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DOCUMENT RESUME
ED 068 312 SE 014 712
TITLE What Will Happen if . . . A Programmed InstructionCourse on Drugs and Their Effects.
INSTITUTION Health Services and Mental Health Administration(DHEW), Bethesda, Md.
REPORT NO DHEW-HSM-72-9134PUB DATE 72NOTE 54p.AVAILABLE FROM Superintendent of Documents, Government Printing
Office, Washington, D.C. 20402 (Stock No. 1724-0233,$0.55)
EDRS PRICE MF-$0.65 HC-$3.29DESCRIPTORS Drug Abuse; *Drug Education; Health Education;
*Instructional Materials; Programed Instruction;*Programed Texts; *Secondary Grades; Social Studies;*Units of Study (rubject Fields)
ABSTRACTDeveloped by the National Institute of Mental Health,
this booklet offers a programed instruction course on drugs and theireffects. The purpose of the text is to learn about specific drugswhich are currently being used and abused by a large group of peoplein our society. Narcotics, stimulants, depressants, hallucinogens,and marihuana are studied. The material is self-teaching, requiringabout two hours for completion. Each page is divided into framescontaining statements and questions with space provided for writtenanswers. Answers for individual frames are printed opposite thefollowing frame in the answer column to allow for movement down thepage without exposing answers to the current question prematurely. Areview section is included. (BL)
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,`IA
. .
ja
a A A
how
to u
se th
is p
rogr
amIf
this
is th
e fir
st ti
me
you
have
use
d a
prog
ram
med
inst
ruct
ion
cour
se, y
ou s
houl
d re
ad th
ese
inst
ruct
ions
to b
e su
re y
ouun
ders
tand
how
to p
roce
ed.
Thi
s m
ater
ial i
s se
lf-te
achi
ng a
nd y
ou s
houl
d w
ork
thro
ugh
itat
you
r ow
n pa
ce. T
he p
rogr
am w
ill p
roba
bly
take
you
abo
ut 2
hour
s to
com
plet
e if
you
go th
roug
h it
in o
ne s
ittin
g. T
here
are
spec
ified
pla
ces
in th
e te
xt w
here
you
can
sto
p fo
r br
eaks
if y
ouw
ish.
Eac
h pa
ge is
div
ided
into
par
ts b
y ho
rizon
tal l
ines
. Eac
h pa
rt is
calle
d a
"fra
me.
" A
fram
e m
ay h
ave
just
a fe
w li
nes
or a
n en
tire
page
. It m
ay in
clud
e a
stat
emen
t and
a q
uest
ion,
it m
ay in
clud
eon
ly a
sta
tem
ent,
or it
may
incl
ude
only
a q
uest
ion.
You
will
know
you
hav
e co
mpl
eted
a fr
ame
whe
n yo
u co
me
to th
e ne
xtho
rizon
tal l
ine.
All
fram
es a
re c
ompl
eted
on
the
page
on
whi
chth
ey b
egin
.
All
fram
es w
hich
incl
ude
a qu
estio
n w
ill p
rovi
de a
spa
ce fo
ryo
ur w
ritte
n an
swer
.It
is s
tron
gly
reco
mm
ende
d th
at y
ouW
RIT
E o
ut y
our
answ
er in
the
spac
e pr
ovid
ed. T
hese
que
stio
nsar
e no
t des
igne
d as
a te
st; t
hey
are
desi
gned
to h
ave
you
resp
ond
to th
e m
ater
ial y
ou a
re le
arni
ng. Y
ou w
ill r
etai
n m
ore
info
rmat
ion
if yo
u fo
llow
this
pro
cess
.
The
ans
wer
to th
e qu
estio
n fo
r ea
ch in
divi
dual
fram
e is
prin
ted
dire
ctly
opp
osite
the
follo
win
g fr
ame
in th
e an
swer
col
umn
onth
e rig
ht. F
or e
xam
ple,
the
answ
er to
que
stio
n 1-
1 is
prin
ted
inth
e co
lum
n to
the
right
of a
nd d
irect
ly o
ppos
ite q
uest
ion
1-2;
the
answ
er to
que
stio
n 1-
2 is
prin
ted
to th
e rig
ht o
f and
dire
ctly
oppo
site
que
stio
n 1-
3, a
nd s
o on
. Thi
s al
low
s yo
u to
mov
e a
shie
ld d
own
the
page
with
out e
xpos
ing
the
answ
er to
the
curr
ent
ques
tion
prem
atur
ely.
Whi
le y
ou a
re w
orki
ng o
n a
fram
e yo
u sh
ould
kee
p al
l of t
here
mai
ning
dat
a co
vere
d. C
heck
eac
h re
spon
se a
s yo
u pr
ocee
d.If
you
find
you
are
choo
sing
inco
rrec
t ans
wer
s, g
o ba
ck o
ver
the
text
ual m
ater
ial.
Rer
ead
the
fram
es u
ntil
you
unde
rsta
nd th
eco
rrec
t res
pons
e.
Thi
s pr
ogra
m w
as p
repa
red
by C
reat
ive
Stu
dies
Inc.
, Bos
ton,
Mas
sach
uset
ts, u
nder
con
trac
t #H
SM
-42-
70-1
42 fr
om th
eN
atio
nal I
nstit
ute
of M
enta
l Hea
lth, U
.S. D
epar
tmen
t of H
ealth
,E
duca
tion,
and
Wel
fare
, Hea
lth S
ervi
ces
and
Men
tal H
ealth
Adm
inis
trat
ion.
For
sal
e by
the
Sup
erin
tend
ent o
f Doc
umen
ts, U
.S. G
over
nmen
t Prin
ting
Offi
ceW
ashi
ngto
n, D
.C. 2
0402
Pric
e 55
cen
tsS
tock
Num
ber
1724
-023
3
tabl
e of
con
tent
s
page
I.in
trod
uctio
n: d
efin
ing
our
term
s2
(fra
mes
I -1
to 1
-17
)
II.na
rcot
ics
(fra
mes
N-1
8 to
N-4
6)
III.
stim
ulan
ts
(fra
mes
S-4
7 to
S-7
3)
7
16
IV.
depr
essa
nts
24(f
ram
es D
-74
to D
-98)
V.
hallu
cino
gens
32
(fra
mes
H-9
9 to
H-1
24)
VI.
mar
ihua
na(f
ram
es M
-125
to M
-147
)
VII.
revi
ew
(fra
mes
R-1
48 to
R-1
63)
1
39 46
2
part
Iin
trod
uctio
n: d
efin
ing
our
term
s
1-1
The
pur
pose
of t
his
text
is to
hel
p yo
u le
arn
abou
t spe
cific
dru
gs w
hich
are
curr
ently
bei
ng u
sed
and
abus
ed
by a
larg
e gr
oup
of p
eopl
e in
our
soc
iety
.
Bef
ore
one
can
disc
uss
the
char
acte
ristic
s of
spe
cific
dru
gs, h
owev
er, i
t is
nece
ssar
y to
unde
rsta
nd th
epa
rtic
ular
lang
uage
of t
he s
ubje
ct m
atte
r.
We
shal
l beg
in, t
here
fore
, by
defin
ing
the
rele
vant
term
s th
at w
ill b
e us
ed th
roug
hout
the
text
.G
o on
tone
xt fr
ame.
1-2
Eac
h dr
ug w
e sh
all d
iscu
ss c
an c
reat
e a
spec
ific
kind
of d
epen
denc
e. S
uch
depe
nden
ce m
aybe
onl
y ps
y-
chol
ogic
al o
r it
may
be
both
psy
chol
ogic
al a
nd p
hysi
cal.
The
nat
ure
of d
epen
denc
y fo
r a
part
icul
ar d
rug
is e
xpre
ssed
in te
rms
of it
s
and
char
acte
ristic
s.
1-3
Let u
s ex
amin
e th
e ch
arac
teris
tics
of p
sych
olog
ical
dep
ende
nce.
The
indi
vidu
al w
ho is
psy
chol
ogic
ally
dep
ende
nt o
n a
drug
has
a s
tron
g ne
ed to
con
tinue
taki
ng th
e dr
ugpe
riodi
cally
or
cont
inuo
usly
. His
bod
y do
es n
ot r
eally
nee
d th
e dr
ug, b
ut h
e ha
s a
crav
ing
for
it if
hedo
esn'
t
take
it. H
e w
ants
to b
e in
wha
teve
r st
ate
the
drug
put
s hi
m in
.
Whe
n an
indi
vidu
al fe
els
a st
rong
nee
d to
take
a c
hem
ical
sub
stitu
te p
erio
dica
lly o
r co
ntin
uous
lyhe
is s
aid
to
have
a
1-1
Go
on to
next
fram
e.
1-2
phys
ical
psyc
holo
gica
l(e
ither
ord
er)
1-4
Wha
t hap
pens
if s
uch
a dr
ug is
dis
cont
inue
dor
den
ied?
If a
str
ong
psyc
holo
gica
l dep
ende
nce
has
deve
lope
d,th
e in
divi
dual
will
und
oubt
edly
see
kto
get
mor
e of
it b
ecau
se h
e fe
els
ata
loss
with
out i
t. If
it is
per
man
ently
deni
ed, h
e w
ill p
roba
bly
go th
roug
ha
perio
d of
rea
djus
tmen
t acc
ompa
nied
by
som
e em
otio
nal t
raum
a. If
the
depe
nden
ce is
psy
chol
ogic
al, a
nd n
otph
ysic
al, t
here
will
be
no p
hysi
cal c
ompl
icat
ions
follo
win
g di
scon
tinu-
ance
of t
he d
rug.
Whe
n a
drug
that
pro
duce
s ps
ycho
logi
cal
depe
nden
ce is
dis
cont
inue
d th
e in
divi
dual
will
hav
e to
rea
djus
t
(phy
sica
lly/p
sych
olog
ical
ly)
1-3
psyc
holo
gica
lde
pend
ence
1-5
A s
econ
d el
emen
t of d
rug
depe
nden
ceis
the
deve
lopm
ent o
f tol
eran
ce.
Thi
s m
eans
that
the
body
's c
ells
beco
me
accu
stom
ed to
a c
erta
in le
vel o
f dru
g an
d no
long
er r
espo
ndto
that
dos
e le
vel.
The
dos
e of
the
drug
mus
t the
n be
incr
ease
d to
ach
ieve
the
desi
red
effe
ct.
Whe
n an
indi
vidu
al b
ecom
es to
lera
ntto
a p
artic
ular
dos
e of
a d
rug,
he
mus
t (in
crea
se/d
ecre
ase)
the
dose
to
achi
eve
the
desi
red
effe
cts
1-4
psyc
holo
gica
lly
1-6
An
indi
vidu
al c
an d
evel
op to
lera
nce
to a
dru
g on
whi
ch h
e is
onl
yps
ycho
logi
cally
, and
not
phy
sica
lly, d
epen
d-en
t. F
or e
xam
ple,
tole
ranc
eto
LS
D d
evel
ops
rapi
dly.
But
ther
eis
no
evid
ence
that
the
drug
crea
tes
phys
ical
depe
nden
ce.
Alth
ough
an
indi
vidu
al is
psy
chol
ogic
ally
depe
nden
t on
a dr
ug, h
e ca
n de
velo
pto
it.
1117
,
1-5
incr
ease
1-7
A th
ird fa
ctor
in d
rug
use
is th
e de
velo
pmen
t of p
hysi
cal d
epen
denc
e.T
he m
ost r
elia
ble
crite
ria o
f whe
ther
adr
ug p
rodu
ces
phys
ical
dep
ende
nce
is th
e ap
pear
ance
of p
hysi
cal w
ithdr
awal
sym
ptom
s vi
tien
the
drug
isdi
scon
tinue
d.
Phy
sica
l with
draw
al s
ympt
oms
(alw
ays,
som
etim
es, n
ever
)oc
cur
whe
n a
drug
that
has
prod
uced
phy
sica
l dep
ende
nce
is d
isco
ntin
ued.
1-6
tole
ranc
e
3
4
1-8
......
....
With
draw
al o
ccur
s be
caus
e th
e co
ntin
uous
adm
inis
trat
ion
of a
dru
g ha
s pr
oduc
ed c
erta
in c
hang
es in
the
body
's c
ells
. The
bod
y no
w n
eeds
the
drug
to fu
nctio
n in
its
accu
stom
ed fa
shio
n.
If th
e dr
ug is
dis
cont
inue
d, th
e no
rmal
func
tioni
ng o
f the
bod
y is
dis
rupt
ed. T
he p
roce
ss o
f with
draw
al a
llow
sth
e ce
lls to
ret
urn
to th
eir
pre-
drug
ged
stat
e an
d re
duce
s th
e le
vel o
f tol
eran
ce.
The
with
draw
al p
roce
ss is
a (
phys
ical
/psy
chol
ogic
al)
read
just
men
t.
1-7
alw
ays
1-9
Phy
sica
l with
draw
al d
oes
not m
ean
an in
divi
dual
is n
o lo
nger
dep
ende
nt o
n a
drug
. He
still
mus
t ove
rcom
e
his
depe
nden
cy if
it d
evel
oped
.
1-8
phys
ical
1-10
Tol
eran
ce is
alw
ays
deve
lope
d to
a d
rug
that
pro
duce
s ph
ysic
al d
epen
denc
e. In
add
ition
, psy
chol
ogic
alde
pend
ence
can
als
o de
velo
p.1-
9
psyc
holo
gica
l
1-11
To
revi
ew, w
hen
an in
divi
dual
exp
erie
nces
a s
tron
g de
sire
to c
ontin
ue ta
king
a d
rug
for
emot
iona
l, ra
ther
than
phys
ical
, rea
sons
we
wou
ld s
ay th
at h
e ha
s de
velo
ped
ade
pend
ence
on
the
drug
.
a1-
10
Go
on to
next
fram
e.
1-12
With
reg
ard
to a
dru
g th
at p
rodu
ces
phys
ical
dep
ende
nce
com
plet
e th
e fo
llow
ing
sent
ence
s:
a) T
oler
ance
(al
way
s, s
omet
imes
, nev
er)
deve
lops
.
1-11
psyc
holo
gica
l
b) T
here
are
(al
way
s, s
omet
imes
, nev
er)
phys
ical
with
draw
al s
ympt
oms
upon
dis
-co
ntin
uanc
e.
1-13
With
reg
ard
to a
dru
g th
at p
rodu
ces
only
psy
chol
ogic
alde
pend
ence
, com
plet
e th
e fo
llow
ing
sent
ence
s:
a) T
oler
ance
(al
way
s, s
omet
imes
, nev
er)
deve
lops
.
b) T
here
are
(al
way
s, s
omet
imes
, nev
er)
phys
ical
with
draw
al s
ympt
oms
upon
dis
-co
ntin
uanc
e.
1-12
a) a
lway
s
b) a
lway
s
1-14
Ext
rem
e dr
ug d
epen
denc
e w
ould
incl
ude
whi
ch o
f the
follo
win
g?
a) p
hysi
cal d
epen
denc
e
b) p
sych
olog
ical
dep
ende
nce
c) d
evel
opm
ent o
f tol
eran
ce
d) w
ithdr
awal
sic
knes
s up
on d
isco
ntin
uanc
e
e) p
sych
olog
ical
trau
ma
upon
dis
cont
inua
nce
f)al
l of t
he a
bove
1-13
a) s
omet
imes
b) n
ever
5
6
1 -1
5T
hrou
ghou
t the
text
we
will
ref
er to
the
sour
ce o
f spe
cific
dru
gs a
s be
ing
eith
er n
atur
al,
synt
hetic
, or
sem
i.sy
nthe
tic. N
atur
al r
efer
s to
a d
rug
that
is o
btai
ned
dire
ctly
from
a p
lant
, e.g
., m
arih
uana
com
esfr
om th
epl
ant C
anna
bis
sativ
a.
Syn
thet
ic d
rugs
are
man
ufac
ture
d in
the
labo
rato
ry fr
om th
eir
activ
e in
gred
ient
s. M
ost o
f the
se d
rugs
will
have
com
mer
cial
trad
e na
mes
as
wel
l as
gene
ric n
ames
.
Cer
tain
dru
gs fa
ll be
twee
n th
ese
clas
sific
atio
ns a
nd a
re c
alle
d se
mis
ynth
etic
. For
exa
mpl
e,m
orph
ine
is a
natu
ral d
rug
obta
ined
dire
ctly
from
the
opiu
m p
oppy
. Her
oin,
how
ever
, is
deriv
ed b
y tr
eatin
g th
em
orph
ine
chem
ical
ly. H
eroi
n, th
eref
ore,
is c
lass
ified
as
sem
i-syn
thet
ic.
Cla
ssify
the
follo
win
g dr
ugs
as n
atur
al, s
emi-s
ynth
etic
, or
synt
hetic
.
a) m
orph
ine
b) m
arih
uana
c) h
eroi
n
d) S
econ
al
1-14
f)al
l of t
heab
ove
1-16
The
re a
re m
any
poss
ible
def
initi
ons
for
the
term
dru
g ab
use.
For
exa
mpl
e, o
ne in
divi
dual
may
def
ine
it as
taki
ng a
ny d
rug
with
out m
edic
alsu
perv
isio
n. A
noth
er m
ight
say
it is
any
use
of a
n ill
egal
dru
g. A
third
mig
ht s
ay th
at s
ocie
ty c
anno
t def
ine
drug
abu
se;e
ach
pers
on h
as th
e
right
to d
o w
hat h
e w
ants
to h
is b
ody
and
his
min
d.
Obv
ious
ly, t
here
is a
wid
e ra
nge
of p
ossi
ble
defin
ition
s in
bet
wee
n.
1-15
a) n
atur
alb)
nat
ural
c) s
emis
ynth
etic
d) s
ynth
etic
1-17
In th
e ne
xt fe
w s
ectio
ns, w
e w
ill d
iscu
ss th
e m
ain
char
acte
ristic
s of
five
cat
egor
ies
ofdr
ugs.
In g
ener
al, t
he
disc
ussi
on w
ill in
clud
e th
e de
finiti
on, d
eriv
atio
n, m
etho
ds o
f adm
inis
trat
ion,
and
effe
ct o
f eac
h dr
ug.
1-16
Go
on to
next
fram
e.
GO
ON
TO
NE
XT
SE
CT
ION
part
IIna
rcot
ics
N-1
8 A
nar
cotic
is a
dru
g th
at r
elie
ves
pain
and
indu
ces
slee
p. T
he n
arco
ticdr
ugs
(als
o ca
lled
opia
tes)
incl
ude:
opiu
m a
nd m
orph
ine,
der
ived
from
the
opiu
m p
oppy
see
d po
d; h
eroi
n, o
btai
ned
by c
hem
ical
lyal
terin
g m
or-
phin
e; a
nd v
ario
us s
ynth
etic
dru
gs o
f sim
ilar
char
acte
ristic
s su
chas
met
hado
ne.
Nar
cotic
dru
gs a
re d
efin
ed a
s th
ose
whi
chan
d
N-1
9In
this
text
dru
gs a
re c
lass
ified
pha
rmac
olog
ical
ly. H
owev
er, t
he F
eder
aldr
ug la
ws
clas
sify
a n
umbe
r of
drug
s ac
cord
ing
to th
eir
pote
ntia
l for
abu
se, w
heth
er th
eyar
e be
nefic
ial a
nd s
afe
for
med
ical
trea
tmen
t and
whe
ther
they
cou
ld r
esul
t in
psyc
holo
gica
l or
phys
ical
dep
ende
nce.
One
exa
mpl
eis
coc
aine
, ast
imul
ant
whi
ch w
ill b
e di
scus
sed
in th
e ne
xt c
hapt
er. A
noth
er is
mar
ihua
na, d
iscu
ssed
inP
art V
I. N
eith
er c
ocai
ne n
orm
arih
uana
is a
nar
cotic
.
N-1
8
relie
ve p
ain
indu
ce s
leep
(eith
er o
rder
)
N-2
0M
ost o
f thi
s ch
apte
r w
ill b
e de
vote
d to
a d
iscu
ssio
n of
her
oin
and
mor
phin
e.
One
impo
rtan
t diff
eren
ce b
etw
een
the
two
drug
s is
in th
eir
stre
ngth
. Her
oin
is fr
om tw
o to
six
tim
es s
tron
ger
than
mor
phin
e. S
ince
her
oin
is r
arel
y so
ld in
its
pure
form
, how
ever
, the
act
ual s
tren
gth
of a
ny d
rug
sam
-pl
ing
depe
nds
on h
ow m
uch
it ha
s be
en d
ilute
d w
ith a
dditi
ves.
Mor
phin
e is
(st
rong
er/w
eake
r)th
an h
eroi
n.
7
N-1
9
Go
on to
next
fram
e.
8
N-2
1S
econ
dly,
alth
ough
mor
phin
e is
pre
scrib
ed to
rel
ieve
pai
n, h
eroi
n is
not
use
d in
med
icin
e. It
sus
e in
any
situ
-at
ion
in th
e U
nite
d S
tate
s ot
her
than
med
ical
res
earc
h is
ille
gal.
Labe
l the
follo
win
g st
atem
ents
as
Tru
e or
Fal
se:
a) M
orph
ine
is p
resc
ribed
to r
elie
ve p
ain
b) In
its
pure
form
, her
oin
is s
tron
ger
than
mor
phin
e
c) T
he u
se o
f mor
phin
e is
ille
gal
N-2
0
wea
ker
N-2
2 O
piat
es a
re d
epre
ssan
ts. T
hey
depr
ess
spec
ific
area
s of
the
brai
n, r
elie
ving
tens
ion.
The
y al
so d
imin
ish
othe
rpr
imar
y dr
ives
suc
h as
hun
ger,
thirs
t, an
d se
x.
The
abi
lity
to d
epre
ss s
peci
fic a
reas
of t
he b
rain
giv
es m
orph
ine
its m
edic
alus
e as
an
N-2
1
a) T
rue
b) T
rue
c) F
alse
N-2
3H
eroi
n an
d m
orph
ine
can
be s
niffe
d bu
t the
y ar
e us
ually
adm
inis
tere
d by
inje
ctio
n ei
ther
just
und
er th
e sk
in(c
alle
d "s
kin-
popp
ing"
) or
dire
ctly
into
a v
ein
(cal
led
"mai
nlin
ing"
).
The
usu
al s
pot f
or in
ject
ion
is th
e in
side
of t
he a
rm. H
owev
er, b
ecau
se fr
eque
nt in
ject
ions
res
ult i
n no
tice-
able
sca
rs, t
o av
oid
dete
ctio
n m
any
addi
cts
expe
rimen
t with
diff
eren
t par
ts o
f the
ana
tom
y, fo
r ex
ampl
e,un
der
the
tong
ue o
r ey
elid
.
The
mos
t com
mon
met
hod
of h
eroi
n ad
min
istr
atio
n in
the
Uni
ted
Sta
tes
is:
a) b
y ta
blet
b) b
y in
trav
enou
s in
ject
ion
c) b
y sm
okin
g
d) b
y sn
iffin
g
N-2
2
anal
gesi
c or
pain
kill
er
N-2
4 T
he a
ddic
t's "
wor
ks,"
or w
hat h
e ne
eds
to g
ive
him
self
an in
ject
ion,
gen
eral
lyin
clud
e a
hypo
derm
ic s
yrin
ge,
a sp
oon,
cot
ton,
mat
ches
, and
a r
ope
or b
elt.
The
her
oin
is m
ixed
into
a li
quid
sol
utio
n by
cook
ing
it on
the
spoo
n. It
is th
en s
trai
ned
thro
ugh
the
cotto
n in
to th
esy
ringe
. The
rop
e or
bel
t is
used
to ti
e of
fth
e up
per
arm
, for
exa
mpl
e, c
reat
ing
pres
sure
and
mak
ing
the
vein
sta
nd o
ut s
o it
may
be
easi
ly lo
cate
d.
N-2
3
b) b
y in
trav
enou
sin
ject
ion
N-2
5 T
he h
eroi
n "f
ix"
fol!o
ws
a fa
irly
pred
icta
ble
cour
se. I
mm
edia
tely
afte
r in
ject
ion
the
indi
vidu
al e
xper
ienc
esan
inte
nse
"hig
h" th
at la
sts
abou
t 1m
inut
e.
Thi
s "h
igh"
is s
ough
t for
its
sens
e of
tran
quili
ty a
nd e
upho
ria, a
s w
ell
as th
e fe
elin
g of
war
mth
and
atin
glin
g se
n- 't
ion
in th
e ab
dom
en s
aid
to b
e si
mila
r to
org
asm
.
A s
tron
g de
sire
for
a he
roin
"hi
gh"
isan
indi
catio
n of
depe
nden
ce.
N-2
4
Go
on to
next
fram
e.
N-2
6 T
his
"hig
h" is
usu
ally
follo
wed
by s
ever
al h
ours
of d
row
sine
ss, a
ccom
pani
edby
an
inab
ility
to c
once
ntra
te,
less
ened
phy
sica
l act
ivity
, and
leth
argy
.
Mos
t of t
he ti
me
the
addi
ct is
unde
r th
e dr
ug's
influ
ence
, he
is "
on th
eno
d,"
in a
dre
amy
stat
e.
Thi
s ge
nera
l sle
epin
ess
and
stat
e of
unaw
aren
ess
is c
ause
d by
the
fact
that
opi
ates
vario
us fu
nctio
ns o
f the
bra
in.
N-2
5
psyc
holo
gica
l
N-2
7 T
he in
tens
e pa
rt o
f the
her
oin
"hig
h" la
sts
abou
t:a)
a m
inut
e
b) a
n ho
ur
c) 2
hou
rs
d) 8
hou
rs
N-2
6
depr
ess
9
10
N-2
8F
or m
ost o
f the
tim
e an
indi
vidu
al is
und
er th
e ef
fect
s of
a n
arco
tic h
e w
ill b
e:
a) n
oisy
and
agg
ress
ive
b) h
avin
g ha
lluci
natio
ns
c) s
leep
y
d) in
pai
n
N-2
7
a) a
min
ute
N-2
9 O
ne o
f the
mos
t im
port
ant f
acto
rs in
opi
ate
depe
nden
ce is
the
deve
lopm
ent o
f tol
eran
ce.
Rep
eate
d ad
min
istr
atio
n of
eve
n sm
all d
oses
lead
s to
incr
ease
d to
lera
nce.
Thi
s m
eans
the
indi
vidu
al h
as to
incr
ease
his
dos
age
to a
chie
ve th
e sa
me
effe
cts.
As
tole
ranc
e de
velo
ps, o
ne n
eeds
to u
se (
smal
ler/
the
sam
e/la
rger
)do
ses
to a
chie
veth
e de
sire
d ef
fect
.
N-2
8
c) s
leep
y
N-3
0 H
owev
er, w
hen
tole
ranc
e ha
s de
velo
ped,
the
cells
hav
e ad
just
ed to
the
pres
ence
of t
he d
rug,
and
req
uire
the
drug
to fu
nctio
n no
rmal
ly.
If th
e us
er m
aint
ains
a c
onst
ant l
evel
of t
he d
rug
in h
is s
yste
m, h
e m
ay b
e ab
le to
func
tion
norm
ally
and
may
not f
eel e
ither
the
"hig
h" o
r th
e dr
owsi
ness
usu
ally
ass
ocia
ted
with
the
drug
.
In s
uch
a si
tuat
ion,
the
addi
ct m
ay li
ve a
nor
mal
life
and
may
con
tinue
his
dep
ende
nce
to a
void
goi
ng th
roug
hw
ithdr
awal
. Thi
s pr
esup
pose
s th
at th
e in
divi
dual
has
the
fund
s to
sup
port
his
hab
it.
If its
dis
cont
inua
nce
is fo
llow
ed b
y w
ithdr
awal
, we
say
that
her
oin
has
prod
uced
depe
nden
ce.
N-2
9
larg
er
N-3
1M
etha
done
is a
syn
thet
ic n
arco
tic w
hich
has
bee
nus
ed a
s a
subs
titut
e fo
r he
roin
in th
e tr
eatm
ent o
f opi
ate
depe
nden
ce. C
urre
nt r
esea
rch
indi
cate
s th
atan
add
ict c
an b
e ke
pt c
omfo
rtab
le, t
hat i
s, h
e w
ill n
ot h
ave
with
-dr
awal
sym
ptom
s, b
y su
bstit
utin
g or
ally
adm
inis
tere
dm
etha
done
for
inje
ctab
le h
eroi
n. B
esid
es it
sus
e in
trea
tmen
t of w
ithdr
awal
(de
toxi
ficat
ion)
, it
can
be u
sed
in lo
ng te
rm tr
eatm
ent a
nd r
ehab
ilita
tion
beca
use
whi
le o
n fu
ll do
ses
of m
etha
done
, the
add
ict
appa
rent
ly d
oes
not f
eel t
he e
ffect
s of
the
"hig
h"of
her
oin.
He
also
doe
s no
t exp
erie
nce
the
leth
argy
that
norm
ally
follo
ws
the
high
. How
ever
, met
hado
ne is
still
a n
arco
tican
d do
es p
rodu
ce p
sych
olog
ical
and
phy
sica
l dep
ende
nce.
A s
ynth
etic
nar
cotic
use
d in
the
trea
tmen
t of
hero
in a
ddic
tion
is c
alle
d
N-3
0
phys
ical
N-3
2 W
ithdr
awal
from
opi
ate
depe
nden
ceca
n be
a s
ever
e pr
oces
s. A
s w
e ha
ve s
aid,
fear
of t
his
with
draw
al s
ick-
ness
is o
ften
a pr
imar
y ca
use
of c
ontin
ued
addi
ctio
n to
her
oin.
With
draw
alsy
mpt
oms
begi
n a
few
hou
rs a
fter
the
last
"fix
." T
hey
reac
h th
eir
peak
in th
e ne
xt 2
4to
48
hour
s an
d w
ithin
abo
ut 1
0 da
ys th
e m
ost
seve
resy
mpt
oms
disa
ppea
r.
Onc
e th
e ad
dict
has
gon
e th
roug
h w
ithdr
awal
, he
is n
o lo
nger
phy
sica
lly d
epen
dent
on th
e dr
ug. T
hus,
if h
e1-
4 Jgo
es b
ack,
it is
bec
ause
he
is s
till
depe
nden
t on
it.
N-3
1
met
hado
ne
N-3
3 T
he s
ympt
oms
of w
ithdr
awal
from
opi
ates
depe
nd o
n th
e se
verit
y of
the
depe
nden
ce a
nd th
ede
gree
of t
oler
-an
ce a
chie
ved.
It is
usu
ally
cha
ract
eriz
ed b
y:ne
rvou
snes
s, a
nxie
ty, a
nd s
leep
less
ness
; yaw
ning
, run
ning
nose
, hoa
rsen
ess,
and
swea
ting;
enl
arge
men
t of p
upils
, goo
sefle
sh,
and
twitc
hing
of m
uscl
es; d
iarr
hea
and
abdo
min
alcr
amps
;in
crea
se in
bre
athi
ng r
ate,
blo
odpr
essu
re, a
nd te
mpe
ratu
re; a
nd a
feel
ing
of d
espe
ratio
n w
ith th
e ob
sess
ive
desi
re to
sec
ure
mor
e of
the
:Jru
g.
All
inal
l, th
ese
sym
ptom
s ar
e th
e op
posi
teof
the
drug
ged
stat
e af
ter
afix
, whi
ch is
cha
ract
er-
ized
by
N-3
2
psyc
holo
gica
lly
11
12
N-3
4 W
hich
of t
he fo
llow
ing
are
sym
ptom
s of
opi
ate
with
draw
al?
N-3
3
a) d
row
sine
sssl
eepi
ness
,
b) te
nsio
nle
thar
gy
c) c
ram
ps, v
omiti
ng, a
nd d
iarr
hea
(or
equi
vale
nt)
d) in
crea
sed
brea
thin
g ra
te, b
lood
pre
ssur
e, a
nd te
mpe
ratu
re
e) d
ecre
ased
bre
athi
ng r
ate,
blo
od p
ress
ure,
and
tem
pera
ture
f) c
ompu
lsio
n to
get
ano
ther
fix
N-3
5 T
he w
orst
par
t of t
he w
ithdr
awal
per
iod
occu
rsto
hour
s af
ter
the
last
"fix
."N
-34
b) te
nsio
nc)
cra
mps
, vom
iting
,an
d di
arrh
ead)
incr
ease
d br
eath
-in
g ra
te, b
lood
-pr
essu
re, a
ndte
mpe
ratu
ref)
com
puls
ion
toge
t ano
ther
fix
N-3
6W
ithdr
awal
from
her
oin
usua
lly ta
kes
a to
tal o
f abo
utda
ys to
com
plet
e.N
-35
24 to
48
N-3
7T
o re
view
, opi
ate
depe
nden
ce is
cha
ract
eriz
ed b
y th
e de
velo
pmen
t of t
oler
ance
, psy
chol
ogic
al d
epen
denc
e,an
d ph
ysic
al d
epen
denc
e. T
he th
ree
are
inte
rrel
ated
.
Psy
chol
ogic
ally
, the
add
ict m
ay in
itial
ly s
eek
the
"hig
h" o
r he
may
be
look
ing
for
the
esca
pe o
f bei
ng"o
n th
eno
d."
How
ever
, onc
e he
has
dev
elop
ed to
lera
nce,
he
may
no
long
er fe
el th
ese
effe
cts.
At t
his
poin
t he
may
mai
ntai
n hi
s le
vel o
f dep
ende
nce
to a
void
'goi
ng th
roug
h w
ithdr
awal
.
N-3
610
N-3
8 W
e ha
ve s
aid
that
the
indi
vidu
al d
evel
ops
a to
lera
nce
to h
eroi
n an
d m
orph
ine
that
lead
s hi
m to
take
larg
eran
d la
rger
dos
es. H
cwev
er, t
oler
ance
is a
rev
ersi
ble
proc
ess.
Ifan
add
ict w
ithdr
aws
from
his
hab
it, h
is le
vel
of to
lera
nce
is r
educ
ed.
Whe
n an
indi
vidu
al g
oes
thro
ugh
with
draw
al fr
om o
piat
es h
is le
vel o
f tol
eran
ce
a) d
ecre
ases
b) s
tays
the
sam
e
c) in
crea
ses
N-3
7
Go
on to
next
fram
e.
N-3
9If
an in
divi
dual
with
red
uced
tole
ranc
e w
ere
sudd
enly
to ta
ke th
esa
me
dose
his
bod
y ha
d be
com
e us
ed to
befo
re w
ithdr
awal
, he
wou
ld s
uffe
r th
e ef
fect
s of
ove
rdos
age.
Ove
rdos
age
occu
rs w
hen
the
indi
vidu
al ta
kes
a do
se o
fa
drug
gre
ater
than
that
for
whi
ch h
e ha
s de
velo
ped
a
N-3
8
a) d
ecre
ases
N-4
0O
verd
osag
e of
opi
ates
can
pro
ve fa
tal b
ecau
se o
piat
es d
epre
ss th
e pa
rt o
f the
brai
n th
at c
ontr
ols
brea
thin
g.T
here
fore
, an
over
dose
res
ults
in r
espi
rato
ry fa
ilure
,co
ma,
and
fina
lly d
eath
.
Ove
rdos
age
may
als
o oc
cur
if an
add
ict i
s gi
ven
a pu
rer
form
of t
he d
rug
than
he
has
barg
aine
d fo
r. S
ince
all
hero
in tr
affic
is il
lega
l the
buy
er h
as n
o gu
aran
tee
as to
wha
t he
is g
ettin
g. It
may
not
eve
n be
her
oin.
Ove
rdos
age
coul
d oc
cur
if th
e ad
dict
wer
e su
dden
ly g
iven
form
of h
eroi
n th
atex
ceed
s hi
s to
lera
nce.
N-3
9
tole
ranc
e
N-4
1O
verd
osag
e of
opi
ates
can
occ
ur if
the
indi
vidu
al's
is lo
wer
than
exp
ecte
d or
if
the
dose
take
n is
than
exp
ecte
d.
N-4
0
a pu
rer
13
14
N-4
2 O
verd
osag
e of
opi
ates
can
pro
ve fa
tal b
ecau
se th
ey d
epre
ss th
e
of th
e br
ain.
N-4
1to
lera
nce
pure
r
N-4
3O
piat
e de
pend
ence
is c
hara
cter
ized
by
whi
ch o
f the
follo
win
g?
a) d
evel
opm
ent o
f tol
eran
ce fo
r th
e dr
ug's
effe
cts
b) p
sych
olog
ical
dep
ende
nce
on th
e dr
ug's
effe
cts
c) w
ithdr
awal
sym
ptom
s up
on d
isco
ntin
uanc
e of
the
drug
.
d) a
ll of
the
abov
e
N-4
2
resp
irato
ry o
rbr
eath
ing
cent
er
f--L ,)
N-4
4 O
piat
e ad
dict
ion
does
not
pro
duce
a s
ense
of f
ello
wsh
ip a
nd c
omm
unal
sha
ring
repo
rted
by
som
e m
arih
uana
user
s, n
or a
feel
ing
of s
elf-
insi
ght,
repo
rted
ly s
ough
t by
LSD
use
rs. O
piat
e de
pend
ence
may
lead
one
to p
er-
sona
l neg
lect
and
mal
nutr
ition
as
wel
l as
to d
ropp
ing
out o
f pro
duct
ive
soci
ety.
The
add
ict r
arel
y ha
s tim
e to
do a
nyth
ing
othe
r th
an lo
ok fo
r he
roin
to fe
ed h
is h
abit.
N-4
5It
is u
nusu
al fo
r he
roin
to b
e sh
ared
or
give
n aw
ay to
one
's fr
iend
s un
less
a p
ushe
r is
del
iber
atel
y tr
ying
toho
ok s
omeo
ne fo
r fu
ture
bus
ines
s. T
he c
ost o
f her
oin
proh
ibits
suc
h ge
nero
sity
. An
addi
ct m
ust s
pend
betw
een
$50
and
$200
a d
ay to
feed
his
hab
it. T
he h
igh
cost
of h
is h
abit
ofte
n ca
uses
the
user
to r
esor
t to
crim
inal
mea
ns to
obt
ain
mon
ey. T
his
may
take
the
form
of a
nyth
ing
from
sho
plift
ing
to p
rost
itutio
n to
arm
ed r
obbe
ry. T
o ob
tain
$10
0 ca
sh, t
he a
ddic
t may
hav
e to
ste
al $
700
wor
th o
f goo
ds.
N-4
3
d) a
ll of
the
abov
e
N-4
4
Go
on to
next
fram
e.
, i I
N-4
6B
ecau
se in
mos
t cas
es th
e dr
ug is
adm
inis
tere
d in
trav
aneo
usly
, the
re is
gre
at d
ange
r of
infe
ctio
n, s
kin
absc
esse
s, a
nd h
epat
itis
from
poo
rly s
teril
ized
nee
dles
.
Som
e si
de e
ffect
s of
her
oin
addi
ctio
n ar
e
N-4
5
Go
on to
next
fram
e.
TH
IS IS
TH
E E
ND
OF
TH
E S
EC
TIO
N. I
T IS
A G
OO
D T
IME
TO
TA
KE
A B
RIE
F R
ES
T.
15
16
part
lllst
imul
ants
S-4
7W
hat i
s a
stim
ulan
t? Y
ou h
ave
prob
ably
inge
sted
som
e st
imul
ant t
oday
; for
exa
mpl
e, th
e ca
ffein
e fr
om y
our
mor
ning
cof
fee
or te
a or
nic
otin
e fr
om to
bacc
o.
Alth
ough
caf
fein
e, a
nat
ural
stim
ulan
t, m
ay a
ggra
vate
suc
h co
nditi
ons
as e
pile
psy,
ulc
ers,
and
hyp
erte
nsio
n,th
e ef
fect
s of
caf
fein
e on
the
aver
age
indi
vidu
al a
re c
onsi
dere
d re
lativ
ely
mild
.
The
effe
cts
of c
ocai
ne, a
noth
er n
atur
al s
timul
ant,
are
not m
ild h
owev
er, p
artic
ular
ly w
hen
it is
inje
cted
.
It is
diff
icul
t to
cate
goriz
e th
e ef
fect
s of
am
phet
amin
es (
synt
hetic
stim
ulan
t*;)
bec
ause
the
inte
nsity
of t
hedr
ug's
effe
ct is
onl
y pa
rtia
lly d
epen
dent
on
the
dose
take
n. In
divi
dual
s ta
leng
sm
all,
med
ical
ly p
resc
ribed
dose
s ha
ve b
een
know
n to
hav
e ve
ry in
tens
e re
actio
ns.
Am
phet
amin
es, c
affe
ine,
nic
otin
e, a
nd c
ocai
ne a
re a
ll ex
ampl
es o
f
N-4
6
mal
nutr
ition
,dr
oppi
ng o
utof
soc
iety
,in
fect
ion
(or
equi
vale
nt)
S-4
8S
timul
ants
are
so-
calle
d be
caus
e th
ey d
irect
ly s
timul
ate
the
cent
ral n
ervo
us s
yste
m.
Coc
aine
, a n
atur
al s
timul
ant,
is o
btai
ned
from
the
leav
es o
f the
coc
a bu
sh (
Ery
thox
ylon
coc
a), f
ound
pre
-do
min
antly
in S
outh
Am
eric
a. A
lthou
gh it
has
a li
mite
d m
edic
al u
se a
s a
loca
l ane
sthe
tic fo
r ey
e an
d no
sesu
rger
y, it
is o
ften
foun
d on
the
blac
k m
arke
t.
NO
TE
: The
ille
gal u
se o
f coc
aine
is c
ontr
olle
d th
roug
h th
e C
ompr
ehen
sive
Dru
g A
buse
Pre
vent
ion
and
Con
trol
Act
of 1
970.
Coc
aine
has
a li
mite
d m
edic
al u
se a
s a
N-4
7
stim
ulan
ts
S-4
9A
mph
etam
ines
mak
e a
pers
on fe
el fu
ll of
ene
rgy.
It w
as fo
r th
is r
easo
n th
at th
ey w
ere
orig
inal
ly g
iven
toW
orld
War
II p
ilots
to k
eep
them
ale
rt d
urin
g lo
ng p
erio
ds o
f str
ess.
Am
phet
amin
es a
re c
urre
ntly
pre
scrib
ed fo
r a
varie
ty o
f rea
sons
. For
exa
rre:
!'4, t
hey
are
used
to tr
eat d
epre
s-si
on, n
arco
leps
y (u
ncon
trol
labl
e at
tack
s of
sle
ep),
and
hyp
erac
tivity
in c
hild
ren.
The
y ar
e pr
obab
ly m
ost
com
mon
ly k
now
n as
app
etite
sup
pres
sant
s. A
t one
tim
e th
ey w
ere
used
to tr
eat c
olds
and
hay
feve
r be
caus
eth
ey s
hrin
k th
e na
sal m
embr
anes
.
In g
ener
al, w
e ca
n sa
y th
at th
e ef
fect
of a
mph
etam
ines
is q
uite
diff
eren
t fro
m th
at o
f nar
cotic
s. W
here
as a
pers
on ta
king
nar
cotic
s is
usu
ally
sle
epy
and
leth
argi
c, s
omeo
ne ta
king
stim
ulan
ts te
nds
to b
e
N-4
8
loca
lan
esth
etic
4i4
DS
-50
The
thre
e m
ost c
omm
on s
ynth
etic
stim
ulan
ts a
re:
Am
phet
amin
e, m
arke
ted
as B
enze
drin
e an
d of
ten
calle
d "B
enni
es";
Dex
troa
mph
etam
ine,
mar
kete
d as
Dex
edrin
e an
d ca
lled
"Dex
ies"
or
"pep
pill
s"; a
nd
Met
ham
phet
amin
e, m
arke
ted
as M
ethe
drin
e an
d kn
own
as "
Spe
ed."
NO
TE
: We
shal
l con
tinue
to u
se th
e te
rm "
amph
etam
ine"
in it
s m
ore
gene
ral s
ense
.
S-4
9
aler
t, en
-er
getic
(or
equi
vale
nt)
S-5
1A
mph
etam
ines
are
usu
ally
take
n in
pill
or
caps
ule
form
, exc
ept f
or M
ethe
drin
e, w
hich
is a
lso
foun
d in
crys
tal o
r liq
uid
form
and
is o
ften
inje
cted
.
Wha
t oth
er c
ateg
ory
of d
rugs
is u
sual
ly a
dmin
iste
red
by in
ject
ion'
S-5
0
Go
on to
next
fram
e.
17
18
S-5
2C
lass
ify e
ach
of th
e fo
llow
ing
drug
s as
nar
cotic
s or
stim
ulan
ts:
a) c
ocai
ne
b) m
etha
done
c) D
exed
rine
d) h
eroi
n
e) a
mph
etam
ine
S-5
1
narc
otic
s
S-5
3A
mph
etam
ines
(st
imul
ate/
depr
ess)
the
cent
ral n
ervo
us s
yste
m.
S-5
2a)
stim
ulan
tb)
nar
cotic
c) s
timul
ant
d) n
arco
tice)
stim
ulan
t
S-5
4F
or w
hich
of t
he fo
llow
ing
cond
ition
s ar
e am
phet
amin
es p
resc
ribed
?
a) o
besi
ty
b) te
nsio
n
c) d
epre
ssio
n
d) p
ain
S-5
3
stim
ulat
e
S-5
5A
dmin
istr
atio
n of
a s
timul
ant b
y in
ject
ion
prod
uces
the
mos
t im
med
iate
and
inte
nse
effe
cts.
The
use
r is
hit
with
a s
urge
of a
lert
ness
and
ene
rgy.
Thi
s st
imul
atin
g an
d ex
citin
g "h
igh"
is th
e pr
imar
y go
al s
ough
t by
thos
e w
ho ta
ke s
timul
ants
for
kick
s. S
omet
imes
, the
effe
cts
may
be
so in
tens
e th
at th
e ab
user
will
vol
unta
rily
seek
sed
atio
n.
An
inje
ctio
n of
stim
ulan
ts ta
kes
effe
ct (
fast
er/s
low
er)
than
a ta
blet
.
S-5
4
a) o
besi
ty
c) d
epre
ssio
n
117.
,INK
-Err
oirm
teT
rpr7
tr;..
..
..
I-
S-5
6T
here
are
sev
eral
sou
rces
of s
uppl
y fo
r :th
ose
in s
earc
h of
syn
thet
ic s
timul
ants
. Oth
er th
an le
gal p
resc
riptio
ns,
they
may
be
obta
ined
thro
ugh
fake
pre
scrip
tions
, dru
gsto
re r
obbe
ries,
and
loca
l pus
hers
. Tee
nage
rs o
ften
dono
t hav
e to
look
furt
her
than
the
hom
e m
edic
ine
ches
t for
am
phet
amin
es. I
t has
bee
n es
timat
ed th
at a
t lea
ston
e-th
ird o
f the
eig
ht b
illio
n am
phet
amin
e ta
blet
s le
gally
pro
duce
d ea
ch y
ear
win
d up
in n
on-m
edic
al h
ands
.It
is a
lso
prob
able
that
ther
e is
ille
gal p
rodu
ctio
n.
Nirs
oiLa
wb.
S-5
5
fast
er
S-5
7A
mph
etam
ines
, eve
n if
take
n in
pre
scrib
ed d
oses
, may
hav
e se
rious
sid
e ef
fect
s, in
clud
ing
incr
ease
d he
art
rate
and
blo
od p
ress
ure,
whi
ch c
ause
hea
rt p
alpi
tatio
ns. O
ther
sid
e ef
fect
s ar
e of
ten
dila
ted
pupi
ls, s
wea
t-in
g, a
nd d
iarr
hea.
Hig
h do
ses
of s
timul
ants
res
ult i
n ex
trem
e te
nsio
n, lo
ud e
gois
m, t
alka
tiven
ess
and
nerv
ousn
ess.
Thi
s is
know
n in
sla
ng te
rmin
olog
y as
bei
ng "
stru
ng o
ut."
"S
peed
frea
ks"
(tho
se w
ho u
se M
ethe
drin
e re
gula
r..')
ofte
n do
not
sle
ep o
r ea
t for
day
s at
a ti
me.
Am
phet
amin
es m
ay p
rodu
ce w
hich
of t
he fo
llow
ing
effe
cts?
a)-
extr
eme
hung
er
b) te
nsio
n an
d ne
rvou
snes
s
c) e
nhan
cem
ent o
f sub
ject
ive
expe
rienc
e
d) h
eart
pal
pita
tions
S-5
6
Go
on to
the
next
fram
e.
S-5
8V
ery
little
is k
now
n ab
out a
n in
divi
dual
's p
redi
spos
ition
to th
e ab
ove
side
effe
cts.
Res
earc
h ha
s sh
own
that
inso
me
indi
vidu
als
even
one
am
phet
amin
e ta
blet
will
mak
e th
em fe
el "
stru
ng o
ut."
Doc
tors
may
pre
scrib
e su
chm
edic
atio
n w
ithou
t ade
quat
e kn
owle
dge
of w
heth
er a
pat
ient
can
take
thes
e dr
ugs
with
out s
uch
serio
us s
ide
effe
cts
occu
rrin
g.
S-5
7b)
tens
ion
and
nerv
ousn
ess
d) h
eart
pal
pita
tions
19
WIV
IMae
.....0
20
S-5
9U
nlik
e na
rcot
ics,
stim
ulan
ts d
o no
t usu
ally
lead
to p
hysi
dal d
epen
denc
y. C
hron
ic lo
w-d
ose
use
of s
timul
ants
S-5
8m
ay le
ad to
psy
chol
ogic
al d
epen
denc
e.
Bas
ical
ly, t
here
are
two
mot
ivat
ions
for
stim
ulan
t dep
ende
nce.
(1)
Firs
t is
the
indi
vidu
al w
ho o
rigin
ally
took
am
phet
amin
es u
nder
doc
tor's
ord
ers.
His
med
ical
pro
blem
sm
ay n
o lo
nger
exi
st, b
ut h
e co
ntin
ues
to u
se th
e dr
ug b
ecau
se th
e st
ate
it pu
ts h
im in
has
bec
ome
a w
ayof
life
. He
prob
ably
take
s sm
all d
oses
and
is a
ble
to fu
nctio
n fa
irly
norm
ally
.
(2)
Sec
ond
is th
e in
divi
dual
who
has
bec
ome
psyc
holo
gica
lly d
epen
dent
on th
e dr
ug fo
r its
inte
nsel
y st
imu-
latin
g ef
fect
s. H
e w
ants
the
"hig
h" h
e ca
n ge
t fro
m it
and
con
tinue
s to
take
the
drug
bec
ause
he
does
not w
ant t
o fe
el th
e de
pres
sion
that
Occ
urs
whe
n th
e dr
ug w
ears
off.
Thi
s in
divi
dual
may
take
mas
sive
dose
s an
d ca
nnot
func
tion
norm
ally
eith
er w
hile
on
the
drug
or
for
the
perio
d of
tim
e af
ter
it is
dis
-co
ntin
ued.
Chr
onic
low
dos
e, n
onm
edic
al u
se o
f stim
ulan
ts m
ay r
esul
t in
a (p
hysi
cal/p
sych
olog
ical
)de
pend
ency
.
Go
on to
next
fram
e.
S-6
0T
o re
view
, lis
t at l
east
two
phys
ical
effe
cts
of ta
king
hig
h do
ses
of s
timul
ants
.
S-6
1S
hort
ly a
fter
taki
ng c
ocai
ne o
r am
phet
amin
es, a
n in
divi
dual
may
bec
ome
whi
ch o
f the
follo
win
g?
a) tr
anqu
il
b) te
nse
c) d
row
sy
d) s
leep
less
S-5
9
psyc
holo
gica
l
S-6
0an
y tw
o:In
crea
sed
hear
tra
te a
nd b
lood
pres
sure
,di
late
d pu
pils
,sw
eatin
g,di
arrh
ea,
hear
t pal
pi-
tatio
ns
S-6
2W
hen
an in
divi
dual
take
s hi
gh d
oses
of s
timul
ants
, he
may
dev
elop
tole
ranc
e. H
owev
er, s
uch
tole
ranc
eus
ually
dev
elop
s ve
ry s
low
ly a
nd o
nly
at v
ery
high
dos
es.
With
res
pect
to s
timul
ants
, tol
eran
ce (
neve
r/so
met
imes
/alw
ays)
deve
lops
.
S-6
1
b) te
nse
d) s
leep
less
S-6
3A
sin
gle
larg
e do
se o
r a
chro
nic
abus
e of
stim
ulan
ts c
an r
esul
t in
an o
verd
ose
of th
e dr
ug in
the
syst
em.
Thi
s ca
n le
ad to
a s
tate
of d
rug
psyc
hosi
s w
hich
is s
omet
imes
sev
ere
enou
gh to
req
uire
hos
pita
lizat
ion
for
tem
pora
ry in
sani
ty.
Suc
h a
stat
e of
psy
chos
is is
cha
ract
eriz
ed b
y ha
lluci
natio
ns a
nd fe
elin
gs o
f per
secu
tion.
Indi
vidu
als
ofte
nov
eres
timat
e th
eir
stre
ngth
and
act
on
thes
e 1.
-:al
ings
of p
erse
cutio
n w
ith e
xtre
mel
y ag
gres
sive
beh
avio
r.
The
se a
re (
phys
ical
/psy
chol
ogic
al)
sym
ptom
s of
ove
rdos
age.
S-6
2so
met
imes
S-6
4In
add
ition
, the
re h
ave
been
rar
e ca
ses
whe
re a
n ex
trem
e ov
erdo
se o
f stim
ulan
ts h
as r
esul
ted
in d
eath
beca
use
the
body
cou
ld n
ot h
andl
e th
e ef
fect
s of
the
drug
.
An
over
dose
of s
timul
ants
can
lead
to w
hich
of t
he fo
llow
ing?
a) te
mpo
rary
insa
nity
b) p
aral
ysis
c) d
eath
d) k
idne
y fa
ilure
S-6
3
psyc
holo
gica
l
S-6
5R
ecen
t res
earc
h ha
s in
dica
ted
that
the
natu
re o
f am
phet
amin
e de
pend
ence
diff
ers
depe
ndin
g on
the
dose
sth
at a
re ta
ken.
Sin
ce to
lera
nce
to h
igh
dose
s de
velo
ps a
nd w
ithdr
awal
sym
ptom
s ha
ve b
een
foun
d to
occ
ur,
larg
e am
ount
s of
am
phet
amin
es a
re c
onsi
dere
d to
pro
duce
phy
sica
l dep
ende
ncy.
Phy
sica
l dep
ende
nce
on a
mph
etam
ines
may
dev
elop
whe
ndo
ses
are
take
n ch
roni
cally
.
S-6
4a)
tem
pora
ryin
sani
ty
c) d
eath
21
22
S-6
6In
add
ition
to p
hysi
cal w
ithdr
awal
sym
ptom
s, if
an
indi
vidu
al h
as b
een
taki
ng la
rge
dose
s of
am
phet
amin
es,
a de
ep, a
nd s
omet
imes
sui
cida
l dep
ress
ion
may
res
ult w
hen
the
drug
is d
isco
ntin
ued.
Thu
s bo
th p
hysi
cal a
nd p
sych
olog
ical
sym
ptom
s oc
cur
durin
gfr
om a
mph
etam
ines
.
S-6
5
larg
e
S-6
7La
bel e
ach
of th
e fo
llow
ing
stat
emen
ts a
s T
rue
or F
alse
:
a) C
hron
ic u
se o
f stim
ulan
ts m
ay le
ad to
phy
sica
l dep
ende
nce
b) C
hron
ic u
se o
f hig
h do
ses
of s
timul
ants
can
lead
to p
hysi
cal d
epen
denc
e
c) T
oler
ance
nev
er d
evel
ops
from
the
use
of s
timul
ants
d) C
hron
ic u
se o
f stim
ulan
ts le
ads
to p
sych
olog
ical
dep
ende
nce
e) A
dee
p de
pres
sion
ofte
n fo
llow
s w
hen
one
stop
s ta
king
stim
ulan
ts
S-6
6
with
draw
al
S-6
8T
o re
view
, lis
t thr
ee n
+im
illan
ts:
17
S-6
9W
hat i
s/ar
e th
e pr
imar
y m
edic
al u
se/u
ses
of a
mph
etam
ines
?
S-6
7
a) F
alse
b) T
rue
c) F
alse
d) T
rue
e) T
rue
S-6
8
caffe
ine
coca
ine
amph
etam
ines
(any
ord
dr)
S-7
0T
oler
ance
(ne
ver/
som
etim
es/a
lway
s)de
velo
ps in
the
use
of s
timul
ants
.S
-69
appe
tite
con
trol
;us
ed a
gain
stfa
tigue
and
depr
essi
on (
oreq
uiva
lent
)
S-7
1O
verd
oses
of s
timul
ants
can
res
ult i
n a
drug
psy
chos
is. T
his
lead
s to
wha
t kin
d of
beh
avio
r'S
-70
som
etim
es
S-7
2P
sych
olog
ical
with
draw
al fr
om s
timul
ants
is c
hara
cter
ized
by
a de
ep
S-7
1T
empo
rary
psyc
hosi
s; h
al-
luci
natio
ns;
feel
ings
of
pers
ecut
ion
S-7
3O
n th
e fo
llow
ing
char
t, no
te w
heth
er e
ach
char
acte
ristic
is (
alw
ays,
som
etim
es, n
ever
) de
velo
ped
from
the
chro
nic
mis
use
of n
arco
tics
and
stim
ulan
ts.
NA
RC
OT
ICS
ST
IMU
LAN
TS
a) P
hysi
cal D
epen
denc
e
b) P
sych
olog
ical
Dep
ende
nce
c) T
oler
ance
S-7
2
depr
essi
on
EN
D O
F S
EC
TIO
N. G
O O
N T
O N
EX
T S
EC
TIO
N.
23
24
part
IV
depr
essa
nts
D-7
4B
arbi
tura
tes
are
the
mos
t com
mon
of t
he d
rugs
cla
ssifi
ed a
s de
pres
sant
s, o
r se
dativ
es. T
here
are
som
etr
anqu
ilize
rs (
Milt
own,
Equ
ine!
, Val
ium
, and
Lib
rium
, for
exa
mpl
e), g
ener
ally
cal
led
min
or tr
anqu
ilize
rs, t
hat
are
also
incl
uded
in th
is c
ateg
ory.
In m
any
way
s ba
rbitu
rate
s ar
e th
e m
ost d
ange
rous
dru
gs w
e sh
all d
iscu
ss: t
hey
prod
uce
a st
rong
psy
cho.
logi
cal a
nd p
hysi
cal d
epen
denc
y; th
e pr
oces
s of
with
draw
al is
con
side
rabl
y m
ore
seve
re th
an it
is fo
r he
roin
;an
d, th
ey m
ay p
rovi
de th
e ea
sies
t dru
g ro
ute
to d
eath
. In
this
cou
ntry
alo
ne, a
bout
3,0
00 p
eopl
e di
e ea
chye
ar, i
nten
tiona
lly a
nd u
nint
entio
nally
, fro
m b
arbi
tura
te o
verd
ose.
Bar
bitu
rate
s an
d m
inor
tran
quili
zers
are
in th
e ca
tego
ry o
f dru
gs c
alle
d
S-7
3
a) a
lway
s, s
ome
times
b) a
lway
s, a
lway
s
c) a
lway
s, s
ome-
times
D-7
5B
arbi
tura
tes
are
synt
hetic
dru
gs th
at a
ct to
dep
ress
the
cent
ral n
ervo
us s
yste
m, t
hus
indu
cing
sle
ep a
ndre
duci
ng a
nxie
ty a
nd te
nsio
n.
Thi
s is
the
oppo
site
of t
he a
ctio
n of
coc
aine
and
am
phet
amin
es, w
hich
the
cent
ral
nerv
ous
syst
em.
D-7
4
depr
essa
nts
orse
dativ
es
D-7
6B
arbi
tura
tes
have
man
y le
gitim
ate
med
ical
use
s in
add
ition
to th
e w
ell-k
now
n on
e of
indu
cing
sle
ep a
ndre
duci
ng te
nsio
n; b
arbi
tura
tes
are
ofte
n us
ed to
trea
t hig
h bl
ood
pres
sure
and
pep
tic u
lcer
s. S
ome
are
also
used
in th
e tr
eatm
ent o
f epi
leps
y.
For
whi
ch o
f the
follo
win
g pu
rpos
es a
re b
arbi
tura
tes
pres
crib
ed?
a) to
indu
ce s
leep
b) to
dep
ress
app
etite
c) to
rel
ieve
pai
n
d) to
trea
t hig
h bl
ood
pres
sure
D-7
5
stim
ulat
e
D-7
7In
sla
ng te
rmin
olog
y, b
arbi
tura
tes
are
ofte
n re
ferr
ed to
by
the
colo
r of
the
tabl
et. F
or e
xam
ple,
am
ong
quic
kst
artin
g, s
hort
act
ing
barb
itura
tes,
sod
ium
pen
toba
rbita
l (N
embu
tal)
is o
ften
calle
d a
"yel
low
jack
et";
sodi
um s
ecob
arbi
tal (
Sec
onal
) is
som
etim
es k
now
n as
a "
red
devi
l."
Exa
mpl
es o
f slo
w s
tart
ing,
long
er a
ctin
g ba
rbitu
rate
s ar
e ph
enob
arbi
tal (
Lum
ina!
),an
d am
obar
bita
l (A
my-
tal)
calle
d "b
lue
ange
ls."
Bar
bitu
rate
s ar
e ge
nera
lly ta
ken:
a) in
trav
enou
sly
b) in
pill
or
caps
ule
form
c) in
liqu
id fo
rm
D-7
6
a) to
indu
ce s
leep
d) to
trea
t hig
hbl
ood
pres
sure
D-7
8T
o re
view
, cla
ssify
the
follo
win
g dr
ugs
as n
arco
tics,
stim
ulan
ts, o
r de
pres
sant
s:
a) m
orph
ine
b) p
heno
barb
ital
c) a
mph
etam
ine
d) h
eroi
n
e) B
enze
drin
e
f)S
econ
al
D-7
7
b) In
pill
or
caps
ule
form
25
26
D-7
9B
arbi
tura
tes
are
ofte
n m
isus
ed b
ecau
se th
ey a
re e
asily
obt
aina
ble
and
are
ofte
n ta
ken
with
out a
dequ
ate
med
ical
sup
ervi
sion
.
One
def
initi
on o
f mis
use
is s
impl
y ta
king
mor
e th
an is
pre
scrib
ed. W
e ar
e no
t ref
errin
g he
re to
"ove
rdos
e,"
(an
amou
nt ta
ken
that
cou
ld r
esul
t in
the
mis
user
's d
eath
) bu
t to
larg
e do
ses.
Suc
h do
ses
may
res
ult i
n a
stat
e si
mila
r to
alc
ohol
into
xica
tion,
cha
ract
eriz
ed b
y st
agge
ring
wal
k, s
lurr
ed s
peec
h, a
nd p
oor
coor
dina
tion.
In a
dditi
on, t
he in
divi
dual
may
be
drow
sy, u
nabl
e to
con
cent
rate
and
may
suf
fer
from
impa
ired
judg
emen
tan
d m
emor
y.
An
indi
vidu
al s
uffe
ring
from
bar
bitu
rate
into
xica
tion
is li
kely
to b
e ac
cide
nt-p
rone
bec
ause
of (
list t
hree
rea
-
sons
):
D-7
8
a) n
arco
tic
b) d
epre
ssan
t
c) s
timul
ant
d) n
arco
tic
e) s
timul
ant
f) d
epre
ssan
t
0-80
Par
adox
ical
ly, s
omeo
ne w
ho h
as ta
ken
mas
sive
dos
es o
f bar
bitu
rate
s m
ay fi
nd th
at h
e is
not
rel
axed
. The
drug
may
hav
e an
ant
agon
istic
effe
ct, m
akin
g th
e-in
divi
dual
mor
e te
nse
and
jitte
ry. A
sim
ilar
feel
ing
of e
xcita
-tio
n of
ten
occu
rs fr
om to
o m
uch
alco
hol.
An
indi
vidu
al w
ho lo
oks
and
acts
dru
nk b
ut d
oes
not h
ave
the
smel
l of a
lcoh
ol o
n hi
s br
eath
may
be
suffe
ring
from
D-7
9po
or c
oord
in-
atio
n, im
-pa
ired
judg
e-m
ent a
nd m
emor
y,dr
owsi
ness
, (or
equi
vale
nt, a
nyor
der)
D-8
1 A
sec
ond
patte
rn o
f mis
use
invo
lves
the
com
bina
tion
of b
arbi
tura
tes
and
alco
hol.
Alc
ohol
is c
hem
ical
ly a
nd p
harm
acol
ogic
ally
. a d
epre
ssan
t. T
here
fore
, alc
ohol
act
s to
inte
nsify
the
seda
tive
effe
ct o
f the
bar
bitu
rate
s. T
he tw
o, a
ctin
g to
geth
er, m
ay c
ause
an
indi
vidu
al to
ent
er a
com
a ev
en w
hen
the
sepa
rate
leve
ls o
f eac
h ar
e w
ithin
the
stan
dard
, non
toxi
c le
vel.
Alc
ohol
(in
crea
ses/
decr
ease
s)th
e ef
fect
s of
bar
bitu
rate
s.
D-8
0
barb
itura
tein
toxi
catio
n
D-8
2C
ombi
ning
bar
bitu
rate
s w
ith o
ther
dep
ress
ant d
rugs
(su
ch a
s na
rcot
ics,
ane
sthe
tics,
or
tran
quili
zers
) w
illre
sult
in th
e sa
me
dang
er a
s w
hen
barb
itura
tes
are
com
bine
d w
ith:
a) a
lcoh
ol
b) a
mph
etam
ines
D-8
1
incr
ease
s
D-8
3 A
third
pat
tern
of b
arbi
tura
te m
isus
e is
som
etim
es c
alle
d "t
he h
ouse
wife
syn
drom
e."
Thi
s is
a c
ycle
of
amph
etam
ine-
barb
itura
te u
sage
. A w
oman
take
s am
phet
amin
es to
sup
pres
s he
r ap
petit
e, a
nd is
ove
rstim
u-la
ted
and
jitte
ry a
t bed
time.
Bar
bitu
rate
s ar
e ta
ken
to in
duce
sle
ep. A
mph
etam
ines
are
res
umed
the
next
mor
ning
bot
h fo
r di
et a
nd to
ove
rcom
e th
e gr
oggi
ness
of t
he d
epre
ssan
t. S
uch
a pa
ttern
can
lead
to th
epr
oble
ms
of b
oth
amph
etam
ine
and
barb
itura
te d
epen
denc
y. O
f cou
rse
this
pat
tern
may
be
equa
lly a
ppli-
cabl
e to
the
husb
and.
The
"ho
usew
ife s
yndr
ome"
is a
pat
tern
of
11D
-84
Rel
ated
to th
e ab
ove
is th
e te
enag
e pi
ll-po
ppin
g pa
rty
whe
re th
e in
divi
dual
may
not
eve
n kn
ow w
hat h
e is
taki
ng"u
ps,"
"do
wns
," o
r bo
thor
how
muc
h he
is ta
king
. Unf
ortu
nate
ly, t
he s
ourc
e of
sup
ply
for
man
yof
. hes
e pa
rtie
s is
not
the
neig
hbor
hood
pus
her,
but
the
hom
e m
edic
ine
cabi
net.
D-8
2
a) a
lcoh
ol
D-8
3
amph
etam
ine-
barb
itura
teus
age
D-8
5T
o re
view
: In
prop
er d
oses
, bar
bitu
rate
s ar
e us
ed to
hel
p an
indi
vidu
alD
-84
Go
on to
next
fram
e.
27
1
28
D-8
6B
arbi
tura
tes
are
also
som
etim
es u
sed
in th
e tr
eatm
ent o
f (na
me
one)
D-8
5sl
eep
orre
lax
D-8
7H
igh
dose
s of
bar
bitu
rate
s m
ay le
ad to
a s
tate
that
res
embl
esD
-86
any
one:
high
blo
odpr
essu
re,
pept
ic u
lcer
,ep
ileps
y
D-8
8 A
n in
divi
dual
who
has
com
bine
d al
coho
l and
bar
bitu
rate
s m
ay g
o in
to a
com
a be
caus
e th
e al
coho
l
the
effe
cts
of th
e ba
rbitu
rate
s.
D-8
7al
coho
lin
toxi
catio
n
D-8
9C
ontin
uing
now
with
som
e of
the
mos
t com
mon
res
ults
of b
arbi
tura
te m
isus
e: B
arbi
tura
te d
epen
denc
e is
char
acte
rized
by
a st
rong
psy
chol
ogic
al a
nd p
hysi
cal d
epen
denc
e on
the
drug
. It i
s fu
rthe
r ch
arac
teriz
ed b
yth
e de
velo
pmen
t of t
oler
ance
.
As
an in
divi
dual
bui
lds
tole
ranc
e, h
e w
ill n
eed
(sm
alle
r, th
e sa
me,
larg
er)
drug
to a
chie
ve th
e sa
me
effe
ct.
dose
s of
the
D-8
8in
crea
ses
orin
tens
ifies
D-9
0B
arbi
tura
te d
epen
denc
e is
sim
ilar
to o
piat
e de
pend
ence
in m
any
way
s. A
n im
port
ant d
iffer
ence
is in
the
natu
re o
f the
with
draw
al p
roce
ss.
The
pat
tern
of b
arbi
tura
te w
ithdr
awal
is a
s fo
llow
s:
For
the
first
8 to
12
hour
s th
e in
divi
dual
may
app
ear
fine
beca
use
he is
stil
l und
erth
e dr
ug's
influ
ence
.O
nce
the
drug
wea
rs o
ff, th
ere
are
sign
s of
incr
easi
ng n
ervo
usne
ss, h
eada
che,
anx
iety
, mus
cle
twitc
hing
,D
T's
, wea
knes
s, in
som
nia,
nau
sea,
and
a s
udde
n dr
op in
blo
odpr
essu
re.
The
se e
ffect
s re
ach
thei
r pe
ak in
abo
ut 1
4 ho
urs.
In th
e ne
xt 2
day
s, th
e in
divi
dual
may
exp
erie
nce
hallu
-ci
natio
ns, d
eliri
um, a
nd fi
nally
, con
vuls
ions
that
can
be fa
tal.
Thu
s, th
e m
ost c
ritic
al p
erio
d du
ring
barb
itura
te w
ithdr
awal
is:
a) im
med
iate
ly a
fter
the
final
dos
e
b) a
bout
1 d
ay a
fter
the
final
dos
e
c) a
bout
2 d
ays
afte
r th
e fin
al d
ose
D-8
9la
rger
D-9
1T
here
fore
, with
draw
al fr
om b
arbi
tura
tes
shou
ld b
e un
dert
aken
with
str
ict m
edic
al s
uper
visi
on.
Abr
uptly
dis
-co
ntin
uing
the
drug
s m
ay le
ad to
an
acut
e m
edic
al e
mer
genc
y. H
owev
er, w
ithdr
awal
can
be a
ccom
plis
hed
bysl
owly
rev
ersi
ng th
e pr
oced
ure
by w
hich
the
indi
vidu
al b
uilt
up to
lera
nce
to th
e dr
ug in
the
first
plac
e; th
atis
, by
a gr
adua
l red
uctio
n in
dos
e. H
owev
er, t
he in
divi
dual
mig
ht s
till b
e ps
ycho
logi
cally
dep
ende
nt.
Onc
e th
e in
divi
dual
is n
o lo
nger
phy
sica
lly d
epen
dent
on
the
drug
, he
(is, i
s no
t)cu
red.
D-9
0
c) a
bout
2 d
ays
afte
r th
e fin
aldo
se
D-9
2T
o be
trul
y cu
red,
the
indi
vidu
al m
ust a
lso
over
com
e hi
s st
rong
psy
chol
ogic
al d
epen
denc
eon
the
drug
.D
-91
is n
ot
29
30
D-9
3H
owev
er, t
here
is a
lim
it to
the
leve
l of t
oler
ance
the
body
will
dev
elop
to b
arbi
tura
tes.
Thi
s up
per
limit
varie
s fr
om in
divi
dual
to in
divi
dual
. But
, onc
e th
is li
mit
is p
asse
d, th
e in
divi
dual
will
suf
fer
from
an
over
dose
of b
arbi
tura
tes.
The
effe
cts
of s
uch
an o
verd
ose
are
the
sam
e as
thos
e re
sulti
ng fr
om a
com
bina
tion
of b
arbi
tura
tes
and
alco
hol o
r na
rcot
icst
hat i
s, th
e in
divi
dual
may
go
into
a
D-9
2
Go
on to
next
fram
e.
D-9
4 A
n ov
erdo
se o
f bar
bitu
rate
s ca
n le
ad to
com
a an
d de
ath
thro
ugh
resp
irato
ry a
rres
t.
Suc
h de
aths
can
be
trac
ed e
ither
to a
leve
l of b
arbi
tura
tes
high
er th
an th
e in
divi
dual
's s
yste
m c
an s
up-
port
, or
to a
sub
toxi
c le
vel o
f bar
bitu
rate
s in
com
bina
tion
with
or
CA
D r
D-9
3
com
a
D-9
5 M
any
deat
hs tr
aced
to b
arbi
tura
tes
occu
r be
caus
e, a
s ha
s be
en s
aid,
the
drug
s im
pair
both
the
mem
ory
and
judg
emen
t of t
he u
ser.
Thu
s, th
e in
divi
dual
som
etim
es d
oes
not r
emem
ber
how
man
y pi
lls h
e ha
s al
read
y ta
ken
and
keep
s ta
king
them
unt
il he
goe
s in
to a
com
a.
D-9
4al
coho
l,na
rcot
ics,
tran
quili
zers
,or
ane
sthe
tics
(any
ord
er)
D-9
6M
inor
tran
quili
zers
are
ano
ther
cat
egor
y of
syn
thet
ic d
rugs
that
cal
m, r
elax
, and
dim
inis
h an
xiet
y. T
hey
also
act
to r
elax
mus
cles
and
may
cau
se d
row
sine
ss.
The
y ar
e si
mila
r to
bar
bitu
rate
s in
effe
ct, a
nd, w
hen
take
n in
ther
apeu
tic d
oses
und
er m
edic
al s
uper
vi-
sion
, do
not l
ead
to p
hyS
ical
dep
ende
nce.
D-9
5
Go
on to
next
fram
e.
D-9
7 T
he m
ost c
omm
only
pre
scrib
ed tr
anqu
ilize
rs a
re: M
iltow
n, E
quin
al, L
ibriu
m, a
nd V
aliu
m.
D-9
6
The
se tr
anqu
ilize
rs c
an le
ad to
psy
chol
ogic
al a
nd p
hysi
cal d
epen
denc
e w
hen
mis
used
. In
addi
tion,
the
user
dev
elop
s to
lera
nce
if th
ey a
re u
sed
too
ofte
n.
Thu
s, s
ome
tran
quili
zers
can
pro
duce
the
sam
e ty
pe o
f dep
ende
ncy
as
Go
on to
next
fram
e.
D-9
8 O
n th
e fo
llow
ing
char
t, no
te w
heth
er e
ach
char
acte
ristic
is (
alw
ays/
som
etim
es/n
ever
) de
velo
ped
from
the
D-9
7ch
roni
c m
isus
e of
nar
cotic
s, s
timul
ants
, and
dep
ress
ants
.ba
rbitu
rate
sN
AR
CO
TIC
SS
TIM
ULA
NT
SD
EP
RE
SS
AN
TS
or o
piat
es
a) Phy
sica
lC
)C
o
b) Psy
chol
og-
ical
De-
pend
ence
c) Tol
eran
ce
TH
IS IS
TH
E E
ND
OF
TH
E S
EC
TIO
N.
TH
IS IS
A G
OO
D T
IME
TO
TA
KE
A B
RE
AK
.
31
32
part
Vha
lluci
noge
nsH
-99
The
cat
egor
y of
dru
gs c
alle
d ha
lluci
noge
ns o
r ps
yche
delic
s in
clud
es s
uch
drug
s as
LS
D, p
eyot
e, m
esca
line,
psilo
cybi
n, S
TP
, DM
T, m
orni
ng g
lory
see
ds, a
nd m
arih
uana
. In
this
cha
pter
we
shal
l dea
l prim
arily
with
LSD
and
mes
calin
e. T
he fo
llow
ing
chap
ter
will
be
devo
ted
to m
arih
uana
.
LSD
and
mes
calin
e ar
e in
the
clas
sific
atio
n of
dru
gs c
alle
d
D-9
8a)
alw
ays,
som
e-tim
es, a
lway
sb)
alw
ays,
alw
ays,
alw
ays
c) a
lway
s, s
ome-
times
, alw
ays
H-1
00 H
allu
cino
gens
(or
psy
ched
elic
s) a
re d
rugs
cap
able
of p
rovo
king
cha
nges
of s
ensa
tion,
thin
king
, sel
f-aw
are-
ness
, and
em
otio
n. T
he e
ffect
s va
ry w
idel
y fr
om in
divi
dual
to in
divi
dual
and
from
one
use
to th
e ne
xt.
The
y ra
nge
from
ple
asan
t im
ages
and
feel
ings
to te
rror
and
dre
ad.
Hal
luci
noge
ns p
rovo
ke c
hang
es in
and
H-9
9
hallu
cino
gens
or p
sych
edel
ics
H-1
01 L
SD
lyse
rgic
aci
d di
ethy
lam
ide
is s
ynth
esiz
ed fr
om e
rgot
, a fu
ngus
that
spo
ils r
ye g
rain
. Alth
ough
it is
prob
ably
the
mos
t wid
ely
know
n ha
lluci
noge
n, it
s le
gal u
se is
res
tric
ted
to m
edic
al r
esea
rch.
LSD
is s
ynth
esiz
ed fr
om
H-1
00se
nsat
ion,
thin
king
,se
lf- a
war
enes
s,an
d em
otio
n(a
ny o
rder
)
H-1
02 L
SD
is a
tast
eles
s, o
dorle
ss, c
olor
less
liqu
id w
hich
can
be
put i
n su
gar
cube
s, c
ooki
es, o
r cr
acke
rs.
The
liqui
d ca
n al
so b
e in
ject
ed, o
r ta
ken
in ta
blet
or
caps
ule
form
.
It is
(po
ssib
le, i
mpo
ssib
le)
to te
ll vi
sibl
y if
a co
okie
has
bee
n im
preg
nate
d w
ith L
SD
.
H-1
01
ergo
t
H-1
03 L
SD
is o
ne o
f the
mos
t pot
ent d
rugs
kno
wn.
A d
ose
of 2
5 m
icro
gram
s (p
g's)
,an
am
ount
alm
ost i
nvis
ible
to th
e na
ked
eye,
will
pro
duce
a m
ild e
ffect
on
mos
t peo
ple.
Dos
es o
f abo
ut 1
00 p
g's
are
cons
ider
ed a
vera
ge.
LSD
is s
o po
tent
that
the
amou
nt e
quiv
alen
t to
two
aspi
rins
will
pro
vide
abo
ut 6
,500
aver
age
dose
s. B
e-ca
use
of th
e hi
gh p
oten
cy o
f LS
D, a
sm
all v
aria
tion
in d
osag
e m
ay p
rodu
ce a
larg
e va
riatio
n in
effe
ct.
H-1
02
impo
ssib
le
H-1
04 T
he a
ctua
l phy
sica
l effe
cts
of L
SD
are
wel
l doc
umen
ted.
It pr
oduc
es c
hang
es in
the
body
by
actin
g on
the
cent
ral a
nd s
ympa
thet
icne
rvou
s sy
stem
s, r
esul
ting
inin
crea
sed
puls
e an
d he
art r
ate,
a r
ise
in b
lood
pre
ssur
e an
d te
mpe
ratu
re, p
upil
dila
tion,
trem
ors,
sw
eaty
palm
s, c
hills
, nau
sea,
lack
of a
ppet
ite, e
tc. I
n or
dina
ry d
oses
, how
ever
, the
se e
ffect
sar
e in
sign
ifica
nt.
At o
rdin
ary
dose
s, L
SD
pro
duce
s m
inor
(ph
ysic
al/p
sych
olog
ical
)ch
ange
s.C
2 f
H-1
03
Go
on to
next
fram
e.
H-1
05 T
he p
sych
olog
ical
effe
cts
of L
SD
are
con
side
rabl
ym
ore
diffi
cult
to d
escr
ibe
and
vary
wid
ely
from
per
son
to p
erso
n. T
he "
prop
er s
et,"
that
is, t
he e
xpec
tatio
ns a
nd a
ttitu
des
of th
eus
er a
nd th
e se
tting
in w
hich
the
drug
is ta
ken,
is o
f fun
dam
enta
l im
port
ance
.
Impo
rtan
t det
erm
inan
ts o
f how
a p
erso
n re
acts
to L
SD
may
be
his
H-1
04
phys
ical
H-1
06 W
hen
take
n or
ally
, sym
ptom
s of
the
influ
ence
of L
SD
app
ear
in 3
0 to
45
min
utes
. If i
njec
ted,
they
appe
ar in
5 to
10
min
utes
. An
aver
age
trip
last
s fr
om 6
-24
hour
s, d
epen
ding
on
the
amou
nt ta
ken.
The
inte
nsity
of t
hetr
ip is
dep
ende
nt o
n th
e am
ount
take
n an
d on
the
psyc
holo
gica
l set
of t
he u
ser.
Wha
t fac
tors
influ
ence
the
inte
nsity
of a
n LS
D tr
ip?
H-1
05ex
pect
atio
nsan
d en
viro
n-m
ent (
oreq
uiva
lent
)
33
34
H-1
07 In
gen
eral
, the
LS
D e
xper
ienc
eco
nsis
ts o
f cha
nges
in p
erce
ptio
ns a
nd th
ough
t.
Per
cept
ual c
hang
es d
escr
ibed
by
user
sin
clud
e di
ffere
nt p
erce
ptio
ns o
f sig
ht, h
earin
g, to
uch,
body
imag
e,
and
time.
Col
ors
may
see
m to
inte
nsify
or
chan
ge; s
hape
s an
d sp
atia
l rel
atio
nshi
ps m
ay s
eem
topu
lsat
e an
d
chan
ge in
dim
ensi
on o
r as
sum
e lif
elik
equ
aliti
es. S
ensi
tivity
to s
ound
incr
ease
s, b
ut th
e so
urce
of th
e so
und
is o
ften
elus
ive.
Cha
nges
in th
ough
t inc
lude
a fr
ee fl
ow o
f ide
asof
all
kind
s so
that
ord
inar
y, tr
ivia
l eve
nts
may
ass
ume
unus
ual i
mpo
rtan
ce.
H-1
06
psyc
holo
gica
lse
t and
dose
H-1
08 U
sers
of L
SD
ref
er to
it a
s a
"con
scio
usne
ss-e
xpan
ding
" dr
ug. T
his
is p
artly
bec
ause
of th
e ef
fect
s w
e ha
ve
just
des
crib
ed. B
ut, i
n ad
ditio
n, it
is b
ecau
seLS
D b
reak
s do
wn
the
defe
nse
mec
hani
sms
of th
ein
divi
dual
that
serv
e to
shu
t som
e th
ings
out
of
his
cons
ciou
snes
s, a
nd w
hich
allo
w h
im to
cho
ose
the
bits
of i
nfor
mat
ion
that
are
allo
wed
to e
nter
.
The
se d
efen
se m
echa
nism
s of
ten
shut
out
of o
urm
inds
thin
gs th
at d
istu
rb u
s. U
nder
the
influ
ence
of L
SD
thes
e ba
rrie
rs a
re r
emov
ed a
nd a
gre
at d
eal o
f inf
orm
atio
nab
out o
nese
lf an
d on
e's
wor
ld is
bro
ught
from
the
subc
onsc
ious
to th
e co
nsci
ous
leve
l.
Thi
s ef
fect
may
lead
use
rs to
feel
that
:
a) th
e w
orld
is le
ss m
eani
ngfu
l
b) th
ey h
ave
gain
ed a
bet
ter
unde
rsta
ndin
g of
them
selv
es a
nd th
e w
orld
aro
und
them
1=1
H-1
09 T
his
kind
of e
xper
ienc
e m
ay b
ebe
nefic
ial t
o an
indi
vidu
al w
ho c
an c
ope
with
the
situ
atio
n. A
n un
stab
le p
er-
son,
psy
chol
ogic
ally
unp
repa
red
to s
eehi
mse
lf w
ithou
t the
se d
efen
ses,
may
dev
elop
aps
ycho
sis
from
the
expe
rienc
e.
The
indi
vidu
al.w
ho h
as h
ad -
a ha
d tr
ip fe
els
alon
e in
the
wor
ld a
nd b
ecom
es fr
ight
ened
. He
som
etim
es is
so
over
whe
lmed
that
he
pani
cs b
ecau
se h
e fe
ars
he w
ill n
ever
"com
e do
wn"
to r
ealit
y.
The
ext
rem
e fr
ight
of s
uch
an e
xper
ienc
e m
aype
rsis
t and
rec
ur fo
r so
me
time
afte
r th
e us
e of
the
drug
.In
addi
tion
the
indi
vidu
al m
ay e
xper
ienc
e "f
lash
back
s,"
whi
ch a
re a
ctua
l rec
urre
nces
of t
he L
SD
exp
erie
nce.
Whi
ch o
f the
oth
er d
rugs
we
have
dis
cuss
ed m
ay le
adto
a d
rug
psyc
hosi
s'
H-1
07
Go
on to
next
fram
e.
H-1
08
b) they
hav
e ga
ined
a be
tter
unde
r-st
andi
ng o
f the
m-
selv
es. a
nd th
ew
orld
aro
und
them
H-1
10 B
ecau
se o
f the
pos
sibi
lity
of "
frea
king
out
," p
eopl
e w
ho ta
ke L
SD
ofte
n pr
ovid
e th
emse
lves
with
a g
uide
afr
iend
who
is n
ot u
nder
the
influ
ence
of t
he d
rug.
Thi
s gu
ide
atte
mpt
s to
ens
ure
that
no
phys
ical
har
m c
omes
to th
e us
er a
nd w
ill tr
y to
"ta
lk h
im d
own"
if p
anic
set
s in
. In
such
a s
ituat
ion
the
user
's ju
dgem
ent i
s ap
t te
be fa
ulty
and
he
may
do
haza
rdou
s th
ings
.
Unf
ortu
nate
ly, h
is fr
iend
will
not
nec
essa
rily
have
the
expe
rtis
e to
con
trol
the
situ
atio
n.
A d
rug
psyc
hosi
s m
ay o
ccur
as
a re
sult
of a
n LS
D tr
ip b
ecau
se a
n un
stab
le in
divi
dual
may
not
be
able
to
cope
with
the
brea
kdow
n of
his
H-1
09
amph
etam
ines
H-1
11 A
n in
divi
dual
on
an L
SD
trip
may
pan
ic.b
ecau
se h
e w
onde
rs if
he
will
be
abIe
toH
-110
norm
al d
efen
sem
echa
nism
s.
H-1
12 It
is p
ossi
ble,
und
er m
edic
al s
uper
visi
on, t
o co
unte
ract
the
effe
cts
of a
bad
trip
with
sed
ativ
es a
nd tr
anqu
il-iz
ers.
How
ever
, ind
iscr
imin
ate
use
of d
rugs
to c
ount
erac
t a b
ad tr
ip m
ay le
ad to
furt
her
phys
ical
and
psy
cho.
logi
cal p
robl
ems.
For
exa
mpl
e, th
e us
e of
stim
ulan
ts o
r ot
her
psyc
hede
lic d
rugs
wou
ld te
nd to
incr
ease
the
effe
cts
of L
SD
.
Alth
ough
cer
tain
sed
ativ
e dr
ugs
may
hel
p co
unte
ract
a b
ad tr
ip, t
he u
se o
f stim
ulan
ts w
illit.
H-1
11
"com
e do
wn"
or
retu
rn to
real
ity
H-1
13 It
is p
ossi
ble
to d
evel
op to
lera
nce
to L
SD
if th
e sa
me
dose
is ta
ken
daily
. The
effe
cts
of L
SD
are
so
inte
nse,
how
ever
, tha
t peo
ple
usua
lly h
ave
no d
esire
to ta
ke th
is d
rug
mor
e th
an o
nce
a w
eek.
If o
ne d
id ta
ke L
SD
daily
, by
the
four
th d
ay, p
ract
ical
ly n
o ef
fect
s w
ould
be
notic
ed. B
ut th
is to
lera
nce
is r
ever
sed
quic
kly
usua
lly w
ithin
48
hour
sif t
he d
rug
is d
isco
ntin
ued.
The
refo
re, w
e w
ould
say
that
tole
ranc
e to
LS
D is
(ra
rely
/ofte
n)de
velo
ped.
H-1
12
inte
nsify
35
36
H-1
14 A
mon
g ha
bitu
al u
sers
of L
SD
, tw
ice
a m
onth
usa
ge is
con
side
red
heav
y us
age.
At t
his
rate
, tol
eran
ce (
is/is
not)
likel
y to
dev
elop
.
H-1
15 L
SD
doe
s no
t pro
duce
phy
sica
l dep
ende
nce:
The
refo
re, t
here
are
no
phys
ical
with
draw
al s
ympt
oms
upon
dis
-co
ntin
uanc
e.
How
ever
, "fla
shba
cks"
or r
ecur
renc
es o
f the
dru
gged
sta
tem
ay p
ersi
st fo
r m
onth
s af
ter
the
drug
has
been
dis
cont
inue
d.
Alth
ough
ther
e is
no
evid
ence
of p
hysi
cal w
ithdr
awal
upo
n di
scon
tinua
nce
of L
SD
,m
ay o
ccur
mon
ths
afte
r th
e dr
ug h
as b
een
used
.
Cu
:-11
6 T
o re
view
, the
use
r of
LS
D r
arel
y de
velo
ps to
lera
nce
to th
e dr
ugan
d if
he d
oes,
it is
usu
ally
rev
erse
d in
ave
ry s
hort
tim
e. N
or d
oes
he e
xper
ienc
e ph
ysic
al w
ithdr
awal
sym
ptom
s si
nce
LSD
doe
s no
t lea
d to
phys
ical
dep
ende
nce.
How
ever
, one
may
dev
elop
ade
pend
ence
on
the
effe
cts
of th
e dr
ug.
H-1
17 C
urre
ntly
, sci
entis
ts a
re n
ot in
agr
eem
ent o
n th
e sp
ecifi
c lo
ng te
rm r
isks
of t
akin
g LS
D, a
lthou
gh m
any
harm
ful e
ffect
s ar
e su
spec
ted.
Am
ong
the
issu
es b
eing
deb
ated
are
the
poss
ibili
ty o
f ser
ious
long
term
men
tal i
llnes
s re
sulti
ng fr
om a
bad
trip
, the
pos
sibi
lity
of c
hrom
osom
al d
amag
e, a
nd th
e ef
fect
s of
flas
hbac
ks.
Alth
ough
non
e of
thes
e lo
ng te
rm d
ange
rs h
as b
een
conc
lusi
vely
pro
ven,
the
wou
ld-b
e us
er o
f LS
D s
houl
d be
awar
e th
at th
ey m
ay c
onst
itute
a s
erio
us r
isk.
H-1
13
rare
ly
H-1
14is
not
H-1
15fla
shba
cks
H-1
16ps
ycho
logi
cal
H-1
18 A
n in
divi
dual
may
pan
ic d
urin
g an
LS
D tr
ip if
:
a) h
e is
or
feel
s al
one
b) h
e ca
nnot
cop
e w
ith th
e ef
fect
s on
the
drug
s on
him
self
c) h
e is
afr
aid
he w
on't
be a
ble
to c
ome
back
to r
ealit
y
d) a
ll of
abo
ve
H-1
17
Go
on to
next
fram
e.
H-1
19 P
eyot
e, th
e so
urce
of m
esca
line,
ano
ther
hal
luci
noge
n, is
lega
lly u
sed
by th
e A
mer
ican
Indi
ans
of th
e N
ativ
eA
mer
ican
Chu
rch
of N
orth
Am
eric
a in
thei
r re
ligio
us c
erem
onie
s. H
owev
er, a
ny o
ther
use
, with
the
exce
ptio
n.
of m
edic
al r
esea
rch,
is il
lega
l.
H-1
18
d) a
ll of
abo
ve
H-1
20 M
esca
line
is d
eriv
ed fr
om th
e M
exic
an p
eyot
e ca
ctus
. It i
s av
aila
ble
an th
e ill
egal
mar
ket i
n a
varie
ty o
f
C.A
.)fo
rms
rang
ing
from
who
le o
r ch
oppe
d ca
ctus
"bu
ttons
" to
cap
sule
s of
pow
der
or v
ials
of l
iqui
d. It
is u
sual
lyP
ryta
ken
oral
ly b
ut m
ay b
e in
ject
ed. M
esca
line
has
a ch
arac
teris
tic b
itter
tast
e so
whe
n ta
ken
oral
ly it
is u
sual
lym
ixed
with
cof
fee,
tea,
milk
, or
oran
ge ju
ice.
Mes
calin
e is
foun
d in
thre
e fo
rms:
,an
d
H-1
19
Go
on to
next
fram
e.
H-1
21 A
lthou
gh m
esca
line
is a
bout
4,0
00 ti
mes
wea
ker
than
LS
D, i
n la
rge
enou
gh d
oses
it w
ill p
rodu
ce a
ppro
xi-
H-1
20m
atel
y th
e sa
me
effe
cts.
Bec
ause
muc
h lo
wer
dos
es c
an b
e ta
ken,
ther
e is
con
side
rabl
y le
ss r
isk
of h
avin
g a
"bad
trip
."ca
ctus
"but
tons
,"T
he e
ffect
s of
mes
calin
e ar
e m
ost s
imila
r to
pow
der,
and
liqui
da)
her
oin
b) "
spee
d"
c) L
SD
d) M
iltow
n
37
38
H-1
22 T
o re
view
, peo
ple
ofte
n ta
ke L
SD
bec
ause
they
feel
that
the
chan
ges
in th
eir
perc
eptio
n ca
used
by
the
drug
help
them
gai
n a
bette
r un
ders
tand
ing
of
H-1
21
c) L
SD
H-1
23 T
akin
g LS
D in
com
bina
tion
with
any
oth
er d
rug
is d
ange
rous
, par
ticul
arly
if it
is ta
ken
in c
ombi
natio
n w
ith
stim
ulan
ts o
r ot
her
psyc
hede
lic d
rugs
. The
se d
rugs
(in
crea
se/d
ecre
ase)
the
effe
cts
ofth
e LS
D.
H-1
22th
emse
lves
and
the
wor
ldar
ound
them
(or
equi
vale
nt)
H-1
24 T
he n
atur
e of
dep
ende
ncy
prod
uced
by
the
chro
nic
use
of m
esca
line
is s
imila
r to
LS
D. T
here
is a
pot
entia
lfo
r ps
ycho
logi
cal d
epen
denc
e al
thou
gh th
ere
is n
o ev
iden
ce o
f phy
sica
l dep
ende
nce
deve
lopi
ng. T
oler
ance
may
dev
elop
but
it is
rar
e.
With
res
pect
to th
e ch
roni
c us
e of
mes
calin
e an
d LS
D la
bel t
he fo
llow
ing
stat
emen
ts a
s T
rue
or F
alse
:
a) P
hysi
cal d
epen
denc
e is
pro
duce
d
b) P
sych
olog
ical
dep
ende
nce
is p
rodu
ced
c) T
oler
ance
alw
ays
deve
lops
.
H-1
23in
crea
se
TH
IS IS
TH
E E
ND
OF
PA
RT
V.
part
VI
mar
ihua
naM
-125
Wha
t is
mar
ihua
na?
Wha
t has
mot
ivat
ed a
n es
timat
ed 1
2 to
20
mill
ion
peop
le in
the
Uni
ted
Sta
tes
to tr
y it?
H-1
24
a) F
alse
b) T
rue
c) F
alse
M-1
26 M
arih
uana
com
es fr
om C
anna
bis
sativ
a, th
e he
mp
plan
t whi
ch g
row
s fr
eely
as
a co
mm
on w
eed
in m
any
cli-
mat
es a
nd m
any
soils
. Pha
rmac
olog
ical
ly it
is u
sual
ly c
lass
ified
as
a m
ild h
allu
cino
gen
but i
t has
als
o be
enre
port
ed to
hav
e se
dativ
e or
hyp
notic
qua
litie
s.
Pha
rmac
olog
ical
ly, m
arih
uana
is c
lass
ified
as
a
M-1
25G
o on
tone
xt fr
ame.
;`..
M-1
27 W
hen
the
culti
vate
d C
anna
bis
sativ
a pl
ant i
s fu
lly r
ipe,
a s
ticky
, gol
den
yello
w r
esin
with
a m
inty
frag
ranc
eco
vers
its
flow
er c
lust
ers
and
top
leav
es. I
t is
this
res
in w
hich
con
tain
s th
e ac
tive
ingr
edie
nts
of m
arih
uana
, as
do th
e le
aves
them
selv
es.
Sci
entis
ts h
ave
rece
ntly
isol
ated
and
syn
thes
ized
one
of t
he a
ctiv
e in
gred
ient
s in
the
resi
n. It
is c
alle
d A
9te
tra
hyd
roca
n n
ab i
nol (
TH
C).
The
act
ive
ingr
edie
nts
of m
arih
uana
are
foun
d in
the
of th
e C
anna
bis
sativ
a pl
ant.
M-1
26
hallu
cino
gen
M-1
28 T
he p
oten
cy o
f the
dru
g de
pend
s on
the
amou
nt o
f TH
C in
the
resi
n. A
s w
ith a
ny d
rug
purc
hase
d ill
egal
ly,
how
ever
, the
buy
er h
as n
o gu
aran
tee
as to
its
actu
al s
tren
gth.
Has
hish
com
es fr
om th
e flo
wer
ing
tops
of t
he m
ost p
oten
t var
ietie
s of
the
Can
nabi
s pl
ant.
It is
from
five
toei
ght t
imes
str
onge
r th
an m
arih
uana
.
Mar
ihua
na w
ill p
rodu
ce a
(le
ss/m
ore)
inte
nse
effe
ct th
an a
sim
ilar
quan
tity
of h
ashi
sh.
M-1
27re
sin
and
leav
es
39
40
M-1
29 In
the
Uni
ted
Sta
tes,
mar
ihua
na is
gen
eral
ly s
mok
ed in
cig
aret
tes
or p
ipes
.T
he s
mok
e is
dee
ply
inha
led
and
held
in th
e lu
ngs
for
as lo
ng a
s po
ssib
le; o
ne c
igar
ette
or
"join
t" is
ofte
n sh
ared
by s
ever
al p
eopl
e. M
ari-
huan
a ca
n al
so b
e ad
ded
to fo
od.
Mar
ihua
na c
igar
ette
s ar
e ha
nd r
olle
d an
d ar
e sm
alle
r th
an r
egul
ar c
igar
ette
s; th
e en
dsof
the
pape
r ar
eus
ually
eith
er tu
cked
in o
r tw
iste
d. T
obac
co m
ay b
e m
ixed
with
the
drie
d le
aves
to a
ct a
s a
bind
er.
To
slow
com
bust
ion,
the
ciga
rette
is li
cked
bef
ore
light
ing
it. T
he s
mok
e gi
ven
off b
y th
ese
ciga
rette
s ha
s a
char
acte
r-is
tic o
dor
that
res
embl
es th
e sw
eet s
mel
l of b
urni
ng g
rass
or
rope
.
The
sm
oke
from
mar
ihua
na is
dis
tingu
isha
ble
from
the
smok
e of
reg
ular
toba
cco
beca
use
of it
s ch
arac
teris
tic
M-1
28
less
M-1
30 T
he e
ffect
s of
mar
ihua
na v
ary
grea
tly fr
om in
divi
dual
to in
divi
dual
. It i
s es
timat
ed th
at a
larg
e pr
opor
tion
ofus
ers
feel
not
hing
at a
ll, p
artic
ular
ly th
e fir
st ti
me
they
use
the
drug
. For
thos
e w
hoac
know
ledg
e th
e dr
ug's
effe
cts,
feel
ings
ran
ge fr
om d
epre
ssio
n to
exc
item
ent,
from
trus
t to
susp
icio
n, d
epen
ding
on
a va
riety
of
fact
ors.
The
effe
cts
of th
e dr
ug a
re m
edia
ted
by p
sych
olog
ical
and
per
sona
lity
diffe
renc
es a
mon
g in
divi
dual
s an
d by
the
user
's r
elat
ions
hip
to o
ther
s in
the
room
who
mig
ht b
e ex
perie
ncin
g th
e sa
me
sens
atio
ns. T
he e
ffect
s of
the
drug
are
als
o de
pend
ent u
pon
the
stre
ngth
and
the
amou
nt u
sed
and
the
man
ner
in w
hich
it w
as s
mok
edor
inge
sted
.
List
thre
e fa
ctor
s th
at w
ill d
eter
min
e ho
w m
arih
uana
affe
cts
a pa
rtic
ular
indi
vidu
al:
M-1
29
odor
M-1
31 B
elow
are
som
e of
the
mos
t com
mon
rea
ctio
ns to
sm
okin
g m
arih
uana
.
One
gen
eral
ly b
egin
s to
feel
the
drug
's e
ffect
s w
ithin
5 to
10
min
utes
afte
r he
has
beg
unsm
okin
g. E
ffect
sm
ay b
e fe
lt by
inha
ling
from
thre
e to
a d
ozen
tim
es. T
here
may
be
anin
itial
feel
ing
of r
estle
ssne
ss, a
ccom
-pa
nied
by
fear
and
anx
iety
. Thi
s co
mm
on e
xper
ienc
e fo
r th
e fir
st ti
me
user
is o
ften
alle
viat
edif
supp
ortiv
efr
iend
s ar
e pr
esen
t. B
ecau
se th
e dr
ug p
uts
mos
t ind
ivid
uals
in a
hig
hly
sugg
estib
le s
tate
of m
ind,
they
can
usua
lly b
e ta
lked
out
of t
heir
fear
s. It
is u
nusu
al fo
r su
ch p
aran
oid
feel
ings
to r
ecur
with
subs
eque
nt u
sage
unle
ss th
e in
divi
dual
has
dee
p-se
ated
per
sona
lity
prob
lem
s.
Afte
r in
halin
g si
x tim
es o
n a
mar
ihua
na c
igar
ette
, ,on
e is
like
ly to
sta
rt fe
elin
g its
effe
cts:
a) im
med
iate
ly
b) w
ithin
10
min
utes
c) w
ithin
a h
alf h
our
M-1
30
Any
thre
eor
equ
ival
ent:
pers
onal
ity,
stre
ngth
,do
se,
setti
ng
M-1
32 F
eelin
gs o
far
e lik
ely
to o
ccur
the
first
tim
e on
e ex
perie
nces
the
effe
cts
of m
arih
uana
.
M-1
31
b) w
ithin
10
min
ute
M-1
33 T
his
first
per
iod
is fo
llow
ed s
hort
ly b
y a
feel
ing
of e
upho
ria. P
hysi
cally
, the
re is
a fe
elin
g of
light
head
edne
ssan
d, m
enta
lly, a
hei
ghte
ned
perc
eptio
n of
eve
n th
e m
ost s
impl
e an
d fa
mili
ar o
bjec
ts, a
lthou
gh th
e ex
act
natu
re o
f the
per
cept
ion
may
not
be
reca
lled
once
the
drug
's e
ffect
s ha
ve w
orn
off.
Unc
ontr
olle
dla
ught
erof
ten
occu
rs, b
roug
ht o
n fo
r no
app
aren
t rea
son.
Min
or h
allu
cina
tions
or
delu
sion
s m
ay o
ccur
dep
endi
ng o
nth
e po
tenc
y of
the'
drug
.
Psy
chot
ic r
eact
ions
due
to th
e in
fluen
ce o
f mar
ihua
na a
re e
xtre
mel
y ra
real
thou
gh n
ot u
nhea
rd o
feve
nin
fairl
y un
stab
le in
divi
dual
s.
Whi
ch o
f the
follo
win
g ar
e ch
arac
teris
tic e
ffect
s of
mar
ihua
na?
a) s
hort
ness
of b
reat
h
b) e
upho
ria
c) h
eart
pal
pita
tions
d) m
inor
hal
luci
natio
ns
M-1
32
fear
and
anxi
ety
41
42
M-1
34 T
he s
ense
of t
ime
and
spac
e fr
eque
ntly
bec
omes
dis
tort
ed. H
ence
, act
iviti
es w
hich
req
uire
goo
d ju
dgem
ent
of ti
me
and
spac
e; s
uch
as d
rivin
g, s
houl
d be
avo
ided
. Tas
ks r
equi
ring
any
amou
nt o
f con
cent
ratio
n, s
uch
asre
adin
g, w
ill a
lso
be d
iffic
ult.
Driv
ing
whi
le u
nder
the
effe
cts
of m
arih
uana
sho
uld
be a
void
ed b
ecau
se th
e dr
ug im
pairs
the
indi
vidu
al's
sens
e of
and
M-1
33
b) e
upho
ria
d) m
inor
hallu
cina
tions
M-1
35 T
he e
ffect
s of
mar
ihua
na la
st fr
om 2
to 4
hou
rs, d
epen
ding
on
the
stre
ngth
and
am
ount
of t
he d
rug
smok
ed.
The
use
r th
en fa
lls in
to a
dre
amle
ss s
leep
and
wak
es w
ithou
t a h
ango
ver.
In g
ener
al, t
he e
ffect
s of
mar
ihua
na a
re (
calm
ing/
ener
gizi
ng)
M-1
34tim
e an
dsp
ace
(eith
eror
der)
M-1
36 M
arih
uana
doe
s no
t inc
ite p
eopl
e to
agg
ress
ive
or v
iole
nt b
ehav
ior.
Usu
ally
it r
esul
ts in
a le
thar
gy n
ot c
on-
duci
ve to
phy
sica
l act
ivity
. The
re is
no
evid
ence
that
mar
ihua
na e
ither
incr
ease
s or
impa
irs s
exua
l des
ire o
rpo
wer
s.
Thu
s, a
ny r
elea
se o
f inh
ibiti
ons
unde
r th
e in
fluen
ce o
f mar
ihua
na te
nds
to b
e (p
hysi
cal/v
erba
l)
M-1
35
calm
ing
M-1
37 T
o re
view
, sen
satio
ns th
at c
hara
cter
ize
use
of m
arih
uana
incl
ude
whi
ch o
f the
follo
win
g?
a) fe
elin
g of
incr
ease
d ph
ysic
al s
tren
gth
b) p
oor
judg
men
t and
an
inab
ility
to c
once
ntra
te
c) h
eigh
tene
d pe
rcep
tion
d) in
crea
sed
aler
tnes
s an
d en
ergy
e) s
ense
of e
upho
ria
f)di
stor
ted
sens
e of
spa
ce a
nd ti
me
g) a
ll of
abo
ve
M-1
36
verb
al
INV
M-1
38 In
add
ition
, whe
n un
der
the
influ
ence
of m
arih
uana
, the
indi
vidu
al m
ay e
xper
ienc
e de
lusi
ons
and
M-1
37
b) p
oor
judg
men
tan
d an
inab
ility
to c
once
ntra
te
c) h
eigh
tene
dpe
rcep
tion
e) s
ense
of e
upho
ria
f) d
isto
rted
sen
se o
fsp
ace
and
time
M-1
39 T
he e
ffect
s of
mar
ihua
na:
a) a
re v
irtua
lly th
e sa
me
with
all
user
sC
JIb)
last
for
seve
ral d
ays
c) v
ary
grea
tly fr
om in
divi
dual
to in
divi
dual
d) c
anno
t at a
ll be
def
ined
M-1
38
mild
hallu
cina
tions
M-1
40 T
he e
ffect
s of
sm
oked
mar
ihua
na u
sual
ly la
st a
bout
:
a) 2
to 4
hou
rs
b) 1
0 ho
urs
c) im
poss
ible
to d
eter
min
e
M-1
39
c) v
ary
grea
tly fr
omin
divi
dual
toin
divi
dual
43
44
M-1
41 S
cien
tists
bel
ieve
that
mar
ihua
na q
uick
ly e
nter
s th
e bl
oods
trea
m a
nd a
cts
on th
e br
ain
and
the
nerv
ous
syst
em. A
s ye
t, ho
wev
er, t
hey
don'
t kno
w e
xact
ly h
ow it
wor
ks.
The
sho
rt te
rm p
hysi
cal e
ffect
s of
sm
okin
g m
arih
uana
are
: red
deni
ng o
f the
eye
s, in
crea
sed
puls
e ra
te, a
nddr
ynes
s of
the
mou
th a
nd th
roat
.
Mor
e su
bjec
tive
repo
rts
also
incl
ude
a gr
eat t
hirs
t and
hun
ger
and
a gr
eate
r ap
prec
iatio
n fo
r fo
od.
Long
tim
e he
avy
user
s of
mar
ihua
na s
omet
imes
dev
elop
a c
hron
ic b
ronc
hial
cou
gh.
M-1
40
a) 2
to 4
hou
rs
M-1
42 T
here
is n
o ev
iden
ce th
at m
arih
uana
pro
duce
s ph
ysic
al d
epen
denc
e. N
eith
er is
ther
e an
y ev
iden
ce th
at it
will
lead
the
user
to ta
ke o
ther
str
onge
r dr
ugs.
As
with
alm
ost a
ny d
rug,
one
can
dev
elop
a p
sych
olog
ical
dep
ende
nce
on m
arih
uana
. Man
y pe
ople
find
the
expe
rienc
e pl
easu
rabl
e an
d us
e th
e dr
ug p
erio
dica
lly to
rel
ax a
nd a
chie
ve a
mild
hig
h. A
n in
divi
dual
who
uses
the
drug
chr
onic
ally
, how
ever
, may
just
wan
t to
esca
pe n
orm
al li
fe s
tres
ses
or to
trea
t his
per
sona
lity
prob
lem
s. S
uch
peop
le a
re g
ener
ally
cal
led
"pot
head
s."
Chr
onic
use
of m
arih
uana
may
lead
to a
(ph
ysic
al/p
sych
olog
ical
)de
pend
ency
.
M-1
41
Go
on to
next
fram
e.
M-1
43 W
hich
of t
he fo
llow
ing
are
true
con
cern
ing
mar
ihua
na?
a) It
is p
hysi
cally
add
ictin
g.
b)It
alm
ost a
lway
s le
ads
to u
se o
f str
onge
r dr
ugs.
c)It
may
lead
to p
sych
olog
ical
dep
ende
nce.
d) A
ll of
abo
ve.
M-1
42ps
ycho
logi
cal
M-1
44 T
o re
view
, mar
ihua
na is
der
ived
from
the
plan
t.M
-143
c)It
may
lead
tops
ycho
logi
cal
depe
nden
ce.
M-1
45 M
arih
uana
's c
omm
on e
ffect
s ar
e a
feel
ing
of a
and
a fe
elin
g of
hei
ghte
ned
M-1
44he
mp
orC
anna
bis
sativ
a
M-1
46 M
arih
uana
use
rs a
re li
kely
to fe
el w
hich
of t
he fo
llow
ing:
a) a
ggre
ssiv
e
b) v
iole
nt
c) s
light
ly le
thar
gic
d) h
ungr
y an
d th
irsty
M-1
45di
stor
ted
sens
e of
spac
e an
d tim
epe
rcep
tion
M-1
47 If
, as
has
been
sai
d, th
ere
are
no p
rove
n ha
rmfu
l effe
cts
in th
e oc
casi
onal
use
of m
arih
uana
, wha
t, th
en, i
sth
e da
nger
?
1) It
is s
till n
ot k
now
n fo
r su
re w
hat a
ll th
e lo
ng te
rm e
ffect
s of
usi
ng m
arih
uana
are.
Nor
is it
kno
wn
wha
tch
ange
s th
e oc
casi
onal
use
r in
to th
e ch
roni
c us
er.
2) C
hron
ic u
se o
f mar
ihua
na, e
spec
ially
by
teen
ager
s, c
an b
e ha
rmfu
l if i
t is
used
toes
cape
rea
lity:
the
indi
vidu
al o
ften
does
not
lear
n th
ene
cess
ary
skill
s fo
r liv
ing.
3) M
arih
uana
is c
lass
ified
as
an il
lega
l dru
g an
d (a
s of
the
publ
icat
ion
of th
is te
xt)
the
use,
sal
e, a
nd p
osse
s-si
on o
f mar
ihua
na is
a fe
lony
in m
ost S
tate
s. T
he lo
ng te
rmim
plic
atio
ns o
f fel
onio
us a
rres
t are
obv
ious
.
M-1
46
c) s
light
ly le
thar
gic
d) h
ungr
y an
dth
irsty
TH
IS IS
TH
E E
ND
OF
PA
RT
VI.
PA
RT
VII
IS A
RE
VIE
W O
F A
LL T
HE
MA
TE
RIA
L T
HA
T H
AS
BE
EN
CO
VE
RE
D. Y
OU
MA
Y W
ISH
TO
TA
KE
A B
RE
AK
OR
LO
OK
OV
ER
TH
E T
EX
T B
EF
OR
E Y
OU
BE
GIN
TH
E R
EV
IEW
.
45
46
part
VII
revi
ewR
-148
At t
he b
egin
ning
of t
his
cour
se th
e di
fficu
lty o
f def
inin
g th
e te
rm d
rug
abus
e w
asdi
scus
sed.
Now
that
you
are
near
the
end
of th
e pr
ogra
m, p
leas
e sp
end
a fe
wm
inut
es c
onsi
derin
g w
hat f
acto
rs d
eter
min
e w
heth
er o
rno
t a d
rug
is b
eing
abu
sed.
You
sho
uld
now
be
able
to w
rite
your
ow
n de
finiti
on o
f dru
g ab
use.
Dru
g ab
use
is
M-1
47
Go
on to
next
fram
e.
R-1
49 T
he r
est o
f thi
s se
ctio
n w
ill r
evie
w th
e m
ater
ial c
over
ed in
Par
ts IV
I. R
efer
bac
k to
the
orig
inal
sec
tions
if yo
u
have
diff
icul
ty.
Cla
ssify
the
follo
win
g dr
ugs
as n
arco
tics,
stim
ulan
ts, o
r de
pres
sant
s:
a) m
orph
ine
b) B
enze
drin
e
c) a
mph
etam
ine
d) b
arbi
tura
te
e) h
eroi
n
f) S
econ
al
R-1
48
Go
on to
next
fram
e.
71"1
71.1
"MM
M Ir
rrt.w
w. !
Tim
rA
me.
mg.
..
D
R-1
50 N
arco
tics
(dep
ress
/stim
ulat
e)th
e ne
rvou
s sy
stem
.R
-149
a) n
arco
ticb)
stim
ulan
tc)
stim
ulan
td)
dep
ress
ant
e) n
arco
ticf)
dep
ress
ant
R-1
51 O
piat
e de
pend
ence
is c
hara
cter
ized
by
whi
ch o
f the
follo
win
g?
a) h
eart
dis
ease
b) d
evel
opm
ent o
f tol
eran
ce to
dru
g's
effe
cts
c) h
allu
cina
tions
d) d
esire
for
the
drug
's e
ffect
s
e) w
ithdr
awal
sym
ptom
s up
on d
isco
ntin
uanc
e of
dru
gs
R-1
50
depr
ess
-111
10
R-1
52 A
mph
etam
ines
(st
imul
ate/
depr
ess)
the
cent
ral n
ervo
us s
yste
m.
R-1
51
b) d
evel
opm
ent o
fto
lera
nce
todr
ug's
affe
cts
d) d
esire
for
the
drug
's e
ffect
se)
with
draw
alsy
mpt
oms
upon
disc
ontin
uanc
eof
dru
gs
47
NM
!
C-
48
R-1
53 F
or w
hich
of t
he fo
llow
ing
med
ical
pro
blem
s ar
e am
phet
amin
es p
resc
ribed
?
a) o
besi
ty
b) te
nsio
n
c) fa
tigue
d) p
ain
R-1
52st
imul
ate
R-1
54 W
ith r
egar
d to
stim
ulan
ts, l
abel
eac
h of
the
follo
win
g st
atem
ents
as
Tru
e or
Fal
se:
a) C
hron
ic lo
w d
ose
use
of s
timul
ants
lead
s to
phy
sica
l dep
ende
nce
b) T
oler
ance
may
dev
elop
whe
n la
rge
dose
s of
am
phet
amin
es a
re ta
ken
c) C
hron
ic u
se o
f stim
ulan
ts m
ay le
ad to
psy
chol
ogic
al d
epen
denc
e
d) A
dee
p de
pres
sion
may
follo
w th
e di
scon
tinua
nce
of s
timul
ants
R-1
55 F
or w
hich
of t
he fo
llow
ing
are
barb
itura
tes
pres
crib
ed?
a) to
indu
ce s
leep
b) to
dep
ress
app
etite
c) to
rel
ieve
pai
n
d) to
trea
t hig
h bl
ood
pres
sure
R-1
53
a) o
besi
ty
c) fa
tigue
R-1
54
a) F
alse
b) T
rue
c) T
rue
d) T
rue
R-1
56 A
lcoh
ol (
incr
ease
s/de
crea
ses)
the
effe
cts
of b
arbi
tura
tes.
R-1
55a)
to in
duce
sle
epd)
to tr
eat h
igh
bloo
d pr
essu
re
R -
157
With
res
pect
to b
arbi
tura
tes,
labe
l the
follo
win
g st
atem
ents
as
Tru
e or
Fal
se:
a) C
hron
ic u
se le
ads
to p
hysi
cal d
epen
denc
e
b) T
oler
ance
rar
ely
deve
lops
c) W
ithdr
awal
sym
ptom
s ar
e m
ild
d) O
verd
osag
e ca
n ca
use
deat
h
R-1
56in
crea
ses
R-1
58 W
ithdr
awal
from
bar
bitu
rate
s is
cha
ract
eriz
ed b
y w
hich
of t
he fo
llow
ing
sym
ptom
s?
a) p
rolo
nged
sle
ep
b) in
som
nia
c) h
allu
cina
tions
and
del
irium
d) le
thar
gy
R-1
57a)
Tru
e
b) F
alse
c) F
alse
d) T
rue
49
50
R-1
59 W
ith r
espe
ct to
con
tinue
d us
e of
LS
D, l
abel
the
follo
win
g st
atem
ents
as
Tru
e or
Fal
se:
a) P
hysi
cal d
epen
denc
e m
ay d
evel
op.
b) P
sych
olog
ical
dep
ende
nce
may
dev
elop
c) T
oler
ance
may
dev
elop
.
d) P
hysi
cal w
ithdr
awal
sym
ptom
s m
ay d
evel
op u
pon
disc
ontin
uanc
e
R-1
58
b) in
som
nia
c) h
allu
cina
tions
and
delir
ium
R-1
60 L
SD
(br
eaks
dow
n/in
tens
ifies
)no
rmal
def
ense
mec
hani
sms.
R-1
59
a) F
alse
b) T
rue
c) T
rue
d) F
alse
R-1
61 A
lthou
gh th
e lo
ng te
rm c
ompl
icat
ions
of L
SD
hav
eno
t bee
n co
nfirm
ed, w
hich
of t
he fo
llow
ing
cons
titut
es a
serio
us r
isk?
a) s
ever
e ph
ysic
al d
epen
denc
e
b) r
ecur
rent
hal
luci
natio
ns d
ays,
wee
ks, a
nd m
onth
s af
ter
inge
stio
n
c) k
idne
y m
alfu
nctio
n
R-1
60
brea
ks d
own
R-1
62 T
he e
ffect
s of
mar
ihua
na:
a) a
re v
irtua
lly th
e sa
me
with
all
user
s
b) la
st fo
r se
vera
l day
s
c) v
ary
grea
tly fr
om in
divi
dual
to in
divi
dual
d) c
anno
t at a
ll be
def
ined
R-1
61
b) r
ecur
rent
hallu
cina
tions
days
, wee
ks,
and
mon
ths
afte
rin
gest
ion
R-1
63 W
ith r
espe
ct to
mar
ihua
na, l
abel
the
follo
win
g st
atem
ents
Tru
e or
Fal
se:
a)It
lead
s to
phy
sica
l dep
ende
nce
b) It
alm
ost a
lway
s le
ads
to u
se o
f str
onge
r dr
ugs
c) T
oler
ance
to th
e dr
ug q
uick
ly d
evel
ops
R-1
62
c) v
ary
grea
tlyfr
omin
divi
dual
toin
divi
dual
TH
IS IS
TH
E E
ND
OF
TH
E R
EV
IEW
SE
CT
ION
.
51
R-1
63
a) F
alse
b) F
alse
c) F
alse
U. S
. GO
VE
RN
ME
NT
PR
INT
LN
G O
FFIC
E :
1972
0 -
466
-565
U.S
. DE
PA
RT
ME
NT
OF
HE
ALT
H, E
DU
CA
TIO
N, A
ND
WE
LFA
RE
Health S
ervices and Mental H
ealth Adm
inistration
National Institute of M
ental Health
5600 Fishers Lane
Rockville, M
aryland20852
DH
EW
Publication N
o. (HS
M) 72-9134
Printed 1972
