Anabolic Steroids

Historically, drugs used to increase the ability of an athlete to perform in a given sport included the use of stimulants to diminish the onset of fatigue or opiates to diminish the pain of exertion. Recently, abuse of ana-bolic-androgenic steroids (derivatives of testosterone) has increased. They are used to increase muscle size and definition (in the case of body-building competitors) and are sometimes coabused with other growth enhancers, such as human growth hormone. In sports in which mass, physical size, or even total strength (a function of total muscle mass) is important, the abuse of anabolic steroids provides a shortcut to attainment of the physical stature that might otherwise require much more extensive training and exercise. However, it is a misconception to believe that anabolic steroid abuse is limited to professional athletes and body builders. There is clear evidence that these drugs are abused by adult men and women who are not athletes, who are blue-collar and white-collar workers, and by male and female athletes at the college, high school, and junior high school levels. For more details see Chapter 63.

^Study Questions

1. A 28-year-old man, a long-term opioid user, is brought to the emergency department with typical abstinence symptoms and asks for your help in breaking his heroin habit. What do you do?

(A) You prescribe a 3-day regimen of meperidine.

(B) You prescribe methadone and indicate it may be for an extended period.

(C) You prescribe a one-time dose of naltrexone.

2. A patient is brought into the emergency department on Saturday night exhibiting paranoia and hostility and tells you that he is being pursued by strangers. He is emaciated, hungry, and filthy. What is the best solution for this case?

(A) He has schizophrenia and should be admitted to the psychiatric ward.

(B) He abuses alcohol and should undergo detoxification.

(C) He has acutely abused a stimulant and should be treated with a neuroleptic drug.

(D) He abuses heroin and should be prescribed methadone maintenance.

3. Barbiturate abuse is much less common now than it was 25 years ago. What is the main reason?

(A) Barbiturate use is much less now than it was 25 years ago.

(B) Barbiturates available today are much safer than those of 25 years ago.

(C) People who abuse drugs today choose heroin and cocaine over barbiturates.

(D) The antidotes to barbiturates prevent the abuse.

4. The most widely abused drug in the world is

(A) Marijuana

(D) Alcohol

(E) Amphetamine

5. A patient has piloerection, mydriasis, increased blood pressure, and abdominal cramps. Your diagnosis is

(A) Alcohol abstinence

(B) Barbiturate abstinence

(C) Benzodiazepine abstinence

(D) Opioid abstinence

(E) Amphetamine abstinence

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Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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