Drugs Many Drugs Have Been

Drugs

Many drugs have been used for medical purposes at one time or another. Pick two drugs that have been used in this capacity and explain the medical rationale behind their use. Conclude with a description of why each drug was later banned from medical usage.

Cocaine and heroin both made their way into the modern pharmaceutical lexicon as medically valid substances. The analgesic effects of cocaine rendered it an easily accessible and effective method of pain relief, and the drug was used as an anesthetic during surgery in the nineteenth century (Burnett & Adler 2008). In particular, cocaine was found to be a potent surface anesthetic and could therefore be used as a local anesthetic during surgery ("History of Cocaine, Medical Use"). Over the counter preparations containing cocaine ranged from quack medicine formulas to energy drinks such as Coca Cola. Cocaine was also indicated for hay fever and asthma as well as a general tonic and stimulant (Burnett & Adler 2008, Spillane 2003). Brian & Coward (1989) state, "cocaine and its derivatives are still popular local anesthetics in operations of the ear, nose and throat and it is also used in a preparation given to alleviate the pain (physical and mental) of terminal diseases."

The opiates enjoyed an even more extensive and widespread legitimate medical use. Both morphine and heroin were commonly administered for pain relief. Opiates grew in popularity during the Civil War to treat injured soldiers (Brecher 1972). The production of heroin began in the late nineteenth century after its potency was discovered to surpass that of morphine (Hostzafi 2001). Numerous compounds based on opiates remain relevant in modern pharmacology, even though heroin itself is a controlled substance.

Burnett & Adler (2008) note, "By 1893, occasional reports of fatality were associated with cocaine use, and, in 1895, the Lancet reported a series of 6 deaths." Reports of addictions also contributed to the eventual ban of the drug in the United States under the Harrison Narcotics Act of 1914. However, research had already enabled the creation of safe synthetic analgesics based on studying the chemical compounds cocaine contains. Heroin and other opiates are also classified as narcotics because of their extremely addictive qualities. In the interests of public health, the government has cracked down on both heroin and cocaine.

What are the two basic ways of looking at drugs? Be sure to note both consistency and differences between medical families of drugs and legal schedules.

All drugs, whether illegal or legal, can become dangerous substances when abused. Therefore, the legal classification of drugs means little in terms of how toxic or addictive a substance may be. Many of the world's most potent medications prescribed by doctors are as harmful if not more so than some of the drugs classified as controlled or banned substances. However, the two basic ways of looking at drugs is determined by their legal schedule. Almost drugs have the potential for both harm and good depending on how they are used.

Medical families of drugs are classified according to their effects on the brain or body, whereas legal classifications are based on their perceived public health effects. A legal classification of a drug does not preclude it from being studied in a scientific environment but in some cases drugs are banned entirely from medical research, after it has been determined that medical applications are unlikely. Both the medical and legal scheduling of drugs take into account issues like public health, including likelihood of addiction. Medical families are more sophisticated, referring to various psychoactive properties a drug may have, including specific actions on the brain. The legal scheduling of drugs does not take into account whether a substance is a stimulant or a depressant but rather, what its possible potential for harm or abuse might be.

Legal scheduling of drugs exists more for law enforcement purposes. Scheduling classification levels inform the severity of penalties for possession or distribution of the substance, and are in part based on the perceived degree of harm that substance causes. According to the Drug Enforcement Agency (DEA), however, the placement of drugs on schedule "is based upon the substance's medical use, potential for abuse, and safety or dependence liability."

Regarding drug legislation, contrast the harm-reduction approach and the zero tolerance approach toward drug abuse. Provide one example of each approach.

Harm-reduction and zero tolerance are two radically different approaches toward drug abuse. A zero tolerance approach is, by definition, an inflexible and heavy-handed approach to drug use and abuse. Zero tolerance often focuses on young offenders, making penalties for drug possession or distribution harsh. In some cases, zero tolerance implies that a minor may be tried as an adult. Zero tolerance policies are frequently "attacked as inflexible, harsh and lacking in common sense," (Cauchon 1999). On the other hand, the zero tolerance approach arose because of a crisis in drug abuse levels among young people and the connection between drug use and violent crime. Proponents of the zero tolerance policy would point out that early intervention may help deter involvement in drugs, and also that zero tolerance helps keep schools safe.

A harm-reduction approach to drug abuse is "based on compassionate pragmatism instead of moralistic idealism," (Marlatt 2007). Instead of using the criminal justice as a treatment intervention, the harm-reduction approach refers drug users, especially youth, to counselors or psychologists. Advocates of the harm-reduction approach and the zero tolerance approach are both concerned about the effects of drug use and abuse on public health and safety. Both zero tolerance and harm reduction aim to reduce instances of drug abuse and promote public safety. The zero tolerance approach presents drug users as criminals, whereas the harm-reduction approach presents drug users as individuals in need of help.

A student caught using marijuana in high school would be treated two very different ways depending on whether the school and community promoted a harm reduction vs. A zero tolerance approach. A zero tolerance approach would involve local law enforcement officials. The student would likely be sent to a juvenile detention center. A harm reduction approach would involve school counselors and if appropriate, psychologists. Because of the tremendous strain incarceration can place on young people and their families, a harm reduction policy is a more reasonable approach to the problem of drug abuse.

Describe both the principle and acute effects of heroin on the mind and body.

The effects of heroin on the mind and body depend, in large part, to the quality of the substance and the method of use. Heroin comes in a variety of quality grades, and the process used to process the drug may alter its effects. Likewise, the effects of heroin differ depending on the method of administration. Smoking, injecting, and snorting heroin are the three most common ways the drug is used recreationally. Individual differences also determine the effects of heroin, with some individual reacting differently to the drug than others. Furthermore, some users will reap more pleasurable effects than others and thus be more likely to abuse the drug.

The immediate or acute effects of injecting heroin include euphoric, flushing, and a sense of heaviness in the body. The user drifts in a state of mind somewhere between waking and sleep: a hypnagogic reverie-type experience (Partnership for a Drug-Free America). Most users appreciate the sedation that heroin offers. Dry mouth and a profound state of relaxation are the main acute physical effects of the drug. Some of the more unpleasant acute side effects from using heroin include constipation, fatigue, and vomiting (Partnership for a Drug-Free America).

Heroin's principle long-term effects also vary from individual to individual and depend also on frequency and duration of abuse. Heroin is highly addictive, and long-term use is strongly correlated with dependency. Method of use also has an impact on the long-term effects. Injection is the most dangerous method of heroin use. Besides the risk of acquiring an infectious disease, injection can cause "collapsed veins," and various infections at the point of entry. Pulmonary and cardiovascular complications are among the most serious and common of the principle long-term health effects of abusing heroin. Liver disease is also possible (Partnership for a Drug-Free America). Use of poor quality heroin can lead to the introduction of highly toxic additives into the body that can cause deleterious effects of their own. Withdrawal from heroin can be a painful process, and addicts frequently have to use scaffolding drugs like methadone when weaning themselves off the drug.