FitSugar

"Cocaine" Pulled From Shelves

FitSugar — Tue, 08 May 2007 03:00:00 -0700

The energy drink called Cocaine was pulled from shelves because of nationwide concerns about its name.

The FDA issued a warning letter last month to the distributer, Redux Beverages LLC of Las Vegas, saying that they were illegally marketing the drink as a "legal alternative" to the street drug and as a dietary supplement." On the company's website, the drink is advertised as “Speed in a Can,” “Liquid Cocaine” and “Cocaine - Instant Rush.”

The company argued that their energy drink has NO cocaine in it and nobody thinks it does. The drink provides a cocaine-like energy boost because it contains more caffeine than any other energy drink (and twice as much as coffee). The FDA is just concerned that although it's not actually "cocaine," the drink is glorifying the use of this illegal drug.

So the energy drink has been pulled from shelves until they come up with a new name for it (chances are low that they will name it Meth, but you never know). I guess we will just have to stick to Red Bull spiked with espresso.

Fittingly Mad: Liquid Cocaine

FitSugar — Sun, 05 Nov 2006 10:00:00 -0800

Energy drinks have gained enormous popularity in the past few years despite the extremely high levels of sugar and caffeine found in almost any energy drink on the market.

The name energy leads you, the consumer, to believe you are drinking a good thing (maybe something that will help you excel in your work out) when you're not, and it could not be further from it. One can of energy drink tends to have 4 times the caffeine than a can of coke and about 7 teaspoons of sugar. The worst part is that since energy drinks are so hot right now, makers are just random companies (clothing manufacturers, motorcycle makers, etc) jumping on the bandwagon. One Las Vegas based producer even named their drink Cocaine: The Legal Alternative. Could it sound any more unhealthy? What's more? Energy drinks are not currently regulated in the United States so anyone and everyone can make and drink them.

To find out how you can get more energy without one drop of Liquid Cocaine, read more

If you're looking for more energy, rather than reaching for another can of Red Bull try taking a look at your lifestyle and figure out what is draining you and how you can give yourself a little extra sleep or "You Time". Try reevaluating your diet. Are you eating healthy enough?

Still feeling slow? Drinks containing Ginseng have been known to boost energy.

Still not feeling as energetic as you'd like? Vitamin "B" is known as the energy vitamin and lack of "B" could be responsible for your lack in pep; most multivitamins will contain appropriate daily recommended amounts. Keep in mind, it is always wise to consult your doctor before adding any new supplements to your diet.

Source

Cocaine (On the skin)

admin — Thu, 04 Sep 2008 20:06:56 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Cocaine (koe-KANE)

Used before a medical procedure to numb your mouth, throat, or nose. This medicine is a topical anesthetic.

Brand Name(s)

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to cocaine.

How to Use This Medicine

Liquid

A nurse or other trained health professional will give you this medicine.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breast feeding.
Make sure your doctor knows if you are allergic to other medicines.
Make sure your doctor knows if you have any irritation in your mouth, throat, or nose.
Tell your doctor about any disease or illness you have before your procedure.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Blurred vision.
Cough.
Feeling nervous, restless, agitated, or anxious.
Slow or fast heartbeat.
Tremor or seizure.
Extreme weakness
Slow or shallow breathing
Fever

If you notice these less serious side effects, talk with your doctor:

Fever, chills.
Nausea, vomiting, or pain in your stomach.
Blurred vision

Review Date: 8/4/2008

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 45_5087

Cocaine withdrawal

admin — Wed, 03 Sep 2008 17:53:12 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Cocaine withdrawal occurs when a heavy cocaine user cuts down or quits taking the drug.

Causes, incidence, and risk factors

Cocaine produces a sense of extreme joy by causing the brain to release higher than normal amounts of some biochemicals. However, cocaine's effects on the body can be very serious or even deadly.

When cocaine use is stopped or when a binge ends, a crash follows almost immediately. This crash is accompanied by a strong craving for more cocaine. Additional symptoms include fatigue, lack of pleasure, anxiety, irritability, sleepiness, and sometimes agitation or extreme suspicion.

Cocaine withdrawal often has no visible physical symptoms like the vomiting and shaking that accompanies the withdrawal from heroin or alcohol.

In the past, people underestimated the addictive properties of cocaine. However, cocaine is addictive when addiction is defined as a desire for more of the drug, despite negative consequences.

The level of craving, lack of pleasure, and depression produced by cocaine withdrawal rivals or exceeds that felt with other withdrawal symptoms.

See also:

Symptoms

Primary symptoms may include:

Depressed mood
Fatigue
Generalized malaise
Vivid and unpleasant dreams
Agitation and restless behavior
Slowing of activity
Increased appetite

The craving and depression can last for months following cessation of long-term heavy use (particularly daily). Withdrawal symptoms can also be associated with suicidal thoughts in some people.

During withdrawal, there can be powerful, intense cravings for cocaine. However, the "high" associated with ongoing use becomes less and less pleasant, and can produce fear and extreme suspicion rather than joy. Just the same, the cravings may remain powerful.

Signs and tests

A physical examination and history of cocaine use are sufficient to diagnose this condition.

Treatment

The withdrawal from cocaine may not be as unstable as withdrawal from alcohol. However, the withdrawal from any chronic substance abuse is very serious. There is a risk of suicide or overdose.

Symptoms usually disappear completely over time. People experiencing cocaine withdrawal often attempt to self-medicate with alcohol, sedatives, hypnotics, or antianxiety medications, such as diazepam (Valium). Self-medication or replacement is not advised, because each simply shifts addiction from one substance to another.

Because at least 50% of people addicted to cocaine have a co-existing mental disorder (particularly depression and attention-deficit disorder), these conditions must be considered and treated aggressively.

Relapse rates are dramatically reduced when these conditions are treated appropriately. All prescription drugs should be monitored carefully in patients who abuse substances.

Support Groups

The 12-step support groups, such as Cocaine Anonymous or Narcotics Anonymous, have helped many people addicted to cocaine. Alternative groups such as SMART recovery should be recommended for those who do not like the 12-step approach.

Expectations (prognosis)

Cocaine addiction is difficult to treat, and relapse can occur. However, the rates of achieving stabilization are as good as those for other chronic illnesses like diabetes and asthma.

Treatment should start with the least restrictive option and move up if necessary. Outpatient care is as effective as inpatient for most people addicted to cocaine, according to the research.

Presently there are no effective medications for reducing craving, though some are being tested. Some studies have reported that medications such as amantadine and bromocriptine may help to reduce patient's craving, increase energy, and normalize sleep, particularly among those with the most serious problems.

Complications

Depression
Craving and overdose
Suicide

Because many users will abuse more than one drug, other withdrawal syndromes, such as alcohol withdrawal, need to be ruled out.

Calling your health care provider

Call your health care provider if you use cocaine and need help to stop using it.

Prevention

Avoid cocaine use. If you have previously used cocaine and wish to stop, try to avoid people, places, and things you associate with the drug. If you find yourself considering the extreme joy produced by cocaine, force yourself to think of the negative consequences that follow use. Seek support if you find it helpful.

Review Date: 1/22/2008

Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000947

Stroke related to cocaine use

admin — Wed, 03 Sep 2008 17:51:42 -0700

Overview

Definition
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Central nervous system

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Stroke related to cocaine use is a blockage in the blood supply to the brain and loss of brain function in someone who has used the drug, cocaine.

Causes, incidence, and risk factors

Cocaine is a product of the coca plant and an illegal recreational drug. It is a strong stimulant that increases activity of the central nervous system and the nerves that run away from the spinal cord (peripheral nervous system).

Cocaine use can cause a number of medical problems. Stroke related to cocaine probably occurs because cocaine causes blood vessels to narrow (constrict) while it increases blood pressure (hypertension). This vasoconstriction can be severe enough to reduce or block blood flow through the arteries in the brain. Cocaine use also can lead to swelling (inflammation) of the arteries of the brain.

Stroke related to cocaine is most common in men under 40 years old. A history of recent cocaine use is a risk.

A few people who experience stroke after using cocaine have an arteriovenous malformation, which may make them more likely to have a stroke. In these cases the stroke is due to bleeding in the brain instead of decreased blood flow.

Symptoms

Symptoms of cocaine use may include:

Symptoms of a stroke include:

Drowsiness, lethargy, or loss of consciousness
Loss of balance or coordination
Loss of memory
Mood changes
Numbness, tingling, decreased sensation
Personality changes
Slurred speach, inability to speak or understand speech, difficulty reading or writing
Swallowing difficulties or drooling
Uncontrollable eye movements or eyelid drooping
Vertigo
Vision changes
Weakness or paralysis of an arm, leg, side of the face, or any part of the body

Signs and tests

Your health care provider will take a medical history of your symptoms and history of cocaine use.

Signs include:

Abnormal eye movements
Changes in reflexes
Changes in vision or visual fields
Decreased sensation
Muscle weakness

You also may have signs of other disorders that occur with cocaine use.

Tests may include:

Motor tests
Nervous system (neurologic) tests
Sensory tests
Urine or blood toxicology screen

Treatment

Treatment may include not just the stroke, but also other disorders that may occur from cocaine use.

Possible treatments:

Amantadine to reduce the risk of taking drugs again
Dopamine agonist medications for cocaine withdrawal
Drugs to treat irregular heart rhythms (arrhythmias)
Sedatives such as diazepam and midazolam to reduce agitation and sleeping difficulties(insomnia)

A person who is in a coma may need life support, including tubes in the airway and a breathing machine (mechanical ventilation).

It is important to stop using cocaine. Treat cocaine addiction and any other addictions. Treatment should include monitoring for signs of cocaine withdrawal.

Because most people who are addicted to cocain are also addicted to other drugs (such as alcohol or heroin), withdrawal symptoms from these drugs should also be treated. Patients who are taking methadone for heroin addiction should continue to receive their regular dose.

Expectations (prognosis)

The outcome depends on:

Any other health conditions
The severity of the stroke
Withdrawal symptoms

The outcome is often poor, especially with long-term cocaine use. It is possible to die if many body systems stop functioning properly.

Complications

See stroke for a list of complications.

Calling your health care provider

Go to the emergency room or call 911 if you have any symptoms of stroke.

Prevention

Do not use cocaine to prevent having a stroke related to cocaine use.

References

Egred M, Davis GK. Cocaine and the heart. Postgrad Med J. 2005 Sep;81(959):568-71. Review.

Velasquez EM, Anand RC, Newman WP 3rd, Richard SS, Glancy DL. Cardiovascular complications associated with cocaine use. J La State Med Soc. 2004 Nov-Dec;156(6):302-10; quiz 311. Review.

Lucas CE. The impact of street drugs on trauma care. J Trauma. 2005 Sep;59(3 Suppl):S57-60; discussion S67-75.

Review Date: 2/13/2008

Reviewed By: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000743

Cocaine intoxication

admin — Wed, 03 Sep 2008 17:53:11 -0700

Overview

Definition
Alternative Names

Illustrations

Electrocardiogram (ECG)

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Cocaine is a powerful central nervous system stimulant with potent cardiovascular (heart and blood vessel) side effects. Signs of intoxication typically begin with enlarged pupils, a feeling of being "high" (euphoria), agitation, and increased heart rate and blood pressure.

With higher doses, sweating, tremors, confusion, hyperactivity, seizures, stroke, cardiac arrhythmias (irregular heart beats), and sudden death can occur.

See also:

Alternative Names

Intoxication - cocaine

Review Date: 8/9/2007

Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000946

Drug abuse

admin — Thu, 04 Sep 2008 18:49:45 -0700

Overview

Definition
Alternative Names
Information
References

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Drug abuse is the use of illegal drugs, or the misuse of prescription or over-the-counter drugs.

See also:

Alternative Names

Substance abuse; Illicit drug abuse; Narcotic abuse; Hallucinogen abuse

Information

MARIJUANA (also called "grass," "pot," "reefer," "joint," "hashish," "cannabis," "weed," and "Mary Jane")

About 2 in 5 Americans have used marijuana at least once. About 10% of the population uses it on a regular basis.

The source of marijuana is the hemp plant (cannabis sativa). The active ingredients are THC (delta-9-tetrahydrocannabinol) and other cannabinoids, which are found in the leaves and flowering shoots of the plant.

Hashish is a substance taken from the tops of female plants. It contains the highest amount of THC.

The drug dose in marijuana varies greatly depending on how it is prepared.

You may feel the effects of marijuana within seconds to several minutes after breathing in the smoke (from a joint or a pipe), or within 30 - 60 minutes after eating foods containing marijuana, such as "hash brownies."

Because you can feel the effects almost right away, you can stop breathing in at any time to reduce the effect. In contrast, eating marijuana produces effects more slowly. These effects add up and last longer, making unpleasant reactions more likely.

The main effects of marijuana are on behavior, because the drug affects the central nervous system (CNS). Marijuana became popular because it gives people a feeling of joy (euphoria), relaxation, and increased sight, hearing, and taste with low-to-moderate doses. Most users also report an increase in their appetite ("the munchies").

Unpleasant effects that may occur include trouble telling oneself from others, changed body image, lack of orientation, and acute panic reactions or severe paranoia.

Some cases of severe delirium, seeing or hearing things that aren't there (hallucinations), and violence have also been reported. In such cases, marijuana may have been laced with another drug, such as PCP.

Marijuana has specific effects that may decrease your ability to perform tasks that require a lot of coordination (such as driving a car). It affects visual tracking and prolongs the sense of time.

The drug can affect learning because it can reduce your ability to concentrate and pay attention. Studies have shown that learning may become "state-dependent," meaning that information learned while under the influence of marijuana is best remembered in the same state of drug influence.

Other marijuana effects may include:

Airway (bronchial) irritation leading to narrowing of the airways (bronchoconstriction) or airway spasms (bronchospasm)
Bloodshot eyes
Increased heart rate and blood pressure
Pharyngitis, sinusitis, bronchitis, and asthma in heavy users
Possible serious effects on the immune system
Widening of the airways (bronchodilatation)

Regular users, when they stop marijuana use, may have withdrawal effects. These may include:

Agitation
Anxiety
Insomnia
Irritability

Because the substance formed when the body breaks down marijuana may be stored in the body's fat tissue, heavy users may show evidence of marijuana in urine tests for up to 1 month after stopping the drug.

The active substance in cannabis is believed to have medical properties. Many people believe that it can help treat nausea caused by chemotherapy in cancer patients.

Others claim that cannabis stimulates appetite in patients with AIDS, or is useful for treating glaucoma. While the active ingredient in marijuana has been approved as a medication (dronabinol) by the Food and Drug Administration for these purposes, the use of whole marijuana remains very controversial. Currently, cannabis is illegal even for medical use.

PHENCYCLIDINE (PCP, "angel dust")

It is difficult to estimate the current use of phencyclidine in the United States, because many people do not know that they have taken it. Other illegal substances (such as marijuana) can be laced with PCP without the user being aware of it.

A 1986 National Institute of Drug Abuse survey of high school seniors revealed that more than 12% of the students had used substances that cause hallucinations (hallucinogens), and that many of these drugs probably contained PCP.

PCP use in the U.S. dates back to 1967 when it was sold as the "Peace Pill" in the Haight-Ashbury district of San Francisco. It never became very popular because it had a reputation for causing "bad trips."

PCP use grew during the mid-1970s, mainly because of different packaging (sprinkling on leaves that are smoked) and marketing strategies. During the 1980s it became the most commonly used hallucinogen, especially among users aged 15 - 25.

Although phencyclidine was first created by a drug company searching for a new pain reliever (anesthetic), it was not good for human use because of its mind-altering (psychotropic) side effects.

PCP is no longer produced for legitimate, legal purposes. Unfortunately it can be made rather easily and cheaply by anyone who knows organic chemistry. This makes it a prime drug for the illegal drug industry. It is available illegally as a white powder that can be dissolved in either alcohol or water.

PCP may be taken in different ways. How fast it affects the user depends on how it is taken. If dissolved, PCP may be taken through a vein ("shot up") and its effects begin within seconds.

Sprinkled over dried parsley, oregano, or marijuana leaves, it can be smoked. The effects begin within 2 - 5 minutes, peaking at 15 - 30 minutes. Taken by mouth, in pill form, or mixed with food or drinks, PCP's effects usually start within 30 minutes. The effects tend to peak in about 2 - 5 hours.

Lower doses of PCP typically produce feelings of joy (euphoria) and less inhibition, similar to being drunk. Higher doses cause numbness throughout the body, and perception changes that may lead to extreme anxiety and violence.

Large doses may produce paranoia, "hearing voices" (auditory hallucinations), and psychosis similar to schizophrenia. Massive doses, usually from taking the drug by mouth, may cause:

Because of the pain-killing ( analgesic) properties of PCP, users who get seriously injured may not feel any pain.

Ketamine, a substance related to PCP, has become more popular in recent years. It is commonly called "Special K."

HALLUCINOGENS

In addition to PCP, other commonly abused hallucinogens include LSD (lysergic acid diethylamide), psilocybin (mushrooms, "shrooms"), and peyote (a cactus plant containing the active ingredient mescaline).

Some people have used naturally occurring hallucinogens, especially for religious rites, for centuries. The native people of Mexico used mushrooms containing psilocybin, and peyote use was common among southwestern Native Americans.

In contrast, LSD is an artificial substance, first developed by a drug company in 1938. Today, most hallucinogens are used experimentally rather than on a regular basis. Most users report only one or a few uses per year.

LSD is a very strong hallucinogen. Only tiny doses are needed to produce effects. Compared to LSD, psilocybin is 100 - 200 times weaker, and mescaline (peyote) is about 4,000 times weaker.

Hallucinogens can lead to extreme anxiety and lack of reality at the height of the drug experience ("bad trips"). These experiences can come back as a "flashback," even without using the drug again. Such experiences typically occur during times of increased stress, and tend to occur less often and intensely after stopping the drugs.

STIMULANTS ("speed," "crack," "coke," "snow," "crank," "go," "speedball," "crystal," "cross-tops," "yellow jackets")

Cocaine

The abuse of cocaine increased dramatically in the late 1980s and early 1990s, but is now on the decline.

Cocaine may be breathed in through the nose ("snorting"), or dissolved in water and taken through a vein (intravenously). When mixed with heroin for IV use, the combination is called a "speedball."

Through a simple chemical procedure, cocaine may be changed into a smokeable form known as freebase or crack. Smoking produces an instant and intense sense of joy (euphoria), which is attractive to abusers. Other effects include:

Feelings of increased confidence and energy
Less inhibition
Local numbness
Powerful stimulation of the central nervous system

Increased use of and addiction to cocaine probably occur because it produces a very pleasurable high that is very short lived. This encourages the user to use the drug more often or regularly to get the desired effects.

Both the need to use larger amounts of the drugs to get the same effect (tolerance) and dependence may occur with regular cocaine use. Regular users may have:

Depression
Loss of interest in school, work, family, and friends
Memory loss
Mood swings
Sleep problems
Social withdrawal

Because heavy use may cause paranoia, cocaine users may become violent.

AMPHETAMINES

During the 1950s and 1960s, amphetamines were often prescribed for conditions such as fatigue, obesity, and mild depression. Such use has stopped because the drugs are very addictive, and are now considered controlled substances.

Over-the-counter (OTC) amphetamine look-alike drugs are often abused. These drugs typically contain caffeine and other stimulants, and are sold as appetite suppressants or stay-awake/stay-alert aids.

If taken in high doses, these OTC drugs may cause the same high and other effects that occur with amphetamines. Regular users may have:

Dilated pupils
Irritability
Restlessness
Skin flushing
Sleep disturbances
Tremors
Weight loss

INHALANTS

Inhalant use became popular with young teens in the 1960s with "glue sniffing." Since then, a greater variety of inhalants have become popular. Inhalant use typically involves younger teens or school age children. Groups of children will use inhalants usually as an experiment.

Commonly abused inhalants include:

Aerosols for deodorants or hair sprays
Cleaning fluids
Gasoline
Liquid typewriter correction fluid
Model glue
Spray paints

The chemicals are poured into a plastic bag or soaked into rags, then breathed in. The drugs are absorbed through the respiratory tract and cause an altered mental state within 5 - 15 minutes.

Negative effects of inhalant abuse include:

Brain damage
Convulsions
Liver or kidney damage
Nerve damage ( peripheral neuropathy)
Sudden death

Most inhalant use occurs among teens or preteens who do not have access to illegal drugs or alcohol.

OPIATES, OPIOIDS, AND NARCOTICS

Opiates come from opium poppies. These drugs include morphine and codeine. Opioids are artificial substances that have the same effect as morphine or codeine.

Opiates and opioids include:

Heroin
Hydromorphone
Oxycodone
Meperidine
Methadone
Propoxyphene

All of these substances, natural or man-made, are considered narcotics. Used as painkillers, these drugs:

Change perception of painful stimuli
Decrease anxiety
Promote a relaxed state (sedation)

Because heroin is commonly injected into a vein (used intravenously), there are health concerns about sharing contaminated needles among IV drug users. Complications of sharing contaminated needles include hepatitis, HIV infection, and AIDS.

STAGES OF JUVENILE DRUG USE

There are several stages of drug use. Young people seem to move more quickly through the stages than do adults.

Experimental use -- typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures.
Regular use -- the user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to "handle" the drug.
Daily preoccupation -- the user loses any motivation; does not care about school and work; behavior changes become obvious; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase.
Dependence -- cannot face daily life without drugs; denies problem; physical condition gets worse; loss of "control" over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends by this time.

TREATMENT OVERVIEW

As with any other area of medicine, the least intensive treatment should be the starting point.

Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use behavior modification techniques, which are designed to get users to recognize their behaviors.

Treatment programs include counseling both for the person (and perhaps family), and in group settings. Drug abuse treatment programs have a long after-care part (when the user is released from the medical facility), and provide peer support.

Drug addiction is a serious and complicated health condition that requires both physical and psychological treatment and support. It is important to be evaluated by a trained professional to determine the best care.

CALL YOUR HEALTH CARE PROVIDER

If you are concerned about the possibility of getting addicted to any prescribed medications
If you are concerned about possible drug abuse by yourself or a family member
If you are interested in getting more information on drug abuse
If you are seeking treatment of drug abuse for yourself or a family member

Also seek out information and support from local 12-step support groups, such as:

Al-anon/Alateen
Alcoholics Anonymous (AA)
Narcotics Anonymous (NA)

Other support groups include:

LifeRing Recovery
Moderation Management
SMART Recovery

See also:

References

National Institutes of Health. Principles of Drug Addiction Treatment: A Research Based Guide. NIH Publication No. 00-4180, printed October 1999, reprinted July 2000.

Kleber HD, Weiss RD, Anton RF, George TP, Greenfield SF, Kosten TR, et al. Work Group on Substance Use Disorders. Treatment of patients with substance use disorders, second edition. Am J Psychiatry, 2007;164:5-123.

Review Date: 2/6/2008

Reviewed By: Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_001945

Drug abuse and dependence

admin — Thu, 04 Sep 2008 18:47:11 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Support Groups
Expectations (prognosis)
Complications
Calling your health care provider
Prevention

Illustrations

Depression and men

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Drug addiction (dependence) is compulsively using a substance, despite its negative and sometimes dangerous effects. Drug abuse is using a drug excessively, or for purposes for which it was not medically intended.

A physical dependence on a substance (needing the drug to function) is not always part of the definition of addiction. Some drugs (for example, some blood pressure medications) don't cause addiction but do cause physical dependence. Other drugs cause addiction without physical dependence (cocaine withdrawal, for example, doesn't have symptoms like vomiting and chills; it mainly involves depression).

See also:

Alternative Names

Drug addiction; Addiction - drug

Causes, incidence, and risk factors

Drug abuse can lead to drug dependence or addiction. People who use drugs for pain relief may become dependent, although this is rare in those who don't have a history of addiction.

The exact cause of drug abuse and dependence is not known. However, the person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors.

Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, post-traumatic stress disorder, or another psychological problem.

Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.

Signs of drug use in children include but are not limited to:

A change in the child's friends
Withdrawn behavior
Long unexplained periods away from home
Lying
Stealing
Involvement with the law
Problems with family relations
Acting drunk or high (intoxicated), confused, impossible to understand, or unconscious
Distinct changes in behavior and normal attitude
Decreased school performance

Commonly abused substances include:

Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone (Dilaudid), and Oxycontin.
Central nervous system stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). Caffeine and nicotine are the most commonly used stimulants. These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance).
Central nervous system depressants include barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepine (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. The most commonly used, by far, is alcohol. These substances produce a soothing sedative and anxiety-reducing effect and can lead to dependence.
Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "Angel Dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence.
Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish. Although used for their relaxing properties, THC-derived drugs can also lead to paranoia and anxiety.

People may become high on drugs or overdose by accident or on purpose. Drug withdrawal symptoms can occur when a person stops or reduces their use of a substance. Withdrawal symptoms vary, depending on the abused substance. When withdrawal symptoms begin depends on the length of time the drug normally stays within the body. Drug intoxication, overdose, and withdrawal can sometimes be life-threatening.

Symptoms

OPIATES AND NARCOTICS

Symptoms of opiate and narcotic use:

Needle marks on the skin in some cases (called "tracks")
Scars from skin abscesses
Rapid heart rate
Small pupils (pinpoint)
Relaxed and/or euphoric state ("nodding")
Coma, respiratory depression leading to coma, and death in high doses

Symptoms of opiate and narcotic withdrawal:

Anxiety and difficulty sleeping
Sweating
Goose bumps (piloerection)
Runny nose (rhinorrhea)
Stomach cramps or diarrhea
Enlarged (dilated) pupils
Nausea and vomiting
Excessive sweating
Increase in blood pressure, pulse, and temperature

CENTRAL NERVOUS SYSTEMSTIMULANTS

Symptoms of cocaine use:

Exaggerated feeling of well-being (euphoria)
Dilated pupils
Fast heart rate
Restlessness and hyperactivity

Symptoms of cocaine withdrawal:

Fatigue and malaise
Depression
Very clear and unpleasant dreams

CENTRAL NERVOUS SYSTEM DEPRESSANTS

Symptoms of alcohol use:

Slurred speech
Lack of coordination
Decreased attention span
Impaired judgment

Symptoms of alcohol withdrawal:

Anxiety
Shaking (tremors)
Seizures
Increased blood pressure, pulse, and temperature
Delirium

HALLUCINOGENS

Symptoms of LSD use:

Anxiety
Frightening images of things that aren't there (hallucinations)
Paranoid delusions
Blurred vision
Dilated pupils
Tremors

Signs and tests

Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends upon the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests; however, urine drug screens are done more often.

Opiates and narcotics are usually in the urine 12 to 36 hours after the last use, depending on the amount used and how often the drug was used.

CNS stimulants such as cocaine can be found in urine for 1 to 12 days, again depending on how often the drog was used.

CNS depressants such as Valium and Xanax are found up to 7 days after the last day of use, mostly depending on the substance used and how quickly the body removes it (its half-life).

Most hallucinogens also can be found in the urine up to 7 days after the last use. However, marijuana can be found for up to 28 days in regular users.

Treatment

Treatment for drug abuse or dependence begins with recognizing the problem. Though "denial" used to be considered a symptom of addiction, recent research has shown that people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or "confronted."

Treatment of drug dependency involves weaning off the drug gradually (detoxification), support, and stopping the drug (abstinence). People with acute intoxication or drug overdose may need emergency treatment. Sometimes, the person loses consciousness and might need to be on a breathing machine (mechanical respirator) temporarily. The treatment depends on the drug being used.

Detoxification is the gradual withdrawal of an abused substance in a controlled environment. Sometimes a drug with a similar action is taken instead, to reduce the side effects and risks of withdrawal. Detoxification can be done on an inpatient or outpatient basis.

If the person also has depression or another mood disorder, it should be treated. Very often, people start abusing drugs in their effort to self-treat mental illness.

For narcotic dependence, some people are treated with methadone or similar drugs to prevent withdrawal and abuse. The goal is to enable the person to live as normal a life as possible.

Support Groups

Many support groups are available in the community. They include Narcotics Anonymous (NA), Ala-Teen, and Al-Anon. Most of these groups follow the 12-Step program used in Alcoholics Anonymous (AA). SMART Recovery and LifeRing Recovery are programs that do not use the 12-step approach. You can find support groups in your phone book.

Expectations (prognosis)

Drug abuse and dependence may lead to a fatal drug overdose. Some people relapse after they have stopped using drugs. Relapses can lead to continued dependence.

Complications

The complications of drug abuse and dependence include:

Depression
Relapse of drug abuse
Drug overdose
Bacterial endocarditis, hepatitis, thrombophlebitis, pulmonary emboli, malnutrition, or respiratory infections, caused by drug use through a vein (intravenous)
Infection with HIV through shared needles
Unsafe sexual practices, which may result in unwanted pregnancies, sexually transmitted diseases, HIV, or hepatitis.
Problems with the law
Increase in various cancer rates, for example, lung and pharynx cancer are linked to nicotine use, mouth and stomach cancer are associated with alcohol abuse and dependence
Problems with memory and concentration, for example with hallucinogen use, including marijuana (THC)

Calling your health care provider

Call for an appointment with your health care provider if you are addicted to drugs and would like to get off of them, or if you have been cut off from your drug supply and are at risk of withdrawal. Most employers also offer referral services for their employees with substance abuse problems.

Prevention

Drug education programs may be helpful though none has proved effective in the long term.

Review Date: 7/27/2007

Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine, Pediatrics and Psychiatry, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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Source Doc: 1_001522

Toxicology screen

admin — Thu, 04 Sep 2008 19:12:29 -0700

Overview

Definition
Alternative Names
How the test is performed
How to prepare for the test
How the test will feel
Why the test is performed
Normal Values
What abnormal results mean
What the risks are
Special considerations

Illustrations

Blood test

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

A toxicology screen refers to various tests to determine the type and approximate amount of legal and illegal drugs a person has taken.

Alternative Names

Barbiturates - screen; Benzodiazepines - screen; Amphetamines - screen; Analgesics - screen; Antidepressants - screen; Narcotics - screen; Phenothiazines - screen; Drug abuse screen; Blood alcohol test

How the test is performed

Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after swallowing the medication, using stomach contents that are obtained through gastric lavage or after vomiting.

For information on giving a blood sample from a vein, see venipuncture.

For information providing a urine sample, see clean catch urine sample. In some circumstances, you may need to provide the urine sample in the presence of the nurse or technician to verify that the urine sample came from you and was not tampered with.

How to prepare for the test

No special preparation is needed. If able, tell your health care provider what drugs (including over-the-counter medications) you have taken, including when and how much.

This test is sometimes part of an investigation for drug use or abuse. Special consents, handling and labeling of specimens, or other special procedures may be required.

How the test will feel

Blood test:

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Urine test:

A urine test involves normal urination. There is no discomfort.

Why the test is performed

This test is often done in emergency medical situations. It can be used to evaluate possible accidental or intentional overdose or poisoning. It may help determine the cause of acute drug toxicity, to monitor drug dependency, and to determine the presence of substances in the body for medical or legal purposes.

Additional reasons the test may be performed:

Alcoholism
Alcohol withdrawal state
Altered mental state
Analgesic nephropathy
Complicated alcohol abstinence (delirium tremens)
Delirium
Dementia
Drug abuse monitoring
Fetal alcohol syndrome
Intentional overdose
Stroke secondary to cocaine
Unconscious patient

If the test is used as a drug screen, it must be done during a certain time period after the drug is taken or while forms of the drug can still be detected in the body. Examples are below:

Alcohol: 3 to 10 hours
Amphetamines: 24 to 48 hours
Barbiturates: up to 6 weeks
Benzodiazepines: up to 6 weeks with high level use
Cocaine: 2 to 4 days; up to 10 to 22 days with heavy use
Codeine: 1 to 2 days
Heroin: 1 to 2 days
Hydromorphone: 1 to 2 days
Methadone: 2 to 3 days
Morphine: 1 to 2 days
Phencyclidine (PCP): 1 to 8 days
Propoxyphene: 6 to 48 hours
Tetrahydrocannabinol (THC): 6 to 11 weeks with heavy use

Normal Values

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

A normal value usually means that alcohol, prescription medications that are not prescribed, and illegal drugs are not found.

A blood toxicology screen can determine the presence and level (amount) of a drug in your body.

Urine sample results are usually reported as positive (substance is found) or negative (no substance is found).

What abnormal results mean

Elevated levels of alcohol or prescription drugs can be a sign of intentional or accidental intoxication or overdose.

The presence of illegal drugs or drugs not prescribed for the person indicates illicit drug use.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)

Special considerations

Commonly found substances on a toxicology screen include:

Alcohol (ethanol) -- "drinking" alcohol
Amphetamines
Antidepressants
Barbiturates and hypnotics
Benzodiazepines
Cocaine
Marijuana
Narcotics
Non-narcotic pain medicines including acetaminophen and anti-inflammatory drugs
PCP
Phenothiazines (antipsychotic or tranquilizing medications)
Prescription medications, any type

Review Date: 10/29/2007

Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_003578

Agitation

admin — Thu, 04 Sep 2008 19:07:22 -0700

Overview

Definition
Alternative Names
Considerations
Common Causes
Home Care
Call your health care provider if
What to expect at your health care provider's office
References

Illustrations

Central nervous system

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Agitation is an unpleasant state of extreme arousal, increased tension, and irritability.

Alternative Names

Restlessness

Considerations

Extreme agitation can lead to:

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks and even months. Pain, stress, and fever can all increase agitation.

Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it can be a sign of disease.

When agitation lasts for hours and there is changed awareness (altered consciousness), doctors often call this "delirium." Usually this has a medical cause such as alcohol withdrawal or an infection (in elderly adults). Older adults often have delirium while hospitalized.

Common Causes

Causes of agitation include:

Alcohol withdrawal
Caffeine
Cocaine, hallucinogenic drugs, ephedrine
Cocaine withdrawal
Hyperthyroidism
Medical tests that involve injecting a "contrast medium" into the patient
Nicotine withdrawal
Opiate withdrawal
Theophylline or other medicines
Vitamin B6 deficiency

Agitation can be associated with:

Home Care

The following can reduce agitation:

A calm environment
Adequate lighting
Plenty of sleep
Stress-reducing measures

Don't restrain an overly-agitated person if possible. This usually worsens the problem.

Communicating your feelings is important.

Call your health care provider if

Contact your health care provider if you have prolonged or severe agitation, especially if you also have other unexplained symptoms.

What to expect at your health care provider's office

Your health care provider will take a medical history and do a physical examination.

To help better understand your agitation, your doctor may ask the following questions:

Type
- Are you more talkative than usual or do you feel pressure to keep talking?
- Do you find yourself doing purposeless activities (e.g., pacing, hand wringing)?
- Are you extremely restless?
- Are you trembling or twitching?
Time pattern
- Was the agitation a short episode?
- Is the agitation persistent?
  - How long did it last -- for how many day(s)?
Aggravating factors
- Does the agitation seem to be triggered by reminders of a traumatic event?
- Did you notice anything else that may have triggered agitation?
- Do you take any medications, especially steroids or thyroid medicine?
- How much alcohol do you drink?
- How much caffeine do you drink?
- Do you use any drugs, such as cocaine, narcotics, or "speed" (amphetamines)?
Other
- What other symptoms do you have?
- Is there confusion, memory loss, hyperactivity, or hostility (these symptoms can play an important role in diagnosis).

Diagnostic tests may include:

Blood studies (such as CBC, blood differential, thyroid studies, drug screening)
Head CT scan or cranial MRI (head)
Lumbar puncture or spinal tap
Vital signs (temperature, pulse, breathing rate, blood pressure)
X-rays of the skull

References

Moore DP, Jefferson JW. Moore & Jefferson: Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby; 2004:chap 155.

Review Date: 5/26/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_003212