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Chapter 3
             Drug Products and
             Their Regulations


© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter 3: Regulation &
                                                    Legislation
      What is being targeted?
                Certain substances
                Recreational use
                Medicinal use
      Who is doing the regulating?
                U.S. Department of Agriculture/FDA
                U.S. Treasury Department
      Motives
                Public safety concerns?
                Revenue & trade status?
      Impact
© 2011 McGraw-Hill Higher Education. All rights reserved.
Reformism
      Current laws trace back to
       two pieces of legislation
       from the early 1900s
      Racist fears about deviant
       behavior, including drug
       misuse, played a role in the
       development of drug
       regulation
      Laws were developed to
       regulate undesirable
       behaviors
© 2011 McGraw-Hill Higher Education. All rights reserved.
3 Issues Leading to
                                                                 Legislation
           Fraud in patent medicines that were
                 sold directly to the public
                     False therapeutic claims
                     Habit-forming drug content
                     Collier’s magazine series: Great
                          American Fraud
           Opium
                     Sale of opium by merchants
                     Reactions
           Cocaine
                     Availability led to concerns of overuse
                     Concerns of crime


© 2011 McGraw-Hill Higher Education. All rights reserved.
Two Bureaus, Two Types
                                                            of Regulation
                The Pure Food and Drugs Act (1906)
                          U.S. Department of Agriculture
                          Goal: drugs are pure and honestly labeled
                          Foundation for modern laws
                Harrison Act (1914)
                          U.S. Treasury Department
                          Goal: taxation of drugs to restrict commerce in
                           opioids and cocaine to authorized physicians,
                           pharmacists, and legitimate manufacturers
                          Question of motives

© 2011 McGraw-Hill Higher Education. All rights reserved.
From 1906 Act: Regulation of
                                                    Pharmaceuticals

          1. Purity
                     The contents of the product must be accurately listed on the label
                     FDA encouraged voluntary cooperation and compliance

          2. Safety
                     Originally—no legal requirement that medications be safe
                     1938 Food, Drug, and Cosmetic Act required pre-market testing for
                      toxicity
                     Companies required to submit a New Drug Application (NDA) to the
                      FDA
                     Directions must be included
                         Adequate instructions for consumer OR
                         Drug can be used only with physician prescription


© 2011 McGraw-Hill Higher Education. All rights reserved.
Regulation of
                                                            Pharmaceuticals
               3. Effectiveness
                   1962 Kefauver-Harris Amendments
                                    Pre-approval required before human testing
                                    Advertising for prescription drugs must include information about
                                     adverse reactions
                                    Every new drug must be demonstrated to be effective for the
                                     illnesses mentioned on label
                                    Steps
                                                 Preclinical research and development
                                                 Clinical research and development
                                                 Permission to market




© 2011 McGraw-Hill Higher Education. All rights reserved.
From 1914 Act: Registration &
                                                      Taxation
                Early enforcement
                Dr. Webb
                1919 Volstead act & Bureau of Prohibition
                          Prohibited sale of alcohol
                          Penalties for production
                18th Amendment: Prohibition – 1920
                Repealed in 1933 by the 21st Amendment




© 2011 McGraw-Hill Higher Education. All rights reserved.
Comprehensive Drug Abuse
                                             Prevention and Control Act of 1970

           Replaced or updated all previous laws
           Drugs controlled by the Act are under federal
            jurisdiction
           Prevention and treatment funding increased
           Direct control of drugs, not control through
            taxation, is the goal
           Enforcement separated from scientific and
            medical decisions



© 2011 McGraw-Hill Higher Education. All rights reserved.
Comprehensive Drug Abuse
                                             Prevention and Control Act of 1970

           Drug Schedules
                         I – No medical use; high potential for abuse
                         II – Medical use; high potential for abuse
                         III – Medical use; moderate potential for abuse
                         IV – Medical use; mild potential for abuse
                         V – Medical use; low potential for abuse

           Penalties for illegal manufacture, distribution or
            possession were assigned by category
           Rules for prescribing physicians
           Amendments
                         1984
                         1986
                         1988
                         2010

© 2011 McGraw-Hill Higher Education. All rights reserved.
Impact of Drug Enforcement

           Early enforcement
           Prison vs. rehabilitation
              Punishment seemed not to be working
              “Narcotic farms”
              Current issues
           Bureau of Narcotics (Treasury Department)
              “Drug Czar”
              Mandatory minimum sentences (1951)
              1956 Narcotic Drug Control Act toughened penalties
              DEA formed
           State vs. federal law
           Drug screening


© 2011 McGraw-Hill Higher Education. All rights reserved.
Impact of Drug
                                                             Enforcement
           Budget
           Other costs
              Cost of prison population
              Crimes committed to purchase drugs
              Corruption in law enforcement
              Conflicting international policy goals
              Loss of individual freedom
           Effectiveness of control?


© 2011 McGraw-Hill Higher Education. All rights reserved.

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Regulation & Legislation of Drug Products

  • 1. Chapter 3 Drug Products and Their Regulations © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 2. Chapter 3: Regulation & Legislation  What is being targeted?  Certain substances  Recreational use  Medicinal use  Who is doing the regulating?  U.S. Department of Agriculture/FDA  U.S. Treasury Department  Motives  Public safety concerns?  Revenue & trade status?  Impact © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 3. Reformism  Current laws trace back to two pieces of legislation from the early 1900s  Racist fears about deviant behavior, including drug misuse, played a role in the development of drug regulation  Laws were developed to regulate undesirable behaviors © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 4. 3 Issues Leading to Legislation  Fraud in patent medicines that were sold directly to the public  False therapeutic claims  Habit-forming drug content  Collier’s magazine series: Great American Fraud  Opium  Sale of opium by merchants  Reactions  Cocaine  Availability led to concerns of overuse  Concerns of crime © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 5. Two Bureaus, Two Types of Regulation  The Pure Food and Drugs Act (1906)  U.S. Department of Agriculture  Goal: drugs are pure and honestly labeled  Foundation for modern laws  Harrison Act (1914)  U.S. Treasury Department  Goal: taxation of drugs to restrict commerce in opioids and cocaine to authorized physicians, pharmacists, and legitimate manufacturers  Question of motives © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 6. From 1906 Act: Regulation of Pharmaceuticals 1. Purity  The contents of the product must be accurately listed on the label  FDA encouraged voluntary cooperation and compliance 2. Safety  Originally—no legal requirement that medications be safe  1938 Food, Drug, and Cosmetic Act required pre-market testing for toxicity  Companies required to submit a New Drug Application (NDA) to the FDA  Directions must be included  Adequate instructions for consumer OR  Drug can be used only with physician prescription © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 7. Regulation of Pharmaceuticals 3. Effectiveness  1962 Kefauver-Harris Amendments  Pre-approval required before human testing  Advertising for prescription drugs must include information about adverse reactions  Every new drug must be demonstrated to be effective for the illnesses mentioned on label  Steps  Preclinical research and development  Clinical research and development  Permission to market © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 8. From 1914 Act: Registration & Taxation  Early enforcement  Dr. Webb  1919 Volstead act & Bureau of Prohibition  Prohibited sale of alcohol  Penalties for production  18th Amendment: Prohibition – 1920  Repealed in 1933 by the 21st Amendment © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 9. Comprehensive Drug Abuse Prevention and Control Act of 1970  Replaced or updated all previous laws  Drugs controlled by the Act are under federal jurisdiction  Prevention and treatment funding increased  Direct control of drugs, not control through taxation, is the goal  Enforcement separated from scientific and medical decisions © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 10. Comprehensive Drug Abuse Prevention and Control Act of 1970  Drug Schedules  I – No medical use; high potential for abuse  II – Medical use; high potential for abuse  III – Medical use; moderate potential for abuse  IV – Medical use; mild potential for abuse  V – Medical use; low potential for abuse  Penalties for illegal manufacture, distribution or possession were assigned by category  Rules for prescribing physicians  Amendments  1984  1986  1988  2010 © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 11. Impact of Drug Enforcement  Early enforcement  Prison vs. rehabilitation  Punishment seemed not to be working  “Narcotic farms”  Current issues  Bureau of Narcotics (Treasury Department)  “Drug Czar”  Mandatory minimum sentences (1951)  1956 Narcotic Drug Control Act toughened penalties  DEA formed  State vs. federal law  Drug screening © 2011 McGraw-Hill Higher Education. All rights reserved.
  • 12. Impact of Drug Enforcement  Budget  Other costs  Cost of prison population  Crimes committed to purchase drugs  Corruption in law enforcement  Conflicting international policy goals  Loss of individual freedom  Effectiveness of control? © 2011 McGraw-Hill Higher Education. All rights reserved.

Editor's Notes

  1. Image sources: National Library of Medicine (Image Ch03_01CocaWine) Library of Congress Prints and Photographs Division (Image Ch03_02PatMedHoofland) PhotoLink/Getty Images (Image Ch03_11DrugDevelopment)
  2. Image source: Library of Congress Prints and Photographs Division (Image Ch03_09OpiumPoster1)
  3. Image source: Library of Congress Prints and Photographs Division (Image Ch03_09OpiumPoster1)
  4. Image source: Library of Congress Prints and Photographs Division (Images Ch03_06PatMedKentucky, Ch03_04PatMedJayne)
  5. Image source: Fancy photographer/Veer (Image Ch03_17OpiumPoppy)