Chapter 12. Alcohol, Tobacco, and Other Drugs: A Community Concern

Transcription

1 Chapter 12 Alcohol, Tobacco, and Other Drugs: A Community Concern

2 Chapter Objectives (1 of 2) After studying this chapter, you will be able to: 1. Identify personal and community consequences of alcohol and other drug abuse. 2. Describe the trends of alcohol and other drug use by high school students. 3. Define drug use, misuse, and abuse. 4. Define drug dependence. 5. List and discuss the risk factors for the abuse of alcohol and other drugs. 6. Explain why alcohol is considered the number one drug abuse problem in America. 7. Describe the health risks of cigarette smoking. 8. Define the terms over-the-counter and prescription drugs and explain the purposes of these drugs and how they are regulated. 9. Define the terms controlled substances and illicit (illegal) drugs and provide examples.

3 Chapter Objectives (2 of 2) 10. Characterize recent trends in the prevalence of drug use among American high school seniors. 11. List and explain four elements of drug abuse prevention and control. 12. Give an example of primary, secondary, and tertiary prevention activities in drug abuse prevention and control programs. 13. Summarize the federal government s drug abuse control efforts. 14. List and describe an effective community and an effective school drug abuse prevention program. 15. List the five facets of a typical workplace substance abuse prevention program. 16. Name some voluntary health agencies and self-help support groups involved in the prevention, control, and treatment of alcohol, tobacco, and other drug abuse.

4 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

5 Scope of the Current Drug Problem (1 of 3) 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

6 Scope of the Current Drug Problem (2 of 3) Sources: Horgan, C., K. C. Skwara, and G. Strickler (2001). Substance Abuse: The Nation s Number One Health Problem. Princeton, NJ: Robert Wood Johnson Foundation; Centers for Disease Control and Prevention (2008). Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses United States, Morbidity and Mortality Weekly Report, 57(45): ; Centers for Disease Control and Prevention (2016). Data on Drug-Poisoning Deaths. National Center for Health Statistics. Available at Centers for Disease Control and Prevention (2013). Alcohol-Related Disease Impact (ARDI) application. Available at Sacks, J. J., K. R. Gonzales, E. E. Bouchery, L. E. Tomedi, and R. D. Brewer (2015) National and State Costs of Excessive Alcohol Consumption. American Journal of Preventive Medicine, 49(5): e73 e79.; Xu, X., E. E. Bishop, S. M. Kennedy, S. A. Simpson, and T. F. Pechacek (2014). Annual Healthcare Spending Attributable to Cigarette Smoking: An Update. American Journal of Preventive Medicine, 48(3): ; National Institute on Drug Abuse (2014). Trends and Statistics. Available at and U.S. Department of Health and Human Services (2014). The Health Consequences of Smoking 50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Available at

7 Scope of the Current Drug Problem (3 of 3) Data from: Johnston, L. D., O Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use, : Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. Available at

8 Definitions Drug Psychoactive drugs Drug use Drug misuse Drug abuse Drug (chemical) dependence Psychological dependence

9 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

10 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

11 Environmental Risk Factors Personal factors Home and family life School and peer groups Sociocultural environment

12 Types of Drugs Abused and Resulting Legal drugs Problems Alcohol, nicotine, nonprescription (over-thecounter) drugs, prescription drugs Controlled substances and illegal (illicit) drugs Marijuana, narcotics, cocaine and crack cocaine, hallucinogens, stimulants, depressants, club drugs and designer drugs, anabolic drugs, inhalants

13 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

14 Alcohol Number one drug problem in the United States Binge drinking Underage drinking Problem drinkers Alcoholism Blood alcohol concentration (BAC) Fetal Alcohol Spectrum Disorders Fetal Alcohol Syndrome

15 Nicotine Psychoactive and addictive drug present in tobacco products Environmental tobacco smoke (ETS) or secondhand smoke Synar Amendment Tobacco use is single most preventable cause of disease, disability, and death in the U.S. Community efforts: tax increases on cigarettes

16 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

17 Prescription Drugs Can be purchased only with a physician s prescription because they have serious side effects for some people Regulated by the FDA Subject to misuse and abuse; opioid pain relievers Risk of dependence and unintentional overdose Development of drug-resistant strains of pathogens

18 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

19 Marijuana Products derived from hemp plant Most abused illicit drug in the U.S. Often used in conjunction with other drugs polydrug use Acute effects reduced concentration, slowed reaction time, impaired short-term memory, impaired judgment Chronic effects damage to the respiratory system (if smoked), amotivational syndrome

20 Synthetic Marijuana Emerging cause for concern Chemically produced with properties similar to THC Pose serious threat to communities potential for abuse and other adverse health effects, long-term effects unknown In 2011, five chemicals used to produce synthetic marijuana were added to Schedule I of the CSA States have banned synthetic marijuana

21 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

22 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) In 2015, annual prevalence of cocaine use among high school seniors at lowest reported level of 2.5%

23 Hallucinogens Produce illusions, hallucinations, changes in perceptions Synesthesia mixing of the senses Both naturally derived and synthetic LSD, mescaline, peyote, mushrooms

24 El Paso Intelligence Center (EPIC/National Secure System NSS) Stimulants Drugs that increase the activity of the central nervous system Amphetamines Schedule II prescription drugs; widely abused Methamphetamines often made in clandestine labs Total of all clandestine laboratory incidents involving methamphetamine

25 Depressants Slow down the central nervous system May lower anxiety and inhibitions Tolerance develops Strong physical dependence Alcohol, barbiturates, benzodiazepines

26 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

27 Protein-building drugs Anabolic 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

28 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

29 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 the cooperation of various individuals and agencies

30 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

31 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

32 Governmental Drug Prevention and Control Agencies and Programs (1 of 2) Include a multitude of federal, state, and local agencies Aim to reduce either the supply of or the demand for drugs

33 Office of the National Drug Control Policy, The White House (2013). National Drug Control Budget FY 2014 Funding Highlights. Washington, DC: The White House. Available at Accessed June 25, Governmental Drug Prevention and Control Agencies and Programs (2 of 2) Federal drug control spending by function, fiscal years

34 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 Justice Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) Department of Homeland Security

35 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

36 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

37 Discussion Questions How can risk factors for drug abuse be utilized to aid in drug abuse prevention? How should federal, state, and local funds be used to successfully deal with drug abuse problems?