DRUGS AND AMERICAN CULTURE MIDTERM

Covers every lecture up to week seven.

1875: San Francisco Opium Den Ordinance

The first recorded anti-drug law in the U.S. targeted Chinese opium dens.

1906: Pure Food and Drug Act

Required labeling of ingredients in drugs and foods, including habit-forming substances.

1914: Harrison Narcotics Tax Act

Regulated and taxed the production, importation, and distribution of opiates and coca products.

1920: Prohibition

alcohol made illegal, organized crime arises

1933: Repeal of Prohibition

alcohol is legal again with some restrictions

1937: Marihuana Tax Act

Effectively criminalized marijuana by imposing strict regulations and taxes. Judged unconstitutional in 1969.

1970: Controlled Substances Act

This act regulates the manufacture, importation, possession, use and distribution of certain substances. The act classified drugs into schedules based on their potential for abuse and medical use, and the class of drug then determines regulation and control procedures. It aimed to balance medical use with abuse potential of various drugs.

1986: Anti-Drug Abuse Act

Introduced mandatory minimum sentences for drug offenses (examples: 10 years of prison for 1kg of heroin, 5kg of cocaine, 50g of crack cocaine). It also increased funding for law enforcement waging the War on Drugs, and expanded federal support for drug abuse prevention and treatment.

2010: Fair Sentencing Act:

Reduced the disparity between sentences for crack and powder cocaine offenses; eliminated mandatory minimums for simple possession of crack cocaine, but increased penalties for major traffickers

2016-2018 Opioids Crisis Acts:

Acts to fight the opioid crisis included the SUPPORT Act, the 21^st Century CARES Act, and the Comprehensive Addiction and Recovery Act. All these acts aimed to increase support for treatment and prevention of addiction as well as funding to help combat the harms of the opioid crisis.

2018: First Step Act

Expanded on the reforms of the 2010 Act by making that act retroactive (meaning that they allowed the 2010 Act to apply to people sentenced before 2010) and continuing to reduce mandatory minimum sentences for certain drug offenses.

Common Academic Writing Moves

• Conversing with other scholars
• Identifying the research gap
• Noting the research question (either explicitly or
implicitly)
• Outlining the argument
• Methodology in quant/qual research
• Noting limitations and ideas for further study

Burken Parlor Metaphor

a metaphorical representation of discussion between scholars, a conversation between individuals being representative of the interaction and back and forth of articles and journals being created and built upon each other.

Drug use

The consumption of any substance, whether legal or illegal, for various purposes (medical use, recreational use, cultural/ritual use)

Drug misuse

Occurs when a person uses a substance in a way that is not intended or recommended (incorrect dosage, non-medical usage, inappropriate context)

Drug abuse

Characterized by the harmful or hazardous use of substances, leading to significant negative consequences (dependence, loss of control).

Theories of drug use

Psychological theories

social theories

cultural theory

gateway theory

Social factors that contributed to widespread use of opioids (19th century)

Advertising increased, and patent meds were able to be utilized by the press, medicine was becoming more serious and respected.

Political factors that contributed to the widespread use of opioids (19th century)

Medicine was becoming more respected.

major opiate substances derived from the poppy plant

Opium - comes from the pod of the flower after the petals have dried off.

Biological theories of drug misuse and abuse

Genetic predisposition to addiction

Behavioral theories of drug misuse and abuse

Learned behaviors, reinforcement

Cognitive-Behavioral theories of drug misuse and abuse

Beliefs and attitudes towards drugs

Social Learning theory

observing and imitating others

Socio-pharmacologic theory

Social determinants policies and stresses

Psychological Theories

Mental health, self medication

Social Theories

Peer pressure, social acceptance, learned behavior

Cultural Theory

Cultural norms and practices

Gateway Theories

Drugs lead to more drugs, the initial use of less harmful drugs can lead to the use of more dangerous substances

Social Impacts of prohibition

Alcohol intake first started to decline, and then people wanted to continue drinking, so it became a luxury activity where people would drink in private.

Relationship between taxation and prohibition

16th amendment taxed on incomes, taxes off alcohol. The Great Depression happened, and alcohol was legal again, but there were taxes on alcohol to boost the US economy.

how cannabinoids play a role in producing effects from the cannabis plant

Marijuana/Cannabis - Dried leave stems, stems, flowering tops. The most common method of consumption is smocking, but it can also be put in foods.

Hashish - the resin or sap harvested from the plant, more potent than cannabis.

Medical Use

use of cannabis to treat disease or relieve symptoms

Recreational Use

use of cannabis primarily for pleasure

Industrial Use

use of fiber from the plant stem (hemp) in various commercial products (paper, textiles)

Marijuana/Cannabis

Dried leave stems, stems, flowering tops. The most common method of consumption is smocking, but it can also be put in foods.

Hashish

the resin or sap harvested from the plant, more potent than cannabis.

Sativa

Mainly affects the body and is relaxing and calming.

Indica

Mainly affects the mind and has a euphoric energetic effect

LaGuardia report

Mayor LaGuardia of NY commissioned a group to research marijuana for 5 years; the report (1944) found that the problem was not nearly as widespread as had been made out by Anslinger; that marijuana had medicinal benefits; that addiction is rare; that marijuana is rarely linked to crime; that children are generally not smoking it (as had been reported).

Decriminalization

legalization

Harry Anslinger campaign

became the director of the FDA in 1930, in charge of enforcing the prohibition of alcohol. took a special interest in marijuana and largely painted it in similar ways to how alcohol had been described before prohibition: as something that ruined families created addiction, and made people lazy and/or violent. He often made up statistics and stories linking marijuana as the cause of insanity, crime, and murder. He also used the link between marijuana and Mexico to further his cause. “Marihuana Menace”

status of the U.S. today on the legalization of recreational marijuana

Some states legalize it, others don’t.

status of the U.S. today on the legalization of medical marijuana

Some states legalize it, others do not. state-by-state scenarios.

CBD (one of the major cannabinoids in cannabis)

Non-psychoactive may help anxiety, inflammation, nerve-related pain, and more.

THC (one of the major cannabinoids in cannabis)

Psychoactive (makes you feel high), may help seizures, MS chronic pain, nausea, appetite stimulation, Chron’s disease, PTSD.

Shafer Commission report

A group that conducted surveys and requested expert opinions from a wide variety of perspectives: law enforcement, medical professionals, judges, students, and more. The major findings of the report were that marijuana was not a dangerous drug, did not make people aggressive or violent, that ill effects on health were not immediately apparent, and did not impact society at any harmful levels. It recommended prohibiting commercial sales of the drug (i.e., not legalizing it) but not applying criminal sanctions for small amounts of possession and use - “Marihuana: A signal of Mis-understanding.”

Controlled Substances Act of 1970s

regulates the manufacturing, importation, possession, use, and distribution of certain drugs. Classified drugs into different schedules based on their potential for medical use and abuse, the schedule the drug was put in also determined the regulation and control procedures.

Schedule I Drug

Schedule II drug

Crack

produced when you take cocaine powder, mix it with baking soda and water, then heat it. Heating removes the hydrochloride and makes the cocaine into a solid, crystallized form, usually smocked rather than snorted.

Legalization

Decriminalization

Spread of Infectious Diseases

The criminalization of drug use and the lack of harm reduction strategies, such as needle exchange programs, have led to the spread of infectious diseases like HIV/AIDS and hepatitis C. Intravenous drug users often share contaminated needles due to restricted access to clean ones.

Increased Overdose Deaths

The emphasis on punitive measures over treatment has resulted in inadequate access to addiction services and life-saving interventions like naloxone, an opioid overdose reversal drug. This has contributed to a rise in drug overdose deaths.

Barriers to Healthcare

People with drug-related criminal records often face challenges in accessing healthcare, employment, and housing. This stigma and exclusion can perpetuate cycles of poverty and poor health outcomes

Economic Effects of the War on Drugs

America spent $47B to enforce drug prohibition.

The DEA alone costs 3.3B in taxpayer funding.

169M goes to military equipment to fight drugs in 2022.

Goals of Drug Control

Decrease use vs decrease harm

Decreasing crime associated with drug use

Decreasing negative health consequences of drug use, both individual and societal

International cooperation in addressing problems associated with drug use and trafficking

Not all illicit drugs are harmful (heroin via needle vs marijuana via gummy)

Alternative Approaches to Drugs Control

Harm reduction

Drug Courts

Law enforcement assisted diversion

legalization of drugs

Discrimination of drugs

Education and prevention

Incarceration rates

The 1980s-1990s mandatory minimum sentences are widely regarded as having contributed greatly to the increase in incarcerated people

First wave of opioid crisis

Rise in prescription Opioid overdose deaths - started in the 90s. Prescriptions were for generally for acute and serious pain from injury, surgery, cancer, or terminal illnes.

Second wave of opioid crisis

Rise of heroin overdose deaths - started in 2010

Third wave of the opioid crisis

Rise in synthetic Overdose deaths FENTANYL - started in 2013

Origin of the opioid crisis in the 1990s,

Aggressive over-prescribing in the 1990s

The structure of the American healthcare system

Decreased availability of opioids with the decrease in prescribing around 201, driving addicts to another form of opioids.

Purdue and OxyContin

_____: Semi-synthetic narcotic - schedule II drug, pain relief. Overdose symptoms: extreme drowsiness, pinpoint pupils, shallow breathing, slow heart rates, coma, and possible death. Purdue was pushing OxyContin aggressively and claimed that the addiction rate was under 1% (which was a lie). Aggressive marketing worked as physicians increased prescribing of the drug.

PDMPs

a state-run electronic database that tracks the prescribing and dispensing of controlled prescription drugs.

how to identify an opioid overdose

Pain Clinic Laws

Regulations targeting "pill mills" started to be enacted around 2010, with several states passing laws between 2010 and 2013.

Perscription Duration Limits:

Many states began implementing limits on the duration of opioid prescriptions for acute pain around 2016

Abuse-Deterrent Formulations

The FDA started encouraging the development of ADFs around 2010, with the first ADFs being approved and marketed in the early 2010s

Guidelines for Opioid Formulations

The CDC issued its first comprehensive guidelines for opioid prescribing in 2016, with updates and additional guidelines released in subsequent years

Kilwein et al - College students and recreational marijuana

The main argument was trying to see whether the use of cannabis by college students relates to whether it is legal or illegal in the state. Also, it talks about whether or not the perception of cannabis was changing based on the legalization. Listed both the benefits and consequences of recreational marijuana. Educational strategies for college students regarding the use of cannabis.

Civil War Article

The author started with introducing other scholars' argument that the Civil War was a scapegoat rather than a real contributor to the rise in opiate addiction. The author's argument is that although it wasn't the largest contributor, the Civil War was in fact a contributor. The major arguments used were that hypodermic needles weren't necessary to deliver opiates to the body, women weren't the only people addicted to opiates, some soldiers became addicted after the war rather than during, and soldiers are documented as addicts in literature.

What are the policy lessons of National Alcohol Prohibition in the United States?

Hall argues that National Alcohol Prohibition in the U.S. reduced alcohol consumption, but it also created unwarranted consequences, for example, the rise of organized crime, and an underground market for alcohol

Jazz and Marijuana article

The authors main argument is that substance use can become heavily intertwined in both cultural and personal aspects of life. Like we saw with the rise of Jazz in New Orleans, substances can be seen both as a tool for artist creativity, as well as a gateway into a more damaged and addicted culture. These stories indicate how people at that time felt about marijuana/heroin use, seeing it both as a creative miracle and a detriment to the music scene of southern America. 

Medical Marijuana: A Primer on Ethics, Evidence, and Politics by Philipsen et al.

Provide nurses with the ethics of medical marijuana usage to give them a better understanding of their practice. Doctors and medical professionals are the majority for the usage of medical marijuana to provide comfort in their patients' lives, despite the laws and politicians against its usage.

Crack epidemic in the newspapers

The crack epidemic was over sensationalized. It debunked several myths involving stereotypes, crack babies, prisons, and crack whores. He also mentioned that crack is nothing new and is similar to cocaine but just used in another way. The media cannot be the only source of information regarding drugs.

Haggerty et al

The author thinks pharmacists should have more power to say no to filling opioid prescriptions if they spot signs of misuse since they’re experts on meds and can catch red flags via prescription monitoring. The SB273 limited opioid prescription and stricter prescribing guidelines to reduce misuse and dependency