Nonmedical effects

Secobarbital exhibits the same pharmacologic properties as other members of the barbiturate class. Most nonmedical use is with short-acting barbiturates, such as secobarbital. Although there may be considerable tolerance to the sedative and intoxicating effects of the drug, the lethal dose is not much greater in addicted than in normal persons. Tolerance does not develop to the respiratory effect. The combination of alcohol and barbiturates may lead to fatalities because of their combined respiratory depressive effects. Similar outcomes may occur with the benzodiazepines. Severe withdrawal symptoms in epileptic patients may include grand mal seizures and delirium. 

Any discussion of the chemistry of drugs must include some consideration of the nonmedical applications of such compounds. Just as early humans were searching their environment for natural products that would assuage pain and cure disease, so were they also looking for plants and other natural materials with psychoactive effects, materials that would provide an escape from the problems and worries of everyday life, or that would just make a person feel better for a period of time. They also incorporated psychoactive drugs into many of their religious ceremonies. The use of the peyote cactus, magic mushrooms, and similar products dates back centuries, if not millennia, in a variety of cultures. One hardly need point out that the use of psychoactive chemicals for recreational purposes continues in essentially every part of the world today. 

The issue with nonmedical use of drugs today, however, is not only the usual risk involved with the use of any psychoactive drugs but also the increased danger posed by a host of new psychoactive products. Some of these have been developed for legitimate therapeutic purposes, hut many of them are spin-offs with unknown effects and, in some cases, known and harmful effects. As pharmaceutical... 

In a speech before the Congress in 1978, former Commissioner Donald Kennedy stated "the evidence indicates that enteric microorganisms in animals and man, their R-plasmids, and human pathogens form a linked ecosystem of their own in which action at any one point can affect every other." If the vulnerability of microorganisms to antibiotics is reduced by the use of antibiotics for nonmedical purposes in animals, the effectiveness of medical treatment will be diminished in man. Potential risks to animal health also exist, and while the linkage to human health is indirect, animal agriculture faces the risk directly. The... 

As reimbursement systems continue to evolve, the child psychiatrist as medication prescriber in the context of psychotherapy offered by a seperate (usually nonmedical) clinician is a phenomenon growing exponentially in number and complexity. Liability, clinical, boundary, transference-countertransference, and systems issues swirl about the axis connecting these inseparable aspects of treatment. The only way to enssure that split treaters don t split the treatment is through effective communication. 

More recent studies have examined combinations of medical and nonmedical treatments for ADHD, usually in an effort to determine whether one form of treatment is superior to, or enhances the effectiveness of, another. The largest-scale study examining the relative and combined effectiveness of medical and nonmedical interventions for ADHD is the recently completed MTA study (MTA Cooperative Group, 1999). In this 5-year, six-site project, 579 elementary school-age children with ADHD were randomly assigned to one of four 14-month treatment conditions behavioral treat-... 

Although most controlled trials lasted only weeks, the longitudinal study of the effect of psychotherapy versus drugs by May et al. ( 20, 21) is particularly germane. Schizophrenic patients were randomly assigned to either antipsychotics or no medication. After 6 months or more, the initial nonmedication group was then given... 

When determining which method of economic analysis she should use, she eliminated cost-minimization analysis because the treatment alternatives (service versus no service) will not result in equivalent outcomes. A cost-effectiveness analysis would not be appropriate because she is only interested in one particular program. A cost-utility analysis is also not appropriate because quality of life, while included in the project, is not the focus of her project. A cost-benefit analysis could be appropriate. A cost-benefit analysis requires that both the interventions and outcomes be valued in monetary units. She can determine the direct medical and/or nonmedical costs for each patient from data captured by her HMO. The HMO is very interested in costs, both those to implement the service and those it may save as a result. Cynthia decides that the most understandable analysis to present to the HMO is a cost-benefit analysis. 

Narcotics (opiates and opioids) are natural, semisynthetic, and synthetic derivatives of the opium poppy. Drugs such as morphine, codeine, heroin, methadone, Darvon, and Percodan fall into this category. They are all depressants, but they are also potent painkillers, and except for heroin (which is illegal) they are prescribed to relieve pain and to control coughing and diarrhea. But because of their pleasurable effects and addictive properties, they can cause problems when taken for nonmedical reasons. Most nonmedical users take these drugs to experience euphoria, to avoid pain, and to relieve withdrawal symptoms. —... 

A number of important nonmedical issues that affect the delivery of health and medical care need to be addressed to ensure an effective response to a mass casualty event. They include ... 

A small number of reported cases of children have presented with mild to moderate hematological effects, requiring minimal to nonmedical intervention (Babcock et al, 1993, Golej et al, 2001 Osterhoudt and Henretig, 2003 Smolinske et al, 1989 Travis et al, 1993 Watts et al, 1990). 

In the following sections, adverse reactions are considered in connection with the types of iron therapy with which they have most commonly been associated, but any adverse effect of iron can in principle occur with any formulation or as a result of mixed medical and nonmedical exposure. 

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