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+qid,question,relevant answer,primary intent,secondary intent,link,Comment,,
+Q1,Who is most at risk of heroin addiction?,"People who are addicted to prescription opioid painkillers
+People who are addicted to cocaine
+People without insurance or enrolled in Medicaid
+Non-Hispanic whites
+Males
+People who are addicted to marijuana and alcohol
+People living in a large metropolitan area
+18 to 25 year olds",Heroin,Addiction,https://www.cdc.gov/vitalsigns/heroin/index.html,,,
+Q2,How do I know if I am addicted to marijuana?,"Some of the signs that someone might be addicted to marijuana include:
+
+Trying but failing to quit using marijuana.
+Giving up important activities with friends and family in favor of using marijuana.
+Using marijuana even when it is known that it causes problems at home, school, or work",Marijuana,Addiction,https://www.cdc.gov/marijuana/faqs/am-i-addicted-to-marijuana.html,,,
+Q3,Can methadone treat narcotic addiction?,"Methadone is an effective treatment for narcotic addiction. It’s a long-acting opioid that affects the same parts of your brain as the drug you're having a problem with does, but it doesn't get you high. You can take it every day, but you have to go to a special clinic to get it. The correct dose prevents withdrawal symptoms and eases drug cravings.",Methadone,Addiction,https://www.webmd.com/mental-health/addiction/qa/can-methadone-treat-narcotic-addiction,,,
+Q4,Can opioid addiction lead to changes in your brain?,Opioid addiction leads to real changes in certain areas of your brain. Prescription drug addiction alters the circuits responsible for mood and reward behavior.,Opioids,Addiction,https://www.webmd.com/mental-health/addiction/qa/can-opioid-addition-lead-to-changes-in-your-brain,,,
+Q5,Will I Get Addicted to Opioids?,"Anyone who takes prescription opioids can become addicted to them. You may also develop tolerance—meaning that over time you might need higher doses to relieve your pain, putting you at higher risk for a potentially fatal overdose. You can also develop physical dependence—meaning you have withdrawal symptoms when the medication is stopped.
+
+Tell your doctor about your medical history and if you or anyone in your family has a history of substance misuse or addiction to drugs or alcohol. Also, never take opioids in higher amounts or more often than prescribed.",Opioids,Addiction,https://www.cdc.gov/drugoverdose/patients/faq.html,,,
+Q6,What is opioid addiction?,"(Opioid use disorder (OUD)) occurs when attempts to cut down or control use are unsuccessful or when use results in social problems and a failure to fulfill obligations at work, school, and home. Opioid addiction often comes after the person has developed opioid tolerance and dependence, making it physically challenging to stop opioid use and increasing the risk of withdrawal.",Opioids,Addiction,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q7,How does tobacco use lead to addiction?,"For many who use tobacco, long-term brain changes brought on by continued nicotine exposure result in addiction. When a person tries to quit, he or she may have withdrawal symptoms, including: irritability; problems paying attention; trouble sleeping; increased appetite; powerful cravings for tobacco.",Tobacco,Addiction,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q8,How can people get treatment for nicotine addiction?,"Both behavioral treatments and medications can help people quit smoking, but the combination of medication with counseling is more effective than either alone. The U.S. Department of Health and Human Services has established a national toll-free quitline, 1-800-QUIT-NOW, to serve as an access point for anyone seeking information and help in quitting smoking.",Tobacco,Addiction,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q9,What is drug addiction treatment?,"Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.",Treatment,Addiction,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q10,How effective is drug addiction treatment?,"In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.",Treatment,Addiction,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q11,What do I need to know about counseling for opioid addiction?,"Kicking an addiction is a major accomplishment. But for most people with a drug or alcohol addiction, detox is only the beginning of a long-term battle against craving and relapse.
+
+Counseling is an essential part of substance abuse treatment for many people. Cognitive behavioral therapy, family counseling, and other therapy approaches can help people recovering from opioid addiction stay clean. Psychotherapy can also treat the other mental health conditions that often contribute to substance abuse.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/what-do-i-need-to-know-about-counseling-for-opioid-addiction,,,
+Q12,Why is counseling important in opioid addiction treatment?,"Addiction is more than a physical dependence on drugs or alcohol. Even after detox, when physical dependence has resolved, addicts are at high risk for relapse. Psychological and social factors are often powerful stimuli for prescription drug abuse relapse.
+
+These factors can create ongoing, nearly irresistible urges to use. Counseling helps addicts escape craving and learn to cope with life, without using drugs or alcohol.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/why-is-counseling-important-in-opioid-addiction-treatment,,,
+Q13,What therapies are available for opioid addiction?,"Several counseling therapies are available for addiction, and no one established method is known to be better than another. Likewise, no one approach is appropriate for everyone The right drug or alcohol abuse treatment plan is tailored to a person's addiction and his or her individual needs.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/what-therapies-are-available-for-opioid-addiction,,,
+Q14,What is the difference between outpatient treatment and residential treatment for addiction?,"Residential therapy separates the addicted person from the environment that allowed him or her to use drugs or alcohol, and teaches new habits or skills for sober living. A person goes away to a specialized facility for a period of weeks to months. While highly effective in the short term, there is debate as to whether residential programs lead to longer abstinence than outpatient programs.
+
+Outpatient treatment programs are the usual setting for treating ongoing drug or alcohol addiction.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/what-is-the-difference-between-outpatient-treatment-and-residential-treatment-for-addiction,,,
+Q15,How can contingency management therapy help with treating drug addiction?,"In contingency management therapy, a person in treatment for addiction receives positive incentives for staying clean. Vouchers for goods and services, or privileges in a more rigid treatment setting are common incentives. Contingency management therapy is effective in drug rehab studies. But skeptics point out its high costs, and that when incentives stop, its positive effects decline.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/how-can-contingency-management-therapy-help-with-treating-drug-addiction,,,
+Q16,How can maintenance therapy help with treating drug addiction?,"Addiction is a chronic illness. People who have it are likely to relapse.
+
+Once you're through detox, you'll probably need lifelong treatment that includes counseling and possibly medication. Currently, the FDA has three drugs approved for the treatment of opioid addiction and three for the treatment of alcohol addiction.",Treatment,Addiction,https://www.webmd.com/mental-health/addiction/qa/how-can-maintenance-therapy-help-with-treating-drug-addiction,,,
+Q17,Why are drugs more addictive than natural rewards?,"For the brain, the difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain of someone who misuses drugs adjusts by producing fewer neurotransmitters in the reward circuit, or by reducing the number of receptors that can receive signals. As a result, the person's ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.
+
+This is why a person who misuses drugs eventually feels flat, without motivation, lifeless, and/or depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs to experience even a normal level of reward—which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar high—an effect known as tolerance.",Drugs,Addiction,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q18,Why is adolescence a critical time for preventing drug addiction?,"Early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks. Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school. A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens’ tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen’s ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure. Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.",Addiction,Adolescents,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q19,What are the unique needs of adolescents with substance use disorders?,"Adolescent drug abusers have unique needs stemming from their immature neurocognitive and psychosocial stage of development. Research has demonstrated that the brain undergoes a prolonged process of development and refinement from birth through early adulthood. Over the course of this developmental period, a young person’s actions go from being more impulsive to being more reasoned and reflective. In fact, the brain areas most closely associated with aspects of behavior such as decision-making, judgment, planning, and self-control undergo a period of rapid development during adolescence and young adulthood.
+
+Adolescent drug abuse is also often associated with other co-occurring mental health problems. These include attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct problems, as well as depressive and anxiety disorders.
+
+Adolescents are also especially sensitive to social cues, with peer groups and families being highly influential during this time. Therefore, treatments that facilitate positive parental involvement, integrate other systems in which the adolescent participates (such as school and athletics), and recognize the importance of prosocial peer relationships are among the most effective. Access to comprehensive  assessment, treatment, case management, and family-support services that are developmentally, culturally, and gender-appropriate is also integral when addressing adolescent addiction.
+
+Medications for substance abuse among adolescents may in certain cases be helpful. Currently, the only addiction medications approved by FDA for people under 18 are over-the-counter transdermal nicotine skin patches, chewing gum, and lozenges (physician advice should be sought first). Buprenorphine, a medication for treating opioid addiction that must be prescribed by specially trained physicians, has not been approved for adolescents, but recent research suggests it could be effective for those as young as 16. Studies are under way to determine the safety and efficacy of this and other medications for opioid-, nicotine-, and alcohol-dependent adolescents and for adolescents with co-occurring disorders.",Substance use disorder,Adolescents,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q20,Are Alcoholism And Drug Addiction Genetically Inherited?,Research shows that the risk for developing alcoholism and drug addiction runs in families.  But just because there is a genetic predisposition doesn't mean that the child of an alcoholic or addicted parent will automatically become alcoholic or addicted.  Not all children of alcoholic or addicted parents get into trouble with alcohol and drugs.  And some people develop alcoholism and addiction even though no one in their family has a drinking or drug problem.,Addiction,Alcohol,https://tricircleinc.com/faqs/,,,
+Q21,How should I view relapse in my recovery journey?,"Relapse is part of the process. It is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.
+
+Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).",Relapse,Alcohol,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help,,,
+Q22,Does Treatment Work for alcohol use disorder?,"The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment.
+
+Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.",Treatment,Alcohol,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#1,,,
+Q23,What treatments are available for someone with an alcohol problem?,"People commonly think of 12-step programs or 28-day inpatient rehabilitation as the only options for treating alcohol problems. Other choices are available, however. It’s a good idea to start by talking with a primary care doctor to put together an individualized treatment plan. A treatment plan can include:
+
+Behavioral treatments. Counseling led by a health professional aims to change drinking behavior. Types of counseling include cognitive-behavioral therapy, motivational enhancement therapy, and marital and family counseling. It’s important to choose an approach that avoids heavy-handed confrontation, incorporates empathy, and increases motivation while focusing on changing drinking behavior.
+Medications. Three medications are currently approved by the Food and Drug Administration to treat alcohol dependence. These medications help people stop or reduce their drinking and prevent relapse. All approved medications are non-addictive, and can be used alone or in combination with other forms of treatment.
+Mutual-support groups. People who are quitting or cutting back on their drinking may also find peer support through organizations such as Alcoholics Anonymous and other mutual support groups.",Treatment,Alcohol,https://www.rethinkingdrinking.niaaa.nih.gov/q-and-as/Default.aspx,,,
+Q24,What happens after you finish your alcohol use disorder program?,"Once you get back into the swing of your normal life, it might be easy to relapse and start drinking again. So you'll likely want follow-up care for at least a year. You have lots of options, including 12-step programs, private therapy, and group counseling.",Relapse,Alcohol use disorder,https://www.webmd.com/mental-health/addiction/qa/what-happens-after-you-finish-your-alcohol-use-disorder-program,,,
+Q25,What types of detox programs are there for alcohol use disorder?,"Your two basic options for alcohol detox programs are:
+
+Inpatient, where you live at a hospital, detox clinic, or rehab center during the process. You'll have care around the clock to help you through.
+
+Outpatient, where you get some treatment during the day but live at home. This might be as simple as visiting your doctor regularly to get meds.",Treatment,Alcohol use disorder,https://www.webmd.com/mental-health/addiction/qa/what-types-of-detox-programs-are-there-for-alcohol-use-disorder,,,
+Q26,What are types of rehab programs for alcohol use disorder?,"Types of rehab programs for alcohol use disorder include:
+
+Inpatient treatment
+Residential rehab
+Partial hospitalization or day treatment
+Intensive outpatient
+Outpatient",Treatment,Alcohol use disorder,https://www.webmd.com/mental-health/addiction/qa/what-are-types-of-rehab-programs-for-alcohol-use-disorder,,,
+Q27,How do you choose a program for alcohol use disorder?,"You might want to make a list of questions to ask different alcohol treatment programs, such as:
+
+What types of insurance do you take?
+How is your staff trained? Are they licensed?
+Can you send me a sample treatment plan?
+Do you offer counseling and medical services?
+How do you help prevent a relapse?
+Is there aftercare when I'm done with the program?",Treatment,Alcohol use disorder,https://www.webmd.com/mental-health/addiction/qa/how-do-you-choose-a-program-for-alcohol-use-disorder,,,
+Q28,How do behavioral therapies treat drug addiction?,"Behavioral therapies help people in drug addiction treatment modify their attitudes and behaviors related to drug use. As a result, patients are able to handle stressful situations and various triggers that might cause another relapse. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.",Drug addiction,Behavioral therapies,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q29,What kinds of behavioral treatments are available for alcohol problems?,"There is cognitive-behavioral therapy, motivational enhancement therapy, marital and family counseling, and brief interventions. Cognitive–Behavioral Therapy can take place one-on-one with a therapist or in small groups. This form of therapy is focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse. The goal is to change the thought processes that lead to excessive drinking and to develop the skills necessary to cope with everyday situations that might trigger problem drinking. Motivational Enhancement Therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. The therapy focuses on identifying the pros and cons of seeking treatment, forming a plan for making changes in one’s drinking, building confidence, and developing the skills needed to stick to the plan. Marital and Family Counseling incorporates spouses and other family members in the treatment process and can play an important role in repairing and improving family relationships. Studies show that strong family support through family therapy increases the chances of maintaining abstinence (stopping drinking), compared with patients undergoing individual counseling. Brief Interventions are short, one-on-one or small-group counseling sessions that are time limited. The counselor provides information about the individual’s drinking pattern and potential risks. After receiving personalized feedback, the counselor will work with the client to set goals and provide ideas for helping to make a change.
+
+Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.",Alcohol,Behavioral therapies,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#4,,,
+Q30,What happens to your brain if you keep taking drugs?,"Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive and transmit signals. When some drugs of abuse are taken, they can release 2 to 10 times the amount of dopamine that natural rewards do. As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to bring their dopamine function back up to normal. And, they must take larger amounts of the drug than they first did to create the dopamine high—an effect known as tolerance.",Drug use,Brain effects,https://abovetheinfluence.com/faqs/,,,
+Q31,How do drugs work in the brain?,"Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brain’s own chemicals, they don't activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network.
+
+Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons.
+",Drugs,Brain effects,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q32,What other brain changes occur with abuse?,"Chronic exposure to drugs of abuse disrupts the way critical brain structures interact to control behavior—behavior specifically related to drug abuse. Just as continued abuse may lead to tolerance or the need for higher drug dosages to produce an effect, it may also lead to addiction, which can drive an abuser to seek out and take drugs compulsively. Drug addiction erodes a person’s self-control and ability to make sound decisions, while sending intense impulses to take drugs.",Drug abuse,Brain effects,https://abovetheinfluence.com/faqs/,,,
+Q33,How does long-term drug use affect brain circuits?,"We know that the same sort of mechanisms involved in the development of tolerance can eventually lead to profound changes in neurons and brain circuits, with the potential to severely compromise the long-term health of the brain. For example, glutamate is another neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate for this change, which can cause impairment in cognitive function. Similarly, long-term drug abuse can trigger adaptations in habit or nonconscious memory systems. Conditioning is one example of this type of learning, whereby environmental cues become associated with the drug experience and can trigger uncontrollable cravings if the individual is later exposed to these cues, even without the drug itself being available. This learned “reflex” is extremely robust and can emerge even after many years of abstinence.",Drug use,Brain effects,https://abovetheinfluence.com/faqs/,,,
+Q34,How does kratom affect the brain?,"Kratom can cause effects similar to both opioids and stimulants. Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain, especially when users consume large amounts of the plant. Mitragynine also interacts with other receptor systems in the brain to produce stimulant effects. When kratom is taken in small amounts, users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects.",Kratom,Brain effects,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q35,How does stimulation of the brain's pleasure circuit teach us to keep taking drugs?,"Our brains are wired to ensure that we will repeat life-sustaining activities by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again, without thinking about it. Because drugs of abuse stimulate the same circuit, we learn to abuse drugs in the same way.",Drug use,Brain effects,https://abovetheinfluence.com/faqs/,,,
+Q36,What parts of the brain are affected by drug use?,"Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks addiction. Brain areas affected by drug use include: The basal ganglia, which play an important role in positive forms of motivation, including the pleasurable effects of healthy activities like eating, socializing, and sex, and are also involved in the formation of habits and routines. These areas form a key node of what is sometimes called the brain’s “reward circuit.” Drugs over-activate this circuit, producing the euphoria of the drug high. But with repeated exposure, the circuit adapts to the presence of the drug, diminishing its sensitivity and making it hard to feel pleasure from anything besides the drug. The extended amygdala plays a role in stressful feelings like anxiety, irritability, and unease, which characterize withdrawal after the drug high fades and thus motivates the person to seek the drug again. This circuit becomes increasingly sensitive with increased drug use. Over time, a person with substance use disorder uses drugs to get temporary relief from this discomfort rather than to get high.
+The prefrontal cortex powers the ability to think, plan, solve problems, make decisions, and exert self-control over impulses. This is also the last part of the brain to mature, making teens most vulnerable. Shifting balance between this circuit and the circuits of the basal ganglia and extended amygdala make a person with a substance use disorder seek the drug compulsively with reduced impulse control. Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.",Drugs,Brain effects,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q37,How do drugs work in the brain to produce pleasure?,"All drugs of abuse directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The overstimulation of this system, which rewards our natural, life-sustaining behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior.",Drug use,Brain effects,https://abovetheinfluence.com/faqs/,,,
+Q38,How do drugs produce pleasure?,"Pleasure or euphoria—the high from drugs—is still poorly understood, but probably involves surges of chemical signaling compounds including the body’s natural opioids (endorphins) and other neurotransmitters in parts of the basal ganglia (the reward circuit). When some drugs are taken, they can cause surges of these neurotransmitters much greater than the smaller bursts naturally produced in association with healthy rewards like eating, hearing or playing music, creative pursuits, or social interaction.
+
+It was once thought that surges of the neurotransmitter dopamine produced by drugs directly caused the euphoria, but scientists now think dopamine has more to do with getting us to repeat pleasurable activities (reinforcement) than with producing pleasure directly.",Drugs,Brain effects,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q39,What is the association between drinking and cancer?,"Clear patterns have emerged between alcohol consumption and the development of the following types of cancer:
+
+Head and neck cancer: Alcohol consumption is a major risk factor for certain head and neck cancers, particularly cancers of the oral cavity (excluding the lips), pharynx (throat), and larynx (voice box). People who consume 50 or more grams of alcohol per day (approximately 3.5 or more drinks per day) have at least a two to three times greater risk of developing these cancers than nondrinkers. Moreover, the risks of these cancers are substantially higher among persons who consume this amount of alcohol and also use tobacco.
+Esophageal cancer: Alcohol consumption is a major risk factor for a particular type of esophageal cancer called esophageal squamous cell carcinoma. In addition, people who inherit a deficiency in an enzyme that metabolizes alcohol have been found to have substantially increased risks of alcohol-related esophageal squamous cell carcinoma.
+Liver cancer: Alcohol consumption is an independent risk factor for, and a primary cause of, liver cancer (hepatocellular carcinoma). (Chronic infection with hepatitis B virus and hepatitis C virus are the other major causes of liver cancer.)
+Breast cancer: More than 100 epidemiologic studies have looked at the association between alcohol consumption and the risk of breast cancer in women. These studies have consistently found an increased risk of breast cancer associated with increasing alcohol intake. A meta-analysis of 53 of these studies (which included a total of 58,000 women with breast cancer) showed that women who drank more than 45 grams of alcohol per day (approximately three drinks) had 1.5 times the risk of developing breast cancer as nondrinkers (a modestly increased risk). The risk of breast cancer was higher across all levels of alcohol intake: for every 10 grams of alcohol consumed per day (slightly less than one drink), researchers observed a small (7 percent) increase in the risk of breast cancer. 
+The Million Women Study in the United Kingdom (which included more than 28,000 women with breast cancer) provided a more recent, and slightly higher, estimate of breast cancer risk at low to moderate levels of alcohol consumption: every 10 grams of alcohol consumed per day was associated with a 12 percent increase in the risk of breast cancer.
+
+Colorectal cancer: Alcohol consumption is associated with a modestly increased risk of cancers of the colon and rectum. A meta-analysis of 57 cohort and case-control studies that examined the association between alcohol consumption and colorectal cancer risk showed that people who regularly drank 50 or more grams of alcohol per day (approximately 3.5 drinks) had 1.5 times the risk of developing colorectal cancer as nondrinkers or occasional drinkers. For every 10 grams of alcohol consumed per day, there was a small (7 percent) increase in the risk of colorectal cancer.",Alcohol,Cancer,https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body,,,
+Q40,Can using cocaine over and over again lead to addiction?,Yes. Using cocaine repeatedly can lead to addiction; there is no safe way to use it to get high.,Addiction,Cocaine,https://teens.drugabuse.gov/blog/post/what-does-cocaine-do-your-body-test-your-knowledge,,,
+Q41,What are the signs of a cocaine overdose?,"Physical signs include:
+
+Watch for these mental signs of overdose, too:
+
+Increased sweating, body temperature, or heart rate
+Trouble breathing
+Chest pain
+Nausea or vomiting
+Confusion, seizures, tremors
+Anxiety
+Panic
+Paranoia
+Hallucinations
+Delirium",Overdose,Cocaine,https://www.webmd.com/mental-health/addiction/qa/what-are-the-signs-of-a-cocaine-overdose,,,
+Q42,What can a cocaine overdose lead to?,An overdose often leads to a stroke or heart attack. An ER doctor will test for those conditions and try to treat them first. He or she may also use medication to treat other complications you have.,Overdose,Cocaine,https://www.webmd.com/mental-health/addiction/qa/what-can-a-cocaine-overdose-lead-to,,,
+Q43,How is cocaine addiction treated?,"Counseling and other types of therapy are the most common treatments for cocaine addiction. You may need to stay in a rehabilitation center (or rehab). Sessions with a trained therapist can help you make changes to your behavior and thought processes. Medical detox centers can help your body adjust to treatment, but you'll probably have to pay for them out of your own pocket. Most insurers don't cover hospitalization for withdrawal anymore. No medicines are approved to treat cocaine addiction.",Treatment,Cocaine,https://www.webmd.com/mental-health/addiction/qa/how-is-cocaine-addiction-treated,,,
+Q44,What are the symptoms of cocaine withdrawal?,"Symptoms can include:
+
+Depression
+Anxiety
+Fatigue
+Trouble concentrating
+Increased hunger
+Cravings for the drug
+Nightmares
+Chills, nerve pain, muscle aches",Withdrawal,Cocaine,https://www.webmd.com/mental-health/addiction/qa/what-are-the-symptoms-of-cocaine-withdrawal,,,
+Q45,What are some approaches to diagnosis?,"The high rate of comorbidity between drug use disorders and other mental illnesses highlights the need for an integrated approach to intervention that identifies and evaluates each disorder concurrently and provides treatment as appropriate for each patient’s particular constellation of disorders. Enhanced understanding of the common genetic, neural, and environmental substrates of these disorders can lead to improved treatments for individuals with comorbidities and may help diminish the social stigma that makes some patients reluctant to seek the treatment they need. The diagnosis and treatment of comorbid substance use disorders and mental illness are complex, because it is often difficult to disentangle overlapping symptoms. Comprehensive assessment tools should be used to reduce the chance of a missed diagnosis. Patients who have both a drug use disorder and another mental illness often exhibit symptoms that are more persistent, severe, and resistant to treatment compared with patients who have either disorder alone. Patients entering treatment for psychiatric illnesses should be screened for substance use disorders and vice versa. Accurate diagnosis is complicated, however, by the similarities between drug-related symptoms, such as withdrawal, and those of potentially comorbid mental disorders. Thus, when people who use drugs enter treatment, it may be necessary to observe them after a period of abstinence to distinguish between the effects of substance intoxication or withdrawal and the symptoms of comorbid mental disorders. This practice results in more accurate diagnoses and allows for better-targeted treatment.",Treatment,Comorbidity,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/what-are-some-approaches-to-diagnosis,,,
+Q46,Can drinking alcohol prevent or treat coronavirus?,"Drinking alcohol does not prevent or treat coronavirus infection and may impair immune function. While hand sanitizers containing 60-95% ethyl alcohol can help destroy the coronavirus on surfaces, drinking alcohol—including beverages with high percentages of alcohol—offers no protection from the virus.",Alcohol,Covid,https://www.niaaa.nih.gov/news-events/news-noteworthy/drinking-alcohol-does-not-prevent-or-treat-coronavirus-infection,,,
+Q47,"Are people living with HIV at increased risk of being infected with the virus that causes COVID-19?
+","People living with HIV with advanced disease, those with low CD4 and high viral load and those who are not taking antiretroviral treatment have an increased risk of infections and related complications in general.  It is unknown if the immunosuppression of HIV will put a person at greater risk for COVID-19, thus, until more is known, additional precautions for all people with advanced HIV or poorly controlled HIV, should be employed.
+
+At present there is no evidence that the risk of infection or complications of COVID-19 is different among people living with HIV who are clinically and immunologically stable on antiretroviral treatment when compared with the general population.  Some people living with HIV may have known risk factors for COVID-19 complications, such as diabetes, hypertension and other noncommunicable diseases and as such may have increased risk of COVID-19 unrelated to HIV.  We know that during the SARS and MERS outbreaks there were only a few case reports of mild disease among people living with HIV. ",HIV,Covid,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-covid-19-hiv-and-antiretrovirals,,,
+Q48,"As a smoker, is my risk of getting the COVID-19 virus higher than that of a non-smoker?
+","At the time of preparing this Q&A, there are no peer-reviewed studies that have evaluated the risk of SARS-CoV-2 infection associated with smoking. However, tobacco smokers (cigarettes, waterpipes, bidis, cigars, heated tobacco products) may be more vulnerable to contracting COVID-19, as the act of smoking involves contact of fingers (and possibly contaminated cigarettes) with the lips, which increases the possibility of transmission of viruses from hand to mouth. Smoking waterpipes, also known as shisha or hookah, often involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the COVID-19 virus in communal and social settings.",Tobacco,Covid,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-tobacco-and-covid-19,,,
+Q49,"As a smoker, am I likely to get more severe symptoms if infected?",Smoking any kind of tobacco reduces lung capacity and increases the risk of many respiratory infections and can increase the severity of respiratory diseases. COVID-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other respiratory diseases.  Available research suggests that smokers are at higher risk of developing severe COVID-19 outcomes and death.  ,Tobacco,Covid,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-tobacco-and-covid-19,,,
+Q50,"What about using smokeless tobacco, like chewing tobacco?","Using smokeless tobacco often involves some hand to mouth contact.  Another risk associated with using smokeless tobacco products, like chewing tobacco, is that the virus can be spread when the user spits out the excess saliva produced during the chewing process.",Tobacco,Covid,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-tobacco-and-covid-19,,,
+Q51,Does nicotine use affect my chances in the context of COVID-19?,"As of when this Q&A was developed, there is insufficient information to confirm any link between tobacco or nicotine in the prevention or treatment of COVID-19. WHO urges researchers, scientists and the media to be cautious about amplifying unproven claims that tobacco or nicotine could reduce the risk of COVID-19. WHO is constantly evaluating new research, including that which examines the link between tobacco use, nicotine use, and COVID-19.",Tobacco,Covid,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-tobacco-and-covid-19,,,
+Q52,"If drug addiction is a disease, is there a cure?","There is no cure for drug addiction, but it is a treatable disease. Drug addicts can and do recover, but they must always be aware of their addiction and work to never fall into addiction again, which is a lifelong process. Drug addiction therapy uses behavior change or modification and sometimes includes medications that assist the user in refraining from drugs or alcohol. Like people with diabetes or heart disease, people in treatment for drug addiction learn behavioral changes that may be assisted with medications that they need to sustain for the rest of their lives. In other words, drug addicts do get better and can work to permanently refrain from drug use. Scientists know that prolonged abstinence from certain drugs allows some of the drug-induced brain changes to reverse. But addicts have to change their lifestyles and learn how to cope with the world—and they may always have to combat the urge to use drugs. It is not easy!",Drug addiction,,https://abovetheinfluence.com/faqs/,,,
+Q53,Is there a neurological treatment or is research being conducted at the moment to cure depression from a neurological point of view? ,"A fascinating array of brain treatments have been tried for depression over the years ranging from surgical re-section of brain regions, total sleep deprivation, fits induced by drugs like insulin or camphor, to the modern day usage of electroconvulsive therapy and transcranial magnetic therapy. Overactivity in a brain region called Brodmann Area 25 has been the focus of much recent neurological research in depression – however a clinical trial to target this hyperactivity with a deep brain stimulator failed. Additional brain stimulation trials for depression are underway.",Treatment,Depression,https://www.weforum.org/agenda/2017/04/q-a-an-expert-answers-your-questions-on-depression-for-world-health-day-2017/,,,
+Q54,What is drug addiction?,"Drug addiction is the most severe form of a substance use disorder (SUD). An SUD develops when a person’s continued use of alcohol and/or drugs causes significant issues, such as health problems, disability, and failure to meet responsibilities at work, school, or home. An SUD can range from mild to severe.  
+
+Addiction is a complex, chronic brain disease characterized by drug craving, seeking, and use that persists even in the face of devastating life consequences. Addiction results largely from brain changes that stem from prolonged drug use—changes that involve multiple brain circuits, including those responsible for governing self-control and other behaviors. Drug addiction is treatable, with medications (for some addictions) and/or behavioral therapies. However, relapse is common and can happen even after long periods of abstinence, underscoring the need for long-term support and care. Relapse does not signify treatment failure, but rather should prompt treatment re-engagement or modification.",Addiction,Drug addiction,https://www.drugabuse.gov/about-nida/frequently-asked-questions,,,
+Q55,What role can the criminal justice system play in addressing drug addiction?,"It is estimated that about one-half of State and Federal prisoners abuse or are addicted to drugs, but relatively few receive treatment while incarcerated. Initiating drug abuse treatment in prison and continuing it upon release is vital to both individual recovery and to public health and safety. Various studies have shown that combining prison- and community-based treatment for addicted offenders reduces the risk of both recidivism to drug-related criminal behavior and relapse to drug use—which, in turn, nets huge savings in societal costs. A 2009 study in Baltimore, Maryland, for example, found that opioid-addicted prisoners who started methadone treatment (along with counseling) in prison and then continued it after release had better outcomes (reduced drug use and criminal activity) than those who only received counseling while in prison or those who only started methadone treatment after their release. The majority of offenders involved with the criminal justice system are not in prison but are under community supervision. For those with known drug problems, drug addiction treatment may be recommended or mandated as a condition of probation. Research has demonstrated that individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.
+
+The criminal justice system refers drug offenders into treatment through a variety of mechanisms, such as diverting nonviolent offenders to treatment; stipulating treatment as a condition of incarceration, probation, or pretrial release; and convening specialized courts, or drug courts, that handle drug offense cases. These courts mandate and arrange for treatment as an alternative to incarceration, actively monitor progress in treatment, and arrange for other services for drug-involved offenders.
+
+The most effective models integrate criminal justice and drug treatment systems and services. Treatment and criminal justice personnel work together on treatment planning—including implementation of screening, placement, testing, monitoring, and supervision—as well as on the systematic use of sanctions and rewards. Treatment for incarcerated drug abusers should include continuing care, monitoring, and supervision after incarceration and during parole. Methods to achieve better coordination between parole/probation officers and health providers are being studied to improve offender outcomes.",Addiction,Drug addiction,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q56,How do the best treatment programs help patients recover from addiction?,"Stopping drug use is just one part of a long and complex recovery process. When people enter treatment, addiction has often caused serious consequences in their lives, possibly disrupting their health and how they function in their family lives, at work, and in the community.
+
+Because addiction can affect so many aspects of a person's life, treatment should address the needs of the whole person to be successful. Counselors may select from a menu of services that meet the specific medical, mental, social, occupational, family, and legal needs of their patients to help in their recovery.",Treatment programs,Drug addiction,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q57,Does relapse to drug use mean treatment has failed?,"No. The chronic nature of addiction means that for some people relapse, or a return to drug use after an attempt to stop, can be part of the process, but newer treatments are designed to help with relapse prevention. Relapse rates for drug use are similar to rates for other chronic medical illnesses. If people stop following their medical treatment plan, they are likely to relapse. Treatment of chronic diseases involves changing deeply rooted behaviors, and relapse doesn't mean treatment has failed. When a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment. While relapse is a normal part of recovery, for some drugs, it can be very dangerous—even deadly. If a person uses as much of the drug as they did before quitting, they can easily overdose because their bodies are no longer adapted to their previous level of drug exposure. An overdose happens when the person uses enough of a drug to produce uncomfortable feelings, life-threatening symptoms, or death.",Relapse,Drug use,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q58,What environmental factors increase the risk of addiction?,"Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person's risk include the following:
+
+Home and Family: The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children's risk of future drug problems. Peer and School: Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs.",Addiction,Environmental factors,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q59,How big is the problem of heroin overdoses?,"Not only are people using heroin, they are also using multiple other substances, including cocaine and prescription opioids. Nearly all people who use heroin also use at least 1 other drug.
+
+Heroin-involved overdose deaths have increased by nearly 5 times since 2010 (from 3,036 in 2010 to 14,996 in 2018). From 2017 to 2018, the heroin-involved overdose death rate decreased by over 4%. Factors that may contribute to the decrease in heroin-involved deaths include fewer people initiating heroin use, shifts from a heroin-based market to a fentanyl-based market, increased treatment provision for people using heroin, and expansion of naloxone access.",Drugs,Heroin,https://www.cdc.gov/drugoverdose/opioids/heroin.html,,,
+Q60,What is Flakka?,"Flakka is a drug that is similar to bath salts. It is a pale-hued crystal that users eat, snort, inject, or vaporize using an e-cigarette device.
+
+It might also be referred to as Gravel, because of the way it looks.",Designer drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#2,,,
+Q61,What are other names for Flakka?,Gravel,Designer drugs,Illegal drugs,https://www.dea.gov/factsheets/flakka-alpha-pvp,,,
+Q62,How is Flakka used?,"The drug may be eaten, snorted, injected, or vaporized in e-cigarettes.",Designer drugs,Illegal drugs,https://www.dea.gov/factsheets/flakka-alpha-pvp,,,
+Q63,How does Flakka affect the body?,"Paranoia and hallucinations that may lead to violent aggression and self-injury.
+Overdose and death have been linked to the use of this drug.",Designer drugs,Illegal drugs,https://www.dea.gov/factsheets/flakka-alpha-pvp,,,
+Q64,What is Spice?,"This is a mixture of different herbs and chemicals that looks similar to potpourri. Users either smoke it like marijuana or make it into an herbal tea-like drink. It is also known as Black Mamba, Bliss, Bombay Blue, Fake weed, Fire, Genie, K2, Moon Rocks, Skunk, Smacked, Yucatan, or Zohai.",Designer drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#5,,,
+Q65,"What are Bath Salts?
+
+","Bath salts are drugs that came on the scene fairly recently and became popular fast. That may be because they were easy to get and used to be hard to detect in drug tests.
+
+They're highly addictive, and they come in a crystalline powder that users swallow, inhale, or inject.
+
+Despite their name, bath salts have nothing in common with products you can use for a soak in the tub.",Drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#1,,,
+Q66,What is Ecstasy?,Drug taken by mouth in pill or tablet form. You can also snort it or inject it into a vein. Also known as MDMA or Molly. It is a man-made stimulant and hallucinogen.,Drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#2,,,
+Q67,How are mushrooms ingested?,"Psilocybin and peyote mushrooms are eaten, brewed in a tea, or added to foods to get a high. Though cravings may occur, physical dependence isn’t usually present with hallucinogens.",Drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#4,"Changed the question. The original question was ""what are mushrooms"", but the answer provided did not address the question, so I changed it to the present question: ""how are mushrooms ingested""",,
+Q68,What is Salvia?,"An herb in the mint family that’s native to parts of Mexico. Users chew or smoke its leaves. It is also known as Maria Pastora, Sage of the Seers, Diviner’s Sage, Sally-D, and Magic Mint.",Drugs,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#5,,,
+Q69,What is LSD?,"A drug that became popular in the 1960s and is still commonly used today. It's made from an acid found in a fungus that grows on rye and other grains. It is also known as Acid, Blotter, Doses, Hits, Microdots, Sugar Cubes, Trips, Tabs, and Window Panes.",Hallucinogen,Illegal drugs,https://www.webmd.com/mental-health/addiction/street-drugs-risks#3,,,
+Q70,How does alcohol affect your immune system?,"Drinking too much can weaken your immune system, making your body a much easier target for disease.  Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.",Alcohol,Immune system,https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body,,,
+Q71,What is khat?,"Stimulant drug made from the leaves and twigs, evergreen shrub. Active ingredients are cathine and cathinone.",Stimulants,Khat,https://www.dea.gov/factsheets/khat,,,
+Q72,What are street names for khat?,"Abyssinian Tea, African Salad, Catha, Chat, Kat, Miraa, Oat, Qat, Quaadka",Stimulants,Khat,https://www.dea.gov/factsheets/khat,,,
+Q73,How is khat used?,"Chewed
+Dried Khat is used as a tea or chewable paste
+Smoked, sprinkled on food",Stimulants,Khat,https://www.dea.gov/factsheets/khat,,,
+Q74,How does khat affect the body?,"Manic behavior with grandiose delusions
+Chronic use can cause depression and suicide
+Hallucinations, paranoia, nightmares
+Euphoria, increased alertness and energy, hyperactivity
+Increase in blood pressure and heart rate
+Cardiac complications
+Insomnia, gastric disorders",Stimulants,Khat,https://www.dea.gov/factsheets/khat,,,
+Q75,What are street names for LSD?,"Acid, Blotter Acid, Dots, Mellow Yellow, Window Pane",Hallucinogen,LSD,https://www.dea.gov/factsheets/lsd,,,
+Q76,How is LSD used?,"Added to absorbent paper such as blotter paper divided into square dosage units
+Tablets or capsules
+Occasionally in liquid form",Hallucinogen,LSD,https://www.dea.gov/factsheets/lsd,,,
+Q77,How does LSD affect the body?,"Hallucinations
+Distorted perception of shape and size of objects, colors, and sounds
+Acute anxiety and depression
+Flashbacks days and even months after
+Elevated heart rate, higher body temperature, increased blood pressure, dilated pupils
+Overdose symptoms: longer, more intense episodes, psychosis and death.",Hallucinogen,LSD,https://www.dea.gov/factsheets/lsd,,,
+Q78,Isn't taking medications just trading one addiction for another?,"This is not an uncommon concern, but the short answer is “no.” All medications approved for treating alcohol dependence are non-addictive. These medicines are designed to help manage a chronic disease, just as someone might take drugs to keep their asthma or diabetes in check.",Addiction,Medications,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help,,,
+Q79,What FDA-approved medications are available for alcohol problems?,"The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine if they are effective.
+
+Naltrexone can help people reduce heavy drinking.
+
+Acamprosate makes it easier to maintain abstinence.
+
+Disulfiram blocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram.
+
+It is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.
+
+Scientists are working to develop a larger menu of pharmaceutical treatments that could be tailored to individual needs. As more medications become available, people may be able to try multiple medications to find which they respond to best.",Alcohol,Medications,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help,,,
+Q80,What are common medications used to treat drug addiction and withdrawal?,"Opioid
+Methadone
+Buprenorphine
+Extended-release naltrexone
+Lofexidine
+Nicotine
+Nicotine replacement therapies (available as a patch, inhaler, or gum)
+Bupropion
+Varenicline
+Alcohol
+Naltrexone
+Disulfiram
+Acamprosate",Drug addiction,Medications,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q81,"Does drug use cause other mental disorders, or vice versa?","Drug use and other mental illness often co-exist. In some cases, mental disorders such as anxiety, depression, or schizophrenia may come before addiction. In other cases, drug use may trigger or worsen those mental health conditions, particularly in people with specific vulnerabilities. Some people with disorders like anxiety or depression may use drugs in an attempt to alleviate psychiatric symptoms. This may exacerbate their mental disorder in the long run, as well as increase the risk of developing addiction. Treatment for all conditions should happen concurrently.",Drug use,Mental health,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health,,,
+Q82,Why are women more depressed than men?,"Depression is predicted to be the second leading cause of global disability burden by 2020. It is twice as common in women.
+Gender-specific risk could be a likely cause. This includes: gender-based violence, socio-economic disadvantage, income inequality, low social status and rank, and responsibility for the care of others.",Depression,Mental health,https://www.weforum.org/agenda/2020/03/are-women-less-happy-than-men/,I'd consider removing the statistic.,,
+Q83,Can a person overdose on nicotine?,"Nicotine is poisonous and, though uncommon, overdose is possible. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. Nicotine poisoning usually occurs in young children who accidentally chew on nicotine gum or patches used to quit smoking or swallow e-cigarette liquid. Symptoms include difficulty breathing, vomiting, fainting, headache, weakness, and increased or decreased heart rate. Anyone concerned that a child or adult might be experiencing a nicotine overdose should seek immediate medical help.",Tobacco,Nicotine,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q84,Is nicotine addictive?,"Yes. Most smokers use tobacco regularly because they are addicted to nicotine. Addiction is characterized by compulsive drug-seeking and use, even in the face of negative health consequences. The majority of smokers would like to stop smoking, and each year about half try to quit permanently. Yet, only about 6 percent of smokers are able to quit in a given year. Most smokers will need to make multiple attempts before they are able to quit permanently. Medications including varenicline, and some antidepressants (e.g. bupropion), and nicotine-replacement therapy, can help in many cases. A transient surge of endorphins in the reward circuits of the brain causes a slight, brief euphoria when nicotine is administered. This surge is much briefer than the ""high"" associated with other drugs. However, like other drugs of abuse, nicotine increases levels of the neurotransmitter dopamine in these reward circuits, which reinforces the behavior of taking the drug. Repeated exposure alters these circuits' sensitivity to dopamine and leads to changes in other brain circuits involved in learning, stress, and self-control. For many tobacco users, the long-term brain changes induced by continued nicotine exposure result in addiction, which involves withdrawal symptoms when not smoking, and difficulty adhering to the resolution to quit. The pharmacokinetic properties of nicotine, or the way it is processed by the body, contribute to its addictiveness. When cigarette smoke enters the lungs, nicotine is absorbed rapidly in the blood and delivered quickly to the brain, so that nicotine levels peak within 10 seconds of inhalation. But the acute effects of nicotine also dissipate quickly, along with the associated feelings of reward; this rapid cycle causes the smoker to continue dosing to maintain the drug's pleasurable effects and prevent withdrawal symptoms. Withdrawal occurs as a result of dependence, when the body becomes used to having the drug in the system. Being without nicotine for too long can cause a regular user to experience irritability, craving, depression, anxiety, cognitive and attention deficits, sleep disturbances, and increased appetite. These withdrawal symptoms may begin within a few hours after the last cigarette, quickly driving people back to tobacco use. When a person quits smoking, withdrawal symptoms peak within the first few days of the last cigarette smoked and usually subside within a few weeks. For some people, however, symptoms may persist for months, and the severity of withdrawal symptoms appears to be influenced by a person's genes. In addition to its pleasurable effects, nicotine also temporarily boosts aspects of cognition, such as the ability to sustain attention and hold information in memory. However, long-term smoking is associated with cognitive decline and risk of Alzheimer's Disease, suggesting that short-term nicotine-related enhancement does not outweigh long-term consequences for cognitive functioning. In addition, people in withdrawal from nicotine experience neurocognitive deficits such as problems with attention or memory. These neurocognitive withdrawal symptoms are increasingly recognized as a contributor to continued smoking. A small research study also suggested that withdrawal may impair sleep for severely dependent smokers, and that this may additionally contribute to relapse. In addition to the drug's impact on multiple neurotransmitters and their receptors, many behavioral factors can affect the severity of withdrawal symptoms. For many people who smoke, the feel, smell, and sight of a cigarette and the ritual of obtaining, handling, lighting, and smoking the cigarette are all associated with the pleasurable effects of smoking and can make withdrawal or craving worse. Learning processes in the brain associate these cues with nicotine-induced dopamine surges in the reward system—similar to what occurs with other drug addictions. Nicotine replacement therapies such as gum, patches, and inhalers, and other medications approved for the treatment of nicotine addiction may help alleviate the physiological aspects of withdrawal; however, cravings often persist because of the power of these cues. Behavioral therapies can help smokers identify environmental triggers of craving so they can use strategies to avoid these triggers and manage the feelings that arise when triggers cannot be.",Tobacco,Nicotine,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/nicotine-addictive,,,
+Q85,How many people in the U.S. suffer from opioid addiction?,"The U.S Department of Health and Human Services estimates that in 2016, 11.5 million Americans misused prescription opioids and 948,000 Americans used heroin. There were 17,087 deaths resulting from prescription opioid misuse and 15,469 heroin overdose deaths in that same year.",Addiction,Opioid addiction,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q86,What are the best treatments for opioid addiction?,"There is a growing consensus that opioid addiction should be treated with medications along with counseling, and that counseling alone may not be effective in preventing drug overdose and death. Medication treatment uses drugs, such as methadone, buprenorphine (Suboxone, Subutex), and naltrexone (Vivitrol). In essence these drugs substitute for the opioid and are prescribed to reduce opioid dependency and to prevent death by overdose. The length of the treatment course varies depending on how well a patient tolerates the medication, the type of substitute medication, and whether the patient relapses during treatment, but can run from 90 days to several years.",Addiction,Opioid addiction,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q87,Is Buprenorphine a medication used to treat opioid addiction?,Buprenorphine is one of three medications commonly used to treat opioid addiction. The other two are methadone and naltrexone. Cost varies for the different medications. You may need to take this into account when considering your treatment options.,Buprenorphine,Opioid addiction,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q88,May Buprenorphine be prescribed if it is the right choice for me?,"Before you are given the first dose of any medication for opioid addiction, your doctor will ask you questions about your addiction, health, and other problems. You will get a drug test—usually a check of urine or saliva. You also will have a physical exam and tests for diseases that are common to people who abuse drugs. Your liver will be checked to make sure the medication can be safely taken. If buprenorphine is safe and appropriate for you, your doctor may recommend it.
+",Buprenorphine,Opioid addiction,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q89,Can Opioid addiction be treated?,"Opioid addiction is a chronic disease, like heart disease or diabetes. A chronic disease is a medical condition for life. It cannot be cured, but it can be managed. A person with addiction can regain a healthy, productive life.
+",Opioids,Opioid addiction,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q90,Can buprenorphine help treat opioid use disorder?,"Buprenorphine is a drug that can help treat opioid use disorder. It's a shorter acting drug than methadone, another medication that treats opioid use disorder. It hits the same receptors in your brain, but not as strongly.",Buprenorphine,Opioids,https://www.webmd.com/mental-health/addiction/qa/can-buprenorphine-help-treat-opioid-use-disorder,,,
+Q91,Can naltrexone help treat opioid use disorder?,"Naltrexone can help treat opioid use disorder. It blocks opiate receptors. Unlike methadone, another drug used to treat opioid use disorder, it can't ease withdrawal symptoms or cravings. But you can't get high if you use drugs while taking it. Naltrexone works best as part of a broad recovery treatment program. You'll start it when you're done with detox.",Treatment,Opioids,https://www.webmd.com/mental-health/addiction/qa/can-naltrexone-help-treat-opioid-use-disorder,,,
+Q92,What determines the length and severity of opioid withdrawal?,"In general, the length and harshness of opioid drug withdrawal depends on how long you've been abusing the drugs and how much you've been taking.",Withdrawal,Opioids,https://www.webmd.com/mental-health/addiction/qa/what-determines-the-length-and-severity-of-opioid-withdrawl,,,
+Q93,What is opium?,"Non-synthetic narcotic extracted from the poppy plant, made into a liquid, powder or solid. Opium poppy is a key source for many narcotics.",Opioids,Opium,https://www.dea.gov/factsheets/opium,,,
+Q94,What are street names for opium?,"Aunti, Aunti Emma, Big O, Black pill, Chandu, Chinese Molasses, Dopium, Dream Gun, Fi-do-nie, Gee, Guma, Midnight Oil, Zero",Opioids,Opium,https://www.dea.gov/factsheets/opium,,,
+Q95,How is opium used?,"Can be smoked or injected intravenously
+Taken in pill form
+Used in combination with other drugs, such as marijuana and/or methamphetamine",Opioids,Opium,https://www.dea.gov/factsheets/opium,,,
+Q96,How does opium affect the body?,"Euphoric rush, relaxation and relief of physical pain
+Slow breathing, seizures, loss of consciousness
+Addictive
+Coma or death",Opioids,Opium,https://www.dea.gov/factsheets/opium,,,
+Q97,Can a person overdose on kratom?,"There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A 2019 paper analyzing data from the National Poison Data System found that between 2011-2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances. In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances, including illicit drugs, opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications, such as cough syrup. Also, there have been some reports of kratom packaged as dietary supplements or dietary ingredients that were laced with other compounds that caused deaths. People should check with their health care providers about the safety of mixing kratom with other medicines.",Kratom,Overdose,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q98,What is being done to stop the overdose crisis?,"Opioid misuse has become a nationwide public health crisis. Luckily, federal, state, and local governments, advocacy organizations, and health professionals are working together to tackle the crisis from every angle. A holistic public health approach is being undertaken to:
+Improve access to treatment and recovery services
+Promote the use of overdose-reversing drugs
+Strengthen our understanding of the crisis through better public health monitoring
+Develop safe, effective medications strategies for pain management
+Improve medications to treat people who are addicted to opioids Advance better pain management practices",Overdose,Overdose,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q99,What is oxycodone?,"Semi-synthetic opioid drug prescribed for pain as Tylox®, Percodan®, OxyContin®. Derived from the poppy plant, has high potential for abuse.",Opioids,Oxycodone,https://www.dea.gov/factsheets/oxycodone,,,
+Q100,What are street names for oxycodone?,"Hillbilly Heroin, Kicker, OC, Ox, Roxy, Perc, Oxy",Opioids,Oxycodone,https://www.dea.gov/factsheets/oxycodone,,,
+Q101,How is oxycodone used?,"Pills and tablets chewed or swallowed
+Inhaling vapors by heating tablet on foil
+Crushed and sniffed or dissolved in water and injected",Opioids,Oxycodone,https://www.dea.gov/factsheets/oxycodone,,,
+Q102,How does oxycodone affect the body?,"Feelings of relaxation, euphoria, pain relief
+Addictive
+Chronic use of oxycodone with acetaminophen may cause severe liver damage
+Overdose may lead to coma and possible death.",Opioids,Oxycodone,https://www.dea.gov/factsheets/oxycodone,,,
+Q103,Is it okay to drink when pregnant?,"No. There is no known safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol. Several conditions, including fetal alcohol spectrum disorders, have been linked to alcohol use during pregnancy. Women of childbearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.",Alcohol,Pregnancy,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q104,Is it okay to drink when breastfeeding?,"Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns. Alcohol consumption above moderate levels may also impair a mother’s judgment and ability to safely care for her child. Drinking alcoholic beverages is not an indication to stop breastfeeding; however, consuming more than one drink per day is not recommended.",Alcohol,Pregnancy,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q105,What are the unique needs of pregnant women with substance use disorders?,"Using drugs, alcohol, or tobacco during pregnancy exposes not just the woman but also her developing fetus to the substance and can have potentially deleterious and even long-term effects on exposed children. Smoking during pregnancy can increase risk of stillbirth, infant mortality, sudden infant death syndrome, preterm birth, respiratory problems, slowed fetal growth, and low birth weight. Drinking during pregnancy can lead to the child developing fetal alcohol spectrum disorders, characterized by low birth weight and enduring cognitive and behavioral problems. Prenatal use of some drugs, including opioids, may cause a withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). Babies with NAS are at greater risk of seizures, respiratory problems, feeding difficulties, low birth weight, and even death. Research has established the value of evidence-based treatments for pregnant women (and their babies), including medications. For example, although no medications have been FDA-approved to treat opioid dependence in pregnant women, methadone maintenance combined with prenatal care and a comprehensive drug treatment program can improve many of the detrimental outcomes associated with untreated heroin abuse. However, newborns exposed to methadone during pregnancy still require treatment for withdrawal symptoms. Recently, another medication option for opioid dependence, buprenorphine, has been shown to produce fewer NAS symptoms in babies than methadone, resulting in shorter infant hospital stays. In general, it is important to closely monitor women who are trying to quit drug use during pregnancy and to provide treatment as needed.",Substance use disorder,Pregnancy,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q106,Can a person become addicted to medications prescribed by a doctor?,"Yes. People who abuse prescription drugs—that is, taking them in a manner or a dose other than prescribed, or taking medications prescribed for another person—risk addiction and other serious health consequences. Such drugs include opioid pain relievers, stimulants used to treat ADHD, and benzodiazepines to treat anxiety or sleep disorders. Indeed, in 2010, an estimated 2.4 million people 12 or older met criteria for abuse of or dependence on prescription drugs, the second most common illicit drug use after marijuana. To minimize these risks, a physician (or other prescribing health provider) should screen patients for prior or current substance abuse problems and assess their family history of substance abuse or addiction before prescribing a psychoactive medication and monitor patients who are prescribed such drugs. Physicians also need to educate patients about the potential risks so that they will follow their physician’s instructions faithfully, safeguard their medications, and dispose of them appropriately.",Addiction,Prescription drugs,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q107,Can Alcoholism And Drug Addiction Be Treated?,"Yes, alcoholism and addiction can be treated. Alcoholism and addiction treatment programs can help a person stop drinking and using drugs. Treatment has helped millions of people stop drinking and drugging, rebuild their lives and live a life in long-term recovery.",Treatment,Recovery,https://tricircleinc.com/faqs/,,,
+Q108,What is family therapy?,"Family therapy is based on the idea that a family is a system of different parts. A change in any part of the system will trigger changes in all the other parts. This means that when one member
+of a family is affected by a behavioral health disorder such as mental illness or addiction, everyone is affected.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q109,Who can attend family therapy?,"“Family” means a group of two
+or more people with close and enduring emotional ties. Using this definition, each person in treatment for a behavioral health disorder has
+a unique set of family members. Therapists don't decide who should be in family therapy. Instead they ask, “Who is most important to you?”   parents
+ spouses or partners
+ in-laws
+ siblings
+ children                                                                                                                                                                                                                                                                   ",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q110,When should family therapy start?,"Family therapy is typically introduced after the individual in treatment for mental illness or addiction has made progress in recovery. This could be a few months after treatment starts, or a year or more later.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q111,What are the goals of family therapy?,"There are two main goals in family therapy. One goal is to help everyone give the right kind of support to the family member in behavioral health treatment, so that recovery sticks and relapse is avoided. The other goal is to strengthen the whole family’s emotional health, so that everyone can thrive.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q112,Is family therapy the same as family education?,"No, family therapy is more than family education. Many behavioral health programs conduct education sessions for families on such topics as a particular mental illness, drug and alcohol addiction, treatment, relapse, and recovery. Families can use this information to better understand what is happening, how it might affect them, and what to do to help the family member in treatment.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q113,Who conducts family therapy sessions?,"The leader of a family therapy session may be a licensed family therapist, social worker, psychiatrist, psychologist, counselor, clergy member, or some other type of professional. Whatever the title, the leader must meet the legal and professional requirements for working in family therapy. Special training and skills are required, because family therapy is quite different from one- on-one counseling.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q114,How is family therapy organized?,"Family therapy involves the entire family meeting together. Sometimes part of the family meets. The family therapist may work one-on-one with a particular family member, in addition to the family sessions, although this is not typical.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q115,What happens in a particular session?,"There are many things that can happen in family therapy. A session can be devoted to talking about family concerns and how people are feeling. Family members might use the session to talk about a particular crisis or problem that needs solving. Or, they might want to focus on the changes that have been happening.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q116,What if family members are unwilling to take part?,Sometimes what’s needed is simply time. Willing members of the family can choose to get started. Unwilling members can join when they are ready.,Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q117,Is family therapy effective?,"Research suggests that behavioral health treatment that includes family therapy works better than treatment that does not. For people with mental illness, family therapy in conjunction with individual treatment can increase medication adherence, reduce rates of relapse and rehospitalization, reduce psychiatric symptoms, and relieve stress.",Family therapy,Recovery from mental illness,https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784?referer=from_search_result,,,
+Q118,What are some risk factors for addiction?,"Scientists say no single factor can predict whether a person might become addicted to drugs. But they think about half of the risk of addiction may come from a person’s biology and the other half from his or her environment. Some of the environmental factors that could make addiction more likely, especially among teens, include a lack of family involvement, the availability of drugs at school or in the home, or spending time with friends or family who use drugs. Smoking or injecting a drug also increases the risk of addiction, possibly because these methods have the quickest impact on the brain and body. The earlier a person begins using a drug, the more likely he or she is to become addicted. People with anxiety, depression or other mental health disorders such as attention-deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) also have a higher risk of drug addiction.",Addiction,Risk,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q119,Does treatment of ADHD with stimulant medications like Ritalin® and Adderall® increase risk of substance abuse later in life?,"Prescription stimulants are effective at treating attention disorders in children and adolescents, but concerns have been raised that they could make a young person more vulnerable to developing later substance use disorders. On balance, the studies conducted so far have found no differences in later substance use for ADHD-affected children who received treatment versus those that did not. This suggests that treatment with ADHD medication does not affect (either negatively or positively) an individual’s risk for developing a substance use disorder.",Substance abuse,Risk,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q120,Does alcohol and other drug abuse increase the risk for suicide?,"Alcohol and substance abuse problems contribute to suicidal behavior in several ways. Persons who are dependent on substances often have a number of other risk factors for suicide. In addition to being depressed, they are also likely to have social and financial problems.",Drug abuse,Risk,https://www.hhs.gov/answers/mental-health-and-substance-abuse/index.html,,,
+Q121,What is rohypnol?,"Depressant and benzodiazepine with generic name Flunitrazepam. It is not approved for medical use in the United States. Used by cocaine abusers to relieve side effects, and also used as a “date rape” drug.",Depressants,Rohypnol,https://www.dea.gov/factsheets/rohypnol,,,
+Q122,What are street names for rohypnol?,"Circles, Forget Me Pill, La Rocha, Lunch Money Drug, Mexican Valium, Pingus, R2, Roach 2, Ruffies, Rophies, Wolfies",Depressants,Rohypnol,https://www.dea.gov/factsheets/rohypnol,,,
+Q123,How is rohypnol used?,"Oblong olive green tablet, swallowed, crushed and snorted
+Can be dissolved in liquids
+When placed in a light-colored drink, will dye it blue",Depressants,Rohypnol,https://www.dea.gov/factsheets/rohypnol,,,
+Q124,How does rohypnol affect the body?,"Muscle relaxant, decreased anxiety
+Drowsiness, amnesia, sleep
+Slurred speech, loss of coordination
+Impaired mental function, confusion
+Addictive",Depressants,Rohypnol,https://www.dea.gov/factsheets/rohypnol,,,
+Q125,Can behavioral therapy help opioid disorder?,"You can also benefit from behavioral therapy. It can help you:
+
+Manage cravings
+Build healthy habits and thoughts
+Avoid triggers that could lead to relapse. Therapy could be just you as an individual, it could include your entire family, or you could be part of a group with similar issues. ",Treatment,Substance use disorder,https://www.webmd.com/mental-health/addiction/qa/can-behavioral-therapy-help-opioid-disorder,,,
+Q126,What do new studies tell us about treating addiction?,"The past 15 years of imaging studies have shown that there are more types of brain circuitry involved in addiction than researchers previously thought. For instance, these studies have shown that drugs such as cocaine can impair parts of the brain involved in problem solving, reasoning, and planning. As a result, scientists have looked for ways to strengthen these circuits in people at risk for addiction—for instance, through behavioral methods aimed at improving executive function and decision-making. Imaging studies also show that some of the brain circuits involved in addiction are impaired in mental illnesses such as depression and schizophrenia. Saleem M. Nicola, Ph.D., of Albert Einstein College of Medicine, a NARSAD Young Investigator Grantee, and NARSAD Independent Investigator Alan I. Green, M.D., of Dartmouth Medical School are among the researchers using this information to explore whether medications used to treat these mental illnesses could aid the development of new treatments for addiction.",Addiction,Treatment,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,"I don't think this question should be included, given that it says ""new."" I'm not sure when these studies were conducted, but it might be too specific or potentially too outdated to be a part of the dataset here.",
+Q127,Can addiction be treated successfully?,"Yes, addiction is a treatable disorder. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery.",Addiction,Treatment,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q128,Can pregnant women with an opioid addiction get treated?,"Pregnant women with an opioid addiction can get help for their drug problem in ways that are safe for their unborn baby. For instance, buprenorphine and methadone, two types of medicine used to treat opioid addiction, have been shown to be safe and effective treatments in this situation. Not only will treatment help the mother get healthy, it’s also better for the baby.",Addiction,Treatment,https://teens.drugabuse.gov/blog/post/are-some-babies-born-addicted,,,
+Q129,Does treatment for alcohol problems work?,"The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment.
+
+Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.",Alcohol,Treatment,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#11,,,
+Q130,What types of treatment are available for alcohol problems?,"There are behavioral treatments, medications, and mutual-support groups available for alcohol problems. Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial. Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling. Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.",Alcohol,Treatment,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#2,,,
+Q131,How do I select a treatment program for alcohol problems?,"Overall, gather as much information as you can about the program or provider before making a decision on treatment. If you know someone who has first-hand knowledge of the program, it may help to ask about his or her personal experience.
+
+Here are some questions you can ask that may help guide your choice:
+
+What kind of treatment does the program or provider offer? 
+It is important to gauge if the facility provides all the currently available methods or relies on one approach. You may want to learn if the program or provider offers medication and if mental health issues are addressed together with addiction treatment.
+
+Is treatment tailored to the individual? 
+Matching the right therapy to the individual is important to its success. No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.
+
+What is expected of the patient? 
+You will want to understand what will be asked of you in order to decide what treatment best suits your needs.
+
+Is treatment success measured? 
+By assessing whether and how the program or provider measures success, you may be able to better compare your options.
+
+How does the program or provider handle relapse? 
+Relapse is common and you will want to know how it is addressed; when seeking professional help, it is important you feel respected and understood and that you have a feeling of trust that this person, group, or organization can help you. Remember, though, that relationships with doctors, therapists, and other health professionals can take time to develop.",Alcohol,Treatment,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help,,,
+Q132,What can I expect when I meet with healthcare professionals about OUD treatment and my pregnancy?,"The healthcare professionals who are treating your OUD and providing your prenatal care need a complete picture of your overall health. Together, they will make sure you are tested for hepatitis B and C and for HIV. They will ask you about any symptoms of depression or other feelings. You should
+be ready to answer questions about all substances you have used. They need this information to plan the best possible treatment for you and to help you prepare for your baby. These issues may be hard to talk about, but do the best you can to answer their questions completely and honestly. Expect them to treat you with respect and to answer any questions you may have.",Opioids,Treatment,https://store.samhsa.gov/product/Opioid-Use-Disorder-and-Pregnancy/SMA18-5071FS1?referer=from_search_result,Changed the question phrasing.,,
+Q133,What can I expect when I meet with healthcare professionals about OUD treatment while caring for my baby?,"If your medicine is no longer working and you feel sleepy or are tempted to start using again, your healthcare professionals can help. Be honest about any cravings or urges you may have to use opioids. The stress that comes with being a new mother may increase these urges.
+Your healthcare professionals can offer counseling and other support services. But before they do, they need to know if you have other medical and mental health problems. They will test you for these conditions before you leave the hospital and at your follow-up visits to make sure you get the treatment you need. They will continue to recommend support services that allow you and your baby to receive the high-quality health care that you need.
+Your healthcare professionals will work with you to create a birth control plan. Together, you will discuss if you want to have another child, how many children you would like to have, and how you would like to space out the births of your children. At this time, they will check in on how you are doing with breastfeeding and make sure you have the support you need.",Opioids,Treatment,https://store.samhsa.gov/product/Good-Care-for-You-and-Your-Baby-While-Receiving-Opioid-Use-Disorder-Treatment/SMA18-5071FS4?referer=from_search_result,Changed the question phrasing.,,
+Q134,How can I prevent opioid use disorder?,"There are a variety of ways to help reduce exposure to opioids and prevent opioid use disorder, such as:
+
+Prescription drug monitoring programs
+State prescription drug laws
+Formulary management strategies in insurance programs, such as prior authorization, quantity limits, and drug utilization review
+Academic detailing to educate providers about opioid prescribing guidelines and facilitating conversations with patients about the risks and benefits of pain treatment options
+Quality improvement programs in health care systems to increase implementation of recommended prescribing practices
+Patient education on the safe storage and disposal of prescription opioids
+Improve awareness and share resources about the risks of prescription opioids, and the cost of overdose on patients and families.",Opioids,Treatment,https://www.cdc.gov/drugoverdose/prevention/opioid-use-disorder.html,Changed the question phrasing.,,
+Q135,How can I prevent high-risk substance use?,"Research has improved our understanding of factors that help buffer youth from a variety of risky behaviors, including substance use. These are known as protective factors. Some protective factors for high risk substance use include:
+
+Parent or family engagement
+Family support
+Parental disapproval of substance use
+Parental monitoring
+School Connectedness",Substance use,Treatment,https://www.cdc.gov/healthyyouth/substance-use/index.htm,Changed the question phrasing.,,
+Q136,Can I stop taking buprenorphine when I am ready?,"You can become dependent on buprenorphine, as with many medications taken over time. For this reason, if you wish to stop taking buprenorphine, you should work with a substance abuse treatment provider to taper off. This prevents withdrawal symptoms from appearing.",Buprenorphine,Withdrawal,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q137,What are the unique needs of women with substance use disorders?,"Gender-related drug abuse treatment should attend not only to biological differences but also to social and environmental factors, all of which can influence the motivations for drug use, the reasons for seeking treatment, the types of environments where treatment is obtained, the treatments that are most effective, and the consequences of not receiving treatment. Many life circumstances predominate in women as a group, which may require a specialized treatment approach. For example, research has shown that physical and sexual trauma followed by post-traumatic stress disorder (PTSD) is more common in drug-abusing women than in men seeking treatment. Other factors unique to women that can influence the treatment process include issues around how they come into treatment (as women are more likely than men to seek the assistance of a general or mental health practitioner), financial independence, and pregnancy and child care.",Substance use disorder,Women,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q138,Can binge drinking lead to alcohol use disorder?,Binge drinking and heavy alcohol use can increase an individual's risk of alcohol use disorder.,Alcohol,,https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking,,,
+Q139,What biological factors increase risk of addiction?,"Biological factors that can affect a person's risk of addiction include their genes, stage of development, and even gender or ethnicity. Scientists estimate that genes, including the effects environmental factors have on a person's gene expression, called epigenetics, account for between 40 and 60 percent of a person's risk of addiction. Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q140,Are there reasons other than physical addiction why people keep taking drugs?,"Some people keep taking drugs because they become addicted to them. They want more—in fact, they feel like they need more. Eventually, trying to get drugs becomes the most important thing in their lives—using up their time, money, and energy, and hurting people they're close to.
+
+However, those people who don't become addicted to drugs may continue to use drugs for the same reasons they started, including feeling bored or wanting to fit in with a particular group, even though drugs aren't helping them. But whatever the reason, these people need to find healthy and constructive ways to be happy without drugs. They can do this by finding friends who share similar interests, finding healthy activities that make them happy, talking with people about their concerns, and finding friends who enjoy their company when they are not altered by drugs and alcohol.",Drug use,,https://abovetheinfluence.com/faqs/,,,
+Q141,Is drug addiction treatment worth the cost?,"Substance abuse costs our nation over $600 billion annually and treatment can help reduce these costs. Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself. Treatment is also much less expensive than its alternatives, such as incarcerating addicted persons. For example, the average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient, whereas 1 full year of imprisonment costs approximately $24,000 per person.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q142,What is opioid dependence?,Opioid dependence occurs when the body adjusts its normal functioning around regular opioid use. Unpleasant physical symptoms occur when medication is stopped.,Opioids,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q143,What DEA schedule is DMT?,"DMT is Schedule I, but plants containing it are not controlled.",Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q144,How does dopamine reinforce drug use?,"The feeling of pleasure is how a healthy brain identifies and reinforces beneficial behaviors, such as eating, socializing, and sex. Our brains are wired to increase the odds that we will repeat pleasurable activities. The neurotransmitter dopamine is central to this. Whenever the reward circuit is activated by a healthy, pleasurable experience, a burst of dopamine signals that something important is happening that needs to be remembered. This dopamine signal causes changes in neural connectivity that make it easier to repeat the activity again and again without thinking about it, leading to the formation of habits.
+
+Just as drugs produce intense euphoria, they also produce much larger surges of dopamine, powerfully reinforcing the connection between consumption of the drug, the resulting pleasure, and all the external cues linked to the experience. Large surges of dopamine “teach” the brain to seek drugs at the expense of other, healthier goals and activities.
+
+Cues in a person’s daily routine or environment that have become linked with drug use because of changes to the reward circuit can trigger uncontrollable cravings whenever the person is exposed to these cues, even if the drug itself is not available. This learned “reflex” can last a long time, even in people who haven't used drugs in many years. For example, people who have been drug free for a decade can experience cravings when returning to an old neighborhood or house where they used drugs. Like riding a bike, the brain remembers.",Drug use,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q145,What counts as a drink?,"Many people are surprised to learn what counts as a “standard” drink. In the United States, a standard drink is defined as any beverage containing 0.6 fluid ounces or 14 grams of pure alcohol (also known as an alcoholic drink-equivalent). ",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/,"Removed part of the answer because it said, ""the drinks pictured here""",,
+Q146,Is it safe to drink alcohol and drive?,"No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely. The more alcohol consumed, the greater the impairment.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q147,Can I avoid side effects and risks in opioids?,"No. Opioids pose a risk to all patients. Anyone taking prescription opioids is at risk for unintentional overdose or death and can become addicted. From 1999 to 2017, more than 218,000 people died from overdose related to prescription opioids in the United States. Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with opioid use disorder.",Opioids,,https://www.cdc.gov/drugoverdose/patients/faq.html,,,
+Q148,How does drinking affect the liver?,"Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including:
+
+Steatosis, or fatty liver
+Alcoholic hepatitis
+Fibrosis
+Cirrhosis",Alcohol,,https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body,,,
+Q149,How does drinking affect the heart?,"Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:
+
+Cardiomyopathy – Stretching and drooping of heart muscle
+Arrhythmias – Irregular heartbeat
+Stroke
+High blood pressure  ",Alcohol,,https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body,,,
+Q150,How does drinking affect the pancreas?,"Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion. ",Alcohol,,https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body,,,
+Q151,How can family and friends make a difference in the life of someone needing treatment?,"Family and friends can play critical roles in motivating individuals with drug problems to enter and stay in treatment. Family therapy can also be important, especially for adolescents. Involvement of a family member or significant other in an individual's treatment program can strengthen and extend treatment benefits.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q152,Where can family members go for information on treatment options?,"Trying to locate appropriate treatment for a loved one, especially finding a program tailored to an individual's particular needs, can be a difficult process. However, there are some resources to help with this process. For example, NIDA’s handbook Seeking Drug Abuse Treatment: Know What to Ask offers guidance in finding the right treatment program. Numerous online resources can help locate a local program or provide other information, including:
+
+The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a Web site (findtreatment.gov) that shows the location of residential, outpatient, and hospital inpatient treatment programs for drug addiction and alcoholism throughout the country. This information is also accessible by calling 1-800-662-HELP.
+The National Suicide Prevention Lifeline (1-800-273-TALK) offers more than just suicide prevention—it can also help with a host of issues, including drug and alcohol abuse, and can connect individuals with a nearby professional.
+The National Alliance on Mental Illness (www.nami.org) and Mental Health America (www.mentalhealthamerica.net) are alliances of nonprofit, self-help support organizations for patients and families dealing with a variety of mental disorders. Both have State and local affiliates throughout the country and may be especially helpful for patients with comorbid conditions.
+The American Academy of Addiction Psychiatry and the American Academy of Child and Adolescent Psychiatry each have physician locator tools posted on their Web sites at aaap.org and aacap.org, respectively.
+Faces & Voices of Recovery (facesandvoicesofrecovery.org), founded in 2001, is an advocacy organization for individuals in long-term recovery that strategizes on ways to reach out to the medical, public health, criminal justice, and other communities to promote and celebrate recovery from addiction to alcohol and other drugs.
+The Partnership at Drugfree.org (drugfree.org) is an organization that provides information and resources on teen drug use and addiction for parents, to help them prevent and intervene in their children’s drug use or find treatment for a child who needs it. They offer a toll-free helpline for parents (1-855-378-4373).
+The American Society of Addiction Medicine (asam.org) is a society of physicians aimed at increasing access to addiction treatment. Their Web site has a nationwide directory of addiction medicine professionals.
+NIDA’s National Drug Abuse Treatment Clinical Trials Network (drugabuse.gov/about-nida/organization/cctn/ctn) provides information for those interested in participating in a clinical trial testing a promising substance abuse intervention; or visit clinicaltrials.gov.
+NIDA’s DrugPubs Research Dissemination Center (drugpubs.drugabuse.gov) provides booklets, pamphlets, fact sheets, and other informational resources on drugs, drug abuse, and treatment.
+The National Institute on Alcohol Abuse and Alcoholism (niaaa.nih.gov) provides information on alcohol, alcohol use, and treatment of alcohol-related problems (niaaa.nih.gov/search/node/treatment).
+",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q153,How can addiction harm other people?,"Beyond the harmful consequences for the person with the addiction, drug use can cause serious health problems for others. Some of the more severe consequences of addiction are: Negative effects of drug use while pregnant or breastfeeding: A mother's substance or medication use during pregnancy can cause her baby to go into withdrawal after it's born, which is called neonatal abstinence syndrome (NAS). Symptoms will differ depending on the substance used, but may include tremors, problems with sleeping and feeding, and even seizures. Some drug-exposed children will have developmental problems with behavior, attention, and thinking. Ongoing research is exploring if these effects on the brain and behavior extend into the teen years, causing continued developmental problems. In addition, some substances can make their way into a mother's breast milk. Scientists are still learning about long-term effects on a child who is exposed to drugs through breastfeeding. Negative effects of secondhand smoke: Secondhand tobacco smoke exposes bystanders to at least 250 chemicals that are known to be harmful, particularly to children. Involuntary exposure to secondhand smoke increases the risks of heart disease and lung cancer in people who have never smoked. Additionally, the known health risks of secondhand exposure to tobacco smoke raise questions about whether secondhand exposure to marijuana smoke poses similar risks. At this point, little research on this question has been conducted. However, a study found that some nonsmoking participants exposed for an hour to high-THC marijuana in an unventilated room reported mild effects of the drug, and another study showed positive urine tests in the hours directly following exposure. If you inhale secondhand marijuana smoke, it's unlikely you would fail a drug test, but it is possible.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health,,,
+Q154,What are the other health consequences of drug addiction?,"People with addiction often have one or more associated health issues, which could include lung or heart disease, stroke, cancer, or mental health conditions. Imaging scans, chest X-rays, and blood tests can show the damaging effects of long-term drug use throughout the body. For example, it is now well-known that tobacco smoke can cause many cancers, methamphetamine can cause severe dental problems, known as meth mouth, and that opioids can lead to overdose and death. In addition, some drugs, such as inhalants, may damage or destroy nerve cells, either in the brain or the peripheral nervous system (the nervous system outside the brain and spinal cord). Drug use can also increase the risk of contracting infections. HIV and hepatitis C (a serious liver disease) can occur from sharing injection equipment or from unsafe practices such as condom-less sex. Infection of the heart and its valves (endocarditis) and skin infection (cellulitis) can occur after exposure to bacteria by injection drug use.",Drug addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q155,What are the health effects of kratom?,"Reported health effects of kratom use include:
+
+nausea
+itching
+sweating
+dry mouth
+constipation
+increased urination
+loss of appetite
+seizures
+hallucinations; symptoms of psychosis have been reported in some users.",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q156,What helps people stay in treatment?,"Because successful outcomes often depend on a person’s staying in treatment long enough to reap its full benefits, strategies for keeping people in treatment are critical. Whether a patient stays in treatment depends on factors associated with both the individual and the program. Individual factors related to engagement and retention typically include motivation to change drug-using behavior; degree of support from family and friends; and, frequently,  pressure from the criminal justice system, child protection services, employers, or family. Within a treatment program, successful clinicians can establish a positive, therapeutic relationship with their patients. The clinician should ensure that a treatment plan is developed cooperatively with the person seeking treatment, that the plan is followed, and that treatment expectations are clearly understood. Medical, psychiatric, and social services should also be available. Because some problems (such as serious medical or mental illness or criminal involvement) increase the likelihood of patients dropping out of treatment, intensive interventions may be required to retain them. After a course of intensive treatment, the provider should ensure a transition to less intensive continuing care to support and monitor individuals in their ongoing recovery.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q157,How can inhalant abuse be recognized?,"Early identification and intervention are the best ways to stop inhalant abuse before it causes serious health consequences. Parents, educators, family physicians, and other health care practitioners should be alert to the following signs:
+Chemical odors on breath or clothing
+Paint or other stains on face, hands, or clothes
+Hidden empty spray paint or solvent containers, and chemical-soaked rags or clothing
+Drunk or disoriented appearance
+Slurred speech
+Nausea or loss of appetite
+Inattentiveness, lack of coordination, irritability, and depression",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/how-can-inhalant-abuse-be-recognized,,,
+Q158,What are the other medical consequences of inhalant abuse?,"Inhalant abusers risk an array of other devastating medical consequences. The highly concentrated chemicals in solvents or aerosol sprays can induce irregular and rapid heart rhythms and lead to fatal heart failure within minutes of a session of prolonged sniffing. This syndrome, known as ""sudden sniffing death,"" can result from a single session of inhalant use by an otherwise healthy young person. Sudden sniffing death is associated particularly with the abuse of butane, propane, and chemicals in aerosols. Inhalant abuse also can cause death by—
+
+asphyxiation — from repeated inhalations that lead to high concentrations of inhaled fumes, which displace available oxygen in the lungs;
+suffocation — from blocking air from entering the lungs when inhaling fumes from a plastic bag placed over the head;
+convulsions or seizures — from abnormal electrical discharges in the brain;
+coma — from the brain shutting down all but the most vital functions;
+choking — from inhalation of vomit after inhalant use; or
+fatal injury — from accidents, including motor vehicle fatalities, suffered while intoxicated. Based on independent studies performed over a 10-year period in three different states, the number of inhalant-related fatalities in the United States is approximately 100–200 per year. Animal and human research shows that most inhalants are extremely toxic. Perhaps the most significant toxic effect of chronic exposure to inhalants is widespread and long-lasting damage to the brain and other parts of the nervous system. For example, chronic abuse of volatile solvents, such as toluene or naphthalene (the volatile ingredient in mothballs), damages the protective sheath around certain nerve fibers in the brain and peripheral nervous system. This extensive destruction of nerve fibers is clinically similar to that seen with neurological diseases such as multiple sclerosis. The neurotoxic effects of prolonged inhalant abuse include neurological syndromes that reflect damage to parts of the brain involved in controlling cognition, movement, vision, and hearing. Cognitive abnormalities can range from mild impairment to severe dementia. Inhalants also are highly toxic to other organs. Chronic exposure can produce significant damage to the heart, lungs, liver, and kidneys. Although some inhalant-induced damage to the nervous and other organ systems may be at least partially reversible when inhalant abuse is stopped, many syndromes caused by repeated or prolonged abuse are irreversible. Abuse of inhalants during pregnancy also may place infants and children at increased risk of developmental harm. Animal studies designed to simulate human patterns of inhalant abuse suggest that prenatal exposure to toluene can result in reduced birth weights, occasional skeletal abnormalities, delayed neurobehavioral development, and altered regulation of metabolism and body composition in males, as well as food intake and weight gain in both sexes. A number of case reports note abnormalities in newborns of mothers who chronically abuse solvents, and there is evidence of subsequent developmental impairment in some of these children. However, no well-controlled prospective study of the effects of prenatal exposure to inhalants in humans has been conducted, and it is not possible to link prenatal exposure to a particular chemical to a specific birth defect or developmental problem. Finally, a 2008 survey of over 13,000 high school students has identified an association between disordered eating (defined as a positive response to one or more of three questions about engaging in inappropriate behaviors for weight control during the past 30 days) and inhalant use among both male and female students.
+",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/what-are-other-medical-consequences-inhalant-abuse,,,
+Q159,What are the short- and long-term effects of inhalant use?,"Although the chemical substances found in inhalants may produce various pharmacological effects, most inhalants produce a rapid high that resembles alcohol intoxication, with initial excitation followed by drowsiness, disinhibition, lightheadedness, and agitation. If sufficient amounts are inhaled, nearly all solvents and gases produce anesthesia — a loss of sensation — and can lead to unconsciousness. The chemicals found in solvents, aerosol sprays, and gases can produce a variety of additional effects during or shortly after use. These effects are related to inhalant intoxication and may include belligerence, apathy, impaired judgment, and impaired functioning in work or social situations; nausea and vomiting are other common side effects. Exposure to high doses can cause confusion and delirium. In addition, inhalant abusers may experience dizziness, drowsiness, slurred speech, lethargy, depressed reflexes, general muscle weakness, and stupor. For example, research shows that toluene can produce headache, euphoria, giddy feelings, and the inability to coordinate movements. Inhaled nitrites dilate blood vessels, increase heart rate, and produce a sensation of heat and excitement that can last for several minutes. Other effects can include flush, dizziness, and headache. A strong need to continue using inhalants has been reported by many individuals, particularly those who have abused inhalants for prolonged periods over many days. Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. A recent survey of 43,000 American adults suggests that inhalant users, on average, initiate use of cigarettes, alcohol, and almost all other drugs at younger ages and display a higher lifetime prevalence of substance use disorders, including abuse of prescription drugs, when compared with substance abusers without a history of inhalant use.
+",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/what-are-short-long-term-effects-inhalant-use,,,
+Q160,What role can the juvenile justice system play in addressing adolescent drug abuse?,"Involvement in the juvenile justice system is unfortunately a reality for many substance-abusing adolescents, but it presents a valuable opportunity for intervention. Substance use treatment can be incorporated into the juvenile justice system in several ways. These include:
+
+screening and assessment for drug abuse upon arrest
+initiation of treatment while awaiting trial
+access to treatment programs in the community in lieu of incarceration (e.g., juvenile treatment drug courts)
+treatment during incarceration followed by community-based treatment after release
+Coordination and collaboration between juvenile justice professionals, drug abuse treatment providers, and other social service agencies are essential in getting needed treatment to adolescent offenders, about one half of whom have substance use disorders",Drug abuse,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q161,What does it mean to be above the legal limit for drinking?,"The legal limit for drinking is the alcohol level above which a person is subject to legal penalties (e.g., arrest or loss of a driver’s license).
+
+Legal limits are measured using either a blood alcohol test or a breathalyzer.
+Legal limits are typically defined by state law, and may vary according to individual characteristics, such as age and occupation.
+All states in the United States have adopted 0.08% (80 mg/dL) as the legal limit for operating a motor vehicle for drivers aged 21 years or older (except for Utah, which adopted a 0.05% legal limit in 2018). However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.
+
+Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q162,How long does drug addiction treatment usually last?,"Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum, and some opioid-addicted individuals continue to benefit from methadone maintenance for many years. Treatment dropout is one of the major problems encountered by treatment programs; therefore, motivational techniques that can keep patients engaged will also improve outcomes. By viewing addiction as a chronic disease and offering continuing care and monitoring, programs can succeed, but this will often require multiple episodes of treatment and readily readmitting patients that have relapsed.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q163,"Why is being able to ""hold your liquor"" a concern?","For some people, it takes quite a few drinks to get a buzz or feel relaxed. Often they are unaware that being able to ""hold your liquor"" isn't protection from alcohol problems, but instead a reason for caution. They tend to drink more, socialize with people who drink a lot, and develop a tolerance to alcohol. As a result, they have an increased risk for developing alcohol use disorder. The higher alcohol levels can also harm the liver, heart, and brain without the person drinking noticing until it's too late. And all people who drink need to be aware that critical decision–making abilities and driving–related skills are already diminished long before a person shows physical signs of intoxication.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/Q-and-As/Default.aspx,,,
+Q164,What are the long-term effects of drug use?,"It depends on the drug, but all drugs can cause negative health effects and can lead to addiction. Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
+
+Individuals who suffer from addiction often have one or more accompanying medical issues, including lung and cardiovascular disease, stroke, cancer, mental disorders, and obesity; and drug use can also make them susceptible to contracting HIV, hepatitis, and other diseases. Imaging scans, chest x-rays, and blood tests show the damaging effects of drug abuse throughout the body. In addition, some drugs are toxic to nerve cells and may damage or destroy them either in the brain or the peripheral nervous system. Some of these effects occur when drugs are used at high doses or for prolonged periods of time. However, some may occur after just one use.
+
+In addition to health effects like those described above, drugs can also have negative social consequences that can really hurt people—being unreliable, forgetting things, telling lies, stealing money for drugs, sometimes even getting violent with people they love. Their biggest ambition becomes getting high. While addiction may result from any drug use, there are unique health effects for each drug.",Drug use,,https://abovetheinfluence.com/faqs/,,,
+Q165,"What are the effects of mixing marijuana with alcohol, tobacco or prescription drugs?","Using alcohol and marijuana at the same time is likely to result in greater impairment than when using either one alone. Using marijuana and tobacco at the same time may also lead to increased exposure to harmful chemicals, causing greater risks to the lungs, and the cardiovascular system. Also, be aware that marijuana may change how prescription drugs work. Always talk with your doctor about any medications you are taking or thinking about taking and possible side effects when mixed with other things like marijuana.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q166,What are the unique risks associated with nitrite abuse?,"Nitrites are abused mainly by older adolescents and adults. Typically, individuals who abuse nitrites are seeking to enhance sexual function and pleasure. Research shows that abuse of these drugs in this context is associated with unsafe sexual practices that greatly increase the risk of contracting and spreading infectious diseases such as HIV/AIDS and hepatitis.
+
+Animal research raises the possibility that there may also be a link between abuse of nitrites and the development and progression of infectious diseases and tumors. The research indicates that inhaling nitrites depletes many cells in the immune system and impairs mechanisms that fight infectious diseases. A study found that even a relatively small number of exposures to butyl nitrite can produce dramatic increases in tumor incidence and growth rate in animals.",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/what-are-unique-risks-associated-nitrite-abuse,,,
+Q167,"How many ""drinks"" are in a bottle of wine?","A typical 25-ounce (750 ml) bottle of table wine holds about 5 ""standard"" drinks, each containing about 5 ounces. This serving size of wine contains about the same amount of alcohol as a 12-ounce regular beer or 1.5 ounces of 80-proof spirits.
+
+Get to know what 5 ounces looks like by measuring it out at home. That way you can estimate how many standard drinks you're being served in a restaurant or bar that uses large glasses and generous serving sizes.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/,,,
+Q168,Are there specific drug addiction treatments for older adults?,"With the aging of the baby boomer generation, the composition of the general population is changing dramatically with respect to the number of older adults. Such a change, coupled with a greater history of lifetime drug use (than previous older generations), different cultural norms and general attitudes about drug use, and increases in the availability of psychotherapeutic medications, is already leading to greater drug use by older adults and may increase substance use problems in this population. While substance abuse in older adults often goes unrecognized and therefore untreated, research indicates that currently available addiction treatment programs can be as effective for them as for younger adults.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q169,How have rates of opioid misuse among teenagers in the U.S. changed over time?,"According to an annual survey of 8th, 10th and 12th –graders nationwide, pain medication misuse has dropped from 9.5 percent in 2004 to 4.2 percent in 2017. 35.8 percent of 12th-graders in 2017 said that the drugs were “easily available” to them, compared to more than 54 percent in 2010.",Opioids,,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q170,What other factors increase the risk of addiction?,"Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier people begin to use drugs, the more likely they are to develop serious problems. This may be due to the harmful effect that drugs can have on the developing brain. It also may result from a mix of early social and biological risk factors, including lack of a stable home or family, exposure to physical or sexual abuse, genes, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.
+How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this powerful contrast drives some people to repeatedly use drugs to recapture the fleeting pleasurable state.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q171,What is peyote and mescaline?,"Small spineless cactus with active ingredient mescaline, a hallucinogen. Has disc-shaped “buttons” that are cut off and used.",Hallucinogen,,https://www.dea.gov/factsheets/peyote-and-mescaline,,,
+Q172,What are street names for peyote and mescaline?,"Buttons, Cactus, Mesc, Peyoto",Hallucinogen,,https://www.dea.gov/factsheets/peyote-and-mescaline,,,
+Q173,How is peyote and mescaline used?,"Fresh or dried buttons are chewed
+Buttons soaked in water to produce intoxicating liquid
+Ground into powder for capsules and swallowed
+Smoked with marijuana and tobacco",Hallucinogen,,https://www.dea.gov/factsheets/peyote-and-mescaline,,,
+Q174,How does peyote and mescaline affect the body?,"Hallucinations
+Altered perceptions of space and time
+Nausea and vomiting, increased heart rate
+Rise in body temperature
+Impaired motor coordination
+Euphoria, anxiety",Hallucinogen,,https://www.dea.gov/factsheets/peyote-and-mescaline,,,
+Q175,What are the principles of effective treatment?,"Research shows that when treating addictions to opioids (prescription pain relievers or drugs like heroin or fentanyl), medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling. Medications are also available to help treat addiction to alcohol and nicotine. Additionally, medications are used to help people detoxify from drugs, although detoxification is not the same as treatment and is not sufficient to help a person recover. Detoxification alone without subsequent treatment generally leads to resumption of drug use. For people with addictions to drugs like stimulants or cannabis, no medications are currently available to assist in treatment, so treatment consists of behavioral therapies. Treatment should be tailored to address each patient's drug use patterns and drug-related medical, mental, and social problems.",Treatment,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q176,What is psilocybin?,Hallucinogenic chemical obtained from certain types of fresh and dried mushrooms. Has slender stems topped by caps with dark gills on the underside.,Hallucinogen,,https://www.dea.gov/factsheets/psilocybin,,,
+Q177,What are street names for psilocybin?,"Magic mushrooms, Shrooms, Mushrooms",Hallucinogen,,https://www.dea.gov/factsheets/psilocybin,,,
+Q178,How is psilocybin used?,"Ingested orally
+Brewed as tea
+Added to foods to mask bitter flavor",Hallucinogen,,https://www.dea.gov/factsheets/psilocybin,,,
+Q179,How does psilocybin affect the body?,"Hallucinations
+Large amounts can cause panic attacks and psychosis
+Nausea and vomiting
+Muscle weakness, lack of coordination
+Overdose may result in psychosis or death",Hallucinogen,,https://www.dea.gov/factsheets/psilocybin,,,
+Q180,Is harmful use of alcohol a public health problem?,"Yes, the harmful use of alcohol is an important public health problem. It impacts people and societies in many ways.
+
+It is well known that there is a causal relationship between alcohol consumption and a range of mental and behavioural disorders, including alcohol dependence, other noncommunicable conditions such as liver diseases, some cancers, cardiovascular diseases, as well as injuries resulting from violence and road accidents. Furthermore, there are causal relationships between harmful use of alcohol and incidence of infectious diseases such as tuberculosis and pneumonia, as well as the course of HIV/AIDS. More than this, harmful use of alcohol creates considerable negative health and social consequences for people other than the drinker.",Alcohol,,https://www.who.int/news-room/q-a-detail/is-harmful-use-of-alcohol-a-public-health-problem,,,
+Q181,Why is it important to quit smoking?,Many people in recovery smoke tobacco. But smoking can be more harmful than you think. It causes more deaths than illnesses related to other addictions. Quitting smoking improves the chances of long-term recovery. Counseling and medication can help you quit smoking for good!,Tobacco,,https://store.samhsa.gov/product/You-Can-Quit-Tobacco/SMA18-5069YCQ?referer=from_search_result,,,
+Q182,What will you do when you quit?,"Don't let smoking hold you back anymore.
+Get back to doing what you love. What will you do first? Play and exercise. Throw a ball around with your kids/grandkids, go for a walk, or swim.
+Get outside. Check out your neighborhood.
+Take the dog for a walk or go to the park.
+Treat yourself. Save the money you would have spent on cigarettes or use it for a new hobby.
+Celebrate. Celebrate special occasions with something active like dancing or going for a hike.
+Give back. Sign up for a run or walk to support a cause you are passionate about. Train with friends and family for an extra boost of support.",Tobacco,,https://store.samhsa.gov/product/You-Can-Quit-Tobacco/SMA18-5069YCQ?referer=from_search_result,,,
+Q183,What is remission?,"A medical term meaning that major disease symptoms are eliminated or diminished below a predetermined, harmful level.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q184,Can research-based programs prevent drug addiction in youth?,"Yes.The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q185,How can the workplace play a role in substance abuse treatment?,"Many workplaces sponsor Employee Assistance Programs (EAPs) that offer short-term counseling and/or assistance in linking employees with drug or alcohol problems to local treatment resources, including peer support/recovery groups. In addition, therapeutic work environments that provide employment for drug-abusing individuals who can demonstrate abstinence have been shown not only to promote a continued drug-free lifestyle but also to improve job skills, punctuality, and other behaviors necessary for active employment throughout life. Urine testing facilities, trained personnel, and workplace monitors are needed to implement this type of treatment.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q186,What are schedule I drugs?,"Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are:
+
+heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q187,What are schedule II drugs?,"Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are:
+
+Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q188,What are schedule III drugs?,"Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are:
+
+Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q189,What are schedule IV drugs?,"Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are:
+
+Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q190,What are schedule V drugs?,"Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are:
+
+cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q191,How does science provide solutions for drug use and addiction?,Scientists study the effects drugs have on the brain and behavior. They use this information to develop programs for preventing drug use and for helping people recover from addiction. Further research helps transfer these ideas into practice in the community. The consequences of drug use are vast and varied and affect people of all ages.,Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/introduction,,,
+Q192,How can you prevent opioid withdrawal symptoms?,"Your doctor can give you medicines to prevent withdrawal symptoms, a process called detoxification (detox). The most common ones are buprenorphine (Subutex), methadone (Methadose), and naltrexone (Revia).",Withdrawal,,https://www.webmd.com/mental-health/addiction/qa/how-can-you-prevent-opioid-withdrawal-symptoms,,,
+Q193,What is opioid tolerance?,"Opioid tolerance occurs when a person using opioids begins to experience a reduced response to medication, requiring more opioids to experience the same effect.",Opioids,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q194,What is U-47700?,"U-47700, nicknamed “U4,” “pink,” or “pinky,” is a highly potent synthetic opioid that looks like a white or light pink powder. A lot of times, it is often either sold in baggies or pressed into pills to look like legal painkillers. Abuse of this drug is similar to heroin, and prescription and designer opioids.",Designer drugs,,https://www.dea.gov/factsheets/u-47700,,,
+Q195,What are street names for U-47700?,"Pinky, Pink or U4",Designer drugs,,https://www.dea.gov/factsheets/u-47700,,,
+Q196,How is U-47700 used?,"This drug is usually snorted, swallowed or injected.",Designer drugs,,https://www.dea.gov/factsheets/u-47700,,,
+Q197,How do research-based prevention programs work?,"These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:
+
+Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.
+Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.
+Indicated programs are designed for youth who have already started using drugs.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy,,,
+Q198,Why do people take drugs?,"In general, people take drugs for a few reasons:
+
+To feel good. Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the high is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opioids such as heroin is followed by feelings of relaxation and satisfaction.
+To feel better. Some people who suffer from social anxiety, stress, and depression start using drugs to try to feel less anxious. Stress can play a major role in starting and continuing drug use as well as relapse (return to drug use) in patients recovering from addiction.
+To do better. Some people feel pressure to improve their focus in school or at work or their abilities in sports. This can play a role in trying or continuing to use drugs, such as prescription stimulants or cocaine.
+Curiosity and social pressure. In this respect, teens are particularly at risk because peer pressure can be very strong. Adolescence is a developmental period during which the presence of risk factors, such as peers who use drugs, may lead to substance use.",Drugs,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q199,How many times does someone have to take a drug to become an addict?,"No one knows. A person’s genetic makeup plays a role. That’s why some people seem to get addicted almost immediately, but for others, it takes more time. There is a lot we still don’t know about who becomes addicted and why, and after how much drug exposure. We do know that each person is different, so it’s a little like playing a game of chance if you choose to use drugs. But, if you do, the earlier you stop, the more likely you will be to avoid addiction and the harmful brain changes that lead to it.
+Here’s the science behind it: With repeated drug use, dopamine function in a drug abuser’s brain becomes abnormal. Because dopamine is involved in feelings of pleasure and motivation, the person feels flat, lifeless, and depressed when they are not taking the drug. Without drugs, an abuser’s life seems joyless. Now the abuser needs drugs just to bring dopamine levels up to normal levels. They need it just to get them close to where they were before they even tried drugs in the first place. Larger amounts of the drug are needed to create a dopamine flood or high, an effect known as tolerance.
+By abusing drugs, the addicted person has changed the way his or her brain works. Drug abuse and addiction lead to long-term changes in the brain. These changes cause addicted drug users to lose the ability to control their drug use. Drug addiction is a disease.",Addiction,,https://abovetheinfluence.com/faqs/,,,
+Q200,Can you get addicted even though you only did it once in a while?,"No one wakes up in the morning and says, “I'm going to be an addict.” Addiction is a process – not an event. Most people who start using drugs do so with the intention of only using once or occasionally. But drugs affect the brain, so even with only occasional use, changes are happening that could lead to addiction. The “occasional” use of drugs can quickly change to frequent use and then to constant use. No one knows when the “chemical switch” goes off in your brain or who will get addicted. It’s a little like playing Russian Roulette—you just never know. The only thing we do know is that if you don't do drugs, you definitely won't get addicted.",Addiction,,https://abovetheinfluence.com/faqs/,,,
+Q201,Why do drug-addicted persons keep using drugs?,"Nearly all addicted individuals believe at the outset that they can stop using drugs on their own, and most try to stop without treatment. Although some people are successful, many attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences, including an inability to exert control over the impulse to use drugs despite adverse consequences—the defining characteristic of addiction. Understanding that addiction has such a fundamental biological component may help explain the difficulty of achieving and maintaining abstinence without treatment. Psychological stress from work, family problems, psychiatric illness, pain associated with medical problems, social cues (such as meeting individuals from one’s drug-using past), or environmental cues (such as encountering streets, objects, or even smells associated with drug abuse) can trigger intense cravings without the individual even being consciously aware of the triggering event. Any one of these factors can hinder attainment of sustained abstinence and make relapse more likely. Nevertheless, research indicates that active participation in treatment is an essential component for good outcomes and can benefit even the most severely addicted individuals.",Addiction,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q202,Is there a difference between physical dependence and addiction?,"Yes. Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.",Addiction,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q203,Are opioids addictive?,"Yes. Over time, opioid use can change the brain, leading to addiction. Addiction means a person continues to use a drug despite negative consequences, and actively tries to get more and more of the drug. Many people get addicted to opioids, leading to deadly overdoses — taking enough to make you stop breathing. However, many people who take prescription opioids for pain become dependent, not addicted.  Dependence means your body has gotten used to the drug, and it will hurt and feel uncomfortable if you suddenly stop. Patients using prescription opioids should ask their doctors how to safely stop using them. A person can be dependent on a drug without being addicted. But sometimes dependence can lead to addiction, if you don't make an effort to stop taking them.",Addiction,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q204,"How do adolescents become addicted to drugs, and which factors increase risk?","Addiction occurs when repeated use of drugs changes how a person’s brain functions over time. The transition from voluntary to compulsive drug use reflects changes in the brain’s natural inhibition and reward centers that keep a person from exerting control over the impulse to use drugs even when there are negative consequences—the defining characteristic of addiction.Some people are more vulnerable to this process than others, due to a range of possible risk factors. Stressful early life experiences such as being abused or suffering other forms of trauma are one important risk factor. Adolescents with a history of physical and/or sexual abuse are more likely to be diagnosed with substance use disorders. Many other risk factors, including genetic vulnerability, prenatal exposure to alcohol or other drugs, lack of parental supervision or monitoring, and association with drug-using peers also play an important role. At the same time, a wide range of genetic and environmental influences that promote strong psychosocial development and resilience may work to balance or counteract risk factors, making it ultimately hard to predict which individuals will develop substance use disorders and which won’t.",Addiction,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q205,Is it possible for teens to become addicted to marijuana?,"Yes. Contrary to common belief, marijuana is addictive. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent, or 1 in 6) and among daily users (to 25–50 percent).Thus, many of the nearly 7 percent of high-school seniors who (according to annual survey data) report smoking marijuana daily or almost daily are well on their way to addiction, if not already addicted, and may be functioning at a sub-optimal level in their schoolwork and in other areas of their lives. Long-term marijuana users who try to quit report withdrawal symptoms including irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to stay off the drug. Behavioral interventions, including Cognitive-Behavioral Therapy and Contingency Management (providing tangible incentives to patients who remain drug-free) have proven to be effective in treating marijuana addiction. Although no medications are currently available to treat marijuana addiction, it is possible that medications to ease marijuana withdrawal, block its intoxicating effects, and prevent relapse may emerge from recent discoveries about the workings of the endocannabinoid system, a signaling system in the body and brain that uses chemicals related to the active ingredients in marijuana. Legalization of marijuana for adult recreational use and for medicinal purposes is currently the subject of much public debate. Whatever the outcome, public health experts are worried about use increasing among adolescents, since marijuana use as a teen may harm the developing brain, lower IQ, and seriously impair the ability to drive safely, especially when combined with alcohol.",Addiction,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,"Deleted a portion of the answer because it said ""see descriptions below"", or something along those lines.",,
+Q206,How is cutting-edge science helping us better understand addiction?,"Two cutting-edge areas of science, genetics and brain imaging, are significantly advancing our understanding of cocaine addiction. Researchers estimate that genetics contributes 42 to 79 percent of the risk for cocaine use and dependence. Of course, with a complex disease such as addiction, many different genes are involved, and their expression can be influenced by the environment. There appears to be significant overlap in the genes that put people at risk for all addictive substances, perhaps indicating a common biological pathway for addiction regardless of the drug. In genome-wide association studies (GWAS), researchers examine whether certain gene variants are more frequently found in people with a substance use disorder, which eventually might help identify those at increased risk for drug addiction. Identifying genes linked to addiction is only the first step. Candidate-gene research examines the links between substance use and specific genes that encode proteins that appear to be related to addiction. For example, researchers have found connections between various aspects of cocaine addiction and the genes that encode for particular dopamine receptors and the enzymes that break down this neurotransmitter. Because environmental factors typically shape the impact of genes on disease risk, researchers must also identify how particular gene-by-environment interactions influence the course of addiction. Research in the field of epigenetics is uncovering how the environment induces long-term changes in gene expression—influencing the pattern of gene expression—without altering the DNA sequence. In animal research, scientists are determining how long-term cocaine exposure changes gene expression in the brain, particularly in the reward pathway. Studies have linked specific cocaine-induced epigenetic changes to neuroadaptations and behavioral hallmarks of addiction, such as sensitivity to cocaine’s rewarding effects. The epigenetic changes induced by cocaine can be passed to the next generation, even if the drug exposure does not occur prenatally. Although much more genetic and epigenetic research is needed, understanding addiction at the molecular level offers great promise for improving diagnosis, for example by discovering biomarkers for disease severity or treatment response. Although more research is needed, brain-imaging might be used to detect biomarkers for drug addiction vulnerability, as these technologies have yielded insights into the processes underlying craving and how medications may quell the brain’s response to cocaine cues. A relatively new neuroimaging technology called default-mode or resting-state functional magnetic resonance imaging (rs-fMRI) reveals brain activity when people are alert but not performing a particular task; researchers use this technique to compare functional brain networks of people who have used cocaine for a long time and those who have not. These studies suggest that there is reduced connectivity between various brain circuits and between the two hemispheres among people with cocaine dependence. Researchers have also correlated reduced connectivity between particular brain circuits with important addiction-related behaviors, including risk for relapse and impulsivity. Neuroimaging technologies are also documenting how the brains of cocaine users may recover after periods of abstinence. For example, these techniques indicate that years of cocaine use are associated with reduced grey matter in particular brain regions. However, people who maintained cocaine abstinence for approximately 9 months showed grey matter levels similar to or greater than those of people who had never used the drug. Further analysis indicated that the increased grey matter occurred in regions other than the ones altered by cocaine use, suggesting that the neurobiological changes involved in recovery are more complex than simply reversing the changes related to addiction. The researchers also found that increased grey matter volume in brain regions involved with behavioral control were associated with longer duration of abstinence. fMRI technologies have also revealed that abstinence from cocaine has important, restorative effects on the brain. Although current cocaine users demonstrated reduced brain activity in a brain circuit that mediates response inhibition during a motor control task, individuals who had attained abstinence for an average of 8 months showed similar patterns of activation and levels of performance to those who had never used the drug.The results suggest that abstinence helps restore the functioning of this brain circuit. Researchers are engaged in several large-scale, collaborative projects to map the human connectome, which is the brain’s network of interconnected circuits. For example, the National Institutes of Health supports the Human Connectome Project to generate maps of the developing, adult, and aging brain. By having a map of the typical brain, scientists will further understand how neural functioning differs in behavioral disorders—knowledge that will drive improved diagnostics and treatments.  ",Addiction,,https://www.drugabuse.gov/publications/cocaine/how-cutting-edge-science-helping-us-better-understand-addiction,,,
+Q207,What do parents needs to know about addiction?,"As a parent of a teenager, you may have spoken to your child about illegal drugs and their harmful effects. But did you know that legally prescribed medicines are also a
+cause of concern? An alarming number of teenagers are more likely to have abused prescription and over-the-counter drugs than some illegal drugs, like ecstasy, cocaine, crack, and methamphetamines. The dangers of prescription medicine abuse include dependence, slower brain activity, irregular heartbeats, dangerously high body temperature, heart failure, or lethal seizures. Prescription drug abuse also increases emergency room visits and suicide attempts. In 2009, more than 1 million emergency room visits involved the nonmedical use of prescription drugs. The easiest way for teens to obtain prescription
+medicines is from their friends or their parents’
+medicine cabinet. It’s so common that it could happen even in your house!
+■■ Nearly one in four teens (23 percent) report taking a
+prescription drug not prescribed to them by a doctor
+at least once in their lives.
+■■ Almost half of teens (47 percent) say it is easy to get
+prescription drugs from a parent’s medicine cabinet.
+■■ Teens are abusing everything from pain medicines to
+stimulants, sedatives, and tranquilizers.
+Parents can make a difference. Kids who continue
+to learn about the risks of drugs at home are up to 50
+percent less likely to use drugs than those who are not
+taught about the dangers. Only 22 percent of teens
+report discussing the risks of abusing any prescription
+drug without a doctor’s prescription with their parents.
+It’s up to YOU to talk openly with your kids!",Addiction,,https://store.samhsa.gov/product/Talking-Your-Kids-About-Prescription-Drug-Abuse-Not-Worth-Risk-Parents/SMA12-4676B1?referer=from_search_result,,,
+Q208, Can drug addiction lead to other mental disorders?,"It’s not uncommon for a person with a drug addiction to have another mental illness, but scientists say it’s difficult to know whether addiction is the cause of the mental illness, or whether people with mental illnesses turn to drug use to “self-medicate.” It’s also likely that some of the same genes and brain regions involved in addiction are also involved in other brain and behavior disorders, such as schizophrenia and depression. Several studies show that in some cases marijuana can produce psychotic symptoms similar to those experienced by people with schizophrenia.",Addiction,,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q209,Are there any links between prescription opioid addiction and heroin addiction?,"The connection between prescription opioid and heroin addiction has changed over time, according to several studies. In the 1960s, more than 80 percent of patients who sought treatment for an opioid addiction began their drug use with heroin. Today, nearly 80 percent of heroin users say that their first opioid use was a prescription drug.",Addiction,,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q210,Can addiction be cured?,"Like other chronic diseases such as heart disease or asthma, treatment for drug addiction usually isn't a cure. But addiction can be managed successfully. Treatment enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives.",Addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q211,"Why do some people become addicted, while others don't?","Great question, and a hard one. We don't fully understand yet why this is so. We know that genes play a part, because an inclination for addiction can run in families, and because different strains of mice, rats, and other animals differ in how readily they develop addiction-like behaviors after they’re exposed to drugs.
+
+We also know that a person’s environment plays a part in addiction. For example, what are the factors that encourage someone who has tried a drug to keep on taking it to the point where they can’t stop? Many scientists are trying to untangle the answers so that we can find better ways to prevent and treat addiction. ",Addiction,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q212,What properties in drugs make them addicting?,"Different drugs act on the brain in different ways, but they all cause release of the neurotransmitter dopamine in the brain’s reward area, which is what causes the pleasurable sensation (the high). Once a person uses a drug repeatedly, their brain starts to adjust to these surges of dopamine; the brain cells (neurons) make fewer dopamine receptors, or they simply produce less dopamine.
+
+The result is a lower amount of “dopamine signaling” in the reward area—it’s like “turning down the volume” on the reward signal. Then the person may start to find natural “rewards”—like food, relationships, or sex—less pleasurable; that’s one of the signs of addiction. ",Addiction,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q213,Are video games more addictive than drugs?,"No, they aren't more addictive—for example, they don't cause painful physical withdrawal when you stop. Technically, video games wouldn't be considered addictive. But they do act on some of the same systems in the brain as addictive drugs. For instance, they produce bursts of dopamine and some people think that playing video games a lot might cause problems similar to drug use, such as being unable to get satisfaction from other things in life. ",Addiction,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,"Removed some of the answer because it said ""as described in #3 above."""
+Q214,Can you get addicted to cough and cold medicines?,"A person can also get addicted to cough and cold medicines. Addiction happens when somebody can't stop using a drug, even though using it has bad effects on their life.",Addiction,,https://teens.drugabuse.gov/blog/post/can-you-get-addicted-cough-and-cold-medicines,,,
+Q215,"Are some babies born addicted?
+","No. Babies born to mothers who have problems with drugs aren't born addicted, but the babies can be born with drugs in their system. This can cause them a great deal of discomfort. Once the supply of drugs (delivered through the mother’s umbilical cord) goes away, babies can experience painful withdrawal symptoms and other health problems.",Addiction,,https://teens.drugabuse.gov/blog/post/are-some-babies-born-addicted,,,
+Q216,Can I get addicted even though I only do it once in a while?,"YES. For most, addiction to alcohol and drugs is a process — not an event.  Most people who use alcohol and drugs do so with an intention of only using once or “once in a while.”  No one decides that they want to become addicted to alcohol and drugs.  But, we are dealing with addictive drugs that directly affect the brain.  It is easy for occasional use to change to frequent use or constant use — that is addiction.  The only thing we know for sure:  if you don't drink alcohol and don't do drugs, you definitely won't become addicted.",Addiction,,https://tricircleinc.com/faqs/,,,
+Q217,Is a drug addiction a disease?,"Drug addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the drug addict and those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain.",Addiction,,https://tricircleinc.com/faqs/,,,
+Q218,Is there a cure for addiction?,"Since addiction is considered a disease, many wonder if it is curable like other diseases with medication. The answer is there is no real cure for addiction, but it is treatable. By receiving treatment for alcohol or drug addiction, you learn the coping mechanisms necessary to learn how to deal with any triggers that might come your way causing you to use again. With individualized treatment, you get the right treatment based off your needs and addiction. When achieving abstinence from substances, your brain can reverse your cravings for substances.",Addiction,,https://tricircleinc.com/faqs/,Similar to 210,,
+Q219,How do I know if I am addicted?,"If you can't stop taking a drug even if you want to, or if the urge to use drugs is too strong to control, even if you know the drug is causing harm, you might be addicted.  Here are some questions to ask yourself:
+
+Do you think about drugs a lot?
+Did you ever try to stop or cut down on your drug usage but couldn't?
+Have you ever thought you couldn't fit in or have a good time without the use of drugs?
+Do you ever use drugs because you are upset or angry at other people?
+Have you ever used a drug without knowing what it was or what it would do to you?
+Have you ever taken one drug to get over the effects of another?
+Have you ever made mistakes at a job or at school because you were using drugs?
+Does the thought of running out of drugs really scare you?
+Have you ever stolen drugs or stolen to pay for drugs?
+Have you ever been arrested or in the hospital because of your drug use?
+Have you ever overdosed on drugs?
+Has using drugs hurt your relationships with other people?",Addiction,,https://www.drugabuse.gov/publications/step-by-step-guides-to-finding-treatment-drug-use-disorders/if-you-have-problem-drugs-adults/how-to-recognize-substance-use-disorder,,,
+Q220,What is an agonist?,"A chemical substance that binds to and activates certain receptors on cells, causing a biological response.
+Fentanyl and methadone are examples of opioid receptor agonists.",Drugs,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q221,How can we achieve an AIDS-free generation?,"Although more research is needed, the scientific and medical communities continue to develop and disseminate effective HIV prevention and treatment approaches. Three key principles underlie NIDA’s strategy: (1) substance use disorder and HIV are linked in ways that extend beyond injection drug use; (2) substance use disorder and HIV remain intertwined epidemics in the United States and around the world—therefore, SUD treatment is HIV prevention; and (3) the STTR approach, especially when implemented in high-risk populations or settings, can decrease viral load and HIV incidence at a population level, improving outcomes for all. Implementing these evidence-based strategies will bring the United States closer to the goal of an ""AIDS-free generation.""",HIV,,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/how-can-we-achieve-aids-free-generation,"Maybe we should unabbreviate ""STTR"" in the answer.",,
+Q222,What is binge drinking?,"Binge drinking for men is drinking 5 or more standard alcoholic drinks, and for women, 4 or
+more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days.",Alcohol,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q223,What is heavy drinking?,"Defined by the CDC as consuming 8 or more drinks per week for women, and 15 or more
+drinks per week for men, and by the Substance Abuse and Mental Health Services Administration (SAMHSA), for
+research purposes, as binge drinking on 5 or more days in the past 30 days.",Alcohol,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q224,What is Disulfiram?,"Disulfiram is a medication that inhibits normal breakdown of acetaldehyde which is produced by the
+metabolism of alcohol, thus rapidly increasing acetaldehyde in the blood which produces an aversive
+response. Thus, once disulfiram is taken by mouth, any alcohol consumed results in rapid buildup of
+acetaldehyde and a negative reaction or sickness results. The intensity of this reaction is dependent
+on the dose of disulfiram and the amount of alcohol consumed. Effects from a disulfiram-alcohol
+reaction include warmth and flushing of the skin, increased heart rate, palpitations, a drop in blood
+pressure, nausea and/or vomiting, sweating, dizziness, and headache. In this way, disulfiram
+essentially punishes alcohol consumption and indirectly rewards abstinence.",Alcohol,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q225,What is Acamprosate?,"Acamprosate is a medication that normalizes the alcohol-related neurochemical changes in the
+brain glutamate systems and thereby reduces the symptoms of craving that can prompt a relapse
+to pathological drinking. Acamprosate has been found to be an effective medication when used
+concurrently with behavioral interventions and, as with other medications for alcohol use disorders,
+works best in motivated patients. Reviews show that acamprosate is effective in reducing relapse and effective when used to maintain abstinence from alcohol.",Alcohol,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q226,What is a standard drink?,"Based on the 2015-2020 Dietary Guidelines for Americans, a standard drink is defined
+as 12 fl. oz. of regular beer, 8-9 fl. oz. of malt liquor, 5 fl. oz. of table wine, or 1.5 fl. oz. of
+80-proof distilled spirits. All of these drinks contain 14 grams (0.6 ounces) of pure alcohol.",Alcohol,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q227,Why is alcohol toxic to the brain?,"Excessive alcohol use damages brain cells and the fibers that connect brain regions, shrinks certain brain regions, and stops new brain cells from maturing. Some brain regions, such as the ones involved in memory, continue to make new neurons during adolescence through the expansion of neural stem cells. But alcohol specifically targets neural stem cells, so its negative impact is magnified in adolescents.",Alcohol,,https://store.samhsa.gov/product/In-Brief-Chronic-Substance-Use-and-Cognitive-Effects-on-the-Brain-An-Introduction/SMA16-4973?referer=from_search_result,,,
+Q228,Is drinking alcohol a problem?,"While drinking alcohol is itself not necessarily a problem—drinking too much can cause a range of consequences, and increase your risk for a variety of problems.",Alcohol,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts,,,
+Q229,Who should avoid drinking alcohol?,"Certain people should avoid alcohol completely, including those who:
+
+Plan to drive or operate machinery, or participate in activities that require skill, coordination, and alertness
+Take certain over-the-counter or prescription medications
+Have certain medical conditions
+Are recovering from alcohol use disorder or are unable to control the amount that they drink
+Are younger than age 21
+Are pregnant or trying to become pregnant",Alcohol,,https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking,,,
+Q230,How is someone diagnosed with alcohol use disorder?,"To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.",Alcohol,,https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders,,,
+Q231,How many people in the U.S. have alcohol use disorder?,"An estimated 15 million people in the United States have AUD. Approximately 5.8 percent or 14.4 million adults in the United States ages 18 and older had AUD in 2018. This includes 9.2 million men and 5.3 million women. Adolescents can be diagnosed with AUD as well, and in 2018, an estimated 401,000 adolescents ages 12–17 had AUD.",Alcohol,,https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders,,,
+Q232,What is alcohol use disorder?,"Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.
+
+In the past year, have you:
+
+Had times when you ended up drinking more, or longer than you intended?
+
+More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
+
+Spent a lot of time drinking? Or being sick or getting over the aftereffects?
+
+Experienced craving — a strong need, or urge, to drink?
+
+Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
+
+Continued to drink even though it was causing trouble with your family or friends?
+
+Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
+
+More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
+
+Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
+
+Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
+
+Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#1,,,
+Q233,Should I speak to a doctor about my alcohol problems?,"For anyone thinking about treatment, talking to a primary care physician is an important first step — he or she can be a good source for treatment referrals and medications. A primary care physician can also:
+
+Evaluate whether a patient’s drinking pattern is risky
+
+Help craft a treatment plan
+
+Evaluate overall health
+
+Assess if medications for alcohol may be appropriate",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#3,,,
+Q234,"Is ""lite"" beer light in alcohol?","Not necessarily. Although they have fewer calories, many light beers have almost as much alcohol as regular beer—about 85% as much, or 4.2% versus 5.0% alcohol by volume, on average.
+
+Check the alcohol content of your beverage. Malt beverages are not required to list their alcohol content on the labels, so you may need to visit the bottler's Web site.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/,,,
+Q235,Why do women face higher risks for alcohol-related problems?,"Studies show that women start to have alcohol-related problems sooner and at lower drinking levels than men do and for multiple reasons. On average, women weigh less than men. Also, alcohol resides predominantly in body water, and pound for pound, women have less water in their bodies than men.
+
+This means that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration (BAC, the amount of alcohol in the blood) will tend to be higher, putting her at greater risk for harm. Other biological differences may contribute as well.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/Q-and-As/Default.aspx,,,
+Q236,What medications interact harmfully with alcohol?,"Some medicines that you might never have suspected can react with alcohol, including many that can be purchased ""over the counter"" without a prescription. Even some herbal remedies don't mix well with alcohol. Some of these medicines that interact harmfully with alcohol include, but are not limited to, Alavert (Loratadine), Atarax (Hydroxyzine), Benadryl (Diphenhydramine), Clarinex (Desloratadine), Claritin (Loratadine), and Dimetapp (Brompheniramine).",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/Q-and-As/Default.aspx,,,
+Q237,Can I do anything to protect my liver from the effects of too much alcohol?,"There is no scientific evidence that anything will prevent liver damage from too much alcohol. Liver damage from alcohol misuse happens in stages. Some relatively mild damage may happen after a single binge drinking episode, but this reverses itself if the heavy alcohol use stops. If heavy drinking continues, however, liver damage can progress to several more advanced stages, including cirrhosis, and reversal of liver damage becomes much more difficult, if not impossible. In advanced stages, the only treatment is liver transplant. The best way to avoid damaging your liver is by not misusing alcohol, if you choose to drink. If you already have liver damage, stopping drinking could prevent progression to more serious liver disease. Even the standard recommended dose of acetaminophen can increase the risk of liver damage, particularly among people who drink heavily. ",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/Q-and-As/Default.aspx,,,
+Q238,What can cause a hangover?,"There are several reasons why people experience hangovers from drinking. One component is dehydration. Alcohol causes the body to get rid of too much fluid, and the dehydration that results can cause headaches, nausea, thirst, and other symptoms of hangovers.
+
+While some people think that alcohol helps a person sleep, it actually disrupts sleep, and that can contribute to the grogginess that accompanies hangovers. ",Alcohol,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q239,"Why is age of first use of alcohol so critically important?
+","Kids who start drinking alcohol before age 15 are 5 times more likely to develop alcohol abuse or dependence than people who first used alcohol at age 21 or older. A study published in the Archives of Pediatrics & Adolescent Medicine showed that 47% of those who began drinking before age 15 experienced alcohol dependence at some point in their life, compared to 9% percent of those who began drinking at age 21 or older.",Alcohol,,https://tricircleinc.com/faqs/,,,
+Q240,"What is a ""standard drink"" of alcohol?","A standard alcohol drink contains about 14 grams of pure alcohol (0.6 ounces):
+
+12-ounces of Beer or Cooler
+8-ounces of Malt Liquor
+5-ounces of Wine
+1.5-ounces or “shot” of Distilled Spirits/Liquor (e.g., rum, gin, vodka, or whiskey).
+
+Note: These are approximate, as different brands and types of alcoholic beverages vary in their actual alcohol content.",Alcohol,,https://tricircleinc.com/faqs/,,,
+Q241,Does drinking alcohol protect me against getting COVID-19?,Drinking alcohol does not protect you from COVID-19.,Alcohol,,https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/stress-coping/alcohol-use.html,Re-phrased the question,,
+Q242,What is the relation between drinking alcohol and COVID-19?,"Drinking alcohol weakens your body’s ability to fight infections, increasing the risk of complications and making it harder to get better if you are sick.
+Alcohol use can increase the risk of acute respiratory distress syndrome and pneumonia, which are sometimes associated with COVID-19.",Alcohol,,https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/stress-coping/alcohol-use.html,Re-phrased the question,,
+Q243,What are the consequences and health effects of binge drinking?,"While drinking any amount of alcohol can carry certain risks, crossing the binge threshold increases the risk of acute harm, such as blackouts and overdoses. Binge drinking also increases the likelihood of unsafe sexual behavior and the risk of sexually transmitted infections and unintentional pregnancy. These risks are greater at higher peak levels of consumption. Because of the impairments it produces, binge drinking also increases the likelihood of a host of potentially deadly consequences, including falls, burns, drownings, and car crashes.
+
+Alcohol affects virtually all tissues in the body. Data suggest that even one episode of binge drinking can compromise function of the immune system and lead to acute pancreatitis (inflammation of the pancreas) in individuals with underlying pancreatic damage. Excessive alcohol use, including repeated episodes of binge drinking, over time contributes to liver and other chronic diseases, as well as increases in the risk of several types of cancer, including head and neck, esophageal, liver, breast, and colorectal cancers.",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/binge-drinking,"Deleted part of the answer because it said, ""please see this chart.""",,
+Q244,How Does Binge Drinking Affect Adolescents?,"Brain development, once thought to taper off at the end of childhood, enters a unique phase during the adolescent years. Research indicates that repeated episodes of binge drinking during the teen years can alter the trajectory of adolescent brain development and cause lingering deficits in social, attention, memory, and other cognitive functions",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/binge-drinking,,,
+Q245,What Is “High-Intensity” Drinking?,"“High-intensity drinking” is defined as alcohol intake at levels twice or more the gender-specific threshold for binge drinking. This dangerous drinking pattern means 8 or more drinks for women and 10 or more drinks for men on one occasion. Research suggests that high-intensity drinking peaks around age 21 and is most common among young adults attending college.
+
+This pattern of drinking is of particular concern because it is associated with an even greater risk of severe health and safety consequences. More research is needed to identify interventions that can be used to discourage this pattern of use.",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/binge-drinking,,,
+Q246,What is a hangover?,"A hangover refers to a set of symptoms that occur as a consequence of excessive alcohol use. Typical symptoms include fatigue, weakness, thirst, headache, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability, sweating, and increased blood pressure. A hangover can vary from person to person.",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers,,,
+Q247,What is an alcohol overdose?,"An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions—such as breathing, heart rate, and temperature control—begin to shut down. Symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizure, trouble breathing, slow heart rate, clammy skin, dulled responses such as no gag reflex (which prevents choking), and extremely low body temperature. Alcohol overdose can lead to permanent brain damage or death.",Alcohol,,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose,,,
+Q248,Why do women face higher risks due to drinking?,"Studies show that women start to have alcohol-related problems sooner and at lower drinking levels than men do and for multiple reasons. On average, women weigh less than men. Also, alcohol resides predominantly in body water, and pound for pound, women have less water in their bodies than men.
+
+This means that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration (BAC, the amount of alcohol in the blood) will tend to be higher, putting her at greater risk for harm. Other biological differences may contribute as well.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/q-and-as/Default.aspx,REPEAT OF Q235. SIMILAR QUESTION. THE ANSWER IS THE SAME.,,
+Q249,What medications interact harmfully with alcohol?,"Some medicines that you might never have suspected can react with alcohol, including many that can be purchased ""over the counter"" without a prescription. Even some herbal remedies don't mix well with alcohol. The pamphlet Harmful Interactions: Mixing Alcohol with Medicines lists medications that can cause harm when taken with alcohol and describes the effects that can result. It does not include all possible medicines that may interact with alcohol, however. Protect yourself by avoiding alcohol if you are taking a medication and don't know its effect, or talk to your pharmacist or other health care provider.",Alcohol,,https://www.rethinkingdrinking.niaaa.nih.gov/q-and-as/Default.aspx,I think we should only keep the first two sentences.,,
+Q250,Why is alcohol dangerous during pregnancy?,"Alcohol in the mother’s blood passes to the baby through the umbilical cord. Drinking alcohol during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities. These disabilities are known as fetal alcohol spectrum disorders (FASDs).",Alcohol,,https://www.cdc.gov/ncbddd/fasd/alcohol-use.html,,,
+Q251,What is alcohol?,"Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q252,Why do some people react differently to alcohol than others?,"Alcohol affects every organ in the body. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes. However, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. The intensity of the effect of alcohol on the body is directly related to the amount consumed.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q253,Is beer or wine safer to drink than liquor?,"No. One 12-ounce beer has about the same amount of alcohol as one 5-ounce glass of wine or 1.5-ounce shot of liquor. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q254,What does moderate drinking mean?,"According to the Dietary Guidelines for Americans, moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men. This definition refers to the amount consumed on any single day and is not intended as an average over several days. However, the Dietary Guidelines do not recommend that people who do not drink alcohol start drinking for any reason.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q255,What is excessive alcohol use?,"Excessive alcohol use includes binge drinking, heavy drinking, any alcohol use by people under the age 21 minimum legal drinking age, and any alcohol use by pregnant women.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q256,What does it mean to get drunk?,"“Getting drunk” or intoxicated is the result of consuming excessive amounts of alcohol. Binge drinking typically results in acute intoxication.
+
+Alcohol intoxication can be harmful for a variety of reasons, including:
+
+Impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech.
+Dilation of blood vessels, causing a feeling of warmth but resulting in rapid loss of body heat.
+Increased risk of certain cancers, stroke, and liver diseases (e.g., cirrhosis), particularly when excessive amounts of alcohol are consumed over extended periods of time.
+Damage to a developing fetus if consumed by pregnant women.
+Increased risk of motor-vehicle traffic crashes, violence, and other injuries.
+Coma and death can occur if alcohol is consumed rapidly and in large amounts.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q257,What does it mean to drink heavily?,"For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q258,What health problems are associated with excessive alcohol use?,"Excessive drinking both in the form of heavy drinking or binge drinking, is associated with numerous health problems, including
+
+Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders.
+Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns, and firearm injuries.
+Violence, such as child maltreatment, homicide, and suicide.
+Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders.
+Sudden infant death syndrome (SIDS).
+Alcohol use disorders.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q259,How do I know if it’s okay to drink?,"According to the 2015–2020 Dietary Guidelines for Americans, some people should not drink alcoholic beverages at all, including:
+
+Anyone younger than age 21.
+Women who are or may be pregnant.
+People who are driving, planning to drive, or are participating in other activities requiring skill, coordination, and alertness.
+People taking certain prescription or over-the-counter medications that can interact with alcohol.
+People with certain medical conditions.
+People who are recovering from alcoholism or who are unable to control the amount they drink.
+The Dietary Guidelines also recommend that if alcohol is consumed, it should be in moderation—up to 1 drink per day for women and up to 2 drinks per day for men—and only by adults of legal drinking age. However, the Guidelines do not recommend that people who do not drink alcohol start drinking for any reason. By following the Dietary Guidelines, you can reduce the risk of harm to yourself or others.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q260,I am young. Is drinking bad for my health?,"Yes. Studies have shown that alcohol use by adolescents and young adults increases the risk of both fatal and nonfatal injuries. Research has also shown that people who use alcohol before age 15 are six times more likely to become alcohol dependent than adults who begin drinking at age 21. Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q261,Do all excessive drinkers have an alcohol use disorder?,"No. About 90% of people who drink excessively would not be expected to meet the clinical diagnostic criteria for having a severe alcohol use disorder. A severe alcohol use disorder, previously known as alcohol dependence or alcoholism, is a chronic disease. Some of the signs and symptoms of a severe alcohol use disorder could include:
+
+Inability to limit drinking.
+Continuing to drink despite personal or professional problems.
+Needing to drink more to get the same effect.
+Wanting a drink so badly you can't think of anything else.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q262,How do I know if I have a drinking problem?,"Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a drinking problem, consult your personal health care provider.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q263,What can I do if I or someone I know has a drinking problem?,"Consult your personal health care provider if you feel you or someone you know has a drinking problem. Other resources include the National Drug and Alcohol Treatment Referral Routing Service, available at 1-800-662-HELP. This service can provide you with information about treatment programs in your local community and allow you to speak with someone about alcohol problems.",Alcohol,,https://www.cdc.gov/alcohol/faqs.htm,,,
+Q264,What should I do if I have an alcohol problem?,"If you're worried that you might have alcohol use disorder, don't try to quit cold turkey on your own. The withdrawal can be dangerous. You can get help.
+
+Talking with your doctor is a good first step. They can:
+
+Tell you if you need assistance
+Work with you to put together a treatment plan, possibly including medication
+Refer you to a support group or counseling.",Alcohol,,https://www.webmd.com/mental-health/addiction/qa/what-should-i-do-if-i-have-an-alcohol-problem,,,
+Q265,What kind of help do I need if I have alcohol use disorder?,"Alcohol use disorder is the name doctors give to the range of issues people have with drinking. The care you'll need depends in part on where you fall in that range.
+
+Alcoholism is on the more serious end of the scale. It means your body has learned to depend on alcohol. Once you take it away, the physical effects can be hard to deal with. That’s where detox comes in.",Alcohol,,https://www.webmd.com/mental-health/addiction/qa/what-kind-of-help-do-i-need-if-i-have-alcohol-use-disorder,,,
+Q266,What is detox for alcohol use disorder?,"Detox is when you stop drinking and your body gets rid of the alcohol, which leads to withdrawal symptoms. If you’ve been a heavy drinker for a long time, you can start detoxing within 6 hours of your last drink.",Alcohol,,https://www.webmd.com/mental-health/addiction/qa/what-is-detox-for-alcohol-use-disorder,,,
+Q267,What are warning signs of alcohol use disorder?,"You may have an alcohol use disorder if you:
+
+Drink more, or longer, than you plan to
+Have tried to cut back or stop more than once and couldn’t
+Spend a lot of time drinking, being sick, or hungover
+Want alcohol so badly you can’t think of anything else
+Have problems with work, school, relationships, or family because of alcohol
+Keep having alcohol even though it made you depressed or anxious, hurt your health, or led to a memory blackout
+Have withdrawal symptoms when the buzz wears off, like trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or seeing, hearing, or feeling things that aren't there.",Alcohol,,https://www.webmd.com/mental-health/addiction/qa/what-are-warning-signs-of-alcohol-use-disorder,,,
+Q268,What are amphetamines?,"Prescription stimulants used to treat Attention-deficit hyperactivity disorder (ADHD). Used as a study aid, to stay awake, and to suppress appetites. Prescribed as Adderall®, Concerta®, Dexedrine®, Focalin®, Metadate®, Methylin®, Ritalin®.",Stimulants,,https://www.dea.gov/factsheets/amphetamines,,,
+Q269,What are street names for amphetamines?,"Bennies, Black Beauties, Crank, Ice, Speed, Uppers",Stimulants,,https://www.dea.gov/factsheets/amphetamines,,,
+Q270,How are amphetamines used?,Orally or injected. “Ice” or crystallized methamphetamine hydrochloride is smoked.,Stimulants,,https://www.dea.gov/factsheets/amphetamines,,,
+Q271,How do amphetamines affect the body?,"Similar to cocaine, but slower onset and longer duration
+Increased body temperature, blood pressure and pulse rates, insomnia, loss of appetite, physical exhaustion
+Chronic abuse produces a psychosis that resembles schizophrenia: paranoia, hallucinations, violent and erratic behavior
+Overdose can be fatal",Stimulants,,https://www.dea.gov/factsheets/amphetamines,,,
+Q272,What are anabolic steroids?,"Anabolic steroids are synthetic, or human-made, variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. ""Anabolic"" refers to muscle building, and ""androgenic"" refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers. Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders misuse these drugs in an attempt to boost performance or improve their physical appearance. The majority of people who misuse steroids are male weightlifters in their 20s or 30s. Anabolic steroid misuse is much less common in women. It is difficult to measure steroid misuse in the United States because many national surveys do not measure it. However, use among teens is generally minimal. The 2016 NIDA-funded Monitoring the Future study has shown that past-year misuse of steroids has declined among 8th and 10th graders in recent years, while holding steady for 12th graders.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q273,How do people misuse anabolic steroids?,"People who misuse anabolic steroids usually take them orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions.
+Commons patterns for misusing steroids include: cycling—taking multiple doses for a period of time, stopping for a time, and then restarting; stacking—combining two or more different steroids and mixing oral and/or injectable types; pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero; plateauing—alternating, overlapping, or substituting with another steroid to avoid developing a tolerance. There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,"Maybe we should consider including ""As of the time of the collection of this data, there is no scientific evidence...""",,
+Q274,How do anabolic steroids affect the brain?,"Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a “high”; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior. Misuse of anabolic steroids might lead to negative mental effects, such as paranoid (extreme, unreasonable) jealousy, extreme irritability and aggression (“roid rage”), delusions—false beliefs or ideas, impaired judgment, and mania.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q275,What are other health effects of anabolic steroids?,"People who inject steroids increase their risk of contracting or transmitting HIV/AIDS or hepatitis. Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q276,What are the long-term effects of anabolic steroid misuse?,"Anabolic steroid misuse might lead to serious, even permanent, health problems such as kidney problems or failure; liver damage and tumors; enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people; increased risk of blood clots.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q277,What are other effects as a result of anabolic steroid misuse?,"Several other effects are gender- and age-specific:
+In men:
+shrinking testicles
+decreased sperm count
+baldness
+development of breasts
+increased risk for prostate cancer
+In women:
+growth of facial hair or excess body hair
+decreased breast size
+male-pattern baldness
+changes in or stop in the menstrual cycle
+enlarged clitoris
+deepened voice
+In teens:
+stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
+stunted height (if teens use steroids before their growth spurt)
+Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q278,Are anabolic steroids addictive?,"Even though anabolic steroids do not cause the same high as other drugs, they can lead to a substance use disorder. A substance use disorder occurs when a person continues to misuse steroids, even though there are serious consequences for doing so. The most severe form of a substance use disorder is addiction. People might continue to misuse steroids despite physical problems, high costs to buy the drugs, and negative effects on their relationships. These behaviors reflect steroids' addictive potential. Research has further found that some steroid users turn to other drugs, such as opioids, to reduce sleep problems and irritability caused by steroids. People who misuse steroids might experience withdrawal symptoms when they stop use, including fatigue; restlessness; loss of appetite; sleep problems; decreased sex drive; steroid cravings. One of the more serious withdrawal symptoms is depression, which can sometimes lead to suicide attempts.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q279,How can people get treatment for anabolic steroid addiction?,"Some people seeking treatment for anabolic steroid addiction have found a combination of behavioral therapy and medications to be helpful. In certain cases of addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient's hormonal system.",Steroids,,https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids,,,
+Q280,What are analgesics?,Pain relieving medications including over-the-counter medications like acetaminophen (Tylenol®) or ibuprofen (Advil®) and prescription opioids.,Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q281,What is an analog?,"Drugs that are similar in chemical structure or pharmacologic effect to another drug, but are not identical.",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q282,What is Ayahuasca?,"A tea made in the Amazon from a plant (Psychotria viridis) containing the hallucinogen DMT, along with another vine (Banisteriopsis caapi) that contains an MAO inhibitor preventing the natural breakdown of DMT in the digestive system, which enhances serotonergic activity. It was used historically in Amazonian religious and healing rituals.",Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts,,,
+Q283,What are the street names for Ayahuasca?,"Aya, Hoasca, Vine, Yagé",Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q284,Are there any commerical names for Ayahuasca?,There are no commercial names for Ayahuasca.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q285,What are common ways Ayahuasca is taken?,Ayahuasca is commonly swallowed as tea.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q286,What are the short-term effects of Ayahuasca?,Strong hallucinations including altered visual and auditory perceptions; increased heart rate and blood pressure; nausea; burning sensation in the stomach; tingling sensations and increased skin sensitivity.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q287,What are the long-term effects of Ayahuasca?,"There are possible changes to the serotoninergic and immune systems, although more research is needed. ",Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q288,What happens if I take Ayahuasca with alcohol?,The combination of Ayahuasca and alcohol is unknown.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q289,What are the withdrawal symptoms associated with Ayahuasca?,The withdrawal symptoms of Ayahuasca are unknown.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q290,Is Ayahuasca addictive?,It is not known whether ayahuasca is addictive. There are no FDA-approved medications to treat addiction to ayahuasca or other hallucinogens.,Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q291,Are behavioral therapies effective for Ayahuasca use?,"More research is needed to find out if ayahuasca is addictive and, if so, whether behavioral therapies are effective.",Ayahuasca,,https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ayahuasca,,,
+Q292,What are barbiturates?,"Depressant drug used to help sleep, relieve anxiety and muscle spasms, prevent seizures. Prescribed names: Fiorina®, Pentothal®, Seconal®, or Nembutal®",Barbiturates,,https://www.dea.gov/factsheets/barbiturates,,,
+Q293,What are street names for barbiturates?,"Barbs, Block Busters, Christmas Trees, Goof Balls, Pinks, Red Devils, Reds & Blues, Yellow Jackets",Barbiturates,,https://www.dea.gov/factsheets/barbiturates,,,
+Q294,How are barbiturates used?,Barbiturates are used by swallowing a pill or injecting a liquid,Barbiturates,,https://www.dea.gov/factsheets/barbiturates,,,
+Q295,How do barbiturates affect the body?,"Lack of inhibition, relief of anxiety, sleepiness; impairment of memory, judgment and coordination; irritability
+Paranoia and suicidal thought
+Tolerance is easily developed, requiring larger doses each time
+Overdose can occur easily and can be fatal. Signs: Shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma",Barbiturates,,https://www.dea.gov/factsheets/barbiturates,,,
+Q296,What are benzodiazepines?,"Sometimes called “benzos,” these are sedatives often used to treat anxiety, insomnia, and other conditions. Combining benzodiazepines with opioids increases a person’s risk of overdose and death.",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q297,Does Buprenorphine help you think and function normally?,It is legal and taken under a doctor’s care. It is NOT just another drug to abuse.,Buprenorphine,,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q298,Is Buprenorphine produced under safe conditions and sold legally?,"There is no risk of getting tainted doses, which can happen with street drugs. Also, risk of overdose on this medication is very small.",Buprenorphine,,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q299,Can I work with healthcare providers to manage my pain?,"If you have chronic pain, talk to your healthcare providers about it at your next scheduled appointment, or set up a new appointment just for this purpose. Don’t put off talking to your care providers in hope that the pain will go away. Medical professionals may be able to determine what’s causing the pain and help you deal with that problem. Even if the source of pain remains a mystery, care providers can work with you to try different strategies until you find a combination that reduces your suffering.",Chronic pain,,https://store.samhsa.gov/product/You-Can-Manage-Your-Chronic-Pain-To-Live-a-Good-Life-A-Guide-for-People-in-Recovery-from-Mental-Illness-or-Addiction/SMA15-4783?referer=from_search_result,,,
+Q300,What is the difference between acute pain and chronic pain?,"Acute pain usually starts suddenly and has a known cause, like an injury or surgery. It normally gets better as your body heals. Chronic pain is pain lasting 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or even an unknown reason.",Chronic pain,,https://www.cdc.gov/drugoverdose/patients/faq.html,,,
+Q301,What is cocaine?,"Cocaine is a powerfully addictive stimulant drug. For thousands of years, people in South America have chewed and ingested coca leaves (Erythroxylon coca), the source of cocaine, for their stimulant effects.The purified chemical, cocaine hydrochloride, was isolated from the plant more than 100 years ago. In the early 1900s, purified cocaine was the main active ingredient in many tonics and elixirs developed to treat a wide variety of illnesses and was even an ingredient in the early formulations of Coca-Cola®. Before the development of synthetic local anesthetic, surgeons used cocaine to block pain. However, research has since shown that cocaine is a powerfully addictive substance that can alter brain structure and function if used repeatedly.
+Today, cocaine is a Schedule II drug, which means that it has high potential for abuse but can be administered by a doctor for legitimate medical uses, such as local anesthesia for some eye, ear, and throat surgeries. As a street drug, cocaine appears as a fine, white, crystalline powder and is also known as Coke, C, Snow, Powder, or Blow. Street dealers often dilute (or “cut”) it with non-psychoactive substances such as cornstarch, talcum powder, flour, or baking soda to increase their profits. They may also adulterate cocaine with other drugs like procaine (a chemically related local anesthetic) or amphetamine (another psychoactive stimulant). Some users combine cocaine with heroin—called a Speedball.
+People abuse two chemical forms of cocaine: the water-soluble hydrochloride salt and the water-insoluble cocaine base (or freebase). Users inject or snort the hydrochloride salt, which is a powder. The base form of cocaine is created by processing the drug with ammonia or sodium bicarbonate (baking soda) and water, then heating it to remove the hydrochloride to produce a smokable substance. The term crack, which is the street name given to freebase cocaine, refers to the crackling sound heard when the mixture is smoked.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-cocaine,,,
+Q302,What is the scope of cocaine use in the United States?,"According to the National Survey on Drug Use and Health (NSDUH), cocaine use has remained relatively stable since 2009. In 2014, there were an estimated 1.5 million current (past-month) cocaine users aged 12 or older (0.6 percent of the population). Adults aged 18 to 25 years have a higher rate of current cocaine use than any other age group, with 1.4 percent of young adults reporting past-month cocaine use. The 2015 Monitoring the Future survey, which annually surveys teen attitudes and drug use, reports a significant decline in 30-day prevalence of powder cocaine use among 8th, 10th, and 12th graders from peak use in the late 1990s. In 2014, 1.1 percent of 12th graders and only 0.8 percent of 10th and half a percent of 8th graders reported using cocaine in the past month. Repeated cocaine use can produce addiction and other adverse health consequences. In 2014, according to the NSDUH, about 913,000 Americans met the Diagnostic and Statistical Manual of Mental Disorders criteria for dependence or abuse of cocaine (in any form) during the past 12 months. Further, data from the 2011 Drug Abuse Warning Network (DAWN) report showed that cocaine was involved in 505,224 of the nearly 1.3 million visits to emergency departments for drug misuse or abuse. This translates to over one in three drug misuse or abuse-related emergency department visits (40 percent) that involved cocaine.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states,,,
+Q303,How is cocaine used?,"Users primarily administer cocaine orally, intranasally, intravenously, or by inhalation. When people snort the drug (intranasal use), they inhale cocaine powder through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. Users also may rub the drug onto their gums (oral use). Dissolving cocaine in water and injecting it (intravenous use) releases the drug directly into the bloodstream and heightens the intensity of its effects. When people smoke cocaine (inhalation), they inhale its vapor or smoke into the lungs, where absorption into the bloodstream is almost as rapid as by injection. This fast euphoric effect is one of the reasons that crack became enormously popular in the mid-1980s. Cocaine use ranges from occasional to repeated or compulsive use, with a variety of patterns between these extremes. Any route of administration can potentially lead to absorption of toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result in sudden death.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/how-cocaine-abused,,,
+Q304,How does cocaine produce its effects?,"The brain’s mesolimbic dopamine system, its reward pathway, is stimulated by all types of reinforcing stimuli, such as food, sex, and many drugs of abuse, including cocaine. This pathway originates in a region of the midbrain called the ventral tegmental area and extends to the nucleus accumbens, one of the brain’s key reward areas. Besides reward, this circuit also regulates emotions and motivation. In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds to specialized proteins called dopamine receptors on the neighboring neuron. By this process, dopamine acts as a chemical messenger, carrying a signal from neuron to neuron. Another specialized protein called a transporter removes dopamine from the synapse to be recycled for further use. Drugs of abuse can interfere with this normal communication process. For example, cocaine acts by binding to the dopamine transporter, blocking the removal of dopamine from the synapse. Dopamine then accumulates in the synapse to produce an amplified signal to the receiving neurons. This is what causes the euphoria commonly experienced immediately after taking the drug.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/how-does-cocaine-produce-its-effects,,,
+Q305,What are some ways that cocaine changes the brain?,"Use of cocaine, like other drugs of abuse, induces long-term changes in the brain. Animal studies show that cocaine exposure can cause significant neuroadaptations in neurons that release the excitatory neurotransmitter glutamate. Animals chronically exposed to cocaine demonstrate profound changes in glutamate neurotransmission—including how much is released and the level of receptor proteins—in the reward pathway, particularly the nucleus accumbens. The glutamate system may be an opportune target for anti-addiction medication development, with the goal of reversing the cocaine-induced neuroadaptations that contribute to the drive to use the drug. Although addiction researchers have focused on adaptations in the brain’s reward system, drugs also affect the brain pathways that respond to stress. Stress can contribute to cocaine relapse, and cocaine use disorders frequently co-occur with stress-related disorders.The stress circuits of the brain are distinct from the reward pathway, but research indicates that there are important ways that they overlap. The ventral tegmental area seems to act as a critical integration site in the brain that relays information about both stress and drug cues to other areas of the brain, including ones that drive cocaine seeking. Animals that have received cocaine repeatedly are more likely to seek the drug in response to stress, and the more of the drug they have taken, the more stress affects this behavior. Research suggests that cocaine elevates stress hormones, inducing neuroadaptations that further increase sensitivity to the drug and cues associated with it.",Cocaine,,https://www.drugabuse.gov/publications/cocaine/what-are-some-ways-cocaine-changes-brain,,,
+Q306,What are the short-term effects of cocaine use?,"Cocaine’s effects appear almost immediately after a single dose and disappear within a few minutes to an hour. Small amounts of cocaine usually make the user feel euphoric, energetic, talkative, mentally alert, and hypersensitive to sight, sound, and touch. The drug can also temporarily decrease the need for food and sleep. Some users find that cocaine helps them perform simple physical and intellectual tasks more quickly, although others experience the opposite effect. The duration of cocaine’s euphoric effects depend upon the route of administration. The faster the drug is absorbed, the more intense the resulting high, but also the shorter its duration. Snorting cocaine produces a relatively slow onset of the high, but it may last from 15 to 30 minutes. In contrast, the high from smoking is more immediate but may last only 5 to 10 minutes. Short-term physiological effects of cocaine use include constricted blood vessels; dilated pupils; and increased body temperature, heart rate, and blood pressure. Large amounts of cocaine may intensify the user’s high but can also lead to bizarre, erratic, and violent behavior. Some cocaine users report feelings of restlessness, irritability, anxiety, panic, and paranoia. Users may also experience tremors, vertigo, and muscle twitches. Severe medical complications can occur with cocaine use. Some of the most frequent are cardiovascular effects, including disturbances in heart rhythm and heart attacks; neurological effects, including headaches, seizures, strokes, and coma; and gastrointestinal complications, including abdominal pain and nausea. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures. Many cocaine users also use alcohol, and this combination can be particularly dangerous. The two substances react to produce cocaethylene, which may potentiate the toxic effects of cocaine and alcohol on the heart. The combination of cocaine and heroin is also very dangerous. Users combine these drugs because the stimulating effects of cocaine are offset by the sedating effects of heroin; however, this can lead to taking a high dose of heroin without initially realizing it. Because cocaine's effects wear off sooner, this can lead to a heroin overdose, in which the user's respiration dangerously slows down or stops, possibly fatally.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-short-term-effects-cocaine-use,,,
+Q307,What are the long-term effects of cocaine use?,"With repeated exposure to cocaine, the brain starts to adapt so that the reward pathway becomes less sensitive to natural reinforcers. At the same time, circuits involved in stress become increasingly sensitive, leading to increased displeasure and negative moods when not taking the drug, which are signs of withdrawal. These combined effects make the user more likely to focus on seeking the drug instead of relationships, food, or other natural rewards. With regular use, tolerance may develop so that higher doses, more frequent use of cocaine, or both are needed to produce the same level of pleasure and relief from withdrawal experienced initially. At the same time, users can also develop sensitization, in which less cocaine is needed to produce anxiety, convulsions, or other toxic effects. Tolerance to cocaine reward and sensitization to cocaine toxicity can increase the risk of overdose in a regular user. Users take cocaine in binges, in which cocaine is used repeatedly and at increasingly higher doses. This can lead to increased irritability, restlessness, panic attacks, paranoia, and even a full-blown psychosis, in which the individual loses touch with reality and experiences auditory hallucinations. With increasing doses or higher frequency of use, the risk of adverse psychological or physiological effects increases. Animal research suggests that binging on cocaine during adolescence enhances sensitivity to the rewarding effects of cocaine and MDMA (Ecstasy or Molly). Thus, binge use of cocaine during adolescence may further increase vulnerability to continued use of the drug among some people. Specific routes of cocaine administration can produce their own adverse effects. Regularly snorting cocaine can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum leading to a chronically inflamed, runny nose. Smoking crack cocaine damages the lungs and can worsen asthma. People who inject cocaine have puncture marks called tracks, most commonly in their forearms, and they are at risk of contracting infectious diseases like HIV and hepatitis C. They also may experience allergic reactions, either to the drug itself or to additives in street cocaine, which in severe cases can result in death. Cocaine damages many other organs in the body. It reduces blood flow in the gastrointestinal tract, which can lead to tears and ulcerations. Many chronic cocaine users lose their appetite and experience significant weight loss and malnourishment. Cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system. Chest pain that feels like a heart attack is common and sends many cocaine users to the emergency room. Cocaine use is linked with increased risk of stroke, as well as inflammation of the heart muscle, deterioration of the ability of the heart to contract, and aortic ruptures. In addition to the increased risk for stroke and seizures, other neurological problems can occur with long-term cocaine use. There have been reports of intracerebral hemorrhage, or bleeding within the brain, and balloon-like bulges in the walls of cerebral blood vessels. Movement disorders, including Parkinson’s disease, may also occur after many years of cocaine use. Generally, studies suggest that a wide range of cognitive functions are impaired with long-term cocaine use—such as sustaining attention, impulse inhibition, memory, making decisions involving rewards or punishments, and performing motor tasks. Former cocaine users are at high risk for relapse, even following long periods of abstinence. Research indicates that during periods of abstinence, the memory of the cocaine experience or exposure to cues associated with drug use can trigger strong cravings, which can lead to relapse.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use,,,
+Q308,Why are cocaine users at risk for contracting HIV/AIDS and hepatitis?,"Drug intoxication and addiction can compromise judgment and decision-making and potentially lead to risky sexual behavior, including trading sex for drugs, and needle sharing. This increases a cocaine user’s risk for contracting infectious diseases such as HIV and hepatitis C (HCV).There are no vaccines to prevent HIV or HCV infections. Studies that examine patterns of HIV infection and progression have demonstrated that cocaine use accelerates HIV infection. Research indicates that cocaine impairs immune cell function, promotes replication of the HIV virus, and potentiates the damaging effects of HIV on different types of cells in the brain and spinal cord, resulting in further damage. Studies also suggest that cocaine use accelerates the development of NeuroAIDS, neurological conditions associated with HIV infection. Symptoms of NeuroAIDS include memory loss, movement problems, and vision impairment.Cocaine users with HIV often have advanced progression of the disease, with increased viral load and accelerated decreases in CD4+ cell counts. Infection with HIV increases risk for co-infection with HCV, a virus that affects the liver. Co-infection can lead to serious illnesses—including problems with the immune system and neurologic conditions. Liver complications are very common, with many co-infected individuals dying of chronic liver disease and cancer. Although the link between injection drug use and HIV/HCV is well established, more studies are needed to understand the molecular mechanisms underlying this increased risk of co-infection in non-injecting substance users. The interaction of substance use, HIV, and hepatitis may accelerate disease progression. For example, HIV speeds the course of HCV infection by accelerating the progression of hepatitis-associated liver disease. Research has linked HIV/HCV co-infection with increased mortality when compared to either infection alone. Substance use and co-infection likely negatively influence HIV disease progression and the ability of the body to marshal an immune response.Patients with HIV/HCV co-infection can benefit from substance abuse treatment and antiretroviral therapies, when closely monitored. Antiretroviral treatment is not effective for everyone and can have significant side effects, necessitating close medical supervision. Testing for HIV and HCV is recommended for any individual who has ever injected drugs, since the disease is highly transmissible via injection. ",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/are-cocaine-abusers-risk-contracting-hivaids-hepatitis-b-c,,,
+Q309,What are the effects of maternal cocaine use?,"Most women who are addicted to cocaine are of childbearing age. Estimates suggest that about 5 percent of pregnant women use one or more addictive substances, and there are around 750,000 cocaine-exposed pregnancies every year. Although women may be reluctant to report substance use patterns because of social stigma and fear of losing custody of their children, they should be aware that drug use while pregnant is associated with specific risks that may be reduced with appropriate care. Cocaine use during pregnancy is associated with maternal migraines and seizures, premature membrane rupture, and separation of the placental lining from the uterus prior to delivery. Pregnancy is accompanied by normal cardiovascular changes, and cocaine use exacerbates these—sometimes leading to serious problems with high blood pressure (hypertensive crises), spontaneous miscarriage, preterm labor, and difficult delivery. Cocaine-using pregnant women must receive appropriate medical and psychological care—including addiction treatment—to reduce these risks. Sex-specific addiction treatment and comprehensive services—including prenatal care, mental health counseling, vocational/employment assistance, and parenting skills training—can promote drug abstinence and other positive health behaviors. Motivational incentives/contingency management as an adjunct to other addiction treatment is a particularly promising strategy to engage women in prenatal care and counseling for substance use.
+It is difficult to estimate the full extent of the consequences of maternal drug use and to determine the specific hazard of a particular drug to the unborn child. This is because multiple factors—such as the amount and number of all drugs used, including nicotine or alcohol; extent of prenatal care; exposure to violence in the environment; socioeconomic conditions; maternal nutrition; other health conditions; and exposure to sexually transmitted diseases—can all interact to influence maternal and child outcomes. Similarly, parenting styles, quality of care during early childhood, exposure to violence, and continued parental drug use are strong environmental factors influencing outcomes.
+Babies born to mothers who use cocaine during pregnancy are often prematurely delivered, have low birth weights and smaller head circumferences, and are shorter in length than babies born to mothers who do not use cocaine. Dire predictions of reduced intelligence and social skills in babies born to mothers who used crack cocaine while pregnant during the 1980s—so-called ""crack babies""—were grossly exaggerated. However, the fact that most of these children do not show serious overt deficits should not be overinterpreted to indicate that there is no cause for concern.Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet significant, later deficits in some children. These include behavior problems (e.g., difficulties with self-regulation) and deficits in some aspects of cognitive performance, information processing, and sustained attention to tasks—abilities that are important for the realization of a child’s full potential. Some deficits persist into the later years, with prenatally exposed adolescents showing increased risk for subtle problems with language and memory. Brain scans in teens suggests that at-rest functioning of some brain regions—including areas involved in attention, planning, and language—may differ from that of non-exposed peers. More research is needed on the long-term effects of prenatal cocaine exposure.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-effects-maternal-cocaine-use,,,
+Q310,How is cocaine addiction treated?,"Presently, there are no medications approved by the U.S. Food and Drug Administration to treat cocaine addiction, though researchers are exploring a variety of neurobiological targets. Past research has primarily focused on dopamine, but scientists have also found that cocaine use induces changes in the brain related to other neurotransmitters—including serotonin, gamma-aminobutyric acid (GABA), norepinephrine, and glutamate. Researchers are currently testing medications that act at the dopamine D3 receptor, a subtype of dopamine receptor that is abundant in the emotion and reward centers of the brain. Other research is testing compounds (e.g., N-acetylcysteine) that restore the balance between excitatory (glutamate) and inhibitory (GABA) neurotransmission, which is disrupted by long-term cocaine use. Research in animals is also looking at medications (e.g., lorcaserin) that act at serotonin receptors. Several medications marketed for other diseases show promise in reducing cocaine use within controlled clinical trials. Among these, disulfiram, which is used to treat alcoholism, has shown the most promise. Scientists do not yet know exactly how disulfiram reduces cocaine use, though its effects may be related to its ability to inhibit an enzyme that converts dopamine to norepinephrine. However, disulfiram does not work for everyone. Pharmacogenetic studies are revealing variants in the gene that encodes the DBH enzyme and seems to influence disulfiram’s effectiveness in reducing cocaine use. Knowing a patient’s DBH genotype could help predict whether disulfiram would be an effective pharmacotherapy for cocaine dependence in that person. Finally, researchers have developed and conducted early tests on a cocaine vaccine that could help reduce the risk of relapse. The vaccine stimulates the immune system to create cocaine-specific antibodies that bind to cocaine, preventing it from getting into the brain. In addition to showing the vaccine’s safety, a clinical trial found that patients who attained high antibody levels significantly reduced cocaine use. However, only 38 percent of the vaccinated subjects attained sufficient antibody levels and for only 2 months. Researchers are working to improve the cocaine vaccine by enhancing the strength of binding to cocaine and its ability to elicit antibodies. New vaccine technologies, including gene transfer to boost the specificity and level of antibodies produced or enhance the metabolism of cocaine, may also improve the effectiveness of this treatment. A pharmacogenetics study with a small number of patients suggests that individuals with a particular genotype respond well to the cocaine vaccine—an intriguing finding that requires more research. In addition to treatments for addiction, researchers are developing medical interventions to address the acute emergencies that result from cocaine overdose. One approach being explored is the use of genetically engineered human enzymes involved in the breakdown of cocaine, which would counter the behavioral and toxic effects of a cocaine overdose. Currently, researchers are testing and refining these enzymes in animal research, with the ultimate goal of moving to clinical trials.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers,,,
+Q311,How is cocaine addiction treated via behavioral interventions?,"Many behavioral treatments for cocaine addiction have proven to be effective in both residential and outpatient settings. Indeed, behavioral therapies are often the only available and effective treatments for many drug problems, including stimulant addictions. However, the integration of behavioral and pharmacological treatments may ultimately prove to be the most effective approach. One form of behavioral therapy that is showing positive results in people with cocaine use disorders is contingency management (CM), also called motivational incentives. Programs use a voucher or prize-based system that rewards patients who abstain from cocaine and other drugs. On the basis of drug-free urine tests, the patients earn points, or chips, which can be exchanged for items that encourage healthy living, such as a gym membership, movie tickets, or dinner at a local restaurant. CM may be particularly useful for helping patients achieve initial abstinence from cocaine and stay in treatment. This approach has recently been shown to be practical and effective in community treatment programs. Research indicates that CM benefits diverse populations of cocaine users. For example, studies show that cocaine-dependent pregnant women and women with young children who participated in a CM program as an adjunct to other substance use disorder treatment were able to stay abstinent longer than those who received an equivalent amount of vouchers with no behavioral requirements. Patients participating in CM treatment for cocaine use who also experienced psychiatric symptoms—such as depression, emotional distress, and hostility—showed a significant reduction in these problems, probably related to reductions in cocaine use.
+Cognitive-behavioral therapy (CBT) is an effective approach for preventing relapse. This approach helps patients develop critical skills that support long-term abstinence—including the ability to recognize the situations in which they are most likely to use cocaine, avoid these situations, and cope more effectively with a range of problems associated with drug use. This therapy can also be used in conjunction with other treatments, thereby maximizing the benefits of both. Recently, researchers developed a computerized form of CBT (CBT4CBT) that patients use in a private room of a clinic. This interactive multimedia program closely follows the key lessons and skill-development activities of in-person CBT in a series of modules. Movies present examples and information that support the development of coping skills; quizzes, games, and homework assignments reinforce the lessons and provide opportunities to practice skills. Studies have shown that adding CBT4CBT to weekly counseling boosted abstinence and increased treatment success rates up to 6 months after treatment. Therapeutic communities (TCs)—drug-free residences in which people in recovery from substance use disorders help each other to understand and change their behaviors—can be an effective treatment for people who use drugs, including cocaine.TCs may require a 6- to 12-month stay and can include onsite vocational rehabilitation and other supportive services that focus on successful re-integration of the individual into society. TCs can also provide support in other important areas—improving legal, employment, and mental health outcomes. Regardless of the specific type of substance use disorder treatment, it is important that patients receive services that match all of their treatment needs. For example, an unemployed patient would benefit from vocational rehabilitation or career counseling along with addiction treatment. Patients with marital problems may need couples counseling. Once inpatient treatment ends, ongoing support—also called aftercare—can help people avoid relapse. Research indicates that people who are committed to abstinence, engage in self-help behaviors, and believe that they have the ability to refrain from using cocaine (self-efficacy) are more likely to abstain. Aftercare serves to reinforce these traits and address problems that may increase vulnerability to relapse, including depression and declining self-efficacy. Scientists have found promising results from telephone-based counseling as a low-cost method to deliver aftercare. For example, people who misused stimulants who participated in seven sessions of telephone counseling showed decreasing drug use during the first 3 months, whereas those who did not receive calls increased their use. Voucher incentives can boost patients' willingness to participate in telephone aftercare, doubling the number of sessions received according to one study.
+
+Community-based recovery groups—such as Cocaine Anonymous—that use a 12-step program can also be helpful in maintaining abstinence. Participants may benefit from the supportive fellowship and from sharing with those experiencing common problems and issues.",Cocaine,,https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers,,,
+Q312,Is cocaine addictive?,"Yes. You may have strong cravings for the drug and the high it brings. You’ll need a stronger dose to feel the same high. This can become an addiction. Stronger, more frequent doses put you at risk of overdose and serious problems with you heart, stomach, lungs, and thinking.",Cocaine,,https://www.webmd.com/mental-health/addiction/qa/what-can-lead-to-an-overdose-and-how-can-cocaine-affect-you,,,
+Q313,Why is there comorbidity between substance use disorders and mental illnesses?,"The high prevalence of comorbidity between substance use disorders and other mental illnesses does not necessarily mean that one caused the other, even if one appeared first. Establishing causality or directionality is difficult for several reasons. For example, behavioral or emotional problems may not be severe enough for a diagnosis (called subclinical symptoms), but subclinical mental health issues may prompt drug use. Also, people’s recollections of when drug use or addiction started may be imperfect, making it difficult to determine whether the substance use or mental health issues came first. Three main pathways can contribute to the comorbidity between substance use disorders and mental illnesses: Common risk factors can contribute to both mental illness and substance use and addiction; mental illness may contribute to substance use and addiction; substance use and addiction can contribute to the development of mental illness.",Comorbidity,,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-there-comorbidity-between-substance-use-disorders-mental-illnesses,,,
+Q314,What are the treatments for comorbid substance use disorder and mental health conditions?,"Integrated treatment for comorbid drug use disorder and mental illness has been found to be consistently superior compared with separate treatment of each diagnosis. Integrated treatment of co-occurring disorders often involves using cognitive behavioral therapy strategies to boost interpersonal and coping skills and using approaches that support motivation and functional recovery. Patients with comorbid disorders demonstrate poorer treatment adherence and higher rates of treatment dropout than those without mental illness, which negatively affects outcomes. Nevertheless, steady progress is being made through research on new and existing treatment options for comorbidity. In addition, research on implementation of appropriate screening and treatment within a variety of settings, including criminal justice systems, can increase access to appropriate treatment for comorbid disorders.
+Treatment of comorbidity often involves collaboration between clinical providers and organizations that provide supportive services to address issues such as homelessness, physical health, vocational skills, and legal problems. Communication is critical for supporting this integration of services. Strategies to facilitate effective communication may include co-location, shared treatment plans and records, and case review meetings. Support and incentives for collaboration may be needed, as well as education for staff on co-occurring substance use and mental health disorders.",Comorbidity,,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/what-are-treatments-comorbid-substance-use-disorder-mental-health-conditions,,,
+Q315,What is Continuum of Care?,"An integrated system of care that guides and tracks a person over time through a comprehensive array of health
+services appropriate to the individual’s need. A continuum of care may include prevention, early intervention, treatment, continuing care, and recovery support.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q316,What is delirium tremens?,"Delirium tremens, also called DTs or withdrawal delirium, is a severe type of withdrawal from alcohol addiction. It usually starts about 2 to 3 days after someone with alcohol use disorder ends a long drinking binge. DTs usually last for 2 to 3 days, but symptoms may linger for as long as a week.",Withdrawal,,https://www.webmd.com/mental-health/addiction/qa/what-is-delirium-tremens,,,
+Q317,What are depressants?,"Depressants will put you to sleep, relieve anxiety and muscle spasms, and prevent seizures. ",Depressants,,https://www.dea.gov/taxonomy/term/316,,,
+Q318,"I take drugs because I feel depressed—nothing else seems to work. If I stop, I'll feel much worse—how do I deal with that?","It is very possible you need to find treatment for both depression and addiction. This is very common. It’s called ""comorbidity,"" ""co-occurrence,"" or ""dual diagnosis"" when you have more than one health problem at the same time. It is important that you discuss all of your symptoms and behaviors with your treatment team. There are many nonaddictive drugs that can help with depression or other mental health issues. Sometimes health care providers might not communicate with each other as well as they should, so you can be your own best advocate and make sure all of your health providers know about all of the health issues that concern you. People who have co-occurring issues should be treated for all of them at the same time",Depression,,https://www.drugabuse.gov/publications/step-by-step-guides-to-finding-treatment-drug-use-disorders/if-you-have-problem-drugs-adults/how-to-recognize-substance-use-disorder,,,
+Q319,What are the symptoms of depression? ,"Abraham Lincoln, the former American president, who suffered from recurrent bouts of depression all his life, noted that when by himself, “he was so overcome with terrible melancholy, that he never dare carry a knife in his pocket.”
+
+The way depression manifests itself can be strongly influenced by culture, the environment and the underlying cause. For example, at the turn of the century, depression usually presented with weight loss and depressed people with weight gain were diagnosed as “atypical”. Today, symptoms of weight gain and food cravings are far more common symptoms of depression – mirroring the growth of obesity and over-eating in our society.",Depression,,https://www.weforum.org/agenda/2017/04/q-a-an-expert-answers-your-questions-on-depression-for-world-health-day-2017/,,,
+Q320,"Are sleeping disorders and anxiety/overthinking, signs of depression?","Yes, they can be. Depression-related ruminations often result in insomnia and anxiety. But it also important to realize that there are many other causes for anxiety (e.g. Post-Traumatic Stress Disorder, phobias) and sleep problems (e.g. sleep apnea) besides depression. Treating depression can sometimes relieve all these associated symptoms.",Depression,,https://www.weforum.org/agenda/2017/04/q-a-an-expert-answers-your-questions-on-depression-for-world-health-day-2017/,,,
+Q321,What are the root causes of depression? ,"We don’t know the root cause yet but it is likely a combination of psychological, social and biochemical factors. Simplistic theories such as ""depression is due to lack of serotonin"" are false. While there is a clear biological basis, one cannot underestimate the role of mental factors. That is one reason why hearing the words “I don’t love you anymore” or “you’re fired” can lead to a complex downward spiral. Does this spiral originate in the mind or the brain?
+
+Triggers include social isolation, major life changes or stress, loss of a loved one, thyroid or B-vitamin deficiencies, brain strokes, and genetics. Because depression can present differently in different people and have different causes, it is important to seek professional help.",Depression,,https://www.weforum.org/agenda/2017/04/q-a-an-expert-answers-your-questions-on-depression-for-world-health-day-2017/,,,
+Q322,How do dissociative drugs work?,"Laboratory studies suggest that dissociative drugs, including PCP, ketamine, and DXM, cause their effects by disrupting the actions of the brain chemical glutamate at certain types of receptors—called N-methyl-D-aspartate (NMDA) receptors—on nerve cells throughout the brain. Glutamate plays a major role in cognition (including learning and memory), emotion, and the perception of pain (the latter via activation of pain-regulating cells outside of the brain). PCP also alters the actions of dopamine, a neurotransmitter responsible for the euphoria and “rush” associated with many abused drugs.
+
+Salvia divinorum works differently. While classified as a dissociative drug, salvia causes its effects by activating the kappa opioid receptor on nerve cells. These receptors differ from those activated by the more commonly known opioids such as heroin and morphine.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-effects-common-dissociative-drugs-brain-body,,,
+Q323,What are the short-term effects of dissociative drugs? ,"Dissociative drugs can produce visual and auditory distortions and a sense of floating and dissociation (feeling detached from reality) in users. Use of dissociative drugs can also cause anxiety, memory loss, and impaired motor function, including body tremors and numbness. These effects, which depend on the amount of the drug taken, are also unpredictable—typically beginning within minutes of ingestion and lasting for several hours, although some users report feeling the drug’s effects for days. In addition to these general effects, different dissociative drugs can produce a variety of distinct and dangerous effects. For example, at moderate to high doses, PCP can cause a user to have seizures or severe muscle contractions, become aggressive or violent, or even experience psychotic symptoms similar to schizophrenia. At moderate to high doses, ketamine can cause sedation, immobility, and amnesia. At high doses, ketamine users also report experiencing terrifying feelings of almost complete sensory detachment likened to a near-death experience (called a “K-hole,” similar to a bad LSD trip). Salvia users report intense but short-lived effects—up to 30 minutes—including emotional mood swings ranging from sadness to uncontrolled laughter.
+
+DXM, which is safe and effective as a cough suppressant and expectorant when used at recommended doses (typically 15 to 30 milligrams), can lead to serious side effects when abused. For example, use of DXM at doses from 200 to 1,500 milligrams can produce dissociative effects similar to PCP and ketamine and increase the risk of serious central nervous system and cardiovascular effects such as respiratory distress, seizures, and increased heart rate from the antihistamines found in cough medicines.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-effects-common-dissociative-drugs-brain-body,,,
+Q324,What are the long-term effects of dissociative drugs?,"While the long-term use of most dissociative drugs has not been investigated systematically, research shows that repeated use of PCP can lead to tolerance and the development of a substance use disorder that includes a withdrawal syndrome (including craving for the drug, headaches, and sweating) when drug use is stopped. Other effects of long-term PCP use include persistent speech difficulties, memory loss, depression, suicidal thoughts, anxiety, and social withdrawal that may persist for a year or more after chronic use stops.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-effects-common-dissociative-drugs-brain-body,,,
+Q325,How does drug abuse affect the HIV Epidemic?,"Drug abuse and addiction have been inextricably linked with HIV/AIDS since the beginning of the epidemic. While intravenous drug use is well known in this regard, less recognized is the role that drug abuse plays more generally in the spread of HIV by increasing the likelihood of high-risk sex with infected partners. The intoxicating effects of many drugs can alter judgment and inhibition and lead people to engage in impulsive and unsafe behaviors. Also, people who are abusing or addicted to drugs may engage in sexually risky behaviors to obtain drugs or money for drugs. Nearly one-quarter of AIDS cases stem from intravenous drug use, and one in four people living with HIV/AIDS in the period of 2005–2009 reported use of alcohol or drugs to an extent that required treatment. Drug abuse and addiction can also worsen the progression of HIV and its consequences, especially in the brain. For example, in animal studies, methamphetamine increased the amount of HIV virus present in the brain; and in human studies, HIV caused greater neuronal injury and cognitive impairment in methamphetamine abusers compared to non-drug users.",Drug abuse,,https://www.drugabuse.gov/publications/research-reports/hivaids/how-does-drug-abuse-affect-hiv-epidemic,,,
+Q326,What medications and devices help treat drug addiction?,"Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.
+
+Treating withdrawal. When patients first stop using drugs, they can experience various physical and emotional symptoms, including restlessness or sleeplessness, as well as depression, anxiety, and other mental health conditions. Certain treatment medications and devices reduce these symptoms, which makes it easier to stop the drug use.
+Staying in treatment. Some treatment medications and mobile applications are used to help the brain adapt gradually to the absence of the drug. These treatments act slowly to help prevent drug cravings and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment.
+Preventing relapse. Science has taught us that stress cues linked to the drug use (such as people, places, things, and moods), and contact with drugs are the most common triggers for relapse. Scientists have been developing therapies to interfere with these triggers to help patients stay in recovery.",Drug addiction,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery,,,
+Q327,Why is counseling and family therapy important in treating drug addiction?,Addiction doesn't only affect your life; your whole family is transformed. Strong relationships with family and friends are essential for successful drug or alcohol abuse treatment. Various counseling methods include the spouse and other family members of the addicted person.,Drug addiction,,https://www.webmd.com/mental-health/addiction/qa/why-is-counseling-and-family-therapy-important-in-treating-drug-addiction,,,
+Q328,What is the difference between individual therapy and group therapy for opioid addiction?,"While any counseling therapy for drug or alcohol abuse treatment is better than none, group therapy is generally preferred over individual therapy. In group therapy, a person is more likely to be both challenged and supported by peers who are also going through drug rehab.
+
+Individual therapy can be helpful in the case of a dual diagnosis: coexisting depression, bipolar disorder, or other significant mental health condition that requires treatment in its own right, separate from the opioid addiction.",Drug addiction,,https://www.webmd.com/mental-health/addiction/qa/what-is-the-difference-between-individual-therapy-and-group-therapy-for-opioid-addiction,,,
+Q329,What is drug diversion?,A medical and legal concept involving the transfer of any legally prescribed controlled substance from the person for whom it was prescribed to another person for any illicit use.,Drugs,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q330,What are the effects ecstasy?,"Ecstasy increases levels of several chemicals in the brain, including serotonin, dopamine, and norepinephrine. It alters your mood and makes you feel closer and more connected to others. Users get a sense of euphoria and a boost in energy. When the drug wears off, though, it can lead to confusion, depression, anxiety, and sleep problems.",Drug effects,,https://www.webmd.com/mental-health/addiction/street-drugs-risks#2,,,
+Q331,What are the effects of mushrooms?,"The effects start within about 20 minutes and last as long as 6 hours. Similar to LSD, mushrooms can cause hallucinations, an altered perception of time, and an inability to tell the difference between what’s real and what’s not.
+
+Taking high doses or using them for a long time can cause panic, psychosis, or flashbacks. They can also cause extreme pupil dilation, nausea, and vomiting.",Drug effects,,https://www.webmd.com/mental-health/addiction/street-drugs-risks#4,,,
+Q332,What are the effects of salvia?,"The drug creates intense but short-lived effects, which start within 5 to 10 minutes and last about 30 minutes. The hallucinogenic effects include changes in vision, mood, emotions, and body sensations.
+
+Little is known about the health effects of salvia, though animal studies show it may have an impact on learning and memory. The Drug Enforcement Administration doesn’t consider salvia an illegal drug, but several states have passed laws to regulate its use.",Drug effects,,https://www.webmd.com/mental-health/addiction/street-drugs-risks#5,,,
+Q333,What are the effects of Spice?,"Compounds in Spice act on the same parts in the brain as THC, the psychoactive ingredient in marijuana. As a result, the effects are very similar, such as feeling happier and more relaxed. But the compounds in Spice can lead to a stronger effect.
+
+Users also report severe anxiety, paranoia, and hallucinations.
+
+Other effects of Spice can include:
+
+Rapid heart rate
+Vomiting
+Confusion
+Seizures
+Increased blood pressure
+Heart attack (rarely)",Drug effects,,https://www.webmd.com/mental-health/addiction/street-drugs-risks#5,,,
+Q334,What is drug misuse?,"The use of prescription drugs without a prescription, or in a different way than prescribed.",Drug abuse,,https://www.cdc.gov/drugoverdose/patients/faq.html,,,
+Q335,What are drug schedules?,"Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential. The abuse rate is a determinate factor in the scheduling of the drug; for example, Schedule I drugs have a high potential for abuse and the potential to create severe psychological and/or physical dependence. As the drug schedule changes-- Schedule II, Schedule III, etc., so does the abuse potential-- Schedule V drugs represents the least potential for abuse. A Listing of drugs and their schedule are located at Controlled Substance Act (CSA) Scheduling or CSA Scheduling by Alphabetical Order. These lists describes the basic or parent chemical and do not necessarily describe the salts, isomers and salts of isomers, esters, ethers and derivatives which may also be classified as controlled substances. These lists are intended as general references and are not comprehensive listings of all controlled substances.",Drug schedules,,https://www.dea.gov/drug-scheduling,,,
+Q336,Do opioids show up on drug tests?,"Just like other drugs, opioids can show up on a drug test within hours of being taken. Opioids, including heroin, can show up on a drug test for days, and in some cases weeks, after being taken. How long they stay in your system depends on how long a person has been taking the drug, the amount of drug they use, or the person’s metabolism (how your body handles the drug).",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q337,Why do adolescents take drugs?,"Adolescents experiment with drugs or continue taking them for several reasons, including:
+
+To fit in: Many teens use drugs “because others are doing it”—or they think others are doing it—and they fear not being accepted in a social circle that includes drug-using peers.
+To feel good: Abused drugs interact with the neurochemistry of the brain to produce feelings of pleasure. The intensity of this euphoria differs by the type of drug and how it is used.
+To feel better: Some adolescents suffer from depression, social anxiety, stress-related disorders, and physical pain. Using drugs may be an attempt to lessen these feelings of distress. Stress especially plays a significant role in starting and continuing drug use as well as returning to drug use (relapsing) for those recovering from an addiction.
+To do better: Ours is a very competitive society, in which the pressure to perform athletically and academically can be intense. Some adolescents may turn to certain drugs like illegal or prescription stimulants because they think those substances will enhance or improve their performance.
+To experiment: Adolescents are often motivated to seek new experiences, particularly those they perceive as thrilling or daring.",Drugs,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q338,What drugs are most frequently used by adolescents?,"Alcohol and tobacco are the drugs most commonly abused by adolescents, followed by marijuana. The next most popular substances differ between age groups. Young adolescents tend to favor inhalant substances (such as breathing the fumes of household cleaners, glues, or pens), whereas older teens are more likely to use synthetic marijuana (“K2” or “Spice”) and prescription medications—particularly opioid pain relievers like Vicodin® and stimulants like Adderall®. In fact, the Monitoring the Future survey of adolescent drug use and attitudes shows that prescription and over-the-counter medications account for a majority of the drugs most commonly abused by high-school seniors.",Drugs,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q339,Are over-the-counter (OTC) drugs dangerous?,"All drugs, regardless of whether they are illegal, prescription, or over-the-counter (available without a prescription), change the body’s function or chemistry and can be harmful. OTC drugs are available to the public with the understanding that they will be used only as directed and to treat a particular ailment.
+
+For example, the common pain reliever, ibuprofen (more commonly known as Advil), can cause kidney damage if taken for prolonged periods. Just like with any drug, overdoses from over-the-counter medication can occur. From 1999 to 2004, there was a seven-fold increase in cases related to the abuse of DXM reported to poison control centers nationwide. Most of these cases were among 15 and 16 year olds. The health risks of abusing OTC cough and cold remedies include impaired judgment, nausea, loss of coordination, headache, vomiting, loss of consciousness, numbness of fingers and toes, abdominal pain, irregular heartbeat, aches, seizures, panic attacks, psychosis, cold flashes, dizziness, diarrhea, addiction, restlessness, insomnia, high blood pressure, coma, and death.
+
+An overdose on over-the-counter drugs can vary greatly depending on what other drugs they are mixed with, the amount of drugs taken, and how they are taken. Some over-the-counter drugs can cause serious problems or even death if used incorrectly. The only safe way to take over-the-counter medications is exactly as directed on the bottle and to treat the symptoms for which they are intended.",Drugs,,https://abovetheinfluence.com/faqs/,,,
+Q340,What do drugs make you feel like?,"Depending on the drug, some people might say they feel pleasant or relaxed. However, in many cases, these feelings may be followed by even more powerful sensations, such as depression, anxiety, nausea, confusion, lack of control, paranoia, guilt, embarrassment, hangovers, loneliness, and cravings for more drugs. People who use drugs to have fun or to forget their problems may never really learn how to find things in their lives that truly make them fulfilled or find ways to cope with difficulties, and they may keep returning to drugs because they haven’t learned other ways to be happy.",Drugs,,https://abovetheinfluence.com/faqs/,,,
+Q341,"If taking drugs makes people feel good or better, what's the problem?","When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person's life. Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel “normal.” They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the signs of an addiction. Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose.",Drugs,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q342,Do people choose to keep using drugs?,"The initial decision to take drugs is typically voluntary. But with continued use, a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. These changes help explain the compulsive nature of addiction.",Drugs,,https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction,,,
+Q343,Can drugs affect animals?,"Yes. Chemicals can have different effects in different animals—for instance, chocolate is delicious to humans and poisonous to dogs—so even small amounts of a drug could be very harmful for your pet. Alcohol can cause a dog to suffer dangerous drops in blood pressure, blood sugar, and body temperature, to have seizures, and to stop breathing.
+
+In dogs and cats poisoned by marijuana, signs may be seen within 3 hours, such as a lack of energy, low heart rate, low blood pressure, respiratory depression, hyperactivity, seizures, vomiting, and coma. Also, your pet wouldn’t understand that it had been given a drug, and the sensations that might feel like a “high” to a human would be a very scary experience for an animal.",Drugs,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q344,How can I help someone if they are on drugs?,"One of the best things you can do for a friend with a serious drug problem is let them know you are there to support them. Tell them you’re concerned about their drug use and encourage them to seek help from a trusted adult; maybe a teacher, coach, parent, or counselor can help. 
+
+You can also help by being a strong positive influence; help them get involved in non-drug-using activities like joining a club, playing music, or playing a sport. However, if your friend is becoming a negative influence in your life, you might have to step away from the friendship for a while.",Drugs,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q345,How do drugs get into a person’s hair?,"For a drug to get into the hair from inside, it first has to enter a person’s bloodstream. This happens when a drug is injected into a vein, or when it’s smoked, snorted, or swallowed.",Drugs,,https://teens.drugabuse.gov/blog/post/how-do-drugs-get-person-s-hair,,,
+Q346,Is teen drug use related to brain size?,"Recently, researchers found another connection: Teens who use nicotine, alcohol, and marijuana (or weed) have two brain areas that are smaller than average when they become adults.
+
+This doesn’t necessarily mean that teen drug use causes those brain areas to be smaller. Other factors could also be involved. But this connection (what scientists call a correlation) is worth knowing about, and is being studied by scientists.",Drugs,,https://teens.drugabuse.gov/blog/post/teen-drug-use-related-brain-size,,,
+Q347,Coronavirus (COVID-19) and Drug Use: What’s the Connection?,"The coronavirus pandemic has changed people’s lives everywhere. Our daily routines, including our school and work situations, are a lot different than they were just a few weeks ago.  A coronavirus is one type of virus; colds and flu are also caused by viruses. The disease caused by this coronavirus is called COVID-19. It’s a respiratory disease, which means it attacks the lungs and affects a person’s breathing. (For more information on coronavirus and COVID-19, visit coronavirus.gov.) We know that smoking, vaping, using meth, or misusing opioids can all have an impact on the lungs. People whose lungs have been affected by drug use may be at higher risk of serious complications from COVID-19.",Drugs,,https://teens.drugabuse.gov/blog/post/coronavirus-covid-19-and-drug-use-what-s-connection,,"We might want to remove the ""just a few weeks ago"" part of the answer.",
+Q348,What drugs are the most commonly abused?,"Each year, the National Institute on Drug Abuse (NIDA) tracks drug use trends among high school students (8th, 10th and 12th grades) through the Monitoring the Future Study (MTF). The following is a list of the most commonly abused drugs among 12th graders, starting with the most frequent:  marijuana, Adderall, Vicodin, tranquilizers, cough medicine, sedatives, hallucinogens, MDMA/ecstasy, OxyContin, cocaine, salvia and Ritalin.",Drugs,,https://tricircleinc.com/faqs/,,,
+Q349,What are illicit drugs?,"The nonmedical use of a variety of drugs that are prohibited by law. These drugs can include: amphetamine- type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q350,What are narcotic drugs?,"Originally referred to any substance that dulled the senses and relieved pain. Some people use the term to refer to all illegal drugs but technically, it refers only to opioids. Opioid is now the preferred term to avoid confusion.",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q351,What is the non-medical use of drugs?,"Taking prescribed or diverted prescription drugs (drugs not prescribed to the person using them) not in the way, for the reasons, in the amount, or during the time-period prescribed.",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q352,What are prescription drug monitoring programs (PDMPs)?,"State or territorial-run electronic databases that track controlled substance prescriptions. PDMPs help providers identify patients at risk of opioid misuse, opioid use disorder, and/or overdose due to overlapping prescriptions, high dosages, or co-prescribing of opioids with benzodiazepines.",Drugs,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q353,How do people use fentanyl?,"When prescribed by a doctor, fentanyl can be given as a shot, a patch that is put on a person’s skin, or as lozenges that are sucked like cough drops. The illegally used fentanyl most often associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose. ",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q354,How does fentanyl affect the brain?,"Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions.  After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug. When people become addicted, drug seeking and drug use take over their lives. Fentanyl's effects include extreme happiness, drowsiness, nausea, confusion, constipation, sedation, problems breathing, and unconsciousness",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q355,Can you overdose from fentanyl?,"Yes, a person can overdose on fentanyl. An overdose occurs when a drug produces serious adverse effects and life-threatening symptoms. When people overdose on fentanyl, their breathing can slow or stop. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can lead to a coma and permanent brain damage, and even death.",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q356,How can a fentanyl overdose be treated?,"Many drug dealers mix the cheaper fentanyl with other drugs like heroin, cocaine, MDMA and methamphetamine to increase their profits, making it often difficult to know which drug is causing the overdose. Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone. Because of this, if you suspect someone has overdosed, the most important step to take is to call 911 so he or she can receive immediate medical attention. Once medical personnel arrive, they will administer naloxone if they suspect an opioid drug is involved. People who are given naloxone should be monitored for another two hours after the last dose of naloxone is given to make sure breathing does not slow or stop. Some states have passed laws that allow pharmacists to dispense naloxone without a personal prescription. This allows friends, family, and others in the community to use the auto-injector or nasal spray versions of naloxone to save someone who is overdosing. People who are or know someone at risk for an opioid overdose can be trained on how to give naloxone and can carry it with them in case of an emergency. Naloxone is available as an injectable (needle) solution, a hand-held auto-injector (EVZIO®), and a nasal spray (NARCAN® Nasal Spray).",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q357,Can fentanyl use lead to addiction?,"Yes. Fentanyl is addictive because of its potency. A person taking prescription fentanyl as instructed by a doctor can experience dependence, which is characterized by withdrawal symptoms when the drug is stopped. A person can be dependent on a substance without being addicted, but dependence can sometimes lead to addiction. Addiction is the most severe form of a substance use disorder (SUD). SUDs are characterized by compulsive drug seeking and drug use that can be difficult to control, despite harmful consequences. When someone is addicted to drugs, they continue to use them even though they cause health problems or issues at work, school, or home. An SUD can range from mild to severe. People addicted to fentanyl who stop using it can have severe withdrawal symptoms that begin as early as a few hours after the drug was last taken. These symptoms include: muscle and bone pain; sleep problems; diarrhea and vomiting; cold flashes with goose bumps; uncontrollable leg movements; severe cravings. These symptoms can be extremely uncomfortable and are the reason many people find it so difficult to stop taking fentanyl. There are medicines being developed to help with the withdrawal process for fentanyl and other opioids. The FDA has approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. Also, the NSS-2 Bridge device is a small electrical nerve stimulator placed behind the person’s ear, that can be used to try to ease symptoms for up to five days during the acute withdrawal phase. In December 2018, the FDA cleared a mobile medical application, reSET®, to help treat opioid use disorders. This application is a prescription cognitive behavioral therapy and should be used in conjunction with treatment that includes buprenorphine and contingency management.",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q358,How is fentanyl addiction treated?,"Like other opioid addictions, medication with behavioral therapies has been shown to be effective in treating people with a fentanyl addiction. Medications: Buprenorphine and methadone work by binding to the same opioid receptors in the brain as fentanyl, reducing cravings and withdrawal symptoms. Another medicine, naltrexone, blocks opioid receptors and prevents fentanyl from having an effect. People can discuss treatment options with their health provider. Counseling: Behavioral therapies for addiction to opioids like fentanyl can help people modify their attitudes and behaviors related to drug use, increase healthy life skills, and help them stick with their medication. Some examples include: cognitive behavioral therapy, which helps modify the patient's drug use expectations and behaviors, and effectively manage triggers and stress contingency management, which uses a voucher-based system giving patients “points” based on negative drug tests. They can use the points to earn items that encourage healthy living. Motivational interviewing, which is a patient-centered counseling style that addresses a patient’s mixed feelings to change. These behavioral treatment approaches have proven effective, especially when used along with medicines. ",Fentanyl,,https://www.drugabuse.gov/publications/drugfacts/fentanyl,,,
+Q359,What is GHB - Gamma-Hydroxybutyric Acid?,"Prescribed as Xyrem, it is also known as the “date rape drug."" It comes in a liquid or as a white powder that is dissolved in water, juice, or alcohol. In liquid form, GHB is clear and colorless and slightly salty in taste.",Drugs,,https://www.dea.gov/factsheets/ghb-gamma-hydroxybutyric-acid,,,
+Q360,What are street names for GHB?,"G, Georgia Home Boy, Goop, Grievous Bodily Harm, Liquid X, Scoop, Liquid Ecstasy",Drugs,,https://www.dea.gov/factsheets/ghb-gamma-hydroxybutyric-acid,,,
+Q361,How is GHB used?,"Usually a liquid, mixed in a beverage
+White powder normally dissolved in a liquid",Drugs,,https://www.dea.gov/factsheets/ghb-gamma-hydroxybutyric-acid,,,
+Q362,How does GHB affect the body?,"Hallucinations
+Euphoria, drowsiness, decreased anxiety, excited and aggressive behavior
+Overdose symptoms: unconsciousness, seizures, slowed heart rate, greatly slowed breathing, lower body temperature, vomiting, nausea, coma, death
+Addictive. Withdrawal symptoms: insomnia, anxiety, tremors, increased heart rate and blood pressure, psychotic thoughts.",Drugs,,https://www.dea.gov/factsheets/ghb-gamma-hydroxybutyric-acid,,,
+Q363,What are hallucinogens and dissociative drugs?,"Hallucinogens are a class of drugs that cause hallucinations—profound distortions in a person’s perceptions of reality. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be man-made, and they are commonly divided into two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). When under the influence of either type of drug, people often report rapid, intense emotional swings and seeing images, hearing sounds, and feeling sensations that seem real but are not. While the exact mechanisms by which hallucinogens and dissociative drugs cause their effects are not yet clearly understood, research suggests that they work at least partially by temporarily disrupting communication between neurotransmitter systems throughout the brain and spinal cord that regulate mood, sensory perception, sleep, hunger, body temperature, sexual behavior, and muscle control.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-hallucinogens,,,
+Q364,How widespread is the abuse of hallucinogens and dissociative drugs?,"According to the 2013 National Survey on Drug Use and Health, 229,000 Americans ages 12 and older reported current (past-month) use of LSD and 33,000 reported current use of PCP (Substance Abuse and Mental Health Services Administration, 2013). Among high school seniors, salvia was significantly more popular than LSD or PCP when it was added to the Monitoring the Future survey in 2009. Past-year use was reported to be 5.9 percent for salvia, 2.7 percent for LSD, and 1.3 percent for PCP. Fortunately, rates have dropped significantly for saliva—to 1.8 percent in 2014—with LSD and PCP use dropping slightly. While regular use of hallucinogenic and dissociative drugs in general has remained relatively low in recent years, one study reported that the United States ranks first among 36 nations in the proportion of high school students ever using LSD or other hallucinogens in their lifetime (6 percent versus 2 percent in Europe). Additionally, tourism to the Amazon for the purpose of using ayahuasca has become increasingly popular among Americans and Europeans in recent years, and ayahuasca use has also been reported in major cities in Brazil and abroad. Although DMT is a schedule I drug, plants containing DMT are not scheduled, and there is ambiguity over ayahuasca’s legal status in the United States. Two U.S. Brazilian churches have obtained permission to import and use these plants in their ceremonies.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/why-do-people-take-hallucinogens,,,
+Q365,Why do people take hallucinogenic or dissociative drugs?,"Hallucinogenic and dissociative drugs have been used for a variety of reasons. Historically, hallucinogenic plants have been used for religious rituals to induce states of detachment from reality and precipitate “visions” thought to provide mystical insight or enable contact with a spirit world or “higher power.” More recently, people report using hallucinogenic drugs for more social or recreational purposes, including to have fun, help them deal with stress, or enable them to enter into what they perceive as a more enlightened sense of thinking or being. Hallucinogens have also been investigated as therapeutic agents to treat diseases associated with perceptual distortions, such as schizophrenia, obsessive-compulsive disorder, bipolar disorder, and dementia. Anecdotal reports and small studies have suggested that ayahuasca may be a potential treatment for substance use disorders and other mental health issues, but no large-scale research has verified its efficacy.",Hallucinogen,,https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-facts-about-dissociative-drugs,,,
+Q366,How do hallucinogens work?,"Classic hallucinogens are thought to produce their perception-altering effects by acting on neural circuits in the brain that use the neurotransmitter serotonin. Specifically, some of their most prominent effects occur in the prefrontal cortex—an area involved in mood, cognition, and perception—as well as other regions important in regulating arousal and physiological responses to stress and panic.",Hallucinogen,,https://www.drugabuse.gov/publications/hallucinogens-dissociative-drugs/how-do-hallucinogens-lsd-psilocybin-peyote-dmt-ayahuasca-affect-brain-body,,,
+Q367,What are the short-term effects of hallucinogens?,"Ingesting hallucinogenic drugs can cause users to see images, hear sounds, and feel sensations that seem real but do not exist. Their effects typically begin within 20 to 90 minutes of ingestion and can last as long as 12 hours. Experiences are often unpredictable and may vary with the amount ingested and the user’s personality, mood, expectations, and surroundings. The effects of hallucinogens like LSD can be described as drug-induced psychosis—distortion or disorganization of a person’s capacity to recognize reality, think rationally, or communicate with others. Users refer to LSD and other hallucinogenic experiences as “trips” and to acute adverse or unpleasant experiences as “bad trips.” On some trips, users experience sensations that are enjoyable and mentally stimulating and that produce a sense of heightened understanding. Bad trips, however, include terrifying thoughts and nightmarish feelings of anxiety and despair that include fears of losing control, insanity, or death.
+
+Like LSD and psilocybin, DMT produces its effects through action at serotonin (5-HT) receptors in the brain. Some research has suggested that DMT occurs naturally in the human brain in small quantities, leading to the hypothesis that release of endogenous DMT may be involved in reports of alien abductions, spontaneous mystical experiences, and near-death experiences, but this remains controversial.
+
+Specific short-term effects of LSD, psilocybin, peyote, DMT, and ayahuasca include:
+
+LSD
+
+Increased blood pressure, heart rate, and body temperature
+Dizziness and sleeplessness
+Loss of appetite, dry mouth,and sweating
+Numbness, weakness, and tremors
+Impulsiveness and rapid emotional shifts that can range from fear to euphoria, with transitions so rapid that the user may seem to experience several emotions simultaneously
+Psilocybin
+
+Feelings of relaxation (similar to effects of low doses of marijuana)
+Nervousness, paranoia, and panic reactions
+Introspective/spiritual experiences
+Misidentification of poisonous mushrooms resembling psilocybin could lead to unintentional, potentially fatal poisoning
+Peyote
+
+Increased body temperature and heart rate
+Uncoordinated movements (ataxia)
+Profound sweating
+Flushing
+DMT
+
+Increased heart rate
+Agitation
+Hallucinations frequently involving radically altered environments as well as body and spatial distortions
+Ayahuasca
+
+Increased blood pressure
+Severe vomiting (induced by the tea)
+Profoundly altered state of awareness and perceptions of otherworldly imagery",Hallucinogen,,https://www.drugabuse.gov/publications/hallucinogens-dissociative-drugs/how-do-hallucinogens-lsd-psilocybin-peyote-dmt-ayahuasca-affect-brain-body,,,
+Q368,What are the long-term effects of hallucinogens?,"LSD users quickly develop a high degree of tolerance to the drug’s effects, such that repeated use requires increasingly larger doses to produce similar effects. Use of hallucinogenic drugs also produces tolerance to other drugs in this class, including psilocybin and peyote. Use of classic hallucinogens does not, however, produce tolerance to drugs that do not act directly on the same brain cell receptors. In other words, there is no cross-tolerance to drugs that act on other neurotransmitter systems, such as marijuana, amphetamines, or PCP, among others. Furthermore, tolerance for hallucinogenic drugs is short-lived—it is lost if the user stops taking the drugs for several days—and physical withdrawal symptoms are not typically experienced when chronic use is stopped. The long-term residual psychological and cognitive effects of peyote remain poorly understood. Although one study found no evidence of psychological or cognitive deficits among Native Americans who use peyote regularly in a religious setting, those findings may not generalize to those who repeatedly abuse the drug for recreational purposes. Peyote users may also experience hallucinogen persisting perception disorder (HPPD)—also often referred to as flashbacks. The active ingredient mescaline has also been associated, in at least one report, to fetal abnormalities. Long-term effects of DMT use and abuse and addiction liability are currently unknown. Unlike most other hallucinogens, DMT does not appear to induce tolerance.
+As with some other hallucinogens, there is little information to suggest that ayahuasca use creates lasting physiological or neurological deficits, especially among those using the brew for religious activities.
+
+Overall, two long-term effects—persistent psychosis and HPPD—have been associated with use of classic hallucinogens. Although occurrence of either is rare, it is also unpredictable and may happen more often than previously thought, and sometimes both conditions occur together. While the exact causes are not known, both conditions are more often seen in individuals with a history of psychological problems but can happen to anyone, even after a single exposure. There is no established treatment for HPPD, in which flashbacks may occur spontaneously and repeatedly although less intensely than their initial occurrence. Some antidepressant and antipsychotic drugs can be prescribed to help improve mood and treat psychoses, however. Psychotherapy may also help patients cope with fear or confusion associated with visual disturbances or other consequences of long-term LSD use. More research on the causes, incidence, and long-term effects of both disorders is being conducted.",Hallucinogen,,https://www.drugabuse.gov/publications/hallucinogens-dissociative-drugs/how-do-hallucinogens-lsd-psilocybin-peyote-dmt-ayahuasca-affect-brain-body,,,
+Q369,What is heroin and how is it used?,"Heroin is an illegal, highly addictive drug processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants. It is typically sold as a white or brownish powder that is ""cut"" with sugars, starch, powdered milk, or quinine. Pure heroin is a white powder with a bitter taste that predominantly originates in South America and, to a lesser extent, from Southeast Asia, and dominates U.S. markets east of the Mississippi River. Highly pure heroin can be snorted or smoked and may be more appealing to new users because it eliminates the stigma associated with injection drug use. ""Black tar"" heroin is sticky like roofing tar or hard like coal and is predominantly produced in Mexico and sold in U.S. areas west of the Mississippi River. The dark color associated with black tar heroin results from crude processing methods that leave behind impurities. Impure heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-heroin,,,
+Q370,What is the scope of heroin use in the United States?,"According to the National Survey on Drug Use and Health (NSDUH), in 2016 about 948,000 Americans reported using heroin in the past year, a number that has been on the rise since 2007. This trend appears to be driven largely by young adults aged 18–25 among whom there have been the greatest increases. The number of people using heroin for the first time is high, with 170,000 people starting heroin use in 2016, nearly double the number of people in 2006 (90,000). In contrast, heroin use has been declining among teens aged 12–17. Past-year heroin use among the nation’s 8th, 10th, and 12th graders is at its lowest levels since 1991, at less than 1 percent in each grade level. It is no surprise that with heroin use on the rise, more people are experiencing negative health effects that occur from repeated use. The number of people meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for dependence or heroin use disorder increased dramatically from 214,000 in 2002 to 626,000 in 2016. The fifth and the current version of the DSM, DSM-5, no longer separates substance abuse from dependence, but instead provides criteria for opioid use disorder that range from mild to severe, depending on the number of symptoms a person has. Data on the scope and severity of opioid use disorder in the United States are not yet available for these new criteria. Heroin use no longer predominates solely in urban areas. Several suburban and rural communities near Chicago and St. Louis report increasing amounts of heroin seized by officials as well as increasing numbers of overdose deaths due to heroin use. Heroin use is also on the rise in many urban areas among young adults aged 18-25. Individuals in this age group seeking treatment for heroin use increased from 11 percent of total admissions in 2008 to 26 percent in the first half of 2012.
+",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states,,,
+Q371,What effects does heroin have on the body?,"Heroin binds to and activates specific receptors in the brain called mu-opioid receptors (MORs). Our bodies contain naturally occurring chemicals called neurotransmitters that bind to these receptors throughout the brain and body to regulate pain, hormone release, and feelings of well-being. When MORs are activated in the reward center of the brain, they stimulate the release of the neurotransmitter dopamine, causing a reinforcement of drug taking behavior.The consequences of activating opioid receptors with externally administered opioids such as heroin (versus naturally occurring chemicals within our bodies) depend on a variety of factors: how much is used, where in the brain or body it binds, how strongly it binds and for how long, how quickly it gets there, and what happens afterward.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-used,,,
+Q372,What are the immediate (short-term) effects of heroin use?,"Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors. People who use heroin typically report feeling a surge of pleasurable sensation—a ""rush."" The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities.  Nausea, vomiting, and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-immediate-short-term-effects-heroin-use,,,
+Q373,What are the long-term effects of heroin use?,"Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced abruptly. Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (""cold turkey""), and leg movements. Major withdrawal symptoms peak between 24–48 hours after the last dose of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months. Finally, repeated heroin use often results in heroin use disorder—a chronic relapsing disease that goes beyond physical dependence and is characterized by uncontrollable drug-seeking, no matter the consequences. Heroin is extremely addictive no matter how it is administered, although routes of administration that allow it to reach the brain the fastest (i.e., injection and smoking) increase the risk of developing heroin use disorder. Once a person has heroin use disorder, seeking and using the drug becomes their primary purpose in life.
+",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use,Last sentence is a bit offensive.,,
+Q374,How is heroin linked to prescription drug misuse?,"Harmful health consequences resulting from the misuse of opioid medications that are prescribed for the treatment of pain, such as Oxycontin®, Vicodin®, and Demerol®, have dramatically increased in recent years. For example, almost half of all opioid deaths in the U.S. now involve a prescription opioid. People often assume prescription pain relievers are safer than illicit drugs because they are medically prescribed; however, when these drugs are taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed, they can result in severe adverse health effects including substance use disorder, overdose, and death, especially when combined with other drugs or alcohol. Research now suggests that misuse of these medications may actually open the door to heroin use. Some also report switching to heroin because it is cheaper and easier to obtain than prescription opioids.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-linked-to-prescription-drug-misuse,,,
+Q375,What are the medical complications of chronic heroin use?,"No matter how they ingest the drug, chronic heroin users experience a variety of medical complications, including insomnia and constipation. Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health of the user as well as from heroin’s effect of depressing respiration. Many experience mental disorders, such as depression and antisocial personality disorder. Men often experience sexual dysfunction and women’s menstrual cycles often become irregular. There are also specific consequences associated with different routes of administration. For example, people who repeatedly snort heroin can damage the mucosal tissues in their noses as well as perforate the nasal septum (the tissue that separates the nasal passages). Medical consequences of chronic injection use include scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses (boils), and other soft-tissue infections. Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems. Sharing of injection equipment or fluids can lead to some of the most severe consequences of heroin use—infections with hepatitis B and C, HIV, and a host of other blood-borne viruses, which drug users can then pass on to their sexual partners and children.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use,,,
+Q376,Why does heroin use create special risk for contracting HIV/AIDS and hepatitis B and C?,"Heroin use increases the risk of being exposed to HIV, viral hepatitis, and other infectious agents through contact with infected blood or body fluids (e.g., semen, saliva) that results from the sharing of syringes and injection paraphernalia that have been used by infected individuals or through unprotected sexual contact with an infected person. Snorting or smoking does not eliminate the risk of infectious disease like hepatitis and HIV/AIDS because people under the influence of drugs still engage in risky sexual and other behaviors that can expose them to these diseases. People who inject drugs (PWIDs) are the highest-risk group for acquiring hepatitis C (HCV) infection and continue to drive the escalating HCV epidemic: Each PWID infected with HCV is likely to infect 20 other people. Of the 30,500 new HCV infections occurring in the United States in 2014, most cases occurred among PWID. Hepatitis B (HBV) infection in PWIDs was reported to be as high as 25 percent in the United States in 2014, which is particularly disheartening since an effective vaccine that protects against HBV infection is available. There is currently no vaccine available to protect against HCV infection. Drug use, viral hepatitis and other infectious diseases, mental illnesses, social dysfunctions, and stigma are often co-occurring conditions that affect one another, creating more complex health challenges that require comprehensive treatment plans tailored to meet all of a patient’s needs. For example, NIDA-funded research has found that substance use disorder treatment, along with HIV prevention and community-based outreach programs, can help people who use drugs change the behaviors that put them at risk for contracting HIV and other infectious diseases. They can reduce drug use and drug-related risk behaviors such as needle sharing and unsafe sexual practices and, in turn, reduce the risk of exposure to HIV/AIDS and other infectious diseases.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/why-are-heroin-users-special-risk-contracting-hivaids-hepatitis-b-c,,,
+Q377,How does heroin use affect pregnant women?,"Heroin use during pregnancy can result in neonatal abstinence syndrome (NAS). NAS occurs when heroin passes through the placenta to the fetus during pregnancy, causing the baby to become dependent, along with the mother. Symptoms include excessive crying, fever, irritability, seizures, slow weight gain, tremors, diarrhea, vomiting, and possibly death. NAS requires hospitalization and treatment with medication (often morphine) to relieve symptoms; the medication is gradually tapered off until the baby adjusts to being opioid-free. Methadone maintenance combined with prenatal care and a comprehensive drug treatment program can improve many of the outcomes associated with untreated heroin use for both the infant and mother, although infants exposed to methadone during pregnancy typically require treatment for NAS as well. A NIDA-supported clinical trial demonstrated that buprenorphine treatment of opioid-dependent mothers is safe for both the unborn child and the mother. Once born, these infants require less morphine and shorter hospital stays compared to infants born of mothers on methadone maintenance treatment. Research also indicates that buprenorphine combined with naloxone (compared to a morphine taper) is equally safe for treating babies born with NAS, further reducing side effects experienced by infants born to opioid-dependent mothers. A NIDA-funded study found that treating NAS babies with sublingual buprenorphine resulted in a shorter duration of treatment than oral morphine, and also resulted in a shorter length of hospital stay, with similar rates of adverse events.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/how-does-heroin-abuse-affect-pregnant-women,,,
+Q378,What can be done for a heroin overdose?,"Overdose is a dangerous and deadly consequence of heroin use. A large dose of heroin depresses heart rate and breathing to such an extent that a user cannot survive without medical help. Naloxone (e.g., Narcan®) is an opioid receptor antagonist medication that can eliminate all signs of opioid intoxication to reverse an opioid overdose. It works by rapidly binding to opioid receptors, preventing heroin from activating them. Because of the huge increase in overdose deaths from prescription opioid misuse, there has been greater demand for opioid overdose prevention services. Naloxone that can be used by nonmedical personnel has been shown to be cost-effective and save lives. In April 2014, the U.S. Food and Drug Administration (FDA) approved a naloxone hand-held auto-injector called Evzio®, which rapidly delivers a single dose of naloxone into the muscle or under the skin, buying time until medical assistance can arrive. In 2015, the FDA approved a Narcan® nasal spray that is sprayed directly into one nostril. Since Evzio® and Narcan® can be used by family members or caregivers, it greatly expands access to naloxone. In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) continually updates its Opioid Overdose Prevention Toolkit that provides helpful information necessary to develop policies and practices to prevent opioid-related overdoses and deaths. The kit provides material tailored for first responders, treatment providers, and individuals recovering from an opioid overdose.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-can-be-done-for-heroin-overdose,,,
+Q379,What are the treatments for heroin use disorder?,"A variety of effective treatments are available for heroin use disorder, including both behavioral and pharmacological (medications). Both approaches help to restore a degree of normalcy to brain function and behavior, resulting in increased employment rates and lower risk of HIV and other diseases and criminal behavior. Although behavioral and pharmacologic treatments can be extremely useful when utilized alone, research shows that for many people, integrating both types of treatments is the most effective approach.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder,,,
+Q380,What pharmacological treatments are available for heroin use disorder?,"Scientific research has established that pharmacological treatment of opioid use disorder increases retention in treatment programs and decreases drug use, infectious disease transmission, and criminal activity. When people addicted to opioids like heroin first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea, and vomiting), which may be severe. Medications can be helpful in this detoxification stage to ease craving and other physical symptoms that can often prompt a person to relapse. The FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. While not a treatment for addiction itself, detoxification is a useful first step when it is followed by some form of evidence-based treatment. Medications developed to treat opioid use disorders work through the same opioid receptors as the addictive drug, but are safer and less likely to produce the harmful behaviors that characterize a substance use disorder. Three types of medications include: (1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids. A particular medication is used based on a patient’s specific medical needs and other factors. Effective medications include: Methadone (Dolophine® or Methadose®) is a slow-acting opioid agonist. Methadone is taken orally so that it reaches the brain slowly, dampening the ""high"" that occurs with other routes of administration while preventing withdrawal symptoms. Methadone has been used since the 1960s to treat heroin use disorder and is still an excellent treatment option, particularly for patients who do not respond well to other medications. Methadone is only available through approved outpatient treatment programs, where it is dispensed to patients on a daily basis. Buprenorphine (Subutex®) is a partial opioid agonist. Buprenorphine relieves drug cravings without producing the ""high"" or dangerous side effects of other opioids. Suboxone® is a novel formulation of buprenorphine that is taken orally or sublingually and contains naloxone (an opioid antagonist) to prevent attempts to get high by injecting the medication. If a person with a heroin use disorder were to inject Suboxone, the naloxone would induce withdrawal symptoms, which are averted when taken orally as prescribed. FDA approved buprenorphine in 2002, making it the first medication eligible to be prescribed by certified physicians through the Drug Addiction Treatment Act. This approval eliminates the need to visit specialized treatment clinics, thereby expanding access to treatment for many who need it. Additionally, the Comprehensive Addiction and Recovery Act (CARA), which was signed into law in July 2016, temporarily expands prescribing eligibility to prescribe buprenorphine-based drugs for medication-assisted treatment to qualifying nurse practitioners and physician assistant through October 1, 2021. In February 2013, FDA approved two generic forms of Suboxone, making this treatment option more affordable. The FDA approved a 6-month subdermal buprenorphine implant in May 2016 and a once-monthly buprenorphine injection in November 2017, which eliminates the treatment barrier of daily dosing. Naltrexone (Vivitrol®) is an opioid antagonist. Naltrexone blocks the action of opioids, is not addictive or sedating, and does not result in physical dependence; however, patients often have trouble complying with the treatment, and this has limited its effectiveness. In 2010, the injectable long-acting formulation of naltrexone (Vivitrol®) received FDA approval for a new indication for the prevention of relapse to opioid dependence following opioid detoxification. Administered once a month, Vivitrol® may improve compliance by eliminating the need for daily dosing.
+",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder,,,
+Q381,What behavioral therapies are available for heroin use disorder?,"The many effective behavioral treatments available for opioid use disorder can be delivered in outpatient and residential settings. Approaches such as contingency management and cognitive-behavioral therapy have been shown to effectively treat heroin use disorder, especially when applied in concert with medications. Contingency management uses a voucher-based system in which patients earn ""points"" based on negative drug tests, which they can exchange for items that encourage healthy living. Cognitive-behavioral therapy is designed to help modify the patient’s expectations and behaviors related to drug use and to increase skills in coping with various life stressors. An important task is to match the best treatment approach to meet the particular needs of the patient.",Heroin,,https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder,,,
+Q382,Why is HIV screening important?,"The risk of HIV transmission is lower when people who are infected with HIV receive ART to suppress their viral load. Despite CDC’s recommendations and efforts to increase HIV testing. One survey found that only about 19 percent of people aged 15 to 44 were tested for HIV during the past year. This means that people who may have HIV are unaware of their status and, thus, are not receiving ART, which increases the transmission rate nation-wide. Because HIV, drug use, and addiction are inextricably linked, one strategy for reducing incidence is to implement HIV testing at SUD treatment facilities. An analysis of nationally representative data from privately funded SUD treatment programs found that most programs provided education and prevention services. While the proportion of programs offering on-site HIV testing and the percentage of patients who received testing increased in recent years, fewer than one-third of programs offered on-site testing. In those programs, fewer than one-third of patients received testing. NIDA is collaborating with the Substance Abuse and Mental Health Services Administration (SAMHSA) and others to expand rapid HIV testing to drug treatment facilities to better identify HIV infections and engage patients more efficiently in comprehensive treatment for both substance use disorder and HIV infection. Many health insurance providers cover HIV testing without a co-pay or deductible. To find a local HIV testing center visit: https://www.cdc.gov/hiv/.",HIV,,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-hiv-screening-important,,,
+Q383,What are some methods for HIV prevention and treatment for individuals with substance use disorders?,"Research indicates that SUD treatment, sterile syringe programs, community-based outreach, testing, and linkage to comprehensive care for HIV and other infections are the most effective ways to reduce transmission among individuals who use drugs. Because these individuals often face barriers to testing, treatment, and adhering to ART, unique supports are needed for prevention and treatment within this population. PrEP is an important component of HIV prevention. In this approach, people who are at significant risk but not infected with HIV take a daily oral dose of medication to prevent them from contracting the virus. The World Health Organization recommends PrEP as one component of prevention for individuals at high risk for HIV. As with all medications, adherence is critical to effectiveness. There have been some promising results of PrEP among people who inject drugs, with one clinical trial finding that it decreased the risk of HIV infection by as much as 84 percent for those who were highly adherent, but only about 50 percent overall. More research is needed on optimizing PrEP adherence and the best ways to integrate it into SUD treatment. Despite research indicating that PrEP is generally safe and effective for those who are at significant risk of HIV infection, strategies to increase access to PrEP among injection drug users should be explored. People continue to be infected by HIV through unsafe contact with others who are either unaware that they have the virus or have inadequately suppressed their viral load. The STTR model of care is specifically designed to address these two drivers of new HIV infections, particularly considering the well-documented delays in testing and treatment experienced by individuals with substance use disorders. This approach involves reaching out to high-risk, hard-to-reach drug-using populations who have not recently been tested for HIV (seeking); engaging them in HIV testing (testing); initiating, monitoring, and maintaining ART for those testing positive (treating); and retaining patients in care (retaining). Studies find that behavioral treatments such as cognitive behavioral therapy and motivational interviewing not only reduce drug use but also improve adherence to ART regimens and medications for HCV. Among men who have sex with men (MSM), SUD treatment is associated with reduced drug use and risky sexual behavior, and those with HIV report improvements in viral load. Addiction pharmacotherapies also reduce the risk for HIV. Pooled results from multiple studies indicate that methadone or buprenorphine treatment for opioid use disorder is associated with a 54 percent reduction in risk of HIV infection among people who inject drugs. HIV-infected people who inject drugs are more likely to initiate ART when engaged in methadone treatment. Because people who inject drugs also have a relatively high prevalence of mental illness, research suggests that fully integrated addiction, psychiatric, and HIV care might increase the likelihood of ART adherence and improve health outcomes.
+
+
+Incorporating rapid on-site HIV testing into SUD treatment is an important component of efforts to identify those who are infected, initiate care earlier, and reduce transmission. However, treatment programs may not have sufficient resources to provide HIV testing. Reducing barriers by providing start-up costs and staff training on how to support individuals who test positive, and addressing staffing needs are crucial to establishing and maintaining rapid on-site HIV testing in SUD treatment facilities. Researchers estimate that testing people who inject drugs for HIV every 6 months is cost effective, compared with annual testing, at $133,200 in incremental costs per quality-adjusted life year gained.
+
+ART has improved the survival of people with HIV, including those who inject drugs, so that they now tend to live as long as those who are not infected with the virus. Most patients, regardless of injection drug use history, can achieve viral suppression with ART, which can significantly reduce transmission of HIV to others. This approach, called Treatment as Prevention, is a crucial part of efforts to reduce the spread of the virus and a key component of the STTR strategy. The Treatment as Prevention approach relies on identifying undiagnosed individuals, linking them to treatment with ART, and retaining them in care. Retention in treatment is key to achieving full viral suppression (i.e., virus is below detectable levels) and preventing transmission of HIV. CDC estimates that 49 percent of people with HIV in the United States had full viral suppression in 2014. Data from 2011 showed that among people whose viral load was not suppressed, 20 percent had never been diagnosed with HIV, 66 percent were diagnosed but not engaged in medical care for HIV, 4 percent were engaged in HIV medical care but not prescribed ART, and 10 percent were prescribed ART but had not achieved viral suppression.
+
+",HIV,,https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/what-are-some-methods-hiv-prevention-treatment-individuals-substance-use-disorders,,,
+Q384,What do drugs and alcohol have to do with HIV?,"Drug and alcohol use can lead to risky behaviors that can
+increase your exposure to HIV/AIDS. For example, using
+or sharing drug materials, like needles or cotton, increases
+your chances of becoming infected with HIV.",HIV,,https://store.samhsa.gov/product/Drugs-Alcohol-and-HIV-AIDS-A-Consumer-Guide-for-African-Americans/SMA15-4248?referer=from_search_result,,,
+Q385,What if I already have HIV?,"There are different types of HIV, called strains. Even if you are already infected with one strain of the virus, using alcohol or other drugs puts you at risk of being infected with a different one. Medications that you might be taking to treat one strain of the infection may not be effective on another strain. If you are pregnant, you could even infect your unborn baby.",HIV,,https://store.samhsa.gov/product/Drugs-Alcohol-and-HIV-AIDS-A-Consumer-Guide-for-African-Americans/SMA15-4248?referer=from_search_result,,,
+Q386,Can mothers living with HIV breastfeed their children in the same way as mothers without HIV?,"WHO recommends that all mothers living with HIV should receive life-long antiretroviral therapy (ART) to support their health and to ensure the wellbeing of their infants.
+
+WHO released guidelines in July 2016 advising that, in countries that have opted to promote and support breastfeeding together with ART, mothers living with HIV who are on ART and adherent to therapy should breastfeed exclusively for the first 6 months, and then add complementary feeding until 12 months of age. Breastfeeding with complementary feeding may continue until 24 months of age or beyond.",HIV,,https://www.who.int/news-room/q-a-detail/hiv-and-infant-feeding,,,
+Q387,What is hydromorphone?,"Prescribed at Dilaudid®, it is used as a pain reliever. Hydromorphone is 2-8x more potent than morphine but shorter duration and greater sedation. Available in tablets, rectal suppositories, oral solutions, and injectable formulations.",Drugs,,https://www.dea.gov/factsheets/hydromorphone,,,
+Q388,What are street names for hydromorphone?,"D, Dillies, Dust, Footballs, Juice, Smack",Drugs,,https://www.dea.gov/factsheets/hydromorphone,,,
+Q389,How is hydromorphone used?,Orally or by injecting tablets dissolved in solution.,Drugs,,https://www.dea.gov/factsheets/hydromorphone,,,
+Q390,How does hydromorphone affect the body?,"Euphoria, relaxation, sedation, and reduced anxiety. It may also cause mental clouding, changes in mood, nervousness, restlessness, constipation, nausea, vomiting, impaired coordination, loss of appetite, rash, slow or rapid heartbeat, and changes in blood pressure.
+Overdose symptoms: severe respiratory depression, stupor or coma, lack of skeletal muscle tone, cold and clammy skin, constricted pupils, and reduced blood pressure and heart rate.",Drugs,,https://www.dea.gov/factsheets/hydromorphone,,,
+Q391,What are inhalants?,"Inhalants are volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering, effect. Although other abused substances can be inhaled, the term ""inhalants"" is used to describe a variety of substances whose main common characteristic is that they are rarely, if ever, taken by any route other than inhalation. This definition encompasses a broad range of chemicals that may have different pharmacological effects and are found in hundreds of different products. As a result, precise categorization of inhalants is difficult. One classification system lists four general categories of inhalants — volatile solvents, aerosols, gases, and nitrites — based on the forms in which they are often found in household, industrial, and medical products.",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/what-are-inhalants,,,
+Q392,What is the scope of inhalant abuse?,"According to the 2010 National Survey on Drug Use and Health (NSDUH), there were 793,000 persons aged 12 or older who had used inhalants for the first time within the past 12 months; 68.4 percent were under the age of 18. In fact, inhalants — particularly volatile solvents, gases, and aerosols — are often the easiest and first options for abuse among young children who use drugs. NIDA’s annual MTF survey of 8th-, 10th-, and 12th-graders consistently reports the highest rates of current, past-year, and lifetime inhalant use among 8th-graders. Inhalant use has decreased significantly among 8th-, 10th-, and 12th-graders compared to its peak years in the mid-1990s. According to the 2011 MTF survey, past-year use was reported as 7.0, 4.5, and 3.2 percent, for 8th-, 10th-, and 12th-graders, respectively. Data compiled by the National Capital Poison Center also show a decrease in the prevalence of inhalant cases reported to U.S. poison control centers — down 33 percent from 1993 to 2008. The prevalence was highest among children aged 12 to 17, peaking among 14-year-olds. Demographic differences in inhalant use have been identified at different ages. The MTF survey indicates that in 2011, 8.6 percent of 8th-grade females reported using inhalants in the past year, compared with 5.5 percent of 8th-grade males. In terms of ethnicity, Hispanics have the highest rates of past-year use among 8th- and 10th-graders, compared to both Blacks and Whites. People from both urban and rural settings abuse inhalants. Further, research on factors contributing to inhalant abuse suggests that adverse socioeconomic conditions, a history of childhood abuse, poor grades, and school dropout are associated with inhalant abuse.",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/what-scope-inhalant-abuse,,,
+Q393,How are inhalants used?,"Inhalants can be breathed in through the nose or the mouth in a variety of ways, such as—""sniffing"" or ""snorting"" fumes from containers; spraying aerosols directly into the nose or mouth; ""bagging"" — sniffing or inhaling fumes from substances sprayed or deposited inside a plastic or paper bag; ""huffing"" from an inhalant-soaked rag stuffed in the mouth; and inhaling from balloons filled with nitrous oxide. Inhaled chemicals are absorbed rapidly into the bloodstream through the lungs and are quickly distributed to the brain and other organs. Within seconds of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech; the inability to coordinate movements; euphoria; and dizziness. In addition, users may experience lightheadedness, hallucinations, and delusions. Because intoxication lasts only a few minutes, abusers frequently seek to prolong the high by inhaling repeatedly over the course of several hours, which is a very dangerous practice. With successive inhalations, abusers can suffer loss of consciousness and possibly even death. At the least, they will feel less inhibited and less in control. After heavy use of inhalants, abusers may feel drowsy for several hours and experience a lingering headache.",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/how-are-inhalants-used,,,
+Q394,How do inhalants produce their effects?,"Many brain systems may be involved in the anesthetic, intoxicating, and reinforcing effects of different inhalants. Nearly all abused inhalants (other than nitrites) produce a pleasurable effect by depressing the CNS. Nitrites, in contrast, dilate and relax blood vessels rather than act as anesthetic agents. Evidence from animal studies suggests that a number of commonly abused volatile solvents and anesthetic gases have neurobehavioral effects and mechanisms of action similar to those produced by CNS depressants, which include alcohol and medications such as sedatives and anesthetics. A 2007 animal study indicates that toluene, a solvent found in many commonly abused inhalants — including model airplane glue, paint sprays, and paint and nail polish removers — activates the brain's dopamine system. The dopamine system has been shown to play a role in the rewarding effects of nearly all drugs of abuse.",Inhalants,,https://www.drugabuse.gov/publications/research-reports/inhalants/how-do-inhalants-produce-their-effects,,,
+Q395,"Since inhalants are found in household products, aren't they safe?","No. Even though household products such as spray paint, glue, and gasoline have legal and useful purposes, they are harmful and dangerous when used as inhalants. These products are not intended to be inhaled.",Inhalants,,https://store.samhsa.gov/product/Tips-for-Teens-The-Truth-About-Inhalants/PEP18-04?referer=from_search_result,,,
+Q396,"Doesn't it take many ""huffs"" before you're in danger?","No. The first “huff” can kill you. Or the 10th. Or the 100th. Every huff can be dangerous. Even if you have tried inhalants before without experiencing a problem, there’s no way of knowing how your body will react the next time.",Inhalants,,https://store.samhsa.gov/product/Tips-for-Teens-The-Truth-About-Inhalants/PEP18-04?referer=from_search_result,,,
+Q397,Can inhalants make me lose control?,"Yes. Inhalants affect your brain and can cause you to feel less inhibited and less in control. You can become reckless, uncoordinated, and aggressive.",Inhalants,,https://store.samhsa.gov/product/Tips-for-Teens-The-Truth-About-Inhalants/PEP18-04?referer=from_search_result,,,
+Q398,What are street names for inhalants?,"Huff, Rush, Whippets, Gluey",Inhalants,,https://www.dea.gov/factsheets/inhalants,,,
+Q399,How are inhalants used?,"Inhaled through nose or mouth
+Huffing inhalant-soaked rag stuffed in mouth
+Inhaling from balloon with nitrous oxide
+Sniffing or snorting the substance from a container or dispenser
+Inhaling fumes from substances in a bag",Inhalants,,https://www.dea.gov/factsheets/inhalants,,,
+Q400,How do inhalants affect the body?,"Slight stimulation, feeling less inhibition, loss of consciousness
+Damages sections of brain controlling thinking, moving, seeing
+Slurred speech, loss of coordination, euphoria, dizziness
+Long term use may cause damage to nervous system and organs
+Sudden sniffing death may occur from suffocation or asphyxiation",Inhalants,,https://www.dea.gov/factsheets/inhalants,,,
+Q401,What is an intervention?,"A professionally delivered program, service, or policy designed to prevent substance
+misuse (prevention intervention) or treat a substance use disorder (treatment intervention).",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q402,What is ketamine?,"General, short-acting anesthetic with hallucinogenic effects. Sometimes used to facilitate sexual assault crimes.",Ketamine,,https://www.dea.gov/factsheets/ketamine,,,
+Q403,What are street names for ketamine?,"Special K, Cat Valium, Kit Kat, K, Super Acid, Super K, Purple, Special La Coke, Jet, Vitamin K",Ketamine,,https://www.dea.gov/factsheets/ketamine,,,
+Q404,How is ketamine used?,"Injected
+Liquid mixed with liquids
+Powder that is snorted mixed in drinks, or smoked",Ketamine,,https://www.dea.gov/factsheets/ketamine,,,
+Q405,How does ketamine affect the body?,"Hallucinatory effects last 30-60 minutes
+Distorts sights and sounds
+Induces feelings of calmness and relaxation, relief from pain
+Immobility and amnesia
+Body feels out of control
+Agitation, depression, unconsciousness
+Hallucinations
+Flashbacks",Ketamine,,https://www.dea.gov/factsheets/ketamine,,,
+Q406,What is kratom?,"Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects.
+
+Kratom is not currently an illegal substance and has been easy to order on the internet. It is sometimes sold as a green powder in packets labeled ""not for human consumption."" It is also sometimes sold as an extract or gum.",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q407,What are other names for kratom?,"Kratom sometimes goes by the following names:
+
+Biak
+Ketum
+Kakuam
+Ithang
+Thom",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q408,How do people use kratom?,"Most people take kratom as a pill, capsule, or extract. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q409,Is kratom addictive?,"Like other drugs with opioid-like effects, kratom might cause dependence, which means users will feel physical withdrawal symptoms when they stop taking the drug. Some users have reported becoming addicted to kratom. Withdrawal symptoms include:
+
+muscle aches
+insomnia
+irritability
+hostility
+aggression
+emotional changes
+runny nose
+jerky movements",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q410,How is kratom addiction treated?,There are no specific medical treatments for kratom addiction. Some people seeking treatment have found behavioral therapy to be helpful. Scientists need more research to determine how effective this treatment option is.,Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q411,Does kratom have value as a medicine?,"In recent years, some people have used kratom as an herbal alternative to medical treatment in attempts to control withdrawal symptoms and cravings caused by addiction to opioids or to other addictive substances such as alcohol. There is no scientific evidence that kratom is effective or safe for this purpose; further research is needed.",Kratom,,https://www.drugabuse.gov/publications/drugfacts/kratom,,,
+Q412,What is marijuana?,"Marijuana—also called weed, herb, pot, grass, bud, ganja, Mary Jane, and a vast number of other slang terms—is a greenish-gray mixture of the dried flowers of Cannabis sativa. Some people smoke marijuana in hand-rolled cigarettes called joints; in pipes, water pipes (sometimes called bongs), or in blunts (marijuana rolled in cigar wraps). Marijuana can also be used to brew tea and, particularly when it is sold or consumed for medicinal purposes, is frequently mixed into foods (edibles) such as brownies, cookies, or candies. Vaporizers are also increasingly used to consume marijuana. Stronger forms of marijuana include sinsemilla (from specially tended female plants) and concentrated resins containing high doses of marijuana’s active ingredients, including honeylike hash oil, waxy budder, and hard amberlike shatter. These resins are increasingly popular among those who use them both recreationally and medically. The main psychoactive(mind-altering) chemical in marijuana, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol (THC). The chemical is found in resin produced by the leaves and buds primarily of the female cannabis plant. The plant also contains more than 500 other chemicals, including more than 100 compounds that are chemically related to THC, called cannabinoids.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-marijuana,,,
+Q413,What is the scope of marijuana use in the United States?,"Marijuana is the most commonly used psychotropic drug in the United States, after alcohol. In 2018, more than 11.8 million young adults reported marijuana use in the past year. Its use is more prevalent among men than women. Marijuana use is widespread among adolescents and young adults. According to the Monitoring the Future survey—an annual survey of drug use and attitudes among the Nation’s middle and high school students—most measures of marijuana use by 8th, 10th, and 12th graders peaked in the mid-to-late 1990s and then began a period of gradual decline through the mid-2000s before levelling off. However, in 2019, there was a significant increase in daily use in the younger grades. In addition, teens’ perceptions of the risks of marijuana use have steadily declined over the past decade. In 2019, 11.8% of 8th graders reported marijuana use in the past year and 6.6% in the past month (current use). Among 10th graders, 28.8% had used marijuana in the past year and 18.4% in the past month. Rates of use among 12th graders were higher still: 35.7% had used marijuana during the year prior to the survey and 22.3% used in the past month; 6.4% said they used marijuana daily or near-daily. With the growing popularity of vaping devices, teens have started vaping THC (the ingredient in marijuana that produces the high), with nearly 4% of 12th graders saying they vape THC daily. Medical emergencies possibly related to marijuana use have also increased. The Drug Abuse Warning Network (DAWN), a system for monitoring the health impact of drugs, estimated that in 2011, there were nearly 456,000 drug-related emergency department visits in the United States in which marijuana use was mentioned in the medical record (a 21% increase over 2009). About two-thirds of patients were male and 13% were between the ages of 12 and 17. It is unknown whether this increase is due to increased use, increased potency of marijuana (amount of THC it contains), or other factors. It should be noted, however, that mentions of marijuana in medical records do not necessarily indicate that these emergencies were directly related to marijuana intoxication.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states,,,
+Q414,What are marijuana's effects?,"When marijuana is smoked, THC and other chemicals in the plant pass from the lungs into the bloodstream, which rapidly carries them throughout the body to the brain. The person begins to experience effects almost immediately. Many people experience a pleasant euphoria and sense of relaxation. Other common effects, which may vary dramatically among different people, include heightened sensory perception (e.g., brighter colors), laughter, altered perception of time, and increased appetite. If marijuana is consumed in foods or beverages, these effects are somewhat delayed—usually appearing after 30 minutes to 1 hour—because the drug must first pass through the digestive system. Eating or drinking marijuana delivers significantly less THC into the bloodstream than smoking an equivalent amount of the plant. Because of the delayed effects, people may inadvertently consume more THC than they intend to. Pleasant experiences with marijuana are by no means universal. Instead of relaxation and euphoria, some people experience anxiety, fear, distrust, or panic. These effects are more common when a person takes too much, the marijuana has an unexpectedly high potency, or the person is inexperienced. People who have taken large doses of marijuana may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity. These unpleasant but temporary reactions are distinct from longer-lasting psychotic disorders, such as schizophrenia, that may be associated with the use of marijuana in vulnerable individuals. Although detectable amounts of THC may remain in the body for days or even weeks after use, the noticeable effects of smoked marijuana generally last from 1 to 3 hours, and those of marijuana consumed in food or drink may last for many hours.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuana-effects,,,
+Q415,How does marijuana produce its effects?,"THC’s chemical structure is similar to the brain chemical anandamide. Similarity in structure allows the body to recognize THC and to alter normal brain communication. Endogenous cannabinoids such as anandamide function as neurotransmitters because they send chemical messages between nerve cells (neurons) throughout the nervous system. They affect brain areas that influence pleasure, memory, thinking, concentration, movement, coordination, and sensory and time perception. Because of this similarity, THC is able to attach to molecules called cannabinoid receptors on neurons in these brain areas and activate them, disrupting various mental and physical functions and causing the effects described earlier. The neural communication network that uses these cannabinoid neurotransmitters, known as the endocannabinoid system, plays a critical role in the nervous system’s normal functioning, so interfering with it can have profound effects. For example, THC is able to alter the functioning of the hippocampus and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely and may have problems playing sports or engaging in other physical activities. THC, acting through cannabinoid receptors, also activates the brain’s reward system, which includes regions that govern the response to healthy pleasurable behaviors such as sex and eating. Like most other drugs that people misuse, THC stimulates neurons in the reward system to release the signaling chemical dopamine at levels higher than typically observed in response to natural stimuli. This flood of dopamine contributes to the pleasurable ""high"" that those who use recreational marijuana seek.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/how-does-marijuana-produce-its-effects,,,
+Q416,Does marijuana use affect driving?,"Marijuana significantly impairs judgment, motor coordination, and reaction time, and studies have found a direct relationship between blood THC concentration and impaired driving ability. Marijuana is the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes, including fatal ones. Two large European studies found that drivers with THC in their blood were roughly twice as likely to be culpable for a fatal crash than drivers who had not used drugs or alcohol. However, the role played by marijuana in crashes is often unclear because it can be detected in body fluids for days or even weeks after intoxication and because people frequently combine it with alcohol. Those involved in vehicle crashes with THC in their blood, particularly higher levels, are three to seven times more likely to be responsible for the incident than drivers who had not used drugs or alcohol. The risk associated with marijuana in combination with alcohol appears to be greater than that for either drug by itself. Several meta-analyses of multiple studies found that the risk of being involved in a crash significantly increased after marijuana use—in a few cases, the risk doubled or more than doubled. However, a large case-control study conducted by the National Highway Traffic Safety Administration found no significant increased crash risk attributable to cannabis after controlling for drivers’ age, gender, race, and presence of alcohol.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/does-marijuana-use-affect-driving,,,
+Q417,What are marijuana's long-term effects on the brain?,"Substantial evidence from animal research and a growing number of studies in humans indicate that marijuana exposure during development can cause long-term or possibly permanent adverse changes in the brain. Rats exposed to THC before birth, soon after birth, or during adolescence show notable problems with specific learning and memory tasks later in life. Cognitive impairments in adult rats exposed to THC during adolescence are associated with structural and functional changes in the hippocampus. Studies in rats also show that adolescent exposure to THC is associated with an altered reward system, increasing the likelihood that an animal will self-administer other drugs (e.g., heroin) when given an opportunity. Imaging studies of marijuana’s impact on brain structure in humans have shown conflicting results. Some studies suggest regular marijuana use in adolescence is associated with altered connectivity and reduced volume of specific brain regions involved in a broad range of executive functions such as memory, learning, and impulse control compared to people who do not use. Other studies have not found significant structural differences between the brains of people who do and do not use the drug. Several studies, including two large longitudinal studies, suggest that marijuana use can cause functional impairment in cognitive abilities but that the degree and/or duration of the impairment depends on the age when a person began using and how much and how long he or she used. Among nearly 4,000 young adults in the Coronary Artery Risk Development in Young Adults study tracked over a 25-year period until mid-adulthood, cumulative lifetime exposure to marijuana was associated with lower scores on a test of verbal memory but did not affect other cognitive abilities such as processing speed or executive function. The effect was sizeable and significant even after eliminating those involved with current use and after adjusting for confounding factors such as demographic factors, other drug and alcohol use, and other psychiatric conditions such as depression. Some studies have also linked marijuana use to declines in IQ, especially when use starts in adolescence and leads to persistent cannabis use disorder into adulthood. However, not all of the studies on the link between marijuana and IQ have reached the same conclusion, and it is difficult to prove that marijuana causes a decline in IQ when there are multiple factors that can influence the results of such studies, such as genetics, family environment, age of first use, frequency of use, having a cannabis use disorder, duration of use, and duration of the study. Key research in this area to date is described below. A large longitudinal study in New Zealand found that persistent marijuana use disorder with frequent use starting in adolescence was associated with a loss of an average of 6 or up to 8 IQ points measured in mid-adulthood. Those who used marijuana heavily as teenagers and quit using as adults did not recover the lost IQ points. People who only began using marijuana heavily in adulthood did not lose IQ points. Two shorter-duration prospective longitudinal twin studies found that  youth who used marijuana showed significant declines in verbal ability (equivalent to 4 IQ points) and general knowledge between the preteen years (ages 9 to 12, before use) and late adolescence/early adulthood (ages 17 to 20); however those who went on to use marijuana at older ages already had lower scores on these measures at the start of the study, before they started using the drug. Also, no predictable difference was found between twins when one used marijuana and one did not. More research will be needed to answer definitively whether marijuana use causes long-term IQ losses and whether factors that weren’t measured in the prior research, such as the increasing amounts of THC in cannabis and the emergence of new cannabis products, are relevant. Also, the ability to draw definitive conclusions about marijuana’s long-term impact on the human brain from past studies is often limited by the fact that study participants use multiple substances, and there is often limited data about the participants’ health or mental functioning prior to the study. Over the next decade, the National Institutes of Health is funding the Adolescent Brain Cognitive Development (ABCD) study—a major longitudinal study that will track a large sample of young Americans from late childhood (before first use of drugs) to early adulthood. The study will use neuroimaging and other advanced tools to clarify precisely how and to what extent marijuana and other substances, alone and in combination, affect adolescent brain development. Distribution of cannabinoid receptors in the rat brain. Brain image reveals high levels of cannabinoid receptors in many areas, including the cortex, hippocampus, cerebellum, and nucleus accumbens (ventral striatum). Memory impairment from marijuana use occurs because THC alters how the hippocampus, a brain area responsible for memory formation, processes information. Most of the evidence supporting this assertion comes from animal studies. For example, rats exposed to THC in utero, soon after birth, or during adolescence, show notable problems with specific learning/memory tasks later in life. Moreover, cognitive impairment in adult rats is associated with structural and functional changes in the hippocampus from THC exposure during adolescence. As people age, they lose neurons in the hippocampus, which decreases their ability to learn new information. Chronic THC exposure may hasten age-related loss of hippocampal neurons. In one study, rats exposed to THC every day for 8 months (approximately 30% of their lifespan) showed a level of nerve cell loss at 11 to 12 months of age that equaled that of unexposed animals twice their age.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuanas-long-term-effects-brain,,,
+Q418,Is marijuana a gateway drug?,"Some research suggests that marijuana use is likely to precede use of other licit and illicit substances and the development of addiction to other substances. For instance, a study using longitudinal data from the National Epidemiological Study of Alcohol Use and Related Disorders found that adults who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an alcohol use disorder within 3 years; people who used marijuana and already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening. Marijuana use is also linked to other substance use disorders including nicotine addiction. Early exposure to cannabinoids in adolescent rodents decreases the reactivity of brain dopamine reward centers later in adulthood. To the extent that these findings generalize to humans, this could help explain the increased vulnerability for addiction to other substances of misuse later in life that most epidemiological studies have reported for people who begin marijuana use early in life. It is also consistent with animal experiments showing THC’s ability to ""prime"" the brain for enhanced responses to other drugs. For example, rats previously administered THC show heightened behavioral response not only when further exposed to THC but also when exposed to other drugs such as morphine—a phenomenon called cross-sensitization. These findings are consistent with the idea of marijuana as a ""gateway drug."" However, the majority of people who use marijuana do not go on to use other, ""harder"" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs and are, like marijuana, also typically used before a person progresses to other, more harmful substances. It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-gateway-drug,,,
+Q419,"How does marijuana affect school, work, and social life?","Research has shown that marijuana’s negative effects on attention, memory, and learning can last for days or weeks after the acute effects of the drug wear off, depending on the person’s history with the drug. Consequently, someone who smokes marijuana daily may be functioning at a reduced intellectual level most or all of the time. Considerable evidence suggests that students who smoke marijuana have poorer educational outcomes than their nonsmoking peers. For example, a review of 48 relevant studies found marijuana use to be associated with reduced educational attainment (i.e., reduced chances of graduating). A recent analysis using data from three large studies in Australia and New Zealand found that adolescents who used marijuana regularly were significantly less likely than their non-using peers to finish high school or obtain a degree. They also had a much higher chance of developing dependence, using other drugs, and attempting suicide. Several studies have also linked heavy marijuana use to lower income, greater welfare dependence, unemployment, criminal behavior, and lower life satisfaction. To what degree marijuana use is directly causal in these associations remains an open question requiring further research. It is possible that other factors independently predispose people to both marijuana use and various negative life outcomes such as school dropout. That said, people report a perceived influence of their marijuana use on poor outcomes on a variety of life satisfaction and achievement measures. One study, for example, compared people involved with current and former long-term, heavy use of marijuana with a control group who reported smoking marijuana at least once in their lives but not more than 50 times. All participants had similar education and income backgrounds, but significant differences were found in their educational attainment: Fewer of those who engaged in heavy cannabis use completed college, and more had yearly household incomes of less than $30,000. When asked how marijuana affected their cognitive abilities, career achievements, social lives, and physical and mental health, the majority of those who used heavily reported that marijuana had negative effects in all these areas of their lives. Studies have also suggested specific links between marijuana use and adverse consequences in the workplace, such as increased risk for injury or accidents. One study among postal workers found that employees who tested positive for marijuana on a pre-employment urine drug test had 55% more industrial accidents, 85% more injuries, and 75% greater absenteeism compared with those who tested negative for marijuana use.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/how-does-marijuana-use-affect-school-work-social-life,,,
+Q420,Is there a link between marijuana use and psychiatric disorders?,"Several studies have linked marijuana use to increased risk for psychiatric disorders, including psychosis (schizophrenia), depression, anxiety, and substance use disorders, but whether and to what extent it actually causes these conditions is not always easy to determine. Recent research suggests that smoking high-potency marijuana every day could increase the chances of developing psychosis by nearly five times compared to people who have never used marijuana. The amount of drug used, the age at first use, and genetic vulnerability have all been shown to influence this relationship. The strongest evidence to date concerns links between marijuana use and psychiatric disorders in those with a preexisting genetic or other vulnerability. Research using longitudinal data from the National Epidemiological Survey on Alcohol and Related Conditions examined associations between marijuana use, mood and anxiety disorders, and substance use disorders. After adjusting for various confounding factors, no association between marijuana use and mood and anxiety disorders was found. The only significant associations were increased risk of alcohol use disorders, nicotine dependence, marijuana use disorder, and other drug use disorders. Recent research has found that people who use marijuana and carry a specific variant of the AKT1 gene, which codes for an enzyme that affects dopamine signaling in the striatum, are at increased risk of developing psychosis. The striatum is an area of the brain that becomes activated and flooded with dopamine when certain stimuli are present. One study found that the risk of psychosis among those with this variant was seven times higher for those who used marijuana daily compared with those who used it infrequently or used none at all. Another study found an increased risk of psychosis among adults who had used marijuana in adolescence and also carried a specific variant of the gene for catechol-O-methyltransferase (COMT), an enzyme that degrades neurotransmitters such as dopamine and norepinephrine.  Marijuana use has also been shown to worsen the course of illness in patients who already have schizophrenia. As mentioned previously, marijuana can produce an acute psychotic reaction in non-schizophrenic people who use marijuana, especially at high doses, although this fades as the drug wears off. Inconsistent and modest associations have been reported between marijuana use and suicidal thoughts and attempted suicide among teens. Marijuana has also been associated with an amotivational syndrome, defined as a diminished or absent drive to engage in typically rewarding activities. Because of the role of the endocannabinoid system in regulating mood and reward, it has been hypothesized that brain changes resulting from early use of marijuana may underlie these associations, but more research is needed to verify that such links exist and better understand them.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders,,,
+Q421,What are marijuana's effects on lung health?,"Like tobacco smoke, marijuana smoke is an irritant to the throat and lungs and can cause a heavy cough during use. It also contains levels of volatile chemicals and tar that are similar to tobacco smoke, raising concerns about risk for cancer and lung disease. Marijuana smoking is associated with large airway inflammation, increased airway resistance, and lung hyperinflation, and those who smoke marijuana regularly report more symptoms of chronic bronchitis than those who do not smoke. One study found that people who frequently smoke marijuana had more outpatient medical visits for respiratory problems than those who do not smoke. Some case studies have suggested that, because of THC’s immune-suppressing effects, smoking marijuana might increase susceptibility to lung infections, such as pneumonia, in people with immune deficiencies; however, a large AIDS cohort study did not confirm such an association. Smoking marijuana may also reduce the respiratory system’s immune response, increasing the likelihood of the person acquiring respiratory infections, including pneumonia. Animal and human studies have not found that marijuana increases risk for emphysema. Whether smoking marijuana causes lung cancer, as cigarette smoking does, remains an open question. Marijuana smoke contains carcinogenic combustion products, including about 50% more benzoprene and 75% more benzanthracene (and more phenols, vinyl chlorides, nitrosamines, reactive oxygen species) than cigarette smoke. Because of how it is typically smoked (deeper inhale, held for longer), marijuana smoking leads to four times the deposition of tar compared to cigarette smoking. However, while a few small, uncontrolled studies have suggested that heavy, regular marijuana smoking could increase risk for respiratory cancers, well-designed population studies have failed to find an increased risk of lung cancer associated with marijuana use. One complexity in comparing the lung-health risks of marijuana and tobacco concerns the very different ways the two substances are used. While people who smoke marijuana often inhale more deeply and hold the smoke in their lungs for a longer duration than is typical with cigarettes, marijuana’s effects last longer, so people who use marijuana may smoke less frequently than those who smoke cigarettes. Additionally, the fact that many people use both marijuana and tobacco makes determining marijuana’s precise contribution to lung cancer risk, if any, difficult to establish. Cell culture and animal studies have also suggested THC and CBD may have antitumor effects, and this has been proposed as one reason why stronger expected associations are not seen between marijuana use and lung cancer, but more research is needed on this question.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuanas-effects-lung-health,,,
+Q422,What are marijuana’s effects on other aspects of physical health?,"Within a few minutes after inhaling marijuana smoke, a person’s heart rate speeds up, the breathing passages relax and become enlarged, and blood vessels in the eyes expand, making the eyes look bloodshot. The heart rate—normally 70 to 80 beats per minute—may increase by 20 to 50 beats per minute or may even double in some cases. Taking other drugs with marijuana can amplify this effect. Limited evidence suggests that a person’s risk of heart attack during the first hour after smoking marijuana is nearly five times his or her usual risk. This observation could be partly explained by marijuana raising blood pressure (in some cases) and heart rate and reducing the blood’s capacity to carry oxygen. Marijuana may also cause orthostatic hypotension (head rush or dizziness on standing up), possibly raising danger from fainting and falls. Tolerance to some cardiovascular effects often develops with repeated exposure. These health effects need to be examined more closely, particularly given the increasing use of ""medical marijuana"" by people with health issues and older adults who may have increased baseline vulnerability due to age-related cardiovascular risk factors. A few studies have shown a clear link between marijuana use in adolescence and increased risk for an aggressive form of testicular cancer (nonseminomatous testicular germ cell tumor) that predominantly strikes young adult males. The early onset of testicular cancers compared to lung and most other cancers indicates that, whatever the nature of marijuana’s contribution, it may accumulate over just a few years of use. Studies have shown that in rare cases, chronic use of marijuana can lead to Cannabinoid Hyperemesis Syndrome—a condition marked by recurrent bouts of severe nausea, vomiting, and dehydration. This syndrome has been found to occur in persons under 50 years of age and with a long history of marijuana use. Cannabinoid Hyperemesis Syndrome can lead sufferers to make frequent trips to the emergency room, but may be resolved when a person stops using marijuana.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuanas-effects-on-other-aspects-of-physical-health,,,
+Q423,Is marijuana safe and effective as medicine?,"The potential medicinal properties of marijuana and its components have been the subject of research and heated debate for decades. THC itself has proven medical benefits in particular formulations. The U.S. Food and Drug Administration (FDA) has approved THC-based medications, dronabinol (Marinol®) and nabilone (Cesamet®), prescribed in pill form for the treatment of nausea in patients undergoing cancer chemotherapy and to stimulate appetite in patients with wasting syndrome due to AIDS. The FDA also approved a CBD-based liquid medication called Epidiolex® for the treatment of two forms of severe childhood epilepsy, Dravet syndrome and Lennox-Gastaut syndrome. It’s being delivered to patients in a reliable dosage form and through a reproducible route of delivery to ensure that patients derive the anticipated benefits. CBD does not have the rewarding properties of THC.
+In addition, several other marijuana-based medications have been approved or are undergoing clinical trials. Nabiximols (Sativex®), a mouth spray that is currently available in the United Kingdom, Canada, and several European countries for treating the spasticity and neuropathic pain that may accompany multiple sclerosis, combines THC with another chemical found in marijuana called cannabidiol (CBD). Researchers generally consider medications like these, which use purified chemicals derived from or based on those in the marijuana plant, to be more promising therapeutically than use of the whole marijuana plant or its crude extracts. Development of drugs from botanicals such as the marijuana plant poses numerous challenges. Botanicals may contain hundreds of unknown, active chemicals, and it can be difficult to develop a product with accurate and consistent doses of these chemicals. Use of marijuana as medicine also poses other problems such as the adverse health effects of smoking and THC-induced cognitive impairment. Nevertheless, a growing number of states have legalized dispensing of marijuana or its extracts to people with a range of medical conditions. An additional concern with ""medical marijuana"" is that little is known about the long-term impact of its use by people with health- and/or age-related vulnerabilities—such as older adults or people with cancer, AIDS, cardiovascular disease, multiple sclerosis, or other neurodegenerative diseases. Further research will be needed to determine whether people whose health has been compromised by disease or its treatment (e.g., chemotherapy) are at greater risk for adverse health outcomes from marijuana use.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine,,,
+Q424,What are the effects of secondhand exposure to marijuana smoke?,"People often ask about the possible psychoactive effect of exposure to secondhand marijuana smoke and whether a person who has inhaled secondhand marijuana smoke could fail a drug test. Researchers measured the amount of THC in the blood of people who do not smoke marijuana and had spent 3 hours in a well-ventilated space with people casually smoking marijuana; THC was present in the blood of the nonsmoking participants, but the amount was well below the level needed to fail a drug test. Another study that varied the levels of ventilation and the potency of the marijuana found that some nonsmoking participants exposed for an hour to high-THC marijuana (11.3% THC concentration) in an unventilated room showed positive urine assays in the hours directly following exposure; a follow-up study showed that nonsmoking people in a confined space with people smoking high-THC marijuana reported mild subjective effects of the drug—a ""contact high""—and displayed mild impairments on performance in motor tasks. The known health risks of secondhand exposure to cigarette smoke—to the heart or lungs, for instance—raise questions about whether secondhand exposure to marijuana smoke poses similar health risks. At this point, very little research on this question has been conducted. A 2016 study in rats found that secondhand exposure to marijuana smoke affected a measure of blood vessel function as much as secondhand tobacco smoke, and the effects lasted longer. One minute of exposure to secondhand marijuana smoke impaired flow-mediated dilation (the extent to which arteries enlarge in response to increased blood flow) of the femoral artery that lasted for at least 90 minutes; impairment from 1 minute of secondhand tobacco exposure was recovered within 30 minutes. The effects of marijuana smoke were independent of THC concentration; i.e., when THC was removed, the impairment was still present. This research has not yet been conducted with human subjects, but the toxins and tar levels known to be present in marijuana smoke raise concerns about exposure among vulnerable populations, such as children and people with asthma.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-effects-secondhand-exposure-to-marijuana-smoke,"Only potential issues I see here are the use of words such as "" at this point very little research has been conducted on this question"". Might be outdated by the time Charla is up and running. ",,
+Q425,Can marijuana use during and after pregnancy harm the baby?,"More research is needed on how marijuana use during pregnancy could impact the health and development of infants, given changing policies about access to marijuana, as well as significant increases over the last decade in the number of pregnant women seeking substance use disorder treatment for marijuana use. One study found that about 20% of pregnant women 24-years-old and younger screened positive for marijuana. However, this study also found that women were about twice as likely to screen positive for marijuana use via a drug test than they state in self-reported measures. This suggests that self-reported rates of marijuana use in pregnant females may not be an accurate measure of marijuana use. Additionally, in one study of dispensaries, nonmedical personnel at marijuana dispensaries were recommending marijuana to pregnant women for nausea, but medical experts warn against it. There is no human research connecting marijuana use to the chance of miscarriage, although animal studies indicate that the risk for miscarriage increases if marijuana is used early in pregnancy. Some associations have been found between marijuana use during pregnancy and future developmental and hyperactivity disorders in children. Evidence is mixed as to whether marijuana use by pregnant women is associated with low birth weight or premature birth, although long-term use may elevate these risks. Research has shown that pregnant women who use marijuana have a 2.3 times greater risk of stillbirth. Given the potential of marijuana to negatively impact the developing brain, the American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists counsel women against using marijuana while trying to get pregnant, during pregnancy, and while they are breastfeeding. It is important to note that despite the growing popularity of using marijuana in vaping devices, the Food and Drug Administration recommends that pregnant women should not use any vaping product, regardless of the substance. Some women report using marijuana to treat severe nausea associated with their pregnancy; however, there is no research confirming that this is a safe practice, and it is generally not recommended. Women considering using medical marijuana while pregnant should not do so without checking with their health care providers. Animal studies have shown that moderate concentrations of THC, when administered to mothers while pregnant or nursing, could have long-lasting effects on the child, including increasing stress responsivity and abnormal patterns of social interactions. Animal studies also show learning deficits in prenatally exposed individuals. Human research has shown that some babies born to women who used marijuana during their pregnancies display altered responses to visual stimuli, increased trembling, and a high-pitched cry, which could indicate problems with neurological development. In school, marijuana-exposed children are more likely to show gaps in problem-solving skills, memory, and the ability to remain attentive. More research is needed, however, to disentangle marijuana-specific effects from those of other environmental factors that could be associated with a mother's marijuana use, such as an impoverished home environment or the mother's use of other drugs. Prenatal marijuana exposure is also associated with an increased likelihood of a person using marijuana as a young adult, even when other factors that influence drug use are considered. Very little is known about marijuana use and breastfeeding. One study suggests that moderate amounts of THC find their way into breast milk when a nursing mother uses marijuana. Some evidence shows that exposure to THC through breast milk in the first month of life could result in decreased motor development at 1 year of age. There have been no studies to determine if exposure to THC during nursing is linked to effects later in the child's life. With regular use, THC can accumulate in human breast milk to high concentrations. Because a baby's brain is still forming, THC consumed in breast milk could affect brain development. Given all these uncertainties, nursing mothers are discouraged from using marijuana. New mothers using medical marijuana should be vigilant about coordinating care between the doctor recommending their marijuana use and the pediatrician caring for their baby.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/can-marijuana-use-during-pregnancy-harm-baby,,,
+Q426,What treatments are available for marijuana use disorders? ,"Marijuana use disorders appear to be very similar to other substance use disorders, although the long-term clinical outcomes may be less severe. On average, adults seeking treatment for marijuana use disorders have used marijuana nearly every day for more than 10 years and have attempted to quit more than six times. People with marijuana use disorders, especially adolescents, often also suffer from other psychiatric disorders (comorbidity). They may also use or be addicted to other substances, such as cocaine or alcohol. Available studies indicate that effectively treating the mental health disorder with standard treatments involving medications and behavioral therapies may help reduce marijuana use, particularly among those involved with heavy use and those with more chronic mental disorders. The following behavioral treatments have shown promise: Cognitive-behavioral therapy: A form of psychotherapy that teaches people strategies to identify and correct problematic behaviors in order to enhance self-control, stop drug use, and address a range of other problems that often co-occur with them. Contingency management: A therapeutic management approach based on frequent monitoring of the target behavior and the provision (or removal) of tangible, positive rewards when the target behavior occurs (or does not). Motivational enhancement therapy: A systematic form of intervention designed to produce rapid, internally motivated change; the therapy does not attempt to treat the person, but rather mobilize his or her own internal resources for change and engagement in treatment. Currently, the FDA has not approved any medications for the treatment of marijuana use disorder, but research is active in this area. Because sleep problems feature prominently in marijuana withdrawal, some studies are examining the effectiveness of medications that aid in sleep. Medications that have shown promise in early studies or small clinical trials include the sleep aid zolpidem (Ambien®), an anti-anxiety/anti-stress medication called buspirone (BuSpar®), and an anti-epileptic drug called gabapentin (Horizant®, Neurontin®) that may improve sleep and, possibly, executive function. Other agents being studied include the nutritional supplement N-acetylcysteine and chemicals called FAAH inhibitors, which may reduce withdrawal by inhibiting the breakdown of the body’s own cannabinoids. Future directions include the study of substances called allosteric modulators that interact with cannabinoid receptors to inhibit THC’s rewarding effects.",Marijuana,,https://www.drugabuse.gov/publications/research-reports/marijuana/available-treatments-marijuana-use-disorders,,,
+Q427,The legal use of marijuana is spreading in the United States. Does that mean marijuana isn't addictive?,"No. Although marijuana is not as addictive as alcohol or nicotine, nine percent of those who have tried marijuana at least once will become addicted to the drug. Researchers who analyzed 20 years’ worth of marijuana studies concluded that one in ten people worldwide who try the drug will become addicted. Marijuana was the illicit drug with the largest number of persons with past-year dependence or abuse in 2013, followed by pain relievers and cocaine. Of the almost seven million persons aged 12 or older who were classified with illicit drug dependence or abuse in 2013, more than four million had marijuana dependence or abuse (representing 1.6 percent of the total population aged 12 or older).",Marijuana,,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q428,"I know a few ""straight A"" students and famous people who use marijuana and they seem to do OK. What's that about?","Marijuana affects everyone differently. Some people seem to be able to use it for a while, while others experience negative consequences and can get hooked early on. Remember, we never know when addiction actually starts, and a person’s genetics seem to play a major role, meaning that some people get addicted much faster than others. The bottom line is that no matter how in control someone may seem, there are chemical changes occurring in his or her brain, and sooner or later, it can affect his or her ability to perform mentally and physically.",Marijuana,,https://abovetheinfluence.com/faqs/,,,
+Q429,Does marijuana use lead to the use of other drugs?,"The “gateway drug” concept—where using one drug leads a person to use other drugs— generates a lot of controversy. Researchers haven’t found a definite answer yet, but as of today the research does suggest that, while most people who smoke marijuana do not go on to use other drugs, most teens who do use other illegal drugs try marijuana first.
+
+For example, the risk of using cocaine is much greater for those who have tried marijuana than for those who have never tried it. However, this risk is also greater for people who have used alcohol and tobacco.",Marijuana,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q430,Is medical marijuana good for you?,"The marijuana plant has not been approved by the FDA for the treatment of any medical condition. A pill form of THC (the main chemical in marijuana that affects the brain) is already available for certain conditions, such as nausea associated with cancer chemotherapy and weight loss in patients with AIDS.
+
+Early research suggests that some of the active ingredients in marijuana, like THC and cannabidiol (CBD), might be able to help treat conditions and diseases like epilepsy, cancer, or addiction. Scientists are studying THC and CBD to try to develop new medications. However, smoked marijuana is unlikely to be an ideal medication because of its negative health effects, including the risk of addiction and the damage that smoking can do to your lungs.",Marijuana,,https://teens.drugabuse.gov/blog/post/eight-questions-teens-about-drugs-and-alcohol,,,
+Q431,Does marijuana use lead to the use of other drugs?,"While most marijuana smokers do not go on to use other illegal drugs, long-term studies of high school students show that few young people use other illegal drugs without first using marijuana. Using marijuana puts people in contact with people who are users and sellers of other drugs and are more likely to be exposed to and urged to try other drugs.",Marijuana,,https://tricircleinc.com/faqs/,,,
+Q432,Marijuana is just a plant... is it really that dangerous?,"Yes, marijuana is a plant but it has very real health consequences, including drug addiction.  While some people think marijuana is a “harmless drug,” actual experience and the real science show a different reality. More teens are in treatment with a primary diagnosis of marijuana dependence than for all other illegal drugs combined.",Marijuana,,https://tricircleinc.com/faqs/,"Would be good to have a date here, i.e. as of ""2018"" more teens are in treatment...",,
+Q433,Does marijuana use lead to other drug use?,"The majority of people who use marijuana do not go on to use other, “harder” substances. More research is needed to understand if marijuana is a “gateway drug” – a drug that is thought to lead to the use of more dangerous drugs (such as cocaine or heroin)",Marijuana,,https://www.cdc.gov/marijuana/faqs/does-marijuana-lead-to-other-drugs.html,,,
+Q434,Is marijuana medicine?,"The marijuana plant has chemicals that may help symptoms for some health problems. More and more states are making it legal to use the plant as medicine for certain conditions. But there isn’t enough research to show that the whole plant works to treat or cure these conditions. Also, the U.S. Food and Drug Administration (FDA) External has not recognized or approved the marijuana plant as medicine.",Marijuana,,https://www.cdc.gov/marijuana/faqs/is-marijuana-medicine.html,,,
+Q435,Is it safe for a breastfeeding mom to use marijuana?,"We do not yet know. Chemicals from marijuana can be passed to your baby through breast milk. THC is stored in fat and is slowly released over time, meaning that your baby could still be exposed even after you stop using marijuana. However, data on the effects of marijuana exposure to the infant or baby through breastfeeding are limited and conflicting. To limit potential risk to the infant, breastfeeding mothers should reduce or avoid marijuana use.",Marijuana,,https://www.cdc.gov/marijuana/faqs/breastfeeding-while-using-marijuana.html,,,
+Q436,"Can secondhand marijuana smoke affect nonsmokers, including children?","Secondhand marijuana smoke contains tetrahydrocannabinol (THC), the chemical responsible for most of marijuana’s psychological effects, and many of the same toxic chemicals in smoked tobacco. Smoked marijuana has many of the same cancer-causing substances as smoked tobacco, but there are still a lot of unanswered questions around secondhand marijuana smoke exposure and its impact on chronic diseases such as heart disease, cancer, and lung diseases.",Marijuana,,https://www.cdc.gov/marijuana/faqs/secondhand-smoke.html,,,
+Q437,How is marijuana used?,"There are many ways of using marijuana, and each one affects users differently. Marijuana can be rolled up and smoked like a cigarette (a joint) or a cigar (a blunt). Marijuana can also be smoked in a pipe. Sometimes people mix it in food and eat it or brew it as a tea (edibles). Smoking oils, concentrates, and extracts from the marijuana plant are on the rise. People who use this practice call it “dabbing.”",Marijuana,,https://www.cdc.gov/marijuana/faqs/how-is-marijuana-used.html,,,
+Q438,What determines how marijuana affects a person?,"Like any other drug, marijuana’s effects on a person depends on a number of factors, including the person’s previous experience with the drug or other drugs, biology (e.g., genes), gender, how the drug is taken, and how strong it is.",Marijuana,,https://www.cdc.gov/marijuana/faqs/affects-of-marijuana.html,,,
+Q439,Is it possible for someone to become addicted to marijuana?,"Yes, about 1 in 10 marijuana users will become addicted. For people who begin using younger than 18, that number rises to 1 in 6.",Marijuana,,https://www.cdc.gov/marijuana/faqs/marijuana-addiction.html,,,
+Q440,Is it possible to “overdose” or have a “bad reaction” to marijuana?,"A fatal overdose is unlikely, but that doesn’t mean marijuana is harmless. The signs of using too much marijuana are similar to the typical effects of using marijuana but more severe. These signs may include extreme confusion, anxiety, paranoia, panic, fast heart rate, delusions or hallucinations, increased blood pressure, and severe nausea or vomiting. In some cases, these reactions can lead to unintentional injury such as a motor vehicle crash, fall, or poisoning.",Marijuana,,https://www.cdc.gov/marijuana/faqs/overdose-bad-reaction.html,,,
+Q441,How harmful is K2/Spice (synthetic marijuana or synthetic cannabinoids)?,"Synthetic cannabinoids (e.g., synthetic marijuana, K2, Spice, Spike)—or plants sprayed with unknown chemicals—are dangerous and unpredictable. Synthetic cannabinoids are not marijuana, but like THC, they bind to the same cannabinoid receptors in the brain and other organs.
+
+Research shows that synthetic cannabinoids affect the brain much more powerfully than marijuana creating unpredictable and, in some cases, life-threatening effects including nausea, anxiety, paranoia, brain swelling, seizures, hallucinations, aggression, heart palpitations, and chest pains.",Marijuana,,https://www.cdc.gov/marijuana/faqs/how-harmful-is-k2-spice.html,,,
+Q442,How is eating and drinking foods that contain marijuana (edibles) different from smoking marijuana?,"Because marijuana contains tetrahydrocannabinol (THC), there are health risks associated with using marijuana regardless of the how it is used. Some of these negative effects include having difficulty thinking and problem-solving, having problems with memory, learning and maintaining attention and demonstrating impaired coordination. Additionally, frequent use can lead to becoming addicted to marijuana. However, some risks may differ by the way it is used.
+
+Smoke from marijuana contains many of the same toxins, irritants, and carcinogens as tobacco smoke. Smoking marijuana can lead to a greater risk of bronchitis, cough, and phlegm production. Whereas, edibles, which take longer to digest, take longer to produce an effect. Therefore, people may consume more to feel the effects faster. This may lead to people consuming very high doses and result in negative effects like anxiety, paranoia and, in rare cases, an extreme psychotic reaction (e.g. delusions, hallucinations, talking incoherently, and agitation).",Marijuana,,https://www.cdc.gov/marijuana/faqs/edibles.html,,,
+Q443,"It’s legal in many states, so doesn’t that mean marijuana is safe?","The fact that it’s legal does not mean that it is safe. Using marijuana at an early age can lead to negative health consequences.
+
+Heavy marijuana use (daily or near-daily) can do damage to memory, learning, and attention, which can last a week or more after the last time someone used.
+Using marijuana during pregnancy or while breastfeeding may harm the baby, just like alcohol or tobacco.
+Marijuana use has been linked to anxiety, depression, and schizophrenia, but scientists don’t yet know whether it directly causes these diseases.
+Smoking any product, including marijuana, can damage your lungs and cardiovascular system.",Marijuana,,https://www.cdc.gov/marijuana/faqs/is-marijuana-safe-because-its-legal.html,,,
+Q444,What are the health risks of marijuana (THC)?,"Use of THC, which comes from marijuana, has been associated with a wide range of health effects, particularly with prolonged heavy use. The best way to avoid potentially harmful effects is not to use THC, including through e-cigarette, or vaping, products. Persons engaging in ongoing marijuana use that leads to significant impairment or distress should seek evidence-based treatment by a healthcare professional. These effects range from short-term problems with attention, memory, learning, to longer-term problems such as psychosis, anxiety, suicidal ideation and attempts, depression, and substance use disorder. It is not known whether these are causal relationships or simply associations. The best way to avoid potentially harmful effects is to not use marijuana. ",Marijuana,,https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/faq/index.html,,,
+Q445,"How does marijuana use in e-cigarette, or vaping, products affect youths?","Marijuana use, including through use of e-cigarette, or vaping, products can impact your health. Regardless of the substance used, e-cigarette, or vaping, products should never be used by youths. Marijuana use can harm the developing adolescent brain and impact attention, learning, and memory. Starting to use marijuana at a younger age leads to higher risks of more problematic use later in life. Youth marijuana use has also been associated with antisocial and oppositional behaviors, nicotine use, poor school performance, use of other illicit substances and the development of substance use disorders, and impairments in social relationships. ",Marijuana,,https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/faq/index.html,,,
+Q446,"What should I do if I am currently using marijuana/THC in an e-cigarette, or vaping, product for medical use?","CDC and FDA recommend that people not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers. If you have recently used a THC-containing product in an e-cigarette, or vaping, product and you have symptoms like those reported in this outbreak, see a healthcare provider. We do not know if there are different health risks of using different forms of marijuana, such as smoking, vaping, and edibles, or whether transitioning from one form to another might reduce harm. Talk with your healthcare provider about other available treatment options for the conditions.",Marijuana,,https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/faq/index.html,,,
+Q447,Is marijuana safe for older people?,"About 4.2% of those 65 and older reported using marijuana in 2018, up from 2.4% in 2015. Cannabis has medical uses, such as pain relief. But it can also cause problems, especially in older people or those with heart disease. Even when you use it legally, it may:
+
+Boost the effects of other drugs you take
+Hurt your short-term memory
+Raise your blood pressure, heart rate, and breathing rate
+Increase your risk of a heart attack shortly after you smoke it
+Talk to your doctor before you try it.",Marijuana,,https://www.webmd.com/mental-health/addiction/qa/is-marijuana-safe-for-older-people,,,
+Q448,How do other mental health conditions relate to substance use in adolescents?,"Drug use in adolescents frequently overlaps with other mental health problems. For example, a teen with a substance use disorder is more likely to have a mood, anxiety, learning, or behavioral disorder too. Sometimes drugs can make accurately diagnosing these other problems complicated. Adolescents may begin taking drugs to deal with depression or anxiety, for example; on the other hand, frequent drug use may also cause or precipitate those disorders. Adolescents entering drug abuse treatment should be given a comprehensive mental health screening to determine if other disorders are present. Effectively treating a substance use disorder requires addressing drug abuse and other mental health problems simultaneously.",Mental health,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q449,What is flat affect?,"If you’re happy or upset, people usually can see it on your face and hear it in your voice. But sometimes your emotions and how you express them don’t match up. You may be elated or depressed, but others can’t tell.
+
+This is called a flat affect. People who have it don’t show the usual signs of emotion like smiling, frowning, or raising their voice. They seem uncaring and unresponsive.
+
+Flat affect can be brought on by different conditions.",Mental health,,https://www.webmd.com/mental-health/flat-affect#1,,,
+Q450,What is derealization?,"Derealization is a mental state where you feel detached from your surroundings. People and objects around you may seem unreal. Even so, you’re aware that this altered state isn’t normal.
+
+More than half of all people may have this disconnection from reality once in their lifetime. But about 2% of people experience it often enough for it to become a type of dissociative disorder.",Mental health,,https://www.webmd.com/mental-health/mental-derealization-overview#1,,,
+Q451,What is apathy?,A loss of interest in life could be one sign of apathy. Learn what to look for and how to deal with apathy if you or a loved one has it.,Mental health,,https://www.webmd.com/mental-health/what-is-apathy#1,,,
+Q452,Could remote working harm your mental health?,"Remote working is becoming more popular than ever. A study released by the Swiss office provider IWG found that 70% of professionals work remotely at least one day a week, while 53% work remotely for at least half of the week. Some multinationals have their entire staff working remotely, with no fixed office presence at all, which can result in having employees situated all over the world.
+
+New technology makes all this possible. While there are certainly benefits, there are also a number of pitfalls. As remote working becomes the new normal for many, it’s important companies adapt and put the right policies in place to ensure their employees feel part of the team and don’t burn out.",Mental health,,https://www.weforum.org/agenda/2019/10/remote-working-from-home-increase-stress-anxiety-mental-health,Relevant?,,
+Q453,Are education & employment strongly linked to mental health?,"The risk factors for mental health and substance use disorders are complex. It is rarely the case that a mental health disorder can be attributed to a single factor or cause. This group of disorders typically result from the interaction of individual attributes, social variables and environmental factors. Not only are these hard to directly identify, but also change and evolve throughout our life-course.
+
+We must therefore be cautious when attempting to imply strong relationships between risk factors and mental health disorders. Nonetheless, there are a number of environmental, social and economic scenarios that appear to relate to the prevalence of mental health disorders. Level of education appears to have an important link to depression prevalence; but even stronger than this is our status of employment.",Mental health,,https://www.weforum.org/agenda/2018/06/global-mental-health-five-key-insights-which-emerge-from-the-data,Relevant?,,
+Q454,What are neurological disorders and how many people are affected by them?,"Neurological disorders are diseases of the central and peripheral nervous system. In other words, the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscles. These disorders include epilepsy, Alzheimer disease and other dementias, cerebrovascular diseases including stroke, migraine and other headache disorders, multiple sclerosis, Parkinson's disease, neuroinfections, brain tumours, traumatic disorders of the nervous system due to head trauma, and neurological disorders as a result of malnutrition.",Mental health,,https://www.who.int/topics/mental_health/qa/en/,Not sure this is relevant to the dataset.,,
+Q455,What can patients taking methadone do to stay safe?,"• Methadone can be addictive. Patients should take care not to abuse it.
+• Never use more methadone than the amount prescribed.
+• If you miss a dose or if you feel it
+is not working, do not take extra. For pain management patients, take only the recommended dose at the recommended time. For patients in methadone maintenance treatment for addiction, contact your clinic for instructions.
+• No one should use methadone if it has not been prescribed for them.
+• Be especially careful if taking methadone for the first time.",Methadone,,https://store.samhsa.gov/product/Follow-Directions-How-to-Use-Methadone-Safely/SMA09-4409?referer=from_search_result,Added more context to the question.,,
+Q456,What things shouldn't I do when taking methadone?,"• Do not consume alcohol or medicines that contain alcohol.
+• Be careful when driving, operating heavy machinery or doing
+anything that requires you to be alert. Methadone, like many other medications, can slow thinking and reaction time and make you drowsy.
+• Store methadone at room temperature and away from light.
+• Always take methadone in the exact dosage amount and form you have been prescribed.
+• Take steps to prevent children from accidentally taking methadone.
+• Never give methadone to anyone else even if the person has similar symptoms or suffers from the same condition as you because it can be dangerous.",Methadone,,https://store.samhsa.gov/product/Follow-Directions-How-to-Use-Methadone-Safely/SMA09-4409?referer=from_search_result,Re-worded the question.,,
+Q457,What are the side effects of methadone?,"Some side effects are emergencies. Patients should stop taking methadone—and contact a physician or emergency services right away— if they:
+• Have difficulty breathing or shallow breathing
+• Feel light-headed or faint
+• Get hives or a rash; have swelling of the face, lips, tongue or throat
+• Feel chest pain
+• Have a fast or pounding heartbeat
+• Have hallucinations or confusion",Methadone,,https://store.samhsa.gov/product/Follow-Directions-How-to-Use-Methadone-Safely/SMA09-4409?referer=from_search_result,,,
+Q458,How is methadone used?,"If you need methadone for pain, your doctor will write a prescription for it. For an addiction, you’ll get it from a special treatment program. You can find programs through the Substance Abuse and Mental Health Services Association treatment locator (https://findtreatment.samhsa.gov/) or by calling 1-800-662-HELP (4357).
+
+Methadone comes in tablet, powder, and liquid forms. You have to have a prescription to get it. Your providers will give you the dose that should work best for you. They also might change your dose during treatment. Tell your doctor how you feel when you use it. Don’t stop taking methadone without talking to them.",Methadone,,https://www.webmd.com/mental-health/addiction/what-is-methadone#1,,,
+Q459,What are methadone risks?,"Heart disease
+A heart rhythm disorder
+An electrolyte imbalance
+Breathing problems or lung disease
+A history of head injury, brain tumor, or seizures
+Liver or kidney disease
+Problems urinating
+Gallbladder, pancreas, or thyroid problems
+A condition for which you take sedatives",Methadone,,https://www.webmd.com/mental-health/addiction/what-is-methadone#2,,,
+Q460,Can pregnant or breastfeeding women take methadone? ,"Women who are pregnant or breastfeeding may take methadone. It can cross your placenta or go into your breast milk. Your doctor will keep this in mind when deciding on a treatment plan.
+
+If you’re pregnant and have a heroin or pain pill addiction, it’s especially important to get treatment to keep yourself and your baby safe. Babies born to women who take methadone might go into withdrawal. But most of them have fewer health problems than infants whose mothers used heroin or other opioids.",Methadone,,https://www.webmd.com/mental-health/addiction/what-is-methadone#3,,,
+Q461,What drugs can affect how methadone works?,"Other narcotics
+Drugs that make you sleepy or slow your breathing
+Drugs that change your serotonin level",Methadone,,https://www.webmd.com/mental-health/addiction/qa/which-drugs-can-affect-how-methadone-works,,,
+Q462,What is methamphetamine?,"Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. Also known as meth, blue, ice, and crystal, among many other terms, it takes the form of a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. Methamphetamine was developed early in the 20th century from its parent drug, amphetamine, and was used originally in nasal decongestants and bronchial inhalers. Like amphetamine, methamphetamine causes increased activity and talkativeness, decreased appetite, and a pleasurable sense of well-being or euphoria. However, methamphetamine differs from amphetamine in that, at comparable doses, much greater amounts of the drug get into the brain, making it a more potent stimulant. It also has longer-lasting and more harmful effects on the central nervous system. These characteristics make it a drug with high potential for widespread misuse. Methamphetamine has been classified by the U.S. Drug Enforcement Administration as a Schedule II stimulant, which makes it legally available only through a nonrefillable prescription. Medically it may be indicated for the treatment of attention deficit hyperactivity disorder (ADHD) and as a short-term component of weight-loss treatments, but these uses are limited and it is rarely prescribed; also, the prescribed doses are far lower than those typically misused.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-methamphetamine,,,
+Q463,What is the scope of methamphetamine misuse in the United States?,"According to the 2017 National Survey on Drug Use and Health (NSDUH), approximately 1.6 million people (0.6 percent of the population) reported using methamphetamine in the past year, and 774,000 (0.3 percent) reported using it in the past month. The average age of new methamphetamine users in 2016 was 23.3 years old. An estimated 964,000 people aged 12 or older (about 0.4 percent of the population) had a methamphetamine use disorder in 2017—that is, they reported clinically significant impairment, including health problems, disability, and failure to meet responsibilities at work, school, or home as a result of their drug use. This number is significantly higher than the 684,000 people who reported having methamphetamine use disorder in 2016. The 2018 Monitoring the Future (MTF) survey of adolescent drug use and attitudes reported that about 0.5 percent of 8th, 10th, and 12th graders had used methamphetamine within the past year. Use of methamphetamine by adolescents has declined significantly since 1999, when this drug was first added to the survey.The Treatment Episode Data Set (TEDS) provides information on admissions to substance abuse treatment facilities that are licensed or certified by state substance use agencies. According to TEDS data, nationwide treatment admissions for methamphetamine misuse dropped from 68 per 100,000 individuals in 2005 to 49 per 100,000 in 2015. An important caveat to these national numbers is the degree to which they mask regional variability. While methamphetamine is available across the US, highest availability is in the western and midwestern regions of the US; more than 70 percent of local law enforcement agencies from the pacific and west central regions of the US report methamphetamine as the greatest drug threat in their area. NIDA’s National Drug Early Warning System (NDEWS), which tracks drug trends in sentinel sites across the country, found that treatment admissions for methamphetamine as the primary substance of use were less than one percent in sites east of the Mississippi River, but ranged from 12-29 percent in the sites west of the Mississippi. Nationwide, overdose deaths from the category of drugs that includes methamphetamine increased by 7.5 times between 2007 and 2017. About 15 percent of all drug overdose deaths involved the methamphetamine category in 2017, and 50 percent of those deaths also involved an opioid. In 2017, 5 of the 12 NDEWS sites reported increases in methamphetamine overdose deaths: Washington, Colorado, Texas, Florida, and Georgia.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-scope-methamphetamine-misuse-in-united-states,,,
+Q464,How is methamphetamine misused?,"Methamphetamine comes in several forms and can be smoked, snorted, injected, or orally ingested.The preferred method of using the drug varies by geographical region and has changed over time. Smoking or injecting methamphetamine puts the drug very quickly into the bloodstream and brain, causing an immediate, intense ""rush"" and amplifying the drug’s addiction potential and adverse health consequences. The rush, or ""flash,"" lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria—a high, but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes. As with many stimulants, methamphetamine is most often misused in a ""binge and crash"" pattern. Because the pleasurable effects of methamphetamine disappear even before the drug concentration in the blood falls significantly, users try to maintain the high by taking more of the drug. In some cases, people indulge in a form of binging known as a ""run,"" foregoing food and sleep while continuing to take the drug for up to several days.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/how-methamphetamine-misused,,,
+Q465,"How is methamphetamine different from other stimulants, such as cocaine?","The methamphetamine molecule is structurally similar to amphetamine and to the neurotransmitter dopamine, a brain chemical that plays an important role in the reinforcement of rewarding behaviors, but it is quite different from cocaine. Although these stimulants have similar behavioral and physiological effects, there are some major differences in the basic mechanisms of how they work. In contrast to cocaine, which is quickly removed from and almost completely metabolized in the body, methamphetamine has a much longer duration of action, and a larger percentage of the drug remains unchanged in the body. Methamphetamine therefore remains in the brain longer, which ultimately leads to prolonged stimulant effects. Although both methamphetamine and cocaine increase levels of dopamine, administration of methamphetamine in animal studies leads to much higher levels of dopamine, because nerve cells respond differently to the two drugs. Cocaine prolongs dopamine actions in the brain by blocking the re-absorption (re-uptake) of the neurotransmitter by signaling nerve cells. At low doses, methamphetamine also blocks the re-uptake of dopamine, but it also increases the release of dopamine, leading to much higher concentrations in the synapse (the gap between neurons), which can be toxic to nerve terminals.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/how-methamphetamine-different-other-stimulants-such-cocaine,,,
+Q466,What are the immediate (short-term) effects of methamphetamine misuse?,"As a powerful stimulant, methamphetamine, even in small doses, can increase wakefulness and physical activity and decrease appetite. Methamphetamine can also cause a variety of cardiovascular problems, including rapid heart rate, irregular heartbeat, and increased blood pressure. Hyperthermia (elevated body temperature) and convulsions may occur with methamphetamine overdose, and if not treated immediately, can result in death.
+The exact mechanisms whereby drugs like methamphetamine produce euphoria (the pleasurable high) are still poorly understood. But along with euphoria, methamphetamine use releases very high levels of the neurotransmitter dopamine in the reward circuit, which ""teaches"" the brain to repeat the pleasurable activity of taking the drug. Dopamine is involved in motivation and motor function and its release in the reward circuit is a defining feature of addictive drugs. The elevated release of dopamine produced by methamphetamine is also thought to contribute to the drug's deleterious effects on nerve terminals in the brain.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-immediate-short-term-effects-methamphetamine-misuse,,,
+Q467,What are the long-term effects of methamphetamine misuse?,"Long-term methamphetamine abuse has many negative consequences, including addiction. Addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use and accompanied by functional and molecular changes in the brain. As is the case with many drugs, tolerance to methamphetamine’s pleasurable effects develops when it is taken repeatedly. Abusers often need to take higher doses of the drug, take it more frequently, or change how they take it in an effort to get the desired effect. Chronic methamphetamine abusers may develop difficulty feeling any pleasure other than that provided by the drug, fueling further abuse. Withdrawal from methamphetamine occurs when a chronic abuser stops taking the drug; symptoms of withdrawal include depression, anxiety, fatigue, and an intense craving for the drug.In addition to being addicted to methamphetamine, people who use methamphetamine long term may exhibit symptoms that can include significant anxiety, confusion, insomnia, mood disturbances, and violent behavior.They also may display a number of psychotic features, including paranoia, visual and auditory hallucinations, and delusions (for example, the sensation of insects creeping under the skin). Psychotic symptoms can sometimes last for months or years after a person has quit using methamphetamine, and stress has been shown to precipitate spontaneous recurrence of methamphetamine psychosis in people who use methamphetamine and have previously experienced psychosis.
+These and other problems reflect significant changes in the brain caused by misuse of methamphetamine. Neuroimaging studies have demonstrated alterations in the activity of the dopamine system that are associated with reduced motor speed and impaired verbal learning.Studies in chronic methamphetamine users have also revealed severe structural and functional changes in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in these individuals. Research in primate models has found that methamphetamine alters brain structures involved in decision-making and impairs the ability to suppress habitual behaviors that have become useless or counterproductive. The two effects were correlated, suggesting that the structural change underlies the decline in mental flexibility. These changes in brain structure and function could explain why methamphetamine addiction is so hard to treat and has a significant chance of relapse early in treatment.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-misuse,,,
+Q468,What are the risks of methamphetamine misuse during pregnancy?,"Our knowledge of the effects of methamphetamine misuse during pregnancy is limited because studies of this issue have used small samples and did not account for other possible drug use besides methamphetamine in research samples. But the available research indicates increased rates of premature delivery, placental abruption (separation of the placental lining from the uterus), and various effects on babies prenatally exposed to methamphetamine, including small size, lethargy, and heart and brain abnormalities. A large NIDA-funded prospective, longitudinal study examined developmental outcomes in infants and children born to mothers who misused methamphetamine. In infancy, they were more likely to show decreased arousal, increased stress, and poor quality of movement. By ages 1 and 2, toddlers showed delayed motor development. Preschool and school-age children had subtle but significant attention impairments and were more likely to have cognitive and behavioral issues in school related to difficulties with self-control and executive function.",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-risks-methamphetamine-misuse-during-pregnancy,,,
+Q469,Are people who misuse methamphetamine at risk for contracting HIV/AIDS and hepatitis B and C?,"Methamphetamine misuse raises the risk of contracting or transmitting HIV and hepatitis B and C—not only for individuals who inject the drug but also for noninjecting methamphetamine users. Among people who inject drugs, HIV and other infectious diseases are spread primarily through the re-use or sharing of contaminated syringes, needles, or related paraphernalia. But regardless of how methamphetamine is taken, its strong effects can alter judgment and inhibition and lead people to engage in risky behaviors like unprotected sex. Methamphetamine misuse is associated with a culture of risky sexual behavior, both among men who have sex with men and in heterosexual populations, a link that may be attributed to the fact that methamphetamine and related stimulants can increase libido. (However, long-term methamphetamine misuse may be associated with decreased sexual functioning, at least in men.) The combination of injection practices and sexual risk-taking may result in HIV becoming a greater problem among people who misuse methamphetamine than among other drug users, and some epidemiologic reports are already showing this trend. For example, while the link between HIV infection and methamphetamine misuse has not yet been established for heterosexuals, data show an association between methamphetamine misuse and the spread of HIV among men who have sex with men. Methamphetamine misuse may also worsen the progression of HIV disease and its consequences. In animal studies, methamphetamine has been shown to increase viral replication. Clinical studies in humans suggest that current methamphetamine users taking highly active antiretroviral therapy (HAART) to treat HIV may be at greater risk of developing AIDS than non-users, possibly because of poor medication adherence. Methamphetamine users with HIV also have shown greater neuronal injury and cognitive impairment due to HIV, compared with those who do not misuse the drug.
+
+NIDA-funded research has found that, through substance use disorder treatment, prevention, and community-based outreach programs, drug users can change their HIV risk behaviors. Drug misuse and drug-related risk behaviors, such as needle sharing and risky sexual practices, can be reduced significantly, thus decreasing the risk of exposure to HIV and other infectious diseases. Therefore, drug treatment is HIV prevention.
+",Methamphetamine,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/are-people-who-misuse-methamphetamine-risk-contracting-hivaids-hepatitis-b-c,,,
+Q470,What does meth look like?,"Methamphetamine is a white, odorless, bitter-tasting, crystalline powder that dissolves easily in water or alcohol. It can be made from ingredients that are used in products such as batteries, drain cleaner, fertilizer, nail polish remover, and paint thinner.",Methamphetamine,,https://store.samhsa.gov/product/Tips-for-Teens-The-Truth-About-Methamphetamine/PEP18-03?referer=from_search_result,,,
+Q471,"What is the ""crash"" effect of using meth?","Using meth causes the brain to release a chemical called dopamine, which gives the user a feeling of pleasure. However, once the drug is no longer in the user’s system, this pleasurable sensation can be followed by unpleasant feelings of drug withdrawal, sometimes called a “crash.” These feelings can include depression, anxiety, fatigue, and intense craving for more of the drug. The “crash” often leads a person to use more meth to avoid these uncomfortable physical and psychological effects.",Methamphetamine,,https://store.samhsa.gov/product/Tips-for-Teens-The-Truth-About-Methamphetamine/PEP18-03?referer=from_search_result,,,
+Q472,What are street names for methamphetamine?,"Meth, Speed, Ice, Shards, Bikers Coffee, Stove Top, Tweak, Yaba, Trash, Chalk, Crystal, Crank, Shabu",Methamphetamine,,https://www.dea.gov/factsheets/methamphetamine,,,
+Q473,How is methamphetamine used?,"Powder, pill
+Smoked, snorted, injected
+To intensify the effects, users may take higher doses of the drug, take it more frequently, or change their method of intake",Methamphetamine,,https://www.dea.gov/factsheets/methamphetamine,,,
+Q474,How does methamphetamine affect the body?,"Highly addictive
+Agitation, increased heart rate and blood pressure
+Increased respiration and body temperature
+Anxiety, paranoia
+High doses can cause convulsions, cardiovascular collapse, stroke or death",Methamphetamine,,https://www.dea.gov/factsheets/methamphetamine,,,
+Q475,What is morphine?,"Non-synthetic narcotic (opioid) made from opium, prescribed as Kadian®,MS-Contin®, Oramorph SR®, MSIR®, RMS®, Roxanol®. Very effective for pain relief, high potential for abuse.",Morphine,,https://www.dea.gov/factsheets/morphine,,,
+Q476,What are street names for morphine?,"Dreamer, Emsel, First Line, God’s Drug, Hows, MS, Mister Blue, Morpho, Unkie",Morphine,,https://www.dea.gov/factsheets/morphine,,,
+Q477,How is morphine used?,"Injected
+Oral solutions
+Tablets, capsules, suppositories",Morphine,,https://www.dea.gov/factsheets/morphine,,,
+Q478,How does morphine affect the body?,"Euphoria and relief of pain
+Addictive
+Overdose signs: cold and clammy skin, sleepiness, lowered blood pressure and slow pulse rate, coma and possible death",Morphine,,https://www.dea.gov/factsheets/morphine,,,
+Q479,What is naloxone?,"A prescription medication to prevent overdose deaths of opioids such as heroin, morphine, and oxycodone by blocking opioid receptor sites to reverse the toxic effects of the overdose; it is given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection.",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q480,What is naltrexone?,"A medication that blocks the euphoric and sedative effects of opioids. It is not an opioid and is neither intoxicating nor addictive. It is administered as a daily pill or monthly injection by any licensed medical practitioner or pharmacist. An extended-release injectable form, Vivitrol, is approved for treatment of opioid and alcohol use disorders and its effects last for about 28 days.",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q481,Is it safe to take opioids if you are pregnant?,"Opioid use during pregnancy — even if taken as a doctor instructed — can lead to miscarriage or low birth weight. It can also cause neonatal abstinence syndrome, a medical condition where the baby is born dependent on opioids and has withdrawal symptoms after being born. If a pregnant woman tries to stop taking opioids suddenly without medical help, she can put the baby at risk. It is important for the mother to tell her doctor about all drugs she is taking or planning to take so that the baby has a greater chance of being born healthy. There are treatments that can help.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q482,I have heard about something called fentanyl. What is that?,"Fentanyl is an opioid drug that is 50 times more powerful than heroin. Medically, it is used to treat extreme pain and for surgeries. But now it’s being made illegally and is sometimes mixed with other drugs, leading to overdose.",Fentanyl,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q483,What are opioids?,"Opioids are naturally found in the opium poppy plant. Some opioid medications are made from this plant while others are made by scientists in labs. Opioids have been used for hundreds of years to treat pain, cough, and diarrhea.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids,,,
+Q484,What are the most commonly used opioids?,"The most commonly used prescription opioids are oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, and morphine. Heroin is an opioid, but it is not a medication. Fentanyl is a powerful prescription pain reliever, but it is sometimes added to heroin by drug dealers, causing doses so strong that people are dying from overdoses.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids,,,
+Q485,How do opioids work?,"Your brain is full of molecules called receptors that receive signals from other parts of the body. Opioids attach to receptors on nerve cells in the brain, spinal cord, and other organs. This allows them to block pain messages sent from the body to the brain, which is why they are prescribed for serious injuries or illnesses. When the opioids attach to the receptors, they also cause a large amount of dopamine to be released in the pleasure centers of the brain. Dopamine is the chemical responsible for making us feel reward and motivates our actions. The dopamine release caused by the opioids sends a rush of extreme pleasure and well-being throughout the body.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids,,,
+Q486,What are the health effects of opioids on the brain and body?,"In the short term, the release of dopamine into your body can make some people feel really relaxed and happy. But it can also cause more harmful effects, like extreme sleepiness, confusion, nausea, vomiting, and constipation. Over time, opioids can lead to insomnia, muscle pain, heart infections, pneumonia, and addiction.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids,,,
+Q487,What is prescription opioid misuse?,"Taking your prescription in ways other than instructed, like taking more than your prescribed dose or taking it more often
+Getting and using prescription pills from a friend or family member, even if it’s for a real medical condition
+Taking prescription drugs to get high
+Mixing prescription opioids with alcohol or other drugs",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/faqs-about-opioids,,,
+Q488,Is opioid addiction a disease?,"Opioids are drugs that slow down the actions of the body, such as breathing and heartbeat. Opioids also affect the brain to increase pleasant feelings. They get their name from opium, a drug made from the poppy plant.
+Opioid medications are prescribed to treat pain and sometimes for other health problems such as severe coughing. Heroin is an illegal opioid that is smoked, snorted, or injected to get a good feeling, often called a “rush” or “high.” People also sometimes seek this feeling by taking large doses of prescription opioids.",Opioids,,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,"10/19: I can't access the link. I think the Q/A is fine, however.",,
+Q489,What are semi-synthetic opioids?,"A group of opioids that include such drugs as oxycodone, hydrocodone, hyrdromorphone, and oxymorphone.",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q490,What is opioid use disorder?,"Having either a heroin use disorder (i.e., dependence or abuse) or pain reliever use disorder related to their misuse of prescription pain relievers in the past year, or if they had both disorders.",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q491,What is opioid use?,"Any use of prescription opioids, heroin, or synthetic opioids (e.g., fentanyl).",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q492,What are natural opioids?,A group of opioids that include such drugs as morphine and codeine,Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q493,What are synthetic opioids other than methadone?,"A group of opioids that include such drugs as fentanyl, fentanyl analogs, and tramadol.",Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Hispanic-Latino-Population-An-Urgent-Issue/PEP20-05-02-002?referer=from_search_result,,,
+Q494,What is an opioid-related overdose death?,Death resulting from unintentional or intentional overdose involving an opioid.,Opioids,,https://store.samhsa.gov/product/The-Opioid-Crisis-and-the-Black-African-American-Population-An-Urgent-Issue/PEP20-05-02-001?referer=from_search_result,,,
+Q495,What are opioids made of?,"These pain relievers are made from opium, which comes from the poppy plant.",Opioids,,https://www.webmd.com/mental-health/addiction/qa/what-are-opioids-made-of,,,
+Q496,What side effects do opioids have?,"These drugs are generally safe when you take them for a short time, as prescribed by your doctor. But in addition to helping you manage the pain, they can also give you a feeling of well-being or euphoria.
+
+And each of those effects could lead you to misuse the drug or take it in a way your doctor didn’t intend. You might:
+
+Take a higher dose than prescribed
+Take someone else’s prescription, even for a legitimate problem, like pain
+Take it to get high
+ ",Opioids,,https://www.webmd.com/mental-health/addiction/qa/what-side-effects-do-opioids-have,,,
+Q497,What are the symptoms of opioid use disorder (OUD)?,"Using more of the drugs or using them longer than you intended
+Can’t control or cut down use
+Spend lots of time finding drugs or recovering from use
+Have a strong desire or urge to use
+Use despite legal or social problems
+Stop or cut down important activities
+Use while doing something dangerous, like driving
+Use despite physical or mental problems
+Become tolerant -- need more of the drug or need to take it more often
+Have withdrawal -- physical symptoms when you try to stop",Opioids,,https://www.webmd.com/mental-health/addiction/qa/what-are-the-symptoms-of-opioid-use-disorder-oud,,,
+Q498,What are the symptoms of opioid dependence?,"Anxiety
+Irritability
+Craving for the drug
+Rapid breathing
+Yawning
+Runny nose
+Salivation
+Goosebumps
+Nasal stuffiness
+Muscle aches
+Vomiting
+Abdominal cramping
+Diarrhea
+Sweating
+Confusion
+Enlarged pupils
+Tremors
+Loss of appetite; using more of the drugs or using them longer than you intended
+Can’t control or cut down use
+Spend lots of time finding drugs or recovering from use
+Have a strong desire or urge to use
+Use despite legal or social problems
+Stop or cut down important activities
+Use while doing something dangerous, like driving
+Use despite physical or mental problems
+Become tolerant -- need more of the drug or need to take it more often
+Have withdrawal -- physical symptoms when you try to stop",Opioids,,https://www.webmd.com/mental-health/addiction/qa/what-are-the-symptoms-of-opioid-dependence,,,
+Q499,What are prescription opioids?,"Prescription opioids are often used to treat chronic and acute pain and, when used appropriately, can be an important component of treatment. However, serious risks are associated with their use, and it is essential to carefully consider the risks of using prescription opioids alongside their benefits. These risks include misuse, opioid use disorder (addiction), overdoses, and death.",Opioids,,https://www.cdc.gov/drugoverdose/data/prescribing.html,Re-worded the question.,,
+Q500,What is fentanyl?,"Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.",Opioids,,https://www.cdc.gov/drugoverdose/opioids/fentanyl.html,Duplicate of Q482. It's essentially the same question but worded slightly differently with a slightly different answer as well.,,
+Q501,Are deaths involving illicitly manufactured fentanyl on the rise?,"Rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, increased 10% from 2017 to 2018. Over 31,000 people died from overdoses involving synthetic opioids (other than methadone) in 2018.",Opioids,,https://www.cdc.gov/drugoverdose/opioids/fentanyl.html,,,
+Q502,What are the risks of using prescription opioids for chronic pain?,"Patients with chronic pain deserve safe and effective pain management. While evidence supports short-term effectiveness of opioids, there is insufficient evidence that opioids effectively treat chronic pain in the long run. Further, there is evidence that nonopioid treatments can be effective with less harm. Evidence of the significant risks of long-term opioid therapy has grown considerably in recent years. Opioid use disorder and overdose are real risks of prescription opioid use—particularly with high doses and long-term use.",Opioids,,https://www.cdc.gov/drugoverdose/prescribing/faq.html,,,
+Q503,Are opioids necessary?,"Opioid medications are one of many ways to treat pain. It may be helpful to know that:
+
+Acute pain: usually starts suddenly and has a known cause, like an injury or surgery. It normally gets better as your body heals.
+Chronic pain: pain lasts 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or even an unknown reason.
+Prescription opioids can be used to treat severe acute pain, but there is no evidence that they are as effective for long-term use. If you’re prescribed an opioid, the best approach is to try the lowest possible dose in the smallest quantity. Opioids should only be used when necessary and only for as long as necessary. Generally, for acute pain this is often 3 days or less; more than 7 days is rarely needed. Before taking opioid medication for chronic pain:
+
+Discuss with your doctor pain treatment options, including ones that do not involve prescription drugs.
+Tell your doctor about your medical history and if you or anyone in your family has a history of substance misuse or addiction to drugs or alcohol.
+Discuss all of the risks and benefits of taking prescription opioids.
+Talking openly with your healthcare provider will help to make sure you’re getting care that is safe, effective, and right for you. Set up a follow-up appointment with your doctor to reevaluate your pain and, if you have been taking opioids for more than a few days, give you guidance on the best way to cope with possible withdrawal symptoms when you stop.",Opioids,,https://www.cdc.gov/drugoverdose/patients/faq.html,,,
+Q504,What are Extended-release/long-acting (ER/LA) opioids?,Slower-acting medication with a longer duration of pain-relieving action.,Opioids,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q505,What are immediate-release opioids?,Faster-acting medication with a shorter duration of pain-relieving action.,Opioids,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q506,What are opioid analgesics?,"Commonly referred to as prescription opioids, medications that have been used to treat moderate to severe pain in some patients. Categories of opioids for mortality data include:
+Natural opioid analgesics, including morphine and codeine;
+Semi-synthetic opioid analgesics, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone;
+Methadone, a synthetic opioid that can be prescribed for pain reduction or for use in MAT for opioid use disorder (OUD). For MAT, methadone is used under direct supervision of a healthcare provider;
+Synthetic opioid analgesics other than methadone, including drugs such as tramadol and fentanyl.",Opioids,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q507,Can you overdose on opioids?,"Yes, you can. In fact, overdose deaths have almost tripled in the last 15 years and the majority of these deaths involve opioids. One of the ways opioids work to relax your body is by slowing down your breathing. When misused, opioids can slow your breathing too much. This can cause you to stop breathing entirely and lead to an overdose. For some people, just one dose is enough to make them stop breathing.",Overdose,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q508,Can you stop an opioid overdose?,"Yes, if you act quickly. If you think a friend or family member has overdosed on opioids, call 911 so they can receive immediate medical attention. When paramedics arrive, they will likely give the person naloxone. Naloxone works to quickly block the effects of opioids. It is available as an injectable solution, an auto-injector, and a nasal spray. Some states require a doctor to prescribe naloxone, but other states allow pharmacies to sell naloxone without a personal prescription. This lets friends and family members use it to save someone who is overdosing. But naloxone doesn't take the place of medical care, and after using it, the person who overdosed should immediately get medical help.",Overdose,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q509,What is an overdose?,Injury to the body (poisoning) that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.,Overdose,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q510,What can teenagers do to protect themselves from peer pressure to use opioids?,"Take charge of your own health. The best thing teenagers can do is to turn away from peer pressure to use opioids “for fun” and to only take opioids as prescribed by your doctor. Even then, opioids should be taken for as short a time as possible. If your doctor or dentist prescribes opioids for a painful condition, ask them how quickly you can stop taking them or if there are other medications to use instead.",Opioids,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q511,What is physical dependence?,Adaptation to a drug that produces symptoms of withdrawal when the drug is stopped.,Withdrawal,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q512,What is the scope of prescription drug misuse?,"Misuse of prescription opioids, CNS depressants, and stimulants is a serious public health problem in the United States. Although most people take prescription medications responsibly, in 2017, an estimated 18 million people (more than 6 percent of those aged 12 and older) have misused such medications at least once in the past year. According to results from the 2017 National Survey on Drug Use and Health, an estimated 2 million Americans misused prescription pain relievers for the first time within the past year, which averages to approximately 5,480 initiates per day. Additionally, more than one million misused prescription stimulants, 1.5 million misused tranquilizers, and 271,000 misused sedatives for the first time. The reasons for the high prevalence of prescription drug misuse vary by age, gender, and other factors, but likely include ease of access. The number of prescriptions for some of these medications has increased dramatically since the early 1990s. Moreover, misinformation about the addictive properties of prescription opioids and the perception that prescription drugs are less harmful than illicit drugs are other possible contributors to the problem. Although misuse of prescription drugs affects many Americans, certain populations such as youth and older adults may be at particular risk. Misuse of prescription drugs is highest among young adults ages 18 to 25, with 14.4 percent reporting nonmedical use in the past year. Among youth ages 12 to 17, 4.9 percent reported past-year nonmedical use of prescription medications. After alcohol, marijuana, and tobacco, prescription drugs (taken nonmedically) are among the most commonly used drugs by 12th graders. NIDA’s Monitoring the Future survey of substance use and attitudes in teens found that about 6 percent of high school seniors reported past-year nonmedical use of the prescription stimulant Adderall® in 2017, and 2 percent reported misusing the opioid pain reliever Vicodin®. Although past-year nonmedical use of CNS depressants has remained fairly stable among 12th graders since 2012, use of prescription opioids has declined sharply. For example, past-year nonmedical use of Vicodin among 12th graders was reported by 9.6 percent in 2002 and declined to 2.0 percent in 2017. Nonmedical use of Adderall® increased between 2009 and 2013, but has been decreasing through 2017. When asked how they obtained prescription stimulants for nonmedical use, around 60 percent of the adolescents and young adults surveyed said they either bought or received the drugs from a friend or relative. Youth who misuse prescription medications are also more likely to report use of other drugs. Multiple studies have revealed associations between prescription drug misuse and higher rates of cigarette smoking; heavy episodic drinking; and marijuana, cocaine, and other illicit drug use among U.S. adolescents, young adults, and college students. In the case of prescription opioids, receiving a legitimate prescription for these drugs during adolescence is also associated with a greater risk of future opioid misuse, particularly in young adults who have little to no history of drug use. More than 80 percent of older patients (ages 57 to 85 years) use at least one prescription medication on a daily basis, with more than 50 percent taking more than five medications or supplements daily. This can potentially lead to health issues resulting from unintentionally using a prescription medication in a manner other than how it was prescribed, or from intentional nonmedical use. The high rates of multiple (comorbid) chronic illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions make medication (and other substance) misuse more dangerous in older people than in younger populations. Further, a large percentage of older adults also use over-the-counter medicines and dietary and herbal supplements, which could compound any adverse health consequences resulting from nonmedical use of prescription drugs.",Prescription drugs,,https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse,,,
+Q513,Is it safe to use prescription drugs in combination with other medications?,"The safety of using prescription drugs in combination with other substances depends on a number of factors including the types of medications, dosages, other substance use (e.g., alcohol), and individual patient health factors. Patients should talk with their health care provider about whether they can safely use their prescription drugs with other substances, including prescription and over-the-counter (OTC) medications, as well as alcohol, tobacco, and illicit drugs. Specifically, drugs that slow down breathing rate, such as opioids, alcohol, antihistamines, CNS depressants, or general anesthetics, should not be taken together because these combinations increase the risk of life-threatening respiratory depression. Stimulants should also not be used with other medications unless recommended by a physician. Patients should be aware of the dangers associated with mixing stimulants and OTC cold medicines that contain decongestants, as combining these substances may cause blood pressure to become dangerously high or lead to irregular heart rhythms.",Prescription drugs,,https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/it-safe-to-use-prescription-drugs-in-combination-other-medications,,,
+Q514,What classes of prescription drugs are commonly misused?,"Opioids, CNS Depressants, and Stimulants",Prescription drugs,,https://www.drugabuse.gov/publications/misuse-prescription-drugs/what-classes-prescription-drugs-are-commonly-misused,,,
+Q515,Are prescription drugs safe to take when pregnant?,"Some prescription medications taken by a pregnant woman can cause her baby to develop dependence, which can result in withdrawal symptoms after birth, known as neonatal abstinence syndrome (NAS). This can require a prolonged stay in neonatal intensive care and, in the case of opioids, treatment with medication. Women should consult with their doctors to determine which medications they can continue taking during pregnancy. Opioid pain medications require particular attention; rising rates of NAS have been associated with increases in the prescription of opioids for pain in pregnant women. NAS associated with opioid use (heroin or prescription opioids) increased fivefold from 2000 to 2012, with a higher rate of increase in more recent years.",Prescription drugs,,https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/are-prescription-drugs-safe-to-take-when-pregnant,,,
+Q516,How can prescription drug misuse be prevented?,"Physicians, their patients, and pharmacists all can play a role in identifying and preventing nonmedical use of prescription drugs. More than 84 percent of Americans had contact with a health care professional in 2016, placing doctors in a unique position to identify nonmedical use of prescription drugs and take measures to prevent the escalation of a patient’s misuse to a substance use disorder. By asking about all drugs, physicians can help their patients recognize whether a problem exists, provide or refer them to appropriate treatment, and set recovery goals. Evidence-based screening tools for nonmedical use of prescription drugs can be incorporated into routine medical visits. Doctors should also take note of rapid increases in the amount of medication needed or frequent, unscheduled refill requests. Doctors should be alert to the fact that those misusing prescription drugs may engage in ""doctor shopping""—moving from provider to provider—in an effort to obtain multiple prescriptions for their drug(s) of choice. Prescription drug monitoring programs (PDMPs), state-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients, are also important tools for preventing and identifying prescription drug misuse. While research regarding the impact of these programs is currently mixed, the use of PDMPs in some states has been associated with lower rates of opioid prescribing and overdose, though issues of best practices, ease of use, and interoperability remain to be resolved. In 2015, the federal government launched an initiative directed toward reducing opioid misuse and overdose, in part by promoting more cautious and responsible prescribing of opioid medications. In line with these efforts, in 2016 the Centers for Disease Control and Prevention (CDC) published its CDC Guideline for Prescribing Opioids for Chronic Pain to establish clinical standards for balancing the benefits and risks of chronic opioid treatment. Then, in 2017, President Trump established the President's Commission on Combating Drug Addiction and the Opioid Crisis. The commission outlined several priority areas aimed at improving the prevention and treatment of opioid addiction. Coordinated federal efforts to reduce opioid addiction and overdose are ongoing.",Prescription drugs,,https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented,,,
+Q517,How can prescription drug addiction be treated?,"Years of research have shown that substance use disorders are brain disorders that can be treated effectively. Treatment must take into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and medications, when available. Multiple courses of treatment may be needed for the patient to make a full recovery. The two main categories of drug use disorder treatment are behavioral treatments (such as contingency management and cognitive-behavioral therapy) and medications. Behavioral treatments help patients stop drug use by changing unhealthy patterns of thinking and behavior; teaching strategies to manage cravings and avoid cues and situations that could lead to relapse; or, in some cases, providing incentives for abstinence. Behavioral treatments, which may take the form of individual, family, or group counseling, also can help patients improve their personal relationships and their ability to function at work and in the community. Addiction to prescription opioids can additionally be treated with medications including buprenorphine, methadone, and naltrexone. These drugs can prevent other opioids from affecting the brain (naltrexone) or relieve withdrawal symptoms and cravings (buprenorphine and methadone), helping the patient avoid relapse. Medications for the treatment of opioid addiction are often administered in combination with psychosocial supports or behavioral treatments, known as medication-assisted treatment (MAT). A medication to reduce the physical symptoms of withdrawal (lofexidine) is also available.",Prescription drugs,,https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-addiction-be-treated,,,
+Q518,Why do kids abuse prescription drugs?,"They are seeking psychological or physical pleasure.
+■■ They want to fit in with groups of friends and are in
+search of acceptance and bonding.
+■■ They do not realize the risks of taking medicines that
+have not been prescribed specifically for them or the
+danger of not following a prescription’s directions.
+■■ It is easier to get prescription drugs than illegal drugs.",Prescription drugs,,https://store.samhsa.gov/product/Talking-Your-Kids-About-Prescription-Drug-Abuse-Not-Worth-Risk-Parents/SMA12-4676B1?referer=from_search_result,"Nothing wrong, just think it might be good to include a statement such as ""including but not limited to""",,
+Q519,What is the best way to prevent prescription drug abuse?,"The best way to prevent prescription drug abuse is to first educate yourself. That way, you can accurately and adequately present the facts when you talk with your teen. Be sure you can recognize the signs of prescription drug abuse:
+Fatigue, red or glazed eyes, and repeated health complaints
+Sudden mood changes, including irritability, negative attitude, personality changes, and general lack of interest in hobbies/activities
+Secretiveness and withdrawing from family
+Decreased or obsessive interest in school work
+Missing prescription medicines from your medicine cabinet
+Additional filled prescriptions on your pharmacy record that you did not order
+Some of these warning signs might signal other problems as well. If you recognize any of these signs, contact your teen’s physician or other healthcare professional.",Prescription drugs,,https://store.samhsa.gov/product/Talking-Your-Kids-About-Prescription-Drug-Abuse-Not-Worth-Risk-Parents/SMA12-4676B1?referer=from_search_result,,,
+Q520,What could possibly happen to me if I abuse prescription drugs? ,"The truth is:
+■■ Abusing certain painkillers is similar to abusing heroin because their ingredients affect the brain in the same way.
+■■ Sleeping pills can slow your breathing and your heart, which can be fatal—especially if combined with certain prescription pain medicines, alcohol, or over-the-counter cold remedies.
+■■ Abusing medicines intended to treat ADHD can cause irregular heartbeats or deadly seizures. Mixing them with cold medicines could make these dangerous effects worse.",Prescription drugs,,https://store.samhsa.gov/product/Prescription-Drugs-They-Can-Help-But-Also-Hurt-Not-Worth-the-Risk-for-Teens-/SMA12-4677B2?referer=from_search_result,,,
+Q521,How do I know if one of my friends (or I) have a problem?,"Prescription drugs are intended to make people who have a condition or illness better. When people use them for anything other than their recommended purposes, they are at risk for serious health consequences. Here are some things to look for if you suspect your friends are abusing prescription drugs:
+■■ Are they hanging out with new friends or withdrawing from your group of friends entirely?
+■■ Do these friends hold parties where everyone contributes medicines that are taken, often with alcohol or other illegal substances?
+■■ Is there a notable change in their personality? Perhaps starting arguments?
+■■ Do they seem drowsier on some days and have a lot more energy on others?
+■■ Are they less interested in hobbies or school activities that they had been involved with?",Prescription drugs,,https://store.samhsa.gov/product/Prescription-Drugs-They-Can-Help-But-Also-Hurt-Not-Worth-the-Risk-for-Teens-/SMA12-4677B2?referer=from_search_result,,,
+Q522,What if I need help with my or my friend's prescription drug use?,"If you notice a friend who needs help for abusing prescription drugs—or if you feel your own misuse has spiraled out of control—there are ways to get
+help. Talk to a parent, teacher, guidance counselor, or other trusted adult. The sooner you acknowledge the problem, the better the chances
+are of overcoming an addiction—and ultimately saving a life.",Prescription drugs,,https://store.samhsa.gov/product/Prescription-Drugs-They-Can-Help-But-Also-Hurt-Not-Worth-the-Risk-for-Teens-/SMA12-4677B2?referer=from_search_result,,,
+Q523,Are prescription drugs dangerous?,"ALL drugs are chemicals that affect the body. But some people don’t realize that prescription drugs and over-the-counter drugs can be equally as dangerous as street drugs. The very reason prescription drugs require a prescription from a doctor is because they are powerful substances and need to be regulated and taken under a physician’s care to ensure that patients take them safely.
+Even if a person is prescribed a medication, taking more of that drug, or taking it more often than recommended, is dangerous. The most recent research on deaths in the U.S. due to unintentional poisoning over a five-year period shows that nearly all poisoning deaths are attributed to prescription and illegal drugs. Prescription opioids such as hydrocodone, oxycodone, and methadone account for the greatest percentage of deaths from prescription drugs.
+Side effects of prescription drugs, including painkillers, depressants, and stimulants, include respiratory depression, dizziness, slurred speech, poor concentration, feelings of confusion, increased heart rate and breathing, excessive sweating, vomiting, tremors, anxiety, hostility and aggression, suicidal and homicidal tendencies, convulsions, lack of energy, inability to concentrate, nausea and vomiting, apathy, heart attacks, addiction, coma, and death.
+Prescription drugs can also be addictive. Between 1995 and 2005, treatment admissions for abuse of prescription pain relievers grew more than 300 percent. Additionally, getting prescription drugs without a prescription is illegal and may subject a person to arrest and prosecution. Regardless of how you acquire a prescription medication, using these types of drugs without a valid prescription and medical supervision is unsafe and illegal.",Prescription drugs,,https://abovetheinfluence.com/faqs/,,,
+Q524,Is abuse of prescription medications as dangerous as other forms of illegal drug use?,"Psychoactive prescription drugs, which include opioid pain relievers, stimulants prescribed for ADHD, and central nervous system depressants prescribed to treat anxiety or sleep disorders, are all effective and safe when taken as prescribed by a doctor for the conditions they are intended to treat. However, they are frequently abused—that is, taken in other ways, in other quantities, or by people for whom they weren’t prescribed—and this can have devastating consequences. In the case of opioid pain relievers such as Vicodin® or OxyContin®, there is a great risk of addiction and death from overdose associated with such abuse. Especially when pills are crushed and injected or snorted, these medications affect the brain and body very much like heroin, including euphoric effects and a hazardous suppression of breathing (the reason for death in cases of fatal opioid overdose). In fact, some young people who develop prescription opioid addictions shift to heroin because it may be cheaper to obtain. ADHD medications such as Adderall® (which contains the stimulant amphetamine) are increasingly popular among young people who take them believing it will improve their school performance. This too is a dangerous trend. Prescription stimulants act in the brain similarly to cocaine or illegal amphetamines, raising heart rate and blood pressure, as well as producing an addictive euphoria. Other than promoting wakefulness, it is unclear that such medications actually provide much or any cognitive benefit, however, beyond the benefits they provide when taken as prescribed to those with ADHD.",Prescription drugs,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q525,Why have prescription opioids become so widely misused in the U.S.?,"There are several possible reasons for the recent increase in prescription opioid abuse, according to National Institute of Drug Abuse Director and BBRF Scientific Council Member Nora D. Volkow, M.D. In her 2014 testimony before Congress, Dr. Volkow cited a drastic increase in opioid prescriptions filled; greater acceptability among the public for opioid medications being used for several purposes; and aggressive marketing of opioid drugs by pharmaceutical companies as reasons for crisis levels of opioid abuse. The number of prescriptions has increased from 76 million in 1991 to almost 207 million in 2013, she testified.",Prescription drugs,,https://www.bbrfoundation.org/faq/frequently-asked-questions-about-addiction,,,
+Q526,Why can't I stop using drugs on my own?,"Repeated drug use changes the brain, including parts of the brain that enable you to exert self-control. These and other changes can be seen clearly in brain imaging studies of people with drug addictions. These brain changes explain why quitting is so difficult, even if you feel ready.",Drugs,,https://www.drugabuse.gov/publications/step-by-step-guides-to-finding-treatment-drug-use-disorders/if-you-have-problem-drugs-adults/how-to-recognize-substance-use-disorder,,,
+Q527,What role do 12-step groups or other recovery support services play in addiction treatment for adolescents?,"Adolescents may benefit from participation in self- or mutual-help groups like 12-step programs or other recovery support services, which can reinforce abstinence from drug use and other changes made during treatment, as well as support progress made toward important goals like succeeding in school and reuniting with family. Peer recovery support services and recovery high schools provide a community setting where fellow recovering adolescents can share their experiences and support each other in living a drug-free life. It is important to note that recovery support services are not a substitute for drug abuse treatment. Also, there is sometimes a risk in support-group settings that conversation among adolescents can turn to talk extolling drug use; group leaders need to be aware of such a possibility and be ready to direct the discussion in more positive directions if necessary.",Recovery,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q528,How do I know when I am in recovery?,"Here are four signs:
+•I can address problems as they happen, without using drugs or alcohol, and without getting stressed out.
+•I have at least one person I can be completely honest with.
+•I have personal boundaries and know which issues are mine and which ones belong to other people.
+•I take the time to restore my energy—physical and emotional— when I am tired.",Recovery,,https://store.samhsa.gov/product/The-Next-Step-Toward-a-Better-Life/SMA14-4474?referer=from_search_result,,,
+Q529,How do you escape from the misery and risks of drug addiction? ,"Most people cannot do it on their own. They need help to return to normal, healthy living. One important form of help is called medication-assisted treatment.
+There are three, equally important parts to this form of treatment:
+• Medication
+• Counseling
+• Support from family and friends.",Recovery,,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q530,What are recovery-supportive houses?,"Recovery-supportive houses provide both a substance-free environment and mutual support from
+fellow recovering residents. Many residents stay in recovery housing during and/or after outpatient
+treatment, with self-determined residency lasting for several months to years. Residents often
+informally share resources with each other, giving advice borne of experience about how to access
+health care, find employment, manage legal problems, and interact with the social service system.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q531,What are peer recovery coaches?,"Peer recovery coaches are:
+• Individuals in recovery who help others with substance use disorders achieve and maintain recovery using
+four types of support:
+Š Emotional (empathy, caring, concern);
+Š Informational (practical knowledge and vocational assistance);
+Š Instrumental (concrete assistance to help individuals gain access to health and social services);
+Š Affiliational (introductions to healthy social contacts and recreational pursuits).
+• Embedded in the community in a variety of settings, including recovery community organizations;
+community health, mental health, or addiction clinics; sober living homes and recovery residences; and
+recovery high school and collegiate recovery programs.
+• Peer workers in various treatment and recovery contexts including primary care, emergency departments,
+mental health clinics, criminal justice, child welfare, homeless agencies, and crisis outreach teams.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q532,What is telephone case monitoring?,"Telephone case monitoring is another long-term recovery management and monitoring method for maintaining contact with patients without requiring an in-person appointment. It can be provided by professionals or by peers, although only the former approach has been rigorously studied.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q533,What is recovery?,"A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Even individuals with severe and chronic substance use disorders can, with help, overcome their substance use disorder and regain health and social function. This is called remission. When those positive changes and values become part of a voluntarily adopted lifestyle, that is called “being in recovery”. Although abstinence from all substance misuse is a cardinal feature of a recovery lifestyle, it is not the only healthy, pro-social feature.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q534,How does sleep loss affect recovery?,"Sleep loss can have significant negative effects on the physical, mental, and emotional well-being of people in recovery. It can also interfere with substance abuse treatment. Persistent sleep complaints after withdrawal are associated with relapse to alcohol use. Poor sleep quality before a quit attempt from cannabis use is a risk factor for lapsing back into use within 2 days.",Recovery,,https://store.samhsa.gov/product/Treating-Sleep-Problems-of-People-in-Recovery-From-Substance-Use-Disorders/SMA14-4859?referer=from_search_result,,,
+Q535,What if I have been in rehab before?,"This means you have already learned many of the skills needed to recover from addiction and should try it again. Relapse should not discourage you. Relapse rates with addiction are similar to rates for other chronic diseases many people live with, such as hypertension and asthma. Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse sometimes goes with the territory—it does not mean treatment failed. A return to drug use indicates that treatment needs to be started again or adjusted, or that you might benefit from a different approach.",Relapse,,https://www.drugabuse.gov/publications/step-by-step-guides-to-finding-treatment-drug-use-disorders/if-you-have-problem-drugs-adults/how-to-recognize-substance-use-disorder,,,
+Q536,What is relapse?,The return to alcohol or drug use after a significant period of abstinence.,Relapse,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q537,What is relapse prevention training?,"Relapse prevention training teaches people how to identify their relapse triggers, how to cope with cravings, how to develop plans for handling stressful situations, and what to do if they relapse. A trigger is anything that makes a person crave a drug. Triggers often are connected to the person’s
+past use, such as a person he or she used drugs with, a time or place, drug use paraphernalia (such as syringes, a pipe, or a bong), or a particular
+situation or emotion.",Relapse,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q538,"What are signs of drug use in adolescents, and what role can parents play in getting treatment?","If an adolescent starts behaving differently for no apparent reason—such as acting withdrawn, frequently tired or depressed, or hostile—it could be a sign he or she is developing a drug-related problem. Parents and others may overlook such signs, believing them to be a normal part of puberty. Other signs include: a change in peer group
+carelessness with grooming
+decline in academic performance
+missing classes or skipping school
+loss of interest in favorite activities
+changes in eating or sleeping habits
+deteriorating relationships with family members and friends
+Parents tend to underestimate the risks or seriousness of drug use. The symptoms listed here suggest a problem that may already have become serious and should be evaluated to determine the underlying cause—which could be a substance abuse problem or another mental health or medical disorder. Parents who are unsure whether their child is abusing drugs can enlist the help of a primary care physician, school guidance counselor, or drug abuse treatment provider.",Drug use,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q539,Are steroids addictive and can steroid abuse be treated?,"Some adolescents—mostly male—abuse anabolic-androgenic steroids in order to improve their athletic performance and/or improve their appearance by helping build muscles. Steroid abuse may lead to serious, even irreversible, health problems including kidney impairment, liver damage, and cardiovascular problems that raise the risk of stroke and heart attack (even in young people). An undetermined percentage of steroid abusers may also become addicted to the drugs—that is, continuing to use them despite physical problems and negative effects on social relations—but the mechanisms causing this addiction are more complex than those for other drugs of abuse. Steroids are not generally considered intoxicating, but animal studies have shown that chronic steroid use alters the same dopamine reward pathways in the brain that are affected by other substances. Other factors such as underlying body image problems also contribute to steroid abuse. Moreover, when people stop using steroids, they can experience withdrawal symptoms such as hormonal changes that produce fatigue, loss of muscle mass and sex drive, and other unpleasant physical changes. One of the more dangerous withdrawal symptoms is depression, which has led to suicide in some people discontinuing steroids. Steroid abuse is also frequently complicated by abuse of other substances taken either as part of a performance-enhancing regimen (such as stimulants) or to help manage pain-, sleep-, or mood-related side effects (such as opioids, cannabis, and alcohol). Because of this complicated mix of issues, treatment for steroid abuse necessarily involves addressing all related mental and physical health issues and substance use disorders simultaneously. This may involve behavioral treatments as well as medications to help normalize the hormonal system and treat any depression or pain issues that may be present. If symptoms are severe or prolonged, hospitalization may be needed.",Steroids,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q540,What is a substance?,"A psychoactive compound with the potential to cause health and social problems, including substance use disorders (and their most severe manifestation, addiction).",Substance use disorder,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q541,What role can medical professionals play in addressing substance abuse (including abuse of prescription drugs) among adolescents?,"Medical professionals have an important role to play in screening their adolescent patients for drug use, providing brief interventions, referring them to substance abuse treatment if necessary, and providing ongoing monitoring and follow-up. Screening and brief interventions do not have to be time-consuming and can be integrated into general medical settings.",Substance abuse,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q542,Are there medications to treat adolescent substance abuse?,"Several medications are approved by the FDA to treat addiction to opioids, alcohol, and nicotine in individuals 18 and older. In most cases, little research has been conducted to evaluate the safety and efficacy of these medications for adolescents; however, some health care providers do use these medications “off-label,” especially in older adolescents.",Substance abuse,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q543,What is substance abuse?,"Alcoholism and drug dependence and addiction, known as substance use disorders, are complex problems. People with these disorders once were thought to have a character defect or moral weakness; some people mistakenly still believe that. However, most scientists and medical researchers now consider dependence on alcohol or drugs to be a long-term illness, like asthma, hypertension (high blood pressure), or diabetes. Most people who drink alcohol drink very little, and many people can stop taking drugs without a struggle. However, some people develop a substance use disorder—use of alcohol or drugs that is compulsive or dangerous (or both).",Substance abuse,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q544,Why do some people develop a problem but others don’t?,"Substance use disorder is an illness that can affect anyone: rich or poor, male or female, employed or unemployed, young or old, and any race or ethnicity. Nobody knows for sure exactly what causes it, but the chance of developing a substance use disorder depends partly on genetics—biological traits passed down through families. A person’s environment, psychological traits, and stress level also play major roles by contributing to the use of alcohol or drugs. Researchers have found that using drugs for a long time changes the brain in important, long-lasting ways. It is as if a switch in the brain turned on at some point. This point is different for every person, but when this switch turns on, the person crosses an invisible line and becomes dependent on the substance. People who start using drugs or alcohol early in life run a greater risk of crossing this line and becoming dependent. These changes in the brain remain long after a person stops using drugs or drinking alcohol.",Substance abuse,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q545,Who provides treatment for substance abuse?,"Many different kinds of professionals provide treatment for substance use disorders. In most treatment programs, the main caregivers are specially trained individuals certified or licensed as substance abuse treatment counselors. About half these counselors are people who are in recovery themselves. Many programs have staff from several different ethnic or cultural groups. Most treatment programs assign patients to a treatment team of professionals. Depending on the type of treatment, teams can be made up of social workers, counselors, doctors, nurses, psychologists, psychiatrists, or other professionals.",Substance abuse,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q546,What types of substance abuse treatment programs are available?,"Several types of treatment
+programs are available:
+•Inpatient treatment
+•Residential programs
+•Partial hospitalization or
+day treatment
+•Outpatient and intensive outpatient programs
+•Methadone clinics (also called opioid treatment programs)",Substance abuse,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q547,What happens in substance abuse treatment?,"Not all treatment programs are alike, but most follow this general idea:
+First, the counselor will ask you questions about your drinking or drug use, your physical health, and other issues in your life. This is called assessment. The counselor will use the answers to your questions to determine how to help you. Many counselors are in recovery and know what you are going through.
+Together, you and the counselor will make a treatment plan. The treatment plan is a written outline of your goals and antidrink/drug activities. It will also contain the “tools” you will need to help you stay sober. These can include:
+•Help in identifying triggers (a trigger is anything that makes you crave alcohol or drugs)
+•Relapse prevention training
+•Stress management
+•Selfhelp groups in which you are comfortable
+•Medicine for pain, cravings, or depression
+•Time or money management skills
+•Job skills",Substance abuse,,https://store.samhsa.gov/product/The-Next-Step-Toward-a-Better-Life/SMA14-4474?referer=from_search_result,,,
+Q548,What are two goals of substance abuse treatment?,"One goal is to help you stop using. The other goal is to help you relearn how to live without drugs or alcohol. It can take a long time for substance abuse to develop, and it can take a long time to relearn how to live without using.",Substance abuse,,https://store.samhsa.gov/product/The-Next-Step-Toward-a-Better-Life/SMA14-4474?referer=from_search_result,,,
+Q549,Is substance abuse increasing in older people?,"Growing numbers of older adults are abusing alcohol and drugs. Some reports estimated substance abuse disorders among people over 50 would hit 5.7 million in 2020. That’s more than double the number in 2006. It's been called the ""invisible epidemic.""",Substance abuse,,https://www.webmd.com/mental-health/addiction/qa/is-substance-abuse-increasing-among-older-people,,,
+Q550,How do I know if I am abusing prescription drugs?,"If you are abusing them, you may be taking larger doses than your doctor prescribed, or using them for reasons other than prescribed. Your doctor may notice that you call more often for refills for the medication or that you're asking for larger amounts of it. This may also be a sign of abusing prescription drugs. Also, your pharmacist may notice prescription drug abuse by spotting false or altered prescription forms or multiple prescriptions for controlled substances from different doctors.",Substance abuse,,https://www.webmd.com/mental-health/addiction/qa/how-do-i-know-if-i-am-abusing-prescription-drugs,,,
+Q551,Which older people are most at risk of abusing alcohol or drugs?,"Among people 50 and up with substance abuse problems, men are more likely to abuse alcohol. Women are more likely to abuse prescription drugs. You're at a higher risk of abusing drugs or alcohol in your later years if you:
+
+Are white
+Have a higher income
+Live alone
+Lost your spouse
+Retired unexpectedly or were laid off
+Have long-lasting (chronic) pain
+Are disabled
+Have a history of substance abuse or mental illness",Substance abuse,,https://www.webmd.com/mental-health/addiction/qa/which-older-people-are-most-at-risk-of-abusing-alcohol-or-drugs,,,
+Q552,What is the long-term outlook for people with opioid disorder?,"Substance abuse disorder is a chronic illness, which means you’ll have it for the rest of your life. Most people have a relapse at some point. Some people take the medications that help manage withdrawal symptoms, or other drugs like them, for years.",Substance abuse,,https://www.webmd.com/mental-health/addiction/qa/what-is-the-longterm-outlook-for-people-with-opioid-disorder,,,
+Q553,What are substance misuse problems or consequences?,"Any health or social problem that results from substance misuse. Substance misuse problems or consequences may affect the substance user or those around them, and they may be acute (e.g., an argument or fight, a motor vehicle crash, an overdose) or chronic (e.g., a long-term substance-related medical, family, or employment problem, or chronic medical condition, such as various cancers, heart disease, and liver disease). These problems may occur at any age and are more likely to occur with greater frequency of substance misuse.",Substance abuse,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q554,How prevalent is substance misuse and suicide?,"In 2013, there were more than 41,000 deaths as a result of suicide in the U.S. Suicide is the tenth leading cause of death, claiming more lives each year than death due to motor vehicle crashes. It is the second leading cause of death for young people age 10 to 24, as well as for those age 25 to 42.",Substance abuse,,https://store.samhsa.gov/product/In-Brief-Substance-Use-and-Suicide-/sma16-4935?referer=from_search_result,,,
+Q555,"
+What should you or a loved one do if you suspect a problem with alcohol or drugs?","If you think you might have an alcohol or drug problem, first talk to your doctor. They can assess you, and help you find treatment if needed. Depending on your situation, it could include:
+
+A session with your doctor
+Medication
+Individual or group therapy
+A detox program
+Support groups
+Treatment usually works even better for older people than for younger ones.",Substance abuse,,https://www.webmd.com/mental-health/addiction/qa/what-should-you-or-a-loved-one-do-if-you-suspect-a-problem-with-alcohol-or-drugs,,,
+Q556,What if I can’t stop using drugs or alcohol?,"Don’t be afraid or ashamed to ask for help. Call the Drug and Alcohol Treatment Hotline (1-800-662-HELP [4357]) for help in getting treatment. It can be your first step toward recovery. If you decide to get drug or alcohol treatment in addition to HIV treatment, let your current doctor know. He or she can work with your drug or alcohol treatment provider to make sure the two types of treatment work together.",Substance use,,https://store.samhsa.gov/product/Drugs-Alcohol-and-HIV-AIDS-A-Consumer-Guide-for-African-Americans/SMA15-4248?referer=from_search_result,,,
+Q557,What is Lean?,Prescription cough medicines that contain promethazine (an antihistamine) or codeine are sometimes combined with soda and candy in a drink called “lean” or “sizzurp.”,Drugs,,https://teens.drugabuse.gov/blog/post/what-lean,,,
+Q558,What are some common signs substance abuse is present?,"Substance abuse affects different people in different ways depending on the substance and the individual. There are many common signs that are directly related to when a person becomes addicted to a substance though, and they may include:
+
+Letting primary responsibilities slip through the cracks. Examples include: failure to complete school work leading to flunking or not attending work because you’re too hungover.
+Financial and legal consequences are becoming a factor because of your substance abuse. Examples include: proven guilty of driving while under the influence, stealing to support your addiction, or getting into fights while under the influence.
+Relationship problems are starting to arise due to your substance abuse. Relationships are beginning to become distant between you and your partner, family members, co-workers, etc. Often times the relationship will become mostly a common battle or lead to a total loss of the relationship.
+Compulsive behaviors revolving around the substance. Examples include: stealing money, driving while intoxicated, having unprotected sex, etc.",Substance use,,https://tricircleinc.com/faqs/,,,
+Q559,What is high-risk substance use?,"For the purposes of addressing HIV and STD prevention, high-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice involvement, school dropout, loss of life). This includes misuse of prescription drugs, use of illicit drugs (i.e., cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy), and use of injection drugs which have a high risk of infection of blood-borne diseases such as HIV and hepatitis.",Substance use,,https://www.cdc.gov/healthyyouth/substance-use/index.htm,,,
+Q560,What are the symptoms of substance use disorders?,"One of the most important signs of substance addiction or dependence is continued use of drugs or alcohol despite experiencing the serious negative consequences of heavy drug or alcohol use. Often, a person will blame other people or circumstances for his or her problems instead of realizing that the difficulties result from use of drugs or alcohol. For example, your partner may believe he was fired from jobs because his bosses didn’t know how to run a business. Or your daughter may believe she got a ticket for driving under the influence of alcohol because the police were targeting her. Perhaps your loved one has even blamed you. People with this illness really may believe that they drink normally or that “everyone” takes drugs. These false beliefs are called denial, and denial is part of the illness. Other important symptoms of substance use disorders include
+•Tolerance—A person will need increasingly larger amounts of alcohol or drugs to get high.
+•Craving—A person will feel a strong need, desire, or urge to use alcohol or drugs, will use alcohol or a drug despite negative consequences, and will feel anxious and irritable if he or she can’t use them. Craving is a primary symptom of addiction.
+•Loss of control—A person often will drink more alcohol or take more drugs than he or she meant to, or may use alcohol or drugs at a time or place he or she had not planned. A person also may try to reduce or stop drinking or using drugs many times, but may fail.
+•Physical dependence or withdrawal symptoms—In some cases when alcohol or drug use is stopped, a person may experience withdrawal symptoms from a physical need for the substance. Withdrawal symptoms differ depending on the drug, but they may include nausea, sweating, shakiness, and extreme anxiety. The person may try to relieve these symptoms by taking either more of the same or a similar substance.
+",Substance use disorder,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q561,What is telehealth?,"The use of digital technologies such as EHRs, mobile applications, telemedicine, and web-based tools to support the delivery of health care, health-related
+education, or other health-related services and functions.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q562,What is telemedicine?,"Two-way, real-time interactive communication between a patient and a physician or other health care professional at a distant site. Telemedicine is a subcategory of telehealth. Telemedicine refers specifically to remote clinical services, whereas telehealth can include remote nonclinical services such as provider training, administrative meetings, and continuing medical education, and patient-focused technologies, in addition to clinical services.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q563,Is adolescent tobacco use treated similarly to other drug use?,"Yes. People often don’t think of tobacco use as a kind of “drug abuse” that requires treatment, and motives for quitting smoking may be somewhat different than motives for quitting other drugs. But tobacco use has well-known health risks—especially when begun in the teen years—and the highly addictive nicotine in tobacco can make treatment a necessity to help an adolescent quit. Laboratory research also suggests that nicotine may increase the rewarding and addictive effects of other drugs, making it a potential contributor to other substance use disorders.",Tobacco,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q564,What is tobacco?,"Tobacco is a plant grown for its leaves, which are dried and fermented before being put in tobacco products. Tobacco contains nicotine, an ingredient that can lead to addiction, which is why so many people who use tobacco find it difficult to quit. There are also many other potentially harmful chemicals found in tobacco or created by burning it.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q565,How do people use tobacco?,"People can smoke, chew, or sniff tobacco. Smoked tobacco products include cigarettes, cigars, bidis, and kreteks. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip, and snus; snuff can also be sniffed.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q566,How does tobacco affect the brain?,"The nicotine in any tobacco product readily absorbs into the blood when a person uses it. Upon entering the blood, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with drugs such as cocaine and heroin, nicotine activates the brain’s reward circuits and also increases levels of the chemical messenger dopamine, which reinforces rewarding behaviors. Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q567,What are other health effects of tobacco use?,"Although nicotine is addictive, most of the severe health effects of tobacco use comes from other chemicals. Tobacco smoking can lead to lung cancer, chronic bronchitis, and emphysema. It increases the risk of heart disease, which can lead to stroke or heart attack. Smoking has also been linked to other cancers, leukemia, cataracts, Type 2 Diabetes, and pneumonia. All of these risks apply to use of any smoked product, including hookah tobacco. Smokeless tobacco increases the risk of cancer, especially mouth cancers. Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Smoking while pregnant may also be associated with learning and behavioral problems in exposed children. People who stand or sit near others who smoke are exposed to secondhand smoke, either coming from the burning end of the tobacco product or exhaled by the person who is smoking. Secondhand smoke exposure can also lead to lung cancer and heart disease. It can cause health problems in both adults and children, such as coughing, phlegm, reduced lung function, pneumonia, and bronchitis. Children exposed to secondhand smoke are at an increased risk of ear infections, severe asthma, lung infections, and death from sudden infant death syndrome.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q568,What are behavioral treatments for tobacco use?,"Behavioral treatments use a variety of methods to help people quit smoking, ranging from self-help materials to counseling. These treatments teach people to recognize high-risk situations and develop strategies to deal with them. For example, people who hang out with others who smoke are more likely to smoke and less likely to quit.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q569,What are nicotine replacement therapies?,"Nicotine replacement therapies (NRTs) were the first medications the U.S. Food and Drug Administration (FDA) approved for use in smoking cessation therapy. Current FDA-approved NRT products include chewing gum, transdermal patch, nasal sprays, inhalers, and lozenges. NRTs deliver a controlled dose of nicotine to relieve withdrawal symptoms while the person tries to quit.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q570,What other medications are available for tobacco use cessation?,"Bupropion (Zyban®) and varenicline (Chantix®) are two FDA-approved non-nicotine medications that have helped people quit smoking. They target nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people start smoking again.",Tobacco,,https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products,,,
+Q571,What is the scope of tobacco use and its cost to society?,"Approximately one fourth of the population uses tobacco products, and 19.4 percent smoke cigarettes. According to the 2016 National Survey on Drug Use and Health (NSDUH), an estimated 63.4 million people aged 12 or older used a tobacco product during the past month, including 51.3 million cigarette smokers. Smoking rates continue to go down year to year; the percentage of people over age 18 who smoke cigarettes declined from 20.9 percent in 2005 to 15.8 percent in 2016, according to the 2017 National Health Interview Survey. However, smoking rates are substantially higher among some of the most vulnerable people in our society. The 25 percent of Americans with mental disorders, including addiction, account for 40 percent of the cigarettes smoked in the U.S. More than 40 percent of people with a General Education Development certificate (GED) smoke—which is the highest prevalence of any socioeconomic group. Also, people who live in rural areas, particularly in the South Atlantic states, use all forms of tobacco at higher rates than people who live in urban areas. These differences cannot be fully explained by different levels of poverty or affluence. Smoking among youth is at historically low levels. According to the NIDA-sponsored Monitoring the Future (MTF) survey, in 2015, an estimated 4.7 million middle and high school students used tobacco products during the past month, according to data from the National Youth Tobacco Survey (NYTS) e-cigarettes) were the most commonly used tobacco products among middle (5.3 percent) and high school (16.0 percent) students in 2015. E-cigarettes deliver synthetic nicotine and do not contain tobacco; however, they are classified as tobacco products for regulatory purposes. These findings are echoed by other studies, including the MTF survey. Scientists have not yet determined the medical consequences of long-term e-cigarette use or the secondhand effects of e-cigarette vapor. Between 1964 and 2012, an estimated 17.7 million deaths were related to smoking leads to more than 480,000 deaths annually. If current smoking rates continue, 5.6 million Americans who are currently younger than 18 will die prematurely from smoking-related disease. In addition to the tremendous impact of premature deaths related to tobacco use, the economic costs are high. Experts estimate that between 2009 and 2012, the annual societal costs attributable to smoking in the United States were between $289 and $332.5 billion. This includes $132.5 to $175.9 billion for direct medical care of adults and $151 billion for lost productivity due to premature deaths. In 2006, lost productivity due to exposure to secondhand smoke cost the country $5.6 billion. About 70 percent of current smokers’ excess medical care costs could be prevented by quitting.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-scope-tobacco-use-its-cost-to-society,"We might consider removing the MTF Study information, as it is outdated. Although cigarette smoking is on a decline, the prevalence of tobacco vaping has increased.",,
+Q572,How does tobacco deliver its effects?,"The smoke from combustible tobacco products contains more than 7,000 chemicals. Nicotine is the primary reinforcing component of tobacco; it drives tobacco addiction. Hundreds of compounds are added to tobacco to enhance its flavor and the absorption of nicotine. Cigarette smoking is the most popular method of using tobacco; however, many people also use smokeless tobacco products, such as snuff and chewing tobacco, which also contain nicotine. E-cigarettes, which deliver nicotine in the absence of other chemicals in tobacco, have become popular in recent years. The cigarette is a very efficient and highly engineered drug-delivery system. By inhaling tobacco smoke, the average smoker takes in 1–2 milligrams of nicotine per cigarette. When tobacco is smoked, nicotine rapidly reaches peak levels in the bloodstream and enters the brain. A typical smoker will take 10 puffs on a cigarette over the roughly 5 minutes that the cigarette is lit. Thus, a person who smokes about 1 pack (20 cigarettes) daily gets 200 ""hits"" of nicotine to the brain each day. Among those who do not inhale the smoke—such as cigar and pipe smokers and smokeless tobacco users—nicotine is absorbed through mucous membranes in the mouth and reaches peak blood and brain levels more slowly. Immediately after exposure to nicotine, there is a ""kick"" caused in part by the drug’s stimulation of the adrenal glands and resulting discharge of epinephrine (adrenaline). The rush of adrenaline stimulates the body and causes an increase in blood pressure, respiration, and heart rate. Like other drugs, nicotine also activates reward pathways in the brain—circuitry that regulates reinforcement and feelings of pleasure.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/how-does-tobacco-deliver-its-effects,,,
+Q573,What are the physical health consequences of tobacco use?,"Cigarette smoking harms nearly every organ in the body, and smoking is the leading preventable cause of premature death in the United States. Although rates of smoking have declined, it is estimated that it leads to about 480,000 deaths yearly. Smokers aged 60 and older have a twofold increase in mortality compared with those who have never smoked, dying an estimated 6 years earlier. Quitting smoking results in immediate health benefits, and some or all of the reduced life expectancy can be recovered depending on the age a person quits. Although nicotine itself does not cause cancer, at least 69 chemicals in tobacco smoke are carcinogenic, and cigarette smoking accounts for at least 30 percent of all cancer deaths. The overall rates of death from cancer are twice as high among smokers as nonsmokers, with heavy smokers having a four times greater risk of death from cancer than nonsmokers. Foremost among the cancers caused by tobacco use is lung cancer. Cigarette smoking has been linked to about 80 to 90 percent of all cases of lung cancer, the leading cause of cancer death for both men and women, and it is responsible for roughly 80 percent of deaths from this disease. Smoking increases lung cancer risk five to tenfold, with greater risk among heavy smokers. Smoking is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, and bladder, as well as acute myeloid. Cigarette smoking is not the only form of tobacco use associated with cancers. Smokeless tobacco has been linked to cancer of the pharynx, esophagus, stomach, and lung, as well as to colorectal cancer. In addition to cancer, smoking causes lung diseases such as chronic bronchitis and emphysema, and it has been found to exacerbate asthma symptoms in adults and children. Cigarette smoking is the most significant risk factor for chronic obstructive pulmonary disease (COPD). Survival statistics indicate that quitting smoking results in repair to much of the smoking-induced lung damage over time. However, once COPD develops, it is irreversible; COPD-related lung damage is not repaired with time. Smoking also substantially increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm. Cardiovascular disease is responsible for 40 percent of all smoking-related deaths. Smoking causes coronary heart disease, the leading cause of death in the United States. Smoking is also linked to many other major health conditions—including rheumatoid arthritis, inflammation, and impaired immune function. Even young smokers aged 26 to 41 report reduced health-related quality of life compared with nonsmoking peers, according to a cross-sectional population study. Recent animal research also identified a pathway between the pancreas and a part of the brain active in nicotine intake, potentially linking cigarette smoking to the risk of developing Type 2 Diabetes.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-physical-health-consequences-tobacco-use,,,
+Q574,What are the effects of secondhand and thirdhand tobacco smoke?,"Secondhand smoke is a significant public health concern and driver of smoke-free policies. Also called passive or secondary smoke, secondhand smoke increases the risk for many diseases. Exposure to environmental tobacco smoke among nonsmokers increases lung cancer risk by about 20 percent. Secondhand smoke is estimated to cause approximately 53,800 deaths annually in the United States. Exposure to tobacco smoke in the home is also a risk factor for asthma in children. Smoking also leaves chemical residue on surfaces where smoking has occurred, which can persist long after the smoke itself has been cleared from the environment. This phenomenon, known as ""thirdhand smoke,"" is increasingly recognized as a potential danger, especially to children, who not only inhale fumes released by these residues but also ingest residues that get on their hands after crawling on floors or touching walls and furniture. More research is needed on the risks posed to humans by thirdhand smoke, but a study in mice showed that thirdhand smoke exposure has several behavioral and physical health impacts, including hyperactivity and adverse effects on the liver and lungs.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-effects-secondhand-thirdhand-tobacco-smoke,,,
+Q575,What are the risks of smoking during pregnancy?,"Smoking during pregnancy is linked with a range of poor birth outcomes—including low birth weight and preterm birth; restricted head growth; placental problems; increased risk of still birth; increased risk of miscarriage. Health and developmental consequences among children have also been linked to prenatal smoke exposure, including poorer lung function; persistent wheezing; and asthma, possibly through DNA methylation; visual difficulties, such as strabismus, refractive errors, and retinopathy. Unfortunately, smoking by pregnant women is common. In 2014, 8.4 percent of women smoked at any time during pregnancy, with those aged 20 to 24 who were American Indian or Alaska Natives having higher rates, at 13 percent and 18 percent, respectively. One fifth of women who smoked during the first 6 months of pregnancy quit by their third trimester. Overall cessation rates were highest for those with the highest educational attainment and private insurance. Therefore, there is a clear need to expand smoking cessation treatment to younger women and to those of lower socioeconomic status.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-risks-smoking-during-pregnancy,,,
+Q576,How many adolescents use tobacco?,"Most people who use tobacco started during adolescence, and those who begin at a younger age are more likely to develop nicotine dependence and have trouble quitting. According to the 2017 Monitoring the Future Survey, 9.7 percent of 12th graders, 5.0 percent of 10th graders, and 1.9 percent of 8th graders used cigarettes in the past month. Analyses of the 2012 National Youth Tobacco Survey (NYTS) found that 20.8 percent of current adolescent tobacco users reported wanting to use tobacco within 30 minutes of waking—a classic symptom of nicotine dependence. This study also found that 41.9 percent reported strong cravings for tobacco. Other research has found that light and intermittent smoking among adolescents is associated with the same level of difficulty quitting as daily smoking. Any exposure to nicotine among youth is a concern. The adolescent brain is still developing, and nicotine has effects on the brain’s reward system and brain regions involved in emotional and cognitive functions. Research suggests that the nicotine-related changes to these areas of the brain during adolescence may perpetuate continued tobacco use into adulthood. These changes also contribute to a higher rate of other substance use disorders among people who use tobacco during adolescence, sometimes referred to as a ""gateway"" effect. Mental health, beliefs about smoking, perception of schoolmates’ smoking, and other substance use are additional factors that can influence an adolescent’s risk for smoking and nicotine dependence. Emotional problems—including depression and recent negative life events—are associated with tobacco use among adolescents. Smoking among peers and within social groups is a major environmental factor that influences adolescent smoking; social smoking is a more important motivator for adolescents compared to adult smokers. It is common for adolescent smoking to follow an intergenerational pattern, which has genetic, epigenetic, and environmental influences. Data from parents and adolescents suggests that current parental nicotine dependence is strongly linked with adolescent smoking and dependence. Other factors—such as parents’ education, marital status, and parenting behavior also influence teen smoking.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/how-many-adolescents-use-tobacco,,,
+Q577,Are there gender differences in tobacco smoking?,"Generally, men tend to use all tobacco products at higher rates than women. In 2015, 16.7 percent of adult males and 13.6 percent of adult females smoked cigarettes. Such differences may relate to a combination of physiological (particularly ovarian hormones), cultural, and behavioral factors. Results from neuroimaging studies suggest that smoking activates men’s reward pathways more than women's. This finding is consistent with the idea that men smoke for the reinforcing effects of nicotine, whereas women smoke to regulate mood or in response to cigarette-related cues. A study of stress responses and craving among male and female smokers who were trying to quit found that during abstinence, lower levels of the stress hormone cortisol predicted relapse in men. However, high cortisol levels were predictive of relapse in women. Other work on abstinence found that smoking a cigarette with nicotine, as compared to a de-nicotinized cigarette, alleviated the symptoms of withdrawal and negative mood to a greater extent in men than women. Women obtained equal relief from cigarettes with and without nicotine, suggesting that they found the drug less rewarding than men. Cigarette craving is a major reason why smokers find it hard to quit, and this strong urge to smoke can be evoked by sensory cues and stress. Research suggests that women experience stronger craving than men in response to stress, but men may be more responsive to environmental cues. Additionally, longitudinal data from international surveys conducted in four industrialized countries indicated that men and women did not differ in their desire to quit, plans to quit, or quit attempts. However, women were 31 percent less likely to quit successfully. One reason why women may have difficulty quitting is post-cessation weight gain. This concern should be addressed in behavioral counseling and adjunct treatments for all smokers. The overall lower cessation rate for women may reflect sex differences in response to particular medications. For example, varenicline has greater short- and immediate-term efficacy (at 3 and 6 months) among women smokers. However, women and men show similar 1-year quit rates when using varenicline. In contrast, a combination of varenicline plus bupropion was less effective for cessation among women compared with men. Another particular concern related to tobacco use among women is smoking during pregnancy. ",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/are-there-gender-differences-in-tobacco-smoking,"I'm not sure why this is highlighted, but I will copy/paste it into the other spreadsheet I made for Q/As with potential issues.",,
+Q578,Do people with mental illness and substance use disorders use tobacco more often?,"There is significant comorbidity between tobacco use and mental disorders. People with mental illness smoke at two to four times the rate of the general population. Among people with a mental illness, 36.1 percent smoked from 2009 to 2011, compared with 21.4 percent among adults with no mental illness. Smoking rates are particularly high among patients with serious mental illness (i.e., those who demonstrate greater functional impairment). While estimates vary, as many as 70-85 percent of people with schizophrenia and as many as 50-70 percent of people with bipolar disorder smoke. Rates of smoking among people with mental illness were highest for those younger than 45, those with low levels of education, and those living below the poverty level. Longitudinal data from NSDUH (2005–2013) indicate that smoking among adults without chronic conditions has declined significantly, but remains particularly high among those reporting anxiety, depression, and substance use disorders. Smoking is believed to be more prevalent among people with depression and schizophrenia because nicotine may temporarily lessen the symptoms of these illnesses, such as poor concentration, low mood, and stress. But it is important to note that smoking cessation has been linked with improved mental health—including reduced depression, anxiety, and stress, and enhanced mood and quality of life. Analyses of longitudinal NSDUH data also found a higher prevalence of smokeless tobacco use among individuals with mental health and substance use disorders. Other research drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions found that all types of substance dependence were associated with dependence on nicotine. Smoking is also highly prevalent among people in treatment for substance use disorders, with most studies finding rates between 65-85 percent among patients in addiction treatment. Additionally, smokers with a mental health disorder tend to smoke more cigarettes than those in the general population. The average number of cigarettes smoked during the past month was higher among those with a mental illness compared with those without one—331 versus 310 cigarettes. High cigarette consumption is a particular problem for people with serious mental illness. Although adults with serious mental illness comprised only 6.9 percent of past-month smokers, they consumed 8.7 percent of all cigarettes sold, according to data from the 2008–2012 NSDUH. People with mental and substance use disorders do not quit smoking at the same rate as those in the general population. Survey responses from people who have smoked at some point during their lives indicated that fewer smokers with mental illness had quit compared to those without psychiatric disorders: 47.4 percent of lifetime smokers without mental illness smoked during the past month, compared with 66 percent of those with mental illness. Having a mental disorder at the time of cessation is a risk factor for relapse to smoking, even for those who have sustained abstinence for more than a year. Many smokers with mental illness want to quit for the same reasons cited by others (such as health and family), but they may be more vulnerable to relapse related to stress and negative feelings. The disparity in smoking prevalence is costing lives. A recent study found that tobacco-related diseases accounted for approximately 53 percent of deaths among people with schizophrenia, 48 percent among those with bipolar disorder, and 50 percent among those with depression. Since the 1980s, many providers have believed that people with schizophrenia smoke to obtain relief from symptoms like poor concentration, low mood, and stress. But research is now showing that smoking is associated with worse behavioral and physical health outcomes in people with mental illness, and quitting smoking is showing clear benefits for this population. Comprehensive tobacco control programs and enhanced efforts to prevent and treat nicotine addiction among those with mental illness would reduce illness and deaths. Integrated treatment—concurrent therapy for mental illness and nicotine addiction—will likely have the best outcomes. Smokers who receive mental health treatment have higher quit rates than those who do not. Moreover, evidence-based treatments that work in the general population are also effective for patients with mental illness. For example, people with schizophrenia showed better quit rates with the medication bupropion, compared with placebo, and showed no worsening of psychiatric symptoms. A combination of the medication varenicline and behavioral support has shown promise for helping people with bipolar and major depressive disorders quit, with no worsening of psychiatric symptoms. A clinical trial found that a combination of varenicline and cognitive behavioral therapy (CBT) was more effective than CBT alone for helping people with serious mental illness stop smoking for a prolonged period—after 1 year of treatment and at 6 months after treatment ended.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often,,,
+Q579,How can we prevent tobacco use?,"The medical consequences of tobacco use—including secondhand exposure—make tobacco control and smoking prevention crucial parts of any public health strategy. Since the first Surgeon General’s Report on Smoking and Health in 1964, states and communities have made efforts to reduce initiation of smoking, decrease exposure to smoke, and increase cessation. Researchers estimate that these tobacco control efforts are associated with averting an estimated 8 million premature deaths and extending the average life expectancy of men by 2.3 years and of women by 1.6 years. But there is a long way yet to go: roughly 5.6 million adolescents under age 18 are expected to die prematurely as a result of an illness related to smoking. Prevention can take the form of policy-level measures, such as increased taxation of tobacco products; stricter laws (and enforcement of laws) regulating who can purchase tobacco products; how and where they can be purchased; where and when they can be used (i.e., smoke-free policies in restaurants, bars, and other public places); and restrictions on advertising and mandatory health warnings on packages. Over 100 studies have shown that higher taxes on cigarettes, for example, produce significant reductions in smoking, especially among youth and lower-income individuals. Smoke-free workplace laws and restrictions on advertising have also shown benefits. Prevention can also take place at the school or community level. Merely educating potential smokers about the health risks has not proven effective. Successful evidence-based interventions aim to reduce or delay initiation of smoking, alcohol use, and illicit drug use, and otherwise improve outcomes for children and teens by reducing or mitigating modifiable risk factors and bolstering protective factors. Risk factors for smoking include having family members or peers who smoke, being in a lower socioeconomic status, living in a neighborhood with high density of tobacco outlets, not participating in team sports, being exposed to smoking in movies, and being sensation-seeking. Although older teens are more likely to smoke than younger teens, the earlier a person starts smoking or using any addictive substance, the more likely they are to develop an addiction. Males are also more likely to take up smoking in adolescence than females. Some evidence-based interventions show lasting effects on reducing smoking initiation. For instance, communities utilizing the intervention-delivery system, Communities that Care (CTC) for students aged 10 to 14 show sustained reduction in male cigarette initiation up to 9 years after the end of the intervention.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/how-can-we-prevent-tobacco-use,"We might want to consider removing the male vs female smoking rate in the answer, but otherwise, I think it's okay to keep.",,
+Q580,What research is being done on tobacco use?,"New scientific developments can improve our understanding of nicotine addiction and spur the development of better prevention and treatment strategies. An estimated 50-75 percent of the risk for nicotine addiction is attributable to genetic factors. A cluster of genes (CHRNA5-CHRNA3-CHRNB4) on chromosome 15 that encode the α5, α3, and β4 protein subunits that make up the brain receptor for nicotine are particularly implicated in nicotine dependence and smoking among people of European descent. Variation in the CHRNA5 gene influences the effectiveness of combination NRT, but not varenicline. Other research has identified genes that influence nicotine metabolism and therefore, the number of cigarettes smoked, responsiveness to medication, and chances of successfully quitting. For example, the therapeutic response to varenicline is associated with variants for the CHRNB2, CHRNA5, and CHRNA4 genes, while bupropion-related cessation is linked with variation in genes that affect nicotine metabolism. Smoking can also lead to persistent changes in gene expression (epigenetic changes), which may contribute to associated medical consequences over the long term, even following cessation. Epigenetic changes may serve as a potential biomarker for prenatal tobacco smoke exposure. Researchers found tobacco-specific changes at 26 sites on the epigenome, and this pattern predicted prenatal exposure with 81 percent accuracy. A large scale meta-analysis of data on epigenetic changes associated with prenatal exposure to cigarette smoke also identified many epigenetic changes that persisted into later childhood. More research is needed to understand the long-term health impacts of these changes. Cutting-edge neuroimaging technologies have identified brain changes associated with nicotine dependence and smoking. Using functional magnetic resonance imaging (fMRI), scientists can visualize smokers’ brains as they respond to cigarette-associated cues that can trigger craving and relapse. Such research may lead to a biomarker for relapse risk and for monitoring treatment progress, as well as point to regions of the brain involved in the development of nicotine addiction. A neuroimaging technology called default-mode or resting-state fMRI (rs-fMRI) reveals intrinsic brain activity when people are alert but not performing a particular task. Using this technique, researchers are examining the neurobiological profile associated with withdrawal and how nicotine impacts cognition. Comparisons between smokers and nonsmokers suggest that chronic nicotine may weaken connectivity within brain circuits involved in planning, paying attention, and behavioral control—possibly contributing to difficulty with quitting. fMRI studies also reveal the impact of smoking cessation medications on the brain—particularly how they modulate the activity of different brain regions to alleviate withdrawal symptoms and reduce smoking. A review of these studies suggested that NRT enhances cognition during withdrawal by modulating activity in default-network regions, but may not affect neural circuits associated with nicotine addiction. Some imaging techniques allow researchers to visualize neurotransmitters and their receptors, further informing our understanding of nicotine addiction and its treatment. Using these techniques, researchers have established that smoking increases the number of brain receptors for nicotine. Individuals who show greater receptor upregulation are less likely to stop smoking. Combining neuroimaging and genetics may yield particularly useful information for improving and tailoring treatment. For example, nonsmoking adolescents with a particular variant in the CHRNA5-CHRNA3-CHRNB4 gene cluster (which is associated with nicotine dependence and smoking) showed reduced brain activity in response to reward in the striatum as well as the orbitofrontal and anterior cingulate cortex. This finding suggests that genetics can influence how the brain processes rewards which may influence vulnerability to nicotine dependence. Neuroimaging genetics also shows that other genes, including ones that influence dopamine neurotransmission, influence reward sensitivity and risk for addiction to nicotine.",Tobacco,,https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-research-being-done-tobacco-use,,,
+Q581,Why combine smoking cessation and substance use disorder treatment?,"Quitting smoking increases the odds of long-term recovery, whereas continued smoking following treatment increases the likelihood of relapse to substance use.
+● Tobacco cessation can have mental health benefits.
+● Quitting smoking at any age has physical health benefits that begin almost immediately and continue for years.
+● Quitting smoking can increase clients’ sense of mastery, helping them focus on a positive lifestyle.",Tobacco,,https://store.samhsa.gov/sites/default/files/d7/priv/sma18-5069qg.pdf,,,
+Q582,What is tolerance?,Alteration of the body’s responsiveness to alcohol or a drug such that higher doses are required to produce the same effect achieved during initial use.,Addiction,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q583,How do we get more substance-abusing people into treatment?,"It has been known for many years that the ""treatment gap” is massive—that is, among those who need treatment for a substance use disorder, few receive it. In 2011, 21.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, but only 2.3 million received treatment at a specialty substance abuse facility. Reducing this gap requires a multipronged approach. Strategies include increasing access to effective treatment, achieving insurance parity (now in its earliest phase of implementation), reducing stigma, and raising awareness  among both patients and healthcare professionals of the value of addiction treatment. To assist physicians in identifying treatment need in their patients and making appropriate referrals, NIDA is encouraging widespread use of screening, brief intervention, and referral to treatment (SBIRT) tools for use in primary care settings through its NIDAMED initiative. SBIRT, which evidence shows to be effective against tobacco and alcohol use—and, increasingly, against abuse of illicit and prescription drugs—has the potential not only to catch people before serious drug problems develop, but also to identify people in need of treatment and connect them with appropriate treatment providers.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q584,How do other mental disorders coexisting with drug addiction affect drug addiction treatment?,"Drug addiction is a disease of the brain that frequently occurs with other mental disorders. In fact, as many as 6 in 10 people with an illicit substance use disorder also suffer from another mental illness; and rates are similar for users of licit drugs—i.e., tobacco and alcohol. For these individuals, one condition becomes more difficult to treat successfully as an additional condition is intertwined. Thus, people entering treatment either for a substance use disorder or for another mental disorder should be assessed for the co-occurrence of the other condition. Research indicates that treating both (or multiple) illnesses simultaneously in an integrated fashion is generally the best treatment approach for these patients.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q585,Is the use of medications like methadone and buprenorphine simply replacing one addiction with another?,"No. Buprenorphine and methadone are prescribed or administered under monitored, controlled conditions and are safe and effective for treating opioid addiction when used as directed. They are administered orally or sublingually (i.e., under the tongue) in specified doses, and their effects differ from those of heroin and other abused opioids. Heroin, for example, is often injected, snorted, or smoked, causing an almost immediate ""rush,"" or brief period of intense euphoria, that wears off quickly and ends in a ""crash."" The individual then experiences an intense craving to use the drug again to stop the crash and reinstate the euphoria.The cycle of euphoria, crash, and craving—sometimes repeated several times a day—is a hallmark of addiction and results in severe behavioral disruption. These characteristics result from heroin’s rapid onset and short duration of action in the brain. In contrast, methadone and buprenorphine have gradual onsets of action and produce stable levels of the drug in the brain. As a result, patients maintained on these medications do not experience a rush, while they also markedly reduce their desire to use opioids. If an individual treated with these medications tries to take an opioid such as heroin, the euphoric effects are usually dampened or suppressed. Patients undergoing maintenance treatment do not experience the physiological or behavioral abnormalities from rapid fluctuations in drug levels associated with heroin use. Maintenance treatments save lives—they help to stabilize individuals, allowing treatment of their medical, psychological, and other problems so they can contribute effectively as members of families and of society.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q586,Where do 12-step or self-help programs fit into drug addiction treatment?,"Self-help groups can complement and extend the effects of professional treatment. The most prominent self-help groups are those affiliated with Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA), all of which are based on the 12-step model. Most drug addiction treatment programs encourage patients to participate in self-help group therapy during and after formal treatment. These groups can be particularly helpful during recovery, offering an added layer of community-level social support to help people achieve and maintain abstinence and other healthy lifestyle behaviors over the course of a lifetime.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q587,Can exercise play a role in the treatment process?,"Yes. Exercise is increasingly becoming a component of many treatment programs and has proven effective, when combined with cognitive-behavioral therapy, at helping people quit smoking. Exercise may exert beneficial effects by addressing psychosocial and physiological needs that nicotine replacement alone does not, by reducing negative feelings and stress, and by helping prevent weight gain following cessation. Research to determine if and how exercise programs can play a similar role in the treatment of other forms of drug abuse is under way.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q588,"How does drug addiction treatment help reduce the spread of HIV/AIDS, Hepatitis C (HCV), and other infectious diseases?","Drug-abusing individuals, including injecting and non-injecting drug users, are at increased risk of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and other infectious diseases. These diseases are transmitted by sharing contaminated drug injection equipment and by engaging in risky sexual behavior sometimes associated with drug use. Effective drug abuse treatment is HIV/HCV prevention because it reduces activities that can spread disease, such as sharing injection equipment and engaging in unprotected sexual activity. Counseling that targets a range of HIV/HCV risk behaviors provides an added level of disease prevention. Injection drug users who do not enter treatment are up to six times more likely to become infected with HIV than those who enter and remain in treatment. Participation in treatment also presents opportunities for HIV screening and referral to early HIV treatment. In fact, recent research from NIDA’s National Drug Abuse Treatment Clinical Trials Network showed that providing rapid onsite HIV testing in substance abuse treatment facilities increased patients’ likelihood of being tested and of receiving their test results. HIV counseling and testing are key aspects of superior drug abuse treatment programs and should be offered to all individuals entering treatment. Greater availability of inexpensive and unobtrusive rapid HIV tests should increase access to these important aspects of HIV prevention and treatment.",Treatment,,https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/frequently-asked-questions,,,
+Q589,Can opioid addiction be treated?,"Quitting opioids can be hard, but it is possible. There are three FDA-approved medicines to treat opioid addiction. Medicines like buprenorphine and methadone bind to the same receptors in the brain as prescription opioids to reduce cravings. Naltrexone is another medication that treats opioid addiction by preventing opioids from having an effect on the brain. Additionally, a medicine named lofexidine was recently approved to help lessen withdrawal symptoms for people who are trying to stop using opioids.Counseling and therapy are also important to help people stop using opioids, rebuild relationships with friends and family, and build healthy life skills. A combination of behavioral therapy and medication has proven to be very effective in treating opioid addiction. Doctors develop treatment plans to fit the unique needs of the patient.",Treatment,,https://www.drugabuse.gov/publications/opioid-facts-teens/more-faqs-about-opioids,,,
+Q590,How can parents participate in their adolescent child's treatment?,"Parents can actively support their child and engage with him or her during the treatment and recovery process. Apart from providing moral and emotional support, parents can also play a crucial role in supporting the practical aspects of treatment, such as scheduling and making appointments, as well as providing needed structure and supervision through household rules and monitoring. Also, several evidence-based treatments for adolescents specifically address drug abuse within the family context. Family-based drug abuse treatment can help improve communication, problem-solving, and conflict resolution within the household. Treatment professionals can help parents and other family members identify ways they can support the changes the adolescent achieves through treatment.",Treatment,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q591,What are the unique treatment needs of adolescents from different racial/ethnic backgrounds?,"Treatment providers are urged to consider the unique social and environmental characteristics that may influence drug abuse and treatment for racial/ethnic minority adolescents, such as stigma, discrimination, and sparse community resources. With the growing number of immigrant children living in the United States, issues of culture of origin, language, and acculturation are important considerations for treatment. The demand for bilingual treatment providers to work with adolescents and their families will also be increasing as the diversity of the U.S. population increases.",Treatment,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q592,What treatments are effective for people who misuse methamphetamine?,"The most effective treatments for methamphetamine addiction at this point are behavioral therapies, such as cognitive-behavioral and contingency management interventions. For example, the Matrix Model—a 16-week comprehensive behavioral treatment approach that combines behavioral therapy, family education, individual counseling, 12-step support, drug testing, and encouragement for non-drug-related activities—has been shown to be effective in reducing methamphetamine misuse. Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, have also been shown to be effective. Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR), an incentive-based method for promoting cocaine and methamphetamine abstinence, has demonstrated efficacy among methamphetamine misusers through NIDA’s National Drug Abuse Clinical Trials Network.
+
+Although medications have proven effective in treating some substance use disorders, there are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the misuse of methamphetamine by an individual addicted to the drug.
+",Treatment,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-treatments-are-effective-people-who-misuse-methamphetamine,"I think it's overall okay, but I'm wondering if we should say ""as of the time of publication"" as opposed to saying ""currently"" in the sentence that reads, "" there are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the misuse of methamphetamine by an individual addicted to the drug.""",,
+Q593,What treatments are under development for methamphetamine use and addiction?,"There are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the use of methamphetamine by an individual addicted to the drug. NIDA has made research on the development of medications to treat addiction to stimulants and other drugs a priority, and NIDA-funded researchers are investigating a number of pharmacological approaches for treating methamphetamine use disorder. When developing drug treatments, researchers typically examine the impact of potential medications that have neurobiological effects that may counter the known physiological consequences of chronic methamphetamine use. They may also test medications that have shown promise in treating other addictions or other psychiatric disorders. The following targets and strategies have shown promise in animal or human studies related to methamphetamine use disorder. The neuroimmune system: Chronic methamphetamine use is associated with activation of microglia, cells that mediate inflammation in the central nervous system. Drugs like ibudilast and minocycline are being studied for their capacity to inhibit activation of microglia. Cognitive enhancement: Chronic methamphetamine use is also associated with cognitive problems, such as impaired decision-making and impaired behavioral inhibition. Several drugs are under investigation for their potential to improve cognition in people who use methamphetamine. Dopamine agonist treatment: Medications based on activation of the same receptors targeted by an addictive drug are effective in treating other addictions, such as the use of methadone or buprenorphine to treat opioid use disorder and the use of nicotine replacement to assist smoking cessation. Since methamphetamine targets the dopamine system, some stimulant medications that activate dopamine receptors (agonists) and that are often used to treat attention-deficit hyperactivity disorder (ADHD) are being investigated as potential medications to treat methamphetamine use disorder. Other monoamine (serotonin, norepinephrine, dopamine) targets: Methamphetamine withdrawal symptoms are similar to depression, leading researchers to investigate the utility of antidepressants that act on the serotonin and norepinephrine systems for methamphetamine use disorder. Antipsychotic medications also act on the dopamine system and may have promise for ameliorating the effects of chronic methamphetamine use. The opioid system: The euphoric effects of addictive drugs likely involve the opioid system. Candidate medications in this category include the opioid antagonist naltrexone (currently being studied in combination with the antidepressant bupropion) and the opioid partial agonist buprenorphine. GABA and glutamate systems: Several medications targeting disruptions in the balance of excitation and inhibition (mediated by the neurotransmitters GABA and glutamate) are being investigated to treat methamphetamine use disorder.Hormones: The hormones cholecystokinin-8 and oxytocin have both shown promise in reducing the rewarding properties of methamphetamine in animals. Nonpharmacological treatments do not involve use of medications. Such therapies may instill behavioral changes by altering brain activity patterns (TMS), helping people learn how to monitor and control brain activity to curb symptoms of addiction (neurofeedback), or keeping drugs out of the brain (vaccines). Although further research is needed on these approaches, they may provide additional options for treatment providers and patients. Transcranial Magnetic Stimulation: TMS is a noninvasive method of stimulating the brain using magnetic pulses for therapeutic purposes. Researchers are studying this approach as a treatment for substance use disorders, but this work is in very early stages. Neurofeedback: Neurofeedback (also called neurotherapy or neurobiofeedback) is a type of biofeedback that uses real-time displays of brain activity—most commonly electroencephalography—to teach people how to regulate their own brain function. In one study, neurofeedback to treatment for methamphetamine use disorder reduced addiction severity and improved mental health and overall quality of life. Vaccines and antibodies: Methamphetamine vaccines, which recruit the body’s immune system to keep the drug from entering the brain, are currently being tested in animals, and a human clinical trial is currently underway to test an immunologic agent called a monoclonal antibody, which binds to methamphetamine and neutralizes it before it can exert its effects.",Treatment,,https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-treatments-are-under-development-methamphetamine-use-addiction,"Same comment as above. Use of the word ""currently.""",,
+Q594,Can treatment includes medication?,"Medication-assisted treatment is treatment for addiction that includes the use of medication along with counseling and other support. Treatment that includes medication is often the best choice for opioid addiction. If you are addicted, medication allows you to regain a normal state of mind, free of drug-induced highs and lows. It frees you from thinking all the time about the drug. It can reduce problems of withdrawal and craving. These changes can give you the chance you need to focus on the lifestyle changes that lead back to healthy living.",Treatment,,https://store.samhsa.gov/product/The-Facts-about-Buprenorphine-for-Treatment-of-Opioid-Addiction/SMA15-4442?referer=from_search_result,,,
+Q595,What is Cognitive-Behavioral Therapy?,"Cognitive-Behavioral Therapy is a short-term approach, usually involving 12 to 24 weekly individual sessions. These sessions typically explore the positive and negative consequences of substance use, and they use self-monitoring as a mechanism to recognize cravings and other situations that may lead the individual to relapse. They also help the individual develop coping strategies.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q596,What is contingency management?,"Contingency management, which involves giving tangible rewards to individuals to support positive behavior change has been found to be effective
+in treating substance use disorders. In this therapy, patients receive a voucher with monetary value that can be exchanged for food items, healthy recreational options (e.g., movies), or other sought-after goods or services when they exhibit desired behavior such as drug-free urine tests or participation in treatment activities.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q597,What is Community Reinforcement Approach?,"Community Reinforcement Approach (CRA) Plus Vouchers is an intensive 24-week outpatient program
+that uses incentives and reinforcers to reward individuals who reduce their substance use. Individuals
+are required to attend one to two counseling sessions each week that emphasize improving relations,
+acquiring skills to minimize substance use, and reconstructing social activities and networks to support
+recovery. Individuals receiving this treatment are eligible to receive vouchers with monetary value if
+they provide drug-free urine tests several times per week.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q598,What is Motivational Enhancement Therapy?,"Motivational Enhancement Therapy (MET) is a counseling approach that uses motivational interviewing
+techniques to help individuals resolve any uncertainties they have about stopping their substance use.
+MET works by promoting empathy, developing patient awareness of the discrepancy between their goals
+and their unhealthy behavior, avoiding argument and confrontation, addressing resistance, and supporting
+self-efficacy to encourage motivation and change. The therapist supports the patient in executing the
+behaviors necessary for change and monitors progress toward patient-expressed goals.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q599,What is The Matrix Model?,"The Matrix Model is a structured, multi-component behavioral treatment that consists of evidence-based practices, including relapse prevention, family therapy, group therapy, drug education, and self-help, delivered in a sequential and clinically coordinated manner. The model consists of 16 weeks of group sessions held three times per week, which combine CBT, family education, social support, individual counseling, and urine drug testing.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q600,What is Twelve-Step Facilitation Therapy?,"Twelve-Step Facilitation (TSF), an individual therapy typically delivered in 12 weekly sessions, is designed to prepare individuals to understand, accept, and become engaged in Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or similar 12-step programs.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q601,What is Family behavior therapy?,"Family behavior therapy (FBT) is a therapeutic approach used for both adolescents and adults that addresses not only substance use but other issues the family may also be experiencing, such as mental disorders and family conflict. FBT includes up to 20 treatment sessions that focus on developing
+skills and setting behavioral goals. Basic necessities are reviewed and inventoried with the client, and the family pursues resolution strategies and addresses activities of daily living, including violence prevention and HIV/AIDS prevention.",Treatment,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
+Q602,How does cognitive behavioral therapy (CBT) work?,"Cognitive behavioral therapy -- or CBT -- teaches a person how to recognize moods, thoughts, and situations that stimulate drug craving. A therapist helps the person avoid these triggers, and replace negative thoughts and feelings with healthier ones that are more consistent with sobriety.
+
+The skills learned in cognitive behavioral therapy can last a lifetime, making it a potentially powerful method of drug abuse treatment. However, not all therapists are trained in cognitive behavioral therapy techniques, which can be complex.",Treatment,,https://www.webmd.com/mental-health/addiction/qa/how-does-cognitive-behavioral-therapy-cbt-work,,,
+Q603,What is a brief intervention?,"Screening and brief interventions aim to identify current or potential problems with substance use and motivate those at risk to change their substance use behaviour. Brief interventions in primary care can range from 5 minutes of brief advice to 15-30 minutes of brief counselling. Generally, brief interventions are not intended to treat people with serious substance dependence, however, they are a valuable tool for treatment for problematic or risky substance use. Brief interventions can also be used to encourage those with more serious dependence to accept more intensive treatment within the primary care setting, or referral to a specialised alcohol and drug treatment agency. The aim of the intervention is to help the patient understand that their substance use is putting them at risk and to encourage them to reduce or give up their substance use. Brief interventions should be personalised and offered in a supportive, non judgemental manner.",Treatment,,https://www.who.int/substance_abuse/activities/en/Draft_Brief_Intervention_for_Substance_Use.pdf,,,
+Q604,What is medication-assisted treatment (MAT)?,"Treatment for opioid use disorder combining the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.",Treatment,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q605,What is non-opioid therapy?,"Methods of managing pain that does not involve opioids. These methods can include, but are not limited to, acetaminophen (Tylenol®) or ibuprofen (Advil®), cognitive behavioral therapy, physical therapy, acupuncture, meditation, exercise, medications for depression or for seizures, or interventional therapies (injections).",Treatment,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q606,What is non-pharmacologic therapy?,"Treatments that do not involve medications, including physical treatments (e.g., exercise therapy, weight loss) and behavioral treatments (e.g., cognitive behavioral therapy).",Treatment,,https://www.cdc.gov/drugoverdose/opioids/terms.html,,,
+Q607,"What does long-term, open-ended treatment for drug addiction mean?","The idea of long-term, open-ended treatment runs counter to the one-time view that a person was likely ""cured"" in a relatively short time after attending a drug or alcohol rehab program. However, evidence is mounting that lifelong treatment with counseling or therapy and sometimes medication should be standard treatment for most people with a relapsing addiction.",Treatment,,https://www.webmd.com/mental-health/addiction/qa/what-does-longterm-openended-treatment-for-drug-addiction-mean,,,
+Q608,Do girls and boys have different treatment needs?,"Adolescent girls and boys may have different developmental and social issues that may call for different treatment strategies or emphases. For example, girls with substance use disorders may be more likely to also have mood disorders such as depression or to have experienced physical or sexual abuse. Boys with substance use disorders are more likely to also have conduct, behavioral, and learning problems, which may be very disruptive to their school, family, or community. Treatments should take into account the higher rate of internalizing and traumatic stress disorders among adolescent girls, the higher rate of externalizing disruptive disorders and juvenile justice problems among adolescent boys, and other gender differences that may play into adolescent substance use disorders.",Substance use disorder,,https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions,,,
+Q609,What is inpatient treatment?,"Inpatient treatment, provided in special units of hospitals or medical clinics, offers both detoxification and rehabilitation services. Several years ago,
+many hospital-based treatment programs existed. Today, because of changes in insurance coverage, inpatient treatment is no longer as common as it used to be. People who have a mental disorder or serious medical problems as well as a substance use disorder are the ones most likely to receive inpatient treatment. Adolescents may also need the structure of inpatient treatment to make sure a full assessment of their substance use and mental disorders can be done.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q610,What are residential programs?,"Residential programs provide a living environment with treatment services. Several models of residential treatment (such as the therapeutic community) exist, and treatment in these programs lasts from a month to a year or more. The programs differ in some ways, but they are similar in many ways.
+Residential programs often have phases of treatment, with different expectations and activities during each phase. For example, in the first phase, an adult’s contact with family, friends, and job may be restricted. An adolescent may be able to have contact with his or her parents but not with friends or with school. This restriction helps the person become part of the treatment community and adjust to the treatment setting. In a later phase, a person may be able to start working again, going “home” to the facility every evening. If your loved one is in a residential treatment program, it is important that you know and understand the program rules and expectations. Often residential programs last long enough to offer general equivalency diploma (GED) preparation classes, training in job-seeking skills, and even career training. In residential programs for adolescents, the participants attend school as a part of the program. Some residential programs are designed to enable women who need treatment to bring their children with them. These programs offer child care and parenting classes. Residential programs are best for people who do not have stable living or employment situations and/or have limited or no family support. Residential treatment may help people with very serious substance use disorders who have been unable to get and stay sober or drug free in other treatment program.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q611,What are partial hospitalization or day treatment programs?,"Partial hospitalization or day treatment programs also may be provided in hospitals or free-standing clinics. In these programs, the person attends treatment for 4 to 8 hours per day but lives at home. These programs usually last for at least 3 months and work best for people who have a stable, supportive home environment.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q612,What are outpatient and intensive outpatient programs?,"Outpatient and intensive outpatient programs provide treatment at a program site, but the person lives elsewhere (usually at home). Outpatient treatment is offered in a variety of places: health clinics, community mental health clinics, counselors’ offices, hospital clinics, local health department offices, or residential programs with outpatient clinics. Many meet in the evenings and on weekends so participants can go to school or work. Out-patient treatment programs have different requirements for attendance. Some programs require daily attendance; others meet only one to three times per week.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q613,What are intensive outpatient treatment programs?,"Intensive outpatient treatment programs require a person to attend 9 to 20 hours of treatment activities per week. Outpatient programs last from about 2 months to 1 year. People who do best in an outpatient program are willing to attend counseling sessions regularly, have supportive friends or family members, have a place to live, and have some form of transportation to get to treatment sessions (some programs will provide transportation if needed).",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q614,What are opioid treatment programs (OTPs)?,"Opioid treatment programs (OTPs), sometimes known as methadone clinics, offer medication-assisted outpatient treatment for people who are dependent on opioid drugs (such as heroin, OxyContin, or vicodin). These programs use a medication, such as methadone or LAAM, to help a person not use illicit opioids. OTPs provide counseling and other services along with the medication.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q615,What actually happens in treatment programs?,"Although treatment programs differ, the basic ingredients of treatment are similar. Most programs include many or all elements presented below.
+Assessment
+All treatment programs begin with a clinical assessment of a person’s individual treatment needs. This assessment helps in the development of an effective treatment plan.
+Medical Care
+Programs in hospitals can provide this care on site. Other outpatient or residential programs may have doctors and nurses come to the program site for a few days each week, or a person may be referred to other places for medical care. Medical care typically includes screening and treatment for HIV/AIDS, hepatitis, tuberculosis, and women’s health issues.
+A Treatment Plan
+The treatment team, along with the person in treatment, develops a treatment plan based on the assessment. A treatment plan is a written guide to treatment that includes the person’s goals, treatment activities designed to help him or her meet those goals, ways to tell whether a goal has been met, and a timeframe for meeting goals. The treatment plan helps both the person in treatment and treatment program staff stay focused and on track. The treatment plan is adjusted over time to meet changing needs and ensure that it stays relevant.
+Group and Individual Counseling
+At first, individual counseling generally focuses on motivating the person to stop using drugs or alcohol. Treatment then shifts to helping the person stay drug and alcohol free. The counselor attempts to help the person see the problem and become motivated to change; change his or her behavior; repair damaged relationships with family and friends; build new friendships with people who don’t use alcohol or drugs; create a recovery lifestyle.
+Group counseling is different in each program, but group members usually support and try to help one another cope with life without using drugs or alcohol. They share their experiences, talk about their feelings and problems, and find out that others have similar problems. Groups also may explore spirituality and its role in recovery.
+Individual Assignments
+People in treatment may be asked to read certain things (or listen to audiotapes), to complete written assignments (or record them on audiotapes), or to try new behaviors.
+Education About Substance Use Disorders
+People learn about the symptoms and the effects of alcohol and drug use on their brains and bodies. Education groups use videotapes or audiotapes, lectures, or activities to help people learn about their illness and how to manage it.
+Life Skills Training
+This training can include learning and practicing employment skills, leisure activities, social skills, communication skills, anger management, stress management, goal setting, and money and time management.
+Testing for Alcohol or Drug Use
+Program staff members regularly take urine samples from people for drug testing. Some programs are starting to test saliva instead of urine. They also may use a BreathalyzerTM to test people for alcohol use.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q616,What are family education and counseling services?,"This education can help you understand the disease and its causes, effects, and treatment. Programs provide this education in many ways: lectures, discussions, activities, and group meetings. Some programs provide counseling for families or couples. Family counseling is especially
+critical in treatment for adolescents. Parents need to be involved in treatment planning and followup care decisions for the adolescent. Family members also need to participate as fully as possible in the family counseling the program offers.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q617,Why does treatment take so long?,"Substance use disorders affect every part of a person’s life. For that reason, treatment needs to affect every part of a person’s life as well.
+Treatment involves more than helping someone stop drinking alcohol or using drugs. Actually, stopping alcohol use or drug use is just the beginning of the recovery process. Your family member will need to learn new ways to cope with daily life. He or she will need to relearn how to deal with stress, anger, or social situations and how to have fun without using drugs or drinking. Learning these new skills is a lot of work.
+Many people enter treatment only because of pressure from the legal system, employers, parents, spouses, or other family members. The first step in treatment then is to help them see that they do have a problem and to become motivated to change for themselves. This process often takes time.
+Your family member also will need time to understand and begin to use the support of the self-help groups mentioned before. These groups will be important to his or her recovery for many years to come. Remember: It can take a long time for the disease to develop and it is often chronic; therefore, it can take a long time to treat it.",Treatment programs,,https://store.samhsa.gov/product/What-Is-Substance-Abuse-Treatment-A-Booklet-for-Families/SMA14-4126?referer=from_search_result,,,
+Q618,What are vaping devices?,"Vaping devices, also known as e-cigarettes, e-vaporizers, or electronic nicotine delivery systems, are battery-operated devices that people use to inhale an aerosol, which typically contains nicotine (though not always), flavorings, and other chemicals. They can resemble traditional tobacco cigarettes (cig-a-likes), cigars, or pipes, or even everyday items like pens or USB memory sticks. Other devices, such as those with fillable tanks, may look different. Regardless of their design and appearance, these devices generally operate in a similar manner and are made of similar components. More than 460 different e-cigarette brands are currently on the market. Some common nicknames for e-cigarettes are: e-cigs; e-hookahs; hookah pens; vapes; vape pens; mods (customizable, more powerful vaporizers).",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q619,How do vaping devices work?,"Most e-cigarettes consist of four different components, including: a cartridge or reservoir or pod, which holds a liquid solution (e-liquid or e-juice) containing varying amounts of nicotine, flavorings, and other chemicals; a heating element (atomizer); a power source (usually a battery); a mouthpiece that the person uses to inhale. In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The person then inhales the resulting aerosol or vapor (called vaping).",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q620,What is the prevalence of vaping among teens?,"Vaping devices are popular among teens and are now the most commonly used form of nicotine among youth in the United States. Some research shows that many teens do not even realize that vaping cartridges contain nicotine, and assume the pods contain only flavoring. The easy availability of these devices, alluring advertisements, various e-liquid flavors, and the belief that they're safer than cigarettes have helped make them appealing to this age group. In addition, they are easy to hide from teachers and parents because they do not leave behind the stench of tobacco cigarettes, and are often disguised as flash drives. Further, a study of high school students found that one in four teens reported using e-cigarettes for dripping, a practice in which people produce and inhale vapors by placing e-liquid drops directly onto heated atomizer coils. Teens reported the following reasons for dripping: to create thicker vapor (63.5 percent), to improve flavors (38.7 percent), and to produce a stronger throat hit—a pleasurable feeling that the vapor creates when it causes the throat to contract (27.7 percent). More research is needed on the risks of this practice.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,"Nothing wrong persay, but I think we should take out "" are now the most commonly used form of nicotine among youth in the United States."" I just wonder about recency (ie if this data is analyzed 4 years from now and this is no longer the case.",,
+Q621,How does vaping affect the brain?,"The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette. Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors. Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q622,What are the heath effects of vaping?,"E-cigarette use exposes the lungs to a variety of chemicals, including those added to e-liquids, and other chemicals produced during the heating/vaporizing process. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal nanoparticles from the device itself. The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporizing device. Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease. More research is needed on the health consequences of repeated exposure to these chemicals. There are also reports of lung illnesses and deaths related to inhalation of certain vaping oils into the lungs, which have no way to filter out toxic ingredients.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q623,Is vaping safer than smoking cigarettes?,"Research so far suggests that vaping devices might be less harmful than combustible cigarettes when people who regularly smoke switch to them as a complete replacement. But nicotine in any form is a highly addictive drug. Research suggests it can even prime the brain’s reward system, putting vapers at risk for addiction to other drugs.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q624,What are the health effects of vaping on teens?,"The teen years are critical for brain development, which continues into young adulthood. Young people who use nicotine products in any form, including e-cigarettes, are uniquely at risk for long-lasting effects. Because nicotine affects the development of the brain's reward system, continued nicotine vaping can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen's developing brain. Nicotine also affects the development of brain circuits that control attention and learning. Other risks include mood disorders and permanent problems with impulse control—failure to fight an urge or impulse that may harm oneself or others.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,,,
+Q625,Can vaping help a person quit smoking?,"Some people believe e-cigarettes may help lower nicotine cravings in those who are trying to quit smoking. However, e-cigarettes are not an FDA-approved quit aid, and there is no conclusive scientific evidence on the effectiveness of vaping for long-term smoking cessation. It should be noted that there are seven FDA-approved quit aids that are proven safe and can be effective when used as directed. Vaping nicotine has not been thoroughly evaluated in scientific studies. For now, not enough data exists on the safety of e-cigarettes, how the health effects compare to traditional cigarettes, and if they are helpful for people trying to quit smoking.",Vaping,,https://www.drugabuse.gov/publications/drugfacts/vaping-devices-electronic-cigarettes,"Similar to the orange highlight above, I'm thinking about recency of information, but if we put a disclaimer in the paper saying that information is likely to change, then I think we'll be okay.",,
+Q626,"Should I get vaccinated for the flu if using e-cigarettes, or vaping products?","CDC recommends everyone 6 months of age and older should get a flu vaccine, including people who use e-cigarette, or vaping products. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations and deaths.",Vaping,,https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/faq/index.html,,,
+Q627,What is withdrawal?,Withdrawal describes the various symptoms that occur after a person abruptly reduces or stops long-term use of a drug.,Withdrawal,,https://www.drugabuse.gov/about-nida/frequently-asked-questions,,,
+Q628,How long does withdrawal last?,"Length of withdrawal and symptoms vary with the type of drug. For example, physical symptoms of heroin withdrawal may include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes. These physical symptoms may last for several days, but the general depression, or dysphoria (opposite of euphoria), that often accompanies heroin withdrawal may last for weeks. In many cases, withdrawal can be treated with medications to ease the symptoms, but treating withdrawal is not the same as treating addiction.",Withdrawal,,https://www.drugabuse.gov/about-nida/frequently-asked-questions,,,
+Q629,What are wrap-around services?,"Wrap-around services are non-clinical services that facilitate patient engagement and retention in treatment as well as their ongoing recovery. This can include services to address patient needs related to transportation, employment, childcare, housing, legal and financial problems, among others.",Recovery,,https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result,,,
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