HOW HAVE FEDERAL LAWS BEEN EFFECTIVE?

Escalation in drug-related incarceration rates

Incarcerations have mostly been for Posession

NOTE: The Increase in Incarceration rates for Drug-related Crime is International

However, availability of many “Illicit: substances appear unchanged

Cocaine production seems unaffected

Cocaine prices seem stable

A consideration:Is the War aimed in the right directions?

Despite the Laws People Still Use

How do we measure use of Psychoactive substances?

• A difficult issue-– Substance Abuse and Mental Health Services

Administration (SAMHSA): measures drug use prevalence by sponsoring the “National Survey on Drug us and Health” (NSDUH)- (formerly known as the “National Household survey on Drug Use”)• drug use info regarding people of 12 yrs and older

– Data from households from every state and across many demographic variables..n= 68,736 survey respondents

Appendix A. NSDUH methodology

Example-Drug Use Stats- NSDUH a SAMHSA study

(substance abuse and mental Health Services Administration)

Link to 2008 SAMHSA Report

NSDUH 2008 vs. Our ClassOur Class College Students (2008)

NSDUHin last year last month in Last Year Last month

Alcohol 91.8% 85.7% 70.6% 50.7%MJ 67.3% 59.1% 30.9% 16.5%Hall 24.2% 6.1 % 8.2% 1.7%Stimulants 22.4 % 14.2% 5.8% 1.5%XTC 4.0% 0.0 % 5.1% 1.3%

Drug Use by Students in our class- Cont’

N=49 Ever in the last year?

Percentages/ (Freq)

In the past month? In the past week?

Today?

Alcohol 91.8 /45 85.7/42 71.4 /35 8.1 /4

Marijuana 67.3 /33 59.1/ (29 44.8 /22 10.2 /5

Hallucinogens 24.4 /12 6.1/3 2.0/1 0- THANK-YOU!

Cocaine or amphetamines

22.4 /11 14.2/7 8.1/4 0

XTC 4.0/2 0 0 0

Opiates 26.5 /13 14.2/7 6.1/3 4.0/2

Benzodiazepines 20.4 /10 16.3/8 8.1/4 6.1/3

ouch!!!

Legal control of drug use has cost a lot

Have U.S. Drug Policies worked to reduce drug use or availability??

Complexities of Drug use, Drug abuse and DRUG TAKING BEHAVIOR

Is there a drug abuse problem in our country?

Does Use Mean Abuse?

The Spectrum of Use

• Use – Periodic non-problematic use• Misuse – Periodic use• Abuse – A pattern of misuse• Dependence – Compulsive problematic use,

often with physiological dependence

Use

• Many drugs can be used relatively safely• Most people who use drugs do not develop

problems; however, this varies with the type of drug

• Drugs are used for many reasons– Social– Religious– Coping– Experimentation

Misuse

• Periodic circumscribed negative consequences– College students and alcohol– “It only happened once.”– Sometimes the consequences are catastrophic

What is drug abuse?

• The Diagnostic and Statistical Manual – APA guidelines for diagnostic evaluation of psychological problems– “Substance-related disorders”

DSM-IV:Abuse

• Use-related Failure to fulfill obligations• Use in Physically dangerous situations• Use-related Legal problems• Use-related Social/Psychological problems– *Dependence criteria not met– It is assumed that an individual meeting the

criteria for “drug dependence” have already met the criteria for abuse

What is Drug Dependence?

DSM-IV:Dependence

• Tolerance

Tolerance

• After regular use, a larger dose is required to produce a given effect

• A given dose of the drug has less effect upon repetition

DSM-IV:Dependence

• Tolerance• Withdrawal syndromes

Physical Dependence

• An adaptive state produced by repeated use of a drug which manifests itself by intense physiological disturbances (withdrawal syndrome) when use of the drug is halted (abstinence).

• Withdrawal syndrome- a constellation of symptoms that occur when an individual stops using the drug to which dependence has developed. Symptoms typically in reverse direction of the effects caused by the drug (considered a “rebound effect.”)

Withdrawal Syndromes

Example: Opiate drugs tend to reduce body temp and decrease activity of the

digestive system.

Opiate withdrawal syndromes include fever, and diarrhea

For some drugs a withdrawal Syndrome may be associated with

Psychological dependence

• A condition characterized by intense drive or cravings for a drug experienced during periods ob abstinence.– Abstinence: periods of time when the individual has

stopped using

• Now considered the most prominent factor in relapse.– Relapse: return to drug use after a period of abstinence

DSM-IV:Dependence

• Tolerance• Withdrawal• Taking more than intended

DSM-IV:Dependence

• Tolerance• Withdrawal• Taking more than intended• Unable to successfully cut down or control

DSM-IV:Dependence

• Tolerance• Withdrawal• Taking more than intended• Unable to cut down or control• Excessive time spent re: drug– Thinking about, talking about, acquiring etc…

DSM-IV:Dependence

• Tolerance• Withdrawal• Taking more than intended• Unable to cut down or control• Excessive time spent re drug• Important activities given up– Loss of interest/motivation/ability

DSM-IV:Dependence

• Tolerance• Withdrawal• Taking more than intended• Unable to cut down or control• Excessive time spent re drug• Important activities given up• Continuing use despite problems

How Large is the Problem? Depends how it is measured… Treatment Statistics

Economic Indications

SO ?

• Whatever your perspective on drug use and abuse, its difficult to argue that drug use is in no way problematic.

• Especially when considering the harmful effects of drug addiction/Abuse to the individual and to society.

• Yet the issues are complex and simple approaches are clearly less than optimally effective

Yet there is ample rationale to study drug taking behavior

• It is a social problem• Many drugs can cause physical harm to the

individual• General Insight into behavior• Insight into the functions of the nervous system• Insights into pharmacology of neural transmission

Psychopharmacology

• The Study of Psychoactive Drugs and Their Effects

Names of DrugsBrand, trade, ‘proprietary’ name: e.g., Adderal®different preparations, companies, etc.

Generic, (common) ‘nonproprietary’ name: d-amphetamine

Chemical name: alpha-methylphenethylamine

Street names: e.g..Bennies, black beauties, bumble bees, co-pilots, Crank, Cross tops, Crystal meth, Dexies, Footballs, Hearts, Hot Ice, Ice, L.A. glass, Meth, MDMA, Pep pills, Speed, Uppers

Mostly I will use the generic name.

Example: Valium7-chloro--1-methyl-5-phenyl-3H-1,4-

benzodiazepin-2[1H]-one

diazepam

valium

tranks, downers, blues, yellows

• chemical

• generic

• trade

• street

Classifying Drugs-another difficult issue

– Therapeutic vs. non-therapeutic– Legal vs. illegal– Recreational vs. medicinal– Mechanism of action– Site of action– By origin– By chemical structure– Behavioral effects

Classifying Drugs

• Ultimately, as practiced, the classification of drugs is political/social as much as it is scientific.

• Two most common classifications– Scheduling– Behavioral effects

• Both have associated problems

Behavioral Effects Classification

• Classified by effects on behavior and/or central nervous system– Depressants– Stimulants– Narcotics/Analgesics– Psychedelics

Although the Behavioral class system is generally useful…

• Consider the problem of classification based on behavioral effects.– What is the behavioral effect of alcohol?– What is the behavioral effect of Nicotine?

Nonetheless, the behavioral effect classification system would generally be as follows:

• Depressants• Actions in the nervous system lead to

decreased physiological activity and sedation– Alcohol – – Barbiturates – – Benzodiazepines –

Stimulants

• Increase physiological processes and motor behavior– Cocaine– Amphetamine – – Caffeine – – Nicotine –

Narcotic Analgesics (Opiates)

• increase activity in the endogenous opiate system leading to pain suppression, feelings of euphoria, well-being, and respiratory depression– Heroin – – Codeine – – Morphine – – Vicodin, Percocet, etc. –

Psychedelics

• Alter mood state and perception via action on the CNS. – LSD (acid)– Psylocibin (mushrooms)– Phencyclidine (PCP)

Marijuana-

• Vs. many other drugs, the problems of classification are at least recognized

• In a class by itself– Complex behavioral effects– Main effect is on cannabinoid neurotransmitter

system

Take-Home Message

• Drug classification systems are only a convenient tool for communicating superficial characteristics of a drug. Almost all classification systems breakdown fairly quickly when deeper consideration is given to the individual drugs within each class.