1. Module 1: Alcohol Science and the Law Module 1: Alcohol Science and the Law presented by Linda Chezem, JD LEGAL ETHICS ISSUES

2. Module 1: Alcohol Science and the Law The Aim Use knowledge created by research to inform and improve law and policy Implement effective humane and cost effective approaches We can – Reduce public health burden from alcohol – Reduce the justice system burden from alcohol

3. Module 1: Alcohol Science and the Law The State of the Art Practices Excise police have adopted new technology. Communities understand the issues and respect the cultural differences toward alcohol. Everyone understands the science of alcohol and why alcohol is not an illegal drug.

4. Module 1: Alcohol Science and the Law In This Session… Trace the development of alcohol related law and policy to present time. Gain a basic understanding of the most current knowledge derived from in alcohol research and science. Apply the science to the law regarding alcohol specific law and policy.

5. Module 1: Alcohol Science and the Law Development of Alcohol Related Law and Policy Code of Hammurabi Religious writings ̶Samsons mother admonished to refrain from strong drink United States - Whiskey tax rebellion ̶Constitutional Amendments ̶21 st amendment leaves alcohol regulation to the states ̶Arguments that federal attempts to police alcohol use are ill considered –EUDL is maybe a better idea than anyone realized States and local governments use alcohol as a revenue source ̶Direct tax as well as sales tax

6. Module 1: Alcohol Science and the Law Constitutional Considerations 10 th Amendment to the United States Constitution. 18 th Amendment to the United States Constitution. 21 st Amendment to the United States Constitution.

7. Module 1: Alcohol Science and the Law 21 st Amendment The transportation or importation into any State, Territory, or possession in the United States for delivery or use therein of intoxicating liquors. In violation of the laws thereof, is hereby prohibited.

8. Module 1: Alcohol Science and the Law Identify the Sources of the Law Constitutions – United States – State and Territorial Federal statutes – Regulations – Agency guidelines, etc. (NOT law) State and Territorial Statutes – Regulations Local Ordinances as authorized by the state or territorial Constitution and statutes

9. Module 1: Alcohol Science and the Law Law Regulates alcohol to reduce harm from misuse. Criminal Justice system (all levels) cost $204 billion in 2005. 20% of the 14 million criminal cases filed can be attributed to DUI, PI and Illegal consumption.

10. Module 1: Alcohol Science and the Law Current knowledge from research Alcohol is not just a drug. It is a legal beverage and usually consumed in beverage form. (Yes, I know about inhaling). Alcohol misuse is NOT always addiction or dependence. Alcohol misuse results from genes and environment. – G+E= alcohol use or misuse or nonuse.

11. Module 1: Alcohol Science and the Law None Light Moderate Heavy None Small Moderate Severe Alcohol Problems Alcohol Use Low Risk At Risk Problem Dependent Relationship between Alcohol Use and Alcohol Problems…

12. Module 1: Alcohol Science and the Law Law and Science of Drinking Developmentally and legally, adolescent alcohol consumption is harmful. Age alone does not make alcohol use safe. We need more answers from alcohol research. Alcohol misuse does not equal addiction. Problem Drinking & Alcohol Use Disorders Underage drinking College age Binge drinking

13. Module 1: Alcohol Science and the Law Alcohol Use in United States In 2005, an estimated 88.2 % of persons aged 21 or older had used alcohol at sometime in their lives. – 11.8 % were lifetime non-drinkers (SAMHSA, 2006). Overall past-year (i.e., eliminating those who have quit drinking or whose usage is extremely infrequent) population usage is approximately 65% (Falk et al, 2008). – About 8.5% of drinkers have an alcohol use disorder.

14. Module 1: Alcohol Science and the Law What is the Problem? Underage alcohol use is a problem. In marked contrast, the vast majority of adult drinkers (> 80%) use alcohol without problems.

15. Module 1: Alcohol Science and the Law Neuroscience Research Addictive substances (including drugs and ALCOHOL) activate similar physiological pathways, activate the same brain reward circuit, and can produce similar addictive behavior. However, eating, sex, and maternal nursing -- behaviors essential to human life -- are all dependent on that same reward circuitry. In fact, the nursing instinct was found to be more biologically rewarding than ingesting cocaine (Ferris, 2005). Other pleasure-producing stimuli such as music and art rely on the reward circuit.

16. Module 1: Alcohol Science and the Law Alcohol is NOT Just Addiction Pharmacologically, alcohol is quite distinct from other drugs of abuse. It must be consumed at a level a thousand- to a million-fold higher than that of other drugs to have any neuroactive effects. Alcohol heavy use damages the brain. Concentrations of alcohol reached during heavy drinking are neurotoxic. Alcohol replaces nutritive calories and can cause malnutrition and vitamin deficiency, which separately damage the brain. Alcohol and nutritional disorders result in characteristic neuropathologic lesions, and the resulting neurological disorders engender a large and important public health problem quite separate from alcohol addiction.

17. Module 1: Alcohol Science and the Law Alcohol Health Impacts Alcohol modifies immune function. It causes damage to digestive system organs such as the liver and the pancreas. It has been linked to some cancers, such as esophageal and oral cancer. Excessive use can lead to alcohol cardiomyopathy. Alcohol exposure can permanently affect unborn children when mothers drink during pregnancy, leading to fetal alcohol syndrome, the leading cause of preventable mental retardation in the US.

18. Module 1: Alcohol Science and the Law Alcohol for Older People At the same time, moderate alcohol use (in contrast to disordered use) reduces risks for: – Heart Disease – Stroke – Osteoporosis – Diabetes – And some age-related dementias (e.g. Alzheimers)

19. Module 1: Alcohol Science and the Law UNDERAGE DRINKING Teenagers who begin drinking before age 15 have four times the risk of developing alcohol dependence later in life. Adolescents with histories of extensive alcohol use have noticeable changes in brain function that impair learning, memory (Brown et al., 2000), and problem solving; smaller hippocampal volume (De Bellis et al., 2000). Teens who use alcohol and drugs are more likely to be involved in violent behaviors.

20. Module 1: Alcohol Science and the Law A Developmental Perspective Adolescents drink less frequently than adults, but more per occasion.

21. Module 1: Alcohol Science and the Law What are Family Influences? Genes Family environment (including parental) Gene X environment interaction

22. Module 1: Alcohol Science and the Law Genes Confirmed for Alcoholism, a Common Complex Disorder Alcohol-specific Aldehyde Dehydrogenase (ALDH2) Alcohol Dehydrogenase (ADH2; ADH4)

23. Module 1: Alcohol Science and the Law Non-Specific to Alcohol (i.e., shared with mental disorders, personality traits, and other endophenotypes). – GABRA2AD/Drug Dependence/Conduct Disorder/eeg-beta – GABRA6AD/response sensitivity – GABRG3AD/severity – CHRM2AD/Major Depression/eeg-delta, theta – SERTAD/phobia – OPMR1naltrexone responsiveness/reinforcement response – COMTAnxiety/cognition/stress response

24. Module 1: Alcohol Science and the Law Alcohol Dependence Across the Lifespan 18 + yrs. - NIAAA NESARC ( Grant, et al., (2004) Drug and Alcohol Dependence, 74:223-234) 12-17 yrs - U.S. Substance Abuse and Mental Health Services Administration 2003 National Survey on Drug Use and Health (NSDUH)

25. Module 1: Alcohol Science and the Law Apply the Research to the Law Identify scientific research that is applicable to the specific alcohol related law or policy at issue. – Neighbor hood-zoning and sales outlets – Family-health education – Individuals- ̶Retain age 21 as the minimum legal drinking age ̶Change the law to allow for expungement of records

26. Module 1: Alcohol Science and the Law Alcohol and Medical Emergencies Nine states have enacted a version of the law. The statutes are referred to as: – Call 911 – Good Samaritan Policies – Medical Amnesty Policies – Lifeline Law Many colleges and universities also have rules to encourage students to call for medical assistance.

27. Module 1: Alcohol Science and the Law Indiana Law on Public Intoxication Subject to section 6.5 of this chapter – it is a Class B misdemeanor for a person to be in a public place or a place of public resort in a state of intoxication caused by the person's use of alcohol or a controlled substance (as defined in IC 35-48-1-9).

28. Module 1: Alcohol Science and the Law Indiana Law on Underage Drinking (a) Subject to IC 7.1-5-1-6.5, it is a Class C misdemeanor for a minor to knowingly: (1) possess an alcoholic beverage; (2) consume it; or (3) transport it on a public highway when not accompanied by at least one (1) of his parents or guardians. (b) If a minor is found to have violated subsection (a) while operating a motor vehicle, the court may order the minor's driver's license suspended for up to one (1) year. However, if the minor is less than eighteen (18) years of age, the court shall order the minor's driver's license suspended for at least sixty (60) days.

29. Module 1: Alcohol Science and the Law The New Indiana Statute: IC 7.1-5-1-6.5. (a) A law enforcement officer may not take a person into custody based solely on the commission of an offense involving alcohol described in subsection (b) if the law enforcement officer, after making a reasonable determination and considering the facts and surrounding circumstances, reasonably believes that all of the following apply: (1) The law enforcement officer has contact with the person because the person either: (A) requested emergency medical assistance; or (B) acted in concert with another person who requested emergency medical assistance; …for an individual who reasonably appeared to be in need of medical assistance due to alcohol consumption.

30. Module 1: Alcohol Science and the Law Additional Requirements (2) The person described in subdivision (1)(A) or (1)(B): (A) provided: (i) the person's full name; and (ii) any other relevant information requested by the law enforcement officer; (B) remained at the scene with the individual who reasonably appeared to be in need of medical assistance due to alcohol consumption until emergency medical assistance arrived; and (C) cooperated with emergency medical assistance personnel and law enforcement officers at the scene.

31. Module 1: Alcohol Science and the Law Immunity from Prosecution (b) A person who meets the criteria of subsection (a)(1) and (a)(2) is immune from criminal prosecution for an offense under: (1) section 3 of this chapter if the offense involved a state of intoxication caused by the person's use of alcohol; (2) section 6 of this chapter if the offense involved the person being, or becoming, intoxicated as a result of the person's use of alcohol; and… (3) IC 7.1-5-7-7.

32. Module 1: Alcohol Science and the Law A Person or Persons Request Emergency Medical Assistance For an individual who reasonably appeared to be in need of medical assistance due to ALCOHOL consumption. – And provided: (i) the person's full name; and (ii) any other relevant information requested by the law enforcement officer; – And remained at the scene with the individual until emergency medical assistance arrived; and cooperated with emergency medical assistance personnel and law enforcement officers at the scene. A Person who requests services AND who meets the criteria is immune from criminal prosecution for Public Intoxication and Under age violations.

33. Module 1: Alcohol Science and the Law Module 1: Alcohol Science and the Law presented by Linda Chezem, JD LEGAL ETHICS ISSUES