Amphetamines Health Dictionary

A drug or other agent that prompts the activity of a body system or function. For example, the sight and smell of food stimulates salivation, and the rods and cones in the retina of the eye are stimulated by light. Another example is the use of amphetamines and ca?eine to stimulate the central nervous system and make an individual more alert and active – or, if taken in excess, hyperactive. In treatment procedures, electrical stimulation may be used to bring muscles into action. Aromatics, spices and bitters are traditional stimulants of digestive processes.... stimulant

Literally, substances meant to oppose depressions or sadness, and generally heterocyclic types such as Elavil, MAO inhibitors like phenelzine, or lithium carbonate. This category of substances formerly included stuff like amphetamines and other stimulants. Our only plants that could fit the current definition would be Hypericum, Peganum and perhaps Oplopanax.... antidepressant

Proprietary name for amphetamine sulphate (see AMPHETAMINES).... benzedrine

In the United Kingdom, controlled drugs are those preparations referred to under the Misuse of Drugs Act 1971. The Act prohibits activities related to the manufacture, supply and possession of these drugs, and they are classi?ed into three groups which determine the penalties for o?ences involving their misuse. For example, class A includes COCAINE, DIAMORPHINE, MORPHINE, LSD (see LYSERGIC ACID DIETHYLAMIDE and PETHIDINE HYDROCHLORIDE. Class B includes AMPHETAMINES, BARBITURATES and CODEINE. Class C includes drugs related to amphetamines such as diethylpropion and chlorphentermine, meprobamate and most BENZODIAZEPINES and CANNABIS.

The Misuse of Drugs Regulations 1985 de?ne the classes of person authorised to supply and possess controlled drugs, and lay down the conditions under which these activities may be carried out. In the Regulations, drugs are divided into ?ve schedules specifying the requirements for supply, possession, prescribing and record-keeping. Schedule I contains drugs which are not used as medicines. Schedules II and III contain drugs which are subject to the prescription requirements of the Act (see below). They are distinguished in the British National Formulary (BNF) by the symbol CD and they include morphine, diamorphine (heroin), other opioid analgesics, barbiturates, amphetamines, cocaine and diethylpropion. Schedules IV and V contain drugs such as the benzodiazepines which are subject to minimal control. A full list of the drugs in each schedule can be found in the BNF.

Prescriptions for drugs in schedules II and III must be signed and dated by the prescriber, who must give his or her address. The prescription must be in the prescriber’s own handwriting and provide the name and address of the patient and the total quantity of the preparation in both words and ?gures. The pharmacist is not allowed to dispense a controlled drug unless all the information required by law is given on the prescription.

Until 1997 the Misuse of Drugs (Noti?cation and Supply of Addicts) Regulations 1973 governed the noti?cation of addicts. This was required in respect of the following commonly used drugs: cocaine, dextromoramide, diamorphine, dipipanone, hydrocodeine, hydromorphone, levorphanol, methadone, morphine, opium, oxycodone, pethidine, phenazocine and piritranide.

In 1997 the Misuse of Drugs (Supply to Addicts) Regulations 1997 revoked the 1973 requirement for noti?cation. Doctors are now expected to report (on a standard form) cases of drug misuse to their local Drug Misuse Database (DMD). Noti?cation by the doctor should be made when a patient ?rst presents with a drug problem or when he or she visits again after a gap of six months or more. All types of misuse should be reported: this includes opioids, benzodiazepines and central nervous system stimulants. The data in the DMD are anonymised, which means that doctors cannot check on possible multiple prescribing for drug addicts.

The 1997 Regulations restrict the prescribing of diamorphine (heroin), Diconal® (a morphine-based drug) or cocaine to medical practitioners holding a special licence issued by the Home Secretary.

Fuller details about the prescription of controlled drugs are in the British National Formulary, updated twice a year, and available on the Internet (see www.bnf.org).... controlled drugs

A group of chemical substances produced illegally whose properties and effects are similar to those of drugs of abuse. They may be derived from narcotic ANALGESICS, AMPHETAMINES or HALLUCINOGENS. Ecstasy is a widely used designer drug and has caused deaths among teenagers. Designer drugs are potentially dangerous, especially if taken with alcohol.... designer drugs

A means of encouraging EXCRETION via the KIDNEYS of a compound by altering the pH and increasing the volume of the urine. Forced diuresis is occasionally used after drug overdoses, but is potentially dangerous and so only suitable where proper intensive monitoring of the patient is possible. Excretion of acid compounds, such as salicylates, can be encouraged by raising the pH of the urine to 7·5–8·5 by the administration of an alkali such as bicarbonate (forced alkali diuresis) and that of bases, such as AMPHETAMINES, by lowering the pH of the urine to 5·5–6·5 by giving an acid such as ammonium chloride (forced acid diuresis).... forced diuresis

A substance that mimics at least part of adrenalin or catecholamine responses. The term is a little biased towards the minority of sympathetic functions that are adrenergic. A better name might be adrenalomimetic, epinephromimetic, catecholamimetic...or speedomimetic. Examples: coffee, ephedrine, amphetamines.... sympathomimetic

Unpleasant physical and mental symptoms that occur when a person stops using a drug or substance on which he or she is dependent (see DEPENDENCE). The symptoms include tremors, sweating, and vomiting which are reversed if further doses are given. Alcohol and hard drugs, such as morphine, heroin, and cocaine, are among the substances that induce dependence, and therefore withdrawal symptoms, when stopped. Amphetamines and nicotine are other examples.... withdrawal symptoms

(dexamphetamine) n. see amphetamines.... dexamfetamine

the nonclinical, or recreational, use of pharmacologically active substances such that continued use results in adverse physiological or psychological effects (see dependence). Substances commonly misused include alcohol (see alcoholism), *amphetamines, *cannabis, *cocaine, *Ecstasy, *heroin, *lysergic acid diethylamide (LSD) and organic solvents (by inhalation), but also many prescribed medications, such as co-codamol, quetiapine, or pregabalin.... substance misuse

Medicines are drugs made stable, palatable and acceptable for administration. In Britain, the Medicines Act 1968 controls the making, advertising and selling of substances used for ‘medicinal purposes’, which means diagnosing, preventing or treating disease, or altering a function of the body. Permission to market a medicine has to be obtained from the government through the MEDICINES CONTROL AGENCY, or from the European Commission through the European Medicines Evaluation Agency. It takes the form of a Marketing Authorisation (formerly called a Product Licence), and the uses to which the medicine can be put are laid out in the Summary of Product Characteristics (which used to be called the Product Data Sheet).

There are three main categories of licensed medicinal product. Drugs in small quantities can, if they are perceived to be safe, be licensed for general sale (GSL – general sales list), and may then be sold in any retail shop. P (pharmacy-only) medicines can be sold from a registered pharmacy by or under the supervision of a pharmacist (see PHARMACISTS); no prescription is needed. P and GSL medicines are together known as OTCs – that is, ‘over-thecounter medicines’. POM (prescription-only medicines) can only be obtained from a registered pharmacy on the prescription of a doctor or dentist. As more information is gathered on the safety of drugs, and more emphasis put on individual responsibility for health, there is a trend towards allowing drugs that were once POM to be more widely available as P medicines. Examples include HYDROCORTISONE 1 per cent cream for skin rashes, CIMETIDINE for indigestion, and ACICLOVIR for cold sores. Care is needed to avoid taking a P medicine that might alter the actions of another medicine taken with it, or that might be unsuitable for other reasons. Patients should read the patient-information lea?et, and seek the pharmacist’s advice if they have any doubt about the information. They should tell their pharmacist or doctor if the medicine results in any unexpected effects.

Potentially dangerous drugs are preparations referred to under the Misuse of Drugs Act 1971 and subsequent regulations approved in 1985. Described as CONTROLLED DRUGS, these include such preparations as COCAINE, MORPHINE, DIAMORPHINE, LSD (see LYSERGIC ACID

DIETHYLAMIDE (LSD)), PETHIDINE HYDROCHLORIDE, AMPHETAMINES, BARBITURATES and most BENZODIAZEPINES.

Naming of drugs A European Community Directive (92/27/EEC) requires the use of the Recommended International Non-proprietary Name (rINN) for medicinal substances. For most of these the British Approved Name (BAN) and rINN were identical; where the two were di?erent, the BAN has been modi?ed in line with the rINN. Doctors and other authorised subscribers are advised to write titles of drugs and preparations in full because uno?cial abbreviations may be misinterpreted. Where a drug or preparation has a non-proprietary (generic) title, this should be used in prescribing unless there is a genuine problem over the bioavailability properties of a proprietary drug and its generic equivalent.

Where proprietary – commercially registered

– names exist, they may in general be used only for products supplied by the trademark owners. Countries outside the European Union have their own regulations for the naming of medicines.

Methods of administration The ways in which drugs are given are increasingly ingenious. Most are still given by mouth; some oral preparations (‘slow release’ or ‘controlled release’ preparations) are designed to release their contents slowly into the gut, to maintain the action of the drug.

Buccal preparations are allowed to dissolve in the mouth, and sublingual ones are dissolved under the tongue. The other end of the gastrointestinal tract can also absorb drugs: suppositories inserted in the rectum can be used for their local actions – for example, as laxatives – or to allow absorption when taking the drug by mouth is di?cult or impossible – for example, during a convulsion, or when vomiting.

Small amounts of drug can be absorbed through the intact skin, and for very potent drugs like OESTROGENS (female sex hormones) or the anti-anginal drug GLYCERYL TRINITRATE, a drug-releasing ‘patch’ can be used. Drugs can be inhaled into the lungs as a ?ne powder to treat or prevent ASTHMA attacks. They can also be dispersed (‘nebulised’) as a ?ne mist which can be administered with compressed air or oxygen. Spraying a drug into the nostril, so that it can be absorbed through the lining of the nose into the bloodstream, can avoid destruction of the drug in the stomach. This route is used for a small number of drugs like antidiuretic hormone (see VASOPRESSIN).

Injection remains an important route of administering drugs both locally (for example, into joints or into the eyeball), and into the bloodstream. For this latter purpose, drugs can be given under the skin – that is, subcutaneously (s.c. – also called hypodermic injection); into muscle – intramuscularly (i.m.); or into a vein – intravenously (i.v.). Oily or crystalline preparations of drugs injected subcutaneously form a ‘depot’ from which they are absorbed only slowly into the blood. The action of drugs such as TESTOSTERONE and INSULIN can be prolonged by using such preparations, which also allow contraceptive ‘implants’ that work for some months (see CONTRACEPTION).... medicines

See also MEDICINES. Government legislation covers the manufacture, sale and prescription of drugs in the UK. As well as stating which drugs may be sold over the counter (OTC) without a doctor’s or dentist’s prescription, and those which can be obtained only with such a prescription, government regulations determine the extent of availability of many substances which are liable to be abused – see Misuse of Drugs Act 1971 (below). The Misuse of Drugs Regulations 1985 de?ne those individuals who in their professional capacity are authorised to supply and possess controlled drugs: see the schedules of drugs listed below under the 1985 regulations.

Misuse of Drugs Act 1971 This legislation forbids activities relating to the manufacture, sale and possession of particular (controlled) drugs. These are classi?ed into three grades according to their dangers if misused. Any o?ences concerning class A drugs, potentially the most damaging when abused, carry the toughest penalties, while classes B and C attract lesser penalties if abused.

Class A includes: cocaine, dextromoramide, diamorphine (heroin), lysergic acid (LSD), methadone, morphine, opium, pethidine, phencyclidine acid and injectable preparations of class B drugs.

Class B includes: oral amphetamines, barbiturates, codeine, glutethimide, marijuana (cannabis), pentazocine and pholcodine.

Class C includes: drugs related to the amphetamines, anabolic and androgenic steroids, many benzodiazepines, buprenorphine, diethyl propion, human chorionic gonadotrophin (HCG), mazindol, meprobamate, pemoline, phenbuterol, and somatropin.

Misuse of Drugs Regulations 1985 These regulations de?ne those people who are authorised in their professional capacity to supply and possess controlled drugs. They also describe the requirements for legally undertaking these activities, such as storage of the drugs and limits on their prescription.

Drugs are divided into ?ve schedules and some examples follow.

I: Almost all are prohibited except in accordance with Home O?ce authority: marijuana (cannabis), LSD.

II: High potential for abuse but have

accepted medical uses: amphetamines, cocaine.

III: Lower potential for abuse: barbiturates, meprobamate, temazepam.

IV: Lower potential for abuse than I to III. Minimal control: benzodiazepines.

V: Low potential for abuse: generally compound preparations containing small amounts of opioids: kaolin and morphine (antidiarrhoeal medicine), codeine linctus (cough suppressant).

(See also CONTROLLED DRUGS.)... misuse of drugs

These are drugs that destroy, or prevent the action of, monoamine oxidase (MAO). Monoamines, which include NORADRENALINE and tyramine, play an important part in the metabolism of the BRAIN, and there is some evidence that excitement is due to an accumulation of monoamines in the brain. MAO is a naturally occurring ENZYME which is concerned in the breakdown of monoamines. MAOIs were among the earliest ANTIDEPRESSANT DRUGS used, but they are now used much less than tricyclic and related antidepressants, or SELECTIVE SEROTONIN-REUPTAKE INHIBITORS (SSRIS) and related antidepressants, because of the dangers of dietary or drug interactions – and because MAOIs are less e?ective than these two groups.

An excessive accumulation of monoamines can induce a dangerous reaction characterised by high blood pressure, palpitations, sweating and a feeling of su?ocation. Hence the care with which MAOI drugs are administered. What is equally important, however, is that in no circumstances should a patient receiving any MAOI drug eat cheese, yeast preparations such as Marmite, tinned ?sh, or high game. The reason for this ban is that all these foodstu?s contain large amounts of tyramine which increases the amount of certain monoamines such as noradrenaline in the body. (See MENTAL ILLNESS.)

There are also certain drugs, such as AMPHETAMINES and PETHIDINE HYDROCHLORIDE, which must not be taken by a patient who is receiving an MAOI drug. The MAOIs of choice are phenelzine or isocarboxazid because their stimulant effects are less than those of other MAOIs, making them safer.... monoamine oxidase inhibitors (maois)

(ADHD, attention deficit disorder, hyperkinetic disorder) a developmental disorder characterized by grossly excessive levels of activity and a marked impairment of the ability to attend and concentrate. The behaviour may be predominantly hyperactive-impulsive, predominantly inattentive, or combined. It is hypothesized that the majority of patients have a higher than normal number of dopamine transporter complexes, reducing the amount of freely available dopamine in the synaptic cleft. This leads to cognitive problems, including an inability to keep attention, to focus attention, and to perform organizational planning. Learning is impaired as a result, and behaviour can be disruptive and may be defiant or aggressive. ADHD is highly genetic. It is estimated to affect up to 5% of children; the prevalence is lower in adults because the number of dopamine transporter complexes in the brain naturally declines over time. Untreated, many children later develop *conduct disorder or *personality disorders. Treatment usually involves drugs (such as amphetamines and *methylphenidate) and behaviour therapy; the family needs advice and practical help.... attention-deficit/hyperactivity disorder

Pu’erh tea is a type of post-fermented tea produced in China. Read this article to find out more about its many health benefits! About Pu’erh Tea Pu’erh tea is a post-fermented tea produced in the Chinese province Yunnan. Post-fermented teas are different from other types of tea in the sense that, after the leaves are dried and rolled, they undergo a microbial fermentation process. The pu’erh teais available as loose leaves or as tea brick (tea leaves packed in molds and pressed into block form). There are also two categories of pu’erh tea: the raw type and the ripe type. Raw pu’erh tea can count as a type of green tea. Ripened or aged pu’erh tea is often mistakenly called a type of black tea, though it isn’t. How to prepare Pu’erh Tea Pu’erh tea can be bought and prepared in loose leaf form, in tea bag form, or in compacted cake form. If you’re using leaves, add a teaspoon to a cup of freshly boiled water and let it steep for about 20 seconds before you pour off the water; this process id called rinsing, in order to prepare the leaves for the tea. Next, pour freshly boiled water again, let it steep for 30 seconds or one minute. This will give the tea a mild, but pleasant flavor. If you want a stronger flavor, you can let it steep up to 50 minutes, until it turns as dark as coffee. Pu’erh leaves can be resteeped several times (4-8 times). Just add about 20 more seconds to each steeping process. The same applies to pu’erh tea in compacted cake form. To get the leaves, either flake off pieces of the cake, or steam the entire cake until it becomes soft. Pu’erh Tea Benefits Pu’erh tea had important health benefits related to blood circulation. It can help lower blood cholesterol levels. It also boosts the flow of blood and enhances your blood circulation. Drinking pu’erh tea can help prevent cancer, as it helps prevent the formation and growth of cancer cells. It also promotes a proper, healthy digestion, and is good for your spleen. You don’t have to worry even if you’re on a diet; drinking pu’erh tea will help you lose weight, as it breaks down and reduces the fat in your body. As pu’erh tea contains caffeine, drinking it helps keep you alert and focused. It also helps with removing toxins from your body, and it can prove to be useful if you’re dealing with various aches and pains. Pu’erh tea can also help you if you’ve got a hangover, especially if you get a headache. Also, it can act as a substitute for coffee, and can have a relaxing effect on you. Pu’erh Tea Side Effects Because of its caffeine content, pu’erh tea shouldn’t be consumed by pregnant or breastfeeding women, as it can affect the baby. Also, you shouldn’t drink pu’erh tea if you’ve got anxiety, bleeding disorders, heart problems, diabetes, irritable bowel syndrome, glaucoma, high blood pressure or osteoporosis. It can affect your condition in all of these cases. Pu’erh tea can also interact with medications. A few examples include amphetamines, cimetidine, ephedrine, adenosine, or medications for depression, asthma and slow blood clotting. The list includes more, so if you’re under medication, make sure you check with your doctor first, to see if it’s safe to drink pu’erh tea.   Pu’erh tea has important health benefits, though the same goes for side effects, as well. Make sure it’s safe to drink pu’erh tea, and then you can enjoy a cup of tea without having to worry about its side effects.... pu’erh tea pros and cons

(drug dependence) n. the physical and/or psychological effects produced by the habitual taking of certain drugs, characterized by a compulsion to continue taking the drug; in ICD-11 (see International Classification of Diseases) it is known as drug dependency syndrome. In physical dependence withdrawal of the drug causes specific symptoms (withdrawal symptoms), such as sweating, vomiting, or tremors, that are reversed by further doses. Substances that may induce physical dependence include alcohol and the ‘hard’ drugs morphine, heroin, and cocaine. Dependence on ‘hard’ drugs carries a high mortality, partly because overdosage may be fatal and partly because their casual injection intravenously may lead to infections such as *hepatitis and *AIDS. Treatment is difficult and requires specialist skills. Much more common is psychological dependence, in which repeated use of a drug induces reliance on it for a state of wellbeing and contentment, but there are no physical withdrawal symptoms if use of the drug is stopped. Substances that may induce psychological dependence include nicotine, cannabis, barbiturates, cocaine, and amphetamines.... dependence

An overall title for a group of psychiatric disorders typ?ed by disturbances in thinking, behaviour and emotional response. Despite its inaccurate colloquial description as ‘split personality’, schizophrenia should not be confused with MULTIPLE PERSONALITY DISORDER. The illness is disabling, running a protracted course that usually results in ill-health and, often, personality change. Schizophrenia is really a collection of symptoms and signs, but there is no speci?c diagnostic test for it. Similarity in the early stages to other mental disorders, such as MANIC DEPRESSION, means that the diagnosis may not be con?rmed until its response to treatment and its outcome can be assessed and other diseases excluded.

Causes There is an inherited element: parents, children or siblings of schizophrenic sufferers have a one in ten chance of developing the disorder; a twin has a 50 per cent chance if the other twin has schizophrenia. Some BRAIN disorders such as temporal lobe EPILEPSY, tumours and ENCEPHALITIS seem to be linked with schizophrenia. Certain drugs – for example, AMPHETAMINES – can precipitate schizophrenia and DOPAMINE-blocking drugs often relieve schizophrenic symptoms. Stress may worsen schizophrenia and recreational drugs may trigger an attack.

Symptoms These usually develop gradually until the individual’s behaviour becomes so distrubing or debilitating that work, relationships and basic activities such as eating and sleeping are interrupted. The patient may have disturbed perception with auditory HALLUCINATIONS, illogical thought-processes and DELUSIONS; low-key emotions (‘?at affect’); a sense of being invaded or controlled by outside forces; a lack of INSIGHT and inability to acknowledge reality; lethargy and/or agitation; a disrespect for personal appearance and hygiene; and a tendency to act strangely. Violence is rare although some sufferers commit violent acts which they believe their ‘inner voices’ have commanded.

Relatives and friends may try to cope with the affected person at home, but as severe episodes may last several months and require regular administration of powerful drugs – patients are not always good at taking their medication

– hospital admission may be necessary.

Treatment So far there is no cure for schizophrenia. Since the 1950s, however, a group of drugs called antipsychotics – also described as NEUROLEPTICS or major tranquillisers – have relieved ?orid symptoms such as thought disorder, hallucinations and delusions as well as preventing relapses, thus allowing many people to leave psychiatric hospitals and live more independently outside. Only some of these drugs have a tranquillising e?ect, but their sedative properties can calm patients with an acute attack. CHLORPROMAZINE is one such drug and is commonly used when treatment starts or to deal with an emergency. Halperidol, tri?uoperazine and pimozide are other drugs in the group; these have less sedative effects so are useful in treating those whose prominent symptoms are apathy and lethargy.

The antipsychotics’ mode of action is by blocking the activity of DOPAMINE, the chemical messenger in the brain that is faulty in schizophrenia. The drugs quicken the onset and prolong the remission of the disorder, and it is very important that patients take them inde?nitely. This is easier to ensure when a patient is in hospital or in a stable domestic environment.

CLOZAPINE – a newer, atypical antipsychotic drug – is used for treating schizophrenic patients unresponsive to, or intolerant of, conventional antipsychotics. It may cause AGRANULOCYTOSIS and use is con?ned to patients registered with the Clorazil (the drug’s registered name) Patient Monitoring Service. Amisulpride, olanzapine, quetiapine, risperidone, sertindole and zotepine are other antipsychotic drugs described as ‘atypical’ by the British National Formulary; they may be better tolerated than other antipsychotics, and their varying properties mean that they can be targeted at patients with a particular grouping of symptoms. They should, however, be used with caution.

The welcome long-term shift of mentally ill patients from large hospitals to community care (often in small units) has, because of a lack of resources, led to some schizophrenic patients not being properly supervised with the result that they fail to take their medication regularly. This leads to a recurrence of symptoms and there have been occasional episodes of such patients in community care becoming a danger to themselves and to the public.

The antipsychotic drugs are powerful agents and have a range of potentially troubling side-effects. These include blurred vision, constipation, dizziness, dry mouth, limb restlessness, shaking, sti?ness, weight gain, and in the long term, TARDIVE DYSKINESIA (abnormal movements and walking) which affects about 20 per cent of those under treatment. Some drugs can be given by long-term depot injection: these include compounds of ?upenthixol, zuclopenthixol and haloperidol.

Prognosis About 25 per cent of sufferers recover fully from their ?rst attack. Another 25 per cent are disabled by chronic schizophrenia, never recover and are unable to live independently. The remainder are between these extremes. There is a high risk of suicide.... schizophrenia

The ?eld of medicine concerned with physical ?tness and the diagnosis and treatment of both acute and chronic sports injuries sustained during training and competition. Acute injuries are extremely common in contact sports, and their initial treatment is similar to that of those sustained in other ways, such as falls and road traf?c incidents. Tears of the muscles (see MUSCLES, DISORDERS OF), CONNECTIVE TISSUE and LIGAMENTS which are partial (sprains) are initially treated with rest, ice, compression, and elevation (RICE) of the affected part. Complete tears (rupture) of ligaments (see diagrams) or muscles, or fractures (see BONE, DISORDERS OF – Bone fractures) require more prolonged immobilisation, often in plaster, or surgical intervention may be considered. The rehabilitation of injured athletes requires special expertise

– an early graded return to activity gives the best long-term results, but doing too much too soon runs the risk of exacerbating the original injury.

Chronic (overuse) injuries affecting the bones (see BONE), tendons (see TENDON) or BURSAE of the JOINTS are common in many sports. Examples include chronic INFLAMMATION of the common extensor tendon where it

attaches to the later EPICONDYLE of the humerus – common in throwers and racquet sportspeople – and stress fractures of the TIBIA or METATARSAL BONES of the foot in runners. After an initial period of rest, management often involves coaching that enables the athlete to perform the repetitive movement in a less injury-susceptible manner.

Exercise physiology is the science of measuring athletic performance and physical ?tness for exercise. This knowledge is applied to devising and supervising training regimens based on scienti?c principles. Physical ?tness depends upon the rate at which the body can deliver oxygen to the muscles, known as the VO2max, which is technically di?cult to measure. The PULSE rate during and after a bout of exercise serves as a good proxy of this measurement.

Regulation of sport Sports medicine’s role is to minimise hazards for participants by, for example, framing rule-changes which forbid collapsing the scrum, which has reduced the risk of neck injury in rugby; and in the detection of the use of drugs taken to enhance athletic performance. Such attempts to gain an edge in competition undermine the sporting ideal and are banned by leading sports regulatory bodies. The Olympic Movement Anti-Doping Code lists prohibited substances and methods that could be used to enhance performance. These include some prohibited in certain circumstances as well as those completely banned. The latter include:

stimulants such as AMPHETAMINES, bromantan, ca?eine, carphedon, COCAINE, EPHEDRINE and certain beta-2 agonists.

NARCOTICS such as DIAMORPHINE (heroin), MORPHINE, METHADONE HYDROCHLORIDE and PETHIDINE HYDROCHLORIDE.

ANABOLIC STEROIDS such as methandione, NANDROLONE, stanazol, TESTOSTERONE, clenbuterol, androstenedone and certain beta-2 agonists.

peptide HORMONES, mimetics and analogues such as GROWTH HORMONE, CORTICOTROPHIN, CHORIONIC GONADOTROPHIC HORMONE, pituitary and synthetic GONADOTROPHINS, ERYTHROPOIETIN and INSULIN. (The list produced above is not comprehen

sive: full details are available from the governing bodies of relevant sports.) Among banned methods are blood doping (pre-competition administration of an athlete’s own previously provided and stored blood), administration of arti?cial oxygen carriers or plasma expanders. Also forbidden is any pharmacological, chemical or physical manipulation to affect the results of authorised testing.

Drug use can be detected by analysis of the URINE, but testing only at the time of competition is unlikely to detect drug use designed to enhance early-season training; hence random testing of competitive athletes is also used.

The increasing professionalism and competitiveness (among amateurs and juveniles as well as professionals) in sports sometimes results in pressures on participants to get ?t quickly after injury or illness. This can lead to

players returning to their activity before they are properly ?t – sometimes by using physical or pharmaceutical aids. This practice can adversely affect their long-term physical capabilities and perhaps their general health.... sports medicine

(in the UK) an Act of Parliament restricting the use of dangerous drugs. These controlled drugs are divided into three classes: class A drugs (e.g. heroin, morphine and other potent opioid analgesics, cocaine, LSD) cause the most harm when misused; class B drugs include amphetamines, barbiturates, and cannabis, and class C drugs include most benzodiazepines and anabolic steroids. The Act specifies certain requirements for writing prescriptions for these drugs. The Misuse of Drugs (Supply to Addicts) Regulations 1997 and the Misuse of Drugs Regulations 2001 lay down who may supply controlled drugs and the rules governing their supply, prescription, etc.... misuse of drugs act 1971