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 ViewsConservative

– 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 short-term 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 short-term effects (continued)

Sensations and feelings change much moredramatically than the physical signs. The user may feel several different emotions at once or swing rapidly fromone 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

• Erythroxylum coca (Erythroxylaceae). 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.com/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 frommistakes involving prescriptionmedications, 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 non-conventional 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 non-medical 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 alcohol-related 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?!?