Greenlove24′s Weblog

This blog is my final blog reflecting on drugs and how they affect our society.  I have spent a semester studying this topic, and some of my preconceptions of drugs have changed.  If you will look back at my blog on 9/3/08, A First Look at Drugs, you will have a good basis of how I felt about drugs initially.

The definition of a drug is still the same to me.  I still agree with Levinthal’s definition of drugs in Drugs, Behavior, and Modern Society: “A chemical substance that, when taken into the body, alters the structure or functioning of the body in some way, excluding those nutrients considered to be related to normal functioning.”  Drugs are taken to alter something about your being.  The definition of a drug is made ambiguous by the intention in which a drug is taken.  Anything that is intentionally taken to change the structure or functioning of your body is a drug.  If someone drinks a lot of orange juice with the intention of purposely building up the amount of Vitamin C in their body, they are using the orange juice as a drug to alter their normal body structure and functioning.

My thoughts about drugs have changed, and become less concrete.  Initially, I was focused on illicit drugs and how they are 100% horrible because they are illegal.  I thought of the word “drug” with only negative connotation.  A drug was not the same as a prescription drug.  I never called pills from the doctor drugs, they were medicine.  Now, I realize they are all drugs, even coffee and Coca-Cola.  They all affect our body’s structure and functioning.  I thought that any and all illicit drugs are dangerous and will ruin your life or get you a ticket to jail.  I thought that anyone associated with drugs was a bad person, period.  I did not see the gray area of drugs that is definitely clear to me now.  Not all drug users are bad.  Not all drugs are horrible.  There is not a concrete line that decides if a person’s drug use is right or wrong.  Only the user knows why they are taking the drug.  Looking in from the outside, it is easy to say that a cocaine addict is recreationally using the drug to make them feel better, but that addict may not see it that way.  Most people use drugs recreationally for a reason.  Most drug users feel they need the drugs to fill a void or make them feel better.  Most drug users aren’t using drugs for the hell of it or for shits and giggles.  They are using drugs out of what they think is necessity.  Drug use is a situational matter, so no one person has the right to judge why or if a person should use drugs.  Only the drug user is in the position to know and understand their personal use.   

Along with what I have already talked about above, there are some other things about drugs that I have learned and feel every person should know.  The population should know that even prescription medications are dangerous.  Doctors and pharmacists are all human and make mistakes.  A doctor may have written down the wrong drug or the wrong dosage.  A pharmacist may have dispensed the wrong medicine or given you someone else’s drugs.  There are endless possibilities as to how something could go wrong with taking drugs.  Also, people need to know that taking drugs is always a trial and error process.  A friend could take 3 Oxycontin and feel great, but that high of a dose could be potentially lethal to my body.  All drugs, recreational and medicinal, affect people differently.   There is no way to tell how they are going to work in your body until you try them.  The last thing that I learned is that the law is not always right.  I always thought that if something is against the law, then do not question it.  Now, the main question I pose about drugs and legality is Marijuana’s status as a Schedule I Drug.  I no longer agree with that law.  I think it needs to be changed, so Marijuana’s medicinal use can be utilized by people that need it.

Drugs affect our society in good and bad ways.  Before spending this semester learning about drugs in our society, I only thought about how drugs negatively affected our society.  I only thought about the underground drug market, violence, and crime associated with illicit drugs.  Now, I see that drugs affect our society in a great way as well.  Drugs allow many people to function every day.  They allow people to live longer and feel better.  They are helping me right now.  On a big scale, drugs are a good thing in society, but all good things can be abused and corrupted.  This is why some people pop hydros, when someone else needs them to be able to walk without back pain.  Having the bad affects of drugs in our society is worth the good affects they give us.  As a society, we need drugs in some way, shape, or form.     

     There is usually a negative connotation associated with the term “mental illness.“  Mental illnesses are recognized by the majority as disorders in normal brain functioning.  Since people with mental illnesses are in the minority, the majority has decided for them that this abnormal functioning of the brain needs to be treated and fixed.  Tancredi takes a stance against the majority in saying, “to whatever extent mental illness is reflective of distortions in thinking and personality, it seems inappropriate for treatments to be directed at correcting this ‘disorder’” (520).  Is it a human being’s right to decide if another human being’s state of mind is ill or normal?  In the eye of the mentally ill, one’s disorder produces thoughts and feelings that make up their reality.  It may go to the extreme that an individual does not know that the “mental illness” they experience every day is not normal, so they may not want to be treated and “fixed.”  The majority’s helping hand and mending treatments are not always welcomed with open arms by the mentally ill.      

Most citizens in the United States enjoy their Constitutional rights to privacy, freedom of religion, freedom of speech, and due process of law. However, many mentally ill patients in this country have not possessed these same fundamental rights.  These rights are presumed to be the rights given to humanity, and by taking rights away from some mentally ill people, society has treated them as lesser humans.  The way to improve these illegal and ethically wrong actions is to empower mentally ill patients “by respecting ethical values of autonomy, informed consent, and personal dignity” (Brendel 152).

Mentally ill patients can either be voluntarily or involuntarily admitted to psychiatric facilities.  In both methods of admittance, the patients will initially be treated as if they have autonomy, but this has not always been the case.  Forty percent of patients involuntarily committed to a facility would never commit another person (Olsen 706).  This statistic is probably due largely to the fact that until the late 1970s, “if a patient was involuntarily committed to a mental institution, he/she was deemed incompetent to enter into a host of decisions that other citizens engage in freely” (Tancredi 514).    The patient could not vote, enter into marriage or divorce, sign a will, and most significantly, could not refuse treatment.  The patient was denied not only the above basic rights, but the right to due process of law to determine if they were actually incompetent or not.

The Rogers v. Okin case in the 1970s was a turning point in regard to the right of involuntarily committed, competent patients to refuse psychiatric treatment.  This case decided that if an involuntarily admitted patient refuses treatment, they should go through a competency hearing to follow Constitutional due process rights.  A patient’s competency is measured by their ability to make rational decisions regarding their psychiatric treatment by assessing their treatment options, risks and benefits, doctor’s recommendations, and any other viable information in the decision making situation.  If the patient is unable to make rational decisions regarding their treatment, they are named incompetent and the court appoints a guardian to make their treatment decisions.  The guardian is “expected to ‘stand and act in the place of the patient’ which essentially would mean that his obligation would be to glean the patient’s preference and substitute this perspective for his own view” (Tancredi 517).  Once incompetent, a patient is not always deemed so.  “Courts recognize that competency is not a constant quality, but that it may fluctuate over time” (Meisel 81).

The Rogers case, along with other similar cases, brought about the idea of informed consent.  Informed consent is now a legal condition in which the doctor must disclose all information to the patient regarding any psychological treatment decision and get consent from the patient or legally appointed guardian before initiating treatment.  Informed consent is a great right for a patient to have, because it allows patients to “assess benefits and risks in light of their own values” (Force and Gallant 146).  With this liberty, a patient can refuse experimental treatments and medications on the basis of unwanted side effects.  The only situation that informed consent is not needed from the patient or legal guardian is if the patient is dangerous to self or others.

According to most U.S. state laws, when a mentally ill patient becomes imminently dangerous to self or others, many of their rights are stripped.  All mentally ill people that are deemed imminently dangerous are immediately hospitalized.  Possible dangers include:  “malnutrition, dehydration, neglect of medical conditions, or reckless behavior” and violent behavior (Blass et al. 846).  The risk of the laws as stated is that “suicide and homicide have a low probability of occurring in the ‘imminent’ time frame required by most U.S. state statutes” (Olsen 708).  Violent events are difficult to predict due to the low probability of occurrences.  This means that the state relies on the low probability statistic itself to prevent harm to self or others.  With no certain precautions, there is the continuous and ongoing risk that any mentally ill patient could become dangerous at any moment.  This risk is practically uncontrollable due to the fact that crime outside of the mentally ill population is of the same unpredictable nature.

Coercion is the most recent concern in psychiatric treatment.  Coercion could be in the form of threat of harm or force, the use of force, or the use of manipulation and persuasion.  The patient’s care givers may have “strong impulses to render aid, which might lead them toward persuasion and, sometimes, even toward deception and coercion ‘in the best interests of the patient.’  Use of ethically shady means to this ethically noble end” could potentially be lethal to a trustworthy relationship between the patient and the doctor, because the doctor will have feelings of guilt, while the patient feels pressured and manipulated (Force and Gallant 148).  Olsen states, “When influence is considered inevitable, neither good or bad in itself, and continuous in the degree of intensity, then the label ‘coercion’ applies to that point at which the use of influence creates moral discomfort” (709).  A doctor asking questions to their patient about their opinion on past forced treatment is coercive, because the doctor puts the patient in the position that they feel like they need to supply a sought after answer.  In Soliday’s study, the patients expressed, “…the best way to avoid another [solitary confinement] is to acknowledge therapeutic benefit, even if this is not how they really feel” (Olsen 706).  Using coercion is a good way for doctors to gain self-satisfaction in their aims, but it in no way supports medical ethics which uphold “beneficence, the obligation of health professionals to act in their patients’ best interest” (Blass et. al. 846).

The use of cruelty, isolation, and restraints for psychiatric treatment are additional ethical concerns in psychiatric treatment.  Similar to a young child being punished for disobediently eating a cookie before dinner, mentally ill patients receive punishment for unfavorable behavior like swearing, lying, and tardiness.  In a case in the 1970s, “apomophine, a drug which induces violent vomiting, was used as a way to condition such behaviors” (Tancredi 515).  This particular punishment is no longer legally used, but isolation and restraints are.  Research shows that after seclusion, patients were questioned about their experience, and “only half agreed that seclusion was necessary” (Olsen 706).  When deciding the context in which isolation and restrains can be used, Olsen believes, “Even the most restrictive interventions of seclusion and restraint can be applied with little ethical conflict if the patient desires the intervention” (711).

Contrary to Olsen’s beliefs regarding seclusion and restraint, these mechanisms of punishment are unnecessary unless all other methods of treatment have been exhausted.  Seclusion and restraint are only needed in severe cases of extremely intense behavior, and should be regarded with much ethical thought.  For instance, if a woman told her friend she wanted to die, that does not mean the friend should try to murder the woman.  Likewise, even if a patient admits to desiring intervention, it does not mean that they should be treated with less ethical consideration.  It is not a doll that is strapped to a bed or locked in an isolated room, it is a human being.  All humans should be treated with equal respect and humanity, no matter their mentality or requests. 

Each patient should be viewed as “an individual agent with unique characteristics” (Brendel 151).  There is not a specific methodology to treat every mentally ill patient.  If only methodological treatment is used, “the patient may reap some benefit but may also feel that some meaningful aspects of his or her existence have been overlooked or neglected” (Brendel 151).  All aspects of their illness and humanity should be evaluated to treat a patient properly and successfully.  In other words, there are no two people exactly alike in the entire world.  So, why would we consider generalizing an individual’s personal wellness?  We must acknowledge the differences in character and illness.  The treatment that follows must be tailored to fit that particular person’s needs.

In the event that a mentally ill individual does not want care or treatment, as long as they are not dangerous to self or others, let them live the way they choose.  Every citizen of the U.S. has a Constitutional right to privacy, and cases similar to, and including the Rogers case “have concluded that the constitutional right to privacy must also encompass other important health care decisions, specifically the right to decide about taking neuroleptic medications” (Meisel 76).  Some treatments and medications have “the potential to affect and change a patient’s mood, attitude, and capacity to think, thereby implicating first amendment interests, too” (Meisel 76).  Forcing a patient to be restrained, confined, or accept treatment for the sake of their mentality is a violation of their Constitutional rights.

What does it mean to be in a natural state of mind?  The term “natural,” of and within itself is an abstract idea.  An individual’s “natural state of being” is nothing more than the product of one’s own reality.  Moreover, if a person has been unstable and not in possession of a sound mind his entire life, then is his state of mind not natural to him?  What we must consider is that we have the capacity, by forcibly administering drugs and treatment, to disrupt and perhaps destroy a person’s concept of natural.  It is not our right or place to determine and ultimately manipulate someone’s mind through psychiatric treatment.

Works Cited

Blass, David M., et al. “Ethical Issues in Mobile Psychiatric Treatment with Homebound Elderly Patients: The Psychogeriatric Assessment and Treatment in City Housing Experience.” Journal of the American Geriatrics Society 54.5 (May 2006): 843-848. PsycINFO. EBSCO. Torreyson Library, Conway, AR. 17 Nov. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=psyh&AN=2006-05668-009&site=ehost-live.

Brendel, David H. “Healing Psychiatry: A Pragmatic Approach to Bridging the Science/Humanism Divide.” Harvard Review of Psychiatry 12.3 (May 2004): 150-156. Academic Search Elite. EBSCO. Torreyson Library, Conway, AR. 17 Nov. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=afh&AN=14083803&site=ehost-live.

Force, Robert, and Donald M. Gallant., ed.  Legal and Ethical Issues in Human Research and Treatment:  Psychopharmacologic Considerations.  New York:  Spectrum Publications, 1978.

Meisel, Alan. “Making Mental Health Care Decisions: Informed Consent and Involuntary Civil Commitment.” Behavioral Sciences & the Law 1.4 (Oct. 1983): 73-88. Academic Search Premier. EBSCO. Torreyson Library, Conway, AR. 18 Nov. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=aph&AN=12149571&site=ehost-live.

Olsen, DP. “Influence and coercion: relational and rights-based ethical approaches to forced psychiatric treatment.” Journal of Psychiatric & Mental Health Nursing 10.6 (Dec. 2003): 705-712. CINAHL. EBSCO. Torreyson Library, Conway, AR. 17 Nov. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=cin20&AN=2004093549&site=ehost-live.

Tancredi, L R. “The right to refuse psychiatric treatment: some legal and ethical considerations.” Journal Of Health Politics, Policy And Law 5.3 (1980 Fall 1980): 514-522. MEDLINE. EBSCO. Torreyson Library, Conway, AR. 16 Nov. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=cmedm&AN=7462583&site=ehost-live.

Currently in the United States, the culture of young adult education is changing due to an increase in the illicit use of prescription stimulants for the purpose of enhancing academic performance.  This illicit use is largely due to the “expression of a basic human drive to stimulate the human organism beyond its normal metabolic state” (Mosher and Akins 63).  Students illicitly take prescription stimulants to enhance their academic performance with the following motives:  to get more energy, enhance alertness, improve concentration, and delay the need of sleep.   The main prescription stimulants that are illicitly used by students today are methylphenidate, commonly known as Ritalin, and a combination of dextroamphetamine and amphetamine, commonly known as Adderall.

            The prescription stimulant drug illicitly used most frequently is Ritalin.  According to Drugs and Drug Policy, Ritalin was discovered accidentally during the 1950s in Rhode Island.  It was given to children to help with their headaches, but resulted in “an increase in their activity level and also improved their academic performance” (Mosher and Akins 82).  In 1961, the FDA approved Ritalin for sale in the United States.  Ritalin was the first prescription drug used to treat attention deficit/hyperactivity disorder (ADHD) and continues to “dominate the market in prescriptions written for ADHD” (Levinthal 111).  Ritalin has a rapid onset and relatively short duration of effects.  When taken to treat ADHD in school age children, Ritalin is taken in two doses per day.

            A single dose of Adderall, the other prescription stimulant illicitly used by an immense population of young adult students, has effects lasting longer than Ritalin and has a slower onset and drop-off of effects.  School age children that are prescribed time release Adderall usually only need one dose per day to function normally.  With this drug, the dose increments are slow and gradual, allowing for the drug to have a more consistent concentration in the body at a given time.  Adderall is still a relatively young drug.  It was released for sale in 1996, so it is no surprise that it is not as widely used as Ritalin which is nearly half a century old.  Since there are more Ritalin prescriptions written, it is the more prevalent stimulant prescription on college campuses, making it the dominant choice to enhance academic performance due to its higher availability rate.

            The effects of Ritalin and Adderall on the body and mind are practically identical, due to their related properties.  Ritalin is an amphetamine-like drug and Adderall is an amphetamine derived drug.  When taken orally, both drugs produce a “slow but steady increase in dopamine activity in the brain” (Levinthal 111).  This increased activity of dopamine causes there to be “an improvement in attention and decreased distractibility” and may also “heighten one’s motivation with regard to a particular task, enhancing the salience and interest in that task and improving performance” (Levinthal 112).  No wonder students are using these drugs illicitly to enhance academic performance, right?

            The use of these prescription stimulants not only provides students with a way to study more efficiently and effectively, but it also does not have the drug behavior context and reputation of other illicit usage of drugs.  Ritalin and Adderall are “seen as less risky and ‘cleaner’ than illegal drugs” (Mosher and Akins 176).  They are made in government approved laboratories, prescribed by licensed physicians, dispensed by pharmacies, and contained in a labeled bottle.  The use of someone else’s prescription drugs seems innocent, strategic, and legitimate; not illegal, irresponsible, and dangerous. 

            An individual’s consumption of a prescription drug that is not directly prescribed to them is in fact illegal, irresponsible, and dangerous.  According to the Drug Enforcement Administration (DEA), the distribution or dispersion and the acquiring or obtaining of prescription drugs are both illegal and punishable by law.  Some other factors that make illicit prescription stimulant use irresponsible and dangerous are that an individual illicit user cannot be 100% positive that the source of the prescription stimulant is legitimate.  If the drugs are bought from or given to the user by a friend, it is more likely that those drugs are in fact the prescription stimulant the user wanted, but it cannot be certain.  There is much room for human error in the drug culture.  That friend may have grabbed the wrong pills or mistaken the type of pill the illicit user wanted.  It is also never certain how an individual will react to any drug.  All drug consumption and effects are situational.  A student may take Ritalin in order to improve their focus, but end up having too much energy and hyperactivity to focus.  Illicit drug use and abuse is trial and error in most cases.

            Illicit prescription stimulant use not only produces the favored effects previously discussed, but it also can cause detrimental effects.  Some detrimental effects of long term prescription stimulant abuse that make Ritalin and Adderall risky drugs to abuse include “racing heart, nausea, headaches, and insomnia, and prolonged or heavy abuse may result in a state of ‘paranoid psychosis identical to that of chronic methamphetamine abuse’” (Mosher and Akins 82).  According to Drugs and Drug Policy, there is little difference in the effects of Ritalin, cocaine, and methamphetamine.  A feeling of euphoria, which is also related to increased levels of dopamine activity in the brain, is usually only seen when the drugs are administered through snorting, injection, and smoking.  This feeling can lead to an increased chance of addiction to the drugs.  Users do not want to feel the drop from prescription stimulants, so they keep taking the stimulants in order to continuously feel the positive effects of the drugs.  This continuous intake of prescription stimulants leads to dependence and addiction.  It may be perceived that the illicit use of Ritalin and Adderall is less risky than the illicit use of other drugs, but that perception would have a huge gap between it and actuality.

Illicitly using prescription stimulants to enhance academic performance is most prevalent among college students.  In a recent study, it was found that “college students (5.7%) reported higher rates of non-medical use of methylphenidate (Ritalin) than their same-age peers not attending college (2.5%)” (McCabe et al. 97).  As Teter states, “it may be the common features of the college environment (e.g., staying awake for extended periods of time) that lead to higher rates of illicit use of prescription stimulants” (258).

The overall prevalence of illicit use of prescription drugs in the college environment varies according to what individual study at which particular university is being evaluated.  When research was conducted at only one university, the percentage of students that have illicitly used prescription stimulants in their lifetime ranged from 8.1%-20%.  In a national survey, it was found that approximately 6.9% of college students had illicitly used prescription stimulants in their lifetime (McCabe et al. 98).

The most widely used motivations for illicitly using prescription stimulants are to get more energy, delay the need of sleep, improve concentration, and enhance alertness in succeeding order according to Prevalence and Motives for Illicit Use of Prescription Stimulants in an Undergraduate Student Sample.  In a study at the University of Michigan, 69% of non-medical users of stimulants reported using stimulants to get more energy, 61% used prescription stimulants to stay awake, 58% used the drugs to help them concentrate, and 43% used the drugs to increase their alertness (Teter et al. 256 and 260).  In this study, it was also found that some other motives for illicitly using prescription stimulants outside of the academic realm are for experimental purposes, to feel good and get high, and to lose weight.  These purposes are measured at up to 43%, but are still not as significant as motives involving the enhancement of academic performance.

In the college environment, there are some student characteristics and university characteristics in which illicit use of prescription stimulants is more prevalent.  Students under the age of 23 are more likely to be illicit prescription stimulant users.  Males tend to use more than females by about 3%.  The white population illicitly uses more than any other race.  Individuals that are in a Greek organization illicitly use almost 5% more than non-members.  Individuals in a higher socio-economic status are also more likely to illicitly use prescription stimulants (McCabe et al. 99 and 103).  Being “more perfectionistic is associated with greater use as well” (Low 283).  Universities that have more competitive admissions criteria show a higher use of illicit prescription stimulants among their students.  Students that attend small, competitive colleges tend to be “more willing to experiment with amphetamines to enhance academic performance” (Low 286).  Universities in the Northeast region of the United States showed the highest percentage of student illicit use of prescription stimulants.  All of the characteristics in this paragraph play a role in the likelihood of college students to illicitly use prescription stimulants.                    

Another factor that may have a take part in the likelihood of illicit use of prescription stimulants is the amount of prescription stimulants available to young adult students.  It is widely believed that ADHD is over diagnosed and prescription stimulants are overprescribed.  Ritalin prescriptions in the “United States increased by 260% between 1990 and 1995” (Babcock and Byrne 143).  In association with Ritalin, “11 million prescriptions are written for this drug every year, and more adolescents have used the substance illegally than are taking it as a result of a doctor’s prescription” (Mosher and Akins 83). In a national survey, it was found that “of the undergraduate students who were medically prescribed stimulant medication for ADHD, approximately 54% had been approached to divert their medication.  Over 90% of non-medical users of prescription stimulants who reported a source indicated they obtained prescription stimulants from peers and friends” (McCabe et al. 103-104).  It is far too easy to get a prescription stimulant from a doctor or illicitly obtain it from an individual, especially in a college environment.  Prescription stimulants are easily accessible and readily given, allowing them to be illicitly used and abused more frequently.

The illicit use of prescription stimulants to enhance academic performance is a concern to our society.  For many young adults, illicit prescription abuse instigates additional illegal and risky behaviors.  Marijuana use was ten times more likely, binge drinking was almost seven times more likely, cocaine use was over 20 times more likely, and incidents of drinking and driving were five times more likely for young adult students who illicitly used prescription stimulants in the past year (McCabe et al. 102).  Once an individual has cheated in a class and gotten away with it once, it becomes easier to cheat the second time knowing that they got away with it previously.  In the same mindset, young adult users may view no harm or risk in experimenting with other drugs and dangerous behavior if they are already illicitly using prescription stimulants.  This mindset brings an experimental and less honorable culture to young adult students. 

In Drugs and Drug Policy, a senior in high school named Costello said, “Nothing bad comes from it, only good” (Mosher and Akins 175).  Costello takes several pills of Ritalin a day, and has developed some problems sleeping.    Students like Costello are putting their health in jeopardy in effort to reach exceptionally high standards of performance.  Costello said that nothing bad came from using prescription stimulants, but he had already accepted and overlooked his sleeping problems. For the most part, users only see the positive effects and results of the drugs they are ingesting.  There is nothing bad happening to them, so why not experiment with other drugs too? 

Just like cheating on a test, taking drugs to enhance academic performance is not the honorable way to succeed; even though, it gets users the results they want.  It may be on a smaller scale than heroin use, but illegal prescription stimulant use is still unethical and dishonorable.  Society needs to recognize and accentuate the degradation of integrity associated with illicitly taking prescription stimulants, or young adult students will probably continue to see no problem in taking them. 

In weighing their options between studying the natural way or using prescription stimulants, there is an increase in students reaching for academic success using the latter.  If students do not know the effects these drugs could have on them and the impact consuming the drugs has on their integrity, they think, “why not use a drug that will aid me to do better?”  Society needs to inform young adult students of the detrimental effects and degradation of integrity associated with illicit prescription stimulant abuse, so that young adult students no longer see drugs like Ritalin and Adderall as harmless and innocent.    

Works Cited

Babcock, Quinton, and Tom Byrne. “Student Perceptions of Methylphenidate Abuse at a Public Liberal Arts College.” Journal of American College Health 49.3 (Nov. 2000): 143. Academic Search Premier. EBSCO. Torreyson Library, Conway, AR. 15 Oct. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=aph&AN=3918728&site=ehost-live.

Levinthal, Charles F. Drugs, Behavior, and Modern Society. 5^th ed. Boston:  Pearson Education, 2008.

Low, KG, and AE Gendaszek. “Illicit use of psychostimulants among college students: a preliminary study.” Psychology, Health & Medicine 7.3 (Aug. 2002): 283-287. CINAHL. EBSCO. Torreyson Library, Conway, AR. 6 Oct. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=cin20&AN=2009449017&site=ehost-live.

McCabe, SE, et al. “Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey [corrected] [published erratum appears in ADDICTION 2005 Apr;100(4):573].” Addiction 100.1 (2005): 96-106. CINAHL. EBSCO. Torreyson Library, Conway, AR. 6 Oct. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=cin20&AN=2005060253&site=ehost-live.

Mosher, Clayton J. and Scott Akins.  Drugs and Drug Policy:  The Control of Consciousness Alteration.  Thousand Oaks:  Sage Publications, 2007.

Teter, CJ, et al. “Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample.” Journal of American College Health 53.6 (May 2005): 253-262. CINAHL. EBSCO. Torreyson Library, Conway, AR. 6 Oct. 2008 http://0-search.ebscohost.com.ucark.uca.edu/login.aspx?direct=true&db=cin20&AN=2009047473&site=ehost-live.

Drugs that are used to alter mood and behavior were not as widely accepted three decades ago as they are today.  There was a common attitude that drugs used to alter mood and behavior were “only for the mentally ill.”  Now, it is common for everyday people to take drugs to alter their mood in behavior.  This group of drugs has become safer and more convenient to use since three decades ago.  Many people with mental disorders such as depression, anxiety, autism, and bipolar disorder use these drugs to lead a life as close to normal as possible.  Since deinstitutionalization in the 1960s, people with less severe mental disorders can lead normal lives by taking medications every day instead of being locked in a mental hospital.  Currently, more people put their pride aside and come forward with their mental disorders and reach out for help.  A few decades ago, it was not as accepted to admit to having a mental disorder.  More people realize the prevalence of mental disorders in our society now.  1 in 6 people will experience depression in their lifetime, so obviously, it is not just the “mentally ill” that need drugs to alter their mood and behavior.  Mental disorders can happen to anyone, not just crazy people.

The use of sleep aid medications is also rising exponentially in America.  I think more Americans are turning to these medications, because we experience more stress, anxiety, and worry as time progresses.  America as a whole has the want to be the best, always.  We compromise anything to achieve this goal.  We will work 100 hours a week and not sleep for 36 hours if that is what it takes.  We stress ourselves and put ourselves in bad health.  Many people cannot sleep at night, because they have too much still going on in their mind.  They are thinking of what they should be doing instead of sleeping and what they have to do the following day.  We do not value down time and rest as much as we value accomplishments.  We do not win a social prize for taking a day off to read a book.  Some Americans are taking sleeping aids on a need-based situation, because they cannot sleep naturally.  But I feel that the reason they need sleep aids is on a want-based situation.  Americans do not have to be so busy and strung out.  It is the choice of the individual to be stressed out of their mind, or lead a more relaxed lifestyle.

I have never had any personal experiences with anyone that had to take medications for anxiety, panic, or sleep aid.  I think that there are people that need medications for mental disorders, but the amount of people that are currently taking these medications is high.  Medication is not the only option for treatment.  I think that it is important to try therapy first, and if that does not work alone, begin treatment with medication alongside therapy.

Using anti-psychotic drugs and other medications on those with diagnosed psychiatric disorders against their will is necessary to medicate anyone who has a mental disorder and is unable to think rationally or take care of themselves.  Doctors are going to do what is best for the patient.  Some people with mental disorders are not in a rational mindset, and do not know what is best for them.  It is a sad and upsetting situation, but something has to be done to help them.  They do not know how to help themselves, so it is the duty of the people who love them to ensure that they are treated and hopefully get better.

Hallucinogens are a class of drugs that produce distortions in perception and body image at moderate doses.  The major categories of hallucinogens are hallucinogens related to serotonin, hallucinogens related to norepinephrine, hallucinogens related to acetylcholine, and miscellaneous hallucinogens.  Hallucinogens related to serotonin include lysergic acid diethylamide (LSD), psilocybin, lysergic acid amide, dimethyltryptamine, and harmine.  Hallucinogens related to norepinephrine include mescaline, DOM or STP, and MDMA (Ecstasy).  Hallucinogens related to acetylcholine include atropine, scopolamine, hyoscyamine, and ibotenic acid.  Miscellaneous hallucinogens include phencyclidine (PCP) and ketamine.

In Food of the Gods, McKenna makes a claim that the homo sapien brain evolved due to the ingestion of hallucinogens.  He says that we are more complex due to our consciousness and emotions that originated from hallucinogens.  McKenna’s case for the evolution of the homo sapien brain is interesting, but does not seem likely to me.  Humans are not the only species that ingest hallucinogens.  Hallucinogenic mushrooms for example are on the ground and can easily be eaten by cattle, but cattle do not show the brain development we have.

I believe that taking drugs can change the way you see the world.  Taking drugs alters the chemicals in your brain and the concentration of these chemicals, so this obviously changes your emotions, perceptions, and consciousness.  Many hallucinogen users claim that your senses are immediately sharper when using.  Some people even say that you can see sounds and taste colors.  I have no personal experience, but a few friends of mine have said that they have had revelations when using hallucinogens.  They said things are seen in a different mind set, and everything seems to slow down, so they notice everything about their environment.

Hallucinogenic drug use in the 1960s, especially LSD use, inspired the hippie culture which promotes peace, love, and happiness.  This makes sense, because when using LSD and marijuana, the user’s consciousness is more aware of its surroundings.  It seems that users tend to be more appreciative and passionate about everything be it a tree or a box of cereal.  The hippie culture promotes close, accepting, and loving relationships.  There seems to be no harm in that.

I feel that Americans are overmedicated.  We go to the doctor for any ache or pain, modest or severe.  Generally speaking, we can get a medication for whatever symptoms we describe to a doctor.  We can say we feel like we are sick, and a prescription is whipped out to us.  Getting prescription medication is taken too lightly.  Doctors need to be more thorough in prescribing medicine.  If a patient really does not have a flu, they should not be given the medicine to treat a flu on a pretense that they are probably going to get it.  Antibiotics are the quick answer to any problem or symptom.  Overmedicating leads to higher tolerance to the medicines.  It is not smart on the doctor’s part or the patient’s part to prescribe or take medicine that is not absolutely needed, because when the symptoms are actually severe, they may not be relived by the drugs due to a build up of tolerance.

It is not moral to prescribe a drug to someone who may not understand all the risks of a medication.  A prescriber should know all of the risks associated with the medication and educate the patient of these before prescribing that drug for treatment.  The patient should know what drugs they are taking and what the drugs are doing to help them.  A drug prescription should be written after all options of treatment are discussed with the patient.  A doctor should tell the patient their options and the risks and advantages of each treatment, and then a drug prescription should be made after a consensus between the doctor and the patient.  With this method of prescription, the doctor and patient are aware of all risks and are working together to treat the illness.

The fact is that patients are not properly informed about medications.  Prescription advertisements only make the drug out to be the fabulous and blissful answer to the patients’ symptoms.  The tiny text on the screen shows the risks, but no one has time to read that microscopic font.  We are distracted by the happy people dancing and singing on the screen.  Personally, I think drug companies should spend less money on advertisements (In a perfect world zero!) and more on research and development of new and better drugs.  As a consumer, we should be paying for the drug to be developed and manufactured, not advertised and campaigned.  In our country, the government does not subsidize the prices of name brand medications.  The prices are raised with no limit due to the competition of drug companies to make better drugs.  The price increase is unfair and wrong to U.S. citizens, because some people cannot afford the medication they need due to the inflated prices.  The price gauge hurts the American people’s pocket book, but does increase the quality of drugs in the U.S.

Given the rise of prescription misuse and abuse, and the rise of drug-related health problems and prescription recalls, there should be reform in the drug industry.  Like I stated earlier in this blog, getting a prescription should be more of a process, not a hand out.  Prescriptions should be not taken lightly be the prescriber or the patient.  There are already steps being taken to ensure drugs are safe and effective, but humans are the ones running the clinical tests.  It is impossible to make 100% sure that a drug is absolutely safe.  There are risks with every drug.  A good current reform is that many doctors are printing out prescriptions instead of handwriting them.  This makes sure that the pharmacist can read the prescription.  There are always ways to double and triple check in the drug industry.  The process of FDA approval needs to always be through and not rushed in any way.

Inhalants are substances that can be inhaled through the lungs that cause mind-altering effects.  Some common inhalants are nitrous oxide, ether, glues, paint thinners, lighter fluid, aerosol products, gasoline, and household cleaning supplies.  Inhalant products are categorized as depressant drugs, in that inhaling them causes inhibition of the central nervous system.  Some immediate effects of inhalants are giddiness, euphoria, dizziness, and slurred speech. 

Nitrous oxide and ether are used medically, but become dangerous when improperly used.  Users could experience nausea, sensory distortions, or vomiting.  It is especially dangerous to drive under the influence of nitrous oxide.  Other abused inhalants are not meant to be intentionally inhaled into the body, so they are more harmful to our body.  Users could experience delusions that lead to impulsive or destructive behavior, loss of consciousness, choking, or sudden death, brought on by cardiac dysrhythmia.  Some specific ingredients of inhalants that are dangerous include butane, propane, acetone, benzene, hexane, toluene, and gasoline.  Inhalation containing these ingredients could cause damage to the mucous membranes, risks for cancer-related disorders and anemia, muscular weakness and muscle atrophy, reduction of short-term memory, loss of hearing, difficulties of movement and coordination, spastic muscle disorders, and liver problems.  The inhalation of certain solvents by pregnant women causes a risk of infant birth defects.

Inhalants are abused for the rapid feeling of intoxication and “floating euphoria” they cause.  The hangover of inhalants compared to alcohol is less unpleasant, another reason for inhalant abuse.  People choose inhalants to get high, because they are easily available, inexpensive, and easy to carry around and conceal.  Inhalants do not have to be bought on the illegal market, so they seem to be a better means to get high than using illicit drugs.

With the exception of medical use, I do not agree with inhalant use at all.  I think that the idea of inhaling chemicals into my body for any reason is senseless.  The risks are too high.  The effects of inhalants are only felt for around 15 minutes, so the high that users are going for is short-lived.  If I was going to get high, I would want a more durable high.  Inhalants seem to be a quick fix, like many other drugs.  The connotation of inhalant usage is petty.  I watched Intervention on T.V. one night, and the segment was on a young woman addicted to inhalants.  The whole show I was thinking, “This woman is pathetic.  She looks ridiculous.  She is actually sucking on a computer duster can!”  Inhalant use is just silly to me.  I have never experienced it or been around it, so my opinion is solely based on what I have read and seen on Intervention.

Narcotics are opiate-related or opiate-derived drugs.  The three groups of narcotics are opium, heroin, and synthetic opiates.  An example of opium is morphine.  Heroin is an opiate-derived drug that is three times as potent as morpine.  An example of a synthetic opiate is OxyContin.  Narcotic drugs are used primarily to relieve pain, treat acute diarreah, and suppress coughing.  These drugs can be addictive, because they cause elevated stages of euphoria.  They can become habitual, because with the strong good feeling comes strong withdrawal effects.

Opiates have had a long history of addiction.  This addiction has dated back to 1200 b.c. in Egypt.  Egyptians used opium for literally almost every ailment.  In 1680, an opium drink known as Laudanum was derived, and used widely in Europe and the US. This initially was used medicinally; however, it led to recreational use due to its enjoyable effects. This trend led to a more lax society, and an apparent decline in motivation.   Around the same period, it became common in China to smoke opium, which led to the Opium Wars between China and Britan.

Drug abusers become addicted to the point of devoting their lives to the drug.  I think this happens due to user’s chemical dependency on the drug.  This dependency is due to the fact that the drug makes the user feel better.  Their body needs the drug to function correctly, or they will experience immediate and severe withdrawals.  Addicts see the drug as their only option.  They need the drug.

Tobacco and opium are closely related in the fact that they are both highly addictive, have a high potential of abuse, and both can cause many related deaths.  Tobacco is more socially acceptable than opium, because the major health effects are gradual, the habit is more casual, and in history, tobacco has never had a negative effect on a culture as a whole.  All of these facts are the total opposite when it comes to opium.  While tobacco causes more deaths over a long period of drug use, an opium user could over dose on opium in the first use.  This makes opium a dangerous drug and more risky to use. Its withdrawal effects are more extreme.  The drug use becomes habitual due to these strong withdrawal effects and the feeling of euphoria associated.  Users keep using the drugs to feel the way they want to feel.  To maintain this feeling, users will devote much of their time and money to obtaining the drugs.  This lifestyle is negative for the individual, their loved ones, and society.  The fact that opium is illegal makes the drug harder to come by, and more expensive.  A major example of the way opium has negatively affected society is the Opium Wars in China.

     According to Time magazine, there were 872,721 marijuana related arrests in the US in 2007.  After hearing the former statement, I was shocked that there was so much law enforcement focused around marijuana enforcement alone.  This statistic has further sparked my interest in learning more about marijuana and why its legality is strictly enforced in the US.  After searching on the web, I found on norml.org that nearly one in eight US drug prisoners are behind bars for marijuana, and taxpayers are spending over $1 billon annually to incarcerate these offenders.  This is an outrageous amount of money!  In my opinion, this money that we supply the government should be used for something else.  There are many other more dangerous things that our law enforcement should be focusing on to keep us safe.  In the following paragraphs, I will explain what I have learned about marijuana, and my opinion of its legality.

     I do not agree with the placement of marijuana as a Schedule I drug with heroin, LSD, mescaline, and PCP.  Since it is placed in this category, marijuana violations have harsher punishments than most other drugs.  Some characteristics that put drugs into the Schedule I category are having high potential for abuse and no accepted medical use.  Neither of those characteristics describe marijuana.  Marijuana is not a drug that causes physical dependence, because its concentration in our system is lowered gradually.  This also means that it does not cause withdrawal effects.  Many experts including doctors, pharmacists, and government agencies such as the National Institute on Drug Abuse (NIDA) have approved the use of marijuana as a drug, but it is still categorized as a Schedule I drug in the US.  Marijuana has a medical use, but due to its legality, this use is not being utilized as it should be.    

     Our marijuana policy as a nation is a no tolerance policy.  Laws vary from state to state, but the federal law that marijuana is entirely illegal trumps all state laws.  A possession as small as one ounce or less could send an offender to jail for a year.  If a cannabis plant is found on your property, by federal law, the government can seize your house and property.  Some states even have a law that if you possess a joint, your license is revoked, even if the offense is not automobile related.  In the Netherlands, marijuana laws are more relaxed.  Coffee shops are allowed to sell drugs, but they must follow these restrictions:  no advertising, no sales of hard drugs (heroin, cocaine, ecstasy, and amphetamines), no nuisance, no admission to coffee shops for minors under 18, and no sales of more than 5 grams per transaction.  The Netherlands also give out educational information about the risks of marijuana to tourists and the youth.  Instead of having the “no-no attitude” toward marijuana like the US, they educate their youth about the facts of marijuana and let them make an educated decision about it.  This is like what we do for tobacco and alcohol use.  The usage rates of marijuana seem to be unaffected by the strict laws of the US or the relaxed laws in the Netherlands, so I think the Netherlands have a better policy on marijuana than we do without dealing with the high money and time investment of enforcement of strict marijuana laws.

     Marijuana is way less dangerous than many other drugs.  To this day, there has never been a death from overdose of marijuana.  The same can definitely not be said for most other drugs.  The biggest risk of smoking marijuana is possibility of negative respiratory effects.  This risk is from the inhalation of unfiltered smoke, tar, hydrocarbons, and an unknown amount of possible contaminants.  The thing about this risk is that it could largely be avoided.  There are certain ways to filter marijuana when smoking to lower these risks.  There is also a method recently looked into that involves vaporizing marijuana before inhaling it which is even better than filtration.  If marijuana was legalized for medical use, I think that safer ways of inhaling it would be further looked into.  Even if marijuana was only smoked, the risk is somewhat like the risk people take smoking tobacco, yet tobacco is illegal.  Marijuana causes no form of brain damage, yet alcohol, a legal drug, can cause some brain damage.  It seems that marijuana is not as dangerous as some drugs that are accepted and legal in our society.  I think that the pre-conception that marijuana is bad and dangerous is what keeps marijuana laws so strict.  I used to have this view of the drug, but after reading, researching, and learning more about marijuana, I do not see it as an extremely harmful drug.  I think it is a drug that could be used to do many good things in the medical field, and is less harmful than most other illicit drugs.  The laws on marijuana are too harsh, and need to be changed.  A good starting point would be changing marijuana to a Schedule II drug, so the plant form could be used in medical treatment.  The passing of decriminalization laws regarding marijuana would also be a good start.  This would lower the amount of arrests and money spent regulating marijuana use and possession; therefore, turning the focus of law enforcement to controlling drug dealing and trafficking more.

     I agree with Levinthal’s definition of drugs in Drugs, Behavior, and Modern Society:  “A chemical substance that, when taken into the body, alters the structure or functioning of the body in some way, excluding those nutrients considered to be related to normal functioning.”  A drug is taken to alter something about your being, and the taking of a drug is usually intentional.  The intention behind taking a drug can make the definition of a drug ambiguous.  If a drug is something a person takes to alter the structure or functioning of their body with intention, then some things that are not usually considered drugs actually cross over into the drug category. 

     Drugs affect our American culture diversely.  They contribute to some of the violence and crime in our society.  In most cases, money drives most of the violence and crime associated with drugs, not the drugs themselves.  Sometimes I think if illicit drugs were not so hard to obtain, then some violence and crime would decrease, because the high monetary value of drugs would not be as important to our culture. According to Drugs, Behavior, and Modern Society by Levinthal, there are actually more U.S. deaths per year from tobacco and alcohol use than all other drug usage.  This is ironic, because the two drugs that lead to death most often are legal not illicit drugs.     

     The line between right and wrong drug use is very blurred.  Recreational drug use is not always harmful and horrible, but it is still illegal, making it technically wrong.  Instrumental drug use is great, but all good things can be abused.  With all kinds of drug use, moderation is the key.  The scary thing with most drugs is that they are addictive, and that leads an uncontrollable lack of moderation.  People do drugs to get the effects of the drugs, and sometimes become dependent on the way they make them feel.

     So far in my life, I have used drugs in my life mainly for medicinal purposes.  I only take the prescribed dose of a drug when needed.  I depend on drugs to make me feel better when I am feeling ill, and I cannot imagine not having drugs to fall back on for this purpose.  I have also experimented recreationally with drugs twice in my life.  Both of these experiences were casual, and not extremely exciting or enticing.  I feel that I do not need to use drugs recreationally at all, but their instrumental use is necessary in my life.