The Spectrum of Use and the Historical Context Lecture 2 Chapters 1 & 2

Drugs Are Old Drugs have been around since the dawn of time… probably

Coming on the Scene Alcohol as early as 6400 years BC (Middle East) Opium 5000 BC (China) Cannabis 3000 years BC (Middle East) Coca 3000 BC Tobacco 100 BC (Mexico) Cocaine Extracted 1855 Heroin 1874 MDMA (XTC) 1912 LSD 1938

A History of Drug Laws in the US 1906 Pure Food and Drug Act 1914 Harrison Narcotic Act 1920 Alcohol Prohibited 18th Amendment 1930 Establishment of FBN, now DEA 1933 Alcohol back 21st Amendment 1937 Marijuana Tax Act 1970 Controlled Substances Act 1984 Scheduling Act 1986 Anti-drug Abuse Act (Mandatory Minimum) 1988 Chemical Diversion and Trafficking Act 1996 Comprehensive Meth Control Act Compassionate Use Acts

Despite the Laws People Still Use

Drug Use Stats Alcohol 98% 98% 72% 71.8% Pot 79.6% 47% 25% 16.8% Our Class Our Class UNCW College Ever Last 30 Students (L30) Students ` (L30) Alcohol 98% 98% 72% 71.8% Pot 79.6% 47% 25% 16.8% Hall 41.7% 4% 4.9% 1.1% Cocaine 32.7% 12.2% 4.8% 2.2% XTC 26.5% 4.1% 1.1% 1% Opiates 51% 22.4% 8-10% Benzos 40.8% 26.5% 4-10% Stimulants 38.8% 16.2% 4-10%

Quantity/Frequency Class Alcohol 12.2% on 20 or more days Pot 15(30.1%) on 15 or more days 3(6.1%) of you are high right now

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 depends on the 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

DSM-IV Abuse 1. Failure to fulfill major role obligations 2. Use in hazardous situations 3. Legal problems 4. Use despite problems 20

DSM-IV Dependence 1. Tolerance 2. Withdrawal 3. Larger amounts/longer period than intended 4. Inability to, or persistent desire to, cut down or control 5. A great deal of time spent obtaining, using, or recovering 6. Important activities given up or reduced 7. Use despite problems caused or exacerbated by use 21

How Does One Move Through the Spectrum?

Public Health Model Agent Factors – Properties of the drug or substance Host Factors – Characteristics of the person Environment Factors – Context/Situation