A Brief History of Drugs An overview of drug policy and use in the United States from the mid-1800s to the present

Drug Scheduling ( Schedule I –high potential for abuse –no currently accepted medical use in treatment in U. S. –lack of accepted safety for use under medical supervision. –examples: Gamma hydroxy butyrate ( GHB), heroin, Lysergic acid diethylamide (LSD), marijuana, 3,4-Methylenedioxymethamphetamine ( MDMA/Ecstasy). Schedule II –high potential for abuse. –currently accepted medical use in treatment in U. S. –abuse may lead to severe psychological or physical dependence. –examples: cocaine, methadone, methamphetamine, morphine, phencyclidine (PCP). Schedule III –potential for abuse less than Schedules I and II. –currently accepted medical use in treatment in U.S. –abuse may lead to moderate or low physical dependence or high psychological dependence. –examples: anabolic steroids, codeine, ketamine, Marinol, some barbiturates

Drug Scheduling (cont.) Schedule IV –low potential for abuse relative to Schedule III. –currently accepted medical use in treatment in U.S. –abuse may lead to limited physical dependence or psychological dependence relative to Schedule III. –examples: fenfluramine, Halcion, Meridia, Rohypnol, Valium. Schedule V –as Schedule IV but less dangerous –examples: buprenorphine, over-the-counter cough medicines with codeine. Alcohol and nicotine are not scheduled drugs. Neither is salvia divinorum.

Scheduling Process Proceedings may be initiated by –Drug Enforcement Administration (DEA) –Department of Health and Human Services (HHS) –Any interested party (drug manufacturer, medical society, public interest group, individual citizen) Criteria –potential for abuse –currently accepted medical use in the US –international treaties. DEA (legal)  HHS (scientific/medical)  FDA  NIDA  public  DEA Exceptions to process –International treaties –"to avoid an imminent hazard to the public safety"

...Drug Trade International illicit drug business: $400B, 8% of international trade –Drug profit margins up to 300%. –Interdiction intercepts 10-15% of heroin, 30% of cocaine. –Estimated 75% of international drug shipments would need to be intercepted to substantially reduce the profitability of drug trafficking. Profits for pharmaceutical companies = $81B Sales for herbal medications = $4B

Drug Use in U.S. in (age 12+) Alcohol: 104 million (46.6%) Tobacco: 65.5 million (29.3%) Illicit Drugs: 17.0 million (6.3%)

Cost of Substance Abuse

Past Month Illicit Drug Use by Age: Increases for youths aged and for year olds –Increases for marijuana, cocaine, heroin, hallucinogens, pain relievers, tranquilizers, stimulants, and methamphetamine No changes for year olds and for 35 and older adults. –Slight declines noted in LSD and metamphetamine use

Drug Use ( )

Drug Use in year olds

Marijuana Use

Illicit Drugs vs. Other Harms 5 times as many people die from alcohol each year (100K) as from illicit drugs and misuse of legal pharmaceuticals (20K) 15 times as many people die from poor diets and activity patterns (300K) 20 times as many people die from tobacco (400K)

Drug War... More than 80% of increase in federal prison population from 1985 to 1995 due to drug convictions, mostly possession Approximately $8.6 billion per year to keep drug offenders in prison War budget: ~$100 million in 1972, ~$20 billion in 2002 Approximately 2/3 of budget goes to law enforcement, 1/3 to treatment –> 1.5 million people arrested on drug charges each year (400K in prison) Federal anti-drug spending, (in billions)

Percentage of drug arrests targeting Share of possession arrests that are for Drug offenders behind bars Prison inmates getting drug treatment Sources: Bureau of Justice Statistics; Department of Justice; FBI; ONDCP