A Brief History of Drugs An overview of drug policy and use in the United States from the mid-1800s to the present Drug Scheduling (http://www.usdoj.ov/dea/pubs/scheduling.html) • Schedule I – high potential for abuse – no currently accepted medical use in treatment in U. S. – lack of accepted safety for use under medical supervision. – examples: Gamma hydroxy butyrate (GHB), heroin, Lysergic acid diethylamide (LSD), marijuana, 3,4-Methylenedioxymethamphetamine (MDMA/Ecstasy). • Schedule II – high potential for abuse. – currently accepted medical use in treatment in U. S. – abuse may lead to severe psychological or physical dependence. – examples: cocaine, methadone, methamphetamine, morphine, phencyclidine (PCP). • Schedule III – potential for abuse less than Schedules I and II. – currently accepted medical use in treatment in U.S. – abuse may lead to moderate or low physical dependence or high psychological dependence. – examples: anabolic steroids, codeine, ketamine, Marinol, some barbiturates Drug Scheduling (cont.) • Schedule IV – low potential for abuse relative to Schedule III. – currently accepted medical use in treatment in U.S. – abuse may lead to limited physical dependence or psychological dependence relative to Schedule III. – examples: fenfluramine, Halcion, Meridia, Rohypnol, Valium. • Schedule V – as Schedule IV but less dangerous – examples: buprenorphine, over-the-counter cough medicines with codeine. Alcohol and nicotine are not scheduled drugs. Neither is salvia divinorum. Scheduling Process • Proceedings may be initiated by – Drug Enforcement Administration (DEA) – Department of Health and Human Services (HHS) – Any interested party (drug manufacturer, medical society, public interest group, individual citizen) • Criteria – potential for abuse – currently accepted medical use in the US – international treaties. • DEA (legal) HHS (scientific/medical) FDANIDApublicDEA • Exceptions to process – International treaties – "to avoid an imminent hazard to the public safety" ...Drug Trade • International illicit drug business: $400B, 8% of international trade – Drug profit margins up to 300%. – Interdiction intercepts 10-15% of heroin, 30% of cocaine. – Estimated 75% of international drug shipments would need to be intercepted to substantially reduce the profitability of drug trafficking. • Profits for pharmaceutical companies 1970-1998 = $81B • Sales for herbal medications = $4B Drug Use in U.S. in 2000-07 (age 12+) Alcohol: 104 million (46.6%) Tobacco: 65.5 million (29.3%) Illicit Drugs: 17.0 million (6.3%) Cost of Substance Abuse - 2008 Past Month Illicit Drug Use by Age: 1999-2001 • Increases for youths aged 12-17 and for 1825 year olds – Increases for marijuana, cocaine, heroin, hallucinogens, pain relievers, tranquilizers, stimulants, and methamphetamine • No changes for 26-34 year olds and for 35 and older adults. – Slight declines noted in LSD and metamphetamine use Drug Use (2002-2007) Drug Use in 12-17 year olds Marijuana Use Illicit Drugs vs. Other Harms • 5 times as many people die from alcohol each year (100K) as from illicit drugs and misuse of legal pharmaceuticals (20K) • 15 times as many people die from poor diets and activity patterns (300K) • 20 times as many people die from tobacco (400K) Drug War... • More than 80% of increase in federal prison population from 1985 to 1995 due to drug convictions, mostly possession • Approximately $8.6 billion per year to keep drug offenders in prison • War budget: ~$100 million in 1972, ~$20 billion in 2002 • Approximately 2/3 of budget goes to law enforcement, 1/3 to treatment – > 1.5 million people arrested on drug charges each year (400K in prison) Federal anti-drug spending, 19812009 (in billions) Sources: Bureau of Justice Statistics; Department of Justice; FBI; ONDCP Share of possession arrests that are for Percentage of drug arrests targeting Drug offenders behind bars Prison inmates getting drug treatment