Compilation of Physical and Health Education Fourth Grading Period Lessons

S.Y. 2010-2011

Submitted by: IV-13

Table of Contents

Part 1: Physical Education
I. Recreational Games …………………………………………………………………. 2 II. Scrabble …………………………………………………………………………….. 4 III. Dominoes ……………………………………………………………………………. …………….. 18 IV. Arm Wrestling ……………………………………………..………………...…… 24 V. Chess ………………………………………………………………………………... 27

Part 2: Health
I. Killer Drugs ……………………………………………………………………………….…………. 43 II. Narcotics …………………………………………………………………………… 49 II.1 Narcotics and Its Effects ....................................................................................... 54 IV. Drug Dependence ……………………………………………………………..….. 57 V. Drug Abuse Effects and Treatment ………………………………………………………… 61


Physical Education


Recreation is referred to as a leisure-time activity for the purpose of entertainment. It is a socially-accepted activity that provides immediate and inherent satisfaction. It is an activity where you can express yourself resulting to sharing, creating and achieving satisfaction. Leisure comes from the Latin word licerewhich means “allow” or to “permit”. According to Merriam-Webster dictionary, leisure is defined as a time free from work and duties, convenience and relaxation. Recreational activities are classified as indoor and outdoor activities. The following are just a few of its examples: Indoor Activities • Collecting pictures • Collecting souvenirs • Cooking • Dancing • Internet games • Play station • Playing indoor sports such as badminton & table tennis • Singing • Watching tv/movies Outdoor Activities • Camping is an outdoor recreational activity. The participants (known as campers) leave urban areas, their home region, or civilization and enjoy nature while spending one or several nights outdoors, usually at a campsite. Camping may involve the use of a tent, caravan, cabin, a primitive structure, or no shelter at all. In many parts of the world, 'camping' refers exclusively to the use of tents or similar portable structures. Camping as a recreational activity became popular in the early 20th century. Campers frequent national parks, other publicly owned natural areas, and privately owned campgrounds. Camping is a key part of the program of many youth organizations around the world, such as Scouting. It is used to teach self-reliance and team work. Camping is also used as a cheap form of accommodation for people attending large open air events such as sporting meetings and music festivals. Organizers often provide a field and other basic amenities.
• • •

Disc flying Gardening Hiking is an outdoor activity which consists of walking in natural environments, often on hiking trails. It is such a popular activity that there are numerous hiking organizations

worldwide. The health benefits of different types of hiking have been confirmed in studies In the United States and United Kingdom, hiking refers to cross-country walking of a longer duration than a simple walk and usually over terrain where hiking boots are required. A day hike refers to a hike that can be completed in a single day, often applied to mountain hikes to a lake or summit, but not requiring an overnight camp, in which case the term backpacking is used. Bushwhacking specifically refers to difficult walking through dense forest, undergrowth, or bushes, where forward progress requires pushing vegetation aside. In extreme cases of bushwhacking where the vegetation is so dense that human passage is impeded, a machete is used to clear a pathway. Australians use the term bushwalking for both on- and off-trail hiking. New Zealanders use tramping (particularly for overnight and longer trips), walking or bushwalking. Multi-day hiking in the mountainous regions of India, Nepal, North America, South America, and in the highlands of East Africa is also called trekking; the Dutch refer to trekking also. Hiking a long-distance trail from end-to-end is also referred to as trekking and as thru-hiking in some places, for example on the Appalachian Trail (AT) or Long Trail (LT) in Vermont. The Long Trail is the oldest long-distance hiking trail in the United States.
• • •

• •

Jogging Kite flying Mountaineering or mountain climbing is the sport, hobby or profession of hiking, skiing, and climbingmountains. While mountaineering began as attempts to reach the highest point of unclimbed mountains, it has branched into specializations that address different aspects of the mountain and consists of three areas: rock-craft, snow-craft and skiing, depending on whether the route chosen is over rock, snow or ice. All require experience, athletic ability, and technical knowledge to maintain safety. The UIAA or Union Internationale des Associations d'Alpinisme is the world governing body in mountaineering and climbing, addressing issues like access, medical, mountain protection, safety, youth and ice climbing. nature tripping playing outdoor sports such as: Dodgeball – is any game in which players try to hit other players on the opposing team with balls and avoid being hit themselves. Surfing is a surface water sport in which a person (the surfer) rides a board (the surfboard) on the crest of a wave as it carries the surfer towards the shore. Two major subdivisions within stand-up surfing are longboarding and shortboarding, reflecting differences in surfboard design including surfboard length, and riding style. In tow-in surfing (most often, but not exclusively, associated with big wave surfing), a motorized water vehicle, such as a personal watercraft tows the surfer into the wave front, helping the surfer match a large wave's higher speed, a speed


that is generally, but not exclusively a speed that a self-propelled surfer can not match. Surfing-related sports such as paddleboarding and sea kayaking do not require waves, and other derivative sports such as kitesurfing and windsurfing rely primarily on wind for power, yet all of these platforms may also be used to ride waves. References: MAPEH in Action IV p.271

Scrabbleis a word game in which two to four players score points by forming words from individual lettered tiles on a game board marked with a 15-by-15 grid. The words are formed across and down in crossword fashion and must appear in a standard dictionary. Official reference works (e.g. The Official Scrabble Players Dictionary) provide a list of permissible words. The Collins Scrabble checker can also be used to check if a word is allowed. The name Scrabble is a trademark of Hasbro, Inc. in the United States and Canada and of Mattel elsewhere. The game is sold in 121 countries in 29 different language versions. One hundred and fifty million sets have been sold worldwide, and sets are found in one out of every three American homes.

In 1938, architect Alfred Mosher Butts created the game as a variation on an earlier word game he invented called Lexiko. The two games had the same set of letter tiles, whose distributions and point values Butts worked out meticulously performing a frequency analysis of letters from various sources including The New York Times. The new game, which he called "CrissCrosswords," added the 15-by-15 game board and the crossword-style game play. He manufactured a few sets himself, but was not successful in selling the game to any major game manufacturers of the day. In 1948, James Brunot, a resident of Newtown, Connecticut — and one of the few owners of the original Criss-Crosswords game — bought the rights to manufacture the game in exchange for

granting Butts a royalty on every unit sold. Though he left most of the game (including the distribution of letters) unchanged, Brunot slightly rearranged the "premium" squares of the board and simplified the rules; he also changed the name of the game to "Scrabble," a real word which means "to scratch frantically." In 1949, Brunot and his family made sets in a converted former schoolhouse in Dodgingtown, a section of Newtown . They made 2,400 sets that year, but lost money. According to legend, Scrabble's big break came in 1952 when Jack Strauss, president of Macy's, played the game on vacation. Upon returning from vacation, he was surprised to find that his store did not carry the game. He placed a large order and within a year, "everyone had to have one." In 1952, unable to meet demand himself, Brunot sold manufacturing rights to Long Island-based Selchow and Righter (one of the manufacturers who, like Parker Brothers and Milton Bradley Company, had previously rejected the game). Selchow& Righter bought the trademark to the game in 1972. JW Spears began selling the game in Australia and the UK on January 19, 1955. The company is now a subsidiary of Mattel, Inc. In 1986, Selchow and Righter sold the game to Coleco, who soon after went bankrupt. The company's assets, including Scrabble and Parchesi, were purchased by Hasbro. In 1984, Scrabble was turned into a daytime game show on NBC. Scrabble ran from July 1984 to March 1990, with a second run from January to June 1993. The show was hosted by Chuck Woolery. The tagline of the show in promo broadcasts was, "Every man dies; not every man truly Scrabbles."

Game details
The game is played by two to four players on a square (or nearly square) board with a 15-by-15 grid of cells (individually known as "squares"), each of which accommodates a single letter tile. In official club and tournament games, play is always between two players (or, occasionally, between two teams each of which collaborates on a single rack). The board is marked with "premium" squares, which multiply the number of points awarded: dark red "triple-word" squares, pink "double-word" squares, dark blue "triple-letter" squares, and light blue "double-letter" squares [In 2008, Hasbro changed the colors of the premiums squares to orange for TW, red for DW, blue for DL, and green for TL]. The center square (H8) is often marked with a star or logo, and counts as a double-word square. The game contains 100 tiles, 98 of which are marked with a letter and a point value ranging from 1 to 10. The number of points of each lettered tile is based on the letter's frequency in standard English writing; commonly used letters such as E or O are worth one point, while less common letters score higher, with Q and Z each worth 10 points. The game also has two blank tiles that are unmarked and carry no point value. The blank tiles can be used as substitutes for any letter; once laid on the board, however, the choice is fixed.

Notation system
In the notation system common in tournament play, columns are labeled "A-O" and rows "1-15". A play is usually identified in the format xy WORD score or WORD xy score, where x denotes the column or row on which the play's main word extends,y denotes the second coordinate of the

main word's first letter, and WORD is the main word. Although unnecessary, additional words formed by the play are occasionally listed after the main word and a slash. In the case where the play of a single tile formed words in each direction, one of the words is arbitrarily chosen to serve as the main word for purposes of notation. When a blank tile is employed in the main word, the letter it has been chosen to represent is indicated with a lower case letter, or, in handwritten notation, with a square around the letter. Parentheses are sometimes also used to designate a blank, although this may create confusion with a second (optional) function of parentheses, namely indication of an existing letter or word that has been "played through" by the main word. Example 1: A(D)DITiON( AL ) D3 74 (played through the existing letter D and word AL , using a blank for the second I, extending down the D column and beginning on row 3, and scoring 74 points)

Sequence of play
Before the game, the letter tiles are either put in an opaque bag or placed face down on a flat surface. Opaque cloth bags and customized tiles are staples of clubs and tournaments, where games are rarely played without both. Next, players decide the order in which they play. The normal approach is for players to draw tiles: the player who picks the letter closest to the beginning of the alphabet goes first (with blank tiles ranked higher than A's). In North American tournaments, the rules of the US-based North American Scrabble Players Association (NASPA) stipulate instead that players who have gone first in the fewest number of games in the tournament have priority, or failing that, those who have gone second the most. In the case of a tie, tiles are drawn as in the standard rules. At the beginning of the game, and after each turn until the bag is empty (or until there are no more face-down tiles), players draw tiles to replenish their "racks", or tile-holders, with seven tiles, from which they will make plays. Each rack is concealed from the other players. During a turn, a player will have seven or fewer letter tiles in their rack from which to choose a play. On each turn, a player has the option to: (1) pass, forfeiting the turn and scoring nothing; (2) exchange one or more tiles for an equal number from the bag, scoring nothing, an option which is only available if at least seven tiles remain in the bag; or (3) form a play on the board, adding its value to the player's cumulative score. A proper play uses any number of the player's tiles to form a single continuous word ("main word") on the board, reading either left-to-right or top-to-bottom. The main word must either use the letters of one or more previously played words, or else have at least one of its tiles horizontally or vertically adjacent to an already played word. If words other than the main word


are newly formed by the play, they are scored as well, and are subject to the same criteria for acceptability. When the board is blank, the first word played must cover H8, the center square. The word must consist of at least two letters, extending horizontally or vertically. H8 is a premium square, so the first player to play a word receives a double score. A blank tile may take the place of any letter. It remains as that letter thereafter for the rest of the game. Individually, it scores no points regardless of what letter it is designated, and is not itself affected by premium tiles. However, its placement on a double-word or triple-word square does cause the appropriate premium to be scored for the word in which it is used. While not allowed in official or tournament play, a common "house rule" allows players to "recycle" blank tiles by later substituting the corresponding letter tile. After playing a word, the player draws letter tiles from the bag to replenish their rack to seven tiles. If there are not enough tiles in the bag to do so, the player takes all of the remaining tiles. After a player plays a word, their opponent may choose to challenge any or all the words formed by the play. If any of the words challenged is found to be unacceptable, the play is removed from the board, the player returns the newly played tiles to their rack and their turn is forfeited. In tournament play, a challenge is to the entire play rather than any one word, so a judge (human or computer) is used, and players are not entitled to know which word or words caused the challenge to succeed. Penalties for unsuccessfully challenging an acceptable play vary within club and tournament play, and are described in greater detail below. With North American rules, the game ends when (1) one player plays every tile in their rack, and there are no tiles remaining in the bag (regardless of the tiles in their opponent's rack); or (2) when six successive scoreless turns have occurred and the score is not zero-zero. When the game ends, each player's score is reduced by the sum of his/her unplayed letters. In addition, if a player has used all of his or her letters, the sum of the other player's unplayed letters is added to that player's score; in tournament play, a player who "goes out" adds double this sum, and the opponent is not penalized. Scoreless turns can occur when a player passes, when a player exchanges tiles, or when a player loses a challenge. The latter rule varies slightly in international tournaments.

Premium square colors Square Double letter Triple letter Double word International version Light blue Dark blue Pink

US & Canada version Blue Green Red

Triple word



Each word formed in the play is scored this way:
• • • • •

Any tile played from the player's rack onto a previously vacant square that is a "doubleletter" or "triple-letter" premium square has its point value doubled or tripled as indicated. Add the normal point value of all other letters in the word (whether newly played or existing). For each newly played tile placed on a "double-word" premium square, the total of each word containing that tile is doubled (or redoubled). For each newly placed tile placed on a "triple-word" premium square, the total of each word containing that tile is tripled (or re-tripled). Premium squares affect the score of each word made in the same play by constituent tiles played upon those squares. Premium squares, once played upon, are not counted again in subsequent plays. Players can score quadruple or nontuple (9x) word scores by spanning two double or triple word scores with a single word.

If a player uses all seven of the tiles in the rack in a single play, a bonus of 50 points is added to the score of that play (this is called a "bingo" in Canada and the United States, a "Scrabble" in Spain and a "bonus" elsewhere). These bonus points are added after totaling the score for that turn. When the letters to be drawn have run out, the final play can often determine the winner. This is particularly the case in close games with more than two players. The player who goes out first gets the sum of all remaining unplayed tiles added to their score. Players with tiles remaining on their rack have the sum of their remaining tiles subtracted from their score.

Acceptable words
Acceptable words are the primary entries in some chosen dictionary, and all of their inflected forms. Words that are hyphenated, capitalized (such as proper nouns), or apostrophized are not allowed, unless they also appear as acceptable entries: "Jack" is a proper noun, but the word JACK is acceptable because it has other usages (automotive, vexillological, etc.) that are acceptable. Acronyms or abbreviations, other than those that have been regularized (such as AWOL, RADAR, LASER, and SCUBA), are not allowed. Variant spellings, slang or offensive terms, archaic or obsolete terms, and specialized jargon words are allowed if they meet all other criteria for acceptability. There are two popular competition word lists used in various parts of the world: TWL and SOWPODS (also referred to as "Collins"). The North American 2006 Official Tournament and Club Word List, Second Edition (OWL2), became official for use in American, Canadian, Israeli and Thai club and tournament play on March 1, 2006 (or, for school use, the bowdlerizedOfficial Scrabble Players Dictionary, Fourth Edition (OSPD4)). Early printings of OWL2 and OSPD4 must be amended according to corrigenda posted at the National Scrabble Association web site. North American competitions use the Long Words List for longer words.

The OWL2 and the OSPD4 are compiled using four (originally five) major college-level dictionaries, including Merriam-Webster (10th and 11th editions, respectively). If a word appears (or historically appeared) in at least one of the dictionaries, it is included in the OWL2 and the OSPD4, unless the word has only an offensive meaning, in which case it is only included in the OWL2. The key difference between the OSPD4 and the OWL2 is that the OSPD4 is marketed for "home and school" use, and has been expurgated of many words which their source dictionaries judged offensive, rendering the Official Scrabble Players Dictionary less fit for official Scrabble play. The OSPD4 is available in bookstores, whereas the OWL2 is only available from the National Scrabble Association's retail website (as of July 2009, NSA membership is no longer required to purchase the OWL). In all other countries the competition word list is the Tournament and Club Word List (Collins) published in May 2007 (see SOWPODS), which lists all words of from 2 to 15 letters and is thus a complete reference. This list contains every word in the OWL2 mentioned above plus words sourced from Chambers and Collins English dictionaries. This book is used to adjudicate at the World Scrabble Championship and all other major international competitions outside of North America .

The penalty for a successfully challenged
play is nearly universal: the offending player removes the tiles played and forfeits the turn. (However, in some online games, an option known as "void" may be used, wherein unacceptable words are automatically rejected by the program. The player is then required to make another play, with no penalty applied.) The penalty for an unsuccessful challenge (where all words formed by the play are deemed valid) varies considerably, including:

The "double challenge" rule, in which an unsuccessfully challenging player must forfeit the next turn. This penalty governs North American (NASPA-sanctioned) tournaments, and is the standard for North American, Israeli and Thai clubs. Because loss of a turn generally constitutes the greatest risk for an unsuccessful challenge, it provides the greatest incentive for a player to "bluff", or play a "phony" – a plausible word that they know or suspect to be unacceptable, hoping their opponent will not call them on it. Players have divergent opinions on this aspect of the double-challenge game and the ethics involved, but officially it is considered a valid part of the game. A pure "single challenge" or "free challenge" rule, in which no penalty whatsoever is applied to a player who unsuccessfully challenges. This is the default rule in the United Kingdom and the Republic of Ireland, as well as for many tournaments in Australia, although these countries do sanction occasional tournaments using other challenge rules. A modified "single challenge" rule, in which an unsuccessful challenge does not result in the loss of the challenging player's turn, but is penalized by the loss of a specified number of points. The most common penalty is five points. The rule has been adopted in Singapore (since 2000), Malaysia (since 2002), South Africa (since 2003), New Zealand (since 2004), and Kenya, as well as in contemporary World Scrabble Championships (since 2001). Some countries and tournaments (including Sweden) use a 10-point penalty

instead. In most game situations, this penalty is much lower than that of the "double challenge" rule; consequently, such tournaments encourage a greater willingness to challenge and a lower willingness to play dubious words.

Historic evolution of the rules
The North American "box rules" (that are included in each game box, as contrasted with tournament rules) have been edited four times: in 1953, 1976, 1989, and 1999.[10] The major changes in 1953 were as follows:
• • • •

It was made clear that words could be played through single letters already on the board. It was made clear that a player could play a word parallel and immediately adjacent to an existing word provided all crosswords formed were valid. It was made clear that the effect of two word premium squares were to be compounded multiplicatively. The previously unspecified penalty for having one's play successfully challenged was stated: withdrawal of tiles and loss of turn.

The major changes in 1976 were as follows:
• • • •

It was made clear that the blank tile beats an A when drawing to see who goes first. A player could now pass his/her turn, doing nothing. A loss-of-turn penalty was added for challenging an acceptable play. If final scores are tied, the player whose score was highest before adjusting for unplayed tiles is the winner.

The editorial changes made in 1989 did not affect game play. The major changes in 1999 were as follows:
• • • •

It was made clear that a tile can be shifted or replaced until the play has been scored. It was made clear that a challenge applies to all the words made in the given play. Playing all seven tiles is officially called a "Bingo". In what was certainly an editorial blunder, it was made clear that a player can form more than one word in one row on a turn

Historic evolution of the rules
The North American "box rules" (that are included in each game box, as contrasted with tournament rules) have been edited four times: in 1953, 1976, 1989, and 1999.[10] The major changes in 1953 were as follows:

It was made clear that words could be played through single letters already on the board.


• • •

It was made clear that a player could play a word parallel and immediately adjacent to an existing word provided all crosswords formed were valid. It was made clear that the effect of two word premium squares were to be compounded multiplicatively. The previously unspecified penalty for having one's play successfully challenged was stated: withdrawal of tiles and loss of turn.

The major changes in 1976 were as follows:
• • • •

It was made clear that the blank tile beats an A when drawing to see who goes first. A player could now pass his/her turn, doing nothing. A loss-of-turn penalty was added for challenging an acceptable play. If final scores are tied, the player whose score was highest before adjusting for unplayed tiles is the winner.

The editorial changes made in 1989 did not affect game play. The major changes in 1999 were as follows:
• • • •

It was made clear that a tile can be shifted or replaced until the play has been scored. It was made clear that a challenge applies to all the words made in the given play. Playing all seven tiles is officially called a "Bingo". In what was certainly an editorial blunder, it was made clear that a player can form more than one word in one row on a turn.

Club and tournament play
Main article: English language Scrabble Tens of thousands play club and tournament Scrabble worldwide. The intensity of play, obscurity of words, and stratospheric scores in tournament games may come as a shock to many parlor players. All tournament (and most club) games are played with a game clock and a set time control. Although casual games are often played with unlimited time, this is problematic in competitive play among players for whom the number of evident legal plays is immense. Almost all tournament games involve only 2 players; typically, each has 25 minutes in which to make all of his or her plays. For each minute by which a player oversteps the time control, a penalty of 10 points is assessed. The number of minutes is rounded up, so that if a player oversteps time control by two minutes and five seconds, the penalty is 30 points. In addition, the players use special tiles called Protiles which, unlike wooden tiles, are not engraved thereby eliminating the potential for a cheating player to "Braille" (feel for particular tiles, especially blanks, in the bag). Players are allowed "tracking sheets", preprinted with the letters in the initial pool, from which tiles can be crossed off as they are played. Tracking tiles is an important aid to strategy, especially during the endgame, when no tiles remain to be drawn and each player can determine exactly what is on the opponent's rack.


The most prestigious (regularly held) tournaments include: 1. The World Scrabble Championship: held in odd years, the last was in Johor Bahru, Malaysia in 2009.[11] 2. The National Scrabble Championship: an open event attracting several hundred players, held around July/August every year or two, most recently in Dallas, Texas on August 7–11, 2010. 3. The Brand's Crossword Game King's Cup: the largest tournament in the World. Held annually around the end of June or beginning of July. Other important tournaments include: 1. The World Youth Scrabble Championships: entry by country qualification, restricted to under 18 years old. Held annually since 2006. 2. The National School Scrabble Championship: entry open to North American school students. Held annually since 2003. 3. The Canadian Scrabble Championship: entry by invitation only to the top fifty Canadian players. Held every two to three years. Clubs in North America typically meet one day a week for three or four hours and some charge a small admission fee to cover their expenses and prizes. Clubs also typically hold at least one open tournament per year. Tournaments are usually held on weekends, and between six and nine games are played each day. Detailed statistics on tournaments and players in North America can be found at There are also clubs in the UK and many other countries. A list of internationally rated SOWPODS tournaments can be found here.[12] During off hours at tournaments, many players socialize by playing consultation (team) Scrabble, Clabbers, Anagrams, Boggle and other games.

Computer players
Maven is a computer opponent for the game, created by Brian Sheppard. The official Scrabble computer game in North America uses a version of Maven as its artificial intelligence and is released by Atari. Outside of North America , the official Scrabble computer game is released by Ubisoft. Quackle is an open-source alternative to Maven of comparable strength.[13]

Console and computer video game versions
Several computer and video game versions of Scrabble have been released for various platforms, including PC, Mac, Amiga, Commodore 64, Sinclair ZX Spectrum, Game Boy, Game Boy Color, Game Boy Advance, Nintendo DS, PlayStation, PlayStation 2, PlayStation Portable, iPod, iPad,, Palm OS, Amstrad CPC, Xbox 360, Kindle and mobile phones.


The Nintendo DS version of Scrabble 2007 Edition made news when parents became angry over the game's AI using potentially offensive language during gameplay[14].

Scrabble on the Internet
A number of sites offer the possibility to play Scrabble online against other users. The game is available to play for free at, part of Electronic Arts. The Internet Scrabble Club (ISC) "" , which is free of charge, is frequented continuously by thousands of players, including many of the game's most renowned experts. The social networking site Facebook had offered an online variation of Scrabble called Scrabulous as a third-party application add-on. On January 15, 2008, it was reported that Hasbro and Mattel were in the process of suing the creators of Scrabulous for copyright infringement. On July 24, 2008, Hasbro filed a copyright infringement lawsuit against the creators of Scrabulous.[15] On July 28, 2008 the Scrabulous Facebook application was disabled for users in North America , [16] eventually re-appearing as "Lexulous" in September 2008, with changes made to distinguish it from Scrabble. On December 20, 2008 Hasbro withdrew their lawsuit against RJ Softwares.[17] There is also a version in Turkish as a Facebook application named 'SKRABL Turkce' which offers only 2 player game. Mattel launched its official version of online Scrabble, Scrabble by Mattel on Facebook in late March 2008.[19][20] The application was developed by Gamehouse, a division of RealNetworks who has been licensed by Mattel.[20] However since Hasbro controls the copyright for North America with the copyright for the rest of the world belonging Mattel, [19] the Facebook application is available only to players outside the United States and Canada.[20] Ownership of the rights to Scrabble by multiple companies is limiting the introduction of the game to Facebook[20] and, between its launch date and April 6, 2008, fewer than 2000 users had registered, compared with 600,000 registered Scrabulous users.[20] As of November 3, 2008, the official Facebook Scrabble game has 203,644 monthly active users. The new "official" application has been heavily criticised in Facebook reviews, particularly by former users of the Scrabulous application which allowed American and Canadian users to play opponents in other countries, which is no longer possible: the Scrabble Beta application is only available in the USA and Canada , whereas Scrabble Worldwide is only available to other countries. Some have complained that they have been unable to use the new application due to technical bugs and glitches, and many have criticized Hasbro for failing to reach an agreement with Scrabulous developers. [21] In addition, the Facebook version only allows automatic verification of words, making it impossible to play invalid words, and making challenges redundant. RealNetworks has stated that the application is currently in its beta stage and there have been reports of a number of bugs and limitations. [20] The Original Scrabble now exists on Facebook, and was developed by Electronic Arts.

Scrabble "TV game show" board game version (1987)
In 1987, a board game was released by Selchow& Righter, based on the Scrabble game show which aired on NBC from 1984 to 1990 (and for six months in 1993). Billed as the "Official Home Version" of the game show (or officially as the "TV Scrabble Home Game"), game play

bears more resemblance to the game show than it does to a traditional Scrabble game, although it does utilize a traditional Scrabble game board in play.

Super Scrabble
A new licensed product, Super Scrabble, was launched in North America by Winning Moves Games in 2004 under license from Hasbro, with the deluxe version (with turntable and lock-in grid) released in February 2007. A Mattel-licensed product for the rest of the world was released by Tinderbox Games in 2006. This set comprises 200 tiles in slightly modified distribution to the standard set and a 21x21 playing board.

The following records were achieved during competitive club or tournament play, according to authoritative sources, including the book Everything Scrabble by Joe Edley and John D. Williams, Jr. (revised edition, Pocket Books, 2001) and the Scrabble FAQ. When available, separate records are listed based upon different official word lists: 1) OSPD or OCTWL, the North American list also used in Thailand and Israel; 2) OSW, formerly the official list in the UK; and 3) SOWPODS, the combined OSPD+OSW now used in much of the world. To date, new editions or revisions of these lists have not been considered substantial enough to warrant separate record-keeping.
• • •

• •

• • •

High game (OSPD) – 830 by Michael Cresta( Mass. ), October 12, 2006. Cresta defeated Wayne Yorra 830-490.[22][23] High game (OSW) – 793 by Peter Preston (UK), 1999.[24] High game (SOWPODS) – Nicholas Mbugua set a new Kenya record with 789 on June 3, 2007 at the 2nd WSC Qualifier in Machakos. Russell Honeybun set a new Australian record with 764 in August 2007. High combined score (OSPD) – 1320 (830-490) by Michael Cresta and Wayne Yorra, in a Lexington , Mass. , club, 2006.[22][23] High combined score (OSPD) in a tournament game – 1134 (582-552) by Keith Smith ( Tex. ) and Stefan Rau ( Conn. ), Round 12 of the 2008 Dallas Open. (Rau's losing score of 552 included three phony words which were not challenged.)[25] High combined score (OSPD) in a tournament game with no phony words played – 1127 (725-402) by Laurie Cohen ( Ariz. ) and Nigel Peltier ( Wash. ), in a tournament in Ahwatukee , Arizona , February 16, 2009.[26] High combined score (SOWPODS) – 1157 (627-530) by Phillip EdwinMugisha( Uganda ) and VannithaBalasingam ( Malaysia ), at the 2009 World Scrabble Championship.[27] Highest losing score (OSPD) – 552 by Stefan Rau ( Conn. ) to Keith Smith's ( Tex. ) 582, Round 12 of the 2008 Dallas Open.[25] Highest tie game (OSPD) – 502-502 by John Chew and Zev Kaufman, at a 1997 Toronto Club tournament.[28] Highest tie game (SOWPODS) – 510-510 by Michael Gongolo (Kenya) and Patrick Mpundu (Zambia), at the East and Central Africa Scrabble Championships 2007 in Kampala, Uganda[28]

• • • • •

Highest opening move score (OSPD) – MuZJIKS (with a blank for the U) 126 by Jesse Inman (S.C.) at the National Scrabble Championship, 2008.[29] The highest possible legal score on a first turn is MUZJIKS 128, using an actual U rather than a blank. Highest opening move score (SOWPODS) – BEZIQUE 124 by Joan Rosenthal. [30] BEZIQUE 124 by Sally Martin.[30] Highest single play (OSPD) – QUIXOTRY 365 by Michael Cresta( Mass. ), 2006.[22][23] Highest single play (SOWPODS) – CAZIQUES 392 by Karl Khoshnaw.[31] Highest average score, two-day tournament (OSPD) – 471 by Chris Cree ( Tex. ) over 18 rounds at the Houston , Tex. Tournament, 2007.[32] Highest average score, two-day tournament (SOWPODS) – 499.94 by Nigel Richards (MY) over 16 rounds at the 7th Lim Boon Heng Cup, Singapore , 2009.[33]

In the absence of better documentation, it is believed that the following records were achieved under a formerly popular British format known as the "high score rule", in which a player's tournament result is determined only by the player's own scores, and not by the differentials between that player's scores and the opponents'. As a result, play in this system "encourages elaborate setups often independently mined by the two players",[24] and is profoundly different from the standard game in which defensive considerations play a major role. While the "high score" rule has unsurprisingly led to impressively high records, it is currently out of favor throughout the world; associating its records with normal competitive play is misleading.

High game score of 1,049 by Phil Appleby of Lymington, Hants ,UK, on June 25, 1989 in Wormley, Herts , UK . His opponent scored just 253 points, giving Appleby a record victory margin of 796 points. High single-turn score of 392, by Dr. Saladin Karl Khoshnaw[31] in Manchester, UK , in April 1982. The word he used was CAZIQUES, meaning "native chiefs of West Indian aborigines".

Hypothetical scores in possible and legal but highly unlikely plays and games are far higher, primarily through the use of words that cover three triple-word-score squares. The highest reported score for a single play is 1780 (OSPD) and 1785 (SOWPODS) using oxyphenbutazone.[34] When only adding the word sesquioxidizing to these official lists, one could theoretically score 2015 (OSPD) and 2044 (SOWPODS) points in a single move. [34] The highest reported combined score for a theoretical game is 3,986 points using OSPD words only.[35] Other records are available for viewing at Total ScrabblePDF, an unofficial record book which includes the above as sources and expands on other topics.

International versions
Versions of the game have been released in several other languages. The game was called Alfapet when it was introduced in Sweden in 1954. However, since the mid-1990s, the game has also been known as Scrabble in Sweden .Alfapet is now another crossword game, created by the owners of the name Alfapet.


For languages with digraphs counted as single letters, such as Welsh and Hungarian, the game features separate tiles for those digraphs.

Variations of the game include Speed Scrabble, AlphaJax, Literati, Alfapet, Funworder, Skip-ACross, Scramble, Spelofun, Square-write, PalabrasCruzadas ("crossed words"), Word for Word, Lexulous, Wordipelago, Wordfeud, and Words With Friends. While these games are similar to the original Scrabble game, they include minor variations. For example, Literati draws random tiles instead of providing a finite number of tiles for the game, assigns different point levels to each letter and has a slightly different board layout whereas Lexulous assigns eight letters to each player instead of the customary seven. Duplicate Scrabble is a popular variant in French speaking countries. Every player has the same letters on the same board and the players must submit a paper slip at the end of the allotted time (usually 3 minutes) with the highest scoring word they have found. This is the format used for the French World Scrabble Championships but it is also used in Romanian and Dutch. There is no limit to the number of players that can be involved in one game, and at Vichy in 1998 there were 1485 players, a record for French Scrabble tournaments.

Game board formats
The game has been released in numerous game board formats appealing to various user groups. The original boards included wood tiles and many "deluxe" sets still do.

Travel editions
Editions are available for travelers who may wish to play in a conveyance such as a train or plane, or who may wish to pause a game in progress and resume later. Many versions thus include methods to keep letters from moving, such as pegboards, recessed tile holders and magnetic tiles. Players' trays are also designed with stay-fast holders. Such boards are also typically designed to be folded and stowed with the game in progress.

Production and Marketing Company, 1954 – metal hinged box, Bakelite tiles inlaid with round magnets, chrome tile racks, silver colored plastic bag and cardboard box covered with decorative paper. The box, when opened flat, measures 8½″ x 7¾″ and the tiles measure ½″ x ½″ each. Spear's Games, 1980s – boxed edition with pegboard, plastic tiles with small feet to fit snugly in the pegboard. Racks are clear plastic, allowing some sorting while holding tiles fairly snugly. Set comes with a drawstring plastic bag to draw tiles and a cardboard box. It is possible to save a game in progress by returning the board to the box. There is risk of players' trays being mixed and upset, and the box lid, held on by friction, is subject to upset. Selchow& Righter, 1980s – pocket edition with plastic "magnetic" board and tiles. Tile racks are also plastic with asymmetrical shape to provide handhold. All elements fit in a plastic envelope for travel and to permit a pause in the game. Plastic letters are very small

and tend to lose their grip if not placed with slight lateral movement and if they are not perfectly clean. Game format is extremely small, allowing Scrabble games for backpackers and others concerned about weight and size. Hasbro Games, 2001 – hinged plastic board with clear tile-shaped depressions to hold tiles in play. Board is in a black, zippered folio such that board and tiles may be folded for travel, even with game in play. Reverse side of board contains numbered mounts for racks, holding tiles face down, allowing secure and confidential storage of tiles while game is paused. Some versions have tile racks with individual tile slots, thus not permitting easy sorting of tiles in rack.

Deluxe editions
At the opposite end, some "deluxe" editions offer superior materials and features. These include editions on a rotating turntable so players can always face the board with the letters upright. More serious players often favor custom Scrabble boards, often made of Lucite or hardwood, that have superior rotating mechanisms and personalized graphics.

Large print edition
An edition has been released (in association with the RNIB) with larger board and letters for players with impaired vision. The colours on the board are more contrasting and the font size is increased from 16 to 24 point. The tiles are in bold 48 point.

Works detailing tournament Scrabble
An introduction to tournament Scrabble and its players can be found in the book Word Freak by Stefan Fatsis. In the process of writing, Fatsis himself progressed into a high-rated tournament player. There have been numerous documentaries made about the game, including:
• • •

Word Wars (2004) by Eric Chaikin and Julian Petrillo, about the "tiles and tribulations on the Scrabble game circuit". Scrabylon (2003), by Scott Petersen, which "gives an up-close look at why people get so obsessed with that seemingly benign game..." Word Slingers by Eric Siblin and Stefan Vanderland (produced for CBC, 2002), which follows four expert Canadian players at the 2001 World Championship in Las Vegas .


Dominoes (or dominos) generally refers to the collective gaming pieces making up a domino set (sometimes called a deck or pack) or to the subcategory of tile games played with domino pieces. In the area of mathematical tilings and polyominoes, the word domino often refers to any rectangle formed from joining two congruent squares edge to edge. The traditional SinoEuropean domino set consists of 28 dominoes, colloquially nicknamed bones, cards, tiles, tickets, stones, or spinners. Each domino is a rectangular tile with a line dividing its face into two square ends. Each end is marked with a number of spots (also called pips) or is blank. The backs of the dominoes in a set are indistinguishable, either blank or having some common design. A domino set is a generic gaming device, similar to playing cards or dice, in that a variety of games can be played with a set.

Construction and composition of domino sets
European-style dominoes are traditionally made of ivory/bone, or a dark hardwood such as ebony, with contrasting black or white pips (inlaid or painted). Alternately, domino sets have been made from many different natural materials: stone (e.g., marble, granite or soapstone); other hardwoods (e.g., ash, oak, redwood and cedar); metals (e.g., brass or pewter); ceramic clay, or even frosted glass or crystal. These sets have a more novel look, and the often heavier weight makes them feel more substantial, but such materials and the resulting products are usually much more expensive than polymer materials. Modern commercial domino sets are usually made of synthetic materials, such as ABS or polystyreneplastics, or Bakelite and other phenolic resins; many sets approximate the look and feel of ivory while others use colored or even translucent plastics to achieve a more contemporary look. Modern sets also commonly use a different color for the dots of each different end value (one-spots might have black pips while two-spots might be green, three red, etc.) to facilitate finding matching ends. Occasionally, one may find a domino set made of card stock like that for playing cards. Such sets are lightweight, compact and inexpensive, but like cards are more susceptible to minor disturbances such as a sudden breeze. The traditional set of dominoes contains one unique piece for each possible combination of two ends with zero to six spots, and is known as a double-six set because the highest-value piece has six pips on each end (the "double six"). The spots from one to six are generally arranged as they are on six-sided dice, but because there are also blank ends having no spots there are seven possible faces, allowing 28 unique pieces in a double-six set. However, this is a relatively small number especially when playing with more than four people, so many domino sets are "extended" by introducing ends with greater numbers of spots, which increases the number of unique combinations of ends and thus of pieces. Each progressively larger set increases the maximum number of pips on an end by three, so the common extended sets are double-nine, double-twelve, double-fifteen and double-eighteen. Larger sets such as double-twenty-one can theoretically exist but are rarely seen in retail stores, as identifying the

number of pips on each domino becomes difficult, and a double-twenty-one set would have 253 pieces, far more than is normally necessary for most domino games even with eight players.

Domino pieces were historically carved from ivory or animal bone with small, round pips of inset ebony. The game's name comes from the pieces' resemblance to Venetian Carnival masks known as domini, which were white with black spots. These masks were so named, in turn, because they resembled Frenchpriests' winter hoods, being black on the outside and white on the inside. The name ultimately derives from the Latindominus, meaning "lord" or "master." The oldest domino sets have been dated from around 1120 A.D. Modern dominoes, as most of the Western world knows them, however, appear to be a Chinese invention. They were apparently derived from cubic dice, which had been introduced into China from Indiasome time in the distant past. Each domino originally represented one of the 21 results of throwing two dice. One half of each domino is set with the pips from one die and the other half contains the pips from the second die. Chinese sets also introduce duplicates of some throws and divide the dominoes into two classes: military and civil. Chinese dominoes are also longer than typical European dominoes. Over time Chinese dominoes also evolved into the tile set used to play Mah Jong, a game which swept across the United States in the early to mid 1920s and has enjoyed moderate popularity, especially in its "solitaire" form, since that time. It is played a lot in the Caribbean, especially in Barbados and Jamaica . The early 18th century witnessed dominoes making their way to Europe, making their first appearance in Italy. The game changed somewhat in the translation from Chinese to the European culture. European domino sets contain neither class distinctions nor the duplicates that went with them. Instead, European sets contain seven additional dominoes, with six of these representing the values that result from throwing a single die with the other half of the tile left blank, and the seventh domino representing the blank-blank (0–0) combination. Ivory Dominoes were routinely used in 19th century rural England in the settling of disputes over traditional grazing boundaries, and were commonly referred to as "bonesticks" (see Hartley, Land Law in West Lancashire in the mid- 19th Century, Farm Gazette, March 1984).

Tiles and suits
Domino tiles, also known as bones, are twice as long as they are wide, a line in the middle suggesting a division into two squares. The value of either side is the number of spots or pips. In the most common variant (Double Six) the values range from blank or 0 (no pips) to 6.[1] The sum of the two values, i.e. the total number of pips, may be referred to as the rank or weight of a tile, and a tile with more pips may be called heavier than a lighter tile with fewer pips. Tiles are generally named after their two values; e.g. 2–5 or 5–2are alternative ways of describing the tile with the values 2 and 5. Tiles that have the same value on both ends are called doubles, and are typically referred to as double-zero, double-one etc.[1] Tiles with two different values are called singles.[2]

Every tile belongs to the two suits of its two values, e.g. 0–3 belongs both to the blank suit (or 0 suit) and to the 3 suit. Naturally the doubles form an exception in that each double belongs to only one suit.[1] In 42, the doubles are treated like an additional suit of doubles, so that e.g. the double-six 6–6 belongs both to the 6 suit and the suit of doubles.

Domino sets
The five most common domino sets commercially available]are: Set Double-6 Double-9 Double-12 Double-15 Double-18 Tiles 28 55 91 136 190 Pips 168 495 1092 2040 3420

These numbers may be computed quite easily using triangular numbers: for double-n dominoes, there are tiles and pips. Generally the most commonly used sets are double-6 and double-9, though the other three sets are more popular for games involving several players or for players looking for long domino games.

Basic rules
Most domino games are blocking games, i.e. the objective is to empty one's hand whilst blocking the opponents. In the end, a score may be determined by counting the pips in the losing players' hands. In scoring games the scoring is different and happens mostly during gameplay, making it the principal objective.[2]

Block game
The most basic domino variant is for two players and requires a double six set. The 28 tiles are shuffled face down and form the stock or boneyard. Each player draws seven tiles; the remainder are not used. Once the players begin drawing tiles, they are typically placed on-edge before the players, so that each player can see his own tiles, but none can see the value of other players' tiles. Every player can thus see how many tiles remain in the other players' hands at all times during gameplay. One player begins by downing (playing the first tile) one of their tiles. This tile starts the line of play, a series of tiles in which adjacent tiles touch with matching, i.e. equal, values. The players alternately extend the line of play with one tile at one of its two ends. A player who cannot do this passes. The game ends when one player wins by playing their last tile, or when the game is blocked because neither player can play. If that occurs, whoever caused the block gets all of the remaining player points not counting their own.[1]


Draw game
In the Draw game, players are additionally allowed to draw as many tiles as desired from the stock before playing a tile, and they are not allowed to pass before the stock is (nearly) empty.[1] The score of a game is the number of pips in the losing player's hand plus the number of pips in the stock. Most rules prescribe that two tiles need to remain in the stock. [2] The Draw game is often referred to as simply "dominoes".[3] Adaptations of both games can accommodate more than two players, who may play individually or in teams.[1]

Line of play
The line of play is the configuration of played tiles on the table. Typically it starts with a single tile, from which it grows in two opposite directions when the players add matching tiles. (In practice the players often play tiles at right angles when the line of play gets too close to the edge of the table.) The rules for the line of play often differ from one variant to another. In many rules the doubles serve as spinners, i.e. they can be played on all four sides, causing the line of play to branch. Sometimes the first tile is required to be a double, and serves as the only spinner. [2] In some games such as Chicken Foot, all sides of a spinner must be occupied before anybody is allowed to play elsewhere. Matador has unusual rules for matching. Bendomino uses curved tiles, so that one side of the line of play (or both) may be blocked for geometrical reasons. In Mexican Train and other Trains games, the game starts with a spinner from which various trains branch off. Most trains are owned by a player, and in most situations players are only allowed to extend their own train.

Minor details
In many versions of the game, the player with the highest double leads with that double, for example "double six". If no one has it the next highest double is called - "double five?", then "double four?", etc. until the highest double in any of the players hands is played. If no player has an "opening" double, the next heaviest domino in the highest suit is called - "six - five?", "six - four?". In some variants the players take turns picking dominoes from the stock until an opening double is picked and played; in other variants the hand is reshuffled and each player picks seven dominoes. After the first hand, the winner or winning team of the previous hand is allowed to pick their dominoes first, and begins by playing any domino in his or her hand. Playing the first bone of a hand is sometimes called setting, leading, downing, or posing the first bone. Dominoes aficionados often call this procedure smacking the bone down. After each hand the bones are shuffled, and each player draws the number of bones required (7). Play generally proceeds "clockwise". The next player, and all players in turn, must play a bone with an end that matches one of the open ends of the layouts. In some versions of the games, the pips or points on the end, and the section to be played next to it must add up to a given number; [For example in a

double six set the "sum" would be six, requiring a "blank" to be played next to a "6," a "1" next to a "5", a "2" next to a "4", etc.] The stock of bones left behind, if any, is called the bone yard, and the bones therein are said to be sleeping. In draw games, players take part in the bone selection, typically drawing from the bone yard when they don't have a "match" in their hand. Generally, if a player inadvertently picks up and sees one or more extra dominoes, those dominoes becomes part of his or her hand. A player who can play a tile may or may not be allowed to pass anyway. Passing can be signalled by tapping twice on the table or by saying "go" or "pass". Play continues until one of the players has played all the dominoes in his or her hand, (and calls "out!", "I win", or "domino!") and wins the hand, or until all the players are blocked and no legal plays are left. This is in some areas referred to as a lockdown or "sewed up". In a common version of the game, the next player after the block, picks up all the dominoes in the bone yard, as if trying to find the (non-existent) match. If all the players are blocked, or locked out the player with the lowest hand / pip count wins. In team play, the team with the lowest individual hand wins. In the case of a tie, the first of tied players or the first team in the play rotation wins. In games where points are accrued, the winning player scores a point for each pip on each bone still held by each opponent, or the opposing team. If no player went out, however, the win is determined by the lightest hand; sometimes only the excess points held by opponents. A game is generally played to 100 points, the tally being kept with paper and pencil. In more common games, mainly urban rules, games are played to 150, 200, or 250 points. In some games the tally is kept by creating houses, where the beginning of the house (the first ten points) is a large +, the next ten points are O, and scoring with a 5 is a /, and are placed in the four 'corners' of the house. In some versions, if a lockdown occurs then the first person to call the lockdown will gain the other players bones and add the amount of the pips to their house. Also, the first person to call rocks if they believe or know the person that called "domino" or "lockdown" miscounted the pips will count the pips themselves; if the person that called rocks finds that the number of pips the player called is different, the points become his after proving that he is correct in his counting.

Games using more dominoes
With bigger domino sets, especially with the Double Fifteens and Double Eighteens, it is possible to have more players. Double 9s is good for 4 to 6 players and each player would start with 7 dominoes in their hand. Double 12s, 15s, and 18s are good for up to 10 to 15 players, each with 7 dominoes. If you have fewer players and more dominoes, start with more dominoes in each player's hand, but leave enough dominoes in the bone pile to draw from. When using the larger sets, make sure you have plenty of playing room as they can spread out considerably. Double 6s = 7 rounds, double 9s = 10 rounds, double 12s = 13 rounds, double 15s = 16 rounds, double 18s = 19 rounds.


Card games using domino sets
Apart from the usual blocking and scoring games, there are also domino of games of a very different character, such as solitaire or trick-taking games. Most of these are adaptations of card games and were once popular in certain areas to circumvent religious prescriptions against playing cards.[6] A very simple example is a Concentration variant played with a double-six set; two tiles are considered to match if their total pip count is 12. A popular domino game in Texas is 42. The game is similar to the card game spades. It is played with four players paired into teams. Each player draws seven dominoes, and the dominoes are played into tricks. Each trick counts as 1 point, and any domino with a multiple of 5 dots counts toward the total of the hand. 35 points of "five count" + 7 tricks = 42 points, hence the name.

Competitive play
Dominoes is played at a professional level, similar to poker. Numerous organisations and clubs of amateur domino players exist around the world[citation needed]. Some organisations, including the International Federation of Dominos and the FédérationInternationale de Domino (FIDO), organise international competitions. The 2008 and 2009 Double FIDO domino world champion from the UK is Darren Elhindi.

Other uses of dominoes
Besides playing games, another common use of dominoes is standing them on end in long lines so that when the first tile is toppled, it topples the second, which topples the third, etc., resulting in all of the tiles falling. For large and elaborate arrangements, special blockages are employed at regular distances to prevent a premature toppling from undoing more than a section of the dominoes while still being able to be removed without damage. Arrangements of millions of tiles have been made that have taken many minutes to fall. By analogy, the phenomenon of small events causing similar events leading to eventual catastrophe is called the domino effect. The phenomenon also has some theoretical relevance (amplifier, digital signal, information processing),[7] and this amounts to the theoretical possibility of building domino computers.[8] Dominoes are also commonly used as components in Rube Goldberg machines. The Netherlands has hosted an annual domino toppling exhibition called Domino Day since 1986. The event held on November 18, 2005 knocked over 4 million dominoes by a team from Weijers Domino Productions. On Domino Day 2008 (November 14, 2008), the Weijers Domino Productions team attempted to set 10 records:[9][10] 1. 2. 3. 4. 5. Longest domino spiral (200 m) Highest domino climb (12 m) Smallest domino tile (7 mm) Largest domino tile (4.8 m) Longest domino wall (16 m)

6. Largest domino structure (25,000 tiles) 7. Fastest topple of 30 metres of domino tiles (4.21 sec, time by Churandy Martina: 3.81 sec) 8. Largest number of domino tiles resting on a single domino (727 tiles) for more than 1 hour 9. Largest rectangular level domino field (1 million tiles ) 10. A new record of 4,345,027 tiles This record attempt was held in the WTC Expo hall in Leeuwarden. The artist who toppled the first stone was the FinnishacrobatSalimaPeippo. At one time, Pressman Toys manufactured a product called Domino Rally that contained tiles and mechanical devices for setting up toppling exhibits. In Berlin on November 9, 2009, giant dominoes were toppled in a 20th anniversary commemoration of the fall of the Berlin Wall. Former Polish president and Solidarity leader Lech Wałęsa set the toppling in motion. A similar physical phenomena can be seen in Newton's cradle. =====================================================================

Arm Wrestling
Arm wrestlingis a sport with two participants. Each participant places one arm, both put either the right or left, on a surface, with their elbows bent and touching the surface, and they grip each other's hand. The goal is to pin the other's arm onto the surface, with the winner's arm over the loser's arm. History The matches began In Gilardi's saloon In Petaluma, CA. in 1952. Bill Soberanes, a young journalist was the founder of the organized sport. He was the Inspiration for the annual Petaluma , then Northern California and then the California armwrestling championship. In 1962 Bill and Dave Devoto got together to form the World's Wristwrestling Championship, Inc. and take it to one of Petaluma 's largest auditoriums. The event was tremendously successful and exciting things began to happen. In 1968 Charles Schultz did 11 comic strips where snoopy was coming to Petaluma to win the World's Wristwrestling Championship. Unfortunately In the final strip he was eliminated because the official armwrestling rules stated you must lock your thumbs with the opposing

competitor. Snoopy had no thumb. Drats. These comic strips were done in dozens of different languages and distributed through out the world. In 1969 Dave Devoto contracted with the American Broadcasting Corporation and the World's Wristwrestling Championship began a wonderful l6 year relationship with ABC's Wide World of Sports.Armwrestling came of age. A story in Playboy magazine substantiated the fact that our televised event was the highest rated show in the young history of Wide World of Sports. Most of the competitors in the sport today first became aware of Armwrestling through ABC's productions of the Wide World of Sports World's Wristwrestling Championship. The televised championships ran from 1969 through 1984. We love Wide World of Sports. In October 1995 the event was filmed by the Learning Channel and shown four times throughout the World. The World's Wristwrestling - Armwrestling Championship is always held the second Saturday in October in Petaluma , California . On October 12, 1996 the event was filmed by NBC's World News Today and shown throughout the World on October 13, 1996. On October 14, 2000 the event was filmed by CBS and shown on the 16th on the Bryant Gumbel show. Part of the event was also shown on the Evening Magazine weeks later. ArmSports, armwrestling and wristwrestling are all the same sport using the same type table with pegs. We have been consultants on movies and television videos regarding ArmSports, Armwrestling and Wristwrestling and are making our facilities available to all Armsports competitors and organizers. Our goal is to provide information and organization to all who have interest in our sport.

Description Various factors can play a part in one's success in arm wrestling. Technique and overall arm strength are the two greatest contributing factors to winning an arm wrestling match. Other factors such as the length of an arm wrestler's arm, his/her muscle and arm mass/density, hand grip size, wrist endurance and flexibility, reaction time, as well as countless other traits, can add to the advantages of one arm wrestler over another It is sometimes used to prove who is stronger between two or more people. In competitive arm wrestling, as sanctioned by the United States Armwrestling Federation (USAF), arm wrestling is performed with both competitors standing up with their arms placed on a tournament arm wrestling table Arm wrestling tournaments are also divided into weight classes as well as left and right-handed divisions. Furthermore, strict rules such as fouls given to penalties (such as the competitor's elbow leaving a matted area where the elbow is to remain at all times, or a false start), and trying to escape a possible arm pin by breaking the grip with the opponent may result in a loss at the table Paraphrasing USAF rules, arm wrestlers must straighten their wrists without a time lapse of one minute during competition.


The World Armwrestling Federation (WAF) is the universally recognized global governing body of amateur arm wrestling and comprises more than 85 member countries. Some noted top arm wrestling competitors include John Brzenk (hailed as the greatest arm wrestler of all time) Alexey Voevoda and Jerry Cadorette. Allen Fisher is of high acclaim, for he has won 25 world championships.He is one of the oldest current arm wrestlers at 53 years of age. Heidi Andersson is a female armwrestler from Sweden who has won eight world championships between 1998 and 2010. Competitive styles John Brzenk is known mostly for his array of techniques which change almost every time he is engaged in competition, even with the same opponent within the same match. As of Summer 2008, John Brzenk is ranked #1 in North America Ron Bath is known for his use of the Top Roll technique which emphasizes a 'roll' of the wrist as he brings the opponent's wrist down.TravisBagent, like Brzenk, is known for his wide array of techniques, coupled with his massive strength and explosive style.Many of Bagent's matches have ended in seconds. However, Bagent is most well known for his colorful remarks and rather rude comments against his opponents.Bagent is considered the best left-handed arm wrestler in the world and is currently ranked second overall in North America, as of Summer of 2008. Joe "The Blaster" Caggiano, the 1981 world champion, has trained most modern champions. Other competitors such as Matt Girdner, Michael Selearis, Sean Madera, MarcioBarboza, and Christian Binnie, are known for their reliance on strength, coupled with the hook technique, where the wrist turns into a hooked grip after the referee has started the match. "The Hook" or "Hooking" is a generic term used to describe any move derived from the inside system of arm wrestling the second generic system or style of Arm wrestling is known as outside arm wrestling "the Top Roll" or "Top Rolling", while the "Tricep Press", "Shoulder Pressing", or Shoulder Rolling" is often described as the third generic system or style of arm wrestling. [citation needed] and certain arm wrestlers depend on the straps such as Jason Vale who won the 1997 Petaluma World Championships in the super heavy weight class at only 175 pounds using the strap technique Many arm wrestlers will have a signature style or favourite technique, while others have enjoyed success by becoming extremely well rounded. Within each of the three broad technical systems of arm wrestling there are numerous clearly identifiable techniques which have been developed and enhanced over time. Great Britain's most successful Armwrestler and former two time European and World Middleweight Champion Neil Pickup is one of today's leading Armwrestlers widely recognized as having originated and developed techniques to suit the genetic make up of individual Armwrestlers. Neil Pickup has enjoyed an Amateur and Professional career spanning more than 20 years during which time he has won more than 60 International titles across 5 different weight classes on both his right and left arms, while also training numerous World Champions both male and female. This success has been largely attributed to his technical prowess, experience and understanding of the athletes whole body as a lever.


Avoiding injury Arm wrestling puts enormous torque/twist on the upper arm's humerus bone to a degree seen in few other physical activities.[3] Most people's bones are not accustomed to being significantly stressed in this direction, and injuries can occur surprisingly easily. The arm typically fails because of a diagonal break at or below the midpoint between the shoulder and the elbow. The natural tendency of an inexperienced arm wrestler is to push the hand, wrist, and shoulder in the same coordinated direction, against the force being applied by the opponent. This is how we throw a baseball or hit a tennis ball. However, turning one's shoulder this way simply adds to the torque already being applied to the humerus by the opponent. US Arm Sports advises of the danger of "letting your shoulder get inside your hand." It is better to pivot your shoulders so that you never look away from your hand.[citation needed] If the tendons and ligaments are to weak to support the pressure that your muscles make it can come to a complete tendon blow (pop) .However , you can strengthen your tendons with many methods . Experienced arm wrestlers have tendons 3 - 4 times bigger than average people . When arm wrestling you are putting your tendons and ligaments under great stress . When tendons are in pain , they require blood so they can heal faster . All doctors and many arm wrestlers will recommend doing rehab ( training / therapy , exercising with light weights and many repetitions for 30 - 45 minutes non-stop to pump the blood into arms ) . Tendons can get bigger in with the time and it is a very slow process. =====================================================================

Chess is a two-player board game played on a chessboard, a square-checkered board with 64 squares arranged in an eight-by-eight grid. Each player begins the game with sixteen pieces: one king, one queen, two rooks, two knights, two bishops, and eight pawns. The object of the game is to checkmate the opponent's king, whereby the king is under immediate attack (in "check") and there is no way to remove or defend it from attack on the next move. The game's present form emerged in Europe during the second half of the 15th century, an evolution of an older Indian game, Shatranj. Theoreticians have developed extensive chess strategies and tactics since the game's inception. Computers have been used for many years to create chess-playing programs, and their abilities and insights have contributed significantly to modern chess theory. One, Deep Blue, was the first machine to beat a reigning World Chess Champion when it defeated Garry Kasparov in 1997.

Organized competitive chess began during the 16th century. The first official World Chess Champion, Wilhelm Steinitz, claimed his title in 1886; the current World Champion is ViswanathanAnand from India. In addition to the World Championship, there is the Women's World Championship, the Junior World Championship, the World Senior Championship, the Correspondence Chess World Championship, the World Computer Chess Championship, and Blitz and Rapid World Championships (see fast chess). The Chess Olympiad is a popular competition among teams from different nations. Online chess has opened amateur and professional competition to a wide and varied group of players. Chess is a recognized sport of the International Olympic Committee, and international chess competition is sanctioned by the FIDE. Chess is one of the world's most popular games, played by millions of people worldwide at home, in clubs, online, by correspondence, and in tournaments. Some other popular forms of chess are fast chess and computer chess. There are many chess variants that have different rules, different pieces, and different boards. These variants include blindfold chess and Fischer Random Chess/Chess960.

The official rules of chess are maintained by the World Chess Federation. Along with information on official chess tournaments, the rules are described in the FIDE Handbook, Laws of Chess section.[1]

Chess is played on a square board of eight rows (called ranks and denoted with numbers 1 to 8) and eight columns (called files and denoted with letters a toh) of squares. The colors of the sixtyfour squares alternate and are referred to as "light squares" and "dark squares". The chessboard is placed with a light square at the right-hand end of the rank nearest to each player, and the pieces are set out as shown in the diagram, with each queen on its own color. The pieces are divided, by convention, into white and black sets. The players are referred to as "White" and "Black", and each begins the game with sixteen pieces of the specified color. These consist of one king, one queen, two rooks, two bishops, two knights, and eight pawns.

White always moves first. After the initial move, the players alternately move one piece at a time (with the exception of castling, when two pieces are moved). Pieces are moved to either an unoccupied square or one occupied by an opponent's piece, which is captured and removed from play. With the sole exception of en passant, all pieces capture opponent's pieces by moving to the square that the opponent's piece occupies. A player may not make any move that would put or leave his king under attack. If the player to move has no legal moves, the game is over; it is either a checkmate—if the king is under attack—or a stalemate—if the king is not. Each chess piece has its own style of moving. In the diagrams, the dots mark the squares where the piece can move if no other pieces (including one's own piece) are on the squares between the piece's initial position and its destination.

• • • • •

The king moves one square in any direction. The king has also a special move which is called castling and involves also moving a rook. The rook can move any number of squares along any rank or file, but may not leap over other pieces. Along with the king, the rook is involved during the king's castling move. The bishop can move any number of squares diagonally, but may not leap over other pieces. The queen combines the power of the rook and bishop and can move any number of squares along rank, file, or diagonal, but it may not leap over other pieces. The knight moves to any of the closest squares that are not on the same rank, file, or diagonal, thus the move forms an "L"-shape two squares long and one square wide. The knight is the only piece that can leap over other pieces. The pawn may move forward to the unoccupied square immediately in front of it on the same file; or on its first move it may advance two squares along the same file provided both squares are unoccupied; or it may move to a square occupied by an opponent's piece which is diagonally in front of it on an adjacent file, capturing that piece. The pawn has two special moves: the en passant capture and pawn promotion.

Once in every game, each king is allowed to make a special move, known as castling. Castling consists of moving the king two squares along the first rank toward a rook (which is on the player's first rank[note 1]) and then placing the rook on the last square the king has just crossed. Castling is permissible only if all of the following conditions hold:[
• • •

Neither of the pieces involved in castling may have been previously moved during the game. There must be no pieces between the king and the rook. The king may not currently be in check, nor may the king pass through squares that are under attack by enemy pieces, nor move to a square where it is in check.

En passant
When a pawn advances two squares and there is an opponent's pawn on an adjacent file next to its destination square, then the opponent's pawn can capture it en passant (in passing), and move to the square the pawn passed over. However, this can only be done on the very next move, or the right to do so is lost. For example, if the black pawn has just advanced two squares from g7 to g5, then the white pawn on f5 can take it via en passant on g6 (but only on white's next move).

When a king is under immediate attack by one or two of the opponent's pieces, it is said to be in check. A response to a check is a legal move if it results in a position where the king is no longer under direct attack (that is, not in check). This can involve capturing the checking piece; interposing a piece between the checking piece and the king (which is possible only if the attacking piece is a queen, rook, or bishop and there is a square between it and the king); or moving the king to a square where it is not under attack. Castling is not a permissible response to

a check. The object of the game is to checkmate the opponent; this occurs when the opponent's king is in check, and there is no legal way to remove it from attack. It is illegal for a player to make a move that would put or leave his own king in check.

End of the game
Although the objective of the game is to checkmate the opponent, chess games do not have to end in checkmate—either player may resign if the situation looks hopeless. It is considered bad etiquette to continue playing when in a truly hopeless position.[3] If it is a timed game, a player may run out of time and lose, even with a much superior position. Games also may end in a draw (tie). A draw can occur in several situations, including draw by agreement, stalemate, threefold repetition of a position, the fifty-move rule, or a draw by impossibility of checkmate (usually because of insufficient material to checkmate). As checkmate from some positions cannot be forced in fewer than 50 moves (such as in the pawnless chess endgame and two knights endgame), the fifty-move rule is not applied everywhere,[note 2] particularly in correspondence chess.

Time control
Besides casual games without any time restriction, chess is also played with a time control, mostly by club and professional players. If a player's time runs out before the game is completed, the game is automatically lost (provided his opponent has enough pieces left to deliver checkmate). The duration of a game ranges from long games played up to seven hours to shorter rapid chess games, usually lasting 30 minutes or one hour per game. Even shorter is blitz chess, with a time control of three to fifteen minutes for each player, and bullet chess (under three minutes). In tournament play, time is controlled using a game clock that has two displays, one for each player's remaining time.

Notation for recording moves
Chess games and positions are recorded using a special notation, most often algebraic chess notation.[5] Abbreviated (or short) algebraic notation generally records moves in the format "abbreviation of the piece moved – file where it moved – rank where it moved." For example, Qg5 means "queen moves to the g-file and 5th rank (that is, to the square g5). If there are two pieces of the same type that can move to the same square, one more letter or number is added to indicate the file or rank from which the piece moved, e.g. Ngf3 means "knight from the g-file moves to the square f3". The letter P indicating a pawn is not used, so that e4 means "pawn moves to the square e4". If the piece makes a capture, "x" is inserted before the destination square. Thus Bxf3 means "bishop captures on f3". When a pawn makes a capture, the file from which the pawn departed is used in place of a piece initial, and ranks may be omitted if unambiguous. For example, exd5 (pawn on the e-file captures the piece on d5) or exd (pawn on e-file captures something on the dfile).


If a pawn moves to its last rank, achieving promotion, the piece chosen is indicated after the move, for example e1Q or e1=Q. Castling is indicated by the special notations 0–0 for kingside castling and 0–0–0 for queenside castling. A move that places the opponent's king in check usually has the notation "+" added. Checkmate can be indicated by "#" (occasionally "++", although this is sometimes used for a double check instead). At the end of the game, "1–0" means "White won," "0–1" means "Black won," and "½–½" indicates a draw.[6] Chess moves can be annotated with punctuation marks and other symbols. For example "!" indicates a good move, "!!" an excellent move, "?" a mistake, "??" a blunder, "!?" an interesting move that may not be best, or "?!" a dubious move, but not easily refuted.[7] For example, one variant of a simple trap known as the Scholar's mate, animated in the picture to the right, can be recorded: 1. 2. 3. 4. e4 e5 Qh5?! Nc6 Bc4 Nf6?? Qxf7# 1–0

Strategy and tactics
Chess strategy consists of setting and achieving long-term goals during the game – for example, where to place different pieces – while tactics concentrate on immediate maneuver. These two parts of the chess-playing process cannot be completely separated, because strategic goals are mostly achieved by the means of tactics, while the tactical opportunities are based on the previous strategy of play. A game of chess is normally divided into three phases: opening, typically the first 10 to 25 moves, when players move their pieces into useful positions for the coming battle; middlegame, usually the fiercest part of the game; and endgame, when most of the pieces are gone, kings typically take a more active part in the struggle, and pawn promotion is often decisive.

History Predecessors
chess is commonly believed to have originated in northwest India during the Gupta empire,[26][27] [28][29] where its early form in the 6th century was known as caturaṅga (Sanskrit: four divisions [of the military] –infantry,cavalry,elephants, andchariotry,represented by the pieces that would evolve into the modern pawn, knight, bishop, and rook, respectively). The earliest evidence of chess is found in the neighboring Sassanid Persia around 600, where the game came to be known under the name chatrang. Chatrang is evoked inside three epic romances written in Pahlavi (Middle Persian). Chatrang was taken up by the Muslim world after the Islamic conquest of Persia (633–644), where it was then named shatranj, with the pieces largely retaining their Persian names. In Spanish "shatranj" was rendered as ajedrez ("al-shatranj"), in Portuguese as xadrez, and in Greek as zatrikion (which comes directly from the Persian chatrang), but in the rest of Europe it was replaced by versions of the Persian shāh ("king"), which was familiar as an

exclamation and became the English words "check" and "chess".[note 3] Murray theorized that Muslim traders came to European seaports with ornamental chess kings as curios before they brought the game of chess.[28] The game reached Western Europe and Russia by at least three routes, the earliest being in the 9th century. By the year 1000 it had spread throughout Europe .[30] Introduced into the Iberian Peninsula by the Moors in the 10th century, it was described in a famous 13th-century manuscript covering shatranj, backgammon, and dice named the Libro de los juegos. Another theory contends that chess arose from the game xiangqi (Chinese Chess) or one of its predecessors,[31] although this has been contested.[32]

Origins of the modern game (1000–1850)
Around 1200, the rules of shatranj started to be modified in southern Europe , and around 1475, several major changes made the game essentially as it is known today.[30] These modern rules for the basic moves had been adopted in Italy and Spain .[33][34] Pawns gained the option of advancing two squares on their first move, while bishops and queens acquired their modern abilities. The queen replaced the earlier vizier chess piece towards the end of the 10th century and by the 15th century had become the most powerful piece;[35] consequently modern chess was referred to as "Queen's Chess" or "Mad Queen Chess".[36] These new rules quickly spread throughout western Europe. The rules about stalemate were finalized in the early 19th century. To distinguish it from its predecessors, this version of the rules is sometimes referred to as western chess[37] or international chess.[38] Writings about the theory of how to play chess began to appear in the 15th century. The Repetición de Amores y Arte de Ajedrez (Repetition of Love and the Art of Playing Chess) by Spanish churchman Luis Ramirez de Lucena was published in Salamanca in 1497.[34]Lucena and later masters like PortuguesePedro Damiano, ItaliansGiovanni Leonardo Di Bona, GiulioCesarePolerio and Gioachino Greco, and Spanish bishop RuyLópez de Segura developed elements of openings and started to analyze simple endgames. François-André DanicanPhilidor, 18th-century French chess master In the 18th century, the center of European chess life moved from the Southern European countries to France . The two most important French masters were François-André DanicanPhilidor, a musician by profession, who discovered the importance of pawns for chess strategy, and later Louis-Charles Mahé de La Bourdonnais, who won a famous series of matches with the Irish master Alexander McDonnell in 1834.[39] Centers of chess activity in this period were coffee houses in big European cities like Café de la Régence in Paris and Simpson's Divan in London.[40][41] As the 19th century progressed, chess organization developed quickly. Many chess clubs, chess books, and chess journals appeared. There were correspondence matches between cities; for example, the London Chess Club played against the Edinburgh Chess Club in 1824.[42]Chess

problems became a regular part of 19th-century newspapers; Bernhard Horwitz, Josef Kling, and Samuel Loyd composed some of the most influential problems. In 1843, von der Lasa published his and Bilguer'sHandbuch des Schachspiels (Handbook of Chess), the first comprehensive manual of chess theory.

Birth of a sport (1850–1945)
The "Immortal Game", Anderssen-Kieseritzky, 1851 The first modern chess tournament was held in London in 1851 and was won by German Adolf Anderssen, relatively unknown at the time. Anderssen was hailed as the leading chess master and his brilliant, energetic attacking style became typical for the time, although it was later regarded as strategically shallow.[43][44] Sparkling games like Anderssen'sImmortal game and Evergreen game or Morphy'sOpera game were regarded as the highest possible summit of the chess art.[45] Deeper insight into the nature of chess came with two younger players. American Paul Morphy, an extraordinary chess prodigy, won against all important competitors (except Howard Staunton, who refused to play), including Anderssen, during his short chess career between 1857 and 1863. Morphy's success stemmed from a combination of brilliant attacks and sound strategy; he intuitively knew how to prepare attacks.[46]Prague-born Wilhelm Steinitz later described how to avoid weaknesses in one's own position and how to create and exploit such weaknesses in the opponent's position.[47] The scientific approach and positional understanding of Steinitz revolutionized the game. Steinitz was the first to break a position down into its components. [48] Before Steinitz, players brought their queen out early, did not completely develop their other pieces, and mounted a quick attack on the opposing king, which either succeeded or failed. The level of defense was poor and players did not form any deep plan.[49] In addition to his theoretical achievements, Steinitz founded an important tradition: his triumph over the leading German master Johannes Zukertort in 1886 is regarded as the first official World Chess Championship. Steinitz lost his crown in 1894 to a much younger player, the German mathematician Emanuel Lasker, who maintained this title for 27 years, the longest tenure of all World Champions.[50] It took a prodigy from Cuba, José RaúlCapablanca (World Champion 1921–27), who loved simple positions and endgames, to end the German-speaking dominance in chess; he was undefeated in tournament play for eight years, until 1924. His successor was Russian-French Alexander Alekhine, a strong attacking player who died as the World champion in 1946. He briefly lost the title to Dutch player Max Euwe in 1935 and regained it two years later.[51] Between the world wars, chess was revolutionized by the new theoretical school of so-called hypermodernists like AronNimzowitsch and Richard Réti. They advocated controlling the center of the board with distant pieces rather than with pawns, which invited opponents to occupy the center with pawns, which become objects of attack.[52] After the end of the 19th century, the number of master tournaments and matches held annually quickly grew. Some sources state that in 1914 the title of chess grandmaster was first formally conferred by Tsar Nicholas II of Russia to Lasker, Capablanca, Alekhine, Tarrasch, and Marshall, but this is a disputed claim.[note 4] The tradition of awarding such titles was continued by

the World Chess Federation (FIDE), founded in 1924 in Paris . In 1927, the Women's World Chess Championship was established; the first to hold the title was Czech-English master Vera Menchik.[53]

Post-war era (1945 and later)
After the death of Alekhine, a new World Champion was sought. FIDE, who have controlled the title since then (except for one interruption), ran a tournament of elite players. The winner of the 1948 tournament, Russian Mikhail Botvinnik, started an era of Soviet dominance in the chess world. Until the end of the Soviet Union , there was only one non-Soviet champion, American Bobby Fischer (champion 1972–1975).[54]Botvinnik revolutionized opening theory. Previously Black strove for equality, to neutralize White's first-move advantage. As Black, Botvinnik strove for the initiative from the beginning.[55] In the previous informal system of World Championships, the current champion decided which challenger he would play for the title and the challenger was forced to seek sponsors for the match. FIDE set up a new system of qualifying tournaments and matches. The world's strongest players were seeded into Interzonal tournaments, where they were joined by players who had qualified from Zonal tournaments. The leading finishers in these Interzonals would go on the "Candidates" stage, which was initially a tournament, and later a series of knock-out matches. The winner of the Candidates would then play the reigning champion for the title. A champion defeated in a match had a right to play a rematch a year later. This system operated on a three-year cycle. Botvinnik participated in championship matches over a period of fifteen years. He won the world championship tournament in 1948 and retained the title in tied matches in 1951 and 1954. In 1957, he lost to VasilySmyslov, but regained the title in a rematch in 1958. In 1960, he lost the title to the 23year-old Latvian prodigy Mikhail Tal, an accomplished tactician and attacking player. Botvinnik again regained the title in a rematch in 1961. Following the 1961 event, FIDE abolished the automatic right of a deposed champion to a rematch, and the next champion, ArmenianTigranPetrosian, a genius of defense and a strong positional player, held the title for two cycles, 1963–1969. His successor, Boris Spassky from Russia (champion 1969–1972), was able to win in both positional and sharp tactical style. [56] The next championship, the so-called Match of the Century, saw the first non-Soviet challenger since World War II, American Bobby Fischer, who defeated his Candidates opponents by unheard-of margins and clearly won the world championship match. In 1975, however, Fischer refused to defend his title against Soviet Anatoly Karpov when FIDE refused to meet his demands, and Karpov obtained the title by default.[57] Fischer modernized many aspects of chess, especially by extensively preparing openings.[58] Karpov defended his title twice against Viktor Korchnoi and dominated the 1970s and early 1980s with a string of tournament successes.[59]Karpov's reign finally ended in 1985 at the hands of another Soviet player from Baku, Azerbaijan, Garry Kasparov. Kasparov and Karpov contested five world title matches between 1984 and 1990; Karpov never won his title back. [60] In 1993, Garry Kasparov and Nigel Short broke with FIDE to organize their own match for the title and formed a competing Professional Chess Association (PCA). From then until 2006, there were two simultaneous World Champions and World Championships: the PCA or Classical champion extending the Steinitzian tradition in which the current champion plays a challenger in

a series of many games, and the other following FIDE's new format of many players competing in a tournament to determine the champion. Kasparov lost his Classical title in 2000 to Vladimir Kramnik of Russia .[61] The World Chess Championship 2006 reunified the titles. Kramnik beat the FIDE World Champion VeselinTopalov and became the undisputed World Chess Champion. [62] In September 2007, he lost the title to ViswanathanAnand of India , who won the championship tournament in Mexico City. Anand defended his title in the revenge match of 2008.[63]

In the Middle Ages and during the Renaissance, chess was a part of noble culture; it was used to teach war strategy and was dubbed the "King's Game".[64] Gentlemen are "to be meanly seene in the play at Chestes", says the overview at the beginning of Baldassare Castiglione's The Book of the Courtier (1528, English 1561 by Sir Thomas Hoby), but chess should not be a gentleman's main passion. Castiglione explains it further: And what say you to the game at chestes? It is truely an honest kynde of enterteynmente and wittie, quothSyrFriderick. But me think it hath a fault, whiche is, that a man may be to couning at it, for who ever will be excellent in the playe of chestes, I beleave he must beestowe much tyme about it, and applie it with so much study, that a man may assoonelearne some noble scyence, or compase any other matter of importaunce, and yet in the ende in beestowing all that laboure, he knoweth no more but a game. Therfore in this I beleave there happeneth a very rare thing, namely, that the meane is more commendable, then the excellency.[65] Many of the elaborate chess sets used by the aristocracy have been lost, but others partially survive, such as the Lewis chessmen. Chess was often used as a basis of sermons on morality. An example is Liber de moribushominumetofficiisnobiliumsive super ludoscacchorum ('Book of the customs of men and the duties of nobles or the Book of Chess'), written by an Italian Dominican monk Jacobus de Cessolis circa 1300. This book was one of the most popular of the Middle Ages.[66] The work was translated into many other languages (the first printed edition was published at Utrecht in 1473) and was the basis for William Caxton's The Game and Playe of the Chesse (1474), one of the first books printed in English.[67] Different chess pieces were used as metaphors for different classes of people, and human duties were derived from the rules of the game or from visual properties of the chess pieces:[68] The knyght ought to be made alle armed upon an hors in suchewyse that he haue an helme on his heed and a spere in his ryghthande/ and couerydwyth his sheld/ a swerde and a mace on his lyftsyde/ Claddwyth an hawberk and plates to fore his breste/ leggeharnoys on his legges/ Spores on his heelis on his handes his gauntelettes/ his hors well broken and taught and apte to bataylle and couerid with his armes/ whan the knyghtes ben maad they ben bayned or bathed/ that is the signe that they sholdlede a newelyf and newemaners/ also they wake alle the nyght in prayers and orysonsvnto god that he wyllegyue hem grace that they may gete that thynge that they may not gete by nature/ The kynge or pryncegyrdeth a boute them a swerde in signe/ that they sholdabyde and kepehym of whom they take theyr dispenses and dignyte.[69]

Known in the circles of clerics, students, and merchants, chess entered into the popular culture of Middle Ages. An example is the 209th song of CarminaBurana from the 13th century, which starts with the names of chess pieces, Roch, pedites, regina...[70]

During the Age of Enlightenment, chess was viewed as a means of self-improvement. Benjamin Franklin, in his article "The Morals of Chess" (1750), wrote: "The Game of Chess is not merely an idle amusement; several very valuable qualities of the mind, useful in the course of human life, are to be acquired and strengthened by it, so as to become habits ready on all occasions; for life is a kind of Chess, in which we have often points to gain, and competitors or adversaries to contend with, and in which there is a vast variety of good and ill events, that are, in some degree, the effect of prudence, or the want of it. By playing at Chess then, we may learn: I. Foresight, which looks a little into futurity, and considers the consequences that may attend an action [...] II. Circumspection, which surveys the whole Chess-board, or scene of action: – the relation of the several Pieces, and their situations [...] III. Caution, not to make our moves too hastily. With these or similar hopes, chess is taught to children in schools around the world today. Many schools host chess clubs, and there are many scholastic tournaments specifically for children. Tournaments are held regularly in many countries, hosted by organizations such as the United States Chess Federation and the National Scholastic Chess Foundation.[72] A Large sized Chess game is made available on a seasonal basis inside the Enoch Pratt Free Library in Baltimore, Maryland Chess is often depicted in the arts; significant works where chess plays a key role range from Thomas Middleton's A Game at Chess to Through the Looking-Glass by Lewis Carroll to The Royal Game by Stefan Zweig and Vladimir Nabokov's The Defense. The thriller film Knight Moves is about a chess grandmaster who is accused of being a serial killer. Chess is featured in films like Ingmar Bergman's The Seventh Seal and Satyajit Ray's The Chess Players. In the video gameKiller 7, the protagonist and the antagonist frequently play chess together; in the survival horror game Deadly Premonition, chess is the theme of a puzzle. Chess is also present in the contemporary popular culture. For example, J. K. Rowling's Harry Potter plays "Wizard's Chess", while the characters of Star Trek prefer "Tri-Dimensional Chess". The hero of Searching for Bobby Fischer struggles against adopting the aggressive and misanthropic views of a real chess grandmaster.[73] Chess has been used as the core theme of a musical, Chess, by Tim Rice, BjörnUlvaeus, and Benny Andersson. Approximately 600 million people worldwide know how to play chess.[74]


Place in culture
Noble chess players, Germany , c. 1320 Main article: Chess in the arts and literature

In the Middle Ages and during the Renaissance, chess was a part of noble culture; it was used to teach war strategy and was dubbed the "King's Game".[64] Gentlemen are "to be meanly seene in the play at Chestes", says the overview at the beginning of Baldassare Castiglione's The Book of the Courtier (1528, English 1561 by Sir Thomas Hoby), but chess should not be a gentleman's main passion. Castiglione explains it further: And what say you to the game at chestes? It is truely an honest kynde of enterteynmente and wittie, quothSyrFriderick. But me think it hath a fault, whiche is, that a man may be to couning at it, for who ever will be excellent in the playe of chestes, I beleave he must beestowe much tyme about it, and applie it with so much study, that a man may assoonelearne some noble scyence, or compase any other matter of importaunce, and yet in the ende in beestowing all that laboure, he knoweth no more but a game. Therfore in this I beleave there happeneth a very rare thing, namely, that the meane is more commendable, then the excellency.[65] Two kings and two queens from the Lewis chessmen at the British Museum Many of the elaborate chess sets used by the aristocracy have been lost, but others partially survive, such as the Lewis chessmen. Chess was often used as a basis of sermons on morality. An example is Liber de moribushominumetofficiisnobiliumsive super ludoscacchorum ('Book of the customs of men and the duties of nobles or the Book of Chess'), written by an Italian Dominican monk Jacobus de Cessolis circa 1300. This book was one of the most popular of the Middle Ages.[66] The work was translated into many other languages (the first printed edition was published at Utrecht in 1473) and was the basis for William Caxton's The Game and Playe of the Chesse (1474), one of the first books printed in English.[67] Different chess pieces were used as metaphors for different classes of people, and human duties were derived from the rules of the game or from visual properties of the chess pieces:[68] The knyght ought to be made alle armed upon an hors in suchewyse that he haue an helme on his heed and a spere in his ryghthande/ and couerydwyth his sheld/ a swerde and a mace on his lyftsyde/ Claddwyth an hawberk and plates to fore his breste/ leggeharnoys on his legges/ Spores on his heelis on his handes his gauntelettes/ his hors well broken and taught and apte to bataylle and couerid with his armes/ whan the knyghtes ben maad they ben bayned or bathed/ that is the signe that they sholdlede a newelyf and newemaners/ also they wake alle the nyght in prayers and orysonsvnto god that he wyllegyue hem grace that they may gete that thynge that they may not gete by nature/ The kynge or pryncegyrdeth a boute them a swerde in signe/ that they sholdabyde and kepehym of whom they take theyr dispenses and dignyte.[69]

Known in the circles of clerics, students, and merchants, chess entered into the popular culture of Middle Ages. An example is the 209th song of CarminaBurana from the 13th century, which starts with the names of chess pieces, Roch, pedites, regina...[70] the National Scholastic Chess Foundation.[72] A Large sized Chess game is made available on a seasonal basis inside the Enoch Pratt Free Library in Baltimore, Maryland Chess is often depicted in the arts; significant works where chess plays a key role range from Thomas Middleton's A Game at Chess to Through the Looking-Glass by Lewis Carroll to The Royal Game by Stefan Zweig and Vladimir Nabokov's The Defense. The thriller film Knight Moves is about a chess grandmaster who is accused of being a serial killer. Chess is featured in films like Ingmar Bergman's The Seventh Seal and Satyajit Ray's The Chess Players. In the video gameKiller 7, the protagonist and the antagonist frequently play chess together; in the survival horror game Deadly Premonition, chess is the theme of a puzzle. Chess is also present in the contemporary popular culture. For example, J. K. Rowling's Harry Potter plays "Wizard's Chess", while the characters of Star Trek prefer "Tri-Dimensional Chess". The hero of Searching for Bobby Fischer struggles against adopting the aggressive and misanthropic views of a real chess grandmaster.[73] Chess has been used as the core theme of a musical, Chess, by Tim Rice, BjörnUlvaeus, and Benny Andersson. Approximately 600 million people worldwide know how to play chess.

Organization of competitions
Contemporary chess is an organized sport with structured international and national leagues, tournaments, and congresses. Chess's international governing body is FIDE (FédérationInternationale des Échecs). Most countries have a national chess organization as well (such as the US Chess Federation and English Chess Federation) which in turn is a member of FIDE. FIDE is a member of the International Olympic Committee,[80] but the game of chess has never been part of the Olympic Games; chess does have its own Olympiad, held every two years as a team event. The current World Chess Champion ViswanathanAnand (left) playing chess against his predecessor Vladimir Kramnik The current World Chess Champion is ViswanathanAnand of India .[81] The reigning Women's World Champion is HouYifan from China . The world's highest rated female player, JuditPolgár, has never participated in the Women's World Chess Championship, instead preferring to compete with the leading men and maintaining a ranking among the top male players.[82] Other competitions for individuals include the World Junior Chess Championship, the European Individual Chess Championship, and the National Chess Championships. Invitation-only

tournaments regularly attract the world's strongest players. Examples include Spain's Linares event, Monte Carlo's Melody Amber tournament, the Dortmund Sparkassen meeting, Sofia's Mtel Masters, and Wijkaan Zee's Corus tournament. Regular team chess events include the Chess Olympiad and the European Team Championship. The 38th Chess Olympiad was held 2008 in Dresden, Germany; Armenia won the gold in the unrestricted event for the second time in a row after Turin 2006, and Georgia took the top medal for the women. The World Chess Solving Championship and World Correspondence Chess Championships include both team and individual events. Besides these prestigious competitions, there are thousands of other chess tournaments, matches, and festivals held around the world every year catering to players of all levels. Chess is promoted as a "mind sport" by the Mind Sports Organisation

Titles and rankings
The best players can be awarded specific lifetime titles by the world chess organization FIDE:[83]

• • •

Grandmaster (shortened as GM; sometimes International Grandmaster or IGM is used) is awarded to world-class chess masters. Apart from World Champion, Grandmaster is the highest title a chess player can attain. Before FIDE will confer the title on a player, the player must have an Elo chess rating (see below) of at least 2500 at one time and three favorable results (called norms) in tournaments involving other Grandmasters, including some from countries other than the applicant's. There are other milestones a player can achieve to attain the title, such as winning the World Junior Championship. International Master (shortened as IM). The conditions are similar to GM, but less demanding. The minimum rating for the IM title is 2400. FIDE Master (shortened as FM). The usual way for a player to qualify for the FIDE Master title is by achieving a FIDE rating of 2300 or more. Candidate Master (shortened as CM). Similar to FM, but with a FIDE rating of at least 2200.

All the titles are open to men and women. Separate women-only titles, such as Woman Grandmaster (WGM), are available. Beginning with Nona Gaprindashvili in 1978, a number of women have earned the GM title, and most of the top ten women in 2006 hold the unrestricted GM title.[note 5] International titles are awarded to composers and solvers of chess problems and to correspondence chess players (by the International Correspondence Chess Federation). National chess organizations may also award titles, usually to the advanced players still under the level needed for international titles; an example is the Chess expert title used in the United States . In order to rank players, FIDE, ICCF, and national chess organizations use the Elo rating system developed by Arpad Elo. Elo is a statistical system based on the assumption that the chess performance of each player in their games is a random variable. Arpad Elo thought of a player's true skill as the average of that player's performance random variable, and showed how to

estimate the average from results of player's games. The US Chess Federation implemented Elo's suggestions in 1960, and the system quickly gained recognition as being both fairer and more accurate than older systems; it was adopted by FIDE in 1970.[note 6] The highest ever FIDE rating was 2851, which Garry Kasparov had on the July 1999 and January 2000 lists.[84] In the most recent list (July 2010), the highest rated player is Magnus Carlsen of Norway , with a rating of 2826.[note 5]

Mathematics and computers
See also: Computer chess, List of mathematicians who studied chess, Human-computer chess matches, Deep Blue versus Garry Kasparov, and Chess engine Mathematicians Euler, Legendre, de Moivre, and Vandermonde studied the knight's tour. The game structure and nature of chess is related to several branches of mathematics. Many combinatorical and topological problems connected to chess were known of for hundreds of years. In 1913, Ernst Zermelo used chess as a basis for his theory of game strategies, which is considered as one of the predecessors of game theory.[85] The number of legal positions in chess is estimated to be between 1043 and 1047 (a provable upper bound[86]), with a game-tree complexity of approximately 10123. The game-tree complexity of chess was first calculated by Claude Shannon as 10120, a number known as the Shannon number. [87] Typically an average position has thirty to forty possible moves, but there may be as few as zero (in the case of checkmate or stalemate) or as many as 218.[88] The most important mathematical challenge of chess is the development of algorithms that can play chess. The idea of creating a chess-playing machine dates to the 18th century; around 1769, the chess-playing automaton called The Turk became famous before being exposed as a hoax.[89] Serious trials based on automatons, such as El Ajedrecista, were too complex and limited to be useful. Since the advent of the digital computer in the 1950s, chess enthusiasts and computer engineers have built, with increasing degrees of seriousness and success, chess-playing machines and computer programs. The groundbreaking paper on computer chess, "Programming a Computer for Playing Chess," was published in 1950 by Shannon .[note 7] He wrote: The chess machine is an ideal one to start with, since: (1) the problem is sharply defined both in allowed operations (the moves) and in the ultimate goal (checkmate); (2) it is neither so simple as to be trivial nor too difficult for satisfactory solution; (3) chess is generally considered to require "thinking" for skillful play; a solution of this problem will force us either to admit the possibility of a mechanized thinking or to further restrict our concept of "thinking"; (4) the discrete structure of chess fits well into the digital nature of modern computers.[91] The Association for Computing Machinery (ACM) held the first major chess tournament for computers, the North American Computer Chess Championship, in September 1970. CHESS 3.0, a chess program from Northwestern University, won the championship. Nowadays, chess programs compete in the World Computer Chess Championship, held annually since 1974. At

first considered only a curiosity, the best chess playing programs, for example Rybka, have become extremely strong. In 1997, a computer won a chess match against a reigning World Champion for the first time: IBM'sDeep Blue beat Garry Kasparov 3½–2½ (it scored two wins, one loss, and three draws).[92][93] In 2009, a mobile phone won a category 6 tournament with a performance rating 2898: chess engine Hiarcs 13 running on the mobile phone HTC Touch HD won the Copa Mercosur tournament with nine wins and one draw.[94] With huge databases of past games and high analytical ability, computers can help players to learn chess and prepare for matches. Internet Chess Servers allow people to find and play opponents all over the world. The presence of computers and modern communication tools have raised concerns regarding cheating during games, most notably the "bathroom controversy" during the 2006 World Championship

There is an extensive scientific literature on chess psychology. [note 8][note 9][97][98][99][100]Alfred Binet and others showed that knowledge and verbal, rather than visuospatial, ability lies at the core of expertise.[101][102] In his doctoral thesis, Adriaan de Groot showed that chess masters can rapidly perceive the key features of a position. [103] According to de Groot, this perception, made possible by years of practice and study, is more important than the sheer ability to anticipate moves. De Groot showed that chess masters can memorize positions shown for a few seconds almost perfectly. The ability to memorize does not alone account for chess-playing skill, since masters and novices, when faced with random arrangements of chess pieces, had equivalent recall (about half a dozen positions in each case). Rather, it is the ability to recognize patterns, which are then memorized, which distinguished the skilled players from the novices. When the positions of the pieces were taken from an actual game, the masters had almost total positional recall.[104] More recent research has focused on chess as mental training; the respective roles of knowledge and look-ahead search; brain imaging studies of chess masters and novices; blindfold chess; the role of personality and intelligence in chess skill; gender differences; and computational models of chess expertise. The role of practice and talent in the development of chess and other domains of expertise has led to a lot of research recently. Ericsson and colleagues have argued that deliberate practice is sufficient for reaching high levels of expertise in chess.[105] Recent research indicates that factors other than practice are also important. For example, Gobet and colleagues have shown that stronger players start playing chess earlier, that they are more likely to be lefthanded, and that they are more likely to be born in late winter and early spring.[106] =====================================================================




What is a drug? Drug is any chemical substance that changes either the mind or the body. Many substances thought to be harmless can actually be harmful if misused. There are the over-thecounter (OTC) drugs, like aspirin, which does not need prescription in buying. And there are prescription drugs which cannot be legally purchased without a written prescription from a physician. These drugs are controlled substances because they are powerful and can be dangerous when improperly used. Drug Use against Abuse Modern drugs have been very useful and have done marvelous effects. These have essentially wiped out epidemic diseases like smallpox and polio, help in fighting different infectious diseases, and control sugar level of diabetic individuals. When used under medical supervision, these drugs serve a useful purpose. But when abused or used without medical supervision, they can cause serious problems. A healthy person need not depend on drugs. What are the reasons why people abuse drugs? • Peer pressure • Curiosity • Boredom • Relaxation • Cope with stress • Escape from reality • Fun and socialization • Lack of attention What are the types of drug users? • Experimental users. Individuals who start trying different drugs once or twice. It is the curiosity on the effect rather than the danger of the drugs. They think of taking a few and stop but most of these situations lead to using it more often. • Occasional users. These users think drugs make them more sociable and acceptable to their peers that most of the time leads to a regular habit. • Regular users. These users maintain a drugged feeling and would deny it although they become psychologically dependent on drugs. They become ineffective in carrying out their routine at home, school or work. • Dependent users. These individuals rely on drugs physically and psychologically. They go to great lengths to get drugs and without it, they become severely distressed, mentally and physically.


Commonly Abused Drugs Substances: Category and Name Tobacco Nicotine Found in cigarettes, Not cigars, bidis, and scheduled/smoked, smokeless tobacco (snuff, snorted, chewed spit tobacco, chew) Increased blood pressure, and heart rate/chronic lung disease; cardiovascular disease; stroke; cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, bladder, and acute myeloid leukemia; adverse pregnancy outcomes; addiction Examples ofCommercial and Street Names DEA Schedule*/ How Administered** Intoxication Effects/Potential Health Consequences

Alcohol Alcohol (ethyl alcohol) Found in liquor, beer, and Not In low doses, euphoria, wine scheduled/swallowed mild stimulation, relaxation, lowered inhibitions; in higher doses, drowsiness, slurred speech, nausea, emotional volatility, loss of coordination, visual distortions, impaired memory, sexual dysfunction, loss of consciousness/increased risk of injuries, violence, fetal damage (in pregnant women); depression; neurologic deficits; hypertension; liver and heart disease; addiction; fatal overdose Boom, gangster, hash, hash oil, hemp I/swallowed, smoked Euphoria; relaxation; slowed reaction time; Blunt, dope, ganja, grass, I/swallowed, smoked distorted sensory perception; impaired herb, joint, bud, Mary balance and Jane, pot, reefer, green,

Cannabinoids hashish marijuana

trees, smoke, sinsemilla, skunk, weed

Opioids Heroin Diacetylmorphine:smack, I/injected, smoked, horse, brown sugar, dope, snorted H, junk, skag, skunk, white horse, China white; cheese (with OTC cold medicine and antihistamine) Laudanum, paregoric: big O, black stuff, block, gum, hop

coordination; increased heart rate and appetite; impaired learning, memory; anxiety; panic attacks; psychosis/cough, Euphoria; drowsiness; impaired coordination; dizziness; confusion; nausea; sedation; feeling of heaviness in the body; slowed or arrested breathing/constipation; II, III, V/swallowed, endocarditis; hepatitis; HIV; addiction; fatal smoked overdose Increased heart rate, blood pressure, body temperature, metabolism; feelings of exhilaration; increased energy, mental alertness; tremors;reduced appetite; irritability; anxiety; panic; paranoia; violent behavior; psychosis/weight loss, insomnia; cardiac or cardiovascular complications; stroke; seizures; addiction Also, for cocaine—nasal damage from snorting Also, for methamphetamine— severe dental problems


Stimulants Cocaine Cocaine II/snorted, smoked, hydrochloride:blow, injected bump, C, candy, Charlie, coke, crack, flake, rock, snow, toot Biphetamine, II/swallowed, Dexedrine:bennies, black snorted, smoked, beauties, crosses, hearts, injected LA turnaround, speed, truck drivers, uppers


Methamphetamine Desoxyn: meth, ice, II/ swallowed, crank, chalk, crystal, fire, snorted, smoked, glass, go fast, speed injected

Club Drugs

MDMA Ecstasy, Adam, clarity, I/swallowed, snorted, MDMA—mild (methylenedioxy- Eve, lover's speed, peace, injected hallucinogenic effects; methamphetamine) uppers increased tactile sensitivity; empathic Flunitrazepam*** Rohypnol: forget-me pill, IV/swallowed, feelings; lowered Mexican Valium, R2, snorted inhibition; anxiety; roach, Roche, roofies, chills; sweating; teeth roofinol, rope, rophies clenching; muscle GHB*** GammaI/swallowed cramping/sleep hydroxybutyrate:G, disturbances; depression; Georgia home boy, impaired memory; grievous bodily harm, hyperthermia; addiction liquid ecstasy, soap, scoop, goop, liquid X Flunitrazepam— sedation;muscle relaxation; confusion; memory loss; dizziness; impaired coordination/addiction GHB—drowsiness; nausea;headache; disorientation; loss of coordination; memory loss/unconsciousness; seizures; coma Dissociative Drugs Ketamine PCP and analogs Ketalar SV: cat Valium, K, Special K, vitamin K III/injected, snorted, Feelings of being smoked separate from one’s body and environment; Phencyclidine:angel dust, I, II/swallowed, impaired motor boat, hog, love boat, smoked, injected function/anxiety; peace pill tremors; numbness; Salvia, Shepherdess’s I/chewed, memory loss; nausea Herb, Maria Pastora, swallowed, smoked magic mint, Sally-D Also, for ketamine— analgesia; impaired memory; delirium; respiratory depression and arrest; death Also, for PCP and analogs—analgesia; psychosis; aggression; violence; slurred speech;

Salvia divinorum

Dextromethorphan Found in some cough and Not (DXM) cold medications: scheduled/swallowed Robotripping, Robo, Triple C

loss of coordination; hallucinations Hallucinogens LSD Lysergic acid diethylamide: acid, blotter, cubes, microdot yellow sunshine, blue heaven Buttons, cactus, mesc, peyote I/swallowed, absorbed through mouth tissues Also, for DXM—

Mescaline Psilocybin

I/swallowed, smoked

Magic mushrooms, I/swallowed purple passion, shrooms, little smoke Anadrol, Oxandrin, Durabolin, DepoTestosterone, Equipoise: roids, juice, gym candy, pumpers Solvents (paint thinners, gasoline, glues); gases (butane, propane, aerosol propellants, nitrous oxide); nitrites (isoamyl, isobutyl, cyclohexyl):laughing gas, poppers, snappers, whippets III/injected, swallowed, applied to skin

Other Compounds Anabolic steroids


Not scheduled/inhaled through nose or mouth

References: MAPEH in Action IV pp. 402-403 ==================================================================== =

The term narcotic (pronounced /nɑrˈkɒtɨk/) originally referred medically to any psychoactive compound with sleep-inducing properties. In the United States of America it has since become associated with opioids, commonly morphine and heroin. The term is, today, imprecisely defined and typically has negative connotations.[1] When used in a legal context in the US, a narcotic drug is simply one that is totally prohibited, or one that is used in violation of strict governmental regulation, such as PCP or marijuana. From a pharmacological standpoint it is not a useful term. History The term "narcotic" is believed to have been coined by the Greek physician Galen to refer to agents that numb or deaden, causing loss of feeling or paralysis. It is based on the Greek word ναρκωσις (narcosis), the term used by Hippocrates for the process of numbing or the numbed state. Galen listed mandrake root, altercus (eclata).[3]seeds, and poppy juice (opium) as the chief examples.[4][5] “Narcotic” is a term derived from the Greek word narke, meaning "stupor". It originally referred to any substance that relieved pain, dulled the senses, or induced sleep.[6] Now, the term is used in a number of ways. Some people define narcotics as substances that bind at opioid receptors (cellular membrane proteins activated by substances like heroin or morphine) while others refer to any illicit substance as a narcotic. From a legal perspective, narcotic refers to opium, opium derivatives, and their semi-synthetic substitutes.[7] Though in U.S. law, due to its numbing properties, cocaine is also considered a narcotic. Narcotic Abuse Overview Pain is one of the most common reasons people seek medical treatment. Doctors can prescribe several different drugs to relieve pain. The most potent pain-relieving drugs are narcotics. In the United States, narcotics are widely prescribed to treat painful conditions. Narcotics are often prescribed in conjunction with other less potent drugs (such as nonsteroidalantiinflammatory medications) or as a pill that has a combination of a narcotic with either acetaminophen (for example, Tylenol) or aspirin (Arthritis Pain, Aspergum Cherry, AspergumOrginal, Aspir-Low, Aspirin Lite Coat, Aspirin Low Strength, Bayer Aspirin, Bayer Aspirin Regimen, Bayer Childrens Aspirin, Bufferin, Bufferin Arthritis Strength, Easprin, Ecotrin, Empirin, Fasprin, Genacote, Halfprin, Norwich Aspirin, St. Joseph Aspirin, St. Joseph Aspirin Adult Chewable, Stanback Analgesic, Tri-Buffered Aspirin, Zorprin). Acetaminophen is also commonly found in many different products that are available as over-the-counter (OTC)

medications. With the public often using OTC products that contain acetaminophen as well as prescription narcotics that might also have acetaminophen, the U.S. Food and Drug Administration (FDA) has become concerned about dangerous interactions from combining these medications. There is not just the potential for narcotic abuse but the concern that patients are accidentally ingesting too much acetaminophen from combining these products with the potential for severe liver damage or even death. The use of prescription pain relievers without a doctor's prescription only for the experience or the feeling it causes is often called "nonmedical" use. Narcotic use is considered abuse when people use narcotics to seek feelings of well-being apart from the narcotic's pain-relief applications. The U.S. Substance Abuse and Mental Health Services (SAMHSA) report that after marijuana, nonmedical use of painkillers is the second most common form of illicit drug use in the United States. According to SAMHSA, 21% of people age 12 and older (5.2 million individuals) reported using prescription pain relievers nonmedically in 2007. The U.S. Drug Enforcement Agency suggests that the number of people abusing any prescription drugs is even higher at 7 million individuals. SAMHSA's Drug Abuse Warning Network reported that approximately 324,000 emergency department visits in 2006 involved the nonmedical use of pain relievers (this includes both prescription and over-the-counter pain medications). According to the U.S. Department of Health and Human Services, there were an estimated 90,232 emergency department visits related to narcotic analgesic abuse in 2001.

Morphine (Avinza, Kadian, Morphine IR, MS Contin, MSIR, Oramorph SR, Roxanol) and codeine are natural derivatives of the opium poppy. Related medications that are semisynthetic include drugs such as heroin, oxycodone (Percocet, Percodan, OxyContin), and hydrocodone and acetaminophen (Vicodin). Synthetic medications in this class include drugs such as methadone (Diskets, Dolophine, Methadose), meperidine (Demerol), and fentanyl. All medications in this group are called opiates or narcotics. Some chemicals, called endorphins, occur naturally in the body and produce a morphinelike effect.

The most commonly abused illicit narcotic is heroin, but all prescription narcotics have the potential for abuse. In 2008, the Florida Medical Examiners Commission noted that prescription opioid painkillers (such as Vicodin, Percocet, and OxyContin) caused more deaths than illicit substances such as heroin.

Narcotics have many useful pain-relieving applications in medicine. They are used not only to relieve pain for people with chronic diseases such as cancer but also to relieve acute pain after operations. Doctors may also prescribe narcotics for painful acute conditions, such as corneal abrasions, kidney stones, and broken bones.


When people use narcotics exclusively to control pain, it is unlikely that they become addicted or dependent on them. A patient is given a dosage of opioids strong enough to reduce their awareness of pain but not normally potent enough to produce a euphoric state. Adequate pain control is the goal for the medical use of narcotics. Thus, patients or health-care professionals should not allow fear of addiction to interfere with using narcotics for effective pain relief. The difference between opioid abuse, dependence, and addiction There is somewhat of a continuum between opioid abuse, opioid dependence, and addiction. Individuals who use narcotics to the extent that they start to interfere with the person's ability to do routine activities or fulfill regular responsibilities at home, at school, or at work would be considered to be abusing opioids. Other signs that individuals are abusing opioids include maladaptive behaviors that impact adversely on relationships, worsening of interpersonal problems, or frequent involvement with legal problems related to opioid use. Individuals who have opioid dependence often will manifest some of the following symptoms.
• • • • • • •

Ingestion of larger and larger amounts of opioids or for longer periods of time than intended Desire or compulsion to take the drug with significant amount of time spent trying to obtain opioids Withdrawal symptoms if the drug is stopped or the amount taken is reduced The need for increased amounts of drug to achieve the original effects (tolerance) Social, recreational, occupational, or pleasurable activities are neglected Persistent use of narcotics even when evidence that is harmful to their body, mood, thinking, or actions Addiction is elevated narcotic abuse that becomes a craving, with compulsive need to use opioids and often self-destructive behavior

Narcotic Abuse Causes Narcotic drugs produce their effect by stimulating opioid receptors in the central nervous system and surrounding tissues. The abuse of narcotics occurs as a result of the euphoria and sedation that narcotics produce within the central nervous system. Abusers of intravenously injected heroin describe the effects as a "rush" or orgasmic feeling followed by elation, relaxation, and then sedation or sleep. Narcotics used for short-term medical conditions rarely require weaning since stopping the medication after a brief period rarely produces adverse effects. If circumstances allow, the dose for people using narcotics over an extended period of time for medical purposes is slowly lowered over a few weeks to prevent withdrawal symptoms. The goal is to wean individuals off narcotics so that they are pain-free or able to use a less potent nonnarcotic analgesic.


Narcotic Abuse Symptoms Narcotics users can develop tolerance, as well as psychological and physical dependence to opioids when they take them over an extended period of time.
• • • •

Tolerance refers to a decreased response to a drug, with increasing doses required to achieve comparable effects. Psychological dependence refers to compulsive drug use in which a person uses the drug for personal satisfaction, often in spite of knowing the health risks. Physical dependence occurs when a person stops using the narcotic but experiences a withdrawal syndrome (or set of symptoms). Signs and symptoms of narcotic abuse o analgesia (feeling no pain), o sedation, o euphoria, o respiratory depression (shallow breathing), o small pupils, bloodshot eyes, o nausea, vomiting, o itching skin, flushed skin, o constipation, o slurred speech, o confusion, poor judgment, and o needle marks on the skin. Signs and symptoms of narcotic withdrawal: The withdrawal syndrome from narcotics generally includes signs and symptoms opposite of the drug's intended medical effects. The severity of the withdrawal syndrome increases as the drug dose increases. The longer the duration of the physical dependence to the narcotic increases, the more severe the withdrawal syndrome. Symptoms of heroin withdrawal generally appear 12-14 hours after the last dose. Symptoms of methadone withdrawal appear 24-36 hours after the last dose. Heroin withdrawal peaks within 36-72 hours and may last seven to 14 days. Methadone withdrawal peaks at three to five days and may last three to four weeks. Although uncomfortable, acute narcotic withdrawal for adults is not considered lifethreatening unless the person has a medical condition that compromises their health (for example, if someone has severe heart disease). Some of the signs and symptoms of narcotic withdrawal are listed below:

o o o o o o o

Anxiety Irritability Craving for the drug Increased respiratory (rapid breathing) Yawning Runny nose Salivation


o o o o o o o o

Gooseflesh Nasal stuffiness Muscle aches Nausea or vomiting Abdominal cramping Diarrhea Sweating Confusion


o o o

Enlarged pupils Tremors Lack of appetite


Complications of narcotic abuse: Many complications can result from narcotic abuse, the most common being infectious conditions. o Infections of the skin and deeper layers o Abscesses in skin, lungs, and brain o Infection of the heart valves o Pneumonia o Fluid in the lungs o Liver dysfunction o Intestinal slowdown o Seizures o Coma and other neurological complications o Infectious arthritis o Loss of menstrual cycle o Overdose and death o Premature and growth-retarded infants o Neonatal withdrawal: Up to 70% of babies delivered from pregnant women who use narcotics experience neonatal withdrawal, a potentially fatal condition.

When to Seek Medical Care People who use narcotics or other drugs of abuse and are interested in quitting should contact their doctor or local hospital for information on how to get involved with a detoxification and addiction recovery program.
• • •

Any person suspected of narcotic overdose requires immediate medical attention and must be taken to a hospital's emergency department. The main physical signs of narcotic overdose are small pupils and respiratory depression (shallow breathing) that can lead to decreased oxygen in the blood, coma, and death. Street methods of overdose resuscitation, such as packing the person in ice or injecting milk or saliva, do not work.

Exams and Tests The initial diagnosis of narcotic overdose in the emergency department is made based on obtaining a history and considering the signs and symptoms that the patient is experiencing. Almost all unconscious people receive a drug called naloxone (Narcan), which is known as a narcotic antagonist because it blocks and reverses the effects of narcotics. After the initial resuscitation, opioids are easy to detect in a routine urine test. Information from friends and family or indicators such as pill bottles or drug paraphernalia may provide important clues to the emergency doctors about the person's drug use and abuse. Information from friends and family or indicators such as pill bottles or drug paraphernalia may provide important clues to the emergency doctors about the person's drug use and abuse.

Narcotic Abuse Treatment

Overdose: An unconscious person suspected of overdosing on narcotics is given naloxone, a narcotic antagonist. When given intravenously, it is effective in one to two minutes in reversing the coma and respiratory depression caused by a narcotic. o Withdrawal: Treating people who are addicted to narcotics is difficult. The most common long-term treatment of the narcotic withdrawal syndrome is substituting methadone for the illicit drug, followed by a slow process of then weaning the abuser off the methadone. Buprenorphine (Buprenex) is another medicine that can be used in the process of detoxification, with the concept being to replace one opioid (for example, heroin) with another and then taper the second opioid slowly. o The drug clonidine (Catapres) has been shown to relieve some of the symptoms of withdrawal, especially salivation, runny nose, sweating, abdominal cramping, and muscle aches. Clonidine, when used in combination with naltrexone (ReVia), a long-acting narcotic antagonist, produces a more rapid detoxification. o Buprenorphine is also used in the treatment of withdrawal symptoms

Next Steps

Outlook The first steps in remaining drug free are overcoming withdrawal symptoms and the physical dependence of narcotics. In addition, many treatment programs are available in the community to help addicts deal with usually intense, longer-term psychological dependence that goes along with being addicted to narcotics. (PICTURES) Narcotics The term "narcotic," derived from the Greek word for stupor, originally referred to a variety of substances that dulled the senses and relieved pain. Today, the term is used in a number of ways. Some individuals define narcotics as those substances that bind at opiate receptors (cellular membrane proteins activated by substances like heroin or morphine) while others refer to any illicit substance as a narcotic. In a legal context, narcotic refers to opium, opium derivitives, and their semi-synthetic substitutes. Cocaine and coca leaves, which are also classified as "narcotics" in the Controlled Substances Act (CSA), neither bind opiate receptors nor produce morphine-like effects, and are discussed in the section on stimulants. For the purposes of this discussion, the term narcotic refers to drugs that produce morphine-like effects. Narcotics are used therapeutically to treat pain, suppress cough, alleviate diarrhea, and induce anesthesia. Narcotics are administered in a variety of ways. Some are taken orally, transdermally

(skin patches), or injected. They are also available in suppositories. As drugs of abuse, they are often smoked, sniffed, or injected. Drug effects depend heavily on the dose, route of administration, and previous exposure to the drug. Aside from their medical use, narcotics produce a general sense of well-being by reducing tension, anxiety, and aggression. These effects are helpful in a therapeutic setting but con tribute to their abuse. Narcotic use is associated with a variety of unwanted effects including drowsiness, inability to concentrate, apathy, lessened physical activity, constriction of the pupils, dilation of the subcutaneous blood vessels causing flushing of the face and neck, constipation, nausea and vomiting, and most significantly, respiratory depression. As the dose is increased, the subjective, analgesic (pain relief), and toxic effect become more pronounced. Except in cases of acute intoxication, there is no loss of motor coordination or slurred speech as occurs with many depressants. Among the hazards of illicit drug use is the ever-increasing risk of infection, disease, and overdose. While pharmaceutical products have a known concentration and purity, clandestinely produced street drugs have unknown compositions. Medical complications common among narcotic abusers arise primarily from adulterants found in street drugs and in the non-sterile practices of injecting. Skin, lung, and brain abscesses, endocarditis (inflammation (the fining of the heart), hepatitis, and AIDS are commonly found among narcotic abusers. Since there is no simple way to determine the purity of a drug that is sold on the street, the effects of illicit narcotic use are unpredictable and can be fatal. Physical signs of narcotic overdose include constricted (pinpoint) pupils, cold clammy skin, confusion, convulsions, severe drowsiness, and respiratory depression (slow or troubled breathing). With repeated use of narcotics, tolerance and dependence develop. The development of tolerance is characterized by a shortened duration and a decreased intensity of analgesia, euphoria, and sedation, which creates the need to consume progressively larger doses to attain the desired effect. Tolerance does not develop uniformly for all actions of these drugs, giving rise to a number of toxic effects. Although tolerant users can consume doses far in excess of the dose they took, physical dependence refers to an alteration of normal body functions that necessitates the continued presence of a drug in order to prevent a withdrawal or abstinence syndrome. The intensity and character of the physical symptoms experienced during withdrawal are directly related to the particular drug of abuse, the total daily dose, the interval between doses, the duration of use, and the health and personality of the user. In general, shorter acting narcotics tend to produce shorter; more intense withdrawal symptoms, while longer acting narcotics produce a withdrawal syndrome that is protracted but tends to be less severe. Although unpleasant, withdrawal from narcotics is rarely life threatening. The withdrawal symptoms associated with heroin/morphine addiction are usually experienced shortly before the time of the next scheduled dose. Early symptoms include watery eyes, runny nose, yawning, and sweating. Restlessness, irritability, loss of appetite, nausea, tremors, and drug craving appear as the syndrome progresses. Severe depression and vomiting are common. The heart rate and blood pressure are elevated. Chills alternating with flushing and excessive sweating are also characteristic symptoms. Pains in the bones and muscles of the back and extremities occur, as do muscle spasms. At any point during this process, a suitable narcotic can

be administered that will dramatically reverse the withdrawal symptoms. Without intervention, the syndrome will run its course, and most of the overt physical symptoms will disappear within 7 to 10 days. The psychological dependence associated with narcotic addiction is complex and protracted. Long after the physical need for the drug has passed, the addict may continue to think and talk about the use of drugs and feel strange or overwhelmed coping with daily activities without being under the influence of drugs. There is a high probability that relapse will occur after narcotic withdrawal when neither the physical environment nor the behavioral motivators that contributed to the abuse have been altered. There are two major patterns of narcotic abuse or dependence seen in the United States. One involves individuals whose drug use was initiated within the context of medical treatment who escalate their dose by obtaining the drug through fraudulent prescriptions and "doctor shopping" or branching out to illicit drugs. The other; more common, pattern of abuse is initiated outside the therapeutic setting with experimental or recreational use of narcotics. The majority of individuals in this category may abuse narcotics sporadically for months or even years. Although they may not become addicts, the social, medical, and legal consequences of their behavior is very serious. Some experimental users will escalate their narcotic use and will eventually become dependent, both physically and psychologically. The younger an individual is when drug use is initiated, the more likely the drug use will progress to dependence and addiction. Narcotics of Natural Origin The poppy Papaversomniferum is the source for non-synthetic narcotics. It was grown in the Mediterranean region as early as 5000 B.C., and has since been cultivated in a number of countries throughout the world. The milky fluid that seeps from incisions in the unripe seedpod of this poppy has, since ancient times, been scraped by hand and air-dried to produce what is known as opium. A more modern method of harvesting is by the industrial poppy straw process of extracting alkaloids from the mature dried plant. The extract may be in liquid, solid, or powder form, although most poppy straw concentrate available commercially is a fine brownish powder. More than 500 tons of opium or its equivalent in poppy straw concentrate are legally imported into the United States annually for legitimate medical use. Synthetic Narcotics In contrast to the pharmaceutical products derived from opium, synthetic narcotics are produced entirely within the laboratory. The continuing search for products that retain the analgesic properties of morphine without the consequent dangers of tolerance and dependence has yet to yield a product that is not susceptible to abuse. A number of clandestinely produced drugs, as well as drugs that have accepted medical uses, fall within this category.


Drug Dependence
Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects. A person may have a physical dependence on a substance without having an addiction. For example, certain blood pressure medications do not cause addiction but they can cause physical dependence. Other drugs, such as cocaine, cause addiction without leading to physical dependence. Tolerance to a drug (needing a higher dose to attain the same effect) is usually part of addiction. Causes Drug abuse can lead to drug dependence or addiction. People who use drugs for pain relief may become dependent, although this is rare in those who don't have a history of addiction. The exact cause of drug abuse and dependence is not known. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors. Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, post-traumatic stress disorder, or another mental health problem. Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.

People who are more likely to abuse or become dependent on drugs include those who:
• • • • •

Have depression, bipolar disorder, anxiety disorders, and schizophrenia Have easy access to drugs Have low self-esteem, or problems with relationships Live a stressful lifestyle, economic or emotional Live in a culture where there is a high social acceptance of drug use

Commonly abused substances include:

Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone (Dilaudid), and oxycodone (Oxycontin).

Central nervous system (CNS) stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance). Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety-reducing effect, which can lead to dependence. Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence. Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish.

There are several stages of drug use that may lead to dependence. Young people seem to move more quickly through the stages than do adults.
• •

Experimental use -- typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures. Regular use -- the user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to "handle" the drug. Daily preoccupation -- the user loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase. Dependence -- cannot face daily life without drugs; denies problem; physical condition gets worse; loss of "control" over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends.

Symptoms Some of the symptoms and behaviors of drug dependence include:
• • • • • • • • • •

Confusion Continuing to use drugs even when health, work, or family are being harmed Episodes of violence Hostility when confronted about drug dependence Lack of control over drug abuse - being unable to stop or reduce alcohol intake Making excuses to use drugs Missing work or school, or a decrease in performance Need for daily or regular drug use to function Neglecting to eat Not caring for physical appearance

• • •

No longer taking part in activities because of drug abuse Secretive behavior to hide drug use Using drugs even when alone

See: Drug abuse for more information about symptoms that may be present when using these drugs. For information about symptoms of withdrawal, see also:
• •

Cocaine withdrawal Opiate withdrawal

Exams and Tests Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends upon the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests. However, urine drug screens are done more often. Opiates and narcotics are usually in the urine 12 to 36 hours after the last use, depending on the amount used and how often the drug was used. CNS stimulants such as cocaine can be found in urine for 1 to 12 days, again depending on how often the drug was used. CNS depressants such as Valium and Xanax are found up to 7 days after the last day of use, mostly depending on the substance used and how quickly the body removes it (its half-life). Most hallucinogens also can be found in the urine up to 7 days after the last use. However, evidence of marijuana can be found for up to 28 days after its last use in regular users. Treatment Treatment for drug abuse or dependence begins with recognizing the problem. Though "denial" used to be considered a symptom of addiction, recent research has shown that people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or "confronted." Treatment of drug dependency involves stopping drug use either gradually or abruptly (detoxification), support, and staying drug free (abstinence).

People with acute intoxication or drug overdose may need emergency treatment. Sometimes, the person loses consciousness and might need to be on a breathing machine (mechanical respirator) temporarily. The treatment depends on the drug being used.

Detoxification is the withdrawal of an abused substance in a controlled environment. Sometimes a drug with a similar action is taken instead, to reduce the side effects and risks of withdrawal. Detoxification can be done on an inpatient or outpatient basis.

As with any other area of medicine, the least intensive treatment should be the starting point. Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use behavior modification techniques, which are designed to get users to recognize their behaviors. Treatment programs include counseling, both for the person (and perhaps family), and in group settings. Drug abuse treatment programs have a long after-care part (when the user is released from the medical facility), and provide peer support. Drug addiction is a serious and complicated health condition that requires both physical and psycholocial treatment and support. It is important to be evaluated by a trained professional to determine the best care. If the person also has depression or another mood disorder, it should be treated. Very often, people start abusing drugs in their effort to self-treat mental illness. For narcotic dependence, some people are treated with methadone or similar drugs to prevent withdrawal and abuse. The goal is to enable the person to live as normal a life as possible.

Drug dependence is substance addiction which is the physical and/or psychological need for a drug. When using drugs becomes the focus of a person's life and interferes with his or her ability to cope without the drug, dependence is likely. A dependency on drugs tends to involve the user associating with other drug abusers as well as behavioral and health changes. When an addict tries to stop using the substance, withdrawal symptoms result, so treatment is usually done gradually with medical supervision.

Drug Dependency
How to Know When Your Teen Is in Trouble By Gary Direnfeld, MSW, RSW

Is your teen drug dependent? Would you even know? Teens and drugs is certainly not a new issue. In fact, many parents will admit to drug use in their teenage years. As such, some parents are less able to recognize drug dependency in their teens, confusing it for perhaps their own "experimental" drug use. While it is certainly common for teens to "experiment" or to simply desire to find out what being "high" feels like, there are some teens who are at risk for developing drug dependencies – a reliance on drugs to maintain a sense of well-being. Drug dependency can lead to poor school performance, conflict with family, friends and within the community, and conflict with the law. Teens who are drug dependent are at risk for less achievement socially and economically as adults. Generally, teens at risk for drug dependency share several factors. They may have low selfesteem, poor relationships with parents or siblings and poor school performance. There may also be family difficulties, such as the death of a close or extended family member or the separation or divorce of parents. While prolonged "experimentation" alone can lead to drug dependency, if drug use coincides with these factors, there can be an increased risk for developing a drug dependency. Facing turmoil in one's personal life at a time when trying illicit drugs can minimize the emotional pain of the situation and thus increase the desirability of the drug. Ongoing drug use lends the user to then associate with other similar drug users where drug use is normalized, accepted and encouraged by the group. Consider these warning signs:
• • • • • • • • •

Stressors as noted above. Change in peer group. Decrease in school performance. Staying out late at night. Breaking house rules. Secretive behavior. Fatigue, lethargy and apathy (lack of motivation). May admit to some drug use, but rationalizes and "enjoys" it. Adamantly denies drug use in a manner disproportionate to the question.

Normal healthy teens may show a few of these signs anyway, but a drug-dependent youth will show several signs. If you suspect your teen may be drug dependent, you should take action including:
• • • • • •

Talk to your teen about your concerns (if non-responsive, you talk; they listen). Although controversial, consider searching their room for drugs and drug paraphernalia (destroy if found). Set curfews, limits on behavior and reasonable expectations for appropriate performance. Look to engage your teen in activities that are fun and incompatible with drug use. Consider attending counseling with your teen. Consult your physician.

If your teen is drug dependent, by definition, they are out of control. It will be necessary for you to take control in the short turn at least to help them overcome their dependency. Never fall into the trap of denying their problem, because it is too difficult for you to admit! A drug-dependent teen can use clean and sober parents for support and direction. ====================================================================

What Are the Ways to Prevent Drug Addiction? The best solution to drug addiction is to prevent it in the first place. While established addicts can overcome their dependence and find a measure of peace, it often wreaks untold damage in the process. Friends and family members suffer as they watch their loved one disintegrate. The sooner one steps in to stop the addiction, the better. Recognize the Signs
1. Signs of drug abuse often appear long before any concrete evidence does. Symptoms vary

by drug, but often accompany a deterioration in appearance, a loss of interest in school or work, radical changes in social life, weight loss, odd sleeping habits and an overall downturn in emotional health. If you spot them in someone close to you, talk to them about it rather than ignoring it. Apply a similarly objective eye to your own habits if you use drugs. Denial and delusion play a huge part in addiction because the user refuses to confront the extent of his problem. Ask yourself whether your drug use is negatively affecting other parts of your life. Spot the Dangers 2. Respect the power of any drug you put in your body, and that includes prescription drugs. Keep in regular contact with your doctor and talk to her about any medication you might be taking. Follow the instructions for your prescription to the letter and do not deviate

from them in any way. If you drink, be aware of the frequency and amount you indulge, and limit it to reasonable amounts (no more than a glass or two a day). Communicate 3. Communication is the No. 1 means of preventing drug abuse, especially with young people. Talk to those around you who might use drugs and establish an atmosphere of trust that fosters communication. If you have children, discuss drug use with them and let them know they can come to you with any concern. Listen when they talk, and don't dismiss their concerns about things like peer pressure. A bond of openness established before the other person reaches the age of potential drug abuse not only reduces the risk of addiction but makes him more willing to come to you if a problem does develop. Top 5 Ways to Prevent Substance Abuse If only we could prevent drug abuse, we’d have less problems. People wouldn’t become addicted; we’d have less people living out on the streets, less problems with family life, less people losing their jobs, and less crime. While it is impossible to prevent everyone from using drugs, there are things we can do to keep ourselves from abusing drugs or alcohol. If we share this knowledge with those closest to us, we may be able to prevent them from doing drugs also. People begin abusing drugs for a variety of reasons. If we are aware of those reasons and work to fix these areas of our lives without drugs, we will be on our way to preventing drug abuse. Below are the top 5 ways to prevent drug abuse: 1. Effectively deal with peer pressure. The top reason teens start using drugs is because their friends talk them into it. No one likes to be left out, and teens (and sometimes adults too) find themselves doing things they normally wouldn’t do, just to fit in. In these cases we need to either find a better group of friends that won’t pressure us to do harmful things, or we need to find a good way to say no. Teens should prepare ahead of time a good excuse or plan to keep from giving in to a tempting situation. 2. Deal with life pressure. Another way people become drawn into addiction is through their failure to deal with the pressures of life. People today are overworked and overwhelmed and often we feel like we deserve a break or a reward for all we do. Drugs will only make a person’s life more stressful, but we often fail to see this in the moment. To prevent using drugs as a reward, we need to find other ways to handle stress and to unwind. A person can take up exercising, or reading a good book, or volunteering with the needy. Anything positive that is relaxing will help take the mind off using drugs to relieve stress. 3. Get help for mental illness. Mental illness and substance abuse often go hand in hand. Those with mental illness often turn to drugs as a way to ease their pain. Those suffering from some form of mental illness such as depression, anxiety, or post traumatic stress disorder should seek the help of a trained professional for treatment, before it leads to substance abuse.

4. Look at risk factors. If we are aware of the biological, physical, and environmental risk factors that we possess we will be more likely to overcome them. A history of substance abuse in the family, living in a social setting that glorifies drug abuse, and family life that models drug abuse can all be risk factors. 5. Keep a balanced life. People take up drugs when something in their life is not working, or when they are unhappy about where their life is going. It is important to look at the big picture of life, and have priorities in order. Drug Addiction: Top 4 Ways to Treat Drug Addicts Drug addiction is a rising menace which surfaced in the olden times. Ever since drug addiction started to rise, especially after the "hippie revolution", the deterioration of physical as well as mental health saw no boundaries. This led to drug addiction being considered as an international health crisis. While drug addictions can be grouped into various categories, the main abuses which drug addicts are habitual of administering include smoke related drugs, alcohols and banned substances which can either be chewed or directly injected into the bloodstream of the individual. Let us now discuss 4 ways to cure these patients through drug addiction help. Take Baby Steps While Curing A Patient Drug addiction treatment is a methodical procedure which needs to be followed step by step. Whenever you happen to try and aid a drug addict, you need to ensure that you do not do so with haste. This is so as drug addiction treatment calls for slow steps towards success and it is therefore a steady procedure. For example, if a person is a known drug addict and he is used to smoking fifteen cigarettes a day, you need to ensure that he reduces the number to three cigarettes by the end of the month. Once again, the process needs to be slow and restructured at the end of each week. In case you ask the patient to quit smoking drugs from the first day itself, his/her body would not be able to bear the strain and this in turn would lead to serious complications. Drug Addiction Rehab Is Not A Permanent Solution While most people are under the impression that drug addiction can be treated through the means of a drug addiction rehab, the truth is that a rehab center can only provide a temporary relief to your problems. There is no doubt that the patient would never be allowed to either smoke or drink while he/she is inside the rehab center, the moment he/she steps out, he/she would be back to his/her normal habits. Drug addiction help through the means of a rehab center is not permanent. It is like a jail which keeps a convict under control for a specified time period. After the period is over, the convict is back doing what he does best-committing crimes. Friends And Family Play An Important Role Drug addiction help can be provided through the means of friends and family members. In case

you happen to have a drug addiction case in your family, it is your responsibility to get the patient back on track. Addiction to drugs is a bad habit which needs to be dropped through an able councilor. While there are various councilors available in the market, most of them are very expensive and obviously, they do not have a lot of time to spare on a single case. This is when the role of a family comes into picture. If you wish to cure a patient of his addiction to drugs, you need to be able to make sure that you convince the patient's friends and family to take an active interest in the process. A Natural Therapy Is Always The Best Cure Drug abuse addictions are a very serious problem and if you wish to permanently cure a patient, you need to pay adequate attention towards the choice of the de-addiction therapy. While there are many traditional therapies which do not work well as they are temporary in nature, there are others which are considered permanent. They are natural therapies which work on the mindset of the patient. Once the patient's mindset is changed, he/she can take control of his life without any external assistance. If you wish to end drug abuse addictions permanently, you need to adopt a natural therapy.

In the past, society viewed drug addiction as a moral flaw. Popular "treatments" involved imprisonment, sentencing to asylums, and church-guided prayer. Not surprisingly, these methods were generally ineffective. Today we understand that addiction is a brain disease characterized by fundamental and longlasting changes in the brain. Modern treatments are based on scientific research. Treatment is tailored to the individual, and typically involves a combination of drug and behavioral therapy. Today's methods are very effective, with 40-70% of patients remaining drug-free. Victorian-era treatments for alcoholism were often both ineffective and inhumane. Detoxification For some addictive drugs, suddenly stopping use can cause painful withdrawal symptoms. In the past, the resulting suffering was considered a necessary part of rehabilitation. It was the punishment for having the moral flaw of being an addict. Today we understand that while detoxification is the necessary first step to recovery from drug addiction, there is no reason for the patient to suffer. In fact, allowing painful withdrawal decreases an addict's chances of recovery. To avoid withdrawal symptoms, today's doctors often give patients medication that makes them feel similar to being on the addictive drug and gradually reduce their dose over time. This stabilizes the person's brain long enough to get through the detoxification process. Examples of this type of treatment include methadone and

LAAM for opiate withdrawal; nicotine replacement therapies (patch, gum) and bupropion for nicotine withdrawal; and benzodiazepine and anti-seizure drugs for barbiturate withdrawal. "The idea that if we can detox [an addict], they're cured, is nonsense." Dr. Glen Hanson

Counseling, support groups and other forms of therapy are crucial to preventing relapse. In order to stay off drugs, addicts must learn new ways of thinking and behaving. Cognitive and behavior therapy can include such things as learning to: . talk openly about personal experiences . manage problems without turning to drugs . identify and correct problematic behavior . identify and correct harmful patterns of thinking . recognize drug cravings . identify and manage high-risk situations . establish motivation to change . improve personal relationships . develop refusal skills . manage time more efficiently Bupropion, the drug in the anti-depressants "Zyban" and "Wellbutrin", can also help people quit smoking. This drug inhibits the uptake of dopamine and is taken just before quitting to "prime" the brain and reduce withdrawal.

The brain changes that characterize addiction can persist long after an addict stops using. As a result, addicts can easily relapse, and often do. Using drugs to treat cravings and prevent relapse buys crucial time for behavioral and cognitive therapies to begin working.

The classic example of a maintenance-based drug treatment is methadone. Taken once a day, methadone suppresses heroin withdrawal for about 24 hours. Itself a narcotic, users of methadone experience a "high" and withdrawal symptoms, but both are much milder than those resulting from heroin. As a result, it is possible to maintain an addict on methadone without severe health effects. But patients often require continuous treatment, sometimes over many years. Some politicians oppose the use of Methadone but research shows it saves lives.

Naltrexone alcohol and opiates Blocks opiate receptors, preventing dopamine release. Because the addict no longer receives pleasure from the drug, cravings diminish. Disulfiram alcohol 5-10 minutes after drinking alcohol, the patient experiences severe nausea, vomiting and headache for 30 minutes to several hours. Fortunately, most people don't need to 'test' this to experience the deterrent effect of the drug. Methadone and LAAM (Levo-alpha-acetylmethadol) opiates Work on the same receptor as heroin, but with much more gradual "ups" and "downs" and longer-lasting effects. These drugs reduce cravings and block the effects of opiates. Acamprosate alcohol Decreases the irritability characteristic of early recovery and decreases the pleasurable effects of alcohol. It most likely works by stabilizing the activity of the neurotransmitters GABA and glutamate in the brain. Buprenorphine/naloxone opiates A combination of two drugs that reduces craving and blocks the effects of opiates. Unlike methadone, it has mild withdrawal effects.

Treating addicts who end up in the criminal justice system adds another layer of complexity to the issue. How should law enforcement deal with administering drug addiction treatment? Innovative approaches such as drug court may prove to be the answer. Drug courts deal with offenders charged with less-serious crimes such as possession or being under the influence of drugs. In lieu of serving a jail sentence, offenders must plead guilty to the charge, agree to take part in treatment, get regular drug tests, and report to the judge for at least one year. If they fail to complete any of the requirements they may be incarcerated. But if they complete the requirements, the charges against them are dropped and they graduate from the program.

Developing improved treatments for addiction is becoming easier thanks to the discovery of addiction susceptibility genes. Each new addiction gene identified becomes a potential 'drug target'. The more we understand about the mechanism of addiction, the more effectively we will be able to treat it. Learning how to reverse or stabilize signals or pathways in the brain may help us to restore proper brain function in drug addicts. Researchers are working hard to find effective treatments for cocaine and amphetamine addiction. There are a few drugs in clinical trials, but none are approved for treatment.

Dr. Kelly Lundberg How drug courts work and why they have been so successful.

Old drug treatment methods were a shotgun approach. Doctors were willing to try anything to get their patients to kick the habit, even things that would seem pretty crazy today. For example, in the 1950s and 1960s drugs like LSD were used experimentally in an attempt to treat alcoholism and other addictions. The idea of using hallucinogenic drugs to treat drug addiction was abandoned as these drugs themselves became illegal. However, addiction treatment with hallucinogens is experiencing a renaissance with the increasing popularity of ibogaine therapy. Ibogaine is derived from a root used in an African religion to "visit the ancestors." Although illegal in the US, some 20 or 30 ibogaine clinics are in operation worldwide primarily to treat heroin addiction. Ibogaine is thought to rewire the addicted brain as the patient undergoes the intense multi-day treatment. Ibogaine is very controversial for many reasons including the occurrence of fatal heart arrhythmia in some patients. Effects of Drug Abuse On the Individual People who use drugs experience a wide array of physical effects other than those expected. The excitement of a cocaine effect, for instance, is followed by a "crash" : a period of anxiety, fatigue, depression, and an strong desire to use more cocaine to alleviate the feelings of the crash. Marijuana and alcohol interfere with motor control and are factors in many automobile accidents. Users of marijuana and hallucinogenic drugs may experience flashbacks, unwanted recurrences of the drug's effects weeks or months after use. Abrupt abstinence from certain drugs result in withdrawal symptoms. For example, heroin withdrawal symptoms cause vomiting, muscle cramps, convulsions, and delirium. With the continued use of a physically addictive drug, tolerance develops; i.e., constantly increasing amounts of the drug are needed to duplicate the initial effect. Sharing hypodermic needles used to inject some drugs dramatically increases the risk of contracting AIDS and some types of hepatitis . In addition, increased sexual activity among drug users, both in prostitution and from the disinhibiting effect of some drugs, also puts them at a higher risk of AIDS and other sexually transmitted diseases . Because the purity and dosage of illegal drugs such as heroin are uncontrolled, Drug Overdose is a constant risk. There are over 10,000 deaths directly attributable to drug use in the United States every year; the substances most frequently involved are cocaine, heroin, and morphine, often combined with alcohol or other drugs. Many drug users engage in criminal activity, such as burglary and prostitution, to raise the money to buy drugs, and some drugs, especially alcohol, are associated with violent behavior.

Effects on the Family The user's preoccupation with the substance, plus its effects on mood and performance, can lead to marital problems and poor work performance or dismissal. Drug use can disrupt family life and create destructive patterns of codependency, that is, the spouse or whole family, out of love or fear of consequences, inadvertently enables the user to continue using drugs by covering up, supplying money, or denying there is a problem. Pregnant drug users, because of the drugs themselves or poor self-care in general, bear a much higher rate of low birth-weight babies than the average. Many drugs (e.g., crack and heroin) cross the placental barrier, resulting in addicted babies who go through withdrawal soon after birth, and fetal alcohol syndrome can affect children of mothers who consume alcohol during pregnancy. Pregnant women who acquire the AIDS virus through intravenous drug use pass the virus to their infant. Effects on Society Drug Abuse affects society in many ways. In the workplace it is costly in terms of lost work time and inefficiency. Drug users are more likely than nonusers to have occupational accidents, endangering themselves and those around them. Over half of the highway deaths in the United States involve alcohol. Drug-related crime can disrupt neighborhoods due to violence among drug dealers, threats to residents, and the crimes of the addicts themselves. In some neighborhoods, younger children are recruited as lookouts and helpers because of the lighter sentences given to juvenile offenders, and guns have become commonplace among children and adolescents. The great majority of homeless people have either a drug or alcohol problem or a mental illness-many have all three. The federal government budgeted $17.9 billion on drug control in 1999 for interdiction, prosecution, international law enforcement, prisons, treatment, prevention, and related items. In 1998, drug-related health care costs in the United States came to more than $9.9 billion. Effects of Drug Addiction Here is an example of the effects of drug addiction. An individual tries drugs or alcohol. The drugs or alcohol appear to solve their problems and in turn they feel better. Now that they seem better able to deal with life, the drugs or alcohol they previously used become invaluable to them. The individual looks to drugs or alcohol as the cure for their unwanted feelings and problems. The painkilling effects of drugs or alcohol become the solution to their emotional or physical discomfort. Inadvertently the drug or alcohol now becomes invaluable because it helped them feel better. This release from the individual's unwanted feelings and problems is the main reason they uses drugs or alcohol a second or third time. It is then just a matter of time before they become fully addicted and lose their ability to control their drug or alcohol use. Drug addiction then results from excessive or continued abuse of physiologically or physically habitforming drugs in an attempt to resolve or escape from the underlying symptoms of discomfort or unhappiness. The effects of drug addiction are felt on many levels: personal, friends and family, and societal. Individuals who use drugs and alcohol experience a wide array of physical effects due to their

drug and alcohol addiction that they had never anticipated. One such example is the depression an individual feels following their use of cocaine. Additional effects of drug addiction include tolerance, withdrawal, sickness, overdoseage, and resorting to a life of crime. Family and friends feel the effects of drug addiction as well. The user's preoccupation with the substance, plus its effects on mood and performance, can lead to marital problems and poor work performance or dismissal. The effects of drug addiction can disrupt family life and create destructive patterns of codependency, that is, the spouse or whole family, out of love or fear of consequences, inadvertently enables the user to continue using drugs by covering up, supplying money, or denying there is a problem. The effects of drug addiction on society manifests itself through lost work time and inefficiency. Drug users are more likely than nonusers to have occupational accidents, endangering themselves and those around them. Over half of the highway deaths in the United States involve alcohol. Drug-related crime can disrupt neighborhoods due to violence among drug dealers, threats to residents, and the crimes of the addicts themselves. In some neighborhoods, younger children are recruited as lookouts and helpers because of the lighter sentences given to juvenile offenders, and guns have become commonplace among children and adolescents. Regardless of the drug used, there are many effects of drug addiction. Such as: Family/relationship problems. Drug use may lead to conflict with family or friends. Family and friends may be very frustrated and concerned when they are manipulated or pressured for money or possessions, or when the person using drugs fails or refuses to recognize their drug use is causing problems. Work/school problems. Drug users may take increased sick days and be unable to work properly. Accidents. Drug use may affect a person's ability to respond appropriately to a given situation, their ability to think clearly and to maintain attention, and may cause physical symptoms such as blurred vision, cramps, and nausea. Such effects can increase the risks of car accidents, drownings, and reduce the ability to be able to safely cross roads. Legal problems. Each state has laws governing the manufacture, possession, distribution and use of drugs. The four main types of offenses related to illegal drugs are: use, possession, cultivation and trafficking of drugs. Drug use may also lead to other legal concerns such as crimes committed in order to raise sufficient money to support ongoing drug use, and violent assaults. Financial problems. The cost of maintaining ongoing drug use may mean that there is not enough money left to pay for a range of goods and services. This may include regular bills, food and clothing, and other purchases that may increase a person's quality of life, such as entertainment and leisure.

Health problems. Tobacco, alcohol and illegal drugs can all have serious health effects if used over a long period of time. Lifestyle changes such as poor eating habits and inadequate sleep can increase the chances of experiencing a variety of health complications. People who inject drugs are at risk of contracting hepatitis B, hepatitis C and HIV (the virus that causes AIDS). Sexual problems. Certain types of drugs may lead a person to feel sexually aroused, but can actually reduce their ability to perform sexually. Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person's ability to choose not to do so becomes compromised, and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior. Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives. Too often, addiction goes untreated: According to SAMHSA's National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4 percent of the U.S. population) aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4 percent of those who needed treatment) received treatment at a specialty facility (i.e., hospital, drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.1 Principles of Effective Treatment Scientific research since the mid–1970s shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:
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Addiction is a complex but treatable disease that affects brain function and behavior. No single treatment is appropriate for everyone. Treatment needs to be readily available. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. Remaining in treatment for an adequate period of time is critical.

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Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. Many drug–addicted individuals also have other mental disorders. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse. Treatment does not need to be voluntary to be effective. Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

Effective Treatment Approaches Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual's life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining a drug–free lifestyle. Medications Medications can be used to help with different aspects of the treatment process. Withdrawal. Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself "treatment"—it is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated. Treatment. Medications can be used to help reestablish normal brain function and to prevent relapse and diminish cravings. Currently, we have medications for opioids (heroin, morphine), tobacco (nicotine), and alcohol addiction and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. Most people with severe addiction problems, however, are polydrug users (users of more than one drug) and will require treatment for all of the substances that they abuse.

Opioids: Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for the treatment of opiate addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and should only be used in patients who have already been detoxified. Because of compliance issues, naltrexone is not as widely used as the other medications. All medications help patients disengage from drug seeking and related criminal behavior and become more receptive to behavioral treatments. Tobacco: A variety of formulations of nicotine replacement therapies now exist— including the patch, spray, gum, and lozenges—that are available over the counter. In addition, two prescription medications have been FDA–approved for tobacco addiction: bupropion and varenicline. They have different mechanisms of action in the brain, but both help prevent relapse in people trying to quit. Each of the above medications is recommended for use in combination with behavioral treatments, including group and individual therapies, as well as telephone quitlines. Alcohol: Three medications have been FDA–approved for treating alcohol dependence: naltrexone, acamprosate, and disulfiram. A fourth, topiramate, is showing encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some but not all patients—this is likely related to genetic differences. Acamprosate is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (an unpleasant or uncomfortable emotional state, such as depression, anxiety, or irritability). It may be more effective in patients with severe dependence. Disulfiram interferes with the degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea, and palpitations if the patient drinks alcohol. Compliance can be a problem, but among patients who are highly motivated, disulfiram can be very effective.

Behavioral Treatments Behavioral treatments help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in treatment longer. Treatment for drug abuse and addiction can be delivered in many different settings using a variety of behavioral approaches. Outpatient behavioral treatment encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group drug counseling. Some programs also offer other forms of behavioral treatment such as—
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Cognitive–behavioral therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs. Multidimensional family therapy, which was developed for adolescents with drug abuse problems—as well as their families—addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.

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Motivational interviewing, which capitalizes on the readiness of individuals to change their behavior and enter treatment. Motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs.

Residential treatment programs can also be very effective, especially for those with more severe problems. For example, therapeutic communities (TCs) are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. TCs differ from other treatment approaches principally in their use of the community—treatment staff and those in recovery—as a key agent of change to influence patient attitudes, perceptions, and behaviors associated with drug use. Patients in TCs may include those with relatively long histories of drug addiction, involvement in serious criminal activities, and seriously impaired social functioning. TCs are now also being designed to accommodate the needs of women who are pregnant or have children. The focus of the TC is on the resocialization of the patient to a drug-free, crime–free lifestyle. Treatment Within the Criminal Justice System Treatment in a criminal justice setting can succeed in preventing an offender's return to criminal behavior, particularly when treatment continues as the person transitions back into the community. Studies show that treatment does not need to be voluntary to be effective.



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