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By D. Stan. University of Memphis.

Performance may not be as sharp as in a drug-free state cheap 400mg viagra plus visa erectile dysfunction pump pictures, but performance is in the normal range generic viagra plus 400mg without prescription erectile dysfunction causes medscape. If a pregnant woman uses opiates regularly the fetus soon adapts to the presence of the drug and seems to develop normally, although an infant can be born resonant with (that is, dependent on) the drug and undergo withdrawal. Intermittent use of opi- ates is more damaging to a fetus than regular use, with the changing drug environment causing extra stress as a fetus copes with one condition and then another. Opiates cause fetal metabolism to increase, diverting energy away from body development. Infants born to opiate users are commonly smaller 24 The Encyclopedia of Addictive Drugs than normal, and early slowness of brain development has been observed. Evidence exists that fetal exposure causes long-lasting problems in children, involving impulsiveness and inattention, but some researchers feel that home environment (often involving a single-parent opiate abuser with additional problems) is a better explanation for those difficulties. For information about specific opiate class depressants, see alphabetical list- ings for: buprenorphine, codeine, dihydrocodeine, etorphine, heroin, hy- drocodone, hydromorphone, morphine, nalbuphine, opium, oxycodone, pholcodine, and thebaine. Opioid Class Opioids are often called opiates, which is satisfactory for practical purposes because the two classes of drugs basically produce the same effects in the same way. If the history of a product were traced backward through its manufacturing processes, opiates generally would begin with the opium plant, but opioids would generally begin in a laboratory. Despite this technical distinction, the terms opiates and opioids are often used synonymously. Some of these sub- stances are called “semisynthetic” and are referred to as “opiate/opioid. Anabolic substances build up parts of living organisms, as opposed to catabolic substances, which decompose those parts. Anabolic steroids are abused mainly by persons desiring to increase muscle mass, such as compet- itive athletes and body builders. Steroids can improve muscle strength in fe- males and in castrated males, but scientific evidence is weaker for intact males. Still, steroids do seem to promote muscle mass, endurance, and overall athletic performance while dosage continues. Some scientists suspect that any perfor- mance enhancement experienced from anabolic steroids comes not from mus- cle power but from psychological effects, with the drugs increasing a user’s aggressiveness. Anabolic steroids can produce mania, anger, impulsiveness, euphoria, and feelings of invincibility—a combination that may lead some users into harmful social interactions. The combination can produce other types of unwise behavior as well, such as extravagant expenditures of money and taking reckless physical risks. Reports exist of paranoia and hallucinations developing while using steroids and disappearing when steroid usage is stopped. Drug Types 25 Sports governing authorities banned the use of anabolic steroids by com- petitors. Various other drugs are prohibited as well, but in 1988 most of the failed drug tests ordered by the International Olympic Committee revealed anabolic steroids, the most common one being nandrolone. In the 1990s a study involving 58,625 college students found only 175 steroid takers to study. Similar association of steroids with other illicit drug usage is found at the high school level.

So Introduction 7 although Schedule I is often viewed as a list of the most dangerous drugs buy 400 mg viagra plus with visa erectile dysfunction shots, relatively harmless ones are listed if they are unapproved for medical use in the United States generic viagra plus 400mg free shipping low testosterone erectile dysfunction treatment, while drugs that can easily kill even when administered in a hospital setting are listed in schedules indicating less danger of abuse. Still, the general rule is that drugs are scheduled according to their abuse potential, with drugs in lower-numbered schedules having more abuse potential than drugs in higher-numbered schedules. Some illicit drug makers try to avoid scheduling regulations altogether by tweaking the chemical composition of a substance just enough that it is no longer the molecule defined in a schedule. Schedule I is for drugs ruled as being most prone to abuse, lacking generally accepted use in the American health care system, and being so dangerous that health practitioners cannot safely administer these drugs to patients. Except for specially authorized scientific studies, possession of a Schedule I substance is illegal under any circumstance. Sometimes federal authorities change a drug’s sched- ule, and states may lag behind in conforming. A drug user who runs afoul of a state schedule can be punished as severely as a person who runs afoul of a federal schedule. A further complication is that although a drug that is un- listed in any schedule is presumed to be unscheduled, official pages of sched- ules do not necessarily specify all scheduled substances. Sometimes the official pages have not caught up with official decisions; sometimes a chemical is covered if it is derived from a scheduled substance, without a separate listing for the chemical being required. The list of sources at the end of this book tells how to find the official pages of schedules. For many years, stimulants, depressants, and hallucinogens basically com- prised the entire contents of schedules. The anabolics can be used to build muscle mass and have long been popular among athletes seek- ing an edge in competitions. Anabolic steroids can have other effects as well, 8 The Encyclopedia of Addictive Drugs effects particularly harmful to young persons whose bodies are still devel- oping. Rising concern about injury to younger athletes caused the strict regulations of scheduling to be applied to these drugs, although other types of control (requiring prescriptions and suppressing nonmedical sales) had long been in place. Penalties for illegal use or possession of a drug depend partly upon its schedule. A related purpose of scheduling involves control of scheduled substances through tracking pre- scriptions written by health care practitioners and by tracking inventory rec- ords of pharmacies. Pregnancy Categories Legal drugs are placed in a Pregnancy Category, a system used to classify the risk of birth defects if the substance is used by a pregnant woman. Food and Drug Administration system that was in place as the twenty-first century began. Studies using pregnant women do not show birth defects caused by the drug in the first trimester, and evidence has not emerged show- ing risk later in pregnancy. Studies using pregnant women have not been conducted, but experiments with pregnant animals fail to demonstrate birth defects. Al- ternatively, animal experiments have produced birth defects, but studies using pregnant women have not. Animal experiments have produced birth defects, but no studies have used pregnant women to examine the potential for human birth defects. Alternatively, no animal or human studies have been conducted to determine the drug’s potential for causing birth defects. Studies or reports of clinical experience indicate that the drug causes human birth defects, but using the drug during pregnancy may be so important to the woman’s health that fetal risk is justified (for example, no acceptable alternative therapy is available to deal with the woman’s illness).

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