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