DRUGS AND ALCOHOL
Hard vs. Soft Drugs
• Some drugs are considered by some to be more
addictive than other drugs.
• “Hard” are powerfully addictive, lead users to
abandon responsibility.
• “Soft” allow some users to continue to go to work
and school and not dismiss all responsibility.
• Legal vs. Illegal
Philosophical Views
Conservative
– James Wilson
– William J. Bennett
Moderate
– Milton Friedman
– Joseph DesJardins & Ronald Duska
– Bonnie Steinbock
Liberal
– Ethan Nadelmann
– Walter Block
James Wilson
• Dr. Wilson was chairman of the National
Advisory Council for Drug Abuse
Prevention
• Argues that legalizing drugs would lead to
an “exponential explosion of users!
Anti-legalization
• Argues that drugs should not be legalized.
He thinks that since we cannot know the
consequences of legalization, we ought to
leave the current system in place.
• Even though we did not know the
consequences of prohibition initially he
thinks it is better to keep the current
system than risk letting the cork of the pill
bottle and having society crumble as the
result of legalization.
Support for his view
• In the United States there were
approximately 500,000 Heroine users in
1972. There were the same number,
500,000 in 1990.
• United Kingdom, 1968 2,000 heroine
Users, 1972 20,000 in London alone.
• Argues that how many people use a drug
when it is illegal is no evidence for how
many will use it if it is legal.
Milton Friedman
• “An Open Letter to Bill Bennett”
• Milton Friedman argues that the economic
cost of prohibition does not justify the
benefit.
• He think our resources would be better
spent on education and treatment, instead
of on police, jails and court rooms.
In Support of his View
• Legalization would reduce street crime.
• Alcohol and tobacco cause more deaths
than illicit drugs
• Prohibition leads to powerful crime
syndicates, including narco-trafficos such
as FARC in Colombia.
William J. Bennett
• Served as Director of the Office of
National Drug Control Policy and US
secretary of Education
In support of his view
• Decriminalization of Heroine lead to a
400% increase in Heroine users in Britain.
• Legalizing alcohol after probation lead to a
350% increase in alcohol consumption.
• We don’t know what would happen if we
decriminalized drugs.
Joseph DesJardins &
Ronald Duska
• “Drug Testing in Employment”
• Argue that drug testing is only justified if
the company has a relevant and justifiable
reason for this knowledge.
Drug use lowers job performance
• Some argue that drug use lowers job
performance. This may be true, but how
low can you go? Should the company
have all employees working 100% all the
time? What about 50%, 80%?
• If drugs don’t make you totally
unproductive, then perhaps the company
has no right to know if you do or do not
use.
Can the Employee cause harm
• They argue that there are 2 reasons to test
employees.
• 1) lower productivity
• 2) danger to consumers and other
employees
• They argue for limited testing based upon
#2.
Limited Drug Testing
• They argue for limited drug testing, and
only in cases where there is a legitimate
reason to test, such a steroids in the MLB
but not pot in the NFL- (Ricky Williams)
• Or if your actions may have dangerous
consequences to others because of your
incompetence that is a result of drug use.
Bonnie Steinbock
• Argues that society has reason to
intercede in drug addiction, and that
contrary to Block there is no natural right
to get high. Further she employs a public
health approach to drug use and law. She
argues that the libertarian view of people
quietly getting high in the privacy of their
own homes is unrealistic.
Reality check
• The reality of drug use is that it plays a
significant factor in 40% of all murders in
the US, 70% of all cases of infant neglect.
Ethan Nadelmann
• Executive Director of Drug Policy Alliance.
• Pro legalization and decriminalization of
drugs.
In support of his View
• Domestic law enforcement blame
international law enforcement,
international blame local law enforcement.
• Increased spending has done little to stem
the supply or number of drug users.
• In fact cocaine purity has gone up 50% in
the last 10 years.
Cost
• The cost of prohibition has increased
dramatically, without any measurable
decline.
• The cost to taxpayers
• Drugs and crime
• Corruption
• Medical cost and public health
TYPES OF DRUGS
•
•
•
•
•
•
•
•
•
•
Alcohol
Tobacco
Marijuana
Heroine
LSD
Xtasy
Cocaine
Crack
Prescription Drugs/ Steroids
Natural Herbs
Steroids
• Commonly abused
steroids: Anadrol,
Oxandrin, Dianobol,
Winstrol, Durabolin,
Depo-Testosterone, and
Equipoise
• What is the form of
steroids?
• There are more than
100 types of anabolic
steroids, and each
requires a prescription
What are the methods of usage?
• Oral ingestion
• Injection
• Rubbed on the skin in the form of gels or
creams
Who uses steroids?
• Steroid use among young adults and high
school students is much more prevalent
among males than females.
• Among 19-22 year olds surveyed in 2000,
18.9% reported having a friend who was a
current user of steroids.
• 1.4% of young adults (ages 19-28)
surveyed in 2000 reported using steroids
at least one time during their lives.
How do steroids get to the United
States?
• Illicit anabolic steroids are often sold at gyms,
competitions, and through mail operations.
• Steroids are also illegally diverted from U.S.
pharmacies or synthesized in clandestine
laboratories.
• Anabolic steroids are illicitly smuggled from
Mexico and European countries to the United
States.
• Recent DEA reporting indicates that Russian,
Romanian, and Greek nationals are significant
traffickers of steroids.
What are some consequences of
steroid use?
• Effects associated with anabolic steroid abuse
range from acne and breast development in
men, increased irritability and aggression, to
liver cancer, heart attacks, and high cholesterol.
• People who inject steroids run the risk of
contracting or transmitting hepatitis or HIV.
• Withdrawal symptoms include mood swings,
fatigue, restlessness, loss of appetite, insomnia,
reduced sex drive, and depression.
• This depression can lead to suicide attempts
and can persist for a year or more after the
abuser stops taking the drugs.
GHB (gamma hydroxybutyric
acid)
• Street Names: Liquid Ecstasy,
Scoop, Easy Lay, Georgia
Home Boy, Grievous Bodily
Harm, Liquid X, and Goop.
• What are the different forms of
GHB?
• An odorless, colorless liquid
form
• White powder material.
How is GHB used?
• Usually ingested in a
liquid mixture; most
commonly mixed with
alcohol
Who uses GHB?
• GHB has become popular among teens
and young adults at dance clubs and
"raves."
• Body builders sometimes use GHB for its
alleged anabolic effects.
• How does GHB get to the United States?
• Because the drug is easy to synthesize
and manufacture, local operators usually
handle distribution.
How much does GHB cost?
• GHB is usually sold by the capful, and
sells for $5 to $25 per cap.
What are some consequences of
GHB use?
• In lower doses, GHB causes drowsiness,
dizziness, nausea, and visual disturbances.
• At higher dosages, unconsciousness, seizures,
severe respiratory depression, and coma can
occur.
• Overdoses usually require emergency room
treatment, including intensive care for
respiratory depression and coma.
• GHB has been used in the commission of sexual
assaults because it renders the victim incapable
of resisting, and may cause memory problems
that could complicate case prosecution.
Emergency Department Drug
Mentions - GHB
Ketamine
• Street terms for Ketamine:
jet, super acid, Special "K",
green, K, cat Valium1
What does Ketamine look like?
• Ketamine comes in a clear liquid and a
white or off-white powder form.
How is Ketamine used?
• Ketamine is a tranquilizer most commonly
used on animals.
• The liquid form can be injected, consumed
in drinks, or added to smokable materials.
• The powder form can be used for injection
when dissolved.
• In certain areas, Ketamine is being
injected intramuscularly.
Who uses Ketamine?
• Ketamine, along with the other "club
drugs," has become popular among teens
and young adults at dance clubs and
"raves."
How does Ketamine get into the
United States?
• Marketed as a dissociative general anesthetic
for human and veterinary use, the only known
source of Ketamine is via diversion of
pharmaceutical products.
• Recent press reports indicate that a significant
number of veterinary clinics are being robbed
specifically for their Ketamine stock.
• DEA reporting indicates that a major source of
Ketamine in the United States is product
diverted from pharmacies in Mexico
OxyContin®
• What is OxyContin®?
• OxyContin® is the brand name of a time-release formula
of the analgesic chemical oxycodone. OxyContin®,
which is produced by the pharmaceutical company
Purdue Pharma, is prescribed as a pain medication.
• Instances of abuse of this drug have increased in recent
years.
• Street terms for OxyContin®: Hillbilly heroin, Oxy,
Oxycotton
• What does OxyContin® look like?
• OxyContin® comes in tablet form.
What are the methods of usage?
•
•
•
•
Chewing the tablets
Snorting crushed tablets
Dissolving tablets in water and injecting
These methods cause a faster, highly
dangerous release of medication.
Who abuses OxyContin®?
• An increase in illegal use has been
especially apparent on the East Coast.
• 9% or 19.9 million Americans have used
pain relievers illegally in their lifetime.
How much does OxyContin® cost?
• When legally sold, a 10-mg tablet of
OxyContin® will cost $1.25 and an 80-mg
tablet will cost $6.
• When illegally sold, a 10-mg tablet of
OxyContin® can cost between $5 and
$10. An 80-mg tablet can cost between
$65 and $80.
What are some consequences of
illicit OxyContin® use?
• Long-term usage can lead to physical
dependence.
• A large dosage can cause severe respiratory
depression that can lead to death.
• Withdrawal symptoms include restlessness,
muscle and bone pain, insomnia, diarrhea,
vomiting, cold flashes with goose bumps, and
involuntary leg movements.
Emergency Department Drug
Mentions - OxyCodone
LSD
• LSD, aka "acid," is odorless, colorless,
and has a slightly bitter taste and is
usually taken by mouth. Often LSD is
added to absorbent paper, such as blotter
paper, and divided into small, decorated
squares, with each square representing
one dose.
Physical Psychological shortterm effects
The effects of LSD are unpredictable. They depend on
the amount taken; the user's personality, mood, and
expectations; and the surroundings in which the drug
is used
Usually, the user feels the first effects of the drug 30 to
90 minutes after taking it. The physical effects include
dilated pupils, higher body temperature, increased
heart rate and blood pressure, sweating, loss of
appetite, sleeplessness, dry mouth, and tremors.
Health Hazards of LSD
• LSD trips are long - typically they begin to
clear after about 12 hours. Some users
experience severe, terrifying thoughts and
feelings, fear of losing control, fear of
insanity and death, and despair while
using LSD. In some cases, fatal accidents
have occurred during states of LSD
intoxication.
Flashbacks
– Many LSD users experience flashbacks, recurrence of certain
aspects of a person's experience, without the user having taken
the drug again
– A flashback occurs suddenly, often without warning, and may
occur within a few days or more than a year after LSD use
– Flashbacks usually occur in people who use hallucinogens
chronically or have an underlying personality problem; however,
otherwise healthy people who use LSD occasionally may also
have flashbacks
– . Bad trips and flashbacks are only part of the risks of LSD use
– LSD users may manifest relatively long-lasting psychoses, such
as schizophrenia or severe depression
Physical Psychological shortterm effects (continued)
Sensations and feelings change much more
dramatically than the physical signs. The user may feel
several different emotions at once or swing rapidly from
one emotion to another. If taken in a large enough
dose, the drug produces delusions and visual
hallucinations. The user's sense of time and self
changes. Sensations may seem to "cross over," giving
the user the feeling of hearing colors and seeing
sounds. These changes can be frightening and can
cause panic attacks.
MDMA (Ecstasy)
•
•
•
•
•
•
Street terms for MDMA
Ecstasy
XTC,
Go,
X,
Hug Drug
What does Ecstasy look like?
• Ecstasy is distributed in tablet form.
Individual tablets are often imprinted with
graphic designs or commercial logos, and
typically contain 100 mg of MDMA.
Ecstasy Facts
• How is Ecstasy used?
• Ecstasy is usually ingested in tablet form,
but can also be crushed and snorted,
injected, or used in suppository form.
• Who uses Ecstasy?
• In 2000, more than 6.4 million people age
12 and older reported that they have used
Ecstasy at least once in their lives.
How does Ecstasy get to the
United States?
• The vast majority of Ecstasy consumed
domestically is produced in Europe.
• A limited number of Ecstasy laboratories
operate in the United States.
• Law enforcement seized 17 clandestine
Ecstasy laboratories in the United States
in 2001 compared to 7 seized in 2000
How much does Ecstasy cost?
• It costs as little as 25 to 50 cents to
manufacture an Ecstasy tablet in Europe.
• Street value of that same Ecstasy tablet
can be as high as $40, with a tablet
typically selling for between $20 and $30.
What are some of the
consequences of using Ecstasy?
• In addition to chemical stimulation, the drug
reportedly suppresses the need to eat, drink, or
sleep.
• When taken at raves, where all-night dancing
usually occurs, the drug often leads to severe
dehydration and heat stroke in the user since it
has the effect of "short-circuiting" the body's
temperature signals to the brain.
Overdose
• An Ecstasy overdose is characterized by a rapid
heartbeat, high blood pressure, faintness, muscle
cramping, panic attacks, and, in more severe cases, loss
of consciousness or seizures. One of the side effects of
the drug is jaw muscle tension and teeth grinding. As a
consequence, Ecstasy users will often suck on pacifiers
to help relieve the tension.
• Ecstasy may cause hyperthermia, muscle breakdown,
seizures, stroke, kidney and cardiovascular system
failure, possible permanent damage to sections of brain
critical to thought and memory, and death
Death
• Ecstasy may cause hyperthermia, muscle
breakdown, seizures, stroke, kidney and
cardiovascular system failure, possible
permanent damage to sections of brain
critical to thought and memory, and death!
Emergency Department Drug
Mentions - MDMA (Ecstasy)
Club Drugs: Operation X-Out
• DEA Administrator Asa Hutchinson believes that
Operation X-Out is important because "the use
of Ecstasy and predatory drugs among our youth
is fast reaching epidemic levels.
• Unscrupulous dealers and promoters are
marketing Ecstasy, Rohypnol, GHB, Ketamine
and other lesser known drugs to individuals who,
all too often, do not truly understand their
potentially devastating effects,"
• "Not only is the DEA targeting these traffickers,
we're also reaching out to communities in an
unprecedented way to get them involved."
Methamphetamine
Methamphetamine
• Amphetamine, Dextroamphetamine,
Methamphetamine, and their various salts are
collectively referred to as amphetamines.
• Their chemical properties and actions are so
similar that even experienced users have
difficulty knowing which drug they have taken.
Methamphetamine is the most commonly
abused.
• Street terms for methamphetamine: Meth, poor
man's cocaine, crystal meth, ice, glass, speed.
What Does Methamphetamine
Look Like?
• Typically meth is a white
powder that easily dissolves in
water.
• Another form of meth, in clear
chunky crystals, called crystal
meth, or ice.
• Meth can also be in the form of
small, brightly colored tablets.
The pills are often called by
their Thai name, yaba.
What are the methods of usage?
•
•
•
•
Injecting
Snorting
Smoking
Oral ingestion
Who uses methamphetamine and
amphetamines?
• During 2000, 4% of the U.S. population
reported trying methamphetamine at least
once in their lifetime.
• Abuse is concentrated in the western,
southwestern, and mid-western United
States.
How do methamphetamine get to
the United States?
• Clandestine laboratories in California and
Mexico are the primary sources of supply for
methamphetamine available in the United
States.
• Domestic labs that produce methamphetamine
are dependent on supplies of the precursor
chemical pseudo ephedrine, which is sometimes
diverted from legitimate sources. It is smuggled
from Canada, and to a lesser extent from
Mexico.
How much do methamphetamine
and amphetamines cost?
• Prices for methamphetamine vary throughout
different regions of the United States.
• At the distribution level, prices range from
$3,500 per pound in parts of California and
Texas to $21,000 per pound in southeastern and
northeastern regions of the country. Retail prices
range from $400 to $3,000 per ounce
What are some consequences of
methamphetamine use?
• Effects of usage include addiction, psychotic behavior,
and brain damage .
• Withdrawal symptoms include depression, anxiety,
fatigue, paranoia, aggression, and intense cravings.
• Chronic use can cause violent behavior, anxiety,
confusion, insomnia, auditory hallucinations, mood
disturbances, delusions, and paranoia.
• Damage to the brain cause by meth usage is
similar to Alzheimer's disease, stroke, and
epilepsy!
Emergency Department Drug
Mentions - Methamphetamine
Heroin
• Street terms for heroin: smack, thunder, hell
dust, big H, nose drops.
• What does heroin look like?
• Pure heroin is a white powder with a bitter taste.
• Most illicit heroin varies in color from white to
dark brown.
• "Black tar" heroin is sticky like roofing tar or hard
like coal, and its color may vary from dark brown
to black.
How is heroin used?
• Injecting
• Smoking
• Snorting
Who uses heroin?
• In the United States in
1999 there were
104,000 new heroin
users.
• In 2000, approximately
1.2% of the population
reported heroin use at
least once in their
lifetime.
How does heroin get to the United
States?
• The U.S. heroin market is supplied entirely
from foreign sources of opium.
• Production occurs in South America,
Mexico, Southeast Asia, and Southwest
Asia
How much does heroin cost?
• Nationwide, in 2000, South American heroin
ranged from $50,000 to $200,000 per kilogram.
Southeast and Southwest Asian heroin ranged
in price from $40,000 to $190,000 per kilogram.
Wholesale-level prices for Mexican heroin were
the lowest of any type, ranging from $13,200 to
$175,000 per kilogram.
• The wide range in kilogram prices reflects
variables such as buyer/seller relationships,
quantities purchased, purchase frequencies,
purity, and transportation costs
What are some consequences of
heroin use?
• One of the most significant effects of heroin use is
addiction. Once tolerance happens, higher does become
necessary to achieve the desired effect, and physical
dependence develops.
• Chronic use may cause collapsed veins, infection of
heart lining and valves, abscesses, liver disease,
pulmonary complications, and various types of
pneumonia.
• May cause depression of central nervous system, cloudy
mental functioning, and slowed breathing to the point of
respiratory failure.
• Heroin overdose may cause slow and shallow breathing,
convulsions, coma, and possibly death.
Emergency Department Drug
Mentions - Heroin
Cocaine
• Street terms for cocaine:
• Blow, nose candy, coke
• What are the different forms of
cocaine?
• White crystalline powder
• "Crack" or "rock" cocaine is an
off-white chunky material.
How is cocaine used?
• Powder cocaine is generally snorted or
dissolved in water and injected.
• Crack cocaine is usually smoked
Who uses cocaine?
• Cocaine is the second most commonly
used illicit drug in the United States.
• About 10 percent of Americans over the
age of 12 have tried cocaine at least once
in their lifetime, about 2 percent have tried
crack, and nearly one percent is currently
using cocaine
How does cocaine get to the United
States?
• The United States-Mexico border is the
primary point of entry for cocaine
shipments being smuggled into the United
States.
Narco-traffico& FARC
• Organized crime
groups based in
Colombia control the
worldwide supply of
cocaine.4
Coca
• Erythroxyl
um coca
(Erythroxyl
aceae).
Tree
native to
South
America.
Cocaine History
• Active Drug. Cocaine an alkaloid, was
isolated by Germans in 1850.
• Used medicinally as a local analgesic, it is
now replaced in part by synthetic
derivatives such as novacain (procaine)
and xylocaine (lidocaine). Obtained from
leaves that are harvested dried and
extracted using organic solvents.
History
• Has been used for at least
3500 years by South
American people (Incas)
living at high elevations Incan artifact showing
coca use}.
• They chew the leaves with
lime alkali (taken by
poporo stick)
• Helps reduce fatigue.
• Traditionally only used by
ruling class (plant was
sacred).
Conquistadors
• Spanish explorers introduced idea of
adding lime (calcium carbonate) which
releases the cocaine from the leaves when
chewed. Increased productivity and
endurance of enslaved Indians.
Original Formula
Coke
• 1886 in Atlanta
Georgia, Coca Cola
was invented by J. S.
Pemberton.
• At that time it did
contain cocaine which
was removed in 1903.
• The Harrison Act of
1914 first regulated
the use of cocaine (as
well as opium,
morphine and heroin).
Freudian Slip?
• 1884, Sigmund Freud was an
enthusiastic advocate of
cocaine use.
• Coca-wine was widely used,
e.g. by Jules Verne, Thomas
Edison, John Philip Sousa.
• Sir Arthur Conan Doyle's
"Sherlock Holmes" was written
under influence of cocaine.
How much does cocaine cost?
• Cocaine prices depend upon the purity of
the product.
• Cocaine remained low and stable, which
suggests a steady supply to the United
States.
• Nationwide, prices ranged from $12,000 to
$35,000 per kilogram
What are some consequences of
cocaine use?
• Cocaine is powerfully addictive.
• Smoking crack can cause severe chest
pains with lung trauma and bleeding.
• The mixing of cocaine and alcohol create
cocaethylene while increasing risk of
sudden death.
• Cocaine-related deaths are often a result
of cardiac arrest or seizures followed by
respiratory arrest.
Emergency Department Drug
Mentions - Cocaine
Marijuana
• Marijuana
• Street Terms:
grass, pot,
weed, bud,
Mary Jane,
dope, indo,
hydro;
ganga.
• What does marijuana look like?
• A green, brown, or gray mixture of dried,
shredded leaves, stems, seeds, and
flowers of the hemp plant.
• Other forms, less common in the United
States, are hashish and hashish oil.
What are the methods of usage?
• Marijuana is usually
smoked as a
cigarette (called a
joint) or in a pipe or
bong.
Who uses marijuana?
• Marijuana is the most
commonly used illicit
drug.
• At least one-third of
Americans have used
marijuana sometime in
their lives.
Others, Never Have.
GROW IN WILD OR HOME!
Indoor labs
Marijuana Alternatives…
• Hawaiian Gold Bud
• http://www.herbalsmokeshops.co
m/hawaiian-herbal-hybrid.html
Emergency Department Drug
Mentions - Marijuana
FDA and Prescription Drugs
• There are two issues in this section,
• 1) How the FDA APPROVES DRUGS
• 2) PEOPLE ARE ABUSING
PERSCRITION AND OVER THE
COUNTER DRUGS.
Drug approval Process
• How a drug is placed on the market.
• Drug companies run tests on their own drugs. The
results of these tests are given to the Center for Drug
Evaluation and Research. The CDER never tests the
drugs themselves. In the 1990’s CDER reformed the
review process to speed the acceptance of new drugs.
Now CDER can review new drugs in less than a year
before they are approved.
Changing evolution
Are drugs wrong?
Survival of the wealthy vs. Survival of the Fit
– Dick Cheney
– Magic Johnson
– Insulin and Myopia
• Effectiveness of drugs.
– Meningococcal Meningitis Vaccine is only
affective against 70% of the disease.
Strange diseases
•
Drugs for Public Speaking...
• Is that even a disease?
– Paxil CR– a drug for social phobia
• “Situations that can trigger the social phobia that in
an earlier era might have been deemed severe
shyness include public speaking, performing in
public, eating in front of others or using public
bathrooms.” (Forbes Magazine)
Misdiagnosis
7,000 Americans die from
mistakes involving prescription
medications, while thousands
more suffer serious or
uncomfortable side effects.
Death by Medicine
• A Book by Gary Null PhD, Carolyn Dean MD ND,
Martin Feldman MD, Debora Rasio MD, Dorothy
Smith PhD
•
Over the next ten years, 1.06 million people will
die because of an Adverse Drug Reaction and 7.8
million people will suffer iatrogenic deaths.
•
Approximately 56% of the population of America
has been treated unnecessarily by the medical
industry.
Side effects from poor testing
•
Thalidomide –
• “Thalidomide (tha-lid-o-mide) was first marketed in
Europe in the late 1950's. It was used as a sleeping pill
and to treat morning sickness during pregnancy. At that
time no one knew thalidomide caused birth defects.”
(FDA)
Side Effects • Zoloft – an antidepression Medication
• “dry mouth, insomnia, sexual side effects, diarrhea, nausea,
and sleepiness” (Zoloft website)
Prozac – an anti depression Medication
• “Antidepressants increased the risk of suicidal thinking and
behavior in children and adolescents with depression and
other psychiatric disorders. Patients starting therapy should
be observed closely for worsening depression symptoms,
suicidal thoughts or behavior, or unusual changes in
behavior.” (Prozac Website)
Alternative Medicine
• Millions of Americans spend billions of
dollars on alternative remedies with
unproven effects.
• Rigorous science is starting to test those
treatments and mostly finds them lacking.
• Despite Tests, Many Consumers Swear
by Remedies
Just don’t work
• Major government-funded research indicated
that two wildly popular arthritis pills, glucosamine
and chondroitin, worked no better than a
placebo at relieving mild arthritis pain.
• Saw palmetto had no effect on prostate
problems;
• Echinacea does not cure the common cold.
• St. John's wort does not to treat major
depression, causes glaucoma.
• Shark cartilage has no effect on cancers.
Placebo Effect
• Placebo effect - just thinking you're taking
something useful can make you think
there's a benefit.
• The placebo effect was huge in patients
unknowingly taking dummy pills in the
arthritis study.
Mind over Matter
• Imaging tests have shown changes in the brains of
placebo users, suggesting that the effect is not just
"in your mind," it's also in the brain, says
Dr. Stephen Straus, director of NIH's National
Center for Complementary and Alternative Medicine.
• "Their wishful thinking that they're going to get better
is harnessing the body's own mechanism for
relieving pain," said Dr. Straus, whose agency was
formed seven years ago to stringently test nonconventional remedies.
ALCOHOL
ALCOHOL
• ALCOHOL
– Hard Liquor
– Beer
– Wine
Alcohol on Campus
• College binge drinking a problem
• Health is compromised when 5 or more
drinks are consumed per occasion. At this
point the P450 complex in the liver, which
neutralizes toxicity, cannot handle toxicity
levels appropriately.
• One drink= ½ oz alcohol per shot, 5 oz
wine, 12 oz beer
Academic Performance
• 40% of poor academic performance at college has been
linked to drinking
• 7% of first year dropouts are
related to alcohol
• Alcohol intake is inversely
related to GPA
• 80% of campus vandalism
involved alcohol
• 70% of violent behavior on
campus involved alcohol
• 75% of men and 55% of women involved in
acquaintance rape were under the influence of alcohol
Drinking- It’s not a Game.
• Young Adults are prone to drink
excessively…
Alcoholism
• AKA alcohol dependence, is a disease that
includes the following four symptoms:
• Craving--A strong need, or urge, to drink.
• Loss of control--Not being able to stop drinking
once drinking has begun.
• Physical dependence--Withdrawal symptoms,
such as nausea, sweating, shakiness, and
anxiety after stopping drinking.
• Tolerance--The need to drink greater amounts
of alcohol to get "high."
Is Alcoholism a Disease?
• Yes, alcoholism is a disease. The craving that an
alcoholic feels for alcohol can be as strong as
the need for food or water. An alcoholic will
continue to drink despite serious family, health,
or legal problems.
• Like many other diseases, alcoholism is chronic,
meaning that it lasts a person's lifetime; it
usually follows a predictable course; and it has
symptoms. The risk for developing alcoholism is
influenced both by a person's genes and by his
or her lifestyle.
Alcoholism May Be Inherited as
Brain Overexcitability
• For the first time, researchers have linked
a gene that regulates a specific chemical
in the brain to a person's risk of
alcoholism.
• Studies have identified a major brain
chemical known as gamma-amino butyric
acid (GABA) that is involved in many
nerve pathways affecting alcohol abuse
and dependence.
GABA
• Many effects from alcohol involve GABA -- the
difficulty walking, the lessened anxiety, the
sleepiness, and even alcohol preference.
• GABA is also involved in alcohol withdrawal and
in the craving for greater amounts of alcohol to
soothe nervousness.
• Researchers found consistent evidence of
alcohol dependence and one particular gene
that regulates GABA activity -- called GABRG3.
Addiction
• Nearly 1.9 million Americans 12 and older
received treatment for alcohol problems in
1992.
• In 1992, more than seven percent of the
population ages 18 years and older nearly 13.8 million Americans had
problems with drinking.
A life time addiction
• 5-10% of people exposed to alcohol will develop
impairment
• It takes an adult 5-10 years to establish
alcoholism, while it takes an adolescent only 4-5
years
• Children of alcoholics are more likely to
experience a euphoric rush from consumption
• Alcohol involved in 50% of all motor vehicle
fatalities
• Associated with Fetal Alcohol Syndrome and
Sudden Infant Death Syndrome
Banning the ads
• Nations banning the advertising of distilled
spirits, compared to nations with no bans,
had approximately 16 percent lower
alcohol consumption.
• Countries banning beer and wine ads had
11 percent lower consumption.
3rd leading cause of Death
• Alcohol contributes to 100,000 deaths
annually, making it the third leading cause
of preventable mortality, after tobacco and
diet/activity patterns.
• Among 8,541 deaths attributed to nonmedical use of other drugs in1993, 40
percent also involved alcohol.
Economic Cost
• A 1998 report by the National Institute on
Drug Abuse (NIDA) and the National
Institute on Alcohol Abuse and Alcoholism
(NIAAA) estimated the economic costs of
alcohol abuse in the United States to be
$148.02 billion in 1998, 80% ($119.32
billion) of which were due to alcoholrelated illness (including health care
expenditures, impaired productivity and
premature death).
Legalize and Tax?
• In 1998, states collected $4.0 billion in alcohol and $7.4
billion in tobacco taxes for a total of $11.4 billion.
• For every dollar of such tax revenues, states spent $7.13
on substance abuse and addiction -- $6.83 to shoulder
the burden on public programs, $0.26 for prevention and
treatment, and $0.04 to collect alcohol and tobacco
taxes and run licensing boards."
• Source: National Center on Addiction and Substance
Abuse at Columbia University, Shoveling Up: The Impact
of Substance Abuse on State Budgets (New York, NY:
CASA, Jan. 2001), p. 27.
D.U.I.
• 1 Million DUI arrest annually in the USA• This represents less than 1% of all DUI
incidents!
Is it safe to drink during
pregnancy?
No, drinking during pregnancy is dangerous.
Alcohol can have a number of harmful effects on
the baby.
The baby can be born mentally retarded or with
learning and behavioral problems that last a
lifetime.
We don't know exactly how much alcohol is
required to cause these problems.
We do know, however, that these alcohol-related
birth defects are 100-percent preventable,
simply by not drinking alcohol during pregnancy.
The safest course for women who are pregnant or
trying to become pregnant is not to drink alcohol
at all.
Why legalization of alcohol?
•
•
•
•
Taxes
Important for the economy
Prevents crime
Health
Alcohol Tax - revenue
• Alcohol is a main source of the tax income for the government
• And the sell of alcohol is a multi – billion
dollar business, with imports
and exports all over the world
Total Tax Collection 2003:
8,470,199,000
Who depends on the sell of
alcohol?
•
•
•
•
•
Alcohol is important for the U.S. economy:
Production companies
Distribution companies
Retailer
Advertisement companies
Legalizing prevents crime:
• Legalization of alcohol also prevents the
society from an illegal black- market
• It reduces corruption and crime
• Prohibition failed (1920 – 1933)
Health issues:
• A glass of red wine a day may prevent
cancer and heart- diseases
• A glass of beer during dinner helps to have
a “ better “ sleep at night
• A shot of pure liquor after dinner supports
the digestion
• But only if you drink moderately.
'Hoppy' Beers May Fight Disease
• Research is showing that
beer could join the ranks of
other guilt-inducing but wildly
popular foods -- chocolate,
coffee and red wine -- as a
possible disease-fighter.
• Beer hops contain a unique
micronutrient that inhibits
cancer-causing enzymes.
Xanthohumol
• Xanthohumol has several unique effects.
Along with inhibiting tumor growth and
other enzymes that activate cancer cells, it
also helps the body make unhealthy
compounds more water-soluble, so they
can be excreted.
Guinness: It’s Good for You!
• Most beers made today are low
on hops, and don't contain
much xanthohumol.
• But beers known for being
"hoppy" — usually porter, stout
and ale types — have much
higher levels of the compound.
Tobacco
• Tobacco is a tall, leafy annual plant,
originally grown in South and Central
America, but now cultivated throughout the
world.
• There are many species of tobacco;
Nicotiana tabacum (or common tobacco)
is used to produce cigarettes.
Tobacco: US History
• 1804 mass produced hand rolled
cigarettes
• WWI issuing of cut tobacco to soldiers
• WWII issuing of government packs of
cigarettes
• Filters introduced in the 1950s
• 1964 1st Surgeon General announcement
about tobacco
Nicotine
• Nicotine, a powerful central nervous
system stimulant found naturally in the
tobacco leaf, is classified as a drug.
• Nicotine is one of the main ingredients in
tobacco. In higher doses, nicotine is
extremely poisonous. It is commonly used
as an insecticide.
How is it used?
• Tobacco leaves can be burned and
inhaled (in the form of cigarettes, cigars,
pipes, smoke, etc.) or absorbed through
the mouth (in the form of spit tobacco,
chew, or snuff).
• The membranes in the nose, mouth and
lungs act as nicotine delivery systems transmitting nicotine into the blood and to
the brain.
Health Effects of Cigarette
Smoking
• The adverse health effects from cigarette
smoking account for 440,000 deaths, or
nearly 1 of every 5 deaths, each year in
the United States.
• More deaths are caused each year by
tobacco use than by all deaths from
human immunodeficiency virus (HIV),
illegal drug use, alcohol use, motor vehicle
injuries, suicides, and murders combined.
Smoking & Cancer
• The risk of dying from lung cancer is more than 22 times
higher among men who smoke cigarettes, and about 12
times higher among women who smoke cigarettes
compared with never smokers.
• Cigarette smoking increases the risk for many types of
cancer, including cancers of the lip, oral cavity, and
pharynx; esophagus; pancreas; larynx (voice box); lung;
uterine cervix; urinary bladder; and kidney.
• Rates of cancers related to cigarette smoking vary
widely among members of racial/ethnic groups, but are
generally highest in African-American men.
Cardiovascular Disease (Heart
and Circulatory System)
• Cigarette smokers are 2–4 times more likely to
develop coronary heart disease than
nonsmokers.
• Cigarette smoking approximately doubles a
person’s risk for stroke.
• Cigarette smoking causes reduced circulation by
narrowing the blood vessels (arteries). Smokers
are more than 10 times as likely as nonsmokers
to develop peripheral vascular disease.
Respiratory Disease and Other
Effects
• Cigarette smoking is associated with a
ten-fold increase in the risk of dying from
chronic obstructive lung disease.
• About 90% of all deaths from chronic
obstructive lung diseases are attributable
to cigarette smoking.
SIDS & Osteoporosis
• Cigarette smoking has many adverse
reproductive and early childhood effects,
including an increased risk for infertility, preterm
delivery, stillbirth, low birth weight, and sudden
infant death syndrome (SIDS).
• Postmenopausal women who smoke have
lower bone density than women who never
smoked. Women who smoke have an increased
risk for hip fracture than never smokers.
War on Drugs
• http://www.drugwarfacts.org/economi.htm
The Cost of the War on Drugs
• In 1969, $65 million was spent by the
Nixon administration on the drug war;
• 1982 the Reagan administration spent
$1.65 billion;
• 2000 the Clinton administration spent
more than $17.9 billion;
• 2002, the Bush administration spent more
than $18.822 billion.
According to ONDCP
• $18.822 Billion spent by the federal
government on the drug war in 2002
breaks down as follows:
• Treatment (with Research): $3.587 Billion
• Prevention (with Research): $2.548 Billion
• Domestic Law Enforcement: $9.513 Billion
• Interdiction: $2.074 Billion (11.0% of total)
International: $1.098 Billion (5.8% of total)
Supply and Demand
• In other words, $12.686 Billion in 2002
was directed to supply reduction, i.e. law
enforcement (67.4% of total),
• $6.136 Billion to demand reduction, i.e.
treatment, prevention and education
(32.6% of total).
Economic Cost
• illegal drug abuse cost a total of $97.66
billion in 1992, of which less than 40%
($38.71 billion) was due to drug-related
illness or premature death.
• This figure includes $4.16 billion in
HIV/AIDS and Hepatitis treatment costs.
United Nations Office on Drugs and
Crime
• Value of the global illicit drug market for
the year 2003 was estimated
• $13,000,000,000 at Production level,
• $94,000,000,000 Wholesale
• $322,000,000,000 Retail
Drug Crime
• According to the FBI, 13,714,438 people in
the United States of America were
arrested in 2002. 1,538,813 of these
arrests were due to drug abuse violations.
• 28.8% of all convicted inmates admitted to
being under the influence of some kind of
drug at the time of their offense
Ethical Questions
• Are all illicit drugs the same?
• Is there a distinction to be drawn between
alcohol, nicotine and marijuana on the one hand
and cocaine, heroin and other drugs on the
other?
• Some have argued that when we consider the
effects of the drugs, then such a classification
seems to make sense, but by the same token,
then our prohibition on all drugs does not.
Questions
• Should we stick with are current policy, simply
because it is the one we adopted 50 years ago.
The argument that we can’t predict the
consequences of legalization seems to be
flawed. 1) fifty years ago we could not predict
the consequences of prohibition, did that mean
we should not have adopted the policy that we
did? Further, given those consequences, the war
on drugs as a whole, does such a policy seem to
make sense?
Final Thought
• If drug use is immoral, then we should not
legalize it, no matter how beneficial it should be.
This follows for prostitution, abortion,
euthanasia… any of the topics we have
discussed this semester.
• If there are compelling arguments that show
something to be immoral, then even if there is
evidence that making it legal would have
beneficial social consequences, that is not
reason enough to make it legal.
Can we win?
•Can’t we just say
NO?!?