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Drugs and Drug PolicyIntroduction:- A quarter of 14-15 year olds in the US have already tried an illegal drug- Injection drugs use fuels epidemics of HIV and Hepatitis - 1 in 12 adults suffer a substance abuse disorder- 8 million children live with an addicted parent - *****important to know that alcohol abuse drives those numbers to a much greater extent than does dependence on illegal drugs*****- Cigarette smoking kills more people than alcohol and all illegal drugs combined- The Odyssey depicts what may be the first recorded drug intervention – danger of losing oneself to a drug must then have been familiar to Homer some three millennia ago- Industrialization and urbanization has increased the amount of damage an intoxicated person can do to self and others – car accidents, availability of multiple drugs increases combination of drugs that could be deadly.- Policies to control drugs create harms and hazards of their owno Highly desired commodity illegal creates an opportunity that some illicit entrepreneur is certain to seize on - Turns out that the laws cannot be enforced strictly enough to abolish entirely the use and sale of illegal drugs- If drug abuse and drug-abuse control alike create predictable harms, then figuring out what to do is a hard problem.- Drugs and Drug Policy: What Everyone Needs to Know includes:o Facts about drugs and drug-related behavioro Pharmacologyo Prohibitionso Regulationo Taxeso How drug enforcement, drug prevention, and drug treatment worko Along with characteristics problems and limitations Chapter 1: Why is “Drug” the Name of a Problem?What is a drug?o A drug is a chemical that influences biological function (other than by providing nutrition or hydration)  From plants or labs Effects can be benign or harmful or botho A psychoactive drug is a drug whose influence is in part on mental functions: on mood, perception, cognition, and behavior An abusable psychoactive drug – the topic of this book – is a drug whose mental effects are sufficiently pleasant or interesting or helpful that some people choose to take it for a reason other than to relieve a specific malady. - Scientifically cannabis is not technically a drug- Abusable psychoactive drugs include:o Caffeineo Nicotineo Alcoholo Nitrous oxideo Cocaineo The opiates and opioids (heroin, morphine, codeiene, ocycodone, etc.)o Stimulants (methamphetamine, sedative-hypnotics and central-nervous system depressants such as benzodiazepines (Valium, Xanax, and their ilk)o Barbiturates o Hallucinogens (psychedelics, entheogenes such as LSD, psilocybin, mescalineo “Entactogen” MDMA (ecstasy)Why is drug use a problem?- often is not a problem- most drugs resemble alcohol: many occasional users, fewer heaving users, and fewer still who remain heavy users for years on endIf abusable psychoactives can be used safely where does the problem come in?- abusable drugs can cause 3 distinct problems:o physiological toxicityo behavioral toxicityo addictionWhat does it mean for a drug to be “toxic”?- most dramatic toxic risk is sudden death from overdoseo mixing drugs together- a standard measure of toxicity is the median lethal dose – the quantity of some drug that will kill half of the people exposed to it. o LD50: “lethal dose” “50 percent”o Median effect does: ED50 Generates the “therapeutic index” or “therapeutic ratio”: LD50 divided by ED50. • Higher the index, the smaller the risk of overdose- Tobacco: no overdose but toxic with chronic use- Heroin: large overdose risk (due to small index plus uncertain purity)o But biggest risk comes from shared injection equipment - Toxic risk makes drugs a subclass of the category “potentially unsafe consumer product”What is behavior toxicity? Is it the same as intoxication?- “behavioral toxicity” can mean that drug taking imposes risks on those who don’t engage in it [drunken driving & drunken domestic abuse]- An intoxicant can generate a state of mind in which the ordinary constraints of prudence and conscience are so blunted as to enable extreme behavior, atypical of the actions of the same person when not under the influence. *IN SLIDE FROM POWERPOINT*-pg 4- Form of behavior toxicity is loss of self-control over dosage, example binge drinkingo “first the man takes the drink, then the drink takes a drink, then the drink takes the man.”What is addiction?- A behavior pattern that is difficult to break even once the person figures out the behavior is a problemo Called “substance abuse” or “dependency disorder”- Most people who try drugs never develop an substance-disorder- Pattern for more expensive illicit drugs: trying without consistency - “even most people who develop a bad habit around some drug recover fairly rapidly”- Minority that develops a bad habit develops the sort of persistent bad habit called to mine the word “addiction” or by the description of drug abuse as a “chronic, relapsing disorder”What is dependency?- Two different senseso “physical dependency”- by the presence of a “withdrawal syndrome”: a drug is said to generate physical dependency if a user who stops taking the drug after a period of using it experiences discomfort, or worse.  Medical process of managing withdrawal is called “detoxification”\ Alcohol & opiates powerful physical dependency o “chemical dependency”- the aggravated form of substance-abuse disorder.  Defined by continued drug taking in the face of adverse consequences, diminished voluntary control over the frequency and quantity of drugs taken, “craving” – persistent, intrusive thoughts about drug use that complicate efforts to abstain – and the crowding out of other activities as the effort to obtain drugs and the time spent using them absorbs more and more of the dependent user’s life.Is addiction a disease? Is it a “chronic, relapsing brain disorder”?- “if disease is an abnormal, unwanted, involuntary physical or mental condition, then it’s reasonable to call substance abuse disorder “diseases”- Problem drug users: people who consistently use drugs that they would prefer not to use, or who use drugs in greater quantity or with greater frequency than intended. - “disease” fits because nobody wants to have a drug habit and it can’t be “wished away”- Addiction is a burden because the persistent cravings that can lead to relapse even after years of abstinence- Relapsing group is a


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FSU CCJ 4938r - Drugs and Drug Policy

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