DRUGS AND ALCOHOL

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DRUGS AND ALCOHOL
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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

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Philosophical Views

• Conservative
• James Wilson
• William J. Bennett
• Moderate
• Milton Friedman
• Joseph DesJardins Ronald Duska
• Bonnie Steinbock
• Liberal
• Ethan Nadelmann
• Walter Block

4
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!

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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.

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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.

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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.

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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.

9
William J. Bennett

• Served as Director of the Office of National Drug
  Control Policy and US secretary of Education

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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 dont know what would happen if we
  decriminalized drugs.

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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.

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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 dont make you totally unproductive,
  then perhaps the company has no right to know if
  you do or do not use.

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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.

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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.

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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.

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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.

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Ethan Nadelmann

• Executive Director of Drug Policy Alliance.
• Pro legalization and decriminalization of drugs.

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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.

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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

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TYPES OF DRUGS

• Alcohol
• Tobacco
• Marijuana
• Heroine
• LSD
• Xtasy
• Cocaine
• Crack
• Prescription Drugs/ Steroids
• Natural Herbs

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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

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What are the methods of usage?

• Oral ingestion
• Injection
• Rubbed on the skin in the form of gels or creams

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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.

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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.

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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.

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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.

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How is GHB used?

• Usually ingested in a liquid mixture most
  commonly mixed with alcohol

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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.

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How much does GHB cost?

• GHB is usually sold by the capful, and sells for
  5 to 25 per cap.

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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.

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Emergency Department Drug Mentions - GHB
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Ketamine

• Street terms for Ketamine jet, super acid,
  Special "K", green, K, cat Valium1

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What does Ketamine look like?

• Ketamine comes in a clear liquid and a white or
  off-white powder form.

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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.

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Who uses Ketamine?

• Ketamine, along with the other "club drugs," has
  become popular among teens and young adults at
  dance clubs and "raves."

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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

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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.

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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.

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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.

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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.

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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.

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Emergency Department Drug Mentions - OxyCodone
                                                  
                                                  
                                   
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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.

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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.

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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.

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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

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Physical Psychological short-term 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.

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MDMA (Ecstasy)

• Street terms for MDMA
• Ecstasy
• XTC,
• Go,
• X,
• Hug Drug

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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.

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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.

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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

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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.

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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.

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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

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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!

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Emergency Department Drug Mentions - MDMA
(Ecstasy)
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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."

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Methamphetamine
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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.

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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.

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What are the methods of usage?

• Injecting
• Snorting
• Smoking
• Oral ingestion

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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.

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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.

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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

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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!

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Emergency Department Drug Mentions -
Methamphetamine
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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.

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How is heroin used?

• Injecting
• Smoking
• Snorting

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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.

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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

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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

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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.

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Emergency Department Drug Mentions - Heroin
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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.

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How is cocaine used?

• Powder cocaine is generally snorted or dissolved
  in water and injected.
• Crack cocaine is usually smoked

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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

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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.

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Narco-traffico FARC

• Organized crime groups based in Colombia control
  the worldwide supply of cocaine.4

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Coca

• Erythroxylum coca (Erythroxylaceae). Tree native
  to South America.

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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.

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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).

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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.

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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).

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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.

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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

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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.

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Emergency Department Drug Mentions - Cocaine
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Marijuana

• Marijuana
• Street Terms grass, pot, weed, bud, Mary Jane,
  dope, indo, hydro ganga.

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• 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.

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What are the methods of usage?

• Marijuana is usually smoked as a cigarette
  (called a joint) or in a pipe or bong.

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Who uses marijuana?

• Marijuana is the most commonly used illicit drug.
  
• At least one-third of Americans have used
  marijuana sometime in their lives.

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Others, Never Have.
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GROW IN WILD OR HOME!
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Indoor labs
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Marijuana Alternatives

• Hawaiian Gold Bud
• http//www.herbalsmokeshops.com/hawaiian-herbal-hy
  brid.html

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Emergency Department Drug Mentions - Marijuana
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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.

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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 1990s 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.

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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.

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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)

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Misdiagnosis

• 7,000 Americans die from
• mistakes involving prescription
• medications, while thousands
• more suffer serious or
• uncomfortable side effects.

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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.

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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)

107
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)

108
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

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Just dont 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.

110
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.

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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.

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ALCOHOL
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ALCOHOL

• ALCOHOL
• Hard Liquor
• Beer
• Wine

114
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

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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

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Drinking- Its not a Game.

• Young Adults are prone to drink excessively

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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."

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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.

119
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.

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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.

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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.

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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

123
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.

124
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.

125
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).

126
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.

127
D.U.I.

• 1 Million DUI arrest annually in the USA-
• This represents less than 1 of all DUI incidents!

128
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.

129
Why legalization of alcohol?

• Taxes
• Important for the economy
• Prevents crime
• Health

130
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

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Who depends on the sell of alcohol?

• Alcohol is important for the U.S. economy
• Production companies
• Distribution companies
• Retailer
• Advertisement companies

135
Legalizing prevents crime

• Legalization of alcohol also prevents the society
  from an illegal black- market
• It reduces corruption and crime
• Prohibition failed (1920 1933)

136
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.

137
'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.

138
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.

139
Guinness Its 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.

140
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.

141
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

142
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.

143
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.

144
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.

145
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.

146
Cardiovascular Disease (Heart and Circulatory
System)

• Cigarette smokers are 24 times more likely to
  develop coronary heart disease than nonsmokers. 
• Cigarette smoking approximately doubles a
  persons 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.

147
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. 

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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.

149
War on Drugs

• http//www.drugwarfacts.org/economi.htm

150
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.

151
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)

152
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).

153
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.

154
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

155
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

156
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.

157
Questions

• Should we stick with are current policy, simply
  because it is the one we adopted 50 years ago.
  The argument that we cant 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?

158
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.

159
Can we win?

• Cant we just say NO?!?