Addiction Treatment-Chapter 2

Disease/Health

A general lack of concern about alcoholism and its problems was one of the most significant features of the colonial era. Strong drink was thought to protect against _______________ and be conductive to good _____________. (57)

Racist/Ethnocentrism

A lesson we can learn from the drug wars is that many of them have been inspired by ____________ sentiment and __________________ because they are directed at marginalized groups. They are not based on empirical evidence from scientists on best practices concerning harms caused by drug use. (67)

AA/AA

A major criticism of ____ and other twelve-step groups is their refusal to change with the times, even to modernize the wording of the steps and traditions. Many group members still oppose the use of mood-altering prescription medications that are geared toward the reduction of cravings. On the other hand, this weakness of______, its refusal to modernize, is also, in a real sense, a strength. The strength that comes from stability and structure. (73)

Heroin

After 2012, this drug was in the spotlight, the one causing deaths and other problems. This drug was associated mostly with the white middle class. The statistics on drug use reveal that nearly 90% of those who tried this drug for the first time in the last decade were white. (68)

The communist revolution

After This revolution, the temperance movement was replaced with a belief that the answer to the serious vodka consumption problem would be found in the socialist way of life.

Heroin

After restrictive law such as the Harrison act were passed, doctors became reluctant to prescribe drugs to addicts, and the string cost of ____________ rose astronomically. (60)

Needle exchange

Along with methadone and heroin maintenance, ____________ ____________ is the approach most closely associated with the principles of harm reduction. (81)

Appallingly high

Although the quantity of alcohol consumed did go down during prohibition, the rate of cirrhosis of the liver and the death rate from poisoned liquor was ______________ _________. (63)

Condemn

Although there is a lot of drinking mentioned in the Bible, both the old and new Testaments _______________ Drunkenness. (53)

Four

Another aspect of racism is even evident for a drug used equally by Whites and Blacks and that is considered relatively harmless- marijuana. According to a report by the American Civil Liberties Union, Blacks are nearly _________ times more likely than whites to be arrested for marijuana possession. (68)

Harm reduction/60%

At the same time that Nancy Reagan launched her just say no campaign in the United States, the British government opened a program in Liverpool in response to the AIDS epidemic and started using the term ____________ ________________. The Liverpool public health department and others in northern England began offering medical care, clean drugs, clean needles, and safe injection education to injection users. As the program got underway, the HIV infection rate declined greatly in Britain. Compared to injection drug users in New York City who had an HIV infection rate of _____%, for example, the infection rate in Liverpool was reduced to 0.1%. Today in Britain, specially licensed doctors can provide heroin or cocaine to persons whose addiction to those substances is verified. (81)

The Fertile Crescent/Wages/Ancient Greece

Beer, according to economist Tom Stanage, was first made from fermenting grain in this region? By 3000 BC, it was used to pay __________, and later became the main export of _______________ _____________. (53)

The Kennedy family/Joseph Kennedy

Before prohibition, this family had traded in alcoholic beverages and decided to stay with what they knew best. This member of the family did not sell liquor directly to consumers but the figures at the highest levels of organized crime such as Frank Costello and Lucky Luciano. He was also responsible for shipping huge quantities of Canadian whiskey and scotch into the United States. (63)

Disease model

Central to the disease model is the notion of irreversibility by which alcoholism Inevitably became a progressive disease that could be arrested but never cured. (75)

Beer

Christopher Columbus found indigenous people of the Caribbean drinking ___________ made from fermented maize. (54)

Taxation

Communism was incompatible with alcoholism, or so it was thought. Yet vodka played an important role in Russian cultural life and have been a significant source of government revenue through _____________ since the 16th century. (65)

Naloxone

Consistent with the American tendency to focus more on treatment after the fact and prevention, the life-saving drug, _______________, that can be administered through a no sprayer injection, is now available without a prescription at CVS drug stores in states where it is legal. This is another example of harm reduction.(82)

Quart (32 ounces)

Consumption of copious amounts of alcohol was the norm among early European Americans. Although severe restrictions were placed on drinking by slaves, laborers digging the Erie Canal were allotted a ___________ of whiskey a day. (58)

Minorities/poor whites/drug related assets

Crack cocaine and meth are relatively inexpensive compared to other illicit drugs, and associated with ______________ and _______ ____________. The war on drugs is thus become a war on minorities and the poor. This is only exacerbated by the fact that laws on the books allow law enforcement to seize __________ _____________ _________ at the time of arrest of a drug dealing suspect. (68)

Beer/liquor/marijuana

During prohibition, drinking pattern shifted from ________ to more potent ___________ because the latter was easier for bootleggers to transport. This drug also became increasingly popular. (63)

Doubled

During prohibition, homicide rates in large cities almost _____________. (63)

Anti-marijuana legislation

During the 1920s and 1930s, most US states with large Mexican populations enacted this type of legislation? Because this drug was common among Mexican migrant workers and other marginalized groups, racism seemingly was the key factor in the passage of the restrictive legislation (65)

17th century

Eventually, in this century, Islamic scholars prohibited The use of marijuana due to its psychoactive properties. (55)

Northern Iran

Excavations in 1996 provide evidence of early alcohol use in the form of a yellowish residue preserved in a pottery jar for winemaking by early settlers of this region? archaeologist date the pottery jar as having been produced over 7000 years ago. (53)

50%

Following the mid-1800s, alcohol consumption Dropped by this percentage, and from then on, a minority of the population was dependent on alcohol. (59)

Mushroom/Payote

For more than 2000 years, indigenous societies have utilized various naturally occurring plants such as the sacred _____________ of Mexico and the _____________ cactus. There is evidence that a mushroom call existed in the Mayan culture of Central America. (54)

Hebrews

From the Old Testament of the Bible, we learn of drinking practices of the _____________. Abundant wine made from grapes was regarded as a blessing that could gladden the heart of man. (53)

40,000

Gambling is an activity that has appealed to human being since ancient times. Archaeological evidence indicates that ancient cave dwellers have their own version of dice made of the bones of sheep's or dogs, and _____________ -year-old cave drawings to pick gambling activities. (69)

Greece/Rome

Historical accounts from ancient __________ and __________ and other early civilizations describe the systematic doling out of alcoholic beverages to soldiers, along with food, weapons, and other military rations. (53)

Gin

In 1575, a distillery was founded in Amsterdam, which is still in operation today. From a concoction of grains, herbs, and juniper berries, this alcoholic beverage was created. (56)

Opium/Opium/Opium/Alcohol

In 1909, the import of ________________ was banned. ______________ itself then became increasingly scarce at the consumer level, and heroin, a far more potent substance that was not smoked but injected, became the popular form of this drug. In banning such drugs as ___________ and later ____________, governments actually repressing users toward more dangerous methods or levels of consumption. (59)

The Hughes act

In 1970 this act was passed, Which provided for major research funding by the federal government and emphasized Improved Services for alcoholics. This act created the national Institute on alcohol abuse and alcoholism. The federal seed money Spawned the growth of alcoholism treatment centers across the United States, a growth that, was almost explosive in its intensity. (77)

Cannabis/Cannabis/Hashish

In Islamic nations, which prohibit use of alcohol, there has been much more general use of ______________. the term _________________ is of Persian origin, and ________________ is derived from an Arabic word for grass. (55)

Inebriate's

In his notion of alcohol, especially distilled alcohol, as highly addictive and the compulsion to drink as extremely powerful in some individuals, Benjamin Rush anticipated much of the modern, post-prohibition thinking about alcoholism and other addictions. Rush was also the first American medical practitioner to recommend medical treatment for chronic "_________________" (71)

Eradication efforts/Government subsidies

In recent years mass ________________ __________ coupled with ______________ _______________ to plant standard agricultural crops, have significantly reduced poppy cultivation in Afghanistan. However, after many years of decreasing cultivation, the opium price sharply increased in 2010, making opium more attractive to farmers. (69)

Heroine/crack cocaine/ecstasy/Methamphetamine

In the 1960s, the drug scare concerned ______________; in the 1980s it was __________ ___________; in the 1990s it was about designer drugs such as ________________ and later the focus was on ___________. (67)

Harm reduction

In the context of the Public health crisis, ______________ ______________ refers to strategies for drug users who are either unwilling or unable to stop using drugs. Such strategies are aimed at reducing a wide range of drug-related harms while not necessarily reducing drug use per se. This approach is decidedly optimistic and strength-based because it draws on positive possibility and hope. (81)

Alcohol

In the days before purification, alcohol was often safer than ____________, so Europeans consumed large quantities. (55)

Marijuana/The Marijuana Tax Act of 1937

In the early 20th century in the United States, when anti-immigrant sentiment grew, rumors began to spread the Mexicans were distributing this dangerous plant, and that violent Mexican men were going after white women as a result. The drug was also associated with jazz musicians in New Orleans. Between 1914 and 1931, 29 states outlawed this plant. This provided an excuse for states in the Southwest to search and deport Mexican migrants. The demonization of this plant was an extension of the demonization of the Mexican immigrants. This act of 1937 essentially criminalized the possession of this plant throughout the United States. (60)

Opiate/Morphine

In the late 19th century, a craze developed for patent medicines with a high ___________ content. ___________, which originally have been used for pain relief from battle wounds as far back as the Civil War, was now heralded as a treatment for chronic drinking problems. (59)

China/Chinese

In this region, chemical analysis of the residues found inside pottery jars provide proof that these people's were converting rice, grapes, and honey into alcoholic beverages as early as 7000 - 6600 BCE. (53)

The marijuana tax act

Influenced by media propaganda such as the 1936 motion picture reefer madness, Congress passed this act. A series of harsh anti-drug laws that carry several penalties were enacted in the 1950s. (66)

World War 1/1975

Intolerance for smoking cigarettes began to dissolve. The popularity of cigarettes was boosted tremendously with her free distribution to troops during this war as well as in following wars. The handing out of cigarettes discontinued in this year (59)

The disease concept of alcoholism

Jellinek's book, ____ ______________ ______________ ___ ________________, remains one of the most frequently cited and least read books in the alcoholism field. If more people did read the original, they might be surprised at what Jelinek actually said. He never said alcoholism was a disease; what he said was that alcoholism is like a disease. (75)

Opium/Opium

Like alcohol, the use of this drug goes far back in time as well, to about 5000 BCE. Extracted from the white juice of certain species of poppy, __________ is believed to have been used by the Sumerians, and ancient Middle Eastern people, to enhance their feelings of pleasure and by later civilizations for its medical properties. (54)

Poor/Mood altering substances

Like its predecessor, prohibition, America's war on drugs is directed toward the __________, especially those associated with urban social disorder. Also as with the criminalization of alcohol, criminalization of these drugs represents a desperate attempt to curb the unstoppable desire for __________ ____________ ________________. (67).

The Nile River

Long before vineyards flourished in Bordeaux, a sophisticated wine industry Arose across the banks of this river. In ancient Egypt, both beer and wine were deified and offered to the gods. (53)

Harmful/Marijuana/Marijuana

Many strategies in the war on drugs backfire. As the supply of drugs is reduced, the street market value of the drug increases. Often, drug users turn to a cheaper, more ______________ drug. Restrictions on the sale of _________________, for example, have led many young people to use various forms of synthetic ________________, such as K2 or spice. In fact, these alternatives may affect the brain much more powerfully than __________________. (69)

Greeks/Persians/Chinese/China

Marijuana use can be traced back to cultivation by the ancient _____________, ______________, and __________. as early as 3000 BCE, it was known in ________. (55)

Sale of pseudoephedrine

Matthew's after 2000 exceeded crack use and popularity, and became defined as the major law enforcement problem for the next decade or so. Harm reduction measures were imposed to secure restrictions on the ________ ____ ______________, the key ingredient in the manufacture of meth. (68)

The Mayflower

More beer then water was carried on this famous ship that had set sail to the Americas. But, upon arrival, the supply was dwindling, a fact that caused the captain to land as soon as possible in New England, rather than in Virginia's plan. (57)

Furs

Native Americans adopted the drug alcohol within the cultural context. Because they drank for the hallucinogenic effects they considered drinking small quantities to be pointless. Europeans were quick to take advantage of the Native American propensity to drink to the point of insensibility and played into their vulnerability to cheat them out of _________ and other goods. (57)

Gamma and Delta

Of all the types of alcoholism, according to Jellinek, only these two species can be considered addictions and/or diseases. The significance of Jellinek's writings is his conception of varieties of alcohol problems, as opposed to a conceptualization of alcoholism as one monolithic drinking disorder. (75)

Afghanistan

Relentless pressure by the US government has been exerted on this country to crackdown on farmers who are cultivating opium. About 90% of the worlds heroine comes from this war wracked nation, which has a rugged terrain that is ideally suited for the cultivation of opium poppy plants. (69)

Vomitorium/Vomiting

Self-indulgence in connection with food is demonstrated by the presence of the ___________________ in ancient Rome. The practices of feasting and drinking alcohol included ___________________ so that people could keep repeating these processes. This was the forerunner of the binge-purge cycle known today as bulimia. (54)

Chinese/Chinese

Smoking opium was associated with ______________ immigrant laborers; therefore in ways were feared and resented, as was their drug use. Labor unions resented that these exceptionally hard-working people were willing to work for low wages. Americans thus defamed not only the ________________, but opium as well. The invention of the hypodermic needle and the synthesis of heroin from morphine at the end of the 19th century further exacerbated the problem(59)

Personal cultivation/use/Mexican drug cartels/Gun control

Study show that the legalization of marijuana and several American states is helped reduce the market for the transportation of the drug. Recently the Mexican Supreme Court legalized marijuana for _______________ _____________ and ___________. Mexican political leaders have repeatedly urged the United States to decriminalize marijuana to reduce the ______________ _________ _____________ profits. They also urge a tightening of US __________ __________ laws to clamp down on the flow of weapons into Mexico. (68)

Europe

The 12 step influence is pronounced, although not dominant, in this region. Disease model programs designed along American lines generally are relegated to the private treatment sector and can be expensive. (74)

$240 billion

The 1970s, casinos were legal in just one state, Nevada. Today, legalized gambling has morphed into a $_______ Billion Industry established in all but two states as politicians assert that gambling is an effective way to raise revenue and create jobs. (70)

Temperance/Temperance/Suffrage

The ________________ woman represented the Victorian ideal purity; she thought alcohol is a root intrusion upon the family and a threat to the families very survival. By attacking demon rum as the root cause of family disintegration, ______________ advocates viewed alcohol-related domestic problems as social problems requiring legal solutions. Eventually, this volunteer army of church women led into another movement of renown, the woman's ________________ movement. (61)

Immigrant/Catholic

The anti-________________ and anti-_________________ nativism in the United States combined to give the temperance movement a new and fierce momentum. Saloons, which were frequented by the working-class immigrants, were feared as threats to the middle-class home and as forums for labor union organizers. The anti-saloon league grew out of these sentiments and became a strong lobbying group. (62)

Medical/disease

The assumption that alcoholism is a pathology that lies within the individual and that the pathology can be measured and treated are basic to the _______________ or _____________ model. (75)

Harm reduction

The concept of ____________ ___________ originated first in the 1920s in the United Kingdom as a medical approach that called for prescribing heroin and cocaine to patients who are dependent on these drugs. The goal was to reduce the harm associated with their obtainment and use. (80)

The Harrison Act

The culmination of the fear of addiction in the association of the use of narcotics with the lower classes and foreigners culminated in the passing of this act in 1914. This act severely restricted the amount of opioids or cocaine in any remedy sold without a prescription. Despite this act not being a punitive law, The criminalization process began in earnest with its passage. (60)

2003

The first medically supervised injecting facility in North America opened in Vancouver, Canada in this year to prevent fatal overdoses of heroin. Empirically-based research indicates that the rate of fatal overdoses at this facility has decreased by 35% as a result of the supervision that is provided to these high-risk drug users. (81)

Nicotine/Tobacco/Tobacco

The history of ______________ addiction goes back to when Columbus and his men discovered dried _________________ leaves in Central America. It was introduced to Europe in 1493. By the 1600s, ______________ was a permanent European commodity and used by all social classes. (55)

Distilled Alcohol/al-kuhul

The long road from the sacred to the profane was shortened by the Discovery of ______________ ___________ by Zakariya Razi, a noted Iranian physician and pharmacist. He used it as a medicine in the way that we use rubbing alcohol today. The word alcohol itself is derived from the Arabic world al-kuhul. (54)

five-year

The most disturbing aspects of the war on drugs is the undeniable racism seen in the discrepancy between the senses mandated for possession of the cheaper variety of cocaine crack, used predominantly by inner-city Blacks, and for the more expensive variety powder cocaine used by whites with money. Until recent years, trafficking in 500 g of powder cocaine draws the same ___________ ________ sentence as trafficking in 5 g of crack. Under this act, the ratio is now down to 18:1, however, the disparity still exists. (68)

25 states/4 states

The public attitude toward marijuana increasingly has grown sympathetic, however, and by 2016, this many states and the District of Columbia currently have laws legalizing marijuana and some form, mainly for medicinal use. This many states have legalized marijuana for recreational use, and other states are expected to follow suit in the future. (66)

The 18th amendment

The support of the corporate world, which had an interest in promoting sober worker habits and reducing spending on alcohol, was instrumental in the passage of this amendment to the Constitution, establishing national prohibition of alcohol in 1919 (to begin in 1920).

Lotteries/lotteries/Lotteries

The very beginning of the United States was financed by ___________________ during the Revolutionary war, and _______________________ remained a popular and legal fund raising activity in most states throughout the 18th and 19th centuries. The accessibility and legality of gambling venues have waxed and waned depending on prevailing social Moors. In the reformist era after the Civil War, and again during prohibition, __________________ were banned and gambling went underground. In 1910, gambling was actually made a felony in Nevada. However, by 1931, casino gambling was legal in Nevada. (70)

Tobacco/Lottery Tickets

The year 1890 marked a prohibition many find surprising: the prohibition of _____________ and _____________ _____________. All the while, opium, morphine, and heroin were being sold over-the-counter. (59)

The Spaniards/Spanish

These peoples introduced marijuana to the New World? The word marijuana comes from a _____________ word meaning a substance causing intoxication. (55)

The national minimum drinking age act

This act passed in 1984, restricted the drinking age in public places to the age of 21. (64)

The mental health parity and addiction equity act

This act, passed in 2008, requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care. The affordable care act of 2010 further expands this acts requirements by ensuring that qualified plans offered on the health insurance marketplace cover many behavioral health treatments and services(79)

Norway

This country officially has resisted incorporating treatment based on twelve-step principles and social welfare system. (74)

Benjamin Rush/The Puritans

This doctor, Surgeon General during the American Revolution, had observed firsthand the devastation wrought by rum rations on soldiers. In his pamphlet recording his observations, Rush pinpointed the dangers of potent alcohol. Through such writings and his personal influence, Rush provided a scientific voice to call for an end to the distillation and drinking of whiskey and other spirits.This call was echoed by concerned family members and members of the clergy, especially descendents of this religious group. (58)

Opium

This drug is organic, coming from the dried juice of the poppy. No chemist, no pharmaceutical industry, no physician is needed to produce it or to administer it. Illicit drugs are those that can't be marketed; the medical community has embraced synthetic painkillers and mood changes instead. These drugs have become the illicit or illegal drug remedies. (60)

Opium

This drug was used by physicians in classical Greece and Rome, and it was known to the Arab world as well. During the time of the Crusades, the crusaders were introduced to this product and brought it back to Europe. Later, in Europe, this drug was mixed with alcohol is a fashionable way to escape from pain and boredom. By 1858, 300,000 pounds of this drug were arriving on American shores. Most was for recreational use, but still, it was the most valued remedy for everyday maladies such as indigestion and respiratory problems. The British began illegally smuggling this drug into China in the early 19th century to exchange with Chinese traders for silk, tea, and porcelain.(55)

Anorexia/Anorexics

This eating disorder has its roots in holy fasting practices of 13th-century women whose self-denial provided them with praise and admiration. Some of the holy _______________ were canonized as Saints for their troubles. (54)

Bill W.

This man codified the central principles of AA into the 12 step program. He was selected by Time magazine as one of the hundred most influential people of the 20th century. (72)

Disease model

This model appealed to moderate drinkers and its implication that only some individuals are at risk of addiction. Finally, the American disease model was promoted by the alcohol beverage industry because it removed the blame from the alcohol in its sale and distribution. (75)

Richard Nixon

This president was the first American president to declare what he metaphorically called a war on drugs, a strategy devised to separate himself from the war on poverty. His metaphor grew into a reality as the Reagan, the elder Bush, and Clinton administrations poured billions of dollars into a massive military operation to fight the enemy (drug suppliers) at home and on foreign soil. (66)

The Puritans/Tavern

This religious group, arriving 10 years after the Mayflower, saw alcohol as a blessing from God and as a good and healthy beverage. Colonial Americans of all ages drank daily; pregnant women and children, along with men, consumed a lot of beer. The _______________ was the center of much family, social, and economic activity. (57)

Beta alcoholism

This species of alcoholism involves heavy drinking, causing physical complications such as gastritis and cirrhosis of the liver, yet without physical or psychological dependence on alcohol. (74)

Gamma alcoholism

This species of alcoholism is characterized by increased tissue tolerance, withdrawal symptoms when drinking is discontinued, and loss of control. A marked progression occurs, with interpersonal relations impaired to the highest degree. This variety predominates in Great Britain and Northern Europe. Most AA members have experienced this kind of alcoholism. (75).

Epsilon alcoholism

This species of alcoholism is periodic alcoholism. In their periodic bouts, binge drinkers suffer a great deal of physical and emotional damage. (75)

Delta alcoholism

This species of alcoholism is similar to gamma alcoholism but without the loss of control over the amount consumed, only an inability to abstain for even one day. There are no distressing social problems over the quantity consumed, though health problems may result. This is the predominant pattern in France.

Alpha alcoholism

This species of alcoholism represents an undisciplined use of alcoholic beverages. Drinking may relieve emotional disturbance, but relationship problems are caused thereby. There is psychological dependence but no progression. (74)

E.M. Jellineck

This statistician believed that cultural patterns that differentiate one country from another help account for the drinking patterns. Using letters of the Greek alphabet, this man singled out five species of alcoholism that he considered disease-related. (74)

Motivational theory

This theory deemphasizes the use of negative labels and views substance misusers as being as susceptible to change as the rest of the population. It is decidedly optimistic and strengths-based and draws on positive possibility and hope. The underlying belief is that through effective therapy techniques, the counselor can help people tap into their inner strengths and natural resources. (82)

Protestant/Benjamin Rush

Throughout much of early American history, as we have seen, religious institutions with a ________________ affiliation had viewed alcohol, gambling, and drug addiction as sinful or irresponsible behavior. Only after this Philadelphia physician, ____________ _________ authored his influential pamphlet "An inquiry into the effects of ardent spirits on the human mind and body" (1785) did a paradigm shift begin to emerge. (71)

2 million

Today, more than _____ million members of AA in 150 countries hold meetings in church basements, school gyms, and hospital conference rooms.. (72)

German Scientists

What peoples were responsible for developing a method of isolating cocaine from the coca Bush? (56)

Cocaine

When alcohol was prohibited throughout the country many turned to this drug as a substitute, and some even laced their drinks with it. (59)

Islam

While the Hebrews condoned drinking but not drunkenness, this 7th century religion simply condemned wine altogether, and an effective prohibition against all alcoholic beverages prevailed. (54)

Designated driver/moderate

With regard alcohol use, harm reduction similarly focuses on preventative measures, the best-known of which are _____________ __________ programs and the promotion of ___________________ drinking among youth as an alternative to secretive binge drinking. (82)

Germans/German

With the arrival of this group of people, breweries popped up in the Midwest, more than 2000 of them, especially in the towns where they settled such as Milwaukee, St. Louis, and Chicago. Unfortunately for the beer manufacturers, the antidrinking groups were able to take advantage of anti_________________ sentiment that sprang up in connection with World War I. (63)

Sick

With the end of prohibition in 1933, the population at large began to move toward the view that alcoholics were __________, not sinful. (71)

Alcoholics Anonymous (AA)

_______ grew out of evangelical Christian movements and provided a meeting place where people could share their struggles with sobriety. The creation of this self-help organization was instrumental in reducing some of the stigma associated with alcoholism and in offering a highly structured program for recovery. (72)

Rum/Slave Trade/Rum/Slaves

____________, Made from molasses that was imported in large quantities from Jamaica, figured prominently in the economy of the new nation. For the sake of this drink, New Englanders became the bankers of the ____________ _________ that supplied the molasses needed to produce it. _________ Was transported aboard the same ships that went to Africa to carry the ___________ back to America. (57)

Narcotics Anonymous (NA)

_______________ ___________, which wasn't available until its founding in 1953, was an offshoot of AA, which offered a more humane view of addiction that had existed before. (72)

Cocaine/Cocaine

_________________ Use as coca leaf chewing among South American indigenous peoples dates back centuries. The Spanish conquerors made the drug available to slaves to boost their stamina. This form of ________________ use was not culturally destructive and not associated with addiction. (55)

2%-3%

a large majority of gamblers do not get addicted. Research shows that in any given year, about _____-______ percent of the US population has a gambling problem, but only a small fraction are getting are seeking help. (71)