Transcript Overview_and_Perspectives_lec4

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