Health The Basics The Mastering Health

Edition 12th Edition Donatelle Solutions

Manual
Go to download the full and correct content document:
https://testbankfan.com/product/health-the-basics-the-mastering-health-edition-12th-e
dition-donatelle-solutions-manual/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Health The Basics The Mastering Health Edition 12th

Edition Donatelle Test Bank

https://testbankfan.com/product/health-the-basics-the-mastering-
health-edition-12th-edition-donatelle-test-bank/

Health The Basics 11th Edition Donatelle Test Bank

https://testbankfan.com/product/health-the-basics-11th-edition-
donatelle-test-bank/

Health The Basics Canadian 6th Edition Donatelle Test

Bank

https://testbankfan.com/product/health-the-basics-canadian-6th-
edition-donatelle-test-bank/

Basics of the U.S. Health Care System 2nd Edition Niles

Test Bank

https://testbankfan.com/product/basics-of-the-u-s-health-care-
system-2nd-edition-niles-test-bank/
Access to Health 13th Edition Donatelle Test Bank

https://testbankfan.com/product/access-to-health-13th-edition-
donatelle-test-bank/

Society The Basics 12th Edition Macionis Test Bank

https://testbankfan.com/product/society-the-basics-12th-edition-
macionis-test-bank/

Pathology for the Health Professions 5th Edition

Damjanov Solutions Manual

https://testbankfan.com/product/pathology-for-the-health-
professions-5th-edition-damjanov-solutions-manual/

Community Public Health Nursing Promoting the Health of

Populations 5th Edition Nies Test Bank

https://testbankfan.com/product/community-public-health-nursing-
promoting-the-health-of-populations-5th-edition-nies-test-bank/

Society The Basics 14th Edition Macionis Solutions

Manual

https://testbankfan.com/product/society-the-basics-14th-edition-
macionis-solutions-manual/
 CHAPTER
Recognizing and Avoiding
7 Addiction and Drug Abuse

Overview
Chapter 7 provides students with a general introduction to the physiology of addiction, and
sets the stage for a deeper examination of addiction’s negative impact. Process addictions are
discussed, as are the six categories of drugs and how pharmaceutical, over-the-counter, and
illicit drugs fit into these categories. The difference between drug misuse and drug abuse is
explored. Treatment and recovery options and public health approaches to drug abuse preven-
tion are also discussed. Ultimately, this chapter is intended to help students become aware of
the impacts and effects of drug use, misuse, and abuse.

Learning Outcomes
1. Identify the symptoms of addiction explain the difference between addiction and habit, and
discuss the impact of addiction on friends and family.
2. Describe types of process addictions, such as gambling disorder, exercise addiction,
technology addictions, and compulsive buying disorder.
3. Identify the six categories of drugs and distinguish between drug misuse and drug abuse.
4. Discuss the issues of drug misuse and abuse in the United States, including the misuse
and abuse of over-the-counter drugs and prescription drugs, the prevalence of drug use
on college campuses, and risk factors for drug abuse.
5. Discuss the use and abuse of stimulants, cannabis, narcotics, depressants, hallucinogens,
inhalants, and anabolic steroids.
6. Discuss treatment and recovery options for addicts, and discuss public health approaches
to preventing drug abuse and reducing the impact of addiction on our society.

Lecture Outline
I. What Is Addiction?
A. Addiction is the continued involvement with a substance or activity despite ongoing
negative consequences.
1. The addictive behavior initially provides a sense of pleasure or stability beyond the
addict’s power to achieve in other ways.
2. To be addictive, a substance or behavior must have the potential to produce positive
mood changes such as euphoria, anxiety reduction, or pain reduction.
3. People with physiological dependence on a substance experience tolerance when

Copyright © 2017 Pearson Education, Inc. 107

 increased amounts of the drug are required to achieve the desired effect.
4. They also experience withdrawal, a series of temporary physical and psychological
symptoms that occurs when substance abuse stops.
5. Psychological and physiological dependence are so intertwined that it is not really
possible to separate the two.
B. The Process of Addiction
1. Addictions are characterized by five common characteristics:
a. Compulsion/obsession
b. Loss of control
c. Negative consequences
d. Denial
e. Inability to Abstain
2. Addiction is a process that evolves over time. This pattern is known as nurturing
through avoidance and is a maladaptive way of taking care of emotional needs. See
Figure 7.1.
C. Habit versus Addiction
1. Addiction involves elements of habit, a repeated behavior in which the repetition may
be unconscious.
a. Addiction also involves repetition of a behavior, but the repetition occurs by
compulsion.
D. Addiction Affects Family and Friends
1. Family and friends often struggle with codependence, a self-defeating relationship
pattern in which a person is controlled by the addict’s addictive behavior.
a. Codependency is the addiction to a supportive role in a relationship.
b. Codependents find it hard to set healthy boundaries and often live in the chaotic,
crisis-oriented mode that naturally occurs around addicts.
2. Family and friends can play an important role in getting an addict to seek treatment.
a. Enablers are people who knowingly or unknowingly protect addicts from the natu-
ral consequences of their behavior.
Key Terms: addiction, physiological dependence, tolerance, withdrawal, psychological
dependence, compulsion, obsession, loss of control, negative consequences, denial, inability
to abstain, habit, codependence, enabler
Figure:
Figure 7.1
Cycle of Psychological Addiction
II. Addictive Behaviors
1. Process addictions are addictions to certain behaviors that are addictive because they
are mood altering. They are driven by a pathological pursuit of a reward or relief by
an individual.
A. Gambling Disorder
1. In the United States, between 6 and 8 million people meet the criteria for having a
gambling addiction.
2. The APA now uses the term gambling disorder, and recognizes it as an addictive dis-
order.
3. Characteristics of gambling disorder include preoccupation with gambling,

108 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 unsuccessful efforts to cut back or quit, gambling when feeling distressed, and lying to
family members to conceal the extent of gambling.
4. Like drug addicts, those with gambling disorder live from fix to fix.
a. Most seek excitement more than money.
5. Up to half of those with gambling disorder show withdrawal symptoms similar to a
mild form of drug withdrawal.
B. Compulsive Buying Disorder
1. Compulsive buyers are preoccupied with shopping and spending and exercise little
control over their impulse to buy.
2. Compulsive buying has many of the same characteristics as alcoholism, gambling,
and other addictions.
3. Warning signs include preoccupation with shopping and spending, buying more than
one of the same item, shopping for longer periods than intended, repeatedly buying
much more than he or she needs or can afford, and buying to the point that it interferes
with social activities or work and creates financial problems.
C. Exercise Addiction
1. Exercise addicts use exercise compulsively to try to meet needs—for nurturance, inti-
macy, self-esteem, and self-competency—that an object or activity cannot truly meet.
2. Warning signs of exercise addiction are as follows: only working out by oneself, ad-
hering to a rigid workout plan; exercising for more than two hours
a day, repeatedly; fixation on weight loss or calories burned; skipping work, class, or
social plans for exercise; exercising to the point of pain.
D. Technology Addictions
1. An estimated 1 in 8 Internet users will likely experience Internet addiction.
a. Twelve percent of college students report that Internet use and computer games
have interfered with academic performance.
2. Internet addicts exhibit several signs and symptoms:
a. General disregard for one’s health
b. Sleep deprivation
c. Neglecting family or friends
d. Lack of physical activity
e. Feeling of euphoria while online
f. Lower grades in school
g. Poor job performance
Key Terms: process addiction, gambling disorder, exercise addict, Internet addiction
See It! Video: Woman’s Shopping Addiction Revealed

III. What Is a Drug?

1. Drugs are substances other than food that are intended to affect the structure or func-
tion of the mind or the body through chemical action.
2. Drug misuse involves using a drug for a purpose for which it was not intended.
3. Drug abuse is the excessive use of any drug; it may cause serious harm.
4. Drug misuse and abuse are problems of staggering proportions in our society.
5. Drug abuse costs taxpayers more than $193 billion annually in health care costs, pub-
lic costs related to crime, and lost productivity.
A. How Drugs Affect the Brain

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 109
 1. Pleasure, which scientists call reward, is a powerful biological force for survival. If the
brain does something that feels pleasurable, the brain is wired to want to do it again.
2. One set of nerve cells that are devoted to producing and regulating pleasure sit at the
very top of the brainstem and uses a chemical neurotransmitter called dopamine
3. All addictive drugs can activate the brain’s pleasure circuit, known as the mesolimbic
dopamine system.
a. Drug addiction is a biological, pathological process that alters the way in which the
pleasure center, as well as other parts of the brain, functions.
4. Psychoactive drugs change the way the brain works by affecting chemical
neurotransmission—either enhancing it, suppressing it, or interfering with it.
a. See Figure 7.2 for an illustration of this process.
B. Routes of Drug Administration
1. Route of administration refers to the way in which a drug is taken into the body.
2. There are several routes of drug administration:
a. Oral ingestion: most common
b. Inhalation: has the most rapid effect
c. Injection: is the most dangerous
d. Transdermal: usually in patch form
e. Suppositories: used anally or vaginally
C. Drug Interactions
1. Polydrug use—taking several medications, vitamins, recreational drugs, or illegal
drugs simultaneously—can frequently lead to dangerous health problems.
2. Synergism, also called potentiation, is an interaction of two or more drugs in which
the effects of the individual drugs are multiplied beyond what would normally be
expected if they were taken alone.
a. You might think of synergism as 2 + 2 = 10.
3. Antagonism refers to two drugs working at the same receptor site so that one drug
blocks the action of the other.
4. With inhibition, the effects of one drug are eliminated or reduced by the presence
of another drug at the receptor site.
5. Intolerance occurs when drugs combine in the body to produce extremely uncomforta-
ble reactions.
6. Cross-tolerance occurs when a person develops a physiological tolerance to one drug
that also increases the body’s tolerance to other substances that act similarly on the
body.
Key Terms: drugs, drug misuse, drug abuse, neurotransmitter, psychoactive drugs, oral
ingestion, inhalation, injection, transdermal, suppositories, polydrug use, synergism,
antagonism, inhibition, intolerance, cross-tolerance
Figure:
Figure 7.2
The Action of Cocaine at Dopamine Receptors in the Brain
IV. Drug Misuse and Abuse
A. Abuse of Over-the-Counter Drugs
1. OTC drugs come in many different forms, including pills, liquids, nasal sprays, and
topical creams.

110 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 2. Abuse of OTC drugs occurs when a drug is taken in more than the recommended
dosage, combining it with other drugs, or taking it for longer than is recommended.
3. Several types of OTC drugs are subject to misuse and abuse:
a. Caffeine pills and energy drinks
b. Cold medicines (cough syrups and tablets)
c. Diet pills
B. Nonmedical Use or Abuse of Prescription Drugs
1. Today, the abuse of prescription drugs in the United States is at an all-time high.
a. The latest data suggest that 6.5 million Americans aged 12 and older used prescrip-
tion drugs for nonmedical reasons in the past month.
2. College Students and Prescription Drug Abuse
a. The illicit use of prescription drugs is growing on college campuses.
b. The most commonly abused prescription drugs on college campuses are painkillers.
c. Also of concern are the use of stimulants like Adderall and Ritalin, which are in-
tended to treat attention-deficit/hyperactivity disorder (ADHD).
C. Use and Abuse of Illicit Drugs
1. Illicit Drug Use on Campus
a. Close to 50 percent of college-age students nationwide have tried an illicit drug at
some point; the vast majority of them reported using marijuana.
b. Substance use among college students has many short- and long-term negative con-
sequences.
D. Why Do Some College Students Use Drugs?
1. Positive expectations
2. Genetics and family history
3. Substance use in high school
4. Curiosity
5. Social Norms
6. Mental health problems
7. Sorority and fraternity membership
8. Stress
E. Why Don’t Some College Students Use Drugs?
1. Parental attitudes and behavior
2. Religion and spirituality
3. Student engagement
4. College athletics
5. Healthy social network
Table:
Table 7.1
30-Day Drug Use Prevalence, Full-Time College Students vs. Respondents 1–4 Years
beyond High School
See It! Video: New Report Shows Surge in Heroin Deaths

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 111
V. Common Drugs of Abuse
A. Stimulants
1. A stimulant is a drug that increases activity of the central nervous system; effects
include increased activity, anxiety, and agitation.
2. Cocaine
a. Cocaine is a powerful stimulant made from the leaves of the South American coca shrub
and is one of the most powerful naturally occurring stimulants.
b. Cocaine can be snorted, smoked, or injected.
c. Cocaine is both an anesthetic and a stimulant of the central nervous system.
d. In tiny doses, it can slow heart rate. In larger doses, it can increase heart rate and
blood pressure; reduce appetite; and cause convulsions, muscle twitching, irregular
heartbeat, and even death resulting from an overdose.
3. Amphetamines
a. Amphetamines include a large and varied group of synthetic agents that stimulate
the central nervous system.
b. Small doses improve alertness, lessen fatigue, and elevate mood.
c. Physical and psychological dependence develops with repeated use.
d. High doses over long periods can produce hallucinations, delusions, and
disorganized behavior.
e. Certain types of amphetamines are used for medicinal purposes, such as those that
are prescribed for ADHD.
4. Methamphetamine
a. An increasingly common form of amphetamine, methamphetamine (meth), is a
potent, long-acting, inexpensive drug that is highly addictive.
b. Meth can be snorted, smoked, injected, or orally ingested. The effects depend on
the method of use.
c. Snorting and oral ingestion have shorter effects, while smoking meth can produce a
high lasting over 8 hours.
d. Problems resulting from long-term use are many and include: increased risk of Par-
kinson’s disease, severe weight loss, cardiovascular damage, increased risk of heart
attack and stroke, hallucinations, extensive tooth decay and tooth loss, violence,
paranoia, psychotic behavior, structural and functional changes in the brain, and in-
creased risk for sexually transmitted diseases.
5. Bath Salts
a. Bath salts are a synthetic powder that can be smoked, snorted, injected, or wrapped
in paper and ingested (“bombed”).
b. This drug can have significant negative cardiovascular effects (rapid heart rate, in-
creased blood pressure, and chest pain); psychiatric effects (anxiety, agitation, hal-
lucinations, paranoia, and erratic behavior); and increased risk for depression and
suicide.
6. Caffeine
a. Caffeine is a legal stimulant, but excessive consumption is associated with addic-
tion and certain health problems.
b. Caffeine is found in plant products such as coffee, tea, and chocolate.
c. Caffeine enhances mental alertness and reduces feelings of fatigue.
d. Symptoms of excessive caffeine consumption include chronic insomnia, jitters,
irritability, nervousness, anxiety, and involuntary muscle twitches.

112 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 e. No strong evidence exists to suggest that moderate caffeine use produces harmful
effects in healthy, nonpregnant people, and for most people caffeine poses few
health risks and may actually have some benefit.
7. Khat
a. Khat is a stimulant drug that is found in the young leaves of the Catha edulis
shrub.
b. The leaves are chewed and held in the cheek, releasing the plants stimulants.
c. It increases arousal and alertness, but can lead to paranoia, manic behavior, and
hallucinations.
B. Marijuana and Other Cannabinoids
1. Today, marijuana is the most commonly used illicit drug in the United States.
2. Methods of Use and Short-Term Physical Effects
a. Marijuana is derived from cannabis sativa or cannabis indica (hemp) plants.
b. The psychoactive substance in marijuana is THC.
c. Hashish is derived from the plant resin and contains high concentrations of THC.
d. The most noticeable effect of use is dilation of the eyes; users also experience
coughing, dry mouth and throat, increased thirst and appetite, lowered blood pres-
sure, and muscular weakness.
3. Marijuana and Driving
a. Marijuana substantially reduces a driver’s ability to react and make quick decisions.
b. Combining marijuana and alcohol enhances the impairing effects of both drugs.
4. Effects of Chronic Marijuana Use
a. Lung conditions such as chronic bronchitis, emphysema, and other lung disorders
are associated with smoking marijuana.
b. Frequent and/or long-term marijuana use may significantly increase a man’s risk of
developing testicular cancer.
c. The link between marijuana and common mental health disorders is conflicting but
evidence links use to the development of depression and depressive orders in some
and anxiety disorders in adolescents.
5. Marijuana as Medicine
a. Although classified by the U.S. government as a dangerous drug, marijuana has
been legalized for medicinal uses in 23 states and the District of Columbia.
b. Marijuana can help control the side effects of chemotherapy, it can act as an appe-
tite stimulant for AIDS patient, and can reduce the muscle pain and spasticity
caused by diseases like multiple sclerosis.
6. Synthetic Marijuana (Spice or K2)
a. A diverse family of herbal blends marketed under many names, which contain
dried, shredded plant material and one or more synthetic cannabinoids, with results
that mimic marijuana intoxication but with longer duration and poor detection on
urine drug screens.
b. People smoking Spice may experience several health effects such as hallucinations,
severe agitation, elevated heart rate and blood pressure, coma, suicide attempts, and
drug dependence.
C. Depressants
1. Depressants slow down neuromuscular activity and cause sleepiness or calmness.
If the dosage is high enough, brain function can slow to the point of causing death.
2. Alcohol is the most widely used central nervous system depressant.

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 113
 3. Benzodiazepines and Barbiturates
a. Sedative drugs promote mental calmness and reduce anxiety. Hypnotic drugs
promote sleep or drowsiness.
b. Benzodiazepines, more commonly called tranquilizers, are the most common
sedative-hypnotic drugs; they include Valium, Ativan, and Xanax.
c. Barbiturates are sedative-hypnotic drugs that are less safe than benzodiazepines;
they include Amytal and Seconal.
d. Sedative-hypnotic drugs combined with alcohol can lead to respiratory failure and
even death.
e. Cross-tolerance is a complication specific to sedatives. It occurs when users develop
a tolerance for one sedative or become dependent on it and develop tolerance for
others as well.
4. Rohypnol
a. Rohypnol, or the “date rape” drug, produces a sedative effect, amnesia, muscle
relaxation, and a slowed psychomotor response.
5. GHB
a. GHB (gamma-hydroxybutyrate) is a central nervous system depressant with
euphoric, sedative, and anabolic effects; like Rohypnol, it causes memory loss,
unconsciousness, and amnesia.
D. Opioids (Narcotics)
1. Opioids cause drowsiness, relieve pain, and induce euphoria; they are also called
narcotics.
a. They are derived from opium, a dark, resinous substance made from the milky juice
of the opium poppy seedpod, and they are highly addictive.
b. Some opioids are available by prescription for medical purposes, including
morphine, codeine, Vicodin, Percodan, OxyContin, Demerol, and Dilaudid.
2. Physical Effects of Opioids
a. Opioids are powerful depressants of the central nervous system. In addition to
relieving pain, they lower heart rate, respiration, and blood pressure.
b. Side effects include weakness, dizziness, nausea, vomiting, euphoria, decreased sex
drive, visual disturbances, and lack of coordination.
c. Opioid-like substances called endorphins are manufactured in the body and have
multiple receptor sites in the central nervous system. When endorphins attach them-
selves to these sites, they create a feeling of painless well-being. This same feeling
occurs when opioids are active at the endorphin receptor sites.
3. Heroin
a. Heroin, derived from morphine, has no medical use and is highly addictive.
b. Heroin is a depressant that produces drowsiness and a dreamy, mentally slow feel-
ing. It can cause drastic mood swings, with euphoric highs and depressive lows.
c. Symptoms of tolerance and withdrawal can appear within 3 weeks of first use.
d. There has been an increasing amount of deaths due to heroin overdose as the drug
becomes increasingly common in suburban and rural communities.
d. Heroin is usually injected intravenously (“mainlined”), but people have begun to
smoke or snort it. Within 2 to 3 weeks after starting, because of increased tolerance,
most will begin to inject it.
e. Mainlining causes veins to scar and eventually collapse.
f. Heroin addicts experience a distinct pattern of withdrawal: intense desire for the
drug, sleep disturbances, dilated pupils, loss of appetite, irritability, goosebumps,

114 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 and muscle tremors.
E. Hallucinogens
1. Hallucinogens, or psychedelics, are substances capable of creating auditory or visual
hallucinations and unusual changes in mood, thoughts, and feelings.
2. The mixing of sensory messages that causes hallucinations is known as synesthesia.
Users may also become less inhibited or recall events long buried in the subconscious
mind.
3. LSD
a. Known alternatively as “acid,” LSD is one of the most powerful drugs known to
science. It can produce strong effects in doses as low as 20 micrograms.
b. LSD comes on small squares of blotter-like paper, in thin squares of gelatin, and in
tablets.
c. LSD can take 20 to 60 minutes to take effect and can last 6 to 8 hours.
d. The psychological effects vary and include euphoria, dysphoria, distorted percep-
tion, and auditory and visual hallucinations.
4. Ecstasy
a. Ecstasy is one of the most well-known club drugs. It creates feelings of extreme eu-
phoria, openness and warmth; an increased willingness to communicate; feelings of
love and empathy; increased awareness; and heightened appreciation for music.
b. Effects begin within 20 to 90 minutes and can last for 3 to 5 hours.
c. Ecstasy users are at a greater risk for inappropriate or unintended emotional bonding
and have a tendency to say things they may feel uncomfortable about later.
d. Physical consequences include jaw clenching; tongue and cheek chewing; short-
term memory loss or confusion; increased body temperature heart rate, and blood
pressure.
e. Combined with alcohol, Ecstasy can be dangerous and sometimes fatal.
f. The drug may cause long-lasting neurotoxic effects by damaging brain cells that
produce serotonin.
g. MDMA in powder or crystal form is known as “Molly.” Side effects include grind-
ing ones teeth, feeling anxious, having trouble sleeping, fever, loss of appetite, un-
controllable seizures, elevated blood pressure and body temperature, and
depression.
5. PCP (Phencyclidine)
a. PCP was originally developed as a dissociative anesthetic—it was withdrawn from
the legal market because of its unpredictability and drastic effects.
b. On the illegal market, PCP is a white, crystalline powder that is often sprinkled onto
marijuana cigarettes.
c. The effects depend on the dose and range from slurred speech and impaired coordi-
nation to loss of sensitivity to pain, to violent outbursts and death.
d. Psychologically, PCP may produce either euphoria or dysphoria.
6. Mescaline
a. Mescaline comes from the peyote cactus and is both a powerful hallucinogen and a
central nervous stimulant.
b. Users swallow 10-12 buttons, which taste bitter and generally induce immediate
nausea and vomiting.
c. Those who can keep the drug down feel the effects in 30 to 90 minutes. Effects may
persist for up to 9 or 10 hours.
d. Synthetic chemical relatives are sold on the street as mescaline and can be toxic in

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 115
 small quantities.
7. Psilocybin
a. Psilocybin and psilocin are the active chemicals in a group of mushrooms that are
often called “magic mushrooms.”
b. When consumed these mushrooms are hallucinogenic and have the same physical
effects of LSD.
7. Ketamine
a. The liquid form of Ketamine (“Special K”) is used an anesthetic. For illicit use, it is
stolen from hospitals or medical suppliers, dried, and ground into powder.
b. It causes hallucinations by inhibiting the relay of sensory input.
c. The effects of Ketamine are similar to PCP, but even less predictable.
8. Salvia
a. Salvia is an herb from the mint family. Its main ingredient causes hallucinations by
changing brain chemistry.
b. Associated hallucinations are intense, but are relatively short lasting.
E. Inhalants
1. Inhalants are vapor-producing chemicals that, when inhaled, can cause hallucinations
and create intoxicating and euphoric effects.
2. Because they are inhaled, the volatile chemicals in these products reach the blood-
stream within seconds, but the effects do not last long.
3. An overdose of fumes from inhalants can cause unconsciousness.
4. If a user’s oxygen intake is reduced during the inhaling process, death can result with-
in 5 minutes. Sudden sniffing death syndrome can occur if a user inhales deeply and
then participates in physical activity or is startled.
F. Anabolic Steroids
1. Anabolic steroids are artificial forms of testosterone that promote muscle growth and
strength; they are also called ergogenic drugs.
2. They are used primarily by people who believe the drugs will increase their strength,
power, bulk (weight), speed, and athletic performance.
3. Physical Effects of Steroids
a. Anabolic steroids produce a state of euphoria, diminished fatigue, and increased
bulk and power in both sexes.
b. Adverse side effects include becoming aggressive and violent, acne, liver tumors,
elevated cholesterol levels, hypertension, kidney disease, and immune system dis-
orders. HIV and hepatitis transmission can occur with shared needles.
4. Steroid Use and Society
a. The Anabolic Steroids Control Act (ASCA) of 1990 makes it a crime to possess,
prescribe, or distribute anabolic steroids for ay use other than the treatment of spe-
cific diseases.
Key Terms: stimulants, amphetamines, caffeine, marijuana, tetrahydrocannabinol (THC),
depressants, benzodiazepines, barbiturates, opioids, opium, endorphins, hallucinogens, club
drugs, inhalants, anabolic steroids, ergogenic drugs
Table and Figure:
Table 7.2
Drugs of Abuse: Uses and Effects
Figure 7.3

116 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 Caffeine Content Comparison
VI. Treating and Reducing Drug Abuse
1. There is a huge gap between those who need and those who receive treatment for an
illicit drug or alcohol use problem.
a. The most difficult step is for someone to admit that they are an addict. This is so
difficult because of the power of denial.
2. Recovery from drug addiction is a long-term process and frequently requires multiple
episodes of treatment.
3. Detoxification refers to an early abstinence period during which an addict adjusts
physically and cognitively to being free from the addiction’s influence.
A. Treatment Approaches
1. Outpatient behavioral treatment encompasses a variety of programs for addicts who
visit a clinic at regular intervals.
2. Residential treatment programs can also be very effective and can include therapeutic
communities that offer highly structured programs.
3. 12-Step Programs
a. The 12-step program is nonjudgmental and is based on the idea that a program’s on-
ly purpose is to work on personal recovery.
b. Working the 12 steps includes admitting to having a serious problem, recognizing
there is an outside power that could help, consciously relying on that power, admit-
ting and listing character defects, seeking deliverance from defects, apologizing to
those individuals one has harmed in the past, and helping others with the same
problem.
4. Vaccines against Addictive Drugs
a. A promising new cocaine vaccine is in development. It keeps the user from getting
high by stimulating the immune system to attack the drug when it is taken.
b. Vaccines against nicotine, heroin, and methamphetamine are also in development.
5. Other Pharmacological Treatments
a. Methadone maintenance is one treatment available for people addicted to
heroin and other opioids; it is controversial because of the drug’s own potential for
addiction.
b. There are also a number of other new drug therapies emerging for opioid depend-
ence.
B. Drug Treatment and Recovery for College Students
1. Early intervention increases the likelihood of successful treatment..
2. Treatment includes private therapy, group therapy, cognitive training, nutrition
counseling, and health therapies.
3. Many colleges and universities now offer special services to students recovering from
alcohol and other drug addictions who want to stay in school without being exposed
to excessive drinking or drug use.
C. Addressing Drug Misuse and Abuse in the United States
1. Public opinion polls tell us that the most important strategy for fighting drug abuse is
educating young people.
a. Other approaches include stricter border surveillance to reduce drug trafficking,
longer prison sentences for drug dealers, increased government spending for pre-
vention, antidrug law enforcement, and others.

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 117
 2. Drug education researchers agree that a multimodal approach is best.
3. Harm Reduction Strategies
a. Harm reduction strategies reduce the negative consequences of drug use by incorpo-
rating a spectrum of strategies from safer use to abstinence.
b. Harm reduction strategies are based on the recognition that people have always
used and will always use drugs and therefore attempts to minimize the potential
hazards
associated with drug use, rather than the use itself.
Key Term: detoxification

Additional Chapter Activities

Discussion Questions
1. What are the six categories of drugs and what are some examples in each of the six categories?
2. Provide examples of synergistic effects of drugs. What physiological dangers might be
involved with synergistic drug reactions?
3. What population group do you think is most at risk for abusing OTC drugs? Explain
your answer.
4. What is the history of cocaine use? Do you think anything could have been done
differently in the control of early cocaine use that might have deterred it from being as
popular as it is today?
5. Over the years, use of illegal drugs has grown to affect all aspects of life in the United
States. What might have promoted this migration?
6. Describe reasons why treatment for heroin addiction has not been very successful.
7. What are the most popular drugs on college campuses? Why?
8. At what age should drug education begin? Is there any harm associated with telling
kids about drugs?
9. Steroids are performance-enhancing drugs. How does the NCAA deter steroid use
among collegiate athletes?
10. Do you think “date rape” drugs are a concern on your campus? Explain.
11. Do you think legalization of illicit drugs will decrease the drug problem in the United
States? Why or why not?

Critical Thinking Questions

1. Why do you think individuals with lower levels of income are more likely to become
compulsive gamblers than those with higher levels of income?
2. What are your thoughts about the legalization of marijuana for medical purposes? What
are the pros and cons?
3. Do you know anyone who has a behavioral addiction, such as shopping or gambling?
How does this addiction influence the person’s life? Does the person have any control
over the addiction?
4. How do you think that the legalization of marijuana would influence other drug use in
the United States?

118 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
 5. What would you do if you observed illegal drug use while attending a party on campus?
What if you observed your friend, or the person you attended the party with, using
illegal drugs? How would your response change?
6. How would you react if you found out that a sibling or close friend was experimenting
with meth? What advice would you offer them?
7. How would you describe the difference between a compulsive behavior and an
addiction? Do you think they are one and the same?
8. Do you know anyone who has an addiction to technology? How do you know that he
or she has an addiction and how is it influencing his or her everyday life? What advice
would you offer this person to help in overcoming the addiction?
9. What strategies would you recommend to help a college student recover from an
addiction?

Student Activities

Individual
1. Keep a record for one week of all the time you spend using technology. What devices
do you use most and how are you using them? Based on this information, do you think
you have a technology addiction?
2. Make a list of all the over-the-counter and prescription drugs you have in your home.
What are the drugs used for? Are the drugs current (not past their expiration date)? Are
the drugs stored in a safe place so they are not available to children or other possible
users?

Community
1. What kind of support is offered on your campus to help students who are struggling
with addiction? How would you help a friend if you knew that he or she had a sub-
stance abuse problem?
2. Is medical marijuana available in your community? What criteria must a person meet to
be able to receive medical marijuana?
3. Locate a list of campus rules about illegal drug use. Interview someone in the campus
police department and find out the rates of drug violations on campus. What occurs on
your campus if a student is found using illegal drugs? What if a student athlete is found
to be using illegal drugs? Should different rules apply for different groups of students?
Why or why not?

Diverse Population/Nontraditional
1. Many drugs considered to be prescriptions are available over the counter in other countries.
Why do you think a physician in the United States must prescribe these drugs? Do you
think the medicines available without a prescription in other countries are safe to use?
2. What are some substitutes for OTC drugs in other cultures?
3. Research prescription drug use in other countries. Are the same kinds of drugs used?
Are they used in the same amounts?

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 119
Additional References
A. M. Arria, K. M. Caldeira, K. E. O’Grady, K. B. Vincent, D. B. Fitzelle, E. P. Johnson,
and E. Wish, “Drug Exposure Opportunities and Use Patterns among College Students:
Results of a Longitudinal Prospective Cohort Study,” Substance Use, 29, (2008): 19–38.
G. M. Barnes, J. W. Welte, J. H. Hoffman, and M. O. Tidwell, “Comparisons of Gambling
and Alcohol Use among College Students and Noncollege Young People in the United
States,” Journal of American College Health, 58, (2010): 443–452.
M. A. Herman-Stahl, C. P. Krebs, L. A. Kroutil, and D. C. Heller, “Risk and Protective
Factors for Methamphetamine Use and Nonmedical Use of Prescription Stimulants among
Young Adults Aged 18 to 25,” Addictive Behaviors, 32, (2007): 1003–1015.
J. Hoffman and S. Froemke, (eds.). Addiction: Why Can’t They Just Stop? (New York:
Rodale Books, 2007).
L. D. Johnston, P. M. O’Malley, J. G. Bachman, and J. E. Schulenberg, “Monitoring the
Future: National Survey Results on Drug Use, 1975–2008,” Volume II: College Students
and Adults Ages 19–50 (NIH Publication No. 09-7403, Bethesda, MD: National Institute
on Drug Abuse, 306 pp., 2009) (Available at:
www.monitoringthefuture.org/pubs/monographs/vol2_2008.pdf)
S. E. McCabe, B. T. West, and H. Wechsler, “Trends and College-level Characteristics
Associated with the Non-medical Use of Prescription Drugs among US College Students
from 1993 to 2001,” Addiction, 102, (2007): 455–465.
Substance Abuse and Mental Health Services Administration, Results from the 2011
National Survey, 2012.
J. L. Thome and D. L. Espelage, “Obligatory Exercise and Eating Pathology in College
Females: Replication and Development of a Structural Model,” Eating Behaviors, 8, (2007):
334–349.
K. B. Vincent, K. M. Caldeira, K. E. O’Grady, E. D. Wish, and A. M. Arria, “The Impact of
Positive and Negative Ecstasy-related Information on Ecstasy Use among College Students: Re-
sults of a Longitudinal Study,” Drugs: Education, Prevention, and Policy, 17, (2010): 232–247.
E. M. Wickwire, J. P. Whelan, R. West, A. Meyers, C. McCausland, and J. Leullen,
“Perceived Availability, Risks, and Benefits of Gambling among College Students,”
Journal of Gambling Studies, 23, (2007): 395–408.
J. Yen, C. Ko, C. Yen, C-S. Chen, and C-C. Chen, “The Association between Harmful
Alcohol Use and Internet Addiction among College Students: Comparison of Personality,”
Psychiatry and Clinical Neurosciences, 63, 218–224.
D. A. Yusko, J. F. Buckman, H. R. White, and R. Pandina, “Alcohol, Tobacco, Illicit Drugs,
and Performance Enhancers: A Comparison of Use by College Student Athletes and
Nonathletes,” Journal of American College Health, 57, (2008): 281–290.

120 INSTRUCTOR RESOURCE AND SUPPORT MANUAL FOR HEALTH: THE BASICS, 12e Copyright © 2017 Pearson Education, Inc.
For Further Information
Al-Anon Family Groups
www.al-anon.alateen.org
American Academy of Addiction Psychiatry
www.aaap.org
Community Anti-Drug Coalitions of America
www.cadca.org
Faces & Voices of Recovery
www.facesandvoicesofrecovery.org
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov
SMART Recovery
www.smartrecovery.org

Additional Media
Addiction. Nine Segments.
The following link sends viewers to HBO’s website for the ADDICTION documentary.
There, the viewer will find nine different segments on addiction. Examples of segments
include “Saturday Night in a Dallas ER,” “The Science of Relapse,” “A Mother’s Despera-
tion,” and “The Adolescent Addict.”
www.hbo.com/addiction/thefilm

NIDA Painkillers: Get Back in the Game—Use Painkillers Safely, 3 minutes

In this production of the National Institute of Drug Abuse, NIDA scientists Cindy Miner and
Joni Rutter discuss the prevalence of illicit use of painkillers among adolescents and the
health effects of illicit use of prescription painkillers.
https://www.youtube.com/watch?v=w2M3CxmJggs

NIDA Scientist Ruben Baler Talks about the Dangers and Consequences of Steroid Abuse,
1 minute 49 seconds
In this production of the National Institute of Drug Abuse, NIDA scientist Ruben Baler
discusses the negative health effects of steroid abuse.
https://www.youtube.com/watch?v=z9Ynf2kPNIc

NIH, on the Inside: Gambling Addiction, 7 minutes 26 seconds

In this production of the National Institute of Health, persons addicted to gambling share their
personal struggles. Later in the segment, Dr. Jim Bjork of NIH discusses what the brain of
someone with an addiction resembles.
www.youtube.com/watch?v=8-IrXyNZbww

Copyright © 2017 Pearson Education, Inc. CHAPTER 7 Recognizing and Avoiding Addiction and Drug Abuse 121
Another random document with
no related content on Scribd:
 How odd, how strange and lonely poor Florian felt; he seemed to belong
to no one, and, like the Miller o' Dee, nobody cared for him; and ever and
anon his eyes rested on the mighty castled rock that towers above streets,
monuments, and gardens, with a wonderous history all its own, 'where
treasured lie the monarchy's last gems,' and with them the only ancient
crown in the British Isles. 'Brave kings and the fairest of crowned women
have slept and been cradled in that eyrie,' says an enthusiastic English
writer; 'heroes have fought upon its slopes; English armies have stormed it;
dukes, earls, and barons have been immured in its strong dungeons; a
sainted Queen prayed and yielded up her last breath there eight centuries
ago. It is an imperishable relic—a monument that needs no carving to tell
its tale, and it has the nation's worship; and the different church sects cling
round its base as if they would fight again for the guardianship of a
venerable mother..... And if Scotland has no longer a king and Parliament
all to herself, her imperial crown is at least safely kept up there amid strong
iron stanchions, as a sacred memorial of her inextinguishable independence,
and, if need were, for future use.'

Florian was a reader and a thinker, and he felt a keen interest in all that
now surrounded him; but Shafto lurked in a corner of the smoke-room,
turning in his mind the task of the morrow, and unwisely seeking to fortify
himself by imbibing more brandy and soda than Florian had ever seen him
take before.

After a sound night's rest and a substantial Scottish breakfast had fitted
Shafto, as he thought, for facing anything, a cab deposited him and Florian
(who was now beginning to marvel why he had travelled so far in a matter
that concerned him not, in reality) at the residence of Mr. Kenneth
Kippilaw, W.S., in Charlotte Square—a noble specimen of Adams Street
architecture, having four stately symmetrical corresponding façades,
overlooked by the dome of St. George's Church.

'Lawyers evidently thrive in Scotland,' said Shafto, as he looked at the

mansion of Mr. Kippilaw, and mentally recalled the modest establishment
of Lawyer Carlyon; 'but foxes will flourish as long as there are geese to be
plucked.'
 Mr. Kippilaw was at home—indeed he was just finishing breakfast,
before going to the Parliament House—as they were informed by the
liveried valet, who led them through a pillared and marble-floored
vestibule, and ushered them into what seemed a library, as the walls from
floor to ceiling were lined with handsome books; but every professional
man's private office has generally this aspect in Scotland.

In a few minutes Mr. Kippilaw appeared with a puzzled and perplexed

expression in his face, as he alternatively looked at his two visitors, and at
Shafto's card in his hand.

Mr. Kippilaw was now in his sixtieth year; his long since grizzled hair
had now become white, and had shrunk to two patches far apart, one over
each ear, and brushed stiffly up. His eyebrows were also white, shaggy, and
under them his keen eyes peered sharply through the rims of a gold pince-
nez balanced on the bridge of his long aquiline nose.

Shafto felt just then a strange and unpleasant dryness about his tongue
and lips.

'Mr. Shafto Melfort?' said Mr. Kippilaw inquiringly, and referring to the
card again. 'I was not aware that there was a Mr. Shafto Melfort—any
relation of Lord Fettercairn?'

'His grandson,' said Shafto unblushingly.

'This gentleman with the dark eyes?' asked Mr. Kippilaw, turning to the
silent Florian.

'No—myself,' said Shafto sharply and firmly.

'You are most unlike the family, who have always been remarkable for
regularity of features. Then you are the son—of—of—'

'The late Major Lennard Melfort who died a few weeks ago——'

'Good Heavens, where?'

 'On the west coast of Devonshire, near Revelstoke, where he had long
resided under the assumed name of MacIan.'

'That of his wife?'

'Precisely so—my mother.'

'And this young gentleman, whose face and features seem curiously
familiar to me, though I never saw him before, he is your brother of course.'

'No, my cousin, the son of my aunt Mrs. Gyle. I am an only son, but the
Major ever treated us as if he had been the father of both, so great and good
was his kindness of heart.'

'Be seated, please,' said the lawyer in a breathless voice, as he seated

himself in an ample leathern elbow chair at his writing-table, which was
covered with documents and letters all arranged by his junior clerk in the
most orderly manner.

'This is very sudden and most unexpected intelligence,' said he, carefully
wiping his glasses, and subjecting Shafto's visage to a closer scrutiny again.
'Have you known all these years past the real name and position of your
father, and that he left Kincardineshire more than twenty years ago after a
very grave quarrel with his parents at Craigengowan?'

'No—I only learned who he was, and who we really were, when he was
almost on his deathbed. He confided it to me alone, as his only son, and
because I had been bred to the law; and on that melancholy occasion he
entrusted me with this important packet addressed to you.'

With an expression of the deepest interest pervading his well-lined face,

Mr. Kippilaw took the packet and carefully examined the seal and the
superscription, penned in a shaky handwriting, with both of which he was
familiar enough, though he had seen neither for fully twenty years, and
finally he examined the envelope, which looked old and yellow.

'If all be true and correct, these tidings will make some stir at
Craigengowan,' he muttered as if to himself, and cut round the seal with a
penknife.

'You will find ample proofs, sir, of all I have alleged,' said Shafto, who
now felt that the crisis was at hand.

Mr. Kippilaw, with growing interest and wonder, drew forth the
documents and read and re-read them slowly and carefully, holding the
papers, but not offensively, between him and the light to see if the dates and
water-marks tallied.

'The slow way this old devil goes on would exasperate an oyster!'
thought Shafto, whose apparently perfect coolness and self-possession
rather surprised and repelled the lawyer.

There were the certificate of Lennard's marriage with Flora MacIan,

which Mr. Kippilaw could remember he had seen of old; the 'certificate of
entry of birth of their son, born at Revelstoke at 6 h. 50 m. on the 28th
October P.M., 18—,' signed by the Registrar, and the Major's farewell letter
to his old friend, entrusting his son and his son's interests to his care.

'But, hallo!' exclaimed Mr. Kippilaw, after he had read for the second
time, and saw that the letter of Lennard Melfort was undoubtedly authentic,
'how comes it that the whole of your Christian name is torn out of the birth
certificate, and the surname Melfort alone remains?'

'Torn out!' exclaimed Shafto, apparently startled in turn.

'There is a rough little hole in the document where the name should be.
Do you know the date of your birth?' asked Mr. Kippilaw, partly covering
the document with his hand, unconsciously as it were.

'Yes—28th October.'

'And the year?'

Shafto gave it from memory.

'Quite correct—as given here,' said Mr. Kippilaw; 'but you look old for
the date of this certificate.'
 'I always looked older than my years,' replied Shafto.

Florian, who might have claimed the date as that of his own birth, was—
luckily for Shafto—away at a window, gazing intently on a party of soldiers
marching past, with a piper playing before them.

'Another certificate can be got if necessary,' said Mr. Kippilaw, as he

glanced at the Registrar's signature, a suggestion which made Shafto's heart
quake. 'It must have come from the Major in this mutilated state,' he added,
re-examining with legal care and suspicion the address on the envelope and
the seal, which, as we have said, he had cut round; 'but it is strange that he
has made no mention of it being so in his letter to me. Poor fellow! he was
more of a soldier than a man of business, however. Allow me to
congratulate you, Mr. Melfort, on your new prospects. Rank and a very fine
estate are before you.'

He warmly shook the hand of Shafto, who began to be more reassured;

and saying, 'I must carefully preserve the documents for the inspection of
Lord Fettercairn,' he locked them fast in a drawer of his writing-table, and
spreading out his coat-tails before the fire, while warming his person in the
fashion peculiar to the genuine 'Britisher,' he eyed Shafto benignantly, and
made a few pleasant remarks on the Fettercairn family, the fertility and
beauty of Craigengowan, the stables, kennels, the shootings, and so forth,
and the many fine qualities of 'Leonard'—as he called him—and about
whom he asked innumerable questions, all of which Shafto could answer
truly and with a clear conscience enough, as he was master of all that.

The latter was asked 'what he thought of Edinburgh—if he had ever been
there before,' and so forth. Shafto remembered a little 'Guide Book' into
which he had certainly dipped, so as to be ready for anything, and spoke so
warmly of the picturesque beauties and historical associations of the
Modern Athens that the worthy lawyer's heart began to warm to so
intelligent a young man, while of the silent Florian, staring out into the sun-
lit square and its beautiful garden and statues, he took little notice, beyond
wondering where he had seen his eyes and features before!
 CHAPTER X.

ALONE IN THE WORLD.

'And you were bred to the law, you say, Mr. Melfort?' remarked the old
Writer to the Signet after a pause.

'Yes, in Lawyer Carlyon's office.'

'Very good—very good indeed; that is well! We generally think in

Scotland that a little knowledge of the law is useful, as it teaches the laird to
haud his ain; but I forgot that you are southland bred, and born too—the
more is the pity—and can't understand me.'

Shafto did not understand him, but thought that his time spent in Lawyer
Carlyon's office had not been thrown away now; experience there had 'put
him up to a trick or two.'

'I shall write to Craigengowan by the first post,' said Mr. Kippilaw after
another of those thoughtful pauses during which he attentively eyed his
visitor. 'Lord and Lady Fettercairn—like myself now creeping up the vale
of years—(Hope they may soon see the end of it! thought Shafto) will, I
have no doubt, be perfectly satisfied by the sequence and tenor of the
documents you have brought me that you are their grandson—the son of the
expatriated Lennard—and when I hear from them I shall let you know the
result without delay. You are putting up at—what hotel?'

'At the Duke of Rothesay, in Princes Street.'

'Ah! very well.'

'Thanks; I shall be very impatient to hear.'

'And your cousin—he will, of course, go with you to Craigengowan?'

 Shafto hesitated, and actually coloured, as Florian could detect.

'What are your intentions or views?' Mr. Kippilaw asked the latter.

'He failed to pass for the army,' said Shafto bluntly and glibly, 'so I don't
know what he means to do now. I believe that he scarcely knows himself.'

'Have you no friends on your mother's side, Mr. Florian?'

'None!' said Florian, with a sad inflection of voice.

'Indeed! and what do you mean to do?'

'Follow the drum, most probably,' replied Florian bitterly and a little
defiantly, as Shafto's coldness, amid his own great and good fortune, roused
his pride and galled his heart, which sank as he thought of Dulcie Carlyon,
sweet, golden-haired English Dulcie, so far away.

Mr. Kippilaw shook his bald head at the young man's answer.

'I have some little influence in many ways, and if I can assist your future
views you may command me, Mr. Florian,' said he with fatherly kindness,
for he had reared—yea and lost—more than one fine lad of his own.

It has been said that one must know mankind very well before having the
courage to be solely and simply oneself; thus, as Shafto's knowledge of
mankind was somewhat limited, he felt his eye quail more than once under
the steady gaze of Mr. Kippilaw.

'It is a very strange thing,' said the latter, 'that after the death of Mr.
Cosmo in Glentilt, when Lord and Lady Fettercairn were so anxious to
discover and recall his younger brother as the next and only heir to the title
and estates, we totally failed to trace him. We applied to the War Office for
the whereabouts of Major Lennard Melfort, but the authorities there, acting
upon a certain principle, declined to afford any information.
Advertisements, some plainly distinct, others somewhat enigmatical, were
often inserted in the Scotsman and Times, but without the least avail.

'As for the Scotsman,' said Shafto, 'the Major——'

 'Your father, you mean?'

'Yes,' said he, reddening, 'was no more likely to see such a provincial
print in Devonshire than the Roman Diritto or the Prussian Kreuz Zeitung;
and the Times, if he saw it—which I doubt—he must have ignored. Till the
time of his death drew near, his feelings were bitter, his hostility to his
family great.'

'I can well understand that, poor fellow!' said Mr. Kippilaw, glancing at
his watch, as he added—'You must excuse me till to-morrow: I am already
overdue at the Parliament House.'

He bowed his visitors out into the sun-lit square.

'You seem to have lost your tongue, Florian, and to have a disappointed
look,' said Shafto snappishly, as they walked slowly towards the hotel
together.

'Disappointed I am in one sense, perhaps, but I have no reason to repine

or complain save at our change of relative positions, but certainly not at
your unexpected good fortune, Shafto. It is only right and just that your
father's only son should inherit all that is legally and justly his.'

Even at these words Shafto never winced or wavered in plans or

purpose.

It was apparent, however, to Florian, that he had for some time past
looked restless and uneasy, that he started and grew pale at any unusual
sound, while a shadow rested on his not usually very open countenance.

Betimes next morning a note came to him at the Duke of Rothesay Hotel
from Mr. Kippilaw, requesting a visit as early as possible, and on this errand
he departed alone.

He found the old lawyer radiant, with a letter in his hand from Lord
Fettercairn (in answer to his own) expressive of astonishment and joy at the
sudden appearance of this hitherto unknown grandson, whom he was full of
ardour and anxiety to see.
 'You will lose no time in starting for Craigengowan,' said Mr. Kippilaw.
'You take the train at the Waverley Station and go viâ Burntisland,
Arbroath, and Marykirk—or stay, I think we shall proceed together, taking
your papers with us.'

'Thanks,' said Shafto, feeling somehow that the presence of Mr.

Kippilaw at the coming interview would take some of the responsibility off
his own shoulders.

'Craigengowan, your grandfather says, will put on its brightest smile to

welcome you.'

'Very kind of Craigengowan,' said Shafto, who felt but ill at ease in his
new role of adventurer, and unwisely adopted a free-and-easy audacity of
manner.

'A cheque on the Bank of Scotland for present emergencies,' said Mr.
Kippilaw, opening his cheque-book, 'and in two hours we shall meet at the
station.'

'Thanks again. How kind you are, my dear sir.'

'I would do much for your father's son, Mr. Shafto,' said the lawyer,
emphatically.

'And what about Florian?'

'The letter ignores him—a curious omission. In their joy, perhaps Lord
and Lady Fettercairn forgot. But, by the way, here is a letter for him that
came by the London mail.'

'A letter for him!' said Shafto, faintly, while his heart grew sick with
apprehension, he knew not of what.

'Mr. Florian's face is strangely familiar to me,' said Mr. Kippilaw aloud;
but to himself, 'Dear me, dear me, where can I have seen features like his
before? He reminds me curiously of Lennard Melfort.'

Shafto gave a nervous start.

 The letter was a bulky one, and bore the Wembury and other post-marks,
and to Shafto's infinite relief was addressed in the familiar handwriting of
Dulcie Carlyon.

He chuckled, and a great thought worthy of himself occurred to him.

In the solitude of his own room at the hotel, he moistened and opened
the gummed envelope, and drew forth four closely written sheets of paper
full of the outpourings of the girl's passionate heart, of her wrath at the theft
of her locket by Shafto, and mentioning that she had incidentally got the
address of Mr. Kippilaw from her father, and desiring him to write to her,
and she would watch for and intercept the postman by the sea-shore.

'Bosh,' muttered Shafto, as he tore up and cast into the fire Dulcie's
letter, all save a postscript, written on a separate scrap of paper, and which
ran thus:—

'You have all the love of my heart, Florian; but, as I feel and fear we may
never meet again, I send you this, which I have worn next my heart, to
keep.'

This was a tiny tuft of forget-me-nots.

'Three stamps on all this raggabash!' exclaimed Shafto, whom the girl's
terms of endearment to Florian filled with a tempest of jealous rage. He
rolled the locket he had wrenched from Dulcie's neck in soft paper, and
placed it with the postscript in the envelope, which he carefully closed and
re-gummed, placed near the fire, and the moment it was perfectly dry he
gave it to Florian.

If the latter was surprised to see a letter to himself, addressed in Dulcie's

large, clear, and pretty handwriting, to the care of 'Lawyer Kippilaw,' as she
called him, he was also struck dumb when he found in the envelope the
locket, the likeness, and the apparently curt farewell contained in one brief
sentence!

For a time he stood like one petrified. Could it all be real? Alas! there
was no doubting the postal marks and stamps upon this most fatal cover;
and while he was examining it and passing his hand wildly more than once
across his eyes and forehead, Shafto was smoking quietly at a window, and
to all appearance intent on watching the towering rock and batteries of the
Castle, bathed in morning sunshine—batteries whereon steel morions and
Scottish spears had often gleamed of old.

Though his soul shrank from doing so, Florian could not resist taking
Shafto into his confidence about this unexplainable event; and the latter
acted astonishment to the life!

Was the locket thus returned through the post in obedience to her father's
orders, after he had probably discovered the contents of it?

But Shafto demolished this hope by drawing his attention to the tenor of
the pithy scrap of paper, which precluded the idea that it had been done
under any other influence than her own change of mind.

'Poor Florian!' sneered Shafto, as he prepared to take his departure for

Craigengowan; 'now you had better proceed at once to cultivate the wear-
the-willow state of mind.'

Florian made no reply. His ideas of faith and truth and of true women
were suddenly and cruelly shattered now!

'She has killed all that was good in me, and the mischief of the future
will be at her door!' he exclaimed, in a low and husky voice.

'Oh, Florian, don't say that,' said Shafto, who actually did feel a little for
him; and just then, when they were on the eve of separation, even his false
and artful heart did feel a pang, with the sting of fear, at the career of
falsehood to which he had committed himself; but his ambition, innate
greed, selfishness, and pride urged him on that career steadily and without
an idea of flinching.

After Mr. Kippilaw's remarks concerning how the face of Florian

interested him, and actually that he bore a likeness to the dead Major—to
his own father, in fact—Shafto became more than desirous to be rid of him
in any way. He thought with dread of the discovery and fate of 'the
Claimant,' and of the fierce light thrown by the law on that gigantic
imposture; but genuine compunction he had none!

'Well,' he muttered, as he drove away from the hotel with his

portmanteau, 'I must keep up this game at all hazards now. I have stolen—
not only Florian's name—but his place, so let him paddle his own canoe!'

'I'll write you from Craigengowan,' were his parting words—a promise
which he never fulfilled. Shafto, who generally held their mutual purse
now, might have offered to supply the well-nigh penniless lad with money,
but he did not. He only longed to be rid of him—to hear of him no more. He
had a dread of his presence, of his society, of his very existence, and now
had but one hope, wish, and desire—that Florian Melfort should cross his
path never again. And now that he had achieved a separation between him
and Dulcie, he conceived that Florian would never again go near
Revelstoke, of which he—Shafto—had for many reasons a nervous dread!

Full of Dulcie and her apparently cruel desertion of him, which he

considered due to calm consideration of his change of fortune—or rather
total want of it—Florian felt numbly indifferent to the matter Shafto had in
hand and all about himself.

While very nearly moved to girlish tears at parting from one with whom
he had lived since infancy—with whom he had shared the same sleeping-
room, shared in the same sports and studies—with whom he had read the
same books to some extent, and had ever viewed as a brother—Florian was
rather surprised, even shocked, by the impatience of that kinsman, the only
one he had in all the wide world, to part from him and begone, and to see he
was calm and hard as flint or steel.

'Different natures have different ways of showing grief, I suppose,'

thought the simple Florian; 'or can it be that he still has a grudge at me
because of the false but winsome Dulcie? If affection for me is hidden in his
heart, it is hidden most skilfully.' No letter ever came from Craigengowan.
The pride of Florian was justly roused, and he resolved that he would not
take the initiative, and attempt to open a correspondence with one who
seemed to ignore him, and whose manner at departing he seemed to see
more clearly and vividly now.
 The fact soon became grimly apparent. He could not remain idling in
such a fashionable hotel as the Duke of Rothesay, so he settled his bill
there, and took his portmanteau in his hand, and issued into the streets—
into the world, in fact.

CHAPTER XI.

SHAFTO IN CLOVER.

About six months had elapsed since Shafto and Florian parted, as we
have described, at Edinburgh.

It was June now. The luxurious woods around Craigengowan were in all
their leafy beauty, and under their shadows the dun deer panted in the heat
as they made their lair among the feathery braken; the emerald green lawn
was mowed and rolled till it was smooth as a billiard-table and soft as three-
pile velvet.

The air was laden with the wafted fragrance of roses and innumerable
other flowers; and the picturesque old house, with its multitude of conical
turrets furnished with glittering vanes, its crow-stepped gables and massive
chimneys, stood boldly up against the deep blue sky of summer; and how
sweetly peaceful looked the pretty village, seen in middle distance, through
a foliated vista in the woodlands, with the white smoke ascending from its
humble hearths, the only thing that seemed to be stirring there; and how
beautiful were the colours some of its thatched roofs presented—greenest
moss, brown lichen, and stonecrop, now all a blaze of gold, while the
murmur of a rivulet (a tributary of the Esk), that gurgled under its tiny arch,
'the auld brig-stane' of Lennard's boyhood, would be heard at times, amid
the pleasant voices of some merrymakers on the lawn, amid the glorious
shrubberies, and belts of flowers below the stately terrace, that had long
since replaced the moat that encircled the old fortified mansion, from
whence its last Jacobite lord had ridden forth to fight and die for James
VIII., on the field of Sheriffmuir—King of Scotland, England, France, and
Ireland, as the unflinching Jacobites had it.

A gay and picturesquely dressed lawn-tennis party was busy tossing the
balls from side to side among several courts; but apart from all, and almost
conspicuously so—a young fellow, in a handsome light tennis suit of
coloured flannels, and a beautiful girl were carrying on a very palpable
flirtation.

The gentleman was Shafto, and his companion was Finella Melfort,
Cosmo's orphan daughter (an heiress through her mother), who had returned
a month before from a protracted visit in Tyburnia. They seemed to be on
excellent terms with each other, and doubtless the natural gaiety of the girl's
disposition, her vivacity of manner, and their supposed mutual relationship,
had opened the way to speedy familiarity.

She was a dark-haired and dark-eyed, but very white-skinned little

beauty, with a perfect mignonne face, a petite but round and compact figure,
gracefully formed, and very coquettish and spirituelle in all her ways.

She had received her peculiar Christian name at the special request of
her grandfather, that silly peer being desirous that her name might go down
in the peerage in connection with that of the famous Finella of Fettercairn.

'A winsome pair they would make,' was the smiling remark of Mr.
Kenneth Kippilaw, who was of the party (with three romping daughters
from Edinburgh), to Lord Fettercairn, who smirked a grim assent, as if it
was a matter of indifference to him, which it was not, as his legal adviser
very well knew; and my Lady Drumshoddy, who heard the remark,
bestowed upon him a bright and approving smile in return for a knowing
glance through the glasses of his gold pince-nez.

In Craigengowan the adventurous Shafto Gyle had found his veritable

Capua—he was literally 'in clover.' Yet he never heard himself addressed by
his assumed name without experiencing a strange sinking and fluttering of
the heart.
 The once-despised Lennard Melfort's sword, his commission, and his
hard-won medals earned in Central India and the Terai of Nepaul were now
looked upon as precious relics in his mother's luxurious boudoir at
Craigengowan, and reclaimed from the lumber-attic, his portrait, taken in
early life, was again hung in a place of honour in the dining-hall.

'What a fool my old uncle was to lose his claim on such a place as this,
and all for the face of a girl!' was the exclamation of Shafto to himself when
first he came to Craigengowan, and then he looked fearfully around him lest
the word uncle might have been overheard by some one; and he thought
—'If rascally the trick I have played my simple and love-stricken cousin—
and rascally it was and is—surely it was worth while to be the heir of this
place, Craigengowan. To reckon as mine in future all this grand panorama
of heath-clad hills, of green and golden fields, of purple muirland, and
stately woods of oak and pine where the deer rove in herds; as mine the
trout-streams that flow towards the Bervie; the cascades that roar down the
cliffs; the beautiful old house, with its stables, kennels, and terrace; its
cellars, pictures, plate, and jewellery, old china and vases of marble and
jasper, china and Japanese work; and I possess all that rank and wealth can
give!' and so thought this avaricious rascal, with a capacity for evil actions
far beyond his years.

To the fair inheritance he had come to steal he could not, however, add
as his the blue sky above it, or the waves of the German Sea, which the
North Esk flowed to join; but he was not without sense appreciative enough
to enjoy the fragrance of the teeming earth, of the pine forests where the
brown squirrels leaped from branch to branch, and on the mountain side the
perfume of the golden whin and gorse.

Appraising everything, these ideas were ever recurring to his mind, and
it was full of them now as he looked around him, and at times, like one in a
dream, heard the pretty babble of the high-bred, coquettish girl, who, to
amuse herself, made œillades at him; who called him so sweetly 'Cousin
Shafto,' and who, with her splendid fortune, he was now beginning to
include among the many goods and chattels which must one day accrue to
him.
 Lord and Lady Fettercairn were, of course, fully twenty years older than
when we saw them last, full of wrath and indignation at Lennard for his so-
called mésalliance. Both were cold in heart and self-absorbed in nature as
ever. The latter was determined to be a beauty still, though now upon the
confines of that decade 'when the cunning of cosmetics can no longer
dissemble the retribution of Time the avenger.' The former was bald now,
and the remains of his once sandy-coloured hair had become grizzled, and a
multitude of puckers were about his cold, grey eyes, while there was a
perceptible stoop in his whilom flat, square shoulders.

He was as full of family pride as ever, and the discovery of an

unexpected and authentic heir and grandson to his title, that had never been
won in the field or cabinet, but was simply the reward of bribery and
corruption, and for which not one patriotic act had been performed by four
generations, had given him intense satisfaction, and caused much blazing of
bonfires and consumption of alcohol about the country-side; and smiles that
were bright and genuine frequently wreathed the usually pale and immobile
face of Lady Fettercairn when they rested on Shafto.

We all know how the weak and easy adoption of a pretender by a titled
mother in a famous and most protracted case not many years ago caused the
most peculiar complications; thus Lady Fettercairn was more pardonable,
posted up as she was with documentary evidence, in accepting Shafto Gyle
as her grandson.

We have described her as being singularly, perhaps aristocratically, cold.

As a mother, she had never been given to kissing, caressing, or fondling her
two sons (as she did a succession of odious pugs and lap-dogs), but,
throwing their little hearts back upon themselves, left nurses and maids to
'do all that sort of tiresome thing.'

So Finella, though an heiress, came in for very little of it either, with all
her sweetness, beauty, and pretty winning ways, even from Lord
Fettercairn. In truth, the man who cared so little for his own country and her
local and vital interests was little likely to care much for any flesh and
blood that did not stand in his own boots.
 Lady Fettercairn heard from her 'grand-son' from time to time with—for
her—deep apparent sympathy, and much genuine aristocratic regret and
indignation, much of the obscure story of his boyhood and past life, at least
so much as he chose to tell her; and she bitterly resented that Lennard
Melfort should have sought to put the 'nephew of that woman, Flora
MacIan,' into the army, while placing 'his own son' Shafto into the office of
a miserable village lawyer, and so forth—and so forth!

Fortunate it was, she thought, that all this happened in an obscure village
in Devonshire, and far away from Craigengowan and all its aristocratic
surroundings.

She also thought it strange that Shafto—('Whence came that name?' she
would mutter angrily)—should be so unlike her dark and handsome
Lennard. His eyebrows were fair and heavy; his eyes were a pale, watery
grey; his lips were thin, his neck thick, and his hair somewhat sandy in hue.
Thus, she thought, he was not unlike what her husband, the present Lord
Fettercairn, must have been at the same age.

As for the Peer himself, he was only too thankful that an heir had turned
up for his ill-gotten coronet, and that now—so far as one life was concerned
—Sir Bernard Burke would not rate it among the dormant and attainted
titles—those of the best and bravest men that Scotland ever knew.

As for their mutual scheme concerning Shafto and their granddaughter

Finella, with her beauty and many attractive parts, the former was craftily
most desirous of furthering it, knowing well that, happen what might in the
future, she was an heiress; that marriage with her would give him a firm
hold on the Fettercairn family, though the money of her mother was wisely
settled on the young lady herself.

Indeed, Finella had not been many weeks home from London, at
Craigengowan, before Lady Fettercairn opened the trenches, and spoke
pretty plainly to him on the subject.

Waving her large fan slowly to and fro, and eyeing Shafto closely over
the top of it, she said:
 'I hope, my dearest boy, that you will find your cousin Finella—the
daughter of my dead darling Cosmo—a lovable kind of girl. But even were
she not so—and all say she is—you must not feel a prejudice against her,
because—because——'

'What, grandmother?'

'Because it is our warmest desire that you may marry her.'

'Why, haven't I money enough?' asked Shafto, with one of his

dissembling smiles.

'Of course, as the heir of Fettercairn; but one is always the better to have
more, and you must not feel——'

'What?' asked Shafto, with affected impatience.

'Please not to interrupt me thus. I mean that you must not be prejudiced
against her as an expected parti.'

'Why should I?'

'One hears and reads so much of such things.'

'In novels, I suppose; but as she is so pretty and eligible, why the dickens
——'

'Shafto!'

'What now?' he asked, with some irritability, as she often took him to
task for his solecisms.

'Dickens is not a phrase to use. Exclamations that were suited to the

atmosphere of Mr. Carlyon's office in Devonshire will not do in
Craigengowan!'

'Well—she won't look at me with your eyes, grandmother.'

'How—her eyes——'
 'They will never seem so bright and beautiful.'

'Oh, you flattering pet!' exclaimed my Lady Fettercairn, with a smile and
pleased flush on her old wrinkled face, for her 'pet' had soon discovered that
she was far from insensible to adulation.

Shafto certainly availed himself of the opportunities afforded by

'cousinship,' propinquity, and residence together in a country house, and
sought to gain a place in the good graces or heart of Finella; but with all his
cunning and earnest wishes in the matter—apart from the wonderful beauty
of the girl—he feared that he made no more progress with her than he had
done with Dulcie Carlyon.

She talked, played, danced, and even romped with him; they rambled
and read together, and were as much companions as any two lovers would
be; but he felt nearly certain that though she flirted with him, because it was
partly her habit to appear to do so with most men, whenever he attempted to
become tender she openly laughed at him or changed the subject skilfully;
and also that if he essayed to touch or take her hand it was very deliberately
withdrawn from his reach, and never did she make him more sensible of all
this than when he contrived to draw her aside to the terrace on the afternoon
of the lawn-tennis party.

She had long ere this been made perfectly aware that love and marriage
were objects of all his attention, yet she amused herself with him by her
coquettish œillades and waggish speeches.

'Finella,' said he, in a low and hesitating voice, as he stooped over her, 'I
hope that with all your flouting, and pretty, flippant mode of treating me,
you will see your way to carry out the fondest desire of my heart and that of
our grandparents.'

'Such a fearfully elaborate speech! And the object to which I am to see

my way is to marry you, cousin Shafto?'

'Yes,' said he, bending nearer to her half-averted ear.

'Thanks very much, dear Shafto; but I couldn't think of such a thing.'
 'Why? Am I so distasteful to you?'

'Not at all; but for cogent reasons of my own.'

'And these are?'

'Firstly, people should marry to please themselves, not others. Grandpapa

and grandmamma did, and so shall I; and I am quite independent enough to
do as I please and choose.'

'In short, you will not or cannot love me?'

'I have not said so, you tiresome Shafto!' said she, looking upward at him
with one of her sweetest and most bewitching smiles.

'Then I have some hope, dear Finella?'

'I have not said that either.'

'You may yet love me, then?'

'No; not as you wish it.'

'But why?'

'You have no right to ask me.'

His fair beetling eyebrows knit, and a gleam came into his cold, grey
eyes as he asked, after a pause:

'Is there anyone else you prefer?'

'You have no right to inquire,' replied she, and a keener observer might
have detected that his question brought a tiny blush to her cheek and a fond
smile to her curved lips; 'so please to let this matter drop, once and for ever,
dear Shafto, and we can be such delightful friends—such jolly cousins.'

And so ended one of many such conversations on this topic—

conversations that developed indifference, if not quite aversion, on the part