Chapter 2Social Issues: Substances, Addiction and Related Disorders
Changing AttitudesChanging Attitudes
What made the government change from the laissez-faire What made the government change from the laissez-faire attitude of the 1800s to one of control?attitude of the 1800s to one of control? ToxicityToxicity Dependence (in relation to substance use)Dependence (in relation to substance use) CrimeCrime
Toxicity
Toxic = poisonous, deadly, or dangerous
What makes a drug toxic?
Amount used
How it is used
What the user did while on the drug
Physiological toxicity & behavioral toxicity
Acute effects & chronic effects
Acute effects & chronic effects
Drug-Related Toxicity
Examples of acute toxicity
• Behavioral:“Intoxication” that impairs the actions of drug users and increases the danger to themselves and others
• Physiological: Overdose that causes the user to stop breathing
Examples of chronic toxicity
• Behavioral: Personality and lifestyle changes; effects on relationships
• Physiological: Lung cancer, cirrhosis, heart disease & other health effects
Toxicity & DAWN
A system for collecting data on drug-related deaths and emergency room visits at some U.S. metropolitan hospitals
DAWN collects data on improper use of legal prescription and over-the-counter drugs as well as illicit drugs
What it tells us about how dangerous a drug is - Simply gives us total deaths/ER visits
What it does not tell us about how dangerous a drug is
Consider relative danger vs. total impact of the drug
Number of users vs. number of reported problems
Alcohol is reported only in combination with other drugs
Drug-alcohol and drug-drug combinations are very common
Toxicity & Blood-Borne Diseases
Specific toxicity for users who inject drugs
AIDS, HIV infection, and hepatitis B and C
Sharing needles passes infectious agents directly into the bloodstream
Some states, cities prohibit needle purchase without Rx
Syringe exchange programs
The Concept of Dependence
In relation to substance use, substance-related and addictive disorders dependence has recently undergone extensive review
Text: Three basic processes
Tolerance
Need for increased amount
Diminished effect with continued use
Physical dependence - withdrawal symptoms/syndrome
Psychological dependence
Mental preoccupation
Interference
Different views on dependence
Drugs & Crime: Why We Regulate Drugs
We want to protect society from the dangers of some types of drug use
What are the real costs to a society?
Some laws are not developed as part of a rationally devised plan and may not be realistic or effective
Based on 4 ideas of drugs and crime:
1. Drug use changes personality; creates “criminal type”
2. People under the influence may commit crimes (e.g., many cases of homicide, domestic violence, etc.)
3. Crimes may be carried out to obtain money for drugs
4. Drug use is a crime
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