PUBH 3003 1st Edition Lecture 7Outline of Last Lecture I. Prevention Strategies II. ApproachesIII. TheoriesIV. Signs of riskV. StrategiesVI. Lessons from prevention research Outline of Current LectureI. Controlled Prescription DrugsII. Different types of abused drugs III. Cost of illegal DrugsIV. Drug Schedules V. How should we respond?VI. Drugs around the world Current LectureControlled Prescription Drugs (CPDs)- Threat from CPD use is persistent - Annual economic cost of nonmedical use of prescription opioids in the US estimated at$53 billion in 2011- Estimated 4.9 million nonmedical users of pain relievers - CPDs Increasingly the first drug abused by illicit drug users - National Center for Health Statistics indicated that mortality data from 2009 suggestedlarge decline in motor vehicle crash deaths and continued increase in prescription drugoverdoses- Led to conclusion that drug poisoning alone now causes more deaths than are caused by motor vehicle crashes in the USHeroin- Threat posed by heroin in the US is increasing especially in the Northeast and North Central regionsThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- For the 20 years, the US retail heroin market has been roughly divided by the Mississippi River - Mexican black tar and brown powder heroin west of the Mississippi- South American white powder heroin more common in the east - Increased demand for and abuse of heroin largely being driven by a subset of CPD abusers switching to heroin- Recent study found that heroin abuse was 19 times higher among those who had previously abused pain reliever CPDs- As CPD abusers progress in their addiction, they require increasingly large amounts of opioid medications to achieve a high or stave off withdrawal - Expense quickly mounts, causing some abusers to turn to heroin as a cheaper alternative - Heroin overdose deaths increasing in many cities across the United States including Minneapolis / St. Paul- Some communities training law enforcement officers and first responders to administer naloxone, a drug that can reverse the effects of overdoseMethamphetamine- Seizure data, law enforcement reporting, and localized treatment information all indicate that methamphetamine trafficking and abuse continues to increase throughout the US- The majority of methamphetamine available in US Is Mexico-produced - Highly pure and potent increasingly available - Vast majority of methamphetamine labs seized in the US are small capacityCocaine - Most cocaine available in the US continues to be produced in Columbia and smuggled across the southwest border and to a lesser extent through the Caribbean- Availability and consumption indicators remain at lower levels than in 2006- Emergency department visits for cocaine decreased 9% from 2007 to 2011, while admissions to publically licensed treatment facilities dropped by over 40%Marijuana- Marijuana is the most widely available and commonly abused illicit drug in the US- Large scale Marijuana importation from Mexico as well as increasing domestic indoor growers- Average THC content of Marijuana and hash oil available in the US continues to increase- In 1995, average THC potency of leaf Marijuana was 3.96 percent- In 2013, average THC potency was 12.55 percent - Ingestion of marijuana edibles by children is an increasing concernSynthetic Designer Drugs- Since 2009, US law enforcement officials have encounter more than 240 new syntheticcompounds- Most wholesale quantities of synthetic drugs are purchased over the internet and are shipped form distributors in china - The synthetic drug abuse prevention act of 2012 placed synthetic drugs in Schedule 1- AS synthetic drugs are banned, producers quickly change one or two elements in the banned substance Cost of Drug Abuse - Estimated at over $100 billion per year - Accidental deaths, injuries, health care, dependency treatment, lost productivity, criminal behavior Illegal Drugs vs. Legal Drugs - Legality of a drug can depend on how it is being used and what it is being used for- Amphetamines are used to treat attention deficit disorder- Barbiturates help treat anxiety - Marijuana can relieve cancer- induced nausea- But prescribed use considered to pose a danger - Federal, State, and Local laws- At both state and federal levels most cases stem from charges of possession, manufacturing, or trafficking of controlled substances- Controlled substances are often classified at different levels of “schedules” under federal and state statues Drug Schedules - Schedule 1 Drugs: no currently accepted medical use in US, high potential for abuse (e.g. Marijuana, LSD, Heroin)- Schedule 2 Appropriate medical use but high abuse potential ( e.g. morphine, opium, oxycodone, amphetamine)- Schedule 3: potential for abuse less than drugs in schedule 1 or 2- Schedule 4: Low potential for abuse relative to schedule 3 (Valium, Xanax)How Should we Respond?- Long prison sentences for possession?- Provide offenders with comprehensive treatment? Nora Colkow, Director, National Institute on Drug Abuse- Legalization?- The US leads the world in the number of people incarcerated in federal and state correctional facilities- There are more than 2 million people in American prisons or jails- US prisons tend to be extremely overcrowded- Tough on crime laws in the 1980’s and 1990’s contributed heavily to growing the US prison population- The US accounts for only 5% of the world population, but holds 25% of the worlds prisoners - By the first decade of this century, EVERY state in the US had significant increase in imprisonment rate- “Drug convictions went from 15 inmates per 100,000 adults in 1980 to 184 in 1996… More than half of America’s federal inmates today are in prison on drug convictions. In2009 alone, 1.49 million Americans were arrested on drug charges… and 4 of 5 og those arrests were simply for possession.”Drug Laws in Singapore- Possession of even miniscule amounts of illegal drugs prohibited- Prescribes execution if found guilty of carrying large amounts of particular types of drugs- Burden of proof is with defendant not government - If you are caught with large amounts of drugs, you are presumed to be trafficking Drug Laws Around the World- Drug laws vary Widely- Portugal decriminalized drugs - Uruguay legalized Marijuana in 2013- Mexico’s drug war has turned incredibly violent-