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See also Cannabis sativa tobacco and purchase 500mg actoplus met fast delivery diabetes insipidus how to diagnose, 339 schedule-controlled (See Schedule- Bias cheap actoplus met 500mg fast delivery diabetes mellitus sliding scale, Len buy actoplus met 500mg online metabolic disease drug development, 14 generic 500mg actoplus met with amex metabolic disease for dogs, 493 women’s substance abuse and, 1357 controlled behavior) Bicuculline, 710, 711 Boggs Act of 1951, 132 sexual (See Sexual behavior) ‘‘Big Book. See Beer heroin statistics, 1301 Boot-camp prisons, 1028–1033, 1030 Brief intervention Operation Intercept and, 727 Booth, Evangeline, 935 for alcoholism, 1141–1142, 1148 Bureau of Prisons Bootlegging, 934–936 for tobacco addiction, 1199 boot-camp programs and, 1028–1029 Booze. See Myanmar zero tolerance and, 1371 London gin epidemic, 80, 533 Burn treatment and iatrogenic addiction, Border Patrol Medical Research Council, 1269–1270 620 exclusionary rule and, 511 opium and, 814–815, 818, 1009–1010 Burns and fire, alcohol-related, 9 immigration and, 190–191 tea use in, 874, 1076 Burroughs Wellcome Corp. See Distilled Spirits opium trade and, 821, 876, 1009 Buspirone Council of the United States, Inc. See Intracranial Brooks, Garth, 1105 self-stimulation Brothers (Gang), 566 C Brain structures, 191–197. See Cocaine Anonymous (Drug) Brown & Williamson Tobacco Company, Cabinet Committees, 1284 alcohol effects on, 75–76 1094, 1097 Cacao. See Chocolate amygdala (See Amygdala) Brummer, Bennet, 431 Caesar, Julius, 165 drug discrimination and, 972–973 Budweiser beer. See also specific drug interactions and, 434–437 Bulimia nervosa, 205–206 sources of caffeine, e. Customs 1135–1136, 1136 coffee cultivation in, 279, 874–875 Service Mendocino State Hospital, 1122 Breast cancer and alcohol, 220 Bureau of International Narcotics Matters, methamphetamine epidemic in, 119 Breastfeeding. See specific Society for the Treatment of Alcoholism personality and, 842 causes, e. See Dogs caffeine-related, 212–213, 214 244–245, 929–930 Cannabidiol, 222, 703 cannabis-related, 705 Centers for Disease Control, 1277 Cannabinoids, 222, 703, 875, 1188 cocaethylene-related, 266 on adolescent employment, 34 Cannabinol, 222, 703 cocaine-related, 270–271, 289, 291–292, child abuse studies, 246–247 Cannabis sativa, 221–222, 222, 466, 875. See Latin America aggression and, 53 injection route of administration and, 344 Central Intelligence Agency, 1274–1275 with alcohol, 941–942 tobacco-related, 321–322, 784, Central nervous system. See Brain structures amotivational syndrome and, 109–110, 1100–1102 Central nervous system depressants. See 293 Cardiovascular drugs, 1351–1352 Depressants as aphrodisiac, 140 Central nervous system stimulants. See Cannabis sativa gangs and, 566, 567 Substance Abuse Chemical-dependency programs, 1129, 1220 ganja, 144, 575 Case method of research, 239–244 Betty Ford Center, 1139 hallucinations and, 587–588 Casriel, Daniel, 1135 Hazelden Clinics, 1134, 1244, 1245–1246 hashish, 592–593 Casual drug use, 21–22 Minnesota Model, 1124, 1244–1246 health risks of, 13–14, 881, 882 Catapres. See also Dopamine; Chemical Diversion and Trafficking Act of immunological complications and, 303 Epinephrine; Norepinephrine 1988, 116–117, 1273 Indian Hemp Drugs Commission, 185, agonists for, 224 Chemical Diversion and Trafficking Act of 287, 594 alcohol and, 320 1993, 117 interdiction of, 440–443 cocaine effects on, 291 Chemotherapy Italian use of, 667 vs. See Khat Chesterfield cigarettes, 1094 700–702, 758 Catherine the Great, 80 Chewing tobacco, 1104. See also Tobacco marijuana, 702–707, 703 Cathine, 678, 678–679 Chicago, Illinois memory and, 712 Cathinone, 678, 678–679 Democratic Convention of 1968, 1369 from Mexico, 655–657, 664 Catholic Total Abstention Union, 1079 gangs in, 566, 567, 568–569, 571, 572 in Netherlands, 769, 770, 879 Caudate nucleus, 193–194 Gateway Foundation, 1136 1830 Vol. See Hispanic Americans Christianity and wine, 79 racial profiling and, 947–949 Child abuse, 246–251. See Clinical Institute Withdrawal antisocial personality disorder and, 138 Chronic alcoholism, 102 Assessment for Alcohol child abuse effects on, 248, 249–250 Chronic obstructive pulmonary disease Classical conditioning, 234, 235–239, 1217. See Tobacco industry withdrawal and, 991–992 abuse of (See Child abuse) Cigarette Labeling and Advertising Act of Classroom prevention programs. See Alateen support group, 65–66 1965, 1092 Children, prevention programs and of alcoholics Cigarette smoking, 872–874. See also Liver treatment policy and, 1128–1129 alcohol use in, 80, 253, 1307 disorders Clonazepam, 173, 174–175, 710 ancient, alcohol use in, 79, 145, 164–165 acetaldehyde and, 306–307 Clonidine, 261–263 beer use in, 166–167 alcohol-induced, 72, 322–323 for alcohol withdrawal, 1251 epidemics of drug abuse Cisco (Wine), 39 naltrexone with, 970 hanshi, 145–146, 490 Citalopram, 1026 for opioids withdrawal, 804–805, 1182, opium, 143, 490 City Lights, 710 1253 ginseng use in, 578 Civil Addict Program (California). See United Nations, Commission on Chlorinated hydrocarbons, 643, 645 Civil rights. See Depressants Chlorofluorocarbon propellants, 643 civil commitment programs and, 258, Coalcoholism. See also Cola soft treatment for abuse (See Cocaine Colleges and universities, prevention drinks addiction treatment) programs in, 480 Coca paste, 264–265 in utero exposure to, 17, 247–248, Collins, Wilkie, 709 Coca plant, 265–266, 266, 875. See also 541–542 Colombia as drug source, 283–287, 284, Cocaine withdrawal from (See Cocaine withdrawal) 1054 Bolivian use of, 188–190 women’s use of, 1356 ayahuasca, 157 crop control of, 372–373, 374–375 Cocaine addiction treatment, 271–272, cannabis, 655–656, 664 cultivation of, 372–373 1157–1162 cocaine, 264, 266, 655–658, 656, 657, paste from, 264–265 hypnosis as, 1242 659, 660, 666, 875, 1112 Cocaethylene, 266–267 outpatient vs. See Chocolate Combe, George, 709 as anesthetic, 549 Coda, 1241 Commerce and drug policies, 883 anhedonia and, 129 Codeine, 272, 831–832 Commission on Recognition of Post- as anorectic agent, 129–130 allergic response to, 105 Secondary Accreditation, 933 as aphrodisiac, 140 chemical structure of, 272 Commissions on drugs, 287–288. See Civil commitment buprenorphine and, 207 Codependence, 272–275 Committee on Drug Addiction and Narcotics. See Kola nut Competitive antagonists, 134–135, 863 neurological complications from, 335 Cola soft drinks, 210, 211, 279, 281–282 Complementary reinforcers (Economics), operant conditioning and, 235 Coleridge, Samuel Taylor, 357–358, 358, 168–170 from Peru, 655–658, 656, 666 814–815 Complications. See specific complications, during pregnancy, 893–897, 898–899 Coletti, Shirley, 1137 e. See Economic Alcoholism Prevention, Treatment 1231–1233, 1256–1257 costs of substance abuse; Social and Rehabilitation Act of 1970, for cocaine addiction, 1165 costs of substance abuse 945, 1124–1125 for polydrug addiction, 1192 Cosyntropin, 297 Comprehensive Crime Control Act of 1984, Contingent tolerance, 170–171 Cotinine, 786 152–153 Contract for Life: The Bob Anastas Story Cough suppressants, 272, 743 Comprehensive Drug Abuse Prevention and (Film), 1059 Council for Tobacco Research, 1098, 1099 Control Act of 1970, 700 Contract with America (Manifesto), 1336 Counselors. See also Excessive Schedule I yippies and, 1369–1370 behaviors cannabis, 684–685 Counternarcotics Technology Assessment Compulsory treatment. Single Convention on Narcotic Drugs, of cocaine, 224, 270, 1345–1346, of dogs for drug detection, 412–413 1347–1348 drug discrimination and, 971–974 1035 triplicate prescription and, 1267–1268 as conditioned response, 236–237 motivation and, 984–985 defined, 25 nicotine and, 786–787, 1085 Controlled Substances Handbook, 351 Controls for clinical testing, 966 extinction training for (See Extinction operant (See Operant conditioning) training) place preference, 990–991 Controls of drugs. See Schedules of drugs Convention against Illicit Traffic in Narcotic of nicotine, 786, 1349 Wikler’s theory and, 1338–1339 pharmacotherapy for, 970, 1219 Drugs and Psychotropic Substances Conduct disorder Creativity and drug use, 357–360, 358 (1988) Credentials. See Sudden Infant Death in children, 348–349 Colombia and, 284 substance abuse and, 346–348 Syndrome foreign policy and, 544, 546 Crime. See also Drug laws; Prisons and jails Congress Convention for Suppression of Illicit Traffic Anslinger, Harry J. See Skills training drugs and, 364–371 Connecticut, Norwich State Hospital, 1122 Cordials, 407–408 drunk driving as, 471–472, 473, Conocybe species. See Flurazepam alcohol-induced, 292–293, 319, 333 Crime Control Act of 1990, 117 Dance drugs. See Drug Abuse Resistance Dental preparations with betel nut, 184 in Bolivia, 188–189 Education Department of Defense. Department 1316–1317 of Housing and Urban Development Outcome Studies Cross-sensitization, 112 Department of Justice. Department amphetamines and, 112 Daytop Village, 1135 of Labor barbiturates and, 163, 164 ddC. Department of polydrug detoxification and, 1195–1196 Deaths State Cryptosporidium parvum, 835 alcohol-related, 8, 418, 932 Department of Transportation. See Center for Substance Abuse from accidental poisoning, 877–878 Department of Treasury. See also Addiction; Cuba, as transit country, 1112 1051–1052 specific substances, e. See Extinction Decriminalization, 758–759, 882–888 Minnesota Model and, 1244, 1245 training of cannabis, 701–702, 758, 904 naltrexone for, 752–754 Cults and substance abuse, 377–379 legal regulation and, 685 opioid (See Opioid dependence) Cultural considerations National Families in Action and, 925 physical (See Physical dependence) beliefs and, 1307–1308 parent groups and, 838, 905, 926 pregnancy and (See Pregnancy) in ethnic research, 509–510 vs. See Child Welfare League of Delavirdine, 1061 neonatal withdrawal and, 17 America Delayed hypersensitivity, 104, 105 neurological complications from, 334 Cyclooxygenase-2 inhibitors. See Pemoline Delirium tremens, 332, 382 alcohol and, 87, 326, 1155–1156 Cytochrome P450, 447, 448 chlordiazepoxide for, 255 antidepressants for (See Antidepressants) alcohol and, 75, 306, 860–861 hallucinations and, 73, 587 conduct disorder and, 347 drug interactions and, 437, 438–440 Delusions, 381–382, 806. See also suicide and, 1064, 1066 Cytokines and alcohol, 299–300 Hallucinations Deprol. See Meprobamate Cytoplasm (Neurons), 773–774 Demand (Economics), 167, 1073–1074 DerKokainismus, 1345 Cytoxan. See Contact dermatitis Czech Republic, beer use in, 166–167 drug policies and, 885 Dermatological disorders. See Le Patriarche for cocaine polydrug addiction, Desipramine, 135–136 Diazepam, 173.

So a maximum of 60 grams of fructose from and only from natural fruits and juices cheap actoplus met 500 mg otc diabetes definition ada 2012. So fruit can be eaten and we can eat 15-20 grams easily at a time even three times a day but no more generic actoplus met 500 mg without prescription diabetes mellitus definition. The old key of a minimum of five servings of fruits and veg per day is still the way to go actoplus met 500 mg overnight delivery diabetes insipidus overview. Fifteen grams of fructose is not much -- it represents two bananas buy cheapest actoplus met and actoplus met metabolic disorder vlcad, one-third cup of raisins, or two Medjool dates. There is nothing benign about the fructose consumption inherent in our modern diet. One of the easiest things you can do to quickly improve your health is to eliminate all soda and sweetened beverages from your life. Dextrose (pure glucose) I discourage this in any form as it upsets blood balance 3. Once you realize the hazards of fructose and begin to avoid it in earnest, your diet will significantly improve, which is an essential factor for a long, healthy life. Sugars and Sweetness Many diseases are due to factors that are related to Big Sugar, Big Sugar for its corporate name. Limiting trans-fatty acids, making good sugars (Left handed Fructose), rather than bad sugars (right handed Dextrose). Right handed dextrose sugars such as sugar cane, beet sugar, grape sugar, corn sugar are right handed and they enter the cells too fast. This produces fat more easily, hyperglycemia (mild addiction) and then hypoglycemia (mild depression). There is also a well documented negative effect on the immune system from dextrose. If you use chemicals to strip away vitamins and minerals to make the sugar white, and it gets even worse. Dextrose sugars are at the top of the Glycemic Index tables because they enter the blood stream and the cell so fast. A process that takes time and thus allows for a more smooth delivery of the glucose. Less fat, less stress on organs, less craving, less depression, less blood sugar fluctuations. Crazy food additives that have not been fully tested add to the food and drug problems. So fatty acid deficiency is the number one problem in the world of health care today. Our tongues are mainly proton detectors and sweet fruits the primary thing we crave for taste and health. But then came along the sugars from cane and other dextrose sugars that are problems for the body. The high glycemic foods with dextrose bring up blood sugar very fast we get addicted to the taste and the rush. The high glycemic dextrose sugars drive out blood sugar way up, force the release of extra insulin, this makes the blood sugar go down and the cycle repeats. Immune-depression, nerval-irritation, stress susceptibility, mood disorders and the cycle allows all other diseases and cancer a foothold. Big Sugar and cholesterol are leading to diseases that are killing over a million people a year. As people got more affluent they ate more pig and ate more of the foods that in old were only used sparingly. But now that people eat them every day they are getting the diseases that used to be the King diseases. The shift of sugars to dextrose was a major mistake for health care, The improper use of cooking and the destruction of the oils, too much meat consumption, too much processed foods, profits from fast foods, leaching of minerals and nutrients from the soil, lack of appreciation for the natural, all disobey the rules of the stomach and a medical system that believes it can fix anything when it can’t, and we have a society where the diseases are rampant. The real problem of dextrose versus fructose has not been really discussed because of the problem of the profits of Big Sugar, and their lobbyists. Some hypothesize that fructose, one of the components of sucrose, is a particularly bad kind of sugar. It may not suppress hunger or stimulate the natural feeling of fullness, says Kathleen Melanson, an assistant professor of food and nutrition at the University of Rhode Island in Kingston. It can also lead to higher levels of uric acid, which some believe raises the risk of cardiovascular disease and diabetes, among other woes. The mass de- naturalization of sugar is to remove the brown color and make it white. Sucrose is normally about 30% fructose and 70% glucose, while honey is about 40 to 45 percent fructose, and high- fructose corn syrup is about 55 percent. There are tiny differences in the minerals in some sweeteners; the less processed, the more trace minerals, says Blatner. One study, published earlier this year in the Journal of the American Dietetic Association, found that among sweeteners, dark and blackstrap molasses had the most antioxidant activity. Maple syrup, brown sugar, and honey had a bit less, and refined sugar, corn syrup, and agave nectar had the least. Some find agave so sweet that they use much less of it, which can mean fewer calories. And it comes packaged with plenty of fiber and nutrients, which is more you can say for your average sweetened cereal or drink. Nerve damage, intestinal parasites, psychological imbalance also can be the cause of aggravate. If you were lost in the desert for 3 days and just came out and someone offered you an apple, you wouldn’t say “No, have you got a candy bar. Low Glycemic Food List Low glycemic food is very important for the weight loss plans that you have been trying to work on. The glycemic index of the food is the numerical index that categorizes the carbohydrates according to their response to the glucose from the human body. Glycemic index is usually counted by feeding a fixed portion of food to the test subject after an overnight fast and then calculating the blood sugar counts. Low Glycemic Index More than 80% patients of type 2 diabetes suffer from obesity and high cholesterol levels. Low glycemic diet plan is actually a diet plan that a person needs to follow at least for 28 days, which will help him/her maintain the proper blood glucose levels. Low glycemic index diet generally consists of proteins, low glycemic carbohydrates and omega-3 fatty acids. Yes, given below is a list of low glycemic index foods that you can refer in order to manage your daily diet. Low Glycemic Index Food List: Vegetables Name Glycemic Index Artichoke 15 Asparagus 15 Broccoli 15 Cauliflower 15 Celery 15 Cucumber 15 Eggplant 15 Green Beans 15 Lettuce 15 Peppers 15 Snow Peas 15 Spinach 15 Summer squash 15 Tomatoes 15 Soy beans 15 Dried peas 22 Boiled beans 16 Boiled kidney beans 29 Boiled lentils 29 Zucchini 15 Chickpeas 33 Black-eyed beans 41 Boiled haricot 38 beans Carrots 39 Yam 51 Sweet potato 54 Onions 10 Cabbages 10 Low Glycemic Index Food List: Fruits Name Glycemic Index Apples 38 Apricots (dried) 31 Avocados 44 Cherries 22 Grapefruit 25 Grapes 46 Kiwi fruit 53 Bananas 54 Pear 38 Plum 39 Peach 42 Oranges 44 Low Glycemic Index Food List: Cereals Name Glycemic Index All bran 42 Porridge 49 Pearl barley 25 Rye 34 Wheat kernels 41 Parboiled rice 48 Cracked barley 50 Low Glycemic Index Food List: Others Name Glycemic Index Whole grain bread 50 Multi grain bread 48 Low fat yogurt 14 Chocolate milk 24 Fat free milk 32 Whole milk 27 Skimmed milk 32 Low fat ice cream 50 Soy milk 31 Peanuts 15 Marmalades and jams 49 Canned tomato soup 38 Chocolate bar 49 Macaroni 45 Spaghetti 41 Fettuccine 32 Vermicelli 35 Pound cake 54 Along with the proper ratio of the above mentioned low glycemic foods, one must also concentrate on a low carb diet that will be helpful to maintain the low glycemic index. Relatively less amount of oil, salad dressings, mayonnaise, fresh fruits and green vegetables, cereals and beans and low fat dairy items always top the low glycemic food list.

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As soon as his retainer came out order actoplus met with paypal diabetic plate, and they stopped using flea powder on their dog order actoplus met 500 mg otc diabete oeil, his energy became normal and sinuses cleared up buy actoplus met 500 mg mastercard managing your diabetes lilly. Evelina Rojas order actoplus met visa diabetes or kidney disease in dogs, age 12, was having extreme fatigue with mood problems and sudden fevers. She killed Ascaris and sheep liver flukes with the parasite program but promptly got them back due to a benzene buildup I believe due to using products containing an herbal oil. Her high levels of Streptococcus pneumoniae (cause of fevers), Staphylococcus aureus and Nocardia could not be eliminated until her three baby teeth (with root canals) were pulled. She was toxic with arsenic, a substance that replaces en- ergy with nervous excitement and exhaustion. She also had a backlog of antimony (using baby oil), aluminum, rhenium (hair spray), benzalkonium (toothpaste) and radon. In four months, she had the arsenic and three other toxins eliminated and already had more energy. He had the mirac- idia of the intestinal fluke, sheep liver fluke, and pancreatic fluke in his thyroid! He had been drinking a great deal of regular tea, which let oxalate crystals deposit in his kidney and slow down the excretion of toxins. The parasites were killed with a frequency generator, he changed his diet to get rid of solvents. Change all detergents (for dishes, laundry, and body use) to borax and/or washing soda. Whether you have cysts or not, it is always a good idea to use borax and washing soda instead. If you test positive for it, stop all commercial soap and detergent for all possible uses. The fungus is hosted by another parasite but finds your skin quite satisfactory for a home, at least while your skin immunity is low. It may be low from wearing metal jewelry, having metal tooth fillings, aluminum (from lotions and soaps), cobalt (from shaving supplies), and zirconium (from deodorant. When all these are removed, the skin will dry up quickly in open air or under a heat lamp. The skin that has rash or fungus should be dried with paper towels, unfragranced and uncolored, in order not to contaminate the cloth towels, and thereby transport the tiny infectious spores to other skin loca- tions. The pers are a modern metal is pulled into the body for atrocity, forcing elimination. Allergy to strawberries, perfume, deodorant or chlorinated water, however different they are, can all be expressed the same way, in a rash. The liver has refused (been unable) to detoxify the chemicals in these items and allows them to circulate in the body. Not for long, though, since great damage could be done to brain and other tissues. Try cleaning your liver (page 552) several times or until 1,000 bits of refuse have been washed out of the bile ducts. This relieves the back pressure on that part of the liver, and allows it to do its work again. The day before the liver cleanse you would never eat a strawberry or peanut for fear of a reaction. Each liver cleanse “cures” a different set of allergies sug- gesting that the liver is compartmentalized—different parts having different duties. Experience shows this to be true, although it can take two years to carry out such a program. It is quite destructive to bathe the brain in strawberry chemicals or your toes in maple syrup chemicals. Stay off al- lergy-producing foods and products even if you can tolerate a little or can be “desensitized” to them with shots or homeopathic methods. Use these methods for relief, not license to continue using items that tax your body. Certain childhood diseases produce a rash and this can be diagnosed by testing for the suspected disease with a slide or culture of it. Then use a zapper to kill both the bug and any larger parasites that may have brought it in. Perhaps the true culprit was too big to be seen with a mi- croscope or too small (antigen) to be recognized or just too unimaginable. I inevitably find Trichinella, one of the four common roundworms that infect humans. It is generally believed to re- side in muscles, especially the diaphragm, but in acne cases it is in the skin. Their molting chemicals are quite allergenic; perhaps it is these that are affecting the skin. Since pets pick these worms up daily, there is chronic reinfection in families with pets. She had been treated since teen age with ultraviolet light, Retin A, and antibiotics. Her skin was toxic with strontium and her kidneys had cadmium, silver and beryllium deposits inhibiting ex- cretion. In spite of using parasite herbs for months she got no improvement until the baby was out of diapers. His urinalysis showed “amorphous” crystals (stones of all kinds) and a trace of protein. He was started on kidney herbs so there would be good excretion after killing the Trichinella. His thyroid and kidneys were full of zirconium and titanium from all the lotions he used for his skin. It took four months to clear his Trichinella although there were no young children or pets in the house. His face was beginning to heal, but three months later he had a recurrence, although his parent was not a carrier. Evan Knight, 36, had psoriasis at elbows and knees from age 9 but now it was spreading to his fingers and scalp. He occasionally had bronchitis and puffy eyelids, indicative of Ascaris but at the time of his visit he had Trichinella fluke stages and Echinostomum in his skin. He was started on the parasite program and in three weeks it was clearing instead of advancing. He switched to milk for his beverage to raise his immunity and removed the arsenic, formaldehyde and thulium (from his vitamin C) by doing the necessary cleanups. He killed it in the office with a frequency generator and got imme- diate improvement but four weeks later it was back. This situation would make recovery impossible since he was no doubt reinfecting himself.

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Withdrawal symptom research on mice indicates that dihydroetorphine may do more than substitute for morphine: A dihy- Etorphine 159 droetorphine dose may actually make morphine withdrawal symptoms go away proven actoplus met 500 mg diabetic videos, so further doses of either drug become unnecessary actoplus met 500mg amex diabetes medications youtube. Such a result would be inconsistent with what is known about opiate dependence purchase actoplus met 500mg amex diabetes diet food list, but dis- covery of new facts can change scientific understandings buy actoplus met 500mg mastercard blood sugar test kit. Some researchers believe that etorphine and dihydroetorphine have potential for treating opiate addiction. Dihydroetorphine has been used for that purpose in China but seems to produce even stronger dependence among heroin addicts than meth- adone. So perhaps animal experiment findings that indicate low dependence potential in dihydroetorphine cannot be extrapolated to humans. Giving etorphine and morphine together increases pain relief in mice, while the etorphine does not seem to increase the strength of opiate dependence in the combination. Researchers speculate that the im- proved pain control might be great enough to allow much smaller doses of morphine in humans than would otherwise be needed, which in turn would greatly decrease the amount of dependence otherwise created by normal-size morphine doses. For convenience this drug is here classified as a stimulant simply because other anorectics controlled by the U. Chemistry operates independently of classification schemes, however, and fenfluramine does not act like typical stimulants even though it is related to amphetamine. Fenfluramine can sedate users and has only modest influence on body temperature and blood pressure. Yet it also has characteristics of powerful stimulants: euphoria, hallucinations, paranoia. Fenfluramine can alter time perceptions and snap moods from one extreme to another. In humans fenfluramine has been found effective for diminishing panic at- tacks but has had mixed success when used to treat obsessive behavior. Ex- perimental use against schizophrenia has been unsuccessful, with patients worsening under the drug regimen. A longer study (11 months) found the drug provided only limited help to autistic children, and a still longer study (27 months) found such long-term administration impractical due to unwanted effects and due to changes in the autistic children’s lives. A scientific review of such studies concluded that the drug’s potential nonethe- less merited further trials. Fenfluramine is a drug of many effects, but medically its primary use has been for weight loss. Studies consistently indicate the drug’s effectiveness for Fenfluramine 161 that purpose. Other unwanted actions can include headache, peevish feel- ings, dizziness, tiredness, nausea, vomiting, diarrhea, and frequent urination. Experience indicates that persons need to be weaned off the drug; cold turkey cessation can cause depression or even a medical emergency called “serotonin syndrome. Experimental animals have shown little interest in receiving fenfluramine doses, a classic sign of small addiction potential. Researchers discovered that fenfluramine could be administered in combi- nation with phentermine, an anorectic that works in a different way. Rat experiments showed that fen-phen reduces food intake far more than either drug can do alone, and experience confirmed the same kind of multiplier effect in humans. Such impact allows persons to take lower doses than would be necessary with either drug alone, thereby minimizing any undesired actions of the drugs. Phentermine counteracts fenfluramine’s common sedative quality, allowing users to function more normally. Weight control is one of the most challenging conditions encountered by medical practitioners, and fen-phen became tremendously popular. One study found that almost 90% of 88 obesity patients taking fenfluramine or the closely related drug dexfenfluramine were also taking phentermine and that almost 33% of the 88 patients lacked obesity levels for which these or other anti- obesity drugs were an appropriate treatment. Suddenly, after many years of wide use without much report of alarming adverse effects, in 1997 accounts began associating fenfluramine with rapidly developing fatal heart valve disorders. Food and Drug Administra- tion asked the manufacturer to withdraw fenfluramine and dexfenfluramine from the market. Hot debate then erupted in medical circles about whether heart disease was caused by fenfluramine, phentermine, or the two drugs in combination. Studies purported to confirm that the drugs alone or in combi- nation really did create heart valve affliction. Highly knowledgeable and distin- guished medical authorities took differing stances on the question and raged at one another in scientific journals. An issue also arose of whether fen-phen caused fatal pulmonary hypertension (high pressure in blood circulation to lungs), with researchers reminding fellow scientists that fenfluramine works in ways similar to the anorectic drug aminorex, which had been linked to pulmonary hypertension in the 1960s and was thereafter withdrawn from the market. Particular concern was expressed about fenfluramine’s impact on pul- 162 Fenfluramine monary hypertension and edema among users living or traveling in high al- titudes. Phentermine is a monoamine oxidase inhibitor, and despite a lack of reports about acute adverse interaction with fenfluramine, some researchers noted that a more chronic interaction could cause the kind of heart and pul- monary damage that was appearing. Researchers began reporting organic brain damage from fenfluramine and dexfenfluramine in animal experiments. Investigators now noticed many instances of psychiatric disturbance among persons taking fenfluramine and noted that the disorders implied organic brain damage. The drug was also linked to human angina pectoris (a fright- ening sensation of pain and suffocation typically caused by insufficient oxygen supply to the heart) and to a case of a gangrenous condition resulting in amputation of fingers. As time passed, evidence appeared that the heart valve and pulmonary hypertension disorders could stabilize and even improve after patients stopped taking fen-phen. Scientific debate continues about fenflura- mine’s role in heart ailments and pulmonary hypertension. Despite the beating that fen-phen took from the news media and from many scientists, researchers remain curious about whether the drug combination still has a role in medicine. Even though fenfluramine can cause depression, in- terest arose in possible psychotherapeutic uses. As the twenty-first century began, experimenters reported that fen-phen can ease withdrawal from co- caine. Rat experiments find that fen-phen reduces alcohol intake and elimi- nates alcohol withdrawal symptoms, findings that may be relevant to treatment of alcoholism. Indeed in 1995 one medical practitioner reported suc- cess in treating alcohol and cocaine addicts with fen-phen, sometimes substi- tuting pemoline for phentermine. Experimenters who gave fenfluramine to pregnant mice found no measurable effect on fetal development and no effect on offspring’s ability to perform in learning tests. For primates evidence exists that the drug passes into the fetus and reaches high levels there. Studies comparing the two drugs find little or no difference in effect, although dexfenfluramine was introduced with the hope that it had fewer unwanted actions than fenfluramine when used for weight loss.