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Final Exam Study Review.docx

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Mary Anne Banks

Final Exam Study Review- LESSONS 11-15 Lesson 11: Hallucinogens – Chapter 14 11.1 "Animism and Religion"  Hallucinogens – those chemicals which result in profound changes in the perception of external stimuli, or the production of an internal fantasy world o Have been used for thousands of years because they are almost all produced by plants which grow in most places in the world. However  Use of hallucinogens historically (and in some cases to this day) was associated with religious rituals. o Mescaline, psilocybin or DMT: to ‘bring to life’ and confer human characteristics (like speech) onto inanimate objects, plants or animals (this is known as animism), and alongside this confer deep mystical or spiritual significance to whatever it is the object/plant/animal does or says (an ‘entheogenic’ property of some hallucinogens).  Animism with spiritual significance is a recurring plot device in tales from the major world religions. 11.2 "Terminology and Types"  LSD o Use in North America escalated with the introduction of LSD (which, ironically, is made in a lab, but based on a naturally-occurring chemical). o LSD use peaked in the 1960s and early 1970s given the influence of people like Dr. Timothy Leary (at that time, something like 20% of university students had past-year use of LSD  Has declined since  Currently: 0.5% of students used in the last month (4% prediction)  Psilocybin and Mescaline
 o Psilocybin (magic mushrooms or ‘shrooms’) and mescaline (peyote)  Both the actual use and the predicted use of these drugs are higher than for LSD.  Currently: 1.5% of students used in the last month (7% prediction)  Salvia
 o From a legal perspective, salvia is best described as legal, sort of, for now.  The Government of Canada issued a statement in the fall of 2010 that they would begin to enforce bans on the sale of all natural health products that were not properly licensed beginning about February 2011.  This hasn’t happened yet o In the interest of harm reduction: ‘spiritually significant’ to ‘absolutely terrifying’.  Approximately 15% of students have tried it at some point in their lives, with regular use being quite low  Currently: In recent years less people have been trying  The increase in awareness of what salvia is was not accompanied by an increase in the number of people who had ever tried salvia  MDMA and Ecstasy o Scientific literature makes no distinction between MDMA and Ecstasy  MDMA is chemical name, Ecstasy is the street name o 80% of students have never tried MDMA/Ecstasy o Recently this has become a more popular drug – peaking in late winter 2012, and decreasing in the fall months 11.3 "Hallucinogens and Music"  Link between the characteristics of the music or video or light show that accompanies the use of specific hallucinogens o Ex. Beatles, Blockhead etc. Lesson 12: Performance Enhancing Drugs – Chapter 16 12.1 "Fair vs. Unfair"  “Why is it that steroids provide an ‘unfair’ advantage?” o Olympic athletes of course they take all of the right ‘legal’ supplements. But training like this costs an enormous amount of money! And if you don’t have the money (or the investors backing you), you’re probably not going to win a medal in a sport anyone cares about  Why are steroids ‘cheating’? Don’t you think the kid with unbelievable raw athleticism in some poor developing country thinks that the definition of “unfair” might include a few more things than just taking steroids? Like perhaps all the above-listed items that cost more money for each individual athlete than his / her entire village will make in a lifetime? 12.2: “Historical use of drugs in athletics” and "Steroids"  Steroids have both anabolic (tissue growth) and androgenic (masculinising) effects o Remarkably, “scientific studies” of the effects of steroids on strength and physique enhancement report that the effects of steroids are minimal. But anyone who has had a membership at a real gym (not the fancy gyms with all the electronic equipment – the grungy poorly-lit gyms with just barbells, dumbbells, and benches) has witnessed firsthand the effects of steroids. Year Name 100 m Steroid status time 1988 Ben Johnson 9.79 confirmed STEROIDS seconds 1999 Maurice 9.79 clean, but…admitted to buying steroids (for fellow athletes), Greene seconds and his coach was part of the BALCO scandal 2002 Tim 9.78 confirmed STEROIDS Montgomery seconds 2006 Justin Gatlin 9.77 confirmed STEROIDS seconds 2007 Asafa Powell 9.74 clean seconds 2009 Usain Bolt 9.58 clean seconds  4 of the 6 men who have run sub 9.80 second 100 m dashes have either tested positive for steroids, or been caught with steroids.  It was very difficult at the time, without being cynical, to understand how a country like East Germany, which had a population much, much smaller than Canada, could win such an outrageous number of medals. Certainly the quality of coaching, the quality of the training facilities, etc, can always factor into one country winning a disproportionate number of medals. However, recent reports produced from the time of the East German and Soviet domination of the “steroid Olympics”, and testimonials from the athletes who participated in those Olympics for those countries, in fact reveals widespread steroid use.  Prediction of students that use sterioids: 10%, Actual: 0.1% o Sexual partners in the last year: Actual: 1 person, prediction: 3  “Roid rage” – that uncontrolled outburst of violence – supposedly exhibited by individuals who use steroids. o There is very little scientific evidence supporting the existence of “roid rage”.  People who train heavy – those who go for one rep maxes with legitimately heavy weights – are able to focus, bear down on the weight, and rapidly unleash explosive forces. The more experience you have training like this the better able you are to suddenly turn on this power. And steroids definitely help you train harder and longer, increasing that ability to focus, but also increasing the strength you can apply when focused.  So I personally see “roid rage” as more of a practice effect than pharmacologically- induced violence. When you see a heavily muscled bouncer (for example) “roid raging” as he literally throws your buddy out of the bar – consider the possibility that he did it simply because he can. Not because the drugs caused him to go into a fit of rage. o Stories abound of athletes with massive physiques (which many people just assume must be the product of steroids, but truthfully, good genetics, eating right, and a superior work ethic in the gym can build impressive physiques) losing their minds and getting into all kinds of trouble, and it’s written off as “roid rage”.  Of course, many of these giant athletes participate in extremely violent sports where head injuries are extremely common. And what we are starting to understand is that repeated trauma to the head – even the little hits that don’t result in loss of consciousness or concussions – cause accumulating damage in the brain (even in very young athletes). This brain damage that results is very similar to the brain damage found in the elderly with advanced neurodegenerative disorders like Parkinson’s or Alzheimer’s disease.  This is a condition known as “chronic traumatic encephalopathy”, and it’s a major point of discussion in sports. It is especially concerning in the NFL where probably half the players on each time suffer a blow to the head after basically every snap of the football. Some of these athletes display unusual and often-times violent behaviours off the field that are variously described, by a cynical society, as “roid rage”, being over- paid and self-entitled, etc.  The “Canadian Crippler” Chris Benoit, from the WWE, is a textbook example of someone whose anger problems were assumed to be steroid related, but in fact were due to repeated ‘on the job’ head injuries. 12.3 "Stimulants as Performance Enhancers", "Other Hormonal Manipulations", “Beta-2 agonists”, “Creatine" and “Getting ‘cut’”  Anabolic / androgenic steroids are not the only performance enhancing drugs. o Athletes also use stimulants to boost energy, they use hormones such as human growth hormone with the intent to increase muscle mass and strength, and they often use creatine to help replenish energy to the muscles. Lesson 13: Dietary Substances and Over the Counter – Chapter 3/12 13.1 "Sources and Names of Drugs"  There are three basic routes to discovering a new drug. 1. One route requires the outright discovery of a new chemical which can be used as a drug. a. Here you have a building full of chemists churning out new molecules, and those molecules are tested in what are known as “high throughput assays”, which are tests that can screen potentially hundreds of thousands of new molecules in a short period of time. b. These high throughput assays, rather than testing if the new molecule cures a disease (which would take thousands of years given all the molecules that are created), tests if the new molecule has an effect on some very basic aspect of that disease – like an effect on another biological molecule implicated in that disease (this can be done very quickly). If the chemical passes the simple test, then it is moved to more sophisticated tests involving cells, tissues and even animals. 2. The second route to drug discovery is to take advantage of the fact that cultures around the world have been using parts of specific plants, animals and insects for thousands of years to treat various ailments (this is known as ethnobotanical drug discovery). a. In some cases those treatments are legitimate, and here the role of drug discovery is to isolate the active chemical (not unlike purifying morphine from raw opium). Once the chemical is purified it could be used as is, or perhaps the chemists get involved and modify the molecule to make it even more effective (not unlike modifying morphine to make heroin). 3. The third route is known as ‘repurposing’ – here an existing drug, which is known to be effective in the treatment of one disease, is used to treat a different disease. a. This is a very quick way to drug discovery because a lot of the safety tests will have been done as part of the clinical trials associated with the original disease. Once the drug has been discovered it needs a name – and in fact it gets several names. Consider the well-known drug Prozac. Prozac has a chemical name: (3S)-N-methyl-3-phenyl-3-[4- (trifluoromethyl)phenoxy]propan-1-amine, a brand name: Prozac, and a generic name: fluoxetine. 13.2 "Regulation of Pharmaceuticals" and “Pharmaceutical Industry in Canada”  Before any pharmaceutical is prescribed and sold it must pass through rigorous clinical testing. o In a nutshell, after the drug has been discovered and named, then a New Drug Submission is prepared and submitted to Health Canada, and if approved, there will be many years and phases of clinical trials to determine the safety and efficacy of the new drug.  If the new drug is found to be both safe and effective then (and only then) does it become available for prescription or over-the-counter use. Every drug prescribed to you by a physician in Canada, or every drug that you purchase over-the-counter, is supposed to have gone through this rigorous testing.  As you’ll see, the story for natural health products is very different. If you wonder why rigorous clinical testing is so important, consider thalidomide.  Thalidomide was used to treat morning sickness in expectant mothers. Although, the clinical testing had shown very clearly that thalidomide minimized nausea – it had not been tested in pregnant moms (neither in human nor animal research). It turns out that thalidomide prevents limb growth, and so children are born with only limb buds – perhaps two regular legs but with no arms – only hands coming out of the shoulders. 13.3 "Nonspecific (Placebo) Effects"  One of the purposes of the clinical trials is to assess the extent to which the new drug differs from a placebo – a drug which the user may believe to work, but has no active ingredient. o The placebo effect is a remarkable property of “drugs” that if you think they will have an effect, they very well might have an effect – even if the “drug” you got was a sugar pill.  The effect is incredibly powerful for certain illnesses, especially depression and anxiety.  A recent study in fact showed that over 80% of the anti-depressant effects of the most popular anti-depressant medications, in patients with mild or moderate depression, could be accounted for by the placebo effect  There are other interesting studies that show that the magnitude of the placebo effect depends on the appearance and trustworthiness of the person prescribing the medicine (these studies use actors and actresses dressed up and acting like doctors – perfectly starched white lab coat, stethoscope around the neck, nice haircut, nice genuine smile, sounds convincing). o Interestingly, the placebo affect has a greater impact on some people than others – a recent study of people with social anxiety disorder showed that participants with a certain gene almost all experienced a placebo effect from a fake anti- anxiety drug, while participants without the gene almost never experienced the placebo effect for the same fake anti-anxiety drug o Placebo effects with recreational drugs
  Placebo effects associated with recreational drugs as well as therapeutic drugs. Recreationally the placebo effect is often called the “expectation effect”. The “expectation effect” occurs when someone is given a non-drug (or a tiny / non-psychoactive dose of a recreational drug) – and they act intoxicated or high. 13.4 "Over-the-Counter (OTC) Drugs"  Some common drugs that have successfully navigated this regulatory process: the over-the-counter medications. o Over-the-counter medications like acetaminophen, ibuprofen, etc, are, in fact, available over- the-counter without a doctor’s prescription because of their high safety ratings – if taken as directed on the label (e.g., dose), and not taken by people for whom specific warnings printed on the label
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