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Alcohol, Tobacco, and Other Drugs: A
Community Concern
Chapter 12
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
Consequences of Drug Abuse
Violence Associated with Drug and Alcohol Use
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
Definitions
• Drug
• Psychoactive drugs
• Drug use
• Drug misuse
• Drug abuse
• Drug 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-the-
counter) drugs, prescription drugs
• Illegal (illicit) drugs and controlled substances• 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)
• FAS
Nicotine
• Psychoactive and addictive drug present in tobacco products
• Synar Amendment
• Environmental tobacco smoke (ETS) or secondhand smoke
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
• Over 4,000 prescription drugs available
• Subject to misuse and abuse
• Risk of dependence
• Risk of unintentional overdose
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.
• Acute effects – reduced concentration, slowed reaction time, impaired short term memory, impaired judgment
• Chronic effects – damage to the respiratory system (if smoked), amotivational syndrome
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)
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
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 Health and Human Services
• Substance Abuse and Mental Health Services Administration (SAMSHA)
• National Institute on Drug Abuse
• Department of Homeland Security
• Department of Justice
• Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF)
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?