The document discusses the scope of drug abuse problems in communities, factors that contribute to drug abuse, different types of drugs and their effects, prevention and control efforts at various governmental levels, and spending on drug control programs. It provides definitions of key terms and outlines federal agencies, state and local programs, and non-governmental groups involved in drug prevention and treatment.

1. Alcohol, Tobacco, and
Other Drugs: A
Community Concern
Chapter 12

2. 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

3. Consequences of Drug Abuse

4. Violence Associated with
Drug and Alcohol Use

5. 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

6. Definitions
• Drug
• Psychoactive drugs
• Drug use
• Drug misuse
• Drug abuse
• Drug dependence

7. 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

8. 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

9. Environmental Risk Factors
• Personal factors
• Home and family life
• School and peer groups
• Sociocultural environment

10. 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

11. 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

12. Alcohol
• Number one drug problem in the United States
• Binge drinking
• Underage drinking
• Problem drinkers
• Alcoholism
• Blood alcohol concentration (BAC)
• FAS

13. Nicotine
• Psychoactive and addictive drug present in
tobacco products
• Synar Amendment
• Environmental tobacco smoke (ETS) or
secondhand smoke

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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)

20. Hallucinogens
• Produce illusions, hallucinations, changes in
perceptions
• Synesthesia – mixing of the senses
• Both naturally derived and synthetic
• LSD, mescaline, peyote, mushrooms

21. Stimulants
• Drugs that increase the activity of the central
nervous system
• Amphetamines
• Schedule II prescription drugs; widely abused
• Methamphetamines often made in clandestine
labs

22. Depressants
• Slow down the central nervous system
• May lower anxiety and inhibitions
• Tolerance develops
• Strong physical dependence
• Alcohol, barbiturates, benzodiazapines

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. Federal Drug Control Spending

31. Federal Drug Control Spending

32. 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)

33. 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

34. 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

35. 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
used to successfully deal with drug abuse
problems?