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Midterm Comprehensive Study Guide

by: SamH

Midterm Comprehensive Study Guide SOWK-2220-01

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All material covered on the 1st midterm exam.
Drug Abuse: University and Innercity
Reginald Parquet
Study Guide
Drugs, University, inner, city, inner city, pot, booze, coke, crystal meth, study, guide, Studyguide, Study Guide, midterm, final, test, exam
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This 14 page Study Guide was uploaded by SamH on Sunday February 28, 2016. The Study Guide belongs to SOWK-2220-01 at Tulane University taught by Reginald Parquet in Spring 2016. Since its upload, it has received 115 views. For similar materials see Drug Abuse: University and Innercity in Social Work at Tulane University.

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Date Created: 02/28/16
Alcohol A drink is considered to be: •   4-5 ounces of wine •   10 ounces of wine cooler •   12 ounces of beer •   1-1/4 ounces of distilled liquor (80 proof whiskey, vodka, scotch, or rum) •   Current (past month) use - At least one drink in the past 30 days. •   Binge use - Five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. •   Heavy use - Five or more drinks on the same occasion on each of 5 or more days in the past 30 days. Current Alcohol Use The estimate of 139.7 million current alcohol users aged 12 or older in 2014 corresponds to alcohol use in the past month by slightly more than half (52.7 percent) of the people aged 12 or older. The estimates of past month alcohol use remained steady between 2009 and 2014, but the 2014 estimate was higher than the estimates in most years between 2002 and 2008. Aged 12 to 17 The percentage of adolescents aged 12 to 17 who were current alcohol users was 11.5 percent in 2014. This percentage corresponds to 2.9 million adolescents in 2014 who drank alcohol in the past month. The percentage of adolescents who were current alcohol users in 2014 was lower than the percentages in 2002 through 2012. Although the estimate of current alcohol use among adolescents decreased between 2002 and 2014, about 1 in 9 adolescents aged 12 to 17 were current alcohol users in 2014. Aged 26 or Older More than half (56.5 percent) of adults aged 26 or older in 2014 were current alcohol users. This percentage corresponds to about 116.0 million adults in this age group who drank alcohol in the past month. The percentage of adults aged 26 or older in 2014 who were current alcohol users was higher than the percentages in most years from 2002 to 2011, but it was similar to the percentages in 2012 and 2013. In each year between 2002 and 2014, however, more than half of adults aged 26 or older were current alcohol users (ranging from 52.5 to 56.5 percent). Binge Alcohol Use In 2014, the estimate of 60.9 million binge alcohol users in the past 30 days represents nearly one quarter (23.0 percent) of people aged 12 or older. Estimates of binge drinking among people aged 12 or older did not change over the period from 2002 to 2014. Marijuana The first historical references to marijuana date back to the reign of the Chinese Emperor Shen Nung (2737 B.C.) when it was used as a medicine – treatment for migraine headaches, anticonvulsant, hypnotic, even patients who contracted rabies. Cannabis Sativa 400 different compounds, 61 psychoactive Marijuana is the most commonly used illicit drug (19.8 million past-month users) according to the 2013 National Survey on Drug Use and Health (NSDUH).3 That year, marijuana was used by 81.0 percent of current illicit drug users (defined as having used a drug at some time in the 30 days before the survey) and was the only drug used by 64.7 percent of them. 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 have held steady in the past few years following several years of increase in the previous decade. Teens’ perceptions of the risks of marijuana use have steadily declined over the past decade, possibly related to increasing public debate about legalizing or loosening restrictions on marijuana for medicinal and recreational use. In 2014, 11.7 percent of 8th-graders reported marijuana use in the past year and 6.5 percent were current users. Among 10th-graders, 27.3 percent had used marijuana in the past year and 16.6 percent were current users. Rates of use among 12th-graders were higher still: 35.1 percent had used marijuana during the year prior to the survey and 21.2 percent were current users; 5.8 percent said they used marijuana daily or near-daily. Twenty-three states have legalized medical marijuana and four have legalized recreational use by adults, with several more considering legalization of recreational use for adults and others considering legalized medical marijuana. With the end of prohibition finally in sight, pot growing is coming out of the back country and the basements of stoners and becoming a true… How Does Marijuana Affect the Brain? When marijuana is smoked, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to the brain and other organs throughout the body. It is absorbed more slowly when ingested in food or drink. However it is ingested, THC acts on specific molecular targets on brain cells, called cannabinoid receptors. These receptors are ordinarily activated by chemicals similar to THC that naturally occur in the body (such as anandamide; see picture, above) and are part of a neural communication network called the endocannabinoid system. This system plays an important role in normal brain development and function. The highest density of cannabinoid receptors is found in parts of the brain that influence pleasure, memory, thinking, concentration, sensory and time perception, and coordinated movement. Marijuana over activates the endocannabinoid system, causing the “high” and other effects that users experience. These effects include altered perceptions and mood, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory. What Are the Other Health Effects of Marijuana? Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health. Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections. One study found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than those who don’t smoke marijuana, mainly because of respiratory illnesses. It is not yet known whether marijuana smoking contributes to risk for lung cancer. Associations have also been found between marijuana use and other mental health problems, such as depression, anxiety, suicidal thoughts among adolescents, and personality disturbances, including a lack of motivation to engage in typically rewarding activities. More research is still needed to confirm and better understand these linkages. Marijuana use during pregnancy is associated with increased risk of neurobehavioral problems in babies. Because THC and other compounds in marijuana mimic the body’s own endocannabinoid chemicals, marijuana use by pregnant mothers may alter the developing endocannabinoid system in the brain of the fetus. Consequences for the child may include problems with attention, memory, and problem solving. Additionally, because it seriously impairs judgment and motor coordination, marijuana contributes to risk of injury or death while driving a car. A recent analysis of data from several studies found that marijuana use more than doubles a driver’s risk of being in an accident. The combination of marijuana and alcohol is worse than either substance alone with respect to driving impairment Rising Potency The amount of THC in marijuana samples confiscated by police has been increasing steadily over the past few decades. In 2012, THC concentrations in marijuana averaged close to 15 percent, compared to around 4 percent in the 1980s. For a new user, this may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. Increases in potency may account for the rise in emergency department visits involving marijuana use. For frequent users, it may mean a greater risk for addiction if they are exposing themselves to high doses on a regular basis. However, the full range of consequences associated with marijuana's higher potency is not well understood. For example, experienced users may adjust their intake in accordance with the potency or they may be exposing their brains to higher levels overall, or both. Is Marijuana Addictive? 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 people who use marijuana daily (to 25-50 percent). Cocaine Aged 18 to 25 An estimated 1.4 percent of young adults aged 18 to 25 were current users of cocaine in 2014 and 0.1 percent used crack in the past month. These percentages represent 473,000 young adults who used cocaine, including 29,000 who used crack. The 2014 percentage of young adults who were current cocaine users was lower than the percentages in 2002 through 2007, and it was similar to the percentages between 2008 and 2013. Estimates of current crack use among young adults were similar for most years between 2008 and 2014. Aged 26 or Older In 2014, 0.5 percent of adults aged 26 or older were current users of cocaine, and 0.2 percent used crack in the past month. These percentages represent 1.0 million adults aged 26 or older who currently used cocaine, including 317,000 who currently used crack. Current cocaine use among adults aged 26 or older was stable between 2009 and 2014, and current crack use was stable between 2008 and 2014. Cocaine Use Disorder About 913,000 people aged 12 or older in 2014 had a cocaine use disorder, which represents 0.3 percent of the people aged 12 or older. The percentage of the population aged 12 or older with a cocaine use disorder remained stable between 2009 and 2014. However, the percentage in 2014 was lower than the percentages in 2002 to 2008. Aged 12 to 17 An estimated 0.1 percent of adolescents aged 12 to 17 in 2014 had a cocaine use disorder in the past year, or about 27,000 adolescents. The percentage of adolescents with a cocaine use disorder in 2014 was lower than the percentages in 2002 to 2008, but it was similar to the percentages in 2009 to 2013. Aged 18 to 25 Approximately 185,000 young adults aged 18 to 25 in 2014 had a cocaine use disorder in the past year, which represents 0.5 percent of young adults. Similar to the pattern for adolescents aged 12 to 17, the percentage of young adults with a cocaine use disorder in 2014 was lower than the percentages in 2002 to 2009, but it was similar to the percentages in 2010 to 2013. Aged 26 or Older In 2014, approximately 702,000 adults aged 26 or older had a cocaine use disorder in the past year, which represents 0.3 percent of adults in this age group. The percentage of adults aged 26 or older with a cocaine use disorder in 2014 was lower than the percentages in 2002 to 2008, but it remained steady when compared with the percentages between 2009 and 2013. Cocaine is a stimulant. Cocaine is produced from the plant species Erythroxylon coca. Crack or rock cocaine is produced by heating powder cocaine, water, and baking soda. Up until 1903, Coca-Cola contained 60 mg of cocaine per 8-ounce serving. cocaine was first synthesized by a certain Albert Niemann of the University of Gottigen in Germany in 1859. The active ingredient of the coca plant was first isolated in the West by the German chemist Friedrich Gaedcke in 1855; he named it "Erythroxyline". Albert Niemann described an improved purification process for his PhD; he named the product "cocaine". Nearly 98% of the world’s cocaine is produced by Peru, Bolivia, and Colombia. Peru produces 50% of the world’s cocaine The United States is the world’s largest consumer of cocaine. Two thirds of the cocaine used in the United States is thought to be used by 25% of users. A gram of cocaine might yield 25 – 30 lines. Although crack cocaine is one of the most addictive drugs available one does not becomes addicted to it after one “hit.” Neuropsychological testing has suggested that chronic use of cocaine might cause moderate to severe brain damage in adults. Crack Cocaine Profile “Crack” is the name given to cocaine that has been processed with baking soda or ammonia, and transformed into a more potent, smokable, “rock” form. The name refers to the crackling sound heard when the rock is heated and smoked. Cocaine is a stimulant that has been abused for ages; however, crack cocaine is the most potent form in which the drug has ever appeared. There is great risk when using any form of cocaine, but crack cocaine is the riskiest form of the substance. Smoking a substance allows it to reach the brain more quickly than other routes of administration, and compulsive cocaine use will develop even more rapidly if the substance is smoked rather than snorted. Smoking crack cocaine brings an intense and immediate but very short-lived high that lasts about fifteen minutes. Crack Cocaine's Effects on the Brain Crack cocaine is a strong central nervous stimulant that interferes with, and causes excess amounts of, dopamine in the brain. A neurotransmitter associated with pleasure and movement, dopamine is the neurotransmitter released as part of the brain's reward system. As a result, the psychological effects can be extremely reinforcing; after having tried crack cocaine, the user will rapidly develop an intense craving for the drug since the chemistry of the brain's reward system has been altered. Short-Term Effects The high from crack cocaine begins almost immediately after the vapors are inhaled and lasts about 5 to 15 minutes. After the initial 'rush' subsides, the user experiences an intense desire for more of the drug. Other short-term effects include. •   Increased blood pressure and heart rate •   Constricted peripheral blood vessels •   Increased rate of breathing •   Dilated pupils •   Hyper-stimulation •   Intense euphoria •   Decreased appetite •   Anxiety and paranoia •   Aggressive, paranoid behavior •   Depression •   Intense drug craving •   Sudden death - even one use can cause overdose or death Cocaine bugs” is a hallucinatory experience wherein the person feels as though bugs are crawling on or under his/her skin. Cocaine may exacerbate the medical symptoms of Tourette’s syndrome and Tardive dyskinesia. THE PHYSICAL EFFECTS OF COCAINE THE BRAIN Euphoria and Depression - early side effects include euphoria lasting 5-15 minutes. This 'high' is followed by a crushing 'low' (depression) that leaves the user craving more of the drug. Brain Damage and Addiction - Cocaine and 'crack' have an overwhelming effect on the 'pleasure centers' in the brain. The drugs interfere, alter, damage, and take control of specialized cells that regulate pleasure, well-being and mood. Regular use may shut off the brain's ability to ever be or feel 'normal' without cocaine. Long term use may cause permanent biological drug addiction. THE CENTRAL NERVOUS SYSTEM - increases blood pressure, heart rate, breathing and body temperature. - suppresses desire for food, sex and sleep - can cause strokes, brain seizures, respiratory failure, heart attack, convulsions and death. THE LIVER - Cocaine and crack can damage the liver's ability to detoxify blood, while reducing the production of critical enzymes needed for normal body functions. - Hepatitis can be contracted and cause serious liver damage, or lead to cirrhosis and liver cancer. Hepatitis is highly contagious. THE INTESTINES -   The blood supply is reduced to the intestines, resulting in nausea, diarrhea, painful cramps, inflammation and possible death. THE REPRODUCTIVE SYSTEM - Males and Females - Regular use can result in loss of interest in sex, decreased sexual performance, risk of impotence and infertility - Cocaine and crack can cause miscarriages, developmental disorders and complications during birth - Can result in premature separation of placenta from uterus leading to premature births or stillbirths - Babies run a greater risk of Sudden Infant Death Syndrome (SIDS). Cocaine babies have higher risk of respiratory, kidney trouble, and genital malformation. Visual problems, lack of coordination and retardation are common - Babies can suffer strokes and heart attacks PSYCHOLOGICAL AND PERSONALITY CHANGES - Irritability, anxiety, panic attacks, excitable, 'hyper,' erratic, confused, depressed, non-stop babbling, sleeplessness, chronic fatigue, short tempers, bizarre behavior, aggressiveness and violence, suicidal behavior, paranoia, delusions and hallucinations THE EYES - Dilation of pupils and blurred vision THE THROAT - Inhaling cocaine vapors causes hoarseness, coughing and constant sore throat THE LUNGS - Smoking cocaine damages lung cells' ability to process gases, leaving user with constant cough and shortness of breath. Use may result in respiratory failure -- the brain stops signaling muscles that control breathing, and they stop working. THE HEART - Constricts the heart's blood vessels, increasing blood pressure. This may trigger heart attack, heart failure, irregular heart beat and sudden death. BLOOD VESSELS - Cocaine and crack cause blood vessels to constrict, increasing blood pressure, and risk of heart attack and stroke - Users sharing needles run high risk of infecting themselves with hepatitis or AIDS. Users may pass these diseases to their sexual partners, unborn babies or others. THE BLADDER - Increased need to urinate BODY WEIGHT - Loss of appetite can be so severe that it leads to dramatic weight loss and malnutrition. “Cocaine bugs” is a hallucinatory experience wherein the person feels as though bugs are crawling on or under his/her skin. Individuals burn their arms, scratch themselves, Cocaine may exacerbate the medical symptoms of Tourette’s syndrome and Tardive dyskinesia - repetitive, involuntary, purposeless movements, such as grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the extremities may also occur. Impaired movements of the fingers may also appear. Between 53% and 65% of chronic cocaine abusers develop a drug-induced psychosis similar to paranoid schizophrenia Added Danger: Cocaethylene When people consume cocaine and alcohol together, they compound the danger each drug poses and unknowingly perform a complex chemical experiment within their bodies. Researchers have found that the human liver combines cocaine and alcohol to produce a third substance, cocaethylene, which intensifies cocaine's euphoric effects. Cocaethylene is associated with a greater risk of sudden death than cocaine alone.1 Powdered Cocaine The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. Snorting, or intranasal administration, is the process of inhaling cocaine powder through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. The drug also can be rubbed onto mucous tissues. Injecting, or intravenous use, releases the drug directly into the bloodstream and heightens the intensity of its effects. Smoking involves inhaling cocaine vapor or smoke into the lungs, where absorption into the bloodstream is as rapid as by injection. This rather immediate and euphoric effect is one of the reasons that crack became enormously popular in the mid-1980s. Freebase Cocaine Cocaine use ranges from occasional to repeated or compulsive use, with a variety of patterns between these extremes. Other than medical uses, there is no safe way to use cocaine. Any route of administration can lead to absorption of toxic amounts of cocaine, possible acute cardiovascular or cerebrovascular emergencies, and seizures—all of which can result in sudden death. How does cocaine produce its effects? Research has led to a clear understanding of how cocaine produces its pleasurable effects and why it is so addictive. Scientists have discovered regions within the brain that are stimulated by all types of reinforcing stimuli such as food, sex, and many drugs of abuse. One neural system that appears to be most affected by cocaine originates in a region of the midbrain called the ventral tegmental area (VTA). Nerve fibers originating in the VTA extend to a region known as the nucleus accumbens, one of the brain's key areas involved in reward. Animal studies show that rewards increase levels of the brain chemical (or neurotransmitter) dopamine, thereby increasing neural activity in the nucleus accumbens. 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 and sends a signal to that neuron. Dopamine is then removed from the synapse to be recycled for further use. Drugs of abuse can interfere with this normal communication process. For example, scientists have discovered that cocaine acts by blocking the removal of dopamine from the synapse, which results in an accumulation of dopamine and an amplified signal to the receiving neurons (see image "Cocaine in the brain"). This is what causes the initial euphoria commonly reported by cocaine abusers. 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 or within an hour. Taken in small amounts, cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them perform simple physical and intellectual tasks more quickly, although others experience the opposite effect. The duration of cocaine's euphoric effects depends upon the route of administration. The faster the drug is absorbed, the more intense the resulting high, but also the shorter the duration. The high from snorting is relatively slow to arrive but it may last 15 to 30 minutes; in contrast, the effects from smoking are more immediate but may last only 5 to 10 minutes. The 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. There also can be severe medical complications associated with cocaine abuse. Some of the most frequent are cardiovascular effects, including disturbances in heart rhythm and heart attacks; neurological effects, including strokes, seizures, headaches, 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 followed by respiratory arrest. What are the long-term effects of cocaine use? Cocaine is a powerfully addictive drug. Thus, it is unlikely that an individual will be able to reliably predict or control the extent to which he or she will continue to want or use the drug. And, if addiction takes hold, the risk for relapse is high even following long periods of abstinence. Recent studies have shown that during periods of abstinence, the memory of the cocaine experience or exposure to cues associated with drug use can trigger tremendous craving and relapse to drug use. Users take cocaine in "binges," during which the cocaine is used repeatedly and at increasingly higher doses. This can lead to increased irritability, restlessness, panic attacks, and paranoia—even a full-blown psychosis, in which the individual loses touch with reality and experiences auditory hallucinations. With increasing dosages or frequency of use, the risk of adverse psychological or physiological effects increases. Different routes of cocaine administration can produce different adverse effects. Regularly snorting cocaine, for example, can lead to loss of sense of smell; nosebleeds; problems with swallowing; hoarseness; and an overall irritation of the nasal septum, which could result in a chronically inflamed, runny nose. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. Persons who inject cocaine have puncture marks called "tracks," most commonly in their forearms, and may experience allergic reactions, either to the drug or to some additive in street cocaine, which in severe cases can result in death. Many chronic cocaine users lose their appetite and experience significant weight loss and malnourishment. What are the effects of maternal cocaine use? The full extent of the effects of prenatal cocaine exposure on a child is not completely known, but many scientific studies have documented that babies born to mothers who abuse 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 abuse cocaine. Some may recall that "crack babies" or babies born to mothers who abused crack cocaine while pregnant, were at one time written off as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. However, the fact that most of these children appear normal should not be over interpreted 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, including deficits in some aspects of cognitive performance, information processing, and attention to tasks—abilities that are important for the realization of a child's full potential. What treatments are effective for cocaine abusers? In 2007, cocaine accounted for about 13 percent of all admissions to drug abuse treatment programs. The majority of individuals (72 percent in 2007) who seek treatment for cocaine abuse smoke crack and are likely to be polydrug abusers, or users of more than one substance. The widespread abuse of cocaine has stimulated extensive efforts to develop treatment programs for cocaine. As with any drug addiction, this is a complex disease that involves biological changes in the brain as well as myriad social, familial, and other environmental problems. Therefore, treatment of cocaine addiction must be comprehensive, and strategies need to assess the neurobiological, social, and medical aspects of the patient's drug abuse. Moreover, patients who have a variety of addictions often have other co-occurring mental disorders that require additional behavioral or pharmacological interventions. 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 cocaine-addicted populations is contingency management, or motivational incentives (MI). MI may be particularly useful for helping patients achieve initial abstinence from cocaine and for helping patients stay in treatment. Cognitive-behavioral therapy (CBT) is an effective approach for preventing relapse. CBT is focused on helping cocaine-addicted individuals abstain—and remain abstinent—from cocaine and other substances. The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and addiction. These same learning processes can be harnessed to help individuals reduce drug use and successfully prevent relapse. This approach attempts to help patients recognize, avoid, and cope; that is, they recognize the situations in which they are most likely to use cocaine, avoid these situations when appropriate, and cope more effectively with a range of problems and problematic behaviors associated with drug abuse. This therapy is also noteworthy because of its compatibility with a range of other treatments patients may receive. Community-based recovery groups—such as Cocaine Anonymous—that use a 12-step program, can also be helpful to people trying to sustain abstinence. Participants may benefit from supportive fellowship and from sharing with those experiencing common problems and issues. It is important that patients receive services that match all of their treatment needs. For example, if a patient is unemployed, it may be helpful to provide vocational rehabilitation or career counseling along with addiction treatment. If a patient has marital problems, it may be important to offer couples counseling. A protein that is naturally present in the brain reduces laboratory animals’ attraction to environments in which they have experienced cocaine’s effects. The recent finding could point the way to new treatments to help people overcome addiction to cocaine and perhaps to other drugs.


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