Multiple Choice Questions
- (p. 125)The use of cocaine by members of the general public in Europe was initially in the form of
A. coca powder.
B. pills.
C. drinks, such as coca wine.
D. cigarettes.
Blooms Level: 01. Remember
- (p. 125)Dr. W. S. Halsted, the “father of American surgery,” experimented with cocaine’s ability to produce
A. dependence.
B. a deep sleep.
C. psychosis.
D. local anesthesia.
Blooms Level: 01. Remember
- (p. 126)Which famous physician studied cocaine as a treatment for morphine dependence and depression?
A. Benjamin Rush
B. Sigmund Freud
C. Johns Hopkins
D. Parke Davis
Blooms Level: 01. Remember
- (p. 128)The 1914 New York Times article, “Negro Cocaine ‘Fiends’ are a New Southern menace,”
A. provided solid documentation of increased psychiatric admissions due to cocaine.
B. erroneously said that cocaine increased homicidal tendencies and improved marksmanship.
C. erroneously said that the real problem was the alcohol people were drinking with cocaine.
D. was the first public description of crack cocaine use.
Blooms Level: 01. Remember
- (p. 129)What did the 1914 Harrison Act do?
A. outlawed coca, cocaine, and opium
B. taxed importation and sale of coca, cocaine, and opium
C. taxed possession of marijuana
D. outlawed possession of heroin
Blooms Level: 01. Remember
- (p. 129)Most illicit cocaine in the U.S. is powder cocaine (cocaine hydrochloride), which is
A. also called “rock” or “crack.”
B. a form of ecstasy (MDMA).
C. too stable to be smoked.
D. usually contaminated with strychnine.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 130)The passage of the 1986 Anti-Drug Abuse Act
A. came after over a thousand stories about cocaine had appeared in the national media.
B. did not focus on any particular drug.
C. came in response to increasing concerns about methamphetamine.
D. did not differentiate between crack and powder cocaine.
Blooms Level: 01. Remember
- (p. 130)Although National Survey on Drug Use and Health data indicates greater prevalence of illicit drug use among white Americans, black Americans represented more than 80 percent of those arrested for
A. marijuana possession.
B. selling methamphetamine.
C. all drug offenses.
D. violation of federal crack cocaine laws.
Blooms Level: 01. Remember
- (p. 126-127)In the text, the discussion of media depictions of powder cocaine use in the early 20th century and crack cocaine use in the 1980s was used to illustrate that
A. the U.S. media and drug policies may target people of color disproportionately.
B. the media should be used to publicize the extent of the drug problem.
C. U.S. drug policies have greatly reduced drug use.
D. powder cocaine and crack cocaine are distinctly different drugs.
Blooms Level: 01. Remember
- (p. 131)Cocaine’s effects in the brain
A. result from blocking serotonin reuptake.
B. result from blocking dopamine reuptake.
C. result from blocking norepinephrine reuptake.
D. all of the above.
Blooms Level: 01. Remember
- (p. 131-132)The most common way cocaine is used recreationally is by
A. intravenous injection.
B. insufflation (snorting).
C. mixing it with alcoholic beverages and drinking it.
D. smoking crack.
Blooms Level: 01. Remember
- (p. 132)What is cocaine still used for medically?
A. It is prescribed for weight loss.
B. It is used as a local anesthetic for nasal, laryngeal, and esophageal surgeries.
C. It is used as a local anesthetic for dental surgeries.
D. Cocaine has no medical uses currently.
Blooms Level: 01. Remember
- (p. 132)Cocaethylene
A. is a type of freebase cocaine that uses ether.
B. was one of the popular patent medicines sold around 1900.
C. is formed in the body when cocaine and alcohol are used together.
D. is a precursor for cocaine production.
Blooms Level: 01. Remember
- (p. 133)When laboratory animals are given unlimited opportunities to self-administer cocaine injection
A. most eventually become bored with it and stop taking it.
B. they become completely tolerant to it and it loses its effect.
C. they only inject enough to keep themselves awake.
D. they will readily self-administer it.
Blooms Level: 01. Remember
- (p. 133)Cocaine use during pregnancy now appears to be associated with
A. no consistent negative associations with physical growth, test scores, or language in children.
B. about one-third of all cases of mental retardation.
C. ADHD and depression in school-age children.
D. greater neonatal problems than alcohol or tobacco.
Blooms Level: 01. Remember
- (p. 134)Illicit cocaine comes to the U.S. primarily from
A. Southeast Asia.
B. Afghanistan.
C. South America.
D. Africa.
Blooms Level: 01. Remember
- (p. 135)Amphetamine was developed initially as a substitute for a closely related chemical derived from the Chinese herb ma huang. That chemical is
A. ephedrine.
B. sympathamine.
C. codeine.
D. GHB.
Blooms Level: 01. Remember
- (p. 136)Which of these was NOT one of the early medical uses for amphetamine first studied in the 1930s?
A. treating narcolepsy
B. treating anxiety
C. treating hyperactivity (ADHD)
D. weight control
Blooms Level: 01. Remember
- (p. 136)During World War II, amphetamines
A. became unavailable due to shortages of chemicals.
B. were used by the German military as a “truth serum” for interrogating prisoners.
C. were used by the Japanese, but only for senior officers.
D. were used to decrease fatigue by several nations’ militaries.
Blooms Level: 01. Remember
- (p. 136)Illicit use of intravenous amphetamines first became a big public concern in
A. 2002.
B. the 1930s.
C. the 1960s.
D. the early 1990s.
Blooms Level: 01. Remember
- (p. 138)Crystal meth refers to
A. methamphetamine crystals, which may be smoked.
B. methamphetamine capsules.
C. the “high” experienced after injecting methamphetamine.
D. methamphetamine imported from Colombia.
Blooms Level: 01. Remember
- (p. 138-139)Studies of the mechanism of action of the amphetamines have focused mainly on
A. serotonin and the endorphins.
B. GABA and glutamate.
C. nicotinic receptors.
D. release of norepinephrine and dopamine.
Blooms Level: 01. Remember
- (p. 140)Which of the following is true about the current use of amphetamines to treat depression?
A. Amphetamines are never used because of their abuse potential.
B. Amphetamines are used as mostly as an adjunctive therapy.
C. Amphetamines are more widely used than newer antidepressants, such as SSRIs.
D. Amphetamines are rarely used because they take too long to produce positive effects.
Blooms Level: 01. Remember
- (p. 140)The effect of amphetamines on weight control:
A. is real, but small and limited in duration.
B. is usually to increase weight rather than decrease it.
C. has never been demonstrated.
D. is both medically and cosmetically significant for most patients.
Blooms Level: 01. Remember
- (p. 141)Inattention, hyperactivity, and impulsivity are characteristics of
A. depression.
B. narcolepsy.
C. autism.
D. ADHD.
Blooms Level: 01. Remember
- (p. 141)One “non-stimulant” medication that has been approved for ADHD does not appear to have abuse potential. Atomoxetine is sold under the brand name
A. Ritalin.
B. Strattera.
C. Memantine.
D. Attends.
Blooms Level: 01. Remember
- (p. 141)One of the more disturbing side effects of treating ADHD with amphetamines or methylphenidate (Ritalin) is
A. the high rate of drug dependence that develops.
B. decreased height and weight gains in children.
C. increased numbers of suicide attempts.
D. liver dysfunction.
Blooms Level: 01. Remember
- (p. 142)The ability of stimulants to improve mental performance
A. has never been demonstrated in controlled studies.
B. is a myth—all the evidence shows that amphetamine and similar drugs impair performance.
C. is so clear that these drugs are routinely used to treat Alzheimer’s dementia.
D. depends on the complexity of the task and the dose.
Blooms Level: 01. Remember
- (p. 144)Paranoid psychosis can be produced by:
A. high doses of amphetamines.
B. methamphetamine, but not any other form of amphetamine.
C. withdrawal from long-term amphetamine use.
D. stimulant drugs, but only in certain individuals.
Blooms Level: 01. Remember
True / False Questions
- (p. 126-127)Sigmund Freud was always opposed to the use of cocaine for treating psychiatric conditions.
FALSE
Blooms Level: 01. Remember
- (p. 128)Some of the emotional justification for the 1914 Harrison Act can be found in a New York Times article from that year, called “Negro Cocaine ‘Fiends’ are a New Southern Menace.”
TRUE
Blooms Level: 01. Remember
- (p. 129)Crack cocaine is a very stable form of the drug also known as cocaine hydrochloride.
FALSE
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 131)Studies show that blacks are just as likely as whites to be arrested for violating crack cocaine laws.
FALSE
Blooms Level: 01. Remember
- (p. 133)Use of cocaine during pregnancy has been clearly linked to many kinds of birth defects and mental retardation.
FALSE
Blooms Level: 01. Remember
- (p. 135)The earliest medical use for amphetamine was as a substitute for ephedrine in treating asthma.
TRUE
Blooms Level: 01. Remember
- (p. 143)Scientific data indicate that chronic methamphetamine use causes extreme tooth decay.
FALSE
Blooms Level: 01. Remember
- (p. 129)One major similarity of freebase and crack cocaine is that they both can be smoked.
TRUE
Blooms Level: 01. Remember
- (p. 130)The structure of the cocaine molecule closely resembles the dopamine molecule.
FALSE
Blooms Level: 01. Remember
- (p. 141)The most common drug used in treating ADHD is still Modafinil.
FALSE
Blooms Level: 01. Remember
Essay Questions
- (p. 129)Explain the different preparations of cocaine and how they are used.
Coca paste is produced after soaking, mixing, and mashing coca leaves in an organic substance and after excess liquid is filtered out. In South America, this is often mixed with tobacco and smoked. Cocaine hydrochloride is a salt that mixes easily in water and is so stable that it cannot be heated to form vapors for inhalation. This is either sniffed through the nose or injected intravenously. Freebase is made by extracting cocaine into a volatile organic solvent, such as ether. It can then be smoked, but this is dangerous because of the combination of fire and ether fumes. Crack or rock can be created by combining cocaine with simple household chemicals, like baking soda and water, and then drying it. The resulting lump can be smoked.
Blooms Level: 01. Remember
- (p. 129-130)Discuss why current laws on crack possession have been criticized. Include at least three of these criticisms.
The laws seem to have a selective effect on the black community. The U.S. Sentencing Commission submitted three studies to Congress on these laws. Its findings show 1) the current penalties exaggerate the relative harmfulness of crack cocaine; 2) current penalties sweep too broadly and apply most often to lower-class offenders; 3) current quantity-based penalties overstate the seriousness of most crack cocaine offenses and fail to provide adequate proportionality; and 4) current penalties’ severity mostly affects blacks.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 133)Explain why the addiction potential of cocaine was unrecognized for many years.
At one time, drug addiction was linked to the presence of physical withdrawal symptoms. But many people do not experience cocaine-related withdrawal symptoms. Recent conceptualization of addiction relies on reinforcement and DSM-V criteria which may or may not include physical symptoms.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 136-137)Explain the three consequences for the drug scene from the tightening of restrictions on amphetamines in the 1960s and 1970s.
First, the market began to sell legal, milder stimulants (usually caffeine or ephedrine) that were virtually indistinguishable to the eye from prescription amphetamines. One could not be prosecuted until new regulations were made that made it illegal to distribute any substance misrepresented as a controlled substance. Second, the price of amphetamines went up and quality declined. Therefore, people went back to using cocaine because it was believed to be less dangerous. Third, the number of illegal methamphetamine laboratories increased.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
Chapter 07
Depressants and Inhalants
Multiple Choice Questions
- (p. 147)The CNS depressants include various prescription drugs referred to as
A. GHBs.
B. sedative-hypnotics.
C. entheogens.
D. catecholamines.
Blooms Level: 01. Remember
- (p. 148)Which of these is NOT one of the early sedative-hypnotics used in medicine?
A. chloral hydrate
B. paraldehyde
C. butyrate
D. bromide salts
Blooms Level: 01. Remember
- (p. 148)What has kept paraldehyde from being widely used?
A. danger to the CNS
B. bad taste and odor
C. danger to the respiratory system
D. irritation to the gastric system
Blooms Level: 01. Remember
- (p. 148)How are barbiturates usually classified?
A. duration of action
B. price
C. chemical structure
D. strength of hypnotic effect
Blooms Level: 01. Remember
- (p. 149)Among the barbiturates, when prescribing a sleeping pill (hypnotic), physicians would usually choose a
A. higher dose of a short-acting drug.
B. lower dose of a long-acting drug.
C. higher dose of a long-acting drug.
D. lower dose of a short-acting drug.
Blooms Level: 01. Remember
- (p. 150)Two drugs that were introduced as being safer than the barbiturates, but in the long run proved to be not much safer, were
A. fluoxetine and paroxetine.
B. toluene and xylene.
C. meprobamate and methaqualone.
D. perphenazine and thiazine.
Blooms Level: 01. Remember
- (p. 152)The major advantage of the benzodiazepines over the barbiturates seems to be the
A. lower cost.
B. greater effectiveness.
C. shorter duration of activity.
D. greater safety margin.
Blooms Level: 01. Remember
- (p. 152)Librium (chlordiazepoxide) and Valium (diazepam) were the first widely sold
A. benzodiazepines.
B. barbiturates.
C. methaqualones.
D. sedatives.
Blooms Level: 01. Remember
- (p. 152)The “date-rape” drug Rohypnol (flunitrazepam)
A. is no longer manufactured legally.
B. is sold as a hypnotic agent (sleeping pill) in many countries other than the U.S.
C. was never marketed by any company because of its unusual impairment of memory.
D. is available by prescription in the U.S.
Blooms Level: 01. Remember
- (p. 153)When benzodiazepines bind to their receptor site, they
A. release barbiturates.
B. block acetylcholine receptors.
C. reduce the membrane electrical potential.
D. enhance the inhibitory effects of GABA.
Blooms Level: 01. Remember
- (p. 156)Zolpidem (Ambien) is:
A. an older sleeping pill that is no longer marketed.
B. an intermediate-acting barbiturate.
C. not a benzodiazepine chemically, but it has similar effects.
D. a long-acting benzodiazepine.
Blooms Level: 01. Remember
- (p. 153)The four most widely sold benzodiazepines are all longer-acting drugs sold primarily as
A. anxiolytics.
B. analgesics.
C. hypnotics.
D. antidepressants.
Blooms Level: 01. Remember
- (p. 153)Sedative-hypnotic agents bind to which receptors in the brain?
A. glutamate
B. GHB
C. serotonin
D. GABA
Blooms Level: 01. Remember
- (p. 158)Animal self-administration experiments and studies of drug choice among humans indicate that
A. benzodiazepines have no dependence liability.
B. rats and people are very different in the drugs they choose to self-administer.
C. short-acting barbiturates are more likely to lead to dependence than any of the benzodiazepines.
D. all of the benzodiazepines have high dependence liability.
Blooms Level: 01. Remember
- (p. 158)Withdrawal from long-term use of sedative-hypnotic drugs is characterized by
A. aching, high blood pressure, drowsiness.
B. anxiety, impaired concentration, insomnia, convulsions.
C. rapid mood swings.
D. minor discomfort, but no serious symptoms.
Blooms Level: 01. Remember
- (p. 163)One of the most dangerous acute effects of taking depressants in combination with alcohol is
A. the “cheese reaction”.
B. respiratory depression.
C. seizures.
D. slurred speech.
Blooms Level: 01. Remember
- (p. 158)Which of the following drugs could theoretically be used to treat barbiturate withdrawal?
A. methamphetamine
B. fluoxetine
C. alcohol
D. modafinil
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 160)One of the oldest gaseous anesthetics, popularly known as “laughing gas,” is
A. butane.
B. diazepam.
C. pentobarbital.
D. nitrous oxide.
Blooms Level: 01. Remember
- (p. 161)What household product contains nitrous oxide?
A. fuel gas
B. hair spray
C. spray paint
D. whipped cream dispensers
Blooms Level: 01. Remember
- (p. 161)The modern era of abuse of volatile solvents by young people can be traced to a 1959 newspaper report of
A. gasoline huffing.
B. glue sniffing.
C. lead paint poisoning.
D. nitrite abuse.
Blooms Level: 01. Remember
- (p. 162)Inhalant use has traditionally been more common among
A. poor Hispanic and Native American youth.
B. middle-class white children.
C. middle-class black children.
D. construction workers.
Blooms Level: 01. Remember
- (p. 162)GHB (gamma hydroxybutyric acid)
A. is derived from morning glory seeds.
B. occurs naturally in the brain.
C. is a gas used to make whipped cream.
D. blocks the intoxicating effects of alcohol.
Blooms Level: 01. Remember
- (p. 162)The usual recreational dose of GHB when taken alone is about
A. 10-20 milligrams.
B. 100 micrograms.
C. 1-5 grams.
D. 100-200 grams.
Blooms Level: 01. Remember
- (p. 161)Anecdotally, __________ (or “poppers”) are used to enhance sexual pleasure.
A. nitrous oxide
B. amyl nitrite
C. GHB
D. Rohypnol
Blooms Level: 01. Remember
True / False Questions
- (p. 148)Paraldehyde is a CNS depressant that is currently available in several over-the-counter medications.
FALSE
Blooms Level: 01. Remember
- (p. 149)When barbiturates were the most popular sedative-hypnotics, low doses of the long-acting types were used as sleeping pills.
FALSE
Blooms Level: 01. Remember
- (p. 151-152)Benzodiazepines replaced barbiturates primarily because they were believed to be safer.
TRUE
Blooms Level: 01. Remember
- (p. 152-153)Ambien (zolpidem) is a popular benzodiazepine used to treat anxiety.
FALSE
Blooms Level: 01. Remember
- (p. 151)Sodium pentathol is long-acting barbiturate used to treat insomnia.
FALSE
Blooms Level: 01. Remember
- (p. 158)Among the sedative-hypnotic drugs, short-acting barbiturates seem to be the most likely to lead to drug dependence.
TRUE
Blooms Level: 01. Remember
- (p. 160)Nitrous oxide (“laughing gas”) is a Schedule I controlled substance.
FALSE
Blooms Level: 01. Remember
- (p. 162)The majority of “huffers” (users of inhalants) are above age 25.
FALSE
Blooms Level: 01. Remember
- (p. 160)Volatile solvents that act as CNS depressants are found in a wide variety of household products.
TRUE
Blooms Level: 01. Remember
- (p. 156)According to the DAWN data set, zolpidem-related emergency room visits declined between 2005 and 2010.
FALSE
Blooms Level: 01. Remember
Essay Questions
- (p. 158)Explain how a drug’s rate of onset and duration of action affect psychological dependence and withdrawal. Give examples from this chapter.
Drugs with rapid onset of action will be more likely than slow-acting drugs to produce psychological dependence. Examples include short-acting barbiturates, like secobarbital, and Xanax, a rapid-acting benzodiazepine. Physical dependence occurs when the drug leaves the system more rapidly than the body can adapt. Drugs with a short duration of action, such as secobarbital, leave the body rapidly and are much more likely to produce physical withdrawal symptoms than are longer-acting drugs.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 156)Discuss the use of medications as hypnotics (sleeping pills). What types of drugs are used, and what are some of the concerns associated with the use of sleeping pills? Are there any alternatives to drug use?
Although many people complain of poor sleep, most do not take prescription medications for this. Both benzodiazepine (e.g., Halcion) and non-benzodiazepine (e.g., Ambien) drugs are typically used. Concerns include dependence, respiratory depression when combined with alcohol, and people driving, walking around, etc., while still under the drug’s influence (“sleepwalking”).
Blooms Level: 01. Remember
Blooms Level: 02. Understand
- (p. 162-163)GHB has been used for several purposes. Describe its recent history of various medical and recreational uses and its status as a controlled substance.
GHB was sold as a dietary supplement and used to stimulate muscle growth. In high doses, GHB has alcohol-like effects, and its recreational use led to banning it from dietary supplements in 1990. Its use as a date-rape drug led Congress to direct that GHB be placed on Schedule I in 2000. In 2002, a prescription version (Xyrem) was made available for treating narcolepsy. Xyrem is on Schedule III.
Blooms Level: 01. Remember
Blooms Level: 02. Understand
