Abuse of a chemical leading to a worsening condition or disease requiring clinical treatment, as evidenced by one or more of the following symptoms:
Periodic use of a chemical that makes it impossible to fulfill important social obligations, such as: study, work or manage a household (for example, systematic absences of work related to substance use, absenteeism, prolonged non-attendance children or household).
Periodic use of a chemical in situations where it is life threatening (for example, driving a car or working on a machine while intoxicated).
Periodic legal problems associated with substance use (for example, arrests for unlawful acts committed under the influence of a chemical).
Prolonged use of a chemical, despite constant or regular social or interpersonal problems caused or aggravated by this substance, for example, disputes with the spouse (s) about the consequences of intoxication, fights).

These criteria should not overlap with the criteria for determining dependence on a given chemical substance.
“Unlike others, he (a heroin addict) cannot find a job, make a career, engage in meaningful activities around which he could build his life. Instead, he relies on his habit in everything.”
Psychologist Isodor Chain

Drug tolerance and withdrawal

Among the criteria for dependency in the DSM-4 is tolerance. Another new term is abstinence syndrome. Abstinence is a disease caused by the discontinuation of drug use or its reduction after the body is so accustomed to the presence of the drug in it that can no longer function without it. Clearly defined withdrawal syndrome does not cause all drugs. Abstinence symptoms may be stronger or weaker depending on the individual characteristics and the duration of the drug. Psychological symptoms, such as irritability, depression, and persistent desire for a drug, are usually part of an abstinence syndrome. It depends on their presence or absence whether a person can stop using drugs for a while.

Impact of drug use, tolerance and withdrawal on behavior

In this introductory chapter, attention was drawn to tolerance and withdrawal because these are central problems in psychopharmacology. Without them, the study of the drug and the evaluation of its action are impossible. Detailed consideration of these issues can be found in the following chapters. Now it is important to note that tolerance and abstinence affect the nature of drug use. For example, if tolerance increases, then a person needs to consume an increasing amount of the drug to get the desired effect. This in turn leads to the fact that a person spends more time on the acquisition and use of drugs. In the end, an increase in the number and frequency of drug use leads to the emergence of new physical, social and other problems.
Similarly, withdrawal leads to continued drug use, and most often in high doses. Studies have shown that the desire to get rid of withdrawal symptoms is a powerful incentive for further use of the drug. Abstinence begins when the level of the drug in the blood falls. If a drug is taken at this point, the withdrawal symptoms will disappear. But they will reappear and cause a vicious circle: the use of a drug – withdrawal – again the use of a drug.

The study of the mechanisms of action of tolerance and abstinence is the basis of psychopharmacology, which is looking for incentives for human consumption (or other living beings) of drugs. In Chapter 5, devoted to the principles and methods of psychopharmacology, this issue will be considered in detail.
We have shown that prolonged drug use changes the very nature of this use. The DSM-4 criteria specifically stipulate this duration. Tolerance and abstinence not only lead to changes in the production and consumption of drugs, usually their result is a jumble of one effect on another – the effect of a snowball. In the end, they are added phenomena that fall under other criteria for the diagnosis of diseases caused by drug use.

Focusing on what exactly can be called harmful use of drugs or use associated with harmful effects for a person taking drugs, or for other people. The research on the cost of health care uses the terms “drug abuse” and “alcohol abuse.” However, as already noted, different people put different meanings in the concept of “abuse”. This problem greatly complicates cooperation in the study of drug use. The lack of standard definitions slows down the growth of scientific knowledge. If we cannot figure out what it is that we want to study, it is hardly possible to move forward.

In the United States and other countries, people responsible for health care have solved the problem of definitions by developing diagnostic systems. The diagnosis is based on a group of symptoms, indicated in one word. This gives us an advantage. For example, if two doctors talk about pneumonia, while using a single diagnostic system, each of them clearly understands what the other means by the word “pneumonia”. He means above all a certain group of symptoms. A similar diagnostic system can be created for mental illness. In the US, the organization responsible for creating such a system is the American Psychiatric Association (ARA). Since the beginning of the 50s. The association publishes official diagnostic systems for various mental illnesses or disorders: Diagnostic and Statistical Manual (DSM). In the light of new research, these systems are reviewed from time to time. The latest version of the official diagnostic system was released in May 1994 and is called the DSM-IV. It has a section on chemical use disorders (that is, alcohol and other drugs), which contains definitions of chemical dependency and chemical abuse.
Table 1-1 gives the criteria for making a diagnosis of chemical dependence and abuse according to DSM-4. It is necessary to comment on these criteria. Basically, each criterion is applicable to the definition of dependence and abuse of any drugs and non-medical drug groups. Another important observation is that dependence and abuse are different diagnoses. It is impossible to make one person diagnoses of dependence on a chemical substance and its abuse at the same time, although it is possible to combine diagnoses for different substances.

In terms of dependence, criteria 3–6 define what is called a drug habit. Its essence is that the main thing in human life is the consumption and purchase of drugs, while all other aspects of life are ignored, or much less attention is paid to them. A man uses drugs, despite the risk. He cannot stop using drugs or shorten it for any significant amount of time, even if he wants to. This phenomenon is called loss of control.
The first 2 criteria of dependence introduce two terms: tolerance and abstinence. Next, we analyze them in more detail. In the DSM-4 diagnostic system, a dependency diagnosis can be made based on one of these criteria, or without them. For a more accurate diagnosis, at least 3 of the 7 criteria are needed.
When discussing the definition of addiction given in DSM, you need to consider a widely used term: psychological addiction. Like many other terms related to drugs, a different meaning can be put into the concept of psychological dependence. Most often, psychological dependence is an emotional state characterized by a sense of urgency towards the drug, either to gain an effect associated with its use or to relieve negative feelings associated with its abuse. As you can see, this is a narrower, but less detailed definition than that given in the DSM-4, and it focuses on the desire to use a drug in order to change its psychological state or avoid unpleasant sensations.

In the criteria for the abuse of chemicals, negative events in various spheres of life (family, social, professional) related to the use of chemicals are of prime importance. In relation to abuse, 4 criteria are given, and to make a diagnosis, it suffices to reveal one of them.
These criteria, which are based on the latest developments in the field of disorders associated with the use of chemicals, remove part of the problem of the scientific study of this topic. These are clear descriptive criteria. Of course, they are not perfect and will be refined as scientific knowledge grows.

Since, as a rule, people do not use drugs for medical purposes, it will be absolutely right to say that they like the sensations given by drugs. A very important question arises: what forms such sensations? Part of the answer lies in the chemical action of drugs, but this is not the only reason. Not so long ago, chemical action was called the main factor influencing the character of sensations. But studies of the past 30 years in the field of pharmacology, psychology and sociology have shown that these sensations are not the product of the pharmacological action of chemicals.

In order to better understand the nature of the sensations caused by drugs, we have divided all factors, pharmacological and non-pharmacological, into three groups. The first group consists of pharmacological factors. The first factor is the chemical properties and effects on the body of the drug. The next is his dose, that is, the amount of the substance consumed. The third pharmacological factor is the way of taking the drug, the way in which it enters the body. This is important because it depends on the method of administration which part of the dose reaches the organ affected by the drug and how quickly it will occur.
In Chapter 4, we will look at how to take drugs in detail and how sensations arise from this.
The second group of factors – non-pharmacological.

It consists of the characteristics of the person taking the drug, such as the genetic structure of the organism (inherited biological properties of the organism, which determine the response to the use of various drugs), gender, age, drug abuse tolerance and individuality. An important part of individuality is a psychological series, which includes knowledge, attitudes towards drugs, expectations and thoughts about them. For example, sometimes a firm belief that drugs must produce a certain effect is enough for an effect to take place, although a person has taken some inactive chemical (in pharmacology this is called a harmless medicine prescribed to calm the patient).

The third and last group, which also includes non-pharmacological factors, are circumstances in which the drug is taken. They come in different planes and include the environment, the laws of a given society, prohibiting the use of drugs and the presence or absence of other people at the time of taking the drugs.
All these three groups of factors influence the nature of sensations experienced while taking drugs. Tracing this influence is often very difficult. Still, many people try to do this. The knowledge gained by their efforts forms the basis of this blog.

Experts from the World Health Organization recognize that their definition of drugs is very broad. For research and practical purposes, all substances falling under the category should be divided. Pharmacologists make their own classification, which are based on the basic properties of drugs, related to their clinical structure and methods of use. In this book, drugs are classified according to the following principles:

By origin, for example, opiates are produced from opium poppy grown on plantations. The composition of pure (non-synthetic) opiates includes substances such as morphine and codeine. Heroin, a semi-synthetic drug, belongs to the group of opiates. Since in this classification we are only interested in the source of the drug obtained, then one group will include drugs with different chemical effects.
According to the effects In one group will get drugs with similar effects on the body. For example, both marijuana and atropine cause increased heart rate and dry mouth. Therefore, marijuana can be called atropinopodobnym drug.

For therapeutic use Attention is paid to the fact to change what processes in the body this substance is used. For example, amphetamines are called appetite suppressants. It should be noted that when using drugs, their therapeutic effects may not be taken into account at all. When amphetamines are used for non-medical purposes, their excitatory effects are taken into account. Similarly, morphine is used in medicine as a powerful painkiller, but drug addicts take it because it causes euphoria.

Alcohol, for example, is called a depressant drug because it suppresses the central nervous system. In contrast, cocaine is a stimulant, as it has a stimulating effect on the central nervous system. This classification is not quite suitable for drugs that affect different organs. For example, cocaine, which stimulates the central nervous system, also has an anesthetic effect. Moreover, drugs that are very different in chemical structure and mode of action can affect one and the same part of the body.
Chemical structure For example, barbiturates (phenobarbital, amital, seconol and others) are synthetic substances derived from barbiturate acid and differing in substances reacting with it.
According to the mechanism of action. In principle, this classification is good, but the mechanism of action of some drugs is still unknown.
By name in slang given in a particular subculture or on the black market.

Of all known types of drugs, we are most interested in the so-called psychoactive drugs that have an effect on mood, consciousness and behavior. Psychoactive drugs occupy the main place in the book, because people mostly use them, and they often create serious problems. This book focuses primarily on non-medical use of such

“Smoking, alcohol and drugs destroy the family, raise the cost of health care, overwhelm the educational, criminal procedure and social systems of the nation and contribute to the emergence of an unprecedented wave of violence and homelessness.”

People have been using drugs for thousands of years, but science has taken them up quite recently. The study of drugs involved in pharmacology, its subject – everything related to the action of chemicals on a living organism.
Pharmacology is a part of biology, closely related to physiology and biochemistry. Pharmacology section psychopharmacology – focuses on the effects of drugs on behavior. Although the name of science is a combination of psychology and pharmacology, to understand the effects of drugs on human behavior, environmental factors must also be taken into account, i.e. social. This book is devoted to human psychopharmacology.

People talk a lot about drugs, but it’s not easy to give a precise definition of drugs. With great difficulty, the experts nevertheless developed an acceptable definition. The World Health Organization (WHO) in its report in 1981 defined drugs in a broad sense as “a chemical substance or mixture of substances different from those necessary for normal life activity (like food), the intake of which entails a change in the functioning of the body and, possibly, its structures “.
This basic definition raises the question of what is drug use and abuse. Later in this chapter we will examine in detail the distinction between them, but now it is important for you to understand the general idea. The concept of “drug abuse” is used differently by different people who write on this subject and there is no universally accepted definition. Therefore, the only way to define this concept is to reach agreement between experts. Scientists have reached such an agreement regarding the terms used in scientific studies on alcohol and drugs, as well as in clinical practice. The definition of drug abuse can be given as follows: “drug use is detrimental to the physical and mental state,” legal capacity “and the social status of the person and people experiencing the impact of the person.”

As you can see, the main role in the definition is played by the consequences of the behavior of the addict for himself and the people of his social group. This classification of drugs and their use details this definition. There are some problems with him. The main thing is that the behavior that leads to disastrous consequences within one social or cultural group may not lead to them within another community, or their power of action will be different. Thus, it is impossible to give a definition that works everywhere. But, nevertheless, the term “abuse” in relation to alcohol and other drugs is used very, very often, and therefore it is not necessary to abandon attempts to reach a definition applicable to the absolute majority of situations. For now, the original notion of drug abuse is sufficient.

Before finishing the historical consideration of the subject, one should pay attention to the interesting and long-standing relationship between the use of psychoactive substances as drugs (this is discussed in detail in Chapter 5) and their use for other purposes. Many of these drugs were once used for medicinal purposes. Medicine did not immediately become such a science as we know it now. Even in our century, various folk remedies and so-called “patented drugs” were widespread. Perhaps the best example is the opiates (opium and morphine), which throughout the 19th century were used in the treatment of various diseases – rheumatism, pain, fever, delirium tremens, colds, etc. Opiates served as anesthesia during surgical operations. Doctors widely used opiates and often prescribed them to patients, while very poorly imagining how they affect the body. They only knew that opiates relieve pain and other, mostly incomprehensible, symptoms. Unfortunately, such widespread use led to a significant increase in the number of people falling into physical dependence on these substances. The fact that drugs are addictive was clearly realized only in the 1870s.

There are many more examples. Chloroform and ether were developed as anesthetic drugs, but they also did not pass use for inappropriate purposes: it was in the middle of the last century. In the history of cocaine, there was a period when it was used to treat depression and relieve pain. He was even used as a cure for opium addiction! In the second half of the 19th century, doctors found many uses for marijuana, including the treatment of insomnia and nervous disorders. However, their list was smaller than for opiates. In the twentieth century, we witnessed the emergence of synthetic amphetamine stimulants, and some of them were available for a long time without a prescription.

It is important to understand that in medicine (whether popular or modern), the use of psychoactive substances as medicines and their use for non-medical purposes will always be closely related. In the past, such substances often came into medicine from religious ceremonies and traditional medicine practices. Nowadays, a situation where a substance developed as a drug replenishes the ranks of drugs is common. In any case, it will not be possible to separate medicine and drugs.

Drugs are familiar to people for several thousand years. They were consumed by people of different cultures, for different purposes: during religious ceremonies, to recuperate, to change consciousness, to relieve pain and unpleasant sensations.
Already in the pre-writing period, we have evidence that people knew and used psychoactive chemicals: alcohol and plants, the consumption of which affects consciousness. Archaeological research has shown that as early as 6400 BC people knew beer and some other alcoholic beverages. Obviously, the fermentation processes were discovered by chance (grape wine, by the way, appeared only in 4-3 centuries BC). The first written evidence of intoxicant use is the story of Noah’s drunkenness from the Book of Genesis. Various plants have been used that cause physiological and psychological changes, usually in religious ceremonies or during medical procedures. An example is the use in the Middle East of 5 thousand BC. “grass of joy” (apparently, opium poppy). Around 2700 BC China has already used hemp (as an infusion, as tea): Emperor Shen Nung ordered his subjects to take it as a medicine for gout and absent-mindedness. Stone Age people knew opium, hashish, and cocaine and used these drugs to alter consciousness (during religious rites) and in preparation for the battle. On the walls of the burial complexes of the Indians of Central and South America there are images of people chewing coca leaves (one of the ways to take cocaine), dating from the middle of 3 thousand BC. It should be borne in mind that the fact of using a drug in one culture does not give us the right to assume that in other cultures at the same time people knew this drug and used it. As now, there are similarities and differences in the use of drugs by people of different cultures.

Throughout history, contacts between distant cultures have occurred through trade and war. For example, as a result of the crusades and journeys of Marco Polo, the Europeans recognized opium and hashish, which were widespread in the East. Later travels of Europeans (mainly Englishmen, French, Portuguese and Spaniards) to America brought new discoveries. The main psychoactive substances brought to Europe from America are cocaine (from South America), various hallucinogens (from Central America) and tobacco (from North America). Studies have shown that a two-way exchange took place between cultures. The birthplace of the coffee tree is Ethiopia. The Europeans became acquainted with the coffee drink in the 17th century, the sailors brought coffee beans to South America, which is now the world’s leading coffee producer. We add that from Europe came to America alcohol, obtained by distillation, and in Chile in 1545 hemp appeared.

Until the beginning of the 20th century, there were practically no restrictions on the production and use of drugs. Sometimes attempts were made to reduce or even prohibit the use of certain substances, but they were short-lived and, as a rule, unsuccessful. For example, tobacco, coffee and tea were initially greeted by Europe with hostility. The first European to smoke tobacco – Columbus’ satellite Rodrigo de Jerez – was imprisoned upon his arrival in Spain, as the authorities decided that the devil had settled in him. There have been several attempts to outlaw coffee and tea.

There are also cases when the state did not prohibit drugs, but rather promoted the flourishing of their trade. The best example is armed conflicts between Britain and China in the mid-19th century. They are called the Opium Wars, because English traders imported opium into China. By the mid-19th century, several million Chinese were addicted to opium. At this time, China, of course, came in first place in the world in the consumption of opium, most of which was grown in India and shipped to the country by the British. The Chinese government has passed many opium import control laws, but not one of them (including a total ban) has the desired effect. The British did not want to reduce the opium trade: first, it gave great profits, and secondly, in England itself there was no such surge of drug addiction, although opium was widely used in medicine. In 1839, a conflict broke out: the Chinese government destroyed a large cargo of opium belonging to British and American traders. The first opium war began. Britain won and, by the Nanking Treaty of 1842, received, among other things, the right to use the ports of Hong Kong as compensation for the destruction of opium. Trade continued and in 1856 led to the second war. This second opium war ended in 1858, and according to the terms of the Treaty of Tiensa, China continued to import opium, but could impose large customs duties. The opium trade declined and eventually stopped only at the beginning of the twentieth century, when a campaign began all over the world for allowing the use of drugs for medical purposes only (as painkillers).

In the twentieth century, almost the same drugs were used in Europe and America. Interestingly, many new or well-forgotten old drugs were first used in the United States, and then they spread to other countries, so that America set the tone for international drug use,
Description of the process by an amphetamine user

“Coming from amphetamines can not be compared with anything. You sleep powder, dissolve in water, put into a button accordion. Then you drag your hand with a belt. At this time you are very excited, your heart is pounding because you know that in a couple of minutes you will be happy. And here you go in. “

If stimulants are taken for a long time and regularly, new problems arise. One of them is the development of tolerance to the drug, and in the case of stimulants its character is rather complicated. First, there is a strong tolerance to cocaine. This means that the effect of the first dose taken can be repeated a second time only if the dose increases.

This is how a person using crack describes it:

“You can take so much crack that it will kill you, and you will not notice it, because the lungs are numb and you can be delayed again and again. After the first time, you try to feel the same coming all night. You think that it will happen again with the next dose, and you put another crack in the phone and drag it deeper. But it will be no longer, it will never be like that. Nothing compares to the first puff. ”

Strong tolerance to the physiological effects of cocaine (rapid heartbeat) was studied in humans in the laboratory. This tolerance quickly disappears, usually within a day. Studies of long-term tolerance to cocaine and amphetamines have not yet yielded significant results. In some cases, the development of tolerance to the various actions of stimulants on the body is clearly observed. For example, tolerance to hyperthermia (increase in body temperature) is constantly growing. However, other studies provide results that can be called reverse tolerance or increased sensitivity as a result of prolonged drug use. In these cases, small doses are sufficient for a particular effect. This is absolutely true for the property of cocaine to cause convulsions: the convulsive effect of the drug increases with prolonged use. This phenomenon is called kindling. The effect can also be achieved by electrostimulation. Such a phenomenon can play a role in cases when death from overdose occurs when taking relatively small doses of cocaine. In any case, the presence of normal or inverse tolerance depends on a variety of complex processes occurring during a certain impact on the body.
Addiction

Although the abstinence syndrome caused by cocaine or methamphetamines is not life threatening, it is still strong. The main symptoms include depression, falling out of society, severe anxiety, sleep disorders and, finally, a sense of urgent need for a drug. Many people who have gone through this say that the temptation to resume taking the drug is impossible to resist. From one to five days after the end of the reception, “breaking” lasts: a person is experiencing a deep depression, a complete breakdown and can only think about the drug. Sometimes during the break-up period, a person is so exhausted that he cannot even want to take another dose, but when he recovers a little, desire will flood with a new force. The second phase is abstinence: from 1 to 10 weeks, the person continues to feel a strong desire to take cocaine, he is still in a state of depression of severe or moderate severity, and he cannot feel pleasure. Finally, in the third phase there is a noticeable improvement, but for months or even years, the person sometimes experiences craving for the drug. This is a phase of extinction: the desire to take a dose again is caused by the “prompts” of the environment, which make a person suffer until finally he learns to extinguish these “hints”, possibly through special training.

Not all people who have experimented with cocaine or crack have an addiction, and not everyone who has taken drugs regularly for more than a year has such strong withdrawal symptoms. But if they appear, life becomes a nightmare. The risk of death in overdose, stimulatory psychosis and severe depression – this is not all. Many people who smoke crack often have chest pains associated with heart or lung damage. People who take cocaine through their nose suffer from insomnia, constant fatigue, severe headache, cramps and various infections that enter the body through the nose. Many coca women cannot stop using drugs during pregnancy, and the baby is in grave danger. Withdrawal symptoms last for a very long time, and therefore many people again firmly “sit on the needle” even after a few months of complete abstinence from cocaine.

Cocaine and other drugs.

Cocaine and other stimulants are often taken along with other drugs, especially with alcohol and opiates. As shown by the latest research, when mixing alcohol with cocaine, a new substance is formed in the body – cocaethylene. By its pharmacological properties, it is similar to cocaine, but may be more toxic. Many of the deaths from cocaine overdose are actually linked to cocaethylene poisoning. The combination of cocaine (or amphetamine) with heroin, a speedball, is especially popular among heroin addicts. A mixture of cocaine and heroin is sometimes called the cause of death from overdose (as was the case with John Belushi and Phoenix River), but experiments with a mixture of cocaine and opiates did not record the appearance of additional effects or synergism.

At high doses of stimulants, a characteristic psychosis is observed. Laboratory studies, when volunteers take amphetamines, cocaine, phenmethrazine (Preludin) or methylphenidates (Ritalin), confirm this. Such reactions with large doses of crack create a serious problem.
Paranoid disorder is the most common symptom of stimulatory psychosis. Another frequent symptom is an impulsive, stereotypical behavior; a person shakes, tears his hair, smokes cigarettes one by one, turns some thing in his hands. Sometimes there are hallucinations and goosebumps. Stimulatory psychosis is successfully treated with chlorpromazine (Thorazine) or other substances used in the treatment of schizophrenia.

Of course, large doses of cocaine or amphetamines are always accompanied by the risk of death from overdose. It is difficult to accurately determine the dose at which this risk begins. For cocaine, a small or moderate dose means 15-60 mg. (Usually, the “lane” contains 16–20 mg.) But there have been deaths from cocaine overdose, when people were given only 20 mg as a local anesthetic. Apparently they suffered a rare case of enzyme deficiency, which destroy cocaine in the blood and liver. These cases are exceptions, usually stimulatory psychosis or death occurs at much higher doses. In 1985, more than 500 people died from cocaine overdose in the US, but for many the compelling argument that cocaine kills were the deaths of athletes Len Bias, Don Rogers and film actor John Belushi. Stimulants can kill in different ways:
Cocaine can cause convulsions or a seizure that ends in suffocation.
Cocaine directly affects the nerve cells of the heart, which can cause a change in the rhythm of the heartbeat (arrhythmia). In severe cases, this can lead to fibrillation — a condition where the heart vibrates but does not pump blood.

Cocaine can cause a spasm of the coronary artery and the termination of blood access to the heart muscle. This leads to myocardial infarction and heart failure if the person remains alive.
Cocaine can cause a rupture of the cerebral artery due to high blood pressure, which can cause an attack. These are the most likely causes of death from cocaine overdose. Which factor causes death in a particular case is rarely established. Often the case is further complicated by the fact that other drugs are mixed with cocaine in order to bring about new sensations, and the result of such mixing is often unpredictable.

Stimulants produce many different effects beyond the brain. We discuss the effects of cocaine and amphetamines together, because in practice their measurable effects are identical. Although people taking these drugs claim that there are considerable differences between stimulants, in the laboratory, even experienced drug users cannot distinguish between cocaine and amphetamines or methylphenidates.
Stimulants are a classic example of sympathomomic drugs. This means that they stimulate the activity of the sympathetic branch of the autonomic nervous system, or imitate such activity. So, they produce the same physiological effects that accompany the usual emotional uplift: heartbeat, breathing increase, blood pressure rises, sweating increases. Meanwhile, the blood drains from the viscera and flows to large groups of muscles and the brain. Finally, the body temperature rises and the pupils dilate.

Cocaine and amphetamines also have an anorexic action (that is, they suppress appetite). After taking these drugs, people simply do not want to eat. Because of these properties, amphetamines and phenmetrazine (Preludin) have been prescribed to people on a diet. Patients actually ate noticeably less and lost weight, but in order to maintain this achievement, they had to increase the doses, and when people stopped using the drug, they, as a rule, became stout again. Thus, the benefits of these drugs were outweighed by the risk of drug dependence and side effects, which called into question their use for the treatment of obesity.

Moderate doses of cocaine and amphetamines cause mood elevation. People become more sociable and talkative. Emotional rise and vigor lead to a state of insomnia. These drugs improve physical endurance and strength. For example, a person shows the best results when running or swimming. The results do not increase much, but the athlete gets a significant advantage. Figure 6-2 shows the effects of methamphetamine on cycling. A control injection has little effect on fatigue and a decrease in driving speed, but an injection of methamphetamine (Methedrine), administered three hours after the start of the test, gives a significant improvement in the result, lasting several hours. Although there is no such data on the action of cocaine, it is safe to assume that it has the same effect, but it is less durable. Improving physical characteristics is one of the reasons that cocaine has recently been so common among athletes. When former coach of the Maryland basketball team Lefty Drizel noted this at a conference in June 1987 devoted to drugs, condemnations rained down on him from all sides. He actually advocated testing athletes for drugs, because if they give even the slightest advantage, the athlete will be tempted to take them.
Since stimulants increase the body’s resistance to fatigue, they are often used in the learning process. A person can learn during the whole night. This use of stimulants poses several problems. Information learned under the influence of a drug is easier to remember after taking the same drug. This is the phenomenon of dependence of learning outcomes on the state of the body, which is also observed in cases with other drugs. Recovering information in a sober form is difficult, so do not resort to this method of learning material. In addition, research data suggests that stimulants gradually deteriorate the ability to memorize. Figure 6-3 shows the increase in memorization errors after taking cocaine. Notice that the effect depends on the dose of the drug and the time it is taken, and that a 32 mg injection is much stronger than 96 mg given through the nose. Separate evidence suggests that stimulants reduce the ability to solve complex problems. Here is the case of William Halstead. Halstead’s discoveries at the beginning of our century make it possible to call him the father of modern surgery. But when he studied the anesthetic properties of cocaine, he was probably the first American to become addicted to this drug.

At this time, he published an article in the New York Medical Journal that began:

“Despite the fact that it can be explained in different ways, although at a loss on the possible misunderstanding of why modern hospitals, and, moreover, many, with a certain distrust expressed almost no interest in such a thing as local anesthesia, and with complete confidence Under these circumstances, I do not think that it is worth trying to defend the reputation of surgery instead of trying to win over others, and this prompted me a few months ago to write on this subject most of something like a scrapping article that poor health prevented me from finishing. ”

Cocaine undoubtedly influenced Halstead’s style, and it’s terrible to think about how this surgeon even operated! Thus, the statement that About cocaine improves mental ability – a myth. Another largely misguided notion of cocaine and amphetamines is their ability to increase sexual potential. This question is far from complete. But according to the available data, it is clear that although some people talk about sexual arousal and increased potency when taking stimulants, the majority do not experience anything like this. Many men who take stimulants, on the contrary, develop impotence, and women have a lack of interest in sex, but stimulants do not have such an effect on most people.
“He is necessary for me, he is simply necessary for me. You can’t even imagine this close to yourself.”
Actor John Belushi about cocaine.