Introduction to Drugs and Society Slide Series 1B

Major Types of Commonly Abused Drugs - Overview Alcohol (ethanol) Nicotine (all forms of tobacco) Prescription drugs (many drugs that are prescribed by a physician) Stimulants Major stimulants: amphetamines, cocaine, and crack Minor stimulants: nicotine, caffeine, tea, and chocolate Hallucinogens/psychedelics: LSD, mescaline, peyote, and psilocybin (“magic mushrooms”)

Major Types of Commonly Abused Drugs - Overview (continued) Depressants: barbiturates, benzodiazepines, valium, and alcohol Bath salts (a designer drug) Cannabis: marijuana and hashish Anabolic steroids: a synthetic form of the male hormone testosterone Inhalants/organic solvents: inhalants like gasoline, model glue, paint thinner, certain foods, herbs, and vitamins Narcotics/opiates: opium, morphine, codeine, and heroin

Designer Drugs/Synthetic Drugs or Synthetic Opioids Structural analogs are drugs that result from altered chemical structures of current illicit drugs. It involves modifying the basic molecular skeleton of a compound to form a new molecular species. Designer Drugs /Synthetic Drugs or Synthetic Opioids New categories of hybrid drugs like Ecstasy and Demerol. These relatively recent types of drugs are created as structural analogs of substances already classified under the Controlled Substances Act.

What is the biggest drug problem What is the biggest drug problem? Figure 1 Cigarette smoking and exposure. CDC Info (link) Data from Mokdad, A. H., J. S. Marks, D.F. Stroup, and J. L. Gerberding. “Actual Causes of Death in the United States, 2000.” Journal of the American Medical Association (JAMA), 291 (10 March 2004):1238-1245; Centers for Disease Control and Prevention (CDC). “Smoking and Tobacco Use: Tobacco-Related Mortality.” Atlanta, GA: U. S. Department of Health and Human Services, 18 August 2015a. Available http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/ ; Centers for Disease Control and Prevention (CDC). “Fact Sheets – Alcohol Use and Your Health.” Atlanta, GA: U. S. Department of Health and Human Services, 4 February 2015b. Available http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm; Centers for Disease Control and Prevention (CDC). “2013 Mortality Multiple Cause Micro-Data Files.” Atlanta, GA: Centers for Disease Control and Prevention, December 2014.

Erich Goode’s Four Types of Drug Use Legal instrumental use: Taking prescribed drugs or OTC drugs to relieve or treat mental or physical symptoms Legal recreational use: Using licit drugs like tobacco, alcohol, and caffeine to achieve a certain mental state Illegal instrumental use: Taking nonprescribed drugs to achieve a task or goal Illegal recreational use: Taking illicit drugs for fun or pleasure

Drug Use: Statistics and Trends Social Drugs $90 billion for alcohol $51.9 billion for cigarettes $2 billion for cigars, chewing tobacco, pipe tobacco, roll-your-own tobacco, and snuff $5.7 billion for coffee, teas, and cocoa Prescription Drugs $950 billion worldwide in 2012. $237.5 billion in the United States

Drug Use: Statistics and Trends OTC Drugs $30.8 billion Nonmedical Use of Prescription Drugs In 2014, 52.0 million Americans age 12 or older had used prescription-type drugs non-medically at least once in their lifetime. Miscellaneous Drugs Examples include inhalants, nutmeg, and morning glory seeds Extent of use cannot be verified

National Household Survey on Drug Abuse, 2014 82.1% (217.8 million) Americans used alcohol during their lifetime 61.0% (161.8 million) Americans used cigarettes 49.2% (130.3 million) Americans used any illicit drug(s)

Data from Center for Behavioral Health Statistics and Quality (CBHSQ) Data from Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

Figure 1. 2: Percentage of U. S Figure 1.0.2: Percentage of U.S. residents aged 12 or older reporting lifetime use of alcohol, tobacco, and illicit drugs: 2014. Data from Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

Figure 1.0.3: Past-month use of selected illicit drugs among persons aged 12 or older: 2014. Data from Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

National Household Survey on Drug Abuse, 2014 Most commonly used illicit drugs (Lifetime Use): 117.2 million (44.2%) used marijuana/hashish 54.4 million (20.5%) used nonmedical psychotherapeutics, such as pain relievers, tranquilizers, stimulants, or sedatives (does not include OTC drugs) 39.2 million (14.8%) used cocaine 39.6 million (15.0%) used hallucinogens 36.1 million (13.6%) used pain relievers

FFR1.01 Past Month Substance Use among People Aged 12 or Older: 2018 (not in textbook) Rx = prescription. Note: The estimated numbers of current users of different substances are not mutually exclusive because people could have used more than one type of substance in the past month.

Drug Use: Additional Findings Age Patterns: 18–25 age category reports the most illicit drug use Racial and Ethnic Differences: (rates of use, past month, 2014) Two or more races: 13.5% American Indian/Alaska Natives: 13.4% Black/African American: 12.4% Whites: 10.4% Hispanic or Latino: 8.9% Asians: 4.1%

Figure 1.6 Percentage of past-month illicit drug use among persons aged 12 or older, by age: 2013 and 2014

FFR1.11 Past Year Illicit Drug Use among People Aged 12 or Older: 2015-2018 (not in textbook) Age 2015 2016 2017 2018 12 or Older 17.8+ 18.0+ 19.0 19.4 12 to 17 17.5 15.8 16.3 16.7 18 to 25 37.5 37.7 39.4 38.7 26 or Older 14.6+ 15.0+ 16.1

Figure 1.0.4: Past-month nonmedical use of types of psychotherapeutic drugs (pain relievers, tranquilizers, stimulants, and sedatives) among persons aged 12 or older: 2005–2014 Reproduced from Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

FFR1.42 People Aged 12 or Older with a Past Year Substance Use Disorder (SUD): 2018 (not in text) Rx = prescription. Note: The estimated numbers of people with substance use disorders are not mutually exclusive because people could have use disorders for more than one substance.

FFR1.43 Alcohol Use Disorder (AUD) and Illicit Drug Use Disorder (IDUD) in the Past Year among People Aged 12 or Older with Past Year Substance Use Disorder (SUD): 2018 (not in text)

Drug Overdose – CDC (not in text - source) 70,237 drug overdose deaths occurred in the United States in 2017. The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).

Source (link) Figure 1.0.5: Nonmedical use of pain relievers in the past year among persons aged 12 or older, by state: Percentages, annual averages based on 2013 and 2014. Reproduced from Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

FFR1.21 Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older: 2015-2018 (not in text) Age 2015 2016 2017 2018 12 or Older 4.7+ 4.3+ 4.1+ 3.6 12 to 17 3.9+ 3.5+ 3.1 2.8 18 to 25 8.5+ 7.1+ 7.2+ 5.5 26 or Older 3.7 3.4

Drug Use: Additional Findings Gender Males were more likely than females among persons age 12 or older to be current illicit drug users (11.5% vs. 7.3%). The rate of past-month marijuana use was about twice as high for males as that for females (7.9% vs. 6.2%). Pregnant Women Pregnant women are less likely to use drugs than similar age women who are not pregnant.

Figure 1.0.7: Past-month illicit drug use among persons age 12 or older, by race/ethnicity: 2014 Reproduced from Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

Drug Use: Additional Findings Education: College graduates (6.7%) had the lowest rate of current illicit drug use, while those who did not complete high school (11.%) had the highest use of illicit drugs. Employment: Unemployed persons (18.7%) have a greater tendency to use more illicit- types of drugs than people gainfully employed (10.6% full-time and 13.2% part- time workers).

Drug Use: Additional Findings Criminal Justice: In 2004, 32% of state prisoners and 26% of federal prisoners reported that they had committed their offenses while under the influence of drugs (see Table 1-5). Arrestee Drug Abuse Monitoring (ADAM) reports that at the time of arrest, 40% of arrestees tested positive for the presence of multiple drugs. Approximately 40% tested positive for marijuana, 30% tested positive for cocaine, and 20% tested positive for crack. (National Institute of Justice [NIJ] 2009) @ time of arrest End of PPT Series 1B