PUBH 3003 1st Edition Lecture 23Outline of Last Lecture I. Current Issues in substance abusea. Alcohol i. Drinking ageII. MarijuanaIII. Synthetic drugsIV. Tobaccoa. MentholOutline of Current Lecture:I. Global Drug wara. Drug trafficking b. Impact on society II. Mexico a. Key strategiesIII. U.S Prison systemsa. Need for interventionb. Mental Healthc. Mental Health treatmentsIV. Global commission on Drug Policy a. Legalize drugs as a solution?Current Lecture:Global Drug War:- Since 1909 the international community has worked to eradicate abuse of narcotics- The start of “The War on Drugs” in the U.S o Nixono Early 70’s and late 60’s- Drug Trafficking: cultivation, manufacturing, distribution and sale of substances subject to drug prohibition laws - 2013 World Drug Reporto Global drug use situation remains stableo 5% of world’s adult population is estimated to have used an illicit drugo Injection drug use and HIV remain a public health concernThese 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.o Most widely used illicit drugs are cannabis and Amphetamine-type stimulants (excluding ecstasy)o Other common drugs: opium, cocaineo Maritime trafficking and new trafficking routes are challenges New Substances and non-medical use of prescription pharmaceuticals - Growing problem- 20.4% for lifetime prevalence of non medical use of psychotherapeutics for persons aged 12 and older Impact on society- Negative health consequences o Risk of injection with blood born viruses o 19% of injecting drug users have HIVo with exception of sub- Saharan Africa, injecting drug use accounted for half of all new HIV infections reported globally o global prevalence of HEP C infections among injecting drug was 46.7% (7.4 million) (2010)- Financial Burdeno Crime and criminal justiceo Productivity losses (equivalent to almost 1% of GDP)- Costs associated with drug related crime o Fraud, burglary, robbery, shoplifting Case Study- Opium in Afghanistan - 90% of the world’s opium is grown and harvested in Afghanistan Key Strategies being implemented in the UN1) Alternative Development 2) Crime and Criminal Justice3) Drug abuse/ Demand Reduction (prevention/treatment)4) Drug supply reduction (eradication/ interdiction)5) Laboratory and scientific section (studies level of harm, corruption, crime, and violence)6) Treaty and Legal affairs (extradition) Mexico Case Study: War Without Borders- Drug War in Mexicoo Funding both sides of the drug waro Drugso Moneyo Gunso Corruptiono Violenceo Spillover - Mexico Key Strategieso Anti Corruption Programo Culture of Lawfulness Implementing a standard curriculum, including anti-corruption,in public schools to promote greater respect for the rule of law Focuses on personal and social ethical decision making and therationale for the rule of law  Program expanded to incorporate the culture of lawfulness curriculum into police training o Extradition Send nationals to the US to stand trial and serve time Emphasis on kingpinsGlobal War on Drugs has failed - Report by the Global Commission on Drug Policy (2011)o “War on drugs has failed, with devastating consequences for individuals and societies around the world”o “Political leaders and public figures should have the courage to articulate publicly what many of them acknowledge privately: that the evidence overwhelmingly demonstrates that repressive strategies will not solve the drug problem, and that the war on drugshas not, and cannot, be won”Research and development- According to RAND drug treatment is:o 7 times more cost effective than law enforcement o 11 times more cost effective than interdictiono 23 times more cost effective than drug eradicationReading: Broken Bonds- The health of incarcerated pregnant women, including their nutritional status- How having a incarcerated family member affects a child’s development and health across the life course- Differences in outcomes based on sex of incarcerated parent - The impact of Sesame Street resources on children’s access to health care and other support services, children’s behavior and their family relationships- Isis rising, a prison based pregnancy and parenting support program offered at women’s prison in Shakopee US Prison System- Our Country has o 5% of the world’s citizen populationo 25% of the world’s imprisoned populationo 1 of 108 adults are incarcerated o 1 0f 50 on parole or probation- $74 billion spent yearly on incarceration- $57-$65 billion lost yearly to GDP by incarcerated workers - Need for intervention (recidivism)o 75% of prisoners are rearrested within five years o 60% rearrested within the first yearo 66% rearrested within the first six months of return home - Substance abuse with release of prisoners o Rate of death is 3.5 times higher o Risk highest in first 2 weekso Drug overdose leading cause of death- Mental Health (federal, state and local)o Approximately 1.26 million prisoners in the U.S are mentally ull 45% of federal prisoners 56% of state prisoners 64% of local (jail) inmateso Common Mental Health Issues Bipolar Depressive disorder Anxiety disorders  Psychotic disorders o A 2011 Study of recidivism (inmates who returned to prison) showed: 36.3% suffered from Bipolar Disorder 22.5% suffered from severe depression 18% suffered from schizophrenia or psychosis  22.5% had more than one of the above diagnosis o Mental health treatments 33% of state correctional facilities 24% of federal facilities 17% of local facilities o Other mental Health concerns Mental health affects inmates of every age but most affected are under 35 years old Prison wait time to receive mental health services can be as long as 12 months While waiting these mentally ill people are segregated and forced into isolation which only makes problems worseWhat does the Global commission on Drug Policy Recommend?- End criminalization of drug useo “Patients not criminals”- Experiment with legal models that would undermine organized crime syndicates - Offer health and treatment services for drug users in need- Implement harm reduction measures including syringe access - Abolish abusive practices (forced detention, forced labor, physical and psychological abuse)- emphasize human rights- Invest in activities that can both prevent young people from taking drugs in the first