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Chapter 2 Drugs in Contemporary Society
Chapter 3 Motivations for Drug Use
Chapter 4 Drugs & the Law
Chapter 2 Drugs in Contemporary Society
How does drug use cost
society?
 Your thoughts:
Consequences for Society
 Deaths
 Emergency room visits
 Drugs in the workplace and lost productivity
 Broken homes, illnesses, shorter lives, etc.
 Cost of maintaining habit
 Cost of criminal behavior
 Cost of treating patients
 Fetal alcohol syndrome
 Blood borne illnesses
Getting Information on Drug
Use
 Surveys
 Hospital reports
 Police reports
 Can show trends over
time
 What’s missing?
Extent of Drug Use
 National Survey on Drug Use and Health
 Door-to-door survey of randomly selected
households
 Measures drug use in adults and adolescents
 Monitoring the Future
 Questionnaires given to 8th, 10th and 12th grade
students
Have you used marijuana in
the last 30 days?
ANONYMOUS
A. Yes
B. No
Yes
No
71%
29%
Have you had 5 or more drinks in one sitting
in the last 30 days? ANONYMOUS
A. Yes
B. No
Yes
No
50%50%
Have you used non-prescribed
narcotics in the last 30 days?
ANONYMOUS
A. Yes
B. No
Yes
No
79%
21%
Drug Abuse Warning
Network
 DAWN is a reporting system
that collects information on the
number of times drugs are
implicated in both non-lethal
and lethal visits to emergency
rooms
 Illicit drugs were responsible
for the most emergency room
visits, followed by
pharmaceutical drugs
 Data reflect acute drug
problems, not chronic drug
use
DAWN gives information
on:
A. The number of people
jailed for drug offenses
B. The number of times
drugs are implicated in
emergency room visits
C. The number of people
who admit drug use to
their doctors Thenum
berofpeople
jail..
Thenum
beroftim
esdru..
Thenum
berofpeople
w
..
0%
7%
93%
Changing Attitudes
 What made the
government change
from the laissez-faire
attitude of the 1800s to
one of control?
 Toxicity
 Dependence
 Crime
Society’s perception of drugs:
 Influenced by social and psychological
factors
 Illegal drugs are condemned more than
legal drugs
What do you think about government
regulation of drug use?
A. The government
should be more
involved
B. The government
should be less
involved
C. Our government is
doing a good job
currently
Thegovernm
entshould
..
Thegovernm
entshould
b...
Ourgovernm
entisdoing..
36%
29%
36%
Toxicity
 Physical toxicity:
 Danger to the body as a result of taking the
drug
 Behavioral toxicity:
 Drug interferes with one’s ability to function
 Acute toxicity:
 Danger from a single experience with a drug
 Chronic toxicity:
 Danger posed by repeated exposure to the
drug
Driving while drunk is an
example of:
A. Acute physical
toxicity
B. Chronic physical
toxicity
C. Acute behavioral
toxicity
D. Chronic
behavioral toxicity Acutephysicaltoxicity
Chronicphysicaltoxicity
Acutebehavioraltoxicity
Chronicbehavioraltoxicity
29%
0%
64%
7%
Cirrhosis of the liver is an
example of:
A. Acute physical
toxicity
B. Chronic physical
toxicity
C. Acute behavioral
toxicity
D. Chronic behavioral
toxicity
Acutephysicaltoxicity
Chronicphysicaltoxicity
Acutebehavioraltoxicity
Chronicbehavioraltoxicity
7%
0%0%
93%
Patterns of Use
 Experimental Use
 Infrequent use motivated by curiosity
 Social-Recreational Use
 Taking drugs to share pleasurable experiences
among friends
 Circumstantial-Situational Use
 Short-term use to contend with immediate distress
or pressure
Patterns of Use
 Intensified Use
 Taking drugs on a steady basis to relieve a
problem
 Chronic Use
 Indicates some extent of physical or
psychological dependence
 Compulsive Use
 Acquiring and consuming drugs is the main
focus of life
Changing View on
Dependence
 Early medical model
 True addiction involves physical dependence; key
is treatment of withdrawal symptoms
 Positive reinforcement model
 Drugs can reinforce behavior without physical
dependence
 Psychological dependence is
increasingly viewed as the driving force
behind repeated drug use
 This refutes the sometimes common belief that
drugs that aren’t as strongly physically
addicting are less dangerous
What do you think? Is
addiction
A. Biological
B. Genetic
C. Environmental
D. Psychological
E. Personality
Weakness
F. A combination of
above Biological
Genetic
Environm
ental
Psychological
PersonalityW
eakness
A
com
bination
ofabove
0% 0%
93%
0%
7%
0%
Substance Use Disorder DSM-
5
 Substance use disorders span a
wide variety of problems arising
from substance use, and cover 11
different criteria:
1. Taking the substance in larger amounts
or for longer than you meant to
2. Wanting to cut down or stop using the
substance but not managing to
3. Spending a lot of time getting, using, or
recovering from use of the substance
4. Cravings and urges to use the substance
(psychological dependence)
5. Not managing to do what you should at
work, home or school, because of
substance use
6. Continuing to use, even when it causes
problems in relationships
7. Giving up important social, occupational
or recreational activities because of
substance use
8. Using substances again and again,
even when it puts you in danger
9. Continuing to use, even when the you
know you have a physical or
psychological problem that could have
been caused or made worse by the
substance
10. Needing more of the substance to get
the effect you want (tolerance)
11. Development of withdrawal symptoms,
which can be relieved by taking more of
the substance. (physical dependence)
Impacts of Drug Use
Family stability
Social behavior
Education and career
aspirations
Personal and social
maturation
REMEMBER:
A correlate is:
A. A variable that
causes something
B. A thing you keep
horses in
C. A variable that is
associated with
something
A
variablethatcausess...
A
thingyou
keep
horsesin
A
variablethatisassocia...
0% 0%0%
Family
 Association between drug use and the
likelihood that a couple will separate or divorce
 Women subjected to violence have higher
rates of alcohol dependence and other drug
abuse problems
 Family interventions into adolescent alcohol
use reduce the initiation and frequency of
alcohol use
 Marijuana use by young Black males is
significantly reduced when both parents are
present
Family
 Parental substance abuse is a factor for
1/3 to 2/3 of all children involved with the
child welfare system
 Substance abuse is a factor in many cases
of child abuse and domestic abuse
 Alcohol use is associated with the
perpetration of sexual aggression,
especially toward boys **
Effects of drug use by pregnant
women
 Women whose babies
test positive for drugs
such as cocaine are
subject to losing custody
of their children
 Risks to the baby:
 Low birth weight
 Premature birth
 Miscarriage
 Birth defects
 Difficulty bonding
 Learning disabilities
Which of the following is NOT
associated with drug use in the family?
A. Increased
violence
B. Higher divorce
rates
C. Low IQ
D. They are all
associated
Increased
violence
Higherdivorcerates
Low
IQ
Theyare
allassociated
0% 0%0%0%
Social Behavior
 Drug users display more independence,
rebelliousness, acceptance of deviant
behavior, and rejection of moral and social
norms than nonusers
 Children of parents who use
drugs are more likely to
engage in delinquent behaviors
 Stimulants such as methamphetamines
and cocaine are associated with violence,
while marijuana and heroin are more likely
to produce a passive response
Social Behavior
 Alcohol is the drug involved with the most
violent incidents
 The level of aggression associated with
alcohol is dose related
 Binge drinking is associated with unsafe
sex and violence, and with nonconsensual
sex
Drug users show higher levels of
acceptance of deviant behavior
A. True
B. False
True
False
0%0%
Alcohol is associated
with
0%
0%
0%
0%
0% A. Higher level of violent incidents
B. Dating violence
C. Unsafe sex
D. Nonconsensual sex
E. All of the above
Education
 There is a higher dropout rate from school for those
who used alcohol, illicit drugs, and cigarettes
 There is a relationship between academic
performance and drug use
 Drug use is assumed to be a predictor
of welfare dependency
 Higher Education Act of 1965: College students who
are convicted of a drug offense are denied federal
financial aid
Do you feel that the regulations about
financial aid and drug convictions are
fair?
0%
21%
43%
36% A. Yes
B. No
C. Sometimes
D. I’m undecided
Employment
 Employed drug users have less stable job
histories than nonusers
 Alcohol abusers earn significantly less money
than moderate drinkers and abstainers
 Drug use is associated with higher accident rates
on the job and lower productivity
Drugs in the
Workplace
 Substance abuse in the workplace results in:
 Lessened productivity
 Increased accidents, absenteeism, and health care costs
 Highest rates of drug use are food service workers
and construction workers – identifying drug
problems in top-level managers is more difficult
 Employee Assistance Programs (EAPs) help
workers deal with problems that affect job
performance, including alcohol or drug problems
Drug Testing
 In 2011, the federal government
earmarked $283.1 million for
drug-related activities in schools
 Random workplace drug testing has effectively
identified frequent users of illicit drugs
 In many jurisdictions, physicians are required
to report women who use drugs during
pregnancy or infants who test positive for drug
use by their mothers
Types of Drug
Testing
 Immunoassay is fast and less
expensive than other methods but may give false
positive readings
 Gas chromatography is more expensive and time-
consuming than other methods
 Thin-layer chromatography is simple and
inexpensive, but requires expert interpretation
 Gas chromatography/mass spectrometry is
highly sensitive, but is time-consuming and
expensive http://www.aa
fp.org/afp/201
0/0301/p635.
html
Problems with Drug
Testing
 False positive
 A person tests positive for a drug even
though no drug is present in the person’s
urine
 False negative
 A person tests negative
even though drugs are
present in the person’s
urine
Legality of Drug Testing
 Debated in two
cases before the
U.S. Supreme
Court:
 Skinner v. Railway
Labor Executive
Association
 National Treasury
Employees Union v.
von Raab
 In both cases, the
Supreme Court
ruled that the testing
program was
justified http://www.nolo.com/legal-
encyclopedia/free-books/employee-
rights-book/chapter5-3.html
How is drug use related to
crime?
 Intoxication causes behavior and personality
change
 Crimes may be committed while intoxicated
 Drug use/possession is a crime
 Crimes to fund cost of drug use
 Society tries to protect itself through regulation
 Current laws may not be part of a logical plan,
ineffective or unrealistic
Crime: Drug Business
 Drug trade is a big business with no signs
of slowing down
 Tactics for stopping drug flow into the US –
military force, reducing aid to drug-
producing countries, and promoting crop
substitution – are ineffective
 Results in thousands needing medical care
for drug overdoses, and has an economic
impact on the criminal justice system and
environment
Crime: Drug
Business
 Colombia is the leading
producer of cocaine
 In Laos, Burma, and Thailand,
opium production has largely been
replaced by methamphetamines
 In addition to domestic production,
marijuana is grown in Asia, the
Caribbean, and Mexico – Colombia
is the largest exporter
US National Drug Control
Budget
Crime: Drug Enforcement
• The narcotics trade is
tremendously profitable
• Even after billions of dollars
were spent on curbing drug
production, coca growth in
Colombia rose 27%
• Preventing drugs from
entering the United States or
reducing the amount of drugs
grown in the country is a
matter of demand, not supply
How should we deal with drug
problems?
17%
17%
17%
17%
17%
17% A. Legalize drugs
B. Stop drugs at borders
C. Reduce demand (treatment/education)
D. Prevent production in other countries
E. End the “War on Drugs”
F. I’m not sure
How should we deal with drug problems?
Goldberg Chapter 3
Motivations for Drug Use
What do you think the most
common reason for drug use
is?
14%
21%
29%
7%
29% A. Curiosity
B. Boredom
C. Escape
D. Social
E. Rebellion
Motivations
 We all do things we know we shouldn’t do.
Why?
 Characteristics of drugs can reinforce their use
 Altered states of consciousness
 Societal, community, and family factors play
an important role in whether an individual tries
a drug
 Drug factors play an important role in whether
an individual continues to use a drug
Reasons for Drug Use
 Experimentation:
 Especially among young people, curiosity is a
natural phenomenon that easily leads to
experimentation
 Pleasure/Escape from Boredom:
 An individual who is bored will engage in
something pleasurable to relieve the boredom
 Drugs used to increase pleasure or reduce
boredom provide positive reinforcement
 Drugs taken to alleviate discomfort provide
negative reinforcement
Reasons for Drug Use
 Peer Influence:
 Many young people use drugs to gain peer
acceptance or approval
 Basic values, life goals, and aspirations still are
influenced more by parents
 Spiritual Purposes:
 People have used drugs to communicate with
something or someone greater than themselves
 Psychoactive plants have roles in many
religious and spiritual practices
Reasons for Drug Use
 Self-Discovery:
 Drugs sometimes are used to fill a void in one’s life
 Social Interaction:
 Drugs are used to facilitate interactions with others
 Certain social groups determine how a drug is used
 Rebelliousness:
 Young people rebel against the conventions of
society, including warnings about drugs
Risk Factors
 Community, parental, and
peer attitudes and
behaviors
 Antisocial/problem
behaviors
 Poor school performance
 Perception that use is
prevalent
Protective Factors
 Involvement in religious activities
 Commitment to school, involvement
in extracurricular activities
 Perceived risk of
drug use
 Parents as social
support
Perceived Risk/Availability
Spiral of Psychological
Addiction
Psychological Addiction
Theories of Addiction
 U.S. Department of Health and Human
Services: Addiction is a “chronic, life-
threatening condition that has roots in
genetic susceptibility, social
circumstance and personal behavior”
 No single theory adequately covers
every aspect of drug addiction –
elements of various theories provide
insight into drug addiction
Personality Theory
 Delayed behavioral or emotional development
may be a factor in substance abuse
 Personality characteristics associated with drug
abuse:
 Low self-esteem
 Poor interpersonal skills
 Need for immediate gratification
 Defiant feelings toward authority
 Little tolerance for anxiety, frustration, and depression
 Impulsivity
 Risk taking
 Low regard for personal health
Personality traits associated
with drug use do not include:
A. Impulsivity
B. Lack of
intelligence
C. Need for
immediate
gratification
D. Defiance
Im
pulsivity
Lack
ofintelligence
Need
forim
m
ediate
grati...
Defiance
0% 0%0%0%
Response
Reinforcement Theory
 Reinforcers are stimuli or events that increase
the likelihood of a particular behavior
 Primary reinforcers reduce physiological needs
or are inherently pleasurable; examples are
food, water, and sex
 Secondary reinforcers act as signals for the
increased probability of obtaining primary
reinforcers; example: money
 Drugs can be primary or secondary reinforcers
Reinforcers are:
A. Things that
reward us
B. Things that are
correlated with
drug use
C. Things that make
a behavior more
likely Thingsthatreward
us
Thingsthatare
correlate...
Thingsthatm
ake
a
beha...
0% 0%0%
Response
Biological Theories
 Biological theory is a view of addiction
holding that it is based on genetics and
metabolic imbalances
 Genetic theory: a person is predisposed
to drug addiction, including addiction to
alcohol, by hereditary influence
 Metabolic imbalance: Narcotics help
addicts stabilize the metabolic deficiency
caused by absence of the drug
Biological theories consider
these factors:
A. The biology of the
individual
B. Genetics
C. Metabolic
imbalances
D. All of the above
Thebiology
ofthe
indivi...
Genetics
M
etabolicim
balancesAlloftheabove
0% 0%0%0%
Response
Social Theories
 Social theory is the hypothesis that drug use
is determined by cultural and social influences
 Rewards of drug use may be derived from
groups and others with whom we associate
 Drug abuse may arise from antisocial behavior
 Social theory does not explain drug addiction
Social theories:
A. Attribute drug use
to cultural and
social influences
B. Explain the
phenomenon of
addiction
C. Discount the
importance of
family influence
Attribute
druguseto
cu...
Explain
the
phenom
enon
..
Discountthe
im
portance
..
0% 0%0%
Response
Media Influence
 The impact of the media on drug use is hard to
determine
 Many forms of
mass media feature
drugs:
 Movies
 Advertisements
 Billboards
 Television
 Music
 Celebrities
Small Groups
 1. Discuss what factors are most important in one’s
decision to use or not use alcohol, tobacco, and/or
illegal drugs.
 2. Peers are cited frequently as an important
influence on whether one uses drugs. At what age is
the influence of peers most significant? Are males or
females more affected by peer influence?
 3. The depiction of alcohol use and smoking is
prominent in movies, music videos, and television
shows. Do you feel that alcohol use and smoking
rates are affected by how alcohol and smoking are
shown in videos? If yes, would you try to ban all
alcohol and tobacco use in the media?
Goldberg Chapter 4 Drugs & the Law
Drugs & The Law
 Attempts have been made to
regulate the use of mind-
altering substances since
settlers first arrived in the
New World
 The first substance regulated
was alcohol
 The temperance movement
in the late 1700s advocated
that people become more
educated about the hazards
of alcohol Click picture for
video
Early Regulation
 Alcohol
 1791: Congress passed an excise
tax on whiskey
 Opium
 1833: US treaty regulated international opium trade
 1842: Tax on crude opium shipped to the US
 1875: San Francisco prohibiting smoking in opium
dens
 1890: Only US citizens could manufacture or import
opium
 Proprietary drugs (over-the-counter drugs)
 Pure Food and Drug Act of 1906
Small Group Questions:
 Do drug laws affect whether people use
drugs?
 Should drug laws be aimed at drug users,
sellers, or traffickers?
 Should the role of government be to inform its
citizens about drugs or to prevent its citizens
from using drugs?
 Should a person be prevented from engaging
in self-destructive behavior?
Pure Food & Drug Act 1906
 Before 1906, patent medicines were
largely unregulated
 US Food and Drug Administration
(FDA) was created to assess drug
hazards and prohibit sale of dangerous
drugs
 Law required drug manufacturers to
report adverse reactions to their products
 Law required that the amount or
proportion of drugs in the medicine had
to be listed on the label
The Pure Food & Drug Act was
created to:
A. Stop people from
using opium
B. Establish taxes on
drugs
C. Force people to get
prescriptions for
drugs
D. Keep dangerous
drugs off the
market
Stop
peoplefrom
using...
Establish
taxeson
drugs
Force
peopleto
getpresc...
Keep
dangerousdrugsoff...
0% 0%0%0%
Harrison Act 1914
 The Harrison Act resulted from the need
to limit opiate use
 Law governed the marketing and sale of
narcotics, regulated nonmedical narcotic
use, and made possession of narcotics
without a prescription illegal
 Doctors and pharmacists had to keep
records of the prescriptions they wrote
 To obtain drugs, an increasing number
of people resorted to criminal activity
The Harrison Act:
A. Established taxes
on drugs
B. Made opium illegal
without a
prescription
C. Established jail
time for drug
offenses Established
taxeson
drugs
M
ade
opium
illegalw
ith...
Established
jailtim
e
for...
7%
0%
93%
Prohibition 1919-1933
 Began with the
Temperance
Movement
 19th Amendment
passed in 1919
 Speak-easies
 Bootlegging
 Increase in
organized crime
 Repealed in 1933 by
the 21st Amendment
Marijuana Tax Act 1937
 Forbade the recreational use of marijuana,
but not medicinal or industrial uses
 Anyone using marijuana was required to
pay a tax – failure to comply meant a large
fine or prison term for tax evasion
 AMA and others opposed marijuana
legislation
 The Federal Bureau of Narcotics,
established in 1932, later became the
Drug Enforcement Administration (DEA)
The marijuana tax act made all use of
marijuana illegal.
A. True
B. False
True
False
85%
15%
Food, Drug, and Cosmetic Act
1938
 Under 1906 guidelines, a drug manufacturer
could not be prosecuted for fatalities due to
toxic drugs
 1938 Act required pharmaceutical companies
to file applications with the federal government
demonstrating that all new drugs were safe
and properly labeled
 Manufacturers had to submit a “new drug
application” to the FDA, giving the FDA more
authority and responsibility
Limitations of the 1938
Food,
Drug, and Cosmetic Act Did not cover drugs that were previously marketed
 Drugs had to be proven safe, but not effective
 Government had little authority to enact penalties
 Manufacturers determined whether a drug would be
sold as a prescription or over-the-counter
 Manufacturers conducted their own tests to
determine a drug’s effectiveness
The Food, Drug, & Cosmetic
Act
A. Established taxes
on new drugs
B. Ensured that drugs
were proven
effective
C. Ensured that drugs
were proven safe
D. Enacted stiff
penalties for false
advertising
Established
taxeson
new
...
Ensured
thatdrugsw
ere...
Ensured
thatdrugsw
ere...
Enacted
stiffpenaltiesfor...
0% 0%0%0%
I think the legalization of marijuana was
a good idea.
A. Absolutely.
B. No, I disagree, it
was a bad idea.
C. I’m not sure or
have no opinion.
Absolutely.
No,Idisagree,itw
asab..
I’m
notsure
orhaveno
...
0% 0%0%
Kefauver-Harris
Amendments
 Serious birth defects caused by
thalidomide resulted in
implementation of stronger
regulations regarding drug testing
 Kefauver-Harris Amendments,
1962, gave the FDA the authority to
withdraw drugs from the
marketplace
 Drug advertisements directed to
physicians were required to include
the drug’s side effects and its
contraindicated uses
 Testing procedures required prior
approval from the FDA
Kefauver-Harris
Amendments
 1972 Drug Efficacy Study: The FDA asked the
National Research Council to conduct a study
of new drugs
 Active ingredients were placed in one of three
categories:
 Category I drugs: Determined to be safe, effective,
and properly labeled
 Category II drugs: Not generally recognized as safe
and effective, or recognized as mislabeled; must be
removed from medications within six months
 Category III drugs: Data insufficient to determine
general recognition of safety and effectiveness
Considering the Kefauver-Harris
Amendments, all of the following are true
EXCEPT:
A. The FDA had the
authority to remove
unsafe drugs from
the market
B. Taxes on drug
advertisements were
enacted
C. Advertisements
must include side-
effects
D. Tests were required
prior to a drug’s
approval
TheFDA
had
theauthorit...
Taxeson
drugadvertise...
Advertisem
entsm
ustinc...
Testsw
ererequired
prior..
0% 0%0%0%
Comprehensive Drug Abuse
Prevention and Control Act of
1970
 Comprehensive Drug Abuse Prevention and Control
Act (Controlled Substances Act), effectively replaced
all previous laws dealing with narcotics and
dangerous drugs
 Expanded community health centers and Public
Health Service hospitals for drug abusers
 Established a commission on marijuana and drug
abuse
 Divided drugs into five categories called schedules
The Comprehensive Drug Abuse
Prevention and Control Act replaced all
previous legislation regarding
dangerous drugs
A. True
B. False
True
False
0%0%
Schedule Criteria Examples
I a. High potential for abuse
b. No accepted medical use
c. Lack of accepted safety
Heroin,
marijuana, MDMA
(Ecstasy)
II a. High potential for abuse
b. Currently accepted medical use
c. Abuse may lead to severe dependence
Morphine,
cocaine,
methamphetamine
III a. Potential for abuse less than I and II
b. Currently accepted medical use
c. Abuse may lead to moderate physical dependence or high
psychological dependence
Anabolic steroids,
most barbiturates,
Dronabinol (THC in pill
form)
IV a. Low potential for abuse relative to III
b. Currently accepted medical use
c. Abuse may lead to limited physical or psychological
dependence relative to III
Xanax, barbital,
chloral hydrate,
fenfluramine
V a. Low potential for abuse relative to IV
b. Currently accepted medical use
c. Abuse may lead to limited physical or psychological
dependence relative to IV
Mixture with small
amounts of codeine or
opium
Anti–Drug Abuse Act of
1988
 Legislation that emphasizes stringent
punishment of the drug user, to reduce drug
demand
 Punishment could be waived if the user
completes a drug rehabilitation program
 Greatly increased federal prison population
and led to a new Cabinet position, Director
of National Drug Control Policy
 Under this law, drug users are punished more
stringently than rapists or robbers
The Anti-Drug Abuse Act
A. Emphasized strict
punishment for drug
infractions
B. Allowed offenders to
complete treatment
rather than jail
C. Created lighter
sentences for drug
offenses
D. A & B
E. All of the above
Em
phasized
strictpunis...
Allow
ed
offendersto
co...
Created
lightersentences...
A
&
B
Alloftheabove
0% 0% 0%0%0%
Small Group Questions:
1. Should the sale of drug paraphernalia be illegal?
2. Should people using small amounts of illegal
drugs for personal enjoyment receive harsh
criminal penalties?
3. What are the advantages and disadvantages of
decriminalizing or legalizing drugs?
4. What impact has drug enforcement had on drug
use?
5. Should the vast amount of money spent on
stopping drugs be used differently?
Drug Paraphernalia
 Drug paraphernalia:
 Items that are aids to using drugs (cigarette-
rolling papers, water pipes, razors, clay
pipes, roach clips, spoons, mirrors, and
other products)
 Prosecuting individuals for possessing
drug paraphernalia is viewed as a
deterrent for drug use
The War on Drugs
 In 1988, Congress proclaimed that the
US would be drug-free by 1995
 The monetary expense and human
resources employed to combat illicit
drug use are enormous – yet, the
number of Americans who have used
illegal drugs has increased
 The government’s assault on illicit
drugs has resulted in social tension, ill
health, violent crime, compromised
civil liberties, and international conflict
The War on Drugs has been
largely successful
A. True
B. False
True
False
0%0% Response
http://ezproxy.wwcc.edu
:2048/login?url=http://di
gital.films.com/PortalPla
ylists.aspx?aid=7539&xt
id=50127
Are you for or against legalization of
drugs? (all currently illicit drugs)
A. For legalization
B. Against legalization
C. For legalization,
but only for some
drugs
Forlegalization
Againstlegalization
Forlegalization,butonly...
0% 0%0%
Arguments Against
Legalization
 Some argue that
decriminalization would
increase drug use, addiction,
and drug-related deaths
 Drug-related crimes might fall,
but the number of addicts would
rise
 Legalization would result in
more dysfunctional addicts who
would be unable to support their
lifestyles and drug use through
legitimate means
Arguments For
Legalization
 Legal regulation of drugs
would protect drug takers
and save money
 Billions of dollars spent on
drug enforcement might
be put to use more
effectively if the money
were directed toward
education and treatment
programs
Drug Enforcement
 Drug enforcement is
designed to stem the flow of
drugs coming into the US
and to punish the user
 To stop drugs at their source,
the State Department works
with a number of foreign
governments
 DEA agents help block drugs
from leaving other countries,
eradicate crops, and find and
dismantle illegal laboratories
Problems with
Enforcement
 Farmers make more money from coca
or opium crops than from legal crops
 On a global scale, less than 10% of
illegal crops are consistently eradicated
 Interdiction is especially difficult because
of numerous points of entry
Prevention
 Harm reduction
 Interventions that respond to
needs of drug users and the
community to reduce harm
caused by illicit drug use
 Includes providing sterile syringes to reduce
spread of HIV infection, education, and
increased treatment
 Treats drug abuse as a public health
problem, not a criminal problem
Prevention
 Normalization
 Term used by the Dutch for the
practice of not prosecuting users of
soft drugs such as marijuana
 Using some drugs is not illegal, but
drug traffic is illegal
 Treatment assists physical and
social well-being of addicts rather
than try to stop their addiction
 Result: Netherlands has less drug
use than the US and other
European countries
Racism and Drug
Enforcement
 Questionable search warrants in
inner-city communities
 People of color are stopped and
searched more often than others
on the basis of “drug courier”
profiles
 Despite comparable drug usage, Blacks are incarcerated
at a higher rate than Whites
 Penalties for crack cocaine, used more by poor, are
greater than those for powder cocaine, used more by
middle class
Mandatory Minimum
Sentencing
 Starting in 1984, Congress enacted
mandatory minimum penalties
specifically focusing on drugs and
violent crimes
 It has been shown that mandatory
minimum drug sentences have not acted as deterrents to
further crime
 Mandatory minimum drug sentences give no latitude to
judges to determine appropriate punishments
 Treatment is 15 times more effective for reducing serious
crime than mandatory minimum sentencing

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SOC 204 Goldberg Ch 2 3 & 4 Week 2

  • 1. Chapter 2 Drugs in Contemporary Society Chapter 3 Motivations for Drug Use Chapter 4 Drugs & the Law
  • 2. Chapter 2 Drugs in Contemporary Society
  • 3. How does drug use cost society?  Your thoughts:
  • 4. Consequences for Society  Deaths  Emergency room visits  Drugs in the workplace and lost productivity  Broken homes, illnesses, shorter lives, etc.  Cost of maintaining habit  Cost of criminal behavior  Cost of treating patients  Fetal alcohol syndrome  Blood borne illnesses
  • 5. Getting Information on Drug Use  Surveys  Hospital reports  Police reports  Can show trends over time  What’s missing?
  • 6. Extent of Drug Use  National Survey on Drug Use and Health  Door-to-door survey of randomly selected households  Measures drug use in adults and adolescents  Monitoring the Future  Questionnaires given to 8th, 10th and 12th grade students
  • 7. Have you used marijuana in the last 30 days? ANONYMOUS A. Yes B. No Yes No 71% 29%
  • 8.
  • 9. Have you had 5 or more drinks in one sitting in the last 30 days? ANONYMOUS A. Yes B. No Yes No 50%50%
  • 10.
  • 11. Have you used non-prescribed narcotics in the last 30 days? ANONYMOUS A. Yes B. No Yes No 79% 21%
  • 12.
  • 13. Drug Abuse Warning Network  DAWN is a reporting system that collects information on the number of times drugs are implicated in both non-lethal and lethal visits to emergency rooms  Illicit drugs were responsible for the most emergency room visits, followed by pharmaceutical drugs  Data reflect acute drug problems, not chronic drug use
  • 14. DAWN gives information on: A. The number of people jailed for drug offenses B. The number of times drugs are implicated in emergency room visits C. The number of people who admit drug use to their doctors Thenum berofpeople jail.. Thenum beroftim esdru.. Thenum berofpeople w .. 0% 7% 93%
  • 15. Changing Attitudes  What made the government change from the laissez-faire attitude of the 1800s to one of control?  Toxicity  Dependence  Crime
  • 16. Society’s perception of drugs:  Influenced by social and psychological factors  Illegal drugs are condemned more than legal drugs
  • 17. What do you think about government regulation of drug use? A. The government should be more involved B. The government should be less involved C. Our government is doing a good job currently Thegovernm entshould .. Thegovernm entshould b... Ourgovernm entisdoing.. 36% 29% 36%
  • 18. Toxicity  Physical toxicity:  Danger to the body as a result of taking the drug  Behavioral toxicity:  Drug interferes with one’s ability to function  Acute toxicity:  Danger from a single experience with a drug  Chronic toxicity:  Danger posed by repeated exposure to the drug
  • 19. Driving while drunk is an example of: A. Acute physical toxicity B. Chronic physical toxicity C. Acute behavioral toxicity D. Chronic behavioral toxicity Acutephysicaltoxicity Chronicphysicaltoxicity Acutebehavioraltoxicity Chronicbehavioraltoxicity 29% 0% 64% 7%
  • 20. Cirrhosis of the liver is an example of: A. Acute physical toxicity B. Chronic physical toxicity C. Acute behavioral toxicity D. Chronic behavioral toxicity Acutephysicaltoxicity Chronicphysicaltoxicity Acutebehavioraltoxicity Chronicbehavioraltoxicity 7% 0%0% 93%
  • 21. Patterns of Use  Experimental Use  Infrequent use motivated by curiosity  Social-Recreational Use  Taking drugs to share pleasurable experiences among friends  Circumstantial-Situational Use  Short-term use to contend with immediate distress or pressure
  • 22. Patterns of Use  Intensified Use  Taking drugs on a steady basis to relieve a problem  Chronic Use  Indicates some extent of physical or psychological dependence  Compulsive Use  Acquiring and consuming drugs is the main focus of life
  • 23. Changing View on Dependence  Early medical model  True addiction involves physical dependence; key is treatment of withdrawal symptoms  Positive reinforcement model  Drugs can reinforce behavior without physical dependence  Psychological dependence is increasingly viewed as the driving force behind repeated drug use  This refutes the sometimes common belief that drugs that aren’t as strongly physically addicting are less dangerous
  • 24. What do you think? Is addiction A. Biological B. Genetic C. Environmental D. Psychological E. Personality Weakness F. A combination of above Biological Genetic Environm ental Psychological PersonalityW eakness A com bination ofabove 0% 0% 93% 0% 7% 0%
  • 25. Substance Use Disorder DSM- 5  Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria: 1. Taking the substance in larger amounts or for longer than you meant to 2. Wanting to cut down or stop using the substance but not managing to 3. Spending a lot of time getting, using, or recovering from use of the substance
  • 26. 4. Cravings and urges to use the substance (psychological dependence) 5. Not managing to do what you should at work, home or school, because of substance use 6. Continuing to use, even when it causes problems in relationships 7. Giving up important social, occupational or recreational activities because of substance use
  • 27. 8. Using substances again and again, even when it puts you in danger 9. Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance 10. Needing more of the substance to get the effect you want (tolerance) 11. Development of withdrawal symptoms, which can be relieved by taking more of the substance. (physical dependence)
  • 28. Impacts of Drug Use Family stability Social behavior Education and career aspirations Personal and social maturation
  • 30. A correlate is: A. A variable that causes something B. A thing you keep horses in C. A variable that is associated with something A variablethatcausess... A thingyou keep horsesin A variablethatisassocia... 0% 0%0%
  • 31. Family  Association between drug use and the likelihood that a couple will separate or divorce  Women subjected to violence have higher rates of alcohol dependence and other drug abuse problems  Family interventions into adolescent alcohol use reduce the initiation and frequency of alcohol use  Marijuana use by young Black males is significantly reduced when both parents are present
  • 32. Family  Parental substance abuse is a factor for 1/3 to 2/3 of all children involved with the child welfare system  Substance abuse is a factor in many cases of child abuse and domestic abuse  Alcohol use is associated with the perpetration of sexual aggression, especially toward boys **
  • 33. Effects of drug use by pregnant women  Women whose babies test positive for drugs such as cocaine are subject to losing custody of their children  Risks to the baby:  Low birth weight  Premature birth  Miscarriage  Birth defects  Difficulty bonding  Learning disabilities
  • 34. Which of the following is NOT associated with drug use in the family? A. Increased violence B. Higher divorce rates C. Low IQ D. They are all associated Increased violence Higherdivorcerates Low IQ Theyare allassociated 0% 0%0%0%
  • 35. Social Behavior  Drug users display more independence, rebelliousness, acceptance of deviant behavior, and rejection of moral and social norms than nonusers  Children of parents who use drugs are more likely to engage in delinquent behaviors  Stimulants such as methamphetamines and cocaine are associated with violence, while marijuana and heroin are more likely to produce a passive response
  • 36. Social Behavior  Alcohol is the drug involved with the most violent incidents  The level of aggression associated with alcohol is dose related  Binge drinking is associated with unsafe sex and violence, and with nonconsensual sex
  • 37. Drug users show higher levels of acceptance of deviant behavior A. True B. False True False 0%0%
  • 38. Alcohol is associated with 0% 0% 0% 0% 0% A. Higher level of violent incidents B. Dating violence C. Unsafe sex D. Nonconsensual sex E. All of the above
  • 39. Education  There is a higher dropout rate from school for those who used alcohol, illicit drugs, and cigarettes  There is a relationship between academic performance and drug use  Drug use is assumed to be a predictor of welfare dependency  Higher Education Act of 1965: College students who are convicted of a drug offense are denied federal financial aid
  • 40. Do you feel that the regulations about financial aid and drug convictions are fair? 0% 21% 43% 36% A. Yes B. No C. Sometimes D. I’m undecided
  • 41. Employment  Employed drug users have less stable job histories than nonusers  Alcohol abusers earn significantly less money than moderate drinkers and abstainers  Drug use is associated with higher accident rates on the job and lower productivity
  • 42. Drugs in the Workplace  Substance abuse in the workplace results in:  Lessened productivity  Increased accidents, absenteeism, and health care costs  Highest rates of drug use are food service workers and construction workers – identifying drug problems in top-level managers is more difficult  Employee Assistance Programs (EAPs) help workers deal with problems that affect job performance, including alcohol or drug problems
  • 43. Drug Testing  In 2011, the federal government earmarked $283.1 million for drug-related activities in schools  Random workplace drug testing has effectively identified frequent users of illicit drugs  In many jurisdictions, physicians are required to report women who use drugs during pregnancy or infants who test positive for drug use by their mothers
  • 44. Types of Drug Testing  Immunoassay is fast and less expensive than other methods but may give false positive readings  Gas chromatography is more expensive and time- consuming than other methods  Thin-layer chromatography is simple and inexpensive, but requires expert interpretation  Gas chromatography/mass spectrometry is highly sensitive, but is time-consuming and expensive http://www.aa fp.org/afp/201 0/0301/p635. html
  • 45. Problems with Drug Testing  False positive  A person tests positive for a drug even though no drug is present in the person’s urine  False negative  A person tests negative even though drugs are present in the person’s urine
  • 46.
  • 47. Legality of Drug Testing  Debated in two cases before the U.S. Supreme Court:  Skinner v. Railway Labor Executive Association  National Treasury Employees Union v. von Raab  In both cases, the Supreme Court ruled that the testing program was justified http://www.nolo.com/legal- encyclopedia/free-books/employee- rights-book/chapter5-3.html
  • 48. How is drug use related to crime?  Intoxication causes behavior and personality change  Crimes may be committed while intoxicated  Drug use/possession is a crime  Crimes to fund cost of drug use  Society tries to protect itself through regulation  Current laws may not be part of a logical plan, ineffective or unrealistic
  • 49. Crime: Drug Business  Drug trade is a big business with no signs of slowing down  Tactics for stopping drug flow into the US – military force, reducing aid to drug- producing countries, and promoting crop substitution – are ineffective  Results in thousands needing medical care for drug overdoses, and has an economic impact on the criminal justice system and environment
  • 50.
  • 51. Crime: Drug Business  Colombia is the leading producer of cocaine  In Laos, Burma, and Thailand, opium production has largely been replaced by methamphetamines  In addition to domestic production, marijuana is grown in Asia, the Caribbean, and Mexico – Colombia is the largest exporter
  • 52. US National Drug Control Budget
  • 53. Crime: Drug Enforcement • The narcotics trade is tremendously profitable • Even after billions of dollars were spent on curbing drug production, coca growth in Colombia rose 27% • Preventing drugs from entering the United States or reducing the amount of drugs grown in the country is a matter of demand, not supply
  • 54. How should we deal with drug problems? 17% 17% 17% 17% 17% 17% A. Legalize drugs B. Stop drugs at borders C. Reduce demand (treatment/education) D. Prevent production in other countries E. End the “War on Drugs” F. I’m not sure
  • 55. How should we deal with drug problems?
  • 57. What do you think the most common reason for drug use is? 14% 21% 29% 7% 29% A. Curiosity B. Boredom C. Escape D. Social E. Rebellion
  • 58. Motivations  We all do things we know we shouldn’t do. Why?  Characteristics of drugs can reinforce their use  Altered states of consciousness  Societal, community, and family factors play an important role in whether an individual tries a drug  Drug factors play an important role in whether an individual continues to use a drug
  • 59. Reasons for Drug Use  Experimentation:  Especially among young people, curiosity is a natural phenomenon that easily leads to experimentation  Pleasure/Escape from Boredom:  An individual who is bored will engage in something pleasurable to relieve the boredom  Drugs used to increase pleasure or reduce boredom provide positive reinforcement  Drugs taken to alleviate discomfort provide negative reinforcement
  • 60. Reasons for Drug Use  Peer Influence:  Many young people use drugs to gain peer acceptance or approval  Basic values, life goals, and aspirations still are influenced more by parents  Spiritual Purposes:  People have used drugs to communicate with something or someone greater than themselves  Psychoactive plants have roles in many religious and spiritual practices
  • 61. Reasons for Drug Use  Self-Discovery:  Drugs sometimes are used to fill a void in one’s life  Social Interaction:  Drugs are used to facilitate interactions with others  Certain social groups determine how a drug is used  Rebelliousness:  Young people rebel against the conventions of society, including warnings about drugs
  • 62.
  • 63. Risk Factors  Community, parental, and peer attitudes and behaviors  Antisocial/problem behaviors  Poor school performance  Perception that use is prevalent
  • 64. Protective Factors  Involvement in religious activities  Commitment to school, involvement in extracurricular activities  Perceived risk of drug use  Parents as social support
  • 68. Theories of Addiction  U.S. Department of Health and Human Services: Addiction is a “chronic, life- threatening condition that has roots in genetic susceptibility, social circumstance and personal behavior”  No single theory adequately covers every aspect of drug addiction – elements of various theories provide insight into drug addiction
  • 69. Personality Theory  Delayed behavioral or emotional development may be a factor in substance abuse  Personality characteristics associated with drug abuse:  Low self-esteem  Poor interpersonal skills  Need for immediate gratification  Defiant feelings toward authority  Little tolerance for anxiety, frustration, and depression  Impulsivity  Risk taking  Low regard for personal health
  • 70. Personality traits associated with drug use do not include: A. Impulsivity B. Lack of intelligence C. Need for immediate gratification D. Defiance Im pulsivity Lack ofintelligence Need forim m ediate grati... Defiance 0% 0%0%0% Response
  • 71. Reinforcement Theory  Reinforcers are stimuli or events that increase the likelihood of a particular behavior  Primary reinforcers reduce physiological needs or are inherently pleasurable; examples are food, water, and sex  Secondary reinforcers act as signals for the increased probability of obtaining primary reinforcers; example: money  Drugs can be primary or secondary reinforcers
  • 72. Reinforcers are: A. Things that reward us B. Things that are correlated with drug use C. Things that make a behavior more likely Thingsthatreward us Thingsthatare correlate... Thingsthatm ake a beha... 0% 0%0% Response
  • 73. Biological Theories  Biological theory is a view of addiction holding that it is based on genetics and metabolic imbalances  Genetic theory: a person is predisposed to drug addiction, including addiction to alcohol, by hereditary influence  Metabolic imbalance: Narcotics help addicts stabilize the metabolic deficiency caused by absence of the drug
  • 74. Biological theories consider these factors: A. The biology of the individual B. Genetics C. Metabolic imbalances D. All of the above Thebiology ofthe indivi... Genetics M etabolicim balancesAlloftheabove 0% 0%0%0% Response
  • 75.
  • 76. Social Theories  Social theory is the hypothesis that drug use is determined by cultural and social influences  Rewards of drug use may be derived from groups and others with whom we associate  Drug abuse may arise from antisocial behavior  Social theory does not explain drug addiction
  • 77. Social theories: A. Attribute drug use to cultural and social influences B. Explain the phenomenon of addiction C. Discount the importance of family influence Attribute druguseto cu... Explain the phenom enon .. Discountthe im portance .. 0% 0%0% Response
  • 78. Media Influence  The impact of the media on drug use is hard to determine  Many forms of mass media feature drugs:  Movies  Advertisements  Billboards  Television  Music  Celebrities
  • 79. Small Groups  1. Discuss what factors are most important in one’s decision to use or not use alcohol, tobacco, and/or illegal drugs.  2. Peers are cited frequently as an important influence on whether one uses drugs. At what age is the influence of peers most significant? Are males or females more affected by peer influence?  3. The depiction of alcohol use and smoking is prominent in movies, music videos, and television shows. Do you feel that alcohol use and smoking rates are affected by how alcohol and smoking are shown in videos? If yes, would you try to ban all alcohol and tobacco use in the media?
  • 80. Goldberg Chapter 4 Drugs & the Law
  • 81. Drugs & The Law  Attempts have been made to regulate the use of mind- altering substances since settlers first arrived in the New World  The first substance regulated was alcohol  The temperance movement in the late 1700s advocated that people become more educated about the hazards of alcohol Click picture for video
  • 82. Early Regulation  Alcohol  1791: Congress passed an excise tax on whiskey  Opium  1833: US treaty regulated international opium trade  1842: Tax on crude opium shipped to the US  1875: San Francisco prohibiting smoking in opium dens  1890: Only US citizens could manufacture or import opium  Proprietary drugs (over-the-counter drugs)  Pure Food and Drug Act of 1906
  • 83. Small Group Questions:  Do drug laws affect whether people use drugs?  Should drug laws be aimed at drug users, sellers, or traffickers?  Should the role of government be to inform its citizens about drugs or to prevent its citizens from using drugs?  Should a person be prevented from engaging in self-destructive behavior?
  • 84. Pure Food & Drug Act 1906  Before 1906, patent medicines were largely unregulated  US Food and Drug Administration (FDA) was created to assess drug hazards and prohibit sale of dangerous drugs  Law required drug manufacturers to report adverse reactions to their products  Law required that the amount or proportion of drugs in the medicine had to be listed on the label
  • 85. The Pure Food & Drug Act was created to: A. Stop people from using opium B. Establish taxes on drugs C. Force people to get prescriptions for drugs D. Keep dangerous drugs off the market Stop peoplefrom using... Establish taxeson drugs Force peopleto getpresc... Keep dangerousdrugsoff... 0% 0%0%0%
  • 86. Harrison Act 1914  The Harrison Act resulted from the need to limit opiate use  Law governed the marketing and sale of narcotics, regulated nonmedical narcotic use, and made possession of narcotics without a prescription illegal  Doctors and pharmacists had to keep records of the prescriptions they wrote  To obtain drugs, an increasing number of people resorted to criminal activity
  • 87. The Harrison Act: A. Established taxes on drugs B. Made opium illegal without a prescription C. Established jail time for drug offenses Established taxeson drugs M ade opium illegalw ith... Established jailtim e for... 7% 0% 93%
  • 88. Prohibition 1919-1933  Began with the Temperance Movement  19th Amendment passed in 1919  Speak-easies  Bootlegging  Increase in organized crime  Repealed in 1933 by the 21st Amendment
  • 89. Marijuana Tax Act 1937  Forbade the recreational use of marijuana, but not medicinal or industrial uses  Anyone using marijuana was required to pay a tax – failure to comply meant a large fine or prison term for tax evasion  AMA and others opposed marijuana legislation  The Federal Bureau of Narcotics, established in 1932, later became the Drug Enforcement Administration (DEA)
  • 90. The marijuana tax act made all use of marijuana illegal. A. True B. False True False 85% 15%
  • 91. Food, Drug, and Cosmetic Act 1938  Under 1906 guidelines, a drug manufacturer could not be prosecuted for fatalities due to toxic drugs  1938 Act required pharmaceutical companies to file applications with the federal government demonstrating that all new drugs were safe and properly labeled  Manufacturers had to submit a “new drug application” to the FDA, giving the FDA more authority and responsibility
  • 92. Limitations of the 1938 Food, Drug, and Cosmetic Act Did not cover drugs that were previously marketed  Drugs had to be proven safe, but not effective  Government had little authority to enact penalties  Manufacturers determined whether a drug would be sold as a prescription or over-the-counter  Manufacturers conducted their own tests to determine a drug’s effectiveness
  • 93. The Food, Drug, & Cosmetic Act A. Established taxes on new drugs B. Ensured that drugs were proven effective C. Ensured that drugs were proven safe D. Enacted stiff penalties for false advertising Established taxeson new ... Ensured thatdrugsw ere... Ensured thatdrugsw ere... Enacted stiffpenaltiesfor... 0% 0%0%0%
  • 94. I think the legalization of marijuana was a good idea. A. Absolutely. B. No, I disagree, it was a bad idea. C. I’m not sure or have no opinion. Absolutely. No,Idisagree,itw asab.. I’m notsure orhaveno ... 0% 0%0%
  • 95. Kefauver-Harris Amendments  Serious birth defects caused by thalidomide resulted in implementation of stronger regulations regarding drug testing  Kefauver-Harris Amendments, 1962, gave the FDA the authority to withdraw drugs from the marketplace  Drug advertisements directed to physicians were required to include the drug’s side effects and its contraindicated uses  Testing procedures required prior approval from the FDA
  • 96. Kefauver-Harris Amendments  1972 Drug Efficacy Study: The FDA asked the National Research Council to conduct a study of new drugs  Active ingredients were placed in one of three categories:  Category I drugs: Determined to be safe, effective, and properly labeled  Category II drugs: Not generally recognized as safe and effective, or recognized as mislabeled; must be removed from medications within six months  Category III drugs: Data insufficient to determine general recognition of safety and effectiveness
  • 97. Considering the Kefauver-Harris Amendments, all of the following are true EXCEPT: A. The FDA had the authority to remove unsafe drugs from the market B. Taxes on drug advertisements were enacted C. Advertisements must include side- effects D. Tests were required prior to a drug’s approval TheFDA had theauthorit... Taxeson drugadvertise... Advertisem entsm ustinc... Testsw ererequired prior.. 0% 0%0%0%
  • 98. Comprehensive Drug Abuse Prevention and Control Act of 1970  Comprehensive Drug Abuse Prevention and Control Act (Controlled Substances Act), effectively replaced all previous laws dealing with narcotics and dangerous drugs  Expanded community health centers and Public Health Service hospitals for drug abusers  Established a commission on marijuana and drug abuse  Divided drugs into five categories called schedules
  • 99. The Comprehensive Drug Abuse Prevention and Control Act replaced all previous legislation regarding dangerous drugs A. True B. False True False 0%0%
  • 100. Schedule Criteria Examples I a. High potential for abuse b. No accepted medical use c. Lack of accepted safety Heroin, marijuana, MDMA (Ecstasy) II a. High potential for abuse b. Currently accepted medical use c. Abuse may lead to severe dependence Morphine, cocaine, methamphetamine III a. Potential for abuse less than I and II b. Currently accepted medical use c. Abuse may lead to moderate physical dependence or high psychological dependence Anabolic steroids, most barbiturates, Dronabinol (THC in pill form) IV a. Low potential for abuse relative to III b. Currently accepted medical use c. Abuse may lead to limited physical or psychological dependence relative to III Xanax, barbital, chloral hydrate, fenfluramine V a. Low potential for abuse relative to IV b. Currently accepted medical use c. Abuse may lead to limited physical or psychological dependence relative to IV Mixture with small amounts of codeine or opium
  • 101.
  • 102. Anti–Drug Abuse Act of 1988  Legislation that emphasizes stringent punishment of the drug user, to reduce drug demand  Punishment could be waived if the user completes a drug rehabilitation program  Greatly increased federal prison population and led to a new Cabinet position, Director of National Drug Control Policy  Under this law, drug users are punished more stringently than rapists or robbers
  • 103. The Anti-Drug Abuse Act A. Emphasized strict punishment for drug infractions B. Allowed offenders to complete treatment rather than jail C. Created lighter sentences for drug offenses D. A & B E. All of the above Em phasized strictpunis... Allow ed offendersto co... Created lightersentences... A & B Alloftheabove 0% 0% 0%0%0%
  • 104. Small Group Questions: 1. Should the sale of drug paraphernalia be illegal? 2. Should people using small amounts of illegal drugs for personal enjoyment receive harsh criminal penalties? 3. What are the advantages and disadvantages of decriminalizing or legalizing drugs? 4. What impact has drug enforcement had on drug use? 5. Should the vast amount of money spent on stopping drugs be used differently?
  • 105. Drug Paraphernalia  Drug paraphernalia:  Items that are aids to using drugs (cigarette- rolling papers, water pipes, razors, clay pipes, roach clips, spoons, mirrors, and other products)  Prosecuting individuals for possessing drug paraphernalia is viewed as a deterrent for drug use
  • 106. The War on Drugs  In 1988, Congress proclaimed that the US would be drug-free by 1995  The monetary expense and human resources employed to combat illicit drug use are enormous – yet, the number of Americans who have used illegal drugs has increased  The government’s assault on illicit drugs has resulted in social tension, ill health, violent crime, compromised civil liberties, and international conflict
  • 107. The War on Drugs has been largely successful A. True B. False True False 0%0% Response http://ezproxy.wwcc.edu :2048/login?url=http://di gital.films.com/PortalPla ylists.aspx?aid=7539&xt id=50127
  • 108. Are you for or against legalization of drugs? (all currently illicit drugs) A. For legalization B. Against legalization C. For legalization, but only for some drugs Forlegalization Againstlegalization Forlegalization,butonly... 0% 0%0%
  • 109. Arguments Against Legalization  Some argue that decriminalization would increase drug use, addiction, and drug-related deaths  Drug-related crimes might fall, but the number of addicts would rise  Legalization would result in more dysfunctional addicts who would be unable to support their lifestyles and drug use through legitimate means
  • 110. Arguments For Legalization  Legal regulation of drugs would protect drug takers and save money  Billions of dollars spent on drug enforcement might be put to use more effectively if the money were directed toward education and treatment programs
  • 111.
  • 112. Drug Enforcement  Drug enforcement is designed to stem the flow of drugs coming into the US and to punish the user  To stop drugs at their source, the State Department works with a number of foreign governments  DEA agents help block drugs from leaving other countries, eradicate crops, and find and dismantle illegal laboratories
  • 113. Problems with Enforcement  Farmers make more money from coca or opium crops than from legal crops  On a global scale, less than 10% of illegal crops are consistently eradicated  Interdiction is especially difficult because of numerous points of entry
  • 114. Prevention  Harm reduction  Interventions that respond to needs of drug users and the community to reduce harm caused by illicit drug use  Includes providing sterile syringes to reduce spread of HIV infection, education, and increased treatment  Treats drug abuse as a public health problem, not a criminal problem
  • 115. Prevention  Normalization  Term used by the Dutch for the practice of not prosecuting users of soft drugs such as marijuana  Using some drugs is not illegal, but drug traffic is illegal  Treatment assists physical and social well-being of addicts rather than try to stop their addiction  Result: Netherlands has less drug use than the US and other European countries
  • 116. Racism and Drug Enforcement  Questionable search warrants in inner-city communities  People of color are stopped and searched more often than others on the basis of “drug courier” profiles  Despite comparable drug usage, Blacks are incarcerated at a higher rate than Whites  Penalties for crack cocaine, used more by poor, are greater than those for powder cocaine, used more by middle class
  • 117. Mandatory Minimum Sentencing  Starting in 1984, Congress enacted mandatory minimum penalties specifically focusing on drugs and violent crimes  It has been shown that mandatory minimum drug sentences have not acted as deterrents to further crime  Mandatory minimum drug sentences give no latitude to judges to determine appropriate punishments  Treatment is 15 times more effective for reducing serious crime than mandatory minimum sentencing

Notas del editor

  1. Deaths Emergency room visits Drugs in the workplace and lost productivity Broken homes, illnesses, shorter lives, etc. Cost of maintaining habit Cost of criminal behavior Cost of treating patients Fetal alcohol syndrome Others?
  2. Survey questionnaires Easy to use– inexpensive, efficient Drawbacks Bias in student population (e.g., dropouts not counted) Potential inaccuracy of self-reports (among both users and non-users) National Survey on Drug Use and Health Face-to-face, computer-assisted interviews 68,000 individuals; carefully sampled households across the United States Broken down into different age groups Results published annually Marijuana use among persons ages 12-25, by age group: 1971-2006 (National Survey on Drug Use and Health) In 2008 the percentage use for the age groups of 18-25 and 12-17 remained the same as they were in 2005; 16.5% and 6.7% respectively. Finding similar patterns in two different studies, using different sampling techniques, is a stronger indication that these trends are real and reflect broad changes in American society over time   II. How Did We Get Here? A. Have Things Really Changed? 1. Humans have used psychoactive drugs for thousands of years for therapeutic and recreational purposes. 2. Drug use has affected society in many areas: religion, law, government, economics, language, and education.   III. Drugs and Drug Use Today A. Extent of Drug Use 1. Current information on drug use comes from several sources, including survey questionnaires done in junior highs, high schools, and colleges, but accurate statistics are hard to attain. 2. Self-reports may include a biased sample and be inaccurate or dishonest. 3. The Monitoring the Future Project follows nationwide trends over time in drug use among young people.
  3.  National Survey on Drug Use and Health 22.6 million Americans used illicit drugs 7 million used psychotherapeutic drugs non-medically 1.5 million were current cocaine users 28.8 million drove a car under the influence of alcohol 695,000 Ecstasy users, and 353,000 meth users 16.3% of pregnant women smoked cigarettes 2.5 million received substance abuse treatment for alcohol 69.6 million Americans smoked cigarettes B. Trends in Drug Use 1. The perceived risk decreases as drug use increases; as drug use decreases the perceived risk increases. 2. The perceived availability of marijuana has changed little over time and, therefore, does not appear to explain differences in rates of use. 3. The National Survey on Drug Use and Health is a door-to-door survey estimating drug use in adolescents and adults in the United States. 4. Alcohol and cocaine use in 18- to 25-year-olds stays fairly consistent over time. 5. Drug use patterns seen in multiple surveys are most likely to be accurate. 6. Decreases or increases in drug use are not related to changes in government legislation, but are related to social trends. Have Things Really Changed? 1. Humans have used psychoactive drugs for thousands of years for therapeutic and recreational purposes. 2. Drug use has affected society in many areas: religion, law, government, economics, language, and education.
  4. https://nsduhweb.rti.org/respweb/homepage.cfm Survey questionnaires Easy to use– inexpensive, efficient Drawbacks Bias in student population (e.g., dropouts not counted) Potential inaccuracy of self-reports (among both users and non-users) National Survey on Drug Use and Health Face-to-face, computer-assisted interviews 68,000 individuals; carefully sampled households across the United States Broken down into different age groups Results published annually Marijuana use among persons ages 12-25, by age group: 1971-2006 (National Survey on Drug Use and Health) In 2008 the percentage use for the age groups of 18-25 and 12-17 remained the same as they were in 2005; 16.5% and 6.7% respectively. Finding similar patterns in two different studies, using different sampling techniques, is a stronger indication that these trends are real and reflect broad changes in American society over time   II. How Did We Get Here? A. Have Things Really Changed? 1. Humans have used psychoactive drugs for thousands of years for therapeutic and recreational purposes. 2. Drug use has affected society in many areas: religion, law, government, economics, language, and education.   III. Drugs and Drug Use Today A. Extent of Drug Use 1. Current information on drug use comes from several sources, including survey questionnaires done in junior highs, high schools, and colleges, but accurate statistics are hard to attain. 2. Self-reports may include a biased sample and be inaccurate or dishonest. The Monitoring the Future Project follows nationwide trends over time in drug use among young people. The National Survey on Drug Use and Health (NSDUH) provides national and state-level data on the use of tobacco, alcohol, illicit drugs (including non-medical use of prescription drugs) and mental health in the United States. NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Public Health Service in the U.S. Department of Health and Human Services (DHHS).
  5. Monitoring the Future is an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, a total of approximately 50,000 8th, 10th and 12th grade students are surveyed (12th graders since 1975, and 8th and 10th graders since 1991). In addition, annual follow-up questionnaires are mailed to a sample of each graduating class for a number of years after their initial participation. The Monitoring the Future Study has been funded under a series of investigator-initiated competing research grants from the National Institute on Drug Abuse, a part of the National Institutes of Health. MTF is conducted at the Survey Research Center in the Institute for Social Research at the University of Michigan. http://www.monitoringthefuture.org/
  6. Current laws trace back to two pieces of legislation from the early 1900s Racist fears about deviant behavior, including drug misuse, played a role in the development of drug regulation Laws were developed to regulate undesirable behaviors Fraud in patent medicines that were sold directly to the public False therapeutic claims Habit-forming drug content In the early 1900s, Collier’s magazine ran a series of articles attacking patent medicines— “Great American Fraud” Opium and the Chinese U.S. was involved in international drug trade Opium smoking brought to U.S. by Chinese workers Laws passed against the importation, manufacture, and use of opium– racism involved? Cocaine Present in many patent medicines (and, yes, Coca-Cola!) Viewed as a cause of increasing crime Racist connections
  7. Toxic = poisonous, deadly, or dangerous What makes a drug toxic? Amount used How it is used What the user did while on the drug Specific toxicity for users who inject drugs AIDS, HIV infection, and hepatitis B and C Sharing needles passes infectious agents directly into the bloodstream Some states, cities prohibit needle purchase without Rx Syringe exchange programs Examples of acute toxicity Behavioral: “Intoxication” that impairs the actions of drug users and increases the danger to themselves and others Physiological: Overdose that causes the user to stop breathing Examples of chronic toxicity Behavioral Personality and lifestyle changes Effects on relationships with friends and family Physiological Heart disease Lung cancer Cirrhosis Other health effects
  8. What do “addicts” look like? What drug do they take or what behavior do they engage in (alcohol, cigarettes, illicit drugs, food, sex, gambling, shopping, computer time)? How much time do they spend on their habit? How much of a drug do they take? How do you decide on the definition of dependence? Three basic processes Tolerance Physical dependence Psychological dependence Diminished effect on the body after repeated use of the same drug The body develops ways to compensate for the chemical imbalance caused by the drug Regular drug users may build up tolerance to the extent that their dosage would kill a novice user Physical dependence is defined by the occurrence of a withdrawal syndrome Tolerance typically precedes physical dependence If drug use is stopped suddenly, withdrawal symptoms occur, ranging from mild to severe Physical dependence means the body has adapted to the drug’s presence Psychological or behavioral dependence High frequency of drug use Craving for the drug Tendency to relapse after stopping use Behavior is reinforced by the consequences Over time, this becomes the biggest reason users report they continue to use Early medical model = true addiction involves physical dependence; key is treatment of withdrawal symptoms Positive reinforcement model = drugs can reinforce behavior without physical dependence Psychological dependence is increasingly viewed as the driving force behind repeated drug use This refutes the sometimes common belief that drugs that aren’t as strongly physically addicting are less dangerous Some drugs are more likely than others to lead to dependence Method of use, as well as other factors, influences risk of dependence The “war on drugs” reflects the perspective that drugs are themselves evil Is dependence due to biochemical or physiological actions in the brain? Still no way to scan the brain and know if a person has/had developed dependence Genetic physiological or biochemical markers have been sought as well, but none has proven reliable No way to know if the drug or the drug use changes a person’s personality Many other factors affect personality Sensation-seeking = a personality characteristic statistically associated with early substance use and abuse Alcohol dependence often exists within a dysfunctional family Evidence suggests that dysfunctional relationships play a role in dependence, but they aren’t the only factor Founders of AA characterized alcohol dependence as a disease Others argue that dependence doesn’t have all the characteristics of a disease There are ways to test and treat the effects of alcoholism but not the disease itself There is some disagreement over how to define disease as well Dependence is related to dysfunctions of: Biology Personality Social interactions
  9. Antecedent = a factor that occurs before an event such as the initiation of drug use Still not labeled “causes” Examples of antecedents Aggressiveness Conduct problems Poor academic performance Attachment to a drug-using peer group Parental and community norms that support drug use Alcohol and tobacco are sometimes considered gateways to the use of illicit drugs Kandel & Faust’s 1975 study Gateway substances are perhaps best thought of as early indicators of a basic pattern of deviant behavior resulting from a variety of risk factors
  10. Correlate = a variable that is statistically related to another variable, such as drug use IMPORTANT: Correlates are not causes Socioeconomic status does not correlate well with drug use Personality problems are poor predictors of drug use IV. Correlates of Drug Use A. What Factors Are Considered? 1. Surveyors look for common characteristics in those who use drugs, as compared with those who do not use drugs. 2. Study limitations can make it difficult to determine the effects of some factors. B. Risk and Protective Factors 1. Risk factors are correlated with higher rates of drug use. 2. Risk factors for drug use include having friends who use drugs, engaging in fighting or stealing, perceiving that substance use is prevalent at school, knowing adults who use drugs, and having a positive attitude towards drugs. 3. The kids most likely to use marijuana frequently live in a rough neighborhood, have little parental monitoring, steal and get into fights, may not be involved in religious activities, and do poorly in school. 4. Protective factors are correlated with lower rates of drug use. 5. Protective factors for drug use include perceiving strong sanctions against drug use at school, having supportive parents, being committed to school, being involved in religious activities, and participating in two or more extracurricular activities. 6. Overall, studies of risk and protective factors suggest that adolescents who are more likely to smoke cigarettes, drink heavily, and smoke marijuana are also more likely to engage in other deviant behaviors, such as stealing, fighting, and early sexual behaviors. C. Gender 1. Males are more likely to use alcohol, use tobacco, smoke marijuana, and use cocaine than are females. D. Race 1. Stereotypes regarding drug use by different races may not be supported by findings from the National Survey on Drug Use and Health. E. Level of Education 1. Those with more education (college degrees, compared with those who completed high school only) are much more likely to drink alcohol and somewhat less likely to use tobacco, marijuana, or cocaine. F. Personality Variables 1. Evidence for correlations between traditional personality traits and drug use is somewhat weak and inconsistent. 2. Several studies focus on “impulsivity” as correlating with rates of substance use. 3. Personality factors may play a small role in whether someone decides to try alcohol or marijuana, but they may play a large role in whether drug use develops into a serious problem. G. Genetics 1. Genetic studies are beginning to show clear association with substance-use disorders.
  11. Having low-birthweight babies is a side effect of drug use by pregnant women.
  12. How is drug use related to crime? Intoxication causes behavior and personality change Crimes may be committed while intoxicated Drug use/possession is a crime Crimes to fund cost of drug use Society tries to protect itself through regulation Current laws may not be part of a logical plan, ineffective or unrealistic Drug use may change a person’s personality People under the influence may commit crimes (e.g., many cases of homicide, domestic violence, etc.) Crimes may be carried out to obtain money for drugs Drug use is a crime We want to protect society from the dangers of some types of drug use = legitimate social purpose Some laws are not developed as part of a rationally devised plan and may not be realistic or effective Current laws
  13. These “Pot-Tarts,” seized by law enforcement in 2006, demonstrate the ingenuity of some illicit drug distributors. Upon raiding this facility, investigators found hundreds of marijuana-laced candies and soft drinks, including “Stoney Ranchers,” “Munchy Way,” “Rasta Reece’s,” and “Buddafingers.”
  14. The benefit to farmers makes it hard to combat illegal drug production.
  15. Figure 2.1 U.S. National Drug Control Budget—FY 2012 Funding Highlights
  16. The federal government has steadily increased funding to interdict drugs.
  17. Figure 2.4 Poll Responses to the Question: “Which of the Following Do You Feel Is the Single Best Way to Handle the War on Drugs?” (n = 4,730)
  18. Motives for Drug Use 1. Personal and social variables such as identifying with a deviant subculture increase the likelihood of drug use. 2. Rebellious behavior can serve as a way to demand attention or to make a particular impression. 3. Drug use may be reinforced by the effects of the drug. 4. Drug users are often seeking an altered state of consciousness. 5. Societal, community, and family factors play an important role in determining whether a person tries a drug, but the individual’s experiences with a drug become more important with increasing use.
  19. We all do things that we know, logically, we should not do Eating too much Driving too fast Drinking too much Identification with a deviant subculture is a key factor Fads and cultural trends influence what drugs are used Characteristics of drugs can reinforce their use Altered states of consciousness Societal, community, and family factors play an important role in whether an individual tries a drug Drug factors play an important role in whether an individual continues to use a drug Motives for Drug Use 1. Personal and social variables such as identifying with a deviant subculture increase the likelihood of drug use. 2. Rebellious behavior can serve as a way to demand attention or to make a particular impression. 3. Drug use may be reinforced by the effects of the drug. 4. Drug users are often seeking an altered state of consciousness. 5. Societal, community, and family factors play an important role in determining whether a person tries a drug, but the individual’s experiences with a drug become more important with increasing use.
  20. Risk and Protective Factors 1. Risk factors are correlated with higher rates of drug use. 2. Risk factors for drug use include having friends who use drugs, engaging in fighting or stealing, perceiving that substance use is prevalent at school, knowing adults who use drugs, and having a positive attitude towards drugs. 3. The kids most likely to use marijuana frequently live in a rough neighborhood, have little parental monitoring, steal and get into fights, may not be involved in religious activities, and do poorly in school. 4. Protective factors are correlated with lower rates of drug use. 5. Protective factors for drug use include perceiving strong sanctions against drug use at school, having supportive parents, being committed to school, being involved in religious activities, and participating in two or more extracurricular activities. 6. Overall, studies of risk and protective factors suggest that adolescents who are more likely to smoke cigarettes, drink heavily, and smoke marijuana are also more likely to engage in other deviant behaviors, such as stealing, fighting, and early sexual behaviors.
  21. What do “addicts” look like? What drug do they take or what behavior do they engage in (alcohol, cigarettes, illicit drugs, food, sex, gambling, shopping, computer time)? How much time do they spend on their habit? How much of a drug do they take? How do you decide on the definition of dependence? Three basic processes Tolerance Physical dependence Psychological dependence Diminished effect on the body after repeated use of the same drug The body develops ways to compensate for the chemical imbalance caused by the drug Regular drug users may build up tolerance to the extent that their dosage would kill a novice user Physical dependence is defined by the occurrence of a withdrawal syndrome Tolerance typically precedes physical dependence If drug use is stopped suddenly, withdrawal symptoms occur, ranging from mild to severe Physical dependence means the body has adapted to the drug’s presence Psychological or behavioral dependence High frequency of drug use Craving for the drug Tendency to relapse after stopping use Behavior is reinforced by the consequences Over time, this becomes the biggest reason users report they continue to use Early medical model = true addiction involves physical dependence; key is treatment of withdrawal symptoms Positive reinforcement model = drugs can reinforce behavior without physical dependence Psychological dependence is increasingly viewed as the driving force behind repeated drug use This refutes the sometimes common belief that drugs that aren’t as strongly physically addicting are less dangerous Some drugs are more likely than others to lead to dependence Method of use, as well as other factors, influences risk of dependence The “war on drugs” reflects the perspective that drugs are themselves evil Is dependence due to biochemical or physiological actions in the brain? Still no way to scan the brain and know if a person has/had developed dependence Genetic physiological or biochemical markers have been sought as well, but none has proven reliable No way to know if the drug or the drug use changes a person’s personality Many other factors affect personality Sensation-seeking = a personality characteristic statistically associated with early substance use and abuse Alcohol dependence often exists within a dysfunctional family Evidence suggests that dysfunctional relationships play a role in dependence, but they aren’t the only factor Founders of AA characterized alcohol dependence as a disease Others argue that dependence doesn’t have all the characteristics of a disease There are ways to test and treat the effects of alcoholism but not the disease itself There is some disagreement over how to define disease as well Dependence is related to dysfunctions of: Biology Personality Social interactions
  22. Figure 3.4 A Medical College of Virginia study involving 949 female twin pairs found genetic factors to be more influential than environmental factors in smoking initiation and nicotine dependence. Likewise, a St. Louis University study of 3,356 male twin pairs found genetic factors to be more influential for dependence on nicotine and alcohol.
  23. An estimated $25 billion is spent on advertising tobacco, alcohol, and prescription drugs One study of alcohol marketing worldwide showed that young people are influenced by marketing Advertisements for cigarettes play on many themes, particularly independence After cigarette ads were prohibited from television in 1971, the void was filled with advertisements for smokeless tobacco
  24. Current laws trace back to two pieces of legislation from the early 1900s Racist fears about deviant behavior, including drug misuse, played a role in the development of drug regulation Laws were developed to regulate undesirable behaviors Fraud in patent medicines that were sold directly to the public False therapeutic claims Habit-forming drug content In the early 1900s, Collier’s magazine ran a series of articles attacking patent medicines— “Great American Fraud” Opium and the Chinese U.S. was involved in international drug trade Opium smoking brought to U.S. by Chinese workers Laws passed against the importation, manufacture, and use of opium– racism involved? Cocaine Present in many patent medicines (and, yes, Coca-Cola!) Viewed as a cause of increasing crime Racist connections
  25. Required accurate labeling and listing of ingredients Later amended to require safety testing and testing for effectiveness A law that required those who “produce, import, manufacture, compound, deal in, dispense, or give away” certain drugs to register and pay a special tax Later expanded to include other federal controlled-substance regulations The Pure Food and Drugs Act (1906) U.S. Department of Agriculture Goal: drugs are pure and honestly labeled Harrison Act (1914) U.S. Treasury Department Goal: taxation of drugs to restrict commerce in opioids and cocaine to authorized physicians, pharmacists, and legitimate manufacturers
  26. 1. Purity The contents of the product must be accurately listed on the label FDA encouraged voluntary cooperation and compliance 1912 Sherley Amendment outlawed “false and fraudulent” therapeutic claims on labels Safety Originally—no legal requirement that medications be safe 1938 Food, Drug, and Cosmetic Act required pre-market testing for toxicity Companies required to submit a New Drug Application (NDA) to the FDA FDA became a gatekeeper and expanded greatly Directions must be included Adequate instructions for consumer OR Drug can be used only with physician prescription 3. Effectiveness 1962 Kefauver-Harris Amendments Pre-approval required before human testing Advertising for prescription drugs must include information about adverse reactions Every new drug must be demonstrated to be effective for the illnesses mentioned on label
  27. http://www.druglibrary.org/schaffer/library/studies/cu/cu8.html
  28. http://www.history.com/topics/prohibition
  29. TIMELINE: http://www.pbs.org/wgbh/pages/frontline/shows/dope/etc/cron.html
  30. DIETARY SUPPLEMENTS Regulated more like food than drugs Labels must be accurate Products can’t make unsubstantiated direct claims Products can make general health claims Products can be marketed without first proving safety Early enforcement 18th Amendment Physicians and pharmacists arrested; growth of illegal drug trade Stiffer penalties Jones-Miller Act Prohibition on importation of opium for heroin Prison vs. rehabilitation Punishment seemed not to be working “Narcotic farms” Bureau of Narcotics (Treasury Department) “Drug Czar” Marijuana Tax Act Mandatory minimum sentences (1951) 1956 Narcotic Drug Control Act toughened penalties Drug Abuse Control Act Amendments of 1965 Added new classes of drugs Comprehensive Drug Abuse Prevention and Control Act of 1970 Replaced or updated all previous laws Drugs controlled by the Act are under federal jurisdiction In some cases, state and federal laws conflict Prevention and treatment funding increased Direct control of drugs, not control through taxation, is the goal Enforcement separated from scientific and medical decisions Possession and selling penalties Omnibus Drug Act Drug precursors Drug paraphernalia Office of National Drug Control Policy established
  31. Preclinical research and development IND submitted to the FDA Clinical research and development Phase One—low doses, 20-80 healthy volunteers Phase Two—few hundred patients who could benefit Phase Three—typically 1,000-5,000 patients Permission to market May require 10+ years and costs $1+billion Only 31 new drugs approved by FDA in 2008 Orphan Drug Act—tax and other financial incentives Prescription Drug Marketing Act of 1988—regulation of free samples, etc. 1997 FDA Modernization Act—guidelines for postmarketing reporting, distribution of information on off-label uses
  32. http://www.pharmacytimes.com/print.php
  33. https://www.govtrack.us/congress/bills/100/hr5210#summary
  34. Budget International programs Other federal agencies Other costs Cost of prison population Crimes committed to purchase drugs Corruption in law enforcement Conflicting international policy goals Loss of individual freedom Drug use has not been eliminated About 10-15 percent of illegal drug supply is seized each year When supplies are restricted, prices go up Higher prices and increased difficulty in obtaining drugs may deter some would-be users Difference in penalties from state to state Federal law overrides state law Significant growth in number of Americans in prison In 2007 the number rose to 5.06 prisoners per thousand and in 2008 it dropped slightly to 5.04 per thousand.