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

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

3. 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

12. 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

13. Despite the Laws People Still Use

14. 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% %
Pot 79.6% 47% 25% %
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%

15. 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

16. Does Use Mean Abuse?

17. 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

18. 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

19. Misuse Periodic circumscribed negative consequences
College students and alcohol
“It only happened once.”
Sometimes the consequences are catastrophic

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

21. 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

22. How Does One Move Through the Spectrum?

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