Transcript Chapter 12
Chapter 12 Alcohol, Tobacco, and Other Drugs: A Community Concern Introduction • Use, misuse, and abuse of mind-altering substances predates recorded history • Chronic alcohol and other drug abuse or dependence is regarded as destructive behavior in most cultures • Affects individuals and the surrounding community Scope of the Current Drug Problem • More deaths, illnesses, and disabilities can be attributed to substance abuse than any other preventable health condition • Economic costs include direct costs (health care, premature death, impaired productivity) and indirect costs (crime and law enforcement, courts, jails, social work) • Those abusing are threats to themselves, their families, and their communities Annual Cost in Lives and Economic Cost in $ Billions Drug Use Among High School Seniors Definitions • • • • • • • Drug Psychoactive drugs Drug use Drug misuse Drug abuse Drug (chemical) dependence Psychological dependence Factors that Contribute to Alcohol, Tobacco, and Other Drug Abuse • Risk factors – factors that increase the probability of drug use • Protective factors – factors that lower the probability of drug use • Both can be genetic or environmental Inherited Risk Factors • Most research related to drug dependence and inherited risk is on alcoholism • Research has shown genetic and biological markers may predispose someone to increased susceptibility to develop alcohol-related problems Environmental Risk Factors • • • • Personal factors Home and family life School and peer groups Sociocultural environment Types of Drugs Abused and Resulting Problems • Legal drugs • Alcohol, nicotine, nonprescription (over-thecounter) drugs, prescription drugs • Controlled substances and illegal (illicit) drugs • Marijuana, narcotics, cocaine and crack cocaine, hallucinogens, stimulants, depressants, club drugs and designer drugs, anabolic drugs, inhalants Legal Drugs • Can be legally bought and sold in the marketplace • Includes drugs that can be closely regulated, likely regulated, and not regulated at all Alcohol • • • • • • • Number one drug problem in the United States Binge drinking Underage drinking Problem drinkers Alcoholism Blood alcohol concentration (BAC) Fetal Alcohol Spectrum Disorders • Fetal Alcohol Syndrome Nicotine • Psychoactive and addictive drug present in tobacco products • Environmental tobacco smoke (ETS) or secondhand smoke • Synar Amendment • Tobacco use is single most preventable cause of disease, disability, and death in the U.S. • Community efforts: tax increases on cigarettes Over the Counter Drugs (OTCs) • Legal drugs other than alcohol and tobacco that can be purchased without a physician’s prescription • Carefully regulated by the Food and Drug Administration (FDA) • Most only provide symptomatic relief, not a cure • Subject to misuse and abuse Prescription Drugs • Can be purchased only with a physician’s prescription because they have serious side effects for some people • Regulated by the FDA • Subject to misuse and abuse • Risk of dependence and unintentional overdose • Development of drug-resistant strains of pathogens Controlled Substances and Illicit Drugs • Those regulated by the Controlled Substances Act of 1970 • Cannot be cultivated, manufactured, bought, sold, or used within the confines of the law • Schedule I – high potential for abuse; no accepted medical uses • Schedules II-V – have medical uses; scheduled based on potential for risk of dependence or abuse • Drug Enforcement Agency (DEA) responsible for enforcing Controlled Substances Act Marijuana • Products derived from hemp plant • Most abused illicit drug in the U.S. • Often used in conjunction with other drugs – polydrug use • Acute effects – reduced concentration, slowed reaction time, impaired short term memory, impaired judgment • Chronic effects – damage to the respiratory system (if smoked), amotivational syndrome Synthetic Marijuana • Emerging cause for concern • Chemically produced with properties similar to THC • Pose serious threat to communities – potential for abuse and other adverse health effects, long-term effects unknown • In 2011, five chemicals used to produce synthetic marijuana were added to Schedule I of the CSA • States have banned synthetic marijuana Narcotics • Opium and its derivatives, morphine and heroin, come from an oriental poppy plant • Narcotics numb the senses and reduce pain • High potential for abuse • Opium poppies do not grow in U.S.; drug trafficking problems • Heroin addiction leads to significant community health problems Cocaine and Crack Cocaine • Cocaine is the psychoactive ingredient in the leaves of the coca plant • Powerful and addictive euphoriant/stimulant • Purified forms – salt (white powder), dried paste (crack) • In 2012, annual prevalence of cocaine use among high school seniors at lowest reported level of 2.7% Hallucinogens • Produce illusions, hallucinations, changes in perceptions • Synesthesia – mixing of the senses • Both naturally derived and synthetic • LSD, mescaline, peyote, mushrooms Stimulants • Drugs that increase the activity of the central nervous system • Amphetamines • Schedule II prescription drugs; widely abused • Methamphetamines often made in clandestine labs Clandestine Laboratory Incidents Depressants • • • • • Slow down the central nervous system May lower anxiety and inhibitions Tolerance develops Strong physical dependence Alcohol, barbiturates, benzodiazapines Club Drugs and Designer Drugs • Illicit drugs, primarily synthetic, most commonly encountered at nightclubs and raves • MDMA (ecstasy) most popular club drug • Rohypnol – “date rape” drug • Designer drugs – synthesized by amateur chemists in secret labs • Constantly change design to stay ahead of law enforcement Anabolic Drugs • Protein-building drugs • Anabolic/androgenic steroids, testosterone, human growth hormone • Have some legitimate medical uses • Sometimes abused by athletes and body builders • Acute and chronic side effects Inhalants • Collection of psychoactive breathable chemicals • Paint solvents, motor fuels, cleaners, glues, aerosol sprays • Easy availability • Low cost • Often drug choice of young • Acute and chronic effects Prevention and Control of Drug Abuse • Requires knowledge of: • • • • • Causes of drug-taking behavior Sources of illicit drugs Drug laws Treatment programs Community organizing skills • Persistence, and cooperation of various individuals and agencies Levels of Prevention • Primary prevention aimed at those who have never used drugs • Secondary prevention aimed at those who have used, but are not chronic abusers • Tertiary prevention aimed at drug abuse treatment and aftercare, including relapse prevention Elements of Prevention • • • • • Education Treatment Public policy Law enforcement Education and treatment goals same: • Reduce demand for drugs • Public policy and law enforcement goals same: • Reduce supply and availability of drugs Governmental Drug Prevention and Control Agencies and Programs • Include a multitude of federal, state, and local agencies • Aim to reduce either the supply or demand for drugs Federal Drug Control Spending Federal Drug Control Spending Federal Agencies and Programs • Office of National Drug Control Policy • Department of Justice • Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) • Department of Health and Human Services • Substance Abuse and Mental Health Services Administration (SAMSHA) • National Institute on Drug Abuse • Department of Homeland Security State and Local Agencies and Programs • State departments of health, education, mental health, justice, and law enforcement all address drug abuse prevention and control issues • Some states have passed laws that conflict with federal laws • Local communities have individuals, task forces, or agencies to prioritize problems and decide approaches for solving them Nongovernmental Drug Prevention and Control Agencies and Programs • Community-based drug education programs • School-based drug education programs • DARE, student assistance programs, peer counseling programs • Workplace-based drug education programs • Employee assistance programs • Voluntary health agencies Discussion Questions • How can risk factors for drug abuse be utilized to aide in drug abuse prevention? • How should federal, state, and local funds be used to successfully deal with drug abuse problems?