Drugs & Society SOC 204
Drugs Across the Spectrum
By Raymond Goldberg
Chapter 2 Drugs in Contemporary Society
Chapter 3 Motivations for Drug Use
Chapter 4 Drugs & the Law
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%
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
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
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?
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
Hinweis der Redaktion
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?
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.
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.
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).
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/
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
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
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
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
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.
Having low-birthweight babies is a side effect of drug use by pregnant women.
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
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.”
The benefit to farmers makes it hard to combat illegal drug production.
Figure 2.1 U.S. National Drug Control Budget—FY 2012 Funding Highlights
The federal government has steadily increased funding to interdict drugs.
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)
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.
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.
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.
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
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.
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
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
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
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
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
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
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.