patients com­ ing into treatment, DAWN describes people Drug Policy Office experiencing emergencies with drugs, See Federal drug abuse pol icy. whether or not they are in treatment. -rhe aim of the system is to identify drugs drug use, current that bring people to the attention of emer­ See drug use, recent. gency facilities and to identify the patterns of drug use and trends in these patterns drug use, ever with the idea of doing something about it The concept of ever having used or tried if the problem becomes severe. Approxi­ drugs in the past r Kandel 1975). Contrast mately 15,000 new case descriptions are with drug use, recent. added to the DAWN files each month. Presently funded by DEA and NIDA, drug use, recent (or current) reports are issued quarterly. Drug use during some near time period preceding a survey and including the day drug arrest of su rvey. Some argue that the' "preced­ Apprehension for a crime involving either ing" period should be specified within a the use, possession, cultivation, transporta­ bounded time frame so that measurement tion, or sale of illicit drugs. Drug arrest can be more precise (Richards and Cisin data are often used as an indication of 1975). (RIS 27:334--220 entries) the extent of drug use; V",;e; assumption has been questioned by many. I iyama et drunkenness al. (1976:6) note: lilt may be more appro­ The state of being drunk, often also refer­ priate to view drug arrest data as a red to as INTOXICATION, although some measure of the way in which the public consider t lat drunkenness is a more severe responds to distressing problems rather state of I NEBRIATI ON than intoxication than as evidence of the true extent of nar­ (Stivers 1976:98). In the United States, cotic addiction." (RIS 27:325--23 entries) State statutes employ various legal criteria for determining drunkenness. Lafler v. drug culture Fischer (1964) declared that "When it is See subculture, drug. apparent that a person is under the influ­ ence of liquor, or when his manner is drug education unusual or abnormal and his inebriate con­ Any program designed to provide informa­ dition is reflected in his walk or conversa­ tion on the use of drugs conveyed via a tion, when his ordinary judgment and psychological principle (or force) and to common sense are disturbed, or his usual change individuals' knowledge, attitudes, will power is temporarily suspended, when or behavior in a direction desired by the these symptoms result from the use of educator (Richards 1970). (RIS 27:328--21 liquor, and are manifest, then, within the entries; drug education, evaluation, RIS meaning of the statute, the person is 27: 328--18 entries; drug education materi­ intoxicated, and anyone who makes a sale als, RIS 27:328--4 entries; drug education of liquor to such a person violates the models, RIS 27:328--10 entries; drug law of the state, It is not necessary that knowledge, RIS 27 :329--11 entries) the person would be called 'dead drunk' 36

or hopelessly intoxicated; it is enough that establishing a clear cause-and-effect rela­ his senses are obviously -destroyed or dis­ tionship between a specific drug and a tracted by the use of intoxicating Iiquorll clinical event (Karch and Lasagna 1976: 204) • (Keller and McCormick 1968). There are no direct, simple, dependable cause-and-effect ralationships between any dysfunctional· drug use drug and any behavior. What we loosely As defined by Retka (1977:1), drug use talk about as a drug effect is a combination that results' in physical, psychok)gical, of at least th ree ma in factors: (1) the economic, legal, and/or social harm to the pharmacological properties of the drug; individual drug user or to others affected (2) the social setting or environmental con­ by the drug user's behavior. Retka text in which the drug is taken (see SET­ emphasizes that while not all drug use can TI NG); and (3) the personality or character be clearly identified as functional or dys­ structure, attitudes, and expectations of functional, the effort to Ii nk the function­ the individual user (see SET). However, ality of drug use to the effects of that under specific conditions drugs do have use is helpful in that many such effects certain identifiable, probable effects on can be quantified and an estimate of their most individuals. See also dose-response associated costs generated. It is in rela­ relationship. (auditory effects, RIS tion to such costs that the benefits deriv­ 27:307--8 entries; cardiovascular effects, ing from effective prevention efforts can RIS 27:309--36 entries; cerebral effects, be determined. See also effects, drug. RIS 27:310--20 entries; cognitive effects, RIS 27:311--28 entries; driving performance, RIS 27:323--55 entries; hepatic effects, RIS 27:345--20 entries; perceived effects, RIS 27:363--75 entries; physiological effects, RI S 27: 366--89 entries; pregnancy effects, RIS 27:368--17 entries; psycholog­ ical effects, RIS 27:371--85 entries; pul­ monary effects, RIS 27:375--17 entries; respiratory effects, RIS 27:376--17 entries; ecognine sexual stimulation, RIS 27:384--8 entries; The principal part of the COCA I NE mole­ teratogenic effects, RIS 27:389--17 entries; cule, obtained by hydrolysis of cocaine visual effects, RIS 27:396--15 entries) and other ALKALOIDS of COCA. Cocaine can also be synthesized from ecognine. effects, perceived Includes b~.h the effects the user hopes ecological analysis or fears will be experienced as well as The study of the factors responsible for those the user is awa re of ('xperiencing variation in the prevalence and incidence (0' Donnell 1975). The process of knowing of a condition (such as heroin use) over objects and objective events by means of time, and among different sociocu Itural the senses. Refers to relatively complex groupings, through the use of techniques receptor and neural processes that underlie such as medical geography, statistical our awareness of ourselves and our world geography, and social area analysis. based on discrimination, differentiation, Although frequently used interchangeably and observation. Perception is commonly with the term EPIDEMIOLOGY, the latter treated as an intervening variable depend­ differs in being concerned with the study ent upon stimulus factors, learning, set, of the incidence and prevalence of a moods, and emotional and motivational fac­ disease in a circumscribed community set­ tors. Thus, the meaning of an object or ting, or a carefully defined population objective event is determined both by group (Schmidt 1965; Richman 1977). stimulus conditions and by organism factors (Chaplin 1975). (R1S 27:363--75 entries) effects, drug Any physiological or psychological reac­ effects, subjective tion a user experiences after taking a The effects of a drug as perceived by the drug. Generally, drugs do not produce user under the influence of tlie drug. the same effect in different individuals, These drug effects cannot be observed nor do they produce the same effect in externally but fall in the realm of the drug the same individual at different times under' experience. different circumstances. In fact, one of the characteristics of some drugs is pre­ efficacy, ctrug cisely the variability of their effects. Ability of a drug to safely produce a Thus, one of the fundamental problems in desired, or claimed, treatment result. assessing ADVERSE DRUG REACTIONS is 37 ego and anxieties, makes excessive use of "A psychoanalytic term denoting the part defense mechanisms, and may develop char­ of the personality which ca:-ries on relation­ acter defects or psych iatric symptoms. ships with the external world. "Ego strength is an important concept not liThe ego is conceived as a group of func­ only in asseSSing personality health and tions that enable us to perceive, reason, growth, but in the therapeutrc process. make judgments, store knowlerlge, and One important goal of psychotherapy and solve problems. It has been called the social work is to find ways of increasing executive agency of the personality, and ego strength" (Goldenson 1970). (ego its many functions enable us to modify functioning, R1S 27 :337--9 entries) our instinctual impulses (the id), make compromises with demands of the superego empirical (conscience, ideals), and in general deal Based on facts and experience, systema~ic rationally and effectively with reality. It observation, and experiment rather than operates largely but not entirely on a con­ on general philosophical principle. Valuing scious level, and in a mature person is facts and devaluing specu lation or rational guided less often by the pleasure principle theory (Wolman 1973). than by the reality principle--that is, the practical demands of life. It may, how­ encounter group ever, be torn between these two opposing A form of PSYCHOTHERAPY in which a forces. small group assembles for the purpose of increasing interpersonal awareness, self­ liThe ego, unlike the id, is not ready-made understanding, and personal growth at birth. It develops slowly as the child through open, intensive verbal confronta­ learns to master his impulses, know what tions and discussions of emotional conflicts behavior the world requires, and use intel­ and feelings. Developed out of the sensi­ ligence in meeting difficulties. A person tivity-training groups of the 1960s, partici­ who develops a IIstrong egoll successfully pants are encouraged by group leaders to integrates the demands of the id, superego, become sensitive to the feelings of others and reality. He therefore does not have and to express their feelings and reactions to resort to rigid defenses or escape mech­ to other people openly and honestly, with anisms in handling the stresses of life. no restrictions on what is verbalized. An individual with a IIweak egoll is domi­ See illso group therapy. nated by unconscious impulses and may disintegrate under strain, with the result endorphins that mental symptoms or character defects Endogenous OPIOID biochemical compounds are likely to developll (Goldenson 1970). (peptides) . Substances produced by the (ego functioning, RIS 27:337--9 entries) body that resemble the opiates in their abilities to produce ANALGESIA and a ego strength sense of well-being. The term lIendorphinll IlA term used by psychoanalysts and others is used generically to refer to all of the for the ability of the ego, or conscious endogenous opioid compounds and implies self to maintain an effective balance a pharmacological activity (analogous. to between inner impulses and the demands the activity of the corticosteroid category of outer reality. In Freudian phraseology, of biochemicals) as opposed to a specific it is the capacity of the ego to mediate chemical formulation. Endorphins have so between the id, and superego and reality-­ far been found to be present only in ver­ that is, between instinctual impulses, con­ tebrate animals. Some of the various science, and the situations of life. endorphins that have been identified are methionine-enkephalin I leucine-enkephal in, "A person with a strong ego has high frus­ beta-endorphin, alpha-endorphin, and tration tolerance and is able to control his gamma-endorphin. See also enkephalins; impulses and modify his selfish desires runner's high; ligand; receptors; homeo­ and 'primitive urges' to conform to socially stasis. acceptable patterns. He shows flexibility in handling the stresses of life and does enkephali ns not resort to rigid defenses or inflexible Specific chemical names for ENDORPH I N­ behavior. A person with a weak ego . is type compounds; methionine-enkephalin dominated by unconscious feelings and and leucine-enkephalin. impulses and has poor tolerance for frus­ tration, disappointment, and other forms epidemic of stress. When confronted with psycho­ In regard to diseases, a sudden outbreak logical problems he suffers from conflicts that spreads rapidly through a population 38

and affects a large number at once. By ally for centuries as a drug whose effects extension, refers to the rapid spread of contract blood vessels and smooth muscle any social phenomenon, such as a dancing tissue (especially ,as in 'the uterus). mania or fad (Chaplin 1975). Contrast with endemic. ergot al kaloids Pharmacologically active ingredients of epidemiology ERGOT used medicinally variously for the The study of rates of health-relatea prob­ treatment of mood depression in elderly . lems within given groups, and the occur­ patients, the treatment of migraine head­ rence, distribution, and course of health aches, and the inducement of uterine con­ and disease. The study is usually defined tractions in expectant mothers. One of by a geographic area, frequently a city. the many ergot alkaloids is lysergic amide, A prevalence study considers all known from which LSD-25 can be derived. Clas­ cases at a gi"en time, regardless of when sification: antidepressants. they developed. An 'incidence study is restricted to new cases developing in a escapism gi\-en time period (Encyclopedia of Sociol- A tendency to retreat from the unpleasant, £9Y 1981). Historically, epidemiology especially when it should be dealt with emerged as part of the effort to combat realistically (English and English 1958). infectious diseases and became extended to a number of behavioral problems that ethanol affect individual and community health, See alcohol. sLlch as accidents, mental disorders, smok­ ing, eating, drinking, and other forms of ethchlorvynol drug use. "Contemporary epidemiologists A nonbarbiturate SEDATIVE/HYPNOTIC, and social scientists concerned with iden­ manufactured as Placidyl. tifying and describing drug abuse and drug abusers have utilized a variety of ether data collection techniques with a variety A highly VOLATILE, vaporous liquid devel­ of populations and subpopulations. In oped in the early 18th century. It is t.he pursuit of epidemiological characteris­ used medically as a general anesthetic and tics, analysts have focused upon the use, can produce an intoxicating effect similar misuse, and abuse of as few as a single to that of alcohol. I nhalation of small drug or drug class to as many as all psy­ amounts of ether or drinking a few drops choactive drugs or drug classes ...• of it in water or alcohol as an occasional Probably the most common attempts at recreational inebriant is reported to have understanding the epidemiology of drug been an accepted practice in sophisticated abuse include either surveys of at-risk social circles in the 19th century, espe­ populations in an attempt to secure total cially among students and associates of prevalence projections or studies of iden­ the medical profession. Starting in the tified abusers to at least understand those second half of the 19th century and as for whom drug use has become a problem. recently as World War II, ether was some­ In the former, general population and times used as a beverage alcohol substitute school su rveys have been most utilized. by the poor in numerous areas of Europe, In the latter, studies of persons in treat­ Great Britain, and North America. The ment, under arrest, or admitted to emer­ most extensive documented epidemic of gency rooms have been most utilized. ether use occurred in Northern I reland in Other populations, e. g., known users in the late 19th centu ry (Austin 1978: 173) . the military and workers in industry, have Classification: volatile inhalants. (RI S been studied and other 'indicators' have 27:205--1 entry) been employed, e.g., drug seizures or hepatitis rates" (Chambers and Hunt 1977). ethinamate See also ecological analysis. (RIS 27:339-- A nonbarbiturate SEDATIVE/HYPNOTIC, 65 entries) manufactured as Val mid . ergogenics ethnobotany Drugs that increase the capacity of phys­ The study of humans in relation to plants. ical and mental functioning, especially by See also ethnopharmacology. reducing fatigue. SynonymoLls with STIM- ULANTS. (RIS 27:205--1 entry) ethnography A subdiscipline of cultural (or social) ergot anthropology aimed at the detailed study The rye grain fungus Claviceps purpurea, of the way of life of people. The main or an extract of the fungus used medicin- feature of ethnography is that it requires 39

the di rect observation and participation of term nonpatterned trial of 1 or more drugs, the social scientist in the activities of the either concurrently or consecutively, with group studied. This participation may a variable intensity but maximum frequency vary in quantity and intensity, but the of 10 times per drug, used either singly requisite of personal interaction remains. or in combination. Experimental use is The ethnographic approach seeks to dis­ primarily motivated by curiosity or the cover and understand patterns of behavior desire to experience new feelings or mood in their natural context (Agar 1976; states, or to assess anticipated drug Weppner 1976). effects. It most often occurs in the shared company of one or more drug­ eth nopha rmaco logy experimenting friends or social acquaint­ The study of humans in relationship to ances, and is generally viewed in the drug use. focusing on the social, cultural, context of social activity (National Commis­ and historical aspects. See also pharma­ sion on Marihuana and Drug Abuse cology; ethnobotany. 1973:96). etiology experimental group The study of causes or origins of a Those subjects who are exposed to an disease. experimental or treatment variable and whose behavior or condition is considered etonitazene to reflect the influence, if any. of that An opioid analgesic used primarily for variable. This group is often compared research pu rposes in experiments with to a matched CONTROL GROUP, which animals. Classification: narcotic analgesic has not been exposed to the experimental agonists. condition. euphoria external ization A sense of extreme well-being and optimism, The projection of personal psychological often accompanied by heightened motor processes or states to the environment or activity; may be experienced in some drug­ other individuals, such as occurs in para­ induced states. noid or hallucinatory states (Chaplin 1975). ex-addict extinction Defining the ex-addict, or postaddict, is In the fields of drug abuse and behavioral a more imprecise process than the difficult pharmacology, a behavioral concept that job of defining the addict. On the surface views illicit drug use as a conditional an ex-addict is one who is no longer activity that can be extinguished if the addicted. Being an ex-addict, however, stimulus (e.g., old drug-using friends implies more than just being detoxified. and environments), response (e.g., drug (Long-term addicts commonly exhibit pat­ craving and subsequent use). and reward terns of sporadic voluntary abstinences (e.g., satisfaction of the craving) condi­ from drugs.) It usually implies abstinence tioned behClvior pattern can be broken. for some minimum length of time (e.g .• 6 The hypothesis is that if drug taking is a months, 1 year, 5 years) and a changed conditioned behavior, repeated experience lifestyle away from the drug subculture. of the pattern with resulting denial of the A changed lifestyle is often operationally reward will extinguish the automatic stimu­ defined by a set of measures such as Ius-response reaction. employment, school enrollment, arrests, avoidance of all illicit drug use, avoidance The development of pure, long-acting of excessive alcohol use, the development antagonists such as NAL TREXONE has pro­ or improvement of meaningful relationships, vided a means for effectively blocking opi­ and continuing or completing treatment. ate agonist effects without any an,algesic See treatment outcome. (RIS 27:282--1 or euphoric effects. Extinction is proposed entry) as a major concept associated with naltrex­ one therapy by clinicians such as Wikler expectations, drug use (1976,1973,1965). Wikler (1976:119) Refers to the physiological and psycholog­ describes this process of IIconditioned ical effects the drug user expects to ex­ abstinencell as permitting lithe patient to perience when taking drugs. See also expose himself to conditional environmental effects, perceived; effects, subjective. stimuli which evoke Icravingl and possibly other conditioned abstinence phenomena, experimental drug use without the danger of their reinforcement As defined by the U. S. National Commis­ by the pharmacological actions of opioid sion on Marihuana and Drug Abuse, short- drugs. . Eventually, if the patient so 40

exposes himself frequently enough, such the reverse, that the test indicates a drug conditioned abstinence phenomena should is not present when in fact it is. Nearly become extinguished through repeated non­ all drug-testing techniques are susceptible reinforcement. " to false, or erroneous, test results. Some of the reasons for false results are person­ The validity of the extinction concept has nel and computer clerical errors, errors not been unequivocally borne out by nal­ associated with the collection and transport trexone clinical trial experience (Schecter of specimens, improperly performed tests, 1980), but none of the naltrexone trial and the use of tests not sensitive enough research designs have emphasized this con­ to measure at its level the drug1s presence cept. Wikler (1976:126), on the other (Catlin 1973; DeAngelis 1976). While many hand, feels that naltrexone therapy should clinicians feel that false positives are more have an "active extinction" component in serious errors than false negatives, practi­ which lIinpatients, previously detoxified tioners such as DeAngelis (p. 32) view patients blocked by a narcotic antagonist the potential of false negatives to reinforce be exposed to conditioned stimuli that feeling among street addicts of "beating evoke Icraving' and perhaps other condi­ the system" as equally serious. tioned abstinence phenomena and be per­ mitted to self-inject themselves with heroin family repeatedly ad libitum; hopefully, under A social unit whose members are bound NARCOTIC ANTAGONIST blockade, self­ together by marriage t blood, or personal injection of heroin would ultimately cease." pact, whose closeness or looseness is defined by the group itself, and whose extrapyramidal nervous system size may range from two to several hun­ The fundional components of the brain dred people. The family plays a major that deal with basic, unskilled motor move­ role in influencing family-member behaviors ments, as contrasted with the pyramidal such as the use/nonuse of drugs. (or corticospinal) system, which controls skilled (e. g., related to speech and finger Many have written on this subject. Ger­ and hand) motor movement. stein et al. (1979:20), for example, in their study of female heroin addicts made The development and widespread use of the observation about early family relation­ NEUROLEPTICS has intensified scientific ships and illicit drug use that "the pat­ interest in the extrapyramidal nervous terns and priorities of adult American system. It has been observed that life-style are .•. largely formed during (1) r. :L:roleptics reduce the amount of the adolescence. Such patterns are an outcome brain chemical dopamine in the extrapyra­ of the numerous, often conflicting pres­ midal regions of the brain, (2) low Parkin­ sures operating during this period, in son1s disease is highly associated with low which life-style experimentation including brain dopamine levels, and (3) large doses unorthodox peer-fashioned behavior is of neuroleptics given to psychotic patients expected to occur. Heroin use, as an can induce signs of Parkinsonism. Investi­ example of such experimental behavior, is gative efforts have been centered on trying nonetheless quite powerfully opposed by to determine what the roles of the extra­ most families of orientation, and cannot pyramidal system and dopamine are in main­ happen in them without very disruptive taining mental stability. consequences. Therefore, such 'Jse tends to initiate among friends, to be shielded from familial discovery I and upon discovery to pose a significant 'threat to maintaining family role-relationships. Since adoles­ cent friendship patterns are quite labile, they do not form a~ powerful or sustained an influence on long-term heroin use as countervailing influences from stable family relationships. However, when initiation false positive, false negative occurs in the approving company of an False positive and false negative are terms actual or prospective family member, the used to indicate erroneous results in tests balance of influence is s:f?ficantly shifted that measure the presence (positive) or in a direction favorable to heroin use. absence (negative) of something. A false Whether this influence becomes invested positive measure in screening for drugs, in continued commitment to heroin-based for example, means that the test indicates relationships, in exaggerated fondness for the presence of a drug when in fact none heroin's Ihigh,l or simply reduces expos­ was there. A false negative means just ure to and learning of alternative social ' .. 41

beh'aviors during this formative period-­ involved, indulgent, overprotective parent most likely a combination of all these--the is of the opposite sex of the abuser. long-term result is a greater disposition toward heroin use than where no intimates "Sometimes this overinvolvement even are involved." reaches the point of incest. Further, the abusing offspring may serve a function Data from the 1979 National Survey on for the parents, either as a ch<'mnel for Drug Abuse· indicate that adolescent drug their communication I or as a disrupter use is greatly influenced by the drug use whose distracting behavior keeps their patterns of older family members. Based own fights from crystallizing. Conversely, on data from the survey, Miller and Cisin the abuser may seek a 'sick' state in order (1979) report that "drug abuse behavior to position himself, childlike, as the focus is more likely among those teens whose of the parents' attention. Consequently. mothers smoke cigarettes and/or drink the onset of adolescence, with its threat moderately than among youth whose of losing the adolescent to outsiders, her­ mothers abstain. This general pattern alds parental panic. The family then holds for teenage use of marijuana and becomes stuck at this developmental stage stronger illicit drugs as well as for youth­ and a chronic, repetitive process sets in, ful alcohol and cigarette consumption. centered on the individuation, growing Interestingly, tbe mother-child link is not up, and leaving of the 'identified' patient" substance specific; for example, mothers' (Stanton 1980). use of cigarettes is at least as strongly correlated with teenage aicohol use as it family therapy is with teenage cigarette use. Apparently I "Treatment of more than one member of a children learn general orientations towards family simultaneously in the same session. or away from drug use in accordance with The treatment may be supportive, directive, their mothers' substance-use behavior. or interpreti 'e. The assumption is that a mental disorder in one member of a family "Drug use is also more likeJy among teen­ may be a manifestation of disorder in other agers whose older brothers or sisters use members and may affect interrelationships alcohol and/or illicit drugs--and is less and functioning" (A Psychiatric Glossary likely among those whose older siblings 1975 ). abstain. Analyses of the sibling-sibling behavior link point to drug specific effects, IIFamily treatment is a relative newcomer suggesting that teens may imitate specific to the field of drug abuse. However, it behaviors which are engaged in by their has found rapid acceptance. Data from a older siblings. recent survey of 2,012 drug treatment facilities indicate that the majority of our liB}' contrast, the father's substance use Nation's drug abuse treatment programs does not appear to be related to the sons' provide some kind of family services--in and daughters' drug use. Among the many cases family or marital therapy--as other family-related factors which appear part of their therapeutic armamentarium" to have Iittle or no influence on teenage (Stanton 1980). drug use are: the family's socioeconomic status; the mother's current employment Federal Bureau of Narcotics (FBN) status; and the mother's current marital See Bureau of NarcotiCS, Federal. status (i.e., whether or not a father/step­ father lives in the home). These facts Federal drug ab'lse policy argue aga inst a general 'fami Iy situation' The three principal agencies responsible interpretation of the mother-child and for setting Federal drug abuse policy are sibling-sibling links outlined above; instead, the Drug Policy Office, the NATIONAL it appears that children learn drug use or INSTITUTE ON DRUG ABUSE (NIDA), and abstention behavior from certain older mem­ the DRUG ENFORCEMENT ADMINISTRA­ bers of the family." (family relationships, TION (DEA). The federally recognized RIS 27:342--11 entries) mechanisms for establishing drug abuse policies at the State level are the SINGLE family, nuclear STATE AGENCIES. The husband, wife, and their offspring. Synonymous with conjugal family. liThe Both NIDA and the DEA play key policy­ prototypic drug abuser family--as described making roles, but they also have primary in most of the Iiterature--is one in which functional responsibilities for carrying out one parent is intensely involved with the national policy. The Drug Policy Office abuser, while the other is more punitive, is purely policy oriented, as are several distant, and/or absent. Usually the over- other interagency drug abuse policy coor- 42

dinating, groups such as the Strategy Coast Guard. The Group meets monthly, Council on Drug Abuse, the Principals Clnd is frequently in contact between meet­ Group, and the National Narcotics Intelli­ ings, to discuss policy, issues, and prob­ gence Consumers Committee (Drug Policy lems of mutual concern to the agencies Office 1980). responsible for the operational aspects of Federal drug abuse prevention and control The Drug Policy Office exists within the programs. White House Domestic Policy Staff. The head of the Drug Policy Office (the Asso­ A 1978 intelligence pol icy review conducted ciate Director for Drug Policy within the by the Office of Drug Abuse Policy noted Domestic Policy Staff) is primarily respon­ that no formal interagency mechanisms sible for assisting the President in formu­ existed for the coordination of the narcotics lating policy for, and in coordinating and intelligence effort of the Federal Govern­ overseeing. international as well as domes­ ment. The National Narcotics Intelligence tic drug abuse functions by all executive Consumers Committee (NNICC) was estab­ branch agencies. The Drug Policy Office lished in April 1978 to correct deficiencies advises the Office of Management and Bud­ in this area. and is composed of agencies get regarding budget proposals of those with enforcement, policy, treatment, departments and agencies with drug abuse research, and intelligence responsibilities. program functions. The Drug Policy Office The present membership of the NN ICC also prepares and submits to the President includes the U.S. Coast Guard, U.S. a comprehensive report on Federal drug Customs Service, Drug Enforcement Admin­ abuse policies, including budget data, istration, Federal Bureau of Investigation, titled Annual Report of the Federal Drug Immigration and Naturalization Service, Program. Internal Revenue Service, National Institute on Drug Abuse, Departments of State and The Strategy Council on Drug Abuse was Treasury,. and the Domestic Policy Staff. created by the Drug Abuse Prevention, The Committee is chaired by the Assistant Treatment and Rehabilitation Act of 1973 Administrator for Intelligence of the Drug and was revitalized in.1977. The Council, Enforcement Administration. The Special which ,is responsible for the preparation Assistant for Coordination of Foreign Nar­ of the Federal Strategy f9r Drug Abuse cotics I nformation of the Central Intell i­ Prevention and Control, is composed of gence Agency attends the NN ICC meetings the Attorney General; the Secretaries of as an observer. A counterpart committee State, Defense, Treasury, and Health and also exists within the U.S. Foreign Intelli­ Human Services; the Administrator of Vet­ gence Community. erans Affairs; the Director of the Office of Management and Budget; and six mem­ In addition to the Drug Abuse Policy Office, bers from outside the Federal Government. 23 Federal governmental units were funded In 1979, the Congress amended the law to with a total budget of $902 million to under­ requi re that the nongoverment members take drug abuse program responsibilities include "a representative of State Govern­ in fiscal year 1981. The agencies and ment who is responsible for dealing with their individual fiscal year 1981 budget drug abuse problemsll and lIa representa­ level s are listed below. tive of local government who is responsible for dealing with such problems." Budget FY 1981 The Principals Group provides another (millions coordinating mechanism for the executive Agency of $) branch. Chaired by the Associate Director for Drug Poi icy of the Domestic Policy Drug Policy Office .46 Staff, the Group, which is composed of Department of Health and heads of agencies with primary drug pro­ Human Services gram responsibilities, includes the Assist­ National Institute on Drug ant Secretary of State for International Abuse 234.40 Narcotics Matters, the Director of the Office of Human Development National Institute on Drug Abuse, the Systems 4.70 Administrator of the Drug Enforcement National Institute of Mental Administration, the Commissioner of Cus­ Health 3.90 toms, the Special Assistant to the Secre­ Food and Drug Administration 1.10 tary, Department of Health and Hum<;l[1 Social Security Administration .60 Services, the Assistant Attorney General Department of Education 14.10 for the Criminal Division, Department of Veterans Admi nistration Justice, and the Commandant of the U.S. 58.10 43

Department of Justice teristically reacts to it in a passive manner. Drug Enforcement Administration 205.20 A field-independent person is characterized Bureau of Prisons 83.60 by activity, independence, higher, self­ U.S. Attorney's Office 14.40 esteem, and a more mature body ,mage Federal Bureau of Investigation 5.0 (Arnon et at. 1974). (RIS 27:343--3 Immigration and Naturalization entries) Service 2.50 Criminal Division 2.20 fix Department of State and AI D 38.20 Slang. To inject oneself with narcotics, Depa rtment of Defense 38.0 usually into a vein; an injection or a dose Department of Transportation of narcotics. Also, the amount of drug Coast Guard 101.30 in the bag or packet which makes up the National Highway Transporta­ fix (Lingeman 1969). See also mainlining. tion Safety Administration .81 Federal Aviation Admini'stration .69 flashback Department of the Treasury A spontaneous involuntary recurrence of Customs 73.0 a hallucinogenic drug experience some time Internal Revenue Service 13.40 after the drug has worn off. The phenom­ Department of Labor . .20 enon is not fully understood and some U.S. Department of Agriculture 2.0 ar~ue that flashbacks are ~ normal neur?­ Action 4.30 psychological event much like the experi­ enCe of deja vu, which naturally occurs TOTAL $902.16 among all people (Weil 1972:61-62). These Federal funding criteria phenomena may occur for weeks or months. Although most involve the visual senses, The minimum treatment standards for fed­ flashbacks may occur in any of the senses, erally funded drug treatment programs including taste, smell, feel, hearing, time published in the Federal Register on May sense, and sel f-image. Documented cases 27, 1975, as modified by NfDA's January have indicated that flashbacks may be 12, 1976, issuance of the Physical/Labora­ pleasant (B rown and Stickgold 1976; Keeler tory Examination Matrix. et al. 1968), or at the other extreme, they may be terrifying to the point of driving felony a person to commit suicide (Smart and A crime of a graver or more atrocious Bateman 1967). The mechanism responsible nature tha.l those designated as MISDE­ for flashbacks is not understood, but there MEANoRs and generally punishable either appears to be an inconsistent relationship by death or by imprisonment in a State or between the c)mount and number of times Federal penitentiary. (RI S 27: 343--5 hallucinogens are taken and the occurrence entries) of flashbacks. fe rme ntation fluorocarbons Chemical changes resulting from the opera­ A large group of chlorinated or fluorinated tion of living organisms (mainly yeasts) hydrocarbons now used chiefly a~ refriger­ by enzyme action. ALCOHOL is produced ants. Prior to 1978 they were WIdely used in fermentation by the action of zymase as AEROSOL propellants in household prod­ on hexose sugars. This takes place natur­ ucts and were .subject to abuse because of ally in grape juice through the yeasts on their intoxicating (anesthetic) effects when the skin. [n brewing. fermentation is inhaled. Fluorocarbons and chlorofluoro­ induced by the introduction of yeast carbons were banned from use in household (Keller and McCormick 1968). consumer products on March 16, 1978, by the U. S. En vi ronmental Protection Agency fetal drug toxicity under the Toxic Substance Control Act of See placental passage of drugs. 1976. The aerosol propellants currently used by industry are pentane, pentene, field dependence and other such hydrocarbons. Because The degree to which performance is of their flammability, they are believed to strongly dominated by the organization of pose more of a safety than health threat the prevailing field (Witkin et al. 1962). to society. Classification: volatile inhal­ A state wherein a person depends on the ants. See also sudden sniffing death surrounding environment for structure (SSD) syndrome; volatile inhalants. and support. Field dependence has been shown to be associated with a whole con­ fluphenazine hydrochloride stellation of personality characteristics. An (ANTIPSYCHOTIC) TRANQU ILiZER, Typically, a field-dependent person has manufactured as Proloxin and Permitil. trouble dealing with the world and charac-

387-396 0 - 82 - 4 QL 3 44

flu raze pam hydrochloride Free Clinic, RI S 27: 344--14 entries) An (ANTIANXIETY) TRANQUILIZER, man­ ufactured as Dalmane. frequency of use The absolute or relative number of times formula grants, Drug Abuse Act of 1970 (occasional, regular, etc.) a drug is taken See statewide services contract. either in general or for a specific time period. forensic medicine The application of the various branches of Ft. Worth Hospital medical knowledge to the purposes of the See Public Health Service hospitals. law. Anatomy, toxicology, chemistry, botany, and other fields of science that functional disorder may be used in court to support or dispute A qmdition in which one or more of the a case (Encyclopedia of Sociology 1981). normal activities of the organism cannot be properly performed, though there is free clinic no known pathological change in organic A medical clinic that offers free medical structure that can be related to the dis­ services to all comers, including drug order (English and English 1958). Con­ abusers, and is funded through sources trast with organic disorder. such as donations, THIRD-PARTY PAY­ MENTS, revenue sharing monies, volunteer labor, etc. One of the major proponents of the free clinic movement is David Smith of the Haight Ashbury Free Medical Clinic in San Francisco. According to Dr. Smith (1976:46, 48): "'Free' to the free clinic movement repre­ sents a philosophical concept rather than gambling an economic term. This alternative phi­ See compulsive gambling. losophy of freedom from established approaches reflects itself in the treatment ganja philosophy that health care is a right, A CANNABIS preparation, consisting of not a privilege. Over the last ten years, the resin-rich flowers and top leaves from the free clinic has evolved as a symbol the female plant. The name is of Indian for nonjudgmental, humanistic health care origin and is the term l,lsed in Jamaica for delivery to alienated populations in the marijuana. Classification: cannabis. United States, including hippies, commune (llganja vision," RIS 27:343--1 entry) dwellers, drug abusers, third world minor­ ities, and other 'outsiders' who have been gasoline rejected by the more dominant culture. A volatile, highly foxic, refined mixture of petroleum hydrocarbons whose fumes * * * * have a deliriant effect similar to glue or cleaning fluid when inhaled. Classification: "Free clinics have made major contribu­ volatile inhalants. tions in the field of drug abuse treatment. Rooted in nonjudgmental health care, they generic name believe that drug abusers deserve to be General, usually scientific name for an treated like any other patients who enter entire group or class. As applied to into the health care delivery system. drugs, it is the chemical description of However, in 1967 the treatment of drug the drug class as opposed to a commercial abusers on an outpfltient basis at the com­ brand or trade nare for the same com­ munity level was quite controversial. The pound. domin"'ting legal-political approach to drug abu5 ~ problems at that time was almost glue sniffing exclusively law enforcement-oriented, and Glue sniffing first surfaced as a major fad most drug abuse treatment was taking place in the early sixties. Glues containing aro­ within the framework of inca!I'ceration facil­ matic hydrocarbons, such as toluene, ities controlled by the criminal justice sys­ xylene, and the like, were particularly tem. Further, the free clinics were using subject to abuse because of the intoxicating ex-addicts and street people as para­ properties of these solvents. While the professionals in implementing their commu­ inhalation of volatile substances continues nity-based approach to health care and to be a significant drug-abusing behavior, drug abuse treatment. II (Haight Ashbury particularly among certain groups of youths

L-______-- -~-- 45

(e.g., Native Americans), the glue sniffing habituation fad has just about subsided. The practice An imprecise term generally used to refer has diminished for several reasons includ­ to a state of chronic or continuous attach­ ing the presence and discovery of a cornu­ ment to something such as drugs, which copia of household products from nail polish is less severe or harmful than ADDICTION. to spray paint that are just as readily In regard to drug use the term usually available and have the same abuse poten­ implies a state that is psychological in tial as glues, and the current practice of origin and that is characterized by a desire many glue manufacturers of using harmless rather than .a compulsion to continue use, additives (e.g., mustard compounds) that with little or no tolerance and no (PHYSI­ have obnoxious scents or the ability to CAL) DEPENDENCE (LeDain et al. 1973). produce nausea, thus discouraging their The psychical phenomena of adaptation being sniffed. See also volatile inhalants; and mental conditioning to the repetition hydrocarbons; solvents; toluene. of an effect (Himmelsbach and Small 1937); a condition often used as a synonym for glutethimide (PSYCHOLOGICAL) DEPENDENCE in which A nonbarbiturate hypnotic used in the the habitue desires a drug but suffers no treatment of insomnia. Physical and psy­ ill effects on its discontinuance (Tatum chological dependence on this drug have and Seevers 1931: 108) • According to the occurred. Manufactured as Doriden. WHO Expert Committee (1957), a state of Classification: sedativefhypnotics. (RIS periodic or chronic intoxication produced 27:205--1 entry) .by the repeated consumption of a drug, the main elements of which are (1) desire goal orientation (but not a compulsion) to continue taking Psychological disposition toward achieving the drug for the sense of improved well­ one's objectives. See also amotivational being it engenders; (2) little or no tend­ syndrome. (RrS 27:344--19 entries) ency to increase the dose; (3) some degree of psychic dependence, on the effect of grass the drug I but absence of physical depend­ Slang. See marijuana. ence and hence of an abstinence syndrome; (4) detrimental effects, if any, are primary group therapy on the individual (not society). The technique of treating patients in groups instead of individually; this tech­ The term "habituationll came into use begin­ nique emphasizes the fact that their prob­ ning in the 1920s in order to draw' a djs­ lems are not unique. Lectures and group tinction between "addiction" to the opiates discussion are used as therapeutic meas­ and the compulsive or chronic use of other ures (Zadrozny 1959). drugs that did not appear to produce to the same degree either tolerance or physi­ cal discomfort upon abstinence. In con­ trast to addiction, habituation was linked to a weakness of the individual will rather than specific drug effects and was viewed as a problem of far less magnitude (National Commission on Marijuana and Drug Abuse 1973:123). Attempts to maintain this dichotomy, however, were not success­ habit-forming drug ful, as the nature of chronic drug-using A term used to refer to a drug that may behavior involves a range of complex indi­ produce either (PSYCHOLOGICAL) or vidual-drug interactic 1S that cannot be (PHYSICAL) DEPENDENCE in certain users compartmentalized into two such mutually in certain circumstances. This term is exclusive categories (Grinspoon and often used by drug manufacturers to mean Hedblom 1975:151). As the National Com­ that prolonged use will result in physical mission observes, "determining the point dependence, and specifically that the medi­ where the lesser (habituation) becomes cine contains an opiate, opiate derivative, the greater (addiction) is bound to be synthetic opiate, or barbiturate (LeDain arbitrary, since, as is true in all biological et al. 1973). Others use the term to refer responses, there is a wide range of varia­ to a drug that may be used chronically tion in the same individual and between but does not produce ADDICTION or individuals" (National Commission on Mari­ dependence to the extent of other drugs. huana and Drug Abuse 1973:125). Many See also habituation. were further concerned about the concom- 46

itant tendency to apply the term "addic­ tion" to any misuse of drugs outside medical practice, with a connotation of serious harm to the individual and society. As a result, in the early 1960s the World illusion. Health Organization and American Medical Association, recognizing that the distinc­ hallucinogens tion between addiction and habituation was A major classification of natural and syn­ unclear and unscientific, recommended thetic drugs whose primary effect is to retiring the use of both terms, with the distort the senses; they can produce hallu­ WH 0 committee substituting the term cinations-·-experiences that depart from (DRUG) DEPENDENCE to replace them both reality. These drugs may produce pro­ (Eddy et al. 1965). found alterations in sensation, mood, and consciousness at doses that result in com­ halfway house paratively light physiological activity. A program or facility that attempts to com­ Although most experiences are visual, they bine the advantages of RESIDENTIAL may also involve the sense of hearing, TREATMENT with those of (AMBU LA TORY) touch, smell, or taste, sometimes simultane­ TREATMENT by solving problems through ously. They are also variously known as group interaction and community involve­ PSYCHEDELIC DRUGS (mind-manifesting), ment. Patients live in a group but are psychotomimetics (psychosis-imitating), permitted to leave the facility during the illusionogenics (illusion-producing), psy­ day and perhaps on weekends. Originally chotaraxics and pc;ychodysleptics (mind­ a term given to guidance centers for offen­ disrupting). The.. J terms refer to some­ ders who are "halfway out" of prison on what overlapping effects alleged to occur probation or parole, which sought to assist with this group of drugs, probably none in the demands of daily participation in of which are entirely adequate as descrip­ community life. Now it applies also to tive terms (Schultes 1976). No term fully facilities in which a person who recently satisfies. Psychedelic is the preferred has been discharged from a mental hospital term of users, but hallucinogen has gained attempts to adjust to living outside the the widest support. Included in this clas­ hospital (Zad rozny 1959; Encyclopedia of sification are DIMETHYL TRYPTAMI NE Sociology 1981). They are now perceivea (DMT), LSD-25, METHYLENEDIOXYAM­ as a basic correctional modality that is PHETAMINE (MDA), MESCALINE, PEYOTE, useful in at least 5 ways: (1) a bridge PHENCYCLIDINE (PCP), PSILOCYBIN, between a highly structured institutional PSI LOCI N, and DIMETHOXYMETHAMPHET­ setting in which a person has little individ­ AMINE (STP, DOM). The term has also ual initiative and a relatively unstructured been applied to the pseudohaliucinogens parole setting in which the person has such as NUTMEG and mace. While other much greater individual initiative and drugs, such as alcohol or cannabis, may responsibility; (2) a means for providing produce hallucinations if a very high dose assistance to the newly released parolee is used, they are not classified as hallu­ who is precipitously faced with the many cinogens because this is not the usual and varied problems of being in a commu­ effect expected or experienced. I n low nity; (3) a place to which inmates who doses, the effects of hallucinogens vary have no satisfactory residence plan may widely depending on variations in drug be released; (4) an opportunity for the taken and the unique sensitivity of user parole agent to get a better understanding at the time of use. (RIS 27:205--29 of the parolee by more frequent and inten­ entries) sive observation in the house so that the agent can more effectively provide the haloperidol needed control, treatment, and assistance; An (ANTIPSYCHOTIC) TRANQUILIZER, and (5) an alternative to return to a cor­ manufactured as Haldol. rectional institution (prison) for those parolees who violate the conditions of their hang-loos0 ethic release (Berecochea and Sing 1972). (RIS A phrase coined in the late 1960s to refer 27: 345--8 entries) to an outlook on life generally character­ ized by irreverence towa rd conventional hallucination society. The person with such an outlook A perception of sounds, odors, tactile sen­ seeks to cut loose from the traditional sations, or visual images that are not "establishment, II to rebel against conformity, caused by external stimuli but arise from and to search for new experiences (Such- within the person (Zadrozny 1959). A man 1968). (RIS 27:345--20 entries) sensory perception without external stimu- 47 hard drugs These acts were repealed and replaced by An ambiguous term generally used to the DRUG ABUSE ACT OF 1970. describe drugs legally viewed as narcotics, such as opium and morphine derivatives hash oil and their synthetics. and cocaine. Usually A highly refined oily cannabis extract that contrasted with SOFT DRUGS. contains the highest concentration of THC of all forms of cannabis, up to 40 percent. Harris-Dodd Act Hash oil is thick and can be dark brown, See Drug Abuse Control Amendments of yellow, reddish-yellow, or clear in color. 1965. It can be applied a drop at a time to mari­ juana tobacco or spread on the paper used Harrison Narcotics Act of 1914 to roll JOINTS and cigarettes. It does not The first Federal antinarcotics statute and have the characteristic smell of marijuana the basis of all subsequent narcotics con­ when burned. Crystallized hash oil can trols until the passage of the DRUG ABUSE have a potency of 60 percent THC. The ACT OF 1970. Ostensibly the act was a THC content in hash oil deteriorates tax measure designed for the open control rapidly when not properly refrigerated. and orderly marketing of narcotics, among Classification: cannabis. which were classified the opiates and cocaine. The three central parts of the hashish act stated that (1) anyone engaged in the The dried caked resin produced from the production or distribution of narcotics had tops and leaves of the female CANNABIS to register with the Federal Government plant. Hashish contains a higher concen­ and keep records of all transactions with tration of THe (up to 14 percent) than these drugs; (2) all parties handling the MARIJUANA. Hashish comes in many dif­ drugs through either purchase or sales ferent shapes but is often sold in little had to pay a nomi. :al tax (1 percent per rectangular tablets. The tablets can be ounce); and (3) unregistered persons soft, crumbly, or hard and may be from could purchase drugs only on prescriptions light brown to black in color. It has a from physicians, .and such prescriptions heavy marijuana odor when burned. It is had to be for legitimate medical use. The often smoked in water pipes, which regu­ dispensing of narcotics by registered phy­ late and cool the smoke, or sprinkled on sicians !lin the course of their professional JOINTS or tobacco cigarettes. In India, practicel! was not prohibited. The act's hashish is known as charas. Slang names avowed purpose was then primarily to are listed in appendix B. Classification: bring the domestic drug traffic into cannabis. See also bhang. (RIS 27:205-- observable channels. However, the pos­ 27 entries) session of untaxed narcotics had become a crime and following the passage of the act, Hawaiian baby wood rose the Treasury Department became respon­ A climbing plant of the bindweed family sible for its enforcement and inaugurated originally grown in Hawaiian and Asian a pol icy of prohibiting the prescribing of forests. It is now grown and sold in the narcotics for nonmedical maintenance. In United States., Hawaiian baby wood rose two la ndma rk decisions in 191'9 (U. S. v. seeds contain lysergic acid amides and pro­ Doremus and Webb v. U.S.), tri'eU:"S. duce hallucinogenic effects When consumed. Supreme courfLiPheld fFi'e"actls constitu­ The fuzz coating on the seeds contains tionality and severely restricted the right trace amounts of strychnine that can caUse of doctors to prescribe opiates, asserting nausea and vomiting if not removed before that doctors who maintained narcotic users ingestion. violated the law and that maintenance of a user was illegal unless it was part of an hedonistic attempt to cure (detoxify) the habit. In Pleasu re oriented. A term often inappro­ Linder v. U.S., the Supreme Court later priately or Simplistically used to describe modified tliis stand, implying that if done the motivations of chronic illicit drug users. in good faith a physician could prescribe narcotics to a patient. This ruling, how­ hem!') ever, had little impact. Subsequent legis­ Cannabis plant; particularly the variety lation that supplemented the Harrison Act cultivated for commercial purposes such were the NARCOTIC DRUGS IMPORT AND as for the making of rope. See cannabis. EXPORT ACT OF 1922, the MARIHUANA TAX ACT OF 1937, the BOGGS AMEND­ Henderson Hospita.1 MENT of 1951, the NARCOTICS DRUG The current name of the institution in CONTROL ACT OF 1956 and the DRUG Britain in which the THERA:-:'EUTIC COM­ ABUSE CONTROL AMENDME.NTS OF 1965. MU NITY concept was first utilized among 48

a group of social deviants after World War being while a drug is in effect, as opposed II. Under the guidance of Dr. Maxwell to the RUSH, the initial onset. of euphoria Jones and others, a democratic system was (Ungeman 1969). See contact high. established in which domination of the hos­ pital by "professionals" was replaced by a Himmelsbach test democratic system of open commun ication This test was developed and used exten­ and sharing of problemsolving and dec.ision­ sively at the now defunct Addiction making. The nucleus of this process was Research Center in Lexington, Kentucky, daily meetin~s of the staff and patie:lts. as a means for assessing the severity of a The original name for this clinic, which patient's opiate withdrawal syndrome. It was established in 194,1, was the Social consists of assigning points for various Rehabilitation Unit'of the Belmont Hospital symptoms observed over a set time period. (Jones 1979). The points are then totaled for an overall hepatitis index score. A score of 0-20 points indi­ cates mild illness; 20-30 points, moderate Inflammation of the liver. Serum hepatitis illness; and 30-35 points, severe illness. is an acute viral illness that can be trans­ mitted by parenteral exposure from contam­ The observed symptoms and their point inated needles (Dorland's Illustrated Medical system is shown in the following table. Dictionary 1974). Himmelsbach points heptaba rbital A short-acting BARBITURATE. Classifica­ Signs tion: sedative/hypnotics. and By day By hour heroin symptoms Points LilTiit Points Limit Diacetylmorphine hydrochloride, a semisyn­ thetic opiate derivative isolated in 1898 in Yawning 1 1 1 1 Germany by the pharmacologist Heinrich Lacrymation 1 1 1 1 Dreser in the search for non-habit-forr.;ing Rhinorrhea 1 1 1 1 ANALGESICS to take the place of morphine. Perspiration 1 1 1 1 It was named after the German word Mydriasis 3 3 3 3 "heroisch" meaning large, big, powerful. Tremors Although heroin was considered nonaddictIve (twitching) 3 3 3 3 when first introduced, by 1924 the U.S. "Gooseflesh" 3 3 3 3 Congress had prohibited its manufacture in Anorexia (40 the United States; by 1956 all existing percent stocks on hand were required to be sur­ decrease' in rendered. Heroin is 2 to 3 times as potent caloric in- analgesically as morphine, although in equi­ take) 3 3 potent doses the effects are simlla r. The Restlessness 5 5 5 5 preference for heroin use over morphine is j:mesis (each yet to be thoroughly explained; whatever spell) 5 5 5 physical factors are involved, and the Fever (for logistics of illicit traffic, heroin is most each 0.1 °C potent, least bulky and easiest to conceal, rise over and provides greatest profit. See also mean addic- National Committee on the Treatment of tion level) 10 Intractable Pain. Classification: narcotic Hyperpnea analgesic agonists. Slang names: H, (for each horse, scat, junk, smack, scag, stuff, resp./min Harry, brown sugar. See also appendix B. rise over (RIS 27:206--326 entries) addiction level) 10 heroin maintenance Rise in A.M. The legal prescription of heroin on a regu­ systolic BP lar basis. See also methadone maintenance; (for each 2 British system. mm Hg over hexobarbital mean addic- A short-acting BARBITURATE. Classific1- tion level) 15 10 tion: sedative/hypnotics. Weight loss (A.M. ) (for high each pound The feeling of euphoria or exhilaration from last often associated with drug-taking. The day of addic- continuing state of relaxation and well- tion) 49 history, drug boost with the PARAQUAT scare that Tal

and gasoline. The volatile hydrocarbons establishing standards and goals. /I (Golden­ are commonly divided into the following son 1970) categories: (1) chlorinated--CARBON TETRACHLORIDE, trichloroethane; (2) "[The chronic drug user often] develops FLUOROCARBONS--the aerosol propellants, an identity as participant in a deviant and (3) petroleum hydrocarbons--BENZENE, career. He must relate to institutions, GASOLI NE, NAPHTHA, and TOLUENE; participate in a range of informal relation­ (4) ketones and acetates--ACETONE. Clas­ ships, and develop various roles, in a sification: volatile inhalants. relatively orderly manner. The drug sub­ culture blunts the impact of harsh laws hydrocodone bitartrate while permitting th~ user to assume a new A narcotic ANTITUSSIVE derived from deviant identity--via language, ideal self codeine that exerts its effects on the CEN­ image, skills involved in getting and using TRAL NERVOUS SYSTEM. It is manufac­ drugs, and new norms and world view. tured as Dicodid and is an ingredient in The young user who may not hav;! been many cough preparations. Classification: able to deal with the conventional social narcotic analgesic agonists. system derives a new ideology in the user subculture. II (Winick 1974). See also hydromorphone hydrochloride righteous dope fiend. An OPIOID five times more potent than MORPH I NE as an ANALGESIC. Physical I.E', scale dependence develops after prolonged use, A widely used scale developed by J. B. and withdrawal symptoms are similar to Rotter to yield scores on the dimension of those of morphine in severity. Two mg internal and external LOCUS OF CONTROL. provide the analgesia of 10 to 15 mg of morphine. Manufactured as Dilaudid. illusion Classification: narcotic analgesic agonists. A mistaken or distorted perception. Illu­ sions may be of various sorts, including hydroxyzine hydrochloride illusions of movement, perspective, and An (ANTIANXIETY) TRANQUILIZER, space, but they always involve the distor­ manufactured as Atarax and Sedaril. tion of external stimulus patterns (Chaplin 1975) • For example, the rustling of leaves hypnotics is heard as the sound of voices (Diagnostic See sedative/hypnotics. (RIS 27:210--1 and Statistical Manual of Mental Disorders entry) 1978). Contrast with hallucination; delu­ sion. imipramine hydrochloride A trycyclic ANTIDEPRESSANT, manufac­ tured as Tofranil. See also amitriptyline hydrochloride. (RIS 27:210--1 entry)

impotence iatrogenic The inability of the male to perform sexu­ Induced by a physician; used chiefly in ally, or a lack of fertility. Broadly, a regard to ailments or death. An iatro­ feeling of inability to control events genic illness is a functional disorder (Chaplin 1975)., brought on by a physician's diagnosis or suggestions (Chaplin 1975). indoleaminergic See neurotransmission. identification liThe tendency to incorporate or adopt the inebriation attitudes and behavior of other individuals The state of being drunk or habitually or groups. When the purpose of this drunk. In the late 19th century and again reaction is to increase one's feelings of in the 1930s and 1940s. inebriety was used strength, security or acceptance by taking to refer to alcoholism. During the latter on the q'Jalities of others, it can be c'las­ period, this usage reflected a wish to avoid sified as a defense mechanism. It generally a formal diagnostic declaration implying a operates on an unconscious or half­ disease condition, while implying more than conscious level. simple drunkenness (Keller and McCormick 1968). At the turn of the century it was II Identification is probably the most impor­ also commonly used to refer to chronic tant factor in shaping the personality and users of any drug and was interpreted as

L--______51

a disE:ased state (Jaffe 1978). See also ized so that it tends to remain in existence. alcoholism; drunkenness: intoxication. beyond the life of any given participant (Hoult 1969). infection Medically, a contaminatjon resulting from insufflation a disease-producing organi sm or matter; The inhaling of a substance. Psychoactive more generally, any corruption or harmful drugs most commonly insufflated are effect. Two hazardous infections--TET A­ cocaine, heroin, and the volatile solvents. NUS and HEPATITIS--are common among To be insufflated the substance must be those who inject drugs. Tetanus infections in either powdered or gaseous form, which may result from subcutaneous injection, is absorbed through the membranes of the hepatitis infections from intravenous injec­ nasal and bronchial passages. tion. intake ingestion The process of admitting a client into See administration, routes of. treatment. A routinized procedure that usually includes the taking of information inhalants on the client's demographics and medical See volatile inhalants. history, a medical examination, an explana­ tion of the program, and in certain cases inhibition a detoxification regime. N IDA has specific A mental blockage; a hesitancy to behave, intake requirements for federally funded particularly in a somewhat unconventional treatment programs. They are available ma nner. I n neurology, the stopping of from the Office of Community Assistance. an ongoing process or the prevention of a process from starting, as in the inhibition integrated drug use of antagonistic muscles (Chaplin 1975). Refers to a condition in which the use of (RI S 27: 348--6 entries) drugs is a customary or commonly accepted phenomenon within a society as part of a injection larger life pattern, most commonly occur­ The process of administering a drug by ring in association with other social behav­ introducing or forcing it in liquid form iors or selected settings, such as eating. into some part of the body usually by Often implies not secular but endowed with means of a syringe or hypodermic needle. ritual or ceremonial significance (Child et Drug injections are classified as INTRA­ al. 1965). MUSCU LAR: I NTRAVENOUS, or SUBCU­ TANEOUS. See also adm;nistration, routes intensified drug use of; parenteral; mainlining. As defined by the U. S. National Commis­ sion on Marihuana and Drug Abuse, usually in-kind contribution long-term, patterned use of drugs at a Noncash contributions provided by a con­ minimum level of at least once daily, moti­ tractor or third parties. In-kind contri­ vated by an individual's perceived need butions include charges for real property to achieve relief from a persistent problem and equipment, and the value of goods or stressful situation or by a desire to and services directly benefiting and spe­ maintain a certain self-prescribed level of cifically identifiable to a program. Used performance. A distinguishing characteris­ by drug abuse treatment and prevention tic of this class of behavior is the regular programs to help meet State or local use of one or a combination of drugs, matched funding requirements for Federal escalating to patterns of consumption that financial assistance. might be defined as (DRUG) DEPENDENCE (National Commission on Marihuana and inpatient Drug Abuse 1973:97). One who is received into a hospital or similar institution, generally for temporary intervention strategy medical treatment and care (Fairchild 1976). Any interference that may affect the behav­ Contrast with outpatient. ior of others. In treatment, it is the therapist's direction of or influence on a ins titutional iza tion client's actions (Wolman 1973) . The process of placing a person in an organ ization or an establishment for cor­ in tox icati on rective or thera peutk pu rposes. I n soci­ An abnormal acute or chronic state that ology, the process whereby either an in a medical sense is essentially a poison­ association or a procedure becomes increas­ ing. An altered physiological state result­ ingly organized, systematized, and stabil- ing from ingestion of a psychoactive 52

sUbstance in which normal functioning is joint seriously impeded. Most frequently used Slang. A MARIJUANA cigarette. in reference to drunkenness from the effects of alcohol in the organism, as junkie manifested by such signs as facial flushing, Slang. A person addicted to junk (i.e., slurred speech, unsteady gait, euphoria, heroin); a DOPE FIEND. increased activity, emotion, volubility, disorderly conduct, insensibility, or stupe­ khat faction (Keller and McCormick 1968). The The fresh leaves of the plant Catha edulis, condition of being drunk; INEBRIATION. which are chewed or drunk as tea in The term does not necessarily impJ',( Yemen, East Africa, and the Arabian penin­ DRUNKENNESS, but rather is often"used sula. It is a stimulant and is often used to refer to a state falling within a contin­ to reduce fatigue and hunger and to pro­ uum between drunkenness and a mild HIGH duce a feeling of exhilaration. Also spelled (Stivers 1976:98). chat, q'at, and nat. Classification: stimu­ lants--secondary. intramuscular Within the muscles of the body. See also kief administration, routes of. Ti"is term has many spellings and several meanings. On the American illicit drug intravenous scene it refers to the dried flower pods 'Within a blood vessel. See also administra­ of the marijuana plant and is considered tion, routes of. to be somewhat of a delicacy to smoke. In some parts of the Middle East it is used inventory as a general word for marijuana. In An instrument, usually in the form of a Morocco it is the name for a mixture of list of questions, for assessing the pres­ marijuana and tobacco. It is also spelled ' ence or absence of certain behaviors, kaif, keif, kif, and kiff. See marijuana. interests, attitudes, and the like (Chaplin 1975). A personality inventory usually kilo consists of a series of, statements to which A kilogram (2.2 pounds). Bulk sales of individuals respond .abol.lt themselves either marijuana and heroin are often made in "yes," "no," or "?" kilo lots and the drugs shipped in kilo packages. See also lid; brick. in vitro Outside the living body and in an artificial environment. in vivo In the living body of a plant or animal.

isocarboxazid An MAO INHIBITOR, manufactured as Marplan. Classification: antidepressants. LAAM Levo-alpha-acetylmethadol, an OPIOID that has completed large-scale clinical trials as a alternative treatment drug to METHA­ DONE. 'Whereas methadone must be taken daily, LAAM dosage is three times a week, does not yield a quick high, and appears to provide a level, sustained effect (Blaine and Renault 1976). Classification: nar­ cotic analgesic agonist.s. Jefferson Airplane Slang. A crude device for holding a labeling theory roach (marijuana cigarette butt) that is A perspective from which deviance is con­ made by splitting a used paper match sidered not a quality of t.he act the person nearly in half, placing the roach in commits but is instead a consequence of between, and holding the loose halves the application by others of rules and sanc­ together with the fingers. tions to an offender (Williams 1976). Be­ havior is deviant if people label it so. The jogger's high label ing approach shifts the emphasis from See runner's high. the individual to the social-control appara- 53

tus that specifies behavioral sanctions. reward will tend to be repeated and that Another component of this theory is that behavior that is not rewarded will tend to the stigma of being labeled morally inferior fade away (Encyclopedia of Sociology 1981). may lead to further (SECONDARY) DEVI­ A primary example of learning theory ANCE and the rebuilding of one's self­ applied to the drug field is Becker's (1963) concept in terms of the deviant behavior observation that an individual will be able (Encyclopedia of Sociology 1981). (RIS 27: to use marijuana for pleasure only when 349--1 entry) the individual goes through a process of learning to conceive it as a commodity that lability can be used in this way. No one b~comes The ready capability' for change; readily a user without (1) learning to smoke the or continually undergoing chemical, physi­ drug in a way that will produce real cal, or biological change or breakdown; effects, (2) learning to recognize the the state of being, unstable. effects and connect them with drug lise, and (3) learning to enjoy the sensations La Guardia Report that are perceived. Short title for a study of marijuana ordered by New York Mayor: Fiorello La Guardia in LeDain Commission 1938, carried out by the New York Acad­ See Commission of Inquiry into the Non­ emy of Medicine, with the assistance of Medical Use of Drugs. the New Yorl< Police Department. Headed by George B. Wallace, the committee was legal highs composed of 31 eminent physicians, psychi­ Refers to legal herbs, spices, plants, and atrists 4 clinical psychologists, pharmacol­ chemicals with psychoactive properties.' ogists, chemists, and sociologists. The There are dozens of substances commonly study was in two parts: a clinical study found in the home (e.g., nutmeg, coleus, of the effects of marijuana and a sociolog­ catnip, hops), vegetable garden (e.g., ical study of marijuana users in the city. BROOM, hydrangea, heliotrope), or The report refutes the STEPPING-STONE through chemical supply houses that pro­ HYPOTHESIS, and generally stresses that duce a broad range of pharmacological the sociological, psychological, and medical effects including hallUcination, stimulation, ills commonly attributed to marijuana are and sedation. Each usually requires an exaggerated. See also National Commission extraction process to bring out the active on Marijuana and Drug Abuse. ingredients. Many legal high substances are toxic (even deadly) at high doses or laudanum When ingested in an improper form (e.g., A n alcoholic sol ution containing 10 percent broom, nutmeg, parsley) and are often opium; TINCTURE of opium. This was accompanied by unpleasant side effects the first medicinal form of opium and up such as nausea. Most, however, are harm­ through the 19th century was sold with­ less, milder forms of more potent, illicit out prescription and was used widely for psychoactive substances. a variety of illnesses. See also paregoric. legal ization laughing gas The act of giving legal sanction or validity See nitrous oxide. to a behavior formerly illegal. See also decriminalization. (RIS 27:349--12 entries) laws, arug See the following specific drug laws: Har­ lettuce opium rison Narcotics Act of 1914; Narcotic Drugs See wild lettuce. Import and Export Act of 1922; Marihuana Tax Act of 1937; Uniform State Narcotic levallorphan tartrate Drugs Act; Boggs Amendment; Narcotics A NARCOTIC ANTAGONIST with mixed Control Act of 1956; Drug Abuse Control AGONIST and antagonist properties. Amendments of 1965; Drug Abuse Act of 1970. See also the following court cases: levo-al pha-acety Imethadol Linder v. U.S.; Robinson v. California. See LAAM. learning theory levorphanol tartrate An attempt to account for the manner in An OPIOID, manufactured as Levo­ which the response of an organism is modi­ Dromoran. Classification: narcotic anal­ fied as a result of experience. As stated gesic agonists. at the turn of the century by Edward L. Thorn<;like. a principal premise of this Lexington Hospital theory is that behavior followed by a See Public Health SerVice hospitals. ------~------.------

54

liability, addiction dition incident to opiate use. Under this A differential risk of becoming addicted ruling a physician in good faith and for various categories of drug users. according to fair medical standards could give a drug-dependent person moderate license amounts of opiates to relieve withdrawal Permission or authority to do something symptoms without violating the HA RRISON that would be unlawful or wrong to do in NARCOTICS ACT. At that time, the rul­ the absence of permission or authority ing had no practical effects on law enforce­ (Running Press Dictiona r)/ of Law 1976). ment authorities, who continued to threaten physicians with imprisonment for treating licensing addicts (Austin 1978:219). In regard to drugs, the regulation of sales through the issuance of special permits, locomotor activity usually under special controlled conditions Having to do with physical movement, such and requiring payment of a fee. More as walking and running. Impaired loco­ generally, the granting of special permis­ m()tor activity is a frequent symptom of sion to perform a specified act; the certif­ P_YCHOTROPIC drug use. icate or document granting this permission is called the license. See also controlled locus of control substances; monopoly systems. A descriptive dimension used to refer to the extent to which the behavior of a per­ lifestyle son is primarily determined by internal or Central life interest; the activities on which external factors. A person is considered dominant emphasis is placed in the life of to have an internal locus of con.trol if the individual. For the individual involved important reinforcements are expected to in a deviant subculture, the central life be contingent upon personal actions; a interest or major social role constitutes person is considered to have an external both the deviancy itself and the pursuit locus of control if reinforcement is attrib­ of the means necessary to sustain that uted to luck, chance, fate, or powerful deviance. A number of distinct lifestyles others. See also I. E. scale. (RIS 27: have been identified among drug-using 350--14 entries) populations; for example, Brotman and Freedman (1968) formulated a typology of LSD four types of lifestyles that exist among Generic name for the hallucinogen lysergic heroin users: (1) conformist--highly acid diethylamide-25. 'Discovered by Dr. involved in conventional life; (2) hustler-­ Albert Hoffman in 1938, LSD is one of the highly involved in criminal life; (3) most potent mind-altering chemicals known. two-worlder--highly involved in both con­ A white, odorless powder usually taken ventional and criminal life; and (4) unin­ orally, its effects are highly variable and volved--not significantly involved in either begin within an hour and generally last area. In drug use research, lifestyle 2-12 hours, gradually tapering off. It research focuses on the means that are has been used experimentally in the treat­ pursued to sustain one's drug use eNureo ment of alcoholics and psychiatric patients. 1972). See also career, addiction. (RIS It significantly alters perception, mood, 27: 349--LI2 entries) and psychological processes, and can impair motor coordination and skills. Dur­ ligand ing the 1950s and early 1960s, LSD A molecule that has been formed from the experimentation was legally conducted by complex union of two or more organic mole­ psychiatrists and others in the health and cules. Peptides such as the ENDORPHINS, mental health professions. Sometimes dra­ for example, are ligands of two or more matic, unpleasant psychological reactions amino acid molecules. occur, including panic, great confusion, and anxiety. Strongly affected by SET liquor and SETTING. Classification: hallucino­ Usually refers only to DISTILLED SPIRITS gens. Slang names: acid, sugar. See (in contrast to BEER and WI NE); sometimes also appendix B. (Rl) 27:211--52 entries) any beverage containing ALCOHOL. Linder v. U.S. A 1925 Supreme Court case (268 U. S. 5) in which the court unanimously vindicated as neither improper nor unwise a physi­ cian's prescribing four tablets of morphine and cocaine for relief of a withdrawal con- ~------~ 55

PHENELZINE SULFATE (Nardil); and (2) nonhydrazine type--TRANYLCYPROMI NE SULFATE (Parnate). Classification: anti­ depressants.

Marihuana Tax Act of 1937 The first Federal law designed to locate and control· those individuals engaged in mace transactions involving marijuana by requir­ See nutmeg. Ing al I persons who handled the drug to pay a tax, register as hand lers, and mainlining record their transactions. The act pro­ Slang. The act of injecting a drug, usu­ vided that (1) all persons using the plant ally HEROIN, into a vein; intravenous .for defined industrial or medical purposes injection. must register and pay a tax of $1.00 per ounce, (2) all those using it for purposes maintenance treatment undefined by the act must pay a tax of Treatment in which a person dependent $100 per ounce on unregistered transac­ on a drug, usually an opiate narcotic, is tions, and (3) all persons failing to comply legally supplied with a daily ration of with the above regulations were subject to either the drug to which the person is penalties of tax evasion (a fine of not more dependent or a drug that will prevent than $2,000 and/or a prison sentence of withdrawal symptoms (e.g., METHADONE; not more than 5 years). While theoretically CYCLAZOCI NE; LAAM), thus enabling the only a means of raising revenue, the act person to function norma!ty within the com­ was designed to eliminate recreational use munity. In the United States, because of (concerns over which had recently esca­ strict interpretation and enforcement of lated), by making users who made pUr­ the HARRISON NARCOTICS ACT OF 1914, chases on the illicit market and who, until recently maintenance therapy was therefore, did not pay the high tax liable prohibited and doctors were prevented to arrest on charges of tax evasion. The from giving narcotics to addicts for the law was formulated as a tax measure relief of withdrawal symptoms. However, because many people still argued that Fed­ in the late 1960s METHADONE MAINTE­ eral control over drug use and over the NANCE programs began to be established prescription practices of the medical pro­ under clinical supervision. In Great fession was unconstitutional (Austin 1978; Britain, on the other hand, maintenance Grinspoon 1977:21). treatment has long been part of govern­ ment policy.. Before 1968, addicts could marijuana obtain opiates, including heroin, from thei r An ambiguous term related to the varieties physicians; since then, stricter controls of CANNABIS plants cultivated for their have been placed on opiate narcotics and . intoxicating properties. Marijuana may they may be obt9ined only through special refer specifically to the fresh plant or to clinics. the dried and shredded preparation made from the flowering tops, stems, and leaves major tranquilizers of the female. It is also used to refer See tranquilizers, antipsychot.ic. generally to all of the various intoxicating cannabis preparations. For example, MAO inhibitors descriptions of lithe effects of marijuanall Monoamine oxidase inhibitors, antidepres­ usually relate to all of the various prepa­ sants related chemically to the AMPHETA­ rations. The phrases "marijuana jointll or MI NES and used as psychic mood elevators, IIbag of marijuanall refer to the leafy, dried particularly in the treatment of psychotic product. depression. Potent, unpredictable drugs, they are capable of producing a variety Marijuana is one of the world's oldest cul­ of dangerous side effects. Deaths have tivated plants. It was grown by the resulted from their administration in con- Assyrians for use as incense in the 9th . junction with the following substances, cpntury B.C. It has, thus, been in use whose effects they potentiate: alcohol, for thousands of years, spreading from amphetamines, depressants, antihistamines, the Near East, Central Asia, Africa, South sedatives, anesthetic drugs, and insulin. America, and Europe to North America. MAO inhibitors are divided into two cate­ It is found today in nearly all sectors of gories: (1) the hydrazine type--ISOCAR­ the globe despite its near-universal contra­ BOXAZID (Marplan), NIALAMIDE (Niamid)' band status, and it is deeply ingrained in I -j

56

the cultu res of many countries such as mon!y, but not always, associated with India, Jamaica, Morocco, and N-epal. marijuana use are reddening of the eyes, dryness of the mouth, hunger, mild Recent survey data suggest that marijuana TACHYCARDIA, and reduction of pressure use is making significant inroads in the in the occular fluid of the eyes. United States. The 1979 NATIONAL SUR­ VEY ON DRUG ABUSE sponsored by NIDA Whether the effects of marijuana are sub­ indicates tha"t two-thirds (68.2 percent) ject to TOLERANCE is open to differences of young adults age 18 to 25, three in of opinion. There are strong indications, ten (30.9 percent) of youths age 12 to however, that tolerance does occur. Smith 17, and one-fifth (19.6 percent) of older and Seymour (in press) postulate that the adults age 26 and over report having ever tolerance associated with marijuana use used marijuana. From 1977 to 1979, there would take thE; form of a II UII curve if the was a significant increase in both preva­ degree of tolerance is plotted on one axis lence and current use rates reported among and the extent of use plotted on the other. young adults and older adults, but not Novices (because af inexperience, resist­ among youths. The experience level (tried ance, and largely unknown reasons) often at lea$t once) for young adults rose from exhibit a high tolerance to the intoxicating 59.9 percent in 1 ~77 to 68.2 percent in effects of marijuana. Occasional users 1979 while current use increased 8 percent­ experience the lowest tolerance, and there­ age points (27.~ percent to 35.~ percent). fore get high easier. Heavy users, like Among older adults, lifetime prevalence novices, also exhibit tolerance and seldom increased from 15.3 percent in 1977 to 19.6 receive the full impact of the drug effects percent in 1979 and current use rose from once experienced at earlier stages of use, 3.3 percent to 6.0 percent. according to Smith and Seymour •

Why marijuana's current surge of populari~y The adverse effects of marijuana may be in the United States? Peer pressure, CUrI­ either acute or chronic. Acute adverse osity seeking, less fearfulness about side effects include the acute behavioral toxic­ effects, and antiestablishment symbolism ities and the acute toxic reaction. Acute are all involved to a degree. But certainly behavioral toxicities include inte rference the most important factor is the intoxicat­ with immediate memory and other intellec­ ing effect of the drug itself. The type tually related skills. Such toxic effects of altered sense of reality created by mari­ pose definite impediments to positive per­ juana is the bottom line of why it is experi­ formance in the classroom, particularly by encing such widespread use today. adolescents. Another form of acute behav­ ioral toxicity to marijuana use is believed While marijuana is consumed for its effects, to result in j~lIpaired driving skill and what a user may actually experience is c:'ratic dr;ving. Safety-threatening highly variable and uncertain and may decreases in reaction time, perceptual­ range from zero effects to hallucinations motor coorc.ination, and attention may be and from relaxed euphoria to acute feelings experienced of panic and discomfort. The effect achieved depend:., upon the environment in The other type of acute adverse reaction which the drug is consumed, user feelings at the time of consumption, and the dose. is the acute toxic reaction in which the The dose, in turn, depends upon the route user may experience anywhere f,'om mild to extreme discomfort from the effects of the of ingestion--usually smoked (~igaret~e ?r wet or dry pipe) or eaten (solid or liquid drug. The intoxication brings on a sense preparations)--and THC content (near 0 of loss of control, fear, and self-doubt. percent in hemp to 60 percent in crystal­ Dr. David Snlith and his associates (Smith lized hash oil). It is this broad possible and Seymour, in press) at the Haight combination of variables that makes the Ashbury Free Clinic in San Francisco have effects of marijuana highly inconsistent observed the acute reaction to marijuana between users and for an individual user and describe the malady as fo! lows ", , , from one time to the next. marijuana can precipitate an acute psychotic reaction in a marginally adjusted or poorly organized personality. In such cases, The desired effects of marijuana have been the psychosis is characteristic of the per­ variously described as a sense of well­ sonality structure of the user, not of the being, a dreamy state of rela~ation and drug. The drug intoxication merely tri~­ euphoria, diverted alterations In thought gers the psychosis. This can happen with formations, a more vivid sense of touch a variety of drugs, including LSD and and perceptions, and distorted concepts of time and space. Symptoms fairly com- PCP. Even with better organized personal­ ities, cannabis can precipitate severe, 57 though less profoundly disorganizing, psy­ pounds, including 61 chemicals--the canna­ chological changes, particularly in the binoids--that are specific to cannabi s. presence of threatening environmental Delta-9-THC is generally cited as the psy­ stimuli. I ntoxication may produce a keener choactive ingredient of marijuana, but awareness of existing stresses and may recent" research suggests that other com­ hinder the ability to maintain structural pounds acting independently or interacting defenses. In both cases, problems can with delta-9-THC also contribute to the occur for persons who are quite familiar intoxicating potency of the drug. (For a with the drug but who are caught in a description of the botanical nature of mari­ confluence of various psychosocial stresses, juana, see cannabis.) threatening stimuli, or a higher dose of marijuana than the individual is used to. II Research on the metabolism of marijuana has centered primarily on THC. Like Marijuana has been suspected of having nearly everything else associated with mari­ an impact on several of the body's major juana, the metabolic process is complex organs and functional systems, resulting and not entirely understood. It has been in chronic adverse effects. Among the briefly described by Dr. Reese Jones various targets of current investigation (198():57-58) in the following manner: a re the heart, lungs, immune system, brain, IIAfter absorption, because THC is so fat endocrine system, reproductive system, and soluble, it leaves the bloodstream very cell chromosomes. rapidly. . • . The THC in the blood is rapidly changed to l1-hydroxy-THC, a The most conclusive evidence of adverse metabolite that is also psychoactive, and to effects relates to the lungs. Heavy mari­ at least 20 other known metabolic products juana smoking poses all the potentially that are either relatively inactive or have threatening risks associated with heavy unknown activity. This metabolism mostly tobacco cigarette smoking, including occurs in the liver. . • • THC leaves the chronic bronchitis, emphysema, and lung blood rapidly, not only because it is metab­ cancer. Marijuana can increase the heart olized but also because of its efficient rate in individuals, and it can reduce the uptake by tissues. An understanding of sperm count and motility in males and the pharmacologic properties of TH C is interfere with fertility in females. Studies necessarily complex because of its compli­ of pregnant nonhuman primates and rats cated pharmacokinetic behavior: that is, have shown that marijuana consumed at its apparent entry into multiple body com­ comparable human dosages posed serious partments, THe's multiple metabolites, the threats to their fetuses. There is also formation of both active and inactive metab­ evidence that marijuana use can precipitate olites, and the tendency for TH C and seizures among epileptics. The use of metabolites to bind tightly to proteins in marijuana is, therefore, unwise and contra­ the blood and to remain for long periods indicated among individuals with heart con­ of time in fatty tissues. While stored in ditions, fertility problems, pregnancy, or body fats, THC and its metabolites are epilepsy. slow Iy released back into the bloodstream. Thus, 5 days after a single injection of Evidence related to the adverse effects of THC, 20 percent of the THC remains stored, marijuana on the immunr system, endocrine while 20 percent of its metabolies remain in system, and cell chromosomes is contradic­ the blood. Complete elimination of a single tory and inconclusive. Studies of brain dose can take 30 days. After the passage damage or brain atrophy resulting from of about 6 hours, the step that limits the prolonged marijuana use have been largely rate of elimination of unchanged T HC in the negative in their findings. The issue of blood is not its metabol ism but rather the whether chronic adverse psychological very·slow return to the plasma of THC that effects result from heavy marijuana use has been sequestered in the tissues .... remains cloudy, but many clinicians, includ­ Given the slow clearance of cannabinoids, ing Dr. William Pollin, Director of NIDA, one might predict that repeated administra­ feel that regular use of marijuana may tion of marijuana at intervals of less than seriously interfere with psychological func­ 8 to 10 days should result in accumulation tioning (Pollin 1979:6). of THC or its metabolites in the tissues." The chemistry of marijuana, a natural, The dosage of THC contained in marijuana organic substance, is extremely comp'lex. is extremely variable and, for the ordinary Its chemistry also changes from the fresh user, unpredictable. The potency of dried plant, to the dried preparation, to the leafy marijuana depends upon a number of inhaled smoke produced by burning. Dried variables including the genetics of the marijuana contains over 420 chemical. com- plant, the soil and climate in which it was 58 grow'n, when and how it was harvested, stroke, cerebral palsy, paraplegia, and its sex t how it was prepared t the parts spinal cord injuries. Currently 32 States used, and how it was stored before use. have passed laws facilitating the use of THC content also varies radically across marijuana in research and treatment. Mari­ the spectrum of marijuana preparations: juana is classified as a Schedule I drug hemp and wild U.S. cannabis (less than by the DEA, which operationally defines it 0.5 percent); cultivated marijuana (0.5 to as a hallucinogen without medical applica­ 5 percent--1 to 2 ;1ercent common); sinse­ tion. A bill is now pending in the U. S. milla (up to 6 percent); hashish (8 to 14 Congress that would reschedule marijuana percent); hash oil (15 to 40 percent); hash to allow its use in medical treatment and oil crystals (up to 60 percent). The Uni­ provide for the availability of therapeutic versity of Mississippi School of Pharmacy, marijuana to the medical community. under contract with NI DA, grows, ha rvests, prepares, and assays an assortment of Is marijuana saint or sinner? It is more standardized marijuana strains. The sam­ than likely neither, being not easily ples are labeled with :their exact cannabi­ reduced to simplistic notions of all black noid content and are distributed for use or all white. It is legally contraband, but in research projects around the country. it is widely used. It is undoubtedly toxic, but it also has medical uses, It is the Marijuana has been used as a medical agent recreational drug of choice of millions of since antiquity. The Chinese employed it adults (an estimated 16 to 20 million current as an anesthetic 5,000 years ago. The users), but it is nearly universally consid­ ancient Persians, Greeks, Romans, East ered to be ruinous for adolescents. It is Indians, and Assyrians used cannabis to the target of liberation by the political far­ control muscle spasms, reduce pain, and left and the target of vilification by the treat indigestion, and it has since been far-right. used as an herbal preparation in folk medi­ cine in Asia and Africa. It was accepted Some practicing clinicians in the drug into IIprofessional ll Western medicine around abuse field feel that while marijuana use 1839 and enjoyed medicinal status through­ should not be condoned, other widely used out the 19th century for the treatment of drugs such as alcohol and tobacco pose a host of ills from insomnia to menstrual more of an immediate public health danger cramps. At one time marijuana extracts to society. Smith and Seymcur (in press), were available from such major pharmaceu­ for example, observe that lithe overall tical houses as Parke-Davis, Squibb, and issues surrounding marijuana toxicity are Lilly (Young et al. 1977: 130). With passage emotional'ly charged and fraught with con­ of the proscriptive MARIJUANA TAX ACT tradictions. At the same time that encul­ OF 1937, medicinal marijuana products turation of marijuana use is spreading became more difficult, and less popular, to across population barriers and becoming prescribe. In 1941 marijuana was dropped fashionable in a wide variety of circles, from the two official compendia of drugs public officials and health professionals in the United States, the U.S. PHARMA­ seem to be finding it politically expedient COPEIA and the NATIONAL FORMULARY, to take a hard line agai nst its use. One although it has continued to be used thera­ unfortunate reaction to this surge toward peutically in Asia and the Midd Ie East. abolition is an evident downgrading of the dangers our young face from alcohol and Despite the prejudice and taboo status tobacco, two drugs whose physical dangers marijuana has received in the United States have been demonstrated beyond a doubt. for most of the 20th century, scientists What we are seeing is a condoned resur­ are again looking at it for its medicinal gence of these drugs of high abuse poten­ properties. Marijuana, or its derivatives, tial by the dominant culture, while the are being tested as potential treatment postulated dangers of marijuana are mag­ aids for loss of appetite, anorexia nervosa, nified in the public eye. For example, in heart attack, migraine headache, hyperten­ recent national meetings on marijuana, one sion,asthma, epileptic seizure (see can­ drug expert indicated that marijuana is nabidiol), spasticity, and insomnia. .Two the number one public health problem of the more promising areas of medical among youths, while another drug expert application are for the treatment of occular stated that he would rather see youths pressure associated with glaucoma and as use short-acting drugs like alcohol and an antiemetic for controlling the nausea tobacco rather than marijuana. All scien­ side effects of certain anticancer drugs. tific indicators demonstrate that alcohol There is also evidence marijuana can be produces far more damage and public effective in controlling the spasticity suf­ health risk in adolescents than does mari­ fered by individuals with multiple sclerosis, juana, and the statements described above 59

are based not on scientific evidence but give up their gang association when they rather appeal to public stereotype and cur­ entered their twenties. When Charles rent political ideology that overstates the Winick analyzed the Federal Bureau of dangers of marijuana and underreacts to Narcotics inactive file of addicts (files with the problem of alcohol. There are . . • no new report entries for 5 years), he clinically demonstrated instances of acute discovered that addicts who had been using and chronic toxic dangers involving the heroin for 10 years tended to become i~ac­ use of marijuana. However, these dangers tive in the FBN's files at about age 30. and other postulated effects must be Winick (1962) hypothesized that these indi­ viewed in perspective relative to other viduals went through a maturing-out proc­ drug abuse problems in our society, includ­ ess similar to the urban gang members. ing legally sanctioned drugs such as alco­ hol and tobacco. II Don Waldorf (1973) suggests that length of heroin use may be more important than Research on marijuana continues. While age as a factor in the cessation of heroin few findings on the drug's effects have use. He states tha t, "I t may be that per­ been definitive, the notion that marijuana sons 'burn-out' of heroin use and addiction is IIsafe ll is facing a mounting challenge. after an extended period of use rather According to NlDA's Dr. William Pollin than mature-out with age." (RIS 27:351-- (1979:10), "Unfortunately, the hesitancy of 15 entries) the scientific community in not drawing unwarranted definitive concl usions from Mayor's Committee on Marihuana what are preliminary research findings has See La Guardia Report. led many to conclude that marijuana is with­ out serious medical haza rd, even for the mazindol very young. In reality, the situation is A SYMPATHOMIMETIC AMI NE used as an more like that following the popularization ANORECTIC. Manufactured as Sanorex. of cigarette smoking at the time of World Classification: stimulants--primary. War I. It required 50 years of research for the truly serious implications of ciga­ MDA rette smoking to become apparent • . . See methylenedioxyamphetamine. while much remains to be learned about the health implications of marijuana •.• medical complications our present evidence clearly indicates that Medical problems that occur among drug it is not a 'safe' substance •.• virtually users but are not necessarily caused by all clinicians working with children and drug effects. adolescents agree that regular use of mari­ juana by youngsters is highly undesirable medical drug use • . • there is little serious question that The use of licit prescription and nonpre­ regular use of an intoxicant that blurs real- scription drugs for their intended medic"7 . ity and encourages a kind of psychological inal purposes. Contrast with nonmedical escapism makes growing up more difficult. drug use. While there is controversy over the impli­ cations of present research concerning medical models adult use, few would argue that every Explanatory models that tend to define effort should be made to actively discour.:.. drug abuse or addiction in medical, not age use by children and adolescents." social, terms. Drug abuse is seen as a chronic disease rather than a social prob­ Also spelled marihuana. Classification: lem, an aberrant phenomenon afflicting cannabis. See also Alliance for Cannabis otherwise healthy individuals. Attention Therapeutics; American Council on Mari­ is focused on the drug taken as a disease­ juana; amotivational syndrome; bhang; causing agent, rather than on the per­ cannabis; charas; ganja; hashish; hash oil; sonality of the drug user or the society hemp; kief; kilo; National Commission on in which the user lives. The individual Marijuana and Drug Abuse; National Feder­ and/or social needs to take the drug are ation of Parents; NORML; paraphernalia; deemphasized, and efforts are usually paraquat; sinsemilla; Thai sticks; THC. directed toward medical cures and drug Slang names: pot, grass, reefer. See abuse prevention measures (Jacobs 1976: appendix B for other slang names. (Rl S 115; Siegler and Osmond 1968). See also 27: 211--223 entries). psychosocial models. (RIS 27:351--14 entries) maturing out . A term sociologists first applied to adoles­ meperidine hydrochloride cent urban gang members who tended to One of the most widely used of the OPI-

387-396 0 - 82 - 5 : QL 3 60

o IDS, especially in childbirth and for altogether different from that of the orig­ relief of other severe pains. A drug fre­ inal substance. quently preferred by opiate narcotic abus­ ers in the medical professions, it has methadon pharmacological effects similar to MORPHINE. Original American spelling of the drug Manufactured as Demerol. Classification: METHADONE HYDROCHLORIDE. nat'cotic analgesic agonists. (RIS 27:214-- 1 entry; Demerol uRIS 27:204--2 entries) methadone hydrochloride An OPIOID largely used in the maintenance meprobamate treatment of HERO I N dependency because One of the (ANTIANXIETY) TRANQUILIZ­ (1) it prevents heroin withdrawal symptoms; ERS used for muscle relaxation and seda­ (2) it fulfills the addict's physical need tion. Meprobamate is less potent than the for the drug; (3) at sufficiently high minor tranquilizers derived from BENZODI­ doses it blocks the effects of heroin AZEPI NE such as chlordiazepoxide hydro­ through CROSS-TOLERANCE, thus a shot chloride (Librium) and diazepam (Valium). of street heroin while undergoing metha­ Manufactured as Miltown and Equanil. done treatment will probably give no pleas­ Classification: sedative! hypnotics. (RI S urable effect; (4) it is a longer acting 27:214--1 entry) drug than heroin, the average dose lasting 24 hours, thus making it more convenient mescaline to administer; (5) it is effective orally, An ALKALOID, with hallucinogenic proper­ thus breaking the reliance on the ritual ties, either derived from the heads or of injection; and (6) it can be dispensed "buttons" of the PEYOTE cactus 0" pro­ at a treatment center. The ultimate aim duced synthetically. It is less potent than is to wean addicts from heroin and the LSD, but like LSD it alters perception and heroin lifestyle and allow them to adjust can produce hallucinations. Effects appea r to a new lifestyle through which they can within 2 to 3 hours and last from 4 to 12 then withdraw from methadone and live hours or more. Mescaline belongs to the drug free. It is thus often used not only same chemical group as TMA and MDA (the for maintenance but for DETOXIFICATION phenylethylalanines) and is chemically from opiate addiction by reducing doses related to adrenaline. Slang names are gradually over a short period. Critics listed in appendix B. Classification: hal- argue that because the patient is still lucinogens. (RIS 27:214--7 entries) dependent on an opiate narcotic, it is doubtful users will ever withdraw from metabolic disorder theory of addiction methadone. Data have shown not only A drug addiction paradigm that views that people can become addicted to metha­ addiction as -a function of the manner in done in such legal settings, but that some which the drug is metabolized by the body. people continue to use heroin and other For example, Dole and Nyswander (1967) illicit drugs while takirig methadone and hold that although initial heroin use may that for many methadone has become a drug be psychological in origin, it is the vari­ of preference, thus generating an active able "imprint" of the drug on the nervous illicit market. Some patients complain that system that causes the protracted addiction methadone and the daily "treatment" proc­ syndrome. By treating narcotic addiction ess is just as disruptive as heroin use. as a metabolic disease with the use of a Recently. a neW synthetic opiate, LAAM, narcotic antagonist such as methadone, has been advocated as an alternative to the narcotic hunger that results from the methadone for treatment purposes because physical effects of the opiates is prevented, daily doses are not needed. Slang name: thus allowing the individual to live a more dolly. Trade name: Dolophine. Classifi­ normal life. On this theory, see also cation: narcotic analgesic agonists. (RIS Lukoff (1977:216-217). See also addiction. 27:214--125 entries) metabolism methadone maintenance The process by which the body, using An ambulatory treatment program of main­ enzymes and other internal biochemicals, tenance of heroin addicts on METHADONE, breaks down ingested substances such as begun experimentally in 1964 at Rockefeller foods and drugs so they may be consumed University Hospital, New York. There and eliminated. are two types of programs: the original high-dose model, originally developed by metabolite Drs. Vincent Dole and Marie Nyswander The biochemical byproduct resulting from in the early 1960s (Dole and Nyswander the metabolism of a substance. A metab­ 1965); and the low-dose model. Both olite may produce a chemical effect that is models use the oral administration method, 61

generally in liquid form and dissolved in belong to the same chemical group (the fruit drinks. In the high-dose model, phenylethylalanines) and are chemically treatment begins by increasing the patient's related to adrenaline. Classification: hal­ tolerance until it can accommodate a daily lucinogens. dosage of between 50 and 120 milligrams. The low-dose model stabilizes the patient methylmorphine on 30 milligrams or less a day. (RIS See codeine. 27:351--76 entries; methadone patients, RIS 27:288--53 entries) methylphenidate hydrochlo ride A CNS stimulant similar to AMPHETAMINE, methamphetamine hydrochloride often prescribed for the treatment of A central nervous system stjmulan'~ similar hyperkinesis in children and for weight to amphetamine sulfate (Benzedrine) but control in adults. Manufactured as Ritalin. more potent. The favored drug among Classification: stimulants--primary. See habitual amphetamine users, who frequently also phenmetrazine hydrochloride. (RIS take it by i"travenous injection, which 27:216--6 entries) produces an almost instantaneous onset of the drug's effects, which many users com­ methyprylon pare to a sexual orgasm. Manufactured A nonbarbiturate SEDATIVE/HYPNOTIC, as Methedrine and Desoxyn. Classification: manufactured as Noludar. stimulants--primary. Slang names: meth, speed, crystal. See also appendix B. milieu therapy (RIS 27:216--25 entries; amphetamines, Socioenvironmental therapy in which the RIS 21: 199--136 entries) attitudes and behavior of the staff of a treatment service and the activities pre­ methaqualone scribed for the patient are determined by Nonba rbitu rate sedative/ hypnotic that the patient's emotional and interpersonal produces sleep for about 6 to 8 hours, needs. This therapy is an essential part originally marketed as an alternative to of all INPATIENT treatment (A Psych i­ BARBITURATES. When taken in large atr ic G103sa ry 1975). doses for purposes other than sleep inducement, it produces muscular relaxation, In drug abuse treatment programs, a set feelings of contentment, and total passivity, time and place is reserved for this inter­ a state someWhat resembling drunkenness. action among clients and with the staff First synthesized in 1951, it was once within the milieu of the treatment center. believed not to have the adverse side Subjects frequently include learning to effects associated with barbiturates; recent talk with people about things other than reports stress that it has no advantages drugs, interacting with others \"ithout let­ over other sedatives (Falco 1975). Trade ting anger turn to violence, learning to names include Hymnal, Mandrax, Parest, ask for help when help is needed, learning Quaalude, Somnafac, and Sopor. Classi­ to have a good time without having to get fication: sedative/hypnotics. Slang names: high, and learning to cope with new and ludes, mandrakes, sopors, quads. See unfamiliar situations (Maglin 1975). also appendix B. (RIS 27:216':'-2 entries) mimetic metharbital Imitative. See also psychotomimetic. A long-acting BARBITURATE used in the treatment of epilepsy to control seizures. Minnesota Multiphasic -Personality Manufactu red as Gemonil. Classification: Inventory (MMPI) sedative/hypnotics. (barbiturates, RIS A personality questionnaire consisting of 27: 202--48 entries) 550 items answerable by the responses "true," "false," or "cannot say." The methyl benzene responses distinguish certain psychopatho­ See toluene; also benzene. logical configurations and syndromes as well as normal characteristics. Responses methylenedioxyamphetamine (MDA) are interpreted using 14 scales each with A synthetic hallucinogen related both to a different title, alphabetic abbreviation, MESCALI NE and the AMPHETAMI NES, which and numerical code. The abbreviations is usually swallowed. At low dosage, users and codes for the MMPI scales are: (1) report a sense of well-being with height­ Hs--hypochondriasis; (2) D--depression; ened tactile sensation, intensified feelings, (3) Hy--conversion hysteria; (4) Pd--psy­ but without hallucinations or distortions. chopath;c deviate; (5) Mf--masculinity­ Higher doses produce effects more simi la r femininity; (6) Pa--paranoia; (7) Pt--psy­ to those of LSD. MDA and mescaline . chasthenia; (8) Sc--schizophrenia; (9)

------_.-- - .. -. 62

Ma--hypomania"; and (10) Si--social intro­ monopoly systems version. The four validity scales are: Schemes for the wholesale purchasing and lie (L) score (indicating subject1s attempts package retailing of drugs through a cen­ to 1I100k good ll ); question scale (llcannot tral State agency. The design is to reduce sayll responses); the validity score (a consumption, or commercial promotion, check on response validity); and the K through disinterested management or the score (a correction factJr for the entire elimination of private profit. The agency1s record). The MMPI is widely used, often official stores or, in some cases, specially in conjunction with other tests, as a authorized agents, perfor"m the retailing. screening tool by schools, employers, and In some monopoly systems, licenses are the military. It is also used as a counsel­ also granted for fees to privately owned ing aid, providing a portrait of the outlets such as stores, restaurants, tav­ respondents' personality charact~ristics erns, and hotels. Seventeen U.S. States and pathological tendencies. operate some form of alcohol monopoly sys­ tem (Keller and McCormick 1968). See misdemeanors also licensing. Criminal offenses less serious than felonies that are punishable by a fine or a sen­ moral conduct tence of up to 1 year in a local jail. Con­ A form of behavior that involves a consid­ trast with felony. (RIS 27:353--7 entries) eration or choice of right and wrong, judged in terms of a standard of values misrepresentation, drug or morals, toward which a person recog­ The substitution of a substance or combina­ nizes a duty or feels a sense of respon­ tion of substances for an alleged drug, sibility. It includes both acceptable and such as LSD for mescaline, or sugar for unacceptable or immoral forms of behavior cocaine. See "Iso dilution; adulteration. (Fairchild 1976). misuse, drug morning glory A term often preferred as a substitute for A flowering vine plant of the bindweed DRUG ABUSE (Kaufman 1977). family originally grown in South America and Mexico. It is widely used in the MMPI United States as a garden plant. Its seeds See Minnesota Multiphasic Personality Inven­ contain lysergiC acid amide and when con­ tory. sumed in large quantities (5 to 10 grams) have hallucinogenic effects~ Two varieties modality with high lysergic content are heavenly See treatment modalities, blues and pearly gates. Many seed supply houses treat their morning glory seeds Monitoring the Future with toxins to prevent recreational use or An annual survey of high school seniors methyl mercury to prevent spoilage. Con­ conducted since 1975 by the Institute for sumption of treated seeds can induce diar­ Social Research, University ·of Michigan, rhea, vomiting, nausea, chills, dizziness. Ann Arbor, Michigan 48106. abdominal pain, and mercury poisoning. The series presents descriptive statistical morphine results from surveys of 130 public and The principal active ingredient in OPIUM. private high schools and 16,000 to 18,000 (Raw opium is composed of approximately seniors. The issues addressed include-- 10 percent morphine by weight.) Isolalf.ed drug use and views about drugs in 1803 and named after Morpheus, the changing roles for women Greek god of dreams, morphine first confidence in social institutions received widespread use in the United intergroup and interpersonal attitudes States during the Civil War. (5ee ARMY concerns about conservation and ecology DISEASE.) Still one of the most useful of social and ethical attitudes medical drugs, it is considered by some to be superior to all other pain relievers. The 812 questions dealing with drugs cover In addition to pain relief, it reduces drive drug use and related attitudes and beliefs, states and encourages sleep. Since the drug availability and exposure, surround­ Harrison Narcotics Act and the spread of ing conditions, sod al meaning of drug use, heroin use. the recreational use of mor­ and views of parents, friends, and others phine has declined, although the subjective regarding drugs. effects of the two drugs in equivalent potencies are almost identical. Slang names monoamine oxidase inhibitors are listed in appendix B. Classification: See MAO inhibitors. narcotic analgesic agonists. See also Brompton cocktail. (RIS 27:217--14 entries) 63

I multiple drug use The naltrexone treatment experience, while • The nonmedical use of two or more drugs still in the clinical trial stage, has had taken simultaneously or so closely in time mixed results. The efficacy of the drug that the ~ffects of the first drug have in terms of its duration and opiate block­ not worn off when the second one or later ade effect has been well documented. Nal­ drugs are taken. The term multidrug use trexone treatment research programs, is not applied to a stepwise progression how~ver, have been characterized by rela­ in tile use of difi'erent drugs (Kaufman tively high client dropout rates. Some 1977). See also polydrug use. (RIS 27: therapists have concluded that naltrexone 355--25 entries; multi-drug, RIS 27:217-- therapy is closer to a drug-free approach 214 entries) than to other chemotherapies such as meth­ adone maintenance and, as such, must be multimodality treatment reinforced with strong nonchemical program A program that uses two or more tn"::t­ elements (Taintor et al. 1975; Resnick and ment approaches. Schuyten-Resnick 1976). See also narcotic antagonist; conditioning theory; extinction; sequential treatment. Classification: nar­ cotic antagonists. naphtha A highly flammable hydrocarbon obtained by the distillation of petroleum ~,nd similar to kerosene and gasoline. It has long been used as a SOLVENT in cleaning fluids and Nalline is inhaled for its intoxicating effects. The trade name for NALORPHINE. Also called petroleum ether. Classification: volatile inhalants. Nalii ne test See f'Jarcan test. NARA See Narcotic Addict Rehabilitation Act. nalorphine A semisynthetic derivative of MORPH I NE, Narcan test manufactured as Nalline. It counters the A test used to determine opiate depend­ depression of the central nervous system ency. Also known as the naloxone chal­ created by opiate narcotics and is often lenge. Another similar procedure is the valuable in the treatment of narcotic over­ Nalline test. Both tests rely upon the doses by abolishing respiratory depression. narcotic antagonistic properties of these Nalorphine precipitates pupil dilation in drugs to induce visible symptoms when the presence of opiates, which is the basis administered to persons with opiates in for the Nalline test. (See under NARCAN their systems. These types of tests are TEST.) Classification: narcotic antago­ frequently used to monitor the use of opi­ nists. ates among inmates in prison. naloxone hydrochloride The Nalline test is the older of the two-­ An opiate NARCOTIC ANTAGONIST r of over 100,000 of these tests have been per­ short duration in action, useful intraven­ formed annually in the California State ously but relatively ineffective in oral prison system alone. The test is based administration. A synthetic CONGENER upon the concept that a sma! I dose of of OXYMORPHONE HYDROCHLORIDE. nalorphine (Nalline) produces an increase Manufactured as Narcan. in pupil size in a person actively addicted to narcotics. The subject is placed before naloxone challenge a constant lighting source, the pupils are See Narcan test. measured, 3 rng of nalorphine is injected subcutaneously, and pupil measurements naltrexone are taken again 20, 30, and 40 minutes A pure opiate narcotic antagonist developed after {he injection. I ncreased pupil dila­ by Endo Laboratories (Endo 1639A) in tion of more than 0.5 mm is considered a 1963; an analog of naloxone hydrochloride. positive test (DeAngelis 1976). It has the qualities of being effective orally, long acting, and relatively free of unpleas-· Naloxone (Narcan), unlike nalorphine, is ant side effects, and it does not produce a pure antagonist, and either alone or in opiate withdrawal symptoms with sudden combination with nalorphine has shown discontinuation (Schecter 1980; Julius and evidence of producing more reliable results Renalilt 1976). than the NalJine test. DeAngelis (1976:22) 64

describes the concept underlying the cotics law, the HARRISON NARCOTICS Narcan test as follows: ACT OF 1914, included cocaine as a "nar­ cotic." Marijuana, peyote, and chloral "In the nontolerant, nondependent SUbjEct hydrate were soon also legally and popu­ there is no effect normally. In the subject larly classified as "narcotics" as concerns who has recently had an opiate the pupil over their use grew and controls were will be abnormally constricted. The antag­ extended to include them. The term also onist Narcan will dilate the pupil. If this assumed a social meaning that encompassed happens, the presence of an opiate in the debility, addiction, insanity, crime, and system is suggested but no evidence for death (Bonnie and Whitebread 1974:28). dependence has been found. The application of the term "narcotic" to any illicit drug still remains (Josephson "Narcan has been introduced as a test for 1974:xix). The United Nations Commission physical dependence. It causes Igoose­ on Narcotic Drugs defines a "narcotic" as flesh,' which is a typical sign of with­ any drug under international control, drawal and has nothing to do with acute excluding alcohol and nicotine. Bejerot opiate actives. This sign should be largely (1975:19) defines it as "exclusively a legal independent of whether or not the addict term" referring to those "addicting sub­ has recently used an opiate. If he is not stances which have been subjected to spe­ dependent, the sign will not be elicited." cial national or international legislation." See al so narcotic antagonist. Schultes (1976:5) defines it as "any sub­ stance that has a depressive effect, narcolepsy whether light or great, on the central A condition characterized by fits of sleep nervous system" and includes marijuana. or uncontrollable feelings of extreme sleep­ Because of the confusion and negative con­ iness. It may be pathological in nature notations that have developed around the and may also result as a side effect of word, most authorities today recommend certain drugs. (RIS 27:355--6 entries) that, in terms of pharmacological effects, it should be utilized only to refer to the narcosis analgesic depressant opium, the opiates, From the Greek "narkosis," a benumbing. and the opioids. A reversible state -of pathological reduction in responsiveness and a marked slowing Narcotic Addict Rehabilitation down of the physiological system; a state Act (NARA) of 1966 characterized by stupor or insensibility A Federal law establishing CIVIL COMMIT­ and a feeling of painlessness or well-being MENT of drug abusers to an in-hospital (Chaplin 1975; Dorland's Illustrated Medi­ phase of treatment and an aftercare phase cal Dictionary 1974). in their home communities. The act also provides for assistance and support to narcotic States and municipalities in developing Medically, usually refers to any drug that treatment programs and facilities. NARA dulls a person1s senses and produces a emphasizes total care: hospitalization plus sense of well-being in small doses, and followup supervision and support to causes insensibility, stupefaction, and even maintain an addict's motivation for rehabil­ death in large doses. A drug capable of itation upon return to the community. producing NARCOSIS. Sometimes incor­ Persons eligible for the program are rectly used to refer to all CNS depressants, (1) narcotic addicts charged with certain including barbiturates and alcohol, and Federal offenses who desire to be committed the belladonna group of hallucinogens. for treatment in lieu of prosecution (title Some insist that only those depressant I), (2) addicts convicted of Federal crimes drugs that both sedate and numb or dull who are committed by the court (title II), the sensation of pain (produce ANALGESIA) and (3) addicts who wish voluntarily to should be so classified, thus limiting the apply for commitment (title III). N IDA use of the tp.rm to OPIUM, the OPIATES, has responsibility for patients under title and the OPIOIDS. The term was often I; the Department of Justice has respon­ used loosely in the 19th century to refer sibility for titles II and III. Both the to all nonalcoholic drugs, particularly.those Department of Justice and the Department that could produce sleep or hallucinations. of Health and Human Services have recom­ Beginning in the early 20th century, the mended repeal of NARA on the grounds term came to be a synonym for disapproved, that the procedures are cumbersome, cer­ illicit drugs, or any "street" drug used tain aspects are infrequently used, it has recreation ally that produced sleep or hallu­ not proven to be cost beneficial, and in cination and/oY" appeared addicting or many respects it is incompatible with con- harmful. America's first Federal antinar- tempora ry treatment approaches. (RI S 65

27:355--6 entries; NARA patients, RIS narcotic agonist properties and their cessa­ 27:290--6 entries) tion will induce withdrawal symptoms in a user who has developed a physical depend­ Narcotic Addiction Control ence to opiates. See also extinction. Commission (NACC), New York The State agency that ran the New York Narcotic Drug Control Act of 1956 Addict Commitment Program between 1966 A Federal law that specifically outlawed and 1D79. Established in 1966, the NACC heroin and increased already existing incorporated most of the elements of the penalties for the transportation, sale, and California civil commitment program. (See smuggling of heroin and marijuana into CIVIL ADDICT PROGRAM, CALIFORNIA.) the United States. Restrictions were les­ Addicts could be committed by either civil sened on tapping phone lines, reading or criminal processes, the first applying telegrams of known traffickers in drugs, to addicts who had not been arrested, the and issuing search warrants in narcotics second to those who had been arrested cases; agents of the Federal Bureau of and convicted. Under CIVI L COMMIT­ Narcotics and the Bureau of Customs were MENT, any person could file a petition to empowered to make arrests without war­ get an addict committed for an indefinite rants from a court for any narcotics viola­ period not to exceed 3 years. CRIMINAL tions committed in their presence. A COMMI TMENT was for a maximum of 3 control record system was established years if the crime committed was a misde­ within the Bureau of Narcotics to retain meanor, 5 years if a felony (New York information on all narcotic addicts and vio­ City 1973; Waldorf 1973:105). This agency lators that was to be made available to was known as NACC between 1966 and 1972; Federal, State, a.1d local law enforcement subsequently, it has been known as the officials (Encyclopedia of Sociology 1981). Drug Abuse Control Commission (1973-1975), Most of the provisions of this act were the Office of Drug Abuse Services (1976- repealed and replaced by the DRUG ABUSE 1978), and the Division of Substance Abuse ACT OF 1970. Services (1978-present). All addict com­ mitment centers were closed by 1979. (RIS Narcotic Drugs Import 27:355--9 entries) and Export Act of 1922 A Federal law authorizing the Federal Nar­ narcotic analgesic cotics' Control Board to set import quotas A term often used synonymously with NAR- on the amounts of opium, cocaine, and COTIC. See also opiate narcotics. their derivatives needed to fulfill medical needs. 1n addition, under Section 2f of narcotic antagonist this act, possession without a prescription A drug that blocks or counteracts the was made presumptive evidence of conceal­ effects of OPIATE NARCOTICS. Many ment of drugs illegally imported in violation have been derived by chemically altering of this act, thus making possession for some aspects of natural or synthetic opiate nonmedical use a Federal crime (Bonnie narcotics (Wikler 1958). Among the best and Whitebread 1974:20). Repealed and known antagonists are CYCLAZOCINE, replaced by the DRUG ABUSE ACT OF NALOXONE, NALORPHINE (Nalline), and 1970. NAL TREXONE. In sufficient doses, nar­ cotic antagonists can block the psycholog­ Narcotics Anonymous (NA) ical and physiological effects of opiate Narcotics Anonymous (NA) is a worldwide narcotics, including the development of self-help fellowship for recovered drug TOLERANCE and (PHYSICAL) DEPENDENCE, abusers who give each other support to and can reverse or prevent toxic effects. remain lc1ean." NA was formed in 1953 They can also precipitate an intense acute and has over 700 affiliated chapters across WITHDRAWAL SYNDROME in opiate-narcotic­ the. United States. As its name suggests, dependent individuals who have not been NA has adopted the Alcoholics Anonymous detoxified, and this property is sometimes (AA) model, using an adaptation of the employed for identifying physically depend­ Twelve Steps. Briefly, these steps ent persons for medical and legal purposes. involve-- (See Narcan test.) Narcotic antagonists may be pu re or mixed. The pu re narcotic • Acknowledging that one is a drug abuser antagonists (e.g., naltrexone and naloxone) in reasonable doses will produce little '" Accepting a power greater than oneself effect on an opiate-detoxified or non-opiate­ and turning one's will and life over to dependent person. The mixed, or partial, the care of that higher power (as each narcotic antagonists (e. g., cyclazocine, individual understands the power) nalorphine, and PENT AZOCI NE) have slight 66

GIl Making a moral inventory and redressing Federal alcohol and drug abuse policies. wrongs Address: 918 F Street, N.W., Suite 400, Washington, D.C. 20004 • • Carrying the NA spiritual message to other drug abusers. National Clearinghouse for Smoking and Health In addition, NA uses AA's Twelve Tradi­ Agency within the U. S. Department of tions, which outline the principles that guide Health and Human Services responsible the operation of the organization and indi­ for coordinating information and offering vidual chapters (e.g., reliance on member publications on smoking and health. donations for financial support, rejection Address: 5600 Fishers Lane, Rockville, of professional involvement, maintenance Md. 20857. of anonymity in the press and media). National Commission on The NA fellowship is open to all persons Marihuana and Drug Abuse who have a drug problem, no matter what This commi ssion of nationally promi nent type. Their meetings, held at least weekly, citizens was appointed by President Nixon may consist of Twelve Steps discussions, in 1971. I t undertook a 2-year exami nation talks by guest speakers, and open or topic of drug use, misuse, and abuse and con­ discussions, as well as the AA practice of cluded that the old definitions and old sharing. Demographically, members tend ways of looking at these problems required to be young adults, of mixed socioeconomic a new set of terms and perspectives. The backgrounds, from all races, and of both commission issued two reports (National sexes (although some groups report that Commission on Marihuana and Drug Abuse males predominate). Some members may be 1972, 1973) that define U',,; issues, provide in or have graduated from treatment pro­ data on drug-using behavior, assess the grams, but this is not necessary. The social impact, and formulate a rationale only requirement is the desire to stay toward a coherent social policy toward "clean." Address: Narcotics Anonymous illicit drugs. It posed a number of recom­ World Service Office, P.O. Box 622, Sun mendations, including the decriminalization Valley, Calif. 91352. of marijuana. Narcotics Treatment Administration (NTA) Participants in a comparable study of mari­ A (MULTIMODALlTY) TREATMENT program juana in 1938 appointed by New York Mayor for heroin addicts in the Washington, D. C., Fiorello La Guardia found their recommen­ area aimed :Jt reducing the rising rate of dations similarly ignored by authorities. addiction and related crime, and promoting Young et al. (1977:131) note that the study full-time employment. Established in 1969, group "found no proof of addiction, no the program consists of the following com­ link to aggressive or anti-social behavior, ponents: (1) METHADONE MAINTENANCE; and no sign of tolerance or withdrawal (2) ex-addict counselors; (3) use of hos­ symptoms. Its findings were ignored, pital beds, HALFWAY HOUSES, and out­ however, and marijuana retained its unjust patient facilities that emphasize outpatient association with hard drugs and hardened programs; (4) volunta ry self-referrals and criminals." See also Commission of Inquiry referrals through work-release, probation, into the Non-Medical Use of Drugs. and parole; and (5) a citywide network of programs by means of "purchase of services" National Committee on the contracts, especi ally community-supported Treatment of Intractable Pain self-help organizations (DuPont 1972). Simi­ A nonprofit organ ization whose major pur­ lar to the T ASC program, clients are referred pose is to promote education and research to NTA from the D.C. courts and the on more effective management and allevia­ Department of Corrections .by a special crim­ tion of intractable pain. The NCTI P has inal justice monitoring unit (Colbert and actively campaigned for changes in the Kirchberg 1973). (RIS 27:356--16 entries) law that will allow research on and use of heroin in cases of advanced, chronic pain narcotism victims. Address: Box 34571, Washington, An obsolete term for narcosis or addiction D.C. 20034, (301 )983-1710. See also hos­ to narcotics. pice; Brompton cocktail.

National Association of State Alcohol National Drug Abuse Treatment and Drug Abuse Directors (NASADAD) Utilization Survey (NDATUS) The association was formed to provide a An annual survey of all known drug abuse vehicle for the exchange of information and treatment units. NDATUS is a federally to provide a uniform voice for influencing mandated system, conducted by NIDA to 67

measure the scope and use of drug abuse abuse and alcoholism and the rehabilitation treatment in the United States. The sur­ of affected individuals. In carrying out vey collects national, regional, State, and these responsibilities the Institute conducts clinic-level data from all U.S. treatment and supports res,~arch on the biological, units, federally funded or not. The data psychological, sociological, and epidemio­ provide a basis for comparative analyses logical aspects of alcohol abuse and alcohol­ of treatment utilization across the country ism; supports the training of professional and for forecasts of resource requirements and paraprofessional personnel in preven­ for drug abuse treatment services. tion, treatment, and control of alcoholism; conducts and supports research on the National Federation of Parents development and improvement of alcoholi sm for Drug Free Youth (NFP) services delivery, administration, and The national umbrella organization of the financing; and supports alcoholism services 1,000-odd self-help parent groups located programs and projects. Address: 5600 throughout the country that have banded Fishers Lane, Rockville, Md. 20857. together to deal with the illicit drug use of their children. The NFP promotes, National Institute on Drug Abuse (N IDA) encourages, and assists in the formation The National Institute on Drug Abuse--or and strengthening of local parent groups N IDA--was created by Congress under to act as countervailing forces to prevailing the Drug Abuse Office and Treatment Act social climates that encourage illicit drug of 1972 (Public Law. 92-255). It began use. Contact address: Box n272, Silver operating in 1974 to provide a meaningful Spring, Md. 20906. response to the growing enigma of illicit drug use. Prior to NI DA the Federal drug National Formulary (~£) effort was scattered across many agencies, A book recognized by the Pure Food and and financial support for grassroots treat­ Drug Act of 1906 containing standards for ment programs and drug-related research certain drugs not inc! uded in the U. S. was plagued with uncertainty. With NIDA's Pharmacopeia. See also United States inception the various Federal drug pro­ Adopted Names Council. grams were in large measure consolidated into a single agency. In addition. the National Institute of Mental Health (N IMH) budget for the Federal drug activities N1M H provides leadership, pol icies, and incorporated into NIDA was increased, goals for the Federal effort in the promo­ authority for new programs was granted, tion of mental health, the prevention and and commitments of long-range support treatment of mentill illness, and the reha- were voiced by both the Congress and bilitation of affected individuals. In the White House. carrying out these responsibilities the I nstitute conducts and supports research NIDA is organizationally a part of the U.S. on the biological, psychological, sociological, Department of Health and Human Services. and epidemiological aspects of mental health I t is associated with counterpart agencies and illness; supports the training of pro­ in the areas of alcohol abuse and mental fessional a nd paraprofessional personnel health under the Alcohol, Drug Abuse, in the promotion of mental health and the and Mental Health Administration prevention and treatment of mental illness; (ADAMHA). within the Public Health Serv­ conducts and supports research on the ice. Its annual budget in fiscal year 1981 development and improvement of mental was $235 million. The vast majority--97 health services delivery, administration, percent--of these funds are funneled to and financing; supports mental health State- and community-based programs in services programs and projects including the form of grants and contracts. N I DA facilities construction as appropriate; col­ headquarters are located in Rockville, laborates with and provides techn ical Maryland, just north of the Nation's Capi­ assistance to State authorities and Regional tal. Offices, and supports State and community efforts in planning, establishing, maintain­ NIDA's principal mandate is to support an ing, coordinating, and Xlvaluating more effective response at the Federal, State, effective mental health programs. Address: and local levels to the human problems 5600 Fishers Lane, Rockville, Md. 20857. associated with drug use. Because of the complex nature of its charge, N IDA is National I nstitute on Alcohol engaged in a broad spectrum of activities. Abuse and Alcoholism (NIAAA) These activities are designed to address N IAAA provides leadership, policies, and the many facets of this perplexing issue, goals for the Federal effort in the preven­ wh ich is of such great national concern tion, control, and treatment of alcohol today. They include principally treatment, 68

training, research, prevention, analysis all tribes in the United States and Canada and evaluation, and communications. (Schultes 1976:120). Although the U.S. Address: 5600 Fishers Lane, Rockville, Government at fi rst tried to discourage Md. 20857. See also Statewide Services this church, it gradually became recog­ Contract; Federal drug abuse policy. nized that peyotism as practiced by the Indians was a sincere religion, and the National Organ ization for the courts have upheld it as such under the Reform of Marijuana Laws Bill of Rights. Peyotisrn does not interest See NORML. all Native Americans; many prefer either traditio:1al Christianity or a revival of their National Polydrug Collaborative Project own native religions. (religious uses, RI S See po!ydrug use. 27:376--9 entries)

National Survey on Drug Abuse natural medicine The National Survey on Drug Abuse pro­ A term more easily defined by what it is vides a broad picture of drug abuse in not than what it is. CH "h: scores of the American population. In 1979 it was natural medicine healing h~.llniques, what based on a su rvey of 7.224 persons ran­ they share in common is that they do not domly chosen to be representative of those make use of synthetic chemical remedies living in households in the conterminous or surgical techniques. Among the basic United States. While not completely rep­ concepts of natural medicine are the beliefs resentative of the American population (it that health is a natural state and illness does not sample those living in various results from bodily imbalances, that sick­ institutions, the homeless, or those living ness results when the body's vital force on military bases and overseas), it pro­ or animating energy is impeded, that toxi ns vides a usefu I indication of the general create imbalances in the vital force, and dimensions of the drug problem in the that recovery comes by cooperating with United States and especially of trends in nature to restore the vital force through drug abuse. Similar methodology has been the use of natural substances and mental employed in the six national su rveys that and physical exercises (Carroll 1980). have thus fa r been conducted (1971, 1972, 1974, 1976, 1977, and 1979). Present Examples of natural medicine techniques plans are to conduct the national survey used in the treatment of drug addiction every 2 years, and the 1981 survey is cur­ are acupuncture, acupressure, vitamin rently in progress. Results from the 1977 regimes, natural diets, dance therapy, and 1979 national surveys are published in macrobiotics, hypnotism, and autohypnotism. Abelson et al. (1977), Miller and Cisin (1979), and Fishburne et al. (1979). See nepenthe also marijuana. A potion used by the ancients to dull pain and sorrow. Something capable of causing Native American Church oblivion of suffering. A religion existing among Native Americans that combines elements of Christianity, nervous system native religious rites, and the ritual use The nervous system in humans is composed of peyote. Peyote use first became appar­ of the brain, spinal cord, and nerves. ent among the tribes of the United States Structurally I the nervous system is divided in the latter part of the 19th century, into the 'central nervous system (CNS), when it was used in religious rites and to consisting of the brain and spinal cord, heal the sick; gradually a religion devel­ and the peripheral nervous system, con­ oped around the use of the cactus that sisting of the nerve fibers and cells that combined elements of Christianity with the connect the brain and spinal cord to the vision-quest ritual typical of the Plains rest of the body. Functionally, the nerv­ Indians. The religion teaches brotherly ous system is divided into the somatic love, high moral principles, abstention nervous system and the autonomic nervous from ALCOHOL consumption, and considers system. The somatic nervous system deals peyote a sacrament through which God is with functions of the senses and the volun­ manifested. Those who practice it have tary muscles. The autonomic nervous sys­ faith in the efficacy of peyote as a cure-all tem handles involuntary bodily functions and a true belief in the sacred character such as heartbeat, digestion, and prepara­ of the altered states of consciousness, tion for stress, fight, or flight. The especially visions, induced by the drug. autonomic nervous system is composed of First legally organized as the Firstborn two countervailing parts: the sympathetic Church of Christ, today the Native Ameri­ and parasympathetic systems. The sympa­ can Chu rch cia ims 250,000 members from thetic system energizes the bod)' for action 69

by processes such as releasing sugars nicotine stored in the liver, slowing the digestive The main active ingredient (ALKALOID) process, and increasing heart and breath­ of tobacco. Nicotine is believed to be ing rates. The parasympathetic system responsible for most of the effects of smok­ maintains the .normal involuntary muscle, ing and for the fact that tobacco smoking organ, and gland functions within the body is such a powerful habit. An extremely such as salivation, pupil dilation and con­ toxic substance, its general physical striction, digestion and elimination, normal effects include irritation of lung tissues, heartbeat, etc. constriction of blood vessels, and increased blood pressure and heart rates. The neuroleptic effects of nicotine are complex and unpre­ (ANTIPSYCHOTIC) TRANQUILIZER or. major dictable, appearing to have various differ­ tranquilizer. Over 80 neuroleptic sub­ ent and often opposing simultaneous effects. stances have been identified. They all Generally, it produces CNS stimulation, have certain common biochemical character­ but in high doses it can also have depres­ istics in their molecular structure and the sant effects. Regular cigarette smokers pharmacological property of being an claim it calms the nerves; neophytes feel ANTAGON 1ST to the brain chemical dopa­ dizzy and stimulated. This difference in mine. perception may be due to TOLERANCE to nicotine effects. Although often classified The neuroleptic syndrome in humans as as a stimulant, many authorities prefer to described by Janssen and Van Bever place it in a separate category. Classifica­ (1975) includes reduction of psychotic tion: stimulants--seconda ry. symptoms such as hallucinations, mental confusion, and delusions; reduction of psy­ NIDA chomotor agitation, such as aggressive, See National Institute on Drug Abuse. assaUltive, combative, or destructive behav­ ior; inhibition of panic, fear, and hostility, nitrogen monoxide ~. g., relief from emotional tension and See nitrous oxide. excitement; reduction of initiative and increased indifference toward surround­ nitrous oxide ings; reduction of spontaneous movements A short-acting gaseous anesthetic sometimes and purposeful actions; normal spinal used as an AEROSOL propellant that is reflexes. inhaled for its intoxicating effects. A depressant without depressant effects on Neuroleptics allow patients to bring their the spinal cord. When used therapeuti­ psychoses under control, thus enabling cally, the effects are those of anesthesia their deinstitutionalization under mainte­ and analgesia. In recreational use, when nance therapy. See also extrapyramidal it is in pure form for less than a minute, system. its effects are closer to those of the vaporous anesthetics ETHER and CH LORO­ neurotransmission FORM than other depressants, making the The process by which nerve impulses user giddy or exhilarated for about 5 min- travel acros~ neurons and their connecting utes. Occasionally HALLUCINATIONS synapses. Some of the major neurotrans­ occur. Excessive doses may cause nausea, mission systems are the cholinergic system, vomiting, or unconsciousness, often the adrenergic system, and the indoi"eami­ because of lack of oxygen. Discovered in nergic system. Each of these systems is the 1770lS by Joseph Priestley, but not defined according to the related group of used as an anesthetic until the middle of biochemicals responsible for the transrnis­ the 19th century, it was the first really sion across the synapses. Cholinergic effect ive modern anesthetic, to be followed agents include substances that activate by ether and chloroform. Also called the PARASYMPATHETIC NERVOUS SYSTEM, laughing gas or nitrogen monoxide. Clas­ for example, choline and acetylcholine. sification: volatile inhalants. Adrenergic agents include epinephrine, norepinephine, and dopamine, substance~ nodding that activate the SYMPATHETIC NERVOUS The semi stuporous state characterized by SYSTEM. lndoleaminergeric agents include head bobbing, bowed head, and drooping indole and serotonin (a vasoconstrictor, eyelids experienced by heroin and high­ gastric juice inhibitor, and smooth muscle dose methadone users after the euphoric stimulant) . effects accompanyi ng ingestions have sub­ sided. nialamide An ANTIDEPRESSANT, manufactured as nonmedical drug use Niamid. Use that is not indicated for generally 70

accepted medical reasons, whether under detaching oneself from situations in which medical supervision or not (LeDain et al. there is personal involvement. Free of 1973); thus, any recreational drug use. bias. Contrast with subjective. NORML observed urination National Organization for the Reform of See certified urine. Marijuana Laws (NORML). NORML was founded in 1970 and actively lobbies for 00 the decriminalization of marijuana. the See overdose. destruction of criminal records for mari­ juana law offenders, recognition of the onset medical uses of marijuana, and research In drug research, the term is used to on the effects of marijuana on women of mean the first time a person uses a partic­ childbearing age. NORML policies, how­ ular drug. Also used to refer to the ini­ ever, are against the abusive use of all tiation of the WITHDRAWAL SYNDROME. drugs, the use of marijuana by children. Age of onset is a major variable often and driving while under the intoxicating studied by epidemiologists alone and in effects of ma rijuana or any other drug. relation to other variables. Winick (1974) (legalization of drugs. RIS 27:349--12 suggests an association between the age entries) of onset of heroin use and variables such as the likelihood of continued use, ability nortriptyline hydrochloride to hold a job, criminality, successful reha­ A tricyclic ANTIDEPRESSANT, manufac­ bilitation, and successful social functioning tured as Aventyl and Pamelor. (RIS 27: in general. Winick (1974: 112) states, 220--1 entry) IIThis relationship is crucial because of the fairly consistent evidence that the age nostrum of onset has been declining fairly steadily A quack, secret, or patent medicine (Dor­ and is positively correlated with mixed landIs Illustrated Medical Dictionary 1974). dependencies and earlier criminal involve­ A medicine of secret composition, and usu­ ment in a broader range of offenses. II ally a questionable remedy; a panacea, or (RIS 27:358--75 entries) cure-all. Also a synonym for patent medi­ cine. See proprietary drugs. Contrast operational definition with placebo. Used to define a concept in the most unam­ biguous terms possible for purposes of nutmeg research. It seeks to assign specific mean­ The dried seeds of the East Indian ever- ing to a term, thereby eliminating other green tree of the same name. In low possible implied meanings. The term IIpri­ doses it can produce a mild, brief euphoria, f'" Jry drug problem, II for example, would accompanied by lightheadedness, floating likely have a different meaning to different feelings, and CNS stimulation. High doses drug treatment program staff. It is there­ can produce rapid heart beat, excessive fore operationally defined under the Fed­ thirst, agitation, anxiety, and sometimes eral CODAP reporting program as lithe acute panic. Nutmeg is commonly used as drug that is the major problem in that it a drug substitute by prisoners. Its seed­ has caused the most dysfunction. It is coat, mace, has similar effects. Classifica­ the drug problem for which the client was tion: hallucinogens. admitted to treatmenL II In this way a working definition for reporting purposes nystagmus was established that operationally defined Involuntary rapid eyeball movement. A the term IIprimary drug problem. II common symptom of toxic reaction resulting from excessive drug use. opiate narcotics A major subclass of drugs that, like alco­ hol and barbiturates, are CNS depressants, but, unlike them, are also pain relievers. Sometimes called simply. NARCOTICS or OPIATES, the term 1I 0piate narcotics ll is generally preferred as it avoids confusion over what constitutes a Ilnarcoticll and the semantic problem created by classifying the three distinct forms of OPIUM, OPI­ objective ATES (morphine, codeine), and the syn­ Viewing facts on the basis of evidence and thetic OPIOIDS (methadone, meperidine 1I reason rather than prejudice and emotion; hydrochloride) as liopiates. The nonnar- 71

cotic analgesics such as aspirin differ from opium the opiate narcotics in having far less CNS The NARCOTIC from which all the OPI- depressant effects. Classification: nar­ ATES are derived. It is obtained from cotic analgesic agonists. (opiates, RIS drying the milky discharge of the cut, 27:220--161 entries; opium, RIS 27:222--14 unripe seedpod (capsule) of the opium entries) poppy (Papaver somniferum), which appears soon after the petals begin to fall. opiates The major natural ALKALOIDS obtained Specifically, refers to the two OPIUM alka­ from opium are MORPHINE (10 percent by loids MORPHINE and CODEINE and the weight) and CODEI NE. Opium has been semisynthetic drugs derived from them, used for centuries as a medicinal and rec­ such as HEROl N (diacetylmorphine) and reational drug. Medically, it was formerly HYDROMORPHONE HYDROCHLORIDE used to treat over 50 different diseases. (Dilaudid). (See also PAPAVERI NE.) I n 17th-century England it was praised as Sometimes generally used to refer to opium, God's greatest gift to humanity for the opium alkaloids and their derivatives, and relief of suffering, and until the 20th cen­ the synthetic OPIOIDS as a whole, but it tury it was considered the most useful has been argued that this semantically therapeutic agent available. Recreationally, blurs the specific distinctions between it was primarily smoked or ingested orally. these types (Margolis 1978). Morphine (See LAUDANUM.) The development of and codeine, along with opium, are some­ more effective opiates, opioids, and non­ times referred to as natural opiates, and narcotic ANALGESICS has now virtually their derivatives as semisynthetic opiates. eliminated its use medically, and recrea­ Classification: narcotic analgesic agvnists. tional users have turoi.ld to the intravenous (RIS 27:220--161 entries; opium, RIS 27: injection of more powerfu I opiates such as 222--14 entries) HERO IN. Classification: narcotic analgesic agonists. (RIS 27:222--14 entries; opiates, opiates, natural RIS 27:220--161 entries) Refers to OPIUM and its two alkaloids CODEINE and MORPHINE. organic disorder Impairment of function attributed to spe­ opiates, semisynthetic cifically known or hypothesized pathological Refers to the OPIATES derived from the lack or impairment of organic structure two opium alkaloids MORPHINE and (English and English 1958). A disease CODEINE, such as HEROIN (diacetylmor­ that is the result of a known pathological phine) and HYDROMORPHONE HYDRO­ condition of the tissues (Chaplin 1975). CHLORIDE (Dilaudid). Contrast with functional disorder. opiates, synthetic organic drug See opioids. A plant used as a drug that remains in natural plant form without being subject opioids to extractions' or synthetic processing. Synthetic drugs manufactured to resemble Organic drugs include peyote, marijuana, the opium alkaloids MORPHINE and psilocybin, and crude opium. Contrast CODEINE and their derivatives in action with synthetic drug. and effect. The principal synthetics are MEPERIDINE HYDROCHLORIDE (Demerol) OTC drugs and its related drugs, LEVORPHANOL See over-the-counter drugs. TARTRATE (Levo-Dromoran), METHADONE HYDROCHLORIDE (DolophineL PENTA­ outpatient ZOCI NE (Talwin). and PROPOXYPHENE An ambulatory patient residing in the com­ HYDROCHLORIDE (Darvon). Also called munity while receiving medical care from a "synthetic opiates." Although semantically hospital or clinic. Contrast with inpatient. incorrect, opioid is sometimes used as a general term that includes all of the opium overdose and 0plumlike derivatives, natural and syn­ The administration of-a quantity of drug thetic. Classification: narcotic analgesic larger than that normally or safely taken agonists. (Demerol, RIS 27:204--2 entries; at one time, or to which the system has meperidine, RIS 27:214--1 entry; metha­ acquired TOLERANCE. Usually implies done, RIS 27:214--125 entries; pentazocine, some adverse or toxic reaction, whether RIS 27:222--2 entries; propoxyphene, RIS fatal or not, and is most frequently applied 27: 223--2 entries) to excessive consumption of opiate or hyp- 72

notic-sedative drugs that act to depress the central nervous system causing COMA and often death from respiratory depression or complications such as pneumonia or heart failure. Frequent symptoms of non­ fatal drug overdose, are STU PO Rand AG 1- TATION. Accidental overdoses often occur through (DRUG) AUTOMATISM or the use of a sedative drug with alcohol, which potentiates its effects. (See POTENTIA- Pacific Institute for T ION. ) Opiate overdosage can be arrested Research and Evaluation by the use of a NARCOTIC ANTAGONIST A nonprofit organization concerned with such as NALORPHINE (Nalline). A variety the primary prevention of drug abuse of home remedies may be' employed to keep among adolescents. It produces primary the patient awake and reverse respiratory prevention materials including a popular depression (LeDain et al. 1973; Lingeman series Balancing Head and Heart. An 1969) • The widespread use of the word annotated list of Pacific Institute's and "overdose" on death certificates has been other prevention materials is provided in criticized because there appear to be no the reference, National Institute on Drug consistent toxicologic standards for evalua­ Abuse 1977. Pacific Institute books and tion of what constitutes a lethal dosage videotapes are available through the Pre­ (Lettieri and Backenheimer 1974). In prac­ vention Materials Institute, P.O. Box 152, tice, police and/or coroners often classify Lafayette, Calif. 94549. a death as due to overdose if any evidence of heroin use is found (Brecher 1972). panic reaction See also deaths, drug-related. (RIS Most common of the adverse psychological 27:359--114 entries) reactions to drug use. (See ADVERSE DRUG REACTION.) Characterized by over-the-counter drugs overwhelming fear, intense anxiety, and Drugs that may be purchased without pre­ possibly immobilization, this reaction scription. There are an estimated 350,000 accounts for many of the cases that come OTC products with annual sales of $4 to to the attention of psychiatric personnel. $5 billion (Inhorn 1981). OTC drugs are May be triggered by any drug or may subject to abuse, particularly certain cough appear seemingly spontaneously without remedies that contain potent analgesic/ the drug having been taken again. See euphoric or hallucinogenic substances. talking-down method. (RIS 27:360--1 entry) oxazepam An (ANTIANXIETY) TRANQUiLIZER Papaver somniferum derived from BENZODIAZEPINE, manufac­ Scientific name for the oriental opium tu red as Serax. Classification: sedative/ poppy plant from which opium and its hypnotics. derivatives are produced. oxycodone hydrochloride papaverine A semisynthetic MO RPH I NE derivative, A naturally occurring ALKALOID of OPIUM manufactured as Percodan, Percocet-5, that acts to depress the heart and smooth and Tylox. Used to relieve moderate to muscles. Unlike MORPHINE and CODEINE moderately severe pain. Classification: it has no analgesic, euphoric, or other narcotic analgesic agonists. central nervous system effects. oxymorphone hydrochloride paraldehyde A semisynthetic NARCOTIC ANALGESIC, A potent nonbarbiturate SEDATIVE/HYP­ manufactured as Numorphan. (RIS 27: NOTIC. Although considered safe, it has 222--1 entry) an offensive odor that limits its use. 73 paranoia Swallowing (hallucinogens, amphetamines, A condition characterized by ideas of refer­ barbiturates, legal high plant products, enc~, suspicious thi nking, and high levels assorted psychoactive pills, tablets, of anger; in the most extreme forms, by crystals, and liquids) DELUSIONS of persecution and/or gran­ deur. A paranoid personality is character­ psychedel ic posters ized by unreasonably lofty ambitions, black lights extreme suspicion of others, and a fixed strobe lights and inflexible conceit. In severe instances hard rock or other music may be considered a sign of psychosis. (RrS 27:360--36 entries) paraquat A herbicide. fn 1976 paraquat was sprayed paraphernal ia, drug over illicit marijuana fields in Mexico by The assorted equipment and materials used the Mexican Government at the urging of to store or administer illicit drugs, or to the United States (National Institute on make the drug high more intense. Drug Drug Abuse 1978). In 1977 the U.S. paraphernalia comes in all sizes, shapes, Congress prohibited the use of foreign colors, and materials; some of the more aid for the purchase of paraquat, but widely used items are listed below by Mexico has since continued this form of route of administration and drug. marijuana eradication on its own. With initiation of the Mexican spraying program, Smoking (marijuana, hashish, freebase there were fears that anyone smoking mari­ juana laced with paraquat would be exposed cocaine, PCP, heroin, opium) to a serious health threat. A large number paper envelopes or plastic bags of marijuana samples, particularly on the papers West Coast, were turned into laboratories rolling machines for determining whether they contained pipes paraquat. Home testing kits also become strainers avai lable. Recent studies spqnsored by bongs the CENTER FOR DISEASE CONTROL in water pipes or hookahs Atlanta, however, indicate that the original containers (stash boxes) widespread fear of the health consequences of paraquat spraying was an overreaction Injecting (heroin, morphine, amphetamines, (Smith and Seymour, in press). Two barbiturates) amendments initiated by the Justice Depart­ ment are now pending in Congress for glassine envelopes or plastic bags repeal of the current restrictions on para­ needles quat. syringes (modified eye dropper) tourniquets (belts, rubber hose, string) parasympathetic nervous system cotton wads See nervous system. Snorting (cocaine, heroin) pa rasympathomimetic glassine envelopes or plastic bags A substance that produces action similar razor blades and flat hard surfaces to the stimulation of the parasympathetic (used to pulverize the drug into a nervous system. Also called cholinomimetic. fine powder) See nervous system; neurotransmission. straws rolled up, largf:! denomination dollar bills paregoric spoons TINCTURE of opium (about 4 percent) in containers (usually small and often combination with camphor, anise oil, ben­ elaborate) zoic acid, and glycerin. First prepared in the early 18th century and used medic­ Sniffing (glue, nail polish, gasoline, paint inally to control diarrhea and as an ANAL­ thinner I aerosol products, anesthetics, GESIC to control the discomfort associated miscellaneous commercial products contain­ with teething in babies. See also laudanum. ing volatile solvents) parenteral paper bags Not taken orally through the alimentary plastic bags canal but rather by hypodermic injection rags balloons through some other route, such as SUB':' 74

CUTANEOUS, I NTRAMUSCULAR, I NTRA­ pentoba rbital sodium VENOUS. A short-acting, quick-onset BARBITURATE, manufactured as Seconal. Classification: patent medicines sedative/ hypnotics. (RI S 27: 222--1 entry; See proprietary drugs. barbiturates, RIS 27:202--48 entries) pathogenic pep pills Causing or capable of causing a disease Slang. AMPHETAMINE pills; UPPERS. or mental disorder. Pathogenesis is the (RIS 27:222--1 entry; amphetamines, RIS origin and developmental course of a 27:199--136 entries) disease or mental disorder (Chaplin 1975). perceptual distortion pathological A lack of correspondence between physical Diseased; usually used in reference to reality" and psychological experience such those socially undesirable conditions that as occurs in illusions, pathological states, by analogy can be conceptualized as social dreams, and hypnosis (Chaplin 1975). diseases, such as crime, delinquency, and See effects, perceived. (perception, RIS drug addiction. In psychological terms, 27:364--36 entries) behavior that is persistently morbid or unnatural. In social terms, undesirable periodicals, drug abuse social manifestations or conditions that Periodicals and journals oriented primarily threaten social well-being (Fairchild 1976). to the fields of illicit drug use and alco­ holism include: patterns of drug use A sequence of drug-using behavior by an Addiction Therapist individual or a group. Includes description Addictive Behaviors; An International of kind and amount of drug taken as well Journal as set and setting of drug-taking behavior Advances in Alcohol and Substance Abuse over a certain period of time. The American Journal of Drug and Alcohol National Commission on Marihuana and Drug Abuse Abuse (1973:93-98) identified five patterns, British Journal of Addiction differentiated by degree: EXPERIMENTAL Contemporary Drug Problems DRUG USE, SOCIAL-RECREATIONAL DRUG Drinking and Drug Practices Surveyor USE, CIRCUMSTANTIAL-SITUATIONAL Drug Abuse and Alcoholism Newsletter DRUG USE, I NTENSIFI ED DRUG USE, and Drug and Alcohol Dependence COMPULSIVE DRUG USE. Drug Enforcement Drug Forum PCP Focus on Alcohol and Drug Issues See phencyclidine. International Journal of the Addictions Journal of Alcohol and Drug Education peer culture Journal of Altered States of Conscious- The socioculture that is peculiar to a cer­ ness tain class of equals in society, such as Journal of Drug Education teenagers or persons in a given occupation. Journal of Drug Issues Peer culture is usually not shared with Journal of Psychedelic Drugs those ouside the peer group (Zadrozny Marijuana Monthly 1959). See also subculture, drug. (RIS Mood Altering Drugs 27:362--61 entries) Outlook in Alcohol & Drug Abuse U. S. Journal of Drug and Alcohol pentazocine hydrochloride Dependence A potent ANALGESIC, approximately equiV­ War on Drugs alent on a mg-for-mg basis to codeine. Worldwide Report--Narcotics and Danger- Pentazocine also has very weak NARCOTIC ous Drugs ANTAGONIST properties, with about 1/50 the antagonistic activity of NALORPH I NE. Other periodicals and journals frequently Psychological and physical dependence have featuring articles related to illicit drug use occurred with PARENTERAL pentazocine, include: primarily '0 though not solely, in persons with histori0s of drug abuse. Pentazocine American Journal of Epidemiology is combined with TRIPELENNAMINE in the American Journal of Psychiatry street drug Ts and Bs, which produces a American Journal of Public Health HIGH similar to that of MORPHINE. Classi­ Annals of the New York Academy of fication: narcotic analgesic; agonists. See Sciences also Ts and Bs. (RIS 27:222--2 entries) A rchives of General Psychiatry 75

Crime and Delinquency mood; and (2) it resembles and is pat­ Journal of the American Medical Associ­ terned on an alimentary orgasm (Chessick ation (JAMA) 1960; Hoffman 1964). (RIS 27:366--4 Journal of Occupational Health and entries) Safety Lancet pharmacokinetics New England Journal of Medicine The study of the action of a drug in the body over a period of time, including the peripheral nervous system processes of absorption, distribution, local­ See nervous system. ization in tissues, and excretion (Dorland's Illustrated Medical Dictionary 1974). perphenazine An (ANTIPSYCHOTIC) TRANQUILIZER, pharmacology manufactured as Trilafon. (RIS 27:222--1 The study of the effect of drugs on the entry) living organism. See also ethnopharma­ cology; psychopharmacology. peyote A small cactus, Lophophora williamsii, with phenazocine a spineless head or button, native to north An OPIOID. Classification: narcotic anal­ Mexico and Texas, which contains the hallu­ gesic agonists. cinogen MESCALI NE; sometimes loosely used to refer to mescaline. Its hallucino­ phencyclidine (PCP) genic properties were known to the Aztecs, A synthetic depressant drug developed as who considered it divine and called it an ANESTHETIC agent in surgical proced­ "peyotl." During the 19th century, based ures in the late 1950s, but because of its on the continuing belief in its divine, adverse effects now used medically only supernatural powers, use spread among for veterinary purposes. It is sold and Native Americans, who used it in their userl on the street as a hallucinogen, often religious rites, as an aid to their tradi­ represented as THC, MESCALINE, or tional search for divine visions, and to PSILOCYBIN. A white, crystalline, water­ heal the sick. Eventually this use devel­ soluble powder, it is used orally, injected oped into a religion incorporating elements and sniffed, but most often smoked after of Christianity, which is now known as being sprinkled on parsley, marijuana, or· the NATIVE AMERICAN CHURCH. As a tobacco. The risk of adverse reactions to crucial sacrament of this church, legal PCP is considered. to be great enough to use of peyote is limited only to bona fide outweigh any usefulness in the treatment members. Slang names are listed in of humans; side effects can include agita­ appendix B. Classification: hallucinogens. tion, irritability, extreme excitement, (RI S 27: 223--1 entry; mescaline, RI S 27: visual disturbances and delirium. Unlike 214--7 entries) most hallucinogens, it exerts a CNS depres­ sant effect rather than a stimulant effect. pharmacogenic orgasm In small doses effects can be very unpre­ A term coined by S. Rado (1926) to refer dictable, but it generally produces a state to the pleasurable sensation often reported resembling drunkenness. When used regu­ to be experienced by heroin users after larly, memory, perception, concentration, intravenous injection of the drug. Rado and judgment are often disturbed. In believed that the whole mental personality large, chronic doses, it can cause anes­ of the addict, together with the drug, thesia, sensory disturbance, permanent represents an autoerotic pleasure apparatus. brain and nervous system damage (Petersen The oral zone was the key fixation point and Stillman 1978). Classification: hqllu­ for the libido and the psychosomatic experi­ cinogens. Slang names: angel dust, dust, ence after injecting the drugs functioned crystal, superweed, rocket fuel, goon. as a new edition of the experience that See also appendix B. the infant receives on being satiated after a feeding from the mother's breast. This phendimetrazine tartrate feeling of well-being following the ingestion A SYMPATHOMIMETIC AMI NE used as an of a meal he referred to as the ALIMEN- ANORECTIC. Manufactured as Bacarate, TARY ORGASM. Without heroin; the Bontril, Melfiat, Plegine, Prelu-2, SPRX- addict suffers from a tense depression, 105, Statobex, Trimstat, Trimtabs, and which is relieved by a pharmacogenrc ela­ Wehless-35. Classification: stimulants-­ tion that is characterized by tINO essential primary. points: (1) it is brought about by the ego itsel f, at wi II, and thus gives the phenelzine sulfate addict an omnipotent sense of control over An MAO INHIBITOR, manufactured as Nardi!. Classification: antidepressants.

387-396 0 - 82 - 6 QL 3 76 phenmetrazine hydrochloride not yet become the primary site of maternal­ A CNS stimulant similar to an amphetamine fetal exchange. the fetus acquires nutri­ used in dieting to depress the appetite. tional factors and drugs from surrounding Manufactured as Preludin. Classification: maternal fluids.) Therf,l are very few stimulants--primary. See also methylpheni­ drugs that do not cross the placenta or date hydrochloride. (RIS 27:223--3 entries) enter the maternal fluids and can therefore be given to the mother without any pos­ phenobarbital sibility of di rectly affecting the fetus. A long-acting, slow-onset BARBITURATE Fetal drug toxicity occurs when the fetus that is especially effective as an anticon­ has an adverse reaction to a drug taken vulsant for epilepsy and delirium tremens. by its mother. The type and severity of The phenobarbitals have been in medical adverse effects of a given drug on the use since -1912. Manufactured as Luminal. fetus depend on a multitude of factors, Classification: sedative/hypnotics. Slang including the size and frequency of dose, name: purple hearts. (RIS 27:223--2 th~ route of administration, the stage of entrie's; barbiturates, RIS 27:202--48 pregnancy, maternal health and nutritional entries) status, genetic makeup of the mother and fetus, previous obstetrical history, and Phoen ix House myriad environmental factors--including The nation's largest THERAPEUTIC COM­ concomitant exposure to other drugs, MU NITY system for drug-free treatment smoking status, and perhaps even environ­ and rehabilitation of former heroin users mental pollutants (Finnegan 1979:17-19). as well as users of other drugs. (RIS 27: (birth weights, RIS 27 :308--6 entries; con­ 366--7 entries) genital defects, RIS 27:312--16 entries; infant mortality, RIS 27:3~7--16 entries; piperacetazine neonatal characteristics, RIS 27:356--23 An (ANTIPSYCHOTIC) TRANQU lLlZER. entries; pregnancy effects, R!S 27:368--17 manufactured as Quide. entries; pregnant women, RIS 27:292--22 entries; prenatal care, RIS 27:368--21 piperidyl benzi late entries; teratogenic effects, RIS 27:389--17 See Ditran. entries) pipradrol hydrochloride policy An AMPHETAMINE RELATIVE, manufac:tured See Federal drug abuse policy. as Meratran. Classification: stimulants-­ primary. polydrug use A term widely used in the drug research placebo literature, yet without any real consensus Any substance without relevant pharmaco­ regarding its definition (Johnston 1975:36). logical action. Used in drug research to Nearly all heavy users of illicit drugs use determine and control for the influence of more than one drug. The most common psychological SET. A placebo effect is a definition is the use of more than one drug reaction due to the subject's SET and SET­ at different times without necessarily a TIN G rather than the pha rmacological stror.g preference for any particular drug. properties of tl-. substance. Beecher It has also been operationally defined by (1956) determined from his studies and NIOA for funding purposes as dependence those of others that placebos were fairly on psychoactive drugs in which the primary consistently able to give significant relief drug dependence is not heroin, methadone, from symptoms (e.g., severe postoperative or alcohol (Kaufman 1977). Kaufman (1977) wound pain. pain of angina pectoris, head­ has observed that "multiple drugs are used ache, cough, mood change, seasickness, whenever a given drug is not available, a anxiety, and the common cold) in roughly tolerance develops, tension and depression 35 percent of the respondents tested. are not relieved, boredom with the drug's Beecher has concluded from his extensive effects is experienced." Polydrug users studies that placebos are more effective often develop a "high" orientation and will when the pain or stress symptoms of the take almost any drug or combination of subject are greater, and vice versa. Con­ drugs to experience the state of being trast with nostrum. "high." placental passage of drugs N I DA undertook an extensive effort to The fetus nearly always receives the drugs develop a better knowledge base about taken by its mother and transferred polydrug use by funding the National Poly­ through the placenta. (In the first trimes­ drug Collaborative Project. Under this ter of pregnancy when the placenta has project, 15 pol ydrug use demonstration

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projects were funded around the country uats are inherently predisposed to use, between April 1973 and March 1975. These abuse, and/or addiction to psychoactive pilot projects treated over 2,000 patients drugs. The possibility has been raised who had abused a variety of psychoactive that individuals may be predisposed to drugs, but who did not use a narcotic heroin addiction because of an "ENDOR­ drug as a primary drug of abuse. PH I N deficiency syndrome. t! Dole and The Federal Government initiated these Nyswander theorized over whether innate pilot projects to uncover what was felt to metabolic conditions can predispose an be a hidden population of polydrug abusers individual to heroin addiction. Others by offering a service on a limited scale theorize that elements in the cultural and that 'Nas not readily available at the time. socioeconomic environment may const"· te By idantifying and treating this group predisposing factors for drug addiction. and carefully following their progress on See also at-risk populations. (prediction, discharge to various compor.;nts of the RIS 27:368--28 entries) health and social services systems, it was hoped to learn the characteristics of this predisposition ill-defined population and appropriate Any factor that, illthough not the direct treatment approaches. Findings from the cause of an event, insures that the event National Polydrug Collaborative Project is more likely to occur in its presence than are published by NlDA in several volumes in its absence (Chaplin 1975). There is a under what was fer-merly known as the wide range of predisposir.g factors involved Services Research Monograph Series and in drug use: personality or psychological is now called the Treatment Research and make-up of the user; close personal rela­ Assessment Mone'graph Series. See multiple tions and environment in family, school .. drug use. (multiple drug use, RIS 27:355 and the peer group; social and economic --25 entries) conditions; and the general attitude of the society toward drug use (LeDain et post mortem al. 1973:35). A fter death. An exami nation of a dead body to ascertain cause of death. An prescription autopsy. (RIS 27 :367--20 entriesl The written direction for the preparation and use of a medicine; can also refer to 'postaddict the prescribed medicine itself. See ex-addict, prevention models postnatal Four basic models are presently employed After birth. Postnatal care refers to the under NI DA' drug abuse prevention activ­ medical supervision and treatment of the ities: (1) media-based information/educa­ mother and/or infant after birth. tion campaigns: the dissemination of facts, pot opinions, and other information aimed at reinforcing positive behavior and attitudes Slang. See marijuana. toward drug use among the general public; (2) education programs: formal courses, potency curriculums, and training programs designed A relative tel~m used to compare the to reinforce positive behaviors and atti­ strengths of two or more drugs required tudes, (3) alternatives to dru~ use: pro­ to pl'oduce a given effect; the more potent grams designed and/or manage by target the drug, the less is required. The same groups of individuals engaged in behaviors effect can be achieved by more of a less that correlate highly with dysfunctional potent substance, or less of the same sub­ use and in which ust' is shown to be dis­ stance in a more potent form. Occasionally proportionately high. Focal activities the term is used to refer to the length or include service career and occupational duration of effects (Margolis 1978). alternatives, community restorations, self­ understanding, therapy, and the like, potentiation designed to change attitudes and behaviors The ability of one drug to increase the from a sense of powerlessness and nondi­ activity of another drug taken simultane­ rection to one of self-worth, personal ously. The overall effect of the drugs power, and self-direction; and (4) inter­ taken together is greater than the total vention programs: 'programs designearor effects of each drug taken alone. See hIgh-risk clients that provide groups and also synergistic effects; additive effect. individual counseling and activities as predisposing factors alternatives to drug use, focusing on "It has been theorized, but never conclu­ restructuring the client1s environment, sively demonstrated, f;1at certain individ- social patterns, and mind set (Retka 1977:4). 78 prevention, primary public convenience); a ratio between effort A concept in the mental health field that and acnievement, the capacity of an indi­ refers to actions that anticipate a disorder vidual, organization, facility, operation, and foster optimal health. The concept or activity to produce results in proportion encompasses those activities directed to to. the effort expended (National Institute specifically identified vulnerable high-risk of Mental Health 1977). groups within the community who have not been labeled as psychiatrically ill and progression risk for whom measures can be undertaken to The risk of continuing from experimental avoid the onset of emotional disturbance or occasional use through regular social! and/or to enhance their leve' of positive recreational use to dysfunctional use mental health. Programs are primarily (Chambers 1977:228). educational rather than clinical and are oriented towa rd i ncr~asing people's capac­ prohibition ities for dealing with crises and taking Forbidding; interdiction. The term is fre­ steps to improve their own lives (Klein quently specifically applied to the forbid­ and Gol dstone 1977: 27; National Institute ding by law of the manufacture, sale, on Drug Abuse 1977). See also Do I t Now possession, importation, or transportation Foundation; PYRAMID Project; Pacific of alcoholic beverages or CONTROLLED Institute for Research and Evaluation. SUBSTANCES. prevention, secol1dary promethazi ne hyd rochlo ride InterventiQn to ward off drug abuse or An (ANTI PSYCHOTIC) TRANQU ILllER, addiction di rected at those persons experi­ manufactured as Phenergan, Remsed, and menting with drugs who are linked with liPAN. but not yet absorbed into an addict subcul­ ture and for whom the risk of addiction is propoxyphene hydrochloride high (Brown 1973:139). An OPIOID that has effects similar to those of CODEINE but does not produce nausea preventiof', tertiary or constipation. Originally introduced as The treatment of drug abusers with the a nonnarcotic prescription ANALGESIC, goal of removing or controlling their dis­ evidence now suggests that it is more like ability to a degree that permits them to the narcotic analgesics than formerly real­ be psychologically and socially rehabilitated ized. Manufactured as Darvon. Classifi­ (Brown 1973:139). cation: narcotic analgesic agonists. (RI S 27:223--2 entries) problem drinker An excessive drinker whose drinking proprietary drugs causes personal or public harm. The cate­ Drugs that are protected by some means gory includes (and is often used as a against free competition as to name, prod­ euphemism for) the ALCOHOLIC, particu­ uct, composition, or process of manufac­ larly in business and industrial programs, ture. See also nostrum. and may be used to avoid the pejorative implications of a diagnosis as alcoholic (Keller and McCormick 1968). proprietary medicine Any chemical, drug, or similar preparation prochlorperazine used in the treatment of diseases, if such An (ANTIPSYCHOTIC) TRANQUILIZER, a rticle is protected aga inst free t.~mpetition manufactured as Compazine. as to name, product, composition, u'" proc­ ess of manufacture by secrecy, patent, program effectiveness trademark, or copyright, or by any other The extent to which the needs addressed means (Dorland's Illustrated Medical Dic­ by the program are met, both in the indi­ tionary 1974). vidual clients served and in the service area, generally considering the resources prosodal behavior available and the extent to which the inter­ Activities associated with the dominant mediate functions are operating well values of the society. A major goal of (National Institute of Mental Health 1977). drug abuse treatment is the enhancement of prosocial behavior. In the case of drug program efficiency abuser rehabilitation, prosocial behavior~ The cost in resources of attaining objec­ would include job seeking, education and tives; the relationship between effort and skill upgrading, developing Ir.eaningful effect, or input and output. Evaluation relationships. See also contingency con­ in terms of cost (money, time, personnel, tracting. 79 protriptyline hydrochloride psycholeptics A tricyclic ANTI DEPRESSANT, manufac­ See sedativel hypnotics. tu red as Vivactil. psychological models pseudoheroinism In regard to drug abuse, explanatory Refers to the phenomenon observed by models derived from general psychological Primm and Bath (1973) whereby many regu­ theories. Although there are many schools lar heroin users believe themselves to be of thought, those who espouse psycholog­ physiologically addicted even though they ical models, particularly in regarc' to heroin might not be because of the "infinitesimal" addiction, generally hold that (1) those amount of heroin in the average street who become abusers are psychologically bag (0.5 percent); therefore, upon cessa­ disturbed, (2) drug abusers do further tion of use only minor withdrawal symptoms harm to their psychological state, and might be experienced. (3) sufficient psychological and/or psychi­ atric therapy and support can eventually psilocin enable them to abstain from drugs. An unstable ALKALOID contained in the Although this has been the most generally Psilocybe mexicana mushroom, along with, accepted model, the valiC:ity of each of but in a smaller quantity than, PSILOCY­ these positions has been strongly criticized BI N. Psilocin is the hallucinogenic sub­ (Iiyama et a\. 1976:20). The major criti­ stance to which psilocybin is converted in cism stems from research that indicates no the body. Slang names are listed in common psychiatric diagnosis among drug appendix B. Classification: hallucinogens. abusers, among whom are found all kinds of people (William 1976:17). Se,e also psy­ psilocybin chosocial models; sociological models. A hallucinogenic ALKALOID in a nUlT'ber of mushrooms of Mexico with the common psychomotor name of teonanactyl, such as the Psilocybe Relating to muscular activity or behavior mexicana. Psilocin is an accompanying associated with certain psychological func­ alkaloid. Both are derivatives of trypta­ tions. Psychomotor tests measu re such mine and chemically related to LSD and things as manual coordination, reaction DMT, and are usually taken orally. time, and other behavior skills (LeDain et Extremely expensive to synthesize or al. 1973). (psychomotor performance, RIS extract, most of what passes for psilocybin 27:372--67 entries) sold on the street is actually either LSD or a mixture of LSD and PHENCYCLIDINE (PCP). Slang names are listed in appendix psychopathic personality B. Classification: hall ucinogens. A personality disorder which is not psy­ chotic in nature, which is la<;:king in mani­ psychedelic drugs fest anxiety, and which involves inadequate Consciousness-expanding or mind-manifesting social adjustment (English and English 1958; drugs; the HALLUCINOGENS. This term Chaplin 1975). This term is now rarel y has been widely used in the United States used, and tile psychiatric diagnosis of to refer to hallucinogenic drugs and is "psychopathic personality disorder" has the preferred term of many users them­ been replaced with ANTISOCIAL PERSON­ selves (Goode 1972). Others prefet" the AL/ TY in the Diagnostic and Statistical term hallucinogens, arguing that upsyche­ Manual of Mental Disorders (1978). delic" incorrectly combines two Greek roots (psyche--soul, and delos--visible: evident), is biologically unsound, and has acquired psychopathology meanings beyond the drugs or their effects Broadly, that content area within behav­ (Sehultes 1976). ioral science that specifies, describes, or predicts disordered or deviant behavior psychoactive substances and involves an application of the princi­ The term preferred by many to refer to ples of learning ( motivation, perception, DRUGS that affect the central nervous biology, and genetics insofar as they con­ system and alter mood, perception, or con­ tribute to behJvior in an effort to arrive sciousness. It is preferred as a SUbstitute at general explanatory laws to account for for Udrug U because of the value-laden con­ different kinds of behavior (Sutker 1977). notations and definitional confusions sur­ The study of the significant causes and rounding the latter term. processes in the development of mental disorders as well as the manifestations of psychodysleptic drugs mental disorders (A Psychiatric Glossary See hallucinogens. 1975). (RIS 27:373--9 entries) 80 psychopharmacology fore, the use of the term is questionable The scientific study of the interactive (Siegel 1977). effect of drugs on psychological and behav­ ioral activity (LeDain et al. 1973). The psychosis, toxic term was first used in the 1940s and 195 Os, Chronic or acute psychotic-like behavior but it was not until the discovery of LSD or delirium resulting from impairment of in 1943 and the synthesis of CHLORPROMA­ brain function by drugs or poisons. Char­ ZI NE that a systematic, scientific investi­ acteristic symptoms are an unpleasant and gation of drugs that affect the mind became extreme confusion, disorientation, aggres­ well organized. The science of psycho­ siveness, depression, or hallucinations pharmacology links the disciplines of psy­ (Weil 1972:50). chiatry, psychology, pharmacology, and neurophysiology. See also ethnopharma­ psychosocial models cology. In regard to drug abuse, explanatory models that define it as a problem associ­ psychosis, amphetamine ated with both psychological and social ll A II mo del psychosis that closely resembles factors either as antecedents or conse­ paranoid schizophrenia and has been seen quents. Psychosocial models view drug to result from long-term amphetamine use abuse primarily as a social problem with (Bell 1965). There is often difficulty in societal, psychological, and group deter­ distinguishing amphetamine psychosis from minants, a function of the user's total schizophrenia, but it appears that visual personality in reaction with the sociocul­ hallucinations are more usual in ampheta­ tural environment as the user sees it, mine psychosis cases, while thought dis­ though not to the exclusion of biological order is more usual in schizophrenia cases. or neurochemical factors. See also epi­ There is conflicting evidence i.l the relative demiology; psychological models; sociolog­ importance of drug effect or underlying ical models; medical models. (psychosocial personality factors in precipitation, but attitudes, R I S 27: 375--13 entries) many researchers believe that ampheta­ mine psychosis is produced primarily in psychosomatic persons who already manifest a personal­ Refers to processes that are both somatic ity disJrder or predilection for paranoid (bodily) and psychic (mental) in nature reaction (Ellinwood 1967). (psychosis, drug, or origin. A psychosomatic disorder is RIS 27:374--61 entries) one thClt is of the b.ody but is psychogenic in nature. psychosis, cannabis Also known as hemp psychosis and hemp psychotaraxics insanity.. The belief that cannabis can See hallucinogens. produce psychosis among users of the drug. Most of the reports of hemp psy­ psychotherapeutic drugs chosis come from Eastern lands, such as A term used to refer to those drugs that India, Egypt,· Turkey, and Africa. How­ (1) are used as medicines to alleviate eve r, the la rge numbe r of Eastern cases psychic distress or as adjuncts to treat­ so diagnosed have been credited to the ment of various physical disorders, and frequent lack of any distinction between (2) are typically acquired through a doc­ drug-induced symptoms and independent tor's prescription or over the counter at schizophrenia, and the purposeful and a drugstore (Mellinger et al. 1974). An inadvertent inclusion of cases for which older and less preferred term for such no proper diagnosis has been made (Grin­ drugs is "psychotropics." (RIS 27:223--2 spoon 1977:261). entries) psychosis, cocaine psychotherapy A psychological reaction to prolonged A technique of treating mental disorders cocaine use characterized by halludnations. by means of insight, persuasion, sugges­ The diagnosis of psychosis often emerges tion, reassurance, and instruction so that from the presence of tactile sens;:;tions. the patients may see themselves and their However, psychosis involves more. than problems more realistically and have the hallucinations and usually implies dysfunc­ desire to cope with them. Stric;tly used, tion in an individual's mental processe~, the term includes only techniques such as emotional responses, memory, communica­ psychoanalysis or psychodrama that are tion skills, sense of reality, and behavior. utilized by specialists; more broadly, it is The presence of such a wide range of phe­ applied to any informal talk aimed at per­ nomena in cocaine intoxication is less clear sonal adjustment (Zadrozny 1959; Chaplin than the presence of hallucinations; there- 1975). (RIS 27:375--15 entries) 81 psyc.hotogenic punding Producing HALLUCINATIONS and psychotic Term suggested by Swedish forensic psy­ behavior (Chaplin 1975). chiatrist Rylander for behavior, induced by massive dos~s of amphetamines, wherein psychotomimetic the abuser Io.ses the capacity to perform Characteristic of drugs that produce a complex sequential acts in a rational man- state similar to or symptomatic of psychoses ner. Instead, the abuser persists in (Chaplin 1975). See hallucinogens. repetitive and compulsive, but subjectively rewarding, manipulative tasks for hours psychotropic drugs or even days (Grinspoon and Hedblom Term sometimes used broadly to refer to 1975:103). See also stereotypy. (RIS PSYCHOACTIVE SUBSTANCES; more gener­ 27:375--1 entry) ally used to refer just to the PSYCHO­ THERAPEUTIC DRUGS. pusher See dealing, drug. Public Health Service hospitals Two Federal treatment facilities, originally pusning, drug called Narcotic Farms, established in Lex­ See dealing, drug. ington, Kentucky, in 1935, and in Ft. Worth, Texas, in 1938, which carried the PYRAMID Project major responsibility for the treatment of A prevention resource network developed opiate addiction in the United States for a by the National Institute on Drug Abuse. quarter of a century. Operated in a man­ PYRAMID provides aSSistance, instruction, ner similar to minimum security penal insti­ and support for the development of drug tutions, the hospitals gave priority to the abuse prevention efforts throughout the admission of Federal prisoners and proba­ country. PYRAMI D staff and a nationwide tioners who were addicts sent for with­ network of resource people provide drawal and detoxification; voluntary technical assistance, information, and tech­ patients were admitted when and if space nology transfer of IOrkable models in pre­ was available. In 1945, the hospitals also vention. Special areas of consultation are began providing vocational, counseling, drugs and drug abUSe, prevention strate­ and psychiatric services. Withdrawal treat­ gies, prevention curriculum, program plan­ ment was based on the extent of addiction ning, needs assessment, community support, and, at first, routinely consisted of sub­ staff development, management/organ iza­ cutaneous injections of decreasing amounts tional development, evaluation, training, of morphine over a period of 4 to 10 days. funding, research, conference/workshop Subsequently, methadone was substituted planning, model programs, resource identi­ for morphine, first through subcutaneous fication, special issues, and other technical and later through oral administration. services. The hospitals were also alAthorized to inves­ tigate the cause, treatment, and preven­ Western office: Pacific I nstitute for tion of drug addiction. Until the late Research and Evaluation, 3746 Mt. Diablo 1960s, individuals desiring medical detoxi­ Blvd., Suite 200, Lafayette, Calif. 94549; fication and withdrawal who could not toll free (800)227-0438. afford private sanitariums had only these hospitals to which to turn. Soon after Eastern office: 7101 Wisconsin Avenue, the hospitals opened, volunta ry patients Suite 1006, Bethesda, Md. 20014; (301 )654- accounted for 75 percent of admissions, and 1194. a total of over 100,000 admissions were made to the hospitals during their years of operation. Although the programs have been criticized for their limited success and their prisonlike conditions, these hospitals did serve the goal of introducing the con­ cept of treatment as a general goal and even as an officially stated Government responsibility and provided an atmosphere in which the addict was considered a receptors patient rather than a lawbreaker at a time Sites within the body where chemical sub­ when addiction was heavily stigmatized stances inter'act to produce pharmacological (Cuskeyet al. 1973: 200; Brown 1973:129- actions. The sites consist of large mole­ 130). (RIS 27:395--34 entries) cules on the surface of cells in functional, 82

or target, tissues. Receptors serve the rei nforcement two prima ry functions of (1) somehow rec­ In psychology, technically denotes the ognizing a substance, distinguishing it process or technique whereby a response from others, and (2) transmitting the sig­ to a stimulus is strengthened. See also nal indicating the presence of the sub­ conditioning. stance, which brings about pharmacological action in the target tissue. relapse A reversion to old habits of aberrant Early research on receptors centered behavior (e. g., using heroin) following a around the hormone estrogen. With dis­ seemingly satisfactory social adjustment. covery of the estrogen receptors, research (RI S 27: 332--42 entries) has expanded to find receptor sites for nearly all of the bodily hormones. In 1971 reserpine Avram Goldstein (1976a) and his staff dis­ One of the ALKALOIDS found in Rauwolfia covered specific opiate receptors in the serpentina (or snakeroot), a plant indi­ brains of rats. Human opiate receptor genous to India and neighboring countries, sites in the brain, spinal cord, and intes­ and used in a variety of antipsychotic tines have since been identified. tranquilizers. Unlike .;ome tranquilizers, it has no anticonvulsant or antihistaminic The discovery of opiate receptors led effects, although the phenothiazi ne deriva­ researchers to suspect that their affinity tives such as CHLORPROMAZINE (Thora­ for exogenous opiate ALKALOIDS was only zine) are preferred in medical and coincidental and that the receptors exist psychiatric practice. Classification: anti­ because the body produces its own endog- psychotic tranquilizers. enous opiatelike substances. In 1975 researchers reported the discovery of the residential treatment two endogenous OPIOID peptides, or A program in which the patient resides in ENDORPHINS, labeled methionine-enkephalin the treatment facility, whether a hospital and leucine-enkephalin (Hughes and Kos­ or THERAPEUTIC COMMUNITY. See also terlitz 1977). The discovery of other inpatient. endorphins has followed, but still very little is known about where and how the resistance, drug endorphins are produced and what their The natural ability of an individual to ward exact role is in modulating mood and pain. off the effect of a drug (Winek 1971). recreational drug use righteous dope fiend See social-recreational drug use. A special type identified by Sutter (1966) to whom status is allocated according to regimen the size of his or her heroin habit and A schedule of treatment procedures success as a hustler. RighteoLs dope designed to address ailment and to achieve fiends prefer heroin above all other drugs a therapeutic resu It. and consider themselves members of the elite world of opiate users. regulation risks, drug related As opposed to PROHIBITION, generally refers to a situation in which use of a The risks related to drug taking are affected by a wide variety of pharmacolog­ drug is permitted but regulated by orderly ical, psychological, and sociocultural vari­ controls over such factors as potency, ables. Subsumed within the concept of price, and the conditions of sale and drug-related risk were two basic compo­ licensing. nents: (1) risk to health; and (2) risk of drug-induced behavior. Implicit in the rehabilitation concept of risk and embraced in these risk The restoration of a person to the best types are risk to the individual health, possible level of functioning after suffering welfare, and safety, and risk to society a behavioral disorder (Wolman 1973). (RIS in terms of the public health, wealth, and 27: 376--11 entries) safety. Risk to the individual and public rehabilitation, drug health is posed by such drug-taking con­ The technique of helping drug users give sequences as acute \'eactions in the form up the use of the drugs to which they of overdose and psychological trauma, or are habituated or upon which they are from diseases that may be directly or dependent, and making them feel that they indirectly related to drug use and physical can be useful and respected among their or psychological problems of short or long families, friends, and communities duration. Public safety risks of drug use (Zadrozny 1959). (RIS 27:376--11 entries) arise primarily from the behavior induced 83

by the drug experience, such as crime or occurrence of extremely pleasurable and alterations of perception, judgment, or euphoric mental states experienced by run­ other mental functions, which may result ners while running. The runner's high in disordered or hazardous behavior such has been described as a lIeuphoric sensa­ as loss of impulse control, which may lead tion experienced during running, usually to assaultive, aggressive, or violent acts, unexpected, in which the runner feels a or impaired psychomotor function, which heightened sense of well-being, enhanced may result in hazardous activities such a~ appreciation of nature, and transcendence inadequate operation of a motor vehicle of barriers of time and space" (cited in (National Commission on Marihuana and Pargman and Baker 1980:342). Although Drug Abuse 1973:94). (RIS 27:376--12 not fully understood, the runner's high is entries) believed by many to be associated with the enhanced production of the natural ritual opiatelike substances called ENDORPHINS Usually refers to tne most directly observ­ caused by running regularly. Also called able, manifest, and salient part of a reli­ jogger's high. gious observance;. more generally, any highly predictable sequence of behavior. rush Within the drug field, ritual can refer to Slang. The initial onset of euphoria and a frequent pattern of marijuana smoking physical well-being felt immediately after in which the users sit in a circle and pass a drug has been injected. Distinguished a single cigarette from person to person from HI G H, which is the continuing state (Encyclopedia of Sociology 1981; Agar 1977). of relaxation and well-being experienced Many heroin users are said to be addicted while the drug is effective. Intravenous to the ritual of hypodermic injections and injection produces the quickest, most will not take a heroin substitute that does intense rush (Lingeman 1969). not involve injection. Peele (1978) theo­ rizes that ritual is actually a part of the object of addiction. roach Slang. Marijuana ciga rette butt. Robinson v. California -?\landmark 1962 Supreme Court decision re!>olving the constitutionality of a Cali­ San Pedro cactus fornia statute making it a criminal offense A tall branching cactus originally grown to "be addicted to the use of narcotics." in South America. It is now grown and The court explicitly recognized that addic­ sold in the United States. San Pedro con­ tion constituted an illness rather than a tains mescaline and has hallucinogenic crime, and that a sentence even as short effects when consumed; nausea is not an as 90 days was cruel and thus unconstitu­ uncommon side effect. tional if it were imposed as "punishment" for an "illness." sanctions Rewards or punishments that are used to Rolleston Committee enforce conformity to the social norms and The committee appointed in Britain after laws; a means of (SOCIAL) CONTROL. passage of the Dangerous Drugs Act in Sanctions are often categorized as positive 1920 to recommend procedures for the dis­ (involving a reward) or negative (involving tribution of opiates and the treatment of a penalty), diffuse (informal means of opiate addiction by the medical profession. social control such as ridicule) or orga­ nized (formal methods employed by author­ route::; of administration ized officials). See administration, routes of. SAODAP run See Special Action Office for Drug Abuse Slang. Usually, a period of continuous, Prevention. heavy use of a drug, especially injection of AMPHETAMINE, lasting 3 to 5 days and scheduled drugs endir.g when the user sinks into protracted, See under Drug Abuse Act Df 1970. exhausted sleep (Lingeman 1969) • screening, drug runner's high See detection, drug. The unpredictable and sometimes fleeting

.' 84 secobarbital sodium "Self-help groups are voluntary, small A short-acting BARBITURATE. Manufac­ group structures for mutual aid and the tured as Seconal. Classification: seda­ accomplishment of a special purpose. They tive/hypnotics. (RIS 27:223--4 entries; are usually formed by peers who have come barbiturates, RIS 27:202--48 entries) together for mutual assistance in satisfying a common need, overcoming a common han­ dicap or life-disrupting problem, and sedative/ hypnotics bringing about desired social and/or per­ A major classification of nonnarcotic depres­ sonal change. The initiators and members sant drugs with such primary effects as of such groups perceive that their needs cal mi ng, sedation, or induction of sleep are not, or cannot be, met by or through (hypnosis) . The sedative/hypnotics are existing social institutions. Self-help usually divided into four categories: (1) groups emphasize face-to-face social inter­ barbiturates; (2) alcohol; (3) antianxiety actions and the assumption of personal tranquilizer,,; and (4) nonbarbiturate, responsibility by members. They often proprieta ry drugs ~ The antianxiety tran­ provide material assistance, as well as emo­ l quilizers and the nonbarbiturate sedative/ tional support; they are frequently Icause - hypnotics are often grouped together and oriented, and promulgate an ideology or are the most widely used drugs in medicine. value through which members may attain The sedative/hypnotics are also often called an enhanced sense of personal identity." anxiolytic sedatives, depressants, psycho­ sedatives, or psychoJeptics. (RIS 27:223-- semantic representations, analysis of 5 entries; barbiturates, RIS 27:202--28 Study of the verbal processes associated entries; alcohol, RIS 27:198--118 entries; with certain groupings of words. Vocabu­ tranquilizers, RIS 27:224--18 entries; hyp­ la ry tests, semantic differential scales (5- notics, RIS 27:210--1 entry; sedatives, or 7-point bipolar scales such as hot/cold, RI S 27: 223--5 entries) good/bad, pleasant/unpleasant), and other techniques of verbal analysis arc- employed self-administration experiments in humans to determine the subjects' attitudes toward Typically drugs are made available to vol­ and depth of knowledge of the group of unteers with histories of drug abuse for words being studied. This information is ingestion under conditions that permit the then often correlated with data obtained gathering of empirical information concern­ on subject behaviors. ing the patterns and effects of drug self­ administration. These experiments are Analyses of semantic representations of usually conducted over the course of sev­ drug abuse terms have been made by sev­ eral weeks, and the subject is sequentially eral researchers (Baron and Galizio 1978; exposed to different experimental condi- Haertzen et al. 1970, 1974; Newmeyer tions. These experimental procedures 1976). There is significant evidence that involving controlled laboratory environ­ the degree of illicit drug use, the extent ments were originally developed over 40 of familiarity with drug terms, and one1s years ago in the analysis of ethanol self­ attitudinal persuasions about illicit drug administration, and they have subsequently use are positively correlated. The nature been extended to the analysis of other of this relationship is highly complex, as drugs of abuse (Griffiths et al. 1978; is noted by Baron and Galizio (1978): Babor et al. 1976). liThe precise ways in which semantic rep­ resentations and other verbal pattems con­ self-help groups tribute to more overt actions, such as the Self-help groups have been formed around complex behaviors surrounding use of many different problem areas in which drugs, remain an enigma. One hypothesis behavior control is the primary reward is that language controls other behaviors for participation. Perhaps the most well­ through its discriminative and classifying known self-help group is associated with functions. From this standpoint, the labels alcoholism (Alcoholics Anonymous), but assigned to drugs allow the individual to scores of groups exist across the country respond differentially to subtle environmen­ to deal with such varied problems as drug tal and p@rticularly intrapsychic changes. abuse, ciga rette smoking, weight control, Conversely, labels may lead the individual divorce, neurotic personality, compulsive to respond in common ways to events that gambling, ex-prisoner societal reentry, differ widely in their stimulus properties. family crisis, terminal illness, and the like. In any event, knowledge of the language of drugs allows the user to communicate Although the problem areas may differ, with others who supply and use drugs, self-heip groups have many factors in com­ and on this basis alone must be regarded mon. Katz and Bender (1976:266) cite as an essential part of the entire pattern the following general characteristics: of drug-using behaviors,1I 85 sensation seeking et al. 1973). See also setting. (Rl 5 The process in which the individual actively 27: 381--9 entries) seeks out stimulation from the environment. Zuckerman's (1964, 1972) Sensation-Seeking setting Scale measures five factors: general sensa­ The physical environment in which drug tion seeking, thrill and adventure seeking, use takes place. Some researchers hold experience seeking, DISINHIBITION, and that the SET and setting determine the boredom susceptibility. According to quality of a drug experience. A support­ Zuckerman (1972), drug usage is an aspect ive and friendly setting, along with a fav­ of general sensation seeking rather than orable set, is considered most conducive any specific type; Kohn and Annis (1977) to a positive experience. A supportive argue that drug use is specifically associ­ setting, however, does not guarantee ated with a high optimum level for fanta­ against adverse reactions (Lingeman 1969). sies and unusual perceptual feelings. (RIS 27:381--9 entries) (RIS 27:3.81--13 entries) shoot up sensitization Slang. To inject a drug. The reverse effect of drug TOLERANCE. The effect of increased responsiveness to shooting gallery a drug with repeated use. Subjects may Slang. A place wh~re drug addicts regu­ under certain conditions experience sensi­ larly go to inject themselves with their tization to certain actions of cocaine, for purchases (Fiddle 19?7). example (Stripling and Ellinwood 1977). Also referred to as (REVERSE) TOL­ side effects ERANCE. All actions produced by a drug given at therapeutic dosage with the exception of seq'lential treatment method the specific action for which the drug was A pharmacologically oriented treatment administered. approach proposed by Goldstein (1976b) in which clients go through a sequence of significant other different treatments. The heroin addict An important person who plays a major is first maintained on methadone on a daily role in the life of a subject in addition to basis, then switched to LAAM on a three­ the subject's spouse or dose relatives or times-a-week basis, detoxified and then in lieu of a spouse or close relative. Sig­ placed on a pure antagonist such as nal­ nificant others in the lives of cP'l!nts are trexone, and eventually becomes drug free. frequently identified and become a part of Clients can be repeatedly recycled through the case history established at INTAKE to the sequence until they elevate to the i':lVel drug treatment programs. of becoming drug free. Goldstein (1976b) coined the acronym STEPS (sequential Single State Agency (SSA) treatment employing pharmacologic supports) The primary agency recognized by NIDA, to symbolize this process. for funding purposes, for planning and coordinating drug abuse treatment and serotonin prevention projects and activities in each A vasoconstrictor neurohormone-like bio­ State. See also Statewide Services Con­ chemical found in blood serum, many cells, tract. and the central nervous system. I t plays a role in the transmission of signals to sinsemilla the PARASYMPATHETIC NERVOUS SYSTEM. From the Spanish "sin" (without) and lIsemillall (seed) (r;ronounced seen-seh­ serum mee'-yah). Sinsemilla is the potent flower­ The fluid part of whole blood. ing top (excised of leaves) of the unpolli­ nated and seedless female marijuana plant. SES Keeping the female plants unpollinated See socioeconomic status. creates increasing quantities of a sticky substance containing a high concentration set of THC (the psychoactive ingrediE:.lilt in The psychological state or underlying per­ marijuana) in thei r flowering tops in a vain sonality of an individual that may affect attempt to trap pollen from the male plant the qualitative response to a mind-altering and become fertilized. If the female plant drug or response to a questionnaire or becomes fertilized, it devotes a la rge por­ other stimuli. Such factors as the per­ tion of its chemical energies to makinr~ son's expectations, motivations, and atti­ seeds and in the process lowers its THe tudes may influence drug effects (LeDain content. The growth of sinsemilla requi res 86

the identification and weeding out of the and rehabilitation (Lockwood 1977; Holahan male plants before they begin pollination 1970). (RIS 27:384--16 entries) and the harvesting of the female plants at the peak of their pollen-luring secretions, social controls both of which are difficult to determine. See controls, social. This process for cultivating marijuana has been used in Asia for centuries and is, social drug use for example, used to grow the marijuana See social-recreational drug use. contained in THAI STICKS. Its use in the West was popularized after the drug social-recreational drug use experiences of American soldiers in Vietnam As defined by the U.S. National Commis­ in the 1960s. sion on Marihuana and Drug Abuse, drug use that, like EXPERIMENTAL DRUG USE, THC concentrations in sinsemilla can reach occurs in social settings among friends or 6 percent or more, while ordinary street acquaintances who wish to share a pleasur­ marijuana sometimes contains less than 1 able experience. Unlike experimental use, percent. To increase the potency, growers social and recreational use tends to be in ,California and elsewhere are reportedly more patterned but considerably more using the Cannabis indica species of mari­ varied in terms of frequency, intensity, juana, which contains more THC than its and duration. I t is a vol untary act and, botanical sibling Cannabis sativa. See regardless of the duration of use, tends also marijuana. not to escalate in either frequency or intensity (National Commission on Marihuana situational drug use and Drug Abuse 1973:95). (social inter­ See circumstantial-situational drug use. actions, RIS 27:384--15 entries; sociocul­ tural influences, RIS 27:385--55 entries) skin popping Slang. Injecting a narcotic subcutaneously. social ization The onset of the drug1s effects is not so The process whereby individuals learn and immediate as it is with MAINLINING (inject­ internalize the attitudes, values, behaviors, ing intravenously). Skin popping is often and expectations appropriate to persons used by neophyte users before they pro­ functioning as social beings and as respon­ gress to mai nlining; it is also used by sive, participating members of their society older addicts whose veins are lIused upll (Encyclopedia of Sociology 1981). (Lingeman 1969). socially determined SMSA A phenomenon is socially determined if it Standard Metropolitan Statistical Area. can be most adequately explained in terms of antecedent social conditions rather than sniffing by biological, chemical, geographical, or Inhaling drugs usually of the volatile sol­ other physical or mechanical causes. vent type (e.g., glue sniffing). See insufflation. socioeconomic status The relative position or prestige of an snorting individual in a community that is derived Slang. Inhaling a psychoactive drug, par­ from such factors as amount of income, ticularly cocaine or heroin. See also blow; wealth, or type of occupation (Zadrozny insufflation. 1959; Chaplin 1975); a general designation of social standing (Encyclopedia of Sociology. sobriety 1981). Abbreviated as SES. (socioeco The quality or condition of being temperate nomic factors, RIS 27:385--52 entries) or abstinent in the use of alcoholic bever­ ages; or, the state of not being drunk sociogenic drug use (Keller and McCormick 1968). An expression coined by Erich Goode for drug use. particularly marijuana use, that social costs of drug use from inception is simultaneous with partici­ Costs to society caused by drug use. pation in a specific social group. Goode Various econometric models have been presents seven criteria for determining developed that have totaled costs to soci­ when a drug is sociogenic: (1) used typi­ ety of addiction based on productivity cally in a group; (2) use is shared with losses (employment); criminal justice sys­ intimates; (3) use is shared with those of tem expenditures such as judicial, penal, long-term continuing relations; (4) the and law enforcement expenses and salaries; group shares many of the same values; property crimes; drug education; treatment; (5) value convergence occUr's as a result 87

of progressive group Involvement; (6) drug used to refer to all drugs other than the use reaffirms group solidarity; and (7) opiate ndrcotics, which are labeled HARD users view use as legitimate basis for iden­ DRUGS. tity (Goode 1969:54). solvents sociological models Volatil~ (tending to evaporate easily) liquids In regard to drug abuse, refers to explan­ that dissolve or that are capable of dissolv­ atory theories that seek to identify those ing one or more substances, also referred factors within society and social relations to as "volatile solvents." A subclassifica­ that promote drug use and stress such tion of inhalant drugs in which a large factors as differential association, anomie, aggregate of chemically diverse substances and subcultural influences. Most sociolog­ come from a wide variety of sources, many ical models of d rug abuse rest on the of which are volatile HYDROCARBONS. assumption that people are drug abusers Typical household solvents include glue because of their inability to reach societal (plastic cement), gasoline, paint thinner, goals. Moreover, drug addiction is seen nail polish, nail polish remover, lighter as a problem that is socially defined and and cleaning fluids. The active ingredi­ perceived differently by different societal ents used in these solvent products include groups. Many of these models further acetone, the chlorated hydroca rbons such stress that social problems such as drug as carbon tetrachloride, and the petroleum use, crime, and prostitution meet certain hydrocarbons (toluene, benzene, naphtha, societal needs and will remain in existence and gasoline). Solvents are CNS depres­ as long as those needs remain. These sants and lower heart and breathing rate problems will be eliminated only when the and impair judgment and muscle coordina­ basic societal arrangements that perpetuate tion. Like most inhalants, solvents such them are changed (Jacobs 1976:114-115). as glue, the most commonly used I gener­ The main criticism of sociological models is ally produce a brief period of stimulation their failure to explain why only some with giddiness, euphoria, and muscle trem­ people with a given sociological background ors, followed by a more lengthy, dreamlike become drug users and not others. See stupor. Effects tend to be short-lived and also psychological models; psychosocial mild. The petroleum-based solvents such models. as paint thinner (toluene), lighter fluid (naphtha), and gasoline, generally produce sociopathic personality the most extreme effects. Some of their A personality disorder used to describe components, Ii ke lead, a re known to be chronically antisocial persons who seem quite toxic and to cause tissue or nervous unable or unwilling to live within estab­ system damage. A major cause of concern lished social and moral frameworks and is the effect of solvents in the SUDDEN who tend to pursue self-determined goals SNIFFING DEATH SYNDROME. Classifica­ regard less of the. consequences to self or tion: volatile inhalants. others. This particular label takes into account the fact that sociocultural norms somatic may be flaunted by individuals so labeled. Pertaining to the body as opposed to men­ The term has been used interchangeably tal or psychological origin. with PSYCHOPATHIC PERSONALITY, and both labels have been replaced by ANT 1- somatic concerns (or complaints) SOCIAL PERSONALITY in the Diagnostic Preoccupation with bodily functions and and Statistical Manual of Mental Disorders real or imagined physical symptoms. See (1978). It has been thought by some also PSYCHOSOMATIC. researchers that the nature of the psycho­ pathic/sociopathic personality makes the soporific likelihood of significant improvement in Causing or inducing sleep. therapy or treatment of any kind minimal. However, Vaillant (1975) states that the spaced out " realll sociopath is treatable and is dis­ Slang. To be STONED or HIGH, particu­ tinguished from the psychopath by an larly from a HALLUCI NOGEN. apparent absence of anxiety, supposed lack of motivation for change, and inability Special Action Office for Drug to experience depression (Blaine and julius Abuse Prevention (SAODAP) 1977:5). (sociopathy, RIS 27:386--21 An agency rIo longer existing that was entries) established in 1972 in the Executive Office of the President to review and evaluate soft drugs the functions and policies of all Govern­ A vague, imprec:se term that is sometimes ment agencies involved in the area of drug 88

abuse and to establish policies and prov.ide Financial assistance is also provided to di rection necessa ry to properl y coordi nate the States via formula grants (authorized all the Federal Governmentls efforts against under section 409 of Public Law 92-255) drug abuse (treatment, rehabilitation, edu­ to plan, establish, and evaluate drug abuse cation, training, and research). The basic treatment and prevention programs. For­ mission of the agency was twofold: (1) to mula grants help the SSAs coordinate drug reduce cjrug abuse in the shortest possible abuse programs in their respective States. time; and (2) to develop a comprehensive The formula by which funds are allocated long-term Federal strategy to combat drug reflects relative population and financial abuse (B rown 1973: 132; Sonnen reich et and programmatic need. State plan updates al. 1973: 194) • are prepared by the SSAs and reviewed annually. speed Slang. An AMPHETAMINE, usually Methe­ N IDA has transferred most of the respon­ drine. sibility for supervising federally supported treatment programs to the States. The speedball SWSC is the principal funding mechanism Slang. HEROIN and COCAINE or heroin N I DA has used to transfer these respon­ and AMPHETAMINE injected as a mixture. sibilities. Contracting with States serves The cocaine or amphetamine reportedly to-- enhances the RUSH, while the heroin tem­ pers the unpieasant extremes of the ex­ • Transfer responsibilities for administering hilaration and perhaps prolongs the effects. federally funded treatment services to the States, where these responsibilities spoon may be better coordinated with other Slang. Part of the drug paraphernalia, drug abuse services. or IIworks,1I used by heroin addicts to pre­ pare thei r drugs for if"ljection. Usually • Improve the conSistency and coordination made from a teaspoon whose handle is bent of drug abuse treatment with other non­ back and looped so that a finger may be drug-related health care delivery systems inserted for a steady holding. The spoon within the State. and its contents are heated to prepare an injectable liquid from powdered heroin, or • Allow N I DA to more efficiently lever other solid psychoactive drug, and water. Iimited Federal administrative resources The term is also used as a crude unit of by working through State government. measure for the number of doses in a ll quantity (llbag ) of heroin. • Provide States with greater flexibility in determining how Federal funds are trans­ Standard Metropolitan lated into service delivery at the local Statistical Area (SMSA) level. An area containing at least one central community of 50,000 or more, plus the statistics, drug abuse county in which the central city is located, See Client Oriented Data Acquisition Proc­ plus the contiguous counties that are ess (CODAP), Drug Abuse Reporting defined to be economically closely related Program (DARP), DnJg Abuse Warning to the central city. Network (DAWN), Monitoring the Future, National Drug Abuse Treatment Utilization stash Survey (NDATUS), and National Survey Slang. A hiding place for drugs and on Drug Abuse. drug-taking equipment. Also, the drug supply itsel f. stepping-stone hypothesis The theory that the use of .one drug Statewide Services Contract (SWSC) increases the likelihood of the use of other The primary mechanism through which com­ more serious drugs. Often used in the munity-based treatment services are funded past to relate the use of marijuana to later by NI DA. The SWSC is a cost-sharing use of heroin. Although there is no defin­ contract negotiated with Single State Agen­ itive evidence that use of marijuana neces­ cies through which local drug treatment sarily leads to the use of heroin or any programs are subcontracted. This mecha­ other drugs, there is evidence tl1at an nism allows for drug abuse treatment serv­ initial interest in drugs may lead to an ices to be delivered within a State under expanslon of the one-time usersl drug. the authority of the agency responsible interests and possibly to a commitment to for statewide planning. a way of life that revolves around or is 89

focused on drugs (Grinspoon 1977:251; street addicts O'Donnell and Clayton 1981). (RIS 27: Persons belonging to a well-developed 387--1 entry) street subculture who see themselves as addicts and organize their behavior around STEPS that self-image (Stephens and McBride An acronym meaning Sequential Treatment 1976). A particular type of addict--Iower' Employing Pharmacologic Supports. See class, slum-dwelling, usually a member of sequential treatment method. a mi nority group, who adheres to a deviant set of values, and whose chief attributes stereotyped behavior are the "cool cat" stance, conning, and A behavior that is generally elicited uni­ ANTISOCIAL BEHAVIOR (Stephens and formly in a particular problem situation Levine 1971:351). The phrase "on the and is rarely altered by attendant circum­ street" implies an idle or homeless person stances or motivation, or by the outcome in an urban area who might very well be (English and English 1958). (RIS 27:387-- "down one's street"--that is, doing some­ 6 entries) thing suited to one's taste (Siegel 1978). A distinction is often made between the stereotypy "physician addict" or upper class addict The persistent repetition of senseless acts and the street level or "street addict" by or words. The pathological condition in asserting that street addicts belong to a which the individual manifests mannerisms, "subculture" that is insulated from the irrational and delusional forms of thinking, general culture by a set of unique "values" and inflexibility in behavior patterns. and the need to support the habit, whereas Some degree of stereotypy is characteristic physicians or upper class addicts still of most of the neuroses and psychoses belong to the larger culture b~cause they and often of amphetamine abuse (Dorland's can afford to support their habits by legal !:Iustrated Medical Dictionary 1974; Chaplin means. Thus it is common for scholars to 1975) • See also punding. lump the street or "subcultural addict" and the criminal addict together. Doing stimulants so, however, fails to discriminate between A major classification of drugs that stimu­ different social patter-ns of drug involve­ late the central nervous system (CNS) and ment on the street scene. See righteous excite functional activity in the body, pro­ dope fiend; career, addiction; subculture, ducing an elevation of mood (euphoria), a drug. (RIS 27:295--8 entries) state of wakefulness, increased mental activity, energy, alertness and tension, strung out and suppressing appetite. Sympathetic Slang. Thin and sick looking because of NERVOUS SYSTEM effects include increased long-term drug use; also, the inability to heart and pulse rates and sweating. Stimu­ obtain sufficient drugs to keep comfortable lants are often divided into two main sub­ (Lingeman 1969)-. categories: (1) the primary stimulants, which act mainly on the CNS and only stupor secondarily on the sympathetic nervous A state of semiconsciousness in which the system, and include the AMPHETAMINES, individual is unaware of what is going on AMPHETAMINE RELATIVES, and COCAINE; in his or her surroundings; one of the (2) the secondary stimulants, which also major symptoms of nonfatal drug OVER­ affect the eNS but exert their primary DOSE. influence on the sympathetic nervous sys­ tem, and include N ICOTI NE, CAFFEI NE, subculture, drug and KHAT. (RIS 27:223--19 entries; stimu­ A subculture or society whose members lant reactions, RIS 27: 387--49 entries) share norms le9itimating the use of drugs that are disappro'Jed by the dominant cul­ stillbirth ture and structured around norms regu­ The birth of a dead fetus. lating the type of drugs used as well as the frequency and mode of use. Subcul­ stoned tural theorists studying the onset of ado­ Slang. In a state of drug-induced intoxi­ lescent drug use stress the importance of cation, elation, or euphoria. See also high; interpersonal influences and participation spaced out. in an adolescent subculture that has a dis­ tinctive set of values ()nd conduct norms STP that are at odds with the more conventional Slang. DIMETHOXYMETHAM~HETAMINE values of the adult or parent culture (DOM) . (Johnson 1973; Good'e 1972). Subcultural

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90

theorists focus on the shared norms, self (Fairchild 1976). (RIS 27:388--35 values, role definitions, and patterns of entries) behavior governing consumption of illicit drugs and thus provide a bridge between supply reduction strategy sociological and psychological theories. Federal drug abuse policy goals are g~ared The drug subculture is seen as providing toward reducing both the demand and the a person with an alternative lifestyle cen­ supply of illicit drugs. The supply reduc­ tering around Icultures, RIS 27:322--6 entries) diplomacy and cooperation with foreign governments and international organizations, subcutaneous encouragement of crop eradication programs Beneath the skin. Subcutaneously inject­ with income substitution and rural develop­ ing drugs is also called SKI N-POPPI NG". ment programs, support of international law enforcement prog rams, support of subjective international narcotics control programs Relating to internal mental states, such as by other governments, and support for emotions, feelings, attitudes or concepts; international prevention, treatment, and especially, interpreting experience in tE:rms rehabilitation programs. See also demand of such <;tates (Fairchild 1976). See objec­ reduction strategy; Federal drug abuse tive. policy. substance abuse survey, drug Operationally defined by the Committee on A study that selects a sample from some Substance Abuse and Habitl!al Behavior of larger population in order to ascertain the National Research Council to encompass the prevalence, incidence, and interrela­ fou r behavioral patterns: overeating, tions of selected drug-use-relat,ed variables. cigarette smoking, alcohol abuse, and drug A survey may be any of three types: abuse (Krasnegor 1979). See also opera­ descriptive, exploratory, and explanatory. tional definition.

sudden sniffing death (SSD) syndrome sympathomimetic The most prominent threat to health associ­ A drug that primarily produces effects ated with inhalant abuse is the sudden similar to (or that mimic) those resulting sniffing death (SSD) syndrome related to from stimulation of the sympathetic NERV­ sniffing the' fluorocarbons contained in o US SYSTEM. Only those sympathomimetic aerosols. The term SSD syndrome was drugs that also excite the central nervous coined by Bass (1970) to describe over system (CNS), such as the AMPHETA- 100 deaths during the sixties he had MI NES, are used as recreational drugs. researched and found to be related to Also called adrenomimetic drugs. See also aerosol sniffing. The SSD syndrome is nervous system; neurotransmission. caused when the fluorocarbons (particularly tr ichlorofluoromethane) sensitize the heart sympathetic nervous system to the adrenal hormone epinephrine, which See nervous system. is in itself a strong cardiac stimulant. By potentiating the effect of epinephrine on the heart, wildly erratic heartbeat and symptom increased pulse occur, resulting in the An indicator of the presence of a disease case of the SSD syndrome in heart failure or disorder; more generally, any event and death. The use of fluorocarbons as that indicates the presence of another propellants in household aerosol products event. A symptom cluster or SYNDROME has been banned by the U. S. Envi ronmen­ is a group of related symptoms that typi­ tal Protection Agency since March 16, 1978. cally appear together. suicide symptom, drug toxicity The act of intentionally taking one's own A sign observed or reported by subject life. The person who kills himself or her- (e.g., depression) indicating a toxic drug 91

reaction. The table on this page shows enhanced, by combination with another the signs and symptoms of toxic reactions (Keller and McCormic l< 1968). (RIS 27: to the major classes of abused drugs, as 388--25 entries) outlined by DeAngelis (1976: 10). synthetic drug Synanon Made by chemical process. Contrast with A THERAPEUTIC COMMUNITY for the reha­ organic drug. bilitation of drug addicts established in 1959 in California. As originally estab­ lished, the members of Synanon stayed as long as they liked and were discouraged from leaving until they were judged capable of remaining off drugs, although no "cures" were claimed. Synanon has devel­ oped into a lifestyle movement for both addicts 'and nonaddicts who live within its structure and rules as an alternative soci­ tachyphylaxis ety and social system (Deitch 1973). See See tolerance, evanescent. also D"aytop Village. taking care of business syndrome Slang. Succeeding in what one is doing. A group of related symptoms that typically Among street addicts this expression is occur together; the pattern of symptoms often used to refer to the daily petty hus­ that characterizes a particular disorder or tles used to supply their drug habits. disease; a symptom complex (Dorland1s Preble and Casey (1969: 2) view the Illustrated Medical Dictionary 1974; Encyclo­ addict1s "taking care of business" hustle pedia of SOCiology 1981). as adding significant meaning to the lives of many, particularly lower class, addicts. synergi stic effects According to them, "Thei r behavior is any­ The joint action of two or more separate thing' but an escape from life. They are entities, such as drugs, resulting in a actively engaged in meaningful activities total effect greater than the sum of the and relationships seven days a week. The individual effects. Distinguished from brief moments of euphoria after each admin­ ADDITIVE EFFECT, in which the effects istration of a small amount of heroin con­ of the two are only added together, and stitute a small fraction of their daily lives. from POTENTIATION, in which the action The rest of the time they are aggressively of one drug is induced, or its effect pursuing a career that is exacting, chal-

Common signs and symptoms of patients with mind-/mood-altering drug toxicity

Sedative/ Hallu- Stimu- Tran- Signs and symptoms hypnotics Narcotics cinogens lants Solvents quilizers Alcohol Coma in overdose • • • • .. Convulsions .. • • Depression • Hallucinations " .. Agitation • " • (restlessness) e • • • • • Aggress ive behavior 1& .. ~ .. Paranoia/panic .. III • • • Psychosis • • • • .. Disorientation • .. • • • Ataxia • • .. • .. • Pain masking " .. • • • .. • Parkinsonism " .. Slurred speech • • • Lacrymation .. iii" Nystagmus, lateral • "

387-396 0 - 82 - 7 QL 3 92

lenging, adventurous, and rewarding." tea See career. addiction. The principal chemical constituents of tea are CAFFEI NE, tannin, and essential oil; talking-down method caffeine supplies the stimulating quality, A treatment method employed with persons tannin the strength of the beverage, and who are experiencing a drug PAN IC REAC­ essential oil the flavor and aroma. An TION or a "bad trip. II It is applied when average tea may contain 3.5 percent caf­ the subject is awake and responsive and feine, 15 percent tannin, and a smail per­ utilizes a liberal amount of verbal reassur­ centage of theophylline (the essential oil) ance that what the subject is experiencing (Green and Levy 1976). is transitory and will end once the drug has run its course. Green and Levy (1976) teetotal (t-total) give the following description of the proc­ Complete abstinence from alcoholic bever­ ess: ages. A teetotaler is one practicing or pledged to total abstinence from alcoholic "This method is the treatment of choice beverages. The first syllable IItee- 1I is a provided the youth is not overly aggres­ reduplication for emphasis of the initial sive, psychotic, convulsive, or showing sound in the word IItotal. 1I The term first respiratory depression. The goal is to appeared in 1834 in a letter to the Preston counteract the anxiety, panic, paranoia, Temperance Advocate (Britain) signed "A depression and confusion of the bum trip. Lover of Sociality, and a 'Tee-Total' The manner of the parent should be quiet, Abstainer" (Oxford English Dictionary 1971). relaxed and sympathetic. The youth must be made to feel welcome and to sense that temperance he is wanted. What is needed is rest, The practice of moderation; often used in reassurance, sympathy and support. reference to food and drink, particularly alcoholic beverages. The Temperance "The youth must be reassured that his Movement was a popular movement to mental condition at the moment is due to restrict or prohibit the use of alcoholic the drug and will return to norma!. The beverages that became widespread in distortions and frightening experiences Northern Europe and North America begin­ are related only to the drug itself and do ning in 1800 and culminated in the passage not indicate an emotional illness. The of the Prohibition Amendment in the United youth may need help in verbalizing his States in 1919, and in prohibition, partial experience. The parent can assist in this prohibition, or lesser restrictions in the by reviewing for the youth what is going Scandinavian countries around World War on in the trip, outlining the probable time I. Temperance should not be equated with schedule of events, and emphasizing the PROHIBITION. While many of the various self-limiting aspects. 19th-century temperance advocates became prohibitionists, calling for total abstention "Simple and concrete statements should be from all alcoholic beverages, many only reiterated; who is there, where he is, called for moderation in use, or moderation what is happening, identification of familiar in the use of beer and wine and abstention objects such as books, lamps, table, etc. from spirits (Austin 1978). This assists in the process of self­ identification and permits reality to be teratogenic drugs reassembled .11 Drugs that can cause birth defects. TASC tetanus Treatment Alternatives to Street Crimes, An acute infectious disease that results in a federally funded pilot treatment program II lockjaw ,II generalized muscle spasm, arch­ through which. if local law enforcement ing of the back, and seizures. It is authorities approve. a drug-dependent causeJ by the specific toxin of a bacillus person who has been arrested may enter (Clostridium tetani), which is usually intro­ treatment as a condition of release. When duced through a wound (Dorland's IlIws­ the case comes up for trial, the court may trated Medical Dictionary 1974). take into account the user's cooperation and success in the treatment program and tetrahydrocannabinol may determine that he or she should remain See THC. in the program as an alternative to prose­ cution or possible incarceration subsequent Thai sticks to prosecution. The TASC treatment units Potent, seedless marijuana grown in Thai­ are linked to community programs and use land, Vietnam. and Nepal that is packaged va rious treatment approaches (B rown 1973: and tied in bundles that resemble sticks. 133). (RIS 27:391--3 entries) See sinsemilla. 93

THC (delta-9-THC) ment, companionship, and social pressure. Tetrahydrocannabinol, a psychoactive The interactions between members, and ALKALOID of the CANNABIS plant, first betweetl individuals and the group, are synthesized in 1965. 0 ne of many cannabis utilized to reinforce and strengthen con­ derivatives, it is believed to produce the tinued abstinence. Two types of GROU P primary psychoactive effects. Hashish THERAPY are usually employed. The first usually contains about 12 percent TH C, is confrontation or ENCOUNTER GROUP and HASH OIL up to 40 percent. As pure therapy, in which community members meet THC is very expensive to produce and in regular and frequent sessions in order loses its potency rapidly upon exposure to analyze each other's past drug-taking to air, much of what is sold on the streets behavior and conduct in the program. as THC is PCP or LSD. See marijuana; MILIEU THERAPY is aimed at further cannabi s. Class ification : cannabi s. strengthening internalization of community values. Two of the major modern thera­ Therapeutic Communities of America peutic communities are SYNANON (est. The national association of therapeutic com­ 1959) and DA YTOP VI LLAGE (est. 1963). munity drug abuse treatment programs. While the traditional abstinence community It promotes the drug-free TC concept, requires persons to stay for an extended publishes a newsletter, sponsors and par­ period, usually 1 ,to 2 yea rs, short-term ticipates in conferences, and has become communities have also been established. a central voice for the TC movement. The In MULTIMODALITY TREATMENT commu­ headquarters of the Therapeutk Commu­ nities (such as TINLEY PARK), methadone nities of America are located at 118-21 maintenance and abstinent patients have Queens Blvd., Forest Hills, N. Y. 11375; been combined in the same setting (Deitch (212) 520-5205. 1973; DeLeon and Beschner 1977:7-9). See Henderson Hospital; Asklepieion. therapeutic community (RIS 27:389--19 entries) A generic term describing a wide spectrum of residential treatment approaches and therapeutic dose clients, all of which embrace the fundamen­ Amount of drug prescribed for a patient tal need for individual change through a to induce the desired drug action (Winek communal living milieu in order to render 1971). See also marijuana. (therapeutic stable changes in lifelong self-destructive uses, RIS 27:390--44 entries) and socially destructive behavior. The TC concept was fi rst pioneered by Dr. Maxwell therapeutic index Jones and others in Britain in 1947 as a The ratio between an effective dose of a program for social deviants and again, inde.,. drug and a dose that will be TOXIC. pendently, by Chuck Dederick at SYNANON in California in 1958 using drug addicts. therapeutic intervention In the United States the term has become The belief that with respect to IIdeviantsll largely associated with the treatment of the law should not be concerned with ques­ drug addiction, but the basic concept can tions of guilt and its degrees or with be, and has been, applied to various types determining a fit punishment, but should of deviant or maladjusted behavior. All humanely apply whatever measures are T Cs, however I as noted by Dr. Jones necessary to protect society from further (1979: 147) , have basic simi la rities: transgressions by the same individual. This model, which was given ap~roval by II All subscribe to the power of the client ROBI NSON v. CALIFORN lA, is often pe~,- group; all started as residential com­ extended to include the concept of thera­ munities, although later developments peutic prevention as well as correction, include day centers, clubs, etc.; all claim and applied to the eradication of self­ to espouse a democratic social organization harming as well as society-harmi ng conduct and democratic ideals although in practice (Wexler 1975:67). this is often open to question; all avoid the extreme professionalism of the kind thiopental sodium seen in departments of psychiatry in medi­ An ultra-short-acting BARBITURATE, man­ cal schools and some, like Synanon, repud­ ufactured as Pentothal. Classification: iate professionals altogether. II sedative/hypnotics.

Generally, drug abuse TCs are operated thioridazine hydrochloride as long-term, live-in, 24-hour-a-day resi­ An (ANTI PSYCHOTIC) TRANQU IUZER, dential abstinence treatment experiences, manufactured as Mellaril. (RIS 27:223--1 in which individuals help cure each other entry) through group therapy, mutual reinforce- 94 thiothixene been shown to have numerous adverse An (ANTIPSYCHOTIC) TRANQUILIZER, effects, principally on the bronchopulmo­ manufactured as Navane. nary and cardiovascular systems. Smoking is now believed to be the main cause of third-party payment lung cancer, is associated with cancers of A payment made to a service provider, the mouth and respiratory tract, and facili­ such as a drug abuse treatment agency, tates respiratory infections. Smokers are for (all or part of) the services provided also much more likely than nonsmokers to to a client, by a source external to the develop coronary heart disease, cerebro­ transaction (the third party), such as by vascular disorders, and peripheral vascular an insurance company or government or disease. Overwhelming evidence indicates employer health program. that tobacco smoking is a major health hazard. Pipe and cigar smoking in which thrill seeking tobacco is not regularly inhaled, are less See sensation seeking. hazardous. Tobacco smoking is almost a worldwide phenomenon. Generally, no time perception country·s inhabitants, once introduced to The ability to judge or apprehend the pas­ tobacco, have given it up, nor have other sage of time by the order of occurrence smoking substances been successfully sub­ of experiences, physiological rhythms stituted. See substance abuse. (RIS 27: (Chaplin 1975). 223--14 entries) time-response relationship tolerance The relation between the time that has A decrease in response to a d rug dose elapsed since the administration of a drug that occurs with continued use. It can and the effect produced in that time. Such be caused by both physiological and psy­ a temporal analysis may be restricted to chosocial factors. Tolerance has been short-term (acute) effects of a single dose, shown to be both relative and highly sub­ or may be extended to include the long­ ject to change, and it is now believed that term effects of persistently repeated heroin users can lose their tolerance in (chronic) use of a drug (LeDain et al. several days (Lettieri and Backenheimer 1973) . 1974). Thus many addicts enter treatment programs specifically for the purpose of tincture bringing down their tolerance to manage- A preparation consisting of a drug in an able levels. See also cross-tolerance; alcohol solution, such as LAUDANUM, tolerance, reverse. which is a tincture of opium. Dews (1978) points out that tolerance may Tinley Park develop under a variety of circumstances The first THERAPEUTIC COMMUNITY other than drug US(;l, including exposure to based on a MULTIMODALITY TREATMENT heat, cold, electric shock, hunger, and the approach, founded in Tinley Park, Illinois, like. He delineates three types of pharma­ in 1968, expanding the residential absti­ cological tolerance: dispositional, physio­ nencellodel to include CHEMOTHERAPY. logical, and behavioral. Both abstinent and methadone maintenance patients who need group psychotherapy According to Dews, in the case of disposi­ are combined in the same communal setting tional tolerance, as a result of exposure (Deitch 1973). to a drug, the physicochemical processes handling the drug in the body are so modi­ TMA fied that reduced concentra;tions of the Trimethoxyamphetamine, a synthetic hallu­ drug reach the receptive cells, as in the cinogen with stimulant properties, which case of an increased rate of metabolism of is taken orally or injected. More powerful the drug following repeated administration, than MESCALINE, but less so than LSD. as by the induction of higher activity of Classification: hallucinogens. metabolizing enzymes. tobacco Dews defines physiological tolerance as a Dried leaves of the plant Nicotiana tabacum, change in the receptor cells, or related which are most often inhaled but have been cells, such that the effects of a dose ·of chewed. The three main constituents of the drug are reduced, even though the tobacco smoke are NICOTINE, carbon mon­ receptor cells are subjected to the same oxide, and tar. Nicotine, the main active concentration of the drug. ingredient, makes up about 1.5 percent of the average cigarette. Long-term use has Behavioral tolerance is defined as a change in the effect of a drug due to alteration 95

of environmental constraints. Behavioral HYPNOTICS, such as barbiturates, they tolerance results from behavioral mecha­ do not generally cause hypnosb., drowsi­ nisms in the user's environment. (RIS ness, or loss of alertness, although there 27: 390--17 entries) are many exceptions, especially when taken in amounts larger than necessary. Tran­ tolerance, evanescent quilizers are usually classified according Tolerance toward drugs that lasts for only to thei r therapeutic use into two categories: a short 'time (a few hours). Also termed (1) (ANTIANXIETY) TRANQUILIZERS or tachyphylaxis (Winek 1971). "agents" (formerly called "minor tranquiliz­ ers") such as DIAZEPAM (Valium) and tolerance, reverse CHLORDIAZEPOXIDE HYDROCHLORIDE A condition in which the response to a (Librium); and (2) (ANTIPSYCHOTIC) certain dose of a drug increases with TRANQUILIZERS or "agents" (formerly repeated use. See also croJs-tolerance. called "major tranquilizers") such as RESERPINE (Serpasil) and CHLORPROMA- toluene Z I NE (Thorazine). Much confusion is Methyl BENZENE, the main active ingredi­ caused by the nonspecific use of the gen­ ent in glue and paint thinner. Classifica­ eral label "tranquilizers," particularly as tion: volatile inhalants. See solvents; the antianxiety and antipsychotic tranquil­ glue sniffing. izers are quite dissimilar chemically and pharmacologically in respect to their uses toxic and effects. The antianxiety tranquilizers Poisonous. Toxicity refers to the quality are classified as SEDATIVE/HYPNOTICS; of being poisonous, and toxicology is the the antipsychotic tranquilizers are classi­ science that deals with poisons and their fied separately. (RIS 27:224--18 entries) effects. (toxicity, RIS 27:391--11 entries) tranquilizers, antianxiety toxicomania Those TRANQUILIZERS prescribed as seda­ An extremely strong need or desire for tives to reduce ANXIETY and tension, TOXIC substances, including drugs and sometimes called minor tranquilizers, as alcohol. distinct from the major or (ANTI PSY­ CHOTIC) TRANQUILIZERS. They are tracks widely prescribed as sedatives that have Slang. The linear scar marks and VENOUS relatively few other significant effects on THRO~~BOSIS that occur after repeated emotional, cognitive, or perceptual' proc­ injections of heroin into the veins of the esses, although there is much disagreement arms. A readily visible indicator of sus­ surrounding the extent to which they tained illicit drug use, often tattooed over achieve this goal. Unlike the antipsychotic or covered with long sleeves in attempts tranquilizers, which do not produce to conceal them. euphoria or other pleasant effects and are rarely used nonmedically, the antianxiety trafficking, drug tranquilizers produce effects subjectively The obtaining, transporting, and selling similar to alcohol and barbitur'ates and are of illicit drugs for commercial purposes. often used nonmedically. I n much of the See also dealing, drug. scientific literature, the term is restricted to use of the benzodiazepine derivatives tranquilizers chlordiazepoxide hydrochloride (Librium) A general term for a varied and complex and diazepam (Valium), and of the pro­ group of drugs that have a CNS depres­ panediol derivative meprobamate (Equanil sant effect, relieving anxiety and tension, and Miltown). Sometimes the term is used and sometimes relaxing the skeletal muscles, in a broader sense to refer to other of which were developed since the 1940s as the new nonbarbiturate sedatives such as hopeful replacements for the BARBITU R­ glutethimide (Doriden) and methaqualone ATES and other DEPRESSANTS that had (Quaalude; M'equin). The antianxiety tran­ undesirable side effects. However, tran­ quil izers should not be confused with the quilizers haVE: been shown to have undesir­ ANTIDEPRESSANTS. Classification: seda­ able side effects also, to be habituating, tive/hypnotics. and to be widely misused. Tranquilizers are particularly dangerous as they poten­ tranquilizers, antipsychotic tiate (see POTENTIATION) the effects of A major classification of drugs commonly other depressants such as the opiates, used to treat psychiatric problems falling barbiturates, and alcohol, and a safe dose under the rubric of psychosis. Consists of either when taken together can cause of four classes of drugs: (1) phenothia­ coma and even death. Unlike SEDATIVE/ zines, such as chlorpromazine (Thorazine); 96

(2) Rauwolfia compounds, such as reser­ treatment, drug··free pine (Serpasil); (3) butyrbphenones, such Treatment that calls for complete absti­ as. haloperidol (Haldol); and (4) thioxan­ nence from drug use of any kind. See thines, such as Navane. Rarely used non­ also detoxification. medically, they lack euphoric properties and generally produce unpleasant side treatment modalities effects. Preferred to BARBITURATES as Treatment methods, techniques. Drug calming agents because in moderate doses treatment modalities include therapeutic they calm without inducing sleep, they do communities, residential centers, outpatient not cause physical dependence, and even drug-free treatment clinics, detoxification in large doses they do not induce coma or clinics, and methadone maintenance clinics. anesthesia. Also called major tranquilizers, Modalities also refers to the processes used antip~ychotic agents, or NEUROLEPTICS. in treatment, such as group therapy, indi­ vidual counseling, family therapy, and tranylcypromine sulfate psychopharmacological agents (Blaine and An MAO INHIBITOR used in the treatment Julius 1977:12). See also multimodality of severe mental depression. Manufactured treatment; community-based treatment; as Parnate. Classification: antidepres­ maintenance treatment. (treatment models, sants. RIS :7:392--18 entries)

Treatment Alternatives to Street Crimes treatment outcome See TASC. Refers to the success of a given treatment treatment, ambu latory program in achieving its goals, usually Program in which the patient visits the defined in terms of continued abstinence treatment facility at periodic intervals on from the use of the drug for which the an OUTPATIENT basis. (treatment, outpa­ client is being treated, but also such fac­ tors as increased employment and decreased tient, RIS 27: 298--34 entries) crimi nal ity. In 1973 Cuskey et al. empha­ sized the need for more thorough evaluation treatment, community-based of all treatment modalities, observing that Any treatment program that takes place in a community setting, for example, HALF­ for the most part the standards and goals of treatment programs have not been well WAY HOUSES, parole and probation defined, well evaluated, or well measured. programs, outpatient METHADON E MAl N­ TENANCE programs, or THERAPEUTIC All claim success but define success dif­ ferently, and often programs ignore attri­ COMMU NITIES. Contrast with civil commit- tion and relapse rates, attract or admit ment. (RIS 27:312--3 entries) only certain kinds of personalities and eliminate those prone to failure (Cuskey treatment, compu Isory et al. 1973:202-4). O'Donnell (1965) Involuntary treatment; treatment in which describes the problem of comparing out­ the patient is compelled to initiate treat­ comes of treatment of opiate-dependent ment, or to continue it, or both. Includes individuals. Differences in criteria of both medical and court authorizations for improvement, length of followup, and treatment that do not require consent of nature of the population studied are often the client. See also civil commitment; criminal commitment; diversion. Contrast so great that comparisons may be invalid. He also points out that failure may be with treatment, voluntary. (RIS 27:312-- registered by events other than drug use 7 entries; treatment, nonvoluntary, RIS and that many addicts who return to drug 27:298--11 entries) use at one point in time again may become abstinent yet remain registered as relapsed. treatment, drug abuse See ex-addict. (RIS 27:392--112 entries) Generally, treatment modalities may be classified as drug free or maintenance; residential or ambuiatory; medical or treatment, vol untary nonmedical; selective or nonselective; vol­ Treatment in which the patient both initi­ untary or involuntary. In practice, treat­ ates and continues treatment by choice. ment programs can and do offer virtually any combination of these methods, at times mixing together seemingly opposing ele­ tremor ments (National Commission on Marihuana A trembling or shaking usually from weak­ and Drug Abuse 1973: 315) • See also ness or disease; a feeling of uncertainty treatment outcome. (RIS 27:296--55 entries; or insecurity. See also delirium tremE'ns. treatment, inpatient, RIS 27:297--106 entries; treatment programs, RIS 27:394-- trichloracetaldehyde 31 entries) See chloral hydrate. 97 trichloromethane See chloroform. tricyclic compounds A major category of ANTIDEPRESSANTS. trifluoperazine hydrochloride An (ANTIANXIETY) TRANQUILIZER. Manufactured as Stelazine. unconventional drug use tripelennamine hydrochloride Dr~g use sc n as outside the accepted An antihistamine that has recently come social bounds of d rug-using patterns. into use in combination with- PENTAZOCI NE This term was proposed by Josephson as a substitute for HEROI N. See Ts and (1974:xvi) as a substitute for DRUG Bs. ABUSE. tryptamine Uniform Crime Reports (UCR) Nonhallucinogenic chemical from which the Periodical statistical bulletins issued annu­ hallucinogenic drugs DIMETHYL TRYPTA­ ally by the Federal Bureau of Investigation MINE (DMT), LSD, and PSILOCYBIN can since 1932 that contain data on various be derived. categories of law-breaking and law enforce­ Ts and Bs ment compiled from reports sent in regu­ Slang name for an injected compound made larl,y and ac~ording to a uniform plan by from the brand-name drugs Taiwin (PENTA­ police agencies throughout the Nation. ZOCI NE) and Pysibenzamine (tripelenna­ Critics argue that the statistics fail as mine). Pentazocine is a pain killer, and adequate measures of the magnitude and tripelennamine is an antihistamine. When trends of crime, that a vast amount of crime remains hidden, that much crime ground, bound together, "cooked, II and injected intravenously, it produces a RUSH that is detected is not reported, and that described by users as equivalent to good much that is reported is not recorded quality heroin. Ts and Bs is experiencing (Inciardi and Chambers 1972). increasing use nationally among heroin addicts because it costs less than Jne­ Uniform State Narcotic Drug Act quarter the price of heroin and, unlike An act drafted and promulgated in 1932 sLreet heroin, its potency can be deter­ by the National Conference of Commission­ mined and controlled. There are major ers on Uniform State Laws, a private semi­ health risks associated with the use of Ts official body that proposes a wide variety and Bs, including damage to the small of uniform laws for enactment by States. blood vessels of the lungs, eyes, and Enacted by mo'.;t of the States between brain; seizures and convulsions, and fatal­ 1933 and 1937, the act sought to eliminate ity due to overdose. Other slang names the amalgam of conflicting State narcotic include Tops and Bottoms, Teddies and laws and thE'J weaknesses of State enforce­ Betties. ment proc..:dures,. In this act marijuana wa s classi {led with opiates and' cocaine as tybamate a narcotic drug" At the time the act was An (ANTIANXIETY) TRANQUILIZER, simi­ being drafted, the Federal Bureau of Nar­ lar to but possibly more effective than cotics was under pressure to regulate MEPROBAMATE. Manufactured as Tyba­ marijuana consumption, but the agency tron. Classification: sedative/hypnotics. itself was not eager to take on this task and suggested that an optional clause typology criminalizing marijuana should be included A classification scheme containing two or in the Uniform State Narcotic Drug Act. more categories (types) based on charac­ I t was also proposed to define all the teristics of the things being classified that drugs as "habit formingll and to rename are considered by the classifier to be of the act the Uniform Habit- Forming Drug importance. The criteria most often used Act, but this proposal was defeated in evaluating typologies are "exhaustive­ because of uncertainty over what defined nessll--the extent to which all items being a habit-forming drug. As a result mari­ classified can be placed in 1'1e scheme-­ juana came to be classified as a n;rcotic and "mutual exclusiveness" -toe absence in subsequent State legislation (Bonnie of overlapping between the categories. and Whitebread 1974). Typologies can describe indl.dduals, groups, or whole societies (Encyclopedia United States Adopted Names Council of Sociology 1981). (RIS 27:394--35 The semiofficial organization that confers entries) 98

and keeps track of the generic names of and amphetamine, both the drugs and their new drugs undergoing clinical investiga­ metabolites are found ·in the urine. 1I tion. See also National Formulary; U.S. Pha rmacopeia. Other body fluids such as blood, sweat, and saliva, body tissue, and even the untowa rd effects SYMPATHETIC NERVOUS SYSTEM (e.g., See adverse drug reactions. the Narcan test) can be used to screen for the presence of drugs. Urine testing has uppers become the preferred procedure by many Slang. AMPHETAMI NE pills; sometimes programs because specimens can be easily cocaine. Also called "ups." obtained with minimal facilities and by an unskilled technician, the process is pain­ urinalysis less, it can provide highly reliable results, In its more comprehe.nsive medical meaning, and it is relatively inexpensive. urinalysis consists of a group of tech­ niques for providing information on a urine Of the many different drug urine tests in specimen on a bro~d range of biochemical use today, two characteristics are basic and biomedical health indicators, such as to ail of them--their sensitivity and their the pH level, presence of sugar, and germ specificity in detecting various drugs. count. I n the drug abuse field, however, The sensitivity of a test is determined by urinalysis has cQme tQ be used synony­ the smallest concentration of a drug or mously with testing for the presence of metabol ites that can be detected and is illicitly used drugs. See also urine testing expressed in micrograms per milliliter of for drugs. undiluted urine. The specificity of a test refers to the degree to which it can dis­ urine temperature criminate between closely related drugs, See certified urine. metabolites, or naturally occurring sub­ stances (Catlin 1973). urine testing for drugs The first major use of urine testing to New techniques are still being developed, screen for the illicit use of drugs was by but the most widely used urine tests for Drs. Dole and Nyswander as part of their drugs currently in use are (Catlin 1973; methadone maintenance treatment regimen. DeAngelis 1976)-- At present over 20 million of these tests are routinely performed annually as part Chromatography of drug abuse treatment and military, busi­ Thin layer ness, and penal drug screening programs. Gas-liquid Spectrophotofluorometric (SPF) tests If an individual uses a drug illicitly, Immunoassays traces of it or its metabolite will show up Free radical assay teChnique (FRAT) in the urine. Catlin (1973:2) describes Enzyme multiplied immunoassay this process as follows: technique (EMI T) Radioimmunoassay (RIA) IIWhatever the route of entry into the Hemagglutination Inhibition (H I) body, the drug is carried by the blood Mass spectrometry stream to the brain, liver, kidneys, and Drug screening kits other organs. Once the drug is in the FPN Un iversal Test body, two processes begi n: metabol ism and excretion. Metaboli sm refers to the See certified urine; dirty urine; false posi­ changes in the chemical form of the drug. tive; false negative. For example, as soon as heroin enters the body it is metabolized into morphine, and U.S. Pharmacopeia (USP) in turn morphine is metabolized into mor­ Legally recognized book of standards for phine glucuronide. In fact, although her­ drugs published by the United States oin is the drug taken by the addict, little Pharmacopeial Convention, Inc. It contains or no heroin is found in the urine. What standards for strength and purity and is found are the principal metabolites of formulas for making nearly all drugs cur­ heroin-morphine and morphine-glucuronide. rently in use. The USP, first published Therefore, to detect heroin use, the tests in 1820, is revised every 5 years. Stand­ are designed to detect either morphine, ards contained in the USP were given leg;:!1 morphine-glucuronide, or both. Similarly, status under the National Food and Drugs little or no cocaine is found in the urine; Ac~ of 1907. See also National Formular't; the tests are designed to detect a cocaine UnIted States Adopted Names Council. metabolite. In the case of barbiturates 99

lIintractable" nature of opiate addiction. Of the 386 opiate users in the Robins study, for example, 189 were addicted users while in Vietnam, but only 5 percent continued their addiction after returning to the United States. The others simply stopped using drugs or shifted their drug use patterns to other drugs such as alco­ hoi, amphetamines, or barbiturates. Con­ value orientation tinued drug use has been found to be A person1s disposition toward maki,19 cer­ associated with a high incidence of difficul­ tain value choices, observing certain norms, ties reintegrating into civilian life. These and using certain criteria for the selection findings have been verified by others such of objects toward which to act in C\ given as Nance et al. (1980) and Mintz et al. social situation (Zadrozny 1959). (RIS (1979). 27:395--35 entries) Vin Mariani venous thrombosis A concoction made from coca leaves and A condition characterized by swollen and wine, developed by Angelo Mariani, widely blocked veins, often seen among long-term used and acclaimed in the late 19th cen­ heroin addicts, resulting from frequent tury. injections in a vein (Lingeman 1969). viper victimless crimes Slang. Habitual, long-term marijuana user. Illegal activities in which the participants consent to be involved and in which, vocational rehabilitation therefore, there is tet:hnically no victim. A program of retraining persons with Also called "consensual crimes. n Examples physical defects and handicaps for profit­ include homosexuality, prostitution, gam­ able employment. This term has also been bling, Clnd drug use (Schu r 1965). applied to the retraining of addicts; often Brecher (1972: 45) prefers the expression vocational rehabilitation is one of the goals IIcrimes without complaints. II As the prin­ of addict treatment programs. (RI S 21: cipals in these acts have voluntarily, often 396--9 entries) eagerly, exchanged prohibited goods and services, few complaints to law enforce­ vocational training ment authorities come forward. The Training that sees as its goal directing attempt to prohibit such crimes has thus participants toward acquiring the proper been criticized as an impossible goal and attitudes, habits, and skills necessary for one inevitably leading to law enforcement those occupation~ that demand some degree corruption and illegal behavior stemming of special technical knowledge and skills from the police's zeal to enforce the unen­ (Fairchild 1976; Encyclopedia of Sociology forceable and because of the unlimited 1981) . opportunities for enrichment that these crimes present (Blumberg 1973:109). volatile inhalants A major classification of DEPRESSA NT Vietnam veterans drugs incorporating an aggregate of chem­ Drug use fopiates and cannabis) among ically diverse substances perhaps best American soldiers stationed in Vietnam took described as being volatile (tending to place on a fairly wide scale according to evaporate easily) SOLVENTS .and gases published reports. Lee Robins in her that are usually inhaled and whose effects extensive studies of drug use patterns are short-lived. Some of these drugs have among Vietnam veterans found that, in a been called deliriants although delirium is sample of 898 veterans, 386 had used opi­ only one of many potential effects and is ates while stationed in Vietnam (Robins clearly not restricted to thesB substances. and Helzer 1975; Robins et al. 1974). Many are quite similar in effect to the sedative group; some have certain psyche­ One by-product on the American drug delic or hallucinogenic effects. Most of scene of thousands of Vietnam veterans these substances are not used medically, has been the introduction of drug pr'actices although several have been employed as used in the Orient, such as the 51 NSE- surgical anesthetics: (inhalants, RIS 27: Ml LLA method of cultivating marijuana and 210--5 entries) the use of the more potent Cannabis indica variety of marijUana. Another by-product volunta ry treatment has been the serious rethinking of the See treatment, voluntary.

L ______100

symptoms include tremo r, progressive weak­ ness, dizziness, visual distortion, weight loss, nausea, sudden drop in blood pres- su re, anxiety, convulsions, epilepsyl ike seizures, and psychotic reactions (Lingeman 1969) . There is c. serious debate over the severity and frequency of the appear­ ance of extreme withdrawal. There is much wild lettuce evidence to indicate that withdrawal is to Wild lettuce, also known as lettuce opium a significant extent a function of social (Lactuca virosa), and even crisp lettuce surroundings and not simply dependent (Sativa capita) found at the supermarket, on the amount and length of time a drug contains small amounts of the chemical lac­ is taken. Among U.S. soldiers using her­ tucarium, a mild sedative/hypnotic. When oin in Vietnam, researchers have found extracted and consumed lactucar:um pro­ that withdrawal occurred similarly within duces a very mild psychoactive effect a unit, but that it differed between units; described as similar to that obtained from returning soldiers also underwent far less weak opium. withdrawal than was expected. Within the therapeutic community of DAYTOP VILLAGE, wine the complete suppression of withdrawal An alcoholic beverage obtained by the FER­ has been reportzd among individuals who MENTATION of the juice of grapes, usually experienced extreme withdrawal in prison. containing 8 to 14 percent natural alcohol Extreme withdrawal seems to be rather by volume. Also refers to the fermented rare amon g street users; also, hospital juice of any other fruit, or of other plants patients receiving narcotics dosages and fermentable substances, except those stronger than those available on the street fermented from grains, which are called rarely show evidence of withdrawal (Peele beers. Classification: sedative/hypnotics. 1978:63). Grinspoon and Hedbiom (1975: 153) emphasize that a withdrawal reaction withdrawal syndrome (or symptoms) "is no more than a fairly well-defined set A cluster of characteristic reactions and of physiological symptoms, different to behavior, of varying intensity, depending differE:'nt drugs," which is neither the on the amounts of the drug taken and the major cause nor the most important medical length of time used, sometimes fatally 0, social consequence of drug use. Stud­ severe, which ensue upon abrupt cessation ies by Martin and Jasinski (1969) indicate of a drug upon which the body has devel­ that a pl'otracted opiate withdrawal syn­ oped (PHYSICAL) DEPENDENCE (Lingeman drome consisting of decreased blood pres­ 1969). The traumatic bodily upheaval that sure, pulse rate, pupil diameter, and body can result from cessation of regular admin­ temperature can last up to 6 months. See istration of a drug. Like tolerance, with­ also Himmelsbach test; abstinence. (RIS drawal is difficult to define in precise 27:396--24 entries) medical terms as it is most readily defined by observation of the behavior of the drug works L1ser (Peele 19'77). For opiates, withdrawal Slang. Drug use PARAPHERNALIA for symptoms include anxiety, restlessness, intravenous injection of opiates or other generalized body aches, insomnia, perspira­ illicit substances. Usually includes items tion, hot flashes, nausea, diarrhea, rise such as a homemade syringe, a tourniquet in respiratory rate, cramps, dehydration, (belt, rubber hose, string), and a candle and loss of body weight. For barbiturates, and spoon for "cooking" the injected solu­ tion. 101

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APPENDIXES

A. Drug Classification 116

B. Drug Slang Terms and Bibliography 121

C. Trade Names 127

D. Acronyms Commonly Used in the Drug Abuse Field 129 116

APPENDIX A Drug Classification

The following classification scheme groups drugs first according to their primary pharmacological and psychological action and second according to other shared characteristics, such as chemical structure or duratior, of action. The scheme is arranged alphabetically by generic name (except in the case of the barbiturates, which are listed in order of duration of action), and is the basis on which the drugs defined in this guide are categorized. Trade names, listed in parentheses, were taken from the 35th edition of the Physician's Desk Reference (Oradell, N.J.: Medical Eco­ nomics Company, 1981).1

Drug effects are not precisely the same for all individuals, nor even necessarily the same for the same person at all times, even at the same dosage. They vary widely and often unpredict­ ably, depending on such factors as physiological characteristics, personality and mental state, imagination and mood, expectations of what the drug will do, previous experience with the drug, the condition and properties of the drug being taken, the dosage, the route of administration, and the setting in which it is taken. Nevertheless, for each drug there exist primary effects or experiences and other relatively uniform characteristics. Not all of the over 400 drugs used recreationally are defined in this volume; only those that are most commonly utilized and fre­ quently discussed in the drug research literature are included. Like all the definitions, those for drugs are by no means comprehensive discussions. The user is simply provided a descrip­ tion of each drug's primary effects. Readers interested in learning more about drugs should consult the numerous drug dictionaries and reference articles cited in individual definitions.

Antidepressants Antipsychotic Tranquilizers Cannabis Combinations Hallucinogens Narcotic Analgesic Agonists

Nar(~vtic Antagonists Nonprescription Analgesics Sedative! Hypnotics Stimulants Volatile Inhalants

ANT IDEPRESSA NTS

MAO Inhibitors Isocarboxazid (Marplan) Nialamide (Niamid) Phenelzine sulfate (Nardil) Tranylcypromine sulfate (Parnate)

1 These listings are not exhaustive, and some drugs may be manufactured under other proprietary names as well. ------~------~--~~

117

Tricyclic Amitriptyline hydrochloride (Elavil; Endep) Desipramine hydrochloride (Norpramin; Pertofrane) Doxepin hydrochloride (Adapin; Sinequan) Imipramine hydrochloride (Jan imine; SK-Pramine; Tofranil) Nortriptyline hydrochloride (Aventyl; Pamelor) Protriptyline hydrochloride (Vivactil)

ANTIPSYCHOTIC TRANQUILIZERS

Butyrophenones Drope:-idol (Inapsine; Innovar) Haloperidol (Haldol)

Phenothiazi nes Chlorpromazine (Thorazine) Fluphenazine hydrochloride (Permitil; Proloxin) Perphenazine (Trilafon) Piperacetazine (Quide) Prochlo rpera1!i ne (Compazi ne) Promethazine hydrochloride (Phenergan; Remsed; ZiPAN) Thioridazine hydrochloride (Mellaril) Trifluoperazine hydrochloride (Stelazine)

Reserpates (or Rauwolfia alkaloids) Deserpidine (Harmonyl) Reserpine (Rau-Sed; Serpasil)

Thioxanthines Chlorprothixene (Taractan) Thiothixene (Navane)

CANNABIS

Cannabis derivatives (THC) Hash oil Hashish (charas) Kief Marijuana Sinsemilla

COMBINATIONS

Chlordiazepoxide hydrochloride and amitriptyline hydro- chloride (Limbitrol) Dextroamphetamine sulfate a"d amobarbital (Dexamyl) Meperidine hydrochloride and promethazine hydrochloride (Mepergan) Methamphetamine hydrochlorido and pentobarbital ,sodium (Desbutal) Perphenazine and amitriptyline hydrochloride (Triavil) Secobarbital sodium and amobarbital sodium (Tuinal) 118

HALLUCI NOGENS

Dimethoxymethamphetamine (DOM; STP) Dimethyltryptamine (DMT) Ditran (piperidyl benzilate) Lysergic acid diethylamide-25 (LSD) Mescaline Methylenedioxyamphetamine (MDA) Peyote Phencyclidine (PCP) Psilocin Psilocybin

NARCOTIC ANALGESIC AGONISTS

Opiates Natural codeine hydrocodone bitartrate (Dicodid) morphine opium laudanum papaverine paregoric Semisynthetic heroin (diacetylmorphine) hydromorphone hydroc:lloride (Dilaudid) oxycodone hydrochlorio;:. (Percocet-5; Percodan; Tylox) oxymorphone hydrochloride (Numorphan)

Opioids (synthetic opiates) Etonitazene LA A M (Ievo-al pha-acetyl methadol ) Levo rphanol ta rtrate (Levo-Dromoran) Meperidine hydrochloride (Demerol) Methadone hydrochloride (Dolophine) Pentazocine hydrochloride (Talwin) Phenazocine Propoxyphene hydrochloride (Darvon)

NARCOTIC ANTAGON ISTS

Mixed agonists and antagonists Buprenorphine Cyclazocine Levallorphan tartrate (Lorfan) Nalorphine (Nalline)

Pure Diprenorphine Naloxone hydrochloride (Narcan) Naltrexone

NONPRESCRIPTION ANALGESICS

Acetaminophen (Datril, Tylenol) Aspirin Phenacetin 119

SEDATIVE/HYPNOTICS

Alcohol Beer Distilled spirits (liquor) Wine

Antianxiety tranquilizers Benzodiazepines chlorazepate dipotassium (Tranxene) chlor.diazepoxide hydrochloride (A-Poxide; Librium; SK-Lygen) diazepam (Valium) flurazepam hydrochloride (Dalmane) oxazepam (Serax) Diphenylmethanes diphenhydramine hydrochloride (Benadryl) hydroxyzine hydrochloride (AtaraJ{; Sedaril) Propanediols meprobamate (Equanil; Miltown) tybamate (Tybatran)

Barbitu rates U Itra-short-acting butalbital heptaba rbital hexobarbital thiopental sodium (Pentothal) Short-acting pentobarbital sodium (N embutal) secobarbital sodium (Seconal) Intermediate-acting amobarbital (Amy tal) amobarbital sodium (Amy tal Sodium) butabarbital sodium (Buticaps; Butisol Sodium) Long-acting barbital (Veronal) metharbital (Gemonil) phenobarbital (Luminal)

Nonbarbiturates Bromides Chloral hydrate and other chloral derivatives Ethchlorvynol (Placidyl) Ethinamate (Valmid) Glutethimide (Doriden) Methaqualone (Quaalude; Mequin) Methyprylon (Noludar) Paraldehyde

STIMULANTS

Ergot alkaloids (Circanol; Deapril; Hydergine) 120

Primary Amphetamine relatives benzphetamine hydrochloride (Didrex) clortermine hydrochloride (Voranil) diethylpropion hydrochloride (Tenuate; Tepanil) mazindol (Sanorex) methylphenidate hydrochloride (Ritalin) phendimetrazine tartrate (Bacarate; Bontril; Melfiat; Plegine; Prelu-2; SPRX-l 05; Statobex; Trimstat; Trimtabs; Wehless-35) phenmetrazine hydrochloride (Preludin) pipradrol hydrochloride (Meratran) Amphetamines amphetamine sulfate (Benzedrine) dextroamphetamine sulfate (Dexedrine) methamphetamine hydrochloride (Desoxyn; Methedrine) Cocaine and coca

Secondary Arecoline Caffeine coffee tea Khat Nicotine

VOLATILE INHALANTS

Amyl nitrite

A nesthetics (general) Gaseous nitrous oxide Vaporous ether chloroform

Butyl nitrite

Hydrocarbons Chlorinated carbon tetrachlo ride Fluorocarbons and other aerosol propellants Ketones and acetates acetone Petroleum-based benzene gasoline naphtha toluene 121

APPENDIX B Drug Slang Terms

• Amphetamines • Barbiturates • Cocaine • Hashish 1& Heroin • LSD • Marijuana • Mescaline • Morphine • Peyote • Phencyclidine (PCP) • Psilocybin/Psilocin • Bibliography 122

Amphetamines Roses Red bullets "A" Snap Red devils Bam Sparkle plenties Reds Beans Sparklers Seccy Bennies Speed Seggy Benz Speedball Sleepers Black beauties Splash Softballs Black birds Splivins Stoppers Black bombers Sweets Strawberries Black Mollies Thrusters Stumblers Bombido Truck drivers Tooles Bombita Turkey Tuies Bottles Turnabouts Ups and downs Brain ticklers Uppers Yellow bu Ilets Brownies Uppies Yellow jackets Browns Ups Yellows Bumble bees Wake ups Cartwheels Whites Cocaine Chalk Barbs Chicken powder Barbiturates Bernice Christmas trees Bambs Bernies Coast to coasts Bank bandit pills Bernie's flake Co-pilots Barbs Big bloke Crank Beans Big C Crossroads B lack beauties Billie Hoke Cross tops Block busters Birdie powder Crystal Blue angels Blow Dexies Blue birds Bouncing powder Diet pills Blue bullets Burese Dominoes Blue dolls Burnese Double cross Blue heavens "C" Eye openers Blue"tips Cabello Fives Blues Cacil Footballs Busters Cadillac Forwards Candy C-duct French blue Christmas rolls Came Head drugs Christmas trees Candy Hearts Courage pi lis Candy cee Horse heads Dolls Carrie Inbetweens Double trouble Cecil Jam Downie Charlie Jam Cecil Downs Cholly Jelly babies Drowsy high Coca Jelly beans Gangster pills Coconut Jolly beans G.B. Coke Jugs Goofball Colas L.A. turnabouts Goofers Corine Leapers Gorilla pills Corinne Lid roppers Green dragons Dream Lid proppers Idiot pills Duct Lightning Inbetweens Dust Marathons King Kong pills Dynamite Meth Marshmallow reds Flake Minibennies Mexican reds Foo Foo Dust MMDA Mighty Joe Young Foolish powder Nuggets Nebbies Frisky powder Oranges Nimbies Frisco speedball Peaches Peanuts Gin Pep pills Phennies Girl Pixies Phenos Glad stuff Purple hearts Pills Gold dust Rippers Pink ladies Happy dust Road dope Purple hearts Heaven dust Rosas Rainbows Her 123

Ice Caca Pangonadalot Joy powder Chip Poison Lady' Chinese red Powder Lady snow Chiva Pulborn Love affair Cotics Pure Mayo Crap Racehorse Charlie Mojo Crown crap Ragweed Mosquito Cura Rane Nose candy Deuce Red chicken Nose powder Dirt Doojee Red rock Nose stuff Dope Reindeer dust Number three Duji Sack Paradi,se Dujie Salt Perico Dust Scag Piece Dynamite Scatt Polvo blanco Dyno-pure Schmeek Powder diamonds Eighth Schmeck Rane Estuffa Skid Rock Ferry dust Scott Snort Flea powder Sleeper Snow Foolish powder Smack Snow bird Galloping horse Snow Snow flakes Gamot Speedball Speedball Garbage Stuff Star dust George Smack Sugar Sugar Gravy Sweet stuff Sweet stuff "H" Texas tea Turkey H caps Thing White girl Hairy TNT White horse Half load White boy White lady Hard stuff White girl White mosquitos Harry White junk White powder Helen White lady Wings Hell dust White nurse Witch Hero White stuff Heroina Wings Hashish Him Witch Black hash Hombre Witch hazel Black Russian Horning Burese Horse LSD Dynamite Hot heroin Acid Gomade moto HRN Animal Half moons Isda Barrels Hash Jee gee Beast Quarter moons Jive doo jee Big D Soles Jojee Black tabs Jones Blotter Heroin Joy powder Blue acid Anti freeze Junk Blue chairs Aunt Hazel Kabayo Blue cheers Balloon LBJ Blue mist Balot Lemonade Blue vials Big bag Matsakaw Brown dots Big H Mayo California sunshine Big Harry Mexican mud Cap Blanco Mojo Chief Bomb Morotgara Chocolate chips Bonita Muzzle Coffee Boy Noise Contact lens Bozo Number eight (#8) Crackers Brown Ogoy Cube Brown Rine Oil Cupcakes Brown Sugar Old Steve "D" Caballo Pack Deeda

387-396 0 - 82 - 9 QL 3 124

Domes Marijuana Goof butts Dot Acapulco gold Gong Electrk Kool Ade Ace Gold Flash African black Grass Flat blues Airplane Grasshopper Ghost Atom bomb Green Grape parfait Aunt Mary Grefas Green wedge Baby Greeter Hawaiian sunshine Bale Greta Hawk Bambalacha Griefo Heavenly blue Bar Grifa Haze Bash Griffs Instant Zen Belyando spruce Gungeun "L" Bhang Hanhich Lason sa daga Black Bart Happy cigarette LBJ Black gunion Hay Lucy in the sky with diamonds Black mote Hemb Mellow yellows Blonde Herb Microdots Blue sage Herba Mighty Quinn Bo-bo Home grown Mind detergent Boo Hot sticks Orange cubes Brick Indian Boy Orange micro Broccoli Indian Hay Orange wedges Brown IIJII Owsley Burnies Jay Owsley's blue dot Bush Jane Paper acid Butter flower Jay smoke Peace Can Jive Peace tablets Canadian black Jive sticks Pearly gates Cancelled stick Joint Pellets Carmabis Joy stick Pink Owsley Cavite all sta rs Juanita Pink wedge Charge Juan Valdez Pure love Chicago green Ju-ju Purple barrels Chira Kentucky blue Purple flats Cocktail Kick stick Purple haze Columbian Kif Purple hearts Churus Killer Purple ozoline Crying weed Killer weed Royal blues Dagga Kilter Sacrament Diambista Lakbay diwa Sandoz's Ding Laughing grass Smears Dinkie dows Laughing weed Squirrel Don jem Lid Strawb~rries Drag weed Lhesca Strawberry fields Dry high L.L. Sugar Duby Lobo Sugar lumps Durog Loco weed Sunshine Fatty Log Tabs Fine stuff Love weed Ticket Fingers "Mil Twenty-five Fir Machinery Vials Flowers Macon Wedding bells Fraho Maggie Wedge Frajo Manhattan silver White lightning Fu Mary White Owsley's Gage Mary Jane Window pane Ganga Mary Jonas Yellow dimples Gangster Majoun Yellows Gates Mary Juanas Zen Gauge Mary Warner Ghana Mary Weaver Giggle smoke Meg Good gigg les Messorole 125

Mexican brown Wheat Red cross Mezz Yen pop Reindeer dust M.J. Yerba Sweet Jesus M.O. Yesco Sweet Morpheus Modams Sweet stuff Mohasky Mescaline Tab Mohasty Beans Uhffi Moocah Buttons Uncle Mooster Cactus Unkie Mootos Cactus buttons Upper Mora grifa Chief Ups Mother Mesc White angel Moto Mescal White merchandise M.U. Moon White nurse Mu Topi White silk Muggies White stuff Muggles Morphine Wings Mutah Barnecide Witch Number Big M O.J. Birdie powder Peyote Pack Cacil Bad acid Panama red Cecil Bad seed Panatella Cube Big chief Pin Cube juice Buttons Pod Dreamer Cactus Poke Dust Cactus buttons Pot Emm Dry whiskey Potten bush Emsel Full moon Railroad weed First line Half moon Rainy day woman Foo foo dust H ikori Red dirt Gamot Hikuli Reefer Glad stuff Mesc Righteous bush God1s medicine Mescal Roach Goma Mescal beans. Root Gunk Mescal button~i Rope Happy medicine Topi f Rose Marie Hard stuff Tops Salt and pepper Hell dust Sas fras Hocus Phencyclidine (PCP) Sativa M Angel dust Scissors Mayo Crystal Smoke Melter Cyclone Splim Miss Emma Dead on arrival Snop Miss Morph DOA Stack Mojo Dust of angels Stick Monkey Hog Stink weed Moocah Killer weed Straw Morph PCP Sugar weed Morphie Peace pill Sweet Lucy Morphina Rocket fuel Tea Morpho Supergrass Texas tea Morphy Tic tac Thumb Morshtop Twist M.S. Psi locybin/Psilocyn Viper1s weed Moscop Magic mushroom Weed Piece Mushroom Weed tea Pink 126

BIBLIOGRAPHY Bureau of Narcotics and Dangerous Drugs. Glossary of Terms in the Drug Culture. Washington, D.C.: U.S. Department of Justice, 1970. Cull, J.G., and Hardy, R.E. Types of Drug Abusers and Their Abuse. Springfield, III.: Thomas, 1974. Pp. 184-204. Fisher, R.B., and Christie, G.A. A Dictionary of Drugs: The Medicines You Use. Updated and revised ed. New York: Schocken Books, 1976.

Hardy, R.E., and Cull, J.G. Drug Language and Lore. Springfield, III.: Thomas, 1975.

Keup, W. The vocabulary of the drug user and alcoholic: A glossary. The International Journal of the Addictions, 6(2):347-373, 1971. Kline, N. S.; Alexander, S. F.; and Chamberlain, A. Psychotropic Drugs: A Manual for Emergency Management of Overdosage. Oradell, N.J.: Medical Economics Co., 1974. Lingeman, R.R. Drugs From A to Z: A Dictionary. 2nd ed. New York:- McGraw-Hili, 1974.

Maurer, D.W., and Vogel, V.H. Narcotics and Narcotic Addiction. 4th ed. Springfield, III.: Thomas, 1973. Narcotics and Drug Abuse A to Z. Vol. II. Queen's Village, N. Y.: Sodal Service Publications, Division of Croner Publications, 1971.

National Institute of Mental Health, Clinical Research Center. Peanuts and Tea: A Selected Glos­ sary of Terms Used by Drug Addicts. Lexington, Ky.: the Institute, 1972. Pollock, A.J. The Underworld Speaks: An Insight to Vice, Crime, Corruption. San Francisco: Prevent Crime Bureau, 1935. Pradhan, S.N., and Dutta, S.N. Drug Abuse: Clinical and Basic Aspects. St. Louis, Mo,: Mosby, 1977. Schmidt, J.E. Narcotics: Lingo and Lore. Springfield, III.: Thomas, 1959.

Smith, D.E., and Wesson, D.R. Diagnosis and Treatment of Adverse Reactions to Sedative­ Hypnotics, National Institute on Drug Abuse. DHEW Pub. No. (ADM) 75-144. Washington, D.C.: Supt. of Docs., U.S. Govt. Print. Off., 1974. U.S. Department of Commerce, Joint Publication Service. Reference Aid: Glossary of Narcotics Terms. Washington, D.C.: the Department, 1973.

U.S. Department of Justice. Glossaries of Argot Used by Addicts. Washington, D.C.: the Department, 1970.

U.S. Departments of the Army, the Navy, and the Air Force. Drug Abuse: Clinical Recognition and Treatment, Including the Diseases Often Associated. Appendix D.: Glossary of drug vocabulary. Washington, D.C.: the Departhlents, 1973. "

127

APPENDIX C Trade Names1

Adapin Desoxyn Luminal (doxepin hydrochloride) (methamphetamine hydro­ (phenobarbital) Amy tal chloride) Marplan (amobarbital) Dexamyl (isocarboxazid) Amy tal Sodium {dextroamphetamine sulfate Melfiat (amobarbital sodium) and amoba rbital) (phendimetrazine hydro­ A-Poxide Dexedrine chloride) (chlordiazepoxide hydro­ (dextroamphetamine sulfate) Mellaril chloride) Dicodid (thioridazine hydrochloride) Atarax (hydrocodone bitartrate) Mepergan (hydroxyzine hydrochloride) Didrex (meperidine hydrochloride Aventyl (benzphetamine hydro­ and promethazine hydro­ (nortriptyline hydrochloride) chloride) chloride) Bacarate Dilaudid Mequin (phendimetrazine hydro­ (hydromorphone hydrochlor­ (methaqualone) chloride) ide) Meratran Benadryl Dolophine (pipradrol hydrochloride) (diphenhydramine hydro­ (methadone hydrochloride) Methedrine chloride) Doriden (methamphetamine hydro­ Benzedrine (glutethimide) chloride) (racemic amphetamine Elavil Miltown sulfate) (amitriptyline hydrochloride) (meprobamate) Bontril Endep Nalline (phendimetrazine hydro­ (amitriptyline hydrochloride) (nalorphine) chloride) Equanil Narcan Buticaps (meprobamate) (naloxone hydrochloride) (butabarbital sodium) Gemonil Nardil Butisol Sodium (metharbital) (phenelzine sulfate) (butabarbital sodium) Haldol Navane Circanol (haloperidol) (thiothixene) (ergot alkaloids) Harmonyl Nembutal Compazine (deserpidine) (pentobarbital sodium) (prochlorperazi ne) Hydergine Niamid Dalmane (ergot alkaloids) (nialamide) (flurazepam hydrochloride) Inapsine Noludar Darvon (droperidol) (methyprylon) (propoxyphene hyd rochlo r­ lnnovar Norpramin ide) (droperidol) (desipramine hydrochloride) Datril Janimine Numorphan (acetaminophen) (imipramine hydrochloride) (oxymorphone hydrochloride) Deapril Levo-Dromoran Pamelor (ergot al kaloids) (Ievorphanol tartrate) (nortriptyline hydrochloride) Delysid Librium Parnate (LSD-25) (no longer manu­ (chlordiazepoxide hydro­ (tranylcypromine sulfate) factured) chloride) Pentothal Demerol Limbitrol (thiopental sodium) (meperidine hydrochloride) (chlordiazepoxide hydro­ Percocet-5 Desbutal chloride and amitriptyline (oxycodone hydrochloride) (methamphetamine hydro­ hydro~hloride) Percodan chloride and pentobarbital Lorfan (oxycodone hydrochloride) sodium) (levallorphan tartrate)

1 T he National I nstitute on Drug Abuse does not endorse any product; trade names are provided only to facilitate the reader. r 128

Permitil Serax Triavil (fluphenazine hydrochloride) (oxazepam) (perphenazine and amitrip­ Pertofrane Serpasil tyline hydrochloride) (desipramine hydrochloride) ( reserpine) Trilafon Phenergan Sinequan (perphenazine) (promethazine hydrochloi-ide) (doxepin hydrochloride) Trimstat Placidyl SK-Lygen (phendimetrazine hydro­ (ethch 10 rvynol) (chlordiazepoxide hydro­ chloride) Plegine . chloride) Trimtabs (phendimetrazine hydro­ SK-Pramine (phendimetr<.'zi ne hyd ro­ chloride) (imipramine hydrochloride) chloride) Prelu-2 SPRX-105 Tuinal (phendimetrazi ne hyd ro­ (phendimetrazine hydro­ (secobarbital sodium and chloride) chloride) amobarbital sodium) Preludin Statobex Tybatran (phenmetrazine hydrochloricie) (phendimetrazi ne hydro­ (tybamate) Proloxin chloride) Tylenol (fluphenazine hydrochloride) Stelazine (acetminophen) Quaalude (trifluoperazi ne hydrochlor­ Tylox (methaqualone) ide) (oxycodone hydrochloride) Quide Talwin Valium . (piperacetazi ne) (pentazocine hydrochloride) (diazepam) Rau-Sed Taractan Valmid (reserpine) (chlorprothixene) ( ethinamate) Remsed Tenuate Veronal (promethazine hydrochloride) (diethylpropion hydrochlor­ (barbital) Ritalin ide) Vivactil (methylphenidate hydro­ Tepanil (protriptyline hydrochloride) chloride) (diethylpropion hydrochlor­ Voranil Sanorex ide) (clortermine hydrochloride) (mazindol) Thorazine Wehless-35 Seconal (chlorpromazine) (phendimetrazine hydro­ (secobarbital sodium) Tofranil chloride) Sedaril (imipramine hydrochloride) ZiPAN (hydroxyzine hydrochloride) Tranxene (promethazi ne hyd rochlo ride) (chlo raze pate di potassium) 129

APPENDIX D Acronyms

AA Alcoholics Anonymous MAO monoa~ine oxidase inhibitors ACM American Council on Marijuana MDA methylenedioxyamphetamine and Other Psychoactive Drugs, MMPI Minnesota Multiphasic Person- Inc. ality Inventory ACT Alliance for Cannabis Thera- NA Na rcotics Anonymous peutics NACC Narcotic Addiction Control ADAMHA Alcohol, Drug Abuse, and Commission Mental Health Administration NARA Narcotic Addict Rehabilitation ASC altered state of consciousness Act BNDD Bureau of Narcotics and Dan- NASADAD National Association of State gerous Drugs Alcohol and Drug Abuse BOP Bureau of Prisons Directors CBD cannabidiol NCTIP National Committee on the CETA Comprehensive Employment and Treatment of Intractable Pain Training Act (of 1973 and its NDATUS National Drug Abuse Treat- various amendments) ment Utilization Survey CFR Code of Federal Regulations NF National Formula r:t CHAMPUS Civilian Health and Medical NFl> National Federation of Parents Program of the Uniformed NIAAA National Institute on Alcohol Services Abuse and Alcoholism CNS central nervous system NIDA National Institute on Drug CODAP Client Oriented Data Acquisi- Abuse tion Process NIH National Institutes of Health DARP Drug Abuse Reporting Program NIMH National Institute of Mental DAWN Drug Abuse Warning Network Health DEA Drug Enforcement Administra- NNICC National Narcotics Intelligence tion Consumers Committee DHHS Department of Health and NORML National Organization for the Human Services Reform of Marijuana Laws DMT dimethyltryptamine NTA Narcotics Treatment Adminis- DOM dimethoxymethamphetamine tration EMIT enzyme multiplied immunoassay OD overdose technique OTC drugs over-the-counter drugs FBN Federal Bureau of Narcotics PCP phencyd id i ne FDA Food and Drug Administration PHS Public Health Service, DH HS FFC Federal Fundi ng Criteria RIA radioimmunoassay FPR Federal Procurement Regula- SAODAP Special Action Office for Drug tions Abuse Prevention FRAT free radical assay technique SES socioeconomic status FY fiscal year (Oct. 1 to Sept. SHCC Statewide Health Coordinating 30 for Federal Government) Council HEW Department of Health, Educa- SMSA Standard Metropol itan Statisti- tion~ and Welfare (former name cal Area of D' HS) , SPA State Planning Agency HI hemagglutination inhibition SPF spectrophotofluorometric HSFR Health Services Funding Regu- SSA Single State Agency lations SSD SUdden sniffing death JAMA Journal of the American Medi- STP street name, synthetic hallu- cal Association cinogen dimethoxymethampheta- LAAM levo-al pha-acetylmethadol mine LEAA Law Enforcement Assistance SWSC Statewide Services Contract Administration TA Technical Assistance LSD lysergic acid diethylamide-25 130

TASC Treatment Alternatives to Street Crime TMA trimethoxyamphetamine THC tetrahydrocannabinol (alsol\-9- UCR Uniform Crime Reports THC or delta-9-THC) USP ~harmacopeia THE RESEARCH ISSUES SERIES

DRUGS AND EMPLOYMENT. Atlitudes toward drug use by DRUG ABUSE INSTRUMENT HANDBOOK. A sourcebook contam­ employers and employees; the effects of drug use on work perfor­ ing over 2.000 representative items from 40 instruments used In drug mance, hlnng and firing practices; employer rehabilitation programs. abuse -dsearch. Includes demographic, Interpersonal. intrapersonal. Specific studies on drug use In medicme, sports, and aviation 31 ar1:; drug items. plus detailed summaries describing the Instruments abstracts. Stock No. 017-024-00424-3 ($1.80) utilized. A guide to obtaining and developing instruments. DRUGS AND SEX. The eHects of drugs on sexual behavior. correla­ Stock No. 017-024-00533-9 ($4.65) tions and relationships among a variety of populations. Arranged by DATA ANALYSIS STRATEGIES AND DESIGNS FOR SUB­ drug type: multi-drug. manhuana. amphetamines. LSD. heroin and STANCE ABUSE RESEARCH. 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New readings on 13 topics previously covered by the series: sex, pregnancy, attitude change, family/peer Influ­ ences, employment, crime, criminal justice, cocaine, personality, psychopathology, and driving. Organized by topical area. 135 abstracts. Stock No. 017-024-0087S-1 ($5.25) INTERNATIONAL DRUG USE. Research on drug use in 35 foreign countries with a focus on patterns of use and topics covered by the series. Includes an introductory review and studies on the United Kingdom, Scandinavia, Africa, the near East, Asia, and Latin America. 95 abstracts. Stock No. 017-024-00874-5 ($4.20) PERSPECTIVES ON THE HISTORY OF PSYCHOACTIVE SUBSTANCE USE. Lengthy summaries of 35 significant major events in the history of psychoactive sUbstance use since the Renaissance in the U.S., Europe, and Asia. Substances covered are alcohol, coffee, tobacco, ether, cocaine, amphetamine, cannabis, opium, and the opiates. 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U.S. GOVERNMENT PRINTING OFFICE 1982 0 - 387-396 QL 3